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Hospitals are fundamental infrastructure, and when well-designed can provide a trusted place of refuge and a central point for health and wellbeing services in the aftermath of disasters. The ability of hospitals to continue functioning is dependent on location, the resilience of buildings, critical systems, equipment, supplies, and resources as well as people. Working towards ensuring that the local hospital is resilient is essential in any disaster management system and the level of hospital resilience can be used as an indicator in measuring community resilience. The most popular measure of hospital resilience is the World Health Organisation’s Hospital Safety Index (HSI) used in over 100 countries to assess and guide improvements to achieve structurally and functionally disaster resilient hospitals. Its purpose is to promote safe hospitals where services “remain accessible and functioning at maximum capacity, and with the same infrastructure, before, during and immediately after the impact of emergencies and disasters.” It identifies likely high impact hazards, vulnerabilities, and mitigation/improvement actions.
The HSI can be a valuable tool as part of the 2015-2030 Sendai Framework for Disaster Risk Reduction. However, to date, it has been used infrequently in developed countries. This project pilots the application of the HSI across seven facilities in a North Queensland health service (an area prone to cyclones and flooding), centered on a tertiary referral center, each providing 24-hour emergency health services.
Key indicators of resilience and the result of the audit will be discussed within geographical and cultural contexts, including the benefits of the HSI in augmenting existing hospital assessment and accreditation processes to identify vulnerabilities and mitigation strategies.
The research outcomes are to be used by the health service to improve infrastructure and provide anticipated community benefits, especially through the continuation of health services post disasters.
This descriptive paper aims to describe the design and implementation of a community engaged primary healthcare strategy in rural Australia, the Primary Healthcare Registered Nurse: Schools-Based strategy. This strategy seeks to address the health, education and social inequities confronting children and adolescents through community engaged service provision and nursing practice.
There have been increasing calls for primary healthcare approaches to address rural health inequities, including contextualised healthcare, enhanced healthcare access, community engagement in needs and solutions identification and local-level collaborations. However, rural healthcare can be poorly aligned to community contexts and needs and be firmly entrenched in health systems, marginalising community participation.
This strategy has been designed to enhance nursing service and practice responsiveness to the rural context, primary healthcare principles, and community experiences and expectations of healthcare. The strategy is underpinned by a cross-sector collaboration between a local health district, school education and a university department of rural health. A research framework is being developed to explore strategy impacts for service recipients, cross-sector systems, and the establishment and maintenance of a primary healthcare nursing workforce.
Although in the early stages of implementation, key learnings have been acquired and strategic, relationship, resource and workforce gains achieved.
OBJECTIVES/SPECIFIC AIMS: The study aims to determine the current clinical research training interventions of MD-PhD programs and how effective they are in promoting clinical research self-efficacy. METHODS/STUDY POPULATION: A national survey of MD-PhD trainees was conducted in 2018 to identify clinical research training methods and self-efficacy for clinical research skills. MD-PhD program directors and coordinators from 108 institutions were asked to distribute the survey to their students. Responses were received from 61 institutions (56.5%). Responses were obtained from 647 MD-PhD students in all years of training, representing 17.9% of the 3613 possible participants at the 61 medical schools represented. No compensation was provided for this study. RESULTS/ANTICIPATED RESULTS: The primary methods of clinical research training reported by students included didactics, mentored clinical research, didactics plus mentored clinical research, didactics plus clinical research practicum, and didactics plus mentored clinical research plus clinical research practicum. A quarter of all participants reported having no clinical research training. Clinical research self-efficacy was then correlated with the amount of clinical research training. Students exposed to no clinical research had the lowest self-efficacy in clinical research skills and students experiencing didactics plus mentored clinical research plus clinical research practicum had the highest perceived self-efficacy in clinical research domains. DISCUSSION/SIGNIFICANCE OF IMPACT: This is one of the first studies assessing clinical research training methods for MD-PhD students and assessing their efficacy. We found that of all students questioned, 25% mentioned had not received any type of clinical research training. The remaining students identified 5 research training methods that institutions currently use. This work highlights the importance of clinical research experience students need to improve their self-efficacy, a major influence on research career outcomes.
Rome is one of the world's greatest archaeological sites, preserving many major monuments of the classical past. It is also a city with an important post-Roman history and home to both the papacy and the modern Italian state. Archaeologists have studied the ruins, and popes and politicians have used them for propaganda programs. Developers and preservationists have fought over what should and should not be preserved. This book tells the story of those complex, interacting developments over the past three centuries, from the days of the Grand Tour through the arrival of the fascists, which saw more destruction but also an unprecedented use of the remains for political propaganda. In post-war Rome, urban development predominated over archaeological preservation and much was lost. However, starting in the 1970s, preservationists have fought back, saving much and making the city into Europe's most important case study in historical preservation and historical loss.