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                  <text> Jurnal Internasional Afrika vol. 12 issue 3 2022</text>
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                <text>Jurnal Internasional Aprika vol.12 issue 3 2022</text>
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                  <text> Jurnal Internasional Afrika vol. 12 issue 3 2022</text>
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                <text>Jurnal Internasional Aprika vol.12 issue 3 2022&#13;
African Journal of Emergency Medicine&#13;
Trauma provision in South-West Nigeria: Epidemiology, challenges and&#13;
priorities</text>
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                <text>Trauma&#13;
Trauma system&#13;
Injury prevention&#13;
Prehospital care&#13;
Hospital care&#13;
Trauma registry&#13;
South-West Nigeria</text>
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                <text>Trauma is a crucial public health problem that has been overlooked by developing countries including Nigeria.&#13;
It has led to a worsening trauma trend as recent data suggests. The South-West Region of Nigeria remains one of&#13;
the regions with the most injury prevalence. Since the introduction of the trauma system over half a century ago,&#13;
regionalised trauma systems have become increasingly effective in changing the dynamics of trauma care and&#13;
outcomes. However, similar to most developing countries trauma system is yet to be established in any region in&#13;
Nigeria. This is also met by a lack of a centralised trauma registry, poor implementation of primary prevention&#13;
practices, an informal prehospital care system, and poorly organised in-hospital care for trauma victims. Reversing&#13;
these challenges could be a propelling force to the revolution of trauma provision in the region and extension&#13;
to the nation, Africa, and other developing countries. Nevertheless, the stakeholders such as the government,&#13;
legislature, Non-Governmental-Organisations, law-enforcement agencies, healthcare institutions, trauma experts,&#13;
and the public have a huge role.</text>
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                <text>Tochukwu Nonso Enemuo</text>
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                <text>www.elsevier.com/locate/afjem</text>
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                <text>26 May 2022</text>
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                <text>PERI IRAWAN</text>
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        <name>Jurnal Internasional Keperawatan</name>
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        <name>Trauma Trauma system Injury prevention Prehospital care Hospital care Trauma registry South-West Nigeria</name>
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                  <text> Jurnal Internasional Afrika vol. 12 issue 3 2022</text>
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                <text>Jurnal Internasional Aprika vol.12 issue 3 2022&#13;
African Journal of Emergency Medicine&#13;
The activities and impacts of a community-based volunteer ambulance service in Cape Town, South Africa</text>
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                <text>Volunteer Prehospital Community Emergency medical services</text>
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                <text>Introduction: Volunteering yields valuable benefits to communities, yet globally there is limited published data regarding emergency medical volunteering in communities. Hout Bay Volunteer Emergency Medical Service is thought to be the oldest volunteer ambulance service in Cape Town. The objective of this paper is to quantify the contribution of the community service to the Western Cape Government Health: Emergency Medical Service. This paper describes the inputs, key stakeholder relationships, and the impact of COVID-19 on volunteer input and community needs. Methods: Electronic Computer-Aided Dispatch records were used for analysis. Data extracted included detailed information about all recorded incidents between 1 January 2015 to 31 December 2020. Data were analysed in Google Sheets using Pivot Tables and summary statistics. Results: Between 2015 and 2020 HBVEMS responded to approximately 12% of all call-outs in the Hout Bay area, which equates to 2187.16 h of operational time spent on calls. This excludes standby time, i.e., time spent waiting to be dispatched. There was an expected noticeable difference between response times for ambulances based within Hout Bay, and those from outside Hout Bay. Despite a decline in average call-out rate during the 2020 Level 5 lockdown, the volunteers were able to do more shifts and thus more calls within the community. Call-outs during 2020 were visualised as a ratio of trauma to medical calls. In this period there were noticeably fewer trauma calls. Conclusions: There is a growing need for emergency medical care, and volunteer ambulance services can have a meaningful impact on the continent. The findings support the benefit of developing community-based ambu- lance services, especially in areas that are remote due to distance or topography. The model can be expanded to other communities across the continent. A key factor for success is actively managing stakeholder relationships which include community-based relationships as well as governmental or formal emergency medical services relationships</text>
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                <text>Charmaine Cunningham , Matthew Rosenberg , Jurgen Kahle</text>
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              <elementText elementTextId="20732">
                <text>www.elsevier.com/locate/afjem</text>
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                <text>11 April 2022</text>
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                <text>PERI IRAWAN</text>
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                  <text> Jurnal Internasional Afrika vol. 12 issue 3 2022</text>
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              <elementText elementTextId="20717">
                <text>Jurnal Internasional Aprika vol.12 issue 3 2022&#13;
African Journal of Emergency Medicine&#13;
Severe traumatic brain injuries secondary to motor vehicle crashes in two Namibian regions: A retrospective review</text>
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          <element elementId="49">
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                <text>Traumatic brain injury MVCs Severe Head injury Head trauma TBI</text>
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                <text>Introduction: Traumatic Brain Injuries (TBIs) are a leading cause of morbidity and mortality among trauma patients globally, with motor vehicle crashes (MVCs) being a major contributor. Namibia had a World Health Organization (WHO) estimated MVC-related fatality rate of 30.4 per 100 000 population in 2016, higher than that of the African continent, while no epidemiological studies describing the distribution and determinants of TBIs exist in the country. The study aimed to describe the characteristics of adult patients ( ≥ 18 years) with severe TBI secondary to MVCs which occurred in two regions of Namibia between the years 2014–2018. Methods: A retrospective descriptive observational study was conducted in adult patients who sustained severe TBIs secondary to MVCs in two Namibian regions. The inclusion criteria were patients ≥ 18 years with a severe (as described on the Motor Vehicle Accident Fund system) MVC-related TBI who sustained an injury in the Otjozondjupa or Khomas regions between the years 2014–2018. Results: A total of 87 patients met the inclusion criteria, 65 (74.7%) from the Khomas region, and 22 (25.3%) from the Otjozondjupa region. The overall mean age of patients was 34 years ( SD 11.79), most were male ( n = 78. 89.7%) and 55.2% ( n = 48) of all patients sustained an isolated TBI. The majority of the patients were admitted to a state healthcare facility ( n = 52, 59.8%). Pedestrians were the most injured ( n = 34, 52.3%) in the Khomas region while vehicle drivers were the most injured ( n = 11, 50%) in the Otjozondjupa Region. A total of 34 (39.1%) patients died and 53 (60.9%) were discharged from hospital. Overall, there were no statistically significant relationships between patient outcomes and independent variables. Conclusions: The study was to our knowledge the first to describe the epidemiology of TBIs in Namibia. Young individuals are the main people who sustained TBIs, which may subsequently place a socio-economic burden on the country. There is however limited research in Namibia to guide healthcare planning.</text>
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                <text>Paulus Ambunda, Andrit Lourens&#13;
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              <elementText elementTextId="20721">
                <text>www.elsevier.com/locate/afjem</text>
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                <text>22 April 2022</text>
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                <text>PERI IRAWAN</text>
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        <name>Jurnal Internasional Keperawatan</name>
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                  <text> Jurnal Internasional Afrika vol. 12 issue 3 2022</text>
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                <text>Jurnal Internasional Aprika vol.12 issue 3 2022&#13;
African Journal of Emergency Medicine&#13;
SARS-CoV-2 in children and their accompanying caregivers: Implications for testing strategies in resource limited hospitals</text>
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                <text>SARS-CoV-2 Symptom screening Children and accompanying caregivers</text>
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                <text>Background: Identification of SARS-CoV-2 infected individuals is imperative to prevent hospital transmission, but symptom-based screening may fail to identify asymptomatic/mildly symptomatic infectious children and their caregivers. Methods: A COVID-19 period prevalence study was conducted between 13 and 26 August 2020 at Tygerberg Hos- pital, testing all children and their accompanying asymptomatic caregivers after initial symptom screening. One nasopharyngeal swab was submitted for SARS-CoV-2 using real-time reverse-transcription polymerase chain re- action (rRT-PCR). An additional Respiratory Viral 16-multiplex rRT-PCR test was simultaneously done in children presenting with symptoms compatible with possible SARS-CoV-2 infection. Results: SARS-Co-V 2 RT-PCR tests from 196 children and 116 caregivers were included in the analysis. The SARS-CoV-2 period prevalence in children was 5.6% (11/196) versus 15.5% (18/116) in asymptomatic care- givers ( p &lt; 0.01). Presenting symptoms did not correlate with SARS-CoV-2 test positivity; children without typical symptoms of SARS-CoV-2 were more likely to be positive than those with typical symptoms (10.2% [10/99] vs 1% [1/97]; p &lt; 0.01). Children with typical symptoms (97/196; 49.5%) mainly presented with acute respira- tory (68/97; 70.1%), fever (17/97; 17.5%), or gastro-intestinal complaints (12/97; 12.4%); Human Rhinovirus (23/81; 28.4%) and Respiratory Syncytial Virus (18/81; 22.2%) were frequently identified in this group. Children- caregiver pairs’ SARS-CoV-2 tests were discordant in 83.3%; 15/18 infected caregivers’ children tested negative. Symptom-based COVID-19 screening alone would have missed 90% of the positive children and 100% of asymp- tomatic but positive caregivers. Conclusion: Given the poor correlation between SARS-CoV-2 symptoms and RT-PCR test positivity, universal test- ing of children and their accompanying caregivers should be considered for emergency and inpatient paediatric admissions during high COVID-19 community transmission periods. Universal PPE and optimising ventilation is likely the most effective way to control transmission of respiratory viral infections, including SARS-CoV-2, where universal testing is not feasible. In these settings, repeated point prevalence studies may be useful to inform local testing and cohorting strategies.</text>
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                <text>Liezl Smit , Andrew Redfern , Sadia Murray , Juanita Lishman , Marieke M. van der Zalm , Gert van Zyl , Lilly M. Verhagen ,  Cornéde Vos  , Helena Rabie , Annemarie Dyk , Mathilda Claassen , Jantjie Taljaar , Marina Aucamp , Angela Dramowski </text>
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                  <text> Jurnal Internasional Afrika vol. 12 issue 3 2022</text>
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                <text>Jurnal Internasional Aprika vol.12 issue 3 2022&#13;
African Journal of Emergency Medicine&#13;
Predictors of mortality in emergency centre patients with acute pesticide poisoning in Uganda</text>
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                <text>Introduction: Although the global suicide deaths due to intentional pesticide poisoning disproportionately occur in low income countries (LIC) and lower to middle income Countries (LMIC), there is a scarcity of reports on emergency centre (EC) mortality and its predictors in these settings. Our goal was to determine the case fatality rate of Acute Pesticide Poisoning (APP) presenting to Mbarara Regional Referral Hospital (MRRH) EC and find out whether initial triage category predicted mortality in these patients. Methods: This was a prospective observational longitudinal study. Patients presenting with APP were enrolled using data collection forms. Data collected included initial triage category, vital signs, demographics, initial assessment, and management. They were followed up for 1 week. Results: Out of 66 patients admitted with suspected pesticide poisoning, 61 had complete follow up during the study period. However, only 58 patients had the pesticide ingested confirmed. These were predominantly males 48 (73%) and farmers 28(42%) with a median age of 23 years (IQR 18-31). Majority of patients 58 (88%) were suicide attempts and had ingested mostly organophosphates 23 (35%), amitraz 11(17%), zinc phosphide 7(10%), and aluminium phosphide 4(6%). The median time from ingestion to presentation was 4hours (IQR 2.5-8). More than half 41(62%) of the patients were in the red triage category (ESI-1). The overall case fatality rate of APP was 18%. Majority of patients who died were in the red triage category but the initial triage category was not significantly associated with mortality (p = 0.381). Male gender (p = 0.018), time of admission (p = 0.037), and triage vitals including hypothermia (p = 0.020), hypoxia (p = 0.004), hypotension (p = 0.031), and tachypnea (p = 0.031) were significantly associated with mortality. Discussion: Although initial triage category was a poor predictor, triage vital signs, gender, and time of admission were significantly associated with mortality in patients with APP</text>
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                <text>Justine Athieno Odakha,  Derek Harborne, Harry Chen</text>
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        <name>Acute pesticide poisoning Triage Mortality</name>
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      <tag tagId="2017">
        <name>Jurnal Internasional Keperawatan</name>
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                  <text> Jurnal Internasional Afrika vol. 12 issue 3 2022</text>
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              <elementText elementTextId="20661">
                <text>Jurnal Internasional Aprika vol.12 issue 3 2022&#13;
African Journal of Emergency Medicine&#13;
Oxygen efficient respiratory Aid (OxEra TM ) device: A safety study</text>
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            <elementTextContainer>
              <elementText elementTextId="20662">
                <text>Safety study OxEra Oxygen delivery device</text>
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                <text>Background: Severe Coronavirus Disease 2019 (COVID-19) can develop pneumonia with severe complications. The Oxygen Efficient Respiratory Aid (OxEra TM ) device has been granted SAPHRA approval for emergency COVID-19 pandemic use. The device has the potential to be used widely in the healthcare sector due to its efficient oxygen supply and adjustable wall positive expiratory pressure (PEP). Objectives: We assessed whether the OxEra TM device was safe to use in a healthy adult volunteer population. Our primary objective was to ensure there was no asphyxiation, as assessed by changes observed from baseline End Tidal Carbon Dioxide (ETCO 2 ) exceeding 6.3 mmHg and above the 45 mmHg threshold. We also monitored changes in vital organ signs and assessed the pain and comfort of the participant at various intervals with changes in PEPs. Methods: This was an experimental safety study of the OxEra TM Device on 30 healthy participants at the ICU training centre of Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa. Each participant had basic vital-signs, ETCO 2 , and Oxygen saturation percentages (SpO 2 %) taken at baseline until the end of 2 h. In the first 20 min, the PEP was increased by 5 cmH 2 0 until 20 min, then continued for the rest of the time on a PEP of 5 cmH 2 0. At each interval, vital signs, subjective comfort, pain, and visual scores were measured. Results: Thirty healthy participants were enrolled. There was no significant difference in ETCO 2 from baseline until 2 h. No participant experienced an increase in measured ETCO 2 greater than 45 mmHg and no increase in ETCO 2 from baseline was greater than 6.3 mmHg. The median increase in ETCO 2 over the study period was 2 mmHg. There were no significant changes in respiratory rate and blood pressure. The heart rate decreased significantly (73–68 bpm). The VAS and comfort score had a significant increase over the 2 h from baseline of 0–2 at maximum; however, the PAS scores showed no significant increase. Conclusion: Overall the OxEra TM device achieved the safety endpoints set out. There was no sign of asphyxiation and there were appropriate physiological responses to changes in PEP once applied. The comfort of the mask did worsen over the 2 h; however, the scores were minimally worse on PEP application but improved once-offPEP. No adverse event was recorded at all.</text>
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                <text>Midhun Thomas John  , Sarah Alexandra van Blydenstein , Shahed Omar ,  Joanne Bruins  , Stephilia Tshukutsoane </text>
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              <elementText elementTextId="20665">
                <text>www.elsevier.com/locate/afjem</text>
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        <name>Jurnal Internasional Keperawatan</name>
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        <name>Safety study OxEra Oxygen delivery device</name>
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                  <text> Jurnal Internasional Afrika vol. 12 issue 3 2022</text>
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              <elementText elementTextId="20639">
                <text>Jurnal Internasional Aprika vol.12 issue 3 2022&#13;
African Journal of Emergency Medicine&#13;
Non-specialist emergency medicine qualifications in Africa: Lessons from&#13;
the South African Diploma in Primary Emergency Care</text>
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          <element elementId="49">
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                <text>Education&#13;
Dip PEC&#13;
Non-specialist&#13;
Training&#13;
Africa&#13;
South Africa</text>
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            <description>An account of the resource</description>
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              <elementText elementTextId="20641">
                <text>Introduction: Non-specialist emergency medicine qualifications are an important step in developing the specialty&#13;
of emergency medicine. The Diploma in Primary Emergency Care (Dip PEC) of the Colleges of Medicine of&#13;
South Africa is one of the oldest registrable qualifications. Reviewing its changing role over time has lessons for&#13;
academics developing Emergency Medicine training in Africa.&#13;
Methods: Through a series of meetings and stakeholder engagements, the Council of the College of Emergency&#13;
Medicine conducted a three year review of the qualification focusing on the curriculum, assessment processes,&#13;
success rate and role of the qualification in the South African medical context. A survey of the perceptions of&#13;
graduates over the last six years was also conducted.&#13;
Results: The survey showed candidate numbers increased dramatically from 2011 to 2017, resulting in an entry&#13;
cap. Lessons identified included ensuring that the qualification is responsive to the state of development of emergency&#13;
medicine in the country, needing aligned and valid assessment processes and maintaining the value of the&#13;
qualification in context.&#13;
Discussion: Emergency medicine qualifications are dynamic in and of themselves and how they relate to their&#13;
context. Program designers must prioritize ongoing evaluation from the start</text>
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              <elementText elementTextId="20642">
                <text>H. Geduld  , D. Cloete  , R. Dickerson  , A. Groenewald  , T. Stephens  , D. Fredericks  , A. Parker  , W. Jooste  , S. Lahri </text>
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              <elementText elementTextId="20646">
                <text>PERI IRAWAN</text>
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        <name>Education Dip PEC Non-specialist Training Africa South Africa</name>
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      <tag tagId="2017">
        <name>Jurnal Internasional Keperawatan</name>
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                  <text> Jurnal Internasional Afrika vol. 12 issue 3 2022</text>
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              <elementText elementTextId="20628">
                <text>Jurnal Internasional Aprika vol.12 issue 3 2022&#13;
African Journal of Emergency Medicine&#13;
Level of emergency and disaster preparedness of public hospitals in Northwest Ethiopia: A cross-sectional study</text>
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          <element elementId="49">
            <name>Subject</name>
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            <elementTextContainer>
              <elementText elementTextId="20629">
                <text>Emergency Disaster Hospitals Preparedness Northwest Ethiopia</text>
              </elementText>
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          <element elementId="41">
            <name>Description</name>
            <description>An account of the resource</description>
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              <elementText elementTextId="20630">
                <text>Background: From time to time, the magnitude and type of health emergencies and disasters are increasing. Hospital emergency and disaster preparedness, on the other hand, is still in its early stages in many low- and middle-income countries. In Ethiopia, research on hospital disaster preparedness is severely limited. As a result, the purpose of this study was to determine the level of hospital emergency and disaster preparedness at public hospitals in the east Gojjam zone of Northwest Ethiopia. Methods: A census method was used to include ten hospitals in the East Gojjam zone in a cross-sectional de- scriptive study. An adopted World Health Organization observation checklist was used to assess disaster and emergency preparedness. Each question was assigned a score out of three points, with one indicating low readi- ness and three indicating the highest level of preparation. Finally, the level of preparedness was classified as “low “if the average percentage score ranged from 33.3% to 66.6 %, and as “high ”if the percentage score ranged from 66.7 % to 100 %. The results were then presented in the form of texts, tables, and percentages. Results: The evaluated hospitals’ overall level of emergency and disaster preparedness falls into the low category, with an average calculated preparedness score of 54.75 %. The domain with the lowest preparedness is logistics and finance (43.33 %), while the domain with the highest preparedness is patient care and support services (60 %). Conclusion: According to the findings of this study, the level of emergency and disaster preparedness in the hospitals studied is low. It is therefore recommended that the ministry of health, regional health bureaus, and hospital administrators collaborate to develop an appropriate intervention strategy to address this issue</text>
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                  <text> Jurnal Internasional Afrika vol. 12 issue 3 2022</text>
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                <text>Jurnal Internasional Aprika vol.12 issue 3 2022&#13;
African Journal of Emergency Medicine&#13;
Family presence during patient acute deterioration: A survey of nurses’ attitudes and reflection on COVID-19 in an African setting</text>
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                <text>Nurses’ perceptions Family presence Acute deterioration Emergency centre COVID 19 African relevance</text>
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                <text>Introduction: Acute deterioration refers to a patient who has become physiologically unstable requiring acute care. Family presence during resuscitation efforts has been widely supported by literature. Nurses are often the primary contact for the families of patients in the emergency centre, playing an important role in facilitating family presence during acute care. To describe nurses’ attitudes regarding family presence during the management of acutely deteriorating patients in the emergency centre. Methods: A descriptive quantitative study was conducted in the emergency centres of three public hospitals in the Eastern Cape, South Africa. A total sample of professional nurses ( n = 57) were recruited, to complete the Emergency Department Family Presence (EDFP) survey. Statements about the negative effects of family presence during acute care of a deteriorating patient were presented and respondents were required to agree or disagree. Data were analysed using univariable and multivariable logistic regression. Results: The majority of the nurses agreed with the items in the EDFP survey agreeing that present relatives may misinterpret activities of health care professionals (92.8%) which can result in complaints about the quality of care (91.1%). Nurses with more years of experience (11–21 years) were more likely to disagree with the statements on family presence having negative effects on patient care than nurses with fewer years of experience (0–10 years) (OR:6.92; 95%CI: 1.29–37.28). Discussion: Nurses have the perception that family presence has a largely negative effect on patients, patient care and the families present during acute care. The contextual application of the practice of family presence during acute deterioration in an African setting needs investigation and the need for continued professional education on family centred care is emphasised. Alternative methods of facilitating family presence during the COVID-19 Pandemic must be considered as we advocate for the self determination of families and patients</text>
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                <text>Meghan Botes , Lindokuhle Mabetshe</text>
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                <text>www.elsevier.com/locate/afjem</text>
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