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3. Contributors

Author

Adams, Axel, primary, Affun-Adegbulu, Clara, additional, Al-Rasheed, Rakan S., additional, Alaska, Yasser A., additional, Aldawas, Abdulaziz D., additional, Alesa, Saleh Ali, additional, Alexander, George A., additional, Alhadhira, Abdullah Ahmed, additional, Alhajjaj, Fahad Saleha, additional, Alhazmi, Hazem H., additional, Alhussaini, Zainab Abdullah, additional, Aljerian, Nawfal, additional, Aljohani, Majed, additional, AlKhaldi, Khaldoon H., additional, Alkhattabi, Eyad, additional, Allen, Bryant, additional, Almand, Austin, additional, Alnoaimi, Moza M., additional, Alotaibi, Mohammad, additional, Alpert, Evan Avraham, additional, Alrusayni, Yasir A., additional, Alshammari, Mai, additional, Alsulimani, Loui K., additional, Amanullah, Siraj, additional, Anderson, Arian, additional, Arastehmanesh, David, additional, Ardalan, Ali, additional, Argote-Araméndiz, Killiam A., additional, Artenstein, Andrew W., additional, Bailey, Olivia E., additional, Baker, Russell, additional, Balsari, Satchit, additional, Banner, Gregory T., additional, M, Fermin Barrueto, additional, Bartels, Susan A., additional, Baugh, Joshua J., additional, Berg, Frederic, additional, Bhola, Vijai, additional, Binder, William, additional, Bortolin, Michelangelo, additional, Bounes, Vincent, additional, Bouton, Michael, additional, Brown, Natasha, additional, Jr, Frederick M. Burkle,, additional, Burnett, Lynn Barkley, additional, Burns, Michele M., additional, Sr, Nicholas V. Cagliuso,, additional, Cahill, John, additional, Callaway, David W., additional, Caneva, Duane C., additional, Cattamanchi, Srihari, additional, Caycedo, Alejandra, additional, Cetaruk, Edward W., additional, Chacko, Sneha, additional, Chang, James C., additional, Chiang, Crystal, additional, Chiu, David T., additional, Ciottone, Gregory R., additional, Ciottone, Jonathan Peter, additional, Ciottone, Melissa A., additional, Ciottone, Robert A., additional, Ciottone, Robert G., additional, Ciottone, Vigen G., additional, Clark, Alexander, additional, Clark, Jonathan, additional, Conley, Sean P., additional, Cono, Joanne, additional, Cooper, Arthur, additional, Cormier, Scott B., additional, Court, Michael F., additional, Cunningham, Cord W., additional, Czarnecki, Fabrice, additional, Davis, Supriya, additional, Davis, Timothy E., additional, DeMers, Gerard, additional, Dilling, Sharon, additional, Djalali, Ahmadreza, additional, Donahoe, Timothy, additional, Donahue, Joseph, additional, Dresser, Caleb, additional, Dylik, Jason, additional, Easter, Benjamin, additional, Eastman, Alexander, additional, Ebbeling, Laura, additional, Emetarom, Chigozie, additional, Eyal, Nir, additional, Eyre, Andrew J., additional, Freeman, David J., additional, Friedman, Franklin D., additional, Fritz, Christie, additional, Fung, Frederick, additional, Gallahue, Fiona E., additional, Garbern, Stephanie Chow, additional, Gebhart, Mark E., additional, Gluckman, William A., additional, Goolsby, Craig, additional, Gougelet, Robert M., additional, Granholm, Fredrik, additional, Greenough, P. Gregg, additional, Grimes, Jennifer O., additional, Grosse, Steve, additional, Grossman, Shamai A., additional, Jr, John T. Groves, additional, Guidotti, Tee L., additional, Guo, George, additional, Haessler, Sarah, additional, Hall, Matthew M., additional, Hardin, John W., additional, Harrell, Mason, additional, Hart, MD, Alexander, additional, Harvey, Melissa, additional, Hertelendy, PhD, Attila J., additional, Hiremath, Nishanth S., additional, Hitchens, Jordan, additional, Holstege, Christopher P., additional, Horne, Simon T., additional, Horng, Steven, additional, Hosin, Amer, additional, House, Hans R., additional, Ingrassia, Pier Luigi, additional, Issa, Fadi S., additional, Jacoby, Irving “Jake”, additional, Jaiswal, Rajnish, additional, Jay, Gregory, additional, Jenkins, J. Lee, additional, Joseph, Josh W., additional, Kappler, Shane, additional, Keim, Mark E., additional, Kelman, Julie, additional, Ketterer, Andrew R., additional, Khan, Anas A., additional, Kharel, Ramu, additional, Kharod, Chetan U., additional, Kirsch, Thomas D., additional, Knopov, Anita, additional, Kravitz, Max, additional, Lee, J. Austin, additional, Lemery, Jay, additional, Leventhal, Evan L., additional, Loughlin, Jesse, additional, Ludy, Stephanie, additional, Maguire, Brian J., additional, Mahon, Selwyn E., additional, Maniscalco, Paul M., additional, Manners, Philip, additional, Marcus, Leonard Jay, additional, Margus, Colton, additional, Masri, Taha M., additional, Matthews, Jeff, additional, McKay, Sean D., additional, McKinney, Zeke J., additional, McLellan, Robert K., additional, McNulty, Eric J., additional, Mehkri, Faroukh, additional, Mehta, Mandana, additional, Mendelsohn, Rebecca A., additional, Merin, Ofer, additional, Milsten, Andrew, additional, Molé, Dale M., additional, Molloy, Michael Sean, additional, Morelli, Ilaria, additional, Mothershead, Jerry L., additional, Mulhern, John, additional, Mullendore, Nicole F., additional, Musisca, Nicholas J., additional, Naganathan, Sonya, additional, Nathanson, Larry A., additional, Nelson, Erica L., additional, Nelson, Lewis S., additional, Newbury, Bradford A., additional, Newbury, Kimberly, additional, O’Neill, Ansley, additional, Obernier, Robert, additional, Olagnero, Jacopo M., additional, Oostrom-Shah, Leonie, additional, Ordun, Catherine Y., additional, Parazynski, Scott, additional, Park, Andrew J., additional, Partridge, Robert, additional, S, Jeffrey, additional, Phillips, James P., additional, Pinter, Emily, additional, IV, David P. Polatty, additional, Popieluszko, Patrick, additional, Porcaro, William, additional, Proano, Lawrence, additional, Pruitt, Peter B., additional, Qureshi, Moiz, additional, Ragazzoni, Luca, additional, Rashid, Murtaza, additional, Rega, Paul Patrick, additional, Reilly, Michael J., additional, Restuccia, Marc C., additional, Rifino, James J., additional, Robben, Paul M., additional, Rosenblatt, Joy L., additional, Ryan, Kevin M., additional, Rybasack-Smith, Heather, additional, Salway, Richard James, additional, Samo, Daniel, additional, Sanchez, Leon D., additional, Sanford, Shawn M., additional, Sarin, Ritu R., additional, Sarma, Deesha, additional, Schacht, Jesse, additional, Schwind, Valarie, additional, Shapiro, Geoffrey L., additional, Sheehan, Joshua, additional, Shreve, Brian, additional, Simonyan, Grigor, additional, Smith, Devin M., additional, MD, E. Reed Smith,, additional, MA, Jack E. Smith,, additional, Smith, Montray, additional, Smulowitz, Peter B., additional, Snyder, Angela M., additional, Solano, Joshua J., additional, Stenson, Bryan A., additional, Stewart, Charles, additional, Stewart, M. Kathleen, additional, Sullivan, Patrick, additional, Supple, Jared S., additional, Tin, Derrick, additional, Valente, Jonathan Harris, additional, Vear, Kathryn M., additional, Vidyalakshmi, P.R., additional, Vilas, Faith, additional, Vilke, Gary M., additional, Villano, Janna H., additional, Voskanyan, Amalia, additional, Watson, C. James, additional, Weber, Nancy, additional, Weiner, Scott G., additional, Weinstein, Brielle, additional, Weinstein, Eric S., additional, Werner, Jordan R., additional, MD, Roy Karl Werner,, additional, Whitledge, James D., additional, Wiener, Sage W., additional, Wiesner, Lauren, additional, Williams, Kenneth A., additional, Wing, Robyn, additional, Wolfe, Richard E., additional, Wong, Wendy Hin-Wing, additional, Woolard, Robert, additional, Wuthisuthimethawee, Prasit, additional, and Youssef, Nadine A., additional

Published
2024
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4. Evidence-Based Heatstroke Management in the Emergency Department

Author

Rublee, Caitlin, Dresser, Caleb, Giudice, Catharina, Lemery, Jay, and Sorensen, Cecilia

Subjects
climate change, heatstroke, adaptation, critical care
Abstract

Introduction: Climate change is causing an increase in the frequency and intensity of extreme heat events, which disproportionately impact the health of vulnerable populations. Heatstroke, the most serious heat-related illness, is a medical emergency that causes multiorgan failure and death without intervention. Rapid recognition and aggressive early treatment are essential to reduce morbidity and mortality. The objective of this study was to evaluate current standards of care for the emergent management of heatstroke and propose an evidence-based algorithm to expedite care.Methods: We systematically searched PubMed, Embase, and key journals, and reviewed bibliographies. Original research articles, including case studies, were selected if they specifically addressed the recognition and management of heatstroke in any prehospital, emergency department (ED), or intensive care unit population. Reviewers evaluated study quality and abstracted information regarding demographics, scenario, management, and outcome.Results: In total, 63 articles met full inclusion criteria after full-text review and were included for analysis. Three key themes identified during the qualitative review process included recognition, rapid cooling, and supportive care. Rapid recognition and expedited external or internal cooling methods coupled with multidisciplinary management were associated with improved outcomes. Delays in care are associated with adverse outcomes. We found no current scalable ED alert process to expedite early goal-directed therapies.Conclusion: Given the increased risk of exposure to heat waves and the time-sensitivity of the condition, EDs and healthcare systems should adopt processes for rapid recognition and management of heatstroke. This study proposes an evidence-based prehospital and ED heat alert pathway to improve early diagnosis and resource mobilization. We also provide an evidence-based treatment pathway to facilitate efficient patient cooling. It is hoped that this protocol will improve care and help healthcare systems adapt to changing environmental conditions.

Published
2021

8. Climate Change and the Kidney

Author

Johnson, Richard J., Sánchez-Lozada, Laura G., Newman, Lee S., Lanaspa, Miguel A., Diaz, Henry F., Lemery, Jay, Rodriguez-Iturbe, Bernardo, Tolan, Dean R., Butler-Dawson, Jaime, Sato, Yuka, Garcia, Gabriela, Hernando, Ana Andres, and Roncal-Jimenez, Carlos A.

Published
2019

18. A multinational Delphi consensus to end the COVID-19 public health threat

Author

Lazarus, Jeffrey V., Romero, Diana, Kopka, Christopher J., Karim, Salim Abdool, Abu-Raddad, Laith J., Almeida, Gisele, Baptista-Leite, Ricardo, Barocas, Joshua A., Barreto, Mauricio L., Bar-Yam, Yaneer, Bassat, Quique, Batista, Carolina, Bazilian, Morgan, Chiou, Shu-Ti, del Rio, Carlos, Dore, Gregory J., Gao, George F., Gostin, Lawrence O., Hellard, Margaret, Jimenez, Jose L., Kang, Gagandeep, Lee, Nancy, Matičič, Mojca, McKee, Martin, Nsanzimana, Sabin, Oliu-Barton, Miquel, Pradelski, Bary, Pyzik, Oksana, Rabin, Kenneth, Raina, Sunil, Rashid, Sabina Faiz, Rathe, Magdalena, Saenz, Rocio, Singh, Sudhvir, Trock-Hempler, Malene, Villapol, Sonia, Yap, Peiling, Binagwaho, Agnes, Kamarulzaman, Adeeba, El-Mohandes, Ayman, Barreto, Mauricio, Abdulla, Salim, Addleman, Sarah, Aghayeva, Gulnara, Agius, Raymond, Ahmed, Mohammed, Ramy, Mohamed Ahmed, Aide, Pedro, Aleman, Soo, Alfred, Jean-Patrick, Ali, Shamim, Aliaga, Jorge, Aloudat, Tammam, Alqahtani, Saleh A., Al-Salman, Jameela, Amuasi, John H., Agrawal, Anurag, Anwar, Wagida, Araujo-Jorge, Tania, Artaza, Osvaldo, Asadi, Leyla, Awuku, Yaw, Baker, Michael, Barberia, Lorena, Bascolo, Ernesto, Belcher, Paul, Bell, Lizett, Benzaken, Adele, Bergholtz, Emil, Bhadelia, Nahid, Bhan, Anant, Bilodeau, Stephane, Bitrán, Ricardo, Bluyssen, Philomena, Bosman, Arnold, Bozza, Fernando A., Brinkmann, Melanie M., Brown, Andrew, Mellado, Bruce, Bukusi, Elizabeth, Bullen, Chris, Buonanno, Giorgio, Burgess, Rochelle, Butler, Matthew, Byakika-Kibwika, Pauline, Cabieses, Baltica, Carlsson, Gunilla, Cascini, Fidelia, Chabala, Chishala, Chakroun, Mohamed, Cheng, null, Chetty, Agnes, Chumachenko, Dmytro, Consalves, Gregg, Conway Morris, Andrew, Cordie, Ahmed, Corrah, Tumani, Crabtree-Ramírez, Brenda, Dashdorj, Naranjargal, Davidovitch, Nadav, de Souza, Luis Eugenio, Dhariwal, Akshay Chand, Druică, Elena, Ergonul, Onder, Erondu, Ngozi A., Essar, Mohammad Yasir, Ewing, Andrew, Fanjul, Gonzalo, Feierstein, Daniel, Feigl-Ding, Eric, Figueroa, Ramon, Figueroa, John Peter, Fisher, Dale, Flores, Walter, Forero-Peña, David A., Frumkin, Howard, Gamkrelidze, Amiran, Gandhi, Monica, Garcia, Patricia, Garcia-Basteiro, Alberto L., García-Sastre, Adolfo, Garg, Suneela, Gbeasor-Komlanvi, null, Gershenson, Carlos, Gilada, Ishwar, Giovanella, Ligia, González, Marino, Green, Manfred S., Greenhalgh, Trisha, Griffin, Paul, Griffin, Stephen, Grinsztejn, Beatriz, Anand, Tanu, Guerra, Germán, Guinto, Renzo, Gujski, Mariusz, Guner, Rahmet, Hamdy, Adam, Hâncean, Marian-Gabriel, Haniffa, Abusayeed, Hartigan-Go, Kenneth Y., Hassan, Hoda K., Hay, Simon I., Heino, Matti T. J., Hel, Zdenek, Hotez, Peter, Hu, Jia, Hukić, Mirsada, IJsselmuiden, Carel, Iroko, Davidson, Iskarous, Maged, Izugbara, Chimaraoke, Jacobs, Choolwe, Jadad, Alejandro R., Jehan, Fyezah, Jordan, Ayana, Jroundi, Imane, Kain, Kevin, Kamberi, Fatjona, Karamov, Eduard, Karan, Abraar, Katz, Rebecca, Katzourakis, Aris, Kazembe, Abigail, Khamis, Faryal, Khamzayev, Komiljon, Khanyola, Judy, Khunti, Kamlesh, Kiguli-Malwadde, Elsie, Kim, Woo Joo, Kirenga, Bruce J., Klimovský, Daniel, Kmush, Brittany L., Knaul, Felicia, Kogevinas, Manolis, Kristensen, Frederik, Kumar, Dinesh, Kumar, Raman, Kvalsvig, Amanda, Lacerda, Marcus V., Lal, Arush, Lawton, Tom, Lemery, Jay, Leonardi, Anthony J., Li, Yuguo, Löttvall, Jan, Lounis, Mohamed, Maceira, Daniel, MacIntyre, C. Raina, Madani, Azzeddine, Magiorkinis, Gkikas, Malekzadeh, Reza, Choisy, Marc, Marcelin, Jasmine R., Marks, Guy B., Marr, Linsey, Marrazzo, Jeanne, Martina, Antonieta, Martín-Moreno, José M., Mateos, Carlos, Mayxay, Mayfong, Mazarati, Jean Bapiste, Mboup, Souleymane, McDonald, Jennifer, McMillan, Faye, Mechili, Enkeleint, Medici, Andre, Davis, Sarah L. M., Meier, Petra, Memish, Ziad A., Menon, Jaideep, Menon, Purnima, Mesiano-Crookston, Jonathan, Michie, Susan, Mikolasevic, Ivana, Milicevic, Ognjen, Mishra, Asit Kumar, Mohamed, Rahma, Mokdad, Ali H., Monroy-Valle, Michele, Morawska, Lidia, Moschos, Sterghios A., Motawea, Karam, Mousavi, Sayed Hamid, Mumtaz, Ghina, Munene, Peter K., Muñoz Almagro, Carmen, Muriuki, Janet, Muyingo, Sylvia, Naniche, Denise, Naylor, C. David, Ndembi, Nicaise, Nemec, Juraj, Nesteruk, Igor, Ngaruiya, Christine, Nguyen, Hung, Nikolova, Dafina, Nitzan, Dorit, Norheim, Ole, Noushad, Mohammed, Ntoumi, Francine, Nyborg, Gunhild Alvik, Ochodo, Eleanor, Odabasi, Zekaver, Okwen, Mbah Patrick, Olivia, Keiser, Ong, David S. Y., Opara, Ijeoma, Orozco, Miguel, Oshitani, Hitoshi, Pagel, Christina, Pai, Madhukar, Pálsdóttir, Björg, Papatheodoridis, Georgios, Paraskevis, Dimitrios, Leigh, Jeanna Parsons, Pécoul, Bernard, Peichl, Andreas, Perez-Then, Eddy, Duc, Phuc Pham, Philippe, Cécile, Pineda Rojas, Andrea, Pladsen, Courtney, Pozniak, Anton, Quiroga, Rodrigo, Qureshi, Huma, Rampal, Sanjay, Ranney, Megan, Rathe, Laura, Ratzan, Scott, Raventos, Henriette, Rees, Helen, Reis, Renata, Ricciardi, Walter, Rizk, Nesrine, Robalo, Magda, Robertson, Eleanor, Robinson, Leanne, Rokx, Casper, Ros, Tamsin, Røttingen, John-Arne, Rubin, Meir, Ruxrungtam, Kiat, Sadirova, Shakhlo, Saha, Senjuti, Salgado, Nelly, Sanchez, Lizet, Sangaramoorthy, Thurka, Santamaria-Ulloa, Carolina, Santos, Renata, Sawaf, Bisher, Schneider, Matthias F., Schooley, Robert T., Sener, Alper, Sepulveda, Jaime, Shah, Jaffer, Shibani, Mosa, Shoib, Sheikh, Sikazwe, Izukanji, Šimaitis, Aistis, Gill, Amandeep Singh, Skhvitaridze, Natia, Sokolović, Milka, Solomon, Roma, Solórzano, Xavier, Springer, Sandra A., Šrol, Jakub, Staines, Anthony, Stelfox, Henry T., Strathdee, Steffanie, Sulaiman, Lokman Hakim, Sutton, Brett, Svanæs, Dag, Swed, Sarya, Sypsa, Vana, Sørensen, Kristine, Tajudeen, Raji, Tan, Amy, Tang, Julian, Tanner, Marcel, Sethi, Tavpritesh, Temmerman, Marleen, Than, Kyu Kyu, Tinto, Halidou, Tomètissi, Sênoudé Pacôme, Torres, Irene, Tshering, null, Tsiodras, Sotirios, Tsofa, Benjamin, Vahlne, Anders, Vargas, Juan Rafael, Bernal, Ivan Dario Velez, Ventura, Deisy, Vilasanjuan, Rafael, Vipond, Joe, Wamala-Andersson, Sarah, Wargocki, Pawel, West, Robert, Weyand, Angela, White, Trenton M., Wolff, Guntram, Yao, Maosheng, Yates, Christian A., Yeboah, Georgina, Yee-Sin, Leo, Yi, Siyan, Teo, Yik-Ying, Yong, Poovorawan, Zamora-Mesía, Victor, Øvrehus, Anne, 0000-0001-9618-2299, 0000-0002-4832-9564, 0000-0002-4986-2133, 0000-0003-0790-0506, 0000-0003-0875-7596, 0000-0002-6994-1891, 0000-0002-3869-615X, 0000-0001-5286-4044, 0000-0001-6203-1847, 0000-0002-0121-9683, 0000-0003-1793-6350, 0000-0003-2418-0037, 0000-0002-5095-748X, 0000-0003-4492-3256, 0000-0002-5964-8210, 0000-0002-6779-3151, 0000-0002-8074-4450, Lazarus, Jeffrey V [0000-0001-9618-2299], Romero, Diana [0000-0002-4832-9564], Karim, Salim Abdool [0000-0002-4986-2133], Abu-Raddad, Laith J [0000-0003-0790-0506], Bassat, Quique [0000-0003-0875-7596], Chiou, Shu-Ti [0000-0002-6994-1891], Gao, George F [0000-0002-3869-615X], Gostin, Lawrence O [0000-0001-5286-4044], Jimenez, Jose L [0000-0001-6203-1847], McKee, Martin [0000-0002-0121-9683], Oliu-Barton, Miquel [0000-0003-1793-6350], Pradelski, Bary [0000-0003-2418-0037], Rathe, Magdalena [0000-0002-5095-748X], Trock-Hempler, Malene [0000-0003-4492-3256], Yap, Peiling [0000-0002-5964-8210], Binagwaho, Agnes [0000-0002-6779-3151], Kamarulzaman, Adeeba [0000-0002-8074-4450], Apollo - University of Cambridge Repository, Helsinki Collegium for Advanced Studies, Research Group of Nelli Hankonen, Doctoral Programme in Social Sciences, Academic Disciplines of the Faculty of Social Sciences, RS: CAPHRI - R2 - Creating Value-Based Health Care, International Health, Performance analysis and optimization of LARge Infrastructures and Systems (POLARIS), Inria Grenoble - Rhône-Alpes, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire d'Informatique de Grenoble (LIG), Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Institut National Polytechnique de Grenoble (INPG)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Institut National Polytechnique de Grenoble (INPG)-Centre National de la Recherche Scientifique (CNRS), Internal Medicine, Medical Microbiology & Infectious Diseases, Veritati - Repositório Institucional da Universidade Católica Portuguesa, and Lazarus J. V., Romero D., Kopka C. J., Karim S. A., Abu-Raddad L. J., Almeida G., Baptista-Leite R., Barocas J. A., Barreto M. L., Bar-Yam Y., et al.

Subjects
Pandemics/economics, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences, COVID-19 Vaccines, Delphi Technique, General Science & Technology, International Cooperation, Temel Bilimler (SCI), ÇOK DİSİPLİNLİ BİLİMLER, Public Health/economics, [SHS]Humanities and Social Sciences, SDG 3 - Good Health and Well-being, RA0421 Public health. Hygiene. Preventive Medicine, Medicine and Health Sciences, Humans, prevention and control, human, Settore MED/42 - IGIENE GENERALE E APPLICATA, Health Education, Pandemics, Multidisipliner, Organizations, Multidisciplinary, MULTIDISCIPLINARY SCIENCES, COVID-19/economics, Temel Bilimler, pandemic, Communication, Health Policy, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti, Doğa Bilimleri Genel, COVID-19, 3142 Public health care science, environmental and occupational health, Delphi study, NATURAL SCIENCES, GENERAL, N/A, Public Opinion, Government, Natural Sciences (SCI), Public Health, Natural Sciences
Abstract

Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic . Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches , while maintaining proven prevention measures using a vaccines-plus approach that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.

Published
2022

24. Contributors

Author

Alaska, Yasser A., primary, Aldawas, Abdulaziz D., additional, Alesa, Saleh Ali, additional, Alexander, George A., additional, Alhazmi, Hazem H., additional, Aljerian, Nawfal, additional, AlJohani, Majed, additional, AlKhaldi, Khaldoon H., additional, Allen, Bryant, additional, Alotaibi, Bader S., additional, Alotaibi, Mohammad, additional, Alpert, Evan Avraham, additional, Al-Rasheed, Rakan S., additional, Alshammari, Mai, additional, Alsufyani, Asaad, additional, Amanullah, Siraj, additional, Ardalan, Ali, additional, Artenstein, Andrew W., additional, Aschkenasy, Miriam, additional, Babineau, Matthew R., additional, Babu, Kavita, additional, Bailey, Olivia E., additional, Banner, Gregory T., additional, Barrueto, Fermin, additional, Bartels, Susan A., additional, Becker, Bruce M., additional, Biddinger, Paul D., additional, Blohm, Eike, additional, Blumenthal, Susan R., additional, Borron, Stephen W., additional, Bortolin, Michelangelo, additional, Bouton, Michael, additional, Brewster, Peter, additional, Budd, Churton, additional, Burke, James M., additional, Burkle, Frederick M., additional, Burnett, Lynne Barkley, additional, Cagliuso, Nicholas V., additional, Cahill, John D., additional, Callaway, David W., additional, Caneva, Duane C., additional, Canther, David M., additional, Cattamanchi, Srihari, additional, Cetaruk, Edward W., additional, Chang, James C., additional, Charles-Marcel, Zeno L., additional, Cheh, Anna I., additional, Chiu, David T., additional, Ciccone, Teriggi J., additional, Ciottone, Gregory R., additional, Ciottone, Jonathan Peter, additional, Ciottone, Robert A., additional, Clapp, Diana, additional, Cohen, Raphael G., additional, Conlon, Kathe M., additional, Cono, Joanne, additional, Cranmer, Hilarie, additional, Cunningham, Cord W., additional, Cunnion, Steven O., additional, Curcio, Alison Sisitsky, additional, Darling, Robert G., additional, Davids, Neil B., additional, Davis, Timothy E., additional, Deitchman, Scott, additional, Delaney, John B., additional, Corte, Francesco Della, additional, DeMers, Gerard, additional, Dickerson, William E., additional, Dilling, Sharon, additional, Djalali, Ahmadreza, additional, Donahue, Joseph, additional, Dyer, K. Sophia, additional, Dylik, Jason, additional, Easter, Benjamin, additional, Ebbeling, Laura, additional, Eyal, Nir, additional, Eyre, Andrew J., additional, Fares, Saleh, additional, Farmer, Katherine, additional, FitzGerald, Denis J., additional, Foley, Elizabeth, additional, Fosher, Kerry, additional, Freeman, David, additional, Freitas, Robert L., additional, Friedman, Franklin D., additional, Fung, Frederick, additional, Gallahue, Fiona E., additional, Gans, Lucille, additional, Garbern, Stephanie Chow, additional, Gebhart, Mark E., additional, Geiling, James, additional, Geyer, Brian C., additional, Giordano, Mary Jo, additional, Gluckman, William A., additional, Goudie, J. Scott, additional, Gougelet, Robert M., additional, Graboyes, Benjamin, additional, Greenberg, Michael I., additional, Greenough, P. Gregg, additional, Greiner, Ashley L., additional, Greve, Mark, additional, Grosse, Stephen, additional, Grossman, Shamai A., additional, Guidotti, Tee L., additional, Hack, Jason B., additional, Hall, Matthew M., additional, Hardin, John W., additional, Hick, John L., additional, Hiremath, Nishanth S., additional, Horng, Steven, additional, Horning, Geoffrey D., additional, Horst, Kurt R., additional, Hosin, Ali A., additional, Hosin, Amer, additional, House, Hans R., additional, Ingrassia, Pier Luigi, additional, Jackson, Patrick M., additional, Jacoby, Irving “Jake”, additional, Jaiswal, Rajnish, additional, Janicki, Adam J., additional, Jay, Gregory, additional, John, Miriam, additional, Johnson, Shawn E., additional, Johnston, James R., additional, Jones, Jerrilyn, additional, Jones, Michael D., additional, Joseph, Josh W., additional, Joseph, Patrice, additional, Kearney, Alexis, additional, Keen, Donald, additional, Keim, Mark E., additional, Kenez, Elizabeth, additional, Kennedy, Katharyn E., additional, Khan, Anas A., additional, Kharod, Chetan U., additional, Kim, Sylvia H., additional, King, Kevin, additional, Kirk, Mark A., additional, Kobayashi, Leo, additional, Kulchycki, Lara K., additional, Kulkarni, Rick G., additional, Lauro, Joseph, additional, Lawner, Benjamin J., additional, Le, David V., additional, Lee, Debra, additional, Lee, Terrance T., additional, Lemery, Jay, additional, Linder, Jeanette A., additional, Linder, Lawrence S., additional, Loesch, Michael A., additional, Long, Heather, additional, Longley-Wood, Kate, additional, Mack, Michael D., additional, Mackay, John M., additional, Macnow, Laura, additional, Madsen, James M., additional, Maguire, Brian J., additional, Maher, Patrick J., additional, Mahon, Selwyn E., additional, Malone, John D., additional, Mangini, Marco, additional, Maniscalco, Paul M., additional, Marcozzi, David, additional, Marghella, Pietro D., additional, Matthews, Jeff, additional, McCahill, Peter, additional, McKay, Sean D., additional, Mecham, C. Crawford, additional, Mehta, Mandana, additional, Meinhardt, Patricia L., additional, Melville, Laura Diane, additional, Mills, Angela M., additional, Milsten, Andrew M., additional, Mitchell, Clifford S., additional, Molé, Dale M., additional, Molloy, Michael Sean, additional, Moloney, John, additional, Morelli, Ilaria, additional, Mothershead, Jerry L., additional, Mulhern, John, additional, Mullendore, Nicole F., additional, Nathanson, Larry A., additional, Nelson, Amelia Marie, additional, Nelson, Erica L., additional, Nelson, Lewis S., additional, Nichols, Carey, additional, Nocera, Mariann, additional, Noste, Erin E., additional, Ordun, Catherine Y., additional, Panagos, Peter D., additional, Partridge, Robert, additional, Paul, Jeffrey S., additional, Pettit, Catherine, additional, Pfaff, James, additional, Phillips, James P., additional, Pickett, Jason, additional, Porcaro, William, additional, Postel, Thérèse M., additional, Pozner, Charles N., additional, Vidyalakshmi, P.R., additional, Proano, Lawrence, additional, Pruitt, Peter B., additional, Rabrich, Jeffrey S., additional, Race, Jeffrey D., additional, Ragazzoni, Luca, additional, Rahman-Kahn, Najma, additional, Reed, Kristin Allyce, additional, Reenstra, Wende R., additional, Rega, Paul P., additional, Reilly, Michael J., additional, Reisner, Andrew T., additional, Restuccia, Marc C., additional, Rifino, James J., additional, Riley, James Michael, additional, Robben, Paul M., additional, Ryan, Kevin M., additional, Rybasack-Smith, Heather, additional, Sanchez, Leon D., additional, Sarin, Ritu R., additional, Schnelle, Debra D., additional, Schwind, Valarie, additional, Seheult, Malcolm, additional, Sethuraman, Kinjal N., additional, Shapiro, Geoffrey L., additional, Shapiro, Marc J., additional, Shen, Sam, additional, Shepherd, Suzanne M., additional, Shoff, William H., additional, Sisson, Craig, additional, Skog, Alexander P., additional, Slutzman, Jonathan E., additional, Smith, Devin M., additional, Smith, E. Reed, additional, Smith, Jack E., additional, Smulowitz, Peter B., additional, Snyder, Angela M., additional, Solano, Joshua J., additional, Sorenson, John, additional, Stanford, Kimberly A., additional, Stewart, Charles, additional, Stewart, M. Kathleen, additional, Sulis, Carol, additional, Tashjian, Robert J., additional, Temin, Elizabeth S., additional, Tenner, Andrea G., additional, Thorne, Craig D., additional, Tracy, Jason A., additional, Trounce, Milana, additional, Valente, Jonathan Harris, additional, Venier, Alice, additional, Vilas, Faith, additional, Vilke, Gary M., additional, Villano, Janna H., additional, Vogt, Barbara, additional, Voskanyan, Amalia, additional, Weiner, Scott G., additional, Weinstein, Brielle, additional, Weinstein, Eric S., additional, Weir, Scott D., additional, Werner, Roy Karl, additional, Wiener, Sage W., additional, Williams, Kenneth A., additional, Wing, Robyn, additional, Wong, Wendy Hin-Wing, additional, Wolfe, Richard E., additional, Wood, Stephen P., additional, Woolard, Robert H., additional, Wuthisuthimethawee, Prasit, additional, Yeskey, Kevin, additional, Yousif, Sami A., additional, Youssef, Nadine A., additional, and Yun, Brian J., additional

Published
2016
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25. Chapter 23 : Southern Great Plains. Impacts, Risks, and Adaptation in the United States: The Fourth National Climate Assessment, Volume II

Author

Kloesel, Kevin, primary, Bartush, Bill, additional, Banner, Jay, additional, Brown, David, additional, Lemery, Jay, additional, Lin, Xiaomao, additional, Loeffler, Cindy, additional, McManus, Gary, additional, Mullens, Esther, additional, Nielsen-Gammon, John, additional, Shafer, Mark, additional, Sorenson, Cecilia, additional, Sperry, Sidney K., additional, Wildcat, Daniel R., additional, and Ziolkowska, Jadwiga R., additional

Published
2018
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27. WHAT KEEPS US UP AT NIGHT? BLACK SWANS IN SPACE.

Author

Lemery, Jay, Garbino, Alex, and Hanson, Andrea

Subjects
COMMERCIAL aeronautics, HUMAN space flight, POLAR bear, MEDICAL screening, MENTAL health
Abstract

BACKGROUND: The rise in commercial human spaceflight opportunities for civilians and varying medical screening standards for commercial spaceflight flight participants will result in increased risk of medical event 'outliers' in spaceflight. We illustrate an analogue case from polar medicine to discuss unpredictability in risk models, as well as the need for novel medical systems to better embed flexibility and resilience for long duration missions. OVERVIEW: At 5:30 A.M. on June 14th 2018, a polar bear walked into Summit Station--the NSF's research station in remote Greenland--nearly 300 m from individuals sleeping in arctic tents. Summit Station possessed no bear deterrents other than heavy machinery. Over 40 Station residents were required to shelter in the two hard-sided buildings for 36 hours. Having little recourse to relocated the animal, ultimately hunters were flown to Summit Station and euthanized the bear. The epilogue of this encounter was a cascade of mental health complaints amongst the camp denizens, with reactions that included fear, anger, indifference, anxiety, grief and guilt stemming from the loss of autonomy, experiencing or witnessing a life-threatening encounter and the bear's death. The US-based medical team in support of Summit Station quickly mobilized psychiatric first aid support for the camp, in an effort to normalize reactions, explain coping mechanisms and re-establish a group connection (1). DISCUSSION: When considering medical risk assessment for extreme and/or remote missions, this encounter epitomizes a 'black swan' event-- beyond any historic predictive data and characterized by unpredictability; has a potentially massive impact to the mission; and post-hoc predictability, with a sentiment that this encounter was less random and more predictable than it actually was, often saying it was "bound to happen."(2) As NASA endeavors to create evidence-based risk databases and predictive analytics for long duration missions, the 'black swan effect' reminds us that unforeseen outliers demonstrate the fragility of systems based on prediction and standard deviation; the dangers of placing too much confidence in a narrowly-focused expertise; and how rare and unpredictable events have a much greater impact than regular occurrences. This Arctic event speaks to the importance of resilient progressively earth independent medical systems that include redundant characteristics and improvisational skillsets. Learning Objectives 1. The participants will understand the the fragility of systems based on prediction and standard deviation. 2. Participants will comprehend the dangers of placing too much confi- dence in a narrowly-focused expertise. 3. Participants will discern in large systems how rare and unpredictable events have a much greater impact than regular occurrences. [ABSTRACT FROM AUTHOR]

Published
2024

29. Climate change and women's health: Impacts and policy directions

Author

Sorensen, Cecilia, Murray, Virginia, Lemery, Jay, and Balbus, John

Subjects
Climate change -- Influence -- Research, Health policy -- Analysis, Women's health -- Research, Biological sciences
Abstract

Author(s): Cecilia Sorensen 1,*, Virginia Murray 2, Jay Lemery 1, John Balbus 3 Summary points Climate change impacts on health-including increased exposures to heat, poor air quality, extreme weather events, [...]

Published
2018
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35. The Climate-Smart Emergency Department: A Primer

Author

Linstadt, Hanna, primary, Collins, Amy, additional, Slutzman, Jonathan E., additional, Kimball, Erika, additional, Lemery, Jay, additional, Sorensen, Cecilia, additional, Winstead-Derlega, Christopher, additional, Evans, Kristina, additional, and Auerbach, Paul S., additional

Published
2020
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36. Clinical Implications of Climate Change on US Emergency Medicine: Challenges and Opportunities

Author

Sorensen, Cecilia J., primary, Salas, Renee N., additional, Rublee, Caitlin, additional, Hill, Kimberly, additional, Bartlett, Emily S., additional, Charlton, Paul, additional, Dyamond, Chelsea, additional, Fockele, Callan, additional, Harper, Rachel, additional, Barot, Sabiha, additional, Calvello-Hynes, Emilie, additional, Hess, Jeremy, additional, and Lemery, Jay, additional

Published
2020
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39. Contributors

Author

Adachi, Javier A., primary, Alexander, Martin E., additional, Allen, Robert C., additional, Anderson, Bryan E., additional, Anderson, Susan, additional, Andrews, Christopher J., additional, Askew, E. Wayne, additional, Atkins, Dale, additional, Atwater, Brett D., additional, Auerbach, Paul S., additional, Bacal, Kira, additional, Backer, Howard D., additional, Binford, Greta J., additional, Bookspan, Jolie, additional, Bowman, Warren D., additional, Boyer, Leslie V., additional, Burgess, George H., additional, Bush, Robert K., additional, Bush, Sean Paul, additional, Butler, Frank K., additional, Carleton, Steven C., additional, Carlisle, Betty, additional, Castellani, John W., additional, Chatterjee, Monalisa, additional, Clark, Richard F., additional, Collier, Bryan R., additional, Cooper, Donald C., additional, Cooper, Mary Ann, additional, Crawshaw, Larry Ingram, additional, Cummins, Gregory A., additional, Danzl, Daniel F., additional, Dart, Richard C., additional, Dasgupta, Samhita, additional, Davis, Ian, additional, Davis, Kathleen Mary, additional, Davison, Kevin Jon, additional, Dawson, Chad P., additional, DeLoughery, Thomas G., additional, Donnelly, Mark W., additional, Donner, Howard J., additional, Douglas, Eric, additional, DuPont, Herbert L., additional, Ellis, Thomas J., additional, Erb, Blair Dillard, additional, Erickson, Timothy B., additional, Ericsson, Charles D., additional, Feldman, Joanne, additional, Fowler, Murray E., additional, Fradin, Mark S., additional, Frank, Bryan L., additional, Freer, Luanne, additional, French, Steven P., additional, Gaffin, Stephen L., additional, Gardner, Angela F., additional, Garza, Daniel, additional, Giesbrecht, Gordon G., additional, Graeme, Kimberlie A., additional, Gravatt, Andrea R., additional, Grissom, Colin K., additional, Hackett, Peter H., additional, Hawley, Charles G., additional, Hefle, Sue L., additional, Heggers, John P., additional, Heimbach, David M., additional, Heiskell, Lawrence E., additional, Hendee, John C., additional, Herrmann, Henry J., additional, Holle, Ronald L., additional, Hsia, Renee Y., additional, Hubbell, Franklin R., additional, Hudson, Steve E., additional, Iserson, Kenneth V., additional, Jacobs, Michael E., additional, Jensen, Suzanne C., additional, Kaplan, Lee A., additional, Kazura, James W., additional, Killyon, Garry W., additional, Kizer, Kenneth W., additional, Klein, Judith R., additional, Kuehl, Karen Nolan, additional, Kummerfeldt, Peter, additional, Langer, Carolyn S., additional, Laskin, Daniel M., additional, “Rick” LaValla, Patrick H., additional, Lee, Catherine Yumi, additional, Lemery, Jay, additional, Lewin, Matthew R., additional, Liffrig, James R., additional, Lipman, Grant S., additional, Ly, Binh T., additional, Maeyens, Edgar, additional, Mahadevan, Swaminatha V., additional, Mann, Roberta, additional, Marinelli, Rick, additional, Marks, Ariel Dan, additional, Marks, James G., additional, Martinez, Denise, additional, Matteucci, Michael J., additional, Mazzorana, Vicki, additional, McCauley, Robert L., additional, McCurley, Loui H. (Clem), additional, McNally, Jude T., additional, Mendel, Liran, additional, Messenger, James, additional, Mier, Timothy P., additional, Mitchell, James K., additional, Mohler, David G., additional, Moon, Richard E., additional, Moran, Daniel S., additional, Morenz, Barry, additional, Morris, John A., additional, Mutch, Robert W., additional, Nachat, Arian, additional, Nagy, Roger J., additional, Newman, Andrew B., additional, Nimec, Donna L., additional, Nix, David A., additional, Noji, Eric K., additional, Nolan, Donald B., additional, Norris, Robert L., additional, Olesnicky, Bohdan T., additional, Olson, Sheryl K., additional, Otten, Edward J. (Mel), additional, Patel, Ketan H., additional, Patel, Naresh J., additional, Patel, Sheral S., additional, Platts-Mills, Timothy F., additional, Plotkin, Mark, additional, Reed, Sheila B., additional, Riordan, William P., additional, Roach, Robert C., additional, Robson, Martin C., additional, Roe, Matthew T., additional, Schneider, Sandra M., additional, Schoene, Robert B., additional, Shandro, Jamie, additional, Smith, David J., additional, Steinman, Alan M., additional, Stoffel, Robert C., additional, Suchard, Jeffrey R., additional, Swiontkowski, Marc F., additional, Switzer, Julie A., additional, Taylor, Steve L., additional, Tilling, Robert I., additional, Townes, David A., additional, Traub, Stephen J., additional, Hoesen, Karen B. Van, additional, Van Tilburg, Christopher, additional, Walden, John, additional, Wallace, Helen L., additional, Wang, Andrew, additional, Warrell, David A., additional, Weiss, Eric A., additional, Welling, Lynn E., additional, Wilkerson, James A., additional, Williams, Knox, additional, and Williams, Sarah R., additional

Published
2007
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43. CONTRIBUTORS

Author

ALEXANDER, GEORGE A., primary, ANDERSON, ANGELA C., additional, ARTENSTEIN, ANDREW W., additional, BABU, KAVITA, additional, BARRUETO, FERMIN, additional, BARTON, CARRIE, additional, BECKER, BRUCE M., additional, BERKMAN, MATTHEW, additional, BERN, ANDREW I., additional, BOUKHMAN, MILANA, additional, BREWSTER, PETER, additional, BUDD, CHURTON, additional, BURKE, JAMES M., additional, BURKLE, FREDERICK M., additional, BURNETT, LYNNE BARKLEY, additional, CAGLIUSO, NICHOLAS VINCENT, additional, CAHILL, JOHN D., additional, CANEVA, DUANE C., additional, CASANI, JULIE ANN P., additional, CHAFFEE, MARY W., additional, CHANG, HENRY C., additional, CHANG, JAMES C., additional, CHEH, ANNA I., additional, CHEN, ESTHER H., additional, CICCONE, TERIGGI J., additional, CINAT, MARIANNE E., additional, CIOTTONE, GREGORY R., additional, CIOTTONE, ROBERT A., additional, COBERY, STEVEN T., additional, CONO, JOANNE, additional, CORRIGAN, KELLY J., additional, CORTE, FRANCESCO Della, additional, COURBAN, CHRISTO C., additional, CRANMER, HILARIE, additional, CUNNION, STEPHEN O., additional, DARLING, ROBERT G., additional, DAVIS, DAVID, additional, DAVIS, TIMOTHY, additional, DELAPENA, JENNIFER E., additional, DEY, CHAYAN, additional, DICKERSON, WILLIAM E., additional, DICKSON, ERIC W., additional, DILLING, SHARON, additional, DYER, K. SOPHIA, additional, DYLIK, JASON, additional, EDLOW, JONATHAN A., additional, EIDENBERG, MARSHALL, additional, ENNIS-HOLCOMB, KHAMA D., additional, FITZGERALD, DENIS J., additional, FOSHER, KERRY, additional, FREITAS, ROBERT L., additional, FRIEDBERG, RYAN, additional, FRIEDMAN, FRANKLIN D., additional, FUNG, FREDERICK, additional, FURBERG, ROBERT D., additional, GAASCH, WADE, additional, GALLAHUE, FIONA E., additional, GANS, LUCILLE, additional, GEDDO, ALESSANDRo, additional, GEILING, JAMES, additional, GIANNONE, PAUL, additional, GLUCKMAN, WILLIAM, additional, GORMAN, SUSAN E., additional, GOUDIE, J. SCOTT, additional, GOUGELET, ROBERT M., additional, GRABER, MARK A., additional, GRANT, JILL A., additional, GREENBERG, MICHAEL I., additional, GREENOUGH, P. GREGG, additional, GROSSMAN, SHAMAI A., additional, GUIDOTTI, TEE L., additional, GUTMAN, DEBORAH, additional, HALPERN, PINCHAS, additional, HANFLING, DAN, additional, HAROZ, RACHEL, additional, HARTSTEIN, BONNIE H., additional, HICK, JOHN L., additional, HOOD, STEPHEN F., additional, HOROWITZ, MICHAEL, additional, HORST, KURT R., additional, HOUSE, HANS R., additional, HUNTER, CURTIS J., additional, IMPERATO, JASON, additional, INGRASSIA, PIER LUIGi, additional, JACOBY, IRVING, additional, JAMES, THEA, additional, JASLOW, DAVID, additional, JAY, GREGORY D., additional, JOHN, MIRIAM, additional, JONES, MICHAEL D., additional, KASHUK, JEFFRY L., additional, KEIM, MARK E., additional, KENNEDY, KATHARYN E., additional, KIM, PAUL D., additional, KIM, SYLVIA H., additional, KOBAYASHI, LEO, additional, KULCHYCKI, LARA K., additional, KULKARNI, RICK G., additional, LANG, CHRISTOPHer R., additional, LARKIN, GREGORY L., additional, LeBosquet, THOMAS P., additional, LEE, BRUCE Y., additional, LEE, CATHERINE Y., additional, LEE, DAVID C., additional, LEMERY, JAY, additional, LEMKIN, DANIEL L., additional, LINDER, JEANETTE A., additional, LINDER, LAWRENCE S., additional, LIU, SHAN W., additional, LLEWELLYN, CRAIG H., additional, LOMBARDI, FRANCESCA, additional, LONG, HEATHER, additional, LUCCI, EDWARD B., additional, MACMILLAN, DONALD, additional, MACNOW, LAURA, additional, MADSEN, JAMES M., additional, MAGUIRE, BRIAN J., additional, MALONE, JOHN D., additional, MANISCALCO, PAUL M., additional, MARCOZZI, DAVID, additional, MARGHELLA, PIETRO D., additional, MARTIN, JAMES F., additional, MCKINNELL, JAMES, additional, MCMAHON-DOWNER, MICHELLE, additional, MECHEM, C. CRAWFOrd, additional, MEHTA, SUMERU, additional, MEINHARDT, PATRICIA L., additional, MELVILLE, LAURA DIAne, additional, METZGER, JEFFERY C., additional, MILLS, ANGELA M., additional, MILSTEN, ANDREW M., additional, MITCHELL, CLIFFORD S., additional, MITCHELL, ELIZABETH L., additional, MOLÉ, DALE M., additional, MOLINO, LOUIS N., additional, MOLONEY, JOHN, additional, MONTGOMERY, SEAN, additional, MOTHERSHEAD, JERRY L., additional, NELSON, LEWIS S., additional, NICHOLS, CONSTANCE G., additional, NOLAN, PATRICIA A., additional, NOLTKAMPER, DANIEL F., additional, NTABA, DZIWE W., additional, NUGENT, ANDREW S., additional, OSTER, NEILL S., additional, PANAGOS, PETER D., additional, PARTRIDGE, ROBERT, additional, PESIK, NICKI, additional, PFAFF, JAMES, additional, PORCARO, WILLIAM, additional, PROANO, LAWRENCE, additional, RAHMAN-KAHN, NAJMA, additional, RAHO, VITTORIO J., additional, RAMANUJAM, PRASANTHI, additional, REENSTRA, WENDE R., additional, REISNER, ANDREW, additional, RESTUCCIA, MARK C., additional, RILEY, JAMES MIChael, additional, ROMANOSKY, ALBERT J., additional, ROSEN, PETER, additional, ROSENTHAL, MARC S., additional, RUBIN, JONATHAN M., additional, SANCHEZ, LEON D., additional, SCHNELLE, DEBRA D., additional, SCHUUR, JEREMIAH D., additional, SERGIENKO, ERIC M., additional, SETHURAMAN, KINJAL, additional, SHAPIRO, MARC J., additional, SHEN, SAM, additional, SHEPHERD, SUZANNE M., additional, SHOFF, WILLIAM H., additional, SILER, SEAN MICHael, additional, SISITSKY, ALISON, additional, SISSON, CRAIG, additional, SMULOWITZ, PETER B., additional, SORENSON, JOHN H., additional, STEWART, CHARLES, additional, STEWART, M. KATHLEen, additional, STOCK, KENT J., additional, SULIS, CAROL, additional, SUTINGCO, NICHOLAS, additional, TANG, NELSON, additional, TEMIN, ELIZABETH, additional, TEMPEL, RICHARD A., additional, THORNE, CRAIG D., additional, TRACY, JASON A., additional, TRAUB, STEPHEN J., additional, VALENTE, JONATHAN Harris, additional, VANDERKAM, VICTORIA M., additional, VENABLE, CAROL L., additional, VILAS, FAITH, additional, VILKE, GARY M., additional, SORENSON, BARBARA Vogt, additional, WEINER, SCOTT G., additional, WEINSTEIN, ERIC S., additional, WERNER, ROY KARL, additional, WIENER, SAGE W., additional, WILLIAMS, ABIGAIL, additional, WILLIAMS, KENNETH A., additional, WIMBUSH, TRACY E., additional, WOOLARD, ROBERT H., additional, YESKEY, KEVIN, additional, YOON, SANDRA S., additional, and ZELLEY, PATRICK, additional

Published
2006
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45. Atrial Fibrillation During an Exploration Class Mission

Author

Lipsett, Mark, Hamilton, Douglas, Lemery, Jay, and Polk, James

Subjects
Aerospace Medicine
Abstract

This slide presentation reviews a possible scenario of an astronaut having Atrial Fibrillation during a Mars Mission. In the case review the presentation asks several questions about the alternatives for treatment, medications and the ramifications of the decisions.

Published
2011

46. Atrial Fibrillation During an Exploration Class Mission

Author

Lipset, Mark A, Lemery, Jay, Polk, J. D, and Hamilton, Douglas R

Subjects
Aerospace Medicine
Abstract

Background: A long-duration exploration class mission is fraught with numerous medical contingency plans. Herein, we explore the challenges of symptomatic atrial fibrillation (AF) occurring during an exploration class mission. The actions and resources required to ameliorate the situation, including the availability of appropriate pharmaceuticals, monitoring devices, treatment modalities, and communication protocols will be investigated. Challenges of Atrial Fibrillation during an Exploration Mission: Numerous etiologies are responsible for the initiation of AF. On Earth, we have the time and medical resources to evaluate and determine the causative situation for most cases of AF and initiate therapy accordingly. During a long-duration exploration class mission resources will be severely restricted. How is one to determine if new onset AF is due to recent myocardial infarction, pulmonary embolism, fluid overload, thyrotoxicosis, cardiac structural abnormalities, or CO poisoning? Which pharmaceutical therapy should be initiated and what potential side effects can be expected? Should anti-coagulation therapy be initiated? How would one monitor the therapeutic treatment of AF in microgravity? What training would medical officers require, and which communication strategies should be developed to enable the best, safest therapeutic options for treatment of AF during a long-duration exploration class mission? Summary: These questions will be investigated with expert opinion on disease elucidation, efficient pharmacology, therapeutic monitoring, telecommunication strategies, and mission cost parameters with emphasis on atrial fibrillation being just one illustration of the tremendous challenges that face a long-duration exploration mission. The limited crew training time, medical hardware, and drugs manifested to deal with such an event predicate that aggressive primary and secondary prevention strategies be developed to protect a multibillion-dollar asset like the International Space Station or a mission to the Moon or Mars. Learning Objectives: The audience will become familiar with the risks and challenges inherent to developing a therapeutic strategy for the treatment of atrial fibrillation during a long-term exploration class mission.

Published
2010

50. Associations Between Wildfire‐Related PM2.5 and Intensive Care Unit Admissions in the United States, 2006–2015.

Author

Sorensen, Cecilia, House, John A., O'Dell, Katelyn, Brey, Steven J., Ford, Bonne, Pierce, Jeffrey R., Fischer, Emily V., Lemery, Jay, and Crooks, James L.

Subjects
INTENSIVE care units, WILDFIRE prevention, HOSPITAL admission & discharge, PUBLIC health, RATINGS of hospitals, ZIP codes
Abstract

Wildfire smoke is a growing public health concern in the United States. Numerous studies have documented associations between ambient smoke exposure and severe patient outcomes for single‐fire seasons or limited geographic regions. However, there are few national‐scale health studies of wildfire smoke in the United States, few studies investigating Intensive Care Unit (ICU) admissions as an outcome, and few specifically framed around hospital operations. This study retrospectively examined the associations between ambient wildfire‐related PM2.5 at a hospital ZIP code with total hospital ICU admissions using a national‐scale hospitalization data set. Wildfire smoke was characterized using a combination of kriged PM2.5 monitor observations and satellite‐derived plume polygons from National Oceanic and Atmospheric Administration's Hazard Mapping System. ICU admissions data were acquired from Premier, Inc. and encompass 15%–20% of all U.S. ICU admissions during the study period. Associations were estimated using a distributed‐lag conditional Poisson model under a time‐stratified case‐crossover design. We found that a 10 μg/m3 increase in daily wildfire PM2.5 was associated with a 2.7% (95% CI: 1.3, 4.1; p = 0.00018) increase in ICU admissions 5 days later. Under stratification, positive associations were found among patients aged 0–20 and 60+, patients living in the Midwest Census Region, patients admitted in the years 2013–2015, and non‐Black patients, though other results were mixed. Following a simulated severe 7‐day 120 μg/m3 smoke event, our results predict ICU bed utilization peaking at 131% (95% CI: 43, 239; p < 10−5) over baseline. Our work suggests that hospitals may need to preposition vital critical care resources when severe smoke events are forecast. Plain Language Summary: Wildfire smoke negatively affects people's health. Heavy smoke has been linked to higher rates of hospital admissions, emergency room, admissions, and death. However, we do not know the impact of smoke on Intensive Care Unit (ICU) admissions or on limited hospital resources like ICU beds. To fill this knowledge gap, we linked hospital ICU admissions to smoke levels near those hospitals. We also predicted how many ICU admissions would occur during a simulated severe week‐long smoke event and how many ICU beds would be needed to care for the patients. We found that the link between smoke and ICU admissions was relatively modest, but a severe smoke event could more than double the number of ICU beds needed. Key Points: Associations between smoke PM2.5 and ICU admissions were estimated using a national‐scale cohortSmoke PM2.5 was associated with modest changes in ICU admissionsA simulated smoke wave was found to impose severe strain on ICU resources [ABSTRACT FROM AUTHOR]

Published
2021
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