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The Prevalence of Violence Against Healthcare Workers in the Public Sector – A Trinbagonian Survey
- Darren Dookeeram, Hariharan Seetharaman, Lake Taylor, Cassy Thomas, Kirtesha Thomas, Cherelle Thompson, Takiyah Toppin, Jakeilia Trim, Kanisha Caton, Sade Stoute
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- Journal:
- Prehospital and Disaster Medicine / Volume 38 / Issue S1 / May 2023
- Published online by Cambridge University Press:
- 13 July 2023, pp. s118-s119
- Print publication:
- May 2023
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Introduction:
Violence against healthcare workers (HCWs) and lack of public trust threatens the foundation of the physician-patient relationship in Trinidad. The primary aim of this study was to determine the prevalence of violence against Trinbagonian HCWs in the public sector. Secondary objectives included determining risk factors for violence and mistrust between the public and providers.
Method:A cross-sectional analysis of 434 Trinbagonian HCWs in the public sector was conducted using a modified World Health Organization (WHO) data collection tool, distributed via social media and administrative emails, and snowballed for two months. Fifteen semi-structured interviews were conducted regarding trust in the healthcare system with patients selected from various communities.
Results:Of the 434 respondents, 45.2% experienced violence and 75.8% witnessed violence against HCWs in the past 2 years. Verbal abuse (41.5%) was most common. Perpetrators were patients (42.2%) and patients’ relatives (35.5%). Chi-square analysis highlighted that HCWs with the highest probability of being abused were aged 25-39 (63.8%), had 2-5 years of work experience (24.9%), specialized in emergency & internal medicine (48.6%), and cared for psychiatric & physically disabled patients (p-value <0.001). HCWs believed the threat of violence negatively impacted their performance (64.5%), and further action was necessary for mitigation (86.4%). Patients interviewed doubted physicians' altruism, competence (80%) and honesty (53.3%), expressed mistrust in their physician (46.7%), and cited poor infrastructure/management (66.7%) and dissatisfaction with care (60.0%) as factors that contributed to violence.
Conclusion:Analysis revealed that violence against Trinbagonian HCWs in the public sector deteriorated patient experience and adversely affected psychological well-being, efficiency, and job satisfaction. Results suggested mistrust of HCWs by the population. Interventions should be instituted to support at-risk HCWs and educate the public to avoid recurrence.
Multilateralism as a Determinant of COVID-19 Outcomes in Small Island Developing States: Mitigating Disaster Impact Through Foreign Affairs Investment.
- Darren Dookeeram, Sabastian Borquez, Hariharan Seetharaman, Satesh Bidaisee, Sandeep Maharaj, Dave Dookeeram
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- Journal:
- Prehospital and Disaster Medicine / Volume 38 / Issue S1 / May 2023
- Published online by Cambridge University Press:
- 13 July 2023, p. s98
- Print publication:
- May 2023
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Introduction:
The United Nations (UN) recognizes Small Island Developing States (SIDS) as a heterogenous group with common geographic and socio-economic challenges. Their vulnerability to disasters was exacerbated during COVID-19 because of emerging nationalism and protectionism towards supply chains and resources. This study aimed to determine if multilateralism engagement improved COVID-19 outcomes and if Foreign Affairs investment improved short term COVID-19 outcomes.
Method:Metrics were developed to reflect country parameters, clinical impact of COVID-19, engagement in multilateralism, health systems strength and integration in the International Political Economy. Open-source information was used to quantify proxy measures with the calculated percent spent on foreign affairs being the major proxy of multilateralism and disaster impact as lag time to vaccination, case burden and deaths in the first six months of 2020. Data was collected for each of the 38 SIDS. SPSS was used to assess possible correlations with short- and long-term clinical outcomes of the COVID-19 pandemic.
Results:SIDS were noted to have an average lag of 4.1 months to begin vaccination rollout compared with developed nations and prolonged below global average vaccination rates. Expenditure on Foreign Affairs reduced the vaccination lag (p=0.03), decreased short-term cases (p<0.001) and deaths (p<0.001), Human Development Index improved vaccination rates (p<0.001) and lowered total cases (p=0.03). Foreign Direct Investment (FDI) inflow also decreased vaccination lag (0.02). Dependence on Foreign Aid decreased vaccination rates (p=0.01).
Conclusion:These relationships suggest that there were multiple factors that determined short- and long-term health outcomes in SIDS. Mitigating the impact of a disaster therefore requires a multiple level investment solution that recognizes the importance of other actors in the global system. The COVID-19 experience suggests that engagement in multilateralism is important in countries that have a high vulnerability to disasters such as SIDS. This is valuable for future disasters in vulnerable states.
Chapter 23 - Electricalsafety
- from Part 3 - Anesthesia Equipment
- Edited by Charles Vacanti, Scott Segal, Pankaj Sikka, Richard Urman
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- Book:
- Essential Clinical Anesthesia
- Published online:
- 05 January 2012
- Print publication:
- 11 July 2011, pp 149-154
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Contributors
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- By Aakash Agarwala, Linda S. Aglio, Rae M. Allain, Paul D. Allen, Houman Amirfarzan, Yasodananda Kumar Areti, Amit Asopa, Edwin G. Avery, Patricia R. Bachiller, Angela M. Bader, Rana Badr, Sibinka Bajic, David J. Baker, Sheila R. Barnett, Rena Beckerly, Lorenzo Berra, Walter Bethune, Sascha S. Beutler, Tarun Bhalla, Edward A. Bittner, Jonathan D. Bloom, Alina V. Bodas, Lina M. Bolanos-Diaz, Ruma R. Bose, Jan Boublik, John P. Broadnax, Jason C. Brookman, Meredith R. Brooks, Roland Brusseau, Ethan O. Bryson, Linda A. Bulich, Kenji Butterfield, William R. Camann, Denise M. Chan, Theresa S. Chang, Jonathan E. Charnin, Mark Chrostowski, Fred Cobey, Adam B. Collins, Mercedes A. Concepcion, Christopher W. Connor, Bronwyn Cooper, Jeffrey B. Cooper, Martha Cordoba-Amorocho, Stephen B. Corn, Darin J. Correll, Gregory J. Crosby, Lisa J. Crossley, Deborah J. Culley, Tomas Cvrk, Michael N. D'Ambra, Michael Decker, Daniel F. Dedrick, Mark Dershwitz, Francis X. Dillon, Pradeep Dinakar, Alimorad G. Djalali, D. John Doyle, Lambertus Drop, Ian F. Dunn, Theodore E. Dushane, Sunil Eappen, Thomas Edrich, Jesse M. Ehrenfeld, Jason M. Erlich, Lucinda L. Everett, Elliott S. Farber, Khaldoun Faris, Eddy M. Feliz, Massimo Ferrigno, Richard S. Field, Michael G. Fitzsimons, Hugh L. Flanagan Jr., Vladimir Formanek, Amanda A. Fox, John A. Fox, Gyorgy Frendl, Tanja S. Frey, Samuel M. Galvagno Jr., Edward R. Garcia, Jonathan D. Gates, Cosmin Gauran, Brian J. Gelfand, Simon Gelman, Alexander C. Gerhart, Peter Gerner, Omid Ghalambor, Christopher J. Gilligan, Christian D. Gonzalez, Noah E. Gordon, William B. Gormley, Thomas J. Graetz, Wendy L. Gross, Amit Gupta, James P. Hardy, Seetharaman Hariharan, Miriam Harnett, Philip M. Hartigan, Joaquim M. Havens, Bishr Haydar, Stephen O. Heard, James L. Helstrom, David L. Hepner, McCallum R. Hoyt, Robert N. Jamison, Karinne Jervis, Stephanie B. Jones, Swaminathan Karthik, Richard M. Kaufman, Shubjeet Kaur, Lee A. Kearse Jr., John C. Keel, Scott D. Kelley, Albert H. Kim, Amy L. Kim, Grace Y. Kim, Robert J. Klickovich, Robert M. Knapp, Bhavani S. Kodali, Rahul Koka, Alina Lazar, Laura H. Leduc, Stanley Leeson, Lisa R. Leffert, Scott A. LeGrand, Patricio Leyton, J. Lance Lichtor, John Lin, Alvaro A. Macias, Karan Madan, Sohail K. Mahboobi, Devi Mahendran, Christine Mai, Sayeed Malek, S. Rao Mallampati, Thomas J. Mancuso, Ramon Martin, Matthew C. Martinez, J. A. Jeevendra Martyn, Kai Matthes, Tommaso Mauri, Mary Ellen McCann, Shannon S. McKenna, Dennis J. McNicholl, Abdel-Kader Mehio, Thor C. Milland, Tonya L. K. Miller, John D. Mitchell, K. Annette Mizuguchi, Naila Moghul, David R. Moss, Ross J. Musumeci, Naveen Nathan, Ju-Mei Ng, Liem C. Nguyen, Ervant Nishanian, Martina Nowak, Ala Nozari, Michael Nurok, Arti Ori, Rafael A. Ortega, Amy J. Ortman, David Oxman, Arvind Palanisamy, Carlo Pancaro, Lisbeth Lopez Pappas, Benjamin Parish, Samuel Park, Deborah S. Pederson, Beverly K. Philip, James H. Philip, Silvia Pivi, Stephen D. Pratt, Douglas E. Raines, Stephen L. Ratcliff, James P. Rathmell, J. Taylor Reed, Elizabeth M. Rickerson, Selwyn O. Rogers Jr., Thomas M. Romanelli, William H. Rosenblatt, Carl E. Rosow, Edgar L. Ross, J. Victor Ryckman, Mônica M. Sá Rêgo, Nicholas Sadovnikoff, Warren S. Sandberg, Annette Y. Schure, B. Scott Segal, Navil F. Sethna, Swapneel K. Shah, Shaheen F. Shaikh, Fred E. Shapiro, Torin D. Shear, Prem S. Shekar, Stanton K. Shernan, Naomi Shimizu, Douglas C. Shook, Kamal K. Sikka, Pankaj K. Sikka, David A. Silver, Jeffrey H. Silverstein, Emily A. Singer, Ken Solt, Spiro G. Spanakis, Wolfgang Steudel, Matthias Stopfkuchen-Evans, Michael P. Storey, Gary R. Strichartz, Balachundhar Subramaniam, Wariya Sukhupragarn, John Summers, Shine Sun, Eswar Sundar, Sugantha Sundar, Neelakantan Sunder, Faraz Syed, Usha B. Tedrow, Nelson L. Thaemert, George P. Topulos, Lawrence C. Tsen, Richard D. Urman, Charles A. Vacanti, Francis X. Vacanti, Joshua C. Vacanti, Assia Valovska, Ivan T. Valovski, Mary Ann Vann, Susan Vassallo, Anasuya Vasudevan, Kamen V. Vlassakov, Gian Paolo Volpato, Essi M. Vulli, J. Matthias Walz, Jingping Wang, James F. Watkins, Maxwell Weinmann, Sharon L. Wetherall, Mallory Williams, Sarah H. Wiser, Zhiling Xiong, Warren M. Zapol, Jie Zhou
- Edited by Charles Vacanti, Scott Segal, Pankaj Sikka, Richard Urman
-
- Book:
- Essential Clinical Anesthesia
- Published online:
- 05 January 2012
- Print publication:
- 11 July 2011, pp xv-xxviii
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- Export citation