Features of the mental state of doctors of various specialties during the COVID-19 pandemic.

In the context of the COVID-19 pandemic, the burden on healthcare professionals at all levels has increased significantly, especially those who are at the forefront of the fight for patients' lives. Physicians directly caring for COVID-19 patients are exposed to excessive stress and significant biological and psychosocial risk. Objective. To identify the features of the mental state of doctors of various specialties during the COVID-19 pandemic. Material and methods. The study included 85 doctors of the Arkhangelsk region: 41 anesthesiologists/intensive care physicians (mean age 32.4+/-5.0 years) and 44 general practitioners (mean age 38.9+/-4.2 years). The study was conducted during the third wave of the COVID-19 pandemic (from May to June 2021). We used the following study methods: questionnaire, psychological testing (K. Maslach and S. Jackson Burnout Inventory (MBI), Beck's Depression Inventory, Perceived Stress Scale, World Health Organisation-Five Well-Being Index), mathematical and statistical processing of empirical data. Results and discussion. Analysis of the results showed that about half of the surveyed general practitioners and only 3 (7.3%) of the anesthesiologists/intensive care physicians had a history of COVID-19, having contracted it while performing professional duties. Manifestations of maladaptation, such as low professional competence, lack of soft skills, aggressiveness, introversion, risktaking, recklessness, and family problems, are more pronounced in anesthesiologists/intensive care physicians. They were more likely to have negative emotions and feelings, were less satisfied with themselves and life in general, and had a lower well-being index than general practitioners. General practitioners overestimated their professional burnout severity and more often complained about their state of health. Correlation analysis of the examination results for anesthesiologists/intensive care physicians allowed us to identify direct relationships between the level of perceived stress, overstrain and depression, low mood, difficulties in relationships with relatives and colleagues, dissatisfaction with various aspects of life, inverse relationships between the level of perceived stress and the well-being index. In general practitioners, direct relationships were established between perceived stress and overexertion, and inverse relationships were established between the level of perceived stress, the well-being index, and the reduction of personal achievements. Conclusion. The COVID-19 pandemic negatively impacts anesthesiologists/intensive care physicians more than general practitioners, causing negative emotions and maladaptation. In primary care physicians, the pandemic increases mobilization processes to address emerging professional challenges. Therefore, special attention should be paid to psychological support for anesthesiologists/intensive care physicians.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.

Crisis leadership from the perspective of employees during the COVID-19 pandemic

Purpose: The purpose of the paper is to identify traits and behaviors of organization leaders that were deemed helpful by employees during the COVID-19 pandemic. Design/methodology/approach: This is an exploratory qualitative study that utilized online surveys. Data from 155 participants were subjected to content analysis. Findings: Several interrelated traits and behaviors of effective crisis leadership were identified. These were clustered into three superordinate themes-attending to the person, taking charge and showing the way forward and sustaining the spirit. Research limitations/implications: Findings from this paper can be furthered by conducting quantitative studies to validate themes and/or test a conceptual model of effective crisis leadership. Gathering data from other populations at different points in time during the COVID-19 pandemic may also be useful. Practical implications: A review of leadership development programs and organization norms and values is recommended in order to ensure that they are consistent with crisis leadership competencies. Originality/value: This paper helps address the gap on follower-centered perspectives about organizational leadership responses to crises and highlights the importance of care and compassion in leading employees during difficult times. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Factors Affecting Nursing Surveillance Activity among Clinical Nurses.

Nursing surveillance is a defense mechanism that protects patients from adverse events, as it is a systematic process that contributes to nurses' detection of and intervention in dangerous situations. This descriptive cross-sectional study examined the degree of nursing surveillance activity performed by clinical nurses, nurses' perceived importance of nursing surveillance, and their perception of patient safety culture. The study aimed to identify the predictors of nursing surveillance activity. Participants included 205 clinical nurses from two secondary hospitals and two tertiary hospitals in Changwon-si and Cheongju-si, South Korea, who had at least one year of clinical experience. Nursing surveillance activity was high among nurses who were assigned fewer than 1.88 patients, who worked in a tertiary hospital, and those who scored 7.0 or higher in nurses' perceived expertise. Nursing surveillance activity was significantly positively correlated with nurses' perceived importance of nursing surveillance and patient safety culture. A hierarchical multiple regression analysis was performed to identify the predictors of nursing surveillance activity. Nurses' perceived expertise, perceived importance of nursing surveillance, patient safety culture, and type of hospital explained 65.3% of the variance of nursing surveillance activity. This study is significant as it provides an assessment of the extent and key predictors of nursing surveillance activity.

Investigation on the core competency of residents during Coronavirus disease 2019 outbreak.

Objective To investigate the impact of the outbreak of coronavirus disease 2019 (COVID-19) as an intervention factor on residency training at different stages, and look into the enhancement effect of post-graduation medical training program based on competency of residency training, so as to provide reference for the optimization of medical education at the postgraduate stage. Methods After the initial success of COVID-19 prevention and control, 169 clinical postdoctoral trainess(clinical postdocs) and 515 graduate students specializing in clinical medicine(professional postdocs) were surveyed by an anonymous online questionnaire. To analyze the differences of cognition and self- evaluation of core competence between the two groups. Results There were 141 valid questionnaires collected from clinical postdocs (83.43%, 141/169) and 264 valid questionnaires collected from professional postdocs (51.26%, 264/515). In both groups, more than 85% of the students agreed or strongly agreed that they had a deeper understanding of the profession of doctors during the epidemic. The results of competency self-evaluation showed that, except for the items of "self-improvement", the self-evaluation scores of clinical postdoctoral students on other items were significantly higher than those of professional postdoctoral students (all P <0.05). Conclusions COVID-19, as a factor of emergency intervention, can improve the competency cognition of residents. The core-competency based post-graduation medical education model can comprehensively improve the students' comprehensive ability, which is an effective training program for residents. It is suggested that the vocational planning education for residents should be paid attention to in the stage of college education, and a new mode of college education that is closely combined with the post-graduation education should be further explored.Copyright © 2021 Thomson Reuters and Contributors.

Features of the mental state of doctors of various specialties during the COVID-19 pandemic.

In the context of the COVID-19 pandemic, the burden on healthcare professionals at all levels has increased significantly, especially those who are at the forefront of the fight for patients' lives. Physicians directly caring for COVID-19 patients are exposed to excessive stress and significant biological and psychosocial risk. Objective. To identify the features of the mental state of doctors of various specialties during the COVID-19 pandemic. Material and methods. The study included 85 doctors of the Arkhangelsk region: 41 anesthesiologists/intensive care physicians (mean age 32.4+/-5.0 years) and 44 general practitioners (mean age 38.9+/-4.2 years). The study was conducted during the third wave of the COVID-19 pandemic (from May to June 2021). We used the following study methods: questionnaire, psychological testing (K. Maslach and S. Jackson Burnout Inventory (MBI), Beck's Depression Inventory, Perceived Stress Scale, World Health Organisation-Five Well-Being Index), mathematical and statistical processing of empirical data. Results and discussion. Analysis of the results showed that about half of the surveyed general practitioners and only 3 (7.3%) of the anesthesiologists/intensive care physicians had a history of COVID-19, having contracted it while performing professional duties. Manifestations of maladaptation, such as low professional competence, lack of soft skills, aggressiveness, introversion, risktaking, recklessness, and family problems, are more pronounced in anesthesiologists/intensive care physicians. They were more likely to have negative emotions and feelings, were less satisfied with themselves and life in general, and had a lower well-being index than general practitioners. General practitioners overestimated their professional burnout severity and more often complained about their state of health. Correlation analysis of the examination results for anesthesiologists/intensive care physicians allowed us to identify direct relationships between the level of perceived stress, overstrain and depression, low mood, difficulties in relationships with relatives and colleagues, dissatisfaction with various aspects of life, inverse relationships between the level of perceived stress and the well-being index. In general practitioners, direct relationships were established between perceived stress and overexertion, and inverse relationships were established between the level of perceived stress, the well-being index, and the reduction of personal achievements. Conclusion. The COVID-19 pandemic negatively impacts anesthesiologists/intensive care physicians more than general practitioners, causing negative emotions and maladaptation. In primary care physicians, the pandemic increases mobilization processes to address emerging professional challenges. Therefore, special attention should be paid to psychological support for anesthesiologists/intensive care physicians.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.

Competencies and intervention areas of the school psychologist. Invitation to a discussion

Due also to the effects of Coronavirus, there was an increase of psychological requests and interventions within Italian schools, and the government adopted specific measures. However, the entity of the presence of the school psychologist and the types of competencies and interventions vary substantially between schools. There is therefore a need of clarification on what Italian school psychologists have done and may do. The present paper, based on an analysis of the international and national situations, opens a discussion on the competences and role of psychologists in the Italian schools. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Nurses' clinical competency and its correlates: before and during the COVID-19 outbreak.

BACKGROUND: Clinical competency is the ability to integrate knowledge, skills, attitudes and values into a clinical situation and it is very important in nursing education, clinical settings, nursing management, and crises. This study aimed to investigate nurses' professional competence and its correlates before and during the COVID-19 pandemic. METHODS: We conducted this cross-sectional study before and during the COVID-19 outbreak and recruited all nurses working in hospitals affiliated to Rafsanjan University of Medical Sciences, southern Iran, so we included 260 and 246 nurses in the study before and during the COVID-19 epidemic, respectively. Competency Inventory for Registered Nurses (CIRN) was used to collect data. After inputting the data into SPSS24, we analysed them using descriptive statistics, chi-square and multivariate logistic tests. A significant level of 0.05 was considered. RESULTS: The mean clinical competency scores of nurses were 156.97 ± 31.40 and 161.97 ± 31.36 before and during the COVID-19 epidemic, respectively. The total clinical competency score before the COVID-19 epidemic was not significantly different from that during the COVID-19 epidemic. Interpersonal relationships (p = 0.03) and desire for research/critical thinking (p = 0.01) were significantly lower before the COVID-19 outbreak than during the COVID-19 outbreak. Only shift type had an association with clinical competency before the COVID-19 outbreak, while work experience had an association with clinical competency during the COVID-19 epidemic. CONCLUSION: The clinical competency among nurses was moderate before and during the COVID-19 epidemic. Paying attention to the clinical competence of nurses can improve the care conditions of patients, and nursing managers should improve the clinical competence of nurses in different situations and crises. Therefore, we suggest further studies identifying factors improving the professional competency among nurses.

COVID-19 and its influence on gastroenterology and endoscopy.

This article provides a short overview of the impact of the COVID-19 on gastroenterology and endoscopy. The healthcare worker's and scientists' selfless work helped to accumulate in a short period a large amount of information that helped to fight the new infection and its consequences. As clinicians, we need to continually renew information and promptly change clinical practice based on evidence-based medicine principles.Copyright © 2020, Media Sphera Publishing Group. All rights reserved.

Disaster nursing competencies of rural nurses during COVID-19: A cross-sectional study: Disaster nursing competencies.

Background: : Although rural nurses' roles are indispensable for coronavirus disease 2019 (COVID-19) management, increased roles, workload, burnout, and reduced job satisfaction can hinder their work, potentially affecting nurses' disaster nursing competencies. Aim: : The aim of the study was to identify the predictors of rural nurses' disaster nursing competencies during the COVID-19 pandemic. Methods: : Nurses from rural community hospitals in South Korea (N=204) were surveyed during June-July 2021. We used the Professional Quality of Life and Disaster Nursing Preparedness-Response Competencies questionnaires. Multiple regression analysis was performed to identify the predictors of disaster nursing competencies. Findings: : The mean score for disaster nursing competency of the 204 participants was 110.80 (standard deviation=19.14). Disaster nursing competencies correlated with age, nursing career, compassion satisfaction, and secondary traumatic stress. Compassion satisfaction (ß=.27, p=.004), prior disaster nursing education (ß=.19, p=.005), and prior participation in disaster nursing care (ß=.16, p=.022) predicted disaster nursing competencies, together accounting for 24.2% of the variance. Discussion: : Our findings imply that increasing opportunities for continuing education regarding disaster nursing is crucial to enhance the related competencies in rural nurses. This study also highlights the necessity for stakeholders to develop programs aimed at increasing rural nurses' compassion satisfaction. Conclusion: : Prior disaster nursing education, prior participation in disaster nursing care, and compassion satisfaction predicted disaster nursing competencies among rural nurses, with compassion satisfaction being the strongest predictor.

Harnessing knowledge networking for Global Capability Sourcing: The development imperative

As the world opens up from the clutches of the pandemic to heightened demand for goods and services, businesses inextricably interconnected globally are coping to meet this demand due to worker shortages. In honor of Peter Keen, this editorial offers insight into how the quest for global talent can be addressed. Our work on how knowledge networking enables innovation through the creation of talent pools and the Global Capability Sourcing (GCS) model are combined to offer a view into addressing this challenge. The GCS explains why wages are declining for some skills while rising for others and asks: what role does a company most effectively play in the global sourcing economy? When workers are free to choose where and when they offer their services, the development imperative comes into effect. The development imperative is freedom of choice and can occur through innovation in talent pools stimulated through knowledge networking. When people have greater freedom and capabilities to improve their knowledge and skills, their incomes increase along with the range of choices and capabilities enjoyed by their households and governments. The papers in this issue add to what is known about how digital competency can be stimulated through investments in ICT training programs, how innovations take place in the development context and insights into conducting context-sensitive research. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Developing public health capacities of frontline public health workforce in Uttarakhand

Recent COVID-19 pandemic has highlighted the importance of increase in the ability of public health workforce to detect and respond to the public health threats. For timely implementation of an adequate response and mitigation measure, the standardized and sustainable capacity building programme for frontline public health workforce is the need of hour. National Center for Disease Control (NCDC), Ministry of Health and Family Welfare, in partnership with U.S. Centers for Disease Control and Prevention (CDC), developed a three-month in-service Basic Epidemiology Training programme. This is a tailor-made programme for frontline public health workforce to strengthen epidemiological skills. This training was a practical interactive approach to field epidemiology for three months on the job training for frontline public health workforce that addressed the critical skills needed to conduct surveillance effectively at the local level while focusing on improving disease detection, reporting and feedback. The training also demonstrated the role of learning model in form of interaction between the mentor and the mentees. The importance of handhold support given by the mentors to the mentees in quality outbreak investigations and documentation.

Family caregivers in palliative care: Social work roles and responsibilities

This chapter highlights the key concepts in palliative social work, including caregiver assessment that addresses roles, tasks, coping, unmet needs, and caregiver support along the continuum of illness, including the COVID-19 pandemic. It outlines the key social work skills, with a view toward strengthening and expanding the role for social workers with caregivers. The National Consensus Project's Clinical Practice Guidelines for Quality Palliative Care describe core concepts, structures, and processes necessary for quality palliative care, including eight domains of practice. It is generally best to conduct the caregiver assessment as early as possible so caregiver concerns can be communicated with the entire palliative care team and integrated into the plan of care. A comprehensive caregiver assessment provides a useful roadmap for identifying the role of culture in the beliefs, values, and everyday life of patients and caregivers. The Advanced Palliative Hospice Social Worker Certification, established social work fellowships, and the competency-based training for Educating Social Workers in Palliative and End-of-Life Care hold the promise of creating a stronger palliative social work educational framework/foundation similar to that of other disciplines. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Health care management of patients hospitalized with COVID-19 pneumonia

Patients do not usually have the skills or knowledge to assess the provider's technical competence, but they do know how they feel, how they have been treated, and whether their expectations have been met. Viewed by specialists, patient satisfaction is an element of psychological health that influences the outcome of care. A satisfied and informed patient tends to cooperate with the doctor and more easily accept his recommendations. The purpose of this study is to assess the degree of satisfaction of Covid hospitalized patients regarding the quality of care and treatment. Objectives of the study: identifying the main existing problems and finding solutions to improve the quality of "health care". Materials and methods: a retrospective, descriptive study, using the patient's medical records and a qualitative study, measuring the degree of Covid-19 patient's satisfaction, according to the quality of nursing care and medical treatment during hospitalization. Conclusions: Covid-19 patients were mostly elderly with associated morbidity, from urban areas, especially men. 95.02% of patients were discharged from the hospital with improved condition, and 4.98% died, most of them being unvaccinated.

Experiences of teacher educators utilizing technology in teacher preparation programs

The purpose of this qualitative, phenomenological study was to explore how and to what extent teacher educators evaluate, align, and demonstrate technology within teacher preparation programs. The literature revealed the need for teacher educators to follow frameworks, taxonomies, and standards containing technological, pedagogical, and content knowledge utilized appropriately within various contexts. In addition, teacher preparation program leadership can provide relevant and purposively professional learning as well as the support needed for teacher educators when the TPP leadership possesses a basic understanding of adult learning. Using Teacher Educator Technology Competency #1, ten teacher educators were interviewed regarding their experiences utilizing technology within their teacher preparation program. The findings revealed teacher educators, whose technological knowledge, skills, and attitudes varied, utilized a variety of paths in the evaluation, alignment, and demonstration of technology. When their knowledge and skills were put to the test during the COVID-19 pandemic, most teacher educators transitioned smoothly to the various formats required by the pandemic and have also seen the "blessings in disguise" from this global challenge. Leadership varies among the institutions represented in the study, particularly in the area of technology integration. Many teacher educators have stepped up to the plate and provided the needed leadership in technology integration. This study has implications for policy and practice in the realms of teacher educator technology competencies, technology infusion throughout teacher preparation programs, professional learning, and leadership. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Preparing for professional programs: Strategies and practices for pre-medical education

This study examines the preparation process for students in professional programs and highlights strategies and practices for pre-medical education. The COVID-19 pandemic has highlighted elements of the healthcare system that explore how critical physicians are that can lead with both a global perspective and with compassionate patient care. In order to understand the competencies required for this leadership process, it is critical to consider the medical school lifecycle from the undergraduate education to residency. Working from the admissions process, we consider what competencies are required for medical school success and physician preparedness and we use that to shape a solid pre-medical education. The candidate review process that generally includes academic metrics of grade point average and MCAT score, is extended to include noncognitive factors like empathy, ethical responsibility, resilience, grit and motivation. From providing early exposure to identifying commonalities among successful medical students, it is important to align current curriculum modifications with the future physician needs. Additionally, success among medical students that completed a post-baccalaureate program or engage in premedical programs increase likelihood of success among students that otherwise would not have successfully matriculated based on research on predictive validity. As we consider preparing the next generation of healthcare professionals, it is critical to examine the competencies necessary for medical school preparedness and preparation for leading and practicing medicine in a connected world. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Teachers' digital competence to assist students with functional diversity: Identification of factors through logistic regression methods

We are experiencing a serious health crisis due to COVID-19 that has a major impact on the field of education. The educational system therefore needs to be updated and innovated, with the addition of digital resources, to adapt the teaching and learning processes to students with disabilities. To meet the goal of high-quality education, teachers must have adequate digital competence to face the educational demands that are placed on them. Therefore, the purposes of this study are: to know the teachers' knowledge about digital resources to support students with disabilities (O1);at each educational stage (O2), identify the variables that have a significant impact on the acquisition of teacher competence (O3);propose a selection of useful ICT resources for each type of disability (O4). An ex post facto design was used with 1194 teachers from Andalusia (Spain). The results showed the medium-low level of the teaching staff, especially in the higher education stage. In addition, gender, motivation, attitude and having students with special needs are determining factors in the development of teacher knowledge. The results highlight the urgent need for teachers to be trained in digital resources. We hope that the range of resources proposed in this study will help teachers enhance their teaching practice. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Assessing learning in simulation experiences in graduate programs for speech-language pathology: A phenomenological study

Simulation learning experiences have become an accepted form of andragogy in speech-language pathology following a revision of the 2016 American Speech-Language-Hearing Association (ASHA) Standards allowing students to count simulation hours towards their required hours for graduation. There is a lack of research in the field of speech-language pathology in assessment of student learning in simulation learning experiences used to meet these clinical hours. The purpose of this study was to use qualitative inquiry to further explore how faculty assess student learning in clinical simulation learning experiences used to demonstrate clinical competence in graduate programs in Communication Sciences and Disorders: Speech-Language Pathology (CSD:SLP). The following research questions were addressed: How do faculty experience the assessment of learning in simulation learning experiences? In what ways do faculty assess student learning in simulation learning experiences specifically designed to meet clinical competency standards? What, if any, effect has theCOVID-19 pandemic had on the use of simulation learning experiences and assessment of student learning used to address clinical competency standards? A total of 22 interviews were conducted in 20 different ASHA certified institutions in the US. Key findings included assessment of graduate student learning in simulation learning experiences in graduate CSD:SLP programs is unstructured and inconsistent, programs need more guidance, professional development and structure to maximize student learning, and COVID-19 had significant impacts on the amount and type of simulation experiences offered in graduate CSD:SLP programs. Further research should focus on comparing competency in specific clinical skills to determine competency skills that are best suited for replacement by simulation learning experiences. Ideally, the outcome of this research would be the development of a best practice policy that outlines, based on research outcomes, specifically which clinical skills can be met with simulation learning experiences, and how to integrate and assess student learning in simulation learning experiences used to meet clinical competency standards. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Conceptualizing dimensions and a model for digital pedagogy

The global COVID-19 pandemic has caused a rising interest in the use of digital pedagogies and the need to teach remotely. This article aims to conceptualize the dimensions described below and offer a model for digital pedagogy to provide tools for using digital technologies in teaching. The model for digital pedagogy is discussed in terms of three dimensions: 1) pedagogical orientation;2) pedagogical practices;and 3) the digital pedagogical competencies it provides for the teacher. This study examines how the dimensions of digital pedagogy are presented in the current research literature. The research is conducted through a systematic literature review surveying articles published in the years 2014 to 2019;a total of 12 articles are included in the review. The findings suggest that, first, in many cases, pedagogical orientation is labeled as socio-constructivist and student-centered. Second, pedagogical practices are the methods used to promote students' learning;they involve, for example, collaboration and social knowledge construction. Finally, in addition to technological, pedagogical, and content knowledge, teachers' success in blending digital technologies into their teaching is improved by high self-efficacy and strong peer-collaboration skills. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Postgraduate medical education in the current context.

In recent years, the system of postgraduate education in medicine faces new challenges and the need for improvement. At the same time, it is necessary to search for a reasonable combination of various types of education in order to preserve and improve the professional knowledge of doctors. Aim. To demonstrate and assess the importance of combining distance learning technologies with traditional teaching methods. Material and methods. The paper analyzes the educational process at the Department of Therapy of the I. M. Sechenov First Moscow State Medical University in the period from 2020 to July 2022. The data are based on the results of the annual report of the department, a survey of students, and communication with students using electronic telecommunication technologies (forum, chat, e-mail). Data were analyzed using SPSS Statistics 23.0 software. Results. Department of Therapy of the I. M. Sechenov First Moscow State Medical University has been training doctors for a long time in advanced training programs using traditional and distance learning. In 2020, in connection with the pandemic of a coronavirus disease 2019 (COVID-19), distance learning technologies have been actively developed. Online lectures and video seminars have become an important component of advanced training programs, in which 252 students were trained in 2020, and 376 people from different cities of Russia during 2021 and the first half of 2022. In the first year of the pandemic, two short-term programs were created dedicated to epidemiology, clinic, diagnosis and treatment of patients with COVID-19. They were conducted using online seminars, which made it possible to train 4156 doctors from more than 29 regions of Russia. Most of the listeners noted the high professional level of the programs, the importance of using computer technology in addition to traditional methods. Conclusion. In the modern world, in order to maintain the required level of professional competence of a doctor, combination of traditional educational activities with distance learning should be used.Copyright © 2022 Vserossiiskoe Obshchestvo Kardiologov. All rights reserved.

Effect of coronavirus pandemic on oral and maxillofacial surgical education and training: Developing standards for effective online training

Oral and maxillofacial surgery deals with the diagnosis and treatment of dentofacial problems and usually requires a four year specialized training after a bachelor's degree in dental surgery. The COVID 19 pandemic in early 2020 led to disruptions in the training programs worldwide and urged the supervisors and faculty to devise ways and means to continue the residents' learning experience utilizing different online teaching modalities. An account of some strategies for developing standards for effective online training to equip oral and maxillofacial training programs for similar future emergencies.Copyright © 2022 The Authors