Healthcare Waste-A Serious Problem for Global Health.

Healthcare waste (HCW) is generated in different healthcare facilities (HCFs), such as hospitals, laboratories, veterinary clinics, research centres and nursing homes. It has been assessed that the majority of medical waste does not pose a risk to humans. It is estimated that 15% of the total amount of produced HCW is hazardous and can be infectious, toxic or radioactive. Hazardous waste is a special type of waste which, if not properly treated, can pose a risk to human health and to the environment. HCW contains potentially harmful microorganisms that can be spread among healthcare personnel, hospital patients and the general public, causing serious illnesses. Healthcare personnel are the specialists especially exposed to this risk. The most common medical procedure, which pose the highest risk, is injection (i.e, intramuscular, subcutaneous, intravenous, taking blood samples). The World Health Organization (WHO) estimates that around 16 billion injections are administered worldwide each year. However, if safety precautions are not followed, and needles and syringes are not properly disposed of, the risk of sharps injuries increases among medical staff, waste handlers and waste collectors. What is more, sharps injuries increase the risk of human immunodeficiency virus (HIV), hepatitis B and C viruses (HBV/HCV), tuberculosis (TB), diphtheria, malaria, syphilis, brucellosis and other transmissions. Disposing of medical waste in a landfill without segregation and processing will result in the entry of harmful microorganisms, chemicals or pharmaceuticals into soil and groundwater, causing their contamination. Open burning or incinerator malfunctioning will result in the emission of toxic substances, such as dioxins and furans, into the air. In order to reduce the negative impact of medical waste, waste management principles should be formulated. To minimize health risks, it is also important to build awareness among health professionals and the general public through various communication and educational methods. The aim of this paper is to present a general overwiev of medical waste, its categories, the principles of its management and the risks to human health and the environment resulting from inappropriate waste management.

Comprehensive security, disinformation, and COVID-19: An analysis of the impacts of mis- and disinformation and populist narratives during the pandemic.

The COVID-19 pandemic has generated many fundamental and challenging implications regarding security, for both states and people. This article addresses the pandemic as a security threat, whereby societal and human dimensions of security are intertwined with the narrower (so-called traditional) state dimensions, culminating in comprehensive security. This article uses mixed methods, combining desk research and a selection of narratives or stories from several parts of the world that signify how the intersection of disinformation and populist discourses exacerbated the COVID-19 security challenges. These are analysed through an innovative comprehensive security analytical approach. Drawing on both security theory and policy, the article examines how the COVID-19 pandemic jeopardised security on multiple levels. First, the state's capacity to effectively act and deliver in the domestic sphere waned. Second, the social contract between the state and its citizens eroded as public trust dissipated. This article argues, however, that the most pervasive threat to security during the pandemic pertained to the exploitation of the information domain in relation to the state, society, and people. The article interrogates how mis- and disinformation about the pandemic compounded and exacerbated the security challenges it posed, often relying on existing narratives within right-wing populism movements to increase mistrust and discontent. These largely right-wing populist narratives contributed to broadening the gap between states and people, besides weakening public compliance with state health security measures. The nature of populism and the narratives of particularly right-wing populism contributed to increases in fragmentation, polarisation, and discrimination impacting societal trust. The article concludes with recommendations to mitigate the adverse impacts of mis- and disinformation, including reinvigorating the relationship between state institutions and the people to strengthen comprehensive security.

Ethical and psychosocial considerations for hospital personnel in the Covid-19 crisis: Moral injury and resilience.

This study aims at investigating the nature of resilience and stress experience of health care workers during the COVID-19 pandemic. Thirteen healthcare workers from Italian and Austrian hospitals specifically dealing with COVID-19 patients during the first phase of the pandemic were interviewed. Data was analysed using grounded theory methodology. Psychosocial effects on stress experience, stressors and resilience factors were identified. We generated three hypotheses. Hypothesis one is that moral distress and moral injury are main stressors experienced by healthcare workers. Hypothesis two states that organisational resilience plays an important part in how healthcare workers experience the crisis. Organisational justice and decentralized decision making are essential elements of staff wellbeing. Hypothesis three refers to effective psychosocial support: Basic on scene psychosocial support based on the Hobfoll principles given by trusted and well-known mental health professionals and peers in an integrated approach works best during the pandemic.

Simulation of Trauma Incidents : Modelling the Evolution of Patients and Resources.

Mathematical modeling and simulation with medical applications has gained much interest in the last few years, mainly due to the widespread availability of low-cost technology and computational power. This paper presents an integrated platform for the in-silico simulation of trauma incidents, based on a suite of interacting mathematical models. The models cover the generation of a scenario for an incident, a model of physiological evolution of the affected individuals, including the possible effect of the treatment, and a model of evolution in time of the required medical resources. The problem of optimal resource allocation is also investigated. Model parameters have been identified according to the expertise of medical doctors and by reviewing some related literature. The models have been implemented and exposed as web services, while some software clients have been built for the purpose of testing. Due to its extendability, our integrated platform highlights the potential of model-based simulation in different health-related fields, such as emergency medicine and personal health systems. Modifications of the models are already being used in the context of two funded projects, aiming at evaluating the response of health systems to major incidents with and without model-based decision support.