Implementing Public Health Strategies-The Need for Educational Initiatives: A Systematic Review

Mapping Review of the Correlations Between Periodontitis, Dental Caries, and Endocarditis

Background/Objectives: The correlation between cardiovascular diseases, particularly infective endocarditis, and oral disorders such as periodontitis and dental caries has been widely discussed in the scientific literature. In this mapping review, we aim to examine the available evidence on the link between these conditions, focusing on the pathogenetic mechanisms that underlie the development of endocarditis in patients with oral diseases. Methods: A systematic search was conducted across three major databases-PubMed, Scopus, and ScienceDirect-as well as grey literature in Google Scholar. Relevant articles were selected based on inclusion and exclusion criteria, focusing primarily on systematic reviews. The data extracted included study characteristics, main outcomes, and risk-of-bias evaluations. Results: A total of 13 systematic reviews were included in this mapping review. The findings suggest there is a significant connection between periodontal disease, dental caries, and the incidence of infective endocarditis. The evidence highlights that oral bacteria, particularly Streptococcus species, can enter the bloodstream during daily activities and invasive dental procedures, contributing to the development of endocarditis in susceptible individuals. However, the role of antibiotic prophylaxis in preventing endocarditis following dental procedures remains controversial. Conclusions: This review reinforces the importance of oral health in preventing cardiovascular complications, especially infective endocarditis. Although antibiotic prophylaxis may reduce the risk in high-risk individuals, further research is needed to clarify its effectiveness. Enhanced awareness of and education on the shared risks between oral and cardiovascular health could improve prevention strategies and patient outcomes.

Radiology AI and sustainability paradox: environmental, economic, and social dimensions

Artificial intelligence (AI) is transforming radiology by improving diagnostic accuracy, streamlining workflows, and enhancing operational efficiency. However, these advancements come with significant sustainability challenges across environmental, economic, and social dimensions. AI systems, particularly deep learning models, require substantial computational resources, leading to high energy consumption, increased carbon emissions, and hardware waste. Data storage and cloud computing further exacerbate the environmental impact. Economically, the high costs of implementing AI tools often outweigh the demonstrated clinical benefits, raising concerns about their long-term viability and equity in healthcare systems. Socially, AI risks perpetuating healthcare disparities through biases in algorithms and unequal access to technology. On the other hand, AI has the potential to improve sustainability in healthcare by reducing low-value imaging, optimizing resource allocation, and improving energy efficiency in radiology departments. This review addresses the sustainability paradox of AI from a radiological perspective, exploring its environmental footprint, economic feasibility, and social implications. Strategies to mitigate these challenges are also discussed, alongside a call for action and directions for future research. CRITICAL RELEVANCE STATEMENT: By adopting an informed and holistic approach, the radiology community can ensure that AI's benefits are realized responsibly, balancing innovation with sustainability. This effort is essential to align technological advancements with environmental preservation, economic sustainability, and social equity. KEY POINTS: AI has an ambivalent potential, capable of both exacerbating global sustainability issues and offering increased productivity and accessibility. Addressing AI sustainability requires a broad perspective accounting for environmental impact, economic feasibility, and social implications. By embracing the duality of AI, the radiology community can adopt informed strategies at individual, institutional, and collective levels to maximize its benefits while minimizing negative impacts.

A review of national public health strategies in selected countries

National public health strategies play an essential role in defining a country's vision, policy direction and approaches for ensuring the health of its population. Gaining an understanding of the public health issues which countries prioritize, and how these health issues are improved upon, may provide insights into effective methods of national public health strategy development and delivery. National public health strategies were identified for ten countries and a descriptive analysis of strategy contents and development was undertaken. All of the identified national public health strategies included an overall aim of improving health and wellbeing, and all strategy scopes extended beyond the health domain. Themes or priorities frequently identified included promoting healthy living or behaviors, the strengthening of public health, and equity or equality. Approaches to strategy implementation were considered to be prescriptive or interpretive, with prescriptive approaches including detailed implementation plans with specific actions and key performance indicators, and interpretive approaches including high-level strategic actions along with principles to support their implementation. National public health strategy development was informed by both evidence and engagement with stakeholders, including the public, experts, and representatives from governmental and non-governmental organizations at local, regional and national levels. Overall, while the information gained in this analysis assists in the development of a national public health strategy, variation observed across the included strategies indicates that consideration should be given to factors which vary from country to country. These factors include the national health profile, the political context, underpinning and associated policies, and the availability of resources.

Pandemics: past, present, and future: multitasking challenges in need of cross-disciplinary, transdisciplinary, and multidisciplinary collaborative solutions

The extensive history of pandemics has spanned many centuries, profoundly impacting societies, economies, and public health, and thereby shaping the course of history in various ways. Advances in medicine, science, and public health practices have played a pivotal role in mitigating the effects of pandemics over time. This review explores the scientific landscape of contemporary pandemics, examining their diverse and complex nature. It goes beyond the biological aspects of pandemics to consider socioeconomic, environmental, and technological factors. Through a scientific lens, this study aims to understand the complexities of pandemics and contribute to the expanding knowledge base that helps humanity strengthen its defenses against global health threats. By elucidating the enigmas of pandemics, the study hopes to foster a more resilient and prepared global health environment. Highlighting the importance of a multidisciplinary, cross-disciplinary, and transdisciplinary approach, this exploration emphasizes the critical need to integrate biological, socioeconomic, environmental, and technological domains to develop more robust defenses against these global health challenges.

Healthcare Providers' Experience with Saudi Arabia's 937 Virtual Medical Call Centers and Telehealth

Introduction

This cross-sectional descriptive study evaluates the experiences and perceptions of healthcare providers (HCPs) regarding the 937 medical call center in Saudi Arabia, a key telemedicine initiative.

Aim

 To assess HCP satisfaction, identify challenges, and provide recommendations for improvement.

Methods

Conducted from November 20th to December 15th, 2022, the study surveyed 454 HCPs, achieving a 90.5% response rate.

Results

A majority (86.8%) of respondents were satisfied with the call center, valuing its ease of use and effectiveness in healthcare delivery. However, challenges such as the accuracy of remote medical assessments, the need for clearer telehealth regulations, and concerns over management support and consultation overlaps were identified. The study also highlights the importance of ongoing support and updates, comprehensive telehealth regulations, integration of more medical specialties, and improvements in system integration and data confidentiality.

Conclusion

The study underscores the need for strategic enhancements to the 937 call center to further improve healthcare accessibility and efficiency in Saudi Arabia. These enhancements are vital for aligning telehealth services with Saudi Arabia's healthcare objectives under Saudi Vision 2030.

LSTM-Powered COVID-19 prediction in central Thailand incorporating meteorological and particulate matter data with a multi-feature selection approach

The COVID-19 pandemic has significantly impacted public health and necessitated urgent actions to mitigate its spread. Monitoring and predicting the outbreak's progression have become vital to devise effective strategies and allocate resources efficiently. This study presents a novel approach utilizing Multivariate Long Short-Term Memory (LSTM) to analyze and predict COVID-19 trends in Central Thailand, particularly emphasizing the multi-feature selection process. To consider a comprehensive view of the pandemic's dynamics, our research dataset encompasses epidemiological, meteorological, and particulate matter features, which were gathered from reliable sources. We propose a multi-feature selection technique to identify the most relevant and influential features that significantly impact the spread of COVID-19 in the region to enhance the model's performance. Our results highlight that relative humidity is the key factor driving COVID-19 transmission in Central Thailand. The proposed multi-feature selection technique significantly improves the model's accuracy, ensuring that only the most informative variables contribute to the predictions, avoiding the potential noise or redundancy from less relevant features. The proposed LSTM model demonstrates its capability to forecast COVID-19 cases, facilitating informed decision-making for public health authorities and policymakers.

Nutritional Profiles and Their Links to Insulin Resistance and Anthropometric Variables in a Female Cohort

This study investigates the relationship between dietary habits and metabolic health among women, emphasizing the role of anthropometric parameters as proxies for insulin resistance. We analyzed data from 443 women categorized into two groups based on the presence or absence of clinically diagnosed insulin resistance. Our assessments included dietary quality, socio-demographic characteristics, and a series of anthropometric measurements such as body weight, Body Mass Index (BMI), Waist-Hip Ratio (WHR), Abdominal Volume Index (AVI), and Body Adiposity Index (BAI). The results indicated significant disparities in these parameters, with the insulin-resistant group exhibiting higher average body weight (78.92 kg vs. 65.04 kg, p < 0.001), BMI (28.45 kg/m2 vs. 23.17 kg/m2, p < 0.001), and other related measures, suggesting a strong influence of dietary patterns on body composition and metabolic risk. The study underscores the importance of dietary management in addressing insulin resistance, advocating for personalized dietary strategies to improve metabolic health outcomes in women. This approach highlights the need for integrating dietary changes with lifestyle modifications and socio-demographic considerations to combat metabolic risks effectively.

Strategic Communication for Local Public Health Services in Portugal: A Delphi Study

INTRODUCTION

Strategic communication plays a decisive role in public health planning and project implementation. However, Portuguese Local Public Health Units, which are responsible for community interventions, still lack guidance models, tools, specialized resources, and training in health communication. The aim of this study was to develop a conceptual model of strategic organizational communication for local public health services, in Portugal.

METHODS

This study presents a conceptual model of strategic organizational communication for Local Public Health Units, which was developed through a three-round, modified Delphi online panel. Thirty-seven Portuguese specialists in public health, communication, and community members were invited to analyse a proposed framework, based on an up-to-date literature review. High retention rates were observed in all rounds (first = 22 valid participations; second = 21 valid participations; third = 18 valid participations).

RESULTS

Most participants believed that Portuguese Public Health Units were not prepared to communicate effectively and that they would benefit from adequate planning and identification of a communication lead or team. Websites and social media were also identified as essential for effective communication. The validated conceptual model integrated different partners in health and in the community, with emphasis on the relationships with the national network of health authorities, other Public Health Units, primary health care units, municipalities, and schools. The preferred channels identified for communicating with these partners included interpersonal relationships, email, and mobile phone. No consensus was obtained for preferred communication channels between Local Public Health Units and the media.

CONCLUSION

Strategic planning based on the proposed conceptual model involving different stakeholders, has potential to improve the effectiveness of internal and external communication and facilitate the implementation of public health programs and projects. The proposed model needs to be validated in Local Public Health Units, considering the potential human, material, and financial constraints.

Unleashing the global potential of public health: A framework for future pandemic response

Public health emergencies, especially pandemics, need to be managed globally, and on several levels, emphasizing the importance of leadership, communication, and synchronization of measures, data, and management plans in contrast to the management of the Coronavirus-19 pandemic, which illustrated diverse strategies employed by various nations. This paper aims to review and discuss whether globalized diseases in a globalized world should be managed by globalized public health. Using a systematic literature search, followed by a non-systematic literature review, selected studies were grouped into topics, and analyzed, using content analysis to enhance the conclusive results. The results present a roadmap towards a re-envisioned framework highlighting key areas of focus: data-driven decision-making, robust technology infrastructure, global cooperation, and ongoing public health education, as part of a coordinated global response. This article reveals the weaknesses of current pandemic management systems and recommends new steps to further strengthen the management of future pandemics.

Communication to promote and support physical distancing for COVID-19 prevention and control

BACKGROUND

This review is an update of a rapid review undertaken in 2020 to identify relevant, feasible and effective communication approaches to promote acceptance, uptake and adherence to physical distancing measures for COVID-19 prevention and control. The rapid review was published when little was known about transmission, treatment or future vaccination, and when physical distancing measures (isolation, quarantine, contact tracing, crowd avoidance, work and school measures) were the cornerstone of public health responses globally. This updated review includes more recent evidence to extend what we know about effective pandemic public health communication. This includes considerations of changes needed over time to maintain responsiveness to pandemic transmission waves, the (in)equities and variable needs of groups within communities due to the pandemic, and highlights again the critical role of effective communication as integral to the public health response.

OBJECTIVES

To update the evidence on the question 'What are relevant, feasible and effective communication approaches to promote acceptance, uptake and adherence to physical distancing measures for COVID-19 prevention and control?', our primary focus was communication approaches to promote and support acceptance, uptake and adherence to physical distancing.

SECONDARY OBJECTIVE

to explore and identify key elements of effective communication for physical distancing measures for different (diverse) populations and groups.

SEARCH METHODS

We searched MEDLINE, Embase and Cochrane Library databases from inception, with searches for this update including the period 1 January 2020 to 18 August 2021. Systematic review and study repositories and grey literature sources were searched in August 2021 and guidelines identified for the eCOVID19 Recommendations Map were screened (November 2021).

SELECTION CRITERIA

Guidelines or reviews focusing on communication (information, education, reminders, facilitating decision-making, skills acquisition, supporting behaviour change, support, involvement in decision-making) related to physical distancing measures for prevention and/or control of COVID-19 or selected other diseases (sudden acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), influenza, Ebola virus disease (EVD) or tuberculosis (TB)) were included. New evidence was added to guidelines, reviews and primary studies included in the 2020 review.

DATA COLLECTION AND ANALYSIS

Methods were based on the original rapid review, using methods developed by McMaster University and informed by Cochrane rapid review guidance. Screening, data extraction, quality assessment and synthesis were conducted by one author and checked by a second author. Synthesis of results was conducted using modified framework analysis, with themes from the original review used as an initial framework.

MAIN RESULTS

This review update includes 68 studies, with 17 guidelines and 20 reviews added to the original 31 studies. Synthesis identified six major themes, which can be used to inform policy and decision-making related to planning and implementing communication about a public health emergency and measures to protect the community. Theme 1: Strengthening public trust and countering misinformation: essential foundations for effective public health communication Recognising the key role of public trust is essential. Working to build and maintain trust over time underpins the success of public health communications and, therefore, the effectiveness of public health prevention measures. Theme 2: Two-way communication: involving communities to improve the dissemination, accessibility and acceptability of information Two-way communication (engagement) with the public is needed over the course of a public health emergency: at first, recognition of a health threat (despite uncertainties), and regularly as public health measures are introduced or adjusted. Engagement needs to be embedded at all stages of the response and inform tailoring of communications and implementation of public health measures over time. Theme 3: Development of and preparation for public communication: target audience, equity and tailoring Communication and information must be tailored to reach all groups within populations, and explicitly consider existing inequities and the needs of disadvantaged groups, including those who are underserved, vulnerable, from diverse cultural or language groups, or who have lower educational attainment. Awareness that implementing public health measures may magnify existing or emerging inequities is also needed in response planning, enactment and adjustment over time. Theme 4: Public communication features: content, timing and duration, delivery Public communication needs to be based on clear, consistent, actionable and timely (up-to-date) information about preventive measures, including the benefits (whether for individual, social groupings or wider society), harms (likewise) and rationale for use, and include information about supports available to help follow recommended measures. Communication needs to occur through multiple channels and/or formats to build public trust and reach more of the community. Theme 5: Supporting behaviour change at individual and population levels Supporting implementation of public health measures with practical supports and services (e.g. essential supplies, financial support) is critical. Information about available supports must be widely disseminated and well understood. Supports and communication related to them require flexibility and tailoring to explicitly consider community needs, including those of vulnerable groups. Proactively monitoring and countering stigma related to preventive measures (e.g. quarantine) is also necessary to support adherence. Theme 6: Fostering and sustaining receptiveness and responsiveness to public health communication Efforts to foster and sustain public receptiveness and responsiveness to public health communication are needed throughout a public health emergency. Trust, acceptance and behaviours change over time, and communication needs to be adaptive and responsive to these changing needs. Ongoing community engagement efforts should inform communication and public health response measures.

AUTHORS' CONCLUSIONS

Implications for practice Evidence highlights the critical role of communication throughout a public health emergency. Like any intervention, communication can be done well or poorly, but the consequences of poor communication during a pandemic may mean the difference between life and death. The approaches to effective communication identified in this review can be used by policymakers and decision-makers, working closely with communication teams, to plan, implement and adjust public communications over the course of a public health emergency like the COVID-19 pandemic. Implications for research Despite massive growth in research during the COVID-19 period, gaps in the evidence persist and require high-quality, meaningful research. This includes investigating the experiences of people at heightened COVID-19 risk, and identifying barriers to implementing public communication and protective health measures particular to lower- and middle-income countries, and how to overcome these.

Community engagement and adherence to COVID-19 prevention measures in Northwest Syria: a systematic review

The COVID-19 pandemic has increased the burden on the collapsing health system in northwest Syria. The situation was exacerbated by the low rates of adherence to preventive measures and acceptance of the COVID-19 vaccine. In this study, we systematically analysed studies related to Risk Communication and Community Engagement programs, and community awareness in northwest Syria in order to determine the most widespread prevention methods, the community's perspectives and knowledge of epidemic prevention, and the factors that prevent effective community engagement and uptake of COVID-19 prevention precautions in an area that has been suffering from the scourge of conflict for more than ten years. Based on the research findings, low adherence to COVID-19 prevention measures is mainly due to external factors related to socioeconomic status, scarcity of resources, and poor living conditions. Therefore, this study suggested that integrated multi-sectoral humanitarian programs that address these factors holistically are more effective than solely public health interventions in involving the community to become an active part of the Risk Communication and Community Engagement programs and ensuring their effectiveness.

Characterization of superspreaders movement in a bidirectional corridor using a social force model

During infectious disease outbreaks, some infected individuals may spread the disease widely and amplify risks in the community. People whose daily activities bring them in close proximity to many others can unknowingly become superspreaders. The use of contact tracking based on social networks, GPS, or mobile tracking data can help to identify superspreaders and break the chain of transmission. We propose a model that aims at providing insight into risk factors of superspreading events. Here, we use a social force model to estimate the superspreading potential of individuals walking in a bidirectional corridor. First, we applied the model to identify parameters that favor exposure to an infectious person in scattered crowds. We find that low walking speed and high body mass both increase the expected number of close exposures. Panic events exacerbate the risks while social distancing reduces both the number and duration of close encounters. Further, in dense crowds, pedestrians interact more and cannot easily maintain the social distance between them. The number of exposures increases with the density of person in the corridor. The study of movements reveals that individuals walking toward the center of the corridor tend to rotate and zigzag more than those walking along the edges, and thus have higher risks of superspreading. The corridor model can be applied to designing risk reduction measures for specific high volume venues, including transit stations, stadiums, and schools.

The Right to Refuse: Understanding Healthcare Providers' Perspectives on Patient Autonomy in Emergency Care

Healthcare providers in prehospital care and emergency departments are often at the frontline of medical crises, facing a range of ethical dilemmas, particularly when it comes to patients refusing treatment. This study aimed to delve into the attitudes of these providers toward treatment refusal, unearthing the strategies they employ in navigating such challenging situations while actively working in prehospital emergency health services. Our findings showed that, as the participants' age and experience increased, so did their inclination to respect patient autonomy and avoid persuading them to change their decision about treatment. It was noted that doctors, paramedics, and emergency medical technicians demonstrated a deeper understanding of patients' rights than other medical specialists. However, even with this understanding, the prioritization of patients' rights tended to diminish in life-threatening situations, giving rise to ethical dilemmas. This underlines the complexity of balancing the healthcare professionals' responsibilities and the patients' autonomy, which can generate ethically challenging scenarios for those working in emergency healthcare. By investigating these attitudes and experiences, this study seeks to foster a more profound understanding of the ethical quandaries faced by emergency healthcare providers. Our ultimate aim is to contribute to the development of effective strategies that support both patients and professionals in managing these tough circumstances.

Government as a Facilitator versus Inhibitor of Social Entrepreneurship in Times of Public Health Emergencies

COVID-19 established the need for even more social entrepreneurship globally. It is important for keeping society together in times of crises because it creates an environment that improves the quality of life during hard times and public health emergencies such as COVID-19. Even though it plays a unique role in returning things back to normal after a crisis, it faces opposition from many parts of society, especially the government. Still, there are not many studies that look at what the government should do to help or stop social enterprise during public health emergencies. That is why the goal of this study was to find out how the government has helped or hindered social entrepreneurs. Content analysis was conducted on the carefully mined data from the internet. The research found that regulations for social enterprises should be loosened, especially during and after pandemics and disasters. This could also make it easier to accomplish things in the government. It was also found that, in addition to financial help, capacity building through training can help social enterprises do more and make a bigger difference. This research provides broader guidelines for policymakers and new entrants in the field.

Assessing Thai Hospitals’ Evacuation Preparedness Using the Flexible Surge Capacity Concept and Its Collaborative Tool

According to the concept of “flexible surge capacity,” hospitals may need to be evacuated on two occasions: (1) when they are exposed to danger, such as in war; and (2) when they are contaminated, such as during the Covid-19 pandemic. In the former, the entire hospital must be evacuated, while in the latter, the hospital becomes a pandemic center necessitating the transfer of its non-contaminated staff, patients, and routine activities to other facilities. Such occasions involve several degrees of evacuation—partial or total—yet all require deliberate surge planning and collaboration with diverse authorities. This study aimed to investigate the extent of hospital evacuation preparedness in Thailand, using the main elements of the flexible surge capacity concept. A mixed method cross-sectional study was conducted using a hospital evacuation questionnaire from a previously published multinational hospital evacuation study. The tool contained questions regarding evacuation preparedness encompassing surge capacity and collaborative elements and an open-ended inquiry to grasp potential perspectives. All 143 secondary care, tertiary care, and university hospitals received the questionnaire; 43 hospitals provided responses. The findings indicate glitches in evacuation protocols, particularly triage systems, the inadequacies of surge planning and multiagency collaboration, and knowledge limitations in community capabilities. In conclusion, the applications of the essential components of flexible surge capacity allow the assessment of hospital preparedness and facilitate the evaluation of guidelines and instructions through scenario-based training exercises.

A Survey of Public Health Failures During COVID-19

The prolonged coronavirus disease 2019 (COVID-19) pandemic has raised concerns about the failures in the public health measures used to manage the spread of this deadly virus. This review focuses its attention on research papers that at their core highlight the individual public health measures instituted by organizations, institutions, and the government of the United States (US) since the start of the COVID-19 pandemic and that were published in 2019 to 2022. Together, these sources help paint a well-rounded view of the US management of this pandemic so that conclusions may be drawn from mistakes that were made and this country may respond better in the future to such situations. This paper is unique because it highlights the areas where improvement is needed, whereas other published work describes the measures taken and how they were carried out, not the failures, which leaves a gap in the literature that this paper hopes to fill. Through a deep dive into public health measures, seven areas in which improvements could be made were pinpointed by the authors. Such measures included mask mandates, social distancing, lockdown/quarantine, hand hygiene, COVID-19 testing, travel screening, and vaccine hesitancy. In exploring each measure, a discussion was carried out about its benefits and shortcomings in alleviating the ramifications of a global pandemic. In addition to the poor supply chain for critical products like personal protective equipment (PPE), the miscommunication between states and federal policies did not allow for the entirety of the US to respond cohesively in the face of the COVID-19 pandemic. This general review is crucial to know what is working and what needs to be changed to increase the benefits provided to the population.

Tracing Chinese international students' psychological and academic adjustments in uncertain times: An exploratory case study in the United Kingdom

The worldwide spread of COVID-19 has exerted tremendous influences on the wellbeing of international students and the sustainable development of higher education. The current study adopts an 8-month exploratory case study to trace eight Chinese international students' psychological and academic adjustments in the United Kingdom amid the COVID-19 pandemic. Emerging from the qualitative data constitutive of semi-structured interviews, self-reflection writings, memoing, together with stimulated-recall interviews, findings have demonstrated the three main types of obstruction for such students' adjustments in the foreign land including COVID-specific challenges (i.e., the threat of infect, reduced access to university facilities and resources); COVID-enhanced challenges (i.e., anxiety exacerbated by parents and social media use, anti-Asian racism and hate incidents); and language barriers and cultural differences as long-standing issues. Students' previous lockdown experience, individual resilience, development of monocultural friendship patterns, and institutional provision and support are all factors that have contributed to their ability to overcome or at least mitigate the psychological and academic difficulties. The study offers insight into the impacts of COVID-19 on international students, providing implications that could contribute to the sustainable adjustments of international students in times of disruptive events and inform future responses to global health crises from individual and higher education perspectives.

Global key concepts of civil-military cooperation for disaster management in the COVID-19 pandemic-A qualitative phenomenological scoping review

Background

In the context of a holistic and comprehensive disaster response effort to the COVID-19 pandemic, many countries across the globe mobilized their military forces in order to cope with sudden and exponential surges of critically ill patients with COVID-19 in stretched healthcare systems.

Objective

The purpose of this work is to identify, map, and render world-wide key concepts of civil-military cooperation (CIMIC) in disaster management during the COVID-19 crisis visible.

Material and methods

Literature was systematically searched in three databases (PubMed, Web of Science, Cochrane Library) on 26 January 2022, and analyzed with qualitative, mixed narrative-phenomenological methods in compliance with PRISM-ScR and SRQR.

Results

Forty-five publications were included in the analysis; pertinent authors were from 22 countries covering five continents. We identified three key thematic clusters in the published literature: Cluster (1) Medico-scientific contributions with the participation of military medical personnel or institutions: members of the military acted as subject matter experts, clinical and experimental (co-) investigators as well as co-founders for enabling COVID-19 relevant research. Areas covered were relevant to the COVID-19 patient's clinical journey from prevention, exposure, diagnostics, and treatment and included pertinent fields such as digital health and telemedicine, global and public health, critical care, emergency and disaster medicine, radiology, neurology, as well as other medical specialties, i.e., respiratory care, pulmonology, burn medicine, and transfusion medicine, in addition to environmental and occupational sciences as well as materials science. Cluster (2) CIMIC field experiences or analyses included areas such as political framework, strategy, structure, nature of civil-military interaction, and concrete mission reports in selected countries. Themes covered a broad spectrum of pandemic disaster management subjects such as capacity and surge capacity building, medical and pharmaceutical logistics, patient care under austere circumstances, SARS-CoV-2 testing support, intelligent and innovative information management, vaccination support, and disaster communication. Cluster (3) The military as a role model for crisis management.

Conclusion

Civil-military cooperation made a significant contribution to the level of resilience in crisis management on a global scale, positively impacting a broad spectrum of core abilities during the COVID-19 pandemic.

Individual and collective protective responses during the early phase of the COVID-19 pandemic in 10 different countries: Results from the EUCLID online survey

BACKGROUND

In times of unprecedented infectious disease threats, it is essential to understand how to increase individual protective behaviors and support for collective measures. The present study therefore examines factors associated with individual and collective pathways.

METHODS

Data was collected through an online survey from 4483 participants (70.8% female, M = 41.2 years) across 10 countries from April 15, 2020 to June 2, 2020 as part of the "EUCLID" project (https://euclid.dbvis.de). Structural equation modeling was used to examine individual and collective pathways across and within countries.

RESULTS

Overall, the adoption of individual protective behaviors and support for collective measures were high. Risk perception on the individual level and perceived effectiveness at the collective level were positively associated with both individual protective behaviors and support for collective measures. Furthermore, the model explained considerable variance in individual (40.7%) and collective protective behaviors (40.8%) and was largely replicated across countries.

CONCLUSIONS

The study extends previous research by demonstrating that individual risk perception and perceived effectiveness of collective measures jointly affect individual protective health behaviors and support for collective measures. These findings highlight the need to jointly consider a variety of behavioral actions against infectious disease threats, acknowledging interactions between individual and collective pathways.

Healthcare Supply Chain Management under COVID-19 Settings: The Existing Practices in Hong Kong and the United States

COVID-19 is recognized as an infectious disease generated by serious acute respiratory syndrome coronavirus 2. COVID-19 has rapidly spread all over the world within a short time period. Due to the coronavirus pandemic transmitting quickly worldwide, the impact on global healthcare systems and healthcare supply chain management has been profound. The COVID-19 outbreak has seriously influenced the routine and daily operations of healthcare facilities and the entire healthcare supply chain management and has brough about a public health crisis. As making sure the availability of healthcare facilities during COVID-19 is crucial, the debate on how to take resilience actions for sustaining healthcare supply chain management has gained new momentum. Apart from the logistics of handling human remains in some countries, supplies within the communities are urgently needed for emergency response. This study focuses on a comprehensive evaluation of the current practices of healthcare supply chain management in Hong Kong and the United States under COVID-19 settings. A wide range of different aspects associated with healthcare supply chain operations are considered, including the best practices for using respirators, transport of life-saving medical supplies, contingency healthcare strategies, blood distribution, and best practices for using disinfectants, as well as human remains handling and logistics. The outcomes of the conducted research identify the existing healthcare supply chain trends in two major Eastern and Western regions of the world, Hong Kong and the United States, and determine the key challenges and propose some strategies that can improve the effectiveness of healthcare supply chain management under COVID-19 settings. The study highlights how to build resilient healthcare supply chain management preparedness for future emergencies.

Thinking on your feet: Beauty and auto small businesses maneuver the risks of the COVID-19 pandemic

On March 11, 2020, the World Health Organization officially declared SARS-CoV-2 a pandemic, and governments and health institutions enacted various public health measures to decrease its transmission rate. The COVID-19 pandemic made occupational health disparities for small businesses more visible and created an unprecedented financial burden, particularly for those located in communities of color. In part, communities of color experienced disproportionate mortality and morbidity rates from COVID-19 due to their increased exposure. The COVID-19 pandemic has prompted the public to reflect on risks daily. Risk perception is a critical factor influencing how risk gets communicated and perceived by individuals, groups, and communities. This study explores competing risk perceptions regarding COVID-19, economic impacts, vaccination, and disinfectant exposures of workers at beauty salons and auto shops in Tucson, Arizona, using a perceived risk score measured on a scale of 1-10, with higher scores indicating more perceived risk. The primary differences between respondents at beauty salons and auto shops regarding their perceived risks of COVID-19 vaccination were between the vaccinated and unvaccinated. For every group except the unvaccinated, the perceived risk score of getting the COVID-19 vaccine was low, and the score of not getting the COVID-19 vaccine was high. Study participants in different demographic groups ranked economic risk the highest compared to the other five categories: getting the COVID-19 vaccine, not getting the COVID-19 vaccine, COVID-19, disinfection, and general. A meaningful increase of four points in the perceived risk score of not getting the COVID-19 vaccine was associated with a 227% (95% CI: 27%, 740%) increase in the odds of being vaccinated. Analyzing these data collected during the coronavirus pandemic may provide insight into how to promote the health-protective behavior of high-risk workers and employers in the service sector during times of new novel threats (such as a future pandemic or crisis) and how they process competing risks.

Statistical Study of User Perception of Smart Homes during Vital Signal Monitoring with an Energy-Saving Algorithm

Sensor networks are deployed in people's homes to make life easier and more comfortable and secure. They might represent an interesting approach for elderly care as well. This work highlights the benefits of a sensor network implemented in the homes of a group of users between 55 and 75 years old, which encompasses a simple home energy optimization algorithm based on user behavior. We analyze variables related to vital signs to establish users' comfort and tranquility thresholds. We statistically study the perception of security that users exhibit, differentiating between men and women, examining how it affects the person's development at home, as well as the reactivity of the sensor algorithm, to optimize its performance. The proposed algorithm is analyzed under certain performance metrics, showing an improvement of 15% over a sensor network under the same conditions. We look at and quantify the usefulness of accurate alerts on each sensor and how it reflects in the users' perceptions (for men and women separately). This study analyzes a simple, low-cost, and easy-to-implement home-based sensor network optimized with an adaptive energy optimization algorithm to improve the lives of older adults, which is capable of sending alerts of possible accidents or intruders with the highest efficiency.

Community-Based Response to the COVID-19 Pandemic: Case Study of a Home Isolation centre using Flexible Surge Capacity

Objectives

Coronavirus disease 2019 (COVID-19) has consumed many available resources within contingency plans, necessitating new capacity surges and novel approaches. This study aimed to explore the possibility of implementing the concept of flexible surge capacity to reduce the burden on hospitals by focussing on community resources to develop home isolation centres in Bangkok, Thailand.

Study design

A qualitative study consisted of observational and semi-structured interview data.

Methods

The development and activities of home isolation centres were observed, and interviews were conducted with leaders and operational workforces. Data were deductively analysed and categorised based on the practical elements necessary in disaster and emergency management.

Results

Data were categorised into the seven collaborative elements of the major incident medical management and support model. The command-and-control category demonstrated four subcategories: (1) coordination and collaboration; (2) staff engagement; (3) responsibility clarification; and (4) sustainability. Safety presented two subcategories: (1) patients' information privacy and treatment; and (2) personnel safety and privacy. Communication showed internal and external communications subcategories. Assessment, triage, treatment and transport followed the processes of the COVID-19 treatment protocols according to the World Health Organisation (WHO) guidelines and hospital operations. Several supply- and patient-related challenges were identified and managed during centre development.

Conclusions

The use of community resources, based on the flexible surge capacity concept, is feasible under restricted circumstances and reduced the burden on hospitals during the COVID-19 pandemic. Continuous education among multidisciplinary volunteer teams facilitated their full participation and engagement. The concept of flexible surge capacity may promote an alternative community-based care opportunity, irrespective of emergencies' aetiology.

Supply chain disruption during the COVID-19 pandemic: Recognizing potential disruption management strategies

The COVID-19 pandemic has made a significant impact on various supply chains (SCs). All around the world, the COVID-19 pandemic affects different dimensions of SCs, including but not limited to finance, lead time, demand changes, and production performance. There is an urgent need to respond to this grand challenge. The catastrophic impact of the COVID-19 pandemic prompted scholars to develop innovative SC disruption management strategies and disseminate them via numerous scientific articles. However, there is still a lack of systematic literature survey studies that aim to identify promising SC disruption management strategies through the bibliometric, network, and thematic analyses. In order to address this drawback, this study presents a set of up-to-date bibliometric, network, and thematic analyses to identify the influential contributors, main research streams, and disruption management strategies related to the SC performance under the COVID-19 settings. The conducted analyses reveal that resilience and sustainability are the primary SC topics. Furthermore, the major research themes are found to be food, health-related SCs, and technology-aided tools (e.g., artificial intelligence (AI), internet of things (IoT), and blockchains). Various disruption management strategies focusing on resilience and sustainability themes are extracted from the most influential studies that were identified as a part of this work. In addition, we draw some managerial insights to ensure a resilient and sustainable supply of critical products in the event of a pandemic, such as personal protective equipment (PPE) and vaccines.

The Moral, Ethical, Personal, and Professional Challenges Faced by Physicians during the COVID-19 Pandemic

The COVID-19 pandemic, apart from the main problems concerning the health and life of patients, sparked a discussion about physicians’ moral and social professional attitudes. During a pandemic, physicians have the same ethical, moral, and medical responsibilities, however, the situation is different since they are self-exposed to a danger, which may influence their willingness to work. The problem of the professional moral attitudes of health care workers, recurring in ethical discussions, prompts us to define the limits of the duties of physicians in the event of a pandemic, hence this research aimed to assess these duties from an ethical perspective and to define their boundaries and scope. The study was conducted in May and June 2020 in the city of Lublin, covering all medical centers, and the questionnaire was completed by 549 physicians. The research was conducted in four areas: emergency standby in the event of a disaster, even if it is not requested; willingness to work overtime in the event of a disaster, even without payment; willingness to take health risks by caring for people who are infectious or exposed to hazardous substances; readiness to be transferred to other departments in the event of a disaster. Although most of the respondents declared to be agreed on personal sacrifices in the performance of professional duties, they were not prepared for a high level of personal risk when working in a pandemic. Excessive workload, its overwhelming nature, and personal risk are not conducive to readiness to work overtime, especially without pay. Research shows how important it is to respect the rights and interests of all parties involved in a pandemic. Physicians’ duty to care for a patient is also conditioned by the duty to protect themselves and should not be a tool for intimidating and depersonalizing their social and professional lives.

Transit-Oriented Development: Towards Achieving Sustainable Transport and Urban Development in Jakarta Metropolitan, Indonesia

Transit-Oriented Development (TOD) is advocated for achieving sustainable transportation through development around transit stations. TOD’s global implementation revealed varied outcomes, with many cities failing to achieve the intended objectives. TOD implementation in the Jakarta Metropolitan area still in its infancy. Through a geospatial information system and a survey of 400 commuters who live inside the 1 km radius of planned TOD, this longitudinal study aimed to examine an eight-year lapse between 2013 and 2020 of changes in two aspects, specifically land-use and spatial distribution as well as commuters’ travel behavior and preferences in TOD implementation and travel changes due to the COVID-19 pandemic. Key findings are as follows: increased diversity in the residential function around planned TOD areas in the Jakarta capital and a decrease in the suburbs, reflecting the commuters’ improved readiness to reside in planned TOD areas. Furthermore, kinship relations were the commuters’ main reason when selecting house locations, with no capacity to change their workplaces. A significant increase in public facilities at the expense of green open space (GOS) indicates that TOD implementation was conducted by the government with the sole authority to manage GOS, lacking private sector involvement. The cost factor was the most dominant reason for the commuter’s use of public transportation, instead of new transport modes such as MRT and LRT. Moreover, the commuter’s travel behavior in all studied transit stations, whilst it showed evidence of changes in time and frequency, was not greatly influenced by the COVID-19 related restrictions.

Moderating Effect of a Cross-Level Social Distancing Policy on the Disparity of COVID-19 Transmission in the United States

Currently, coronavirus disease 2019 (COVID-19) remains a global pandemic, but the prevention and control of the disease in various countries have also entered the normalization stage. To achieve economic recovery and avoid a waste of resources, different regions have developed prevention and control strategies according to their social, economic, and medical conditions and culture. COVID-19 disparities under the interaction of various factors, including interventions, need to be analyzed in advance for effective and precise prevention and control. Considering the United States as the study case, we investigated statistical and spatial disparities based on the impact of the county-level social vulnerability index (SVI) on the COVID-19 infection rate. The county-level COVID-19 infection rate showed very significant heterogeneity between states, where 67% of county-level disparities in COVID-19 infection rates come from differences between states. A hierarchical linear model (HLM) was adopted to examine the moderating effects of state-level social distancing policies on the influence of the county-level SVI on COVID-19 infection rates, considering the variation in data at a unified level and the interaction of various data at different levels. Although previous studies have shown that various social distancing policies inhibit COVID-19 transmission to varying degrees, this study explored the reasons for the disparities in COVID-19 transmission under various policies. For example, we revealed that the state-level restrictions on the internal movement policy significantly attenuate the positive effect of county-level economic vulnerability indicators on COVID-19 infection rates, indirectly inhibiting COVID-19 transmission. We also found that not all regions are suitable for the strictest social distancing policies. We considered the moderating effect of multilevel covariates on the results, allowing us to identify the causes of significant group differences across regions and to tailor measures of varying intensity more easily. This study is also necessary to accomplish targeted preventative measures and to allocate resources.

COVID-19 risk perceptions of social interaction and essential activities and inequity in the USA: results from a nationally representative survey

INTRODUCTION

SARS-CoV-2 has disproportionately affected disadvantaged communities across the USA. Risk perceptions for social interactions and essential activities during the COVID-19 pandemic may vary by sociodemographic factors.

METHODS

We conducted a nationally representative online survey of 1592 adults in the USA to understand risk perceptions related to transmission of COVID-19 for social (eg, visiting friends) and essential activities (eg, medical visits or returning to work). We assessed relationships for activities using bivariate comparisons and multivariable logistic regression modelling, between responses of safe and unsafe, and participant characteristics. Data were collected and analysed in 2020.

RESULTS

Among 1592 participants, risk perceptions of unsafe for 13 activities ranged from 29.2% to 73.5%. Large gatherings, indoor dining and visits with elderly relatives had the highest proportion of unsafe responses (>58%), while activities outdoor, accessing healthcare and going to the grocery store had the lowest (<36%). Older respondents were more likely to view social gatherings and indoor activities as unsafe but less likely for other activities, such as going to the grocery store and accessing healthcare. Compared with white/Caucasian respondents, black/African-American and Hispanic/Latino respondents were more likely to view activities such as dining and visiting friends outdoor as unsafe. Generally, men versus women, Republicans versus Democrats and independents, and individuals with higher versus lower income were more likely to view activities as safe.

CONCLUSION

Evidence-based interventions should be tailored to sociodemographic differences in risk perception, access to information and health behaviours when implementing efforts to control the COVID-19 pandemic.

Differences in Ethical Viewpoints among Civilian–Military Populations: A Survey among Practitioners in Two European Countries, Based on a Systematic Literature Review

Civilian–military collaboration in humanitarian crises has been encouraged globally; however, little is known about their diverse ethical viewpoints towards challenging and critical situations, which may cause difficulties in the partnership, and influence the outcomes of their mutual activities. The aim of this study was to identify the diversity of viewpoints and ethical decision-making during exceptional circumstances among civilian and military populations from two different countries, each with diverse background and healthcare organization structures. Possible scenarios, based on a systematic review of the literature, were introduced to Swedish and Polish civilian and military healthcare providers. Variations in the participants’ viewpoints and approaches to ethical decision-making were analyzed according to their characteristics, organizational belonging, and nationality. There were differences between both populations but also within the military and civilian groups, respectively. One significant factor influencing ethical viewpoints was participants’ nationality. Differences in ethical viewpoints between multiagency organizations should be considered in planning and implementation of future transdisciplinary and international collaboration in disaster and emergency management. Further studies and renewed educational initiatives are necessary to validate these differences and to navigate civilian–military as well as other multinational partnerships.

Seroprevalence of anti-SARS-CoV-2 antibodies among staff at primary healthcare institutions in Prishtina

BACKGROUND

Many studies examined the spread of SARS-CoV-2 within populations using seroprevalence. Healthcare workers are a high-risk population due to patient contact, and studies are needed to examine seroprevalence of SARS-CoV-2 antibodies among healthcare workers. Our study investigates the seroprevalence of anti-SARS-CoV-2 antibodies among staff at primary healthcare institutions in Prishtina, and factors associated with seroprevalence.

METHODS

We carried out a cross-sectional survey including SARS-CoV-2 serological testing and questionnaires with primary healthcare workers from primary healthcare facilities in the Prishtina, the capital city of Kosovo. We calculated prevalence of anti-SARS-CoV-2 antibodies, and of self-reported positive PCR test among primary healthcare workers, as well as crude and adjusted ORs for explanatory factors.

RESULTS

Eighty-three of the healthcare workers (17.47%) tested positive for SARS-CoV-2 antibodies IgG or IgM, while 231 (48.63%) either had antibodies or a previous positive PCR test. Odds of seropositivity were affected by male gender (OR 2.08, 95% CI 1.20, 3.61), and infected family members (OR 3.61, 95% CI 2.25, 5.79) of healthcare workers. Higher education, being part of larger families and having infected family members gave higher odds of positive PCR test and seropositivity. Other healthcare workers had lower odds of positive PCR test and seropositivity than physicians.

CONCLUSION

Over 17% of healthcare workers were seropositive for SARS-CoV-2 antibodies and close to half of them were either seropositive or PCR self-reported positive test. Several factors are associated with decreased and increased odds for such outcomes. These findings should be explored further and addressed to Kosovo policy makers, and assist them to intensify vaccination efforts, and maintain control measures until we achieve herd immunity.

Civilian-Military Collaboration before and during COVID-19 Pandemic—A Systematic Review and a Pilot Survey among Practitioners

Due to the similarity in skills and assets, Civilian-Military collaboration has emerged as one of the most reliable partnerships during the disaster and public health emergency management to address all necessary elements of surge capacity, i.e., staff, stuff, structure (space), and systems. This study aimed to evaluate this collaboration before and during the coronavirus 2019 pandemic. The outcomes of the systematic review revealed several published reports on successful civilian-military collaboration and proposed a need for further improvement. One hundred sixty-six individuals from 19 countries responded to nine questions, included in an online survey with the possibility to leave comments if necessary. The questionnaire referred to elements such as command and control, safety, communication, assessment, triage, treatment, and transport, as the crucial components of emergency management. The comprehensive examination of the survey results together with registered comments revealed a possible improvement in collaboration particularly on the strategic levels, i.e., meetings at the command-and-control level, safety, communication, and networking issues. While logistic collaboration seemed to be unchanged, the practical parts of the collaboration, i.e., clinical and non-clinical operational partnership (Triage and Treatment), mutual education, training, and operational understanding of each organization remained unchanged. In conclusion, although the current pandemic may have facilitated a more intense collaboration between civilian and military healthcare organizations, it lacks practical partnership and operative engagement, representing two crucial elements necessary for harmony and compatibility of both systems. Such collaboration may require a political will and perhaps a mutual civilian-military authority.

Research on the Natural Hazard Emergency Cooperation Behavior between Governments and Social Organizations Based on the Hybrid Mechanism of Incentive and Linkage in China

Social organizations have become an important component of the emergency management system by virtue of their heterogeneous resource advantages. It is of great significance to explore the interaction between the local government and social organizations and to clarify the key factors affecting the participation of social organizations in natural hazard emergency responses. With the aim of exploring the relationship between the local government and social organizations, based on evolutionary game theory, the emergency incentive game model and the emergency linkage game model of natural hazard emergency responses were constructed. The evolutionary trajectories of the emergency incentive game system and the emergency linkage game system were described by numerical simulation. Meanwhile, the influence mechanism of government decision parameters on the strategy selection of both game subjects was analyzed. The results show that both governmental incentive strategy and linkage strategy can significantly improve the enthusiasm of social organizations for participating in natural hazard emergency responses. Moreover, they could encourage social organizations to choose a positive participation strategy. Nevertheless, over-reliance on incentives reduces the probability of the local government choosing a positive emergency strategy. In addition, we found that, when both game subjects tend to choose a positive strategy, the strategy selection of the local government drives that of social organizations.

Appraisal of a Contact Tracing Training Program for COVID-19 in Greece Focusing on Vulnerable Populations

BACKGROUND

Contact tracing as an epidemiological strategy has repeatedly contributed to the containment of various past epidemics and succeeded in controlling the spread of disease in the community. Systematic training of contact tracers is crucial in ensuring the effectiveness of epidemic containment.

METHODS

An intensive training course was offered to 216 health and other professionals who work with vulnerable population groups, such as Roma, refugees, and migrants in Greece, by the scientific team of the postgraduate programme "Global Health-Disaster Medicine" of the Medical School, National and Kapodistrian University of Athens, with the support of the Swiss embassy in Greece. The course was delivered online due to the pandemic restriction measures and was comprised of 16 h over 2 days. The course curriculum was adapted in Greek using, upon agreement, a similar training course to what was developed by the Johns Hopkins University Bloomberg School of Public Health. Evaluation of the course was conducted in order to determine the short term satisfaction from participating in this training course.

RESULTS

A total of 70% of the course participants completed the evaluation questionnaires and all trainers gave feedback on the course. The training modules were ranked as extremely useful by the majority of the participants and over 50% of the participants specifically stated that the course content was directly related to their work with vulnerable groups. Content about the ethics of contact tracing and the effective communication skills presented were deemed most useful.

CONCLUSION

The course was well organised and provided the required skills for effective contact tracing. Many course participants intend to use some components in their work with vulnerable populations groups. Contact tracing efforts work best in a systematic and coordinated way and the provision of systematic and organised training can greatly increase its effectiveness.

Big Data for Biomedical Education with a Focus on the COVID-19 Era: An Integrative Review of the Literature

Medical education refers to education and training delivered to medical students in order to become a practitioner. In recent decades, medicine has been radically transformed by scientific and computational/digital advances-including the introduction of new information and communication technologies, the discovery of DNA, and the birth of genomics and post-genomics super-specialties (transcriptomics, proteomics, interactomics, and metabolomics/metabonomics, among others)-which contribute to the generation of an unprecedented amount of data, so-called 'big data'. While these are well-studied in fields such as medical research and methodology, translational medicine, and clinical practice, they remain overlooked and understudied in the field of medical education. For this purpose, we carried out an integrative review of the literature. Twenty-nine studies were retrieved and synthesized in the present review. Included studies were published between 2012 and 2021. Eleven studies were performed in North America: specifically, nine were conducted in the USA and two studies in Canada. Six studies were carried out in Europe: two in France, two in Germany, one in Italy, and one in several European countries. One additional study was conducted in China. Eight papers were commentaries/theoretical or perspective articles, while five were designed as a case study. Five investigations exploited large databases and datasets, while five additional studies were surveys. Two papers employed visual data analytical/data mining techniques. Finally, other two papers were technical papers, describing the development of software, computational tools and/or learning environments/platforms, while two additional studies were literature reviews (one of which being systematic and bibliometric).The following nine sub-topics could be identified: (I) knowledge and awareness of big data among medical students; (II) difficulties and challenges in integrating and implementing big data teaching into the medical syllabus; (III) exploiting big data to review, improve and enhance medical school curriculum; (IV) exploiting big data to monitor the effectiveness of web-based learning environments among medical students; (V) exploiting big data to capture the determinants and signatures of successful academic performance and counteract/prevent drop-out; (VI) exploiting big data to promote equity, inclusion, and diversity; (VII) exploiting big data to enhance integrity and ethics, avoiding plagiarism and duplication rate; (VIII) empowering medical students, improving and enhancing medical practice; and, (IX) exploiting big data in continuous medical education and learning. These sub-themes were subsequently grouped in the following four major themes/topics: namely, (I) big data and medical curricula; (II) big data and medical academic performance; (III) big data and societal/bioethical issues in biomedical education; and (IV) big data and medical career. Despite the increasing importance of big data in biomedicine, current medical curricula and syllabuses appear inadequate to prepare future medical professionals and practitioners that can leverage on big data in their daily clinical practice. Challenges in integrating, incorporating, and implementing big data teaching into medical school need to be overcome to facilitate the training of the next generation of medical professionals. Finally, in the present integrative review, state-of-art and future potential uses of big data in the field of biomedical discussion are envisaged, with a focus on the still ongoing "Coronavirus Disease 2019" (COVID-19) pandemic, which has been acting as a catalyst for innovation and digitalization.