This study assesses the collective community capacity of the National COVID-19 Resiliency Network (NCRN), a multisectoral network mitigating the disproportionate impact of COVID-19 on minoritized populations.

From January to April 2022, we used two concurrent data collection methods: a Collective Community Capacity (C3) survey (n=65) and key informant interviews (KIIs) (n=26). The C3 assessed capacity for creation of a shared vision, engagement in community change, and distributive leadership. KIIs assessed perspectives on network formation and implementation. We used a convergent design and triangulation for interpretation.

NCRN has growing collective community capacity. The C3 survey found high capacity for establishing a shared mission and evidence of mutual commitment, trust, and accountability. About three-quarters of respondents strongly agreed that partners addressed social, economic, and cultural barriers related to COVID-19. Interviewees valued NCRN leaders’ openness, availability, and willingness to listen. Partners learned from one another, increased their health communication capacity, and supported sustainability. They sought greater opportunities to partner and support decision-making.

NCRN developed a collaborative network with a shared vision of improving health equity during and beyond the COVID-19 pandemic, while identifying areas for improvement in distributive leadership. Findings can support other organizations seeking to build collective community capacity to address equity in public health emergencies.

In the field of cancer, many cancer patient associations (CPAs) have been established in Türkiye to support individuals living with cancer (ILCs) throughout the diagnosis and treatment processes. The presence of CPAs for ILCs became more significant after the major earthquakes in southeastern Türkiye in February 2023. The aim of this study is to identify the challenges of ILCs after the earthquakes from the perspective of CPA members.

This study employed a qualitative approach. The data collection method was in-depth interviews. Semi-structured, open-ended interviews were conducted with 15 volunteers who work with ILCs, selected through purposeful sampling. The data were analyzed by using inductive thematic analysis. This study was conducted between April and May 2023.

Three main themes (problems of ILCs caused by earthquakes, access to health care, future concerns) and 11 subthemes were extracted through analyzing interviews.

ILCs experienced diverse difficulties after earthquakes. Members of CPAs observed that acute interventions to injured people and humanitarian aid activities had the first-place importance after the earthquake, while cancer-related care took the second place, anticipating devastating outcomes for the future of their care. CPAs should be supported by the public, local governments, and central government in their endeavors for ILCs.

Flood is one of the major public health concerns increasing the risk of childhood diarrhea. This study aims to explore the association of floods with diarrhea among under-five children in rural India.

A cross-sectional study was carried out using large-scale nationally representative data from the National Family Health Survey-5. The Central Water Commission reports between the years 2018 and 2020 were used to group all the districts as non-flood-affected districts or flood-affected districts. Bivariate and multivariate logistic regression models were employed to assess the association of floods with childhood diarrhea.

The prevalence of diarrhea was higher among children exposed to three consecutive floods during the year 2019-21 than those children not exposed to flood. Children exposed to flood three times between the year 2018-19 to 2020-21 were associated with a 34% higher likelihood of developing diarrhea than those children exposed to flood one or two times.

Our study suggests that community health workers should target mothers belonging to the poor wealth quintile, young mothers, and mothers with young infants and more children to receive child health related counseling in flood-prone areas.

This study aims to compare the demographic, clinical characteristics, and outcomes of burn injuries in toddler and preschool children, and to validate the American Burn Association (ABA) Burn Triage Decision Matrix in the Turkish pediatric population.

A retrospective analysis was conducted on 684 pediatric burn patients (494 toddlers, 190 preschoolers) admitted to our burn center over a 5-year period. Variables including gender, burn etiology, burn area, depth, treatment modalities, complications, length of hospital stay, and mortality were analyzed. The performance of the ABA Burn Triage Decision Matrix was evaluated in both groups.

Scalding was the predominant cause of burns in both groups, with a significant difference in the involvement of anterior trunk (p = 0.027). The mean Total Body Surface Area (TBSA) was comparable between the groups (p = 0.286). There was no significant difference in mortality rates (p = 0.385), treatment modalities, and complications. The ABA Burn Triage Decision Matrix demonstrated consistency in triaging the severity of burn injuries, with a notable discrepancy observed in the moderate risk category of toddler group.

This study highlights the distinct characteristics and outcomes of burn injuries in different pediatric age groups. The ABA Burn Triage Decision Matrix’s validation suggests its utility in enhancing triage accuracy and resource allocation in pediatric populations, especially in disaster-prone regions.

This research identified the key determinants and designed a novel Bayesian three-dimension convolution neural network (3D-CNN) for COVID-19 mass casualty incidents (MCI) triage recommendation.

109 articles between 2019 and 2022 were archived from MEDLINE databases. An empirical review and content analysis were done to find out the triage determinants and a Bayesian 3-D CNN model was designed for triage recommendation.

35 out of 109 articles were used. The severity of infection (signs and symptoms of coronavirus), likelihood of spreading (attitudes of pandemic spreading, personal behaviors, and government policy), and available resources (physician and medication availability, hospital vacancy, and evacuation assets) were the identified determinants. The likelihoods of having COVID-19 were calculated with a Bayesian network based on the parameters of the three determinants, and were pre-processed for training the 3D-CNN model with the COVID19 test result, recover history, and medication outcome for “immediate (hospital admission with immediate medical care)”, “delayed (quarantine center and observation)”, “minimal (home quarantine with medication)”, “semi-minimal (home quarantine without medication)”, or “no priority (no therapeutic resources)” triage recommendation.

The determinants and AI model classify patients to an optimal healthcare facility for reducing disaster medicine risk. The model verification and validation were undergoing.

Modern 21st century armed conflict is characterized by a proliferation of nonstate armed groups, asymmetric warfare, and increased explosive threats such as improvised explosive devices (IEDs), barrel bombs, and cluster munitions. Over the course of the wars in Iraq and Afghanistan, casualty data analysis of preventable deaths led to a radical restructuring of military trauma care through the Joint Trauma System. These changes increased survival among critically injured casualties in Afghanistan from 2.2 to 39.9% from 2001–2017. Many of these practices have been incorporated into civilian trauma systems in high-resource settings (e.g., bystander tourniquet application for hemorrhage control, damage control resuscitation and use of whole blood, trauma registries to benchmark outcomes and quality improvement). In contrast, the structure of humanitarian surgical care in conflict remains largely unchanged. This talk synthesizes gaps and opportunities to translate advances made in military and high-resource trauma systems to humanitarian care in low-resource settings to reduce preventable morbidity and mortality among civilians in conflict.

Provide an overview of the unique demographic populations and surgical conditions (including both trauma and non-traumatic emergencies) encompassed by humanitarian surgical care.

Synthesize the evidence base on (a) civilian conflict casualty epidemiology and (b) trauma intervention in low-resource settings to provide a framework for context-appropriate translation of trauma care advances in military and high-resource settings to low-resource conflict settings.

Highlight gaps and opportunities for targeted research and operational interventions to improve care for vulnerable subpopulations (e.g., pediatric patients, burn victims), leveraging enhanced coordination between the health and protection clusters.

This pilot study assessed the feasibility of measuring time to perform pre-identified lifesaving interventions (LSIs) used during mass-casualty incidents (MCIs).

An observational simulation study involving pre-hospital providers (PHPs) was conducted at London’s Air Ambulance training center. PHPs performed 16 basic-to-advanced LSIs and were video-recorded to capture the LSIs’ time intervals (TTs) (time from picking up equipment to completing the LSIs). TTs are reported in seconds (median and interquartile range [IQR]). Ethical approval was obtained from Queen Mary University.

Seven PHCPs (five paramedics and two physicians) performed 92 LSIs, with paramedics limited to 11 LSIs due to their scope of practice. Physician-only performed LSIs had the longest TT compared to other LSIs, Rapid-sequence intubation 175.00 IQR(162.50–187.50). The longest TT in all LSIs was related to circulation support, with fluid resuscitation taking 99 IQR(88–101) for paramedics and 80 IQR(74.5–85.5) for physicians. LSIs with a median time exceeding 30 seconds were generally characterized by substantial variability, as indicated by a wide IQR.

This pilot study demonstrated the feasibility of recording timings for LSIs. Physician-only performed LSIs had the longest TT but were more complex interventions. Further investigation within a simulated environment is planned.

The Military Unique Curriculum at the Uniformed Services University consists of three high-fidelity simulations to prepare students for future conflicts in austere operational environments. One of these simulations, Operation Bushmaster is a five-day high-fidelity military medical field practicum (MFP) held for fourth-year military medical students and nursing students. During this simulation, students deploy to Fort Indiantown Gap, PA, where they enter the notional country of “Torbia.” Assembled in platoons, the students care for simulated critical condition patients (portrayed by first year medical students) within a stressful combat environment. In addition, while participating in Operation Bushmaster, students fill various roles relevant to their future deployments, including surgeon, platoon leader, assistant platoon leader, preventative medicine technician, ambulance team leader, and behavioral health technician while caring for simulated disease and non-battle injury patients, combat stress casualties, and combat trauma casualties in a variety of scenarios. The simulation concludes with a mass casualty event where students care for over thirty patients during a one-hour time frame. This presentation will explore the educational impact of Operation Bushmaster on student learning and readiness to deploy by describing several educational research studies conducted at Operation Bushmaster. Best practices for developing training simulations like Operation Bushmaster will be described and discussed.

Participants will identify the critical elements of high-fidelity simulations at the Uniformed Services University.

Participants will describe the impact of Operation Bushmaster on military medical trainee learning.

Participants will discuss the value of using high-fidel\ity simulation for disaster training and readiness.

Each year, disasters impact over 50 million, and conflicts are indirectly related to 1,000,000 deaths. Traditionally, humanitarians help in two ways: Deployment: sending healthcare workers to provide direct care, and Development: training local healthcare workers. But these routes limit who can be reached and how quickly. We envision a scalable solution that moves beyond traditional humanitarian avenues to empower the public to save lives and reduce suffering through equitable, open-access education.

Provide the justification for just in time digital education.

Provide various examples of JIT education.

Summarize current JIT domestic and global initiatives.

To analyze terror events in Latin America from 1970 through 2020 utilizing the Global Terrorism Database (GTD).

A retrospective descriptive analysis of data from 17 Latin America Countries from 1970 through 2020 was performed to include number of attacks, deaths, injuries, primary weapon types, location, and primary target types.

A total 30,224 attacks were recorded, resulting in 60,163 deaths and 26,576 injuries. Firearms were the most frequent weapons used (12,651), followed by explosives (12,518), unspecified weapons (3,198), and incendiary devices (1,584). Military-related targets (4,929) were the most frequently targeted entities, followed by private citizens and property (4,906), businesses (4,810), general government facilities (3,994), police (2,955), diplomatic government facilities (604), and religious figures/institutions (464).

The health implications of terrorist attacks are often compounded by violence that pose unique challenges to populations, governments, and aid organizations. Through an understanding of the impact and scope of terrorist activity, Counter-Terrorism Medicine strategies can improve outcomes through all stages of the disaster cycle.

To elucidate the association between financial challenges, healthcare needs, and their subsequent impact on individuals’ mental health, physical well-being, and quality of life.

ChiKobi Health conducted a market research survey consisting of twenty questions. 25 participants responded, providing insights into their emotional states due to health or financial situations, daily energy levels, mental health associations with financial and healthcare situations, overall quality of life, experiences with chronic pain, physical functioning, and interests in healthcare management services and holistic products.

Key findings indicate: 88% of respondents occasionally to often felt emotionally drained due to health or financial situations. 80% rated their overall quality of life as good to excellent, but 40% have experienced chronic pain that interfered with daily activities. 48% felt their physical health was occasionally to always hindered by financial or healthcare limitations. 60% expressed interest in personalized healthcare manager services and 84% in holistic medical products for preventative health needs.

Financial strain and healthcare challenges are significantly intertwined with individuals’ emotional and physical well-being. Given the current global challenges and climate change effects leading to more health-related crises, understanding these interrelationships is paramount for disaster medicine and public health efforts, particularly for vulnerable populations.

Modern warfare has challenged the way in which far-forward medical assistance is provided in such settings. Since the existing approach and tools are insufficient for the changing landscape and humanitarian assistance, steps need to be taken to support an appropriate response. Of particular importance is the revision of a curriculum that fits the civilian medical system and facilitates its adaptation to the context and available resources.

Present the correlation between the asymmetry in warfare, the implementation of an integrated trauma system and its application in the management of civilian casualties.

Understand how lessons from the implementation of trauma care close to the frontlines contribute to generate a model for the provision of trauma care in asymmetric conflict.

The objective of this research is to assess how New York City Health + Hospitals emergency management professionals (EMPs) perceive climate change-related events, to a.) improve communication for increased receptivity and b.) identify gaps in perceived risks.

The study surveys EMPs from 13 geographically different healthcare facilities in NYC about their perceptions on climate change and its related emergency scenarios, preferred information sources on climate change, and the best modes of communication during climate-related extreme weather events.

The results of this study support a.) the importance of official hospital-system guidance regarding climate risks b.) the use of a diverse array of terminology, including messaging that refrains from the phrase ‘climate change’ and instead refers to the ‘future’ c.) the incorporation of clear actionable deliverables and d.) the inclusion of expert voices into messaging. Overall, recent events and upcoming seasonal hazards appear to affect perception of risk more than objective measures. Knowledge of city and temporal factors that impact perceived risk can be mobilized to harness engagement.

The results of this study inform best practices for climate communications to EMPs, critical in preparing our health systems for future climate disasters.

Despite the increasing risk of disasters and health crises worldwide, we are failing to equip the new generation of health care workers with basic education and training in disaster medicine and global public health. Unfortunately, the teaching of disaster medicine is underrepresented in several countries worldwide.

Understand the role of education and training as integral components of disaster preparedness.

Recognize the fundamentals of adult learning and competency-based education and training.

Discover the general principles of education and training in disaster medicine.

Explore the state of the art of simulation-based training in disaster medicine.

Artificial Intelligence (AI) covers a broad range of technologies that offer great potential and raise concerns, including ethical concerns. Some of these apply to any new technology. Potential benefits provide ethical justifications for AI, but what about potential risks and harms? How do we assess unknown harms, especially ‘dual use’ dilemmas where beneficial AI could be hijacked for harmful uses? Other ethical issues relate to the data used in AI. Machine learning offers the potential to process massive amounts of data that can be put to good use in disaster risk reduction, planning and guiding disaster responses. However, the quality of the output depends on the quality of the data input. What ethical responsibilities apply to monitoring data quality? How will privacy and confidentiality be protected for such data, especially if used for disasters in conflict or insecure settings? What if the data is influenced by inequities, or the output is used for stigmatization or discrimination? This presentation will examine these and other ethical issues with AI and disasters.

To identify ethical issues with AI and disasters.

To provide ethical analysis of concerns about AI and disasters.

To propose ethically responsible ways of using AI for disasters.

Caregivers are responsible for the in-home care of children with chronic medical conditions (CMCs) and may have care-related questions in order to support the child’s higher quality of life. We propose using a digital health platform, the personal health library (PHL), facilitating collection, organization, utilization, storage, and retrieval of health information, that will allow us to develop an mHealth smartphone app to facilitate patient/caregiver engagement and self-care management of children with CMCs.

Pilot Application of the PHL in the Pediatric Chronic Medical Conditions Population: We will design the PHL to collect and integrate data from health and non-health information, in various formats and modalities, including 1) Parent/caregiver-reported data; 2) Clinical data and; 3) Social determinants of health (SDoH) data; 4) Observations of Daily Living (ODL) data including the PedsQL Parent Questionnaire and the Functional Status Scale. The app will be customized to provide information regarding training in post-acute hospitalization care and deliver information on troubleshooting medical technology care, i.e. tracheostomy care.

We expect that the design of the PHL application will ultimately provide a layer of support for parents and caregivers of children with CMCs for whom home health is not available following hospitalization.