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This study aimed to examine the effect of volunteers’ health behaviors and disaster preparedness on disaster attitudes.
Methods
The sample comprised 378 volunteers aged 18 to 30 who were affiliated with the largest volunteer network in a non-governmental organization in Turkey. In the study, data were collected with Descriptive Information Form, the Disaster Preparedness Scale, and the Disaster Attitude Scale.
Results
The mean total score of the participants in the Disaster Attitude Scale was 3.06 ± 0.73 (1-5). The mean total scale score of the participants in the Disaster Preparedness Scale was 33.21 ± 8.02 (13-54). Notably, factors such as using alcohol, the status of general health checkups status, and scores on the physical protection and assistance subscales the Disaster Preparedness Scale were significantly associated with the Disaster Attitude Scale total score (P < 0.05).
Conclusions
In this study, regular general health check-ups, alcohol use in general, and physical protection and assistance sub-scales are critical determinants of volunteers’ attitudes toward disasters. The disaster volunteers, health professionals particularly nurses, should develop training programs to enhance volunteers’ disaster attitudes focusing on promoting disaster preparedness and positive health behaviors in both governmental and non-governmental organizations.
A useful way to prepare the public for disasters is to teach them where to get information. The purpose of this study is to evaluate the readability and appropriateness of the content of websites prepared for the public on disaster preparedness.
Methods
In September-October 2022, we evaluated 95 disaster preparedness websites (intended for the public) using the Ateşman Readability Index, JAMA criteria, DISCERN, and a new researcher-created content comparison form. Evaluation scores were compared according to information sources.
Results
Of the websites included in the research, 45.2% represented government institutions (GIG), 38.0% non-profit organizations (NPOG), 8.4% municipal organizations (MOG), and 8.4% other organizations (OG). Those which scored above average on the websites were 36.8% on the content evaluation, 51.6% on the DISCERN scale, 53.7% on the Ateşman Readability Index, and 55.8% on the JAMA criteria. The content evaluation form showed that the scores of the websites belonging to the MOG were higher than the scores of the other websites. Others group websites also scored higher than altered websites on the JAMA criteria.
Conclusions
The study revealed that websites created to increase public knowledge on disaster preparedness are not good enough in terms of readability, quality, and content.
The aim of this study was to develop the Nurse Competency Assessment Scale in Disaster Management (NCASDM) and to conduct psychometric evaluation.
Methods
It is a scale development study. Research data were collected between January and May 2023. In the sample of the study, as stated in the literature, it was aimed to reach at least 10 times the number of draft scale items (n = 600). The psychometric properties of the scale were tested with 697 nurses working in four different hospitals. A three-stage structure was used in the analysis of data: (1) creating the item pool, (2) preliminary evaluation of items, (3) refining of the scale and evaluation of psychometric properties. The content validity, construct validity, internal consistency, and temporal stability of the scale were evaluated according to the scale development guidelines.
Results
The scale items were obtained from online, semi-structured, in-depth individual interviews conducted with nurses who experienced disasters or worked in disasters. The content validity index of the scale was found to be 0.95. According to the exploratory factor analysis, it was found that the scale consisted of 43 items and two subscales, and the subscales explained 79.094% of the total variance. The compliance indices obtained as a result of confirmatory factor analysis were acceptable and at good levels.
Conclusions
The NCASDM was found to be a psychometrically valid and reliable measurement tool. It can be used to evaluate the competency of nurses related to disaster management.
This study was conducted to determine the relationships between nurses’ competency, motivation, and stress levels in disaster management, as well as to shed light on the establishment of effective disaster management programs.
Methods
In our research we used a correlational, descriptive, cross-sectional design. The sample of the study was composed of 498 nurses working in Turkey. The “Descriptive and Professional Characteristics and Disaster Experiences of Nurses” form, the “Competencies for Disaster Nursing Management Questionnaire,” the “Perceived Stress Scale,” and the “Nurses Job Motivation Scale” were used in data collection.
Results
Nurses’ disaster management competency and motivation levels were found to be adequate, and their stress levels were found to be moderate. A weak positive correlation was found between disaster management competency and motivation, but a weak negative correlation was found between stress levels. Age, education level, experience level, training in disaster nursing, and knowledge of duties and responsibilities in disasters were associated with significant differences in terms of disaster competency and its dimensions, motivation, and stress levels.
Conclusions
The study found that nurses’ disaster experiences impacted their competency, feeling of preparedness, and stress and motivation levels, and motivation was found to be a predictor of increasing competency.
Chemical, biological, radiological, and nuclear (CBRN) incidents require meticulous preparedness, particularly in the Middle East and North Africa (MENA) region. This study evaluated CBRN response operational flowcharts, tabletop training scenarios methods, and a health sector preparedness assessment tool specific to the MENA region.
Methods
An online Delphi survey engaging international disaster medicine experts was conducted. Content validity indices (CVIs) were used to validate the items. Consensus metrics, including interquartile ranges (IQRs) and Kendall’s W coefficient, were utilized to assess the panelists’ agreement levels. Advanced artificial intelligence computing methods, including sentiment analysis and machine-learning methods (t-distributed stochastic neighbor embedding [t-SNE] and k-means), were used to cluster the consensus data.
Results
Forty experts participated in this study. The item-level CVIs for the CBRN response flowcharts, preparedness assessment tool, and tabletop scenarios were 0.96, 0.85, and 0.84, respectively, indicating strong content validity. Consensus analysis demonstrated an IQR of 0 for most items and a strong Kendall’s W coefficient, indicating a high level of agreement among the panelists. The t-SNE and k-means identified four clusters with greater European response engagement.
Conclusions
This study validated essential CBRN preparedness and response tools using broad expert consensus, demonstrating their applicability across different geographic areas.
This study evaluates the Emergency Medical Service system and overall emergency preparedness by analyzing ambulance-transported patients during the February 6, 2023 earthquakes, focusing on those without earthquake-related injuries (medical emergencies and traumas not caused by earthquakes).
Methods
A retrospective, observational case series was conducted, involving patients aged 18 and above transported by ambulance between February 6 and March 6, 2023. Patient demographic characteristics, vital signs, diagnoses, treatments, and outcomes were recorded. Predisposing factors for ambulance transportation including post-earthquake health facility issues, housing problems, hygiene, heating, and smoke exposure were meticulously analyzed.
Results
The study included 1872 patients, with a 55.4% hospitalization rate and a 13.7% mortality rate. Cardiovascular emergencies were the primary reason for admission (28.9%). Patients from the hospital in the study’s location form Group 1, whereas those from other earthquake-affected provinces constitute Group 2. Significant predisposing factors for ambulance transportation included post-earthquake health facilities (P < 0.001), housing problems (P < 0.001), hygiene (P < 0.001), heating (P = 0.001), and smoke exposure (P < 0.001). In Group 2, pneumonia (P = 0.001), soft tissue infection (P = 0.002), sepsis (P = 0.004), carbon monoxide poisoning (P < 0.001), and diabetic emergencies (P = 0.013) were statistically significantly more frequent.
Conclusions
Analyzing post-earthquake ambulance-transported patients is vital to comprehend the demand for emergency health care and address post-disaster health care challenges.
It is of critical importance to determine the factors that contribute to nurses’ disaster preparedness. This study aimed to examine nurses’ perceptions of disaster preparedness and the factors affecting it.
Methods:
This descriptive study was conducted with 464 nurses working in the East Marmara region of Türkiye. The data were collected online using the “Personal Information Form,” “The Scale of Perception of Disaster Preparedness on Nurses,” and the “Adult Motivation Scale.” Linear regression analysis was used to analyze the influencing factors.
Results:
It was found that nurses possessed a high level of perceived disaster preparedness, influenced by individual disaster preparedness, status of receiving disaster-related training, willingness to respond in the case of a disaster, disaster plan awareness, experience with caring for disaster victims, extrinsic motivation, and general motivation.
Conclusions:
The results of the study offer evidence that can be implemented by managers and educators to better prepare nurses for disasters. Hospital administrators and policy makers should consider the factors affecting nurses’ perception of disaster preparedness to develop solutions for such disasters.
The catastrophic earthquakes that struck Southern Turkey in 2023 highlighted the pressing need for effective disaster management strategies. The unprecedented scale of the crisis tested the robustness of traditional healthcare responses and highlighted the potential of e-health solutions. Despite the deployment of Emergency Medical Teams, initial responders - primarily survivors of the earthquakes - faced an enormous challenge due to their lack of training in mass-casualty situations. An e-health platform was introduced to support these first responders, offering tools for drug calculations, case management guidelines, and a deep learning model for pediatric X-ray analysis. This commentary presents an analysis of the platform’s use and contributes to the growing discourse on integrating digital health technologies in disaster response and management.
Edited by
Richard Williams, University of South Wales,Verity Kemp, Independent Health Emergency Planning Consultant,Keith Porter, University of Birmingham,Tim Healing, Worshipful Society of Apothecaries of London,John Drury, University of Sussex
Children are considered particularly vulnerable to disasters, but they are also resilient and respond to social support, which is central to disaster mental health services. This chapter reviews the current approach to services for children, presents a framework for response, addresses assessment, examines intervention approaches and the evidence base for intervention, and offers recommendations for future work. Population risk and context are important in guiding the mental health services that children require after disasters. The COVID-19 pandemic presented challenges that were not anticipated in the existing literature, suggesting that the type of event and event characteristics may be more salient than was previously realised. The predominant focus on post-traumatic stress outcomes in the extant literature has been criticised. Disaster preparedness and educational programmes have demonstrated benefit in fostering children’s participation in disaster management, and an emerging evidence base suggests benefit from a variety of intervention approaches.
To identify the predicting factors that contribute to preparedness for public health emergencies among community pharmacists in India.
Methods:
Multistage cluster sampling was done. The geographic breakdown was done based on villages and areas and used as clusters. A simple random method was done in the first stage to select the villages as clusters. From each selected village, a simple random method was done in the second stage to select the areas. From each selected area, all the community pharmacies were selected. The survey questionnaire had 3 sections with 43 items: (A) demographic information, (B) preparedness, (C) response toward infectious diseases. The participants chose “Yes/No”, in sections B and C. A score of 1 was given for “Yes”, and a score of zero was given for “No”.
Results:
Multiple correlation analyses were conducted between participants’ preparedness and response (PR) scores and independent variables. The independent variables such as “More than one Pharmacist working in a pharmacy”, “Pharmacists who are trained more than once on disaster management”, and encountered more than 1 patient with the infectious disease were positively and significantly correlated with the dependent variable (PR scores).
Conclusions:
Community pharmacists were aware of the issues they may face in their community concerning public health emergencies. They believed that the medications available in their pharmacy are sufficient to face any emergency. They could identify the clinical manifestations of public health emergency conditions and provide counselling to the customers toward them. Community pharmacists who were trained more than once in disaster management were the strongest predicting factor.
Identifying early predictors of dialysis requirements in earthquake-related injuries is crucial for optimal resource allocation and timely intervention. This study aimed to develop a predictive scoring system, named SAFE-QUAKE (Seismic Assessment of Kidney Function to Rule Out Dialysis Requirement), to identify patients at high risk of developing acute kidney injury (AKI) and requiring dialysis.
Methods:
A retrospective analysis was conducted on a cohort of 205 patients presenting with earthquake-related injuries. Patients were divided into two groups based on their need for dialysis: the no dialysis group (n = 170) and the dialysis group (n = 35). Demographic, clinical, and laboratory data were collected and compared between the two groups to identify significant predictors of dialysis requirements. The parameters that would form the score were determined by conducting an importance analysis using artificial neural networks (ANNs) to identify parameters that exhibited statistically significant differences in univariate analysis.
Results:
The dialysis group had a significantly longer median duration of being trapped under debris (48 hours) compared to the no dialysis group (eight hours). Blood gas and laboratory analyses revealed significant differences in pH levels, lactate values, creatinine levels, lactate dehydrogenase (LDH) levels, and aspartate transaminase (AST)-to-alanine transaminase (ALT) ratio between the two groups. Based on these findings, the SAFE-QUAKE rule-out scoring system was developed, incorporating entrapment duration (<45 hours), pH levels (>7.31), creatinine levels (<2mg/dL), LDH levels (<1600mg/dL), and the AST-to-ALT ratio (<2.4) as key predictors of dialysis requirements. This score included 139 patients, and among them, only one patient required dialysis, resulting in a negative predictive value of 99.29%.
Conclusions:
The SAFE-QUAKE scoring system demonstrated a high negative predictive value of 99.29% in ruling out the need for dialysis among earthquake-related injury cases. This scoring system offers a practical approach for health care providers to identify patients at high risk of developing AKI and requiring dialysis in earthquake-affected regions.
Little is known about individual European countries or regional capacity to respond to animal welfare emergencies during natural disasters; therefore, it is important to establish baseline information (eg, types of disasters, training) to enable more focused and data-driven actionable support for future disasters.
Methods:
A 55-question survey was distributed by an email link to the 53 World Organisation for Animal Health (WOAH) European Region Members plus 1 observer country.
Results:
Forty-nine countries (91%, n = 54) responded to the survey. Fifty-one percent (25/49) indicated they incorporated animal welfare into their national disaster regulatory framework, whereas 59% (29/49) indicated animal welfare was incorporated in the Veterinary Service National Disaster Management and Risk Reduction Plan. Thirty-nine percent (19/49) indicated they had “no” or “limited” legal authority to manage animal emergencies in natural disasters. Floods, forest fires, and snowstorm/extreme cold were the 3 most commonly reported disasters over the last 10 years with 79% (27/34) reporting Veterinary Services was involved in managing these disasters.
Conclusion:
The survey results indicated a wide range in the capacity of WOAH European Member Countries to respond to animal welfare in natural disasters, highlighting the gaps and potential areas of improvement in this arena.
In 2019, the World Health Organization (WHO) published the Health Emergency and Disaster Risk Management (H-EDRM) framework detailing how effective management of disasters, including mass-casualty incidents (MCIs), can be achieved through a whole-of-health system approach where each level of the health care system is involved in all phases of the disaster cycle. In light of this, a primary health care (PHC) approach can contribute to reducing negative health outcomes of disasters, since it encompasses the critical roles that primary care services can play during crises. Hospitals can divert non-severe MCI victims to primary care services by applying reverse triage (RT), thereby preventing hospital overloading and ensuring continuity of care for those who do not require hospital services during the incident.
Study Objective:
This study explores the topic by reviewing the literature published on early discharge of MCI victims through RT criteria and existing referral pathways to primary care services.
Methods:
A scoping literature review was performed and a total of ten studies were analyzed.
Results:
The results showed that integrating primary care facilities into disaster management (DM) through the use of RT may be an effective strategy to create surge during MCIs, provided that clear referral protocols exist between hospitals and primary care services to ensure continuity of care. Furthermore, adequate training should be provided to primary care professionals to be prepared and be able to provide quality care to MCI victims.
Conclusion:
The results of this current review can serve as groundwork upon which to design further research studies or to help devise strategies and policies for the integration of PHC in MCI management.
This study explores the opinions of academic and practicing pharmacists about ways to prepare pharmacy students for disaster management to enable them to optimize their role in disaster health management.
Methods:
Semi-structured individual interviews were conducted for data collection from April through June 2021. The research participants were 9 pharmacists who were involved in disaster management. The interview guide was developed following a comprehensive literature review on disaster management. Data were analyzed using thematic analysis.
Results:
The main themes identified are knowledge of health and disaster management, specific skills in disaster management, positive attitudes toward involvement in disaster management, and appropriate behavior in the face of a disaster, as well as personal readiness and training to achieve competence and readiness. Participants mentioned that special training in soft skills, especially communication and problem-solving, is essential for students.
Conclusion:
Disaster-specific competencies and personal readiness through training can prepare pharmacy students for disaster management. Soft skills such as communication and problem-solving must be the highest priority.
Human civilisation faces a series of existential threats from the combination of five global and human-engineered challenges, namely climate change, resource depletion, environmental degradation, overpopulation and rising social inequality. These challenges are arguably being manifested in both an increased likelihood and magnified impact of catastrophes like forest fires, prolonged droughts, pandemics and social dislocation/upheaval. This article argues that in understanding and addressing these challenges, important lessons can be drawn from what has repeatedly caused organisational failures. It applies the ‘Ten Pathways to Disaster’ model to a series of disasters/catastrophic events and then argues this model is salient to understanding inadequate responses to the five threats to civilisation. The article argues that because these challenges interact in mutually reinforcing ways, it is critical to address them simultaneously not in isolation.
Disaster governance is an emergent construct in disaster research. It refers to new sets of structural arrangements and processes involving coordinated decisionmaking and action involving multiple actors from government, private sector, and civil society. Disaster governance focuses on managing hazards by reducing exposure, vulnerabilities, and adverse consequences of disasters through improvements in local response capacities, resilience, and various types of assistance to affected communities post-event. The set of structural arrangements engages state actors, private sector actors such as businesses and multi-national corporations, social actors (non-governmental organizations, community-based organizations), and policy actors (advocacy groups, political actors) into an integrated network from local to global scales. The context within which disaster governance arrangements function is influenced by demographic changes, spatial and administrative scales (from local to national), and the phases of emergency management, that are in turn shaped by historical, economic, social, and political processes within and between places. Such contextual understanding explains why disaster governance often is reactive, fragmented, rarely risk-based, and lacks comprehensiveness. This chapter reviews the contextual changes and challenges affecting disaster governance in the United States from the perspective of disaster resilience and long-term recovery. It begins with a short discussion on the changing nature of disaster risk, followed by a section on the current realities of emergency management, the causes and consequences of the decline in federal capabilities, and ends with the challenges for disaster governance in 2021 and beyond.
The coronavirus disease 2019 (COVID-19) pandemic has seen health systems adapt and change in response to local and international experiences. This study describes the experiences and learnings by the Central Adelaide Local Health Network (CALHN) in managing a campaign style, novel public health disaster response.
Methods:
Disaster preparedness has focused on acute impact, mass casualty incidents. In early 2020, CALHNs largest hospital the Royal Adelaide Hospital (RAH) was appointed as the state primary COVID-19 adult receiving hospital. Between the period of February 1, 2020, when the first COVID-19 positive patient was admitted, through to December 31, 2020, the RAH had admitted 146 inpatients with COVID-19, 118 admitted to our hospital in the home service, 18 patients admitted to Intensive Care, and 4 patients died while inpatients. During this time CALHN has sustained an active (physical and virtual) Network Incident Command Centre (NICC) supported by a Network Incident Management Team (NIMT).
Results:
This study describes our key lessons learnt in relation to the management of a campaign style disaster response including the importance of disaster preparedness, fatigue management, and communication. Also described, were the challenges of operating in a command model and the role of exercising and education and an overview of our operating rhythm, how we built capability, and lessons management.
Conclusions:
Undertaking a longer duration disaster response, relating to the COVID-19 pandemic has shown that, although traditional disaster principles still are important, there are many nuances that need to be considered to retain a proportionate response. Our key lessons have revolved around the key tenants of disaster management, communication, capability, and governance.
The transfer rate for patients from an Alternate Care Site (ACS) back to a hospital may serve as a metric of appropriate patient selection and the ability of an ACS to treat moderate to severely ill patients accepted from overwhelmed health-care systems. During the coronavirus infectious disease 2019 (COVID-19) pandemic, hospitals worldwide experienced acute surges of patients presenting with acute respiratory failure.
Methods:
An ACS in Imperial County, California was re-established in November 2020 to help decompress 2 local hospitals experiencing surges of COVID-19 cases. The patients treated often had multiple comorbid illnesses and required a median supplemental oxygen of 3 L/min (LPM) on admission. Numerous interventions were initiated during a 2-wk period to improve clinical care delivery.
Results:
The objectives of this retrospective observational study are to evaluate the impact of these clinical and staff interventions at an ACS on the transfer rate and to provide issues to consider for future ACS sites managing COVID-19 patients.
Conclusions:
The data suggest that continuous, real-time process-improvement interventions helped reduce the transfer rate back to hospitals from 36.7% to 14.5% and that an ACS is a viable option for managing symptomatic COVID-19 positive patients requiring hospital-level care when hospitals are overburdened.
Floods are one of Iran’s most important natural hazards, which cause a lot of damage every year. Various organizations, including non-governmental organizations (NGOs), participate in flood management. The present study aimed to explore the challenges and barriers of NGOs’ participation in the management of the flooding in Iran based on stakeholders’ experiences.
Methods:
This qualitative study is a case study that was conducted using the content analysis approach. Fifteen participants, including 3 national managers, 2 volunteers active in responding to recent floods, and 10 NGO managers/secretaries who had the knowledge or operational experience of participating in disaster management, were approached for interviews. Data were collected using a purposeful sampling method and continued until reaching data saturation.
Results:
Challenges and barriers to NGOs’ participation in flood management were categorized into 4 main categories and 14 subcategories, including policy-making challenges, managerial challenges, executive challenges, and socio-cultural challenges.
Conclusions:
As multiple NGOs take part in responding to disasters and performing relief operations, establishing a unified command and supervision system for effective coordination and collaborations among NGOs and other stakeholders is highly suggested. Further research is needed to develop a measurement tool for assessing the effectiveness of NGOs’ activities during disasters.