Disaster Medicine and Public Health Preparedness最新文献

Monkeypox virus (MPXV) is a contagious disease that has been endemic in central and west Africa since 1970, characterized by symptoms such as fever, headache, and skin rash. While there is no approved treatment for MPXV infections, vaccination has proven effective in limiting its transmission, and previous smallpox vaccinations may also provide protection against monkeypox. However, the dependence of monkeypox on animal hosts makes eradication more complicated than with smallpox. Research should focus on assessing the safety of the vaccines, their duration of immunity, and their efficacy against the prevalent strains of monkeypox. The virus's accelerated rate of mutation poses additional challenges, as does the fact that it can be transmitted through animals, making eradication more complex than with smallpox. A comprehensive global immunization strategy is needed to address these complexities and draw on lessons learned from past eradication efforts.

A hazard vulnerabilities analysis (HVA) is an exercise used by institutions to identify potential threats and is required for credentialing hospitals in the US. To date, there is no documentation of HVA completion in low/middle income countries (LMIC) in the literature. American physicians working together with local physicians and staff from a major referral hospital in Addis Ababa, Ethiopia conducted an HVA in the LMIC setting. Using the Kaiser HVA template, the tool and exercise were tailored to the needs and resources of the LMIC setting. The exercise prompted rich discussion and facilitated the development of a framework to address local hospital threats. Many threats were considered sub-acute or chronic problems that had potential to acutely worsen, putting hospital operations and patient care in jeopardy and impacting staff. Ongoing threats were addressed creatively by the hospital administration, caregivers, and staff, a testament to the resiliency of the system and those working in it. Nonetheless, the hospital benefited from the HVA framework to improve future preparedness. Conducting an HVA in the LMIC setting is feasible, and this example can serve as a basis for HVA completion by other hospitals in similar settings.

Objective: Earthquakes deeply affect people's lives and cause significant psychological damage. This study was conducted to determine the trauma level of midwifery students after the devastating earthquake in Turkey.

Methods: A descriptive cross-sectional study was conducted with 252 students enrolled in the midwifery department of the Faculty of Health Sciences of a state university in Turkey. Data were collected using the participant information form and the Scale for Determining the Level of Post-Earthquake Trauma. Kruskal-Wallis and Mann-Whitney U tests were used for data analysis.

Results: This study found that post-earthquake, students had trauma levels and sub-dimension scores related to behavioral problems, excitement limitation, affective and cognitive structuring, and sleep problems that were above average. The research revealed that students who were present in one of the earthquake-affected provinces, experienced house destruction, suffered the loss of relatives, had previous traumatic events, or received disaster management training had significantly higher levels of trauma.

Conclusions: In this direction, it is of utmost importance for university students in midwifery departments to be prepared for natural disasters like earthquakes. This preparedness will enable them to effectively cope with the physical and psychological issues caused by such disasters, benefiting both their own health and public health.

Objectives: The aim of this descriptive study was to assess diabetes self-management and health care demand procrastination behaviors among earthquake victims with type 2 diabetes.

Methods: The population of the study consisted of earthquake victims with Type 2 diabetes in Hatay, Türkiye. The sample included 202 people with type 2 diabetes who lived in 7 distinct container cities. Data were collected using the Introductory Information Form, Diabetes Self-Management Scale, and Healthcare Demand Procrastination Scale via face-to-face interviews.

Results: Participants' average score on the diabetes self-management scale was 58.34 ± 9.11. Being under the age of 60, employed, visiting a medical center on their own, having received diabetes education, and owning a glucometer were associated with better diabetes self-management, whereas being illiterate and having difficulty covering diabetes-related expenses were associated with poor diabetes management (P < 0.05). Participants' average score on the Healthcare Demand Procrastination Scale was 2.35 ± 0.72. Respondents who didn't have a nearby health care institution, whose diabetes diagnosis duration was between 1-5 years, and who didn't have a glucometer had significantly higher scores on the Healthcare Demand Procrastination Scale (P < 0.05).

Conclusions: Diabetes self-management among earthquake victims with Type 2 diabetes was low. It was also determined that participants' health care demand procrastination behaviors were at a moderate level.

Objectives: Simulation materials for layperson first responder (LFR) trainings used in high-resource settings are prohibitively expensive for use in low- and low-middle income countries. To date, no structured approach to community-engaged design in identifying accessible and acceptable simulation materials for LFR trainings has been developed.

Methods: We conducted 2 workshops with male (18) and female participants (10) in a rural village in the Centre-Est region of Burkina Faso using principles of community-engaged research to define solutions for improvised LFR training materials.

Results: Participants reported a range of reactions to the use of live trainees and animal models for LFR training including considerations around gender sensitivity, use of animals for training purposes in regions of food insecurity, and religious and cultural barriers to consumption of meat after use for training purposes. A range of locally available options for training materials was identified by participants.

Conclusions: Significant sociocultural variability exists across low-resource environments with implications for the acceptability and availability of improvised materials for LFR training. Affected communities should be engaged in the selection and design of improvisation strategies to ensure context-appropriate adaptation.

Objective: Mass casualty incidents (MCI) overwhelm health care systems; however, MCIs are infrequent and require ongoing preparatory efforts. Although there is dedicated disaster medicine education in emergency medicine, most pediatric emergency medicine (PEM) fellows complete pediatric residencies. Pediatric residents have variable exposure to disaster training as part of their curriculum. To improve this, a quality improvement (QI) initiative was implemented to increase MCI comfort and knowledge amongst PEM fellows.

Methods: This study took place in a single-center tertiary pediatric hospital, amongst 1 cohort of PEM fellows. Following a baseline survey, a key driver diagram was developed to guide Plan-Do-Study-Act (PDSA) cycles. A focused disaster curriculum was provided to fellows and specific quick references were developed. Knowledge application interventions included mock triage, response scavenger hunt, and tabletop MCI exercise.

Results: PEM fellow comfort and knowledge of MCI response improved from an average of 2.93 to 6.56 on a 10-point Likert scale, and 3.71 to 6.58 on 10-point Likert scale respectively following the active intervention cycle and showed sustained results over a 6-month period without further interventions.

Conclusions: Utilizing QI methodology, PEM fellow comfort with MCI response, and knowledge of MCI response increased. As MCIs are a rare occurrence, ongoing assessment is necessary to evaluate the need for further interventions to maintain knowledge and comfort levels.

Objective: This study aimed to examine health care workers' (HCWs) perceptions of hospital disaster planning and preparedness within the context of building resilient health care systems. It also evaluated HCWs' involvement in the planning process.

Methods: Thirteen HCWs from 2 Queensland hospitals participated in in-depth, semi-structured interviews. These interviews were audio-recorded with participant consent and transcribed verbatim. Transcripts, recordings, and participant details were coded for confidentiality. Thematic analysis was used to identify essential patterns in the data and make sense of them.

Results: HCWs' perspectives on disaster planning underscored the importance of comprehensive planning, business continuity, proactive approaches emphasizing anticipation and risk mitigation, and implementation of established plans through training, resource management, and operational readiness. HCWs' participation in planning ranged from high engagement through collaboration and continuous improvement to moderate or lower levels focusing on regulatory compliance and resource allocation.

Conclusions: This study highlights HCWs' views regarding disaster planning and preparedness for building resilient health care systems. HCWs emphasised comprehensive planning and proactive preparedness, aligning with global priorities for disaster risk reduction. They stress the importance of education, training, operational readiness, and continuous improvement. This study underlines the vital role of HCWs' participation in disaster planning and the need for comprehensive training initiatives.

The COVID-19 pandemic showed the vital role of Emergency Medical Teams (EMTs) in international surge responses. The EMTs with their internationally skilled team members were able to meaningfully support countries facing the pandemic, especially those who were suffering from scarcity in the quality and quantity of workforce and financial resources within their health systems. This report summarizes the main operational challenges faced by UK-Med and The Polish Center for International Aid (PCPM) Emergency Medical Teams, based on experiences from their 32 COVID-19 deployments. In particular, the paper discusses the hindrances related to Ministries of Health expectations and the changing roles of EMTs during deployments.

Aims: The World Health Organization (WHO) Health Emergency Programme funded three systematic reviews to inform development of guidance for emergency preparedness in health emergencies. The current review investigated the type of learning interventions that have been developed and used during health emergencies, and how they were developed.

Methods: We searched PubMed, CINAHL, Communication and Mass Media Complete (EBSCO), and Web of Science. Study quality was appraised by WHO-recommended method-specific checklists. Findings were extracted using a narrative summary approach.

Results: 187 studies were included. Studies were split between online, in-person, and hybrid modalities, conducted mostly by hospitals and universities, and most frequently training nurses and doctors. Studies emphasized experiential learning to develop and reinforce skills; online learning for knowledge dissemination; multi-sectoral partnerships, institutional support and carefully constructed planning task forces, rapid training development and dissemination, and use of training models.

Conclusion: It Most studies evaluated only knowledge or self-confidence of trainees. Relatively few assessed skills; evaluations of long-term outcomes were rare. Little evidence is available about comparative effectiveness of different approaches, or optimum frequency and length of training programming. Based on principles induced, six recommendations for future JIT training are presented.

The devastating effects of heatwaves and the deficiencies in current response strategies disproportionately affect specific individuals and populations,^1,2 underscoring the urgent need for effective solutions. Lessons from past heat events emphasise the importance of preparedness and effective response strategies.² Understanding the dangers of heatwaves involves recognizing not only individual health impacts but also broader environmental and societal consequences.³ Heat-related illnesses, such as heat exhaustion and heatstroke, can be fatal but are preventable.².