Disaster Medicine and Public Health Preparedness最新文献

Objective: To prevent power lines from igniting wildfires, utility companies in California are authorized to conduct Public Safety Power Shutoffs (PSPS), de-energizing, or shutting off power to equipment during periods of high wildfire risk. This study assessed the association between PSPS and emergency department visits.

Methods: The study quantified the extent to which counties in California experienced PSPS each day between September 15 and November 30, 2019. Linear mixed models were used to estimate the rate of emergency department encounters per 100,000 county residents based on quartiles of PSPS exposure, compared to no PSPS exposure at the county-day level. Analyses examined all emergency department encounters as well as age- and diagnosis-specific visits.

Results: There was an increase of 15 emergency department visits per 100,000 persons aged 65 years and older on days with the highest levels of PSPS exposure compared to days without PSPS. The highest level of PSPS exposure was associated with increased rates of emergency department visits for respiratory, cardiovascular, injury, and mental or behavioral diagnoses.

Conclusions: Despite advanced notification, PSPS events are associated with negative health consequences. Older adults are particularly vulnerable to the unintended adverse health effects of PSPS and should be prioritized in mitigation efforts.

Purpose: Assessing hospital preparedness for nuclear and radiological threats is one of the most effective methods for evaluating the condition of hospitals in relation to such incidents. This study aimed to review the tools used to assess hospital preparedness for nuclear and radiological threats and to analyze the strengths and weaknesses of these instruments.

Materials and methods: In this systematic review, the full texts of 98 studies identified through database searches and 7 studies identified through manual searches were reviewed. Data were extracted from studies that addressed the measurement tools for assessing hospital preparedness for nuclear and radiological threats from 2000 to 2024, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The content quality of the tools was evaluated based on the World Health Organization (WHO) preparedness criteria, and the psychometric properties of the tools were examined using the COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) study criteria.

Results: Among the studies reviewed, only 21 met the inclusion criteria, within which 9 tools for assessing hospital preparedness were identified. Eight tools directly assessed vulnerability in terms of physical space, related equipment, and hospital personnel, while one tool used a different criterion as an indicator of hospital preparedness for nuclear and radiological threats. The findings showed that most of the tools focused solely on evaluating a hospital's vulnerability in terms of physical space, equipment, and personnel, with insufficient attention given to other critical aspects such as protocols, triage, and other important issues.

Conclusion: Given the limitations of existing tools in terms of psychometric evaluation, the lack of theoretical models, the reliance on empirical findings for tool design, and considering the critical importance of measuring and assessing hospital preparedness for nuclear and radiological threats, there is a pressing need in the health sector for the development of scientific tools based on the experiences of process owners and hospital specialists. These tools should adhere to rigorous processes of instrument development and validation.

Introduction: Case study has been frequently conducted in disaster-related research, yet the trends and patterns of disaster-related case study are unclear. This large-scale analysis aimed at better understanding their thematic focus and reporting practices.

Methods: Based on systematic search strategy, publication metadata from 1901 to 2023 were obtained from Elsevier/Scopus and analyzed. Structural topic modeling was employed to identify the focus areas of the topics. The number of topics was determined based on content and diagnostic metrics such as held-out likelihood and semantic coherence. Hierarchical clustering was used to categorize the identified topics. The contents and reporting styles of the most-cited articles within each topic were further analyzed.

Results: This large-scale analysis included 18,782 publications, showing an increase in number. The number of topics was determined as 12. They grouped into 2 overarching categories: public health and social medicine; and earth science and environmental technology. There were variabilities in reporting.

Conclusions: This study highlighted a growing trend in the publication of disaster-related case studies across diverse thematic areas. As variabilities in reporting exist, there is a need for standardization in reporting to enhance transparency in disaster-related case study.

Background: Exercises are an essential component of preparedness and should be used to enhance capability and contribute to continuous improvement. An exercise can be as simple as a planning group discussing an emergency plan or as complex as a major multi-agency event involving several organizations and participants. This study aims to identify and conceptualize quality indicators (QIs) influencing prehospital disaster exercises across structure, conduct, and outcome.

Methods: This research was conducted through a systematic review and searching of the databases of PubMed, Scopus, Web of Science, and Google Scholar. Thematic content analysis was used for data analysis. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for systematic search, and the Critical Appraisal Skills Program (CASP) was used for quality assessment of the final extracted articles.

Results: From an initial set of 3,083 articles, 10 high-quality studies were included for analysis. The quality indicators influencing prehospital disaster exercises were analyzed into 3 themes, 8 categories, and 21 subcategories. The primary themes and related main categories included: Exercise structure QIs (knowledge promotion and cognitive skills, supply of exercise hardware and software requirements and resources desirable management), Exercise conduct QIs (practical proficiency in essential skills and decision-making capacity), and Exercise outcome QIs (evaluation and reporting of exercise, promotion of managerial capabilities and competencies, and development of psychological capabilities).

Conclusion: The findings of this research present a knowledge framework that can help exercise planners in prehospital settings in designing scientifically sound and standardized exercises aimed at enhancing disaster response processes. Furthermore, the implementation and evaluation of both discussion-based and operation-based disaster exercises informed by these identified quality indicators can foster the development of knowledge and promote behavioral change among prehospital staff, and facilitate a standardized response to emergencies and disasters.

Objectives: The aim of this research is to explore the experience of allocating scarce health resources in humanitarian response settings, specifically in relation to decision-making.

Methods: This research utilized an exploratory qualitative design. Participants were identified as clinicians with relevant first-hand experiences with scarce health resource allocation in humanitarian response settings. Participants were purposively recruited to include the broadest perspectives possible. Semi-structured interviews were hosted remotely. Transcripts capturing participant narratives were analyzed using inductive thematic analysis to allow themes to emerge.

Results: Seventeen participants were recruited and interviewed as part of the Scarce Health Resource Allocation in Humanitarian Response Settings (SHARE-HRS) project. Inductive thematic analysis related to decision making revealed 5 key themes: devices; priorities; ideals; context-specific decision making; and weight of decision making. These themes informed the development of the SHARE-HRS Decision Making Model.

Conclusions: While health resource allocation decision-making is not unique to humanitarian settings, there are unique situational challenges faced by humanitarian health care workers. The SHARE-HRS Decision Making Model provides a new insight into how these challenges may be addressed or impact decision-making, and thus offers a structure and common nomenclature for future humanitarian health response operations and research.

Objective: The growing frequency of global disasters highlighted the need to integrate technology into disaster management. This systematic review describes the global landscape of mobile phone technologies for natural hazard-induced disaster prevention, preparedness, response, and recovery.

Method: A systematic review was conducted by searching databases, including Embase and MEDLINE, for studies published in English between 2000 and March 2024 that examined mobile applications for disaster management.

Result: The review included 26 studies covering 77 mobile apps across 14 countries. Most apps were privately owned (78.26%), supported multiple disaster phases (41.56%), and favored the Android platform (46.67%), with GPS being the most common technology (15.58%). Apps primarily targeted the general public (63.64%) and focused on earthquakes (32.47%) and hurricanes (31.17%). Despite their potential, adoption remains low; only 11.33% (6 apps) exceeded 1 million downloads, while 33.96% failed to surpass 1,000 downloads.

Conclusion: This review highlights significant gaps in the development, adoption, and impact of disaster management apps, especially in high-risk regions. Future efforts must focus on enhancing accessibility, addressing user needs, expanding features, and fostering stakeholder collaboration to improve the effectiveness of mobile technologies in disaster preparedness, response, and recovery.

Objective: Health care workers (HCWs) are vital in disaster response. This study explores HCWs' experiences delivering care in the earthquake-affected zone in Türkiye.

Methods: A qualitative study with a phenomenological design was conducted. Eighteen HCWs, including physicians, nurses, and National Medical Rescue Team (UMKE) members, were selected through maximum variation sampling. Data were collected through semi-structured interviews and analyzed thematically using Braun and Clarke's 6-phase approach, following COREQ guidelines.

Results: Three periods (pre-arrival, in the earthquake zone, and post-departure) and 8 themes were identified. In the pre-arrival phase, emotional symptoms and general organization were the main themes. In the earthquake zone, physical symptoms, basic needs, health care organization, health care delivery, and other services were prominent. The post-departure phase focused on emotional symptoms and return to routine work. Overall, emotional difficulties persisted throughout all phases, while organizational problems were concentrated in the pre-arrival and in the earthquake zone periods.

Conclusion: HCWs experienced emotional challenges across all periods and organizational problems in the pre-arrival and in the earthquake zone period. Clear information before arrival, structured orientation upon arrival, balanced staff distribution, and continuous psychological support throughout all phases are essential to protect HCWs' well-being and sustain health care delivery during disasters.

Objective: A standardized framework for evaluating Emergency Medical Teams (EMT) deployments is currently lacking. This study aimed to identify evaluation practices and elucidate stakeholder perspectives on evaluating EMT deployments.

Methods: Qualitative interviews were conducted with seventeen participants from all World Health Organization regions, including EMT members, researchers, funders, EMT deploying organizations, and host governments. Thematic analysis using Braun and Clarke's 6-step process was applied to generate data-driven codes and themes.

Results: Participants generally agreed on the importance of evaluating EMT deployments and sharing lessons learned to establish best practices. Participants recommended that evaluations be carried out externally for objectivity, incorporating both qualitative and quantitative data. They highlighted that voices of local stakeholders are essential but often overlooked. Participants identified evaluation areas which could be used to develop a comprehensive evaluation framework, which included leadership, partner coordination, information management and planning, health operations and technical expertise, operations support and logistics, and finance and administration.

Conclusions: Stakeholders generally recognized the value of establishing a standardized evaluation framework for EMT deployments to enable sharing of best practices and learning for improvement. Further research should prioritize identifying evaluation priorities, with next steps being piloting in both training and deployment settings.

Cyclone Alfred disrupted dialysis services across South-East Queensland. Digital tools, including real-time surveys and AI-assisted analysis, were used to evaluate impact and guide immediate improvements. This low-cost, tech-enabled response demonstrated how agile methods can support disaster resilience and inform planning for vulnerable patient groups during extreme weather events.