Disaster Medicine and Public Health Preparedness最新文献

Objective: Due to frailty, chronic health issues, limited mobility, dependence on assistive devices, and polypharmacy, the geriatric population is more susceptible to the adverse effects of earthquakes. The aim of this study was to determine the factors affecting the quality of life of older adults who experienced the Kahramanmaraş-centered earthquakes in Türkiye on February 6, 2023.

Methods: This cross-sectional interview-based study was conducted with 340 older adults who experienced the earthquakes on February 6, 2023, and visited outpatient departments in Gaziantep. Data were gathered using a demographic form, Modified Fried Frailty Index, and WHO Quality of Life Instrument for Older Adults.

Results: Participants' average age was 71.37 ± 6.56 years, and 56.6% were women. Among them, 20.9% lost a first-degree relative, 15.3% were injured, and 45.3% were displaced. WHOQOL-OLD scores differed significantly by age, marital status, education, chronic illness, polypharmacy, living arrangements, and frailty.

Conclusions: This study highlights the factors influencing the quality of life of older adults in Türkiye after an earthquake. Living with a spouse and having primary or secondary education improved quality of life, while chronic illnesses and displacement had negative impacts. These findings emphasize the importance of considering the specific needs of older adults in disaster preparedness and response.

Objectives: This study aimed to evaluate the impact of temporary housing challenges (THC) after the February 6, 2023, Türkiye earthquake on clinical follow-up non-adherence (CFNA), low-density lipoprotein cholesterol (LDL-C) target achievement, and major adverse cardiac events (MACE) in patients with myocardial infarction (MI).

Methods: A retrospective cohort of 283 MI patients undergoing coronary angiography and stenting between May 6 and November 6, 2023, was analyzed. Patients were divided into Group 1 (THC group: residing in container cities) and Group 2 (non-THC group: living in intact/usable homes). Initial laboratory parameters and 1-year MACE incidence were compared. In MACE-free patients, adherence to 5 scheduled face-to-face visits (week 1, months 1, 3, 6, and 12) and LDL-C goal achievement were evaluated. CFNA was defined as attending fewer than 3 visits. One-year lab results were also compared.

Results: THC independently predicted CFNA (OR: 1.925, P = 0.019) and MACE (OR: 3.937, P = 0.006). Follow-up attendance was lower in Group 1 (week 1: 43.2% vs 69.9%, P <0.001; month 12: 82.2% vs 95.1%, P = 0.008). LDL-C target achievement was significantly lower (6.85% vs 31.07%, P <0.001).

Conclusions: THC adversely impacts clinical follow-up adherence and increases MACE rates. Addressing THC's challenges is essential for improving post-disaster health care outcomes.

Objectives: The January 2025 Los Angeles wildland-urban interface wildfires represent a significant environmental disaster, resulting in widespread evacuations. Beyond the immediate physical and economic devastation, wildfires can have profound and lasting impacts on the mental well-being of affected populations. This study compared mental health outcomes between Southern California residents who evacuated due to the fires and those who did not evacuate.

Methods: Southern California residents (N = 739) were surveyed 2-3 months after the January 2025 wildfires. Logistic regression models assessed the association of evacuation status with depression, anxiety, and PTSD, adjusting for demographics and baseline pre-fire levels of depression and anxiety.

Results: Evacuating was significantly associated with higher odds of depression (AOR = 1.75 [1.08-2.85]) and PTSD (AOR = 2.44 [1.36-4.35]), after controlling for pre-fire mental health status and other demographic covariates. Evacuation status was not associated with anxiety.

Conclusions: These findings support previous research linking wildfire exposure to adverse mental health outcomes and highlight the importance of targeted mental health screening and support for wildfire evacuees, who are at increased risk for depression and PTSD.

Objective: This study explored Italian Emergency Medical Services (EMS) professionals' perceptions regarding a hypothetical wearable device during Mass Casualty Incidents (MCIs), aiming to improve MCI management and patient outcomes. The device includes patient identifier, vital sign monitoring, LED-based triage coding, geolocation, and real-time data transmission. Using the Technology Acceptance Model (TAM), perceived usefulness, perceived ease of use, and behavioral intention to use the device were measured.

Methods: An anonymous online survey was distributed to the 67 EMS dispatch centers across Italy. After an introduction to the device, participants answered demographic and TAM-based questions using a seven-point scale.

Results: Among the 141 respondents, most were males (60.3%), nurses (66.7%), and reported over 10 years of EMS experience (63.1%); 51.8% had prior MCI response experience. The wearable device was positively rated for improving situational awareness and coordination, with concerns about workflow integration and potential rescue delays. The questionnaire showed high internal reliability (Cronbach's α = 0.96). Principal Component Analysis (PCA) highlighted distinct perceptions between features supporting scene coordination and those enhancing triage accuracy.

Conclusions: The study highlights the perceived value of the wearable in improving MCI coordination and situational awareness. However, concerns regarding workflow integration and possible rescue delays warranted further research on real-world application.

Objective: The aim was to document sociodemographic and clinical data of patients with musculoskeletal injuries who applied to the Physical Medicine and Rehabilitation clinic after the earthquake, to share experiences, and thus contribute to preparation for subsequent disasters.

Methods: The study was planned as retrospective, cross-sectional, and analytic. A total of N = 230 earthquake victims, 105 (45.7%) males and 125 (54.3%) females, aged between 1 and 79, were included in our study.

Results: Regarding injury location, the lower extremity was primarily affected with N = 125 (54.3%). The number of amputated patients was N = 29 (12.6%), and the most common location was transfemoral amputation with N = 14 (6.1%) patients. The number of fractures was N = 130 (56.5%), and the most common fracture site was the lower extremity in N = 66 (28.7%) patients. N = 162 (70.4%) of the patients had soft tissue injuries. There was peripheral nerve damage in N = 76 (33%) of the earthquake victims; the most frequently damaged nerve was the peroneal nerve in N = 36 (15.7%) patients. A vertebral fracture was present in N = 9 (3.9%) patients, and the most frequently fractured vertebra was the lumbar vertebra in 11 (4.8%) patients.

Conclusion: Defining the profiles of patients with musculoskeletal injuries in the early period, determining their needs, and including them in the rehabilitation program will ensure successful functional gain.

Background: Emergency medical care in Pakistan remains uncoordinated due to the absence of a platform to connect hospitals, patients, and ambulances. Consequently, during periods of resource shortage and crowding of the emergency department at hospitals, patients and ambulances are unable to select the best site for patient management or transfer of patients, resulting in suboptimal care and poor outcomes.

Objectives: We developed a digital platform called EMCON (Emergency Connection) application, which can be used for inter-hospital and hospital-to-patient/ambulance communication to coordinate patient care. The platform offers real-time information on resource availability, facilitates interhospital patient transfers, coordinates ambulance responses, and assists patients in making decisions about seeking emergency care.

Implementation: The platform offers real-time information on resource availability, facilitates interhospital patient transfers, coordinates ambulance responses, and assists patients in making decisions about seeking emergency care. It has a range of features that allow hospitals to control the data that they share to maintain hospital buy-in, incorporates both electronic and manual data entry for real-time updates in low-resource settings or during electronic medical record disruption, and provides visual content and appointment scheduling services to keep patients engaged.

Results: The pilot testing of the EMCON platform yielded promising outcomes, highlighting its adaptability and effectiveness in diverse health care settings. Integration with an electronic medical record (EMR)-equipped tertiary hospital demonstrated seamless real-time data updates, ensuring efficient resource management and coordination. Meanwhile, the successful implementation at a resource-reliant blood bank underscored EMCON's versatility, allowing manual data entry for hospitals without EMR systems. These results emphasize the platform's practicality and potential to revolutionize emergency health care access in low- and middle-income countries (LMICs). EMCON's ability to bridge coordination gaps and enhance resource allocation holds great promise for improving patient outcomes, particularly in resource-constrained settings.

Conclusion: EMCON serves as a promising solution to address critical coordination issues in emergency care, bridging the gap between hospitals, patients, and ambulances to improve emergency health care access in low-resource settings.

Objective: To describe the results of the Federal Center for Disaster Medicine field hospital work in an outpatient setting in Aleppo, Syria, during the delayed period after the earthquake (from days 33 to 67) for 35 days.

Methods: A retrospective analysis of routinely collected patient data from March 10 to April 13, 2023, was conducted. Descriptive statistics were used to summarize patient demographics, disease spectrum (according to ICD-10), and procedures.

Results: 6812 patients were examined and consulted by various specialists. Of all patients, 40.6% were under the age of 18. In adults, the most commonly diagnosed conditions were diseases of the musculoskeletal system (27.1%), eye diseases (12.0%), circulatory diseases (10.1%), and respiratory diseases (10.0%). Among children, the most common reasons for admission were infectious diseases (68.9%), with respiratory tract infections being the most frequent (48.0%). Surgical interventions were performed in 150 cases; 61 patients required hospitalization.

Conclusions: During disasters, the needs of the population for various types of medical care vary significantly. The main causes of variability, in our opinion, are the time period of work from the disaster onset; the situation in the country and in the healthcare system, preceding the disaster; the climatic conditions during work; and the local endemicity of diseases.

Introduction: This research evaluated Australian governmental disaster inquiries to identify evidence of application of the social determinants of health within their recommendations.

Methods: An analysis was conducted of recommendations from published Australian disaster inquiry reports between 2007 and 2020 against the Social Determinants of Health framework's three overarching principles of action as described by the Commission on Social Determinants of Health, 2005-2008.

Results: Between 2007 and 2020, eight disaster inquiries were conducted, yielding 612 recommendations. Of these reports, 120 recommendations (19.6%) showed alignment with the social determinants of health principles of action. Of these, 48 recommendations (7.8%) demonstrated action on overarching recommendation "Improve daily living conditions"; 59 recommendations (9.6%) demonstrated action on overarching recommendation "Tackle the inequitable distribution of power, money, and resources"; and 13 recommendations (2.1%) demonstrated action on overarching recommendation "Measure and understand the problem and assess the impact of action."

Conclusions: This low alignment underscores a critical gap in current Australian disaster inquiry practices, which historically prioritize emergency management and response over holistic health outcomes. There are opportunities to examine what roles the social environment and public health practice have in shaping disaster management policy and practice in ways that are conducive to strengthening more healthy, resilient societies.