Disaster Medicine and Public Health Preparedness最新文献

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.

The increasing concern related to radiological and nuclear threats within the European Union (EU) has intensified the regional preparedness needs. The anticipated number of injured, contaminated, and irradiated individuals may range from a few to hundreds of thousands, necessitating immediate emergency medical care and hospitalization. Given this potential influx of casualties, the medical teams responsible for initial management may become rapidly overwhelmed, facing immense pressure to formulate appropriate response strategies and treatment options. Therefore, it is critical to establish appropriate supra-national recommendations and appropriate national protocols to guide medical decision-making in such extraordinary circumstances. The EU is proactively preparing for this worst-case scenario. Drawing on a robust and remaining state-of-the-art reference consensus regarding the medical management of mass radiation exposure, a well-established network of 550 European Society for Bone and Marrow Transplantation (EBMT) centers and emergency medicine specialists, and two decades of collective experience in managing acute radiation syndrome (ARS) patients. The European Commission (EC), in collaboration with the World Health Organization (WHO) Europe, is accelerating the dissemination of medical response protocols. This initiative includes the education of healthcare professionals and the implementation of a strategic stockpile of medical countermeasures to address nuclear-related threats effectively.

Objective: The COVID-19 pandemic has placed unprecedented strain on global health systems, significantly affecting both the physical and emotional well-being of populations. Nursing students represent a particularly vulnerable group due to the pandemic’s impact on their mental health and academic progression. This study aims to assess the level of resilience among Spanish university nursing students during the pandemic.

Method: A longitudinal study was conducted with 361 nursing students from March to October 2020. Self-report questionnaires measured emotional intelligence, resilience, anxiety, depression, optimism, and self-efficacy during the first and second COVID-19 waves. Analyses included descriptive statistics, Spearman’s correlations, and hierarchical multiple regression.

Results: Resilience slightly decreased from March to October 2020, while anxiety increased and depression remained stable. Resilience was positively correlated with optimism, self-efficacy, and emotional intelligence, particularly emotion regulation. Higher resilience was predicted by not living alone, greater optimism, and stronger emotion regulation skills.

Conclusions: Spanish nursing students showed variable resilience during COVID-19, positively associated with optimism, self-efficacy, emotional intelligence, and mental health factors like anxiety and depression. Findings highlight the psychological impact of the pandemic and support resilience-focused interventions in nursing education.

Objective: This study examined the health-related issues and proposed solutions among residents who returned or migrated to Namie in Fukushima Prefecture, Japan, after the evacuation order following the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident was lifted. Moreover, this study assessed vulnerable groups comprising individuals who faced difficulties obtaining health services.

Methods: This study conducted semi-structured interviews with 16 participants who lived or worked in Namie. A thematic analysis was employed to analyze the interview data.

Results: The results revealed four themes regarding prioritized health-related issues: poor lifestyle habits cause disease, mental health, inadequate medical and nursing care systems, and social isolation and issues with social relationships in the community. Likewise, four themes were identified for solutions: measures to improve lifestyle habits, enhancement of medical and nursing services, revitalization of community and social relationships, and provision of personalized care and support. Additionally, seven groups that had difficulty accessing health services were identified.

Conclusions: The findings suggest that comprehensive individual support is required during the long-term recovery phase after nuclear disasters to meet the health needs of vulnerable groups.

In sudden-onset industrial disaster, responding effectively to a mass casualty incident (MCI) requires more than clinical readiness; it demands the integration of multiple regulatory frameworks and standards. In the context of an industrial disaster, the International Organization for Standardization 45001 will provide parameters for the creation of the response plan. In addition, the utilization of the Major Incident Medical Management and Support operational framework will expand the complex industrial interagency response. These should be components of the local MCI response plan, which has proven successful worldwide to enhance the capacity and capabilities in responding to complex emergencies.From a policy analysis perspective, the complexity and far-reaching consequences of industrial sudden onset disasters underscore the importance of implementing coordination mechanisms that bring together management systems and operational benchmarks. To build essential competencies among first responders, first receivers, and industrial workers, modular simulation exercises focusing on specific risk management and MCI response components are essential.

Disasters and emergencies, from natural hazards to complex crises, demand a fundamental shift in traditional management paradigms. At all levels of disaster and emergency management, from frontline responders to high-level policymakers, 2 integrated concepts-situational awareness and a disaster mindset-are critical for effective response and resilience. Situational awareness is not merely the collection of data; it's the dynamic and continuous process of perceiving, comprehending, and projecting a holistic understanding of the operational environment, including evolving threats, available resources, and stakeholder dynamics. When fused with a disaster mindset-a psychological and strategic posture characterized by proactive anticipation, radical adaptability, and decisive action under pressure-it creates a powerful framework for navigating uncertainty. This paper, presented as the Frederick M. ("Skip") Burkle lecture, proposes a new, integrated framework that systematically applies these concepts to enhance decision-making and operational effectiveness across all managerial tiers, enabling a transition from a reactive to a proactive and resilient posture in the face of escalating global complexities.