Disaster Medicine and Public Health Preparedness最新文献

Introduction: A mass casualty incident (MCI) is unpredictable and involves many casualties at the same time and place. This brief report will present the results from an evaluation a full-scale MCI exercise, aiming to increase preparedness for such events, from the perspectives of future health-care professionals, as well as personnel in various emergency teams taking part in MCI response.

Methods: All participants in a 2-day, full-scale MCI exercise (N = 206) were invited to participate in an investigator-developed survey.

Results: In total, 124 participants (60.2%) responded to the questionnaire. Most of the respondents were satisfied with the information and frames of the full-scale MCI exercise. Based on their experiences, over half of the respondents perceived that the county ambulance, police, and fire departments were well prepared in case of an MCI in the future. Reported areas of improvement were specifically related to communication lines and triage.

Conclusion: Weakness in communication lines and triage were assumed a threat to effective handling of MCIs. However, further studies are needed to decide the content needed in MCI exercises to effectively increase regional preparedness for such events.

Objective: The present study aimed to analyze the factors that influence the increase in the desire to re-engage volunteer rescuers and saviors of the Red Crescent Society of the Islamic Republic of Iran.

Methods: This qualitative descriptive phenomenological study involved the participation of volunteers who had not volunteered in the Iranian Red Crescent Society (IRCS) for at least one year but expressed a willingness to be re-engaged. The semi-structured in-depth interview process and data collection continued until the theoretical saturation stage was reached. The collected data was analyzed using the interpretive approach and the 7-step Claesian method.

Results: The results show that several factors influence the increase in the desire to reengage volunteer rescuers and members of IRCS. These factors were categorized into 136 codes, 63 main codes, 20 clusters, 7 classes, and 3 themes, namely "organizational support and understanding," "work characteristics," and "organizational credibility." The results of the study indicate that each of the identified factors plays a significant role in the dynamics of the re-engagement process for rescuers and volunteer rescuers within the IRCS.

Conclusions: The experiences of volunteer rescuers and members can be utilized to enhance the recruitment and retention of volunteer human resources within the IRCS.

Humanitarian crises often require urgent medical care to people of concern. Such medical aid includes assessing and treating acute medical needs and ongoing chronic health conditions. Among the people of concern there are children, who are often the most vulnerable population in humanitarian contexts because they often lack the experience, independence, and cognitive and verbal skills to deal with the ordeals they are facing. These limitations might prevent identification and diagnosis of pain. The under-diagnosis and under-treated pain by health care providers might be also due to the perceived urgency of more acute or life-threatening medical needs with limited medical equipment and personnel, lack of awareness, or assessment tools in such contexts. Additionally, due to issues of anonymity and lack of formal guidelines, there is a severe lack of standardized registration of children's pain conditions in humanitarian crises. Finally, acute pain is also a predictor of post-traumatic stress disorder, a common outcome in such disasters. We call on health care providers to use standardized scales to assess children's pain intensity, frequency, and duration, and to treat it appropriately. These will not only reduce children's physical suffering but may also prevent subsequent risk of PTSD.

Objective: The objective of this study was to determine what factors are associated with behavioral health in veterinary disaster responders.

Methods: An online cross-sectional survey was distributed via snowball sampling. Results were analyzed using chi-square analyses.

Results: Responses from 237 veterinarians were analyzed. Being involved in more than 1 disaster event was associated with higher anxiety and/or depression (43.4% vs 28.6%, respectively), difficulty with relationships (28.1% vs 14.3%, respectively), and a greater prevalence of sleep problems (44.6% vs 28.0%, respectively) compared to only being involved in 1 event. Veterinarians that were deployed longer than 2 months had the highest prevalence of anxiety and/or depression (43.9%) and sleep problems (50.0%). Veterinarians that received behavioral health training before deployment had lower rates of anxiety and/or depression (27.8% vs 42.9%, respectively) compared to those who did not receive training. Respondents involved with depopulation had the highest rates of anxiety and/or depression (66.7%) and sleep problems (58.1%).

Conclusions: Factors associated with behavioral health outcomes included the number and length of deployments, receiving behavioral health training, and being involved in depopulation. To reduce the risk of behavioral health outcomes, interventions such as time-off and behavioral health support are needed.

Low temporal stability may complicate the interpretation of survey measures of conspiracy theories (CTs). Current study examines the stability of endorsement of CTs on a popular set of items addressing COVID-19-related CTs. An online survey tapping two CTs about COVID-19 was administered to 179 students of general medicine. The same items were presented twice in March 2022 and once in May 2022. The mean endorsement of the CTs did not differ between March and May. The correlation between answers provided in March and May was low (.5 < r < .7). Most of those reporting agreement with CTs in March reported disagreement in May. Conspiracy believers' responses did not change between two measurements in March but were different in May, suggesting that the low temporal stability was due to situational factors rather than erroneous or random answers. Poor temporal stability of responses endorsing CTs may problematize interpretation of survey data. Respondents' endorsement of CTs may be affected by situational factors, inflating agreement with CTs, and correlations with other survey-based measures.

Objective: The purpose of this study is to examine the national impact of workplace factors during the SARS-CoV-2 pandemic on mental health experienced by non-physician healthcare workers (HCWs).

Methods: This study consisted of an online sample of non-physician HCWs across the United States, including nurses, medical assistants, and physician assistants. The survey consisted of 93 questions, which included the Perceived Stress Scale, the Center for Epidemiological Studies-Depression (CESD-10) scale, questions about COVID-19 vaccination, sources of trusted information, and questions about work environment and training during the COVID-19 pandemic. Descriptive statistics were used to evaluate associations.

Results: In the final sample (N = 220), (81.8%) reported receiving at least one dose of a COVID vaccine. Most respondents trusted the CDC's information on the SARS-CoV-2 virus and COVID-19 disease. Several workplace-related factors that occurred during the pandemic were associated with moderate to high levels of perceived stress, fatigue, and higher risk of developing depression. In particular, concerns about exposing others, experiencing discrimination related to their jobs, and caring for patients who died from COVID-19 were associated with increased perceived stress, depression, and fatigue.

Conclusions: The importance of planning by healthcare facilities should include planning for workplace factors associated with poor mental health among all HCWs.

Objectives: Emergency Medical Services (EMS) workers are critical to effective disaster response. Therefore, it is important to understand their knowledge, skills, and preparedness for disasters. This study investigated factors influencing EMS workers' disaster knowledge, skills, and preparedness in the Saudi Arabian context. The study also sought to identify challenges to disaster preparedness among Saudi Arabian EMS workers.

Methods: A descriptive cross-sectional survey using The Disaster Preparedness Evaluation Tool was distributed to EMS workers in military and government hospitals across 3 Saudi Arabian cities. Responses were recorded on a 6-point Likert scale where higher scores indicated higher knowledge, skills, or preparedness. The results were analysed using descriptive and inferential statistical analysis.

Results: 272EMS workers participated in this study. EMS workers reported a moderate level of knowledge (3.56), skills (3.44), and preparedness (3.73) for disasters. Despite this, EMS workers reported a high level of involvement in regular disaster drills (M = 4.24, SD = 1.274) and a strong interest in further disaster education opportunities (M = 5.43, SD = 1.121). Participants also reported a high skill level with the triage principles used in their workplace during a disaster (M = 4.06, SD = 1.218). The study findings revealed a significant positive correlation between disaster preparedness levels and age, years of experience, education level, and the facility worked in.

Conclusions: EMS workers have moderate disaster knowledge, skills, and preparedness levels. Knowledge, skill, and preparedness have a significant relationship on the EMS workers' demographics. These findings demonstrate the need to invest in preparing Saudi Arabian EMS workers to effectively respond to bioterrorism disasters.

Objective: 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.

Objectives: Following the declaration of the pandemic, students' education has to be done at a distance due to the COVID-19 pandemic. This study evaluated the association of university students' COVID-19 phobia, pain severity, sleep quality, physical activity, fatigue levels, and quality of life on students' achievement.

Methods: This cross-sectional survey was conducted by including 353 students from the university faculty of health sciences. The Pain Quality Assessment Scale was used to assess pain, the Fatigue Severity Scale to evaluate fatigue, the COVID-19 Phobia Scale to assess fear of disease, the International Physical Activity Questionnaire Short Form to evaluate physical activity level, and the Jenkins Sleep Scale to assess sleep quality, The Short Form-36 to determine the quality of life, and Online Learning Systems Acceptance Scale to evaluate satisfaction with distance education. Multiple linear regression and path analysis were conducted to identify factors associated with academic achievement.

Results: It was found that age (B = 0.045; P = 0.040), BMI (B = -0.200; P = 0.004), and physical (B = 0.128; P = 0.008), psychological (B = 0.057; P = 0.012) and social (B = 0.189; P = 0.018) domains of quality of life were associated with the level of achievement.

Conclusions: Precautions must be taken to improve students' academic achievement and quality of life in preparing for the future against infectious and epidemic diseases.