Disaster Medicine and Public Health Preparedness最新文献

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.

Objectives: The Russian-Ukrainian War of 2022 (RUW-2022) was accompanied by the subsequent risk of accidents at a nuclear power plant in Ukraine. This study investigated posttraumatic stress (PTS) symptoms related to media reports of an attack on a Ukrainian nuclear power plant during the RUW-2022 among victims of the Fukushima nuclear disaster and revealed their association with radiation risk perception (RRP) of the accident.

Methods: This cross-sectional study targeted 1193 residents of Naraha Town in Fukushima Prefecture. PTS symptoms were measured using the Japanese version of the Impact of Events Scale-Revised (IES-R). Univariate and multivariate analyses explored the association between IES-R scores and background factors, particularly RRP.

Results: Participants with higher RRP showed significantly higher IES-R scores; furthermore, the proportion of disruption because of radiation anxiety was significantly larger among higher RRP residents. Radiation anxiety mediated the association between RRP and PTS symptoms (total IES-R score and sub-item of intrusion).

Conclusions: People with higher RRP in Fukushima may continue to be at risk of persistent, unwanted PTS symptoms due to future nuclear crises. Therefore, mental health practitioners need to continue providing support in affected areas for a longer period than anticipated. Moreover, a population-based approach to cope with these stressors from media reports is essential.