This study aimed to design, implement, and evaluate a training program on nursing students’ disaster response self-efficacy.

This study was conducted using a pre-test, post-test, and follow up design. A total of 92 nursing students participated in the study. The developed program was implemented both theoretically (online) and practically (in person). Nursing students’ disaster response self-efficacy was measured using the Disaster Response Self-Efficacy Scale that was filled out 1 week before the intervention, and 2 months after the intervention by the students. The students’ satisfaction with the program and their views on the program were also surveyed.

Overall score and all items score had significant improvement in short-, and long-term except in 1 item (item 22). The highest increase in score was related to practical items and referral for psychiatric treatment (items 7, 8, 10, and 18) and the lowest increase was related to communication and ethical skill items (items 20, 21, and 22). It is possible that the students had a higher perception of communication and ethical skills even before the training. Most of the students were satisfied with the program.

A training intervention that can provide theoretical materials online, as well as face-to-face practical programs, can increase nursing students’ disaster response self-efficacy.

The youths’ study and physical activity (PA) patterns may have been affected by lockdown measures due to COVID-19. This study aimed to reveal how youths’ study and PA patterns had changed after implementing and lifting COVID-19 lockdown in China.

The COVID-19 Impact on Lifestyle Change Survey (COINLICS) was used, where 10082 youth participants voluntarily reported their study and PA patterns in the 3 periods before, during, and after COVID-19 lockdown. PA was measured as the weekly frequency of engaging in active transport for commuting/errands, leisure-time walking, leisure-time moderate-/vigorous-intensity physical activity (MVPA), and moderate-/vigorous-intensity housework (MVH); study patterns were measured as the daily average study time and the major study modes. We assessed differences of these variables across educational levels, sex, and periods.

The significant decreases were generally observed during lockdown in the frequency of active transport for commuting/ errands (1.3 to 0.2 days/ week), leisure-time walking (1.0 to 0.2 days/ week), leisure-time MVPA (0.7 to 0.3 days/ week), and MVH (2.3 to 2.0 days/ week), with heterogeneities existing between sexes and across educational levels, except for the increase in MVH engagement among graduate students, especially female (1.5 to 2.4 days/ week). Rebounds were observed in the frequency of all activities except MVH after lifting lockdown (2.0 to 1.9 days/ week). The average study time generally increased during lockdown, with more youths studying for 1 - 4 hours/ day and less studying for < 1 hour/ day, and further increased after lockdown. A main shift of study modes has been from in-class to online study after implementing lockdown.

The youths’ PA level have generally decreased, and study patterns significantly changed during and after lockdown in China. Our results would inform policymakers and educational administrators of the declined PA levels and changed study patterns among youths during COVID-19 lockdown for better policy making. In - class and/ or extracurricular PA programs could be designed to counteract those effects under cooperation of youths’ parents.

The aim of this study was to observe the level of alcohol-based sanitizer, mask use, and physical distancing across indoor community settings in Guelph, ON, Canada, and to identify potential barriers to practicing these behaviors.

Shoppers were observed in June 2022 across 21 establishments. Discrete in-person observations were conducted and electronically recorded using smartphones. Multilevel logistic regression models were fitted to identify possible covariates for the 3 behavioral outcomes.

Of 946 observed shoppers, 69% shopped alone, 72% had at least 1 hand occupied, 26% touched their face, 29% physically distanced ≥ 2 m, 6% used hand sanitizer, and 29% wore masks. Sanitizer use was more commonly observed among people who wore masks and in establishments with coronavirus disease (COVID-19) signage posted at the entrance. Mask use was more commonly observed during days without precipitation and in establishments with some or all touch-free entrances. Shoppers more commonly physically distanced ≥ 2 m when they were shopping alone.

This supports evidence for environmental context influencing COVID-19 preventive behaviors. Intervention efforts aimed at visible signage, tailored messaging, and redesigning spaces to facilitate preventive behaviors may be effective at increasing adherence during outbreaks.

In January 2022, Fiji was hit by multiple natural disasters, including a cyclone causing flooding, an underwater volcanic eruption, and a tsunami. This study aimed to investigate perceived needs among the disaster-affected people in Fiji and to evaluate the feasibility of the Humanitarian Emergency Settings Perceived Needs Scale (HESPER Web) during the early stage after multiple natural disasters.

A cross-sectional study using a self-selected, non-representative study sample was conducted. The HESPER Web was used to collect data.

In all, 242 people participated. The number of perceived serious needs ranged between 2 and 14 (out of a possible 26), with a mean of 6 (SD = 3). The top 3 most reported needs were access to toilets (60%), care for people in the community who are on their own (55%), and distress (51%). Volunteers reported fewer needs than the general public.

The top 3 needs reported were related to water and sanitation and psychosocial needs. Such needs should not be underestimated in the emergency phase after natural disasters and may require more attention from responding actors. The HESPER Web was considered a usable tool for needs assessment in a sudden onset disaster.

This study examined temporal trends in risk perception and intention to return to Tomioka among residents and evacuees with the aim of aiding community recovery.

Responses to questionnaires distributed in 2017 and 2021 were compared regarding demographic information, intention to return to Tomioka, desire to consult radiation experts, and risk perception such as anxiety about food consumption, drinking tap water, self-health, and genetic effects. Questionnaires were distributed to all persons registered with the Tomioka town council, both current residents and evacuees.

In 2021, the proportion of responders who had already returned/ wanted to return and those who did not want to return increased by 3.2% and 6.8% respectively, and the proportion unsure about returning decreased by 10.1%. Anxiety for self-health decreased by 15.4%, for genetic effects decreased by 24.4%, for food consumption decreased by 30.9%, and the latter 2 remained significant factors among responders unsure of returning and among those who did not want to return in 2021.

Risk perception for food and genetic effects was significantly associated with uncertainty about returning or not returning. There is a need for continual monitoring of risk perception trends and implementation of targeted risk communication strategies.

The aim of this study was to evaluate the change in knowledge and skill confidence after implementation of a chemical, biological, radiological, nuclear, and explosive (CBRNE) training course during the Russia-Ukraine War.

Pre/post-test study in the Ukrainian cities of Kyiv, Dnipro, Zaporizhzhia, and Odesa. Fifteen CBRNE courses were conducted over a 3-mo period, August to October 2022. Change in knowledge and skills confidence were evaluated with pre/post-course written exams and practical skill assessments that were observed during the training exercises. Changes were analyzed based on nonparametric Wilcoxon matched-pairs signed-rank testing. Pre/post self-efficacy surveys were analyzed with McNemar’s test for paired data. Course evaluations were conducted with standardized questions which assessed instruction quality, teaching relevance, knowledge gained, and post-course skills confidence.

A total of 523 participants registered and completed 1 of the 15 courses. Overall mean pre-course test score: 57.8% (SD 20.7%); mean post-course test score: 81.4% (SD 11.3%); participants with increasing test scores: 90.7%; mean difference in score (95% confidence interval) 23.6% (21.2%-25.9%), P < 0.0001. Pre/post self-efficacy surveys (4-point Likert scale) noted participants recognized signs and symptoms of a CBRNE incident, and necessary skills to manage CBRNE exposures, P < 0.0001.

The implementation of this CBRNE course for front-line providers in Ukraine was successful. To our knowledge, it was the first implementation of a field course during the current Russian-Ukraine war. Future research should evaluate knowledge retention and impact of our innovative Train-the-Trainer model. Further iterations should emphasize expanding the quantity of training equipment and practical skill sessions.

This work aimed to identify, appraise, and summarize existing knowledge about oral health interventions in the context of natural disasters and verify the main research gaps.

We searched in PubMed (National Library of Medicine, Maryland, USA), EMBASE (Elsevier, Amsterdam, Netherlands) and Epistemonikos (Epistemonikos Foundation, Santiago, Chile) until 2021 for primary studies and systematic reviews, assessing any oral health intervention in the context of natural disasters. The interventions were classified according to Cochrane Effective Practice and Organization of Care (EPOC) categories, and the type of natural disaster was defined according to the classification by the Centre for Research on the Epidemiology of Disasters (CRED).

We assessed a total of 19 studies (majorly in Japan, n = 8), all performed in the context of an earthquake or mixed natural disasters (earthquake and tsunami). Regarding interventions, 12 studies reported a promotional/ preventive intervention, with oral examination being the most frequent. 7 studies reported therapeutic interventions, mainly related to emergency management of fractures and injuries.

The evidence accessed in our study was limited, highlighting the need for further research to focus on different oral health care interventions and outcomes in the context of different natural disasters, thus enhancing the formulation and implementation of recommendations and protocols worldwide.

Medical Reserve Corps’ volunteers underwent stop-the-bleed, triage, and disaster preparedness training to improve victim survival of a mass casualty event.

Volunteer responses to 16 disaster vignettes were recorded as ‘survived’ if correct, or ‘died’ if incorrect. Volunteers’ characteristics were evaluated based on the health outcomes of the vignette victims via logistic regression.

Overall, 69 volunteers evaluated 1104 vignette victims. STB training significantly improved survival from 77.2% to 93.2% (P < 0.001). The training did not improve disaster preparedness (75.5% to 73%) nor triage (33.5% to 35.1%). Volunteer first care provider training in psychological first aid improved victim survival from 10.32 (9.6 - 10.9, 95% CI) to 11.9 (11.28 - 12.5, 95% CI). The odds of survival increased when disaster victims received first care from a volunteer who had a positive perception of the public authority’s truthfulness (1.50, range 1.07 - 2.10); stated a willingness to volunteer (1.65, range 1.2 - 2.26); completed psychological first aid training (1.557, range 1.08 - 2.22); or had 4-or-more years of post-secondary education (1.30, range 1.00 - 1.701).

Psychological first aid training should be a basic requirement for disaster volunteers. Trust in public authority to provide protective public health recommendations increases disaster survival.

In this single-case-by-group comparison, we examine whether previously found cisgender differences in paranoid ideation after a terror attack are also seen in a transgender male emergency worker.

Sixty emergency personnel who were exposed to the 2016 terror attack in Berlin were evaluated 3 to 4 and 21-25 mo after the attack.

On paranoid ideation, the transgender male showed higher scores than cisgender males (+2 standard deviations [SD]) and the overall group (+1 SD).

This underpins the previously identified gender effects. It would be useful to consider specified pre- and postdeployment modules that take cis- and transgender differences into account.

To assess gaps and barriers to effective health communication during epidemics, pandemics, and mass health emergencies.

A systematic literature review was conducted in PubMed (National Library of Medicine, Maryland, USA), SCOPUS (Elsevier, Amsterdam, Netherlands), Cochrane (Cochrane, London, UK), and grey literature between 2000 to 2020.

16043 of 16535 identified citations were eliminated through title/ abstracts screening, 437 through full-text review and 55 articles were assessed qualitatively. Key barriers to effective health communication included misinformation, distrust, limited collaboration, and messaging inconsistency. Lack of information/ research was not the primary challenge. Major gaps were in mass and social media strategies, characteristics of messages, sociocultural contexts, digital communication, rapid response, providers’ attitude and perception, and information source characteristics. Health messaging should be adaptable to information outlets and tailored for the most vulnerable. Denigration of individuals with inaccurate beliefs increases misinformation and baseline knowledge differences and fears should be addressed without polarization. Involving frontline providers in health communication strategies is crucial.

Primary reason for misinformation is the failure of health sector to convincingly convey accurate information. With input from all stakeholders, especially trusted members of communities and providers, health communication should include reinvestment in methods, multidimensional and multidisciplinary approaches, consistent frameworks, improved social media usage, clear, simple, and targeted messaging, and addressing systematic disinformation and misinformation with intention.

A Mass Casualty Incident response (MCI) full scale exercise (FSEx) assures MCI first responder (FR) competencies. Simulation and serious gaming platforms (Simulation) have been considered to achieve and maintain FR competencies. The translational science (TS) T0 question was asked: how can FRs achieve similar MCI competencies as a FSEx through the use of MCI simulation exercises?

T1 stage (Scoping Review): PRISMA-ScR was conducted to develop statements for the T2 stage modified Delphi (mD) study. 1320 reference titles and abstracts were reviewed with 215 full articles progressing for full review leading to 97 undergoing data extraction.

T2 stage (mD study): Selected experts were presented with 27 statements derived from T1 data with instruction to rank each statement on a 7-point linear numeric scale, where 1 = disagree and 7 = agree. Consensus amongst experts was defined as a standard deviation ≤ 1.0.

After 3 mD rounds, 19 statements attained consensus and 8 did not attain consensus.

MCI simulation exercises can be developed to achieve similar competencies as FSEx by incorporating the 19 statements that attained consensus through the TS stages of a scoping review (T1) and mD study (T2), and continuing to T3 implementation, and then T4 evaluation stages.

To explore the health impacts of Hurricane Maria (HM) on HIV care outcomes among people living with HIV who use drugs.

Using data from an ongoing cohort study in San Juan, Puerto Rico (Proyecto PACTo), we measured differences in HIV care outcomes (viral load, viral suppression, and CD4 counts) before and after HM using assessments conducted at 6-month intervals. Generalized estimating equations were used to assess factors associated with HIV care outcomes.

All HIV care outcomes showed a deterioration from pre-HM values to post-HM values (mean viral load increased, CD4 counts decreased, and rate of viral suppression decreased) after controlling for pre-HM sociodemographic and health characteristics. In addition to HM, age (aIRR = 1·01), being homeless (aIRR = 0·78) and having health insurance (aIRR = 1·6) were independently associated with viral suppression.

219 participants completed follow-up visits between April 2017 and January 2018, before and after HM.

People living with HIV who use drugs in Puerto Rico experienced poorer HIV outcomes following HM. Socio-environmental factors contributing to these outcomes is discussed in the context of disaster response, recovery, and program planning.

Industrial disasters can have a myriad of repercussions ranging from deaths, injuries, and long-term adverse health impacts on nearby populations, to political fallout and environmental damage. This is a descriptive epidemiological analysis of industrial disasters occurring between 1995 and 2021 which may provide useful insight for health-care systems and disaster medicine specialists to better prevent and mitigate the effects of future industrial disasters.

Data were collected using a retrospective database search of the Emergency Events Database (EM-DATS) for all industrial disasters occurring between January 1, 1995, and December 31, 2021.

A total of 1054 industrial disasters were recorded from 1995 to 2021. Most of these disasters occurred in Asia (720; 68.3%), with 131 (12.4%) in Africa, 107 (10.2%) in Europe, 94 (8.9%) in the Americas, and 2 (0.2%) in Oceania. Half of these disasters were explosions (533; 50.6%), 147 (13.9%) were collapses, 143 (13.6%) were fires, 46 (4.4%) were chemical spills, 41 (3.9%) were gas leaks, and 34 (3.2%) were poisonings. There were 6 (0.6%) oil spills and 3 (0.3%) radiation events.

A total of 29,708 deaths and 57,605 injuries were recorded as a result of industrial disasters, and they remain a significant contributor to the health-care risks of both workers and regional communities. The need for specialized emergency response training, the potential devastation of an industrial accident, and the vulnerability of critical infrastructure as terror targets highlight the need to better understand the potential immediate and long-term consequences of such events and to improve health-care responses in the future.

Chemical, biological, radiological, and nuclear (CBRN) incidents are those that involve chemical or biological warfare agents or toxic radiological or nuclear materials. These agents can cause disasters intentionally or accidentally. Hospitals play a crucial role in handling CBRN disasters. This study aimed to assess the CBRN preparedness of government hospitals in Riyadh.

A descriptive cross-sectional study was conducted across government hospitals in Riyadh. All government hospitals with more than 100 inpatient beds and an emergency department met the inclusion criteria. Hospital preparedness was assessed using an adaptation of the CBRNE (chemical, biological, radiological, nuclear, or explosive event) Plan Checklist. This adaptation was chosen due to the inclusion of explosive events in hospital disaster readiness, and its structural composition of key clinical guidelines necessary for a comprehensive disaster and readiness plan. Results were described in frequencies across several domains such as foundational considerations and planning which are used to assess plan preparedness using readiness tools, training, and awareness among staff members in accordance to a pre-established emergency plan, placed procedures and their implementation, and modules for preparing for a biological incident, a chemical incident, and a radiological or nuclear incident.

Of the 11 eligible hospitals, 10 participated in the study. Furthermore, CBRN considerations were included in the disaster plans of 7 hospitals. Drills had been conducted in collaboration with local agencies in only 2 hospitals. The staff had been trained to recognize the signs and symptoms of exposure to class (A) biological agents in less than half of the hospitals. Eight of the hospitals had antidotes and prophylactics to manage chemical incidents, but only half of them had radiation detection instruments. Personal protective equipment was available in all hospitals, but rapid access to stockpiles of medications was available in only half of them.

Government hospitals in Riyadh demonstrated insufficient CBRN preparedness as per the CBRNE Plan Checklist. Overall, there was a lack of preemptive planning, application of pre-established policies and procedures, and adequate staff training. Furthermore, several hospitals had insufficient stockpiles of medications and in concrete plans on accessing government stockpiles in the case of an emergency. Therefore, their staffs should be trained to manage CBRN emergencies, and local drills should be conducted to improve their preparedness.