The University of Minnesota Crisis Humanitarian Simulation provides trans-disciplinary training in disaster response. The course directors wished to better understand the learning outcomes and experiences of simulation participants.

The learning outcomes and experiences of participants in the 2019 simulation were assessed using 3 modalities: 1) pre-and post-simulation test, 2) participants’ self-assessment of learning, and 3) qualitative feedback via an anonymous evaluation.

Participant scores on the knowledge survey were significantly higher after the simulation than before the simulation (mean percent correct 71% vs. 48%, P < 0.0001). A significant majority of participants who completed the assessment believed they had main gains within each learning objective. Anonymous evaluations contained both positive feedback and constructive criticism leading to plans for refinements in subsequent training events.

The Humanitarian Crisis Simulation is an effective experiential training program that increases participants’ knowledge in the field of disaster response. Participants also believed they had made gains in each learning objective. The authors’ analysis of elements that have contributed to the success of the program and areas for future program growth and improvement are discussed.

The purpose of this pilot study was to evaluate whether physician assistant (PA) programs in the Midwest integrate both disabilities and emergency preparedness education into 1 curriculum.

A convenience sample was utilized to survey program directors and deans of PA programs. Emails were obtained from the Physician Assistant Education Association. A 26, closed-ended question Qualtrics survey was based on an original study by Tanenhaus et al.1

Out of 43 accredited physician assistant programs surveyed, 9 programs replied (21%), and 1 program did not complete the survey. Six of the 10 programs (66%) responded that their program provided lectures specific to emergency preparedness. All 9 programs responded they do not offer a graduate-level track or concentration in emergency/disaster preparedness, and they do not offer a dual degree or a multidisciplinary program that highlights emergency/disaster preparedness.

This study was conducted to bring awareness to physician assistant students’ education regarding disabilities and emergency preparedness. As public health crises continue to arise, such as coronavirus disease (COVID-19), it is critical to have appropriately trained health care professionals. The study revealed that most programs lack a graduate-level track or concentrations, dual degrees, or extracurricular opportunities related to disabilities and emergency and disaster preparedness.

Researchers at the Centers for Disease Control and Prevention monitor unplanned school closure (USC) reports through online systematic searches (OSS) to assist public health emergency responses. We counted the additional reports identified through social media along with OSS to improve USC monitoring.

Facebook and Twitter data of public-school districts and private schools in counties affected by California wildfires in October and December of 2017 and January of 2018 were retrieved. We computed descriptive statistics and performed multivariable logistic regression for both OSS and social media data.

Among the 362 public-school districts in wildfire-affected counties, USCs were identified for 115 (32%) districts, of which OSS identified 104 (90%), Facebook, 59 (52%), and Twitter, 37 (32%). These data correspond to 4622 public schools, among which USCs were identified for 888 (19.2%) schools, of which OSS identified 722 (81.3%), Facebook, 496 (55.9%), and Twitter, 312 (35.1%). Among 1289 private schools, USCs were identified for 104 schools, of which OSS identified 47 (45.2%), Facebook, 67 (64.4%), and Twitter, 29 (27.9%). USC announcements identified via social media, in addition to those via OSS, were 11 public school districts, 166 public schools, and 57 private schools.

Social media complements OSS as additional resources for USC monitoring during disasters.

The aim of this study was to assess and compare nurses’ and physicians’ knowledge of disaster management preparedness. An effective health-care system response to various disasters is paramount, and nurses and physicians must be prepared with appropriate competencies to be able to manage the disaster events.

This is a cross-sectional study. A total of 636 nurses and 257 physicians were recruited from 1 hospital in Saudi Arabia. Of them, 608 (95.6%) nurses and 228 (83.2%) physicians completed self-administered, online questionnaires. The questionnaire assessed participants’ sociodemographic data, and disaster management knowledge.

The findings revealed that participants had more knowledge regarding the disaster preparedness stage than mitigation and recovery stages. They also reported a need for advanced disaster training areas. A total of 10.1% of nurses’ and 15.6% of physicians’ overall knowledge is explained by their demographic and work-related characteristics.

Both nurses and physicians had to some extent knowledge regarding the information and practices required for disaster management process. It is proposed that hospital managers must look for opportunities to effectively adopt national standards to manage disasters and include nurses and physicians in major-related learning activities because experience has suggested a somewhat low overall perceived competence in managing disaster situations.

The aim of this study was to pilot test the Household Emergency Preparedness Instrument (HEPI) with a diverse sample, allowing for assessment of reliability and validity of the instrument. The HEPI is an international, all-hazards questionnaire created to measure disaster preparedness of households, which results in data that can be used to enhance health promotion/disease prevention for individuals and promote resilience for communities.

A cross-sectional study of faculty, staff, and students (N = 284) was completed to perform factor analysis to establish the HEPI’s construct validity and compare preparedness across groups.

The factor analysis revealed 2 dimensions of general preparedness, explaining 35% of the sample variance (Cronbach’s α = 0.89): preparedness actions and planning (α = 0.86) and disaster supplies and resources (α = 0.80). This factor analysis resulted in the revision of the subscaling of HEPI questions. Consistent with previous studies, faculty/staff, older age, higher income, and those with previous disaster experience were more prepared. The mean score was 15.28 out of 40 points.

The HEPI is easy to administer and explains an acceptable amount of variance. The reliability was strong in this assessment, particularly for a pilot test. Construct, criterion, face, and content validity support the adequacy of the HEPI to capture essentials of household emergency preparedness.

Posttraumatic growth (PTG) is a positive psychological change after challenging life events. The purpose of this study was to investigate the effects of positive and long-term psychological changes in people who experienced the Bam earthquake.

A total of 916 adolescents were surveyed 17 years after the earthquake. Self-report questionnaires were administered to participants. A latent profile analysis (LPA) was conducted to extract the subgroups of adults.

The LPA identified 5 meaningfully profiles that were characterized based on the pattern of PTG dimensions. The common profile was profile, which perceived very low “relating to others” dimension and medium for other PTG dimensions. Also, the results showed significant differences among gender and age and nonsignificant differences in marital status and education level among the profiles of PTG.

For stressful situations, the different dimensions of PTG change indirectly in every person. In Bam, some patterns are seen according to PTG after 17 y. Among these dimensions, the part of “relating to others”, has the greatest change. Another conclusion is that according to a relatively high profile for 5 clusters, it seems the impact of 17 y should be less on PTG as the number of extractive patterns is approximately high for the case.

To model performance of the Sequential Organ Failure Assessment (SOFA) score-based ventilator allocation guidelines during the COVID-19 pandemic.

A retrospective cohort study design was used. Study sites included 3 New York City hospitals in a single academic medical center. We included a random sample (205) of adult patients who were intubated (1002) from March 25, 2020, till April 29, 2020. Protocol criteria adapted from the New York State’s 2015 guidelines were applied to determine which patients would have had mechanical ventilation withheld or withdrawn.

117 (57%) patients would have been identified for ventilator withdrawal or withholding based on the triage guidelines. Of those 117 patients, 28 (24%) survived hospitalization. Overall, 65 (32%) patients survived to discharge.

Triage protocols aim to maximize survival by redirecting ventilators to those most likely to survive. Over 50% of this sample would have been identified as candidates for ventilator exclusion. Clinical judgment would therefore still be needed in ventilator reallocation, thus re-introducing bias and moral distress. This data suggests limited utility for SOFA score-based ventilator rationing. It raises the question of whether there is sufficient ethical justification to impose a life-ending decision based on a SOFA scoring method on some patients in order to offer potential benefit to a modest number of others.

The aim of this study is to explore the feasibility and acceptability of teledentistry as a vehicle that provides enhanced delivery of oral care for the people who need special care (PNSC).

Between January 2018 and September 2020, PNSC who were admitted in the study were either waiting for a follow-up (F) appointment or on a waiting list. An examination via video call was carried out for initial examination (IE) and F purposes. The virtual examination was scored by the clinician who performed the examinations. The experience of the participants was evaluated with a satisfaction questionnaire.

Forty PNSC (26 females, 14 males) between ages 7 and 48 years (21.17 ± 10.62) participated in the study. According to the clinician ratings, the accuracy of the examination was rated as the lowest. The F group had higher scores when compared to the IE group regarding clinician rating. No significant differences were found in terms of the scoring of the clinician and patient/parent satisfaction regarding cooperation status and type of examination (P ≥ 0.05).

Through adequate adaptation of the technology into clinical practice and overcoming the barriers for wider implementation, the teledentistry approach could be a reliable and feasible alternative in triaging, treatment planning, and F purposes for PNSC.

This study’s aim is to assess the disaster management and pediatric first aid-related knowledge, emotion, and attitude levels of of kindergarten and elementary school teachers, as the professionals that are first to provide interventions in the case of a disaster to children ages 0-8, who are considered to be among the vulnerable groups in the context of a disaster.

A total of 119 teachers working in the kindergarten and elementary schools located in the Gümüşhane province of Turkey were included in the study and were asked to fill in a questionnaire that comprises 3 sections. Data collection tools included a sociodemographic questionnaire, teachers’ disaster management knowledge levels, and teachers’ pediatric first-aid knowledge, emotion, and attitude levels.

Analysis of the scores obtained by the teachers from the questionnaire revealed that the teachers, who participated in the study, had a high level of disaster management knowledge and a moderate-to-high level of pediatric first aid knowledge.

It is suggested as a result of this study that the disaster risks and injuries or losses of life associated with disasters that may occur at schools may be reduced with disaster management and first-aid interventions.

The aim of this study is to assess knowledge and attitudes toward Zika virus disease (ZVD) as well as mosquito prevention practices in Malaysia at a nationwide level.

Computer-assisted telephone interviews (CATI) were conducted between June 2019 and February 2020.

There are gaps in knowledge about the symptoms, mode of transmission, and risk of microcephaly. The mean for the Zika-related knowledge score was 5.9 (SD ± 4.4) out of a possible score of 14. The majority perceived little or no risk of getting ZVD (75.0%) and 75.5% were a little or not at all worried about ZVD. A high proportion reported the use of insect sprays or mosquito coils to prevent mosquito bites; however, a relatively lower proportion of people reported fixing mosquito netting on doors and windows, and using mosquito bed nets. The mean for the mosquito prevention practices score was 11.9 (SD ± 4.7) out of a possible score of 27. Important factors influencing mosquito prevention practices include household income, environment factors, risk perception, and Zika-related knowledge.

Zika prevention measures should be targeted in priority toward residents in lower socioeconomic neighborhoods. Campaigns should focus on messages highlighting the high risk of getting dengue.

This project aimed to quantify and compare Massachusetts and Georgia public school districts’ 2017–2018 winter-storm-related Twitter unplanned school closure announcements (USCA).

Public school district Twitter handles and National Center for Education Statistics data were obtained for Georgia and Massachusetts. Tweets were retrieved using Twitter application programming interface. Descriptive statistics and regression analyses were conducted to compare the rates of winter-storm-related USCA.

Massachusetts had more winter storms than Georgia during the 2017–2018 winter season, but Massachusetts school districts posted winter-storm-related USCA at a 60% lower rate per affected day (adjusted rate ratio, aRR = 0.40, 95% confidence intervals, CI: 0.30, 0.52) than Georgia school districts after controlling for the student enrollments and Twitter followers count per Twitter account. A 10-fold increase in followers count was correlated with a 118% increase in USCA rate per affected day (aRR = 2.18; 95% CI: 1.74, 2.75). Georgia school districts had a higher average USCA tweet rate per winter-storm-affected day than Massachusetts school districts. A higher number of Twitter followers was associated with a higher number of USCA tweets per winter-storm-affected day.

Twitter accounts of school districts in Massachusetts had a lower tweet rate for USCA per winter-storm-affected days than those in Georgia.

The objective was to describe a feasible, multidisciplinary pediatric mass casualty event (MCE) simulation format that was less than 2 h within emergency department space and equipment constraints.

This was a prospective cohort study of an MCE in situ simulation program from June-October 2019. Participants rotated through 3 modules: (1) triage, (2) caring for a critical patient in an MCE setting, and (3) being in a disaster leadership role. Triage accuracy, knowledge, self-evaluation of preparedness, and MCE skills by means of pre- and post-test surveys were measured. Wilcoxon matched pairs signed rank test scores and McNemar’s matched pair chi-squared test were performed to evaluate for statistically significant differences.

Forty-six physicians (MD), 1 physician’s assistant (PA), and 22 nurses participated over 4 simulation d. Among the MD/PA group, there was a statistically significant 7% knowledge increase (95% confidence interval [CI], 3%-11%). Nurses did not show a statistically significant knowledge difference (0.04, 95% CI, 0.04%, 14%). There was a statistically significant increase in triage and resource use preparedness (P < 0.01) for all participants.

This efficient, feasible model for a multidisciplinary ED disaster drill provides a multi-modular exposure while improving both MD and PA knowledge and all staff preparedness for MCE.

Literature has previously shown that healthcare staff redeployment has been widely implemented to build capacity, with little focus on nurses. This study aims to manage redeployment more effectively by capturing and scrutinizing nurses’ redeployment experiences.

A cross-sectional short and structured interview was conducted. Data was analyzed using Braun and Clarkes 6 Step Thematic Analysis approach.

55 interviews were conducted predominantly from women (85%, N = 47), over the age of 45 years (45%, N = 25), who were in the role of Specialist Nurse or Staff Nurse (78%, N = 43). 5 critical themes emerged: willingness to work in redeployed role, poor communication, stress and anxiety, feelings of being unsupported and abandoned, and positive experiences despite challenging circumstances.

Nurses in redeployed roles were susceptible to stress and anxiety and were seeking dedicated leadership as they worked during a pandemic with the additional challenge of unfamiliar workspaces and colleagues. Nurses play a major role in the resilience of healthcare service, which cannot be achieved without a comprehensive resilience strategy. Healthcare organisations are required to develop strategies, policies, and enforcement measures to ensure that their staff are well empowered and protected not just during potential redeployment but also in their daily operations.

Although there has been a massive expansion of hospitals in Ethiopia in the last 2 decades, most are primary-level hospitals. Assessing the capability of the hospitals in managing trauma victims is essential to strengthening the hospitals.

We employed a mixed-method approach using quantitative descriptive design triangulated with qualitative research. We audited 10 hospitals using WHO essential trauma care checklist. We interviewed 37 health care professionals, 9 hospital managers, and 12 decision-makers using a semi-structured interview guide. We used the COREQ checklist to report the qualitative finding.

The physical structures of the hospitals were good in all cases. Airway, breathing and circulation management were partially available, with a score ranging from 0 - 3. The extent of injury, lack of radiology service, and scarcity of drugs and supplies were common causes for the referral of trauma victims to Gondar University hospital.

Unavailability of drugs and supplies, lack of diagnostic services, inability to recruit specialist professionals, lack of training, and inconvenient working and living environment were stated as the main barriers to providing trauma care. In the study area, the gaps in trauma care in the primary hospitals can be improved by further commitment of the hospitals, the district, zonal administrators, and the regional health bureau.

The coronavirus disease (COVID-19) pandemic has somehow affected the lives of 80% of the world’s population. Iran has also experienced numerous outbreaks of this disease. The fifth wave having occurred in August 2021 was one of the most agonizing incidences of the pandemic in the country.

We reviewed all of publications and govermental statistics about COVID-19 pandemic In Iran between 2019 to 2021.

The current study discusses the possible dimensions and causes of successive waves of COVID-19 in Iran, namely, the consequences of a significant delay in vaccination administration in due time, the collective overwhelming fallacy toward immunization, the polypharmacy controversy, inadequate community-based participation in risk reduction, and noticeable decrease in the public’s resilience.

A variety of strategies have been recommended in the article to modify the principal challenges in order to help control the pandemic in the country.

With the advancement of technology, disaster preparedness related to hurricane hazards can be taught through an app. This study aimed to examine the effect of using an android-based disaster preparedness app on community knowledge and intentional behavior in hurricane risk areas.

A quasi-experimental study was conducted from October to November, 2020 and a total of 80 respondents were recruited using cluster sampling. The treatment group was given the intervention in the form of the disaster preparedness app for 2 weeks. Meanwhile, the control group received home visits and conventional education about hurricane disasters twice throughout the same period. We then used a Wilcoxon Signed Rank test to analyze the pre-test and post-test and a Mann-Whitney U test to compare between treatment and control groups.

After the implementation of the SiBen app, we found a statistically significant difference in knowledge between treatment and control groups (P < 0.003) and intentional behavior between treatment and control groups (P < 0.001).

The findings indicate that the disaster preparedness app was an effective educational program able to improve the knowledge and intentional behavior among community members in a hurricane risk area.

Nepal female community health volunteers (FCHVs) were the first available health personnel in communities during the 2015 Nepal earthquakes. This study explored the facilitating factors and barriers of the FCHVs during health emergencies.

In-depth interviews with 24 FCHVs and 4 health managers from 2 districts in Nepal (Gorkha and Sindhupalchowk) were conducted using semi-structured interview guides. The qualitative data were analyzed using thematic analysis methods.

FCHVs were the first responders to provide services after the earthquakes and were well accepted by the local communities. Different models of supervision existed, and differences in the workload and remuneration offered to FCHVs were described. A wide range of disaster-related knowledge and skills were required by FCHVs, and lack of prior training was an issue for some respondents. Furthermore, lack of access to adequate medical supplies was a major barrier for FCHVs in the 2015 earthquakes. The 5 identified themes were discussed.

Providing regular disaster response training for FCHVs and strong leadership from the public sector with sustained investments will be essential for increasing the capacities of community health workforces to prepare for and reduce the impacts of future health emergencies in resource-poor settings.

The coronavirus disease 2019 (COVID-19) outbreak is the most threatening public health challenge in the 21th century, and more than 200 countries are affected. Considering that Iran was one of the first countries influenced by the COVID-19 pandemic, this study aimed to explain the crisis management strategies during the COVID-19 pandemic in Ardabil province.

This study used a qualitative method using content analysis in which 12 health-care managers or decision-makers involved in the management of the COVID-19 crisis were recruited through purposeful sampling. In-depth, semi-structured interviews were used to collect data, which continued until data saturation.

Data analysis led to nine categories, including prior preparation for the COVID-19 crisis; challenges and management of workforce shortages; benefiting from the participation of volunteer staff; challenges and strategies for physical space, supplies, and personal protective equipment (PPE); designation of referral centers for COVID-19; protocolized patient transport; benefiting from donations and charity support; management of information about COVID-19; and learning from the prior stages of crisis.

This study revealed that, in critical situations, managers use multiple and, to some extent, unique strategies for decision-making and crisis control. Therefore, the health system can use the findings of the current study for proper response to similar crises and training of future managers.