Escalating global challenges (such as disasters, conflict, and climate change) underline the importance of addressing Chemical, Biological, Radiological, and Nuclear (CBRN) terrorism for sustainable public health strategies. This study aims to provide a comprehensive epidemiological analysis of CBRN incidents in the Middle East and North Africa (MENA) region, emphasizing the necessity of sustainable responses to safeguard healthcare infrastructures.

Utilizing a retrospective approach, this research analyzes data from the Global Terrorism Database (GTD) covering the period from 2003 to 2020. The study focuses on examining the frequency, characteristics, and consequences of CBRN incidents in the MENA region to identify patterns and trends that pose significant challenges to public health systems.

The analysis revealed a significant clustering of CBRN incidents in Iraq and Syria, with a predominant involvement of chemical agents. These findings indicate the extensive impact of CBRN terrorism on healthcare infrastructures, highlighting the challenges in providing immediate health responses and the necessity for long-term recovery strategies.

The study underscores the need for improved healthcare preparedness, robust emergency response systems, and the development of sustainable public health policies. Advocating for international collaboration, the research contributes to the strategic adaptation of healthcare systems to mitigate the impacts of CBRN terrorism, ensuring preparedness for future incidents in the MENA region and beyond.

The coronavirus disease (COVID-19) pandemic necessitated alternative methods to ensure the continuity of medical education. Our study explores the efficacy and acceptability of a digital continuous medical education initiative for medical residents during this challenging period.

From September to December 2020, 47 out of 60 enrolled trainee doctors participated in this innovative digital Continuous Medical Education (CME) approach. We utilized the Script Concordance Test to bolster clinical reasoning skills. Three simulation scenarios, namely Advanced Trauma Life Support (ATLS), Advanced Life Support (ALS), and European Paediatric Life Support (EPLS), were transformed into interactive online sessions via Zoom™. Participant feedback was also collected through a survey.

Consistent Script Concordance Testing (SCT) scores among participants indicated the effectiveness of the online training module. Feedback suggested a broad acceptance of this novel training approach. However, discrepancies observed between formative SCT scores, and summative Multiple-Choice Questions (MCQ) assessments highlighted areas for potential refinement.

Our findings showcase the resilience and adaptability of medical education amidst challenges like the global pandemic. The success of methodologies such as SCT, endorsed by prestigious bodies like the European Resuscitation Council and the American Heart Association, suggests their potential in preparing health care professionals for emergent situations. This research offers valuable insights for shaping future online CME strategies.

The pandemic caused by the SARS-CoV-2 virus, which has been rapidly developing globally since the beginning of 2020, has forced individual states to take many restrictive decisions aimed at stopping the pandemic and controlling the crisis situation. In Poland, the strategy of fighting the pandemic in the initial phase covered the entire country and was based primarily on preventive mechanisms to identify and quell the pandemic.

A retrospective analysis was conducted incorporating media and a literature review. This retrospective analysis was performed using legal acts and press resources and other media reports to investigate every province of Poland.

This research describes one element of the state security system tasks, that of securing an appropriate number of hospital beds for COVID-19 patients. The process focused first on establishing both the purpose and tasks of dedicated hospitals followed by discussions of the potential problems related to the functioning of these specialized facilities for patients infected with SARS-COV-2 virus. Primary attention was given to ensuring both the security of the crisis situation and the diligent monitoring of the current epidemic

In order to effectively use human and infrastructural resources, it was crucial to implement objective, unified methods of organization and management, as well as ongoing evaluation of the results of the conducted activity.

The current hybrid war in Ukraine clearly shows the impacts of modern warfare on civilians. Infrastructure, including healthcare facilities, energy sources, and every entity supporting the lifeline of the people are under attack, leaving no options but to leave the country for those who can. Since the outbreak of the conflict, over three million Ukrainian women and children have migrated to the neighboring countries. Although women and children might be the healthiest groups among refugees, they create other challenges within healthcare.

Qualitative and quantitative methods which describes all possible impacts of the war on the refugees’ situation in three periods of time.

Migration: During this period, besides the risk of trauma, there are other types of diseases such as infectious diseases that influence the outcome of the migration.

Settlement: This period consists of emergency physical and psychological conditions that bring the refugees to the hospitals. Hygenic issues and exposure to new diseases such as Covid-19 can be part of this period. Additionally, there might be social adjustment issues that need to be discussed.

The post-conflict: Consists of PTSD and other psychological impacts of the war, which may change the course of the life of many survivors. The final impact of the failure in social adjustment may also result in long-term socio-cultural issues.

We expect that the results of the submitted projects demonstrate the unforeseen physical and psychological wounds in refugees, irrespective of their age and background. One major outcome would be the failure of the social adjustment and if possible, a comparison with previous wars’ refugees.

The research will conclude by presenting a summary of all results and categorization of the conditions that influence the well-being of refugees as well as the host country. New recommendations will be available based on the experience gained and the results presented.

Saudi Arabia has experienced special challenges calling for effective teamwork in the management of disasters and emergencies, such as wars, earthquakes, and major accidents linked to the Hajj pilgrimage over the years. In 2015, 769 pilgrims died in a crowd stampede during Hajj. The outcome of the incident could have been different if the rescuers had the necessary multiagency and collaborative disaster education. This study aims to determine the development of Saudi HCWs’ teamwork during collaboration exercises.

This study employed two methods to gather data: (observational) during three-level-collaboration (3LC) tabletop-exercises and semi-structured interviews, by employing two theoretical models (team development models). The number of participants was (100) HCWs.

The results of these exercises had a positive impact on the functionality of HCWs and helped them prepare for disaster management and mitigation inside and outside of a medical facility. Based on the theoretical framework of the integration of team members, the participants reported that the trans-professional team developed because they understood the scenarios. In addition, the participants underscored they developed their skills and knowledge of disaster management because of the attempts made in scenario one. Furthermore, on the theoretical framework of team maturity, several participants indicated that immaturity in scenario one is because of the team members not having the same knowledge and skills. While in scenario two, they are mature because of training and challenges resulting in individual development.

This study focused on determining the development of healthcare teamwork during collaborative exercises. HCWs were exposed to two scenarios. The tabletop training enabled HCWs to gain the maturity in team building and disaster management. Immature and overripe HCWs cannot easily embrace teamwork. In addition, the public should be made aware of disasters that may come their way. Continuous training of HCWs and creating public awareness are essential parts of disaster management.

One of the most severe outcomes of the Ukraine war has been the systematic destruction of communities resulting in mass migration of people to Poland. Millions of affected people have arrived in Poland as war refugees requiring medical attention from a fragile health care system overburdened by the COVID-19 pandemic. This study assesses ED utilization in Polish hospitals by Ukrainian refugees.

To assess the impact of Ukrainian refugees on ED utilization in Poland.

Demographic data, chief presenting complaints, diagnosis, and the level of care needed were registered. Bivariate and multivariate logistic regression analysis were performed to yield odds ratios (OR) with a 95% confidence interval.

At the time of investigation, there were 4,000 Ukrainian refugees admitted to Polish hospitals, of which more than half were children. Results are forthcoming.

Although COVID-19 pandemic highlighted the insufficiency of the Polish health care system, resulting in delayed treatment for many patients, the current mass migration from Ukraine emphasizes the lack of a proper organization for crisis management in Poland. Facing an unprecedented and historic challenge, the Polish health care system, operating at the limit of its capacity, is stretched beyond capacity resulting in excess mortality, which exceeded 200,000 deaths during the pandemic. The impact was directly due to the pandemic or the delay in treating other diseases such as cardiovascular diseases and cancer. Inconsistency in medical decision making, lack of proper recommendations from the authorities, and organizational insufficiency requires a renewed focus on adaptive capacity and long-term solutions that promote systems resiliency.

Global climate change (global warming) has been identified as the primary factor responsible for the observed increase in frequency and severity of wildfires (also known as bushfires in some countries) throughout the majority of the world’s vegetated environments. This trend is predicted to continue, causing significant adverse health effects to nearby residential populations and placing a potential strain on local emergency departments (EDs).

The aim of this literature review was to identify papers relating to wildfires and their impact on EDs, specifically patient presentation characteristics, resource utilization, and patient outcomes.

This integrative literature review was guided by the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) guidelines for data collection, and Whittemore and Knafl’s framework for data analysis. Data were collected from OvidSP, MEDLINE, DARE, CINAHL, PubMed, and Scopus databases. Various Medical Subject Headings (MeSH) and keywords identified papers relevant to wildfires/bushfires and EDs.

Literature regarding the relationship between ED presentations and wildfire events, however, is primarily limited to studies from the United States and Australia and indicates particulate matter (PM) is principally linked to adverse respiratory and cardiovascular outcomes. Observable trends in the literature principally included a significant increase in respiratory presentations, primarily with a lag of one to two days from the initial event. Respiratory and cardiovascular studies that stratified results by age indicated individuals under five, over 65, or those with pre-existing conditions formed the majority of ED presentations.

Key learnings from this review included the need for effective and targeted community advisory programs/procedures, prior to and during wildfire events, as well as pre-event planning, development, and robust resilience strategies for EDs.

Over the past five decades, Eastern Europe has seen relatively little in terms of terrorist attacks. The recent escalation of the Russo-Ukrainian conflict has, however, placed a new spotlight on the region, and new questions and concerns around war, conflict, insurgency, and terrorism are being posed. The Russian invasion and extensive combat operations, the largest in Europe since World War II, are occurring across Ukraine where there are 15 active nuclear reactors, not including the Chernobyl site, that are vulnerable to attack or sabotage. In addition, Eastern Europe has been heavily affected by COVID-19, exposing broad vulnerabilities in an otherwise fragile health care system. This raises concerns over the ability of Eastern European health care institutions to absorb surge and manage terrorist attacks or acts of violent extremism. This study provides an epidemiological description of all terrorism-related fatalities and injuries in Eastern Europe sustained from 1970 – 2019.

Data collection was performed using a retrospective database search through the Global Terrorism Database (GTD). The GTD was searched using the internal database functions for all terrorism events which occurred in Eastern Europe from January 1, 1970 - December 31, 2019. Years 2020 and 2021 were not yet available at the time of this study. Primary weapon type, country where the incident occurred, and number of deaths and injured were collated. Results were exported into an Excel spreadsheet (Microsoft Corp.; Redmond, Washington USA) for analysis.

There were 3,901 terrorism-related events in Eastern Europe between the years 1970 and 2019, inclusive. In total, the attacks resulted in 5,391 deaths and 9,538 persons injured. Explosives were the most commonly used weapon type in 59.2% of all attacks in the region, followed by firearms in 27.6%.

From 1970 through 2019, a total of 3,901 terrorist attacks occurred in Eastern Europe, inflicting 5,391 deaths and 9,538 injuries. Of those, 72.3% occurred in Russia and Ukraine. Terrorist attacks sharply declined since the peak in 2014, but there is an overall uptrend in attacks since the 1970s.

In numerous countries, emergency medical services (EMS) students receive curriculum training in effective patient–provider communication, but most of this training assumes patients have intact communication capabilities, leading to a lack of preparedness to interact with patients, who have communication disorders. In such cases, first responders could end up delivering suboptimal care or possibly wrong procedures that could harm the disabled person.

A quasi-experimental design (pretest–posttest) was used to assess the knowledge of EMS students both before and after a translation workshop on how to deal with patients who have hearing and communication disorders during emergencies. Comparisons between pretest and posttest scores were examined using the Wilcoxon signed rank test. The level of knowledge scores was compared before and after the workshop.

The results indicated that EMS students’ scores improved after the workshop. There was a 0.763 increase in the average score of knowledge level. The results of this study show that knowledge translation workshops are a useful intervention to enhance the level of knowledge among EMS students when interacting with hearing and communication patients.

Our results show that such training workshops lead to better performance. Communication is a vital element in a medical encounter between health care providers and patients at all levels of health care but specifically in the prehospital arena. Insufficient or lack of communication with a vulnerable population, who may suffer from various disabilities, has a significant impact on the outcome of treatment or emergency management.