Posttraumatic stress disorder is one of the most studied outcomes after a disaster. Posttraumatic stress symptoms (PTSS) are maladaptive and disabling and can severely impair affected individuals’ psychosocial functioning and quality of life. Consequently, the objective of this research is to investigate the prevalence of PTSS and physical illness among disaster victims.

We analyzed disaster victims’ survey data in South Korea 1 year after a natural disaster (n = 1659). Then, we performed multivariable comparisons of social and work adjustments between individuals with PTSS and individuals with physical illness to examine the association between PTSS and functional impairment.

Individuals with PTSS had a significant association with work and social maladjustments whether or not they had a physical illness; PTSS (+) physical illness (-) group (OR: 1.18, CI: 1.12–1.26, P < 0.001) and PTSS (+) physical illness (+) group (OR: 1.16, CI: 1.08–1.23, P < 0.001). Interestingly, this association was not significant in the group that exclusively presented physical illness.

Our results suggest that PTSS might be a critical factor in social maladjustment during the post-disaster period. Subsequently, an assessment of disaster victims’ PTSS would help ensure effective medical and governmental approaches to assist disaster victims.

The aim of this work was to develop a table-top exercise (TTX) program for mass-casualty incident (MCI) response based on a real incident to evaluate the program.

The TTX program was developed based on the 8 TTX design steps. Convenience sampling was adopted to recruit recently graduated physicians in China. After the TTX training, the participants completed a self-designed questionnaire, as well as the Simulation Design Scale (SDS) and Educational Practices in Simulation Scale (EPSS).

In total, 148 valid questionnaires were collected. The difficulty score of the TTX program was 3.69 ± 0.8. The participants evaluated the program highly, with a score of 4.72 ± 0.54 out of 5. Both the SDS and the EPSS had average scores higher than 4.5. Guided reflection/feedback (M = 4.68, SD = 0.41) and fidelity (M =4.66, SD = 0.57) were the 2 highest-rated SDS subscales. For the EPSS, diverse ways of learning and collaboration were the 2 highest-rated subscales. Multivariate stepwise regression analysis showed that the participants’ evaluations of the TTX training course were related to the EPSS score, the difficulty rating, the evaluation of the instructional props, and the degree of participant involvement (F = 24.385, P < 0.001).

A TTX program for MCIs was developed based on the 2014 Shanghai New Year Crush. The TTX kit is practical and sophisticated, and it provides an effective strategy for MCI training.

“Determine which clients to recommend for discharge in a disaster situation” is a Registered Nurse Activity Statement on the National Council Licensing Exam test plan. The activity statement raised the nursing education research question: could senior student nurses transfer their learning to a novel circumstance, with a high degree of risk, making decisions using patient assessments and determining resource needs? A study with a descriptive quantitative approach was designed with 2 aims. The first was to describe students’ transfer of learning for basic disaster and medical-surgical knowledge and make recommendations for patient dispositions. The second aim was to describe students’ attitudes about their transfer of learning during the tabletop exercise.

A researcher-designed disaster-scenario tabletop exercise and 3 instruments with subject-matter-expert feedback captured participants’ decisions. Eligible senior student nurses volunteered to participate in the replicated study that was extended to 2 universities. Participant decisions and attitude responses were statistically analyzed.

Descriptive and difficulty index statistics described students’ transfer of learning for basic disaster and medical-surgical topics, patient disposition recommendations, and attitudes. The cut-score for optimal transfer of learning was difficulty index (DI) ≤ .49.

Students had positive attitudes and transferred learning to most decisions. Decision DIs ≤ .49 were remediated.

Running exercise courses in different sectors of the health system is one of the important steps to prepare and deploy disaster risk management programs. The present study aimed to identify and explain the components affecting the design of preparedness exercises of the health system in disasters.

This study was a qualitative content analysis. Data were collected by purposeful sampling through in-depth and semi-structured individual interviews with 25 health professionals in disasters who had experience in designing, implementing, and evaluating an exercise. The data were analyzed using the content analysis method.

The data analysis resulted in the production of 50 initial codes, 12 subcategories, 4 main categories of “Coordination, Command, and Guidance of Exercise,” “Hardware and Software Requirements of Exercise,” “Organizational Exercise Resources,” and “Communication and Exercise Public Information” with the original theme of “Exercise Design.”

This study provides a clear picture and rich, constructive information on the concept of designing health system preparedness exercises in disasters. The findings of this study can greatly increase the attention of senior managers in all areas of health, especially managers of prehospitals and hospitals who are in the front line of the response to disasters to design standard and scientific preparedness exercises.

Many triage algorithms exist for use in mass-casualty incidents (MCIs) involving pediatric patients. Most of these algorithms have not been validated for reliability across users.

Investigators sought to compare inter-rater reliability (IRR) and agreement among five MCI algorithms used in the pediatric population.

A dataset of 253 pediatric (<14 years of age) trauma activations from a Level I trauma center was used to obtain prehospital information and demographics. Three raters were trained on five MCI triage algorithms: Simple Triage and Rapid Treatment (START) and JumpSTART, as appropriate for age (combined as J-START); Sort Assess Life-Saving Intervention Treatment (SALT); Pediatric Triage Tape (PTT); CareFlight (CF); and Sacco Triage Method (STM). Patient outcomes were collected but not available to raters. Each rater triaged the full set of patients into Green, Yellow, Red, or Black categories with each of the five MCI algorithms. The IRR was reported as weighted kappa scores with 95% confidence intervals (CI). Descriptive statistics were used to describe inter-rater and inter-MCI algorithm agreement.

Of the 253 patients, 247 had complete triage assignments among the five algorithms and were included in the study. The IRR was excellent for a majority of the algorithms; however, J-START and CF had the highest reliability with a kappa 0.94 or higher (0.9-1.0, 95% CI for overall weighted kappa). The greatest variability was in SALT among Green and Yellow patients. Overall, J-START and CF had the highest inter-rater and inter-MCI algorithm agreements.

The IRR was excellent for a majority of the algorithms. The SALT algorithm, which contains subjective components, had the lowest IRR when applied to this dataset of pediatric trauma patients. Both J-START and CF demonstrated the best overall reliability and agreement.

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.

Hospitalized neonates are vulnerable to natural and man-made disasters because of their persistent requirement for medical resources and may need to be evacuated to safe locations when electricity and medical gas supply become unreliable. In Japan, a triage system for hospitalized neonates, or the Simple Triage and Rapid Treatment for Neonates, Revised (START-Neo-R), has been used to determine whether neonates are in suitable conditions for transportation. However, this scale is not useful to determine the evacuation order of neonates because a considerable number of evacuees are classified into the same categories.

To solve this problem, a novel triage system, Neonatal Extrication Triage (NEXT) was developed. This study tested the validity and reproducibility of both triages and compared them with a standardized prognostic scoring system for hospitalized neonates, the Neonatal Therapeutic Intervention Scoring System (NTISS).

In this retrospective observational study, physicians and nurses independently assessed each neonate hospitalized at a tertiary neonatal intensive care unit (NICU) twice weekly using NEXT and START-Neo-R. The NEXT system comprises six questionnaires regarding medical resources required during transition and transportation, providing composite scores on a 12-point scale. The START-Neo-R classified neonates into five levels based on the severity of disease and dependence on medical care. Inter-rater reliability of both systems was assessed using Cohen’s kappa coefficient, whereas the criterion validity with NTISS was assessed using Spearman’s correlation coefficient.

Overall, 162 neonates were assessed for 49 days, resulting in triage data for 1,079 accumulated patients. Both NEXT scores and START-Neo-R ranks were well-dispersed across different levels without excessive accumulation in specific categories. Inter-rater reliability of NEXT (kappa coefficient, 0.973; 95% confidence interval, 0.969-0.976) and START-Neo-R (kappa coefficient, 0.952; 95% confidence interval, 0.946-0.957) between physicians and nurses was sufficiently high. The correlation coefficient of NEXT and START-Neo-R scores with NTISS scores were 0.889 (P <.001) and 0.850 (P <.001), respectively.

Both START-Neo-R and NEXT had good reproducibility and correlation with the severity of neonates indicated by NTISS. With its well-dispersed scores across different levels, the NEXT system might be a powerful tool to determine the priority of evacuation objectively.

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.

The aim of this study was to examine birth outcomes in areas affected by Hurricane Michael.

Vital statistics data of 2017–2019 were obtained from the state of Florida. Births occurring in the year before and after the date of Hurricane Michael (October 7, 2018) were used. Florida counties were divided into 3 categories reflecting extent of impact from Hurricane Michael. Birth outcomes including incidence of preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA) were also compared before and after Hurricane Michael. Spontaneous and indicated PTBs were distinguished based on previously published algorithms. Multiple regression was used to control for potential confounders.

Both LBW (aRR 1.19, 95% CI: 1.07, 1.32) and SGA (aRR 1.11, 95% CI: 1.01, 1.21) were higher in the year after Michael than the year before in the most-affected area; a similar effect was not seen in other areas. A stronger effect was seen for exposure in the first trimester or in the 2 months after Michael than in the second or third trimester.

Consistent with many previous studies, this study of Hurricane Michael found an effect on fetal growth.

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.

In a mass-casualty incident (MCI) involving children, there is a need to apply accurate triage tools in order to help those who require important care, and at the same time, to avoid unnecessary use of resources. Thus, it is discussed which would be the best triage device to use in these situations. One of the most used is a modification of Simple Triage and Rapid Treatment, JumpSTART, whose performative quality this review focuses on.

This review sought to compare the performance parameters of JumpSTART with other triage algorithms used in pediatric disaster victims.

This systematic review was performed according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered with the PROSPERO database of systematic reviews with the number CRD42021258415. The last update of the search in the databases was on August 12, 2021 and resulted in six documents to be analyzed. The inclusion criteria included the peer-reviewed academic papers in English, Portuguese, Spanish, and Italian languages, and the databases used were PubMed, Scopus, MEDLINE/Bireme (Virtual Library of Health), Web of Science, and CINAHL, which executes the query on the topic, keywords, or abstracts. Also to be included, documents that were available with full-text access through CAPES, Google, or Google Scholar. Books, non-academic research, and content in languages other than the presented ones were represented as exclusion criteria. The Joanna Briggs Institute (JBI) checklists were used to evaluate the methodological quality of the retrieved studies. The results were presented through narrative synthesis. This review was not funded.

Of the collected publications, five articles were used to carry out this review, with the addition of an extra article captured by citation tracking. The findings from the obtained results were that JumpSTART was the preferred tool and presented the fastest speed of use. Only one of the five studies that dealt with accuracy showed JumpSTART as the most accurate algorithm, while three of the other four showed its inferiority in most aspects. In one study, no significant difference was observed amongst the chosen protocols.

There is insufficient evidence to validate JumpSTART as a universal triage tool, given the disparities in the results obtained from the comparisons. No tool performed satisfactorily well, therefore there is an urgent need to create a reliable algorithm.

Acute and chronic stress after severe earthquakes can contribute to cardiovascular events, including heart failure (HF). On April 14, 2016, magnitude 7 earthquakes occurred in the Aso region in the western part of Japan. This study aimed to investigate the clinical characteristics of HF in this area after these earthquakes.

We investigated the clinical characteristics and 1-y mortality rate of patients with HF. Nutritional status was evaluated with the Geriatric Nutritional Risk Index (GNRI) and the Prognostic Nutritional Index (PNI).

Among a total of 58 cardiovascular events, HF was the most frequently observed (n = 28). The mean age of individuals with HF was 85.5 y. The total incidence of HF was significantly higher compared with the average of the prior 2 y. Disaster influence on mental health was suggested by patient history in 20 patients (71%). The 1-y mortality rate among patients with HF was 50%. Among those who died, 93% had malnutrition status (GNRI <92 and /or PNI ≤38).

Our results demonstrated the poor prognosis of patients with HF following the disaster. The prevalence of malnutrition was high in those patients. Careful follow-up is necessary, especially for older people with frailty.

To assess the level of neonatal intensive care unit (NICU) disaster preparedness among pediatric residents.

A mixed-methods study including qualitative interviews and quantitative surveys was used. Interviews guided survey development. Surveys were distributed to residents who rotated through Children’s National NICU. Questions assessed residents’ background in disaster preparedness, disaster protocol knowledge, NICU preparedness, roles during surge and evacuation, and views on training and education.

Survey response was 62.5% (n = 80) with 51.3% of invited residents completing it. Pediatric residents (PGY-2 and PGY-3) (n = 41) had low levels of individual disaster preparedness, particularly evacuations (86%). None were aware of specific NICU disaster protocols. Patient acuity, role ambiguity, knowledge, and training deficits were major contributors to unpreparedness. Residents viewed their role as system facilitators (eg, performing duties assigned, recruiting other residents, and clerical work like documentation). Resident training requests included disaster preparedness training every NICU rotation (48%) using multidisciplinary simulations (66%), role definition (56%), and written protocols (50%). Despite their unpreparedness, residents (84%) were willing to respond.

Pediatric residents lacked knowledge of NICU disaster response but were willing to respond to disasters. Training should include multi-disciplinary simulations that can be refined iteratively to clarify roles, and residents should be involved in planning and execution.