Disaster Medicine and Public Health Preparedness最新文献

Introduction: Community pharmacies fulfill a pivotal function in maintaining the uninterrupted delivery of health care services and safeguarding the medication supply chain during disaster situations. However, the extant evidence regarding the disaster preparedness levels of pharmacies is limited, particularly in regions with high seismic risk.

Objective: The objective of this study was to assess the disaster preparedness levels of community pharmacies in Istanbul and to examine factors associated with their preparedness status.

Methods: In this descriptive cross-sectional study, conducted between December 2024 and April 2025, researchers collected data from 360 pharmacies. These pharmacies were selected using a systematic sampling method. The researchers developed a structured questionnaire to collect the data.

Results: The investigation revealed that only 32.8% of pharmacies had a disaster plan, 91.7% had not conducted drills, 85.6% lacked smoke detectors, and 71.4% lacked fire alarms. Conversely, 87.5% of pharmacies reported collaborating with neighboring pharmacies or regional representatives during disaster situations. The findings of the study indicated that pharmacies that had undergone disaster training exhibited significantly higher levels of safety equipment, planning, and material stockpiles (P < 0.05).

Conclusion: The findings indicate that pharmacies in Istanbul demonstrate proficiency in collaboration and fundamental supply procurement. However, deficiencies are observed in drills, fire safety measures, data backup protocols, and strategic planning. In order to enhance the disaster resilience of pharmacies, it is imperative that training programs be expanded, drills be made mandatory, and institutional governance be strengthened.

Objective: Hospital mass casualty incident (MCI) plans must be able to remain operational during wartime. This study examined the impact of the October 7, 2023, attacks on the activation and execution of an MCI protocol in a hospital in southern Israel.

Methods: This qualitative study employed thematic analysis of semi-structured interviews conducted with 19 Emergency Department (ED) staff members who worked on October 7, 2023. Interview questions were developed by the authors, based on their professional experiences as physicians, with input from personnel involved in the October 7, 2023, response. Thematic saturation was considered achieved when consecutive interviews yielded no new themes.

Results: Three themes were identified. Threats to staff safety affected staff mobilization and prevented evacuation of patients from the ED. The prolonged and evolving nature of the attacks created unpredictability. Limited official information was partially compensated for through alternative information sources. Finally, a culture of frequent MCI drills contributed to maintaining patient flow and standards of care.

Conclusions: During wartime, MCI plans can remain effective by prioritizing staff safety and mitigating burnout. Information should be collected from multiple sources to compensate for uncertainty and limited situational awareness. Frequent, realistic drills help to maintain operational performance under the extreme stress of war.

Background: Floods are increasing with climate change, and evacuating medically vulnerable people receiving home healthcare remains challenging. Patients dependent on medical devices and long-term care face complex challenges throughout the evacuation process. However, key factors influencing successful evacuation and effective support strategies remain underexamined. This study aimed to identify such factors and essential support measures across evacuation phases.

Methods: Semi-structured interviews were conducted with 13 participants-family caregivers, healthcare providers, and municipal officials-from July 2022 to March 2023 in 3 Japanese regions. Snowball sampling was used via medical administrative institutions. Thematic analysis followed COREQ guidelines, focusing on three phases: preparation, evacuation, and post-evacuation. Ethics approval was obtained (MG2022-01).

Results: Preparation showed heterogeneous readiness: some services had hazard maps and manuals/BCPs, whereas household engagement was limited and operationalization was constrained by resources. During evacuation, participants described transport and staffing limitations, difficulty in moving medical equipment, and uncertainty about feasible options, with occasional consideration of vertical evacuation. Post-evacuation challenges centered on shelter sanitation and supplies, continuity of medical support, and coordination of support systems.

Conclusions: A three-phase, multi-stakeholder perspective clarifies how constraints accumulate and informs coordinated planning among municipalities, home-care teams, and families. Limitations include a small, region-specific sample and no direct patient interviews.

Objective: Terrorist attacks targeting the mining sector represent an under-explored threat. This study aims to characterize the epidemiology, distribution, and features of mining-related terrorism events.

Methods: A retrospective search of the Global Terrorism Database was performed, querying attacks between 1970 and 2020 with "business" as primary target type and "mining" as subtype. Attacks were analyzed by region, perpetrating group, modality, and weapon type.

Results: There were 541 mining-related attacks from 1970 to 2020, leading to 617 deaths and 574 injuries. Frequency of mining-related attacks has increased in recent years, particularly after 2010. Geographically, South Asia (23.7%), South America (22.9%), and Southeast Asia (22.7%) had the most attacks. Attacks in sub-Saharan Africa comprised a smaller percentage of attacks (16.6%), but the largest fraction of deaths (60.0%) and injuries (61.5%). Anarchist/revolutionary groups were the most common perpetrators (46.0%). Religious extremist groups were responsible for fewer attacks (6.1%) but had outsized impact in terms of deaths (16.4%) and injuries (17.6%). Armed assault was the most common modality (28.1%) and comprised most deaths (56.9%) and injuries (51.0%). Hostage-taking comprised 19.0% of incidents, with 775 hostages taken. Coal (20.0%) and gold (10.4%) were the most targeted minerals.

Conclusions: Mining-related terrorist attacks have increased in recent years and are characterized by high operational success, politically motivated perpetrating groups, disproportionate lethality in sub-Saharan Africa, and frequent hostage-taking.

Objective: While the World Health Organization established minimum standards for emergency medical teams (EMTs) in 2013, globally recognized competency standards for individual disaster medical responders remain lacking. This study identifies and synthesizes existing competencies, qualifications, and training requirements for physicians, nurses, and paramedics who serve as deployable disaster response specialists on EMTs.

Methods: A scoping review was conducted following PRISMA-ScR guidelines. Comprehensive searches of five databases were performed in September, 2024. Gray literature from 22 governmental and non-governmental organizations was also reviewed. Studies addressing competencies or requirements for disaster specialists (physicians, nurses, paramedics) participating in disaster response were included.

Results: Fifty-four studies were included, most being nursing-focused (n = 28, 51.9%). Studies predominantly originated from the United States (n = 15, 27.8%) and China (n = 9, 16.7%). Training program duration ranged from single-day workshops to multi-week courses, with varied delivery formats. Core competencies identified across professions included Incident Command System knowledge, triage skills, communication abilities, personal protective equipment use, psychological first aid, ethical-legal preparedness, clinical-technical skills, and leadership capabilities.

Conclusions: Substantial convergence exists around core disaster medicine competencies, yet significant variability persists in training approaches and duration. The establishment of globally recognized, evidence-based competency standards for individual disaster medical specialists represents a critical next step.

Objective: The increasing frequency of international disasters necessitates robust military-civilian collaboration, often requiring the U.S. Department of Defense (DoD) to augment civilian humanitarian assistance and disaster relief (HADR) capacity and support U.S. geopolitical objectives.

Methods: A retrospective quantitative analysis was performed on 149 international HADR events involving DoD support between 1997 and 2024. Data were collated from U.S. Department of State records and narrative reports from the DoD. Events were categorized by geographic area, disaster type, and alignment with the United Nations Humanitarian Cluster System.

Results: The DoD supported HADR efforts in 68 countries, with the Philippines, Iraq, and Indonesia being the most frequent recipients. More than 50% of events occurred in South America and the Indo-Pacific. The most common triggers for support were earthquakes, complex emergencies, and tropical cyclones. Mapping activities to the UN Cluster System revealed that the DoD primarily provided support for Logistics, Early Recovery, and Health.

Conclusions: Following major disasters, rapid deployment of DoD capabilities was indispensable in austere environments where civilian federal organizations and local governments were overwhelmed, incapacitated, or nonexistent. Addressing data deficiencies and coordinating military-civilian readiness are critical for enhancing the effectiveness of future responses.

Objective: To evaluate the mental health of play-age children affected by the 2023 Türkiye-Syria earthquakes and their mothers, using single-item scales.

Methods: Four hundred earthquake survivor mother-child dyads were included. The mental health of mothers and children was assessed using single-item screening tools, the Self-Reported Mother Mental Health (SRMH) and the Mother-Reported Child Mental Health (MRCMH).

Results: The prevalence of negative mental health increased from 10% to 52% in play-age children and from 13% to 70% in their mothers after the earthquakes. For post-earthquake negative SRMH, associated factors included limited access to safe water (AOR = 2.52, 95% CI: 1.10-5.75, P = 0.029), good perception of security services (AOR = 0.30, 95% CI: 0.12-0.73, P = 0.008), and post-earthquake negative MRCMH (AOR = 8.65, 95% CI: 4.70-15.91, P < 0.001). For post-earthquake negative MRCMH, associated factors were out-of-house sheltering (AOR = 3.13, 95% CI: 1.72-5.69, P < 0.001), good perception of nutritional services (AOR = 0.46, 95% CI: 0.22-0.96, P = 0.039), pre-earthquake negative MRCMH (AOR = 4.68, 95% CI: 1.87-11.73, P = 0.001), and post-earthquake negative SRMH (AOR = 11.35, 95% CI: 5.92-21.76, P < 0.001).

Conclusion: Post-earthquake mental health outcomes were most consistently predicted by limited basic resources (water and nutrition services), not good service quality, and pre-existing or co-occurring negative mental health.

Objective: Türkiye's recurrent exposure to natural disasters necessitates a well-prepared health care workforce, particularly in terms of psychological readiness. This study investigates the psychological preparedness of undergraduate students enrolled in the Faculty of Health Sciences, with attention to demographic and experiential variables that may influence preparedness levels.

Methods: A cross-sectional study was conducted with 514 undergraduate students enrolled in the Faculty of Health Sciences. Participants were recruited on a voluntary basis, and data were collected through face-to-face surveys using the Psychological Preparedness for Disaster Threat Scale and a personal information form. The data were analyzed using descriptive statistics, independent samples t-tests, ANOVA, and MANOVA.

Results: Preparedness levels differed significantly by gender, age, department, and disaster experience (P <.05). Emergency and Disaster Management students scored the highest. MANOVA confirmed a significant departmental effect (Wilks' lambda = .891, F(12, 1366) = 4.24, P <.001). Students with prior disaster exposure demonstrated significantly higher levels of psychological preparedness.

Conclusions: The findings underscore the critical role of structured disaster education and psychological resilience training within health sciences curricula. Integrating simulation-based learning approaches, gender-sensitive instructional content, and targeted psychosocial support systems may enhance the preparedness of future health care professionals for disaster response.

Rapid mass displacement can transform active conflict into a broader public health emergency by compressing shelter demand and continuity-of-care needs into a narrow time frame. The March 2026 escalation in Lebanon provides a timely case to examine these dynamics within a health system already operating under severe constraints. This paper analyzes the early response phase, focusing on how displacement reshaped shelter operations, access to primary care, continuity of medications, and referral pathways. Much of the resulting health risk emerges from treatment interruption and weakened linkage to essential services. Beyond being a humanitarian outcome, displacement should be understood as a health systems event that can amplify secondary morbidity. In fragile settings, preparedness must prioritize health-protective sheltering, continuity of care, and coordinated referral mechanisms under conditions of disruption.

Background: The escalating frequency and severity of disasters and the emergence of global health threats such as the COVID-19 pandemic have exposed vulnerabilities in hospital preparedness and response systems.

Objective: This study explores leaders' perceptions of the SHEPA tool's application in Saudi hospitals to enhance emergency preparedness.

Methods: A cross-sectional survey of 21 Health Emergency Operations Center (HEOC) leaders assessed familiarity, usefulness, ease of use, and impact using a Likert scale and open-ended questions. Logistic regression was used to analyze differences by occupation and experience.

Results: The study participants primarily consisted of mid-career professionals, with the majority (57.1%) falling within the 25-34 years age group. A significant gender imbalance was observed, with male participants (85.7%) vastly outnumbering their female counterparts (14.3%). Educationally, most participants held a Bachelor's degree (61.9%). Most participants (71-81%) rated the tool highly useful and impactful, though ease of use received mixed reviews. Experienced professionals valued utility more but critiqued impact (OR = 5096 for usefulness; OR = 0.07 for impact). Given the small sample size (N = 21), these logistic regression findings should be interpreted as exploratory and hypothesis-generating rather than confirmatory. However, the consistent patterns suggested that both professional role and experience level meaningfully shaped how the SHEPA tool is perceived, with more senior and experienced staff showing both greater appreciation of its utility and critical assessment of its impacts.

Conclusions: This study highlighted the SHEPA tool's potential to strengthen hospital emergency preparedness in Saudi Arabia, with strong endorsement from health emergency operations centers' leaders. The tool's perceived usefulness and ability to identify improvement areas align with national preparedness goals, though its ease of use and impact evaluation require refinement. The logistic regression findings are exploratory due to the limited sample size and require validation in larger, more diverse cohorts.