Disaster Medicine and Public Health Preparedness最新文献

Armed conflicts undermine medical education by destroying campuses and clinical training sites, displacing students and educators, and disrupting electricity and communications. In Gaza, the destruction of its 2 medical schools and hospitals compromised education for approximately 3,000 medical students. Most students have remained inside Gaza, while a minority have been displaced externally, creating parallel needs for remote curriculum delivery and external placement pathways. In Ukraine, displacement and attacks on education, health, and energy infrastructure similarly disrupted training systems that depend on in-person clinical learning. Educators and clinicians partnered across borders to mitigate these disruptions. In Gaza, Gaza Educate Medics (GEM) and the Union of Gazan Medical Students Initiative (UGMSI) coordinated remote teaching, assessment support, and placement navigation. In Ukraine, Kyiv Medical University (KMU) implemented a dual-campus hybrid model supported by a cross-border partnership. These field examples highlight transnational partnerships as a practical mechanism for sustaining medical education in conflict settings.

Background: The establishment of rapid response teams (RRTs) has gained increasing prominence due to the growing threats of emerging infectious diseases, natural disasters, and other public health emergencies. As a center for Hajj and a regional hub for commerce and travel, the Kingdom of Saudi Arabia (KSA) faces distinct challenges. This study explores the Ministry of Health's main reasons and challenges in establishing RRTs.

Methods: We employed a cross-sectional qualitative design, utilizing in-depth interviews with key stakeholders and document analysis to explore the historical process of establishing RRTs in KSA and the challenges encountered.

Results: Specialists' insights revealed that the concept of RRTs was formally introduced and applied following the initiation of the Field Epidemiology Training Program (FETP) in KSA in 1989. However, its primary implementation began after the Middle East respiratory syndrome (MERS) outbreak in 2014. Identified challenges included a lack of trained personnel and resource availability due to unclear governance. There is a need for real-time data collection and technological solutions, improved inter-agency collaboration and information sharing, and governance.

Conclusions: The establishment of RRTs in KSA is estimated to have started with the initiation of the FETP. The challenges encountered provide valuable lessons for future emergency responses.

The response to disasters or mass casualty incidents requires a multi-hazard approach and a rapid, comprehensive response. Community Emergency Response Teams have been formed around the world, where civilians, often laypersons, are integrated into local disaster response. Professionals have been organized into Disaster Medical Assistance Teams, where they are deployed to respond to a distant site. During the October 7, 2023, large-scale attacks in southern Israel, the country found itself in a new and unfamiliar reality. Initiatives began to prepare the population for possible future MCIs. The objective of this article is to describe initiatives that have developed throughout Israel to train medical professionals, including physicians, nurses, and paramedical personnel in local disaster response. These became known as Professional Community Emergency Response Teams. This includes those trained through Magen David Adom, Israel's National Emergency Medical Service, and those through a Frontline Emergency Medicine model.

Objectives: To identify stakeholders' perceptions of the role of the nurse educator in Hospital Disaster Management (HDM), determine the core competencies required for their effective participation, and establish training areas to enhance their participation during disasters.

Methods: A qualitative hermeneutic-phenomenological design was adopted with 38 stakeholders comprising doctors, clinical nurses, nurse administrators, and nurse educators in tertiary hospitals and nursing colleges in Kerala, India. The responses were collected through in-depth interviews with 15 respondents and focus group discussions with 4 different groups in December 2023.

Results: Themes identified included preparedness gaps, underuse of secondary stakeholders, training and coordination capabilities, training needs, fear of clinical competence and safety, role confusion, elitism, and social responsibility, totaling 7 themes. Participants identified roles, preparedness, variable clinical exposure, and the necessity of planned competency development as unsatisfactory. The nurse educators were able to contribute to training, supervision, documentation, and psychosocial support, provided they are well prepared.

Conclusion: Nurse educators can be of great help to HDM, but are not being used to their full potential due to unclear role expectations and limited readiness. Their competencies can be enhanced and incorporated into institutional disaster plans to build surge capacity and improve coordination in hospital disaster responses.

Objectives: Hazardous materials (HazMat) incidents pose significant risks to public health, safety, and the environment. This study aimed to characterize the temporal trends, geographic distribution, operational settings, and incident types of HazMat events reported in Oman.

Methods: This retrospective descriptive study analyzed data from the national HazMat incident records maintained by the Civil Defence and Ambulance Authority (CDAA). All reported chemical, biological, or radiological incidents between June 1, 2019, and November 30, 2024, were included.

Results: A total of 55 HazMat incidents were recorded during the study period. Reported incidents increased over time, with the highest annual counts observed in 2023 (14 incidents) and 2024 (17 incidents). Muscat Governorate accounted for 39 incidents (71%). Residential neighborhoods were the most common operational setting (26/55, 47%), followed by other public areas (9/55, 16%), while airports, educational institutions, industrial areas, and transportation corridors each accounted for 5 incidents (9%). Gas leaks were the most frequently reported incident type, involved in 28 incidents (51%).

Conclusions: HazMat incidents in Oman increased over the study period and were concentrated in Muscat Governorate. Incidents occurred across diverse operational settings, particularly residential and public environments, while gas leaks represented the most frequently reported incident type.

Objectives: The widespread use of explosive weapons in populated areas (EWIPA) has become a defining feature of modern conflict with devastating consequences for civilians. Practical guidance on sheltering during explosive attacks remains limited, inconsistent, and unevenly integrated with existing scientific and technical evidence. This study explored the landscape of shelter guidance through the perspectives of international humanitarian practitioners working in EWIPA contexts.

Methods: Semi-structured interviews were conducted with 10 practitioners from international humanitarian NGOs, Red Cross societies, and UN agencies engaged in risk education, emergency response, and conflict monitoring. Participants were purposively selected for operational experience in EWIPA-affected regions. Interviews explored 4 domains: guidance content, information sources, dissemination channels, and implementation challenges. Data were analyzed using a hybrid inductive-deductive approach.

Results: Practitioners described various sheltering messages, from general cues like "find cover" to specific techniques including low-profile positioning. Most guidance drew on field experience rather than empirical research. Dissemination strategies varied by context. Challenges included message distortion, difficulty engaging high-risk groups, and absence of standardized recommendations.

Conclusions: Shelter guidance in EWIPA contexts is fragmented and only partially connected to the existing technical and scientific evidence base. Findings highlight the need for coordinated, context-specific, and evidence-informed approaches to strengthen civilian protection.

Objectives: Researchers have revealed that the incidence of aspiration pneumonia (AP) increases following a disaster, not only due to the disaster itself but also due to environmental factors, which will propose dysphagia rehabilitation targets. We aimed to delineate the current status of dysphagia rehabilitation in disasters.

Methods: English literature was searched via scientific databases, representative journal homepages, trial registries, and gray literature.

Results: A total of 242 articles were reviewed in full text, and 31 were included in this review. Most hazards were earthquakes (19/31), and most reports originated from Japan (19/31). The reported issues were summarized according to the International Classification of Functioning, Disability, and Health (ICF) codes. Twenty-seven codes related to areas such as Swallowing, Caring for teeth, and Food were the most frequently reported. In addition, three additional items not formally listed in the ICF were considered: nutrition, oral hygiene, and denture.

Conclusions: The mechanisms of emergency lifestyle-related aspiration pneumonia were identified, and approaches to prevent AP were proposed. We further discuss how to promote dysphagia rehabilitation in disasters. Nevertheless, multidisciplinary coordination is important, and more involvement of rehabilitation specialists is required.

Objective: This study qualitatively examines community experiences related to housing following natural disasters, focusing on damage to home infrastructure, barriers to completing repairs, and the resources needed for recovery and rebuilding.

Methods: Participants included members from 3 historically underserved Houston communities (Kashmere Gardens, Fifth Ward, and Third Ward) with Social Vulnerability Index (SVI) rankings in the 80th percentile. Town hall-style conversations were held within each community; small focus groups were completed within the town halls. Reflexive thematic analysis was used to identify themes, supported by researcher triangulation, reflexivity, and member checking to establish trustworthiness.

Results: Analysis identified 7 key themes :1) Successive Disasters Exacerbate Problems Driven by Gentrification, 2)Insufficient and Unequal Post-Disaster Resources Drive Dependence on Community Support Networks, 3) Systemic Delays in Relief Services to Underserved Communities Underscore The Need for Government Accountability, 4) Growing Distrust in Local Government to Address Evolving Post-Disaster Needs, 5) Navigating Complex Insurance Policies While Being Drained by a Disaster, 6) Trickle-Down Unpreparedness Starts at a City Level, and 7) Steps to Prepare for Future Disasters.

Conclusions: Systemic inequities in disaster preparedness and response affecting low-income Black and Hispanic communities are evident. Addressing these disparities requires prioritizing resource distribution, infrastructure investments, and community-driven planning and resilience building.

This article highlights the critical need for additional security measures in health care facilities during armed conflicts, emphasizing the importance of securing vital resources such as water, electricity, medical care, infrastructure, and essential medical equipment, medications, etc., to ensure proper care for the sick and vulnerable persons. We examine the impact of conflicts in Ukraine and Palestine. This article aims to draw lessons from historical experiences and propose strategies to enhance health care resilience, focusing on key topics such as essential infrastructure, protection of health care facilities, the physical preparedness of hospitals, and the availability of alternative sources for water and electricity. Enhancing the resilience of health services requires comprehensive disaster preparedness plans for hospitals that will ensure reliable power supplies in challenging situations and provide resilient physical protection for health facilities during times of conflict. Medical facilities must prepare for emergencies involving chemical, biological, radiological, or nuclear events, implementing water supply plans, and maintaining sufficient stocks of food and materials.