This article sought to explore how older people maintained their health and managed chronic conditions during the 2019-2020 Black Summer bushfires, floods, and COVID-19 pandemic in Australia. This knowledge is important in the context of intersecting public health and environmental hazards.

Qualitative, semi-structured interviews were undertaken with 19 community-dwelling older people living in South Eastern New South Wales, a region significantly impacted by the successive disasters.

Three themes summarized participants’ experiences. Participants described disruption to daily activities and social networks, delayed treatment and disruption to health services, and the exacerbation of health issues and emergence of new health challenges as challenges to managing health and self-care. Strategies for staying healthy were described as drawing on connections and relationships and maintaining a sense of normalcy. Finally, the compounding nature of disasters highlighted the impact of successive events.

Understanding older people’s experiences of self-care during disasters is critical for developing interventions that are better targeted to their needs. This study highlights the importance of social connectedness, habit, and routine in health and well-being. Results should inform policymaking and guide interventions in health care for older people.

Rinsing only with water or washing with soap and water are common methods of skin decontamination for skin contaminated during a chemical hazard release. The null hypothesis was that a 15-minute water irrigation (decontamination method 1) would not be superior to decontamination using a microfiber towel, followed by a wet wipe (Signature Select Softly Flushable Tissue Better Living Brands LLC, Pleasanton, CA), followed by using another microfiber towel (decontamination method 2).

A simulated contaminant (Magic Fluorescent Glow Paint for Face and Body, iLC Shenzhen Fulimei Technology Co. LTD, Shenzhen, the People’s Republic of China) was applied to the dorsal skin of each subject’s forearms. Then, photographs of these subject’s skin were taken before and after decontamination of the simulated contaminant by using either decontamination method 1 or 2. Each of the subjects underwent both decontamination methods in separate trials, with each subject using one forearm for decontamination method 1 and their other forearm for decontamination method 2. Discrete points of contamination were quantified on the photographs that were taken with the skin illuminated by ambient visible light or ultraviolet light (395nm, Roceei ultraviolet flashlight, China).

Under visible light, no residual contamination was seen by inspecting photographs taken after decontaminating with either method. Under ultraviolet light, less visible contamination was seen by inspecting photographs taken after decontaminating with method 1 than after decontaminating with method 2.

In this study, skin decontamination with water irrigation was superior to skin decontamination without water irrigation.

In August 2023, 68% (n=25,900) of the Northwest Territories, Canada, evacuated from wildfires, including the never previously evacuated capital, Yellowknife. Official evacuation orders extended from August 16 to September 6 for this region, impacting health protection services (HPS) in the Territory for remaining residents, and risks on return.

The Office of the Chief Public Health Officer (OCPHO) reviewed and implemented priorities over a three-day period prior to the evacuation order for time critical HPS to continue remotely or transfer to receiving jurisdictions. On return to community, OCPHO implemented processes for reviewing surveillance objectives to assess for impacts to affected populations.

During evacuation, over 15 reports of animal exposures were assessed remotely for rabies prophylaxis. Individuals requiring sexually transmitted infection (STI) follow-up were referred to receiving jurisdictions. One patient with infectious tuberculosis was transferred to another province. Water plant operators were supported with new communication and out-of-Territory testing protocols. On return, enhanced surveillance included: respiratory viruses, STI and blood borne infections, gastrointestinal illness, and toxic drug supplies.

While some HPS continued to mitigate risks, future surveillance will assess the scale of impacts. Updates to continuity of operations plans need to include considerations for remote and local services.

The COVID-19 pandemic is a disaster event. Exposure to stressors during and after disaster events is associated with negative mental health symptoms. To inform targeted COVID-19 recovery efforts, data are needed to understand which stressors play a key role in this relationship.

Cross-sectional survey data (demographics, impacts of COVID-19, social determinants of health, depression, and anxiety) were collected online from adults living in New York state between May and June 2020. Differences in the proportion of stressors (COVID-19 and social determinants) experienced by race/ethnicity were assessed using chi-square analyses. Logistic regression was used to assess which factors were associated with increased odds of depression and anxiety.

A majority (n = 258, 62.2%) of the 415 respondents reported being directly impacted by the pandemic. Non-white respondents reported a significantly larger proportion of stressors compared to white respondents. Under half of respondents reported depression (n = 171, 41.2%) and anxiety (n = 164, 39.5%). Healthcare and food concerns were associated with increased odds of depression and anxiety, and economic concerns were associated with increased odds of anxiety.

Findings underscore the need to respond to the COVID-19 mental health crisis by addressing social determinants of health.

This study aimed to assess the knowledge, attitude, and practice (KAP) of WeChat users towards health-related public accounts.

The study included 567 participants who completed the questionnaire. Pearson correlation analysis was used to evaluate the correlation among the 3 dimensions. Multivariate analysis identified independent factors associated with KAP scores.

The mean scores for knowledge, attitude, and practice were 6.12 ± 2.29 (61.2% of the total), 55.83 ± 7.33 (69.8% of the total), and 14.07 ± 3.72 (70.4% of the total), respectively. Significant positive correlations were observed between knowledge and practice (r = 0.392, P < 0.001) as well as between attitude and practice (r = 0.319, P < 0.001). Age [OR = 0.29 (0.09, 0.91), P = 0.034], marital status [OR = 2.11 (1.04, 4.29), P = 0.038], income [OR = 2.42 (1.23, 4.75), P = 0.010], and physical condition [OR = 0.45 (0.24, 0.85), P = 0.014] were independent factors associated with KAP scores.

WeChat users in China had relatively adequate knowledge and positive attitudes towards health-related public accounts. The findings highlight the potential of WeChat in enhancing health information dissemination in China.

This article explores the health-related challenges for refugees now residing in the United States and highlights strategies for building resilience in this vulnerable population.

This is a descriptive study identifying six common challenges refugees face when relocating from their country to another country.

Refugees in the United States face many challenges, including language barriers, access to quality education, discrimination based on cultural and religious differences, and inadequate healthcare access. Child refugees, constituting a significant portion of the refugee population, face distinct challenges compared to adults. Many refugees grapple with psychological trauma and access to proper healthcare.

Refugees face many challenges when transitioning to a new country, including losing community, familial support, safety, and cultural norms. To address these challenges in the United States, advocates, and public health advisors must actively engage with refugees to assess their needs and build resilient communities. Proactive outreach tailored to refugees’ vulnerabilities is crucial to ensuring their well-being and successful integration into their new homes.

In Northeast Brazil, the poorest region of the country, indigenous communities face critical health care challenges. Despite legal entitlements to the Unified Health System (SUS), systemic barriers persist, exacerbating health disparities and mortality. This ecological study analyzed mortality trends and causes of death within the Special Indigenous Sanitary District (DSEI) Alagoas-Sergipe over a decade.

Data on deaths from 2012 to 2022 were obtained from the Indigenous Health Secretariat. Causes of death were classified into 13 categories. Mortality rates per 1,000 indigenous inhabitants were calculated, and trends were analyzed using the Mann-Kendall test. The study also compared causes of death by age group.

Mortality rates ranged from 3.3 to 5.2 per 1,000, showing a moderate upward trend over time (τ = 0.5, p = 0.042). Predominant causes included heart and vascular disorders (24.3%), external causes (12.4%), respiratory issues (11.1%), and infections (10.9%). About one-third of pediatric deaths were associated with general neonatal complications.

This study highlights increasing mortality in indigenous communities in Northeast Brazil. The predominant causes of death reflect broader public health concerns. These trends emphasize the urgency for more effective, culturally sensitive public health policies and improved health care access.

DARPA’s In the Moment (ITM) program seeks to develop algorithmic decision makers for battlefield triage that are aligned with key decision-making attributes of trusted humans. ITM also seeks to develop a quantitative alignment score (based on the decision-making attributes) as a method for establishing appropriate trust in algorithmic decision-making systems. ITM is interested in a specific notion of trust, specifically the willingness of a human to delegate difficult decision-making to an algorithmic system. While the AI community often identifies technical performance characteristics (e.g., error rate) as trust factors for autonomous systems, ITM focuses on human attributes and characteristics (e.g., risk tolerance, rule following, or other personality characteristics; subject matter expertise; and human values to name a few) that could be encoded into algorithmic systems. This presentation will provide an overview of ITM program, including the quantitative alignment framework that will produce an alignment score between the human trustor and algorithmic trustee, as well as the evaluation planned to assess the contribution of alignment to the willingness to delegate.

Define how difficult decisions are understood in the context of the In the Moment program.

Describe the role of trust and decision-maker alignment for the In the Moment program.

Discuss the elements of the In the Moment evaluation, including the role of human delegation of difficult decisions.

Wildfires have escalated into a global threat with profound impacts on health, society, and the environment. The increasing frequency and intensity of these disasters, influenced by climate change and urban expansion, necessitate a comprehensive understanding of their direct health consequences.

This study conducted a retrospective analysis of global wildfire disasters from January 2000 to December 2023, utilizing data from the Emergency Events Database (EM-DAT). The analysis focused on the direct health outcomes—mortalities and injuries—excluding indirect effects such as smoke inhalation. Data were meticulously cleaned, categorized, and analyzed using quantitative methods, with statistical tests employed to validate the findings.

The study identified 309 significant wildfire disasters, with forest fires accounting for 80% of these events. These incidents resulted in 1890 fatalities and 14 360 injuries, with the highest tolls observed in Southern Europe, Northern America, and the Australia-New Zealand region. A notable rise in wildfire incidents was observed over the study period, underscoring the critical intersections between climate change, urban expansion, and wildfire risks. The analysis highlighted significant geographical and temporal patterns, emphasizing the regions and factors contributing to heightened wildfire vulnerability.

The findings underscore the urgent need for robust disaster preparedness and effective mitigation strategies. Integrating advanced early warning systems and Traditional Ecological Knowledge into wildfire management practices is essential. The study calls for proactive public health measures and interdisciplinary approaches to address the multifaceted challenges posed by wildfires. Continuous research and policy formulation are crucial to protect vulnerable communities and mitigate the increasing threat of wildfires globally.

Following the declaration of the pandemic, students’ education has to be done at a distance due to the COVID-19 pandemic. This study evaluated the association of university students’ COVID-19 phobia, pain severity, sleep quality, physical activity, fatigue levels, and quality of life on students’ achievement.

This cross-sectional survey was conducted by including 353 students from the university faculty of health sciences. The Pain Quality Assessment Scale was used to assess pain, the Fatigue Severity Scale to evaluate fatigue, the COVID-19 Phobia Scale to assess fear of disease, the International Physical Activity Questionnaire Short Form to evaluate physical activity level, and the Jenkins Sleep Scale to assess sleep quality, The Short Form-36 to determine the quality of life, and Online Learning Systems Acceptance Scale to evaluate satisfaction with distance education. Multiple linear regression and path analysis were conducted to identify factors associated with academic achievement.

It was found that age (B = 0.045; P = 0.040), BMI (B = −0.200; P = 0.004), and physical (B = 0.128; P = 0.008), psychological (B = 0.057; P = 0.012) and social (B = 0.189; P = 0.018) domains of quality of life were associated with the level of achievement.

Precautions must be taken to improve students’ academic achievement and quality of life in preparing for the future against infectious and epidemic diseases.

Emergency Medical Services (EMS) workers are critical to effective disaster response. Therefore, it is important to understand their knowledge, skills, and preparedness for disasters. This study investigated factors influencing EMS workers’ disaster knowledge, skills, and preparedness in the Saudi Arabian context. The study also sought to identify challenges to disaster preparedness among Saudi Arabian EMS workers.

A descriptive cross-sectional survey using The Disaster Preparedness Evaluation Tool was distributed to EMS workers in military and government hospitals across 3 Saudi Arabian cities. Responses were recorded on a 6-point Likert scale where higher scores indicated higher knowledge, skills, or preparedness. The results were analysed using descriptive and inferential statistical analysis.

272EMS workers participated in this study. EMS workers reported a moderate level of knowledge (3.56), skills (3.44), and preparedness (3.73) for disasters. Despite this, EMS workers reported a high level of involvement in regular disaster drills (M = 4.24, SD = 1.274) and a strong interest in further disaster education opportunities (M = 5.43, SD = 1.121). Participants also reported a high skill level with the triage principles used in their workplace during a disaster (M = 4.06, SD = 1.218). The study findings revealed a significant positive correlation between disaster preparedness levels and age, years of experience, education level, and the facility worked in.

EMS workers have moderate disaster knowledge, skills, and preparedness levels. Knowledge, skill, and preparedness have a significant relationship on the EMS workers’ demographics. These findings demonstrate the need to invest in preparing Saudi Arabian EMS workers to effectively respond to bioterrorism disasters.

Strict social distancing and lockdown measures imposed to curb transmission during the early phase of the outbreak of the COVID-19 pandemic posed challenges to people’s psychological wellbeing, limited access to social support, and disrupted routine mental health service delivery. In response, a consortium of mental health stakeholders from Goa, India launched the COVIDAV program, which provided pro-bono virtual psychiatric and counselling consultations across India through an online platform. This study describes the acceptability and feasibility of the program from the perspective of various stakeholders.

Data were collected via a survey with clinicians who had volunteered on COVIDAV (n = 40), in depth interviews of the clinicians (n = 14), and focus group discussion with key collaborators (n = 1). Process data were mapped at various stages during the online platform’s development and use. The qualitative and quantitative data was analysed using thematic analysis and a descriptive analysis respectively.

Over 17 months, 63 clinicians conducted 2245 online sessions through the COVID platform, primarily accessed by youth across the country. The clinicians acknowledged the online platform’s ability to enhance access and reduce stigma. Challenges included session time constraints, connectivity issues, and user interface inconsistencies that interfered with clients’ accessibility to the services. High satisfaction rates amongst the service providers were reported, with 79.3% content with the service provision and 82.8% with pro bono contributions through the platform.

This study illustrates the feasibility, flexibility, and applicability of a rapidly designed pro-bono online platform for delivering mental health care services through the collaboration of stakeholder groups in the mental health care, private, social, and governmental sector. Our findings highlight the potential of rapidly deployed digital platforms, developed via cross-sector partnerships, to meet mental health care needs during unprecedented global emergencies such as the COVID-19 pandemic.

Since the adoption of the Hyogo Framework, much work has been done to mitigate the effects of disasters as adequate preparation will enable Registered emergency nurses (ENs) to mitigate the negative consequences of disasters.

To assess the knowledge, attitude, and practices of ENs in the northern division of Fiji (ND) toward disaster preparedness and management.

A quantitative, cross-sectional study design using a self-administered questionnaire queried 61 ENs working in Emergency Departments (ED) in divisional, sub-divisional hospitals and health centers in the ND.

A low proportion (23%) of these ENs have attended disaster preparedness training from the time they started working with the employer demonstrating they are not prepared to mitigate the effects of disaster on the affected population in the ND. Though they have adequate knowledge and a positive attitude in engaging themselves towards disaster management, only 43% of these ENs were knowledgeable about appropriate policies and procedures. This study found that 72.1% have never read or seen their health disaster management policy.

Given the number of disasters experienced in Fiji every year, there is an urgent need for a comprehensive disaster management policy and training for ENs across the ND.

This study aims to assess the public healthcare system by implementing a scorecard in Hatay and Kahramanmaras provinces in Türkiye after the Kahmaranmaras earthquake.

The methodology employing in this study, action research, informs the active interaction between participants who have been involved in disaster risk reduction in the variety of capacities, such as affected local government, emergency medicine department, nursing and care association.

The scorecard application was carried out with 18 participants in Maraş and 22 in Hatay. The scorecard application shows that the items with the lowest scores in Hatay were related to the resilience of public health infrastructure and key health facilities, and the fulfilment of society’s role in disasters. In Maraş, on the other hand, coping with patient surge in disaster, fulfilment of society’s role in disasters, and mental health services in the context of disasters.

With the participation in scorecard workshop, communications between these stakeholders for community public healthcare system can discuss the best way to prepare and collaborate to promote further community disaster risk reduction planning during post-disaster recovery phase.

The present study aimed to analyze the factors that influence the increase in the desire to re-engage volunteer rescuers and saviors of the Red Crescent Society of the Islamic Republic of Iran.

This qualitative descriptive phenomenological study involved the participation of volunteers who had not volunteered in the Iranian Red Crescent Society (IRCS) for at least one year but expressed a willingness to be re-engaged. The semi-structured in-depth interview process and data collection continued until the theoretical saturation stage was reached. The collected data was analyzed using the interpretive approach and the 7-step Claesian method.

The results show that several factors influence the increase in the desire to reengage volunteer rescuers and members of IRCS. These factors were categorized into 136 codes, 63 main codes, 20 clusters, 7 classes, and 3 themes, namely “organizational support and understanding,” “work characteristics,” and “organizational credibility.” The results of the study indicate that each of the identified factors plays a significant role in the dynamics of the re-engagement process for rescuers and volunteer rescuers within the IRCS.

The experiences of volunteer rescuers and members can be utilized to enhance the recruitment and retention of volunteer human resources within the IRCS.

The Russian–Ukrainian War of 2022 (RUW-2022) was accompanied by the subsequent risk of accidents at a nuclear power plant in Ukraine. This study investigated posttraumatic stress (PTS) symptoms related to media reports of an attack on a Ukrainian nuclear power plant during the RUW-2022 among victims of the Fukushima nuclear disaster and revealed their association with radiation risk perception (RRP) of the accident.

This cross-sectional study targeted 1193 residents of Naraha Town in Fukushima Prefecture. PTS symptoms were measured using the Japanese version of the Impact of Events Scale-Revised (IES-R). Univariate and multivariate analyses explored the association between IES-R scores and background factors, particularly RRP.

Participants with higher RRP showed significantly higher IES-R scores; furthermore, the proportion of disruption because of radiation anxiety was significantly larger among higher RRP residents. Radiation anxiety mediated the association between RRP and PTS symptoms (total IES-R score and sub-item of intrusion).

People with higher RRP in Fukushima may continue to be at risk of persistent, unwanted PTS symptoms due to future nuclear crises. Therefore, mental health practitioners need to continue providing support in affected areas for a longer period than anticipated. Moreover, a population-based approach to cope with these stressors from media reports is essential.