In the present study, the factors inducing the successful immediate mitigation measures and other activities at Haji-Abad village in Golestan Province, Iran, were scrutinized.

To find authentic data, information was gathered from a variety of sources, including mass media documents and interviews with the related Health House attendant (Behvarz) at Haji-Abad and the disaster liaison at the Rural-Urban Healthcare Center, both of whom were among the residents. A thematic analysis was performed on the transcriptions.

The findings showed that apart from the favorable geographical location of the area, appropriate education as well as vast family kinship among the residents were the major causes that induced high-risk perception, adequate collaboration and coordination among the residents and between them and the local authorities, and the women's active participation; these major effects, in turn, helped provide all of the efficient mitigation measures leading to the flood control.

It is recommended that opportunities for people's collaboration in preparedness, mitigation measures, and resilience during the occurrence of disasters be arranged by means of providing related inclusive operational education prior to the incidents. This can simultaneously generate risk perception and help people assume themselves as the owners of the disasters.

Following chemical, biological, radiological, and nuclear disasters, medically unexplained symptoms have been observed among unexposed persons.

This study examined belief in exposure in relation to postdisaster symptoms in a volunteer sample of 137 congressional workers after the 2001 anthrax attacks on Capitol Hill.

Postdisaster symptoms, belief in exposure, and actual exposure status were obtained through structured diagnostic interviews and self-reported presence in offices officially designated as exposed through environmental sampling. Multivariate models were tested for associations of number of postdisaster symptoms with exposure and belief in exposure, controlling for sex and use of antibiotics.

The sample was divided into 3 main subgroups: exposed, 41%; unexposed but believed they were exposed, 17%; and unexposed and did not believe that they were exposed, 42%. Nearly two-thirds (64%) of the volunteers reported experiencing symptoms after the anthrax attacks. Belief in anthrax exposure was significantly associated with the number of ear/nose/throat, musculoskeletal, and all physical symptoms. No significant associations were found between anthrax exposure and the number of postdisaster symptoms.

Given the high incidence of these symptoms, these data suggest that even in the absence of physical injury or illness, there may be surges in health care utilization. (Disaster Med Public Health Preparedness. 2019;13:555-560)

Most medical emergencies requiring first-aid occur at home. Little is known about the prevalence of these medical emergencies.

The objective of this study is to describe medical emergencies occurring at people’s homes requiring first aid; characteristics, burdens and impact on functional outcome, and to address the national public knowledge and practice of first aid.

A confidential, cross-sectional survey, primarily based on the 2015 American Heart Association (AHA) and American Red Cross first aid guidelines, was conducted among adults (>18 years) from 12 educational centers, under the Ministry of Awqaf and Islamic affairs, State of Kuwait.

A total of 3000 self-administered questionnaires were distributed from September 16 2019 to November 30, 2019. The response rate was 34% (n = 1033 participants) of which 1% (n = 11) were partially answered questionnaires leaving 1022 questionnaires for valid statistical analysis. The prevalence of medical emergencies was 118.5 out of 100000 per year and the level of public knowledge was 19%. Medical emergencies were more likely to occur in Hawali province (49%, n = 149), women were more likely to encounter medical emergencies (78%, n = 238). Victims above 18 years of age were more likely to experience hypoglycemia (39%, n = 55) and children were more likely to suffer from hypoglycemia (19%, n = 22) or burns (17%, n = 20). Compliance with First aid guidelines was seen in hypoglycemia (31%, n = 44) but lacking in burn incidents (44%, n = 15). Participants called the ambulance in seizures (50%, n = 13), with 62% of medical emergencies requiring attendance at a health-care facility and 29% requiring hospital admission. Of the victims, 15% missed school or a day of work, and 25% had impaired functional outcomes.

Medical emergencies occurring at home are relatively common in Kuwait, and public training on first aid is low. Kuwait has unique medical emergencies, with hypoglycemia, seizures and burns being the most frequent emergencies that occur at home. These emergencies cause a burden on the health-care system with a quarter of them having negative impact on the victim’s functional outcome.

Hospitals are expected to operate at a high performance level even under exceptional conditions of peak demand and resource disruptions. This understanding is not mature yet and there are wide areas of possible improvement. In particular, the fast mobilization and reconfiguration of resources frequently result into the severe disruption of elective activities, worsening the quality of care. This becomes particularly evident during the on-going coronavirus disease 2019 (COVID-19) pandemic. More resilient resource allocation strategies, that is, which adapt to the dynamics of the prevailing circumstance, are needed to maximize the effectiveness of health-care delivery. In this study, a simulation approach was adopted to assess and compare different hospital’s adaptive resource allocation strategies in responding to a sudden onset disaster mass casualty incident (MCI).

A specific set of performance metrics was developed to take into consideration multiple objectives and priorities and holistically assess the effectiveness of health-care delivery when coping with an MCI event. Discrete event simulation (DES) and system dynamics (SD) were used to model the key hospital processes and the MCI plan.

In the daytime scenario, during the recovery phase of the disaster, a gradual disengagement of resources from the emergency department (ED) to restart ordinary activities in operating rooms and wards returned the best performance. In the night scenario, the absorption capacity of the ED was evaluated by identifying the current bottleneck and assessment of the benefit of different resource mobilization strategies.

The present study offers a robust approach, effective strategies and new insights to design more resilient plans to cope with MCIs. It becomes particularly relevant when considering the risk of indirect damage of emergencies, where all the available resources are shifted from the care of the ordinary to the “disaster” patients, like during the on-going COVID-19 pandemic. Future research is needed to widen the scope of the analysis and take into consideration additional resilience capacities such as operational coordination mechanisms among multiple hospitals in the same geographic area.

The purpose of this study was to assess, through participant self-assessment, the effectiveness of a rapid response team curriculum based on the World Health Organization (WHO) Ebola Virus Disease Consolidated Preparedness Checklist, Revision 1.

A pre-and-post survey for the purpose of process improvement assessment involving 44 individuals was conducted in Angola. The survey was conducted before and after a 6-day training workshop held in Luanda, Angola, in December 2017. A paired t-test was used to identify any significant change on six 7-point Likert scale questions with α <.05 (95% CI).

Two of the 6 questions, “I feel confident the team can effectively work together to accomplish its assigned goals and objectives during a suspected contagious hemorrhagic fever disease outbreak” and “I understand basic pandemic response concepts” changed significantly from the presurvey to the postsurvey. The 4 remaining questions had near statistical significant change or an upward trend.

This Angolan rapid response team training curriculum based on WHO guidelines, After Action Reports, and internationally accepted standard operating procedures provides the nation of Angola with the confidence to rapidly respond at the national level to a highly infectious contagion in the region. (Disaster Med Public Health Preparedness. 2019;13:577-581)

To identify modifiers of emergency medical services (EMS) oversight quality, including facilitators and barriers, and inform best practices and policy related to EMS oversight and system performance.

We used a qualitative design, including 4 focus groups and 10 in-depth, 1-on-1 interviews. Primary data were collected from EMS stakeholders in Michigan from June to July 2016. Qualitative data were analyzed using the rapid assessment technique.

Emergent themes included organizational structure, oversight and stakeholder leadership, interorganizational communication and relationships, competition or collaboration among MCA stakeholders, quality improvement practices, resources, and needs specific to rural communities.

EMS is a critical component of disaster response. This study revealed salient themes and modifiers, including facilitators and barriers, of EMS oversight quality. These findings were evaluated in the context of current evidence and informed state policy to improve the quality of EMS oversight and prehospital care for both routine and disaster settings. Some were particular to geographic regions and communities, whereas others were generalizable.

We aimed to investigate the association between types of housing and allergic symptoms at 3–4 years following the Great East Japan Earthquake.

Our study was based on the ToMMo Child Health Study conducted in 2014 and 2015, a cross-sectional survey of public school children in Miyagi Prefecture, Japan. Of the 46 648 invited schoolchildren in the 2nd to 8th grades, 9884 were included. Presence of eczema, wheezing, and mental health symptoms was defined with questionnaires. To calculate odds ratios (ORs) and 95% CIs for the associations between types of housing and eczema or respiratory symptoms, we fitted generalized linear mixed models, included a random effect for municipality of residence, and adjusted for sex, school grade, survey year, and mental health symptoms.

Prefabricated temporary housing was significantly associated with eczema symptoms (OR, 1.46; 95% CI, 1.06–2.02). Even after adjusting for the presence of mental health symptoms, our analysis produced similar results (OR, 1.42; 95% CI, 1.03–1.96). Conversely, it was not significantly associated with respiratory symptoms (OR, 0.97; 95% CI, 0.61–1.54).

Children living in prefabricated temporary housing had a higher prevalence of eczema symptoms; however, prevalence of respiratory symptoms was not significantly higher.

We sought to systematically identify and analyze state-level legislative responses to Ebola from April 2014 through June 2015.

Using standardized search terms, we searched the LexisNexis State Capital database to identify bills or resolutions that explicitly mentioned Ebola or viral hemorrhagic fever in all 50 US states and Washington, DC, from April 2014 through June 2015. Information was abstracted from relevant bills or resolutions by using an electronic data collection form. Abstracted information was analyzed to identify themes and patterns.

Our search processes returned 273 bills and resolutions; 17 met our inclusion criterion. These 17 bills and resolutions were introduced in 11 states. The primary goals of these materials concerned the following: protecting or acknowledging public health and health care workers (n=4), revising the definition of “communicable disease” (n=3), financial considerations (n=5), establishing a task force (n=2), and updating or creating facilities (n=3). Six bills were enacted and 4 resolutions were adopted.

Approximately 20% of the states introduced bills or resolutions concerning the Ebola outbreak. These bills and resolutions highlight important practice considerations, including protections for those who assist in treating Ebola and revision of laws in the face of emerging infectious disease threats. Policy-makers and emergency planners would benefit from incorporating lessons learned from states’ Ebola responses into their preparedness activities. (Disaster Med Public Health Preparedness. 2016;10:649–653)

We evaluated the effectiveness and cost of a fungal meningitis outbreak response in the New River Valley of Virginia during 2012-2013 from the perspective of the local public health department and clinical facilities. The fungal meningitis outbreak affected 23 states in the United States with 751 cases and 64 deaths in 20 states; there were 56 cases and 5 deaths in Virginia.

We conducted a partial economic evaluation of the fungal meningitis outbreak response in New River Valley. We collected costs associated with the local health department and clinical facilities in the outbreak response and estimated the epidemiological effectiveness by using disability-adjusted life years (DALYs) averted.

We estimated the epidemiological effectiveness of this outbreak response to be 153 DALYs averted among the patients, and the costs incurred by the local health department and clinical facilities to be $30,413 and $39,580, respectively.

We estimated the incremental cost-effectiveness ratio of $198 per DALY averted and $258 per DALY averted from the local health department and clinical perspectives, respectively, thereby assisting in impact evaluation of the outbreak response by the local health department and clinical facilities. (Disaster Med Public Health Preparedness. 2018;12:38–46)