The aim of this study was to explore the clinical decisions that health care students would make if faced with an active shooter event while providing patient care.

A cross-sectional study design was used to survey 245 students from 6 different professional programs. Participants read 4 case-based scenarios, selected 1 of 4 actions in a multiple-choice format, and responded to an open-ended question. Demographic questions asked whether participants had been a victim of violence and whether they have taken a certified active shooter course. Statistical analysis included descriptive statistics and chi-square testing.

For each case, most students chose “patient-centric” versus “provider-centric” actions (range: 66%–94% and 4%–17%, respectively). The gender of the patient made no difference in actions. Those who attended a certified active shooter course tended to act with more “provider-centric” concerns than those who did not take such a course.

A significant majority of interprofessional health care students, when presented with specific case-scenarios, declared they would act to protect themselves and their patients during an active shooter event. This “patient-centric” attitude transcends the oversimplified “Run-Hide-Fight” axiom and must be addressed by all health care educational institutions.

To provide scientific, theoretical support for the improvement of medical disaster training, we systematically analyzed the National Disaster Life Support (NDLS) Course and established a training curriculum with feedback based on the current status of disaster medicine in China.

The gray prediction model is applied to long-term forecast research on course effect. In line with the hypothesis, the NDLS course with feedback capability is more scientific and standardized.

The current training NDLS course system is suitable for Chinese medical disasters. After accepting the course training, audiences’ capabilities were enhanced. In the constructed GM (1,1) model prediction, the developing coefficients of the pretest and the posttest are 0.04 and 0.057, respectively. In light of the coefficient, the model is appropriate for the long-term prediction. The predicted results can be used as the basis for constructing training closed-loop optimization feedback. It can indicate that the course system has a good effect as well.

According to the constructed GM model, the NDLS course system is scientific, practical, and operational. The research results can provide reference for relevant departments and be used for the construction of similar training course systems.

Disaster health care workers experience much greater stress providing psychological first-aid and suffer from the indirect experience of traumatic events. This study examines how disaster health care workers experience disaster mental health.

Twenty-one disaster health care workers recruited from fire stations, community mental health service centers, and disaster trauma centers in Korea participated in this study. Data were collected via in-depth interviews and qualitatively analyzed according to Colaizzi’s phenomenological approach.

Disaster health care workers’ experiences of disaster mental health can be analyzed according to 4 theme categories: (1) commitment to one’s duty as a disaster health care worker; (2) powerlessness and lack of confidence; (3) incident shock and burnout; and (4) incomplete and inadequate healing.

In order to prevent mental health problems and support the disaster health care workers, it is necessary to develop and provide effective, nationwide psychological first-aid training, as well as disaster trauma recovery programs that are tailored to Korean sociocultural context and use immersive digital health care/education technology.

This study explores the experiences and practices of emergency medical services (EMS) providers, as well as the motivations that underpin perceptions toward standard infection prevention and control (IPC). The current literature suggests that EMS providers have a low compliance level with preventive measures, with misperceptions about risks and self-justification of personal skills reported.

The study used qualitative methods and conducted 2 distinct focus group discussions and 20 in-depth interviews with both prehospital and inter-facility EMS providers. Data were thematically analyzed using the Framework approach.

The participants considered respiratory infections the most significant nosocomial risks. Lack of full disclosure of medical history to EMS providers was considered a significant threat. Beliefs about low effectiveness and harmful effects of the influenza vaccine, as well as low perceptions of influenza risks, were common. While apparent misperceptions contributed largely to the inappropriate use of preventive measures, the reliance on intuition and individual experiences was attributed to the inaccessibility of appropriate guidelines, and lack of formal IPC training programs.

There is need to address EMS doubts and fears, improve IPC practices and awareness by institutionalizing IPC training programs, and ensure the design and accessibility of simplified and well-tailored IPC guidelines for EMS providers.

We analyzed characteristics of tornado-related injuries and medical impact on a county-level hospital in China in June 23, 2016. The objective of this study was to describe and analyze local government rescue responses following the tornado.

County hospital medical records of 288 tornado-related injury patients were collected. Descriptive analyses to study injury characteristics and associated risk factors were performed.

Of the studied population, 84% of the wounded were older than 45 years. Only 30 (10.4%) people were sent to the hospital for treatment within 3 hours following the disaster. Heavy objects or collapsing houses accounted for 191 (66.3%) of the documented injuries. The proportion of people with resulting brain injuries was 46.2% of the entire injured population, and the incidence of lower extremity injuries was 27.8%. A total of 89.6% of the wounded had skin and soft tissue injuries. Multiple injuries were found in 129 (44.8%) people and 156 had a single injury (54.2%), and 3 cases with acute stress disorder were admitted to the hospital.

Preparation plans, including tornado warnings, prevention, and rescue, are a basic requirement for the mitigation of tornado-related injuries. Protection awareness of tornado disasters is also critical to ensure injury prevention.

The present opioid epidemic and abuse of fentanyl in the United States has led to an increased risk of exposure to first responders. Law enforcement, fire, and emergency medical services are receiving misinformation on fentanyl health and safety risks and this has led to miscommunication. Understanding the risk perceptions and knowledge of first responders regarding fentanyl can help identify training gaps.

A 15-item 6-point Likert scale online questionnaire was developed and distributed to firefighters, police officers, and emergency medical technicians, regarding perceptions of fentanyl exposure, and additional questions concerning knowledge. The online questionnaire was sent to 15 associations of national and New York State first responders with 3 associations acknowledging and distributing the survey.

Of the 247 participants, 187 served New York State; 92 worked in law enforcement; and the other 95 worked in either fire, emergency medical service, or both. New York State first responders generally agreed with expert risk perceptions and knowledge of fentanyl exposure in the pilot study. Items pertaining to using hand sanitizer, selecting glove type, and dermal exposure to fentanyl had lower agreement with expert beliefs.

Risk perceptions and knowledge could be used to evaluate fentanyl response training among first responders.

With the rising incidence of health care emergencies, there has been a considerable burden placed on health care systems worldwide. We aimed to determine the willingness and capacity of medical students in Ireland to volunteer during health care emergencies.

An online, cross-sectional survey of medical students at the National University of Ireland was conducted in 2015.

Respondents totaling 274 completed the survey (response rate – 30.1%). Of participants, 69.0% were willing to volunteer in the event of a natural disaster and 59.1% in an event of an infectious epidemic, with altruism being the strongest motivational factor. Only a minority of students (23.7%) felt their current skill level would be useful in an emergency setting.

Medical students express a strong interest in actively participating during health care emergencies.

This study reviews patient encounters at a Boston-area community hospital Psychiatric Emergency Services (PES) following the Boston Marathon bombings, with the goal of describing the impact of terrorist attacks on PES encounters.

All PES encounters for 2 months preceding and 2 months following the bombing were identified in the electronic medical record. Demographics, current and past psychiatric problems, and trauma history were assessed for all records. Encounters seen post-bombing were compared with those before the bombing.

Demographics, current and past psychiatric problems, and trauma history were not significantly different before versus after the bombing; 36 of 440 (8.2%) post-bombing encounters directly mentioned the bombings. New-onset posttraumatic stress disorder (PTSD) symptoms caused by the bombing occurred in only 4 encounters (0.9%).

PES encounters after a terrorist event are likely to mirror those seen before a terrorist event, with only a minority of encounters presenting for new PTSD or acute stress disorder.

This study investigated the health effects of Lake Urmia’s drought on adjacent urban and rural areas and people.

The data for sociodemographic status, physical activity, dietary pattern, smoking, and angina of the subjects living in areas adjacent to and far from Lake Urmia were collected through validated questionnaires. Physical examinations, including blood pressure, anthropometrics, and biochemical measurements, were performed.

There were no significant differences between 2 areas in the case of age, sex, educational, and physical activity and smoking status (P > 0.05). The mean systolic and diastolic blood pressures and the prevalence of hypertension, prehypertension, and anemia in cases living in the adjacent areas were significantly higher than those in the control group (P < 0.05). No significant differences were observed between 2 districts in the prevalence of hyperlipidemia, overweight/obesity, asthma, angina, infraction, diabetes, and vitamin D insufficiency/deficiency.

Our data showed that Lake Urmia’s drought has serious effects on hypertension and anemia. More longitudinal and well-designed studies are needed to confirm these results.

To study injury patterns and medical rescue operations related to tornadoes that occur in rural areas, this study investigated the data pertaining to the 2017 Chifeng tornado (China).

Medical records of 52 tornado-related patients were investigated. Data were collected from 3 local hospitals that received all the tornado victims.

A total of 148 injuries were diagnosed. Tornado-related injuries were mainly caused by collapsed houses (51.9%) and direct physical trauma caused by the tornado (38.5%). Most injuries occurred outdoors (63.5%). The head (20.3%) and thorax (14.8%) were most 2 frequent anatomical injury sites. Soft-tissue injuries (43.9%) and contusions and lacerations (37.3%) were the 2 most common injury types. On evaluating the Abbreviated Injury Scale scores, a score of 1 was the most common (66.2%), and a score of 6 was not recorded.

A trailing phenomenon in the distribution of time to admission among the victims of a particular tornado in China was observed. The delivery is timely compared with nondisaster situation. There was a statistically significant difference of injury causes between outdoor and indoor patients. Helmets should be used by potential tornado victims. Basement units capable of functioning as shelters should be built in villages.

The aim of this study was to (1) understand types and amounts of Ebola-related information that health organization employees wanted and obtained through formal, informal, internal, and external organizational communication channels; (2) determine potential discrepancies between information wanted and obtained; and (3) investigate how organizational structure might affect information wanted and obtained through these communication channels.

Primary data were collected from 526 health workers in 9 hospitals and 13 public health departments in Texas from June to November 2015. Survey data were collected for 7 types of Ebola-related information health organization employees wanted and obtained through various types of organizational communication channels. Descriptive statistical analyses, mixed design analysis of variance, regression analyses, and multilevel analyses were used to analyze the data.

Hospital employees (mostly nurses in our sample) received more self-care information than they wanted from every communication channel. However, they received less about all other types of information than they wanted from every communication channel separately and combined. Public health department employees wanted more information than they received from every communication channel separately and combined for all 7 types of information.

Discrepancies existed between the types of Ebola-related information wanted and obtained by employees of hospitals and public health departments.

The aim of this study was to identify the needs of state, tribal, local, and territorial (STLT) public health officials in communicating, implementing, and monitoring nonpharmaceutical interventions (NPIs) during an influenza pandemic.

A Web-based survey collected data from a nonrandom sample of STLT health departments.

A total of 267 of 346 public health officials responded (77.2% response rate). STLTs identified the general public, families, childcare programs, K-12 schools, and workplaces as their priority audiences for NPI communication. Training needs included NPI decision-making strategies, triggers for implementing NPIs, and communicating NPI recommendations to families and communities, as well as a more practical orientation and real-world examples of how to incorporate NPI guidance into preparedness and response activities. Information is needed on health messaging for various populations and settings and on the legal authority for implementing specific NPIs.

Future NPI recommendations by CDC should continue to be based on feedback solicited from STLT health departments. To fill identified gaps, CDC used these findings to create NPI guidance and materials to assist in prepandemic planning and preparedness for STLTs and various community settings.

Landmines remain a potential public health concern in the western and southern border regions of Iran. The aim of this study was to assess the health-related consequences of landmine explosions in Kurdistan Province during the past 4 decades.

This retrospective cross-sectional study was conducted in Kurdistan Province of Iran in 2016-2017. The data gathering process was questionnaire based. Survivors, or a member of the deceased’s family, were interviewed, and 410 questionnaires were completed. Data analysis was performed by using descriptive or analytical tests in SPSS software V.22.

Antipersonnel landmines caused death immediately after the explosion 32.1% of the time, and 67.9% survived with various disabilities, such as blindness, deafness, and limb amputation. Sixty-three percent of the injuries were related to limb amputation, which was the most prevalent injury among survivors. The adjusted regression test revealed a significant relationship between severity of injury and variables such as living in the villages, education, and occupation (P-value < 0.05).

Recognizing the mined areas and intensifying clearance measures are crucial for Kurdistan Province. Providing landmine awareness programs is likely to yield useful results in reducing casualties. Also, landmine survivors should have access to physical and social rehabilitation programs.

Using validated psychological assessment instruments, this study examined the psychological distress associated with potential language barriers experienced by over 135 000 Puerto Rican residents who either temporarily or permanently migrated to the continental United States with the landfall of Hurricane Maria in 2017.

Participants were Puerto Rican residents (n = 107) who remained in Puerto Rico (control) or left the island for at least 3 months because of Hurricane Maria (migrants). Participants completed an online survey in their preferred language (Spanish or English), which assessed self-reported English language proficiency, Kessler Psychological Distress Scale (K6), Posttraumatic Stress Disorder Checklist for DSM 5, Patient Health Questionnaire 9-item depression scale, and the Generalized Anxiety Disorder 7-item scale. It was hypothesized that migrants with lower self-reported English proficiency would have comparatively higher indices of post-disaster distress than those with a higher proficiency.

Dividing the migrant group by preferred language for questionnaire completion, the Fisher’s exact test showed significant differences in prevalence of severe mental distress, as defined by K6 scores above 13, between the Spanish-preferring migrants (30.4%), English-preferring migrants (0%), and controls (9.6%).

Our results support a possible correlation between decreased language proficiency in post-disaster migrants and a higher risk factor for severe mental distress.

This study aimed to identify the important capacities that were most urgently needed during emergency response and factors associated with the Centers for Disease Control and Prevention (CDC) professionals’ field coping-capacity for public health emergency.

Professional workers (N = 1854) from 40 CDC institutions were chosen using the stratified cluster random sampling method in all 13 municipalities of Heilongjiang Province, China. Descriptive analysis and multivariate logistic regression were used.

Of 10 key capacities, the 3 that were most urgently needed during emergency response fieldwork as identified by respondents were crisis communication capacity, personal protection capacity, and laboratory detection capacity. Overall, 38.1% of respondents self-rated as “poor” on their coping-capacity. The logistic regression found that proficiency in emergency preparedness planning, more practical experiences in emergency response, effectiveness in training and drills, a higher education level, and a higher professional position were significantly associated with the individual’s field coping-capacity.

This study identified CDC professionals’ most urgent capacity need and the obstructive factors and highlighted the importance of enhancing the capacity in crisis communication, personal protection, and laboratory detection. Intervention should be targeted at sufficient fund, formalized, and effective emergency training and drills, more operational technical guidance, and all-around supervision and evaluation.