Washington State established a Memorandum of Understanding (MOU) and operational plan in 2012 to coordinate pharmacy infrastructure and workforce during a public health emergency. The objectives of this study were to adapt the MOU operational plan to the context of the coronavirus disease 2019 (COVID-19) pandemic and assess community pharmacies’ organizational readiness to implement COVID-19 testing and vaccination.

This mixed methods study was conducted June-August 2020. Three facilitated discussions were conducted with community pharmacists and local health jurisdiction (LHJ) representatives to test the MOU operational plan. Facilitated discussions were thematically analyzed to inform adaptations to the operational plan. Pharmacists were surveyed to assess their organization’s readiness for COVID-19 testing and vaccination before and after the facilitated discussions using the Organizational Readiness for Implementing Change (ORIC) measure. Survey responses were analyzed using descriptive statistics.

Six pharmacists from 5 community pharmacy organizations and 4 representatives from 2 LHJs participated in at least 1 facilitated discussion. Facilitated discussions resulted in 3 themes and 16 adaptations to the operational plan. Five of 6 community pharmacists (83% response rate) completed both surveys. Mean organizational readiness decreased from baseline to follow-up for COVID-19 testing and vaccination.

Operational plan adaptations highlight opportunities to strengthen MOUs between local and state health departments and community pharmacies to support future emergency preparedness and readiness efforts.

The purpose of the study was to design, develop, and validate a newer tool on radiation emergency preparedness responses (RadEM-PREM IPE tool) to measure communication, knowledge, performance skills in multidisciplinary health science learners.

The study design is a prospective, single centric, pilot study. Five subject experts designed, analyzed, and selected items of the instrument for relevant content and domain. Psychometrics that the tool assessed were content validity, internal consistency, test-retest reliability, and intraclass correlation coefficient. Twenty-eight participants completed test-retest reliability for validation of 21 sorted out items calculated percentage of agreement >70% I-CVI/UA (item content validity index with universal acceptability) and S-CVI/UA (scale content validity index with universal agreement method).

Items with percentage agreement >70% and I-CVI over 0.80 were kept, ranged from 0.70 to 0.78 were revised, and below 0.70 were rejected. Items with kappa values ranging from 0.04 to 0.59 were revised and ≥0.74 were retained. Internal consistency assessed using Cronbach’s alpha was 0.449. Positive correlation between attitude and communication (r = 0.448), between performance and communication (r = 0.443) were statistically significant at 0.01 level. Overall, intraclass correlation coefficient for all the measures is 0.646, which is statistically significant at 0.05 level (P < 0.05).

Study concludes that the RadEM-PREM IPE tool would be a new measuring tool to assess knowledge, performance, and communication skills of interprofessional radiation emergency response team learner’s evaluation.

Health services are the first and most important demand for the affected people after disasters. Hospitals and staff of health centers are directly affected by disasters, and this issue is more critical due to the hospital conditions, such as the presence of patients, medical facilities, and equipment. Therefore, it is necessary to make hospitals retrofit against disasters.

This study was conducted qualitatively to extract experts’ opinions about the factors affecting the retrofitting of health-care facilities in 2021. Semi-structured interviews were the basis of the data. In addition, to obtain data from different sources (triangulation), a focus group discussion (FGD) was held after the interviews.

The findings of this study were extracted from interviewees and FGD in the form of 2 categories, 6 subcategories, and 23 codes. Main categories included external and internal factors. The subcategories of external factors were General government policies to reduce risk, The Programs of the Ministry of Health, and medical universities for retrofitting and Uncontrollable external factors. The subcategories of internal factors were Exposure of managers and staff of health-care organizations to various disasters, determining the types of vulnerabilities in health-care facilities, and Factors related to managerial actions.

Retrofitting health-care facilities is one of the requirements for designing and constructing these facilities. The role of governments in this issue is more than other stakeholders because governments are the trustee of the health system and are responsible for the people’s health. Therefore, governments must plan for the retrofitting of health facilities according to the disaster risk analysis and prioritization and their resources. Although, external factors play a very important role in influencing retrofitting policies, the role of internal factors should not be neglected. None of the internal and external factors alone can have a significant effect on retrofitting activities. For this purpose, a suitable combination of factors should be determined and the goal of the system should be to achieve resistant and resilient facilities against disasters.

The Stop the Bleed course aims to improve bystander hemorrhage control skills and may be improved with point-of-care aids. We sought to create and examine a variety of cognitive aids to identify an optimal method to augment bystander hemorrhage control skills in an emergency scenario.

Randomized trial of 346 college students. Effects of a visual or visual-audio aid on hemorrhage control skills were assessed through randomization into groups with and without prior training or familiarization with aids compared with controls. Tourniquet placement, wound packing skills, and participant comfortability were assessed during a simulated active shooter scenario.

A total of 325 (94%) participants were included in the final analyses. Participants who had attended training (odds ratio [OR], 12.67; P = 9.3 × 10−11), were provided a visual-audio aid (OR, 1.96; P = 0.04), and were primed on their aid (OR, 2.23; P = 0.01) were superior in tourniquet placement with less errors (P < 0.05). Using an aid did not improve wound packing scores compared with bleeding control training alone (P > 0.05). Aid use improved comfortability and likelihood to intervene emergency hemorrhage scenarios (P < 0.05).

Using cognitive aids can improve bystander hemorrhage control skills with the strongest effects if they were previously trained and used an aid which combined visual and audio feedback that they were previously introduced to during the course training.

War may raise the level of distress and post-traumatic stress disorder (PTSD). The study explores the extent to which 4 factors determine levels of PTSD and distress symptoms of Ukraine civilians (without developing PTSD) during the current war.

The data were collected via a Ukrainian internet panel company. 1001 participants responded to a structured online questionnaire. Path analysis was conducted to identify predictive indicators of PTSD scores.

PTSD symptoms positively correlated with respondents’ level of exposure to the war and their sense of danger, and negatively correlated with well-being, family income, and age. Females scored higher on PTSD symptoms. Path analysis showed that higher exposure to war and higher sense of danger increase PTSD and distress symptoms, whereas higher well-being, higher individual resilience, and being a man, as well as older age decrease their level. Despite the strong effects of the coping suppressing factors, most respondents did not reach the critical level of PTSD or distress symptoms.

At least 4 positive and negative factors account for people’s coping with stressful experiences: previous traumatic experiences, individual level of pathology, personality attributes, and socio-demographic characteristics. The balance of these factors protects most people from PTSD symptoms despite their being affected by war traumas.

This is a case report of a huge hospital evacuation with 11 350 inpatients in the 2021 Zhengzhou flood in China, using a mixed methods analysis.

The qualitative part was a content analysis of semi-structured interviews of 6 key hospital staff involved in evacuation management. The evacuation experience was reviewed according to the 4 stages of disaster management: prevention, preparation, response, and recovery.

Because of unprecedented torrential rain, the flood exceeded expectations, and there was a lack of local preventive measures. In preparation, according to the alert, the evacuation was planned to reduce the workload on inpatients and to accept the surge of medical needs by the flood. In response, the prioritization of critically ill patients and large-scale collaboration of hospital staff, rescue teams, and accepting branch made it possible to successfully transfer all 11 350 inpatients. In recovery, restoring medical services and a series of activities to improve the hospital’s vulnerability were carried out.

A hospital evacuation is one of the strategies of the business continuity plan of a hospital. For the evacuation, leadership and collaboration were important. Challenges such as prolonged roadway flooding and the infrastructure issues were needed to be addressed throughout the evacuation process.

Schools may serve as shelters in the event of a disaster, but little is known about the requirements of children with disabilities in such situations. This study, therefore, aimed to investigate disaster preparedness in Japanese special needs schools depending on the designation of welfare shelters.

A questionnaire was distributed to schools nationwide. The respondents (authorities from 531 schools) answered questions about their jobs, disaster experiences, the school type, its students’ disabilities, its designation as a welfare shelter, its evacuation readiness, and the items of a disaster prevention awareness scale. Differences in preparedness among schools and the relationship between preparedness and designation as a welfare shelter were determined.

Most respondents had never experienced a natural disaster. Schools had insufficient resources to cope with disasters. While the majority (68.2%) had resources for children to stay overnight, a substantial minority of schools (31.8%) did not. No differences were found in preparedness among schools with different types of children with disabilities. Schools designated as welfare shelters were significantly better prepared than others.

Special needs schools in Japan have limited disaster preparedness. The designation of schools as welfare shelters may increase their preparedness for disasters.

In Turkey, which is a land of disasters, it is vital for nurses to be prepared before a disaster, and to exhibit an effective attitude and behavior during it. Having a large number of casualties during a disaster may cause inadequacies in receiving basic health care in the hospital.

This study was conducted in a descriptive and cross-sectional style to determine the disaster preparedness and preparedness perceptions of nurses. Data were collected with the Personal Information Form and Nurses’ Perception of Disaster Preparedness Scale (NPDPS).

Nurses’ disaster experience, drill experience, and perusal of the disaster plan positively affected the perception of disaster. The disaster preparedness of the institution positively affected the perception of disaster preparation. A significant difference was determined between the requests for information regarding disaster education and NPDPS. A statistically significant relationship was found between terrorist attacks, earthquake exposure, and the total scale score of NPDPS.

Consequently, nurses and health institutions, whose responsibilities become graver in disasters, have duties such as providing treatment and medical support. Therefore, it was suggested that disaster nursing and disaster management should have been included in the in-service training of nurses.

Despite rising incidences of global disasters, basic principles of disaster medicine training are barely taught in Singapore’s 3 medical schools. The aim of this study was to evaluate the current levels of emergency preparedness, attitudes, and perceptions of disaster medicine education among medical students in Singapore.

The Emergency Preparedness Information Questionnaire (EPIQ) was provided to enrolled medical students in Singapore by means of an online form, from March 6, 2020, to February 20, 2021. A total of 635 (25.7%) responses were collated and analyzed.

Mean score for overall familiarity was low, at 1.50 ± 0.74, on a Likert scale of 1 for not familiar to 5 for very familiar. A total of 90.6% of students think that disaster medicine is an important facet of the curriculum, and 93.1% agree that training should be provided for medical students. Although 77.3% of respondents believe that they are unable to contribute to a disaster scenario currently, 92.8% believe that they will be able to contribute with formal training.

Despite low levels of emergency preparedness knowledge, the majority of medical students in Singapore are keen for adaptation of disaster medicine into the current curriculum to be able to contribute more effectively. This can arm future health-care professionals with the confidence to respond to any potential emergency.

In a mass casualty incident (MCI) exercise, live-actor patients (LAPs) simulated different scenarios in the exercise. This study compared the benefit to LAPs with that to exercise players (EPs) and nonparticipants (NPs).

An MCI exercise was conducted in 2018. Emergency department (ED) nurses were assigned as EPs, LAPs, or NPs and asked to attend a pre-exercise lecture. A pre-exercise survey evaluated all ED nurses’ background, confidence level, and knowledge of MCI management. Knowledge assessment included disaster medicine knowledge (DMK) and on emergency operation plan familiarity (EOPF). The same survey was conducted again after the exercise. A paired t-test was used to analyze the difference before and after the exercise in the 3 groups.

Twenty-nine ED nurses completed both surveys. Confidence improved significantly for both the EP and LAP groups. The DMK of the LAP group improved significantly. EOPF also improved significantly for all 3 groups. A comparison of the improvement levels showed no significant difference between the EP and LAP groups for confidence, DMK, and EOPF.

ED nurses can benefit from participating as LAPs in full-scale MCI exercises. Having ED nurses act as LAPs makes it possible to train more staff in 1 exercise.

Team dynamics and nontechnical skills in general are crucial for emergency medical teams (EMT). No study has ever examined these important issues during a real mission in the field. This study aimed to better investigate team dynamics and nontechnical skills for EMTs; it tried to understand if a real mission, when the people are obliged to work together for the first time, without a prior specific training focused on teamwork, is enough or not to work as an effective team in the field.

The study is designed as a pre-test/post-test survey study, and it collected data from 51 people deployed to Mozambique in 2019. Three indexes (the self-efficacy (SE), the teamwork (TW), and the overall team’s performance (TW12)) were calculated as the average value of the rating given by all the participants. Open text feedback was also collected.

A positive trend was observed comparing the “post” data to the “pre” data, but results did not show a statistical significance, with the only exception of stratified analyses showing a P-value less than 0.05 for SE and TW12 for some categories.

According to the study findings, humanitarian workers feel good but not at their best; training programs focused on team dynamics can be really useful to improve self-confidence of people leaving for a mission.

Residents who lived near the Fukushima Power Plant accident were forced to change their lifestyle after the 2011 accident. This study aimed to elucidate the association of resident lifestyle and psychological factors with onset of hepatobiliary enzyme abnormalities (HEA) after the accident.

This longitudinal study included 15705 residents who underwent a comprehensive health check, as well as a mental health and lifestyle survey between June 2011 and March 2012. Follow-up surveys were conducted between June, 2012 and March 2018. Risk factors for new HEA onset were evaluated using the Cox proportional hazards model, moreover, population attributable risks for new HEA onset were calculated.

HEA developed in 29.7% of subjects. In addition to metabolic factors such as overweight, hyperglycemia, and hyperlipidemia; there were differences in alcohol intake, evacuation, unemployment, educational background, and psychological distress between subjects with and without HEA onset. After we adjusted for potential confounding factors, an association of being overweight, hypertension, and dyslipidemia, as well as alcohol consumption, evacuation, and psychological distress with increased risk of HEA onset was realized. Among these identified risk factors, evacuation accounted for the greatest share.

Metabolic characteristics and disaster-related lifestyle aspects, including mental status, were risk factors for HAE onset after the Fukushima Power Plant accident.