Cancer Care After Türkiye-Syrian Earthquakes: A Qualitative Study.

OBJECTIVES: In the field of cancer, many cancer patient associations (CPAs) have been established in Türkiye to support individuals living with cancer (ILCs) throughout the diagnosis and treatment processes. The presence of CPAs for ILCs became more significant after the major earthquakes in southeastern Türkiye in February 2023. The aim of this study is to identify the challenges of ILCs after the earthquakes from the perspective of CPA members. METHODS: This study employed a qualitative approach. The data collection method was in-depth interviews. Semi-structured, open-ended interviews were conducted with 15 volunteers who work with ILCs, selected through purposeful sampling. The data were analyzed by using inductive thematic analysis. This study was conducted between April and May 2023. RESULTS: Three main themes (problems of ILCs caused by earthquakes, access to health care, future concerns) and 11 subthemes were extracted through analyzing interviews. CONCLUSION: ILCs experienced diverse difficulties after earthquakes. Members of CPAs observed that acute interventions to injured people and humanitarian aid activities had the first-place importance after the earthquake, while cancer-related care took the second place, anticipating devastating outcomes for the future of their care. CPAs should be supported by the public, local governments, and central government in their endeavors for ILCs.

Prosthesis applications and challenges in children with earthquake-related amputations.

BACKGROUND: Amputations are among the most important traumatic injuries caused by earthquakes. However, data on amputee children and prosthesis application is quite limited in the literature. The aim of the study is to evaluate the injury-related data, stump problems, prosthesis application, difficulties and complications experienced with prosthesis during follow-up of children with 2023 Kahramanmaras earthquake-related limb loss. PATIENTS AND METHODS: Sociodemographic and injury-related data, pre-amputation and post-amputation interventions, prosthesis application, current prosthetic problems, and revision surgeries of the amputee children were recorded. RESULTS: Median age of patients (n = 102) admitted to our center was 13.0 years. 67.6 % of patients had one or more concomitant injuries. Median time and number of amputations were 4 (0-57) days and 1 (1-4), respectively. Of the total 120 amputations, 67.5 % (n = 81) were lower extremity amputations. Most common amputation levels were transtibial (29.1 %, n = 35), transfemoral (22.5 %, n = 27), and transhumeral (15.8 %, n = 19). Most amputees (56.8 %) underwent revision surgery after initial amputation. Median duration of time from amputation to prosthesis application was 184 (28-314) days. For 25 prostheses, a socket revision was required. Six patients had surgical revision of the stumps to allow prosthetic fit and mobility (due to bone overgrowth, soft tissue failure, heterotopic ossification). CONCLUSION: Limited healthcare facilities, surgeries performed under emergency conditions, accompanying multiple traumas, inadequate follow-up conditions, and additional difficulties arising from the pediatric patient group lead to difficulties in the care of pediatric amputee patients. Our results will guide the care of this vulnerable patient population in the event of a similar unfortunate disaster.

The impact of scabies in tent cities in Kahramanmaras after the Turkish earthquakes: oral pharmacologic treatment efficacy.

Background: Our study was conducted to determine the impact of scabies in people living in collective living areas such as tent cities and container cities after the February 6 Kahramanmaras earthquakes and to show the effectiveness of oral ivermectin treatment on scabies cases because topical treatments could not be used in this period when access to water was limited. Methods: Among 233 patients diagnosed and treated with scabies in tent and container cities, 192 patients who met the criteria were included in the study. Descriptive statistics were given as number (n), percentage (%), mean, median, standard deviation (SD). In the comparison of categorical data, the chi-square test was applied; in the comparison of numerical data ANOVA analyses was applied. Results: A total of 192 scabies patients (82.4%), 47.9% (N:92) of whom were women, were included in the study. The frequency of scabies in the total population in tent cities and container cities was found to be at least 0.54%. The most common symptoms were pruritis (99.0%) and rash (97.9%). The most common sites of lesion involvement were the umbilicus (87.0.%), forearm (75.0%), and back (70.3%). After the first dose of ivermectin, 159 (82.8%) patients showed complete recovery, while 30 (15.6%) patients showed partial recovery. 3 (1.6%) patients showed no improvement. After the second dose of ivermectin, 173 (90.1%) patients showed complete recovery. There were two (1.0%) patients who did not show improvement after two doses. Due to the deterioration of urban infrastructure after devastating earthquakes, the irregularity of mass living areas, the lack of hygiene conditions, and the difficulty of accessing clean, usable water, oral ivermectin may be the first choice for treatment in terms of ease of use and effectiveness.

Self-care strategies used by disaster responders after the 2023 earthquake in Turkey and Syria: a mixed methods study.

BACKGROUND: Disaster responders are exposed to several physical and mental health risks. This study aimed to describe self-care strategies used by disaster responders after the earthquake in Syria and eastern Turkey in February 2023. METHODS: A study specific web-based questionnaire survey was used to collect quantitative and qualitative data according to a convergent mixed methods approach. Data from 252 disaster responders responding to the earthquakes in Turkey and Syria were analyzed using both descriptive and analytical statistics and summative content analysis of free-text answers. Data were collected in March to July, 2023. RESULTS: The most used self-care strategies included resting, social support from colleagues in the field, extra intake of food or drink, and intake of medicines. The recovery strategies varied due to previous disaster response experience, indicating that supportive self-care strategies can be developed or learned. CONCLUSION: Given the extreme conditions and limited possibilities of external support, sufficient self-care is an essential competence among disaster responders. Self-care strategies can be both external processed such as intake of medicines, social support from others, and internal processes such as personal reflection. Providing oneself with self-care activities seems to be a skill developed with increasing experience supported by pre-deployment training. Therefore, to enhance resilience, self-care strategies should be encompassed in pre-disaster response training.

Spatio-temporal variation and influencing factors of ecol-environment quality in Jiuzhaigou County, Sichuan, China under seismic disturbance.

Accurately monitoring and evaluating changes in ecological environment quality under earthquake disturbances is of great significance for the restoration and protection of regional ecological environment. In view of the "8·8" earthquake in Jiuzhaigou County in 2017, we used high-precision remote sensing image to analyze the vege-tation damage caused by the earthquake, and calculated remote sensing ecological index (RSEI) for the pre-earthquake period, post-earthquake period and 3-year recovery period based on GEE platform to analyze the spatio-temporal variation of ecological environment in Jiuzhaigou County, Sichuan Province. Then, we used geodetector to reveal the influencing factors of spatio-temporal variations in ecological restoration. The results showed that the fractional vegetation cover of Jiuzhaigou County decreased from 0.71 before the earthquake to 0.69 after the earthquake. The area of higher coverage zone decreased by 310.78 km2, while the area of others increased. The mean RESI decreased from 0.50 in the pre-earthquake period to 0.42 in the post-earthquake period, and increased to 0.50 after the 3-year recovery period. The ecological environment quality in the three period was mainly at the good and ave-rage levels, and it was distributed in the central and southern mountains and the eastern river valley. Annual precipitation, elevation, wet and greenness were the main factors controlling ecological quality restoration in Jiuzhaigou County, and the increases in the interaction among these factors would affect the spatial variations of regional ecological environment quality restoration.

Psychological Assessment of Health Care Workers in the Aftermath of the February 2023 Earthquakes in Turkey.

OBJECTIVE: The goal of this study was to examine the psychological and physical effects experienced by health care workers (HCWs) participating in the response to the February 2023 earthquakes in Turkey and to identify any associated factors. METHODS: An online survey was used to collect data from HCWs on duty in earthquake-stricken areas. The following assessment tools were utilized: Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Maslach Burnout Inventory, Posttraumatic Growth Inventory, and Short Form-12. RESULTS: A total of 175 HCWs with a mean age of 37.27 years participated in the study. Of these, 39.4% suffered from PTSD, 30.3% experienced depression, and 31.4% experienced anxiety. Female gender, loss of significant others, and previous psychiatric treatment were found to be associated with worse mental health. Nurses tended to have higher levels of PTSD than the medical doctors; the medical doctors had significantly lower scores on the Posttraumatic Growth Inventory compared with the nurses and the other HCWs and lower mental component summary scores on the Short Form-12 compared with the other HCWs. Meeting basic needs and subjective evaluation of teamwork were also linked to mental health. The study also found that marital status, age, and length of time spent in earthquake-stricken areas were associated with scores on the Maslach Burnout Inventory. CONCLUSIONS: After the earthquake in Turkey, HCWs experienced a significant amount of various adverse mental health outcomes related to certain demographic variables such as gender, profession, previous psychiatric treatment, loss of relatives, and evaluation of living conditions and teamwork. Since HCWs play an essential role in reducing the harmful effects of disasters, recognizing groups at risk and planning tailored interventions may help prevent mental health issues.

Prevalence and Risk Factors of PTSD, Depression, and Grief Among Survivors of 2023 Türkiye Earthquake.

ABSTRACT: This study investigated the prevalence and risk factors of probable posttraumatic stress disorder (PTSD), depression, and complicated grief among 529 adults residing in a container city, 4 months after the 2023 earthquakes in Türkiye. Participants were assessed using the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, the Hamilton Depression Scale, and the Inventory of Complicated Grief. The prevalence rates of probable PTSD, depression, and complicated grief were 21.4%, 15.9%, and 64.7%, respectively. Logistic regression analyses indicated that PTSD was significantly associated with the loss of a loved one, fear of future earthquakes, and decreased perceived life control. Similarly, depression was associated with being trapped under debris, experiencing fear during the earthquake, and reduced perceived life control. These findings suggest that individuals presenting these risk factors warrant closer follow-up for potential psychological issues. Additionally, the impact of fear related to the earthquake and the role of perceived life control emerge as crucial considerations for psychological interventions.

Patients with crush syndrome and kidney disease: lessons learned from the earthquake in Kahramanmaras, Türkiye.

This study investigated in-hospital outcomes and related factors in patients diagnosed with postearthquake crush syndrome after the earthquakes in Kahramanmaras, Türkiye. One thousand twenty-four adult patients diagnosed with crush syndrome were analyzed. Data on demographic characteristics, clinical presentation, laboratory values, treatments, and outcomes were collected. A total of 9.8% of patients died during their hospital stay. Nonsurvivors were generally older, more likely to have preexisting chronic kidney disease, and faced more severe injuries and complications, including hypotension-shock, arrhythmias, elevated markers of renal dysfunction, and higher rates of acute kidney injury (AKI) and compartment syndrome. In addition, intensive care unit needs were higher. Multivariate analysis confirmed that age, injury severity, shock, high potassium, uric acid, and lactate levels on admission, development of AKI, compartment syndrome, and intensive care unit admission were significant predictors of mortality. Better disaster preparedness and improved health care infrastructure could be potential explanations for improved in-hospital mortality in the current era, as compared to previous earthquakes.

The Recent 2023 Earthquake in Nepal: A Global Health Perspective.

As a seismic hotspot, Nepal has endured many catastrophic earthquakes, including the 2023 Jajarkot quake. These quakes worsen the existing fragilities, resulting in difficulties in accessing healthcare, outbreaks of infectious diseases, mental health problems, and nutritional shortfalls. The article examines the complex web of health consequences, such as infectious and non-infectious diseases and malnutrition, highlighting the need for a global health lens in tackling these issues. It also reveals the long-term health effects, such as mental health disorders and increased disease susceptibility, that emerge after the quake and the importance of enhancing coordination and communication, enforcing building codes, and assisting affected communities in response to the seismic hazards. The article identifies mitigation strategies, community involvement, and international cooperation as key elements in building resilience against future quakes. It discusses the role of climate change in seismic risks and the need for research, innovation, and adaptability in global health interventions, suggesting measures such as strengthening primary healthcare, preventing avoidable health problems through education, and improving supply chains. The article calls for a holistic approach to building resilient health systems, emphasizing community engagement, prevention, and preparedness to protect the health of vulnerable groups in seismic regions.

Patterns of psychiatric admissions across two major health crises: L' Aquila earthquake and COVID-19 pandemic lockdown.

BACKGROUND: This study examined psychiatric hospitalisation patterns in San Salvatore Hospital in L' Aquila (Italy), during two major crises: the 2009 earthquake and the COVID-19 pandemic lockdown. The investigation spans two four-year periods, from 2008 to 2011 and from 2019 to 2022, with a focus on the trimester around the earthquake and the first wave/lockdown of the pandemic. METHODS: We analysed weekly psychiatric unit admissions of adults diagnosed with schizophrenia spectrum disorder, major depression, bipolar disorder, and alcohol/substance use disorder. Four-year periods around the Earthquake and COVID-19 Lockdown were divided into sixteen trimesters, and Generalised linear models were used to analyse the relationship between weekly hospitalisation frequency and trimesters by diagnosis using a Poisson distribution. RESULTS: A total of 1195 and 1085 patients were admitted to the psychiatric ward in the 2008-2011 and 2019-2022 periods, respectively. Weekly hospitalisations in the earthquake trimester were lower than during the previous one for all diagnoses (schizophrenia spectrum: -41.9%, p = 0.040; major depression: -56.7%, p = 0.046; bipolar disorder: -69.1%, p = 0.011; alcohol/substance use disorder: -92.3%, p = 0.013). This reduction persisted for 21, 18, and 33 months after the earthquake for schizophrenia spectrum, bipolar, and alcohol/substance use disorders, respectively. Contrarily, patterns of weekly admissions around the COVID-19 lockdown remained substantially stable in the short term. However, a consistent long-term hospitalisation increase for all diagnoses characterised the first half of 2022 (the cessation of anti-COVID-19 measures; schizophrenia spectrum: +68.6%, p = 0.014; major depression: +133.3%, p = 0.033; bipolar disorder: +180.0%, p = 0.034; alcohol/substance use disorder: +475.0%, p = 0.001). CONCLUSIONS: The present study indicated that exposure to major health crises can have both short- and long-term effects on psychiatric ward admission, holding significant implications for current and future major health emergency management strategies.

Cortical morphological changes and associated transcriptional signatures in post-traumatic stress disorder and psychological resilience.

BACKGROUND: Individuals who have experienced severe traumatic events are estimated to have a post-traumatic stress disorder (PTSD) prevalence rate ranging from 10 to 50%, while those not affected by trauma exposure are often considered to possess psychological resilience. However, the neural mechanisms underlying the development of PTSD, especially resilience after trauma, remain unclear. This study aims to investigate changes of cortical morphometric similarity network (MSN) in PTSD and trauma-exposed healthy individuals (TEHI), as well as the associated molecular alterations in gene expression, providing potential targets for the prevention and intervention of PTSD. METHODS: We recruited PTSD patients and TEHI who had experienced severe earthquakes, and healthy controls who had not experienced earthquakes. We identified alterations in the whole-brain MSN changes in PTSD and TEHI, and established associations between these changes and brain-wide gene expression patterns from the Allen Human Brain Atlas microarray dataset using partial least squares regression. RESULTS: At the neuroimaging level, we found not only trauma-susceptible changes in TEHI same as those in PTSD, but also unique neurobiological alterations to counteract the deleterious impact of severe trauma. We identified 1444 and 2214 genes transcriptionally related to MSN changes in PTSD and TEHI, respectively. Functional enrichment analysis of weighted gene expression for PTSD and TEHI revealed distinct enrichments in Gene Ontology biological processes and Kyoto Encyclopedia of Genes and Genomes pathways. Furthermore, gene expression profiles of astrocytes, excitatory neurons, and microglial cells are highly related to MSN abnormalities in PTSD. CONCLUSIONS: The formation of resilience may be by an active compensatory process of the brain. The combination of macroscopic neuroimaging changes and microscopic human brain transcriptomics could offer a more direct and in-depth understanding of the pathogenesis of PTSD and psychological resilience, shedding light on new targets for the prevention and treatment of PTSD.

Improvement of the Surveillance Protocols After Experiencing a Pseudo-Epidemic After 2018 Central Sulawesi Earthquake in Indonesia.

OBJECTIVE: Following a disaster, a pseudo-epidemic can occur due to redundant and duplicated data caused by infrastructure and information system disruptions. This study aims to investigate whether there have been improvements the post-disaster surveillance system in the comparison of diarrhea incidents between Central Sulawesi, Indonesia, and Cianjur, West Java, Indonesia. METHODS: We conducted an analysis of the epidemic-prone disease diarrhea before and during disasters, comparing the data with secondary data from the Early Warning Alert and Response System (EWARS) and the District Health Information System V.02 (DHIS-2). RESULTS: In central Sulawesi in 2018 and Cianjur in 2022, we observed an upsurge in diarrhea cases in the first week after the disaster. Although diarrhea cases increased after the disaster, they remained within acceptable outbreak criteria. Multiplication and redundant data were detected in the DHIS-2 system in Central Sulawesi, likely leading to erroneous overreporting. Changes in surveillance officers and their personal experiences during the disaster contributed to data inconsistencies. As compared to Central Sulawesi, the DHIS-2 reporting form in Cianjur was simplified as an individual form to enhance efficiency and accuracy. CONCLUSIONS: Enhancing valid assessment and conducting thorough investigations are essential to improve surveillance protocols for epidemic-prone diseases following disasters.

Beyond Injuries: February 6th Kahramanmaras Earthquakes and Other Patients Transported by Ambulance.

OBJECTIVE: This study evaluates the Emergency Medical Service system and overall emergency preparedness by analyzing ambulance-transported patients during the February 6, 2023 earthquakes, focusing on those without earthquake-related injuries (medical emergencies and traumas not caused by earthquakes). METHODS: A retrospective, observational case series was conducted, involving patients aged 18 and above transported by ambulance between February 6 and March 6, 2023. Patient demographic characteristics, vital signs, diagnoses, treatments, and outcomes were recorded. Predisposing factors for ambulance transportation including post-earthquake health facility issues, housing problems, hygiene, heating, and smoke exposure were meticulously analyzed. RESULTS: The study included 1872 patients, with a 55.4% hospitalization rate and a 13.7% mortality rate. Cardiovascular emergencies were the primary reason for admission (28.9%). Patients from the hospital in the study's location form Group 1, whereas those from other earthquake-affected provinces constitute Group 2. Significant predisposing factors for ambulance transportation included post-earthquake health facilities (P < 0.001), housing problems (P < 0.001), hygiene (P < 0.001), heating (P = 0.001), and smoke exposure (P < 0.001). In Group 2, pneumonia (P = 0.001), soft tissue infection (P = 0.002), sepsis (P = 0.004), carbon monoxide poisoning (P < 0.001), and diabetic emergencies (P = 0.013) were statistically significantly more frequent. CONCLUSIONS: Analyzing post-earthquake ambulance-transported patients is vital to comprehend the demand for emergency health care and address post-disaster health care challenges.

The Effects of Post-Earthquake Trauma Levels of Nursing Students on their Academic Motivation and Career Decisions.

OBJECTIVES: This study was carried out to determine the effects of post-earthquake trauma levels of nursing students on their academic motivation and career decisions. METHODS: The sample of this descriptive study consisted of 228 students studying at Gaziantep Islamic Science and Technology University, Department of Nursing. The data were collected using an online questionnaire created by the researchers. This online questionnaire form consists of seven questions about socio-demographic characteristics, and it also includes the Determination of Post-Earthquake Trauma Levels Scale, Academic Motivation Scale, and Career Decision Scale. SPSS 23.0 package program was used for the analysis of the data, and P < 0.05 was accepted for the level of significance. RESULTS: It was determined that the post-earthquake trauma level of the students was above the moderate level (63.49 ± 17.29) and that the extrinsic motivation-identified regulation, extrinsic motivation-external motivation, and intrinsic-knowledge levels were more affected by the earthquake (P < 0.05). In addition, it was determined that the mean Career Decision Scale score of the students (74.20 ± 17.35) was below the average. CONCLUSIONS: It was determined that post-earthquake trauma level had positive effects on intrinsic motivation-stimulation, extrinsic motivation, and amotivation, but had no effect on career decision.

Neural Function Desynchronisation in Left and Right Dorsolateral Prefrontal Cortices During Virtual Reality Earthquake Video Viewing.

During natural disasters such as earthquakes, individuals are required to evacuate calmly amidst significant emotional distress, presenting a considerable challenge. Very few studies have measured emotional responses during disasters, and the emotional responses and brain activity during natural disasters are poorly understood. Therefore, this study aimed to investigate emotional responses during an earthquake using immersive virtual reality (VR), focusing on changes in neural connectivity in the left and right dorsolateral prefrontal cortices (DLPFCs). We measured changes in total haemoglobin concentration (Δtotal-Hb) using 2-channel near infrared spectroscopy (NIRS) while 24 healthy young adults viewed earthquake and neutral videos through a head-mounted display (HMD). Spearman's correlation analysis was applied to the time variation in Δtotal-Hb in the left and right DLPFCs, independently for seismic or neutral video conditions. The findings revealed a negative correlation between the left and right total haemoglobin concentration changes during the earthquake video (ρ = -0.53). Conversely, individuals exposed to the neutral video exhibited a positive correlation (ρ = 0.75). The present steady-state analysis suggests that emotional changes induced by virtual earthquake videos disturbed steady-state neural synchronisation between the left and right DLPFCs.

Seismic response of a mid-story isolated stilted structure in mountainous areas.

Research on the SSI effect on flat sites has yielded many valuable conclusions. However, current research on the impacts of various special local terrains on structural dynamics remains limited. For mountainous areas, it is common to construct houses in a multi-step, climbing, and laterally staggered architectural form that follows the mountain terrain. Only through the analysis of the combined action of the upper and lower parts can the seismic performance of this type of structural form be better revealed; considering the influence of SSI effects will be closer to the actual seismic effects. Therefore, to identify the damage factors of the mid-story isolated stilted structures under earthquakes and provide optimized design plans for the structures, six models are established considering three slopes and two types of foundations based on the engineering case in Chongqing, China. Through the elastic-plastic time-history analysis under earthquakes in the down and transverse-slope directions, concludes, compared with not considering SSI, the seismic response of the mid-story isolated stilted structures considering SSI in mountainous areas is amplified. With the increase of the mountain slope, the seismic response of the structures considering SSI increases, and the amplification coefficients are between 1-1.8. The amplification coefficients of the structures without SSI are concentrated around 1, which is less influenced by the slope. The damage to the stilted isolated layer is mainly concentrated in the column and the beam end, and the maximum seismic response appears in the short columns. The foundation soil stress increases with the increase of the mountain slope.

Thoron, radon and microbial community as supportive indicators of seismic activity in groundwater.

Earthquakes have a significant impact on groundwater environments as well as human life. However, identifying active and affected zones from seismic events using isotopic and microbial diversity indicators remains a challenging frontier. To validate the applicability of this coupled method for real-time analysis, we analyzed thoron (220Rn), radon (222Rn), microbial community compositions, and hydrochemistry in groundwater samples during the 2017 Pohang earthquake for the first time. We observed the detection of 220Rn in groundwater right before the aftershocks, with a high correlation to 222Rn concentrations. This indicates that 220Rn and 222Rn can serve as reliable seismic indicators for real-time analysis. The microbial data can assist in identifying affected groundwater zones, particularly when real-time detection of 220Rn is not feasible. At the phylum level, Peregrinibacteria and Firmicutes were only found in samples with detected thoron. At the genus level, hydrogen-oxidizing or sulfur-oxidizing bacteria could serve as indicators of active zones. Two statistical analyses, self-organizing map (SOM) and principal component analysis (PCA) using hydrochemical parameters, also correlated with the results from these coupled indicators. This study demonstrates the theoretical and practical applicability of 220Rn, 222Rn, and microbial community compositions as new multi-faceted ecological indicators, whether for real-time analysis or otherwise.

Rising From the Rubble: Air Quality Concerns in Post-Earthquake Afghanistan.

This position paper highlights the dire impacts of environmental and household air pollution, which were responsible for 6.7 million deaths globally in 2019. These deaths occurred predominantly in low- and middle-income countries, with Afghanistan reporting the highest age-adjusted mortality rate. The situation worsens during large-scale disasters like earthquakes, which release more pollutants into the air, exacerbating health risks and leading to severe conditions such as pulmonary diseases. Because political factors may hinder foreign NGOs and similar organizations from providing direct support, the frequent occurrence of earthquakes in Afghanistan underscores the critical need for emergency response training for local residents. Consequently, it is essential to provide ERT training, including the proper use of protective equipment, to local populations as well as disseminating risk communication through online technologies and other appropriate means.

Association between Disaster Knowledge Level and the First Step of Stockpiling Food for a Disaster.

This study clarifies the association between disaster knowledge levels and beginning to stockpile food at home as a disaster preparedness. This survey was conducted between 18-20 December 2019 using a self-administered web-based questionnaire. The participants were recruited from panel members of an online survey company. A total of 1,200 adults living in the five Japanese prefectures with the highest predicted food shortages after the anticipated Nankai Trough earthquake, took part in the study. Multivariable logistic regression analyses revealed a significant positive relationship between disaster knowledge level and beginning food stockpiling (p for trend <0.001). Compared with those who had a low level of disaster knowledge, participants who had a medium level of knowledge were 2.11 times more likely to begin stockpiling food (adjusted odds ratio [OR]: 2.11, 95% confidence intervals [CI]: 1.49-2.97), whereas those with the highest knowledge level were 2.52 times more likely to begin stockpiling food (adjusted OR: 2.52, 95% CI: 1.79-3.56). Beginning food stockpiling can be the first step toward disaster preparedness. It is considered that people with low disaster knowledge levels are more likely to have no beginning food stockpiling and are at high risk for disasters. These findings suggest ways to approach prioritizing people facing high disaster risk.

Exploring the health challenges of affected people in the 2023 Khoy earthquake: a content analysis.

BACKGROUND: An earthquake has significant effects on health and livelihood of people. It is important to identify health needs and challenges of earthquake victims and use them to prepare for other possible earthquakes. Therefore, the purpose of this study is to explain the challenges and health needs of earthquake victims in Iran. METHODS: This was a qualitative study with 25 participation who were affected by the earthquake in Khoy City, and were selected using purposive sampling by snowball method technique in 2023. The study data was collected through open and semi-structured interviews. To analyze the data, the conventional content analysis with an inductive approach was used. RESULTS: The results show two main categories. The main categories "Management as a missing link in unexpected events" includes 9 subcategories: "The challenge of access to emergency resources and health facilities", "Feeling of abandonment in medical personnel", "Weakness in the structural safety and infrastructure of the health system", "Logistical challenges", "Risk management training", "Crisis response management challenges", "Weakness in the intelligent relief system", "Management of secondary incidents", and "Need to provide medical services and disease prevention". Also, the main categories "Emotional actions of people in crisis" consist of 5 subcategories: "Overexcitement", "Psychological vulnerability of children", "Physical complaints caused by stress", "Confusion caused by the lack of reliable information sources" and "Negative effects of living together with several families". CONCLUSION: To help deal with threats and other challenges in the earthquake crisis, countries should try to improve their capacity to manage natural disasters.