Modeling interdependence between climatic factors, commodities, and financial markets.

This paper introduces a comprehensive approach to studying the impact of climate-related factors on commodity and financial markets using network analysis. We utilize a Bayesian network Vector Autoregressive model to investigate whether climate risk significantly influ-ences commodity prices and financial market returns. Our findings provide evidence of a climate effect on major commodities and global financial markets. Specifically, we identify Crude oil, Cotton, and Sugar as the commodities most affected by climate risk, with Gold demonstrating the least susceptibility. Additionally, we observe that climate-related risk on commodities is likely propagated by patterns such as PNA, NN1, and AO. In terms of financial markets, we find that stock markets in Hong Kong, India, and Spain are the most susceptible to climate risk, while Switzerland's market appears to be the least affected. Furthermore, we document evidence that climate-related risk capable of altering financial markets is likely propagated by factors like ENP, NN1, and WH. Overall, our study underscores the intricate relationship between climate factors and market dynamics, highlighting the importance of considering climate risk in assessing market behavior and performance.

Academy of Breastfeeding Medicine Position Statement: Breastfeeding in Emergencies.

Background: During emergencies, including natural disasters and armed conflict, breastfeeding is critically important. Breastfeeding provides reliable nutrition and protection against infectious diseases, without the need for clean water, feeding implements, electricity, or external supplies. Key Information: Protection, promotion, and support of breastfeeding should be an integral part of all emergency preparedness plans. Breastfeeding specialists should be part of plan development. Emergency protocols should include breastfeeding specialists among emergency relief personnel, provide culturally sensitive environments for breastfeeding, and prioritize caregivers of infants in food/water distribution. Emergency relief personnel should be aware that dehydration and missed feedings can impact milk production, but stress alone does not. Emergency support should focus on keeping mothers and infants together and providing private and/or protected spaces for mothers to breastfeed or express milk. Emergency support should also focus on rapidly identifying mothers with breastfeeding difficulties and breastfeeding mothers and infants who are separated, so their needs can be prioritized. Breastfeeding support should be available to all women experiencing difficulties, including those needing reassurance. Nonbreastfed infants should be identified as a priority group requiring support. Relactation, wet-nursing, and donor milk should be considered for nonbreastfed infants. No donations of commercial milk formula (CMF), feeding bottles or teats, or breast pumps should be accepted in emergencies. The distribution of CMF must be highly controlled, provided only when infants cannot be breastfed and accompanied by a comprehensive package of support. Recommendations: Protecting, promoting, and supporting breastfeeding should be included in all emergency preparedness planning and in training of personnel.

The efficacy of a cellular approach to resilience-oriented operation of distribution grids based on eigenvectors of the Laplacian matrix.

This study aims to address the following research query: In the event of an imminent disaster poised to impact distribution grids, what constitutes the optimal course of action for the distribution system operators to keep the lights on? To address this challenge, we propose a cost-efficient cellular model for enhancing the resilience of smart distribution grids. This model prioritizes resilience in the face of natural disasters or other disruptions that could impact service delivery. This method benefits both grid operators and consumers by ensuring reliable power supply while minimizing energy costs. Furthermore, the model's scalability allows it to be applied to distribution systems of varying sizes. The proposed method utilizes an innovative approach to form optimal cellular network configurations within the grid. As the first step in the formation of cellular topology for the grid, the eigenvectors of the Laplacian matrix of the grid will be used to decide on the optimal configurations. Subsequently, a bi-level mixed-integer linear programming model is proposed to decrease the network costs while simultaneously consider potential power transfer scenarios between the cells and the upstream network during both normal and emergency conditions. The researchers validated the effectiveness of the proposed method through simulations on an IEEE 33-bus test system. The results demonstrate outstanding performance, with a significant increase in the resilience index (96 %) and a substantial reduction in load-shedding costs (80 %), making the network considerably more robust.

Evaluating Saudi Arabian nurses' willingness to respond to nuclear and radiological disasters.

AIM: We evaluated Saudi Arabian nurses' willingness to engage in nuclear and radiological disaster response. BACKGROUND: In the face of rising nuclear and radiological threats, it is essential that nurses are fully prepared to handle the health consequences of such emergencies. As frontline responders, nurses play a critical role in managing high-stakes situations, making their readiness a key factor in ensuring public safety during these crises. METHODS: A cross-sectional survey was conducted among 612 registered nurses in Saudi Arabia. The survey used a structured questionnaire based on the theory of planned behavior, identifying behavioral intentions as the primary outcome and attitudes toward these behaviors, subjective norms, and perceived behavioral control as influencing factors. The data were analyzed using descriptive and inferential statistics. RESULTS: Most respondents lacked specialized training and reported strong behavioral intentions. Attitude and perceived behavioral control were key drivers of these behavioral intentions, with less impact from subjective norms. Behavioral intentions were also shaped by education, the perceived likelihood of nuclear and radiological emergencies in their region, peer influence, perceived self-efficacy, and family concerns. Younger and married nurses showed significantly stronger behavioral intentions. DISCUSSION: Although most nurses lacked specialized training, their strong engagement intentions and positive responses to active learning and training indicate a desire to close this gap through further education. However, inadequate institutional support, trouble communicating with family, and concerns about personal radiation exposure emerged as potential barriers. CONCLUSION: Targeted educational initiatives and support systems are needed to enhance nurses' confidence, competence, and willingness to engage in radiological and nuclear emergency scenarios. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Policymakers should prioritize the development of specialized training programs and support mechanisms for nurses, ensuring they are adequately prepared to respond effectively to increasing radiological and nuclear threats.

Users' Perspective on Revised Simple Simulator for Calculating Nutritional Food Stocks in Preparation for Large-scale Disasters.

OBJECTIVE: In 2020, Japan's Ministry of Health, Labour and Welfare developed an Excel workbook entitled "Simple Simulator for calculating nutritional food stocks in preparation for large-scale disasters." In September 2021, it was modified as the "Revised Simulator" to plan food stockpiles in normal times and post-disaster meals. This study aimed to further improve the Revised Simulator. METHODS: Eight group interviews were conducted with 12 public health dietitians, 9 disaster management officers, and 2 public health nurses from September to November 2021. They provided nutritional support during previous disasters or prepared for predicted future disasters. Qualitative analysis was conducted on interview transcriptions, then the Revised Simulator was improved based on their feedback. RESULTS: The Revised Simulator was improved to the "Simulator for calculating nutritional food stocks and meals for large-scale disasters" with significant changes such as adding specific tags in the food list to denote long shelf life and elderly-friendly foods, as well as displaying bar graphs to visualize the required and supplied amounts of energy and nutrients. CONCLUSIONS: The Revised Simulator was upgraded for planning and assessing stockpiles and meals in ordinary conditions and emergencies. This study will contribute to enhancing the quality and quantity of food supplies during disasters.

Post-disaster damage and loss assessment in the Iranian healthcare sector: a qualitative interview study.

BACKGROUND: Accurate post-disaster damage and loss assessment is critical for the success of subsequent recovery programs. A comprehensive and systematic damage and loss assessment process involves evaluating the physical damage and financial impact of an event on individuals, communities, and assets. To ensure effective recovery, the various components and entities included in the program must be developed appropriately and efficiently. This study aimed to identify the components and entities of the Iranian healthcare sector's post-disaster damage and loss assessment program. METHODS: A qualitative study employing purposive sampling and semi-structured individual interviews was conducted with 18 participants between October 2022 and July 2023, with continuing until data saturation was achieved. Data collection involved semi-structured interviews and observational notes with experts, including representatives from the National Disaster Management Organization (NDMO), the Iranian Red Crescent Society, and the Disaster Risk Management Department of the Ministry of Health and Medical Sciences Universities. The interviews were conducted in the workplace of the participants. Thematic analysis, a conventional qualitative method, was employed for the analysis of the data. Following the transcription of the recorded interviews, the initial codes were extracted, reviewed for accuracy, and classified. RESULTS: The results of this study are based on the insights and experiences of a diverse group of qualified experts in their respective fields. The findings were analysed and classification into ten main themes, 29 sub-themes, and 1,058 codes. The main themes were key concepts and principles of assessment; assessment stages; health system measures in assessment; roles and responsibilities; team composition; information and communication; coordination and collaboration; data collection and analysis; assessment tools and methods; and reporting, documentation, and recommendations. CONCLUSION: An understanding of key concepts and principles enables stakeholders to respond effectively to disasters, make informed decisions, and facilitate recovery and reconstruction efforts.

Oral health among refugees and asylum seekers utilizing Médecins du Monde clinics in mainland Greece, 2016-2017.

BACKGROUND: The oral health of refugees and asylum seekers is understudied. However, oral health has important implications for overall health and wellbeing. This study addresses this gap by characterizing oral health care utilization in Médecins du Monde (MdM) clinics across mainland Greece from 2016 - 2017. METHODS: A retrospective cross-sectional study design was used to estimate proportional morbidities for caries, extraction, developmental, periodontal disease, preventive, and other oral health outcomes. The association between physical health conditions and consultations of interest - upper respiratory tract infections (URTIs) and reproductive health consultations - and oral health were compared using odds ratios (OR) and 95% confidence intervals (CIs). Oral health outcomes between Afghans and Syrians were compared using odds ratios and 95% CIs. RESULTS: Caries (39.44%) and extractions (28.99%) were highly prevalent in our study population. The utilization of preventive dental consultations (37.10%) was high, particularly among males. Individuals with at least one upper respiratory tract infection (OR = 1.52; 95% CI: 1.30 - 1.77; Or = 1.90; 95% CI: 1.53 - 2.36) and women and girls with reproductive health consultations (OR = 1.30; 95% CI: 1.03 - 1.66; OR = 2.03; 95% CI: 1.49 - 2.76) were more likely to have any dental or caries specific consultations. The observed patterns in oral health needs differed between Afghans and Syrians, with Afghans more likely to have preventive screenings and less likely to have caries, extractions, or other conditions. CONCLUSIONS: Displaced populations utilizing MdM dental clinics had high levels of oral health needs, particularly for caries and extractions. The connection between oral and overall health was seen in the study population, and these findings reinforce the public health importance of oral health for improving health and wellbeing of displaced populations. Evidence-informed policy, practice, and programming inclusive of oral health are needed to address both oral and overall health of refugees and asylum seekers in Greece. Future research should investigate not only oral health care needs but also knowledge and beliefs that inform utilization patterns among displaced populations.

Components and entities of post-disaster damage and loss assessment program in healthcare sector: a scoping review.

BACKGROUND: Disasters can cause casualties and significant financial loss. In accordance with the Sendai Framework for Disaster Risk Reduction, areas affected by disasters must be built back better. Accurate post-disaster damage and loss assessments are critical for the success of recovery programs. This scoping review aimed to identify the components and entities of the healthcare sector's post-disaster damage and loss assessment program. METHODS: An comprehensive search for relevant literature was performed using several databases, including the Web of Science, PubMed, Scopus, ProQuest, and Magiran. The search was limited to papers published between 2010 and 2022. In addition, we searched the grey literature for resources related to post-disaster damage and loss assessments. Study selection and data extraction were evaluated by a third reviewer. The main themes were determined through a consensus process and agreement among team members. RESULTS: A total of 845 papers were identified, 41 of which were included in the review. The grey literature search yielded 1015 documents, 23 of which were associated with the study's purpose. The findings were classified into five main themes, 20 subthemes, and 876 codes. The main-themes include the following: Concepts and Definitions; Post-Disaster Damage and Loss Assessment Procedures; Healthcare sector procedures; Assessments Tools, and Methods; Intra-sectoral, Inter-sectoral, and cross-cutting issues. CONCLUSIONS: The existing corpus of literature on post-disaster damage and loss assessment programs within the healthcare sector offers only limited insights into the entities and components involved. It is of great importance that stakeholders have an extensive grasp of these pivotal concepts and principles, as they are fundamental in enabling effective responses to disasters, informed decision-making, and facilitating rehabilitation and reconstruction efforts. Consequently, there is a considerable scope for further investigation in this area. SCOPING REVIEW REGISTRATION NUMBER: https://osf.io/nj3fk .

Technological disasters in Asia: Epidemiological profile from the year 2000 to 2021.

BACKGROUND: Technological disasters in Asia have significant public health and environmental implications, but there is limited epidemiological analysis of these events. This study aims to characterize the epidemiological profile of technological disasters in Asia from 2000 to 2021, focusing on morbidity and mortality trends. METHODS: A retrospective descriptive observational analysis was conducted using data from emergency events database (EM-DAT), DesInventar, NatCAt, and Sigma. The study categorized disasters into transport, industrial, and miscellaneous accidents. Statistical analyses were used to examine frequencies, trends, and correlations among the different disaster types. RESULTS: From 2000 to 2021, Asia experienced 2333 technological disasters, with transport accidents being the most frequent (55.77%), followed by industrial (26.10%) and miscellaneous accidents (18.13%). The overall trend showed a statistically significant decrease in the frequency of these disasters and in average mortality and injury rates. The study highlighted the varying impact of different disaster types, with industrial accidents causing the highest fatality and affected rates despite being less frequent than transport accidents. CONCLUSIONS: The study indicates a declining trend in the frequency and severity of technological disasters in Asia, reflecting improved safety measures and disaster management. However, the high impact of industrial accidents underscores the need for targeted prevention strategies.

Hurricanes and Health: A Scoping Review of Recent Developments in Physical Injuries, Mental Health, and Emergency Interventions.

Hurricanes, as one of the most devastating natural disasters, significantly impact the public's health, causing both physical injuries and long-lasting mental health issues. Although substantial research has focused on hurricane-related injuries, this study aims to synthesize findings from recent literature, specifically evaluating the 10 most recent hurricanes, to identify research gaps and inform future studies. This scoping review, conducted in accordance with PRISMA-Scr guidelines, assessed studies from PubMed, CINAHL, Cochrane databases, and Medline as of February 2024. Eligibility criteria focused on studies examining physical and mental health impacts, COVID-19 effects, and emergency medical services (EMS) interventions related to Hurricanes Ian, Nicholas, Ida, Zeta, Delta, Sally, Laura, Isaias, Hanna, and Dorian. Twenty articles met the inclusion criteria. The studies were categorized into four themes: physical injuries and fatalities, mental health impacts, hurricane-COVID-19 interplay, and EMS interventions. Findings revealed varied mechanisms of injuries and deaths, significant mental health challenges, compounded crises due to COVID-19, and diverse EMS strategies, including AI utilization and strategic planning for medical care delivery. Addressing the social determinants of health and evaluating hurricane readiness initiatives were two gaps in the literature identified. Future research should focus on the mental health impacts and concurrent crisis challenges to develop comprehensive disaster management practices that enhance community resilience against future hurricanes and public health crises.

Resist and recover: Introducing a spring theory for modeling disaster resilience.

This paper presents a new approach for quantitatively modeling the resilience of a system that has been disrupted by a sudden-impact event. It introduces a new theoretical model that explicitly incorporates representations of the enabling and inhibiting forces that are inherent within postdisruption recovery behavior. Based on a new, more comprehensive measure of resilience that is able to capture both negative and positive deviations in performance, a generic mass-spring system is then used to illustrate the applicability of the theoretical model. The interplay between the enabling and inhibiting forces that is revealed by the new model provides a new theoretical basis for understanding the complexity of resilience and disaster recovery. With the addition of the new resilience measure, it lends support for defining and characterizing a new type of resilient behavior: unstable resilience.

The effect of adaptive capacity on resilience to the COVID-19 pandemic: A cross-country analysis.

The COVID-19 pandemic's profound impacts on global health, driven by preparedness gaps and systemic risks, underscore the need to enhance societies' ability to manage both predictable risks and uncertainties inherent in disasters. While disaster research emphasises risk management for predictable threats and adaptive capacity for unexpected challenges, there is a lack of empirical examination of the impact of adaptive capacity on disaster resilience. This study addresses this gap by identifying three key adaptive capacities - quality of institutions, collaborative governance, and social capital - and examining their effects on COVID-19 resilience outcomes, measured by the ability to reduce excess mortality. Analysing secondary data from 129 nations using partial least squares structural equation modelling, the research finds significant positive effects of institutional quality and social capital on resilience outcomes. Conversely, collaborative governance shows a significant negative association, suggesting potentially intricate impacts beyond initial expectations. The findings highlight the need to enhance institutional quality and social capital to address preparedness gaps and unexpected challenges posed by biological hazards such as COVID-19. Future research should explore collaborative governance using a disaggregated approach that considers the roles of different stakeholders in various disaster phases. Contribution: This study advances disaster research by presenting practical methodologies for operationalising adaptive capacities and empirically examining their effects on disaster resilience. For practitioners and policymakers, it highlights the need to adopt a long-term perspective in building disaster resilience, focussing on improving institutional quality and social capital to manage the uncertainties and complexities inherent in disaster scenarios effectively.

Strengthening Maternal and Infant Health Resilience Before Weather and Climate Disasters: Preparedness Resources from CDC's Division of Reproductive Health.

This report describes opportunities to address emergency preparedness to incorporate the needs of pregnant and postpartum populations. This report briefly summarizes data on the impacts of weather and climate disasters on maternal and infant health and outlines opportunities for individuals, health care providers, and public health practitioners to increase capacity to prepare for these occurrences, which are becoming more frequent and costly. Specific resources from the U.S. Centers for Disease Control and Prevention's Division of Reproductive Health are shared to support individual preparedness, communication of disaster safety messages, and emergency preparedness planning capacity among health care providers and health departments.

Understanding the Use of Mobility Data in Disasters: Exploratory Qualitative Study of COVID-19 User Feedback.

BACKGROUND: Human mobility data have been used as a potential novel data source to guide policies and response planning during the COVID-19 global pandemic. The COVID-19 Mobility Data Network (CMDN) facilitated the use of human mobility data around the world. Both researchers and policy makers assumed that mobility data would provide insights to help policy makers and response planners. However, evidence that human mobility data were operationally useful and provided added value for public health response planners remains largely unknown. OBJECTIVE: This exploratory study focuses on advancing the understanding of the use of human mobility data during the early phase of the COVID-19 pandemic. The study explored how researchers and practitioners around the world used these data in response planning and policy making, focusing on processing data and human factors enabling or hindering use of the data. METHODS: Our project was based on phenomenology and used an inductive approach to thematic analysis. Transcripts were open-coded to create the codebook that was then applied by 2 team members who blind-coded all transcripts. Consensus coding was used for coding discrepancies. RESULTS: Interviews were conducted with 45 individuals during the early period of the COVID-19 pandemic. Although some teams used mobility data for response planning, few were able to describe their uses in policy making, and there were no standardized ways that teams used mobility data. Mobility data played a larger role in providing situational awareness for government partners, helping to understand where people were moving in relation to the spread of COVID-19 variants and reactions to stay-at-home orders. Interviewees who felt they were more successful using mobility data often cited an individual who was able to answer general questions about mobility data; provide interactive feedback on results; and enable a 2-way communication exchange about data, meaning, value, and potential use. CONCLUSIONS: Human mobility data were used as a novel data source in the COVID-19 pandemic by a network of academic researchers and practitioners using privacy-preserving and anonymized mobility data. This study reflects the processes in analyzing and communicating human mobility data, as well as how these data were used in response planning and how the data were intended for use in policy making. The study reveals several valuable use cases. Ultimately, the role of a data translator was crucial in understanding the complexities of this novel data source. With this role, teams were able to adapt workflows, visualizations, and reports to align with end users and decision makers while communicating this information meaningfully to address the goals of responders and policy makers.

Rural Natural Disaster Stress: A Survey of Community Resource Use and Effect.

OBJECTIVE: This study identified rural community experiences and preferences related to available resources and their effects on stress following tornadoes and floods. METHODS: The Rural Natural Disaster Stress and Recovery survey was distributed from December 2021 to February 2022 in rural disaster-affected communities. Within the analysis sample (N = 159) of self-selected participants representing both agricultural and non-agricultural occupations, 125 responded to the Resource Use and Effect survey component that evaluated the effects of 22 resources on post-disaster stress. Additional qualitative questions provided further data. RESULTS: The most frequently used resources post-disaster were found to be talking about the event (98.3%), friends and neighbors (97.6%) and family (97.6%). Using a derived Impact per Use score, groups from the neighboring community and personal faith activities most often reduced stress. Resources that increased stress were identified as FEMA or other government organizations; repairing, replacing, or rebuilding property; and following news or social media. Participants reported help from their community (35.8%) or things they did for themselves (31.2%) most effectively decreased disaster stress. Family, friends, faith, neighbors, and community were top choices to decrease stress in a future disaster. CONCLUSION: Rural residents identified available resources for reducing disaster stress, but some common post-disaster activities were found to increase stress. Rural emergency management should adapt response and recovery plans and activities to leverage readily accessible people, groups, and activities to mitigate negative mental and emotional health effects.

Case discussion: The effect of extreme temperatures on an older adult.

Climate change can cause high temperatures that can affect the older adult in significant ways. Older adults may not be aware of the dangers of high temperature days and may continue with old habits such as staying in the sun to garden without sunscreen or a hat as they may have done in years past. High temperatures can cause impairment of the tone and structure of blood vessels by interfering with nitric oxide synthesis and cytokine production and can cause systemic inflammation, all of which significantly contribute to dehydration in older adults, who are known to have a decreased sense of thirst, resulting in increased blood viscosity and the risk of heat induced shock and thrombotic strokes. This case discussion highlights the effects of high temperatures due to climate change on an older adult, and what nurse practitioners need to be aware of when assessing older adults who may be suffering from heat exhaustion or heat stroke, and how to manage appropriately.

Occupational nursing during disasters from the perspective of holistic theory.

Disasters are defined as unpredictable and complex situations. This theoretical-reflective study, conducted from August 2020 to December 2020, reflected on occupational nursing during disasters in light of Myra Levine's holistic theory. The first principle of her model is to conserve human energy, focusing on vital sign measurement; the second, conservation of structural integrity, focuses on multiple injuries; the third, conservation of personal integrity, focuses on relationships; while the fourth, conservation of social integrity, involves public and private dimensions beyond an individual level. Levine's conservation model is of special utility in disaster situations, since it is rooted in occupational nursing care, working toward effective adaptation of nursing processes for individuals and families, aiming to achieve professional autonomy and quality care for patients, their families, and society.

Os desastres caracterizam-se como situações imprevisíveis e complexas. Este artigo objetivou refletir sobre a ótica da enfermagem do trabalho em desastres, fundamentada na teoria holística de Myra Estrin Levine. Trata-se de um estudo teóricoreflexivo desenvolvido no período de agosto a dezembro de 2020. Na teoria holística, o primeiro princípio é a conservação da energia do ser humano, com foco na medida dos sinais vitais. Já a conservação da integridade estrutural foca nas experiências múltiplas com lesões. A conservação da integridade pessoal se refere aos relacionamentos para definirem a si mesmos. Por fim, a conservação da integridade social, por sua vez, envolve a definição do ser que vai além do indivíduo e possui dimensões pública e particular. O modelo holístico de Myra Estrin Levine contribui em especial com a temática de desastres, tendo em vista que, ancorada no cuidado de enfermagem no contexto ocupacional, baseia-se em trabalhar de forma didática a adaptação eficaz do processo de enfermagem aos indivíduos e às famílias, além de contribuir com o processo de enfermagem, visando alcançar a autonomia profissional e a boa qualidade da assistência prestada ao cliente, à família e à sociedade.

Dimensions of hospital resilience emphasized during the COVID-19 pandemic response: A systematic review.

Objectives: Hospitals must maintain their effective operations during and after disasters. Due to the current increase in disasters, hospital resilience has drawn scholarly attention. This study aimed to review studies on the changes in the definition of hospital resilience after COVID-19, build a conceptual framework for careful measurement, and identify the main dimensions of hospital resilience emphasized during the COVID-19 pandemic. Design: The initial phase of this study was a systematic review of articles published before the COVID-19 pandemic to extract the hospital resilience-related dimensions for the second phase. The second phase involved text-mining articles published both before and after the emergence of COVID-19. Setting: In the systematic review phase, 12 databases were searched from 2006 to January 2020, including Scopus, Web of Science, MEDLINE through PubMed, Embase, ERIC, ProQuest, the Cochrane Library, Emerald, Springer, Science Direct/ELSEVIER, Google Scholar, and SID (for Persian language papers). Then, after COVID-19, articles published in these databases between January 2020 and May 2022 were evaluated using text mining. Result: During the systematic phase, 17 out of 1530 papers published before COVID-19 were synthesized to collect components of hospital disaster resilience. These identified components were the inputs for the text-mining phase. The text mining on pre-COVID papers resulted in six clusters, with the highest weight (0.65) belonging to general resilience and disaster preparedness, while in the post-COVID text mining phase, including 70 papers, 8 clusters have been identified, with the highest weight cluster (0.78) focusing on the mental and psychological aspects of resilience among healthcare workers. Conclusion: Following the COVID pandemic, scholarly attention has shifted to the more personal dimensions of hospital resilience, including psychological resiliency. It seems necessary for policymakers to focus more on the individual and psychological resilience of hospital staff.

The Perceptions and Experiences of Older People Living in the Aftermath of Lombok Earthquakes, Indonesia: A Qualitative Study.

INTRODUCTION: Despite the growing knowledge of people's vulnerability following natural disasters, the perspective of older people has received limited attention. This study aimed to explore the perceptions and experiences of older people encountering the 2018 Lombok earthquakes. METHODS: This exploratory qualitative study involved 16 older people living in one of the villages most affected by the 2018 earthquakes in Lombok Island, Nusa Tenggara Barat, Indonesia. The data were collected in June 2019 using semi-structured interviews. Participants' responses were digitally recorded and transcribed verbatim for analysis. The data were analysed using qualitative content analysis managed in NVivo. RESULTS: From older people's perspectives, three themes were generated: surviving the disaster, dealing with life changes and navigating through challenges and hope. Each theme comprised two categories, which reflected the journey of older people from the early to the later phase of the disaster. CONCLUSIONS: Older people experienced critical conditions and difficulties both physically and mentally. They also experienced various emotional responses before accepting living situations following a disaster. Nurses should play a role in fulfilling the physical and mental health needs of older people in post-disaster conditions. IMPLICATIONS FOR PRACTICE: This study can inform nurses and other key stakeholders about the needs of older people during and after natural disasters. Nurses need to be equipped with the skills and abilities to identify and meet the needs of older people in difficult situations and with limited resources.

Factors related to the disaster preparedness of patients on haemodialysis from Sichuan, China, during COVID-19: A cross-sectional study.

AIM: This study aimed to investigate personal preparedness among patients on haemodialysis (HD) and to examine the relationship among sociodemographic characteristics, attitudes toward disaster preparedness and personal preparedness behaviours during natural disaster incidents. DESIGN: A cross-sectional survey was conducted. METHODS: A convenience sampling method was used. A total of 446 participants from six areas of Sichuan province completed the online questionnaire study from February 27 to March 13, 2022. Sociodemographic characteristics, attitudes toward disaster preparedness and personal preparedness behaviours were measured. Descriptive statistics were used to analyse sociodemographic characteristics and attitudes toward disaster preparedness. The relationship among sociodemographic characteristics, attitudes toward disaster preparedness and personal preparedness behaviours were assessed using ordinal regression. Statistical significance was defined as p < 0.05. RESULTS: A total of 446 participants completed the survey. Of these, 42.15% (N = 188) were poorly prepared, 26.23% (N = 117) were moderately prepared and 31.61% (N = 141) were highly prepared. Ordinal regression showed that knowing about disaster preparedness (Odds Ratio (OR) = 1.691, 95% Confidence Interval (CI) = 1.081-2.644, p = 0.021), participating in disaster evacuation exercises (OR = 2.519, 95% CI = 1.595-3.977, p < 0.001) and learning about disaster preparedness (OR = 2.421, 95% CI = 1.542-3.802, p < 0.001) were associated with high preparedness. Compared to patients with a university degree or higher, patients with a junior high school education or lower (OR = 3.491, 95% CI = 1.760-6.925, p < 0.001) and senior high school degree (OR = 2.052, 95% CI = 1.038-4.057, p = 0.039) were associated with high preparedness. Patients who felt very confident and could deal with all their needs (OR = 3.878, 95% CI = 2.904-7.181, p < 0.001) or patients who felt confident and could meet some of their needs (OR = 1.949, 95% CI = 1.124-3.379, p = 0.017) had higher preparedness than those who felt less confident and were not well prepared to take care of their needs. PATIENT OR PUBLIC CONTRIBUTION: After obtaining each participant's consent, they filled out the online questionnaire using their own or a relative's cell phone while undergoing HD. IMPLICATION FOR PRACTICE: It is essential that patients should be educated not only on medical specialty topics, but also on general disaster preparedness. Medical institutions should improve and reinforce preparation training among targeted populations. The low level of preparedness is partly due to the lack of participation of patients in disaster preparedness programs. Dialysis center managers should be urged to implement such programs at their centers.