Deadly yet Preventable? Lessons From South Korea's Halloween Crowd Crush.

Avoidable disasters are both saddening and baffling. In 2022, 159 people, mostly in their 20s, and 30s were crushed to death in Itaewon's narrow alleyway amid South Korea's first pandemic-restrictions-free Halloween celebration. What is particularly sobering about this tragedy is that although many people called police hotlines as crowds became cramped and static, their calls went unheeded for hours. Rather than order independent investigations into the catastrophe (as of January 2024), the President of South Korea at the time focused on superficial issues such as asking the public to refer to the disaster as an "accident" (which it was not, it was an avoidable disaster) and the casualties as "the dead" (who are casualties indeed, instead of victims of a preventable tragedy). In this paper, we examine how officials' complacency about public health and safety dangers, ineffective disaster prevention, and preparedness systems, as well as the government's chronic lack of prioritization of public health and safety may have contributed to the disaster. Furthermore, we discuss the importance of creating integrated public health and safety protection systems to prevent similar tragedies from happening.

Preparing the developing world for the next pandemic: Evidence from China's R&D blueprint for emerging infectious diseases.

BACKGROUND: With double pressures of endemic and imported emerging infectious diseases (EIDs), China's ability to detect, prevent and control the unknown virus is of regional and global interest. This study aimed to establish an R&D Blueprint for EIDs in China by identifying the list of prioritized diseases and medical countermeasures (MCMs) that need proactive actions for the next pandemic. METHODS: The process mainly referred to the World Health Organization's prioritization methodology, supplemented by pipeline landscape, rapid risk assessment and multi-dimensional analysis. The study included five steps: 1) identifying potential pathogens, 2) screening into the long list, 3) prioritizing the long list, 4) identifying the final list and 5) generating an R&D Blueprint. RESULTS: China's R&D Blueprint identified 14 viral pathogens and two virus groups (i.e., Influenza HxNy and Coronavirus X) for proactive and representative MCM development. At least one diagnostic candidate in preclinical study, and one therapeutic and one vaccine candidate in Phase I/II clinical trials for each prioritized pathogen were suggested to be developed as strategic national stockpiles. Various generalized and innovative platform technologies were also highlighted for enhancing overall capacities of EID preparedness and response, covering basic research, experiment, detection, prevention and control, surveillance and information sharing. CONCLUSIONS: This is the first study in developing countries that established an R&D Blueprint of prioritized diseases, countermeasures and technologies. Our findings could help to drive pre-emptive scientific and technological actions toward emerging pathogens that may cause the next epidemic and could provide evidence-based strategies for developing countries to establish their national health research agenda tailored to health and research context under resource-limited settings.

Exploring ambulance clinicians' clinical reasoning when training mass casualty incidents using virtual reality: a qualitative study.

BACKGROUND: How ambulance clinicians (ACs) handle a mass casualty incident (MCI) is essential for the suffered, but the training and learning for the ACs are sparse and they don't have the possibility to learn without realistic simulation training. In addition, it is unclear what type of dilemmas ACs process in their clinical reasoning during an MCI. With virtual reality (VR) simulation, the ACs clinical reasoning can be explored in a systematic way. Therefore, the objective was to explore ambulance clinicians' clinical reasoning when simulating a mass casualty incident using virtual reality. METHODS: This study was conducted as an explorative interview study design using chart- stimulated recall technique for data collection. A qualitative content analysis was done, using the clinical reasoning cycle as a deductive matrix. A high-fidelity VR simulation with MCI scenarios was used and participants eligible for inclusion were 11 senior ACs. RESULTS/CONCLUSION: All phases of the clinical reasoning cycle were found to be reflected upon by the participants during the interviews, however with a varying richness of analytic reflectivity. Non-analytic reasoning predominated when work tasks followed specific clinical guidelines, but analytical reasoning appeared when the guidelines were unclear or non-existent. Using VR simulation led to training and reflection on action in a safe and systematic way and increased self-awareness amongst the ACs regarding their preparedness for MCIs. This study increases knowledge both regarding ACs clinical reasoning in MCIs, and insights regarding the use of VR for simulation training.

Detection of SARS-CoV-2 on the environmental surfaces and its implications for pandemic preparedness.

Even though death due to COVID-19 is no longer a public health emergency, less virulent but highly transmissible forms of SARS-CoV-2 continue to spread in many countries leading to outbreaks and rise in hospitalizations in the affected regions. Lessons learned during the pandemic must be put into action to protect the world's population from another catastrophe like COVID-19. Novel approaches that were developed for tracking the spread of SARS-CoV-2 included analysis of wastewater, air samples, and various environmental surfaces. We conducted a study in Kuwait during the peak of COVID-19 pandemic to examine if SARS-CoV-2 could be detected in swabs taken from frequently touched environmental surfaces. We selected 12 Cooperative Society Stores-two from each governorate of Kuwait-for collection of surface samples. The Cooperative Society Stores are widely distributed across the whole country and cater to daily household needs including groceries and other essential items. These stores operated even during the "lockdown" imposed at the height of the pandemic. We collected swabs from high-touch surfaces including the handles of the shopping carts and freezers, the elevators, the keypads of the point-of-service terminals of cash counters, and the automated teller machines. All the surfaces tested showed a variable presence of SARS-CoV-2 by reverse transcriptase quantitative PCR, showing the validity of the proof-of-concept study. Monitoring of the presence of SARS-CoV-2 by surface sampling thus offers a cheap but effective means of environmental surveillance for coronaviruses. We therefore strongly recommend the addition of surface environmental sampling as a strategy for pandemic preparedness everywhere.

Learning interventions in the WHO Eastern Mediterranean region: supporting Member States to get prepared for better response to health emergencies in the region.

Background: The Eastern Mediterranean Region (EMR) faces numerous public health risks caused by biological, chemical, man-made, and natural hazards. This manuscript aimed to assess the multifaceted interventions and strategies used to strengthen the EMR's preparedness capacities to respond properly to current and upcoming health emergencies. Objective: To address these challenges, it is crucial to implement comprehensive and robust strategic risk assessments and health emergency preparedness frameworks. The World Health Organization (WHO) takes a risk-based approach, emphasizing the significance of all-hazards emergency management and the creation of national health risk profiles using the Strategic Toolkit for Assessing Risk (STAR). Furthermore, the International Health Regulations (IHR) Monitoring and Evaluation Framework (MEF) ensures continuous learning and capacity building among Member States, enhancing their ability to manage health emergencies effectively. Key components include State Party Annual Reporting (SPAR), Joint External Evaluation (JEE), After Action Review (AAR), Intra Action Review (IAR), and Simulation Exercises (SimEx). Moreover, initiatives like One Health, Emergency Care Systems, Safe Hospitals, and Public Health Emergency Operations Centers (PHEOCs) reinforce preparedness and response capacities. Risk communication and community engagement (RCCE) strategies play a pivotal role in disseminating timely information and fostering community resilience. Furthermore, the management of Chemical, Biological, and Radiological (CBRN) incidents remains a priority, necessitating collaboration between the public health and security sectors. This comprehensive approach aims to strengthen health systems, reduce risks, and improve emergency response capabilities throughout the EMR, thereby promoting global health security and resilience. Conclusion: The EMR is addressing public health challenges through frameworks like IHR-MEF, and RCCE. It is strengthening emergency care systems, ensuring safe hospitals, and establishing PHEOCs. Proactive measures to address CBRN events and collaboration are enhancing resilience. The inclusion of the One Health approach underscores the EMR's holistic strategy to address the health threats at the human-animal-environment interface. This demonstrates the EMR's commitment to global health security.

Insights into enhanced learning through virtual reality.

INTRODUCTION: This study investigates the impact of Immersive Virtual Reality (VR) on learning outcomes in radiography training using Virtual Medical Coaching's X-Ray Pro VR software. VR offers immersive experiential learning that may enhance academic performance and professional preparedness. METHODS: The study involved 130 students from two consecutive cohorts: one using traditional training methods and the other using VR software. We employed a mixed-methods approach, integrating quantitative measures of academic performance and clinical competency with qualitative insights into student engagement, enjoyment, and stress levels. The VR group used Virtual Medical Coaching simulation software, while the traditional group used physical simulation machines (Siemens Healthineers) to practice positioning anthropomorphic manikins, adjusting exposure settings, and handling X-ray equipment. Data were collected at four points: immediately post-training and at 1 month, 3 months, and 8 months follow-up. RESULTS: The VR cohort showed significantly higher knowledge retention, work readiness, and lower stress levels compared to the traditional cohort. Among the participants trained in VR, a vast majority (59 out of 65) reported a high level of satisfaction with the immersive nature of the training, emphasizing its realism and direct applicability to clinical scenarios. Quantitative analysis revealed superior performance metrics for the VR group across all measured time points (p < 0.001). Qualitative feedback highlighted enhanced engagement and enjoyment among VR-trained students. CONCLUSION: The results of this study clearly indicate that VR training significantly enhances learning outcomes in radiography education. The VR cohort exhibited higher knowledge retention, work readiness, student engagement, and enjoyment, along with lower stress levels and higher confidence compared to the traditional cohort. These findings support the integration of VR into professional training curricula to improve student performance and engagement.

Training Public Health Nurses on Disaster Shelter Care Using a Flipped Classroom Approach.

OBJECTIVE: With the increase in natural disasters and the expected role of public health nurses (PHNs) in responding, it is crucial to develop evidence-based disaster preparedness and management training programs tailored to the needs of PHNs. This study evaluates the effectiveness of a flipped classroom approach in disaster training for PHNs. METHODS: A total of 42 PHNs completed a 5-hour online training program and an in-person 8-hour training session at a local nursing school. Surveys measuring self-reported confidence and knowledge were completed at the beginning and end of the online and in-person training. RESULTS: The average years of experience as an RN and PHN were 12.3 years and 6.7 years, respectively. Approximately 64% of participants had never deployed during a disaster. The pre- and posttest demonstrated a large effect size, indicating the effectiveness of both online and in-person training. The online training resulted in significant changes in knowledge. The in-person training showed a statistically significant increase in confidence across all measures. CONCLUSIONS: Online and in-person disaster preparedness training programs can effectively enhance the knowledge, skills, and attitudes of PHNs. The majority of participants expressed that the training better prepared them to work in disaster shelters.

Current Capacity for Diagnosing Alzheimer's Disease in Germany and Implications for Wait Times.

Background: Amyloid-targeting therapies for Alzheimer's disease (AD) might become available in Germany soon. The combination of a large pool of prevalent cases and a complex diagnostic process to determine eligibility for these treatments is likely to challenge health systems' capacity. Objective: To analyze Germany's healthcare system capacity to identify treatment-eligible patients in a timely and equitable manner. Methods: We modeled patients' diagnostic journey and projects wait times due to capacity constraints for AD specialist visits and PET scans from 2024 to 2043. Model parameters were derived from published data and expert input. Results: Wait times would be ∼50 months over the model horizon, if patients were referred to specialists based on a brief cognitive assessment in primary care. Wait times for patients with social health insurance are projected to be 1.9 times those of patients with private insurance, with peak wait times of around 76 and 40 months, respectively. Adding a blood test for the AD pathology as additional triage step would reduce wait times to below 24 months. Conclusions: In spite of having a well-resourced health system, Germany is projected to be unable to cope with the demand for biomarker-based AD diagnosis, if a disease-modifying AD treatment were introduced. As these treatments might become available by the end of 2024, decisive action, in particular dissemination of high-performing AD blood tests for triage in primary care, will be needed to prevent delays in access and potentially avoidable and inequitable disease progression.

Knowledge and attitude among Bangladeshi healthcare workers regarding the management and infection prevention and control of Nipah virus.

Background: The Nipah virus (NiV) is a zoonotic pathogen that belongs to the Paramyxoviridae family. It can cause severe respiratory and neurological diseases in humans, with varying clinical symptoms. Recognized as a critical public health concern by the World Health Organization, it requires concerted efforts in research and development to prevent outbreaks. Methodology: An analytical cross-sectional study was conducted on 455 healthcare workers across four major regions in Bangladesh from April 2022 to May 2023. Using multistage convenient sampling and face-to-face interviews with a semi-structured questionnaire, we have examined the level of knowledge, attitudes, and individual perceptions of the preparedness for NiV. Data analysis included univariate and bivariate analyses, followed by binary logistic regression to ascertain the association with demographic factors. Results: The study identified a gender disparity favoring female healthcare workers (HCWs). Approximately 46.15 % of participants demonstrated a good knowledge about NiV, with doctors showing significantly higher knowledge odds (OR = 5.197, p < 0.001). Interestingly, graduate and post-graduate education levels did not yield a statistically significant correlation with knowledge. Specific training received was positively associated with knowledge levels (OR = 1.832, p = 0.014), highlighting the gap in routine infection prevention education. Regional differences were notable, with participants from Chittagong having a lower level of knowledge compared to Dhaka (OR = 0.307, p = 0.004). Attitudes towards NiV were predominantly positive, although higher education inversely correlated with positive attitudes, suggesting a potential gap between theoretical knowledge and practical attitudes. Conclusion: While the attitude towards NiV is generally positive among Bangladeshi HCWs, there is a need to enhance knowledge levels, especially in primary care settings and certain regions. To effectively prepare for NiV outbreaks, it is crucial to prioritize continuous education and practical training. The study underscores the importance of implementing uniform educational strategies to equip HCWs across all categories and regions with adequate NiV knowledge and preparedness.

Affordable Care Act Medicaid expansion, access to health care, and financial behavior of the United States adults.

The access to care benefits of Affordable Care Act (ACA) Medicaid expansions are important for 45-64-year-old adults who are living below 100% of the Federal Poverty Level, a particularly vulnerable group in the United States (US). Gaining coverage from Medicaid expansions should improve access to healthcare and affect social determinants of health, including financial behavior. We analyzed data from 2009 to 2018 from the National Financial Capability Survey (NFCS) and utilize a difference-in-differences model to compare outcomes changes in states with and without expansion before and after the ACA Medicaid expansions. Overall, Medicaid expansion was associated with increased healthcare access for 45-64-year-olds, potentially resulting in better healthcare experience. Results indicate effects of the Medicaid expansion on the financial behavior of 45-64-year-olds, with evidence of credit card bills being paid in full, higher banking activities, and better financial preparedness. These findings have important implications for financial regulators and healthcare policymakers.

Usefulness and limitations of various detector systems for estimation of131I thyroid activity following an RN event.

Following a radiological or nuclear (RN) event, rapid measurement of131I in members of the public is of utmost importance, and much equipment is needed for a high throughput. In this study, three gamma cameras, two thyroid uptake meters and one whole-body counter were calibrated for activity measurements of131I in the thyroid. Minimum detectable activity was derived for the gamma cameras, the thyroid uptake meters and the whole-body counter giving that a committed effective dose (CED) in the interval 2.0-85 µSv, 13-700 µSv and 0.52-6.4 µSv, and thyroid absorbed doses in the interval 0.075-2.1 mGy, 0.48-17 mGy, and 0.020-0.15 mGy, respectively, can be assessed for children, adolescents, and adults. These numbers are based on 10-min measurement, performed at 1, 3 and 7 days after intake, and the CED includes intake by ingestion and inhalation of aerosols Type F, with an activity median aerodynamic diameter (AMAD) of 1 µm. For a fractional signal loss of 63% due to dead time, a CED up to 2.0, 84 and 3.6 Sv and thyroid absorbed dose up to 47 Gy, 2000 Gy and 88 Gy for the three systems, respectively, can be assessed for children and intake by ingestion as a worst-case scenario in terms of CED, measured 7 days after intake. This study demonstrates the potential and limitations of using equipment readily available at larger hospitals for estimation of131I content in thyroid, which could increase the measurement capability following an RN event. .

Rethinking Prehospital Response to Mass Casualty Events: Move, Treat, and Transport.

Herein, we present a simplified approach to prehospital mass casualty event (MASCAL) management called "Move, Treat, and Transport." Prior publications demonstrate a disconnect between MASCAL response training and actions taken during real-world incidents. Overly complex algorithms, infrequent training on their use, and chaotic events all contribute to the low utilization of formal triage systems in the real world. A review of published studies on prehospital MASCAL management and a recent series of military prehospital MASCAL responses highlight the need for an intuitive MASCAL management system that accounts for expected resource limitations and tactical constraints. "Move, Treat, and Transport" is a simple and pragmatic approach that emphasizes speed and efficiency of response; considers time, tactics, and scale of the event; and focuses on interventions and evacuation to definitive care if needed.

Developmental trajectories of professional preparedness among senior nursing students during clinical placement: A longitudinal study.

BACKGROUND: Newly graduated nurses' lack of professional competence is associated with inadequate preparation during their clinical placement as nursing students. Clinical placement is a critical stage in the development of nursing students' professional preparedness. However, research on the trajectory of nursing students' professional preparedness during clinical placement has not yielded findings with the same specificity. OBJECTIVES: The aim of this study is to estimate differences in professional preparedness levels at different clinical placement stages, to identify distinct patterns of professional preparedness trajectories during clinical placement, and to evaluate predictors of these trajectory group memberships. DESIGN: A quantitative longitudinal study. SETTINGS: Participants were recruited on a voluntary basis using convenience sampling at a tertiary hospital in Nanning, China. PARTICIPANTS: 224 senior nursing students were initially invited to participate in the study. A total of 178 nursing students successfully completed the follow-up assessments at baseline, as well as at 1 month, 4 months, and 8 months into their clinical placement. METHODS: Participants completed four online surveys, during which their professional preparedness level was measured using the Perceived Professional Preparedness questionnaire for senior nursing students. Professional preparedness scores at different time points were compared using one-way repeated measures ANOVA and latent growth model. Group-based trajectory model was applied to identify professional preparedness trajectories. Multiple logistic regression was adopted to determine the predictors of trajectory group memberships. RESULTS: The entire sample of Senior nursing students experienced a significant increase in professional preparedness during clinical placement. The best-fitting group-based trajectory model delineated three distinct trajectories: low-slowly increase trajectory (27.53 % of sample), moderate-rapidly increase trajectory (47.19 % of sample) and a high-stably increase trajectory (25.28 % of sample). Male, good and excellent academic performance, and very high degree of professional interest are the predictors of the moderate-rapidly increase trajectory. While male, good and excellent academic performance, high and very high degree of professional interest and participating in medical-related part-time employment are the predictors of the high-stable increase trajectory. CONCLUSIONS: Senior nursing students exhibit different levels of professional preparedness throughout their clinical placement. Simultaneously, three different trajectories were identified among the sample of nursing students. Therefore, in future research, greater attention should be directed towards the professional preparedness levels of nursing students with different trajectories, and early identification and targeted interventions should be prioritized.

Does Disaster Severity Have a Long-Term Effect on Survivors' Disaster Preparedness? A Survey a Decade after the 2008 Wenchuan Earthquake in China.

OBJECTIVES: Disaster experiences have long-term effects on disaster preparedness. This study examined the long-term (10-y) effect of disaster severity of the 2008 Wenchuan earthquake on survivors' disaster preparedness and the moderating effects of household vulnerability. METHODS: The data were collected in January 2018 covering 30 counties in Wenchuan earthquake-stricken areas. The dependent variable was survivors' disaster preparedness (including overall, material, knowledge and awareness, and action preparedness) in 2018. Disaster severity included survivors' housing damage and county death rate caused by the earthquake in 2008. Household vulnerability is a set of conditions that negatively affects the ability of people to prepare for and withstand disaster, proxied by households' per-capita income and the highest years of schooling of household members. We performed multivariable linear regression models to answer the research questions. RESULTS: A higher county death rate was associated with better overall preparedness (ß = 0.043; P < 0.05) and knowledge and awareness preparedness (ß = 0.018; P < 0.05), but housing damage was not significantly associated with disaster preparedness. The positive association of county death rate with overall preparedness (ß = -0.065; P < 0.05) becomes weaker when a household has a higher per-capita income. Also, with the household per-capita income increasing, the associations of county death rate with material preparedness (ß = -0.037; P < 0.05) and action preparedness (ß = -0.034; P < 0.01) become weaker. CONCLUSIONS: Disaster severity has positive and long-term effects on survivors' disaster preparedness. Also, the positive and long-term effects are affected by household vulnerability. Specifically, the positive and long-term effects of disaster severity on disaster preparedness are more substantial when a household is more vulnerable.

Bringing the operating room to the field: lessons learned from on-scene field amputations.

INTRODUCTION: Complicated field extrication may require the assistance of a surgical team to perform an on-scene limb amputation. Although a rare event, when needed, an organized and efficient response is critical to successful outcomes. METHODS: The Los Angeles County Hospital Emergency Response Team (HERT) program and the organization of the team is described, and a multidisciplinary quality improvement process reviewed and analyzed two cases and identified areas for performance improvement. RESULTS: Experience shapes policy and procedures within the HERT program. The timeliness of HERT activation has a major influence on the success of extrication, and regular drills of the multidisciplinary team consisting of trauma surgeons, emergency physicians, nurses, paramedics, and fire department allow for rapid, effective activation. Post-event quality improvement process reviews the timeline of events, provider activation, communication across field and hospital providers, in-hospital events, and medical decision making throughout. Critical analysis of every step helps prepare for any subsequent encounter. CONCLUSION: A well-organized and rehearsed protocol to streamline activation and transportation of a well-trained, designated team, in addition to pre-packaged surgical supplies and an effective communication tree are essential elements of a HERT program.

Pandemic preparedness: why humanities and social sciences matter.

Whilst many lessons were learned from the COVID-19 pandemic, ongoing reflection is needed to develop and maintain preparedness for future outbreaks. Within the field of infectious disease and public health there remain silos and hierarchies in interdisciplinary work, with the risk that humanities and social sciences remain on the epistemological peripheries. However, these disciplines offer insights, expertise and tools that contribute to understanding responses to disease and uptake of interventions for prevention and treatment. In this Perspective, using examples from our own cross-disciplinary research and engagement programme on vaccine hesitancy in South Africa and the United Kingdom (UK), we propose closer integration of expertise, research and methods from humanities and social sciences into pandemic preparedness.

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.

Infectious diseases risk framing in Bulgarian media during early COVID-19 pandemic and the Ebola crisis.

Introduction: Social forces, in conjunction with biological variables, play a crucial role in shaping the overall health of a community, particularly in the context of infectious disease outbreaks. Mass media calibrates risk perception among the public. The present study's aims are to review risk framings in the Bulgarian National Television in the early stages of the COVID-19 pandemic and to compare results with the communication strategies employed when Ebola was exported outside of Africa. The research seeks to provide a quantitative and qualitative understanding of how the media communicated risk during the two crises. It also aims to determine the extent to which messages altered based on the distinct epidemiological characteristics of the two epidemics. Methods: We used interdisciplinary analysis, combining methods from the social sciences and epidemiology. It is based on a controlled study of media content comparing the share and presentation of information on infections during two different outbreaks caused by newly emerging pathogens (in 2014 and 2020), as well as during periods with no specific concern for novel public health threats (JAN 2019 and OCT-NOV 2019). A content analysis was carried out. Results: The findings of the study indicate that during the Ebola crisis, medical frames were used in 92 % of the cases, whereas the majority of the analyzed media coverage of COVID-19 focused on the socio-political frame (97 %). During control periods, the extent of coverage using a medical framework varies between 100 and 86 %. In terms of geographic coverage, the presentation of content followed the principle of proximity. In non-emergency circumstances, clinical practitioners are often preferred candidates for interviews. However, during health crises, the media tends to highlight individuals holding administrative positions and authoritative functions. Conclusion: The present research confirms the hypothesis that public health emergencies increase the volume of infectious disease content on the news. The most frequently selected speaker categories should be briefed timely on outbreak developments in order to feed the media with accurate information.

Predictors of Birth Preparedness and Complication Readiness Practices Among Pregnant Women in Ethiopia, a Systematic Review and Meta-Analysis.

Objectives: We conducted this review to identify factors associated with birth preparedness and complication readiness (BPCR) among pregnant women in Ethiopia. BPCR is a comprehensive approach that helps address delays in seeking care for obstetric problems. Methods: PRISMA was followed and different databases were used to find studies. Adjusted Odds Ratio (AOR) with a 95% Confidence Interval was used to identify factors. The I2 statistic, funnel plot, and Egger test were used to assess the heterogeneity of studies and publication bias. Results: Knowledge of BPCR, danger signs during pregnancy, labor, and postpartum (AOR = 1.99, 95% CI: 1.51, 2.64, AOR = 1.55; 95% CI: 1.35, 1.80; AOR = 1.45; 95% CI: 1.27, 1.63, and AOR = 1.4; 95% CI: 1.21, 1.63), respectively, residency (AOR = 1.49; 95% CI: 1.32, 1.68), antenatal care visit (AOR = 1.59; 95% CI: 1.43, 1.78), history of stillbirth (AOR = 1.58; 95% CI: 1.36, 1.86), and educational status (AOR = 1.62: 95% CI: 1.45, 1.78) were significantly associated with BPCR practice. Conclusion: This study identified some modifiable factors in the practice of BPCR. Integrating counseling and expanding ANC services in health facilities may improve BPCR practice.