Models and components in disaster risk communication: A systematic literature review.

BACKGROUND AND AIM: Risk communication is considered a major factor in disaster risk management by the concerned policymakers and researchers. However, the incoherence of variables affecting risk communication in various studies makes it difficult to plan for disaster risk communication. This study aims to identify and classify the influential components in disaster risk communication. MATERIALS AND METHODS: This systematic review was conducted in 2020. Databases included PubMed, Scopus, and Web of Science. In searching for articles, there was no limit on the date of publication and the language of the article. The research addressed both natural and man-made disasters. The Preferred reporting items for systematic review and meta-analysis protocols (PRISMA) checklist was followed throughout the research, and the quality of the papers was assessed using the mixed methods evaluation tool (MMAT). RESULTS: In searching the articles, 3956 documents were obtained, of which 1025 duplicated articles were excluded. The titles and abstracts of the remaining documents (2931) were examined, of which 2822 were deleted, and the full text of 109 documents was studied for further assessment. Finally, after applying the inclusion and exclusion criteria and reviewing the full texts, 32 documents were considered to extract the data and for quality assessment. On studying the full text of the obtained documents, 115 components were found, which were classified into five groups (message, message sender, message receiver, message environment, message process) and 13 subgroups. In addition, the obtained components were classified as those proposed by the authors of the article and those obtained from disaster risk communication models. CONCLUSION: Identifying the effective components in the disaster risk communication gives a more comprehensive view of risk communication to the disaster managers and executives and provides the decision-makers with an important platform to be able to use the components of risk communication and increase the impact of messages and ultimately increase people's preparedness for disasters in planning operations for the risk communication.

Clinical courses of 24,563 hospitalized COVID-19 patients during the first 12 months of the pandemic in the Central City of Iran.

This study was designed and implemented to analyze and establish documents related to the above cases in the first to third COVID-19 epidemic waves for the use of researchers and doctors during and after the epidemic. The current case series study was conducted on 24,563 thousand hospitalized COVID-19 patients by examining their clinical characteristics within a one-year period from the beginning of the pandemic on 02.22.2020 to 02.14.2021, which included the first to the third waves, based on gender and severity of COVID-19. The mean age of the participants was 56 ± 20.71, and 51.8% were male. Out of a total of 24,563 thousand hospitalized COVID-19 patients until February 2021, there were 2185 mortalities (9.8%) and 2559 cases of severe COVID-19 (13.1%). The median length of hospitalization from the time of admission to discharge or death in the hospital (IQR: 13-41) was estimated to be 21 days. The rate of hospital mortality was higher in severe (37.8%) than in non-severe (4.8%) cases of COVID-19, While the risk of severe cases increased significantly in the third (HR = 1.65, 95% CI: 1.46-1.87, P < 0.001) and early fourth waves (HR = 2.145, 95% CI: 1.7-2.71, P < 0.001). Also, the risk of contracting severe COVID-19 increased significantly in patients aged ≥ 65 years old (HR = 2.1, 95% CI 1.1.93-2.72, P < 0.001). As shown by the results, the rates of hospital mortality (9.3% vs. 8.5%) and severe cases of COVID-19 (13.6% vs. 12.5%) were higher among men than women (P < 0.01). In our study, the mortality rate and severity of COVID-19 were within the scope of global studies. Men experienced higher severity and mortality than women. The was a significantly higher prevalence of old age and underlying diseases in individuals with severe COVID-19. Our data also showed that patients with a previous history of COVID-19 had a more severe experience of COVID-19, while most of these patients were also significantly older and had an underlying disease.

Social vulnerability indicators in pandemics focusing on COVID-19: A systematic literature review.

INTRODUCTION: Social factors can affect the vulnerability of disaster-prone communities. This review aimed to identify and categorize social vulnerability indicators in the COVID-19 pandemic. METHODS: This systematic review was conducted in February 2021. Bibliographies, citation databases, and other available records were investigated based on the aim of the study. The Joanna Briggs Institute (JBI) critical appraisal tools were applied for assessing the included articles retrieved through the comprehensive and systematic literature search. Descriptive and thematic analyses were done to extract the indicators affecting social vulnerability in the COVID-19 pandemic. RESULTS: Thirty-one eligible articles were included and 85 indicators of social vulnerability were extracted. The indicators were categorized in seven main categories, including; Household, community composition; Race, minority status and language; Socioeconomic status; Community health status; Public health infra-structures; Education; Information, technology and communication. CONCLUSION: Regions with higher social vulnerability experienced greater mortality rates during the COVID-19 pandemic. Additional research is needed to measure the social vulnerability index in pandemics to prioritize distribution of scarce resources and ensure effectiveness and equity for all regions of countries.

Prioritized Criteria for Casualty Distribution following Trauma-related Mass Incidents; a Modified Delphi Study.

INTRODUCTION: In the aftermath of mass casualty incidents (MCIs), many decisions need to be made in a fast and influential manner in a high pressure environment to distribute the limited resources among the numerous demands. This study was planned to rank the criteria influencing distribution of casualties following trauma-related MCI. METHODS: This study utilized a modified Delphi methodology, concentrating on extracted criteria attained from preceding systematic literature reviews. The 114 extracted criteria were classified into eight sections including space, staff, equipment, system and structures, triage, treatment, transport, and uncategorized criteria and were imported into an online survey tool. In the first round, experts were asked to rank each criterion on a five-point Likert scale. The second round incorporated feedbacks from the first round, stating percent and median scores from the panel as a whole. Experts were then called upon to reassess their initial opinions regarding uncertain remarks from the first round, and once again prioritize the presented criteria. RESULTS: Fifty-seven criteria were regarded as relevant to the following sections: space: 70% (7/10); staff: 44% (4/9); system / structure: 80% (4/5); equipment: 39.1% (9/23); treatment; 66.7% (6/9); triage: 73.7% (14/19); transport: 38.7% (12/31) and other sections: 12.5% (1/8). The first round achieved nearly 98% (n=48) response rate. Of the 114 criteria given to the experts, 68 (almost 60%) were approved. The highest percentage of approval belonged to the system and structures sections (4/5=80%). The response rate for the second round was about 86% (n=42). A consensus could be reached about nearly 84% (57) of the 68 criteria presented to experts. CONCLUSION: "Casualty Level of Triage on the Scene" and "Number of Available Ambulances" were the two criteria that obtained the highest level of consensus. On the other hand, "gender of casualty", "Number of Non-Medical staff in each Hospital" and "Desire to transport family members together" got lowest level of consensus. This sorted list could be used as a catalogue for developing a decision support system or tool for distribution of victims following mass casualty incidents.

A systematic literature review of criteria and models for casualty distribution in trauma related mass casualty incidents.

INTRODUCTION: Mass casualty incidents impose a large burden on the emergency medical systems, hospitals and community infrastructures. The pre-hospital and hospital capacities are usually bear the burden of casualties large numbers. One of the challenging issues in mass casualty incidents is the distribution of casualties among the suitable health care facilities. OBJECTIVE: To review models and criteria affecting the distribution of casualties during the trauma-related mass causality incidents. MATERIALS AND METHODS: A systematic literature search in the scientific databases which included: PubMed, Scopus and Web of Science was conducted. Relevant literature which was published before August 2017 was searched. Neither the publication date nor language limitations were considered in the literature search. All the trauma-related mass casualty incidents are included in this study. Two independent reviewers conducted the data extraction and quality assessment of the documents was considered using a checklist developed by the researchers. RESULTS: Literature search yielded 4540 documents of which 493 were duplicated and removed. After reviewing the titles and abstracts of the remaining documents (4047), only 73 documents were considered relevant. Finally, the inclusion and exclusion criteria were applied and only 30 documents were considered for data extraction and quality assessment. The study found 491 criteria to be affecting the distribution of casualties following trauma-related mass casualty incidents. These are categorized as pre-hospital (triage, treatment and transport); hospital (space, staff, stuff, system / structure); incidents' characteristics and others. The criteria which were extracted from the models are termed as "model extracted" while the other labeled as "author suggested". CONCLUSION: To the best of our knowledge, this is the first systematic literature review on criteria affecting distribution of casualties following trauma-related mass casualty incidents based on the pre-hospital and hospital capacities. SYSTEMATIC REVIEW REGISTRATION NUMBER: This review was registered in international prospective register of systematic reviews (PROSPERO) with registration number CRD42016049115.

Criteria and models for the distribution of casualties in trauma-related mass casualty incidents: a systematic literature review protocol.

BACKGROUND: One of the most critical practices in mass casualty incident management is vacating the victims from scene of the incident and transporting them to proper healthcare facilities. Decision on distribution of casualties needs to be taken on pre-developed policies and structured decision support mechanisms. While many studies tried to present models for the distribution of casualties, no systematic review has yet been conducted to evaluate the existing models on casualty distribution following mass casualty incidents. A systematic review is therefore needed to examine the existing models of patient distribution and to provide a summary of the models. This systematic review protocol is aimed to examine the existing models and extracting rules and principles of mass casualty distribution. METHODS: This study will comprehensively investigate existing papers with search phrases and terms including "mass casualty incident", distribution, evacuation, and Mesh terms directly corresponding to search phrases. No limitations on the type of studies, date of publication, or language of the relevant documents will be imposed. PubMed, Web of Science, Scopus, and Google Scholar will be searched to access the relevant documents. Included papers will be critically appraised by two independent reviewers. The data including incidents type, scene characteristics, patient features, pre-hospital resources, and hospital resources will be categorized. Subgroup analysis will be conducted when possible. DISCUSSION: To the best of our knowledge, no study has yet addressed the effects and interaction of contributing factors on the decision-making processes for casualty's distribution. This is the first study that comprehensively assesses and critically appraises the current models of casualty distribution. This study will provide evidences about models and criteria for casualty distribution following mass casualty incidents. SYSTEMATIC REVIEW REGISTRATION: PROSPERO Registration Number: CRD42016049115.