Should we offer disaster preparedness and response training workshops across Idaho? A feasibility study.

INTRODUCTION: It is important for individuals and families to prepare for potential disasters to enable communities to generate a consolidated response. It is estimated that 30 percent of residents of the fourth largest city in Idaho, Idaho Falls, are not prepared to deal with disasters. A 1-day training workshop for healthcare professionals and students at Idaho State University in Pocatello was organized to build their capacity for acute disaster response and preparedness. This study assesses the impact of the workshop in improving knowledge and attitudes of the participants toward disaster management. METHODS: A mixed methods study design was employed. Pre- and post-tests were administered to the participants (n = 18) to examine change in self-perceived understanding of disasters, and disaster preparedness and management. Core competencies encompassing knowledge of disaster preparedness were assessed via 18 multiple-choice questions. Participant attitudes toward disaster training exercises in colleges, universities, and healthcare facilities were recorded, and written feedback regarding the workshop obtained. Chi-square and paired t-tests were used to examine changes in disaster preparedness and cumulative knowledge score. Quantitative variables and comments were analyzed using Stata.v.13 and Maxqda, respectively. RESULTS: Our assessment indicates an improvement in mean knowledge score [pretest: 10.7 (2.8), post-test: 12.5 (2.9); p = 0.007] and self-perceived disaster preparedness and management. The attitude of audience toward training workshops was wholly positive in both the pre- and post-tests. Participants commented that the workshop was "excellent," helped them polish their knowledge and skills, trained them to build emergency kits and communication plans, and perform triage amidst crises. CONCLUSION: Training workshops should be offered to communities to build their capacity to prepare for and respond to disasters.

Anabolic steroid use and ischaemic stroke in a young fitness enthusiast.

We report a case of ischaemic stroke in a 34-year-old male recreational bodybuilder following a 3-month period of anabolic androgenic steroid (AAS) use and 1-month period of 'post-cycle therapy' (tamoxifen and clomiphene citrate), the latter treatments aimed at restoring normal endogenous testosterone production after initial AAS use. We hypothesise a transient drug-related prothrombotic state with paradoxical embolisation via an atrial septal defect which was later found on bubble echocardiogram. We highlight a rare but important cause of stroke in younger patients which is relevant given the increasing use of AAS misuse among casual fitness enthusiasts. We explore the various possible mechanisms by which AAS use can increase ischaemic stroke risk in such patients.