Shifting terrains: Understanding residential contaminants after flood disasters.

Flood disasters can induce the mass transport of soils and sediments. This has the potential to distribute contaminants and present novel combinations to new locations - including residential neighborhoods. Even when soil contaminants cannot be directly attributed to the disaster, data on bacterial and heavy metal(loids) can facilitate an environmentally just recovery by enabling reconstruction decisions that fill data gaps to minimize future exposure. These data-gathering interventions may be especially useful in poor, rural, and racially diverse communities where there is a high probability of exposure to multiple hazards and a potential dependency on the financial resources of disaster aid as a means of reducing chronic exposures to other environmental pollutants. At the same time, entering these post-disasters spaces is ethically complex. To acknowledge this complexity, we pilot a framework for work that gathers social-ecological hazard information while retaining a fair-minded approach to transdisciplinary work. Assembled a transdisciplinary team to recruit participants from 90 households subjected to flooding in the southeastern US. Participating households agreed to interviews to elicit flood experience and environmental health concerns, soil sampling for fecal bacteria (E. coli) and soil sampling for selected heavy metals and metalloids (Pb, As, Cd) at their flooded residence. Soil sampling found a wide range of E. coli concentrations in soil (0.4-1115.7 CFU/ dry gram). Heavy metal(loid)s were detected at most residences (As 97.9 %; Ca 25.5 %; Pb 100 %). Individually, heavy metal(loid) concentrations did not exceed regulatory thresholds. Hazard, risk, and mitigation concerns expressed during interviews reveal that integrated human-nature concepts complicate common understandings of how hazard perceptibility (smell, sight, touch, and information) affects research-action spaces. Qualitative analysis of interviews and field notes revealed that soil-related hazards addressed by our biophysical protocols were less salient than changes with direct causal associations with flooding. We conclude by discussing the potential for the social-ecological hazard information that is fair-minded and transdisciplinary (SHIFT) framework to advance environmentally just approaches to research-action spaces after disasters.

Promoting Access to Dental Care in a Developing Caribbean Nation, Post-disaster.

In September 2017, Hurricane Irma struck several Caribbean islands, which suffered catastrophic damage. Anguilla, the most northerly of the Caribbean's Leeward Islands, a developing nation, experienced devastating damage to its social, physical, political, and economic infrastructures. Anguilla's longstanding Dental Unit, a public sector health care facility, was among the services that suffered irreparable destruction. Hurricane Irma's debilitating impact on a developing nation and its citizens' livelihoods exacerbated existing challenges in dental care, and created barriers to access. As part of the rehabilitation process, it was essential to promote access to dental care. This commentary shares examples of some practical and economical approaches that were employed: providing direct access to dental therapists, offering dedicated emergency and routine care appointments, delivering oral health campaigns, partaking in community health fairs, and social media engagement. The commentary also considers future approaches that could be beneficial.

Tonga national emergency medical team response to the 2022 Hunga Tonga-Hunga Ha'apai volcanic eruption and tsunami: the first deployment of the Tonga Emergency Medical Assistance Team (TEMAT).

Problem: The undersea Hunga Tonga-Hunga Ha'apai volcano erupted on 15 January 2022, causing a tsunami that affected Tonga as well as other countries around the Pacific rim. Tonga's international borders were closed at the time due to the coronavirus disease pandemic, but clinical surge support was needed to respond to this disaster. Context: Tonga's Ministry of Health formed the Tonga Emergency Medical Assistance Team (TEMAT) in 2018 to provide clinical care and public health assistance during disasters, outbreaks and other health emergencies. TEMAT was activated for the first time in January 2022 to respond to medical and public health needs following the eruption and tsunami. Action: On 16 January 2022, a five-person TEMAT advance team was deployed to conduct initial damage assessments and provide casualty care. Subsequently, TEMAT rotations were deployed to provide clinical care and public health support across the Ha'apai island group for over 2 months. Outcome: TEMAT deployed to the islands most affected by the volcanic eruption and tsunami within 24 hours of the event, providing emergency clinical, psychosocial and public health services across four islands. TEMAT reported daily to the Ministry of Health and National Emergency Management Office, providing critical information for response decision-making. All TEMAT actions were documented, and an after-action review was conducted following the deployment. Discussion: TEMAT's deployment in response to the 2022 volcanic eruption and tsunami highlighted the importance of national emergency medical teams that are prepared to respond to a range of emergency events.

Meta-Analysis on the Health Effects Resulting from Evacuation or Relocation.

OBJECTIVE: Evacuation and relocation are key actions used to protect the public in response to natural or technological disasters, but there are inherent risks to both. Unfortunately, these risks have not been fully quantified, which limits the ability of emergency managers and the public to effectively balance the risks and benefits of evacuation or relocation. This work provides quantitative data on the risks of health effects from displacement following evacuation or relocation. METHODS: Researchers performed a literature review and meta-analysis of published studies and quantified risks of 14 different health effects, including both physical and socio-behavioral outcomes, from studies of 9 different disaster types. RESULTS: The findings show statistically significant increases in 9 of the 14 health effects in displaced populations, indicating an increased likelihood of experiencing detrimental health effects compared with nondisplaced populations. A pooled analysis of all negative health effects found an odds ratio of 1.49 (95% confidence interval: 1.24-1.79), which shows a significant relationship between displacement and negative health outcomes. CONCLUSIONS: These findings demonstrate that evacuated or relocated populations have an increased risk of experiencing negative health effects associated with displacement. The broad number of disaster types included mean that findings are applicable to any emergency evacuation or relocation.

Health Problems of Increasing Man-Made and Climate-Related Disasters on Forcibly Displaced populations: A Scoping Review on Global Evidence.

Forcibly displaced populations are among the most vulnerable groups in disasters. They experience poorer health conditions compared with nondisplaced individuals. However, a clear picture is lacking regarding the overall health problems encountered by disaster-induced mid- to long-term displaced people. This study investigated these disorders prevalence and identified their correlates among long-settled displaced populations worldwide. The current scoping review follows the PRISMA-ScR guidelines; a systematic search was conducted on PubMed, Web of Science, and CINAHL and included original peer-reviewed studies, commentary, reviews, and grey literature published in English between January 1990 to June 2022. In the thematic and content analysis, the authors applied the narrative review approach to identify themes and sub-themes. Forty-eight documents were identified as fully relevant to this study. The largest number of published papers were from Asia, followed by the Middle East, the United States, and Europe. IDPs in developed countries were the most researched populations. Human-made disasters were addressed by 89% of the included studies. The four main thematic categories included were "physical health," "mental health," "inadequate facilities," and "lack of healthy behaviour." The worsening of noncommunicable diseases had the highest prevalence, followed by communicable diseases. Due to their condition, forcibly displaced migrants face a triple burden of communicable diseases and noncommunicable diseases such as mental health issues. Health-related research and policy need to consider the links among disasters, health problems, and forced migration as a determinant of health in the new era of climate change-driven displacements.

Development of disaster nursing in Nepal: Opportunities and challenges for advanced practice.

AIM: This article discusses the evolution of the field of disaster nursing in Nepal and its challenges and ways to protect the health and well-being of the community during disasters. It also discusses the alignment of field activities with the International Council of Nurses' (ICN) competencies in disaster nursing. BACKGROUND: Disaster nursing has become increasingly important due to the increasing frequency and impact of disasters on health. In Nepal, disaster nursing is a relatively new field, but it has grown over the years with nurses playing a vital role in providing holistic care during disasters, emergencies, and crises. SOURCES OF EVIDENCE: Literature review and experience from the field. DISCUSSION: Following the Nepal earthquake, the concept of the "epidemiology nurse" evolved in Nepal which trained local nurses with disaster nursing knowledge and skills using the digital information, communication, and technology (ICT) toolkit for collecting real-time information. Nurses monitored the environment, conducted physical and mental health assessments, identified the needs of vulnerable populations, provided basic aid, offered mental health support, and shared data with authorities. However, their competencies are not yet enough to fully align with those given by ICN nursing standards. CONCLUSION: Recognizing the valuable contributions of Nepalese nurses in the field, their initiatives can serve as a foundation for advancing their roles in disaster nursing. It is essential to implement national disaster plans and invest in specialized university courses for disaster nursing training. IMPLICATIONS FOR NURSING POLICY: The field experiences of disaster nursing reflected in this article can contribute to the development of policies and practices related to disaster management in adherence to the ICN' guidelines.

Poor attention: The wealth and regional gaps in event attention and coverage on Wikipedia.

Wikipedia is an important source of general knowledge covering a wide range of topics. Moreover, for many people around the world, it also serves as an essential news source for major events such as elections or disasters. Although Wikipedia covers many such events, some events are underrepresented and lack attention, despite their newsworthiness predicted from news value theory. In this paper, we analyze 17 490 event articles in four Wikipedia language editions and examine how the economic status and geographic region of the event location affects the attention and coverage it receives. We find that major Wikipedia language editions have a skewed focus, with more attention given to events in the world's more economically developed countries and less attention to events in less affluent regions. However, other factors, such as the number of deaths in a disaster, are also associated with the attention an event receives. Overall, this work provides a nuanced understanding of attention and coverage on Wikipedia through event articles and adds new empirical analysis to news value theory.

Syndromic Surveillance Implementation During Disaster Events.

INTRODUCTION: Disease surveillance is an integral part of public health. These systems monitor disease trends and detect outbreaks, whereas they should be evaluated for efficacy. The United States Centres for Disease Control and Prevention publish Guidelines for Evaluating Surveillance Systems to encourage efficient and effective use of public health surveillance that are accepted worldwide. OBJECTIVE: This study reviews syndromic surveillance during natural and man-made disasters internationally. It aims to (1) review the performance of syndromic surveillance via pre-specified attributes during disaster and to (2) understand its strengths and limitations. METHODS: PubMed was systematically searched for the articles assessing syndromic surveillance during a disaster. A narrative review was carried out based on those articles. Updated Guidelines for Evaluating Public Health Surveillance Systems were used to review performance of systems. RESULTS: 5,059 studies from PubMed were evaluated, and 16 met inclusion criteria. The majority of these studies considered the implementation of syndromic surveillance useable during disaster events. Studies described systems giving relevant and timely information. Simplicity and timeliness were the most highlighted attributes. CONCLUSION: Syndromic surveillance is simple, flexible, useful and usable during a disaster. Timely data can be obtained, but the quality of this type of data is sensitive to incomplete and erroneous reporting; because of this, a standardized approach is necessary to optimize these systems.

Influence of post-disaster evacuation on childhood obesity and liver dysfunction: The Fukushima Health Management Survey.

BACKGROUND: After the Great East Japan Earthquake and subsequent Fukushima Daiichi Nuclear Power Plant accident in 2011, the Fukushima Prefectural Government launched a long-term health management survey for the population of Fukushima. Results of the Comprehensive Health Check (CHC) showed that some children aged 6-15 years, who resided in the evacuation area at the time of the disaster, had obesity, hyperlipidemia, liver dysfunction, and/or renal dysfunction from as early as 2011. The aim of the present study was to determine the long-term trend of obesity and hepatic enzyme abnormalities in Fukushima children. METHODS: We evaluated the changes in body mass index standard deviation score (BMI-SDS), aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyl transpeptidase from 2011 to 2018. RESULTS: Obesity (BMI-SDS ≥ 2) was significantly associated with hepatobiliary enzyme abnormalities. The mean BMI-SDS was significantly higher in 2011 after the disaster, but then soon showed a gradual decrease. The frequency of obesity did not increase significantly after the disaster. There were no significant differences in the prevalence of hepatobiliary enzyme abnormalities in the children aged 6-15 years of either sex from 2011 to 2018. CONCLUSIONS: In the present study, we found that the increase in the mean BMI-SDS after the disaster was temporary, suggesting that the frequency of obesity and liver dysfunction might not have been significantly influenced by the disaster.

The perceived self-efficacy of senior, middle, and operations managers of the incident command system dealing with emergencies and disasters during the COVID-19 pandemic.

BACKGROUND: Natural disasters, health, terrorism, infectious diseases, and social unrest affect more than 200 million people worldwide each year. The present study is an attempt to evaluate the self-efficacy of senior, middle, and operational managers of the Incident Command System (ICS) of Zahedan University of Medical Sciences in Iran. METHODS: The study examined the perceived self-efficacy of 103 senior, middle, and operational managers of the Incidence Command System (ICS) of Zahedan University of Medical Sciences in 2021. Sampling was done by census using a designed questionnaire based on Bandura's self-efficacy concepts. Based on Factor Analysis, 4 factors were extracted. The factors were labeled and analyzed. RESULTS: The number of people who had passed the crisis management course was 57. Seventy-one participants reported their participation in crisis management. The score obtained by men in Factor 3 (F3) was significantly higher than women, but not in other factors. People with stable employment scored far higher in Factor 1 (F1) than those with unsustainable employment conditions. Those who had passed the Crisis Management courses had a higher average score, but only in the three factors 1, 2, and 4, this difference was significant. CONCLUSION: Even training the temporary staff is an organizational investment that can return benefits to the system. This enhances their perceived self-efficacy and promotes their commitment to the organization. Therefore, empowering these managers should be a priority.

Factors affecting the preparedness of Helicopter Emergency Medical Services (HEMS) in disasters: a systematic review.

BACKGROUND: One of the most significant advantages of Helicopter Emergency Medical Service (HEMS) in disaster relief efforts is their ability to reach inaccessible or remote areas quickly. This is especially important in the aftermath of natural disasters such as earthquakes, floods, or hurricanes, where roads may be blocked or damaged, and conventional ground transportation may not be available. There are many factors can affect the performance of Helicopter Emergency Medical Service (HEMS) in disasters. This study aims to investigate the factors affecting the Helicopter Emergency Medical Service (HEMS) in disasters. METHODS: The systematic search in Cochran Library, PubMed, Scopus, Science Direct, Web of Science, ProQuest, and Google Scholar databases between the first of January in 1975 and the thirty-first of May in 2023. The articles were selected based on the keywords of the authors. At last, the criteria were extracted from the selected ones. RESULTS: The primary search included 839 articles. After studying their title, abstract, and full context, only nine articles, including two qualitative and seven quantitative ones, were chosen for analysis. After analysis and extracting data from the final studies, the preparation factors were categorized into 6 general classes of human resources: training and practicing, management, instructions and standards, equipment, and structure. Among these, the role of training is highlighted by holding practice and maneuvers to improve and prepare the personnel and manage disasters and incidents. CONCLUSION: The results obtained from this systematic review provide a total view of the factors affecting the preparation of the air ambulance during disasters and incidents. It is recommended that senior managers and policy makers use the findings of the present study to identify the factors which affect preparedness of HEMS in disasters and take the necessary measures to eliminate to obstacles.

Telepathology in intraoperative frozen section consultation of breast cancer sentinel node biopsy in Fukushima, Japan following the 2011 triple disaster: diagnostic accuracy and required time during the early implementation phase.

In breast cancer surgery, some medical facilities lack the necessary resources to conduct sentinel lymph node biopsy and its intraoperative frozen section consultation. In the coastal rural area of Fukushima, Japan, which has suffered from physician undersupply following the 2011 triple disaster of earthquake, tsunami and nuclear disaster, we explored the feasibility of telepathology by evaluating the diagnostic accuracy in remote intraoperative frozen section consultation of sentinel lymph node biopsy and its required time. Although examination time has room for improvement, telepathology can be one possible solution in resource-limited areas.

Challenges and perspectives in applying the environmental sensitivity index to pipelines: a review on the prevention and management of oil spills disasters.

The oil spill environmental sensitivity index is a key tool for preventing and dealing with environmental disasters caused by oil spills. This study aims to review the available literature on the subject and highlight the importance of methodological advances to improve how the index is applied in continental areas, especially in regions crossed by pipelines. Most current mapping techniques focus on coastal areas and fail to consider the stretches of land that are vulnerable to geodynamic natural disasters. In this context, the need to implement environmental sensitivity indices specific for pipelines has become urgent. This study also presents an overview of the main accidents around the world and a detailed analysis of the history of Brazilian disasters related to oil spills along continental stretches, with a focus on pipelines and natural disasters. In addition, this work highlights the importance of carrying out new research in mountainous areas of Brazil and is aimed at preventing Natechs (natural hazard triggering technological disasters) and improving contingency plans. As a result, several pathways have been identified, which involves the necessity of resolving gaps in terrestrial environmental sensitivity mapping methodologies, particularly as applied to pipelines. Furthermore, solutions must be capable of integrating terrestrial, fluvial, coastal, and maritime environmental sensitivity mapping techniques. Moreover, the need to implement dynamic risk monitoring systems in real time is critical to help manage such a complex problem.

Research on the site selection of emergency medical facilities from the perspective of country parks.

Post-epidemic era, human society entered the stage of epidemic prevention and control normalized, emergency medical facilities are an important means of epidemic prevention and control, attention-needed can provide construction sites for emergency medical facilities. Disaster prevention and green space can provide construction sites for emergency medical facilities. In comparison, it was found that the site selection conditions of country parks and emergency medical facilities were more compatible. Based on the requirement of the latter's location, using the Delphi method and analytic hierarchy process, through to the country park type, effective safety area, space fragmentation, distance away from the water, in the wind, away from the city center distance, hydrogeology, eight factors such as traffic is quantitative, construct the evaluation system of emergency medical facility location. Taking Nanjing as an example, the Nanjing city region within the scope of the 43 country parks comprehensive comparison. Results show that green hill forest park, the highest scores in addition to the traffic time factor, the remaining seven factor score the highest, the most balanced distribution, security, scalability, rehabilitation, convenience, pollution prevention, and evacuation. It can be preferred as the site selection and construction target of emergency medical facilities. Besides, the Youzishan Forest Park and Dongkeng Country Park comprehensive scores and each factor score is higher, can be used as emergency preplan alternative goals. The score results indicate that the evaluation method for severity exhibits higher levels of differentiation, significant validity, and highly consistent assignment of impact factor weights. In view of the different regional land, impact factor weights assignment can be adjusted adjust measures to local conditions, to effectively make use of the existing conditions, avoid adverse factors.

Experiences of operating room nurses in disaster preparedness of a great disaster in Iran: a qualitative study.

BACKGROUND: In recent years, Iran has encountered a growing frequency of earthquake disasters. Given that nurses constitute the largest group of healthcare providers, it is imperative that they possess adequate disaster preparedness skills, irrespective of the location or time. Despite the operating room nurses' roles in disasters, their experiences and challenges in disaster preparedness have been overlooked. Consequently, this study aimed to investigate the experiences, challenges, perspectives, and factors influencing the disaster preparedness of operating room nurses during the 2017 earthquake in Kermanshah, Iran. METHODS: The present qualitative research was carried out in Iran In 2022 utilizing conventional content analysis. The study involved conducting semi-structured interviews with 16 operating room nurses who had participated in disaster preparedness during the Kermanshah earthquake. The participants were selected using a purposive sampling approach that aimed to achieve maximum diversity. The interviews were continued until the point of data saturation was reached, and the verbatim transcripts were analyzed using conventional content analysis in MAXQDA software. To ensure the rigor of the research, Guba and Lincoln's criteria were employed. RESULTS: The study conducted data analysis to identify the main theme as "insufficient disaster preparedness due to a faded preparedness", along with six major categories and eighteen subcategories related to earthquake disaster preparedness. The major categories included: knowledge and perception of preparedness for disasters; educational and training programs for disaster preparedness; equipment preparedness for disasters; managerial-organizational preparedness for disasters; clinical skills for responding to disasters; and resilient ability in disaster response situations. CONCLUSION: The findings of the study provide valuable insights into the dimensions of disaster preparedness in earthquake disasters among operating room nurses. Nursing managers can utilize these findings to develop effective strategies and provide support in areas such as improving knowledge and educational level, equipment preparedness, strengthening plans and managerial structures, enhancing skills, and explaining resilience strategies to improve the disaster preparedness of operating room nurses and medical organizations' disaster response teams.

Disaster Preparedness of Nursing Students in Northern Cyprus: Descriptive Cross-Sectional Study.

OBJECTIVE: This study aims to evaluate disaster preparedness of undergraduate nursing students. METHODS: This descriptive cross-sectional study included 302 voluntary nursing students from a university in Northern Cyprus. Data were collected through an online survey using Google Forms, which included a descriptive information form and the General Disaster Preparedness Belief Scale (GDPBS). RESULTS: The mean age of the participants was 20.64 ± 2.02 years. Among the participants, 41.7% had prior experience with disasters, and 77.2% expressed a need for disaster education. The average GDPBS total score was high, and the mean score of the sub-dimensions was moderate. Nursing students who expressed a need for disaster education had higher scores on the severity and self-efficacy subscales of the GDPBS (p<0.05). CONCLUSION: The level of disease preparedness was moderate in nursing students in Northern Cyprus. Therefore, education based on the health belief model, which assumes that positive health behaviors are affected by knowledge and attitudes, may be useful to improve disaster preparedness in nursing students.

Improving social resilience amid the COVID-19 epidemic: A system dynamics model.

Social resilience is a key factor in disaster management, but compared to resilience in other fields, research on social resilience is still limited to assessment or evaluation, and there is still a lack of dynamic and procedural research, which is also a challenge. This article constructs a causal feedback model and a system dynamics model of social resilience during the COVID-19 epidemic, so as to analyze the dynamic characteristics and improvement path of social resilience. After verifying the effectiveness of the model, model simulation is conducted and the following important conclusions are drawn: social resilience dynamically changes during the research cycle and is influenced by social entity behavior and social mechanisms; The sensitivity factors for the two variables that measure social resilience, namely panic degree and damage degree, are the real-time information acquisition of public and the epidemic awareness of local government, respectively. Therefore, the path to enhancing social resilience should be pursued from both the public and government perspectives, including improving the public's ability to access real-time information, increasing the timeline of government information disclosure, and enhancing local governments' understanding and awareness of the epidemic.