Critically injured patients have experienced delays in being transported to hospitals during Mass Casualty Incidents (MCIs). Extended pre-hospital times (PHTs) are associated with increased mortality. It is not clear which factors affect overall PHT during an MCI. This systematic review aimed to investigate PHTs in trauma-related MCIs and identify factors associated with delays for triaged patients at incident scenes.

This systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Web of Science, CINAHL, MEDLINE, and EMBASE were searched between January and February 2022 for evidence. Research studies of any methodology, and grey literature in English, were eligible for inclusion. Studies were narratively synthesized according to Cochrane guidance.

Of the 2025 publications identified from the initial search, 12 papers met the inclusion criteria. 6 observational cohort studies and 6 case reports described a diverse range of MCIs. PHTs were reported variably across incidents, from a median of 35 minutes to 8 hours, 8 minutes. Factors associated with prolonged PHT included: challenging incident locations, concerns about scene safety, and adverse decision-making in MCI triage responses. Casualty numbers did not consistently influence PHTs. Study quality was rated moderate to high.

PHT delays of more than 2 hours were common. Future MCI planning should consider responses within challenging environments and enhanced timely triage decision-making.

In this single-case-by-group comparison, we examine whether previously found cisgender differences in paranoid ideation after a terror attack are also seen in a transgender male emergency worker.

Sixty emergency personnel who were exposed to the 2016 terror attack in Berlin were evaluated 3 to 4 and 21-25 mo after the attack.

On paranoid ideation, the transgender male showed higher scores than cisgender males (+2 standard deviations [SD]) and the overall group (+1 SD).

This underpins the previously identified gender effects. It would be useful to consider specified pre- and postdeployment modules that take cis- and transgender differences into account.

One of the most important measures following disasters is setting up a communicable disease surveillance system (CDSS). This study aimed to develop indicators to assess the performance of CDSSs in disasters.

In this 3-phase study, firstly a qualitative study was conducted through in-depth, semistructured interviews with experts on health in disasters and emergencies, health services managers, and communicable diseases center specialists. The interviews were analyzed, and CDSS performance assessment (PA) indicators were extracted. The appropriateness of these indicators was examined through a questionnaire administered to experts and heads of communicable diseases departments of medical sciences universities. Finally, the designed indicators were weighted using the analytic hierarchy process approach and Expert Choice software.

In this study, 51 indicators were designed, of which 10 were related to the input (19.61%), 17 to the process (33.33%), 13 to the product (25.49%), and 11 to the outcome (21.57%). In weighting, the maximum score was that of input (49.1), and the scores of the process, product, and outcome were 31.4, 12.7, and 6.8, respectively.

Through 3 different phases, PA indicators for 4 phases of a chain of results were developed. The authors believe that these PA indicators can assess the system’s performance and its achievements in response to disasters. (Disaster Med Public Health Preparedness. 2019;13:158–164)

We analyzed characteristics of tornado-related injuries and medical impact on a county-level hospital in China in June 23, 2016. The objective of this study was to describe and analyze local government rescue responses following the tornado.

County hospital medical records of 288 tornado-related injury patients were collected. Descriptive analyses to study injury characteristics and associated risk factors were performed.

Of the studied population, 84% of the wounded were older than 45 years. Only 30 (10.4%) people were sent to the hospital for treatment within 3 hours following the disaster. Heavy objects or collapsing houses accounted for 191 (66.3%) of the documented injuries. The proportion of people with resulting brain injuries was 46.2% of the entire injured population, and the incidence of lower extremity injuries was 27.8%. A total of 89.6% of the wounded had skin and soft tissue injuries. Multiple injuries were found in 129 (44.8%) people and 156 had a single injury (54.2%), and 3 cases with acute stress disorder were admitted to the hospital.

Preparation plans, including tornado warnings, prevention, and rescue, are a basic requirement for the mitigation of tornado-related injuries. Protection awareness of tornado disasters is also critical to ensure injury prevention.

The COVID-19 pandemic negatively impacted healthcare worker well-being, leading to increased burnout and decreased workplace engagement. To combat expected stressors from the pandemic, our mid-sized academic health center implemented numerous institutional support, such as town halls, and virtual support groups. This study aimed to evaluate faculty utilization of institutional support, its association with perceived organizational support, received organizational support, and burnout.

A retrospective, cross-sectional survey was distributed to 630 faculty employed at our institution in September 2020, assessing participant demographics, institutional support utilized, perceived organizational support, and burnout, through a combination of self-report measures and qualitative responses.

A total of 79 (12.5%) faculty provided complete responses and were included in the analysis. Qualitative analysis identified 4 primary themes: (1) flexibility and adjusted expectations, (2) direct communication, (3) sense of community, and (4) no support felt, with additional subthemes within each larger theme. Increased utilization of institutional support was associated with decreased odds of experiencing burnout.

Flexibility, communication, and sense of community emerged as important strategies for maintaining faculty well-being and engagement during the early stages of the COVID-19 pandemic. This study suggests that utilization of workplace support is protective against burnout. Perceived support was not beneficial.

Restrictions to minimize social contact was necessary to prevent the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus but may have impacted individuals’ mental well-being. Emotional responses are modulated by contextual information. Living abroad during the coronavirus disease 2019 (COVID-19) pandemic may have boosted the feeling of isolation as the context is unfamiliar.

This study compared the psychological impact of social distancing in national students (living in a familiar context) versus international students (living in an unfamiliar context).

During March/April 2020 (first lockdown in the Netherlands), 850 university students completed an online survey. Structural equation modeling (SEM) was conducted to compare how students’ responses to the virus were predicted by health anxiety, emotional distress, and personal traits.

Compared with national students, international students showed higher levels in 4 identified factors (COVID-19-related worry, perceived risk of infection, distance from possibly contaminated objects, distance from social situations). The factors were mainly predicted by health anxiety across international students, while emotional distress and individual traits (eg, intolerance of uncertainty) played a role across national students.

In the familiar context, individual characteristics (traits) predicted the responses to the virus, while the unfamiliar context drove individuals’ health-focused responses. Living in a foreign country is associated with psychological burdens and this should be considered by universities for more pronounced social support and clear references to health-related institutions.

Vaccine acceptance and trust in vaccines pose a complex process affected by many factors. The present study was conducted to determine coronavirus disease 2019 (COVID-19) vaccine acceptance, trust in vaccines, anxiety levels, and related factors in Turkish society.

The data of this cross-sectional and descriptive-correlational study were collected with the snowball method by using an online questionnaire throughout Turkey. The study was conducted between March 15 and April 3, 2021, with 3148 participants from 7 regions and 81 cities in Turkey.

It was found that the participants accepted the vaccine at 72.8%, and the trust rate in the vaccine was 66.0%. It was also found that women, single participants, those who had immune system diseases, and with COVID-19 had higher Coronavirus Anxiety Scale scores at significant levels. According to Logistic Regression Analysis, gender, age, trust in the vaccine, perception of risk levels regarding COVID-19, and coronavirus anxiety levels are factors affecting the intentions of participants to accept/reject the vaccine. It was determined that male participants were more likely to accept the coronavirus vaccine (P = 0.028). It was found that health-care employees had higher trust in the coronavirus vaccine (P = 0.006) and acceptance rates (P = 0.010) at significant levels compared with the general population.

The COVID-19 vaccine acceptance rate in Turkish society was found to be high, and the level of trust in vaccines and anxiety levels were above the moderate level.

To compare actual patient presentation rates from Belgium’s largest public open-air cultural festival with predictions provided by existing models and the Belgian Plan Risk Manifestations model.

Retrospectively, actual patient presentation rates gathered from the Ghent Festivities (Belgium) during 2013–2019 were compared to predicted patient presentation rates by the Arbon, Hartman, and PRIMA models.

During 7 editions, 8673000 people visited the Ghent Festivities; 9146 sought medical assistance resulting in a mean patient presentation rate (PPR) of 1.05. The PRIMA model overestimated the number of patient encounters for each occasion. The other models had a high rate of underprediction. When comparing deviations in predictions between the PRIMA model to the other models, there is a significant difference in the mean deviation (Arbon: T = 0.000, P < 0.0001, r = −0.8701; Hartman: T = 0.000, P < 0.0001, r = −0.869).

Despite the differences between the predictions of all 3 models, our results suggest that the PRIMA model is a valid tool to predict patient presentations to IEHS during public cultural MG. However, to substantiate the PRIMA model even further, more research is needed to further validate the model for a broad range of MG.

This study aims to assess the knowledge and awareness, and to identify the practice reflection of knowledge concerning Middle East Respiratory Syndrome (MERS) on hospital visitor’s daily life.

A cross-sectional study, conducted in 2 tertiary referral hospitals in Riyadh Saudi Arabia, from February 2015 to February 2016. A total random sample of 305 hospital visitors consented to participate. Data were collected through a self-administered questionnaire consisting of questions regarding awareness and practice of measures to prevent the spread of infection.

Study showed that participants have a fair knowledge regarding the cause of MERS (N = 228; 74.8%). Nearly half of them (47%) stated that camels are the source of the spread of MERS. Approximately 70% of the participants preferred both sanitization and wearing facemasks as preventive measures for MERS. However, only 3.95% practiced not eating camel products, such as milk and meat.

Although hospital visitors showed some knowledge and positive awareness in several aspects of MERS awareness, there are weak areas where knowledge and awareness were not up to recommended guidelines. Continued educational programs are needed to improve awareness and knowledge of all the public toward MERS-coronavirus infection. This study may assist in the development of future strategies on preventive measures of the disease.