To assist communities who suffered from hurricane-inflicted damages, emergency responders may monitor social media messages. We present a case-study using the event of Hurricane Matthew to analyze the results of an imputation method for the location of Twitter users who follow school and school districts in Georgia, USA.

Tweets related to Hurricane Matthew were analyzed by content analysis with latent Dirichlet allocation models and sentiment analysis to identify needs and sentiment changes over time. A hurdle regression model was applied to study the association between retweet frequency and content analysis topics.

Users residing in counties affected by Hurricane Matthew posted tweets related to preparedness (n = 171; 16%), awareness (n = 407; 38%), call-for-action or help (n = 206; 19%), and evacuations (n = 93; 9%), with mostly a negative sentiment during the preparedness and response phase. Tweets posted in the hurricane path during the preparedness and response phase were less likely to be retweeted than those outside the path (adjusted odds ratio: 0.95; 95% confidence interval: 0.75, 1.19).

Social media data can be used to detect and evaluate damages of communities affected by natural disasters and identify users’ needs in at-risk areas before the event takes place to aid during the preparedness phases.

Health-Care Coalitions (HCCs) provide an important emergency response safety net function across the United States in preparedness and responses to disasters. A key challenge is the variation in the maturity and operational readiness of HCCs. The purpose of this study was to identify key tenets that define high-functioning HCCs and help mature HCCs into a higher-functioning state of operations.

This was a qualitative study based on grounded theory methodology using semi-structured interviews for data collection and thematic analysis. Participants were stakeholders (n = 39) of HCCs from across the United States at local, state, and federal levels.

Through an institutional logics lens, the 3 key attributes for high functioning-HCCs were identified as (1) having an established and growing partnership, (2) being value-driven culture, and (3) being response ready. In addition, 3 logics were deemed essential for guiding HCCs: sources of governance, sources of partner engagement, and sources of sustainability. Participant responses describe the importance of these attributes and logics in influencing decision-making processes, supporting a community’s resilience during a disaster, and fostering robust relationships among community partners.

Addressing these attributes and logics in planning and management of HCCs can help establish the foundation for partner collaborations and high-functioning HCCs.

The COVID-19 pandemic resulted in millions of deaths worldwide and is considered a significant mass-casualty disaster (MCD). The surge of patients and scarcity of resources negatively impacted hospitals, patients and medical practice. We hypothesized ICUs during this MCD had a higher acuity of illness, and subsequently had increased lengths of stay (LOS), complication rates, death rates and costs of care. The purpose of this study was to investigate those outcomes.

This was a multicenter, retrospective study that compared intensive care admissions in 2020 to those in 2019 to evaluate patient outcomes and cost of care. Data were obtained from the Vizient Clinical Data Base/Resource Manager (Vizient Inc., Irvine, Texas, USA).

Data included the number of ICU admissions, patient outcomes, case mix index and summary of cost reports. Quality outcomes were also collected, and a total of 1304981 patients from 333 hospitals were included. For all medical centers, there was a significant increase in LOS index, ICU LOS, complication rate, case mix index, total cost, and direct cost index.

The MCD caused by COVID-19 was associated with increased adverse outcomes and cost-of-care for ICU patients.

The unprecedented disruption brought about by the global coronavirus disease 2019 (COVID-19) pandemic had produced tremendous influence on the practice of pharmacy. Sufficient knowledge of pharmacists was needed to deal with the epidemic situation; however, outbreak also aggravated psychological distress among health-care professionals. Therefore, this study aimed to determine knowledge about the pandemic and related factors, prevalence and factors associated with psychological distress among hospital pharmacists of Xinjiang Province, China.

An anonymous online questionnaire-based cross-sectional study was conducted by means of WeChat, a popular social media platform in China, February 23-27, 2020, during the COVID-19 outbreak. The survey questionnaire consisted of 4 parts, including informed consent section, demographic section, knowledge about COVID-19, and assessment of overall mental health through World Health Organization’s Self-Reporting Questionnaire (SRQ-20). A score of 8 or above on SRQ-20 was used as cutoff to classify the participant as in psychological distress. SRQ-20 score and related knowledge score were used as dependent variables, demographic characteristics (such as gender, age, monthly income, etc.) were used as independent variables, and univariate binary logistic regression was used to screen out the variables with P < 0.05. Then, the filtered variables were used as independent variables, and multivariate logistic regression models were used to analyze associations with sufficient knowledge of COVID-19 and psychological distress.

A total of 365 pharmacists participated in the survey, fewer than half (35.1%; n = 128) of pharmacists attained a score of 6 or greater (out of 10) in overall disease knowledge, and most were able to select effective disinfectants and isolation or discharge criteria. In the multivariable model, age ages 31-40 (odds ratio [OR] = 3.25; P < 0.05), ages 41-50 (OR = 2.96; P < 0.05) versus >50 (referent); primary place of practice in hospitals: drug supply (OR = 4.00; P < 0.01), inpatient pharmacy (OR = 2.06, P < 0.01), clinical pharmacy (OR = 2.17, P < 0.05) versus outpatient pharmacy (referent); monthly income Renminbi (RMB, China’s legal currency) 5000-10,000 (OR = 1.77; P < 0.05) versus < 5000 (referent); contact with COVID-19 patients or suspected cases (OR = 2.27; P < 0.01); access to COVID-19 knowledge remote work+ on-site work (OR = 6.07; P < 0.05), single on-site work (OR = 6.90; P < 0.01) versus remote work (referent) were related to better knowledge of COVID-19. Research found that 18.4% of pharmacists surveyed met the SRQ-20 threshold for distress. Self-reported history of mental illness (OR = 3.56; P < 0.05) and working and living in hospital versus delay in work resumption (OR = 2.87; P < 0.01) were found to be risk factors of psychological distress.

Further training of COVID-19 knowledge was required for pharmacists. As specific pharmacist groups were prone to psychological distress, it was important for individual hospitals and government to consider and identify pharmacists’ needs and take steps to meet their needs with regard to pandemic and other work-related distress.

This paper explores compounding challenges for older coastal populations due to accelerated sea level rise at the nexus of physical hazard exposure and place-based socioeconomic and health considerations.

This study applies geospatial analysis to assess the spatial distribution of older adults (age 65+) and their socioeconomic characteristics in Miami-Dade County in Florida. Next, it uses logistic regression to evaluate the socioeconomic determinants of block groups with 20% or more of residents age 65 and older at 3 feet of sea level rise compared to the other block groups in Miami-Dade.

The results show that this study area has an older population clustered in flood-prone locations along the shoreline. The block groups with more than 20% of older adults and sea level rise risk have higher homeownership and vacancy rates, a higher percentage of homes constructed before 1980, and more older individuals who live alone.

This study identifies place-based compounding factors undermining the ability of older residents to adequately cope with accelerated sea level rise flooding in coastal urban locations. Namely, owning an older home in a declining neighborhood and living alone can trap older individuals in place and increase their flood risk.

The objectives of this study were to (1) identify available training programs for emergency response personnel and public health professionals on addressing the needs of Deaf and hard of hearing individuals and older adults, (2) identify strategies to improve these training programs, and (3) identify gaps in available training programs and make recommendations for addressing these gaps.

A literature review was conducted to identify relevant training programs and identify lessons learned. Interviews were conducted by telephone or email with key informants who were subject matter experts who worked with Deaf and hard of hearing persons (n=11) and older adults (n=11).

From the literature, 11 training programs targeting public health professionals and emergency response personnel serving Deaf and hard of hearing individuals (n=7) and older adults (n=4) were identified. The 4 training programs focused on older adults had corresponding evaluations published in the literature. Three (43%) of the 7 training programs focused on Deaf and hard of hearing persons included individuals from the affected communities in the development and implementation of the training. Key informant interviews identified common recommendations for improving training programs: (1) training should involve collaboration across different emergency, state, federal, and advocacy agencies; (2) training should involve members of affected communities; (3) training should be more widely accessible and affordable; and (4) training should teach response personnel varied communication techniques relevant to the Deaf and hard of hearing and older adult communities.

Developing effective, accessible, and affordable training programs for emergency response personnel working with Deaf and hard of hearing persons, some of whom belong to the older adult population, will require a collaborative effort among emergency response agencies, public health organizations, and members of the affected communities. (Disaster Med Public Health Preparedness. 2018;12:606–614)

Exceptional children, like other children, have the right to be educated in a safe environment. Disasters are considered as serious issues regarding safety and security of educational environments. Following disasters, vulnerable groups, especially children with handicaps and disabilities are more likely to be seriously injured. Thus, the present study aimed to evaluate the safety and disaster risk assessment of exceptional schools in Tehran, Iran.

The cross-sectional study was conducted in exceptional schools in Tehran, 2018. First, 55 exceptional schools in all grades were selected based on census sampling method and evaluated by using a checklist designed by Tehran Disaster Mitigation and Management Organization (TDMMO) and Ministry of Education in 2015. The data were analyzed using Excel software and statistical descriptive tests.

Based on the results, school facilities are worn and have unsafe elevators (least safety: 7.69%), yards (least safety: 9.52%), laboratories (least safety: 16.67%), libraries (least safety: 24.24%), fire extinguishing systems (least safety: 28.99%), and storage rooms and kitchens (least safety: 33.33%) which require immediate considerations. In total, the safety of exceptional schools in this study was 70.13%, which suggests medium-risk level.

The educational settings must be reconsidered, along with identifying the risk and safety at school. In addition, a standard should be established for evaluating safety, especially in exceptional schools.

The purpose of this study is to analyze a strategy for the assignment and transportation of injured patients to hospital to decrease the demand on transportation, in both predisaster and postdisaster periods, on the Anatolian side of Istanbul.

Two approaches are used in this study: a Voronoi diagram, and a heuristic approach to the problem of scheduling. A Voronoi diagram is used to divide the city into 74 regions, where each hospital has a certain region of responsibility. The transportation strategy of 1 hospital is modeled by minimizing the makespan (ie, the maximal completion time) and the work-in-process, which are used as different objectives in scheduling theory.

The total waiting time of 100 injured people was minimized to 13,036 min when a total of 3 vehicles was used in the studied region, on the Asian side of Istanbul. The transportation capacity and total operating capacity of the hospitals should be approximately equal.

The people of Istanbul will be in a safer position if the suggested measures are implemented. This is an important consideration, as Istanbul is situated in a region where serious earthquakes are possible at any moment.

The aim of this study was to evaluate the effectiveness of training programs in improving the knowledge about disaster management among Accredited Social Health Activists (ASHAs) in Mysuru, India.

A quasi-experimental study was conducted among 40 ASHAs of 3 Primary Health Centers in Mysuru district. A 3-h disaster management training and workshop followed by a mock-drill was organized in each center. Knowledge about disaster preparedness and management was assessed before and 1 mo after the intervention using a questionnaire by interview method. The data obtained were entered into an MS Excel spreadsheet and analyzed using licensed SPSS 22 software.

The mean score obtained by the ASHAs in pretraining assessment was 37.2 ± 10.4. Improvement was evident in the knowledge and preparedness of ASHAs 1 mo after the training, which showed a mean score of 90.14 ± 5.05. This change in score was statistically significant with a P-value < 0.001 on performing a paired t-test.

Training programs with mock drills and hands-on activities are effective in improving the knowledge of frontline health workers about disaster management. We recommend such training to be organized in all public health facilities.

Public health investigations require rapid assessment, response, and initiation of control measures. In 2012, the New Hampshire Department of Health and Human Services used digital pens to rapidly acquire epidemiologic data during a gastrointestinal illness outbreak.

Menus were obtained and a standard questionnaire was administered to exposed persons using digital pens. Questionnaire data were downloaded into an electronic file for analysis.

Sixty-nine (74%) of 93 exposed persons completed a questionnaire. Of 6389 data entries made on digital paper, 218 (3%) required correction; of these, 201 (92%) involved a free-form variable and 17 (8%) involved a check-box variable. Digital pens saved an estimated 5 to 6 hours of data-entry time.

This outbreak provided an opportunity to assess the value of digital pens for decreasing data-entry burden and allowing more timely data analysis in an emergent setting. Depending on the size of the outbreak and complexity of the survey, there is likely a threshold when use of digital pens would provide a clear benefit to outbreak response. As new technology becomes available for use in emergency preparedness settings, public health agencies must continuously review and update response plans and evaluate investigation tools to ensure timely disease control and response activities. (Disaster Med Public Health Preparedness. 2015;9:349–353)

International airports, ports, and ground crossings are required to have health units for undertaking public health measures during routine times and specific measures during the time of public health emergency of international concern (PHEIC). This study was conducted at a ground crossing of North India to assess the implementation status of International Health Regulations (IHR) (2005) at a ground crossing in the prevention and control of public health emergencies and to assess the risk of imported infections from a ground crossing.

A qualitative study was conducted at the selected point of entry. The World Health Organization (WHO) core capacity assessment tool and in-depth interviews were used for data collection in the form of meetings and visits to isolation sites, and general observations were conducted regarding facilities on routine and other infrastructure and equipment that can be used during emergencies. Respondents were recruited using purposive methods.

The findings reveal that there is lack of awareness among the travelers, which increases the risks of spreading diseases. The overall implementation status at the ground crossing according to the assessment conducted using WHO Tool was 76%. It showed the need for further strengthening of the implementation at the site. Gaps were identified regarding the local capacity for handling chemical, radiological and nuclear hazards, and shortage of regular staff through stakeholders.

The findings from this study, as well as the suggestions and recommendations given by stakeholders, should help revise the current strategies of action. Hence, the gaps identified should be fulfilled to better respond to PHEIC at the ground crossings.

Emergency nurses play a major role in disaster relief in mainland China, but there is no valid instrument to measure the extent of their disaster preparedness. The Disaster Preparedness Evaluation Tool© is a reliable instrument to assess the disaster preparedness of nurse practitioners. The tool has been translated and validated in Saudi Arabia, Taiwan, China and the United States of America.

This study aimed at translating and adapting the Disaster Preparedness Evaluation Tool© (DPET) for emergency nurses in mainland China and determining its psychometric properties.

A total of 2 cross-sectional online surveys were conducted in the emergency departments of 26 public grade III-A hospitals in Guangdong, mainland China. In the first study, 633 emergency nurses were recruited from May to August, 2018. In the second study, 205 were recruited in April 2019.

The instrument was adapted through rigorous forward-backward translation, face validity, and pre-test processes. Exploratory factor and parallel analyses were used in the first study. Confirmatory factor analysis, internal consistency and split-half reliability were used in the second study.

Exploratory factor and parallel analyses extracted a 5-factor solution comprising of 34 items that accounted for 64.06% of the total variance. The fit indices indicated a good model fit. The reliability was good, as indicated by a Cronbach’s alpha of 0.97 and a split-half reliability coefficient of 0.97.

The mainland China version of the DPET (DPET-MC) was a reliable and valid instrument and can be used in practice.