Previous studies have found that public health systems within the United States are inadequately prepared for an act of biological terrorism. As the coronavirus disease (COVID-19) pandemic continues, few studies have evaluated bioterrorism preparedness of Emergency Medical Services (EMS), even in the accelerating environment of biothreats.

This study utilized an Internet-based survey to assess the level of preparedness and willingness to respond to a bioterrorism attack and identify factors that predict preparedness and willingness among Nebraska EMS providers. The survey was available for 1 month in 2021 during which 190 EMS providers responded to the survey.

Only 56.8% of providers were able to recognize an illness or injury as potentially resulting from exposure to a biological agent. The provider Clinical Competency levels ranged from a low of 13.6% (ability to initiate patient care within his/her professional scope of practice and arrange for prompt referral appropriate to the identified condition(s)) to a high of 74% (the ability to respond to an emergency within the emergency management system of his/her practice, institution, and community). Only 10% of the respondents were both willing and able to effectively function in a bioterror environment.

To effectively prepare for and respond to a bioterrorist attack, all levels of the health care system need to have the clinical skills, knowledge, and abilities necessary to treat patients exposed to biological agents. Policy changes and increased focus on training and drills are needed to ensure a prepared EMS system, which is crucial to a resilient state. EMS entities need to be aware of the extent of their available workforce so that the country can be prepared for the increasing threat of bioterrorism or other novel emerging infectious disease outbreaks. A resilient nation relies on a prepared set of EMS providers who are willing to respond to biological terrorism events.

The objective of this research is to identify sociodemographic predictors of depression for a rural population in the US during the COVID-19 pandemic to enhance mental health disaster preparedness.

This study uses t-tests to differentiate between gender and ethnicity groups regarding depression status; binary logistic regression to identify socio-demographic characteristics that predict depression status; and t-test to differentiate between average depression scores, measured by the PHQ-9, pre-COVID-19 pandemic (2019) and after it’s start (2020).

Results indicate that men were less likely than women to report depression. Clients who identified as Latinx/Hispanic were 2.8 times more likely than non-Hispanics to report depression and clients who did not reside in public housing were 19.9% less likely to report depression. There was a statistically significant difference between mean PHQ-9 scores pre- and post-pandemic, with pre-pandemic scores lower on average, with a small effect size.

Building on findings from this study, we propose ways to increase rural access to mental health services, through equitable access to telemedicine, to meet the needs of rural clients to increase disaster preparedness.

The objective of this study is to map vulnerability of Asian countries to the COVID-19 pandemic.

According to the Intergovernmental Panel on Climate Change (IPCC) 2007 framework for natural hazards, vulnerability is a function of exposure, sensitivity, and adaptive capacity. From an extensive literature review, we identified 16 socioeconomic, meteorological, environmental, and health factors that influence coronavirus disease 2019 (COVID-19) cases and deaths. The underlying factors of vulnerability were identified using principal component analysis.

Our findings indicate that the percentage of the urban population, obesity rate, air connectivity, and the population aged 65 and over, diabetes prevalence, and PM2.5 levels all contributed significantly to COVID-19 sensitivity. Subsequently, governance effectiveness, human development index (HDI), vaccination rate, and life expectancy at birth, and gross domestic product (GDP) all had a positive effect on adaptive capacity. The estimated vulnerability was corroborated by a Pearson correlation of 0.615 between death per million population and vulnerability.

This study demonstrates the application of universal indicators for assessing pandemic vulnerability for informed policy interventions such as the COVAX vaccine roll-out priority. Despite data limitations and a lack of spatiotemporal analysis, this study’s methodological framework allows for ample data incorporation and replication.

To explore the health impacts of Hurricane Maria (HM) on HIV care outcomes among people living with HIV who use drugs.

Using data from an ongoing cohort study in San Juan, Puerto Rico (Proyecto PACTo), we measured differences in HIV care outcomes (viral load, viral suppression, and CD4 counts) before and after HM using assessments conducted at 6-month intervals. Generalized estimating equations were used to assess factors associated with HIV care outcomes.

All HIV care outcomes showed a deterioration from pre-HM values to post-HM values (mean viral load increased, CD4 counts decreased, and rate of viral suppression decreased) after controlling for pre-HM sociodemographic and health characteristics. In addition to HM, age (aIRR = 1·01), being homeless (aIRR = 0·78) and having health insurance (aIRR = 1·6) were independently associated with viral suppression.

219 participants completed follow-up visits between April 2017 and January 2018, before and after HM.

People living with HIV who use drugs in Puerto Rico experienced poorer HIV outcomes following HM. Socio-environmental factors contributing to these outcomes is discussed in the context of disaster response, recovery, and program planning.

The study aimed to identify the factors that influence the disaster preparedness of hospitals and validate an evaluation framework to assess hospital disaster preparedness (HDP) capability in the Eastern Province of Saudi Arabia.

A cross-sectional survey of all hospitals (n = 72) in the Eastern Region of Saudi Arabia was conducted. A factor analysis method was used to identify common factors and validate the evaluation framework to assess HDP capacity.

Sixty-three (63) hospitals responded to the survey. A 3-factor structure was identified as key predicators of HDP capacity. The first factor was the most highly weighted factor, which included education and training (0.849), monitoring and assessing HDP (0.723), disaster planning (0.721), and command and control (0.713). The second factor included surge capacity (0.708), triage system (0.844), post-disaster recovery (0.809), and communication (0.678). The third factor represented safety and security (0.638) as well as logistics, equipment, and supplies (0.766).

The identified 3-factor structure provides an innovative approach to assist the operationalization of the concept of HDP capacity building and service improvement, as well as serve as a groundwork to further develop instrument for assessing HDP in future studies.

This work aimed to identify, appraise, and summarize existing knowledge about oral health interventions in the context of natural disasters and verify the main research gaps.

We searched in PubMed (National Library of Medicine, Maryland, USA), EMBASE (Elsevier, Amsterdam, Netherlands) and Epistemonikos (Epistemonikos Foundation, Santiago, Chile) until 2021 for primary studies and systematic reviews, assessing any oral health intervention in the context of natural disasters. The interventions were classified according to Cochrane Effective Practice and Organization of Care (EPOC) categories, and the type of natural disaster was defined according to the classification by the Centre for Research on the Epidemiology of Disasters (CRED).

We assessed a total of 19 studies (majorly in Japan, n = 8), all performed in the context of an earthquake or mixed natural disasters (earthquake and tsunami). Regarding interventions, 12 studies reported a promotional/ preventive intervention, with oral examination being the most frequent. 7 studies reported therapeutic interventions, mainly related to emergency management of fractures and injuries.

The evidence accessed in our study was limited, highlighting the need for further research to focus on different oral health care interventions and outcomes in the context of different natural disasters, thus enhancing the formulation and implementation of recommendations and protocols worldwide.

Evidence of myelosuppression has been negatively correlated with patient outcomes following cases of high dose sulfur mustard (SM) exposure. These hematologic complications can negatively impact overall immune function and increase the risk of infection and life-threatening septicemia. Currently, there are no approved medical treatments for the myelosuppressive effects of SM exposure.

Leveraging a recently developed rodent model of SM-induced hematologic toxicity, post-exposure efficacy testing of the granulocyte colony-stimulating factor drug Neupogen® was performed in rats intravenously challenged with SM. Before efficacy testing, pharmacokinetic/pharmacodynamic analyses were performed in naïve rats to identify the apparent human equivalent dose of Neupogen® for efficacy evaluation.

When administered 1 d after SM-exposure, daily subcutaneous Neupogen® treatment did not prevent the delayed onset of hematologic toxicity but significantly accelerated recovery from neutropenia. Compared with SM controls, Neupogen®-treated animals recovered body weight faster, resolved toxic clinical signs more rapidly, and did not display transient febrility at time points generally concurrent with marked pancytopenia.

Collectively, this work corroborates the results of a previous pilot large animal study, validates the utility of a rodent screening model, and provides further evidence for the potential clinical utility of Neupogen® as an adjunct treatment following SM exposure.

For the pediatric population, there is no consensus on which triage system to use for mass-casualty incidents (MCI). A scoping review was conducted to identify the most accurate triage system for pediatric patients in MCIs.

MEDLINE (NLM, Bethesda, MA, USA), Embase (Elsevier Inc., Amsterdam, Netherlands), CINAHL (EBSCO Information Services, Ipswitch, MA, USA), and The Cochrane CENTRAL Register of Controlled Trials (John Wiley & Sons, Hoboken, NJ, USA), as well as Scopus (Elsevier Inc., Amsterdam, Netherlands), Global Health (Centre for Agriculture and Bioscience International, Wallingford, UK), Global Health Archive (Centre for Agriculture and Bioscience International, Wallingford, UK), and Global Index Medicus (World Health Organization, Geneva, Switzerland) were searched for relevant studies that were divided into 3 categories: accuracy of a single system, comparison of 2 or more primary triage system and comparison of secondary triage systems. Grey literature was also searched.

996 studies were identified from which 18 studies were included. Systems studied were found to have poor inter-rater reliability, had a low level of agreement between providers, had missed critically ill patients or were not externally validated. 11 studies compared pediatric MCI triage algorithms using different strategies and the most accurate algorithm was not identified. A recently developed secondary triage system, specifically for pediatric patients, was found to perform better than the comparison triage system.

Although some algorithms performed better than others, no primary triage algorithm was accurate enough for the pediatric population. However, only 1 secondary triage algorithm was found to be superior to the others.

In numerous countries, emergency medical services (EMS) students receive curriculum training in effective patient–provider communication, but most of this training assumes patients have intact communication capabilities, leading to a lack of preparedness to interact with patients, who have communication disorders. In such cases, first responders could end up delivering suboptimal care or possibly wrong procedures that could harm the disabled person.

A quasi-experimental design (pretest–posttest) was used to assess the knowledge of EMS students both before and after a translation workshop on how to deal with patients who have hearing and communication disorders during emergencies. Comparisons between pretest and posttest scores were examined using the Wilcoxon signed rank test. The level of knowledge scores was compared before and after the workshop.

The results indicated that EMS students’ scores improved after the workshop. There was a 0.763 increase in the average score of knowledge level. The results of this study show that knowledge translation workshops are a useful intervention to enhance the level of knowledge among EMS students when interacting with hearing and communication patients.

Our results show that such training workshops lead to better performance. Communication is a vital element in a medical encounter between health care providers and patients at all levels of health care but specifically in the prehospital arena. Insufficient or lack of communication with a vulnerable population, who may suffer from various disabilities, has a significant impact on the outcome of treatment or emergency management.

Owing to daily exposure to high job stress, nurses need to use coping techniques. One of the coping strategies helping a person to cope with stressful situations effectively is resiliency skills. The aim of this cross-sectional study was to examine the factors related to nurses’ resiliency during the coronavirus disease 2019 (COVID-19) epidemic.

The resiliency of 288 nurses, 145 nurses from the COVID-19 wards , and 143 nurses from other wards were compared using 25-item Connor & Davidson Resilience Questionnaire. This study was conducted in 2021 in four referral hospitals at Shiraz.

The mean age of participants was 32 y. The average resilience score in the in the participants worked in COVID-19 wards was 95.30 for men and 87.72 for women, and in the non-COVID-19 wards was 85.82 for men and 88.48 for women. The mean resiliency scores of nurses working in COVID-19 and non-COVID-19 wards did not show a statistically significant difference. Factors affecting resilience included age, employment status, gender, and job expectancy.

In this study, the resiliency of nurses working in COVID-19 wards did not differed from that of working in non-COVID-19 ones. This result should be further investigated and elaborated. Health policymakers should consider job expectation, gender, age, and employment status of nurses when making plans for future pandemics.