In 2017, members of our workgroup published on the readiness for nuclear and radiological incidents among emergency medical personnel.1 Our findings, along with a review of pertinent literature, suggest that the state of medical preparedness for these incidents is in crisis. A 2018 publication addressing nuclear terrorism preparedness relegates medical preparedness to a low priority and describes it as potentially dangerous.2 The crisis status of medical preparedness for these incidents is addressed.

To establish a prepared medical workforce and trained public for those at risk from nuclear or radiological disasters.

This Institutional Review Board (IRB)-approved survey published an article and used a relevant literature review.

Readiness for nuclear and radiological incidents is lacking in multiple areas including education, training, identifying medical needs, willingness to come to work, and perception of relative risk among medical personnel.1 Confounding this is recent prominent publication downplaying and discouraging medical preparedness for nuclear terrorism.2 The importance of a readied workforce and a prepared public is identified.

In 2013, we formed a multi-national workgroup focused on preparing health professionals and the public for clinical management of casualties during nuclear and radiological disasters. Modeling has demonstrated predictable casualty injury and illness patterns suggesting that early appropriate medical response will save lives. Readiness demands an educated, skillful, and willing-to-engage medical workforce. Our 2017 publication identified several areas that place medical preparedness at risk.1 A significant risk to medical preparedness may lie in prominent publications discouraging the pursuit.2 We firmly believe that medical preparedness is essential and begins with a prepared public.

There are many health challenges faced by those returning from military service. Posttraumatic stress disorder (PTSD) is a serious problem in veterans. PTSD is a risk factor for suicide in veterans. Standard treatments include medication and talk therapy. Non-traditional treatments include civil service and leadership training.

Assess the effectiveness of Veteran Focused Train-the-Trainer (TTT) Community Disaster Response and First Aid (DRAFA) Programs in promoting health, wellness, reintegration, and decreasing PTSD symptoms of veterans.

A longitudinal cohort study was conducted using a convenience sample of veterans living in Denver, Colorado or Reno, Nevada. The sample size was over 50 (N=50+), with 25+ case-matched veterans at each location. This is an ongoing project lasting through the end of 2020. Inclusion criteria selected veterans interested in DRAFA training and education. Exclusion criteria disqualified those who are not a veteran or those unable to perform physical tasks required by curriculum. The null hypothesis was that there is no relationship between the DRAFA TTT program and the health, well-being, and reintegration of veterans back into their communities. Statistical tools used were SPSS Statistics (Version 25) and NVivo 12-12.2.0.3262. Research activities were conducted under the auspices of the University of Colorado and guided by the principles of the Institutional Review Board (IRB).

Results are being evaluated using a mixed methods impact model. The main outcomes measured health, wellness, and reintegration using Veterans RAND-12 Health Quality of Life Survey, the Military to Civilian Reintegration Survey, and a satisfaction survey. Preliminary analysis may indicate a correlation between participation in the DRAFA TTT program and improved health/wellness outcomes, better reintegration into society, and decreased PTSD.

There is growing evidence that expedited structured reintegration programs in community preparedness and disaster leadership roles for veterans alleviate PTSD symptoms and improves quality of life.

In China, many disaster rescue operations need cooperation between civil forces and military forces. Understanding the key elements of civil-military disaster rescue operations is a basic problem faced by Chinese rescuers and scholars.

To summarize the key elements of civil-military disaster rescue operations in China.

On July 17, 2016, an expert round-table meeting was held on our campus to discuss some basic problems in disaster research. The participants arrived at a consensus that the key elements of civil-military disaster rescue operation under Chinese cultural context should be carefully analyzed using Six Sigma (Why, Who, What, When, Where, and How, 5W1H)

The minutes of the meeting was summarized into a brief report.

(1) Why to rescue - it is the responsibility of modern government to protect its people; (2) Who are the rescuers - individuals or groups with passion and ability to do such work, but they should be organized properly; (3) What to do - make vital systems of the community run normally as soon as possible; (4) When to rescue - different disasters have different laws, but it is better to render help in the golden hour; (5) Where to rescue - it depends on the input process (material, human resources, etc.) and output process (patients, waste material, etc.) of the rescue operation, not merely confined to the disaster site; (6) How to rescue - cooperation among all branches of social sectors is vital to succeed, especially civil-military cooperation. Military force is the backbone force in an austere environment.

The discipline of disaster medicine is developing rapidly in China. The research and evaluation framework should be established carefully. Civil forces and military forces should have an identical understanding of the same question. This abstract is only part of the research framework.

Hazardous materials are widely used in modern society, including in industry, business, agriculture, research, healthcare, and other sectors. As sea levels continue to rise around the globe, locations where hazardous materials are produced, stored, transported, or utilized become increasingly vulnerable to flooding, storm surge, and other problems that can result in accidental releases. Such releases can pose threats to health, the environment, and the economic viability of communities.

This paper reports on a new pilot project in Coastal Virginia to increase awareness, enhance safeguards, and strengthen preparedness for the growing threat of hazardous material releases posed by rising sea levels.

Launched under the Institute for Coastal Adaptation and Resilience (ICAR) at Old Dominion University, with support from the ODU Resilience Collaborative, the project includes several components. One part identifies hazardous materials sectors that could be affected by rising seas. Another component consists of case studies of locations that have already been affected. A third component involves stakeholder workshops where participants work collaboratively to enhance safeguards and strengthen preparedness.

Designed in 2017 and 2018, the project secured initial funding early in 2018. Since then, the project has worked to identify sectors and activities that could be affected by rising seas and establish links with key stakeholder agencies, sectors, and organizations. The next steps, to be completed in 2019, involve preparation of case studies from facilities already affected by rising sea levels, and the implementation of the first in a series of stakeholder workshops.

As sea levels rise, more hazardous materials locations become vulnerable. Proactively addressing this threat is an essential part of sea level rise preparedness, adaptation, and resilience. The new pilot project in Coastal Virginia is intended to help address this challenge by increasing awareness and bringing stakeholders together to collaboratively identify practical steps forward.