This study examined how social vulnerability factors—such as caregiving, economic instability, and nonregular employment—affect disaster preparedness and awareness, with a focus on nonlinear associations with evacuation and disaster awareness.

Cross-sectional analysis of a nationally representative survey

Data came from the 2023 Japan COVID-19 and Society Internet Survey (JACSIS), including 28,481 participants. Factor analysis identified two preparedness domains: evacuation awareness and disaster preparedness awareness. Generalized linear models (GLM) assessed associations between awareness scores and sociodemographic and health factors. Sensitivity analysis used a random forest model, and logistic regression examined predictors of low awareness.

Two factors explained 76% of variance in preparedness behaviors. GLM showed that older age (Estimate = 10.99, P < .001), larger household size (Estimate = 4.34, P < .001), high income (Estimate = 0.08, P < .001), and community attachment (Estimate = 0.09, P < .001) were positively related to evacuation awareness, while nonregular employment (Estimate = -0.03, P = .01) and public assistance (Estimate = -0.05, P < .001) were negatively associated. Logistic regression confirmed that reliance on public assistance (OR = 1.54, 95% CI [1.26, 1.87]) and nonregular employment increased odds of low preparedness.

Social vulnerability factors are linked to lower disaster awareness, identifying a subgroup at higher risk. Preparedness policies should account for demographic and economic disparities, emphasizing tailored, community-based strategies to improve resilience among vulnerable populations.

Disaster risk reduction measures are now being developed based on social vulnerability. This study aimed to identify socially vulnerable areas to disasters in Razavi Khorasan Province, Iran.

The research utilized a mixed method approach conducted in 2 stages. First, a vulnerability index was created using 8 sub-indices, and the value of the index was calculated for each of the 91 rural districts in the study area. In the second stage, spatial analysis using Anselin’s Local Moran’s I was performed to identify the most vulnerable districts.

Results indicated that 40 of 91 districts, covering 49% of the total area, had high social vulnerability to disasters. Anselin’s Local Moran’s I analysis identified 2 high-high clusters consisting of 5 districts. The study also found that areas with higher social vulnerability were more susceptible to natural hazards such as floods and earthquakes.

Nearly half of the studied areas exhibited a high level of social vulnerability and were at risk of natural disasters. Implementing general measures to improve the socio-economic status of the population, such as increasing education and income levels, along with specific actions like assisting vulnerable populations in relocating to safer areas, can help mitigate disaster risks.

Violence and suicidality are common in forensic inpatients, most commonly with schizophrenia (SZ), personality disorder (PD), or comorbid SZ and PD (dual diagnosis, DD). There are no biological markers used in risk assessment tools. Lipids may provide a useful biomarker to aid violence prediction, but the roles of diagnosis and sex remain unclear. We therefore investigated lipids in adult forensic inpatients in association with the risk of violence and suicidality by primary diagnosis and sex.

Anonymized data were obtained for all eligible inpatients [n = 230; 114 SZ (75 males), 77 PD (40 males), 39 DD (20 males)] who had been admitted (2002–2021) to Elysium Healthcare (UK-wide) medium/low-secure facilities on lipids, age, sex, diagnosis, medication, risk of violence and suicidality, as well as days in seclusion and on high observations due to violence.

Mean total cholesterol (TC) in the patient sample (4.57, s.d. = 1.09) was lower, relative to the age- and sex-corrected UK population norm (4.91 mmol/l). PD (4.46 ± 1.08 mmol/l) and DD (4.24 ± 0.82 mmol/l), compared to SZ patients (4.77 ± 1.14 mmol/l), had significantly lower TC (not explained by statin use; no effect or interaction involving sex). Lower TC had significant though small associations with more days in seclusion or high observation levels due to violence across all patients, and marginally with suicidality in females.

A low TC-violence (towards others) link exists not only for SZ but also for PD and DD and for males and females, encouraging further enquiry into lipids as a biomarker to aid violence prediction in secure care.

Optimal radiotherapy technique selection for left-sided breast cancer remains challenging. This study compared volumetric-modulated arc therapy (VMAT), VMAT+IMRT (VMAT+IMRT) and IMRT+VMAT (IMRT+VMAT) using an innovative integrated scoring system and risk factor (RF) assessment.

Retrospectively analysed 41 patients with left-sided breast cancer. Treatment plans were evaluated using an integrated scoring system considering tumour coverage and organs at risk (OARs) sparing. RF analysis assessed potential adverse effects on the heart and lungs. Correlation analysis explored relationships between integrated scores and risk factors.

VMAT showed the best overall integrated score (1·0931 ± 0·1707), followed by IMRT+VMAT (1·2011 ± 0·2440) and VMAT+IMRT (1·2264 ± 0·2499). VMAT had the highest percentage of Excellent OAR plans (14·6%), while VMAT+IMRT and IMRT+VMAT showed better PTV coverage (53·7% and 51·2% Excellent, respectively). RF analysis revealed: VMAT (heart RF: 0·341, lung RF: 0·671), VMAT+IMRT (heart RF: 0·294, lung RF: 0·750) and IMRT+VMAT (heart RF: 0·533, lung RF: 0·546). Correlation analysis showed strong positive correlations between integrated scores and lung RF for VMAT (r = 0·671) and VMAT+IMRT (r = 0·750), with IMRT+VMAT showing moderate correlations for lung (r = 0·546) and heart (r = 0·533) RFs.

VMAT demonstrated the best balance between PTV coverage and OAR sparing, hybrid techniques improved target coverage but increased risk to OAR. The RF analysis highlighted varying impacts on heart and lung across techniques. This analysis provides valuable insights for technique selection, potentially improving treatment outcomes and reducing complications in left-sided breast cancer radiotherapy.

The threat of novel pathogens and natural hazards is increasing as global temperatures warm, leading to more frequent and severe occurrences of infectious disease outbreaks and major hurricanes. The COVID-19 pandemic amplified the need to examine how risk perceptions related to hurricane evacuations shift when vaccines become available. This study explores individuals’ expected evacuation plans during the early stages of COVID-19 vaccine availability.

In March 2021, an online survey was disseminated in Puerto Rico and the US Virgin Islands.

An overwhelming majority (72.6%) of respondents said that their vaccination status would not affect their hurricane evacuation intentions. The unvaccinated were significantly more likely to consider evacuating during a hurricane than the vaccinated. Even with vaccines available, respondents suggested they were less likely to evacuate to a shelter during the 2021 season than prior to the COVID-19 pandemic. Respondents generally believed that the risk of contracting COVID-19 at a shelter was greater than the risk of sheltering-in-place during a hurricane.

Government officials need to develop and communicate clear information regarding evacuation orders for municipalities that may be more impacted than others based on the trajectory of the storm, social determinants of health, and other factors like living in a flood zone.

To examine if the current taught undergraduate psychiatry syllabus at an Irish University relates to what doctors in psychiatry consider to be clinically relevant and important.

Doctors of different clinical grades were invited to rate their views on 216 items on a 10-point Likert scale ranging from ‘0 = not relevant’ to ‘10 = very relevant’. Participants were invited to comment on topics that should be excluded or included in a new syllabus. Thematic analysis was conducted on this free-text to identify particular themes.

The doctors surveyed rated that knowledge of diagnostic criteria was important for medical students. This knowledge attained high scores across all disorders with particularly high scores for a number of disorders including major depressive disorder (mean = 9.64 (SD = 0.86)), schizophrenia (mean = 9.55 (SD = 0.95)) and attention deficit hyperactivity disorder (Attention Deficit Hyperactivity Disorder (ADHD); mean = 9.26 (SD = 1.40)). Lower scores were noted for less frequently utilised management strategies (transcranial magnetic stimulation (mean = 4.97 (SD = 2.60)), an awareness of the difference in criteria for use disorder and dependence from psychoactive substances (mean = 5.56 (SD = 2.26)), and some theories pertaining to psychotherapy (i.e. Freud’s drive theory (mean = 4.59 (SD = 2.42)).

This study highlights the importance of an undergraduate programme that is broad based, practical and relevant to student’s future medical practice. An emphasis on diagnosis and management of major psychiatry disorders, and knowledge of the interface between mental health services, other medical specialities and support services was also deemed important.