This study explores how loneliness affects earthquake risk perception and preparedness behaviors among older adults in Japan. Aging is often accompanied by increased vulnerability to natural disasters, and loneliness is hypothesized to compromise effective preparedness. Using the Japanese Older Adult Preparedness Model (JOAPM), which integrates the Protective Action Decision Model (PADM) and cultural context, we examine how loneliness influences both perceived earthquake risk and protective behaviors.

An online survey conducted in April 2024 gathered responses from adults aged 55 and older across 4 earthquake-prone Japanese prefectures. Measures included demographics, disaster experience, loneliness (UCLA Loneliness Scale), risk perception, and preparedness actions such as household adjustments. Regression and mediation analyses assessed the direct and indirect effects of loneliness on preparedness.

Findings show that loneliness has a significant negative direct effect on disaster preparedness. However, it also slightly increases risk perception, which in turn has a positive relationship with preparedness behaviors, suggesting a modest indirect pathway. Overall, the direct negative effect of loneliness outweighs the indirect benefit.

The results highlight the complex role of psychosocial factors in disaster readiness, suggesting that interventions should address information dissemination, self-efficacy, and the emotional isolation experienced by older adults in high-risk areas.

Evaluate and improve the accuracy of disaster triage decisions for pediatric patients among clinicians of various training levels using the Sort, Assess, Life-Saving Intervention, Treatment/Transport (SALT) triage system.

We used an online pediatric disaster triage module to evaluate and improve accuracy of triage decisions. During a pre- and post-test activity, participants triaged 20 fictional patients. Between activities, participants completed a didactic covering concepts of disaster triage, SALT triage, and pediatric limitations of triage systems. We assessed accuracy and improvement with non-parametric tests.

There were 48 participants: 27 pediatric emergency medicine attendings (56%), 9 pediatric emergency medicine fellows (19%), 12 pediatric residents (25%). The median (interquartile range [IQR]) pre-test percent accuracy across all participants was 75 (IQR 65-85). Attendings scored higher than residents 80 (IQR 73-88) compared to 60 (IQR 55-65, P < 0.01) but not significantly higher than fellows 75 (IQR 70-85, P = 0.6). For the 44 participants who completed both the pre- and post-test, median score significantly improved from 75 (65-85) to 80 (75-90), P < 0.01.

The accuracy of triage decisions varies at different training levels. An online module can deliver just-in-time triage training and improve accuracy of triage decisions for pediatric patients, especially among pediatric residents.

The COVID-19 pandemic significantly impacted Saskatchewan, resulting in high per capita case counts and COVID-19-related deaths. While vaccination mandates have been a key strategy to control the pandemic, their impact in Saskatchewan remains poorly documented. This study assessed the effect of COVID-19 vaccine mandates on the incidence of COVID-19 cases and deaths in Saskatchewan during the first year following vaccine rollout.

A single-group interrupted time series analysis with multiple intervention points was conducted using aggregated daily COVID-19 incidence and mortality rates as outcome variables. The models accounted for confounding effects of daily total vaccine doses administered and public health countermeasures, including the stringency index and economic support index, from April 1, 2020 to January 20, 2022. Average daily COVID-19 incidence and mortality rates were estimated for the pre-vaccine rollout period (April 1 to December 14, 2020), and the post-rollout period (December 15, 2020 to January 20, 2022). In addition, nine supplementary initiatives were introduced during the implementation phase. All estimated effects reflected cumulative changes in trend relative to the pre-vaccination period.

Cumulatively, COVID-19 incidence increased faster than the pre-vaccination trend, likely driven by successive variant surges from wild-type to Omicron, while COVID-19–related deaths remained stable across the same period. The implementation of vaccine rollout, prioritization of vaccines for high-risk populations, and proof-of-vaccination policy were effective in reducing daily COVID-19 incidence and deaths in Saskatchewan. Economic support and an increased number of daily vaccine doses administered were also associated with an improved provincial COVID-19 response. Conversely, surges in COVID-19 incidence and deaths occurred following the introduction of the centralized virtual booking system and booster doses. These surges may reflect accessibility challenges, increased testing, emergence of immune-escape variants, relaxation of public health measures before achieving herd immunity, and waning immunity over time.

Economic support, policy measures, and vaccination efforts played important roles in managing public health crises, hence the need for an integrated approach to managing public health crises. However, temporary surges following certain interventions underscore the need for accessible, adaptable strategies that account for variant emergence, immunity waning and public adherence.

Children are uniquely vulnerable to chemical, biological, radiological, and nuclear (CBRN) events due to anatomical, physiological, and psychological differences. Current decontamination practices are adapted from adult protocols.

To evaluate current practices, challenges, and special considerations in pediatric decontamination during CBRN events.

A scoping review was conducted using six databases in accordance with PRISMA-ScR framework. Studies were eligible if they evaluated decontamination methods involving children (0-18 years) in real or simulated CBRN scenarios. Fourteen studies met the inclusion criteria, and data were thematically analyzed into four domains.

Disrobing is widely recognized as a critical first step in the decontamination process, and 43% of the studies reviewed identified it as such. When done immediately and appropriately, it can remove a significant amount of contaminants. Although its effectiveness varies based on how much of the body is covered and the nature of the exposure. Dry decontamination was discussed in 21% of studies, and wet decontamination was the most commonly reported approach, appearing in 93%. Key pediatric challenges included hypothermia, psychological distress, separation from caregivers, and difficulties managing non-ambulatory or special needs populations. Few studies addressed age-specific protocols or long-term psychological impacts. The results are presented in procedural order to reflect the typical sequence of decontamination in CBRN response.

Current decontamination guidelines inadequately address pediatric-specific needs. There is a critical need for standardized, age-appropriate guidelines that integrate caregiver support and psychosocial considerations. A pediatric decontamination algorithm was developed to consolidate current evidence into a practical framework for CBRN mass casualty incidents.

Building collapses, debris removal, new construction, and increased stove use for heating have elevated air pollution in regions affected by the February 6, 2023, Kahramanmaraş earthquake. This study examines the relationship between carbon monoxide (CO) poisoning and air pollution in these areas 1 year after the disaster.

A retrospective analysis of 151 patients from 10 hospitals in 8 cities was conducted, including data on demographics, clinical symptoms, sources of CO exposure, vital signs, laboratory findings, air pollution levels, and outcomes.

Indoor stove use was the primary source of CO exposure. The average Air Quality Index (AQI) was 55 (IQR 44-56), and particulate matter (PM2.5) levels averaged 17.5 μg/m3 (IQR 10-27), exceeding EPA (Environmental Protection Agency) thresholds. AQI levels post-earthquake were significantly higher than pre-earthquake in Kahramanmaraş (AQI1 = 48.5 [IQR 48-55], AQI2 = 55 [IQR 55-80]; P = 0.007), Hatay (AQI1 = 40.5 ± 13.7, AQI2 = 56 [IQR 51-60.5]; P <0.001), and Gaziantep (AQI1 = 44 [IQR 41-56], AQI2 = 55 [IQR 54-55.5]; P = 0.014). Leukocytosis (P = 0.004) and myocardial injury (P <0.001) in CO poisoning cases varied significantly across provinces.

In conclusion, elevated AQI and PM2.5 levels likely worsened myocardial injury in CO poisoning cases due to combined outdoor and indoor pollution effects. These findings emphasize the need for air quality monitoring and mitigation in disaster regions.

To develop an evaluative framework for assessing the emergency response capabilities of higher education institutions to major emerging infectious diseases, enabling institutions to identify preparedness gaps and prioritize improvements across the outbreak lifecycle.

The Haddon Matrix was used as the foundation for the framework. A Delphi study with a Likert scale was conducted, followed by the Analytic Hierarchy Process (AHP) to determine the importance of the indicators.

A consensus was reached on the evaluation system, comprising 3 primary indicators: prevention and preparedness, response and handling, and recovery and rehabilitation. These indicators were further divided into 11 secondary and 34 tertiary indicators. Expert authority coefficients were 0.82 and 0.80, and Kendall’s coefficients were 0.32 and 0.161 (P < 0.001). AHP highlighted prevention and preparedness as the highest-priority domain (weight = 0.426), followed by recovery and rehabilitation (0.326). High-priority items included safety knowledge dissemination, emergency command systems, primary prevention, and timely warning and monitoring.

Integrating the Haddon matrix, Delphi consensus, and AHP, this study delivers a validated, prioritized framework to assess universities’ MEID response capability across phases. External validity beyond Shanghai remains to be established; cross-regional applicability should be empirically tested through multi-site validation, broader stakeholder representation, and evaluation of technology-enabled components, particularly in resource-limited settings.

This study aimed to evaluate the impact of temporary housing challenges (THC) after the February 6, 2023, Türkiye earthquake on clinical follow-up non-adherence (CFNA), low-density lipoprotein cholesterol (LDL-C) target achievement, and major adverse cardiac events (MACE) in patients with myocardial infarction (MI).

A retrospective cohort of 283 MI patients undergoing coronary angiography and stenting between May 6 and November 6, 2023, was analyzed. Patients were divided into Group 1 (THC group: residing in container cities) and Group 2 (non-THC group: living in intact/usable homes). Initial laboratory parameters and 1-year MACE incidence were compared. In MACE-free patients, adherence to 5 scheduled face-to-face visits (week 1, months 1, 3, 6, and 12) and LDL-C goal achievement were evaluated. CFNA was defined as attending fewer than 3 visits. One-year lab results were also compared.

THC independently predicted CFNA (OR: 1.925, P = 0.019) and MACE (OR: 3.937, P = 0.006). Follow-up attendance was lower in Group 1 (week 1: 43.2% vs 69.9%, P <0.001; month 12: 82.2% vs 95.1%, P = 0.008). LDL-C target achievement was significantly lower (6.85% vs 31.07%, P <0.001).

THC adversely impacts clinical follow-up adherence and increases MACE rates. Addressing THC’s challenges is essential for improving post-disaster health care outcomes.

To assess the iodine status of pregnant women from disadvantaged groups in Kahramanmaraş Province 1 year after the earthquake, including factors affecting iodine status.

510 healthy pregnant women were included in the study. A questionnaire was given to pregnant women after the earthquake to assess changes in diet and other social factors. Thyroid function, autoantibodies, thyroglobulin, urinary iodine concentration (UIC), creatinine (Cr) levels, and ultrasound were measured. Thyroid ultrasound was also performed to assess thyroid volume.

The median UIC of the participants was 91.27 μg/g Cr (Q1-Q3 = 62.53-142.86). The rate of low iodine status (<150 μg/g Cr) was 77.3% and the incidence of goiter was 19.2%. After the earthquake, 69% of pregnant women lived in urban areas and 31% in rural areas. 11.8% of the areas where they lived were moderately damaged, 11.4% severely damaged, and 5.9% completely destroyed. 15.1% were still living in temporary shelters 1 year after the earthquake. The risk of low UIC was 2.2 times higher for those living in temporary shelters after the earthquake.

Temporary shelters after the earthquake were the main risk factor for low iodine status. We need to support these groups after disasters and reduce the number of people living in temporary shelters.

Due to frailty, chronic health issues, limited mobility, dependence on assistive devices, and polypharmacy, the geriatric population is more susceptible to the adverse effects of earthquakes. The aim of this study was to determine the factors affecting the quality of life of older adults who experienced the Kahramanmaraş-centered earthquakes in Türkiye on February 6, 2023.

This cross-sectional interview-based study was conducted with 340 older adults who experienced the earthquakes on February 6, 2023, and visited outpatient departments in Gaziantep. Data were gathered using a demographic form, Modified Fried Frailty Index, and WHO Quality of Life Instrument for Older Adults.

Participants’ average age was 71.37 ± 6.56 years, and 56.6% were women. Among them, 20.9% lost a first-degree relative, 15.3% were injured, and 45.3% were displaced. WHOQOL-OLD scores differed significantly by age, marital status, education, chronic illness, polypharmacy, living arrangements, and frailty.

This study highlights the factors influencing the quality of life of older adults in Türkiye after an earthquake. Living with a spouse and having primary or secondary education improved quality of life, while chronic illnesses and displacement had negative impacts. These findings emphasize the importance of considering the specific needs of older adults in disaster preparedness and response.

Evidence suggests that psychological preparedness is associated with better physical disaster preparation, lower mental health impacts, and improved recovery efforts following a disaster. This analysis provides preliminary insights into factors that may be associated with better psychological preparedness and explores the relationship between psychological preparedness and mental health among Australian rural residents.

A cross-sectional survey design was used to collect data regarding factors associated with Psychological Preparedness.

National online study where participants were community members from MMM1 to MMM6 (N = 388). This study used the Awareness, Anticipation and Management (AAM) subscale from the Psychological Preparedness for Disaster Threat Scale (PPDTS).

Individuals who live in an Australian rural area were 11.59 times more likely to have experienced a disaster, compared to those in a metropolitan area. Significant associations were found between higher PPDTS scores and male sex, age, rural location, having experienced a disaster, and specific physical preparedness items. Individuals with elevated levels of depression, anxiety, and stress had statistically significantly lower PPDTS scores.

Investment in psychological preparedness for natural disasters may assist in preventing mental health exacerbation post disasters. This is particularly important in rural communities, which are more likely to experience disasters but have limited mental health support.

The January 2025 Los Angeles wildland-urban interface wildfires represent a significant environmental disaster, resulting in widespread evacuations. Beyond the immediate physical and economic devastation, wildfires can have profound and lasting impacts on the mental well-being of affected populations. This study compared mental health outcomes between Southern California residents who evacuated due to the fires and those who did not evacuate.

Southern California residents (N = 739) were surveyed 2-3 months after the January 2025 wildfires. Logistic regression models assessed the association of evacuation status with depression, anxiety, and PTSD, adjusting for demographics and baseline pre-fire levels of depression and anxiety.

Evacuating was significantly associated with higher odds of depression (AOR = 1.75 [1.08-2.85]) and PTSD (AOR = 2.44 [1.36-4.35]), after controlling for pre-fire mental health status and other demographic covariates. Evacuation status was not associated with anxiety.

These findings support previous research linking wildfire exposure to adverse mental health outcomes and highlight the importance of targeted mental health screening and support for wildfire evacuees, who are at increased risk for depression and PTSD.

The aim was to document sociodemographic and clinical data of patients with musculoskeletal injuries who applied to the Physical Medicine and Rehabilitation clinic after the earthquake, to share experiences, and thus contribute to preparation for subsequent disasters.

The study was planned as retrospective, cross-sectional, and analytic. A total of N = 230 earthquake victims, 105 (45.7%) males and 125 (54.3%) females, aged between 1 and 79, were included in our study.

Regarding injury location, the lower extremity was primarily affected with N = 125 (54.3%). The number of amputated patients was N = 29 (12.6%), and the most common location was transfemoral amputation with N = 14 (6.1%) patients. The number of fractures was N = 130 (56.5%), and the most common fracture site was the lower extremity in N = 66 (28.7%) patients. N = 162 (70.4%) of the patients had soft tissue injuries. There was peripheral nerve damage in N = 76 (33%) of the earthquake victims; the most frequently damaged nerve was the peroneal nerve in N = 36 (15.7%) patients. A vertebral fracture was present in N = 9 (3.9%) patients, and the most frequently fractured vertebra was the lumbar vertebra in 11 (4.8%) patients.

Defining the profiles of patients with musculoskeletal injuries in the early period, determining their needs, and including them in the rehabilitation program will ensure successful functional gain.

This study explored Italian Emergency Medical Services (EMS) professionals’ perceptions regarding a hypothetical wearable device during Mass Casualty Incidents (MCIs), aiming to improve MCI management and patient outcomes. The device includes patient identifier, vital sign monitoring, LED-based triage coding, geolocation, and real-time data transmission. Using the Technology Acceptance Model (TAM), perceived usefulness, perceived ease of use, and behavioral intention to use the device were measured.

An anonymous online survey was distributed to the 67 EMS dispatch centers across Italy. After an introduction to the device, participants answered demographic and TAM-based questions using a seven-point scale.

Among the 141 respondents, most were males (60.3%), nurses (66.7%), and reported over 10 years of EMS experience (63.1%); 51.8% had prior MCI response experience. The wearable device was positively rated for improving situational awareness and coordination, with concerns about workflow integration and potential rescue delays. The questionnaire showed high internal reliability (Cronbach’s α = 0.96). Principal Component Analysis (PCA) highlighted distinct perceptions between features supporting scene coordination and those enhancing triage accuracy.

The study highlights the perceived value of the wearable in improving MCI coordination and situational awareness. However, concerns regarding workflow integration and possible rescue delays warranted further research on real-world application.

Emergency medical care in Pakistan remains uncoordinated due to the absence of a platform to connect hospitals, patients, and ambulances. Consequently, during periods of resource shortage and crowding of the emergency department at hospitals, patients and ambulances are unable to select the best site for patient management or transfer of patients, resulting in suboptimal care and poor outcomes.

We developed a digital platform called EMCON (Emergency Connection) application, which can be used for inter-hospital and hospital-to-patient/ambulance communication to coordinate patient care. The platform offers real-time information on resource availability, facilitates interhospital patient transfers, coordinates ambulance responses, and assists patients in making decisions about seeking emergency care.

The platform offers real-time information on resource availability, facilitates interhospital patient transfers, coordinates ambulance responses, and assists patients in making decisions about seeking emergency care. It has a range of features that allow hospitals to control the data that they share to maintain hospital buy-in, incorporates both electronic and manual data entry for real-time updates in low-resource settings or during electronic medical record disruption, and provides visual content and appointment scheduling services to keep patients engaged.

The pilot testing of the EMCON platform yielded promising outcomes, highlighting its adaptability and effectiveness in diverse health care settings. Integration with an electronic medical record (EMR)-equipped tertiary hospital demonstrated seamless real-time data updates, ensuring efficient resource management and coordination. Meanwhile, the successful implementation at a resource-reliant blood bank underscored EMCON’s versatility, allowing manual data entry for hospitals without EMR systems. These results emphasize the platform’s practicality and potential to revolutionize emergency health care access in low- and middle-income countries (LMICs). EMCON’s ability to bridge coordination gaps and enhance resource allocation holds great promise for improving patient outcomes, particularly in resource-constrained settings.

EMCON serves as a promising solution to address critical coordination issues in emergency care, bridging the gap between hospitals, patients, and ambulances to improve emergency health care access in low-resource settings.