Disaster risk reduction, the Sustainable Goals agenda and the principles of the SUS, in the context of the COVID-19 pandemic. / A redução de risco de desastres, a agenda dos Objetivos Sustentáveis e os princípios do SUS, no contexto da pandemia de COVID-19.

The aim of this study was to analyze the connections between the Sendai Framework for Disaster Risk Reduction, the Sustainable Development Goals (SDGs), and the principles of Brazil's Unified Health System (SUS) in the context of the public health emergency caused by the COVID-19 pandemic and its potential implications for population health. This qualitative, cross-sectional, exploratory study collected data from health professionals with experience in emergency and disaster risk management and treatment practices, which were then processed using the Iramuteq software for lexical analysis. The textual corpus was presented through a descending hierarchical classification that resulted in seven classes grouped into three categories: disaster response in the context of SUS; prevention of future disaster risks; and preparedness and recovery actions based on the Sendai Framework and the SDGs. The study highlighted aspects related to the direct and indirect effects of the COVID-19 pandemic and the challenges related to disaster risk reduction as advocated by the Sendai Framework, emphasizing the need to strengthen the culture of safety and sustainability within the SUS, which aligns with the ODS and social determinants of health.

O objetivo foi analisar os nexos entre o Marco de Sendai para a Redução do Risco de Desastres, os Objetivos de Desenvolvimento Sustentável (ODS) e os princípios do Sistema Único de Saúde (SUS), no contexto da emergência de saúde pública da pandemia de COVID-19, e suas potenciais implicações para a saúde da população. O estudo é qualitativo, transversal, exploratório, com dados coletados junto a profissionais de saúde com experiência em práticas assistenciais e de gestão de risco de emergências e desastres, e tratados pelo software Iramuteq para análise lexical. O corpus textual foi apresentado através da classificação hierárquica descendente, que originou sete classes aglutinadas em três categorias denominadas: resposta a desastres no contexto do SUS; prevenção de futuros riscos de desastres; e ações de preparação e recuperação a partir do Marco de Sendai e dos ODS. Ressaltou-se aspectos sobre os efeitos diretos e indiretos da pandemia de COVID-19 e os desafios relacionados à redução do risco de desastres preconizados no Marco de Sendai, apontando a necessidade de fortalecer a cultura de segurança e sustentabilidade no âmbito do SUS, o que se coaduna com os ODS, bem como aos determinantes sociais da saúde.

Mental Health Needs Due to Disasters: Implications for Behavioral Health Workforce Planning During the COVID-19 Pandemic.

Public health emergencies impact the well-being of people and communities. Long-term emotional distress is a pervasive and serious consequence of high levels of crisis exposure and low levels of access to mental health care. At highest risk for mental health trauma are historically medically underserved and socially marginalized populations and frontline health care workers (HCWs). Current public health emergency response efforts provide insufficient mental health services for these groups. The ongoing mental health crisis of the COVID-19 pandemic has implications for the resource-strained health care workforce. Public health has an important role in delivering psychosocial care and physical support in tandem with communities. Assessment of US and international public health strategies deployed during past public health emergencies can guide development of population-specific mental health care. The objectives of this topical review were (1) to examine scholarly and other literature on the mental health needs of HCWs and selected US and international policies to address them during the first 2 years of the pandemic and (2) to propose strategies for future responses. We reviewed 316 publications in 10 topic areas. Two-hundred fifty publications were excluded, leaving 66 for this topical review. Findings from our review indicate a need for flexible, tailored mental health outreach for HCWs after disasters. US and global research emphasizes the dearth of institutional mental health support for HCWs and of mental health providers who specialize in helping the health care workforce. Future public health disaster responses must address the mental health needs of HCWs to prevent lasting trauma.

Nurses' disaster core competencies and resilience during the COVID-19 pandemic: A cross-sectional study from Turkey.

AIM: The aim of this study is to determine nurses' disaster core competency levels, compare them based on characteristics and examine the relationships with psychological resilience. BACKGROUND: Since nurses constitute a critical part in the health care services, it is important to understand the competencies and effective factors in their disaster preparedness. METHODS: The data were collected from 489 nurses between January and February 2021 with an introductory information form, the Nurses' Perceptions of Disaster Core Competencies Scale and the Connor-Davidson Resilience Scale. RESULTS: The nurses' level of disaster core competencies was above the average, and it was positively correlated with their psychological resilience. The nurses' disaster experiences made higher differences on their disaster core competencies when compared to their personal and professional characteristics. CONCLUSIONS: It is important to provide disaster training and drills to all nurses on a regular basis. However, under disaster conditions, resilience should also be considered and included in the preparation plans for nurses to support their professional competencies and qualifications. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should play a leadership role in planning disaster preparedness training for nurses, and these trainings should be addressed to cover both professional competencies and resilience for nurses to respond effectively to disasters.

What's what in a pandemic? Virus, disease, and societal disaster must be differentiated.

Viruses, the diseases they can trigger, and the possible associated societal disaster represent different entities. To engage with the complexities of viral pandemics, we need to recognize each entity by using a distinctive name.

Pediatric Behavioral Health during the COVID-19 Pandemic: Expert Advice for Preparedness, Response, and Recovery.

The COVID-19 pandemic exacerbated the child mental health crisis and existing disparities. Child anxiety, depression, suicide attempts and completions, and mental-health-related emergency department visits significantly increased. In response to this crisis, the Administration for Strategic Preparedness and Response (ASPR) developed behavioral health task forces associated with funded pediatric centers of disaster excellence. The Health Resources and Services Administration (HRSA) funded the Pediatric Pandemic Network (PPN) to prepare for future endemics and pandemics, with behavioral health identified as a priority in mitigation, preparedness, response, and recovery. This commentary provides insights from pediatric disaster preparedness and response behavioral health subject matter experts. Our roles have been to identify how to build behavioral health professional competencies across disciplines and various medical settings and to strengthen emergency interdisciplinary behavioral health care capability regionally and at the national level. Specific examples of interdisciplinary training and demonstration projects are included as models for enhancing behavioral health situational awareness and developing curricula to support preparedness and response for the current ongoing pandemic and future natural and biological disasters. This commentary also includes a call to action for workforce development to move beyond a boots-on-the-ground mentality for pediatric behavioral health disaster preparedness and response toward a more inclusive role for behavioral health providers of varied specialties. This means that behavioral health providers should become more informed of federal programs in this area, seek further training, and find innovative ways to collaborate with their medical colleagues and community partners.

Jordanian Nurses' Perceived Disaster Preparedness: Factors Influencing Successful Planning.

Background: Current disaster knowledge, skills, and preparedness levels need to be evaluated to guide plans to strengthen disaster readiness. Objective: This study aimed to explore the Jordanian staff nurses' perception regarding their familiarity, attitudes, and practices for disaster preparedness (DP) to reduce the negative impacts of disasters. Methods: This is a cross-sectional, quantitative, descriptive study. The study was conducted on nurses working at governmental and private hospitals in Jordan. A convenience sample of 240 currently working nurses was recruited to participate in the study. Results: The nurses were somewhat familiar with their role in DP (2.9 ± .84). The nurses' overall attitude towards DP was 2.2 ± 0.38, indicating that respondents had medium attitude levels. A low practice level for DP (1.59 ± 0.45) was also observed. Among the studied demographic variables, there was a significant relationship between experience and prior training with improved familiarity and practices. This indicates a need for strengthening nurses' practical skills as well as their theoretical knowledge. However, there is only a significant difference between attitude scale scores and disaster preparedness training (f = 10.120; p=0.002). Conclusions: The study findings support the need for more training (academic and/or institutional) to increase and improve nursing disaster preparedness locally and globally.

The COVID-19 pandemic through the lens of humanitarian logistics. / A pandemia da COVID-19 pelas lentes da logística humanitária.

An integrative literature review (ILR) was conducted to identify the relationship between humanitarian logistics and the development of the COVID-19 pandemic based on research in the SCOPUS, MEDLINE and ENEGEP databases in April and May 2022. In all, 61 articles were evaluated according to the following criteria: original article or review of literature published in a scientific journal; abstract and full text available; article on humanitarian logistics in relation to the COVID-19 pandemic. The resulting sample comprised eleven publications organized and analyzed through a synthesis matrix, where 72% were published in international journals and mostly in 2021 (56%). The presence of the supply chain defines the course of action of economic and social sectors, which in turn determine, by means of an interdisciplinary approach, humanitarian operations in the face of the COVID-19 pandemic. The lack of studies narrows down humanitarian logistics to mitigate the impacts caused by these disasters, both in the context of the current pandemic and in future events of the same nature. However, as a global emergency, it suggests the need to increase scientific knowledge on the subject of humanitarian logistics related to disaster events.

O objetivo do estudo é identificar na literatura a relação entre a logística humanitária e a evolução da pandemia de COVID-19. Trata-se de uma revisão integrativa de literatura (RIL), com busca nas bases de dados SCOPUS, MEDLINE e ENEGEP, de abril e maio de 2022. Um total de 61 artigos foram avaliados conforme os critérios estabelecidos: artigo original ou de revisão de literatura publicado em revista científica; resumo e texto completo disponível; artigo com objeto de investigação sobre a logística humanitária em relação à pandemia de COVID-19. Foram selecionadas 11 publicações, organizadas e analisadas por meio de matriz de síntese. Das publicações, 72% foram em periódicos internacionais, e majoritariamente no ano de 2021 (56%). A presença da cadeia de suprimentos tem determinado a dinâmica de setores econômicos e sociais, estabelecendo, por meio de um olhar interdisciplinar, as operações humanitárias frente à pandemia de COVID-19. Constatou-se escassez de estudos que analisam a logística humanitária com o intuito de amenizar os impactos causados por esses desastres, tanto no contexto da atual pandemia como em eventos futuros da mesma natureza. Contudo, o caráter mundialmente emergencial sugere a necessidade de fortalecer o conhecimento científico acerca da temática da logística humanitária relacionada a eventos de desastres.

Earthquakes as triggers for public health disasters: WHO and health systems' response.

The February 2023 earthquakes in Syria and Türkiye The earthquakes that hit southeast Türkiye and northwest Syria in February 2023 have been the most devastating among several earthquakes witnessed globally in the past decades. As of 28 February 2023, it had caused the death of over 50 000 people and affected more than 18 million others. In northwest Syria alone, the earthquakes affected at least 96 communities and 35 sub-districts, damaging or destroying more than 10 000 buildings, including 48 health facilities, and leaving over 11 000 people homeless (4). More than 45 000 deaths and 85 000 injuries have been reported in Harim, Afrin and Jebel Saman districts, and at least 50 000 families displaced in Aleppo, Homs, Hama, and Latakia.

Adapting preparedness outreach to a virtual world.

Over the last two years, agencies have experimented with new systems and tactics to reach as many people as possible with critical preparedness information. This paper describes how COVID-19 forced FEMA Region 10 to adapt its public education and outreach strategy to a fully online space in order to keep the public informed about potential disasters. The paper discusses how the Individual and Community Preparedness team at FEMA Region 10 reaches thousands of people around the world by hosting regular webinars, live events, workshops and training sessions, and publishing a monthly newsletter. The paper also argues that if preparedness and response organisations are to evolve their outreach strategies and messaging plans and extend the reach of their messages, they must continue to adapt and to meet their target audience where they are.

Effects of disaster-related traumatic events on worry about radiation and COVID-19: A decade after the Fukushima nuclear power plant accident.

Community residents exposed to nuclear power plant (NPP) accidents have long-term worry about the effects of radiation. After the 2011 Fukushima NPP accident, those who experienced traumatic events during the Great East Japan Earthquake (GEJE) tended to have greater worry about radiation. Along with the prolonged worry about radiation, there may also be cognitive changes caused by the traumatic events. We hypothesized that if there were cognitive changes underlying the prolonged worry about radiation, those who experienced the traumatic events would tend to have greater worry about other issues unrelated to radiation. We examined the effects of the traumatic events during the GEJE on community residents' worry about radiation and COVID-19 a decade after the Fukushima NPP accident. Using the data of a longitudinal questionnaire survey following a random sample of 4900 community residents outside the evacuation zone in Fukushima, this study analyzed 774 responses (15.8%). The traumatic events consisted of (1) injury, (2) injury or death of a family member, and (3) the loss of a house or other property. We developed a mediation model drawing paths from the traumatic events to worry about radiation and COVID-19, including posttraumatic stress symptoms (PTSS) as a mediator, using structural equation modeling. The traumatic events directly affected worry about radiation. Although it did not directly affect worry about COVID-19, it did so indirectly through worry about radiation and PTSS. Traumatic events can increase trauma-related worry independently of PTSS and increase trauma-unrelated worry indirectly through trauma-related worry and PTSS.

User Compliance With the Health Emergency and Disaster Management System: Systematic Literature Review.

BACKGROUND: Health-related hazards have a detrimental impact on society. The health emergency and disaster management system (Health EDMS), such as a contact-tracing application, is used to respond to and cope with health-related hazards. User compliance with Health EDMS warnings is key to its success. However, it was reported that user compliance with such a system remains low. OBJECTIVE: Through a systematic literature review, this study aims to identify the theories and corresponding factors that explain user compliance with the warning message provided by Health EDMS. METHODS: The systematic literature review was conducted using Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 guidelines. The search was performed using the online databases Scopus, ScienceDirect, ProQuest, IEEE, and PubMed, for English journal papers published between January 2000 and February 2022. RESULTS: A total of 14 papers were selected for the review based on our inclusion and exclusion criteria. Previous research adopted 6 theories when examining user compliance, and central to the research was Health EDMS. To better understand Health EDMS, based on the literature reviewed, we mapped the activities and features of Health EDMS with the key stakeholders involved. We identified features that require involvement from individual users, which are surveillance and monitoring features and medical care and logistic assistance features. We then proposed a framework showing the individual, technological, and social influencing factors of the use of these features, which in turn affects compliance with the warning message from Health EDMS. CONCLUSIONS: Research on the Health EDMS topic increased rapidly in 2021 due to the COVID-19 pandemic. An in-depth understanding of Health EDMS and user compliance before designing the system is essential for governments and developers to increase the effectiveness of Health EDMS. Through a systematic literature review, this study proposed a research framework and identified research gaps for future research on this topic.

"Of course, drones delivering urgent medicines are necessary. But I would not use them until " Insights from a qualitative study on users' needs and requirements regarding the use of medical drones.

BACKGROUND: The current COVID-19 pandemic, demographic trends, and the increasing shortage of skilled workers pose major challenges for the care of people with and without care needs. The potential of drones as unmanned aerial vehicles in health care is being discussed as an effective innovative way of delivering much-needed medicines, especially in rural areas. Although the advantages are well known, the needs of the users have not yet been taken into account. METHODS: Online-based focus groups (via WebEx) were conducted with participants from different disciplines: nursing, pharmacy, physicians. Focus groups with COVID-19 patients were conducted face-to-face. The focus was primarily on potential problems and requirements of the users regarding the use of drones. Structured and contrastive snowball sampling has been deployed. The focus groups were audio recorded, transcribed by a transcription-company, and coded with the help of the program "f4analyse 2" for content (Elo et al. 2008). RESULTS: Especially during the pandemic situation, delays, and restrictions in the delivery of medicines have been noticed. All interview partners (patients, pharmacists, physicians, and nurses; n = 36 participants) see drones as useful in cases of limited mobility, time-critical medicines (rapid availability), emergencies, and disasters (e.g., floods), but also for the delivery of regular medicines in rural areas (e.g., for the treatment of chronic diseases). Moreover, only 16.7% of the participants have experiences with drones. DISCUSSION: Drone deliveries do not play a role in the health system yet despite their great importance, which is perceived as particularly evident in the pandemic situation. The results lead to the conclusion that this is mainly due to knowledge and application deficits, so that educational and advisory work is absolutely necessary. There is also a need for further studies that go beyond the scope of acceptance research to describing and evaluating concrete scenarios of drone delivery on the basis of a user-centered approach.

Running Toward Disasters: One Bioethicist's Experience in Translational Ethics.

Translational ethics is a practice that aims to apply bioethics insights and process to the real-world contexts of clinical medicine, but also government policy, systems issues, and public health. This work has been a career focus for a relatively small number of bioethicists over the years, but it has drawn greater attention due to the pandemic and a greater realization of the impact of health inequities and systemic injustice. This essay discusses the pathway, rewards, and challenges of translational bioethics as experienced by one bioethicist working with state and national groups on a range of translational ethics issues, often related to public health disasters. There is much remaining work to be done, and the goal of the essay is to encourage rising bioethicists to engage in translational bioethics.

Impact of and mitigation measures for burnout in frontline healthcare workers during disasters: A mixed-method systematic review.

BACKGROUND: Burnout is a global concern for the healthcare community, especially following a disaster response. It is a major obstacle to providing safe and quality health care. Avoiding burnout is essential to ensuring adequate healthcare delivery and preventing psychological and physical health problems and errors among healthcare staff. AIMS: This study aimed to determine the impact of burnout on healthcare staff working on the frontline in a disaster context, including pandemics, epidemics, natural disasters, and man-made disasters; and to identify interventions used to mitigate burnout among those healthcare professionals before, during, or after the disaster. METHOD: A mixed methods systematic review was used and included a joint analysis and synthesis of data from qualitative and quantitative studies. The was guided by the preferred reporting items for systematic review and meta-analyses (PRISMA) of qualitative and quantitative evidence. Several databases were searched, for example, Medline, Embase, PsycINFO, Web of Science, Scopus, and CINAHL. The quality of included studies was assessed using the Mixed Method Appraisal Tool (MMAT), version 2018. RESULTS: Twenty-seven studies met the inclusion criteria. Thirteen studies addressed the impact of burnout in relation to disasters and highlighted the association between burnout and the physical or mental well-being of healthcare workers, work performance, and workplace attitude and behavior. Fourteen studies focused on different burnout interventions including psychoeducational interventions, reflection and self-care activities, and administering a pharmacological product. LINKING EVIDENCE TO ACTION: Stakeholders should consider reducing risk of burnout among healthcare staff as an approach to improving quality and optimizing patient care. The evidence points to reflective and self-care interventions having a more positive effect on reducing burnout than other interventions. However, most of these interventions did not report on long-term effects. Further research needs to be undertaken to assess not only the feasibility and effectiveness but also the sustainability of interventions targeted to mitigate burnout in healthcare workers.

Opportunities to Strengthen the National Disaster Medical System: The Military-Civilian NDMS Interoperability Study.

The definitive care component of the National Disaster Medical System (NDMS) may not be able to effectively manage tens of thousands of casualties resulting from a catastrophic disaster incident or overseas conflict. To address this potential national security threat, Congress authorized the US Secretary of Defense to conduct the NDMS Pilot Program to improve the interoperability, special capabilities, and patient capacity of the NDMS. The pilot's first phase was the Military-Civilian NDMS Interoperability Study, designed to identify broad themes to direct further NDMS research. Researchers conducted a series of facilitated discussions with 49 key NDMS federal and civilian (private sector) stakeholders to identify and assess weaknesses and opportunities for improving the NDMS. After qualitative analysis, 6 critical themes emerged: (1) coordination, collaboration, and communication between federal and private sector NDMS partners; (2) funding and incentives for improved surge capacity and preparedness for NDMS partners; (3) staffing capacity and competencies for government and private NDMS partners; (4) surge capacity, especially at private sector healthcare facilities; (5) training, education, and exercises and knowledge sharing between federal and private sector NDMS partners; and (6) metrics, benchmarks, and modeling for NDMS partners to track their NDMS-related capabilities and performance. These findings provide a roadmap for federal-level changes and additional operations research to strengthen the NDMS definitive care system, particularly in the areas of policy and legislation, operational coordination, and funding.