The leading role of expert safety knowledge in supporting the mission of caring for patients during man-made and natural disasters: state of emergency medicine in Ethiopia, Myanmar, and Ukraine.

Preparedness to endure extreme situations such as natural disasters or military conflicts is not commonplace in healthcare training programs. Moreover, multidisciplinary teams in health services rarely (if ever) include experts in security. However, when emergency situations occur, prevailing healthcare demands do not cease to exist, and unexpected demands often surge due to the shortage of other services and supplies or as a consequence of the emergency condition itself.With services in 45 countries, AIDS Healthcare Foundation (AHF) has operated in several conflict zones, facing broad and challenging security demands. Since 2017 AHF has implemented the Global Department of Safety and Security (GDSS), a dedicated intelligence and safety program that had a key role in the security monitoring, preparedness, and defense responses, assisting staff members and clients during recent conflicts.In this manuscript, we describe the experience of AHF's GDSS in three recent military conflicts in Ethiopia, Myanmar, and Ukraine, and provide insights into steps that can be taken to assure staff safety and support the mission of caring for patients throughout catastrophic events.

Nowcast flood predictions in the Amazon watershed based on the remotely sensed rainfall product PDIRnow and artificial neural networks.

The aim of this study was to develop artificial neural network (ANN) models to predict floods in the Branco River, Amazon basin. The input data for the models included the river levels and the average rainfall within the drainage area of the basin, which was estimated from the remotely sensed rainfall product PDIRnow. The hourly water level data used in the study were recorded by fluviometric telemetric stations belonging to the National Agency of Water. The multilayer perceptron was used as the neural framework of the ANNs, and the number of neurons in each layer of the model was determined via optimization with the SCE-UA algorithm. Most of the fitted ANN models showed Nash-Sutcliffe efficiency index values greater than 0.9. It is possible to conclude that the ANNs are effective for predicting the flood levels of the Branco River, with horizons of 6, 12 and 24 h; thus, constituting a viable option for use in river-flood warning systems in the Amazon basin. For the forecast with a 24-h horizon, it is essential to include the average rainfall of the basin that accumulated over the last 48 h as input data into the ANNs, along with the levels measured by the streamflow stations. The indirect rainfall estimates provided by PDIRnow are an excellent alternative as input data for ANN models used to predict floods and constitute a viable solution for regions where the density of rain gauge stations is low, as is the case in the Amazon basin.

Teaching extent and military service improve undergraduate self-assessed knowledge in disaster medicine: An online survey study among Swedish medical and nursing students.

Background: The purpose of this study was to identify the possible needs for undergraduate disaster medicine education in Sweden and to make informed recommendations for the implementation of disaster medicine content in medical and nursing schools in Sweden. Methods: An online survey was distributed to undergraduate medical and nursing students through the directors of all medical and nursing programs at Swedish universities. The survey contained demographic questions, as well as questions about the amount of disaster medical education and previous experience with rescue, police, or military services. The final survey page contained self-assessments of disaster medical knowledge. Comparative statistics were applied between nursing and medical students, those with previous military service, and those without, as well as between universities. Results: A total of 500 medical and 408 nursing students participated in this study. A median of 2 h of disaster medicine education was provided to senior medical students and 4 h was provided to senior nursing students. Senior medical students scored their disaster medical knowledge lower than nursing students (t-test, p < 0.001). A proportion of 1% had served in rescue services or police, and 7% of the participants had a history of military service, of which 67% served in a medical role. Those who had served in rescue services, police, or the armed forces had a higher self-assessed disaster medical knowledge base than those who had not (p < 0.007 and p < 0.001, respectively). Conclusion: Most medical and nursing students in this study rated their disaster medical knowledge as insufficient. The correlation between the amount of disaster medical education and self-assessed disaster medical knowledge should influence and help direct Swedish educational policies.

Super Bowl LVI: Coordinating the Joint Information Center.

OBJECTIVE: The Super Bowl is one of the biggest annual sporting events that creates unique challenges for public health preparedness. The objective of this brief is to discuss the successes and challenges of the Joint Information Center (JIC) during Super Bowl LVI. METHODS: This study analyzed the JIC within 4 realms: pre-activation planning, public safety and alert messaging, communication, and credentialing and access. RESULTS: Pre-activation planning was not attended by all agencies, which made it difficult for effective communication during the activation period. Innovative platforms and social media themes were successfully deployed to enhance inter-operational communications and public safety messaging. Lastly, delayed credentialing and access to the Super Bowl Stadium decreased the ability to have context to safety preparedness. CONCLUSIONS: This study recommends that many of the JIC's successes should be translated to future mass-gathering events. Additionally, we urge that all agencies participate during pre-activation and activation periods to enhance safety operations and communications moving forward.

Military Medical Role in Civilian Disaster.

US military medical units have responded to natural disasters (eg, hurricanes, earthquakes), relieved overwhelmed civilian health care systems (eg, during the COVID-19 pandemic), and provided support to stabilization efforts after civil unrest. The military will continue to assist civilian agencies with future medical response to similar disasters, contagious outbreaks, or even terrorist attacks. The keys to an effective disaster response are unity of effort, prior coordination, and iterative practice during military-civilian exercises to identify strengths and areas of improvement. Critical care advanced practice nurses are likely to work concurrently with military medical colleagues in multiple scenarios in the future; therefore, it is important for these nurses to understand the capacities and limitations of military medical assets. This article describes the capabilities and collaboration needed between civilian and military medical assets during a variety of disaster scenarios.

Military Response to Medical Crises-Consensus Recommendations for Military-Civilian Transitions of Care.

OBJECTIVE: The threat that New York faced in 2020, as the COVID-19 pandemic unfolded, prompted an unprecedented response. The US military deployed active-duty medical professionals and equipment to NYC in a first of its kind response to a "medical" domestic disaster. Transitions of care for patients surfaced as a key challenge. Uniformed Services University and the Icahn School of Medicine at Mount Sinai hosted a consensus conference of civilian and military healthcare professionals to identify care transition best practices for future military-civilian responses. METHODS: We performed individual interviews followed by a modified Delphi technique during a two-day virtual conference. Patient transitions of care emerged as a key theme from pre-conference interviews. Twelve participants attended the two-day virtual conference and generated best practice recommendations from an iterative process. RESULTS: Participants identified 19 recommendations in 10 "sub-themes" related to patient transitions of care: needs assessment and capability analysis; unified command; equipment; patient handoffs; role of in-person facilitation; dynamic updates; patient selection; patient tracking; daily operations; and resource typing. CONCLUSIONS: The COVID-19 pandemic resulted in an unprecedented military response. This study created 19 consensus recommendations for care transitions between military and civilian healthcare assets that may be useful in future military-civilian medical engagements.

Maintaining School Foodservice Operations in Ohio during COVID-19: "This [Was] Not the Time to Sit Back and Watch".

The COVID-19-related lockdowns led to school closures across the United States, cutting off critical resources for nutritious food. Foodservice employees emerged as frontline workers; understanding their experiences is critical to generate innovations for program operations and viability. The purpose of this cross-sectional study was to characterize COVID-19-related foodservice adaptations for summer and school year meal provision. Public school district foodservice administrators across Ohio were surveyed in December 2020. Questions related to meal provision before, during, and after COVID-19-related school closures. Results indicate the majority of districts continued providing meals upon their closure in Spring 2020 (n = 182, 87.1%); fewer did so in Summer (n = 88, 42.1%) and Fall (n = 32, 15.3%). In Spring and Summer, most districts that offered meals functioned as 'open sites' (67.0% and 87.5%, respectively), not limiting food receipt to district-affiliated students. Most districts employed a pick-up system for food distribution (76-84% across seasons), though some used a combination of approaches or changed their approach within-season. Qualitatively, districts reported both "successes" (e.g., supporting students) and "challenges" (e.g., supply chain). Despite being ill-prepared, districts responded quickly and flexibly to demands of the pandemic. This analysis provides insight for future practice (e.g., establishing community partnerships) and policy (e.g., bolstering local food systems).

Working During Pandemic Disasters: Views and Predictors of EMS Providers.

OBJECTIVES: This study aims to assess the perception and attitude of emergency medical services (EMS) providers toward working during disease outbreaks, and the factors that may influence their decisions to ultimately work or not. METHODS: This is a cross-sectional study assessing the attitude of EMS providers to work during disease outbreaks. Descriptive statistics and regression analyses were performed to assess attitudes toward reporting for duty and factors that influence providers' decisions. RESULTS: Of the 500 surveys distributed, 466 (93.2%) were complete and included for analysis. The majority of participants (70.2%) are male with a mean age of 27 (SD 4.3) years. The study found that the majority (71.1%) of participants are willing to come to work during disease outbreaks. The study found 7 predictors of reporting for duty. Confidence that employer will provide adequate protective gear was the most significant predictor (odds ratio [OR], 3.95; 95% confidence interval [CI] = 2.31-5.42). Concern for family safety was the most important barrier against coming to work (OR, 0.40; 95% CI = 0.21-0.73). CONCLUSIONS: Providing adequate supplies of protective gear along with knowledge and training for disease outbreak are the main factors that enhance providers to fulfill their work expectations.

Discursos sobre o risco no contexto da gestão de emergências e desastres / Discourse on risk in the context of emergency and disaster management / Discursos sobre el riesgo en el contexto de la gestión de emergencias y desastres

Este artigo tem como objetivo compreender e discutir os conceitos de risco produzidos no contexto do Sistema Nacional de Proteção e Defesa Civil (Sinpdec). Esse sistema é a instituição brasileira que concentra maior parte das intervenções sobre riscos no contexto das emergências e desastres. Trata-se de uma pesquisa de orientação qualitativa, fundamentada pelas perspectivas de discurso desenvolvidas por Foucault e pela Psicologia Discursiva. Foram realizadas 36 entrevistas. semiestruturadas, sendo 21 com trabalhadores e trabalhadoras, e 15 com usuários e usuárias. Chamou-nos a atenção que o conjunto de termos encontrados coloca o risco como algo socialmente negativo, que pode provocar danos. Observou-se, além disso, que, no Sinpdec, o risco é fortemente associado aos fenômenos da natureza, fator que limita, no interior do sistema, a problematização das questões políticas e sociais que envolvem a temática. Esperamos que esta pesquisa possa contribuir para a ampliação de sentidos sobre o risco que circunscrevem o contexto estudado.

The aim of this article is to understand and to foster the debate on the concepts of risk elaborated in the context of the National System of Civil Protection and Defense (Sistema Nacional de Proteção e Defesa Civil - Sinpdec). The research, which has a qualitative grounding, is based on discourse perspectives developed by Michel Foucault and the English School of Discursive Psychology. In total, 36 semi-structured interviews were conducted, 21 being with workers and 15 with users. The terms which were found drew our attention since they situated risk as something negative from a social perspective, and that can cause harm. It was also observed that within Sindpec, risk is strongly associated with natural phenomena - this is a limiting factor which, within the system, can restrain the problematization of the political and social questions surrounding the issue. We hope that the research will contribute to the broadening of meanings about risk in this context.

Este artículo tiene por objetivo comprender y discutir los conceptos de riesgos producidos en el contexto del Sistema Nacional de Protección y Defensa Civil (Sinpdec), la institución brasileña que concentra gran parte de las intervenciones sobre riesgos en el contexto de emergencias y desastres. Se trata de una investigación de orientación cualitativa, fundamentada por las perspectivas del discurso desarrolladas por Michel Foucault y por la Psicología Discursiva. Fueron realizadas 36 entrevistas. semi estructuradas, 21 con trabajadores y trabajadoras y 15 con usuarios y usuarias. Nos llamó la atención que el conjunto de términos encontrados establece el riesgo como algo socialmente negativo que puede provocar daños. Se observó, además de eso, que en el Sinpdec el riesgo está fuertemente asociados a los fenómenos de la naturaleza, factor que limita, en el interior del sistema, la problematización de las cuestiones políticas y sociales relacionadas a la temática. Esperamos que la investigación contribuya a la expansión de los significados sobre el riesgo en el contexto estudiado.

Estudo dos protocolos de traumatologia de lesão por projétil de arma de fogo: revisão de literatura / Study of the traumatology protocols for gunshot injuries: literature review

As armas de fogo são instrumentos letais que estão relacionados a uma grande quantia de homicídios no Brasil, além de traumas e violências. Assim, o atendimento pré-hospitalar e hospitalar é importante na tentativa de diminuir os índices de mortalidade por causas externas. Esta revisão de literatura teve como objetivo demonstrar as formas protocoladas de atendimento atuais a um paciente com trauma por projétil de arma de fogo (AU).

Firearms are lethal instruments that are related to a large amount of homicides in Brazil, as well as traumas and violence. Thus, pre-hospital and hospital care is important in the attempt to reduce mortality rates due to external causes. This literature review aimed to demonstrate the current protocol forms of care for a patient with gunshot wound. (AU)

O rejeito e suas diversas marcas: saúde dos trabalhadores da Defesa Civil no rompimento da barragem de Fundão / The reject and its various brands: health of Civil Defense workers in the rupture of the Fundão dam

RESUMO A partir do desastre socioambiental ocorrido em Mariana (MG), em 5 de novembro de 2015, o estudo buscou compreender a atividade dos técnicos da Defesa Civil que atuaram no desastre. A reflexão que aqui se desenvolve parte do esforço de dar visibilidade à atividade desses profissionais que atuam em condições permeadas de imprevisibilidades e pressões. O estudo tem como referenciais os aportes do campo da Saúde do Trabalhador e da ergologia. Trata-se de uma pesquisa empírica, de abordagem qualitativa, realizada por meio de observação direta e entrevistas individuais semiestruturadas com trabalhadores da Defesa Civil. A análise dos resultados foi organizada em duas grandes seções com os seus respectivos desdobramentos: a primeira traz uma contextualização do desastre narrada pelos diversificados profissionais que atuaram; a segunda evidencia desafios e perspectivas que os agentes de defesa civil puderam tirar da catástrofe. Diante da complexidade das situações e da dimensão imprevisível do risco, os agentes de defesa civil são constantemente convocados a 'renormatizar' e a operar escolhas a partir de sua história e de seus valores para lidar com as infidelidades do meio.

ABSTRACT From the socio-environmental disaster that took place on November 5th, 2015 in Mariana (MG), the study sought to understand the activity of Civil Defense technicians who acted in the disaster, aiming to collaborate for actions of worker's health surveillance. The reflection that develops here is part of the effort to give visibility to the activity of those professionals who work in conditions permeated with unpredictability and pressure. The study has as references the contributions from the field of Occupational Health and ergology. This is an empirical research with a qualitative approach, conducted through direct observation and semi-structured individual interviews with Civil Defense professionals. The analysis of the results was organized in two large sections with their respective consequences: the first brings a contextualization of the disaster narrated by the several professionals who worked during it; the second focuses on the challenges and perspectives that civil defense agents have been able to draw from the disaster. Faced with the complexity of situations and the unpredictable dimension of risk, civil defense agents are constantly called upon to 'renormatize' and operate choices based on their history and their values to deal with environmental infidelities.

Educação permanente sobre a atenção psicossocial em situação de desastres para agentes comunitários de saúde: um relato de experiência / Permanent education on psychosocial care in disaster situations for community health agents: an experience report

RESUMO Tendo em vista a ocorrência de desastres socioambientais e a necessidade de uma atenção psicossocial realizada no território onde residem as pessoas afetadas, elaborou-se uma educação permanente. O objetivo deste relato de experiência foi analisar a realização da educação permanente sobre a atenção psicossocial em situações de desastres para Agentes Comunitários de Saúde(ACS) em um município localizado na Região de Saúde do Médio Vale do Itajaí/Santa Catarina/Brasil. Para realização dessa atividade, utilizaram-se metodologias ativas de modo a abordar temáticas voltadas ao desastre, risco, vulnerabilidade e atenção psicossocial. Como principais resultados, destacam-se a identificação de áreas suscetíveis a ocorrência de desastres localizadas nas microáreas de cada agente, a reflexão sobre a contribuição dos ACS para a realização de uma atenção psicossocial, assim como estabelecimento de ações intersetoriais entre esses profissionais e os agentes da Defesa Civil. Por fim, salienta-se que os recursos utilizados por meio da educação ativa possibilitaram a reflexão do processo de trabalho dos ACS. Sugere-se que nas próximas ações busque-se contemplar toda a equipe de saúde por meio da utilização das reuniões de equipe, como espaço potente para esta ação.

ABSTRACT In view of the occurrence of socio-environmental disasters and the need for psychosocial care carried out in the territory where the affected people reside, a permanent education was developed. The objective of this experience report was to analyze the accomplishment of permanent education on psychosocial care in disaster situations for Community Health Agents (CHA)in a municipality located in the Middle Valley Health Region of Itajaí/Santa Catarina/ Brazil. To perform this activity, active methodologies were used in order to address issues related to disaster, risk, vulnerability, and psychosocial care. The main results highlight the identification of areas susceptible to the occurrence of disasters located within the micro areas of each agent, the reflection on the contribution of CHA to the accomplishment of psychosocial care, as well as the establishment of intersectoral actions between these professionals and Civil Defense agents. Finally, it is emphasized that the resources used through active education made it possible to reflect on the work process of CHA. For the next actions, it is suggested that the entire health team be contemplated through the use of team meetings as a potent space for such action.

Iranian Emergency Medical Service Response in Disaster; Report of three Earthquakes.

INTRODUCTION: The earthquake is one of the most natural catastrophic crises that can cause a lot of casualties. Considering an earthquake-prone country, Iran is ranked as one of the world's most dangerous countries. OBJECTIVE: In this article, we describe the actions taken by emergency medical service (EMS) after the earthquake in Kermanshah, Varzaghan, and Bam and compared the strengths and weaknesses of the emergency response program and the limitations and challenges of this system in dealing with these major crises. METHOD: This study is a cross-sectional study that compares some of the information and findings related to three earthquakes that occurred in Iran, including Bam, Varzaghan and Sarpol-e-Zahab earthquakes. The data reported in the present article is descriptive and is based on various independent sources such as National Emergency Operation Center, Local Emergency Operations Center (EOC), the EMS of the country, the World Health Organization, the United Nations, the statistics website, the Forensic Data website, the International Institute of Seismology and Earthquake Engineering, conferences and personal interviews. To ensure the credibility of the information, the authors reported data that had been verified by two or more sources. RESULTS: The characteristics of the geographic area of the 3 earthquakes has been described. Post-earthquake response activities were described in details in subheadings including rapid warning and response, surge capacity plan, rapid response teams, emergency medical teams, increasing the capacity of health facilities, increasing transfer capacity, and handling, transportation and distribution of injuries. CONCLUSION: In the recent earthquake, had been occurred in Sarpol-e-Zahab, the health response of the country was largely satisfactory. The existence of structures such as EOC at various levels, the unified incident command system, emergency operations plan, and Medical Care Monitoring Center are among the most important reasons for satisfactory performance.

A responsabilidade do Estado na perspectiva da legislação da Defesa Civil e de lideranças comunitárias / The responsibility of the State from the perspective of Civil Defense legislation and community leaders / La responsabilidade del Estado en vista de la legislación de la Defensa Civil y de los liderazgos comunitarios

Esta pesquisa buscou compreender a responsabilidade do Estado na gestão de risco de desastres sob a perspectiva de lideranças comunitárias do M'Boi Mirim. Tendo em vista que a região conta com 50 das 407 áreas de risco do município de São Paulo, estando entre os piores índices de exclusão e vulnerabilidade da cidade, e que compete às prefeituras gerenciar áreas de risco, verifica-se a importância de compreender a responsabilidade do Estado neste contexto. Foram analisadas entrevistas de três lideranças comunitárias da região. Desta análise emergiram diversos elementos que contribuem para a situação da região: a inércia do poder público, as dificuldades de diálogo entre população e autoridades governamentais e a diversidade de atores que interferem na solução das questões encontradas, como secretarias municipais que não conversam entre si, políticos que atuam de acordo com seus próprios interesses e a onipresença do tráfico. Verificou-se, ainda, que as lideranças tinham uma perspectiva crítica tanto com relação às ações ou inércia do governo como também com relação à responsabilidade da população.

The aim of this research was to understand the State's responsibility in the disaster risk management in the M'Boi Mirim regions from the perspective of the community leaders. The relevance of the focus on governmental responsibility stems from three issues: that 50 of the 407 areas of risk in the São Paulo municipality are located in this region; that it has one of the worst indicators of vulnerability in the city and that it is a duty of the municipal government to manage areas of risk. Interviews were carried out with three community leaders. Results indicate that various factors contribute to the disaster risk in the region: governmental inertia; the difficult dialogue between population and government authorities and the diversity of actors that interfere in the solution of the problem, such as lack of communication between municipal departments, politicians that act on behalf of their own interests and the omnipresence of drug trafficking. Results also indicate that community leaders have a critical view regarding governmental actions as well as the responsibility of the population.

Esta investigación buscó comprender la responsabilidad del Estado en la gestión del riesgo de desastres desde la perspectiva de líderes comunitarios del barrio M'Boi Mirim. La región cuenta con 50 de las 407 zonas de riesgo del municipio de San Pablo, tiene uno de los peores índices de exclusión y vulnerabilidad de la ciudad, y dado que compete a las alcaldías gestionar estas áreas de riesgo, se ve la importancia de comprender la responsabilidad del estado en este contexto. Se analizaron las entrevistas de tres líderes comunitarios de la región. De este análisis surgieron diversos elementos que contribuyeron para la situación de la región: la inercia del poder público, las dificultades de diálogo entre la población y las autoridades gubernamentales, y la diversidad de agentes que interfieren en la solución de las cuestiones encontradas, por ejemplo, secretarias municipales que no se comunican entre sí, políticos que actúan de acuerdo a sus propios intereses y la omnipresencia del tráfico. De la misma manera, se observó que los lideres tienen una perspectiva critica con relación a las acciones o inercia, así como también con relación a la responsabilidad de la población.

First Rescue Under the Rubble: The Medical Aid in the First Hours After the Earthquake in Amatrice (Italy) on August 24, 2016.

Specific Event Identifiers a. Event Type: Earthquake measuring 6.2 (SD=0.016) on the moment magnitude; b. Event Onset: August 24, 2016 - 03:36:32 CEST (01:36 UTC); c. Location of Event: Central Italy, in the town of Amatrice; d. Geographic Coordinates: latitude (DMS): 42°37'45.77″N; longitude (DMS): 13°17'18.14″E; elevation: 955 meters above sea-level; e. Dates: August 24, 2016 at 4:48 AM; f. Response Type: Medical Relief. ABSTRACT: On August 24, 2016, an earthquake hit the town of Amatrice (Italy). This study aims to document the first medical aid provided to earthquake victims in Amatrice immediately following the earthquake. Patient data were collected and recorded during the first clinical evaluation and before definitive hospitalization. Blood gas tests were performed on survivors extricated from the rubble using the iSTAT (Abbott Point of Care Inc.; Princeton, New Jersey USA) handheld blood analyzer. Performing "victim-side" blood gas tests could provide concrete information to facilitate clinical evaluation and decision making when treating buried victims. After a natural disaster, it is essential to provide effective analgo-sedation to victims. Blasetti AG , Petrucci E , Cofini V , Pizzi B , Scimia P , Pozone T , Necozione S , Fusco P , Marinangeli F . First rescue under the rubble: the medical aid in the first hours after the earthquake in Amatrice (Italy) on August 24, 2016. Prehosp Disaster Med. 2018;33(1):109-113.

La disciplina Preparación para la Defensa en la formación de estudiantes de Medicina / The discipline Preparation for Defense in the training of medical students

Fundamento: las instituciones médicas tienen definido su encargo social, para ello conciben la formación de estudiantes de Medicina con un sólido sistema de conocimientos. Objetivo: caracterizar la disciplina Preparación para la Defensa en la formación de estudiantes de Medicina por la significación especial de esta en su formación integral. Métodos: se desarrolló una investigación descriptiva con predominio de métodos cualitativos en la Universidad de Ciencias Médicas de Pinar del Río, de enero a febrero 2015. Se utilizaron métodos de los niveles teórico, entre ellos: el analítico-sintético, inductivo-deductivo, histórico-lógico y el abstracto a lo concreto; y empíricos: el análisis documental del plan de estudio de la disciplina Preparación para la Defensa, y la encuesta a los estudiantes para indagar sobre el tema. Resultados: la disciplina Preparación para la Defensa declara un sistema de conocimientos, habilidades y valores que garantizan el desempeño de los estudiantes de la carrera de Medicina. La mayoría de los alumnos la consideraron pertinente, y todos reconocieron su valor para la formación integral del profesional ante situaciones de contingencia. Se constató la necesidad de establecer nexos de continuidad con materias de la disciplina Medicina General Integral. Conclusiones: se identificaron las fotalezas de la disciplina para formar modos de actuación positivos en los futuros médicos ante situaciones de contingencias, y se aprecia que sus contenidos pueden enriquecerse con otras materias del currículo a partir de la identificación de los núcleos de contenidos que tienen potencialidades para la integración disciplinar.

Background: the medical institutions have a well defined social commitment, for this, the training of Medicine students is conceived with a solid knowledge system. Objective: to characterize the discipline Preparation for Defense in the training of medical students because of the special significance of this in their comprehensive formation. Methods: a descriptive research was developed with predominance of the qualitative methods in Pinar del Río University of Medical Sciences, from January to February of 2015. Methods of the theoretical level were used, among them, The analytic-synthetic, inductive-deductive, historical-logical and the abstract-concrete; And empirical ones: documentary analysis of the curriculum of the discipline Preparation for Defense and the survey to students to inquire about the subject. Results: the discipline Preparation for Defense declares a system of knowledge, skills and values ??that guarantee the performance of medical students. Most of the students considered it interesting, and all recognized its value for the comprehensive formation of the professional in situations of contingency. It was verified the need to establish continuity links with subjects of the Comprehensive General Medicine discipline. Conclusions: the potentialities of the discipline were identified to form positive ways of performance in future doctors in situations of contingencies, and it is appreciated that their contents can be enriched with other subjects of the curriculum through the identification of the core contents that have potentialities for disciplinary integration.

Knowledge and Attitude of Iranian Red Crescent Society Volunteers in Dealing with Chemical Attacks.

OBJECTIVE: To evaluate the knowledge, attitude, and preparedness of Mahabad Red Crescent Society volunteers in dealing with chemical attacks. METHODS: This prospective cross-sectional study was conducted on 120 Red Crescent Society volunteers in Mahabad City, Iran, during 2014-2015.The knowledge of the volunteers was evaluated and rated using a questionnaire as poor, moderate, and good. Also, the attitude of the volunteers towards the chemical attacks and their preparedness were rated as appropriate and inappropriate using a questionnaire. Data were analyzed using the SPSS software version 21. RESULTS: From a total of 120 volunteers, 62.5% were males. The mean age of the volunteers was 32.0 ± 8.2 years. None of the volunteers had adequate knowledge regarding management of the consequences of chemical terrorist attacks. Only 10 volunteers (8.3%) had appropriate attitude and 7 (5.8%) stated their preparedness for being sent to the crisis zone. Also, 116 volunteers (96.7%) declared that Mahabad Red Crescent Society has an inappropriate level of preparedness to encounter chemical terrorism attacks and release of chemical agents related to petrochemical industrial chlorine resources into the water and wastewater. CONCLUSION: The findings of the present study show poor knowledge and inappropriate attitude of Mahabad Red Crescent Society volunteers, and rescuers in encountering probable chemical attacks and industrial accidents. Furthermore, the Red Crescent Society had an inappropriate level of preparedness in the field of chemical terrorism from the viewpoint of the studied volunteers.

Knowledge and Attitude of Iranian Red Crescent Society Volunteers in Dealing with Bioterrorist attacks.

INTRODUCTION: Bioterrorism is a worldwide problem and has been the focus of attention during recent decades. There is no precise information on the knowledge, attitude, and preparedness of Iranian Red Crescent volunteers in dealing with bioterrorism. Therefore, the present study aimed to evaluate the above-mentioned parameters in Mahabad Red Crescent Society volunteers. METHODS: In this prospective cross-sectional study, the knowledge of 120 volunteers was evaluated and rated as poor, moderate, and good. In addition, attitude of the volunteers and preparedness of Mahabad Red Crescent Society was rated as inappropriate and appropriate using a questionnaire. RESULTS: The mean age of volunteers was 32.0 ± 8.2 years (62.5% male). 2 (1.7%) volunteers had good knowledge while 94 (78.3%) had no knowledge regarding bioterrorist attack management. Only 1 (0.8%) volunteer had appropriate attitude and 6 (5.0%) stated their preparedness for being sent out to the crisis zone. 116 volunteers (96.7%) indicated that Mahabad Red Crescent Society has an inappropriate level of preparedness to encounter bioterrorist attacks. CONCLUSION: The findings of the present study showed poor knowledge and inappropriate attitude of Mahabad Red Crescent Society volunteers in encountering probable bioterrorist attacks. Furthermore, the Red Crescent Society of this town had an inappropriate level of preparedness in the field of bioterrorism from the viewpoint of the studied volunteers.

Fortalecer la comunicación educativa durante el concentrado de Preparación para la Defensa / To strengthen the educational communication during the Preparation for the Defense course

Fundamento: la comunicación educativa permite regular la conducta de profesores y estudiantes, usando recursos persuasivos, estimulando el autoanálisis y propiciando la comprensión crítica del comportamiento. Objetivo: elaborar acciones para fortalecer la comunicación educativa en el concentrado de la asignatura Preparación para la Defensa. Métodos: se realizó un estudio descriptivo transversal en la Universidad de las Ciencias Médicas de Villa Clara, de enero a diciembre de 2013. Se emplearon métodos teóricos: análisis síntesis, inductivo-deductivo e histórico-lógico; y empíricos: la encuesta a estudiantes y profesores que indagaban respecto al comportamiento de la comunicación profesor-profesor, profesor-alumno y alumno-alumno. Resultados: existen algunas dificultades en la comunicación educativa, entre ellas: que está limitada por el corto tiempo que comparten alumnos y profesores, y la existencia de barreras relacionadas con el tono, la rapidez y las curvas de entonación al hablar; y aunque en general la consideran correcta, se elaboraron acciones para fortalecerla. Conclusiones: las acciones fueron valoradas por los especialistas como factibles, objetivas y pertinentes al aportar un nuevo punto de vista al trabajo educativo y contribuir a mejorar la comunicación entre los componentes personales del proceso enseñanza aprendizaje.

Background: the educational communication allows regulating the behavior of professors and students, using persuasive resources, stimulating self-analysis and propitiating the critical understanding of behavior. Objective: to elaborate actions to strengthen the educational communication in the Preparation for the Defense subject course. Methods: it was carried out a cross-sectional descriptive study in Villa Clara University of Medical Sciences, from January to December 2013. Theoretical methods were used: analysis synthesis, inductive-deductive and historical-logical; and empiric ones: the survey was applied to students and professors that were researching about the behavior of professor-professor, professor-student and student-student communication. Results: there are some difficulties in the educational communication, for instance it is limited by the short time that the students and professors share, and the existence of barriers related with tone, speed and the intonation curves when speaking; and although they consider it correct in general, actions were elaborated to strengthen it. Conclusions: the actions were valued by the specialists as feasible, objective and pertinent when contributing to a new point of view of the educational work and to contribute to improve communication among the personal components of the teaching-learning process.