Integrating Inter-Professional Insights for Enhanced Disaster Response: A Cross-Sectional Analysis in Jubail's Royal Commission Hospital, Saudi Arabia.

Introduction: This study aimed to evaluate disaster preparedness and management among an inter-professional team at the Royal Commission Hospital (RCH) in Jubail, Saudi Arabia. Methods: Conducted between May and July 2023, this cross-sectional study involved healthcare providers in both patient-facing and non-patient-facing roles. Participants responded to a comprehensive online questionnaire comprising 22 questions across seven sections covering aspects of emergency response, disaster management, and infection control. The study targeted a minimum sample size of 500 participants, successfully garnering responses from 512 individuals. Results: Of the 512 participants, 59.9% (n=312) were healthcare providers in patient-facing roles, and 40.1% (n=209) were in non-patient-facing roles. The results revealed notable disparities in awareness and preparedness between these two groups. Healthcare providers demonstrated higher awareness levels compared to their non-patient-facing counterparts. For instance, 76.9% of healthcare providers were aware of the hospital's emergency response plan compared to 56.2% of non-healthcare providers (χ² = 52.165, p < 0.001). Similar disparities were observed in understanding the term "disaster" (86.5% vs 54.1%, χ² = 27.931, p < 0.001), and awareness of a command center (73.4% vs 45.2%, χ² = 42.934, p < 0.001). Discussion: These findings underscore the critical need for enhancing awareness, education, and preparedness within healthcare facilities, emphasizing an integrated approach that includes both healthcare and non-healthcare staff. By addressing these gaps, healthcare facilities can significantly improve their emergency response efficiency, disaster management capabilities, and infection control measures, thereby enhancing the overall safety and quality of patient care.

Factors Associated with Falls in Community-Dwelling Older Adults: A Subgroup Analysis from a Telemergency Service.

According to the number of falls, fallers can be single (only one fall) or recurrent (two or more falls), with different risk profiles for loss of independence and frailty. The presence of risk factors in community-dwelling single- and recurrent fallers using a wearable fall-detection device, such as the Personal Emergency Response System (PERS), as part of a telemergency service, is still unknown. This article evaluates how using a PERS, within a telemergency service, helps identify risk profiles and assessment of any differences between non-fallers and fallers in community-dwelling older adults. A sub-group analysis was performed, dividing users into non-fallers (n = 226) and fallers (≥1 fall; n = 89); single-fallers (n = 66) and recurrent fallers (n = 23). Median age was higher in fallers (87.7 years vs. 86), whereas recurrent fallers were less independent, had fewer comorbidities, and had more low-extremity disabilities. The use of the PERS for medical problems (Adjusted OR = 0.31), excluding falls, support calls (Adjusted OR = 0.26), and service demands (Adjusted OR = 0.30), was significantly associated with a fall risk reduction. The findings suggest that the integration within a telemergency service may impact on fall-risk factors.

"Leading through Crisis": A Systematic Review of Institutional Decision-Makers in Emergency Contexts.

This review aims to map studies on governmental and institutional decision-making processes in emergencies. The literature reveals various approaches used by governments in managing emergencies. Consequently, this article suggests the need for a systematic literature review to outline how institutional decision-makers operate during emergencies. To achieve this goal, the most widely used databases in psychological research were consulted, with a specific focus on selecting scientific articles. Subsequently, these studies were rigorously assessed for their relevance using a structured literature selection process following the PRISMA 2020 guidelines. At the conclusion of the review process, nine studies were identified, each suggesting different methods by which governments manage emergencies. This diversity arises because emergency decision-making processes must account for numerous variables that change depending on the type of crisis and the specific context. However, several critical aspects have emerged, such as the centrality of pre-disaster planning to improve intervention practices and methods, attention to information gaps that inevitably arise during an emergency, and the importance of streamlining and delegating decision-making to emergency responders in the field to counter the phenomenon of centralized decision-making that often hampers crucial interventions during emergencies.

Infection prevention and control: Qualitative study of the preparedness and response of Christian health Association of Ghana to Marburg virus disease in Ghana.

Objective: Recent disease outbreaks underscore the importance of robust disease surveillance and infection prevention and control (IPC) programmes to bolster Africa's public health response system. Yet, available evidence shows extensive gaps in the emergency response capacity of faith-based healthcare providers on the continent. Accordingly, this study examines the IPC and surveillance strategies adopted by a faith-based healthcare provider and the challenges encountered during Marburg Virus Disease outbreak (MVD) in Ghana. Method: We collected data from 15 clinical and nonclinical health workers from the Christian Health Association of Ghana (CHAG) and the Ghana Health Service (GHS). Data was collected through online interviews to examine two pillars of the WHO COVID-19 SPRP-AFR (2021) framework. We analyzed the data using Braun and Clarke's thematic analysis. Findings: The facility performed creditably well with contact tracing and other quarantine protocols during MVD outbreak in Ghana. However, it also encountered several challenges in the enforcement of IPC protocols, including human resource constraints, the lack of decontamination equipment, and limited infrastructure, among others. Given these limitations, we assessed that the facility cannot handle major outbreaks. Conclusion: Due to numerous infectious disease outbreaks in Sub-Saharan Africa in recent years, the government of Ghana and faith-based healthcare providers must resource their facilities with the relevant equipment and qualified human resources against future disease outbreaks.

Design and Evaluation of a Low-Power Wide-Area Network (LPWAN)-Based Emergency Response System for Individuals with Special Needs in Smart Buildings.

The Internet of Things (IoT) is a growing network of interconnected devices used in transportation, finance, public services, healthcare, smart cities, surveillance, and agriculture. IoT devices are increasingly integrated into mobile assets like trains, cars, and airplanes. Among the IoT components, wearable sensors are expected to reach three billion by 2050, becoming more common in smart environments like buildings, campuses, and healthcare facilities. A notable IoT application is the smart campus for educational purposes. Timely notifications are essential in critical scenarios. IoT devices gather and relay important information in real time to individuals with special needs via mobile applications and connected devices, aiding health-monitoring and decision-making. Ensuring IoT connectivity with end users requires long-range communication, low power consumption, and cost-effectiveness. The LPWAN is a promising technology for meeting these needs, offering a low cost, long range, and minimal power use. Despite their potential, mobile IoT and LPWANs in healthcare, especially for emergency response systems, have not received adequate research attention. Our study evaluated an LPWAN-based emergency response system for visually impaired individuals on the Hazara University campus in Mansehra, Pakistan. Experiments showed that the LPWAN technology is reliable, with 98% reliability, and suitable for implementing emergency response systems in smart campus environments.

The association between emotional and physical intimate partner violence and COVID-19 vaccine uptake in a community-based U.S. Cohort.

Objective: To estimate risk of being unvaccinated against COVID-19 by experience of intimate partner violence (IPV). Methods: Among 3,343 partnered individuals in a community-based U.S. cohort, we quantified emotional and physical IPV experienced between March and December 2020 and estimated risk of being unvaccinated against COVID-19 through June 2021 by experience of IPV. Experience of recent IPV was defined as endorsement of more frequent or severe IPV since the start of the pandemic or report of any past-month IPV in at least one of four follow-up surveys conducted by the end of December 2020. We created a three-level composite variable - no experience of IPV, experience of emotional but not physical IPV, and experience of physical IPV. Results: Cisgender women, non-binary, or transgender individuals who reported experiencing emotional, but not physical, IPV and those who reported experiencing physical IPV were both at significantly higher risk of being unvaccinated for COVID-19 compared to those who reported experiencing no IPV (ARRemotional violence: 1.28 [95 % CI: 1.09 - 1.51]; ARRphysical violence: 1.70 [95 % CI: 1.41 - 2.05]). Cisgender men who reported experiencing physical IPV were also at significantly higher risk of being unvaccinated for COVID-19 (ARRphysical violence: 1.52 [95 % CI: 1.15 - 2.02]). Conclusions: IPV may increase the risk of low vaccine uptake. Results highlight the need to incorporate IPV prevention and support into public health responses, with targeted resources and consideration for reducing barriers to public health interventions among those impacted.

A scoping review of behavioural science approaches and frameworks for health protection and emergency response.

AIMS: Rapid intervention development, implementation, and evaluation are required for emergency public health contexts, such as the recent COVID-19 pandemic. A novel Agile Co-production and Evaluation (ACE) framework has been developed to assist this endeavour in future public health emergencies. This scoping review aimed to map available behavioural science resources that can be used to develop and evaluate public health guidance, messaging, and interventions in emergency contexts onto components of ACE: rapid development and implementation, co-production with patients or the public including seldom heard voices from diverse communities, and inclusion of evaluation. METHODS: A scoping review methodology was used. Searches were run on MEDLINE, EMBASE, PsycINFO, and Google, with search terms covering emergency response and behavioural science. Articles published since 2014 and which discussed a framework or guidance for using behavioural science in response to a public health emergency were included. A narrative synthesis was conducted. RESULTS: Seventeen records were included in the synthesis. The records covered a range of emergency contexts, the most frequent of which were COVID-19 (n = 7) and non-specific emergencies (n = 4). One record evaluated existing approaches, 6 proposed new approaches, and 10 described existing approaches. Commonly used approaches included the Behavioural Change Wheel; Capability, Opportunity, and Motivation Behaviour model; and social identity theory. Three records discuss co-production with the target audience and consideration of diverse populations. Four records incorporate rapid testing, evaluation, or validation methods. Six records state that their approaches are designed to be implemented rapidly. No records cover all components of ACE. CONCLUSION: We recommend that future research explores how to create guidance involving rapid implementation, co-production with patients or the public including seldom heard voices from diverse communities, and evaluation.

Meeting medical emergency response criteria for hypertension is not associated with an increased likelihood of in-hospital mortality in a tertiary referral center.

Backgrounds: Rapid response team or medical emergency team (MET) calls are typically activated by significant alterations of vital signs in inpatients. However, the clinical significance of a specific criterion, blood pressure elevations, is uncertain. Objectives: The aim of this study was to evaluate the likelihood ratios associated with MET-activating vital signs, particularly in-patient hypertension, for predicting in-hospital mortality among general medicine inpatients who met MET criteria at any point during admission in a South Australian metropolitan teaching hospital. Results: Among the 15,734 admissions over a two-year period, 4282 (27.2%) met any MET criteria, with a positive likelihood ratio of 3.05 (95% CI 2.93 to 3.18) for in-hospital mortality. Individual MET criteria were significantly associated with in-hospital mortality, with the highest positive likelihood ratio for respiratory rate ≤ 7 breaths per minute (9.83, 95% CI 6.90 to 13.62), barring systolic pressure ≥ 200 mmHg (LR + 1.26, 95% CI 0.86 to 1.69). Conclusions: Our results show that meeting the MET criteria for hypertension, unlike other criteria, was not significant associated with in-hospital mortality. This observation warrants further research in other patient cohorts to determine whether blood pressure elevations should be routinely included in MET criteria.

Health Care Workers' Motivations for Enrolling in Massive Open Online Courses During a Public Health Emergency: Descriptive Analysis.

Background: Massive open online courses (MOOCs) are increasingly used to educate health care workers during public health emergencies. In early 2020, the World Health Organization (WHO) developed a series of MOOCs for COVID-19, introducing the disease and strategies to control its outbreak, with 6 courses specifically targeting health care workers as learners. In 2020, Stanford University also launched a MOOC designed to deliver accurate and timely education on COVID-19, equipping health care workers across the globe to provide health care safely and effectively to patients with the novel infectious disease. Although the use of MOOCs for just-in-time training has expanded during the pandemic, evidence is limited regarding the factors motivating health care workers to enroll in and complete courses, particularly in low-income countries (LICs) and lower-middle-income countries (LMICs). Objective: This study seeks to gain insights on the characteristics and motivations of learners turning to MOOCs for just-in-time training, to provide evidence that can better inform MOOC design to meet the needs of health care workers. We examine data from learners in 1 Stanford University and 6 WHO COVID-19 courses to identify (1) the characteristics of health care workers completing the courses and (2) the factors motivating them to enroll. Methods: We analyze (1) course registration data of the 49,098 health care workers who completed the 7 focal courses and (2) survey responses from 6272 course completers. The survey asked respondents to rank their motivations for enrollment and share feedback about their learning experience. We use descriptive statistics to compare responses by health care profession and by World Bank country income classification. Results: Health care workers completed the focal courses from all regions of the world, with nearly one-third (14,159/49,098, 28.84%) practicing in LICs and LMICs. Survey data revealed a diverse range of professional roles among the learners, including physicians (2171/6272, 34.61%); nurses (1599/6272, 25.49%); and other health care professionals such as allied health professionals, community health workers, paramedics, and pharmacists (2502/6272, 39.89%). Across all health care professions, the primary motivation to enroll was for personal learning to improve clinical practice. Continuing education credit was also an important motivator, particularly for nonphysicians and learners in LICs and LMICs. Course cost (3423/6272, 54.58%) and certification (4238/6272, 67.57%) were also important to a majority of learners. Conclusions: Our results demonstrate that a diverse range of health care professionals accessed MOOCs for just-in-time training during a public health emergency. Although all health care workers were motivated to improve their clinical practice, different factors were influential across professions and locations. These factors should be considered in MOOC design to meet the needs of health care workers, particularly those in lower-resource settings where alternative avenues for training may be limited.

Responding to the ripple effects of sexual harassment: an emergency management framework.

Sexual harassment in academia is endemic driven by gender-based inequalities and sustained through organizational tolerance, and its impact extends beyond the primary victim(s). Applying principles of emergency management provides a framework for institutions to balance their obligations to the primary victim(s) while also acknowledging the need to restore the well-being and culture of secondary victims.

Retrospective charts for reporting, analysing, and evaluating disaster emergency response: a systematic review.

OBJECTIVE: Given the frequency of disasters worldwide, there is growing demand for efficient and effective emergency responses. One challenge is to design suitable retrospective charts to enable knowledge to be gained from disasters. This study provides comprehensive understanding of published retrospective chart review templates for designing and updating retrospective research. METHODS: We conducted a systematic review and text analysis of peer-reviewed articles and grey literature on retrospective chart review templates for reporting, analysing, and evaluating emergency responses. The search was performed on PubMed, Cochrane, and Web of Science and pre-identified government and non-government organizational and professional association websites to find papers published before July 1, 2022. Items and categories were grouped and organised using visual text analysis. The study is registered in PROSPERO (374,928). RESULTS: Four index groups, 12 guidelines, and 14 report formats (or data collection templates) from 21 peer-reviewed articles and 9 grey literature papers were eligible. Retrospective tools were generally designed based on group consensus. One guideline and one report format were designed for the entire health system, 23 studies focused on emergency systems, while the others focused on hospitals. Five papers focused specific incident types, including chemical, biological, radiological, nuclear, mass burning, and mass paediatric casualties. Ten papers stated the location where the tools were used. The text analysis included 123 categories and 1210 specific items; large heterogeneity was observed. CONCLUSION: Existing retrospective chart review templates for emergency response are heterogeneous, varying in type, hierarchy, and theoretical basis. The design of comprehensive, standard, and practicable retrospective charts requires an emergency response paradigm, baseline for outcomes, robust information acquisition, and among-region cooperation.

Nurse-led medical emergency response reduces code blue team activations in non-hospitalized patients.

Objective: We describe the creation of a two-tier emergency response system with a nurse-led first responder program titled "MET-RN" (Medical Emergency Team-Registered Nurse) created for ambulatory settings supported by a critical care code blue team for escalation of care. This observational study evaluated the clinical characteristics and effects of a MET-RN program on the code blue response. Methods: A retrospective review of the MET-RN response data was assessed from January 2016 to June 2021. Data collected included time of call, call location, patient comorbidities, triage category (minor, urgent, or emergent), activation trigger, interventions performed, duration of the event, and patient disposition. In instances where the patient was admitted to the hospital, the discharge diagnosis and emergency department (ED) triage score were collected. Differences were tested using analysis of variance (ANOVA) F-tests, with Tukey post-hoc testing where applicable. Results: MET-RN responded to 6,564 encounters from January 2016 to June 2021. The most frequent trigger call was dizziness/lightheadedness, with a prevalence of 12.0%. 33.9% of the patients seen by MET-RN were transported to the ED for further evaluation. Establishing a MET-RN system led to an estimated median of 58.3% reduction in utilization of the code blue team per quarter. Conclusion: The creation of MET-RN first responder system enabled the ambulatory areas to receive minor, urgent, and emergent patient care support, leading to a decrease in utilization of the code blue team for the hospital. A two-tiered response system resulted in an improved allocation of hospital resources and kept critical care teams in high-acuity areas while maintaining patient safety.

The impact of the COVID-19 pandemic on people who use drugs in three Canadian cities: a cross-sectional analysis.

BACKGROUND: The COVID-19 pandemic had a disproportionate impact on the health and wellbeing of people who use drugs (PWUD) in Canada. However less is known about jurisdictional commonalities and differences in COVID-19 exposure and impacts of pandemic-related restrictions on competing health and social risks among PWUD living in large urban centres. METHODS: Between May 2020 and March 2021, leveraging infrastructure from ongoing cohorts of PWUD, we surveyed 1,025 participants from Vancouver (n = 640), Toronto (n = 158), and Montreal (n = 227), Canada to describe the impacts of pandemic-related restrictions on basic, health, and harm reduction needs. RESULTS: Among participants, awareness of COVID-19 protective measures was high; however, between 10 and 24% of participants in each city-specific sample reported being unable to self-isolate. Overall, 3-19% of participants reported experiencing homelessness after the onset of the pandemic, while 20-41% reported that they went hungry more often than usual. Furthermore, 8-33% of participants reported experiencing an overdose during the pandemic, though most indicated no change in overdose frequency compared the pre-pandemic period. Most participants receiving opioid agonist therapy in the past six months reported treatment continuity during the pandemic (87-93%), however, 32% and 22% of participants in Toronto and Montreal reported missing doses due to service disruptions. There were some reports of difficulty accessing supervised consumption sites in all three sites, and drug checking services in Vancouver. CONCLUSION: Findings suggest PWUD in Canada experienced difficulties meeting essential needs and accessing some harm reduction services during the COVID-19 pandemic. These findings can inform preparedness planning for future public health emergencies.

Reported Impact of COVID-19 Workload and Stressors on School Nurses' Provision of Care During the 2021-2022 School Year: A Secondary Analysis of U.S. School Nurse Survey Data.

Many school nurses experienced increased work burden and stress during the COVID-19 pandemic. This analysis examined data from a Centers for Disease Control and Prevention cross-sectional, nationwide survey of school nurses in March 2022 to examine associations between school nurses' ability to conduct their core responsibilities and selected nurse and school factors among school nurses during the 2021-2022 school year and COVID-19 pandemic. Perceived adequate staffing and financial compensation reduced the odds of reported difficulties across all core school nursing tasks. Nurses without a registered nurse license and with higher caseloads were more likely to report difficulty in implementing specific tasks. The impact of these factors varied, with inadequate financial compensation having the largest association with school nurses' difficulty implementing all the core responsibilities. The study results improve our understanding of school nurses' challenges in implementing core school nursing responsibilities during the COVID-19 pandemic in the 2021-2022 school year.

Quantitative blood loss measurement methods for early detection of primary postpartum haemorrhage following vaginal birth: A scoping review.

AIM: To map the commonly used quantitative blood loss measurement methods in clinical practice and provide a solid foundation for future studies. DESIGN AND METHOD: This study adhered to the JBI methodology for scoping reviews and preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews. We conducted a literature search using five databases to retrieve articles published between January 2012 and September 2022. The search was repeated on 29 February 2024. Data extraction and verification were carried out by two independent researchers using a self-designed data extraction form. RESULTS: Ultimately, 26 studies published between 2012 and 2024 were considered eligible for inclusion. Six categories of methods were identified from the 26 articles. Among the included studies, only two involved randomized controlled trials, with the majority being observational studies. The World Health Organization (2012) version of the postpartum haemorrhage diagnostic criteria was predominantly used in most studies. Gravimetric and volumetric methods emerged as the most commonly used methods for quantifying postpartum haemorrhages. The timing of blood collection was inconsistent among the included studies. Only 12 studies mentioned measures for the management of amniotic fluid. CONCLUSIONS: This scoping review supports the replacement of the visual estimation of blood loss with quantitative assessment methods. Supporting a specific assessment approach is not feasible due to the variability of the study. Future research should focus on establishing the best practices for specific quantitative methods to standardize the management of postpartum haemorrhage and reduce the incidence of postpartum haemorrhage-related adverse outcomes. RELEVANCE TO CLINICAL PRACTICE: Healthcare professionals need to acknowledge the low accuracy of visual estimation methods and implement quantitative methods to assess postpartum blood loss. Given the limitations inherent in each assessment method, quantification of blood loss should be combined with assessment of maternal vital signs, physiologic indicators and other factors.

Vaccine Trends in Pakistan: A Review of Immunization Challenges and Setbacks Prompted by Inadequate Disaster Management.

Pakistan bears an incredible burden of vaccine-preventable diseases, and efforts to improve widespread immunization have been hindered by inadequate public health management following disasters and other health emergencies. Through a brief review of Pakistan's health system, an understanding of routine immunization challenges is sought based on the organizational changes made to the planning and delivery of immunization activities. Further, recent immunization trends of measles, polio, and tuberculosis are examined in correspondence to health emergencies prompted by climate change and the COVID-19 pandemic. The national public health response to each disease is discussed, and insight is given to how the devolution of Pakistan's health system may have influenced the severity of each emergency. Focus is given to the potential immunization challenges and how they may impact future initiatives for the control of vaccine-preventable diseases. Although incidence rates suggest increased cases of certain vaccine-preventable diseases and disruptions of immunization activities following recent disasters, further studies may need to be conducted to establish a stronger understanding of the immunization trends noted within this review.

Long-acting reversible contraception use and unmet desire among patients after the Zika Contraception Access Network Program in Puerto Rico.

OBJECTIVES: To describe unmet desire for long-acting reversible contraception (LARC) after the Zika Contraception Access Network (Z-CAN) in Puerto Rico during the 2016-2017 Zika outbreak. STUDY DESIGN: Z-CAN patients completed surveys about contraception experiences over a 3-year period. RESULTS: Of 1809 respondents, 3% never used LARC but reported wanting it since their initial visit. As reasons for not getting LARC, nearly 50% indicated a provider-related reason and 25% reported cost. CONCLUSIONS: Few Z-CAN patients who never used LARC had unmet desire. Provider training in contraception guidelines and strategies to address costs can expand access to the full range of reversible contraception. IMPLICATIONS: Three years after a short-term program provided reversible contraception in Puerto Rico, few respondents had never used but wanted a long-acting reversible contraception method. Nearly half reported provider-related reasons for not receiving long-acting reversible contraception, and 25% reported cost. Provider awareness of contraceptive guidance and method availability can support client-centered care.

A multi-criteria simulation-optimization coupling approach for effective emergency response in marine oil spill accidents.

Effective marine oil spill responses are vital to reduce environmental, societal, and economic damage. This study developed a Multi-Criteria Emergency Response System (MC-ERS) to comprehensively evaluate response efficiency, operational costs, and environmental losses. The proposed system integrates dynamic multiphase simulation of oil weathering and oil cleanup processes and further provides effective planning for multi-stage resource allocation through system optimization. The developed weight-sum model improved the performance of response operations by reducing the complexity of multi-criteria decision-making. Particle Swarm Optimization (PSO) was chosen as the foundational optimization algorithm due to its efficiency in rapid convergence and suitability for complex problems. From extensive comparisons of PSO variants across benchmark functions and inertia strategies, the C-PSO algorithm was developed, demonstrating enhanced optimization performance for MC-ERS. The developed modelling system performance was demonstrated and evaluated through a representative case study. The optimization plan coordinated resource allocation from onshore warehouses to harbors and spill sites, balancing oil recovery efficiency, costs, and ecological losses. Optimized results indicate an oil recovery of up to 76.50% in five days. Additionally, the system cuts costs by 3.45% and environmental losses by 15.75%. The findings enhance the efficiency of marine oil spill emergency response and provide support for such incidents.

Communication in disasters to support families with children with medical complexity and special healthcare needs: a rapid scoping review.

Disasters can disrupt normal healthcare processes, with serious effects on children who depend upon regular access to the health care system. Children with medical complexity (CMC) are especially at risk. These children have chronic medical conditions, and may depend on medical technology, like feeding tubes. Without clear, evidence-based processes to connect with healthcare teams, families may struggle to access the services and supports they need during disasters. There is limited research about this topic, which has been pushed forward in importance as a result of the COVID-19 pandemic. The authors therefore conducted a rapid scoping review on this topic, with the intention to inform policy processes. Both the peer-reviewed and gray literatures on disaster, CMC, and communication were searched in summer 2020 and spring 2021. Twenty six relevant articles were identified, from which four main themes were extracted: 1. Cooperative and collaborative planning. 2. Proactive outreach, engagement, and response. 3. Use of existing social networks to connect with families. 4. Return to usual routines. Based on this review, good practices appear to involve including families, professionals, other stakeholders, and children themselves in pre-disaster planning; service providers using proactive outreach at the outset of a crisis event; working with existing peer and neighborhood networks for support; employing multiple and two-way communication channels, including social media, to connect with families; re-establishing care processes as soon as possible, which may include virtual connections; addressing mental health issues as well as physical functioning; and prioritizing the resumption of daily routines. Above all, a well-established and ongoing relationship among children, their caregivers, and healthcare teams could reduce disruptions when disaster strikes.

Emergency preparedness and response sensitive of migrant populations in Chile: post-pandemic perspectives. / Preparación y respuesta ante emergencias sensibles a poblaciones migrantes en Chile: perspectivas postpandémicas.

On August 31, 2023, the Chilean government ended the health alert for COVID-19. This milestone invites us to reflect on lessons learned in emergency preparedness and response regarding migrant populations in the country. In this context, three perspectives are presented. The first focuses on avoiding pointing to individual responsibility for non-compliance with prevention measures, as this approach ignores structural and historical inequities. Emergency recommendations should be constructed considering a collective approach and diverse sociocultural and political contexts. The second perspective calls for considering and addressing migration as a social determinant of health. During the pandemic, changes in the governance of migration around the world made migration processes more precarious, with risks to the physical and mental health of migrants, which needs better planning and evidence-based decision-making in future pandemics. The third perspective focuses on promoting intercultural health, as effective communication of contagion risks and preventive measures were hampered among migrant populations with diverse worldviews and interpretations of health and disease processes. Responding to the needs of historically marginalized communities requires establishing ways of life that respect diversity in narratives and everyday practices. Governments and health systems must incorporate migration into their emergency preparedness and response strategies, creating the conditions for optimal compliance.

El 31 de agosto de 2023, el Gobierno de Chile puso fin a la alerta sanitaria por COVID-19. Este hito invita a reflexionar sobre lecciones aprendidas respecto a la preparación y respuesta ante emergencias, que sean sensibles e informadas sobre la experiencia de la población migrante de nuestro país. En este marco, se presentan tres perspectivas. La primera se centra en evitar la responsabilización individual en el incumplimiento de las medidas de prevención del contagio, ya que este enfoque ignora las inequidades estructurales e históricas. Las recomendaciones de emergencia se deben construir bajo un abordaje colectivo y con la consideración de los diversos contextos socioculturales y políticos. La segunda perspectiva llama a tomar en cuenta y abordar la migración como determinante social de la salud de la población en la preparación y respuesta ante emergencias. Durante la pandemia, los cambios en la gobernanza de la migración en todo el mundo precarizaron los procesos migratorios, con riesgos para la salud física y mental de las personas que migran. Esto requiere una mejor planificación y decisiones informadas en evidencia científica para futuras pandemias. La tercera perspectiva se enfoca en promover la interculturalidad, dado que la comunicación de los riesgos de contagio y de las medidas preventivas se vio dificultada entre poblaciones migrantes con diversas cosmovisiones e interpretaciones de los procesos de salud y enfermedad. Asimismo, el responder a las necesidades de aquellas comunidades históricamente marginadas, requiere establecer modos de vida que respeten la diversidad en las narrativas y las prácticas cotidianas. Los gobiernos y sistemas sanitarios deben incorporar la migración a sus estrategias de preparación y respuesta ante emergencias, con la construcción de las condiciones para su cumplimiento óptimo.