BACKGROUND: Children are a particularly vulnerable group in natural disasters such as earthquakes, and although they represent a difficult group to research in such situations, there appears to be a lack of literature investigating children\'s experiences in the immediate post-earthquake period. Experienced nurses can shed light on children\'s experiences.
OBJECTIVE: This study was conducted to examine the experiences of nurses caring for children affected by the earthquake in Kahramanmaraş, Turkey.
METHODS: This phenomenological study was conducted with nurses who provided care to children during the Kahramanmaraş earthquake between May and August 2023. The study sample consisted of 14 nurses selected using a purposive sampling technique. Data were collected through in-depth interviews by using the \"Introductory Information Form\" and \"Semi-structured Interview Form\" developed by the researchers. The interviews were subsequently analyzed using Colaizzi\'s method.
RESULTS: The results revealed five themes under two main themes. Under the main theme of nurse, there are subthemes of chaos, helplessness-incompetence, while under the main theme of child, there are subthemes of unresponsiveness, intertwined needs, empathy, and care. The study also highlights the chaotic environment in the immediate aftermath of the earthquake, characterized by a high number of pediatric casualties and psychological trauma, and the nurses\' feelings of helplessness as a result of being separated from their families.
CONCLUSIONS: This study found that nurses caring for children in the earthquake had difficulties in managing children\'s hospital processes and they demonstrated an empathic approach by trying to communicate with the children in their care. The nurses stated that children should be supported psychologically as well as having their basic needs such as water, food, and shelter met.
CONCLUSIONS: Health policymakers should be aware that in the early stages of major disasters such as earthquakes, children are not only physically injured but also have basic needs such as water, shelter, and food, and are emotionally affected. It is recommended that disaster management plans be developed to address all children\'s needs and nurses be provided with psychological support and training to improve their knowledge and skills.

UNASSIGNED: Transnational drug trafficking, political unrest, gang violence, and paramilitarism, which are pervasive in Haiti, have resulted in a mental health crisis for the broader Haitian community. This study explores the mental well-being of Haitians in Haiti and the United States by identifying barriers and facilitators to mental health through the lived experiences of men and women.
UNASSIGNED: Four Focus group discussions conducted in April and November 2023 engaged 28 participants (20 women and eight men) aged between 23 and 60 years from locations in Haiti (Port-au-Prince, Cite Soleil, Cayes, Cap-Haitien, Saint-Marc) and the United States. Discussions revolved around the definition of mental health, stressors, coping mechanisms, risk and protective factors, and barriers to mental health care.
UNASSIGNED: Six principal themes emerged: 1- Chronic Traumatic Stress: continued violence, political instability, unemployment, lack of social support, adverse childhood experiences, family separation, and forced displacement were significant sources of stress. 2- Increased Health Burden: Participants reported experiencing chronic physical and psychological symptoms (i.e., hypertension, anxiety, depression, sleep issues, substance abuse, suicidal ideations, characteristics of post-traumatic stress disorder [PTSD]), which were attributed to Haiti\'s social, political, and infrastructure collapse. 3- Risk Factors: limited access to mental health services, pervasive hopelessness, scarcity of opportunities, and stigma were identified as significant risks. 4- Future Uncertainty: widespread concerns regarding the future predominated. 5- Multigenerational Concerns: Significant anxiety concerning the mental health and development of children, as well as the functionality of mental health practitioners, was noted. 6- Coping and Protective Factors: Effective coping strategies include mental stimulation, peer support, managing digital consumption, engaging in leisurely activities, such as listening to music, and faith/spirituality.
UNASSIGNED: The study\'s findings underscore the sociopolitical and economic crisis in Haiti, which has resulted in violence and a collapse of political, educational, financial, and health infrastructures. These factors were identified as the primary source of chronic distress, contributing to widespread mental health issues, adverse physical symptoms, and disruption in daily life. The implications for practice, healing, research & policy are discussed.

The frequent occurrence of disasters because of Indonesia\'s geographical location within the Ring of Fire calls for effective disaster-management efforts. With the issuance of Law No. 24 of 2007 on Disaster Management, the Indonesian National Disaster Management Agency (Badan Nasional Penanggulangan Bencana or BNPB) was subsequently established. Keeping in mind previous disasters in Indonesia which occur in different regions, that is, Palu and Aceh Tsunami, Cianjur earthquake, and Mount Merapi, Indonesia\'s disaster-management law is general and lacks technical guidelines in addressing the needs of the various regions and the different contours of geography. This article aims to analyse existing Indonesian regulatory and agency problems in disaster management by conducting a normative and comparative approach between the disaster management policy in the United States of America (USA) and Indonesia. The authors chose the USA\'s disaster-management policy in particular as most comparative studies on disaster management law do not involve the USA despite the State\'s ability to provide a comprehensive and consistent policy in the midst of the decentralisation of responsibilities with the numerous states. The authors conclude that according to existing disaster-management laws in USA and Indonesia, the government is obligated to fulfil its citizens\' rights in the event of natural disasters. Furthermore, noting the issues that exist within the Indonesian disaster-management system, Indonesia can adopt the best practices of the USA to improve its disaster-management system. Among others, Indonesia can learn from the USA in the fields of accountability and transparency amongst agencies, the development of Early Warning Systems, an improved system of interagency cooperation, as well as the provision of specific disaster-management assistance.
UNASSIGNED: The findings of this study are expected to serve as evaluation material and to improve government effectiveness in dealing with natural disasters.

UNASSIGNED: Disaster management is an ongoing international concern, and nurses play essential roles in minimizing negative impacts on the health of communities. However, many nurses have limited knowledge and skills on how to respond to disasters effectively. Therefore, this study was conducted to determine the effectiveness of a newly developed educational program on improving nurses\' disaster management and preparedness.
UNASSIGNED: A quasi-experimental study was conducted on 88 nurses working at a public hospital. The educational program included six modules covering various aspects of disaster management. Pre-and post-tests were administered to evaluate changes in perceptions of disaster management competencies. Independent sample t-test, Pearson coefficient correlation, and One-way ANOVA tests were all run using SPSS.
UNASSIGNED: A significant proportion of nurses (78.4%) reported ongoing training in disaster management, while a smaller percentage (21.6%) expressed a contrary opinion. Nurses also had a moderate level of agreement with the disaster preparedness program (Pretest: 2.26 ± 0.34; post-test: 2.29 ± 0.31). Further, the results showed small improvements in nursing perceptions of the operational plan after the educational program (Pretest: M=2.76, SD=0.63; Post-test: M=2.89, SD=0.44), although the differences between pre-and-post assessments were not significant (P > 0.05). The mean values for overall familiarity in the pre-test were 3.16 ± 1.39, while in the post-test, they slightly increased to 3.26 ± 1.18. The findings also showed no statistically significant differences reported in nurses\' attitudes and familiarity towards disaster preparedness based on the gender, marital status, nationality, working shifts, and working hours variables (P > 0.05).
UNASSIGNED: This study demonstrated the significance of providing nurses with the essential knowledge that helps respond to disasters. Online educational programs can help improve nurses\' preparedness to better manage disasters. Future research should investigate additional variables that could enhance nurses\' knowledge and skills related to disaster response.

In the event of a mass casualty incident (MCI), the situation-related shortage of medical resources does not end when the patients are transported from the scene of the incident. Consequently, an initial triage is required in the receiving hospitals. In the first step, the aim of this study was to create a reference patient vignette set with defined triage categories. This allowed a computer-aided evaluation of the diagnostic quality of triage algorithms for MCI situations in the second step.
A total of 250 case vignettes validated in practice were entered into a multistage evaluation process by initially 6 and later 36 triage experts. This algorithm-independent expert evaluation of all vignettes-served as the gold standard for analyzing the diagnostic quality of the following triage algorithms: Manchester triage system (MTS module MCI), emergency severity index (ESI), Berlin triage algorithm (BER), the prehospital algorithms PRIOR and mSTaRT, and two project algorithms from a cooperation between the Federal Office of Civil Protection and Disaster Assistance (BBK) and the Hashemite Kingdom of Jordan-intrahospital Jordanian-German project algorithm (JorD) and prehospital triage algorithm (PETRA). Each patient vignette underwent computerized triage through all specified algorithms to obtain comparative test quality outcomes.
Of the original 250 vignettes, a triage reference database of 210 patient vignettes was validated independently of the algorithms. These formed the gold standard for comparison of the triage algorithms analyzed. Sensitivities for intrahospital detection of patients in triage category T1 ranged from 1.0 (BER, JorD, PRIOR) to 0.57 (MCI module MTS). Specificities ranged from 0.99 (MTS and PETRA) to 0.67 (PRIOR). Considering Youden\'s index, BER (0.89) and JorD (0.88) had the best overall performance for detecting patients in triage category T1. Overtriage was most likely with PRIOR, and undertriage with the MCI module of MTS. Up to a decision for category T1, the algorithms require the following numbers of steps given as the median and interquartile range (IQR): ESI 1 (1-2), JorD 1 (1-4), PRIOR 3 (2-4), BER 3 (2-6), mSTaRT 3 (3-5), MTS 4 (4-5) and PETRA 6 (6-8). For the T2 and T3 categories the number of steps until a decision and the test quality of the algorithms are positively interrelated.
In the present study, transferability of preclinical algorithm-based primary triage results to clinical algorithm-based secondary triage results was demonstrated. The highest diagnostic quality for secondary triage was provided by the Berlin triage algorithm, followed by the Jordanian-German project algorithm for hospitals, which, however, also require the most algorithm steps until a decision.
HINTERGRUND: Die situationsbedingte Verknappung medizinischer Ressourcen endet bei einem Massenanfall von Verletzen (MANV) lageabhängig nicht mit dem Abtransport der Patienten von der Einsatzstelle. Folglich ist in den aufnehmenden Kliniken eine Eingangssichtung erforderlich. Ziel dieser Studie war es im ersten Schritt einen Referenz‐Patientenvignettensatz mit definierten Sichtungskategorien zu erstellen. Dies erlaubte im zweiten Schritt, die rechnergestützte Evaluation der diagnostischen Güte klinischer Sichtungsalgorithmen für MANV-Lagen.
In einen mehrstufigen Bewertungsprozess durch zunächst sechs, später 36 Sichtungsexperten gingen 250 in der Übungspraxis validierte Fallvignetten ein. Diese Algorithmen – unabhängige Expertenbewertung aller Vignetten – dienten als Goldstandard für die Analyse der diagnostischen Güte der folgenden innerklinischen Algorithmen: Manchester Triage System (MTS Modul MANV), Emergency severity Index (ESI), Berliner Sichtungsalgorithmus (BER), die prähospitalen Algorithmen PRIOR und mSTaRT, sowie zwei Projektalgorithmen aus einer Kooperation des Bundesamts für Bevölkerungsschutz und Katastrophenhilfe (BBK) mit dem Haschemitischen Königreich Jordanien – innerklinischer jordanisch-deutscher Projektalgorithmus (JorD) und prähospitaler Sichtungsalgorithmus (PETRA). Jede Patientenvignette durchlief computergestützt eine Sichtung durch alle angegeben Algorithmen, um vergleichend die Testgüte für alle Verfahren zu erheben.
Von den ursprünglich 250 Vignetten konnte eine Sichtungsreferenzdatenbank mit 210 Patientenvignetten algorithmenunabhängig validiert werden. Diese bildeten den Goldstandard für den Vergleich der analysierten Sichtungsalgorithmen. Die Sensitivitäten für die innerklinische Detektion von Patienten der Sichtungskategorie I lagen zwischen 1,0 (BER, JorD, PRIOR) und 0,57 (MANV-Modul MTS). Die Spezifitäten lagen zwischen 0,99 (MTS und PETRA) und 0,67 (PRIOR). Gemessen am Youden-Index ergab sich bei BER (0,89) und JorD (0,88) die beste Gesamtperformance für die Detektion von Patienten der Sichtungskategorie I. Eine Übertriage ist am ehesten bei PRIOR, eine Untertriage beim MANV-Modul von MTS zu erwarten. Bis zum Entscheid SK I benötigen die Algorithmen folgende Schrittanzahlen (Median [IQR]): ESI 1 [1–2]; JorD 1 [1–4]; PRIOR 3 [2–4]; BER 3 [2–6]; mSTaRT 3 [3–5]; MTS 4 [4–5]; PETRA 6 [6–8]. Für die SK II und III besteht ein positiver Zusammenhang zwischen der Schrittanzahl bis zum Entscheid und der Testgüte.
In der vorliegenden Studie konnte eine Übertragbarkeit prähospitaler algorithmenbasierter Vorsichtungsergebnisse auf die Ergebnisse klinischer Algorithmen gezeigt werden. Die höchste diagnostische Güte für die innerklinischen Sichtung lieferten BER und JorD, die allerdings auch die meisten Algorithmusschritte bis zum Entscheid benötigen.

In the event of a mass casualty incident (MCI), the situation-related shortage of medical resources does not end when the patients are transported from the scene of the incident. Consequently, an initial triage is required in the receiving hospitals. In the first step, the aim of this study was to create a reference patient vignette set with defined triage categories. This allowed a computer-aided evaluation of the diagnostic quality of triage algorithms for MCI situations in the second step.
A total of 250 case vignettes validated in practice were entered into a multistage evaluation process by initially 6 and later 36 triage experts. This algorithm-independent expert evaluation of all vignettes-served as the gold standard for analyzing the diagnostic quality of the following triage algorithms: Manchester triage system (MTS module MCI), emergency severity index (ESI), Berlin triage algorithm (BER), the prehospital algorithms PRIOR and mSTaRT, and two project algorithms from a cooperation between the Federal Office of Civil Protection and Disaster Assistance (BBK) and the Hashemite Kingdom of Jordan-intrahospital Jordanian-German project algorithm (JorD) and prehospital triage algorithm (PETRA). Each patient vignette underwent computerized triage through all specified algorithms to obtain comparative test quality outcomes.
Of the original 250 vignettes, a triage reference database of 210 patient vignettes was validated independently of the algorithms. These formed the gold standard for comparison of the triage algorithms analyzed. Sensitivities for intrahospital detection of patients in triage category T1 ranged from 1.0 (BER, JorD, PRIOR) to 0.57 (MCI module MTS). Specificities ranged from 0.99 (MTS and PETRA) to 0.67 (PRIOR). Considering Youden\'s index, BER (0.89) and JorD (0.88) had the best overall performance for detecting patients in triage category T1. Overtriage was most likely with PRIOR, and undertriage with the MCI module of MTS. Up to a decision for category T1, the algorithms require the following numbers of steps given as the median and interquartile range (IQR): ESI 1 (1-2), JorD 1 (1-4), PRIOR 3 (2-4), BER 3 (2-6), mSTaRT 3 (3-5), MTS 4 (4-5) and PETRA 6 (6-8). For the T2 and T3 categories the number of steps until a decision and the test quality of the algorithms are positively interrelated.
In the present study, transferability of preclinical algorithm-based primary triage results to clinical algorithm-based secondary triage results was demonstrated. The highest diagnostic quality for secondary triage was provided by the Berlin triage algorithm, followed by the Jordanian-German project algorithm for hospitals, which, however, also require the most algorithm steps until a decision.
HINTERGRUND: Die situationsbedingte Verknappung medizinischer Ressourcen endet bei einem Massenanfall von Verletzen (MANV) lageabhängig nicht mit dem Abtransport der Patienten von der Einsatzstelle. Folglich ist in den aufnehmenden Kliniken eine Eingangssichtung erforderlich. Ziel dieser Studie war es im ersten Schritt einen Referenz‐Patientenvignettensatz mit definierten Sichtungskategorien zu erstellen. Dies erlaubte im zweiten Schritt, die rechnergestützte Evaluation der diagnostischen Güte klinischer Sichtungsalgorithmen für MANV-Lagen.
In einen mehrstufigen Bewertungsprozess durch zunächst sechs, später 36 Sichtungsexperten gingen 250 in der Übungspraxis validierte Fallvignetten ein. Diese Algorithmen – unabhängige Expertenbewertung aller Vignetten – dienten als Goldstandard für die Analyse der diagnostischen Güte der folgenden innerklinischen Algorithmen: Manchester Triage System (MTS Modul MANV), Emergency severity Index (ESI), Berliner Sichtungsalgorithmus (BER), die prähospitalen Algorithmen PRIOR und mSTaRT, sowie zwei Projektalgorithmen aus einer Kooperation des Bundesamts für Bevölkerungsschutz und Katastrophenhilfe (BBK) mit dem Haschemitischen Königreich Jordanien – innerklinischer jordanisch-deutscher Projektalgorithmus (JorD) und prähospitaler Sichtungsalgorithmus (PETRA). Jede Patientenvignette durchlief computergestützt eine Sichtung durch alle angegeben Algorithmen, um vergleichend die Testgüte für alle Verfahren zu erheben.
Von den ursprünglich 250 Vignetten konnte eine Sichtungsreferenzdatenbank mit 210 Patientenvignetten algorithmenunabhängig validiert werden. Diese bildeten den Goldstandard für den Vergleich der analysierten Sichtungsalgorithmen. Die Sensitivitäten für die innerklinische Detektion von Patienten der Sichtungskategorie I lagen zwischen 1,0 (BER, JorD, PRIOR) und 0,57 (MANV-Modul MTS). Die Spezifitäten lagen zwischen 0,99 (MTS und PETRA) und 0,67 (PRIOR). Gemessen am Youden-Index ergab sich bei BER (0,89) und JorD (0,88) die beste Gesamtperformance für die Detektion von Patienten der Sichtungskategorie I. Eine Übertriage ist am ehesten bei PRIOR, eine Untertriage beim MANV-Modul von MTS zu erwarten. Bis zum Entscheid SK I benötigen die Algorithmen folgende Schrittanzahlen (Median [IQR]): ESI 1 [1–2]; JorD 1 [1–4]; PRIOR 3 [2–4]; BER 3 [2–6]; mSTaRT 3 [3–5]; MTS 4 [4–5]; PETRA 6 [6–8]. Für die SK II und III besteht ein positiver Zusammenhang zwischen der Schrittanzahl bis zum Entscheid und der Testgüte.
In der vorliegenden Studie konnte eine Übertragbarkeit prähospitaler algorithmenbasierter Vorsichtungsergebnisse auf die Ergebnisse klinischer Algorithmen gezeigt werden. Die höchste diagnostische Güte für die innerklinischen Sichtung lieferten BER und JorD, die allerdings auch die meisten Algorithmusschritte bis zum Entscheid benötigen.

This study explores the opinions of academic and practicing pharmacists about ways to prepare pharmacy students for disaster management to enable them to optimize their role in disaster health management.
Semi-structured individual interviews were conducted for data collection from April through June 2021. The research participants were 9 pharmacists who were involved in disaster management. The interview guide was developed following a comprehensive literature review on disaster management. Data were analyzed using thematic analysis.
The main themes identified are knowledge of health and disaster management, specific skills in disaster management, positive attitudes toward involvement in disaster management, and appropriate behavior in the face of a disaster, as well as personal readiness and training to achieve competence and readiness. Participants mentioned that special training in soft skills, especially communication and problem-solving, is essential for students.
Disaster-specific competencies and personal readiness through training can prepare pharmacy students for disaster management. Soft skills such as communication and problem-solving must be the highest priority.

OBJECTIVE: This study aimed to determine nurses\' views of their competence in disaster nursing management.
BACKGROUND: It is an important responsibility of nurses to have the necessary knowledge and skills for the management of disasters and to be prepared for disasters. For this responsibility to be effectively demonstrated, it is important to determine the disaster management competencies of the nurses.
METHODS: A descriptive, cross-sectional, and comparative research design was used in this study. The study population consisted of all nurses in Turkey (N = 227 292). According to the power analysis, the goal was to recruit 599 nurses working between March and April 2021 using a simple random sampling method. However, 530 nurses answered the questionnaire. The response rate is 88.5%. Data were collected online using a sociodemographic characteristics questionnaire and the Competencies for Disaster Nursing Management Questionnaire. The data were analyzed using the Statistical Package for Social Sciences at a significance level of 0.05.
RESULTS: There was a positive correlation between nurses\' duties and responsibilities in disaster management, barriers to developing basic competencies, and nurses\' basic competencies in disaster management (p < 0.001). Nurses have inadequate competencies in disaster management for various reasons. The study was reported with the STROBE checklist.
CONCLUSIONS: Although nurses think they have core competencies, they are not prepared for disasters for various reasons.
CONCLUSIONS: Hospitals should provide nurses with more duties and responsibilities regarding disaster management. Administrators should involve nurses in plans, decisions, and practices regarding disaster management. Decision-makers should develop policies and training programs to remove the barriers preventing nurses from acquiring competencies.

UNASSIGNED: In case of a CBRNE catastrophe, junior doctors (first responders) will be the first to respond to the CBRNE disaster, so they should be fully equipped with the knowledge and skills of managing CBRNE casualties and preventing the endangerment of lives.
UNASSIGNED: To assess the awareness and preparedness of first responders in medical institutions regarding CBRNE casualties\' management and to explore the perceptions of first responders towards CBRNE disaster management.
UNASSIGNED: The present study was a mixed methods study which was conducted during the months of January to March 2020 among 153 study participants. Focus group discussions (FGDs) were conducted along with free listing and pile sorting till data saturation. Data entry was done in an Excel sheet and data analysis was be done using SPSS software v. 21.
UNASSIGNED: Out of the 153 participants only 37 participants (24.1%) had ever heard about the term \"CBRNE\" (chemical, biological, radiological and nuclear disasters) or \"hazmat\" (hazardous material). At the end of FGDs, participants could answer affirmatively that they had heard the term \"decontamination\" of CBRNE casualties. Very few participants could ambiguously explain the meaning of the term \"decontamination\" in the context of CBRNE casualty.
UNASSIGNED: There is an imperative need for enhancing not only knowledge and awareness, but also proper training for first responders to utilizing simulation sessions. This is particularly important as health care professionals are the first line of defence when it comes to identifying and treating patients that have come into contact with CBRNE hazards.

This paper aims to grasp developments and trends in research on information communication, information seeking and information sharing in disasters during 2000-2021. By using bibliometrics software CiteSpace and VOSviewer, the development trends of publications, disciplinary, journals, institutions and regional cooperation are mapped. Keyword co-occurrence analysis is used to further identify the evolution of the research hot points and visualize the research orientation and frontier. The results indicate that the field of information communication in disasters has received growing attention from various disciplines. Results of institutions and regional cooperation show that worldwide cooperation is still lacking and needs to be strengthened in future studies in this field. The key findings are five main research orientations in this field based on keyword co-occurrence, which are public information coordination research, public information behavior and perception research, health information communication research, risk communication and social media research and information technology in emergency management. The findings of this paper can be helpful for academics and emergency managers in disaster information management and risk communication by giving them a comprehensive understanding of people\'s information communication, seeking and sharing.