UNASSIGNED: In areas with limited resources, the lack of preparedness and limited availability of diabetes mellitus services in healthcare facilities contribute to high rates of illness and death related to diabetes mellitus. As a result, this study focused on analyzing the combined prevalence of preparedness and availability of diabetic services in countries with limited resources.
UNASSIGNED: A comprehensive search was conducted across various databases, such as PubMed/MEDLINE, Web of Science, Google Scholar, and African Journal Online. The search aimed to identify primary research articles that assessed the availability and preparedness of services for individuals with type 2 diabetes mellitus specifically. The articles included in the search spanned from January 2000 to 23 February 2024. To analyze the data, a meta-analysis of proportions was performed using the random-effects model. Additionally, the researchers assessed publication bias by examining a funnel plot and conducting Egger\'s test. Heterogeneity and sensitivity analyses were also conducted to evaluate the data. The findings of the study regarding the pooled prevalence of diabetes service preparedness and availability, along with their corresponding 95% confidence intervals, were presented using a forest plot.
UNASSIGNED: A comprehensive analysis was conducted on 16 research articles that focused on service preparedness and 11 articles that examined service availability. The sample sizes for these studies were 3,422 for service preparedness and 1,062 for service availability. The findings showed that the pooled prevalence of diabetes service preparedness was 53.0% (95% CI: 47.0-60.0). Furthermore, in this systematic synthesis, the overall pooled prevalence of service availability for diabetes mellitus was 48% (95% CI: 36.0-67.0), with the highest pooled prevalence observed in Asia, with a pooled prevalence of 58% (95% CI: 38.0-89.0).
UNASSIGNED: Our study reveals a significant disparity in the preparedness and availability of services for diabetes mellitus, which falls below the minimum threshold set by the WHO. These findings should capture the attention of policymakers and potentially serve as a foundation for reevaluating the current approach to diabetes service preparedness and availability. To enhance the availability and preparedness of diabetes services, a tailored, multifaceted, and action-oriented approach to strengthening the health system is required.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/, identifier CRD42024554911.

OBJECTIVE: To investigate the current situation of emergency preparation and emergency drill in the CSSD, and analyze its influence on the nurses\' emergency attitude and ability.
METHODS: This study employed a multicenter stratified sampling method, conducted from January to June 2023 using the online survey, participants completed the general data, emergency preparedness and drill questionnaire, public health emergency response questionnaire and emergency capacity scale. An independent samples t test or Kruskal-Wallis test was used to analyse differences in nurses\' emergency capacity and attitudes.
RESULTS: The data from 15 provinces 55 hospitals in China. Overall, 77.58% of participants\' institutions set up emergency management teams, 85.45% have an emergency plan and revise it regularly. 92.12% store emergency supplies. All survey staff participated in the emergency drill, which predominantly consisted of individual drills (51.52%), with 90.30% being real combat drills, 49.09% of participants engaging in drills every quarter, and 91.52% of the drill\'s participants exceeding 50%. The respondents\' emergency attitude score was (29.346 ± 6.029), their emergency ability score was (63.594 ± 10.413), and those with rescue experience showed a more positive attitude (Z = -2.316, P = 0.021). Different titles, education levels, rescue experience and the frequency of emergency drill affected the emergency rescue ability of the respondents (P < 0.05).
CONCLUSIONS: Most medical institutions establish emergency management systems and plans, yet the content lacks geographical specificity.The duration and participation of emergency drills are high, but the effectiveness of the drills needs to be further improved, and the response capacity and attitudes of CSSD nurses are low. It is recommended that agencies develop comprehensive and targeted contingency plans to strengthen the inspection and evaluation of team strength, equipment and safeguards against the contingency plans, so as to ensure that the measures mandated by the contingency plans can be implemented promptly after the emergency response is initiated.

BACKGROUND: COVID-19 has demonstrated the importance of competent staff with expertise in public health emergency preparedness and response in the civil aviation system. The civil aviation system is a critical sentinel and checkpoint to prevent imported cases and slow the spread of communicable diseases. Understanding the current competencies of staff to deal with public health emergencies will help government agencies develop targeted training and evidence-based policies to improve their public health preparedness and response capabilities.
METHODS: This cross-sectional pilot study was conducted from November 2022 to October 2023, involving 118 staff members from various positions within China\'s civil aviation system. A 59-item questionnaire was translated and developed according to a competency profile. Data were collected using the self-report questionnaire to measure the workforce\'s self-perceptions of knowledge and skills associated with public health emergency proficiency, categorized into (1) general competency, (2) preparedness competency, (3) response competency, and (4) recovery competency. KMO & Bartlett test and Cronbach\'s α reliability analysis were used to test the reliability and validity of the questionnaire. Descriptive statistics, independent sample T-test, ANOVA, and linear regression models were performed to analyze the competencies.
RESULTS: A total of 107 staff members from the aviation system were surveyed in this study. The KMO & Bartlett test, (KMO = 0.919, P < 0.001) and Cronbach\'s α coefficients (α = 0.985) for this questionnaire were acceptable. The results suggested that respondents scored a mean of 6.48 out of 9 for the single question. However, the staff needed to acquire more knowledge in investigating epidemic information (5.92) and case managing (5.91) in the response stage. Overall, males scored higher (409.05 ± 81.39) than females (367.99 ± 84.97), with scores in the medical department (445.67 ± 72.01) higher than management (387.00 ± 70.87) and general department (362.32 ± 86.93). Additionally, those with completely subjective evaluation (425.79 ± 88.10) scored higher than the general group (374.39 ± 79.91). To predict the total score, female medical workers were more likely to have lower scores (β = -34.5, P = 0.041). Compared with those in the medical department, the management workers (β = -65.54, P = 0.008) and general workers (β = -78.06, P < 0.001) were associated with a lower total score.
CONCLUSIONS: There was still a gap between the public health emergency competencies of the civil aviation system and the demand. Staff in China\'s civil aviation systems demonstrated overall competence in public health emergency preparedness and response. However, there was a need to enhance the accumulation of practical experience. Implementing effective training programs for public health emergencies was recommended to mitigate knowledge gaps. Meanwhile, regular training evaluations were also recommended to give comprehensive feedback on the value of the training programs.

Lagos state remains the epicenter of COVID-19 infection in Nigeria. To facilitate the emergency preparedness and response to COVID-19, the State Governor and Incident Commander constituted a Think Tank comprising 13 experts from various disciplines committed to the health of the public. The Think Tank assisted the government with decision-making strategies and supported the emergency operation centre (EOC) for the COVID-19 response. Their main achievements were developing frameworks for decision-making and strategies for phased easing of the State-wide lockdown. The challenges encountered were that it was often viewed as a parallel structure to the EOC and separated from the traditional civil service structure; causing some reluctance to implement ideas generated by the Think Tank. Nevertheless, the Think Tank played an important role during the COVID-19 pandemic; the lessons learned might help other states and resource-limited countries wishing to adopt this approach to emergency response.
RésuméL’État de Lagos reste l’épicentre de l’infection au COVID-19 au Nigeria. Pour faciliter la préparation et la réponse aux situations d’urgence (EPR) face au COVID-19, le gouverneur de l’État a constitué un groupe de réflexion composé de 13 experts de diverses disciplines. Le concept du groupe de réflexion était d’impliquer le secteur privé et le milieu universitaire dans la réponse COVID de l’État de Lagos, reconnaissant qu’un résultat réussi de l’EPR nécessite une expertise dont certaines n’existaient pas au sein de la fonction publique. Le Think Tank a aidé le gouvernement à élaborer des stratégies de prise de décision et a soutenu le centre des opérations d’urgence (COU) pour la réponse à la COVID-19. Leurs principales réalisations ont été l’élaboration de cadres de prise de décision et de stratégies d’assouplissement progressif du confinement à l’échelle de l’État. Les défis rencontrés étaient qu’il était souvent considéré comme une structure parallèle à l’EOC et séparé de la structure traditionnelle de la fonction publique; provoquant une certaine réticence à mettre en œuvre les idées générées. Le groupe de réflexion de l’État de Lagos a démontré un modèle réussi de partenariat public-privé dans le domaine de la santé mis en œuvre par une diversité d’acteurs dans des secteurs critiques. Cela pourrait être considéré comme un modèle utile pour faire face à une myriade de crises similaires auxquelles le secteur de la santé est souvent confronté. Les enseignements tirés pourraient aider d’autres États et pays aux ressources limitées souhaitant adopter cette approche dans les interventions d’urgence.

The coronavirus disease 2019 (COVID-19) pandemic has affected our lives in all aspects, including key fields such as social interaction and economic supply chains. The field of chemical, biological, radiological, nuclear, and explosive substances (CBRNE) was already directly affected by the pandemic in that the COVID-19 virus is, in a sense, a biological agent. This paper elaborates on how the field of CBRNE has changed as a result of the COVID-19 pandemic. It does so by drawing on the results of an interview study with CBRNE practitioners (Fire Brigades, Law Enforcement Agencies, etc.) conducted as part of the European Union project PReparedness against CBRNE threats through cOmmon Approaches between security praCTItioners and the VulnerablE civil society, as well as findings from research literature on links between CBRNE and COVID-19. This paper highlights four areas where the influence of the pandemic on the CBRNE field has been evident. The four areas are as follows: preparedness for CBRNE incidents and likelihood of future CBRNE incidents (with a focus on terrorist attacks), CBRNE training and education, increased awareness of CBRNE-related behaviors and measures among the general public, and greater awareness of the needs of vulnerable groups (older people, etc.).

At the end of 2023, the World Health Organization (WHO) identified climate change as the greatest threat to human health. Global climate change is due to rising atmospheric concentrations of greenhouse gasses, primarily due to the burning of fossil fuels, mainly by populations in developed and developing countries. In 2022, the world experienced the highest temperatures for over 100,000 years. However, in 2022, global investment in fossil fuels increased by 10% and reached more than USD 1 trillion. The 2023 Lancet Commission report concluded that there has been little progress in protecting individuals from the adverse health effects of climate change. It is clear that global action against climate change needs to move more quickly, and the inequalities in the effects of climate change, including the impact on health, are increasing. This article aims to review the ongoing global impact of climate change on human health at individual and population levels, including recent initiatives and medical approaches to prepare for this increasing challenge.

Emergency preparedness initiatives are a Medicare condition of participation in home healthcare, yet limited evidence on the impact of associated programming is available. The purpose of this exploratory pilot study was to examine the outcomes of an individualized emergency preparedness educational program provided by a physical therapist (PT) in the homes of older adults. The investigators recruited older adults (n = 30) using convenience sampling. An emergency preparedness education module was developed. Demographics, functional and environmental outcome measures, a pre- and post-education confidence survey, and learning outcomes were ascertained and analyzed. Participants reported being female (n = 23), 70 to 79 years (n = 15), and 19 individuals reported 35 different lifetime emergency events. Hearing and vision impairments, inability to change a battery or navigate stairs, and environmental deficits including clutter and poor lighting were identified. Closing bedroom doors at nighttime, functioning carbon monoxide and smoke detectors, creating an evacuation plan, and assembling first aid kits were learning outcomes. Trends toward increased confidence were identified, with statistically significant improvements in the ability to respond to a fire (P = .01), a heat wave (P = .03), and to crawl on hands and knees (P = .05) identified. This study provides emerging evidence that PTs have a role in improving an older adult\'s confidence to prepare for and respond to an emergency event.

Considering recent earthquakes and the COVID-19 pandemic, disaster preparedness has come to the forefront of the public health agenda in Nepal. To strengthen the developing health system, many initiatives are being implemented at different levels of society to build resiliency, one of which is through training and education. The first International Conference on Disaster Preparedness and Management convened in Dhulikhel, Nepal on December 1-3, 2023. It brought together international teaching faculty to help deliver didactic and simulation-based sessions on various topics pertaining to disaster preparedness and management for over 140 Nepali healthcare professionals. This paper focuses on the tabletop exercise-based longitudinal workshop portion of the conference on disaster leadership and communication, delivered by United States-based faculty. It delves into the educational program and curriculum, delivery method, Nepali organizer and US facilitator reflections, and provides recommendations for such future conferences, and adaptation to other settings.

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Tailored disaster preparedness interventions may be more effective and equitable, yet little is known about specific factors associated with disaster household preparedness for older adults and/or those with African American/Black identities. This study aims to ascertain differences in the importance features of machine learning models of household disaster preparedness for four groups to inform culturally tailored intervention recommendations for nursing practice. A machine learning model was developed and tested by combining data from the 2018, 2019, and 2020 Federal Emergency Management Agency National Household Survey. The primary outcome variable was a composite readiness score. A total of 252 variables from 15,048 participants were included. Over 10% of the sample self-identified as African American/Black and 30.3% reported being 65 years of age or older. Importance features varied regarding financial and insurance preparedness, information seeking and transportation between groups. These results reiterate the need for targeted interventions to support financial resilience and equitable resource access. Notably, older adults with Black racial identities were the only group where TV, TV news, and the Weather Channel was a priority feature for household disaster preparedness. Additionally, reliance on public transportation was most important among older adults with Black racial identities, highlighting priority needs for equity in disaster preparedness and policy.