BACKGROUND: Disasters can overwhelm healthcare systems, making effective triage a crucial skill for nurses. Role-Play Scenario-Based Disaster Triage Training offers a promising approach to prepare nursing students for these situations. Understanding students\' experiences with this training method can inform its development and effectiveness in fostering disaster preparedness. However, little is known about this training experience of nursing students. In particular, by examining the challenges faced by students, the emotional distress they experience and their achievements, it will provide guidance for the development of education programs in a more comprehensive and student-oriented manner.
OBJECTIVE: The aim of this study is to elucidate the experiences of nursing students regarding Role-Play Scenario-Based Disaster Triage Training.
METHODS: A qualitative approach was employed to comprehend participating students\' experiences. Face-to-face and online semi-structured interviews were conducted with 17 students using an interview guide, and the interactions were recorded for subsequent analysis. Thematic analysis was employed to develop themes.
RESULTS: The study results emphasize the challenges experienced by students during triage training, their gains and the support they need to cope with the challenges they experience. Data were organized around four main themes: \"Challenges of the triage process\" with subthemes such as \"Thinking of the actual earthquake moment\" and \"Ethical dilemmas\"; \"Emotional turmoil\" with subthemes including \"Anxiety\" and \"Fear and Helplessness\"; \"Achievements\" with subthemes such as \"Increase in knowledge and skills\" and \"The importance of the nurse\"; and \"Suggestions\" with subthemes including \"Continuous education\" and \"Mandatory course\".
CONCLUSIONS: The findings of the study provide new insights into the experiences of nursing students during the disaster triage process. The results may contribute to the improvement of future training programs by identifying the challenges and needs faced by nursing students after disaster triage education.

In the aftermath of the US withdrawal from Afghanistan, over 100,000 individuals were evacuated to the United States, primarily arriving through Philadelphia International Airport and Dulles International Airport under Operation Allies Welcome. In Philadelphia, evacuees were greeted at the airport by a medical triage unit (MTU) that was rapidly assembled to provide on-site medical care. The MTU triaged emergent medical complaints, handled minor complaints on-site to reduce impact on local health care systems, distributed patients who did require a higher level of care among area hospitals, and ensured appropriate follow-up care for individuals with ongoing needs. Although there are regional and federal entities whose purview is the establishment and coordination of such responses, these entities were not mobilized to respond immediately when planes began to arrive carrying the first wave of evacuees as this event was not a designated disaster. The MTU was a grassroots effort initiated by local health care providers in coordination with the local Medical Reserve Corps and Department of Public Health. This article presents a framework for similar operations, anticipating an ongoing need for planning for sudden arrivals of large numbers of displaced persons, particularly via air travel, in a time of increasing mass displacement events, as well as a rationale for establishing more robust networks of local medical professionals willing to respond in the case of an emergency and involving them in the emergency planning processes to ensure preexisting protocols are practical.

UNASSIGNED: In June 2019, landslides and floods in Bududa district, eastern Uganda, claimed lives and led to a cholera outbreak. The affected communities had inadequate access to clean water and sanitation.
UNASSIGNED: To share the experience of controlling a cholera outbreak in Bududa district, after landslides and floods.
UNASSIGNED: A descriptive cross-sectional study was carried out in which outbreak investigation reports, weekly epidemiological data and disaster response reports were reviewed.
UNASSIGNED: On 4 - 5th June 2019, heavy rainfall resulted in four landslides which caused six fatalities, 27 injuries, floods and displaced 480 persons. Two weeks later, a cholera outbreak was confirmed in Bududa district. The Ministry of Health (MoH) rapidly deployed oral cholera vaccine (OCV) from local reserves and mass vaccinated 93% of the target population in 22 affected parishes. The outbreak was controlled in 10 weeks with 67 cholera cases and 1 death reported. However, WaSH conditions remained poor, with only, 24.2 % (879/3,628) of the households with washable latrines, 26.8% (1,023/3,818) had hand-washing facilities with soap and 33.6% (1617/4807) used unsafe water.
UNASSIGNED: The OCV stockpile by the MoH helped Uganda to control cholera promptly in Bududa district. High-risk countries should keep OCV reserves for emergencies.

It is the position of the Society for Nutrition Education and Behavior that for effective recovery from and resilience to disasters, it is essential that impacted individuals and communities have access to safe, nutritious, and culturally and contextually appropriate foods and beverages, and receive emergency-related food and nutrition education before, during, and after a disaster. Despite the increasing number, duration, and intensity of disasters worldwide, there is relatively limited guidance for research, policy, and practice about addressing the emergency-related food and nutrition needs of affected populations. Although nutrition emergencies tend to be understudied, emerging efforts are working to advance food and nutrition security during disaster response and recovery. To help elevate the importance of emergency-related food and nutrition education before, during, and after a disaster, Society for Nutrition Education and Behavior, which represents the unique professional interests of nutrition educators worldwide, summarizes the relevant literature and puts forth recommendations for all those who are engaged in this work in the following 4 key areas: (1) improving communication and outreach, (2) fostering community engagement and locally-driven preparedness, (3) building the evidence base and translating the evidence into action, and (4) training current professionals and the next generation of public health leaders. Altogether, before, during, and after a disaster, those who engage in this work, among other allies, can help elevate the importance of nutrition education and other strategies to promote healthy eating behaviors through research, policy, and practice.

Infections are well-known complications in patients following traumatic injuries, frequently leading to high morbidity and mortality. In particular, trauma occurring in disaster settings, both natural and man-made, such as armed conflicts and explosives detonation, results in challenging medical conditions that impede the best management practices. The incidence of invasive fungal infections (IFI) is increasing in trauma patients who lack the typical risk factors like an immune compromised state or others. This narrative review will focus on IFI as a direct complication after natural disasters, wars, and man-made mass destruction with a summary of the available evidence about the epidemiology, clinical manifestations, risk factors, microbiology, and proper management. In this setting, the clinical manifestations of IFI may include skin and soft tissue infections, osteomyelitis, visceral infections, and pneumonia. IFI should be considered in the war inflicted patients who are exposed to unsterile environments or have wounds contaminated with soil and decaying organic matter.

BACKGROUND: The psychological aspect is one of the important aspects of the affected disaster survivors. The change in the disaster management paradigm is one reason for the need to change interventions that previously only focused on handling posttraumatic distress syndrome into interventions to increase post-traumatic growth to prevent post-disaster psychological disorders. This review aims to synthesise recent research to develop further explanations regarding potential strategies to improve the post-traumatic growth of disaster survivors.
METHODS: This is an integrative review of previous studies. Articles were identified via SCOPUS, EMBASE, JSTOR, PROQUEST, MEDLINE and grey literature (Google Scholar). All subject-relevant literature from 2000 to 2022 was identified. This review included quantitative and qualitative studies and literature reviews, with criteria: all types of interventions used to improve the post-traumatic growth of disaster survivors and potential influencing factors that may affect the implementation as well as other relevant outcomes.
RESULTS: From 400 initial search studies, 27 studies (24 quantitative. one qualitative, and two mixed methods) were eligible to be included in the review. Some factors promoting post-traumatic growth included religious coping, culture, social support, the severity of the trauma, coping strategies, education level and work satisfaction.
CONCLUSIONS: By systematically exploring the factors that foster post-traumatic growth of disaster survival, this integrative review will give fundamental information to develop an intervention that prevents or minimises the psychological impacts of a disaster towards survivors.

BACKGROUND: Japan is a country often subject to natural disasters, influenced by a rapidly increasing aging demographic. The current research aims to analyze the food distribution for elderly evacuees who were relocated to a care facility in Wajima City, administered by the non-profit organization Tokushukai Medical Assistant Team (TMAT), post the Noto Peninsula Earthquake on 1 January 2024. A significant portion of the shelter\'s inhabitants were elderly individuals.
METHODS: TMAT\'s operations began immediately after the calamity, concentrating on evaluating the nutritional content of meals provided during the initial and subsequent phases, along with a thorough nutritional assessment. During this process, researchers examined the meal conditions for evacuees, including the elderly and those with disabilities, observed the actual meal distribution at welfare centers, and discussed the challenges and potential solutions.
RESULTS: Throughout the TMAT mission, a total of 700 evacuees received assistance, with 65% being 65 years old or above. An analysis of the nutritional content of the 10 meal varieties served at the shelter revealed inadequate energy and protein levels for elderly individuals, particularly men, indicating the need for future enhancements.
CONCLUSIONS: Following a detailed evaluation of TMAT\'s response to the Noto Peninsula earthquake, it was determined that the food provided in the shelters in the affected areas did not meet the nutritional needs of elderly individuals, especially men, based on nutritional analysis. To stress the importance of establishing an effective framework, it is recommended to promptly revise the emergency food provisions for the elderly population, considering they constitute the majority of the affected individuals.

BACKGROUND: Children and adolescents, after natural and man-made disasters, often exhibit various psychological, emotional, and behavioral issues, showing a range of clinical symptoms related to post-traumatic stress disorder (PTSD) and depression. This review used a network meta-analysis (NMA) approach to compare and rank psychological interventions for PTSD and depression in children and adolescents after exposure to natural and man-made disasters.
METHODS: Randomized studies of psychosocial interventions for PTSD and depression in children and adolescents exposed to natural and man-made disasters were identified. PTSD and depression symptoms at postintervention and 1-12 month follow-up are the outcomes. The standardized mean differences (SMDs) between pairs of interventions at postintervention and follow-up were pooled. Mean effect sizes with 95% credible intervals (CI) were calculated, and the ranking probabilities for all interventions were estimated using the surface under the cumulative ranking curve. Study quality was assessed with version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2).
RESULTS: In total, 26 studies with 4331 participants were included in this NMA. Eye movement desensitization and reprocessing therapy (EMDR) (SMD = - 0.67; 95% CI - 1.17 to - 0.17), exposure therapy (ET) (SMD = - 0.66; 95% CI - 1.11 to - 0.22), and cognitive behavioral therapy (CBT) (SMD = - 0.62; 95% CI - 0.90 to - 0.34) were significantly more effective for PTSD at postintervention than inactive intervention. EMDR (SMD = - 0.72; 95% CI - 1.11 to - 0.33) and ET (SMD = - 0.62; 95% CI - 0.97 to - 0.27) were associated with a higher reduction in PTSD symptoms at follow-up than inactive intervention. EMDR (SMD = - 0.40; 95% CI - 0.78 to - 0.03) and play therapy (PT) (SMD = - 0.37; 95% CI - 0.62 to - 0.12) were significantly more effective for depression at postintervention than inactive intervention. For all psychological interventions in reducing depression symptoms at follow-up compared with inactive intervention, the differences were not significant.
CONCLUSIONS: EMDR appears to be most effective in reducing PTSD and depression in children and adolescents exposed to natural and man-made disasters. In addition, ET and CBT are potentially effective in reducing PTSD symptoms at postintervention, while PT is beneficial in managing depression symptoms at the treatment endpoint.

Disaster, catastrophe, and cataclysm are some English terminologies that describe the severity of adverse events. Civilians, reporters, and professionals often use these terminologies to communicate and report any event\'s severity. This linguistic method is the most practical way to rapidly reach all levels of local/regional/national, and international stakeholders during disasters. Therefore, disaster terminologies play a significant role in disaster management. However, attaining the actual magnitude of a disaster\'s severity cannot be comprehended simply by using these terminologies because they are used interchangeably. Unfortunately, there is no consistent method to differentiate disaster terminologies from one another. Additionally, no globally accepted standard technique exists to communicate the severity level when disasters strike; one observer\'s \'disaster\' can be another\'s \'catastrophe\'. Hence, a nation\'s ability to manage extreme events is difficult when there are no agreed terminologies among emergency management systems. A standard severity classification system is required to understand, communicate, report, and educate stakeholders. This paper presents perceptions of people about disaster terminologies in different geographical regions, rankings and differences in disaster lexical and lexicon. It explores how people perceive major events (e.g., the Covid-19 pandemic), and proposes a ranking of disaster terminologies to create a severity classification system suitable for global use.

BACKGROUND: In the health system, hospitals are intricate establishments that offer vital medical services. Their resilience plays a crucial role in mitigating the societal repercussions of disasters. A hospital must possess the capacity to withstand risks, preserve its fundamental structure and operations, and enhance its preparedness by augmenting various capabilities and promptly recovering from the impacts of potential risks. It enables the hospital to attain a heightened level of readiness. Therefore, this study aimed to develop a resilience model tailored for hospitals to navigate crises and disasters effectively.
METHODS: This mixed-method study was conducted in 2023 in three phases: (1) Identification of the factors influencing the organizational resilience of the hospital, (2) Evaluation of the influential factors by an expert panel. (3) Following the standardization process, we administered 371 questionnaires to individuals, such as university staff managers and supervisors, nursing managers, and research unit managers. The sample size was determined by multiplying the components by 10, resulting in 360 (10 * 36). Therefore, we selected a sample size of 371 participants. Structural Equation Modeling (SEM) was employed to examine the causal relationships between variables. These steps were performed using SPSS 25.0 and AMOS 22 software. Finally, we identified and presented the final model. We utilized AMOS 22 and applied the SEM to assess the correlation between the variables, with a significance level of 0.05.
RESULTS: Findings indicate that the appropriate modeling identified five dimensions comprising 36 components. These dimensions include vulnerability, preparedness, support management, responsiveness and adaptability, and recovery after the disaster. The model demonstrates a good fit, as indicated by the X2/d indices with a value of 2.202, a goodness of fit index (GFI) of 0.832, a root mean square error of estimation (RMSEA) of 0.057, an adjusted comparative fit index (CFI) of 0.931, and a smoothed fit index (NFI) of 0.901.
CONCLUSIONS: Enhancing hospital resilience is crucial for effective preparedness and response to accidents and disasters. Developing a localized tool for measuring resilience can help identify vulnerabilities, ensure service continuity, and inform rehabilitation programs. The proposed model is a suitable framework for assessing hospital resilience. Key factors include human resource scarcity, hospital specialization, and trauma center capacity. Hospitals should prioritize efficient resource allocation, information technology infrastructure, in-service training, waste management, and a proactive organizational framework to build resilience. By adopting this approach, hospitals can better respond to crises and disasters, ultimately reducing casualties and improving overall preparedness.