暂无摘要。

Following the Great East Japan Earthquake (GEJE) and the Fukushima Daiichi nuclear power plant accident in 2011, mandatory evacuation orders were issued to residents living near the nuclear power plant in Fukushima prefecture, including some patients receiving home oxygen therapy. Although the vulnerability of patients with home oxygen therapy (one of the population groups most vulnerable to disasters) has been noted, there is little information on the health effects of evacuation in the event of a radiation disaster. A 90-year-old man diagnosed with chronic obstructive pulmonary disease since the age of 70, and lived in a town located approximately 20 km south of the nuclear power plant, died 8 months after the disaster due to worsening health conditions. This case reveals the potential for both physical and psychological burdens experienced by vulnerable groups like patients undergoing home oxygen therapy during evacuations in times of disaster. Although it is only a case report and the information is limited, severe respiratory distress requiring home oxygen therapy may present a significant risk factor for disaster-related deaths, especially in cases where evacuations are prolonged, such as in nuclear disasters. Due to the challenge of obtaining prompt public support immediately after a disaster, home oxygen therapy patients may need to prioritize self-help and mutual assistance in their disaster preparedness efforts.

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.

UNASSIGNED: This research evaluated the effect of a nurse-facilitated intervention on elderly or medically frail community members\' level of household emergency preparedness as measured in knowledge, actions taken, and supplies gathered. These community members had access and functional needs that must be accommodated during disasters to mitigate their increased risk of injury, illness, and death because of the disaster. With adequate preparedness, it is plausible these community members may survive the aftermath of a disaster without needing assistance from disaster responders.
UNASSIGNED: This was a non-randomized, single group, before-after feasibility study (N = 31) conducted in a one-on-one session with a nurse interventionist in an urban community setting in the United States of America. We used the Household Emergency Preparedness Instrument to measure intervention effectiveness and a Participant Experience Survey to evaluate participant satisfaction with the intervention. The intervention included an educational booklet that provided instruction to participants on how to create a disaster-related evacuation and communication plan and identify community resources. Upon completion of the booklet, participants received a complimentary disaster supply kit.
UNASSIGNED: Mean general preparedness scores increased from 5.5 (SD = 4.1) pre-intervention to 20.2 (SD = 3.1) post-intervention (p < .001). Preparedness in all sub-scales also increased significantly (all ps < .001).
UNASSIGNED: Study findings provide support for the feasibility of the intervention to increase all measured aspects of emergency preparedness (knowledge, behaviors, and supplies) among elderly and medically frail adults with access and functional needs during disasters.

A lack of confidence in the efficacy of respiratory protection can contribute to uncertainty among workers and cast doubt on workplace safety. To date, no research has been conducted to study and understand the introduction of elastomeric half-mask respirators (EHMRs)-without exhalation valves (EVs) or with exhalation valve filters (EVFs), both representing new designs that address source control-in the workplace. To study this issue, researchers collaborated with partners at 32 health delivery settings that received EHMRs from the Strategic National Stockpile during the COVID-19 pandemic. EHMR users (n = 882) completed an online survey between October 2021 and September 2022. Analyses demonstrated that employees were statistically significantly more confident in the efficacy of EHMRs with no EV/with an EVF (including the efficacy in protecting the user from COVID-19) if they had been fit tested and received training. Respondents were also statistically significantly more confident in the efficacy of their EHMR if they had a more positive perception of their organization\'s safety climate. The results provide insights for tailored fit testing and training procedures as manufacturers continue to improve respirator models to enhance worker comfort and use. Results also show that, even during a public health emergency, the role of safety climate cannot be ignored as an organizational factor to support worker knowledge, attitudes, and participation in health and safety behaviors specific to respirator use.

After the hurricanes in 2017 in the U.S. Caribbean, it was essential to rebuild, strengthen, and sustain essential environmental health (EH) services and systems. The National Environmental Health Association, in partnership with the Centers for Disease Control and Prevention, developed an online mentorship program for newly hired and existing EH staff and health department leadership in Caribbean health departments. Participants were provided with both practical and didactic learning and were allowed to evaluate the program. Both mentors and mentees were highly satisfied with the knowledge and skills acquired, and mentees expressed it was relevant to their daily work. Based on the findings, we recommend both an online and a hybrid mentorship program for leadership- and inspector-level workforces in EH and potentially in other fields.

The natural disasters faced by modern urban systems are complex, with multiple disaster-causing factors coexisting and secondary disasters occurring concurrently. With emergency management moving towards smart, natural disaster response has shifted from emergency-centered response to pre-disaster prevention. How to improve the government\'s natural disaster emergency preparedness has become an important issue that needs to be addressed. Based on the TOE (Technology-Organization-Environment) framework, the fsQCA method was used to explore the improvement path of emergency preparedness capacity of 10 pilot units in China to deal with natural disasters in 2020. Analyze the group effects and interrelationships of technology level, simultaneous supporting facilities, organizational construction, financial investment, external pressure, and social repercussions. The results show that: there exist four conditional groupings of high emergency preparedness in two modes. Two modes are organization-environment dual-drive and technology-organization-environment triple-drive, which have multiple concurrencies and follow the principle of consistent results. There are substitution effects in the conditional groupings of high emergency preparedness. There are causal asymmetries in the conditional groupings of high emergency preparedness and non-high emergency preparedness. This study aims to explore the smart emergency preparedness of ten pilot and to provide ideas for the overall development of \"smart emergency response\" and the improvement of emergency preparedness for natural disasters.

OBJECTIVE: To examine nursing home administrator perspectives of infection control practices in nursing homes at the height of the COVID-19 pandemic and characterize lessons learned.
METHODS: Descriptive qualitative study.
METHODS: Administrators from 40 nursing homes across 8 diverse health care markets in the United States.
METHODS: Semistructured interviews were conducted via telephone or Zoom with nursing home administrators. Interviews were repeated at 3-month intervals, for a total of 4 interviews per participant between July 2020 and December 2021 (n = 156). Qualitative analysis of interview transcripts used modified grounded theory and thematic analysis to identify overarching themes.
RESULTS: Three major themes emerged reflecting administrator experiences managing infection control practices and nursing home operations at the height of the COVID-19 pandemic. First, administrators reported that the more stringent infection control protocols implemented to manage and mitigate COVID-19 at their facilities increased awareness and understanding of the importance of infection control; second, administrators reported incorporating higher standards of infection control practices into facility-level policies, emergency preparedness plans, and staff training; and third, administrators said they and their executive leadership were reevaluating and upgrading their facilities\' physical structures and operational processes for better infection control infrastructure in preparation for future pandemics or other public health crises.
CONCLUSIONS: Insights from this study\'s findings suggest important next steps for restructuring and improving nursing home infection control protocols and practices in preparation for future pandemics and public health emergencies. Nursing homes need comprehensive, standardized infection control training and upgrading of physical structures to improve ventilation and facilitate isolation practices when needed. Furthermore, nursing home emergency preparedness plans need better integration with local, state, and federal agencies to ensure effective communication, proper resource tracking and allocation, and coordinated, rapid response during future public health crises.

BACKGROUND: The onset of the COVID-19 pandemic catalysed a monumental shift in the field of continuing professional development (CPD). Prior to this, the majority of CPD group-learning activities were offered in-person. However, the pandemic forced the field to quickly pivot towards more novel methods of learning and teaching in view of social distancing regulations. The purpose of this study was to obtain the perspectives of CPD leaders on the impact of the pandemic to elucidate trends, innovations, and potential future directions in the field.
METHODS: Semi-structured interviews were conducted between April-September 2022 with 23 CPD leaders from Canada and the USA. Interviews were audio-recorded, transcribed, and de-identified. A thematic analysis approach was used to analyse the data and generate themes.
RESULTS: Participants characterised COVID-19 as compelling widespread change in the field of CPD. From the interviews, researchers generated six themes pertaining to the impact of the pandemic on CPD: (1) necessity is the mother of innovation, (2) the paradox of flexibility and accessibility, (3) we\'re not going to unring the bell, (4) reimagining design and delivery, (5) creating an evaluative culture, and (6) a lifeline in times of turmoil.
CONCLUSIONS: This qualitative study discusses the impact of the pandemic on the field of CPD and leaders\' vision for the future. Despite innumerable challenges, the pandemic created opportunities to reform design and delivery. Our findings indicate a necessity to maintain an innovative culture to best support learners, to improve the healthcare system, and to prepare for future emergencies.

Communities across the world are facing extreme events, such as excessive heat, droughts, floods, and wildfires. In the presence of contaminated sites and waste management facilities, communities must consider the impacts of potential releases from these sites due to such events. Impacts of extreme events on sites and consequently on surrounding, often disadvantaged communities result from complex interactions between natural, physical, and social factors. A conceptual framework was developed to identify and provide a shared understanding of key vulnerabilities and pathways that transcend disciplines. A transparent and replicable method was developed to create mappable indicators that represent contaminated sites, waste facilities, contaminant transport via air and water, and population sensitivities. This method can be applied as a screening step to assist states and local communities in prioritizing targeted strategies and resources and determining where in-depth assessments are needed. These indicators can facilitate communication with a broad audience more easily than complex modeling approaches or aggregated indices. Case study results demonstrate the importance of considering indicators in conjunction with each other. The indicator method was developed together with U.S.-based partners, but can be adapted for other countries seeking to understand the potential impacts of extreme events on contaminated sites and communities.