The impact of combat injury on the development of chronic pain and mental health concerns in combat-exposed populations is unknown. This study examined associations of combat injury and injury–related pain with pain-related factors and mental health outcomes, and potential mediation of the relation between combat injury and mental health outcomes by pain-related factors.

Pain interference, pain catastrophizing, pain intensity, post-traumatic stress disorder (PTSD), and major depressive episode (MDE) were assessed in (1) a probability sample of US Army soldiers and veterans cross-sectionally and (2) US Army soldiers before and 1, 3, and 9 months after deployment to Afghanistan. Associations among these variables were modeled using logistic regression and multiple mediation analyses.

Among 5003 service members with cross-sectional data, combat injury–related pain was associated with increased odds of clinically significant pain intensity (OR=2.69), pain interference (OR=3.69), MDE (OR=2.17), and PTSD (OR=3.96) relative to pain from other injuries and conditions. Among 4645 service members assessed pre- and post-deployment, combat injury was associated with increased odds of new-onset pain interference (OR=2.78), pain catastrophizing (OR=2.75), PTSD (OR=4.06), and MDE (OR=2.56) 3 months post-deployment, and PTSD (OR=2.86) and MDE (OR=1.74) 9 months post-deployment. Pain-related factors mediated the relations of combat injury with post-deployment PTSD and MDE.

Combat injury is associated with greater odds of pain interference, pain catastrophizing, PTSD, and MDE compared to other sources of pain in a cohort of US service members. Efforts to address pain-related factors following combat injury may mitigate the risk of subsequent chronic pain and mental health disorders.

Endoscopic lens fogging is a frequent problem during diagnostic nasal endoscopy, often necessitating scope withdrawal and increasing patient discomfort. This study compared the defogging efficacy and nasal mucosal tolerance of Savlon and warm sterile saline.

In this prospective pilot comparative study, 40 adult patients undergoing diagnostic nasal endoscopy with a 0° rigid endoscope were randomly assigned to Savlon or warm sterile saline as the defogging agent. Lens fogging severity, patient-reported discomfort, mucosal irritation and need for repeat defogging were assessed.

Both agents demonstrated comparable effectiveness in preventing lens fogging. However, the Savlon group reported significantly higher nasal discomfort and showed greater mucosal irritation compared with the warm saline group.

Warm sterile saline offers effective lens defogging with improved mucosal tolerance and patient comfort compared with Savlon during routine nasal endoscopy.

The use of telehealth in palliative care has expanded rapidly, offering opportunities to enhance symptom management and provide psychosocial support to patients and families. Nurse-led virtual interventions play a critical role in improving access to care, particularly for those facing geographic or logistical barriers.

To systematically synthesize global evidence on the effectiveness of tele-palliative nursing interventions in improving symptom management and family support for adults with life-limiting illnesses.

This study was conducted as a hybrid umbrella review in accordance with PRISMA 2020 guidelines. Six databases and two trial registries were searched through September 2025. Eligible evidence included (a) systematic reviews, scoping reviews, integrative reviews, and mixed-methods reviews, and (b) primary studies such as randomized controlled trials (RCTs), quasi-experiments, observational studies, and pilot/feasibility studies. Systematic reviews were appraised using AMSTAR-2; primary studies using RoB 2, ROBINS-I, or CASP, as appropriate. A narrative synthesis was employed, with review-level evidence prioritized and primary studies used to contextualize effect directions. Potential overlap of primary studies across included reviews was assessed conceptually to avoid double counting. This approach was selected to integrate both review-level and primary evidence within a unified synthesis framework.

Twenty-eight studies (≈2,500 participants from primary studies only) from North America, Europe, Asia, and Australia were included. Interventions included video consultations, structured telephone follow-ups, remote symptom monitoring, and caregiver education programs delivered by nurses. Across studies, nurse-led telehealth interventions were associated with improvements in access to care, symptom monitoring, patient satisfaction, and aspects of family support. Evidence for symptom severity reduction and caregiver burden was mixed, with moderate heterogeneity. Risk of bias was generally low to moderate, with RCTs offering the strongest evidence.

Tele-palliative nursing is a promising model for delivering symptom management and family support remotely. It demonstrates feasibility and acceptability across diverse settings. However, findings should be interpreted cautiously due to heterogeneity in study designs, reliance on secondary evidence, and variable methodological quality. Further large-scale trials with standardized outcome measures are needed to strengthen the evidence base.

During the COVID-19 pandemic, educators were impacted across domains of psychological, physical, social, and occupational health. Occupational environments, including classrooms, changed significantly due to COVID-19. This study aimed to characterize the nuanced experience of educators during the COVID-19 pandemic.

Participants included 918 United States educators (e.g., teachers, paraeducators, support professionals, and administrators). Educators completed the survey via Qualtrics during November and December of 2020. The survey included eight qualitative questions, and responses were randomized to inductive or deductive datasets for analyses.

Our deductive results showed that individuals reported changes in several facets of health, with educators reporting increases in stress (38.0%) and feelings of isolation (45.9%). Our results also showed impacted occupational health, citing increased responsibility at work (34.0%) and feeling as though their voice was not heard after voicing concerns to either building- or district-level administration (28.2%).

One of the key findings that emerged at the systemic level was educators reporting a lack of decision-making agency within the workplace. Through including educators in the conversations regarding decisions at all levels, agency may be increased. Educators not only shape the students they teach, but the communities within which they work, making a focus on their health paramount.

The southern capital of Kazakhstan, Almaty, located in a seismically active region, experienced two significant earthquakes in January and March 2024. Despite longstanding educational programs, the January event exposed significant gaps in public crisis response, resulting in numerous injuries due to panic-driven behavior. This study aimed to evaluate the shift in public preparedness and crisis communication between these events.

A comprehensive content analysis was conducted using over 500 articles from prominent Kazakh- and Russian language news outlets, 300 official publications by the Ministry for Emergency Situations, and approximately 5,000 social media posts. This analysis examined the timing, content, and public response to emergency communications, assessing changes in behavior influenced by the intensified educational efforts after January.

The January earthquake highlighted critical delays in communication (an average of 20 minutes), leading to widespread panic. Injuries included 12 severe cases from residents jumping from buildings and numerous reports of frostbite, as temperatures reached -15°C. The Ministry for Emergency Situations responded with targeted educational campaigns, distributing over 200,000 printed evacuation guides and conducting over 1,200 focused training sessions. By March, communication response times improved to 5 minutes, and social media analysis revealed a 60% increase in posts mentioning organized and calm public behavior. Posts frequently mentioned that residents knew evacuation points (e.g., nearby schools) and followed pre-established procedures, demonstrating a better understanding of safety protocols.

The comparison of the January and March 2024 earthquakes demonstrates the essential role of adaptive public education and rapid crisis communication in enhancing community preparedness. Targeted interventions improved public knowledge, reduced injuries, and restored confidence in emergency management systems. These findings emphasize the need for continuous, practical, and localized educational efforts to effectively bridge gaps in public readiness for disasters.

The mobile Smart Cyber Operating Theater (SCOT), an advanced medical vehicle developed collaboratively by Tokyo Women’s Medical University and NTT Docomo, has been designed to deliver crucial medical treatment and support under normal as well as disaster situations. This cutting-edge system leverages 5G technology and a cloud-based framework to facilitate real-time sharing of critical medical information, including surgical images and data on patients’ vitals, with surgeons in remote locations. The application of this innovation has greatly improved the decision-making speed and efficacy during medical interventions. In disaster scenarios, demonstration experiments of telemedicine in surgical care were conducted using simulated patients with femur fractures, mandibular fractures, and colonic injuries. Using a robust 5G network alongside a multi-access cloud system, the experiment enabled the seamless sharing of surgical footage and physiological data with remote medical teams, enabling quick clinical decisions. The experiments highlighted the system’s capacity to enable uninterrupted collaboration among medical personnel and provide specialized telemedicine in surgical care. The system addresses three critical challenges in disaster medical care: preventing communication disruptions, ensuring real-time responsiveness, and avoiding loss of medical information. Collectively, the system’s features markedly bolster rapid medical responses and enhance its potential to deliver swift and efficient medical interventions during normal as well as disaster situations. By integrating advanced software and hardware technologies, the system supports the provision of comprehensive medical care in disaster-stricken areas. This is particularly vital in locations where traditional medical infrastructure is compromised. The deployment of the mobile SCOT in disaster situations is expected to improve the outcomes and prognosis of disaster victims, marking a substantial advancement in emergency medical services and highlighting the importance of technological integration in health care.

The Mountain Plains Regional Disaster Health Response System (MPRDHRS) is a US federally funded program to “leverage, build, or augment the highly specialized clinical capabilities critical to unusual hazards or catastrophic events”. MPRDHRS‘ mission is to “provide leadership, knowledge, expertise, and support in disaster response for patients and citizens in our region.” Developing accurate, accessible, and opportune educational materials is

encompassed within MPRDHRS’s mission and objectives.

After performing a gap analysis and curating accessible disaster educational materials, we identified asynchronous, just-in-time (JIT) educational modules (EM) to be high yield for responders in our region. To ensure equal opportunity and appropriate representation, JIT subject matter experts (SME) ought to be recruited by a nomination and strict selection process. A standardized system for module development and recording was implemented.

Thirty-six initial topics were identified as a priority for JIT EM. A diverse and representative group of SMEs was selected, and EMs were recorded. Over two-thirds of modules with their accompanying “one-pager,” where key points are summarized, are currently available on our website. Remaining topics outlined for production are continuously recruited for and produced as the project enters its 2nd year. As of 10/17/24, EMs average 54 views, the most popular module garnering 362 views. Modules can be found at: https://mountainplainsrdhrs.org/just-in-time/

Despite the availability of relevant materials created and distributed by SME networks, professional societies, and federal partners, discovery by non-disaster response experts, particularly in the wake of a disaster, is unlikely. The JIT EMs fill gaps to enable a safe and coordinated response to disasters and can be updated for emerging threats.

The EviMaPS study aimed to identify the state of knowledge and practice on disaster mental health and psychosocial support (MHPSS) initiatives globally. This study was conducted through a collaboration between a multinational team of investigators and the World Health Organization (WHO).

Phase 1 consisted of a key informant survey to identify current and emerging MHPSS policies and programs to reduce mental health risks and enhance protective factors before and after disasters. Phase 2 consisted of a rapid literature review to identify empirical research on the impacts of disaster-related MHPSS initiatives. Programs identified in each stage were mapped against the MHPSS Minimum Services Package (MSP) Checklist, the Inter Agency Standing Committee (IASC) Intervention Pyramid, and the WHO Health Emergency and Disaster Risk Management Framework.

Phase 1 elicited information about 92 programs and 9 policies in use between 2007 and 2024 across 19 countries and regions. Phase 2 elicited 33 primary research articles published between 2007 and 2024 across 13 countries and regions.

The field of disaster mental health is dynamic and evolving. This presentation will underscore the need for an ongoing commitment to recognizing developing practices and building evidence on mental health and psychosocial support initiatives in disaster settings. The implications of the present findings for leading agencies such as the WHO will also be presented, for example, concerning updating guidelines, frameworks, and setting priorities to address research gaps.

The ASEAN Joint Research on Hospital Safety Index (HSI) is one of the implementations of the start-up program under the ASEAN Academic Network on Disaster Health Management (AANDHM). The objective of this joint research is to analyze the implementation of the self-assessment Hospital Safety Index (HSI) for safe hospital evaluation in ASEAN countries. However, conducting multinational research presents unique challenges.

This study employs a narrative approach to analyze the challenge of ASEAN joint research implementation.

The findings indicate three key challenges. First is the challenge of choosing a methodology that is both rigorous and universally applicable in diverse multinational settings. This diversity necessitated several changes and modifications of the research methodology in the proposals, adding substantial delays to project timelines. Secondly, email communication for participant recruitment presents challenges, whereas direct meetings and facilitation by the ARCH Project have proven valuable for initiating further engagement. A third challenge concerns the ethical clearance (EC) process. Understanding and adhering to the various Institutional Review Board (IRB) protocols of each participating country was time-consuming and complex. The Fifth Meeting of the Steering Committee for AANDHM recommended that the research team follow EC and IRB procedures according to their country’s regulations, while participants are only required to undergo EC review if mandated by their country. This guidance helps resolve the EC confusion that stalled the joint research process.

This study reveals that selecting methodologies applied in different contexts of disaster health management and diverse IRB protocols poses significant challenges to the ASEAN Joint Research on Hospital Safety Index. Addressing these issues is essential for developing regional mechanisms for the promotion of joint research activities. Future recommendations include training on developing research methodology, developing efficient communication platforms, and conducting surveys on EC guidelines across ASEAN to enhance research collaboration.

Children are frequently victims of disasters. However, gaps remain in pediatric disaster preparedness. The New York City Pediatric Disaster Coalition (NYCPDC) is funded by the NYC Department of Health and Mental Hygiene (DOHMH) to prepare NYC for mass casualty events involving children. In the fall of 2022, there was a significant

increase in pediatric emergency department visits and hospitalizations due to Rhinovirus, Enterovirus, COVID-19, Influenza, and RSV throughout many areas of the United States. This, coupled with underlying staffing and other shortages, created a strain on the healthcare system. In many facilities, surge capacity was exceeded, Emergency Departments and Pediatric Intensive Care Units were closed to new patients, and inter-hospital transports were denied.

In response, the NYCPDC rapidly (over four days) developed a one-hour webinar focused on: epidemiological data sharing, impacts on patient care, a review of prevention, treatment, and supply issues, and a discussion on current and future strategies to respond to the outbreak. The one-hour webinar included a total of four presenters with representation from the NYCPDC, DOHMH, as well as two major NYC children’s hospitals and a national audience.

Over 400 healthcare workers registered for the webinar from around the United States. Prior to the conclusion of the webinar, participants had the opportunity to ask questions and contribute to the session by sharing their firsthand surge experiences, including capacity expansion, challenges, and best practices. Following the session, a recording of the webinar as well as a curated listing of resources developed in cooperation with the National Pediatric Disaster Coalition were distributed to every participant.

This presentation will provide a summary of the webinar and highlight effective strategies to respond to future outbreaks. This includes managing a large influx of pediatric patients in the emergency department and pediatric intensive care unit, as well as effective transfer strategies.