Empathy involves communicating and understanding others’ emotion in multisensory contexts, including visual and auditory modalities. Schizophrenia (SCZ) patients have impaired empathy, but whether the impact of visual/auditory context would be altered in SCZ patients and people with high social anhedonia (HSoA) remained unclear.

We administered the modified Chinese version of the Empathic Accuracy Task (EAT) to clinical (50 SCZ patients and 50 healthy controls) and subclinical samples (59 HSoA and 60 low social anhedonia [LSoA] participants). The EAT employed audio-only, audiovisual, and audioavatar visual conditions to assess the impact of multimodal information on empathy during positive and negative emotional events.

In positive-valenced context, SCZ patients performed worse than controls in cognitive and affective empathy. The Modality-by-Group interaction on empathic accuracy was significant, that is, SCZ patients performed worse than controls in both audiovisual and audioavatar visual conditions, but comparable to controls in audio-only condition. In negative-valenced context, SCZ patients performed worse than controls in cognitive empathy. The Modality-by-Group interaction on empathic accuracy was significant, that is, SCZ patients performed worse than controls in audio-only and audiovisual conditions. Moreover, HSoA participants exhibited lower cognitive empathy than controls in positive-valenced context; and lower cognitive empathy and empathic motivation in negative-valenced context. No significant Modality-by-Group interaction was found in the HSoA–LSoA sample.

SCZ patients have generalized impairments of cognitive and affective empathy across positive and negative contexts, particularly in multimodal conditions. HSoA individuals are primarily impaired in cognitive empathy and empathic motivation.

Evacuation shelters are essential temporary accommodations during disasters. However, concerns regarding shelter conditions, including safety and comfort, persist. Currently, the Internet is the most widely used source of information. This study aimed to investigate public interest in evacuation shelters in Japan by analyzing online search trends.

Monthly search volumes for search queries were obtained from Yahoo! JAPAN, one of the most frequently used search engines in Japan. The search volume data were obtained from the Yahoo! Japan DS INSIGHT server. We tracked the search volumes for “evacuation shelters” from 2020 to the most recent date, focusing on trends before and after the Noto Peninsula earthquake in January 2024. In addition, we analyzed search queries that included terms related to shelters to assess changes in interest.

The estimated search volume for “evacuation shelters” was 600 in December 2023, which increased to 13,200 in February 2024. In January 2024, searches for sexual assault countermeasures in shelters showed the most significant increase, rising by 13,750% from December 2023 to 5,500. Similar search terms were “shelter sexual harm examples” and “shelter sexual harm,” with 5,100 and 2,100 searches, respectively.

The study findings suggest that public concern about safety in evacuation shelters has increased rapidly in the wake of the 2024 Noto Peninsula earthquake. Concerns about sexual assault were prominent, strongly suggesting a need for countermeasures. These results highlight the importance of strengthening measures to prevent sexual assault and providing information tailored to the needs of the population in the management of evacuation centers, which will contribute significantly to the realization of safer and more secure evacuation centers.

Following the 2021 military coup in Myanmar, widespread conflict and displacement have severely strained healthcare systems along the Myanmar-Thailand border. This pilot study assessed emergency care capacity in the southern Shan and Karenni States, located in the southeastern region of Myanmar.

Interviews were conducted utilizing a modified WHO hospital unit emergency assessment tool across seven healthcare facilities. Cluster analysis methods were used on the data to identify naturally occurring groups across a set of variables provided to investigate healthcare infrastructure. Upon examination of the dendrogram and utilizing Ward’s algorithm, the data from the four clinics were grouped, while the three secondary hospitals were evaluated individually. Descriptive statistics were examined to understand the similarities and differences between locations.

Four clinics and three hospitals were evaluated, and 162 facility characteristics were obtained. All facilities were found to provide basic emergency care services and have at least one emergent bed available, while only one hospital has a 24-hour emergency care unit. Strengths across facilities studied include management of acute respiratory distress, intravenous fluid administration, and burn management. Critical gaps across facilities include an absence of a dedicated triage area and a lack of formalized protocols, quality improvement measures, and reliable access to water and electricity.

This pilot study reveals strengths and gaps in emergency healthcare infrastructure within the southern Shan and Karenni States. These findings underscore the need for targeted interventions to strengthen emergency care capacity in this conflict-affected region, focusing on infrastructure, protocol development, and resource availability.

The COVID-19 pandemic caused residency programs to rapidly transition to using virtual learning for didactic education. A tabletop game-style simulation of a mass casualty incident (MCI) was planned for the summer of 2020; rather than cancel it, the authors developed a method to run the simulation utilizing an online gaming platform (Roll20) to create an MCI drill. This model of virtual, game-style simulation has implications for education across all levels of training, making large-scale MCI simulations available to groups that otherwise would not have the opportunity or resources to participate in person.

This study utilized a cross-sectional survey of fifteen emergency medicine residents who participated in a virtual MCI simulation. The survey assessed learners’ perceptions of the simulation, focusing on preparedness, knowledge gained, impact on clinical practice, and utility and quality of the virtual tool. Survey items included Likert-scale and open-ended questions.

Seven individuals responded to the survey. 85.7% of respondents felt more prepared to deal with an MCI after the exercise and reported that this exercise was practice-changing. 85.7% reported that the virtual platform was a useful educational tool in disaster management and would be useful for other topics. Most participants (57.2%) felt that the pre-exercise instructions were challenging to understand, but 71.5% felt that, nonetheless, the learning objectives were achieved. Open-ended comments included a sense that this teaching method was “fun, innovative, and engaging,” but required more detailed pre-learning to ensure that all individuals could navigate the platform well.

An online role-playing platform is an effective, engaging method of conducting MCI exercises that improves knowledge and changes practice. Remote learning methods have the potential to increase participation in MCI simulations. This study is limited by the small group that participated. A larger study with wider participation is a promising future avenue for research.

In a mass casualty incident, adult medicine-trained emergency physicians and nurses may need to treat pediatric casualties, as part of Field Medical Teams (FMTs) deployed to pre-hospital First Aid Posts. These healthcare professionals are often unaccustomed to managing pediatric patients, who present relatively infrequently to adult general hospital emergency departments in Singapore. A pediatric pre-hospital trauma module was developed to address this gap in knowledge and skills, potentially improving the survival of pediatric casualties in a disaster scenario.

The pediatric module was embedded in the National Disaster Medical Responders’ Course (DMRC) to ensure all emergency medicine medical and nursing staff would progressively benefit from this training. The learning objectives included: 1) effective clinical management of pediatric trauma in a pre-hospital environment with limited medical resources; 2) efficient management of team dynamics in organizing the FMT’s response to pediatric trauma management in a pre-hospital environment; and 3) accurate prioritization during pediatric trauma triaging and evacuation to hospital in a pediatric-predominant mass casualty incident. The curriculum included the following aspects: triage; initial assessment and primary survey; airway, breathing, circulation, and disability considerations focusing on differences between adult and pediatric patients; and team dynamics. Course content was delivered via pre-recorded lectures (given the ongoing COVID-19 pandemic) and hands-on skill stations in small groups.

From April 2022-August 2024, 50 courses with 1144 participants from public healthcare institutions were conducted. Of the participants, 246/1144 (21.5%) were doctors, 787/1144 (68.8%) were nurses, 65/1144 (5.7%) were allied health, and 46/1144 (4.0%) were administrative staff.

Medical responders in a mass casualty incident need to be prepared for managing pediatric casualties, which are infrequently encountered in daily clinical practice. This module is an important component of Singapore’s disaster medical curriculum and will contribute to disaster preparedness for the vulnerable pediatric population.

Global connectivity increases the risk of infectious disease spread. Frontline healthcare workers’ knowledge and preparedness are crucial. HCIDs pose unique challenges due to high mortality and widespread impact. This study examines the current state of resident physicians’ knowledge on HCIDs as well as their comfort and willingness to provide care before and after specialized training.

The study involved emergency medicine learners using a pre- and post-survey design to assess their knowledge and comfort with HCIDs. Participants attended a 30-minute lecture on HCIDs, followed by a hands-on simulation with high-level PPE. The post-survey measured changes in their understanding and comfort after the interventions.

Most participants were emergency medicine residents. 32% had HCID training, 45% PPE training, 35% treated HCID patients, and 48% participated in a drill. Before education, 25% believed PPE would limit care, 38% knew where to find equipment, and 67% knew where to find HCID resources. After the simulation, these numbers increased to 79%, 58%, and 97%, respectively. Confidence in HCID knowledge rose from 2.3 to 3.6, ability to identify risk factors from 2.8 to 3.8, and preparedness from 2.5-3.0 to 3.8. Comfort in determining PPE for COVID was highest, with a 1.4-1.6 point increase for Ebola and Marburg. Biocontainment PPE tasks were rated moderately difficult.

Education and simulation significantly improved emergency medicine residents’ knowledge and preparedness for handling HCIDs. Post-simulation, there was a notable increase in the belief that PPE would limit patient care, awareness of equipment locations, and access to HCID resources. Confidence in identifying risk factors, symptoms, and preparedness for HCID care also saw substantial gains. Comfort in determining PPE for COVID remained the highest, with marked improvements for Ebola and Marburg. Overall, training effectively enhanced participants’ readiness and confidence in managing HCID scenarios, highlighting the importance of continued education and simulation in emergency medicine.

Ensuring continuity of service in any business is a priority, but in most cases, it does not impact life and death, except in a health care setting. How do you ensure that staff engage in the development and testing processes to meet their needs, as well as those of the organization, before activating their plan? This question was recently tested when a Local Health District undertook a project to rewrite the business continuity plans(BCP) to promote and increase awareness of the impact on services.

After extensive research, a BCP template was developed to ensure a standardised approach throughout the Local Health District. Key stakeholders were identified and invited to meetings and exercises. To inform the development of BCPs for each facility, simulated exercises of outages were conducted. This provided information for the development of the BCPs. Scenarios covered interruptions to the supply of power, gas, both medical and natural, and water.

The scenario progressed through discussion and directed questions. The exercises were recorded. This provided an opportunity for the development of the BCP to enhance current response assumptions and gain leverage for further engagement and development of robust and relevant plans.

Over 100 people participated in face-to-face sessions, with the majority being disaster portfolio holders, executives, department managers, and clinical managers. A review of notes taken showed that the exercise elicited a greater appreciation by attendees of the impact (if any) on their specific service and the need for development of service-specific plans. This approach to plan development was successful as it led to the development of contemporary plans while considering facility needs and expectations. This exercise provided an opportunity to review the level of understanding of a Business Continuity plan and the impacts such outages can have on the service delivery of individual departments.

Children around the world are vulnerable to disasters irrespective of the local abundance or scarcity of health resources. Often, children are overlooked in healthcare systems primarily focused on adults. Creating pediatric specific strategies that are adaptable to different geographies is essential to support children, especially during surge incidents. The United States government has recently supported the initiatives, the Administration for Strategic Preparedness and Response (ASPR) Pediatric Disaster Center for Excellence (PDCOE), and the Health Resources and Services Administration (HRSA) Pediatric Pandemic Network (PPN), to improve pediatric care throughout the disaster cycle in the US healthcare system. These initiatives have created partnerships with state, regional, and local entities to promote pediatric disaster response by all healthcare systems and their communities, regardless of local pediatric resources.

The PDCOE, Region 5 for Kids, created a pediatric hazard vulnerability analysis (HVA) toolkit that focuses on pediatric vulnerabilities in all disasters, a regional metrics scorecard to assist regions in understanding their pediatric strengths and gaps, and uses weekly regional hospital metrics to assist with surge mitigation. The PDCOE, Western Regional Alliance for Pediatric Emergency Management (WRAP-EM) created a Surge Toolkit as a just-in-time aid for a respiratory surge. The PPN created the Pediatric Surge All Hospital Handbook (PedSAHH), addressing community-wide needs to integrate pediatric surge planning in all hospitals. WRAPM-EM also created the “15 ‘til 50 Pediatric Mass Casualty Incident Plan Template”. These tools give critical recommendations for planning and just-in-time management of a surge of pediatric patients after a disaster or during a pandemic. While these pediatric surge support tools have been evaluated in a well-resourced country, the strategies described are applicable and adaptable to all communities, regions, and countries. The recommendations can be implemented with local surge practices to ensure that children receive optimal care within the entire disaster cycle.

The escalation of conflicts in the Middle East has led to an increased risk of terrorism resurgence in Europe. During past terrorist incidents, inefficient interagency collaboration has repeatedly been identified as a key obstacle to an efficient response. This study aims to investigate the perspectives of European prehospital emergency medical providers and law enforcement officers on interagency collaboration during terrorist incidents. It seeks to identify barriers, best practices, and opportunities for enhancing collaboration.

Interdisciplinary, international focus group interviews have been conducted online (at time of submission: nine interviews, 45 participants,13 European countries). Each interview has been analyzed using deductive coding for predefined topics, e.g., Command, Communication, and Hot Zone Care. Inductive coding has been used for additional content arising from the discussions.

The paucity of joint training opportunities and the need for political guidance were considered the most pressing issues. Interagency miscommunication, disparate situational awareness, and differing mindsets on the scene were identified to significantly impede provider safety on the scene. Within the national protocols of 73% (33/45) of participants, patient care inside the hot zone relied largely on police forces, including special forces. Concurrently, it has been emphasized that, due to a lack of resources, police forces are likely to focus not on patient care or evacuation but on threat elimination during the initial response phase. Additionally, evacuation resources have been identified as a bottleneck in transferring casualties from the hot zone to a safer zone. In summary, these factors create a therapeutic vacuum for casualties with potentially survivable injuries inside the hot zone.

This study pronounces the need for joint training opportunities, which are anticipated to increase provider safety. Further, it highlights the urgent necessity of political commitment to set a framework that enables providers to diminish the therapeutic vacuum inside the hot zone.

Triage and casualty evacuation are two essential components of the medical management of mass casualty incidents. However, there is a notable lack of scientific evidence supporting the validity of mass casualty triage protocols. This study aims to develop a ‘Drone Integrated, Artificial Intelligence-Based Mass Casualty Triage Decision Support System’ (DIABMaCTDeS) to assist on-scene response teams in making triage decisions and to enhance data transfer from the incident site to emergency management centers.

The development of the system occurred in four phases: (i) respiratory rate, pulse, oxygen saturation and body temperature detection algorithms were created by utilizing image processing techniques applied to drone captured footage; (ii) Drone Integrated Mass Casualty Triage Algorithm (DIMaCTA) was developed using the Delphi method; (iii) an artificial intelligence-based decision support system was built upon the DIMaCTA algorithm; (iv) a user application was developed to facilitate real-time data transfer between field teams and emergency management centers.

According to the preliminary results, the accuracy rate of the pulse, respiration, oxygen saturation, and body temperature detection algorithms varied between 95% and 99%. In the Delphi study, the interquartile range for expert opinions on decision points and scoring criteria was determined to be 1.2, and the total percentage of those who answered “partially agree” and “strongly agree” regarding the structure of the algorithm was 70% or above. These results show that a consensus was reached on the parameters and decision points in the algorithm.

The drone-integrated system enables faster scene access than ground teams, providing data on scene security, victim location, vital signs, and triage priorities. It allows the most urgent cases to be identified and evacuated quickly and safely. The system will significantly aid in the rapid assessment of casualties and data transfer to emergency management centers, both in urban and hard-to-access remote areas, especially where responder safety is uncertain.

The well-being of doctors is crucial for both the individuals and their patients; however, doctors experience higher rates of anxiety, depression, and burnout compared to the general population. The COVID-19 pandemic intensified these issues, particularly among junior doctors. A key step in addressing these challenges is to assess evidence-based well-being interventions implemented during and after the pandemic.

Question: In junior doctors, which well-being interventions were implemented and were effective during and after the COVID-19 pandemic?

This systematic review was reported following PRISMA guidelines using Cochrane risk-of-bias tools and the GRADE framework. Eligibility criteria: Peer-reviewed studies in English reporting on primary data and assessing interventions implemented after January 1, 2020, were included. Exclusions were letters, editorials, commentaries, conference abstracts, and studies that did not isolate junior doctor data.

Information sources: Databases searched included Embase, PubMed, Ovid, and Scopus on October 25, 2023.

Included studies: Twenty-six studies with 7751 participants were included, predominantly from the USA or UK, with a mean age range of 24.2 - 30.0 years. Twenty-four studies were of very-low or low-quality evidence. The three primary categories of implemented interventions were workplace improvements, increasing personal resources, and problem-resolution-focused.

Synthesis of Results: Significance was found in four studies, with p ≤ 0.05 and a quality of evidence higher than a very-low GRADE rating. These results demonstrated a reduction in burnout from an online group coaching intervention and a preparatory course, as well as a reduction in anxiety from a novel transitional role, and after the use of a smartphone application.

Limitations of evidence: Inconsistency in language, lack of definitions, and poor study designs, including limited co-design, hindered drawing meaningful conclusions. The impact of COVID-19 was noted with the modification of interventions and study designs.

Interpretation: Evidence-based interventions to address junior doctor wellbeing from high-quality studies are urgently required.

In recent years, the expansion and prolonged duration of disasters have underscored the importance of addressing traumatic stress among disaster support personnel. Effective support mechanisms are essential to mitigate the psychological impact experienced by individuals engaged in disaster response.

A survey was conducted from August to September 2021 to examine how disaster support personnel manage traumatic stress across various professions and organizational affiliations. A questionnaire was distributed to 1,109 organizations involved in disaster response in Japan, with ethical approval from the Life Design Graduate School Ethics Committee at Toyo University (approval number: 2020- 7S).

Valid responses were obtained from 581 individuals, including members of the Self-Defense Forces (22), police (12), fire services (260), coast guard (6), healthcare (146), social welfare (49), government administration (37), disaster volunteers (29), and psychological and other professionals (20). Qualitative analysis was conducted using the Steps for Coding and Theorization (SCAT) method to examine free-text responses. The analysis identified five key elements necessary for social support to assist disaster responders: the importance of psychological support, assistance from family and peers, workplace environment and interpersonal relationships, ongoing education and training, and structured organizational support systems.

In large-scale disaster settings where multiple professions collaborate, establishing shared rest spaces, providing access to psychological counselors, and conducting regular stress assessments are critical for enhancing mental health support. Furthermore, feedback mechanisms, such as coordination meetings, can strengthen support systems, promote mental well-being, and foster a cooperative, multi-agency approach to sustaining the mental health of disaster response personnel.

Limited facilities provide curative treatment for serious pediatric diseases, often necessitating long-distance transport. However, such transport poses challenges due to the need for extensive medical equipment. In emergencies where no alternatives are available, the Self-Defense Forces may be requested to provide evacuation within the framework of “disaster relief” Protocols. The Air Medical Evacuation Squadron (AMES) specializes in transporting critically ill patients using a fixed-wing aircraft. This study reviews the pediatric cases managed by AMES and analyzes patient characteristics.

Pediatric evacuation cases (n = 34) from 2006 to 2023 were reviewed. It was examined the age, main disease, purpose of transportation, evacuation distance, and use of mechanical ventilators or extracorporeal membrane oxygenation (ECMO) were examined, referring to the medical records held by AMES.

The average age was 5.7 ± 5.8 (0–16) years, and 17 (50%) were 1> year old. In addition, 10 (58.8%) children aged 1> year old were under seven months of age, and one case was under one month of age. The most common diseases were cardiovascular disease (CVD) in 18 patients and respiratory disease (RD) in 14. The purpose of transport was 16 cases of CVD to install a ventricular assist device, 3 cases of RD to undergo lung transplantation, and one case of CVD to undergo heart transplantation. The evacuation distance was 453.7 ± 218.6 miles, of which eight cases were over 600 miles. Twenty-nine patients (85.3%) were fitted with a ventilator, of which eight patients received ECMO (CVD, 6; RD, 2). In all cases, physicians from the transport hospital were on board. No cases of cardiac arrest occurred during evacuation.

The AMES functions adequately as “disaster relief” for the social mission of transporting critically ill pediatric patients.

There is a growing concern about the risk of exposure to acute and lethal doses of ionizing radiation due to terrorist attacks and the recent threat of nuclear weapons. In the event of a radiological or nuclear public health emergency, several thousand people suffer severe injuries from radiation exposure, which can lead to acute radiation syndrome (ARS). Thus, there is a grave need for therapeutic strategies to ameliorate ARS and save the lives of survivors. It was reported that the thrombopoietin receptor agonist romiplostim (RP) has the potential to rescue mice exposed to lethal total-body ionizing radiation (TBI). However, the detailed action mechanism of the radio-mitigative and life-saving effects of RP remains unclear. This study focused on the extracellular vesicles (EVs), which are involved in cell-to-cell communication, because the mechanism of RP action may be related to EVs that reflect the radio-mitigative information.

Female C57BL/6 mice exposed to lethal TBI were treated with RP, and the EVs were isolated from the serum and intraperitoneally injected into other mice with severe ARS.

The 30-day survival rate of mice subjected to lethal TBI with 6.5 Gy of X-rays drastically improved by 50-100% with the administration of EVs in the sera collected weekly from the mice in which radiation damage was alleviated, and the administration of RP avoided mortality. Four responsive microRNAs, namely, miR-144-5p, miR-3620-5p, miR-6354, and miR-7686-5p, showed significant expression changes in an array analysis. In particular, miR-144- 5p was expressed only in the EVs of RP-treated TBI mice.

Specific EVs may exist in the circulating blood of mice that escaped mortality with an ARS mitigator, and their endogenous molecules may be the key to the survival of mice with severe ARS.

The people-centered approach has become the key value of development. Health, as the core value of DRR, can be extended to all sectors for disaster risk reduction. As an international scientific programme co-sponsored by ISC and UNDRR, IRDR has implemented various research projects on analytical methodologies, data standards, computing capacity, multi-hazard early warning, resilient infrastructure, and community-based DRR. A few ICoEs of IRDR are especially focused on the public health impact of climate change and its adaptation via early warning, urban planning, and infrastructure construction. Health-centered infrastructure has become an emerging topic in the IRDR community. While cost-benefit analysis has dominated the planning, design, construction, and management of infrastructure in the past decades, the expected gain/loss of health years provides an alternative for monetary value. This endeavor calls for more extensive and in-depth collaboration and coordination among health sectors and other stakeholders.

Healthcare facilities near nuclear power plants face potential staffing challenges during nuclear accidents due to radiation exposure risks. Four years after the Great East Japan Earthquake, in 2015, we surveyed hospital staff working 11km from a nuclear power plant. 90.8% of respondents indicated willingness to work within national radiation dose limits, and 36.4% were willing to work under conditions reaching 100 mSv cumulative exposure. We conducted a follow-up survey at the same hospital eight years later.

In January 2024, we surveyed staff at a hospital near a nuclear plant regarding their willingness to work under three cumulative radiation exposure levels: 1 mSv, the standard dose limit for radiation workers in Japan, and 100 mSv. The standard annual dose limit for male radiation workers is 50 mSv, while it is 5 mSv per three months for female workers. Respondents indicated whether they were willing, unwilling, or uncertain about working under each exposure level.

The survey had a response rate of 90.2% (358 out of 397). Among respondents, 46.4% (n=166) were willing to work under 1 mSv exposure, 38.5% (n=138) under 50 mSv, and 28.5% (n=102) under 100 mSv. Compared to 2015, Chi-square tests indicated significantly lower acceptance rates across all exposure levels (χ²=187.4, p<0.001).

Hospital staff near nuclear power plants are essential for patient care and evacuation during nuclear incidents. However, many staff members expressed reluctance to work, even at low exposure levels (1 mSv). Enhancing staff preparedness requires improved risk communication and organizational measures to protect staff from radiation exposure, ensuring an effective response in future nuclear disaster scenarios.

Disasters are challenging and traumatic for autistic individuals. They may be sensitive to sensory stimuli, causing them to become overwhelmed because of chaos and noise. Communication difficulties can make it difficult for them to get help or connect with loved ones during disasters. The purpose of this study is to ensure that autistic individuals are recognized and considered in disaster preparedness efforts.

Challenges for Autistics:

Sensory difficulties may lead to panic attacks, sleep disorders, and other behavioral problems. Communication difficulties can make it difficult for them to get help or express their needs. Social difficulties can make it difficult for them to find support or connect with new people during a disaster. They may also experience anxiety in crowds.

Changes in routine cause significant stress and anxiety.

Safety risks. During disasters, autistic individuals may be at risk of getting lost or injured. They may also have difficulty taking the necessary steps to protect themselves.

In disasters, officials need to recognize autistic individuals and provide them with special support. Some common characteristics of autistic individuals:

Avoids eye contact.

Makes repetitive movements.

Has a limited range of languages

Difficulty understanding social rules.

Hypersensitivity or insensitivity to sensory stimuli.

Needs routines and stability.

Some behaviors shown by autistic individuals during disasters:

Confusion.

Anxiety.

Agitation.

Shutdown or self-isolation.

Risk of loss.

Difficulty protecting oneself.

Tips that can help identify autistic individuals:

Look for an identification bracelet or card.

Be patient and understanding.

Speak calmly and avoid eye contact.

Consider sensory needs: Use pictures or simple language instead of giving complex instructions.

Help establish routines.

Get expert support if necessary.

Recognizing autistic individuals during disasters and providing them with special needs is one of the most essential achievements for a resilient society.

Tularemia is a zoonotic disease caused by the gram-negative bacteria Francisella tularensis. It manifests in several forms depending on the infection site. Mainly, these are ulceroglandular, glandular, and pneumonic types. Tularemia has a long history in Georgia, with monitoring efforts initiated after its first recorded case in 1946. Human outbreaks have been documented across various regions, with notable increases in cases over recent decades, emphasizing the importance of enhancing surveillance and preparedness efforts. In this study, we will review a sudden increase in tularemia cases in Georgia in 2023.

Tularemia is classified as an especially dangerous pathogen and requires immediate reporting. Data was extracted through the Electronic Integrated Disease Surveillance System (EIDSS). Probable tularemia cases were patients with compatible clinical manifestations and a positive micro-agglutination test (MAT).

In the period of 2018-2022, 1 or 2 confirmed cases of tularemia were registered per year in EIDSS. However, in 2023, a total of 16 confirmed cases of tularemia were registered. Out of the total, 56.2% were male, and 43.8% - female. The mean age of the cases was 49 years. In 68.8% of cases, ulceloglandular, in 18.7% - glandular, and in 12.5% - pneumonic types were registered. All confirmed cases were registered in the eastern part of the country. The majority of cases were registered in the spring, summer, and autumn seasons (93.8%).

The sudden increase in tularemia cases in Georgia in 2023 underscores the need for heightened surveillance and response measures. With the majority of cases presenting as the ulceroglandular type and occurring in the eastern regions during warmer months, targeted interventions and public health initiatives are essential. This rise in cases, alongside tularemia’s classification as a bioterrorism threat, emphasizes the importance of robust surveillance, timely diagnosis, and effective disease control strategies to mitigate future outbreaks.

The Noto Earthquake Disaster, with a magnitude of 7.6, struck the peninsula region of Japan on January 1, 2024, leading to 245 fatalities in the sparsely populated area. This disaster highlighted the critical role of information literacy in disaster medical support.

The Disaster Medical Assistance Teams (DMATs) encountered cases demonstrating the need for information assessment and response adaptation based on facility characteristics and evolving situations. For instance, medical staff at Hospital A remarked that the view from the hospital windows appeared to be changing. At first, the meaning of this non-technical message was not fully understood. However, this message later proved significant, indicating ongoing structural collapse due to repeated earthquakes. Consequently, the DMATs immediately arranged an urgent patient transfer to safer facilities, avoiding potential casualties. At Facility B, despite adequate medical supplies, persistent disaster-related deaths were reported.

Precise investigations revealed that a severe shortage of healthcare providers and overwhelming fatigue prevent healthcare providers from effectively using these supplies. In response, the DMATs continuously provided nursing support, enabling more effective care. These cases may emphasize the importance of information literacy in disaster medicine. Rather than solely relying on standardized data collection, DMATs need to adapt information collection methods to the individual context of each facility’s characteristics and changing medical demands. Analyzing and interpreting diverse types of information could be important for timely, effective interventions.

In conclusion, enhancing information literacy among DMATs is important to ensure that information collection, interpretation, and application are consistent with institutional demands, which could ultimately improve patient outcomes in disaster settings.

Over the last few decades, the Israeli Ministry of Health (MOH) Disaster and Emergency Division has employed a unique model of military-civilian collaboration to amplify efforts to prepare the Israeli health system for disaster management in all scenarios - both in general hospitals and in community settings. The MOH and Home-front Command (HFC) implement a joint annual preparation program, incorporating civilian training with military-led drills and exercises, in an all-civilian health system. The MOH Disaster and Emergency Division’s Community Health Department and the HFC Community Health Branch jointly prepare all community health organizations: Health Districts, Health Funds, Geriatric and Mental Health Hospitals.

The ongoing “Iron Swords” war, following years of COVID, impacted workforce involvement in emergency preparation and management at all organizational hierarchies. This year, an HFC survey was conducted to assess this impact on perceived readiness for emergencies (PRE), including respondents’ self-perceived awareness of their role in emergencies, ability to implement this role, and belief that their facility can successfully manage emergencies, using a 31-item questionnaire sent to community health and extended-care organizations in Israel.

Significant variance was found between organization types in overall PRE, as well as between employees at different managerial levels and general employees. PRE was also significantly higher in scenarios where preparation included training and exercises.

Utilizing MOH-HFC teams to prepare an all-civilian health system is unique in that it enables the incorporation of a military approach to disaster and emergency management in civilian organizations. This significantly contributes to a “uniform language” of emergency management, and through this, enhances community health organizations’ self-perceived readiness for emergencies. Examples of issues faced and coped with, such as responding to prolonged power outage scenarios, evacuating patients with special medical needs from war zones, providing military aid to hospitals, and more, will be presented.