This study uses psychological reactance theory as a framework for designing effective emergency preparedness messages. Psychological reactance is the motivational state that occurs when individuals perceive their freedom to be threatened. From the standpoint of persuasive message design, reactance is an undesirable outcome that should be avoided whenever possible.

Participants (N = 174) were randomly assigned to view 1 of 2 emergency preparedness messages (choice-enhancing language [“the choice is yours”] vs choice-restricting language [“you must”]) in a between-subjects-posttest-only online survey experiment.

Structural equation modeling revealed that choice-restricting language resulted in greater freedom threat and subsequent reactance. Reactance resulted in a diminished attitude and subsequent intention to prepare an emergency kit.

Public health practitioners would benefit from the inclusion of choice-enhancing language in their public communications, alongside the exclusion of choice-restricting language. Pretesting of messages is recommended to avoid eliciting reactance and subsequent boomerang effects.

Two of the 5 great earthquakes have occurred in Iran between 1990 and 2005. Informal volunteers’ management is a determinant factor in disaster management. This research was conducted to investigate the management challenges of informal volunteers after the Kermanshah earthquake.

The study is qualitative, done by content analysis. Data were gathered by observation and semi-structured interview.

Analysis of 12 interviews resulted in 4 main categories (inappropriate dispatch, volunteers’ inefficiency, decrease in volunteers’ incentive, deficiency of welfare services) and 11 subcategories.

To avoid mistrust and decrease in motivation, proposed actions are: standardize information collection, apply effective communication, create registration networks and accreditation of certificates and expertise, and perform periodic drills.

We recommend the start of extracurricular programs and applying potential volunteers within the preparedness phase, and follow-up at the beginning of the response phase. Decrease of motivation to participate in future events needs to be studied more comprehensively.

In April 2014, the Sewol ferry sank off the coast of Korea, resulting in 304 deaths. Of these, 250 were local high school students from Ansan, and the disaster severely affected their community. This study investigated the association of this disaster with health examination, cancer screening rate, and vaccination rate.

The study subjects were adults ages ≥19 years (11 026 Ansan residents and 1 361 624 non-residents of Ansan) who participated in the 2011–2016 Korea Community Health Survey. The national health screening program examination rate, cancer screening rate, and influenza vaccination rate in Ansan residents and non-residents were assessed and their responses compared using chi-square tests, multiple logistic regression analyses, and a stratification analysis according to depression.

After the disaster (2014–2016), non-residents received more health screening (adjusted odds ratio [aOR] = 1.13, P < 0.001), cancer screening (aOR = 1.41, P < 0.001), and vaccination (aOR = 1.10, P = 0.002) than Ansan residents. This difference was more evident in the group without a depressive mood.

People living in disaster areas show lower rates of medical screening examination and receive fewer vaccinations after the disaster. To decrease health impacts by disaster, efforts to increase community health screenings and vaccinations may be needed.

Treating burn patients in the battlefield is one of the biggest challenges that military doctors and medical personnel can face. Wound patterns have been changed over time due to the introduction of new weapons, and many different aspects play a major role in the management of those burns nowadays. There is a potential gap in care of burn patients in war zones.

A thorough literature search in PubMed, scientific journals, and Internet sites was conducted in regard to burn patients and trauma in war zones.

It is crucial for military surgeons to be able to stabilize burn patients during wartime conflicts, especially those patients who suffer from extreme burn injuries, as specialized treatment should be given. Medical personnel should be aware of all medication types used, the ways to minimize the risk of bacterial infection, and the ways to keep the injured safe.

Injured civilians with burn trauma in the field of battle are deserving care, and special recognition should be given to the non-governmental organizations (NGOs) that strive to ease human suffering in war zones. Proper management of burn patients in war zones is crucial, and military medical staff and NGOs can play a key role in that purpose.

The aim of this study was to determine the involvement of emergency medicine physicians at academic medical centers across the United States as well as their background training, roles in the hospital, and compensation if applicable for time dedicated to preparedness.

A structured survey was delivered by means of email to 109 Chairs of Emergency Medicine across the United States at academic medical centers. Unique email links were provided to track response rate and entered into REDCap database. Descriptive statistics were obtained, including roles in emergency preparedness, training, and compensation.

Forty-four of the 109 participants responded, resulting in a response rate of 40.4%. The majority held an administrative role in emergency preparedness. Formal training for the position (participants could select more than 1) included various avenues of education such as emergency medical services fellowship or in-person or online courses. Of the participants, most (93.18%) strongly agreed that it was important to have a physician with expertise in disaster medicine assisting with preparedness.

The majority of responding academic medical center participants have taken an active role in hospital emergency preparedness. Education for the roles varied though, often consisted of courses from emergency management agencies. Volunteering their time for compensation was noted by 27.5%.

Large scale radiologic and nuclear disasters are rare; however, recent events such as the Fukushima Daiichi nuclear reactor emergency in Japan and current global political tensions have highlighted the need for health-care providers with expertise in managing radiation injuries. Medical Toxicologists have the ability to collaborate with other specialists in filling this critical role.

We conducted a cross-sectional survey to assess the attitudes, experiences, and knowledge of medical toxicologists through the assistance of the American College of Medical Toxicology.

The survey was completed by 114 medical toxicologists during the enrollment period. Medical toxicologists who had a willingness to participate in radiologic or nuclear emergencies or who had taken care of patients contaminated with radioactive material were more likely to perform well on the knowledge assessment.

We identified that there is a group of medical toxicologists who have the willingness, experience, and knowledge to help manage patients in the event of a radiologic or nuclear emergency.

Experience of a major disaster can potentially impact on tobacco consumption. Our objective was to explore the determinants of increasing tobacco consumption after the Great East Japan Earthquake (GEJE).

We conducted a cross-sectional study using data from the Miyagi Prefectural Health Survey 2014: a total of 2632 people were randomly selected from residents aged ≥20 years in Miyagi, Japan. Of 2443 respondents (response rate = 92.8%), 551 current smokers (411 men) were included in the analysis. Odds ratios (OR) and 95% confidence interval (CI) for increasing tobacco consumption were calculated using multivariable logistic regression models including variables of age, sex, disaster-related job status change, education status, self-rated health, and age at smoking initiation.

After adjustments for all variables, significantly higher ORs for increasing tobacco consumption after the GEJE were observed in women (OR = 1.87; 95% CI = 1.10–3.15), 20–39 years old (OR = 5.18; 95% CI = 2.28–11.75), 40–59 years old (OR = 3.97; 95% CI = 1.76–8.94) and respondents who had lost their jobs (OR = 3.42; 95% CI = 1.06–11.05) than the counterpart categories.

This study found 3 determinants of increasing tobacco consumption after a major disaster: being a woman, being of working age, and experiencing disaster-related job loss.

Anesthesiologists play a pivotal role in mass-casualty incidents management. Disaster medicine is part of the anesthesiologist’s core skills; however, dedicated training is still scarce and, often, it does not follow a standardized program.

We designed and delivered a crash course in disaster medicine for Italian anesthesiology residents participating in the nationwide program, Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) Academy Critical Emergency Medicine 2019. Residents totaling 145, from 39 programs, participated in a 75-minute workstation on the principles of disaster management. Following this, each participant was involved in a full-scale mass-casualty drill. A plenary debriefing followed to present simulation data, maximize feedback, and highlight all situations needing improvement.

Overall, participant performance was good: Triage accuracy was 85% prehospital and 84% in-hospital. Evacuation flow respected triage priority. During the debriefing, residents were very open to share and reflect on their experiences. A narrative qualitative analysis of the debriefing highlights that many participants felt overwhelmed by events during the exercise. Participants in coordination positions shared how they appreciated the need to switch from a clinical mindset to a managerial role.

This was an invaluable experience for anesthesiology trainees, providing them with the skill set to understand the fundamental principles of a mass-casualty response.

Health-related quality of life (HQL) among older adults is often neglected and underprioritized in developing countries and is further burdened during natural disasters, such as earthquakes. The main objective of this study was to explore the factors affecting HQL among older adults living in Lalitpur District of Nepal.

A total of 362 older adults participated in this study. Questionnaires were used to interview the respondents on various aspects, such as posttraumatic stress disorder (PTSD) and depression, functional ability, and social support. An analysis was made to explore the factors affecting HQL.

HQL scores ranged between 3.13 and 90.63. A majority of the respondents (215/362; 59.4%) scored ≤ 50, indicating poorer HQL. The multivariate analysis found the impact of the following factors on HQL: functional status (β = 0.295; P < 0.001), PTSD (β = −0.225; P < 0.001), chronic disease (β = −0.168; P < 0.001), social support (β = 0.120; P = 0.019), injury (β = −0.104; P = 0.024), age (β = −0.116; P < 0.001), and accessibility to resources.

Poor HQL of older adults was dependent on various factors. The disaster preparedness program in Nepal needs urgent attention to address the concerns of older adults by incorporating the findings from this study.

This study was focused on reviewing the emergency and disaster preparedness of European hospital pharmacists.

An online survey based on International Pharmaceutical Federation (FIP) guidelines for natural disasters was sent to European hospital pharmacies, with the support of the European Association of Hospital Pharmacists. Additional questions were added about the characteristics of respondents, as well as preparedness and experience of manmade disasters. Descriptive statistics were used to analyze the results.

Hospital pharmacists in France (20%) and Spain (19%) returned most of the 306 questionnaires completed in 27 countries. Half of the respondents had analyzed their regional disaster risk, but 65% had never practiced emergency drills. Fifteen percent of respondents had experienced at least 1 major emergency or disaster event in the last 5 years. Fifty-six percent of those respondents who experienced a disaster subsequently created and promoted internal standard operating procedures (SOPs) for future emergencies, versus 23% for those who had not experienced disasters. Among pharmacists having experienced disasters, 40% organized a post-disaster debriefing to improve their future response.

Results highlighted that most European hospital pharmacists were not fully compliant with FIP guidelines. However, respondents who had experienced disasters were more likely to create and promote SOPs for future disasters. Further worldwide analysis and benchmarking are necessary, and FIP guidelines should be more strongly promoted.