This study examines factors influencing the development of disaster meal provision manuals in food service facilities in earthquake-prone regions of Japan. Given the increasing frequency of natural disasters, ensuring meal service facilities’ preparedness is crucial to safeguarding vulnerable populations, including infants, pregnant women, the elderly, and individuals with chronic conditions.

A survey of 866 meal service facilities in Mie Prefecture, Japan, was conducted to assess disaster preparedness measures. Key factors analyzed included the presence of registered dietitians, disaster preparedness drills, and stockpiling of balanced emergency food supplies. Logistic regression analysis was used to identify predictors of manual development.

The presence of registered dietitians (OR = 2.82, 95% CI: 1.95-4.08), disaster preparedness training (OR = 3.15, 95% CI: 2.18-4.57), and balanced emergency food stockpiles (OR = 2.52, 95% CI: 1.66-3.83) were significant predictors of disaster meal provision manual development.

Findings underscore the essential role of dietitians in disaster nutrition planning and highlight the need for proactive preparedness strategies to enhance food security and facility resilience. These insights can inform policy recommendations in Japan and other disaster-prone regions facing similar challenges.

This study examined the relationship between climate change awareness and belief in disaster preparedness among university students and explored the mediating role of social media use purposes.

A cross-sectional survey was conducted with 418 university students. Data were collected using validated scales measuring climate change awareness, disaster preparedness belief, and social media use purposes. Pearson correlation, multiple linear regression, and bootstrap-based mediation analysis (PROCESS Macro Model 4) were performed.

Climate change awareness was positively associated with both social media use purposes (r = .322, P < 0.001) and disaster preparedness belief (r = .307, P < 0.001). Regression analysis showed that climate change awareness (B = 0.185, P < 0.001) and social media use purposes (B = 0.243, P < 0.001) significantly predicted disaster preparedness belief. Mediation analysis indicated that social media use purposes partially mediated the relationship between climate change awareness and preparedness belief.

Higher climate change awareness was associated with stronger disaster preparedness beliefs among university students. Social media use purposes partially mediate this relationship and function as a complementary digital mechanism linking climate awareness to preparedness beliefs

To identify stakeholders’ perceptions of the role of the nurse educator in Hospital Disaster Management (HDM), determine the core competencies required for their effective participation, and establish training areas to enhance their participation during disasters.

A qualitative hermeneutic-phenomenological design was adopted with 38 stakeholders comprising doctors, clinical nurses, nurse administrators, and nurse educators in tertiary hospitals and nursing colleges in Kerala, India. The responses were collected through in-depth interviews with 15 respondents and focus group discussions with 4 different groups in December 2023.

Themes identified included preparedness gaps, underuse of secondary stakeholders, training and coordination capabilities, training needs, fear of clinical competence and safety, role confusion, elitism, and social responsibility, totaling 7 themes. Participants identified roles, preparedness, variable clinical exposure, and the necessity of planned competency development as unsatisfactory. The nurse educators were able to contribute to training, supervision, documentation, and psychosocial support, provided they are well prepared.

Nurse educators can be of great help to HDM, but are not being used to their full potential due to unclear role expectations and limited readiness. Their competencies can be enhanced and incorporated into institutional disaster plans to build surge capacity and improve coordination in hospital disaster responses.

The widespread use of explosive weapons in populated areas (EWIPA) has become a defining feature of modern conflict with devastating consequences for civilians. Practical guidance on sheltering during explosive attacks remains limited, inconsistent, and unevenly integrated with existing scientific and technical evidence. This study explored the landscape of shelter guidance through the perspectives of international humanitarian practitioners working in EWIPA contexts.

Semi-structured interviews were conducted with 10 practitioners from international humanitarian NGOs, Red Cross societies, and UN agencies engaged in risk education, emergency response, and conflict monitoring. Participants were purposively selected for operational experience in EWIPA-affected regions. Interviews explored 4 domains: guidance content, information sources, dissemination channels, and implementation challenges. Data were analyzed using a hybrid inductive-deductive approach.

Practitioners described various sheltering messages, from general cues like “find cover” to specific techniques including low-profile positioning. Most guidance drew on field experience rather than empirical research. Dissemination strategies varied by context. Challenges included message distortion, difficulty engaging high-risk groups, and absence of standardized recommendations.

Shelter guidance in EWIPA contexts is fragmented and only partially connected to the existing technical and scientific evidence base. Findings highlight the need for coordinated, context-specific, and evidence-informed approaches to strengthen civilian protection.

Violence against health workers and health care facilities in conflict settings is a major public health concern, disrupting service delivery and undermining humanitarian response. While attacks on health care have been widely documented, standardized multicountry comparisons using consistent surveillance metrics remain limited.

A retrospective, descriptive observational analysis was conducted using incident-level, open-source records curated on the United Nations Humanitarian Data Exchange (HDX) from 2016 to 2024, covering 20 conflict-affected settings. Incidents involving harm to aid and health workers and attacks on health care facilities were summarized descriptively and standardized per capita to enable cross-setting comparison.

Across the 20 settings, reported harm to health systems increased after 2021. PSE exhibited the highest per-capita burden, with 407 aid and health-worker fatalities and 420 reported attacks on health care facilities, while Ukraine recorded the highest absolute number of facility attacks (1,060). Myanmar demonstrated a distinct pattern characterized by large-scale arrests of health care workers following the 2021 military coup. Other settings demonstrated variable burdens and harm modalities, including personnel-lethal, infrastructure-destructive, and coercive patterns.

Reported attacks on health care in conflict settings are widespread and heterogeneous. This descriptive, per-capita comparison highlights variability in harm modalities across settings and identifies high-burden contexts that may warrant prioritization for surveillance strengthening, preparedness planning, and protection-focused operational coordination. Further research is needed to examine drivers, impacts on service delivery, and prevention strategies using attribution-aware, mixed-methods approaches.

This study explores the relationship between sustainable earthquake awareness and earthquake stress coping strategies among university students following the February 6, 2023, earthquake.

A descriptive, cross-sectional study was conducted between March and April 2024, involving 239 university students. Following the STROBE checklist, data were collected using the Personal Information Form, Earthquake Stress Coping Scale (ESCS), and Sustainable Earthquake Awareness Scale (SEAS). Ethics approval was obtained, and data were gathered through face-to-face surveys.

The average participant age was 21 years; 67.8% were women, and 20% had direct earthquake experience. Among participants, 67.4% reported negative academic impacts due to the earthquake. Higher SEAS scores were associated with higher income, prior earthquake experiences, having an emergency kit, securing belongings, and participation in earthquake training and drills. Higher ESCS social support-seeking scores correlated with higher income, earthquake preparedness training, drill participation, awareness of emergency meeting areas, and enrollment in the child development department.

The findings highlight gaps in earthquake preparedness among university students while emphasizing the role of personal earthquake experiences in fostering awareness and adaptive coping strategies. Enhancing earthquake preparedness training could improve resilience among students in earthquake-prone regions.

To assess interagency emergency response capabilities for radiological threats through a tabletop exercise (TTX) simulating a nuclear power plant accident, with focus on communication protocols, patient referral pathways, and public information management in Ukraine’s current security context.

A structured 3-day TTX was conducted in September 2024 by the WHO Ukraine Country Office, simulating a cooling system failure at a fictional North-West Nuclear Power Plant. Twelve organizations participated, including regional health authorities, emergency services, and international partners. The exercise employed a progressive scenario that injects testing accident notification, media management, medical response, and evacuation procedures. Performance was evaluated using structured criteria (Achieved, Partially Achieved, Not Achieved) across predefined indicators.

The exercise identified critical preparedness gaps including the absence of regular radiological-nuclear emergency drills in regions without nuclear facilities, challenges in potassium iodide procurement and distribution, staff hesitancy due to inadequate insurance coverage, and lack of standardized decontamination procedures. Communication protocols functioned effectively, though coordination delays were noted. Patient referral pathways required strengthening, particularly for contaminated casualties.

While Ukraine demonstrates functional emergency response frameworks, specific radiological preparedness requires enhancement. Regular multiagency drills, improved staff protection policies, standardized decontamination protocols, and robust public information systems are essential for effective radiological emergency response.

As natural disasters become more frequent and severe, healthcare organizations are tasked with ensuring both operational continuity and workforce wellbeing. This study examines the preparedness, response, and recovery efforts of a nationally ranked children’s hospital in the southeastern United States during the 2024 hurricane season, focusing specifically on the experiences of advanced psychology trainees.

Doctoral and postdoctoral trainees (N = 9) completed a brief anonymous survey examining departmental and organizational hurricane preparedness strategies and response following two successive hurricanes.

Results revealed variable engagement of trainees with preparedness materials and increased distress with threat of the second storm. Communication from training directors was identified as a key support factor, with trainees preferring personalized updates over broader organizational messaging. While most trainees reported their long-term career decisions are unlikely to be impacted by their hurricane experiences, one-third noted that geographic risk may influence future professional choices.

Findings highlight the importance of integrating disaster preparedness into training programs and underscore the need for tailored supports to promote psychological resilience during times of uncertainty. Limitations and recommendations for future multi-site, multi-informant, mixed-methods research are discussed to inform best practices in disaster preparedness for healthcare trainees.

To evaluate the hospital-level impact of the COVID-19 pandemic on U.S. academic medical centers (AMCs) and assess regional variation in care delivery to inform public health emergency preparedness strategies.

We retrospectively analyzed adult inpatient discharges from 106 AMCs using Vizient® Clinical Data Base from October 2019 to December 2023. The study period was divided into pre-COVID (Oct 2019-Mar 2020), early-COVID (Apr 2020-Dec 2020), late-COVD (Jan 2021-May 2023), and post-COVID (Jun-Dec 2023). Outcomes included hospital encounters, length of stay (LOS), ICU admissions, ICU LOS, mortality, and case mix index (CMI). Mixed models assessed temporal and regional variation.

Among 13.5 million discharges, monthly encounters declined during early COVID and rebounded post-COVID (P < 0.0001). Observed LOS increased from 6.2 to 6.7 days during the pandemic and remained elevated post-COVID (P < 0.0001). ICU LOS rose during early and late COVID (P < 0.0001), while ICU admission rates declined slightly over time (P = 0.0112). Mortality peaked at 3.4% during early COVID and returned to 2.8% post-COVID (P < 0.0001).

The COVID-19 pandemic significantly disrupted inpatient operations at U.S. AMCs, with increased LOS, ICU burden, and case complexity. By segmenting the pandemic into phases, we identified patterns in hospital performance that reflect evolving public health challenges.

This study examines the impact of a disaster awareness education program on general disaster preparedness beliefs in Türkiye, utilizing the Health Belief Model as a theoretical framework.

A quasi-experimental, single-group design with pre-test, post-test, and follow-up measurements was employed. Participants were enrolled in a Disaster Awareness Education course at a Public Education Center. Data were gathered using a demographic questionnaire and the General Disaster Preparedness Belief (GDPB) Scale. Repeated measures ANOVA was conducted to assess changes over time.

Significant improvements were observed in perceived susceptibility, perceived severity, perceived barriers, cues to action, and self-efficacy following the intervention. While male participants showed no significant changes, female and middle-income participants experienced substantial improvements. Perceived susceptibility initially increased but reverted to baseline at follow-up. Perceived severity decreased and remained low, whereas perceived barriers declined post-education but were not sustained. Cues to action showed a steady increase, suggesting ongoing motivation. Self-efficacy improved significantly and was maintained over time.

Disaster education has a positive impact on general disaster preparedness beliefs. Tailored interventions may be especially beneficial for specific demographic groups such as males and lower-income individuals. It is recommended that future studies investigate the mechanisms underlying demographic disparities in educational impact, particularly among male and low-income participants.

Disaster preparedness is a critical component of nursing education as nurses are expected to respond effectively to public health emergencies. Various disaster nursing education programs have been developed globally, but their effectiveness across cognitive, affective, and psychomotor domains remains unclear. This meta-analysis evaluated the overall impact of these programs across learning domains.

Eleven experimental or quasi-experimental studies involving nursing students and nurses were included. The pooled effect size was calculated using Hedges’ g. Heterogeneity was assessed using Cochran’s Q and the I2 statistic. Subgroup analyses were conducted by learning domain. Publication bias was assessed via a funnel plot.

The overall effect size was large (Hedges’ g = 1.80, 95% CI: 1.491-2.399, P < .001). Heterogeneity was high (Q = 377.91, P < .001, I2 = 97.4%). The affective domain showed the strongest effect (g = 2.96), followed by psychomotor (g = 1.98) and cognitive (g = 0.66). The funnel plot showed minimal publication bias.

Disaster nursing education programs significantly improve learning outcomes across domains, especially in attitudes and practical skills. These findings support the need for integrated curricula in nursing education.

This qualitative study aimed to explore the lived experiences, challenges, and perceptions of nurses regarding disaster preparedness in non–first-tier (inland) cities in China. Building upon our previous quantitative findings, we sought to understand the psychological, professional, and organizational factors that influence nurses’ disaster response capabilities in resource-limited settings.

A descriptive phenomenological approach was employed. Semistructured in-depth interviews were conducted with 12 nurses from four comprehensive hospitals at or above the second level in Yongcheng City, Henan Province, China, between September and December 2023. Participants were purposively selected based on their involvement in disaster response activities. Interviews were audio-recorded, transcribed verbatim, and analyzed using Colaizzi’s 7-step method.

Five major themes emerged from the analysis: (1) Psychological Stress and Emotional Adaptation, (2) Disaster Emergency Response Capacity and Management, (3) Communication and Collaboration, (4) Challenges in Disaster Nursing Capacity Development, and (5) Impact of Disaster Relief Participation. Key findings revealed that nurses experienced significant psychological pressure during disaster response, struggled with limited specialized training opportunities, faced challenges in team coordination, and identified institutional barriers to disaster preparedness enhancement. Despite these challenges, participants demonstrated strong professional commitment and developed personal coping strategies.

This study provides critical insights into the lived experiences of nurses during disaster response in Chinese non–first-tier cities. The findings highlight the need for systematic psychological support mechanisms, specialized disaster nursing training programs tailored to local contexts, enhanced interhospital collaboration networks, and stronger institutional commitment to disaster preparedness. These insights complement our previous quantitative findings and offer a comprehensive foundation for developing targeted interventions to enhance disaster nursing capabilities in resource-limited settings.

To evaluate anesthesiologists’ preparedness and training needs during a mass casualty event in a resource-limited setting, focusing on hospital disaster planning and response effectiveness.

This study utilized an exploratory mixed-methods design, combining qualitative and quantitative approaches to assess the experiences of anesthesiologists during a catastrophic disaster. Data were collected through interviews and a survey of anesthesiologists who were directly involved in emergency response.

The findings highlight significant gaps in disaster preparedness among hospitals, influenced by factors such as physical infrastructure damage, resource shortages, and limited personnel involvement in disaster planning. Anesthesiologists demonstrated adaptability and commitment despite inadequate training and limited disaster management frameworks. The study underscores the urgent need for standardized disaster preparedness plans, multidisciplinary training, and enhanced psychological support for health care professionals.

This study reveals critical deficiencies in hospital disaster preparedness and anesthesiologists’ training in emergency response. Addressing these gaps through robust disaster planning, simulation-based education, and institutional support is essential to enhance health care systems’ resilience in resource-limited and conflict-affected regions.

This study evaluates the level of disaster preparedness among first-line nurse managers.

The presented study utilizes Bandura’s Social Cognitive Theory of Self-Efficacy as a theoretical framework as it emphasizes that individuals’ confidence in their abilities, shaped by experience, training, and education, plays a significant role in their performance during disaster management and increased by real-world experience as well as education. A descriptive cross-sectional survey design was conducted by using a validated questionnaire based on the International Council of Nurses framework. Data were collected using a convivence sample of 106 first-line nurse managers across hospitals in Jordan between March and May 2023. Descriptive and inferential statistics were utilized.

The results highlighted a moderate level of disaster preparedness (M = 3.52, SD = 0.84), with the highest scores in assessment (M = 3.65, SD = 0.92) and intervention (M = 3.58, SD = 0.98). Significant differences in preparedness were observed based on hospital type, leadership role, disaster training type, and education level. Nurse managers with prior disaster training, higher education, and leadership roles indicated a higher level of preparedness.

This study highlights the need for increased disaster training programs tailored to nurse managers, integrating theoretical knowledge with hands-on experience. Strengthening disaster preparedness in nursing education and hospital policies is essential to ensure effective disaster response and improve patient safety. Findings can guide future strategies for disaster preparedness training and policy development in Jordanian health care settings.