The role of hazard vulnerability assessments in disaster preparedness and prevention in China

Comparing online and onsite simulation modules for improving knowledge and confidence in disaster preparedness among undergraduate medical students

BACKGROUND

Disaster preparedness is one of the critical strategies for effectively managing disasters and has been an area of high focus in the healthcare sector over the past few decades. The current Indian medical undergraduate curriculum does not describe any novel methods for disaster preparedness training. There is a need for a better understanding of novel teaching-learning methods and modes for administering disaster preparedness training among Indian medical students.

OBJECTIVES

Describe the undergraduate medical students' baseline knowledge and confidence level of disaster preparedness. Compare undergraduate medical students' knowledge scores and confidence levels on disaster preparedness after online and onsite delivery of the disaster preparedness module.

METHODS

In this educational interventional study, 103 medical students were divided into two groups and subjected to an online or onsite session of the validated disaster preparedness module (based on the COVID-19 pandemic), encompassing a simulation-based tabletop exercise. Baseline testing was done for 52 participants in the online group and 51 in the onsite group of the study. Post-intervention, they were assessed with single-response type MCQs for knowledge and Likert scale-based questions for confidence scores. The pretest and posttest scores were collected, and the data were analysed using two-tailed t-tests for paired analysis of within-group (online group or onsite group) and heteroscedastic analysis of between-group datasets.

RESULTS

One hundred and three participants completed the exercise-52 participants were from the online group, and 51 were from the onsite group. After the intervention, there was a statistically significant increase in knowledge and confidence in both online and onsite groups. There is, however, no significant difference in the 'percentage change' in 'knowledge' or 'confidence' between the groups.

CONCLUSIONS

Our study indicates that the disaster preparedness module, delivered online and onsite, improves knowledge and confidence among undergraduate medical students. However, there is no superiority between one mode of delivery and the other. We conclude that online training can facilitate disaster preparedness training as a corollary to the prescribed traditional training methods for undergraduate medical students in India.

Vulnerability of migrant women during disasters: a scoping review of the literature

BACKGROUND

Disasters have an unequal impact on the population because of differences in conditions of vulnerability, exposure, and capacity. Migrants and women are among the groups that are at greater risk for and disproportionately affected by disasters. However, despite the large body of evidence that analyzes their vulnerability separately, disaster research that targets migrant women is scant. The aim of this scoping review was to analyze the published scientific literature concerning the vulnerability of migrant women and the consequent negative impact they experience during disasters.

METHODS

A literature search was conducted on December 15th, 2021 on Pubmed, Scopus, and Web of Science databases. No time filter was applied to the search. Information regarding the article's main characteristics and design, migrant women and their migration experience, as well as about the type of disaster was collected. The factors responsible for the vulnerability of migrant women and the negative outcomes experienced during a disaster were extracted and inductively clustered in main themes reflecting several vulnerability pathways. The review followed the Joanna Briggs Institute methodology for scoping reviews and relied on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).

RESULTS

After full text review, 14 articles met the inclusion criteria. All of them adopted a qualitative methodology and focused on COVID-19. The pandemic negatively affected migrant women, by triggering numerous drivers that increased their level of exposure and vulnerability. Overall, six vulnerability factors have been identified: legal status, poverty conditions, pre-existing health conditions, limited agency, gender inequality and language and cultural barriers. These resulted in nine impacts: worsening of mental health status, poor access to care, worsening of physical health conditions, fraud, exacerbation of poverty, gender-based violence, jeopardization of educational path, and unfulfillment of their religious needs.

CONCLUSIONS

This review provided an analysis of the vulnerability factors of migrant women and the pathways leading to negative outcomes during a disaster. Overall, the COVID-19 pandemic demonstrated that health equity is a goal that is still far to reach. The post-pandemic era should constitute the momentum for thoroughly addressing the social determinants of health that systematically marginalize the most vulnerable groups.

The Use of Virtual Reality to Improve Disaster Preparedness Among Nursing Students: A Randomized Study

BACKGROUND

Disaster response inevitably challenges the capacity and capability of nurses. Nursing students are an important reserve force in disaster response; hence, disaster preparedness is increasingly needed.

METHOD

A two-arm randomized controlled trial was adopted. Forty-nine nursing students were assigned into the virtual reality (VR) groups, and 52 were allocated into the control group. Data were collected at baseline and at the end of the study.

RESULTS

After adjustments for basic characteristics, the effects of VR groups on disaster preparedness (F(1,94) = 11.049, p = .001, ηp² = 0.105), confidence (F(1,94) = 6.992, p = .010, ηp² = 0.069) and performance (F(1,94) = 4.298, p = .041, ηp² = 0.044) were assured.

CONCLUSION

Integrating VR groups into the nursing curriculum on disaster response could enhance disaster preparedness, confidence, and performance among nursing students. VR groups represent a cost-effective modality of simulation in nursing education, which could bridge the gap between the lack of disaster training and the high demands for disaster preparedness. [J Nurs Educ. 2022;61(2):93-96.].

Evolving Trends and Research Hotspots in Disaster Epidemiology From 1985 to 2020: A Bibliometric Analysis

Background: Disaster epidemiology has not attracted enough attention in the past few decades and still faces significant challenges. This study aimed to systematically analyze the evolving trends and research hotspots in disaster epidemiology and provide insights into disaster epidemiology.

Methods: We searched the Scopus and Web of Science Core Collection (WoSCC) databases between 1985 and 2020 to identify relevant literature on disaster epidemiology. The retrieval strategies were TITLE-ABS-KEY (disaster epidemiology) and TS = (disaster AND epidemiology). Bibliometrix, VOSviewer 1.6.6 and SigmaPlot 12.5 were used to analyze the key bibliometric indicators, including trends and annual publications, the contributions of countries, institutions, journals and authors, and research hotspots.

Results: A total of 1,975 publications were included. There was an increasing trend in publications over the past 35 years. The USA was the most productive country. The most frequent institutions and journals were Fukushima Medical University and Prehospital and Disaster Medicine. Galea S made significant contributions to this field. “Epidemiology” was the highest-frequency keyword. COVID-19 was highly cited after 2019. Three research hotspots were identified: (i) the short- and long-term adverse health effects of disasters on the population; (ii) COVID-19 pandemic and emergency preparedness; and (iii) disaster management.

Conclusions: In recent decades, the USA was a global leader in disaster epidemiology. Disaster management, the short- and long-term health effects of disasters, and the COVID-19 pandemic reflected the research focuses. Our results suggest that these directions will remain research hotspots in the future. International collaboration is also expected to widen and deepen in the field of disaster epidemiology.

Evaluate Typhoon Disasters in 21st Century Maritime Silk Road by Super-Efficiency DEA

The Belt and Road Initiative involves many countries and areas. As the introducer, China plays a key role in the initiative. However, the coastal areas in China have frequently been hit by typhoons that lead to huge casualties and economic losses. In order to reduce damages caused by natural disasters, this paper selected the coastal regions of the 21st Century Maritime Silk Road as the study areas, specifically Shanghai, Zhejiang, Guangdong, Fujian, and Hainan, to estimate the vulnerability to typhoon disasters based on the historical data about typhoon disasters and the super-efficiency data envelopment analysis (DEA) evaluation model. Although Shanghai is a low-vulnerable region, it needs to pay close attention to the risk of typhoon disasters due to the outstanding economic influence. In addition, it was found that the vulnerability to typhoons in Zhejiang, Guangdong, and Hainan showed a dramatic fluctuation from 2011 to 2016, and Zhejiang's vulnerability in 2013 was extremely high compared to other years. Meanwhile, Guangdong and Hainan are highly vulnerable areas, suffering from typhoon disasters heavily. Moreover, the vulnerability to typhoons for Fujian is relatively low.

Strategy and technology to prevent hospital-acquired infections: Lessons from SARS, Ebola, and MERS in Asia and West Africa

Hospital-acquired infections (HAIs) are serious problems for healthcare systems, especially in developing countries where public health infrastructure and technology for infection preventions remain undeveloped. Here, we characterized how strategy and technology could be mobilized to improve the effectiveness of infection prevention and control in hospitals during the outbreaks of Ebola, Middle East respiratory syndrome (MERS), and severe acute respiratory syndrome (SARS) in Asia and West Africa. Published literature on the hospital-borne outbreaks of SARS, Ebola, and MERS in Asia and West Africa was comprehensively reviewed. The results showed that healthcare systems and hospital management in affected healthcare facilities had poor strategies and inadequate technologies and human resources for the prevention and control of HAIs, which led to increased morbidity, mortality, and unnecessary costs. We recommend that governments worldwide enforce disaster risk management, even when no outbreaks are imminent. Quarantine and ventilation functions should be taken into consideration in architectural design of hospitals and healthcare facilities. We also recommend that health authorities invest in training healthcare workers for disease outbreak response, as their preparedness is essential to reducing disaster risk.

Ethical problems in an era where disasters have become a part of daily life: A qualitative study of healthcare workers in Turkey

Background

Natural disasters, armed conflict, migration, and epidemics today occur more frequently, causing more death, displacement of people and economic loss. Their burden on health systems and healthcare workers (HCWs) is getting heavier accordingly. The ethical problems that arise in disaster settings may be different than the ones in daily practice, and can cause preventable harm or the violation of basic human rights. Understanding the types and the determinants of ethical challenges is crucial in order to find the most benevolent action while respecting the dignity of those affected people. Considering the limited scope of studies on ethical challenges within disaster settings, we set upon conducting a qualitative study among local HCWs.

Methods

Our study was conducted in six cities of Turkey, a country where disasters are frequent, including armed conflict, terrorist attacks and a massive influx of refugees. In-depth interviews were carried out with a total of 31 HCWs working with various backgrounds and experience. Data analysis was done concurrently with ongoing interviews.

Results

Several fundamental elements currently hinder ethics in relief work. Attitudes of public authorities, politicians and relief organizations, the mismanagement of impromptu humanitarian action and relief and the media's mindset create ethical problems on the macro-level such as discrimination, unjust resource allocation and violation of personal rights, and can also directly cause or facilitate the emergence of problems on the micro-level. An important component which prevents humanitarian action towards victims is insufficient competence. The duty to care during epidemics and armed conflicts becomes controversial. Many participants defend a paternalistic approach related to autonomy. Confidentiality and privacy are either neglected or cannot be secured.

Conclusion

Intervention in factors on the macro-level could have a significant effect in problem prevention. Improving guidelines and professional codes as well as educating HCWs are also areas for improvement. Also, ethical questions exposed within this study should be deliberated and actualized with universal consensus in order to guide HCWs and increase humane attitudes.

Major Natural Disasters in China, 1985-2014: Occurrence and Damages

This study aimed to describe the characteristics of natural disasters and associated losses from 1985 to 2014. The Mann-Kendall method was used to detect any long-term trends and abrupt changes. Hotspot analysis was conducted to detect the spatial clusters of disasters. We found an increasing trend in the occurrence of integrated natural disasters (tau = 0.594, p < 0.001), particularly for floods (tau = 0.507, p < 0.001), landslides (tau = 0.365, p = 0.009) and storms (tau = 0.289, p = 0.032). Besides, there was an abrupt increase of natural disasters in 1998–2000. Hotspots of droughts, floods, landslides and storms were identified in central, southern, southwest and southeast areas of China, respectively. Annual deaths from integrated natural disasters were decreasing (tau = −0.237, p = 0.068) at about 32 persons/year, decreasing at 17 persons/year for floods (tau = −0.154, p = 0.239), and decreasing at approximately 12 persons/year for storms (tau = −0.338, p = 0.009). No significant trend was detected in inflation-adjusted damages while a declining trend was detected in the ratio of year damage against GDP (gross domestic product). In conclusion, there has been an increasing trend in occurrence of natural disasters in China with the absence of an increase in life and economic losses. Despite the progress in the disaster adaption, there will be great challenges in disaster control for China in the future.