Six-dimensional force/torque sensor for aerodynamic characteristic study of high-speed train with different wind angles under stationary tornado

Researchers conducted an investigation by tornado simulator to study the impact of wind angle on the aerodynamic characteristics of a reduced (1:150) high-speed train model using six-dimensional force/torque sensor. The reduced scale model size can match the relative size relationship between high-speed train and tornado vortex core in real condition. Results show that the wind angle affects the mean value and standard deviation of the force and moment coefficient of the high-speed train at the same radial position. The variations of the mean value and standard deviation of the pitching moment coefficient of the high-speed train carriage model at 60°and 90°are different from that at other wind angles. The variations of the mean value of the pitching moment coefficient of the high-speed train head model at 0°, 15°and 30°are different from that at other wind angles. The variations of the standard deviation of the pitching moment coefficient of the high-speed train head model at 60°,75°and 90°are different from that at other wind angles. This research will help the further study of the operation safety of high-speed train in the event of a tornado impacting a high-speed train network.

The impact of probabilistic tornado warnings on risk perceptions and responses

Many warnings issued to members of the public are deterministic in that they do not include event likelihood information. This is true of the current polygon-based tornado warning used by the American National Weather Service, although the likelihood of a tornado varies within the boundaries of the polygon. To test whether adding likelihood information benefits end users, two experimental studies and one in-person interview study were conducted. The experimental studies compared five probabilistic formats, two with color and three with numeric probabilities alone, to the deterministic polygon. In both experiments, probabilistic formats led to better understanding of tornado likelihood and higher trust than the polygon alone, although color-coding led to several misunderstandings. When the polygon boundary was drawn at 10% chance, those using probabilistic formats made fewer correct shelter decisions at low probabilities and more correct shelter decisions at high probabilities compared to those using the deterministic warning, although overall decision quality, operationalized as expected value, did not differ. However, when the polygon boundary was drawn around 30%, participants with probabilistic forecasts had higher expected value. The interview study revealed that, although tornado-experienced individuals would not shelter at 10% chance, they would take intermediate actions, such as information-seeking and sharing. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Resilience as Mediator in Relation to Parental Attachment and Posttraumatic Stress Disorder in Adolescents Following the Yancheng Tornado

Resilience and secure parental attachment have been proven as important factors to alleviate the posttraumatic stress disorder (PTSD). However, the effects of the two factors on PTSD and the mechanisms of its effect at different time points in the aftermath of trauma are still unclear. This study explores the relationship among parental attachment, resilience, and development of PTSD symptoms in adolescents from a longitudinal perspective following the Yancheng Tornado. Using cluster sampling method, a total of 351 Chinese adolescents, survivors of a severe tornado, were tested on their PTSD, parental attachment and resilience at 12-months and 18-months after experiencing the natural disaster. The results showed that our proposed model fit the data well: χ2/df = 3.197, CFI = 0.967, TLI = 0.950, RMSEA = 0.079. It revealed that the resilience at 18-months partially mediated the relationship between parental attachment at 12-months and PTSD at 18-months. Research results showed that parental attachment and resilience are key resources for coping with trauma.

Examining Factors Influencing Protective Actions Among Persons with Disabilities During the December 10-11, 2021, Tornado Outbreak in the United States

OBJECTIVE

This study examined various factors influencing protective actions among persons with disabilities exposed to the December 10-11, 2021, tornado outbreak in the US Midwest and Southeastern regions.

METHODS

Survey administration occurred 5 months following the tornado outbreak and included a total of 209 persons with disabilities who lived in one of the counties impacted by tornado warnings. Structural equation modeling was used to examine the direct and indirect effects of hypothesized predictors impacting protective behavioral actions.

RESULTS

Results found that persons with disabilities who had access to more tornado warning sources increased their protective actions, and tornado risk perception further mediated the relationship between warning information sources and protective actions. In addition, results found that persons with disabilities who encountered more situational barriers in their physical and social environment were found to have a decrease in protective action, and having more situational resources was found to contribute to the ability to take protective action.

CONCLUSIONS

The current study's results highlight the need for policies and practices that provide additional physical and social resources for persons with disabilities to seek protection during tornado threats.

Long term temporal trends in synoptic-scale weather conditions favoring significant tornado occurrence over the central United States

We perform a statistical climatological study of the synoptic- to meso-scale weather conditions favoring significant tornado occurrence to empirically investigate the existence of long term temporal trends. To identify environments that favor tornadoes, we apply an empirical orthogonal function (EOF) analysis to temperature, relative humidity, and winds from the Modern-Era Retrospective analysis for Research and Applications Version 2 (MERRA-2) dataset. We consider MERRA-2 data and tornado data from 1980 to 2017 over four adjacent study regions that span the Central, Midwestern, and Southeastern United States. To identify which EOFs are related to significant tornado occurrence, we fit two separate groups of logistic regression models. The first group (LEOF models) estimates the probability of occurrence of a significant tornado day (EF2-EF5) within each region. The second group (IEOF models) classifies the intensity of tornadic days either as strong (EF3-EF5) or weak (EF1-EF2). When compared to approaches using proxies such as convective available potential energy, our EOF approach is advantageous for two main reasons: first, the EOF approach allows for the discovery of important synoptic- to mesoscale variables previously not considered in the tornado science literature; second, proxy-based analyses may not capture important aspects of three-dimensional atmospheric conditions represented by the EOFs. Indeed, one of our main novel findings is the importance of a stratospheric forcing mode on occurrence of significant tornadoes. Other important novel findings are the existence of long-term temporal trends in the stratospheric forcing mode, in a dry line mode, and in an ageostrophic circulation mode related to the jet stream configuration. A relative risk analysis also indicates that changes in stratospheric forcings are partially or completely offsetting increased tornado risk associated with the dry line mode, except in the eastern Midwest region where tornado risk is increasing.

Migration as a Vector of Economic Losses From Disaster-Affected Areas in the United States

We introduce the consideration of human migration into research on economic losses from extreme weather disasters. Taking a comparative case study approach and using data from the Federal Reserve Bank of New York/Equifax Consumer Credit Panel, we document the size of economic losses attributable to migration from 23 disaster-affected areas in the United States before, during, and after some of the most costly hurricanes, tornadoes, and wildfires on record. We then employ demographic standardization and decomposition to determine if these losses primarily reflect changes in out-migration or the economic resources that migrants take with them. Finally, we consider the implications of these losses for changing spatial inequality in the United States. While disaster-affected areas and their populations differ in their experiences of and responses to extreme weather disasters, we generally find that, relative to the year before an extreme weather disaster, economic losses via migration from disaster-affected areas increase the year of and after the disaster, these changes primarily reflect changes in out-migration (vs. the economic resources that migrants take with them), and these losses briefly disrupt the status quo by temporarily reducing spatial inequality.

The influence of individualistic worldviews on severe weather preparation

How do people think they should prepare for tornadoes? To answer this question, we surveyed 340 people in six states in tornado alley and presented eight severe weather preparation choice sets that varied short and long-term benefits and costs with benefits or to the individual or to the community. Fifty-six percent of respondents preferred tornado preparations for the long-term that benefit individuals rather than the community. Correlations between personal characteristics, future expectations, and an individual's preferred preparation strategy show that being married, expecting stronger tornados, and having an individualistic worldview significantly increased the choice of individual preparation options. Past tornado experience and one's current protection level were not significantly related to individual-minded preparation choices. Out of 18 independent variables analyzed, individual worldview was the best predictor of a person's preferences. Individual worldview by itself had better predictive power than a regression model that included an individual's socioeconomic status, past severe weather experience, expectations about future tornados, and current protective measures for severe weather by itself. These findings can inform elected officials considering public policies for natural disaster preparedness and deciding between tradeoffs for keeping government costs low or providing benefits for everyone in the community. Our results are useful for planners and emergency managers who develop strategies to encourage tornado preparation by citizens in the community. For example, emergency managers can replicate the study with options specific to their community to determine what government communications or actions could prompt individuals to put protective measures in place.

Factors Associated with Housing Damage Caused by an EF4 Tornado in Rural Areas of Funing, China

Rural areas are vulnerable to natural disasters and tend to suffer severe losses. An EF4 tornado occurred in Funing on 23 June 2016, killing 99 people, injuring at least 846 people, and destroying more than 2000 houses. Using a multinomial logistic regression model, this study explored the influencing factors between housing damage and variables of building conditions, tornado intensity, and village environmental factors. The results show that 2-story houses and masonry houses were more likely to be slightly damaged or be in a dangerous state. Furthermore, the building area was positively related to houses in two categories: slight damage (SD) and dangerous and requiring immediate repair (DR), indicating that the larger or taller the house, the more severe the damage. In terms of tornado intensity, houses classified as SD were more likely to be hit by EF4 tornados than by EF3 tornados, and houses were damaged more by EF1 or EF2 tornados. This finding demonstrates that the level of housing damage was not strongly correlated with the tornado intensity. Slightly damaged houses exhibited the highest correlation with environmental factors. The proportion of slightly damaged houses was positively correlated with the water area in the village, unlike the proportion of houses in the DR and unable to be repaired (UR) categories. Moreover, the larger the water area of a village, the less housing damage it suffered. These findings provide new insights into minimizing housing damage in wind disasters to improve disaster prevention planning in rural areas.

Mental Health Impacts of Tornadoes: A Systematic Review

Tornadoes are one of the most prevalent natural hazards in the United States, yet they have been underrepresented in the disaster mental health comprehensive literature. In the current study, we systematically reviewed available scientific evidence within published research journals on tornadoes and mental health from 1994 to 2021. The electronic search strategy identified 384 potentially relevant articles. Of the 384 articles, 29 articles met the inclusion criteria, representing 27,534 participants. Four broad areas were identified: (i) Mental health impacts of tornadoes; (ii) Risk factors; (iii) Protective factors; and (iv) Mental health interventions. Overall, results showed adverse mental health symptoms (e.g., post-traumatic stress disorder, depression, anxiety) in both adult and pediatric populations. A number of risk factors were found to contribute to negative mental health, including demographics, tornado exposure, post-tornado stressors, and prior exposure to trauma. Protective factors found to contribute to positive outcomes included having access to physical, social, and psychological resources. Together, these findings can serve as an important resource for future mental health services in communities experiencing tornadoes.

Caregiver support buffers posttraumatic stress disorder symptoms following a natural disaster in relation to binge drinking

OBJECTIVE

We investigate if posttraumatic stress disorder (PTSD) symptoms mediate the effects of disaster severity or prior trauma on binge drinking following disaster exposure and test if support from caregiver moderates the relation between disaster severity and PTSD symptoms as well as prior trauma and PTSD symptoms.

METHOD

A population-based clinical trial used address-based sampling to enroll 1,804 adolescents and parents from communities affected by tornadoes in Missouri and Alabama. Data collection via baseline (averaging 8 months postdisaster), 4-month postbaseline, and 12-month postbaseline semistructured telephone interviews was completed between September 2011 and August 2013. Longitudinal analyses, testing the indirect effects of disaster severity and prior traumatic events on alcohol use through PTSD symptoms, as potentially moderated by support from caregiver, were conducted.

RESULTS

PTSD symptoms mediated the effect of prior trauma, but not disaster severity, on binge drinking. Specifically, those with more prior traumas reported more PTSD symptoms, which in turn increased risk for binge drinking. Support from caregiver moderated the effect of disaster severity, but not prior trauma, on PTSD symptoms. Specifically, the effect of disaster severity on PTSD symptoms was significant for adolescents with average or below-average caregiver support.

CONCLUSION

Findings suggest that PTSD symptomatology is one mechanism by which prior trauma can impact binge drinking among adolescents following exposure to a natural disaster. Caregiver support can serve as a buffer for reducing PTSD symptomatology related to the severity of a natural disaster, which can decrease the likelihood of adolescent binge drinking. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

An alert from the present to the future: The impact of environmental disasters on health of children and adolescents

Storms unleashed devastating tornadoes southern United States. National Weather Service maps revealed one supercell, which may have been a single tornado or a cluster. One of the most devastated sites is the southwestern Kentucky city of Mayfield. In Warren County, where about 12 people were killed, including several children, the process of identifying victims has been slowed because the people who could make those identifications are themselves recovering from injuries sustained in the storm. There's a lot of people injured and in hospitals. The death toll from the devastating tornado outbreak that ripped across six states last weekend held steady at 88 on Tuesday, including at least 13 children. Two-month-old baby was confirmed dead.

Network analysis of posttraumatic stress disorder symptoms among adolescent survivors of a major disaster in China

Objective: Children and adolescents are found to be more vulnerable to developing PTSD than adults over time after major disasters. This study aims to investigate the network structures of PTSD and the directions of relationships between symptoms among adolescent survivors in the year after the Yancheng Tornado in China. Method: A total of 395 youth survivors completed the Child PTSD Symptom Scale (Foa et al., 2001) at 3 months and 12 months following the tornado. Network analysis was used to compare networks of PTSD symptoms and changes over time. Results: Different centrality symptoms existed at different time points. Anger, startle responses, and physiological reactivity were important to the maintenance of PTSD symptoms arising from the tornado at 3 months, while dreams/nightmares and distancing/avoidance were important to maintaining PTSD symptoms at 12 months. Analysis suggested that sleep difficulty and intrusive thoughts were the key PTSD symptoms to be treated at 3 months; sleep remained to be the key symptoms to be treated at 12 months. Conclusions: Our findings suggest that sleep difficulty could be a main cause of other symptoms and trigger the entire symptom system into undesirable psychopathological development among adolescent survivors in the year following major disasters. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Southeast

Prior research has found that Black and Latinx communities in the U.S. face significant disparities that impact both preparedness for severe weather events and the support received after a disaster has occurred. In the current study, we examined key risk and protective factors that impacted mental health among 221 Black and Latinx adult respondents exposed to the 2–3 March 2020 nocturnal tornado outbreak in the U.S. state of Tennessee. Key factors that adversely affected mental health among participants were encountering barriers for receiving tornado warning alerts and tornado-related exposure. Key factors that served a protective mechanism against adverse mental health included having access to physical resources, supportive relationships, and adaptive coping skills. These findings may assist National Weather Service (NWS) personnel, emergency managers, and mental health providers with the development of policies and practices to address barriers and promote protective strategies for future nocturnal tornado events.

A Longitudinal Examination of Interpersonal Violence Exposure, Concern for Loved Ones During a Disaster, and Web-Based Intervention Effects on Posttraumatic Stress Disorder Among Adolescent Victims of the Spring 2011 Tornadoes

Natural disasters are common and devastating, and can affect the mental health of adolescents. It is also common for adolescents to have histories of interpersonal violence (IPV). The current study was a secondary data analysis of a larger randomized clinical trial and examined the moderating effect of IPV history and concern for loved ones during a disaster on treatment condition effects on posttraumatic stress disorder (PTSD) symptoms over time among disaster-exposed adolescents. Participants (n = 979) were recruited postdisaster to participate in a randomized clinical trial examining the efficacy of a web-based intervention, Bounce Back Now (BBN), on mental health symptoms at 4 and 12 months postintervention. It was found that adolescents with an IPV history and who had caregivers that were concerned for loved ones during a disaster had more PTSD symptoms at baseline than those without such histories. Furthermore, caregiver concern for loved ones during a disaster moderated the effect of BBN on PTSD symptoms over time. Specifically, the BBN condition was most effective for adolescents who had caregivers who were concerned for loved ones during the disaster in reductions of PTSD symptoms over time. The current study provides further evidence for the use of technology-based interventions for individuals as a means to address mental health symptoms after a traumatic event, especially among those with more severe traumatic experiences.

Don't Let the Tornado Get You! The Effects of Agency Assignment and Self-Construal on Responses to Tornado Preparedness Messages

This experiment explores the effects of agency assignment and self-construal on responses to tornado preparedness messages. Participants (N = 276) were randomly assigned to one of four conditions crossing agency assignment and self-construal. Results found threat agency associated with greater perceived susceptibility and tornado threat, whereas self-construal was primarily associated with perceived threat severity, such that those primed with interdependent self-construal showed marginally increased perceptions of tornado severity relative to those primed with independent self-construal. Self-construal did not appear to moderate the effects of agency assignment on attitudes or behavioral intentions. Results are discussed in light of potential psychological reactance, suggesting human agency assignment should be used cautiously, since it may pose an increased threat to perceived freedoms in certain instances. Moreover, combining human agency and independent self-construal may trigger negative cognitions directed toward the message and/or its source. It is concluded that cautious, strategic use of agency assignment can improve message acceptance and facilitate adaptive, preparedness actions.

Effects of Autonomic Nervous System Functioning and Tornado Exposure on Long-Term Outcomes of Aggressive Children

This study examined whether pre-disaster indicators of sympathetic and parasympathetic activity moderated the relation between degree of disaster exposure from an EF-4 tornado and changes in the externalizing and internalizing behavior problems of children at-risk for aggression. Participants included 188 children in 4th-6th grades (65% male; 78% African American; ages 9-13) and their parents from predominantly low-income households who were participating in a prevention study when the tornado occurred in 2011. Fourth-grade children who exhibited elevated levels of aggressive behavior were recruited in three annual cohorts. Parent-rated externalizing and internalizing problems were assessed prior to the tornado (Wave 1; W1), and at 4-12 months (W2), 16-24 months (W3), 42-28 months (W4) and 56-60 months (W5) post-tornado. Children's pre-tornado Skin Conductance Level (SCL) reactivity and Respiratory Sinus Arrhythmia (RSA) withdrawal were assessed at W1 using SCL and RSA measured during resting baseline and during the first 5 min of the Iowa Gambling Task (IGT). Children and parents reported their exposure to tornado-related trauma and disruptions at Wave 3. Children displayed less reduction in externalizing problems if there had been higher child- or parent-reported tornado exposure and less RSA withdrawal, or if they had lower parent-reported TORTE and less SCL reactivity or lower SCL baseline. Highlighting the importance of children's pre-disaster arousal, higher levels of disaster exposure negatively affected children's level of improvement in externalizing problems when children had less vagal withdrawal, and when tornado exposure disrupted the protective effects of higher SCL reactivity and higher SCL baseline.

Prior Interpersonal Violence Exposure and Experiences During and After a Disaster as Predictors of Posttraumatic Stress Disorder and Depression Among Adolescent Victims of the Spring 2011 Tornadoes

The purpose of the current report was to examine prior history of exposure to interpersonal violence (IPV), as compared with prior accident or prior disaster exposure, experiences during and after a disaster, and demographic variables as predictors of past month posttraumatic stress disorder (PTSD) and depression severity among adolescents exposed to the tornadoes in Alabama and Missouri. IPV exposure has been consistently identified as a unique category of potentially traumatic events (PTE) that significantly increases risk for development of PTSD and other difficulties relative to other event types among adolescents. A population-based sample of adolescents and caregivers (N = 2,000) were recruited randomly from tornado-affected communities in Alabama and Joplin, Missouri. Participants completed structured telephone interviews on an average of 8.8 months posttornado. Prior history of IPV was prevalent (36.5%), as was reported history of accidents (25.9%) and prior disaster exposure (26.9%). Negative binomial regression analyses with PTSD and depression symptom counts for past month as outcome variables indicated that history of predisaster IPV was most robustly related to PTSD and depression symptoms, such that those with a history of IPV endorsed over 3 times the number of symptoms than those without IPV history. Final model statistics indicated that female gender, physical injury to caregiver, concern about others' safety, prior disaster, prior accident, and prior IPV exposure were also related to PTSD. Predictors of depression symptoms were similar with the exception that concern about others' safety was not a predictor and age was a predictor in the final model. It is important to evaluate potential additive effects of IPV history in addition to recent disaster exposure variables and to consider such history when developing interventions aimed to reduce or prevent symptoms of PTSD and depression among adolescents recently exposed to disaster.

Co-reminiscing with a caregiver about a devastating tornado: Association with adolescent anxiety symptoms

This study explores the association between caregivers' style of co-reminiscing with their adolescents about an EF4 tornado and youth anxiety symptoms several years following the disaster. Caregiver reward of their children's emotional expression, defined as attending to and validating emotionally salient content, is generally associated with adaptive youth psychosocial outcomes. However, caregiver reward of youth recollections that are centered around the youth's negative emotional expression could be an indicator that both caregivers and adolescents are engaged in co-rumination regarding negative emotional experiences. This process may contribute to relatively higher levels of anxiety over time. Adolescents (N = 169) drawn from an ongoing study for aggressive youth (ages 12 to 17; 82% African American) provided individual recollections about their experiences during a devastating tornado 4 to 5 years following the disaster. Caregivers and youth then co-reminisced about their tornado-related experiences. Individual youth recollections were coded for negative personal impact and use of negative emotion words; caregiver-adolescent conversations were coded for caregiver reward of negative emotional expression. Youth who noted more negative personal impacts and used more negative emotion words were higher in parent-rated youth anxiety, and these associations were moderated by caregiver reward of negative emotional expression. The associations between youth recollection qualities and anxiety emerged only when caregivers exhibited high levels of reward of negative emotional expression. These patterns were generally stronger for girls compared to boys. Findings suggest that excessively discussing and rehashing negative experiences, especially several years after the disaster, may be a risk factor for anxiety among disaster-exposed adolescents. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The lodging of crops by tornadoes

It is well known that tornadoes passing over fields can cause significant damage to crops, and tornado tracks of fallen, or lodged, crops can extend for many hundreds of metres. An examination of photographic evidence of such events suggests that, at least for low speed EF0/EF1 events, lodging occurs beneath tornadoes primarily due to a strong radial flow (rather than circumferential flow) at the canopy surface. In order to investigate this effect further, a simple model of a tornado has been developed which, whilst fully satisfying the three dimensional Euler equations, models a circumferential flow at the edge of the tornado boundary layer near the ground, which becomes a radial flow as the ground is approached. This model is then used in a generalised model of lodging to predict lodging track widths and crop fall directions. It is shown that, when expressed in a suitably normalised form, both lodging width and crop fall direction are functions of a normalised translational velocity and a normalised crop lodging velocity. The lodging patterns are of two forms - a forward convergence (FC) where the cropfall converges on the tornado track in a forward direction, and a backward convergence (BC) where the convergence is in the opposite direction to tornado translations. Regions of FC and BC in the normalised parameter plane are calculated. These patterns are very similar to those observed in the field, which gives some confidence in the nature of the model. The model is then used to investigate the sensitivity of lodging width to crop and tornado parameters, and also to carry out a risk analysis to determine the probability distributions of lodging width for specified distributions of crop and tornado parameters.

Women's experiences across disasters: a study of two towns in Texas, United States

Gender, although gaining attention, remains under-researched in disaster risk reduction protocols and response and recovery efforts. This study examines women's experiences of two disasters in small towns in the United States, utilising qualitative interviews with residents of Granbury and West, Texas, during the first year of disaster recovery. Granbury was struck by an EF-4 tornado on 15 May 2013, whereas an explosion occurred at a local fertiliser facility in West on 17 April 2013. The paper explores how women's experiences of inter-gender power dynamics in decision-making, the prioritisation of childcare, and women's participation in the community affect their post-disaster recovery. Previous research highlights different forms of human response and recovery vis-à-vis 'natural' and technological disasters, with less attention paid to gender differences. The results point to the persistent, and similar, effect of gender stratification on women's experiences across different types of disasters in the US and the continued importance of gender-sensitive disaster policies and programmes.

Effect of Providing the Uncertainty Information About a Tornado Occurrence on the Weather Recipients' Cognition and Protective Action: Probabilistic Hazard Information Versus Deterministic Warnings

Currently, a binary alarm system is used in the United States to issue deterministic warning polygons in case of tornado events. To enhance the effectiveness of the weather information, a likelihood alarm system, which uses a tool called probabilistic hazard information (PHI), is being developed at National Severe Storms Laboratory to issue probabilistic information about the threat. This study aims to investigate the effects of providing the uncertainty information about a tornado occurrence through the PHI's graphical swath on laypeople's concern, fear, and protective action, as compared with providing the warning information with the deterministic polygon. The displays of color-coded swaths and deterministic polygons were shown to subjects. Some displays had a blue background denoting the probability of any tornado formation in the general area. Participants were asked to report their levels of concern, fear, and protective action at randomly chosen locations within each of seven designated levels on each display. Analysis of a three-stage nested design showed that providing the uncertainty information via the PHI would appropriately increase recipients' levels of concern, fear, and protective action in highly dangerous scenarios, with a more than 60% chance of being affected by the threat, as compared with deterministic polygons. The blue background and the color-coding type did not have a significant effect on the people's cognition of the threat and reaction to it. This study shows that using a likelihood alarm system leads to more conscious decision making by the weather information recipients and enhances the system safety.

Perceptions and Expected Immediate Reactions to Severe Storm Displays

The National Weather Service has adopted warning polygons that more specifically indicate the risk area than its previous county-wide warnings. However, these polygons are not defined in terms of numerical strike probabilities (p_s ). To better understand people's interpretations of warning polygons, 167 participants were shown 23 hypothetical scenarios in one of three information conditions-polygon-only (Condition A), polygon + tornadic storm cell (Condition B), and polygon + tornadic storm cell + flanking nontornadic storm cells (Condition C). Participants judged each polygon's p_s and reported the likelihood of taking nine different response actions. The polygon-only condition replicated the results of previous studies; p_s was highest at the polygon's centroid and declined in all directions from there. The two conditions displaying storm cells differed from the polygon-only condition only in having p_s just as high at the polygon's edge nearest the storm cell as at its centroid. Overall, p_s values were positively correlated with expectations of continuing normal activities, seeking information from social sources, seeking shelter, and evacuating by car. These results indicate that participants make more appropriate p_s judgments when polygons are presented in their natural context of radar displays than when they are presented in isolation. However, the fact that p_s judgments had moderately positive correlations with both sheltering (a generally appropriate response) and evacuation (a generally inappropriate response) suggests that experiment participants experience the same ambivalence about these two protective actions as people threatened by actual tornadoes.

Public perception of climatological tornado risk in Tennessee, USA

The southeastern United States experiences some of the greatest tornado fatality rates in the world, with a peak in the western portion of the state of Tennessee. Understanding the physical and social characteristics of the area that may lead to increased fatalities is a critical research need. Residents of 12 Tennessee counties from three regions of the state (N = 1804) were asked questions about their perception of climatological tornado risk in their county. Approximately half of participants underestimated their local tornado risk calculated from 50 years of historical tornado data. The percentage of participants underestimating their climatological risk increased to 81% when using model estimates of tornado frequencies that account for likely missed tornadoes. A mixed effects, ordinal logistic regression model suggested that participants with prior experience with tornadoes are more likely to correctly estimate or overestimate (rather than underestimate) their risk compared to those lacking experience (β = 0.52, p < 0.01). Demographic characteristics did not have a large influence on the accuracy of climatological tornado risk perception. Areas where more tornadoes go unreported may be at a disadvantage for understanding risk because residents' prior experience is based on limited observations. This work adds to the literature highlighting the importance of personal experiences in determining hazard risk perception and emphasizes the uniqueness of tornadoes, as they may occur in rural areas without knowledge, potentially prohibiting an accumulation of experiences.

Pattern and spectrum of tornado injury and its geographical information system distribution in Yancheng, China: a cross-sectional study

OBJECTIVES

Few studies of tornado injuries have considered differences related to damage levels and Enhanced-Fujita (EF) scale ratings. This study aimed to evaluate the pattern, spectrum and geographical distribution of injuries related to the Yancheng tornado and provide guidelines for effective emergency medical strategies.

SETTING

The study was conducted at three hospitals which treated patients with injuries related to the tornado in Yancheng, China.

PARTICIPANTS

We obtained the records of 451 patients with tornado-related injuries. Of these, 401 valid trauma medical records were included; 50 other records were excluded for insufficient information. Informed consent was obtained from all patients by telephone.

MAIN OUTCOME MEASURES

We analysed patients' injury sites and types and used the abbreviated injury scale (AIS) to standardise injury severity. Geographical information system and non-parametric tests were used to analyse the effects of geographical factors on casualties.

RESULTS

Women, middle-aged/elderly individuals (age>45 years) and children/adolescents (<18 years) accounted for 51.62%, 77.30% and 12.47% of injured patients, respectively. This caused a dumbbell-shaped age distribution. Head (46.63%), body surface (39.90%) and lower-limb (29.43%) injuries were common, as were soft-tissue injuries (90.77%), fractures (38.90%) and organ damage (19.70%). Minor injuries (AIS=1) were common (60.85%), whereas critical/fatal injuries (AIS≥5) were very rare (2.50%). Although the densities of injury varied among damage levels and EF ratings for different areas, area-wise differences in injury severity (AIS scores) were not significant (p>0.05).

CONCLUSION

We recommend the use of helmets to prevent head injuries caused by tornadoes and suggest prioritising the treatment of high-risk head and multiple-organ injuries. Additionally, medical rescuers should follow the 'same quality and different quantity' principle: the injured in all affected areas should receive equal attention, but numbers of medical personnel should be allocated based on the level of effects from the tornado.

All-Cause Hospital Admissions Among Older Adults After a Natural Disaster

STUDY OBJECTIVE

We characterize hospital admissions among older adults for any cause in the 30 days after a significant natural disaster in the United States. The main outcome was all-cause hospital admissions in the 30 days after natural disaster. Separate analyses were conducted to examine all-cause hospital admissions excluding the 72 hours after the disaster, ICU admissions, all-cause inhospital mortality, and admissions by state.

METHODS

A self-controlled case series analysis using the 2011 Medicare Provider and Analysis Review was conducted to examine exposure to natural disaster by elderly adults located in zip codes affected by tornadoes during the 2011 southeastern superstorm. Spatial data of tornado events were obtained from the National Oceanic and Atmospheric Administration's Severe Report database, and zip code data were obtained from the US Census Bureau.

RESULTS

All-cause hospital admissions increased by 4% for older adults in the 30 days after the April 27, 2011, tornadoes (incidence rate ratio 1.04; 95% confidence interval 1.01 to 1.07). When the first 3 days after the disaster that may have been attributed to immediate injuries were excluded, hospitalizations for any cause also remained higher than when compared with the other 11 months of the year (incidence rate ratio 1.04; 95% confidence interval 1.01 to 1.07). There was no increase in ICU admissions or inhospital mortality associated with the natural disaster. When data were examined by individual states, Alabama, which had the highest number of persons affected, had a 9% increase in both hospitalizations and ICU admissions.

CONCLUSION

When all time-invariant characteristics were controlled for, this natural disaster was associated with a significant increase in all-cause hospitalizations. This analysis quantifies acute care use after disasters through examining all-cause hospitalizations and represents an important contribution to building models of resilience-the ability to recover from a disaster-and hospital surge capacity.

Suicidal ideation among adolescents following natural disaster: The role of prior interpersonal violence

OBJECTIVE

The current study examined variables, including prior traumatic events, disaster exposure, and current mental health symptomatology, associated with suicidal ideation following experience of a natural disaster.

METHOD

Utilizing a sample of 2,000 adolescents exposed to the spring 2011 tornadoes in the areas surrounding Tuscaloosa, Alabama, and Joplin, Missouri, we hypothesized that prior interpersonal violence (IPV), more so than other prior traumatic events or other symptoms, would be associated with suicidal ideation after the disaster.

RESULTS

Suicidal ideation was reported by approximately 5% of the sample. Results of binary logistic regression were consistent with hypotheses in that prior IPV exposure emerged as the variable most robustly related to presence of postdisaster suicidal ideation, even accounting for current symptoms (i.e., posttraumatic stress disorder and depression). Moreover, neither prior accident nor prior natural disaster exposure was significantly associated with postdisaster suicidal ideation, suggesting that something specific to IPV may be conferring risk for suicidality. No other variables, including disaster exposure variables or demographic characteristics, emerged as significantly related.

CONCLUSIONS

Our results suggest that individuals who have a history of IPV may be particularly vulnerable following experience of additional traumatic events and that for suicide risk, the experience of prior IPV may be more relevant to consider in the aftermath of natural disasters beyond variables related to the index trauma or current symptomatology. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Individual relocation decisions after tornadoes: a multi-level analysis

This study examines how multi-level factors affected individuals' relocation decisions after EF4 and EF5 (Enhanced Fujita Tornado Intensity Scale) tornadoes struck the United States in 2013. A telephone survey was conducted with 536 respondents, including oversampled older adults, one year after these two disaster events. Respondents' addresses were used to associate individual information with block group-level variables recorded by the American Community Survey. Logistic regression revealed that residential damage and homeownership are important predictors of relocation. There was also significant interaction between these two variables, indicating less difference between homeowners and renters at higher damage levels. Homeownership diminished the likelihood of relocation among younger respondents. Random effects logistic regression found that the percentage of homeownership and of higher income households in the community buffered the effect of damage on relocation; the percentage of older adults reduced the likelihood of this group relocating. The findings are assessed from the standpoint of age difference, policy implications, and social capital and vulnerability.

You plan, you test and then it happens: Lessons learned from the Schneider warehouse tornado recovery

This paper is about the experience gained and lessons learned while dealing with the long-term recovery of Schneider's Port Logistics Division following extensive damage to three warehouse/ office facilities in Savannah, GA on 25th April, 2015. This paper will provide insight into how the initial assessments were handled, how the skill sets needed by the response teams were determined, and what further actions were triggered as more detailed information was received and assessed by the leadership team. This paper will also provide information as to how closely the company followed its existing contingency and disaster recovery plans, as well as where those plans fell short and where it was necessary to make adjustments as the recovery progressed.

User perception and interpretation of tornado probabilistic hazard information: Comparison of four graphical designs

Effective design for presenting severe weather information is important to reduce devastating consequences of severe weather. The Probabilistic Hazard Information (PHI) system for severe weather is being developed by NOAA National Severe Storms Laboratory (NSSL) to communicate probabilistic hazardous weather information. This study investigates the effects of four PHI graphical designs for tornado threat, namely, "four-color"," red-scale", "grayscale" and "contour", on users' perception, interpretation, and reaction to threat information. PHI is presented on either a map background or a radar background. Analysis showed that the accuracy was significantly higher and response time faster when PHI was displayed on map background as compared to radar background due to better contrast. When displayed on a radar background, "grayscale" design resulted in a higher accuracy of responses. Possibly due to familiarity, participants reported four-color design as their favorite design, which also resulted in the fastest recognition of probability levels on both backgrounds. Our study shows the importance of using intuitive color-coding and sufficient contrast in conveying probabilistic threat information via graphical design. We also found that users follows a rational perceiving-judging-feeling-and acting approach in processing probabilistic hazard information for tornado.

Assessment of the Public Health Risks and Impact of a Tornado in Funing, China, 23 June 2016: A Retrospective Analysis

(1) Background: Tornadoes are one of the deadliest disasters but their health impacts in China are poorly investigated. This study aimed to assess the public health risks and impact of an EF-4 tornado outbreak in Funing, China; (2) Methods: A retrospective analysis on the characteristics of tornado-related deaths and injuries was conducted based on the database from the Funing's Center for Disease Control and Prevention (CDC) and Funing People's Hospital. A change-point time-series analysis of weekly incidence for the period January 2010 to September 2016 was used to identify sensitive infectious diseases to the tornado; (3) Results: The 75 to 84 years old group was at the highest risk of both death (RR = 82.16; 95% CIs = 19.66, 343.33) and injury (RR = 31.80; 95% CI = 17.26, 58.61), and females were at 53% higher risk of death than males (RR = 1.53; 95% CIs = 1.02, 2.29). Of the 337 injuries, 274 injuries (81%) were minor. Most deaths occurred indoors (87%) and the head (74%) was the most frequent site of trauma during the tornado. Five diseases showed downward change-points; (4) Conclusions: The experience of the Funing tornado underscores the relative danger of being indoors during a tornado and is successful in avoiding epidemics post-tornado. Current international safety guidelines need modification when generalized to China.

Prepare to protect: Operating and maintaining a tornado safe room

Operating and maintaining a tornado safe room can be critical to the effective continuity of business operations because a firm's most valuable asset is its people. This paper describes aspects of operations and maintenance (O&M) for existing tornado safe rooms as well as a few planning and design aspects that affect the ultimate operation of a safe room for situations where a safe room is planned, but not yet constructed. The information is based on several Federal Emergency Management Agency safe room publications that provide guidance on emergency management and operations, as well as the design and construction of tornado safe rooms.

Relying on the National Mobile Disaster Hospital as a business continuity strategy in the aftermath of a tornado: The Louisville experience

On 28th April, 2014, a tornado left much of Louisville, MS and the local hospital, Winston Medical Center, in ruin. In the USA, temporary hospital solutions have been used to augment the mainstream healthcare system since the American Civil War. As memories fade, however, the necessary readiness for a temporary hospital also fades, at times leaving a patchwork of resources either underfunded or abandoned. With the creation of the Hospital Preparedness Program, several temporary hospital solutions were created in various states across the USA. In the present case, Mississippi and North Carolina resources were used in Louisville in the aftermath of a direct impact that destroyed the hospital and nursing home. In the hours that followed, after lives were saved and patients safely relocated, a frank assessment confirmed the structural loss of the hospital. Local emergency responders, hospital staff, state and federal representatives all rallied with the aim of saving the community's only hospital. The steps taken in Louisville and the deliberate restoration of these essential services offer a learning opportunity for all involved in healthcare disaster preparedness, response and recovery.

Facebook and Twitter, communication and shelter, and the 2011 Tuscaloosa tornado

This paper represents one of the first attempts to analyse the many ways in which Facebook and Twitter were used during a tornado disaster. Comparisons between five randomly selected campus samples and a city of Tuscaloosa, Alabama, sample revealed that campus samples used Facebook and Twitter significantly more both before and after the tornado, but Facebook usage was not significantly different after the event. Furthermore, differences in social media usage and other forms of communication before the tornado were found for age, education, and years lived in Tuscaloosa. Generally, age and education were inversely proportionate to social media usage. Influences on shelter-seeking actions varied between social media users and three random samples of non-social media users; however, it appears that social media respondents were likely to be using a smartphone simultaneously to access warning polygon information, to receive text message alerts, and to listen or respond to environmental cues.

Deconstruction of destruction stories: narrative, inequality, and disasters

A commonly-held belief is that natural disasters do not discriminate. This paper, though, poses the following theoretical question: what does the elision of race, class, and gender in the news media say about disasters in the neoliberal era? It draws on the author's analysis of two prominent newspapers-The New York Times and USA Today-and their coverage of the recovery process after devastating tornadoes in two towns in the United States (Tuscaloosa, Alabama, and Joplin, Missouri) in 2011. The study asserts that the narrative of the news media is one with which people are familiar and that it fits into larger 'formula stories'. It utilises theoretical treatments of narrative to demonstrate how differences are erased and how they lead to complicity in hegemonic representations. Critical theory is used to elucidate why this occurs, and the paper sources Goldberg (2002) in suggesting that the news media employs 'fantasies of homogenisation' when representing post-disaster communities.

Bridging cultures: Nonprofit, church, and emergency management agency collaboration after the May 2013 Oklahoma tornado outbreak

Community-based organizations, such as nonprofit organizations (NPOs) and churches, play an important role in helping individuals and communities bounce back after a disaster. The nature of disasters requires organizations across sectors to partner together to provide recovery services; however, collaboration is difficult even in times of stability and requires trust and communication to be built through prior collaborative relationships. These prior relationships rarely exist between the majority of the nonprofit sector, churches, and existing emergency management structures. Furthermore, these organizations often have very different cultures, values, and norms that can further hinder successful postdisaster collaboration. The authors use data collected from interviews with nonprofit and church leaders involved in recovery efforts after a series of devastating storms impacted central Oklahoma in 2013 to understand how well nonprofit and church leaders perceive their organizations collaborated with each other and with government and emergency management agencies in response and recovery efforts. Interview data suggest that NPOs and churches without a primary or secondary mission of disaster response and recovery have a difficult time collaborating with organizations involved in existing emergency management structures. The authors suggest that nonprofits with a primary or secondary purpose in disaster response are a potential bridge between other nonprofits and emergency management agencies.

Community emergency department utilization following a natural disaster (the Goderich Tornado)

INTRODUCTION

On 21 August 2011 an F3 tornado hit the Canadian town of Goderich, Ontario, leaving 40 people injured and one dead. Specific medium-term changes in utilization of health care following a disaster have not been analyzed in medical literature. Documenting the emergency department utilization through this subacute period would be helpful to enable institutions and healthcare practitioners to be better prepared for future events.

METHODS

A medical chart review was conducted at the Alexandra Marine and General Hospital in Goderich. All emergency department visits made during the 30 days after the Tornado in 2011 (intervention group), 30 days prior to the tornado in 2011 (primary control group), and during the similar calendar period of 30 days after the tornado in 2010 (seasonal control group) were reviewed. Medical diagnoses of all patients who presented at the emergency department were collected and compared.

RESULTS

Fewer people presented to the emergency department following the tornado than during the control periods, and those who did were significantly older than those who presented in the control periods (p<0.001). A significantly greater number of patients presented with undiagnosed medical problems, many came to refill their medications, and significantly fewer people left the emergency department without being seen (p<0.001).

CONCLUSIONS

This study identifies the medical conditions that are most likely to be seen in an emergency department following a tornado in a rural Ontario community. This information serves to inform the medical community and other hospitals how to increase their level of preparedness should a comparable disaster occur again in the future.

Traumatic lung injury attributed to tornadic activity-induced barometric pressure changes in two dogs

CASE DESCRIPTION A 7-year-old castrated male Italian Greyhound (dog 1) and an approximately 1-year-old female Labrador Retriever (dog 2) were evaluated because of respiratory distress 8 and 10 days, respectively, after a tornado. CLINICAL FINDINGS No obvious external injuries were identified auscultation revealed decreased bronchovesicular sounds in the affected hemithorax of both dogs. Clinicopathologic changes were mild, with evidence of inflammation in both dogs. Thoracic radiography of both dogs revealed pneumothorax and pleural effusion with effacement of the diaphragm; findings on CT included severe pulmonary atelectasis of affected lung lobes with normal bronchial tree configurtion and no evidence of diaphragmatic hernia. TREATMENT AND OUTCOME Exploratory thoracotomy of both dogs confirmed CT findings Pulmonary parenchymal damage consistent with a large rupture was found in both patients. A large hematoma was adhered to the ruptured lung lobe of dog 1. Grossly affected lung tissue was removed; histologic examination revealed atelectasis, pulmonary fib osis, thrombosis, and minimal (dog 1) to marked (dog 2) inflammation Microbial culture of lung tissue yielded no growth for dog 1 and Streptococcus spp and Escherichia coli susceptible to amoxicillin-clavulanic acid for dog 2. Dog 1 had a recurrence of pneumothorax treated by drainage with a thoracostomy tube 1 month after surgery. Eighteen months after surgery, both dogs were reportedly doing well. CLINICAL RELEVANCE Development of clinical signs after a tornado, together with clinical, diagnostic imaging, surgical, and histologic findings led to a presumptive diagnosis of pulmonary barotrauma for both dogs. Long-term outcome for these dogs, treated at a referral hospital, was good.

Web Intervention for Adolescents Affected by Disaster: Population-Based Randomized Controlled Trial

OBJECTIVE

To assess the efficacy of Bounce Back Now (BBN), a modular, Web-based intervention for disaster-affected adolescents and their parents.

METHOD

A population-based randomized controlled trial used address-based sampling to enroll 2,000 adolescents and parents from communities affected by tornadoes in Joplin, MO, and several areas in Alabama. Data collection via baseline and follow-up semi-structured telephone interviews was completed between September 2011 and August 2013. All families were invited to access the BBN study Web portal irrespective of mental health status at baseline. Families who accessed the Web portal were assigned randomly to 1 of 3 groups: BBN, which featured modules for adolescents and parents targeting adolescents' mental health symptoms; BBN plus additional modules targeting parents' mental health symptoms; or assessment only. The primary outcomes were adolescent symptoms of posttraumatic stress disorder (PTSD) and depression.

RESULTS

Nearly 50% of families accessed the Web portal. Intent-to-treat analyses revealed time × condition interactions for PTSD symptoms (B = -0.24, SE = 0.08, p < .01) and depressive symptoms (B = -0.23, SE = 0.09, p < .01). Post hoc comparisons revealed fewer PTSD and depressive symptoms for adolescents in the experimental versus control conditions at 12-month follow-up (PTSD: B = -0.36, SE = 0.19, p = .06; depressive symptoms: B = -0.42, SE = 0.19, p = 0.03). A time × condition interaction also was found that favored the BBN versus BBN + parent self-help condition for PTSD symptoms (B = 0.30, SE = 0.12, p = .02) but not depressive symptoms (B = 0.12, SE = 0.12, p = .33).

CONCLUSION

Results supported the feasibility and initial efficacy of BBN as a scalable disaster mental health intervention for adolescents. Technology-based solutions have tremendous potential value if found to reduce the mental health burden of disasters.

CLINICAL TRIAL REGISTRATION INFORMATION

Web-based Intervention for Disaster-Affected Youth and Families; http://clinicaltrials.gov; NCT01606514.

Dynamical analysis and visualization of tornadoes time series

In this paper we analyze the behavior of tornado time-series in the U.S. from the perspective of dynamical systems. A tornado is a violently rotating column of air extending from a cumulonimbus cloud down to the ground. Such phenomena reveal features that are well described by power law functions and unveil characteristics found in systems with long range memory effects. Tornado time series are viewed as the output of a complex system and are interpreted as a manifestation of its dynamics. Tornadoes are modeled as sequences of Dirac impulses with amplitude proportional to the events size. First, a collection of time series involving 64 years is analyzed in the frequency domain by means of the Fourier transform. The amplitude spectra are approximated by power law functions and their parameters are read as an underlying signature of the system dynamics. Second, it is adopted the concept of circular time and the collective behavior of tornadoes analyzed. Clustering techniques are then adopted to identify and visualize the emerging patterns.

Predictors of compliance with tornado warnings issued in Joplin, Missouri, in 2011

Joplin, a city in the southwest corner of Missouri, United States, suffered an EF-5 tornado in the late afternoon of 22 May 2011. This event, which claimed the lives of 162 people, represents the deadliest single tornado to strike the US since modern record-keeping began in 1950. This study examines the factors associated with responses to tornado warnings. Based on a post-tornado survey of survivors in Joplin, it reveals that tornado warnings were adequate and timely. Multivariate logistic regression identified four statistically significant determinants of compliance with tornado warnings: number of warning sources, whether respondents were at home when the tornado struck, past tornado experience, and gender. The findings suggest several recommendations, the implementation of which will further improve responses to tornado warnings.

Assessing American Red Cross First Aid mobile app user trends: Implications for resilience

OBJECTIVE

Disasters have devastated communities, impacted the economy, and resulted in a significant increase in injuries. As the use of mobile technology increasingly becomes a common aspect of everyday life, it is important to understand how it can be used as a resource. The authors examined the use of American Red Cross mobile apps and aimed to characterize user trends to better understand how mobile apps can help bolster individual and community preparedness, resilience, and response efforts.

DESIGN/MAIN OUTCOME MEASURES

Tornado data were obtained from the National Oceanic and Atmospheric Administration and the National Weather Service. Data for the mobile apps were provided by the American Red Cross. All data were reviewed for 2013, 2014, and three specific tornado events. Data were organized in Microsoft Excel spreadsheets and then graphed or mapped using ArcMap 10.2(™).

RESULTS

Between 2013 and 2014, 1,068 tornado watches and 3,682 tornado warnings were issued. Additionally, 37,957,560 Tornado app users and 1,289,676 First Aid app users were active from 2013 to 2014. Overall, there was an increase in the use of American Red Cross mobile apps during tornado occurrences. Yet the increase does not show a consistent correlation with the number of watches and warnings issued.

CONCLUSIONS

Mobile apps can be a resourceful tool. This study shows that mobile app use increases during a disaster. The findings indicate that there is potential to use mobile apps for building resilience as the apps provide information to support individuals and communities in helping before, during, and after disasters.

Tornado intensity estimated from damage path dimensions

The Newcastle/Moore and El Reno tornadoes of May 2013 are recent reminders of the destructive power of tornadoes. A direct estimate of a tornado's power is difficult and dangerous to get. An indirect estimate on a categorical scale is available from a post-storm survery of the damage. Wind speed bounds are attached to the scale, but the scale is not adequate for analyzing trends in tornado intensity separate from trends in tornado frequency. Here tornado intensity on a continuum is estimated from damage path length and width, which are measured on continuous scales and correlated to the EF rating. The wind speeds on the EF scale are treated as interval censored data and regressed onto the path dimensions and fatalities. The regression model indicates a 25% increase in expected intensity over a threshold intensity of 29 m s⁻¹ for a 100 km increase in path length and a 17% increase in expected intensity for a one km increase in path width. The model shows a 43% increase in the expected intensity when fatalities are observed controlling for path dimensions. The estimated wind speeds correlate at a level of .77 (.34, .93) [95% confidence interval] with a small sample of wind speeds estimated independently from a doppler radar calibration. The estimated wind speeds allow analyses to be done on the tornado database that are not possible with the categorical scale. The modeled intensities can be used in climatology and in environmental and engineering applications. Research is needed to understand the upward trends in path length and width.

Working after a tornado: a survey of hospital personnel in Joplin, Missouri

In 2011, an EF5 tornado hit Joplin, MO, requiring complete evacuation of 1 hospital and a patient surge to another. We sought to assess the resilience of healthcare workers in these hospitals as measured by number reporting to work, willingness to work, personal disaster preparedness, and childcare responsibilities following the disaster. In May 2013, a survey was distributed to healthcare workers at both Joplin hospitals that asked them to report their willingness to work and personal disaster preparedness following various disaster scenarios. For those with childcare responsibilities, scheduling, costs, and impact of hypothetical alternative childcare programs were considered in the analyses. A total of 1,234 healthcare workers completed the survey (response rate: 23.4%). Most (87.8%) worked the week following the Joplin tornado. Healthcare workers report more willingness to work during a future earthquake or tornado compared to their pre-Joplin tornado attitudes (86.2 vs 88.4%, t=-4.3, p<.001; 88.4 vs 90%, t=-3.1, p<.01, respectively), with no change during other scenarios. They expressed significantly higher post-tornado personal disaster preparedness, but only preevent preparedness was a significant predictor of postevent preparedness. Nearly half (48.5%, n=598) had childcare responsibilities; 61% (n=366) had childcare needs the week of the tornado, and 54% (n=198) required the use of alternative childcare. If their hospital had provided alternative childcare, 51% would have used it and 42% felt they would have been more willing to report to work. Most healthcare workers reported to work following this disaster, demonstrating true resilience. Disaster planners should be aware of these perceptions as they formulate their own emergency operation plans.