Overseas large-scale combat operations (LSCOs) could require domestic hospitals to treat large numbers of combat casualties. Our goal was to evaluate the financial impact on hospitals of treating combat casualties during an LSCO.

Using a discrete event simulation model, we explored how 5 civilian hospitals in Omaha, Nebraska, would fare after accepting combat casualties during a National Disaster Medical System (NDMS) activation. We compared changes in financial measures (government payments, hospital revenues) and occupancy measures (civilian patient displacement) under different scenarios for combat casualty reimbursement rates as fractions (75%-125%) of Medicare rates.

Combat casualties replaced 100% of civilian patients at 3 of 5 hospitals, displacing a total of 10,905 civilian patients [95% CI: 10551-11248]. Combat casualty reimbursement at 125% of Medicare rates resulted in government payments of $462 million and net income gains for civilian hospitals of approximately 23 times pre-activation baselines. Combat casualty reimbursement below 125% of Medicare rates led to net income losses.

Large influxes of combat casualties could result in rapid, profound displacement of civilian patients and revenue loss at NDMS-participating facilities, potentially affecting hospitals’ ability and willingness to treat them. Policymakers need to identify appropriate reimbursement rates for combat casualties.

The contribution of active involvement in full-scale disaster exercises to learning processes is widely recognized. Accordingly, this study seeks to explore the learning gains of individuals who participated as live actors and observers in a full-scale avalanche exercise conducted with international collaboration.

This study used a mixed-methods approach integrating qualitative and quantitative research methods. Descriptive statistical techniques were employed to analyze quantitative data, while thematic analysis was utilized to interpret the qualitative data.

Participants reported high levels of satisfaction in the domains of field knowledge (76.5%), Critical Decision-Making (74.6%), motivation (60.8%), and self-confidence (49.1%).

On the other hand, they raised concerns regarding the inadequacy of instructions (58.8%), the lack of up-to-date practices (47%), the realism of the scenario (54.9%), safety measures (56.8%), and communication (72.5%).

The findings suggest that participants demonstrated development in both cognitive and affective domains, regardless of the specific roles they assumed during the exercise. In the cognitive dimension, improvements were observed in high-angle rescue, avalanche search methodologies, understanding of team roles, intervention procedures, prioritization criteria, and safety assessment. In the affective dimension, advancements were noted in recognizing ethical issues, exploration of authority boundaries, willingness to intervene, and self-confidence.

To report on a volunteer-led program supporting local healthcare providers (L-HCPs) and disaster responders after the 2024 Noto Peninsula Earthquake, focusing on its implementation and immediate outcomes.

A volunteer-led initiative established by university alumni deployed medical teams to a local hospital on weekends following the earthquake, providing onsite support to relieve L-HCPs from prolonged strain. The program integrated information and communication technology (ICT) platforms to enable remote support, communication, and structured debriefing sessions for volunteers, facilitating assistance from a wider network.

The project effectively sustained the local health care institution’s capacity by managing diverse patient needs, including a surge in internal medical conditions. It provided essential respite, allowing local physicians crucial personal time, for which they expressed profound gratitude. Volunteer doctors reported effective stress management through the onsite and ICT-based support structure, and the initiative concluded safely without injury.

The project demonstrated that combining onsite medical assistance with strategically implemented ICT effectively mitigates burnout among L-HCPs, providing essential psychological support for deployed volunteers. The findings highlight the significance of sustained recovery-phase support, professional networks, and ICT in disaster response. These experiences highlight the need for comprehensive, system-wide support strategies for all frontline personnel in future disasters.

This research aims to determine the genital hygiene behaviors and risk factors of women of reproductive age after the earthquake.

The descriptive and relationship-seeking research was conducted with 296 women reached online in the Malatya province, where the earthquake in Turkey caused heavy damage. Research data was collected using an online survey form created via Google Forms. Data were obtained using the Personal Information Form and Genital Hygiene Behavior Scale.

In the study, genital hygiene behaviors of women with low education level (p = .004), not working (p = .003), sharing underwear (p = .002), having vaginal itching (p = .006), bathing frequency once a week or less (p = .001), bathing while sitting on a stool (p = .001) and having no knowledge about genital infection (p = .001) were found to be inadequate.

In the study, it was determined that the genital hygiene behaviors of women of reproductive age were negative after the earthquake. It is recommended that health professionals should not ignore the adverse effects that may occur on women’s genital hygiene behaviors after disasters such as earthquakes and take the necessary initiatives.

Mounting evidence indicates a strong correlation between wildfire smoke exposure and health impacts, though limited studies have focused on urban fires or exposures other than smoke. The 2025 LA County Fires presented an opportunity to broaden this evidence base.

In response, the Public Health Extreme Events Research (PHEER) Network developed an ArcGIS Online health exposure map to curate and disseminate information about environmental exposure data collection activities across agencies and researchers.

The map integrates data collection locations with publicly available datasets to reduce duplication of effort. PHEER also partnered with the University of Washington’s Natural Hazards Reconnaissance (RAPID) facility to collect hyperspectral imagery for analysis. Concerns about sharing granular exposure data led PHEER to prioritize disseminating locations and types of data collected rather than the data itself.

PHEER’s approach provides a model for supporting rapid, ethical disaster research in complex urban fire contexts.

Explore the relationship between the severity of psychological distress symptoms and COVID-19-related bereavement, along with various sociodemographic factors and smoking/substance use behaviors during the COVID-19 pandemic.

This study used 962 Missouri residents’ (age: mean 44.8, SD 16.7, range 18-86 years; 67% [641] female) responses in the context of COVID-19 during 2022. Severity of psychological distress was measured using combined responses from PHQ-8 and GAD-7 scales and classified as moderate to severe using a cutoff score of ≥15 in PHQ-8 or ≥10 in GAD-7 scale. Predictors were bereavement (yes/no), current smoking (yes/no), and any substance use and polysubstance use (≥2). Logistic regressions adjusted for age, highest educational level, and employment status.

Approximately 19% experienced loss due to COVID-19; 28% exhibited moderate to severe symptoms of psychological distress. Individuals who experienced COVID-19-related deaths were more likely to suffer from moderate to severe psychological distress symptoms (Adjusted Odds Ratios (AOR): 1.46; 95% CI:1.00, 2.12). Smoking (AOR:1.68; 95% CI: 1.20, 2.36) and polysubstance use (AOR: 2.44; 95% CI: 1.64, 3.65) also exhibited higher odds.

COVID-19 bereavement and smoking/substance use were linked to higher distress. Future research and strategies should integrate bereavement supports with substance-use screening/brief intervention in disaster mental-health services.

This study aimed to explore the earthquake-related experiences of older adults relocated from nursing homes in earthquake-affected regions, the difficulties they faced in adapting to their new environments, and the post-earthquake support they received.

This phenomenological research was conducted through face-to-face semi-structured interviews with 26 participants who had to relocate to a nursing home in southern Turkiye after the earthquake. Qualitative content analysis was based on a deductive and inductive approach.

After the 2023 earthquake in Turkiye, participants experienced a range of emotions and attitudes, including trust, satisfaction, and happiness, as well as fear and anxiety. They experienced social isolation and difficulty adapting to the new nursing home’s dietary habits, climate, and living environment. Although participants received psychosocial and health support services after the earthquake, they recommended organizing more sociocultural activities and providing training on earthquake preparedness.

The findings revealed that emotional distress, adaptation difficulties, and social isolation were prominent challenges during the post-earthquake relocation process. Comprehensive post-earthquake care models are required, which should address older catastrophe survivors’ emotional and social well-being in addition to their physical health.

This study aimed to: (1) identify optimal blended food recipe options using local flours; (2) assess behaviors, attitudes, and practices around the use of blended foods among nutritionally vulnerable groups in Haiti; and (3) evaluate the nutrient composition of prototype blended food product relative to nutrient requirements for vulnerable populations.

Blended food recipes made from local flours were identified through matrix scoring and stakeholder consensus. Focus groups (n = 7) assessed behaviors and attitudes toward blended foods. Prototype recipes were selected based on matrix scoring, program participant feedback, and feasibility of bringing to scale. Nutrient composition of the final prototype was analyzed for consumer information and compared to requirements for young children and pregnant/lactating women.

Two food prototypes resulted. Only the sweet blended food product could be scaled for testing due to the lack of availability of fish for the savory recipe. Focus groups highlighted positive views on balanced nutrition and healthy eating but raised concerns about costs and safety. Nutrient composition analysis of the final prototype showed varying proportions of requirements attained across nutrients.

Blended foods made from Haitian-grown ingredients and food aid offer promise to improve nutrition for target populations but face challenges in scaling to market.

During the COVID-19 pandemic, educators were impacted across domains of psychological, physical, social, and occupational health. Occupational environments, including classrooms, changed significantly due to COVID-19. This study aimed to characterize the nuanced experience of educators during the COVID-19 pandemic.

Participants included 918 United States educators (e.g., teachers, paraeducators, support professionals, and administrators). Educators completed the survey via Qualtrics during November and December of 2020. The survey included eight qualitative questions, and responses were randomized to inductive or deductive datasets for analyses.

Our deductive results showed that individuals reported changes in several facets of health, with educators reporting increases in stress (38.0%) and feelings of isolation (45.9%). Our results also showed impacted occupational health, citing increased responsibility at work (34.0%) and feeling as though their voice was not heard after voicing concerns to either building- or district-level administration (28.2%).

One of the key findings that emerged at the systemic level was educators reporting a lack of decision-making agency within the workplace. Through including educators in the conversations regarding decisions at all levels, agency may be increased. Educators not only shape the students they teach, but the communities within which they work, making a focus on their health paramount.

To explore barriers and facilitators experienced by Australian organizational stakeholders in implementing COVID-19 vaccine rollout for health professional students.

A qualitative study using semi-structured interviews with organizational stakeholders, including senior health department staff, university clinical placement coordinators, and clinical educators across Australia from November 21 to December 20, 2022, via ZOOM. An inductive and then deductive thematic analysis was conducted, guided by the Theoretical Domains Framework.

Nineteen participants were interviewed. Five key domains were generated: environmental context and resources, attention, decision-making, and goals, professional role and identity, emotion, and optimism. Barriers included top-down communication, inconsistent messaging, and limited vaccine access, leading to negative emotions. Enablers included teamwork, adaptability, and optimism.

The findings offer insights into operational challenges and support during the vaccine rollout. These lessons should inform strategies to overcome similar barriers in future large-scale health interventions or emergency responses.

The purpose of this study was to assess senior nursing students’ performance and perceived readiness following a fully immersive VR mass disaster triage simulation and evaluate the effectiveness of VR as an educational modality for emergency preparedness training.

A retrospective observational study assessed BSN students who participated in a VR simulation incorporating START triage and TeamSTEPPS™ principles. Sixty-four students completed the post-experience survey using validated PACT instruments and custom measures.

Students demonstrated successful application of START triage methods and TeamSTEPPS domains during the simulation. Students reported significant increases in perceived knowledge of emergency response (M = 64.3%, SD = 27.5), attitude toward mass disaster training importance (M = 76.8%, SD = 24.5), and ability to respond (M = 66.9%, SD = 26.2). Wilcoxon signed-rank tests revealed significant improvements in understanding of all TeamSTEPPS concepts (P <.05).

VR simulation effectively enhanced nursing students’ perceived readiness for mass disaster response and demonstrated successful application of emergency skills, supporting its integration into nursing curricula for Generation Z learners.