In the aftermath of the 2023 Turkey earthquakes, severely damaged hospitals necessitated efficient patient transportation. This research aims to assess the applicability of trauma assessment tools (TRISS, ISS, RTS) in determining transportation methods for earthquake-affected patients when local hospitals are incapacitated, particularly for patients transported by air ambulance and those who self-arrive from a location 1,100 km away.

This retrospective analysis involved 397 patients from a hospital 1,100 km away from the 2023 Turkey Earthquake. We assessed patients who arrived by air ambulance or self-transport following the earthquake, calculating TRISS, ISS, and RTS scores. We sought intergroup differences to establish transportation strategies.

TRISS and ISS exhibited good predictive value (AUC 0.723 and 0.880, respectively), while RTS was less useful. The median RTS score was 8 for both the Air transfer and Walk-in patients’ groups. The median RTS score was similar for air transfer and walk-in patients. For air transfer patients, most admissions occurred on the first day, while walk-in patients peaked on the eighth day.

ISS and TRISS effectively identify patients requiring air transport post-earthquake. Distant hospitals should prepare to receive air transferred patients within the first five days, and self-admitted patients from the fourth day onward.

This study examined hospital preparedness and radiation risk perception among nurses in Iran, uniquely applying the Transtheoretical Model to identify behavioral predictors of emergency readiness.

This cross-sectional study was conducted among 152 health care workers in three teaching hospitals. Four validated tools assessed hospital preparedness, knowledge, risk perception, and stages of change. Linear regression identified predictors of behavioral progression.

While the hospital equipment domain scored highest (mean 18.3/21), the education domain scored lowest (mean 2.3/4). Notably, 85.5% of nurses remained in the passive stages of change, with only moderate levels of risk perception. Cognitive (β = 0.937) and behavioral processes (β = 0.763) strongly predicted stage advancement, extending previous findings on behavioral determinants of disaster preparedness.

This study suggests that psychological readiness may play an important role in radiation emergency preparedness. Stimulus control and reinforcement management represent critical behavioral targets that are often overlooked in traditional training. Policymakers should consider shifting from awareness-only approaches to stage-matched, behaviorally driven interventions that address nurses’ emotional barriers and support sustained readiness.

This study explored emergency nurses’ lived experiences and perceived challenges during the triage process.

This qualitative study was conducted with 25 emergency department nurses at Atatürk University Research Hospital. Criterion sampling was used to include nurses with direct triage experience. Data were collected through face-to-face, semi-structured interviews and analyzed using Colaizzi’s descriptive phenomenological method. Significant statements were extracted, meanings were formulated, and these were organized into theme clusters. To enhance credibility, 2 researchers conducted the analysis independently, and a consensus was reached through discussion.

Four main themes, 10 sub-themes, and 35 codes were identified. Nurses reported multiple challenges, including lack of institutional support, high patient load, time pressure, and patient dissatisfaction. Decision-making was influenced by both environmental and individual factors. Triage assessment involved a combination of subjective judgment and objective tools. Common errors included misdirection and insufficient questioning. Nurses also suggested improvements related to staffing, training, and organizational conditions.

Triage was experienced as a complex and demanding process shaped by workload, time pressure, and limited support. Findings highlight the importance of organizational and contextual factors in shaping triage practices.

The escalating frequency and severity of disasters and the emergence of global health threats such as the COVID-19 pandemic have exposed vulnerabilities in hospital preparedness and response systems.

This study explores leaders’ perceptions of the SHEPA tool’s application in Saudi hospitals to enhance emergency preparedness.

A cross-sectional survey of 21 Health Emergency Operations Center (HEOC) leaders assessed familiarity, usefulness, ease of use, and impact using a Likert scale and open-ended questions. Logistic regression was used to analyze differences by occupation and experience.

The study participants primarily consisted of mid-career professionals, with the majority (57.1%) falling within the 25-34 years age group. A significant gender imbalance was observed, with male participants (85.7%) vastly outnumbering their female counterparts (14.3%). Educationally, most participants held a Bachelor’s degree (61.9%). Most participants (71-81%) rated the tool highly useful and impactful, though ease of use received mixed reviews. Experienced professionals valued utility more but critiqued impact (OR = 5096 for usefulness; OR = 0.07 for impact). Given the small sample size (N = 21), these logistic regression findings should be interpreted as exploratory and hypothesis-generating rather than confirmatory. However, the consistent patterns suggested that both professional role and experience level meaningfully shaped how the SHEPA tool is perceived, with more senior and experienced staff showing both greater appreciation of its utility and critical assessment of its impacts.

This study highlighted the SHEPA tool’s potential to strengthen hospital emergency preparedness in Saudi Arabia, with strong endorsement from health emergency operations centers’ leaders. The tool’s perceived usefulness and ability to identify improvement areas align with national preparedness goals, though its ease of use and impact evaluation require refinement. The logistic regression findings are exploratory due to the limited sample size and require validation in larger, more diverse cohorts.

Türkiye’s recurrent exposure to natural disasters necessitates a well-prepared health care workforce, particularly in terms of psychological readiness. This study investigates the psychological preparedness of undergraduate students enrolled in the Faculty of Health Sciences, with attention to demographic and experiential variables that may influence preparedness levels.

A cross-sectional study was conducted with 514 undergraduate students enrolled in the Faculty of Health Sciences. Participants were recruited on a voluntary basis, and data were collected through face-to-face surveys using the Psychological Preparedness for Disaster Threat Scale and a personal information form. The data were analyzed using descriptive statistics, independent samples t-tests, ANOVA, and MANOVA.

Preparedness levels differed significantly by gender, age, department, and disaster experience (P <.05). Emergency and Disaster Management students scored the highest. MANOVA confirmed a significant departmental effect (Wilks’ lambda = .891, F(12, 1366) = 4.24, P <.001). Students with prior disaster exposure demonstrated significantly higher levels of psychological preparedness.

The findings underscore the critical role of structured disaster education and psychological resilience training within health sciences curricula. Integrating simulation-based learning approaches, gender-sensitive instructional content, and targeted psychosocial support systems may enhance the preparedness of future health care professionals for disaster response.

To evaluate the mental health of play-age children affected by the 2023 Türkiye–Syria earthquakes and their mothers, using single-item scales.

Four hundred earthquake survivor mother–child dyads were included. The mental health of mothers and children was assessed using single-item screening tools, the Self-Reported Mother Mental Health (SRMH) and the Mother-Reported Child Mental Health (MRCMH).

The prevalence of negative mental health increased from 10% to 52% in play-age children and from 13% to 70% in their mothers after the earthquakes. For post-earthquake negative SRMH, associated factors included limited access to safe water (AOR = 2.52, 95% CI: 1.10–5.75, P = 0.029), good perception of security services (AOR = 0.30, 95% CI: 0.12–0.73, P = 0.008), and post-earthquake negative MRCMH (AOR = 8.65, 95% CI: 4.70–15.91, P < 0.001). For post-earthquake negative MRCMH, associated factors were out-of-house sheltering (AOR = 3.13, 95% CI: 1.72–5.69, P < 0.001), good perception of nutritional services (AOR = 0.46, 95% CI: 0.22–0.96, P = 0.039), pre-earthquake negative MRCMH (AOR = 4.68, 95% CI: 1.87–11.73, P = 0.001), and post-earthquake negative SRMH (AOR = 11.35, 95% CI: 5.92–21.76, P < 0.001).

Post-earthquake mental health outcomes were most consistently predicted by limited basic resources (water and nutrition services), not good service quality, and pre-existing or co-occurring negative mental health.

The increasing frequency of international disasters necessitates robust military-civilian collaboration, often requiring the U.S. Department of Defense (DoD) to augment civilian humanitarian assistance and disaster relief (HADR) capacity and support U.S. geopolitical objectives.

A retrospective quantitative analysis was performed on 149 international HADR events involving DoD support between 1997 and 2024. Data were collated from U.S. Department of State records and narrative reports from the DoD. Events were categorized by geographic area, disaster type, and alignment with the United Nations Humanitarian Cluster System.

The DoD supported HADR efforts in 68 countries, with the Philippines, Iraq, and Indonesia being the most frequent recipients. More than 50% of events occurred in South America and the Indo-Pacific. The most common triggers for support were earthquakes, complex emergencies, and tropical cyclones. Mapping activities to the UN Cluster System revealed that the DoD primarily provided support for Logistics, Early Recovery, and Health.

Following major disasters, rapid deployment of DoD capabilities was indispensable in austere environments where civilian federal organizations and local governments were overwhelmed, incapacitated, or nonexistent. Addressing data deficiencies and coordinating military-civilian readiness are critical for enhancing the effectiveness of future responses.

While the World Health Organization established minimum standards for emergency medical teams (EMTs) in 2013, globally recognized competency standards for individual disaster medical responders remain lacking. This study identifies and synthesizes existing competencies, qualifications, and training requirements for physicians, nurses, and paramedics who serve as deployable disaster response specialists on EMTs.

A scoping review was conducted following PRISMA-ScR guidelines. Comprehensive searches of five databases were performed in September, 2024. Gray literature from 22 governmental and non-governmental organizations was also reviewed. Studies addressing competencies or requirements for disaster specialists (physicians, nurses, paramedics) participating in disaster response were included.

Fifty-four studies were included, most being nursing-focused (n = 28, 51.9%). Studies predominantly originated from the United States (n = 15, 27.8%) and China (n = 9, 16.7%). Training program duration ranged from single-day workshops to multi-week courses, with varied delivery formats. Core competencies identified across professions included Incident Command System knowledge, triage skills, communication abilities, personal protective equipment use, psychological first aid, ethical-legal preparedness, clinical-technical skills, and leadership capabilities.

Substantial convergence exists around core disaster medicine competencies, yet significant variability persists in training approaches and duration. The establishment of globally recognized, evidence-based competency standards for individual disaster medical specialists represents a critical next step.

Immigrant households and those that speak languages other than English are underrepresented in disaster preparedness research. Study authors conducted a needs assessment of Spanish-speaking families to identify strengths and opportunities for education and resources in this population.

In this mixed-methods study, authors partnered with Promotoras de Salud, or Spanish-speaking community health liaisons, to conduct focus groups and surveys with Spanish-speaking family representatives. Recordings were transcribed, translated from Spanish to English, and analyzed using modified grounded theory to identify key themes.

The results demonstrated that while many Spanish-speaking households have experience with disasters, there are significant gaps in information and supplies. Participants reported perceived barriers to preparation including lack of knowledge, language barriers, and lack of sense of belonging. Participants consistently indicated interest in improving disaster preparedness for themselves and their families.

This study demonstrates a clear opportunity to create and share climate disaster preparedness information with Spanish-speaking immigrant populations, who already have valuable experience and resources within their communities. Next steps include expanding outreach to a broader geographic scope of communities and focused assessments of special populations. This study underscores the importance of inclusive, culturally responsive disaster preparedness educational materials.

Terrorist attacks targeting the mining sector represent an under-explored threat. This study aims to characterize the epidemiology, distribution, and features of mining-related terrorism events.

A retrospective search of the Global Terrorism Database was performed, querying attacks between 1970 and 2020 with “business” as primary target type and “mining” as subtype. Attacks were analyzed by region, perpetrating group, modality, and weapon type.

There were 541 mining-related attacks from 1970 to 2020, leading to 617 deaths and 574 injuries. Frequency of mining-related attacks has increased in recent years, particularly after 2010. Geographically, South Asia (23.7%), South America (22.9%), and Southeast Asia (22.7%) had the most attacks. Attacks in sub-Saharan Africa comprised a smaller percentage of attacks (16.6%), but the largest fraction of deaths (60.0%) and injuries (61.5%). Anarchist/revolutionary groups were the most common perpetrators (46.0%). Religious extremist groups were responsible for fewer attacks (6.1%) but had outsized impact in terms of deaths (16.4%) and injuries (17.6%). Armed assault was the most common modality (28.1%) and comprised most deaths (56.9%) and injuries (51.0%). Hostage-taking comprised 19.0% of incidents, with 775 hostages taken. Coal (20.0%) and gold (10.4%) were the most targeted minerals.

Mining-related terrorist attacks have increased in recent years and are characterized by high operational success, politically motivated perpetrating groups, disproportionate lethality in sub-Saharan Africa, and frequent hostage-taking.

Hospital mass casualty incident (MCI) plans must be able to remain operational during wartime. This study examined the impact of the October 7, 2023, attacks on the activation and execution of an MCI protocol in a hospital in southern Israel.

This qualitative study employed thematic analysis of semi-structured interviews conducted with 19 Emergency Department (ED) staff members who worked on October 7, 2023. Interview questions were developed by the authors, based on their professional experiences as physicians, with input from personnel involved in the October 7, 2023, response. Thematic saturation was considered achieved when consecutive interviews yielded no new themes.

Three themes were identified. Threats to staff safety affected staff mobilization and prevented evacuation of patients from the ED. The prolonged and evolving nature of the attacks created unpredictability. Limited official information was partially compensated for through alternative information sources. Finally, a culture of frequent MCI drills contributed to maintaining patient flow and standards of care.

During wartime, MCI plans can remain effective by prioritizing staff safety and mitigating burnout. Information should be collected from multiple sources to compensate for uncertainty and limited situational awareness. Frequent, realistic drills help to maintain operational performance under the extreme stress of war.

Armed conflicts can deteriorate environmental conditions, including air quality, yet their short-term health implications remain underexplored. This study assessed the impact of the 2024 Beirut conflict on air pollution and associated respiratory and dermatological risks.

Satellite-derived air pollution concentrations for Beirut’s Southern Suburbs were compared between the pre-war period (Aug. 1-Sep. 22, 2024) and the war period (Sep. 23-Nov. 29, 2024), using Mann-Whitney U and independent t-tests. Ground-level PM2.5 was measured across 5 sites from October 25 to November 3, 2024. Relative risk (RR) and attributable risk percentage (AR%) for hospital admissions were estimated using exposure-response functions from the Beirut Air Pollution and Health Effects (BAPHE) study. WHO’s AirQ+ tool was applied for the validation of respiratory outcomes.

Median PM2.5 increased from 15.11 μg/m3 pre-war satellite period to 20.21 μg/m3 during the war. Ground-measured wartime median increased from 19.33 μg/m3 to 22.16 μg/m3 in the direct war zone (DWZ). Wartime respiratory admissions increased modestly (RR = 1.011, AR% = 1.13%) in DWZ, while skin disease admissions were higher in DWZ (RR = 1.032, AR% = 3.10%). AirQ+ estimates were aligned with BAPHE-based findings.

The 2024 Beirut conflict elevated air pollution, with measurable short-term health impacts, underscoring the need for environmental monitoring and preparedness during armed conflicts.

Community pharmacies fulfill a pivotal function in maintaining the uninterrupted delivery of health care services and safeguarding the medication supply chain during disaster situations. However, the extant evidence regarding the disaster preparedness levels of pharmacies is limited, particularly in regions with high seismic risk.

The objective of this study was to assess the disaster preparedness levels of community pharmacies in Istanbul and to examine factors associated with their preparedness status.

In this descriptive cross-sectional study, conducted between December 2024 and April 2025, researchers collected data from 360 pharmacies. These pharmacies were selected using a systematic sampling method. The researchers developed a structured questionnaire to collect the data.

The investigation revealed that only 32.8% of pharmacies had a disaster plan, 91.7% had not conducted drills, 85.6% lacked smoke detectors, and 71.4% lacked fire alarms. Conversely, 87.5% of pharmacies reported collaborating with neighboring pharmacies or regional representatives during disaster situations. The findings of the study indicated that pharmacies that had undergone disaster training exhibited significantly higher levels of safety equipment, planning, and material stockpiles (P < 0.05).

The findings indicate that pharmacies in Istanbul demonstrate proficiency in collaboration and fundamental supply procurement. However, deficiencies are observed in drills, fire safety measures, data backup protocols, and strategic planning. In order to enhance the disaster resilience of pharmacies, it is imperative that training programs be expanded, drills be made mandatory, and institutional governance be strengthened.

Children are disproportionately affected by disasters and represent a vulnerable population in such settings. However, no internationally recognized core competencies exist to guide health care providers in caring for children impacted by disasters (particularly non-pediatricians). This study aimed to establish consensus-based core competencies for pediatric disaster response through international expert agreement across disciplines.

A three-round modified Delphi study was conducted following CREDES criteria, using competency statements generated via a comprehensive scoping review of pediatric disaster literature. International disaster medicine experts rated competency statements on a 7-point linear scale (1 = disagree, 7 = agree). Consensus was defined a priori as standard deviation (SD) ≤ 1.0. Data were collected and analyzed using the STAT59 online platform.

57 competencies met consensus criteria across three Delphi rounds, with mean scores ranging from 5.4 to 6.6. The highest-ranked competencies (mean = 6.6) were pediatric vulnerabilities recognition, pediatric transport management, child identification and tracking, and child-parent reunification. Decontamination initiation was also highly ranked (mean = 6.5).

The 57 consensus-based core competencies for pediatric disaster medicine response, spanning 16 practice domains, provide a foundation to further develop standardized curricula, guide preparedness and response efforts, and define minimum training expectations for health care providers caring for children impacted by disasters.