Current Preparedness Research Articles

AI-Driven Innovations in Earthquake Risk Mitigation: A Future-Focused Perspective

This study explores the transformative potential of artificial intelligence (AI) in revolutionizing earthquake risk mitigation across six key areas. Unlike traditional approaches, this paper examines how AI-driven innovations can uniquely enhance early warning systems, enabling real-time structural health monitoring, and providing dynamic, multi-hazard risk assessments that seamlessly integrate seismic data with other natural hazards such as tsunamis and landslides. It introduces groundbreaking applications of AI in earthquake-resilient design, where generative design algorithms and predictive analytics create structures that optimally balance safety, cost, and sustainability. The study also presents a novel discussion on the ethical implications of AI in this domain, stressing the critical need for transparency, accountability, and bias mitigation. Looking forward, the manuscript envisions the development of advanced AI platforms capable of delivering real-time, personalized risk assessments, immersive public training programs, and collaborative design tools that adapt to evolving seismic data. These innovations promise not only to significantly enhance current earthquake preparedness but also to pave the way toward a future where the societal impact of earthquakes is drastically reduced. This work underscores the potential of AI’s role in shaping a safer, more resilient future, emphasizing the importance of continued innovation, ethical governance, and collaborative efforts.

No one really plans to have multiple sclerosis: Transition readiness and quality of life in paediatric multiple sclerosis.

We sought to explore the experiences and perceptions of the quality of life of adolescents with pediatric-onset multiple sclerosis and assess their readiness for academic, employment and/or health care-related transitions. Adolescents with pediatric-onset multiple sclerosis face unique challenges in managing a chronic illness while navigating future scholastic, social and occupational goals. We conducted a qualitative study with in-depth, semi-structured interviews from July 2017 to March 2019. Adolescents with pediatric-onset multiple sclerosis were recruited from a pediatric neurology subspeciality practice until reaching data saturation. A total of 17 interviews were completed via telephone with participants ages 15 through 26. Through content analysis of the interviews, we identified five major themes: (1) receiving a new diagnosis; (2) adapting to life with pediatric-onset multiple sclerosis; (3) evaluating education/career transition preparedness; (4) adjusting within family life and establishing support systems; and (5) assessing current medical services and preparedness for adult medical care. Autonomy in health care management, adequate control of physical symptoms and sufficient family support impacted perceptions of quality of life. Implementing a dedicated transition visit, including the parent(s) of those with pediatric-onset multiple sclerosis, early in adolescence may provide an avenue for appropriate anticipatory guidance regarding available services, independent medical management and continuity of care.

Allied health professionals knowledge and clinical practice in telehealth exercise behavioural change for multiple sclerosis

BackgroundThe growing importance of telehealth in multiple sclerosis (MS) necessitates an understanding of current practices and training needs of health professionals. We aimed to evaluate the knowledge, preparedness, and training preferences of Australian allied health professionals (AHPs) in telehealth exercise therapy and exercise behavioural change for MS patients to inform the development of educational training. MethodsAn online survey was completed by 58 Australian AHPs, including 34 physiotherapists, 14 exercise physiologists, and 10 occupational therapists, focusing on their current practices, preparedness, and training preferences in telehealth exercise and behavioural change for MS. The survey included multiple-choice, Likert scale, and free-text response questions. Data were analysed using binary and multinomial logistic regressions. ResultsNot all AHPs were aware of MS exercise guidelines (67% awareness), with exercise physiologists showing the highest familiarity. There was a significant understanding of the difference between physical activity and exercise, though definitions often lacked clarity. Most AHPs (91%) employed behavioural change strategies in their practice, especially goal-setting (95%), identifying facilitators (67%), and reinforcing progress (66%). While most (72%) felt prepared in promoting exercise to MS clients, there were differences in confidence levels concerning the prescription, modification, and teaching of telehealth exercise programs, with occupational therapists have significant less confidence in those domains compared to other AHPs. Most AHPs expressed interest in additional training, with a preference for online workshops focusing on exercise prescription for MS, behaviour change, and telehealth delivery methods. ConclusionIn our Australian AHP sample we identified that a quarter to a third of AHPs in MS care may not be confident or prepared to promote telehealth exercise and behavioural change to people with MS. Moreover, the findings highlight some disparity in knowledge and confidence levels amongst different AHPs concerning exercise therapy for MS, indicating the need for tailored multidisciplinary training programs. Such programs should address profession-specific educational gaps and training preferences, ensuring effective and safe telehealth exercise prescription in MS care.

Japan’s potential assistance in South Korea’s nuclear deterrence and defense

As North Korea emphasized its “second mission,” the reunification of the two Koreas, with its nuclear weapons, South Korea has been mobilizing all potential resources to deter North Korea’s attempt. Indeed, it rapidly improved its relations with Japan as well as strengthened the U.S. extended deterrence through the “Washington Declaration” in early 2023. The United States, South Korea, and Japan even initiated their trilateral summit meeting to discuss their combined deterrence posture against North Korea. This article evaluates South Korea’s current nuclear preparedness, including preemptive/preventive strikes, missile defense, and civil defense, identifies weaknesses, and analyzes whether Japan can mitigate the weakness.

Disaster Awareness and Preparedness Among Older Adults in Canada Regarding Floods, Wildfires, and Earthquakes

AbstractOlder adults are significantly impacted by natural hazards and disasters that are exacerbated by climate change. Understanding their awareness and preparedness is essential for enhancing disaster resilience. This study investigated the attitudes, actions, and recommendations of older adults regarding natural hazards that pose risks in their geographic area—specifically floods, wildfires, and/or earthquakes in Canada. Methods for this study included survey and focus groups with older adults (n = 161 and n = 10, respectively) and other high-risk groups from across Canada, that are vulnerable to these natural hazards. The main findings from this study are that current awareness and preparedness among older adults is low, though stronger perceptions of risks are associated with risks specific to geographic locations where respondents live. Several barriers, such as hazard vulnerability misperceptions, cost-related reasons, and lack of hazard awareness have resulted in low awareness and preparedness among these populations. The two main recommendations arising from this research are: (1) improve awareness and preparedness with tailor-made emergency preparedness materials for older adults; and (2) adopt community-based approaches to disaster preparedness through existing community groups to strengthen social connections with a focus on locally specific hazards. The findings from this research can be applied to other hazards, including heatwaves and pandemics.

Scanning the Horizon for Environmental Applications of Genetically Modified Viruses Reveals Challenges for Their Environmental Risk Assessment.

The release of novel genetically modified (GM) virus applications into the environment for agricultural, veterinary, and nature-conservation purposes poses a number of significant challenges for risk assessors and regulatory authorities. Continuous efforts to scan the horizon for emerging applications are needed to gain an overview of new GM virus applications. In addition, appropriate approaches for risk assessment and management have to be developed. These approaches need to address pertinent challenges, in particular with regard to the environmental release of GM virus applications with a high probability for transmission and spreading, including transboundary movements and a high potential to result in adverse environmental effects. However, the current preparedness at the EU and international level to assess such GM virus application is limited. This study addresses some of the challenges associated with the current situation, firstly, by conducting a horizon scan to identify emerging GM virus applications with relevance for the environment. Secondly, outstanding issues regarding the environmental risk assessment (ERA) of GM virus applications are identified based on an evaluation of case study examples. Specifically, the limited scientific information available for the ERA of some applications and the lack of detailed and appropriate guidance for ERA are discussed. Furthermore, considerations are provided for future work that is needed to establish adequate risk assessment and management approaches.

The Impact of Exposure to Previous Disasters on Hospital Disaster Surge Capacity Preparedness in Finland: Hospital disaster surge capacity preparedness.

As disasters are rare and high-impact events, it is important that the learnings from disasters are maximized. The aim of this study was to explore the effect of exposure to a past disaster or mass casualty incident (MCI) on local hospital surge capacity planning. The current hospital preparedness plans of hospitals receiving surgical emergency patients in Finland were collected (n = 28) and analyzed using the World Health Organization (WHO) hospital emergency checklist tool. The surge capacity score was compared between the hospitals that had been exposed to a disaster or MCI with those who had not. The overall median score of all key components on the WHO checklist was 76% (range 24%). The median surge capacity score was 65% (range 39%). There was no statistical difference between the surge capacity score of the hospitals with history of a disaster or MCI compared to those without (65% for both, P = 0.735). Exposure to a past disaster or MCI did not appear to be associated with an increased local hospital disaster surge capacity score. The study suggests that disaster planning should include structured post-action processes for enabling meaningful improvement after an experienced disaster or MCI.

Insights and viewpoints from a small-scale survey on current nuclear disaster preparedness measures in Japan after the Fukushima Daiichi Nuclear Power Plant accident

In nuclear disaster prevention, it is essential not only to make daily efforts to prevent accidents from occurring but also to properly apply lessons learnt from actual disasters. Although significant changes have been made to nuclear disaster preparedness in Japan since the Fukushima Daiichi Nuclear Power Plant accident, there is insufficient information on whether these changes have been evaluated as practical and appropriate for the needs of the Japanese public. In this survey, 20 officials of the Cabinet Office and Japan Atomic Energy Agency, in charge of planning nuclear disaster prevention policy, were asked to evaluate the current nuclear disaster prevention plan through a questionnaire, and compare it with that before the accident, and indicate what elements are lacking in the current plan. The survey results revealed that 30% of the participants (six respondents) had a positive view of the enhancement of resources, including physical and human assets. However, as many as 60% (12 respondents) expressed negative sentiments, primarily due to perceived deficiencies in organisational measures, particularly the coordination of these resources. Moreover, the participants expressed keen interest in obtaining health data during evacuation, along with information on the physical and mental effects on evacuees living in evacuation centres. These crucial insights can inform the formulation of effective future preparedness plans for evacuation and radiation protection.

Monkeypox: Next Global Health Emergency Hitting India in 2022

Monkeypox disease which is catalyzed by the zoonotic orthopox monkeypox virus is taking shape in the form of novel threat to the human lives not only in India but also worldwide creating a sense of fear and panic and gaining attention globally after the severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019) pandemic. The present research article discusses about the current scenario and preparedness in India after the first case of the monkeypox disease that has hit the country and what are the master plans that the country should follow in the future to cease the virus transmission.

Advancing Pandemic Preparedness in Healthcare 5.0: A Survey of Federated Learning Applications

The intersection of Federated Learning (FL) and Healthcare 5.0 promises a transformative shift towards a more resilient future, particularly concerning pandemic preparedness. Within this context, Healthcare 5.0 signifies a holistic approach to healthcare delivery, where interconnected technologies enable data-driven decision-making, patient-centric care, and enhanced efficiency. This paper provides an in-depth exploration of FL’s role within the framework of Healthcare 5.0 and its implications for the pandemic response. Specifically, FL offers the potential to revolutionize pandemic preparedness within Healthcare 5.0 in several vital ways: it enables collaborative learning from distributed data sources without compromising individual data privacy, facilitates decentralized decision-making by empowering local healthcare institutions to contribute to a collective knowledge pool, and enhances real-time surveillance, enabling early detection of outbreaks and informed responses. We start by laying out the concepts of FL and Healthcare 5.0, followed by an analysis of current pandemic preparedness and response mechanisms. We delve into FL’s applications and case studies in healthcare, highlighting its potential benefits, including privacy protection, decentralized decision-making, and implementation challenges. By articulating how FL fits into Healthcare 5.0, we envisage future applications in a technologically integrated health system. By examining current applications and case studies of FL in healthcare, we highlight its potential benefits, including enhanced privacy protection and more effective decision support systems. Our findings demonstrate that FL can significantly improve pandemic response times and accuracy. Moreover, we speculate on the potential scenarios where FL could enhance pandemic preparedness and make healthcare more resilient. Finally, we recommend that policymakers, technologists, and educators address potential challenges and maximize the benefits of FL in Healthcare 5.0. This paper aims to contribute to the discourse on next-generation healthcare technologies, emphasizing FL’s potential to shape a more resilient healthcare future.

Vaccination and Antiviral Treatment against Avian Influenza H5Nx Viruses: A Harbinger of Virus Control or Evolution.

Despite the panzootic nature of emergent highly pathogenic avian influenza H5Nx viruses in wild migratory birds and domestic poultry, only a limited number of human infections with H5Nx viruses have been identified since its emergence in 1996. Few countries with endemic avian influenza viruses (AIVs) have implemented vaccination as a control strategy, while most of the countries have adopted a culling strategy for the infected flocks. To date, China and Egypt are the two major sites where vaccination has been adopted to control avian influenza H5Nx infections, especially with the widespread circulation of clade 2.3.4.4b H5N1 viruses. This virus is currently circulating among birds and poultry, with occasional spillovers to mammals, including humans. Herein, we will discuss the history of AIVs in Egypt as one of the hotspots for infections and the improper implementation of prophylactic and therapeutic control strategies, leading to continuous flock outbreaks with remarkable virus evolution scenarios. Along with current pre-pandemic preparedness efforts, comprehensive surveillance of H5Nx viruses in wild birds, domestic poultry, and mammals, including humans, in endemic areas is critical to explore the public health risk of the newly emerging immune-evasive or drug-resistant H5Nx variants.

A Call to Action for a Comprehensive Earthquake Education Policy in Nepal

Earthquakes in Nepal are among the most damaging natural hazards, claiming many lives and causing more widespread destruction than any other natural hazard. Yet, due to other difficulties and challenges, earthquakes are at the forefront of people’s attention only after major events, such as the 1934 or 2015 earthquakes. As a result, current preparedness of the population to earthquakes is far below the optimal level. This calls for an immediate and widespread educational effort to increase awareness and to raise the current young generation responsibly. After describing the current status of earthquake education at various school levels in Nepal, we here propose a series of actions to undertake towards an official education policy, starting from full openness and use of languages, via coordination and teacher's training, to the content, frequency and style of curriculum. We conclude on a timeline of actions, which have various lengths but should start today. We hope that by sharing our researcher and educational experience and thoughts, the actual preparation of the earthquake education policy for Nepal will start being developed under a dedicated team. Elements of the proposal presented here can be used and adapted to other regions at risk around the world.

Analysis of drought coping strategies in northern Ethiopian highlands

One of the most detrimental concerns brought on by a changing climate that annually affects many people's lives is drought. Proactive and reactive drought coping and adapting mechanisms enable farmers to be resilient against climate–induced drought and improve the drylands' current disaster preparedness and early warning systems. The aim of this study was to assess proactive and reactive farmers' drought coping strategies at household level in Raya Valley in southern Tigray, Ethiopia. Agro–climatological based 246 households were sampled from the lowlands, midlands and highlands of the study area. The most effective drought coping mechanisms were discovered using a multinomial logit model. The study area had endured mild to extremely severe drought in the last three decades. The association between the various drought severity and household heads were significant (chi2 = 9.861, df = 3, p < 0.05). Proactive drought coping measures included collecting and storing pasture, conserving soil and water, weather prediction information to adjust saving and farming practices. Livestock feeding with roasted cactus cladode, small business loans, livestock selling, productive safety–net program, and food consumption reduction were the major reactive drought coping strategies. The proactive and reactive drought coping strategies identified in this study should be used to improve the existing disaster preparedness and early warning systems in the face of climate and weather extreme related impacts of climate variability and change.

Supporting and measuring current and future educators' preparedness to facilitate wellbeing of displaced children in schools

IntroductionImmigrant and refugee children face multiple challenges in accessing education. To help facilitate the educational success and wellbeing of these children, teachers need to have self-efficacy in creating a supportive learning environment for them.MethodsBased on a set of highly interconnected competences identified through a literature review and empirical research, the study developed a measurement instrument to assess teachers' generalized perceived self-efficacy in the domain of working with refugee children: the Newcomer's Teacher's Self-Efficacy (NTSE) scale. The scale was tested for validity and internal consistency with 154 practicing and prospective teachers enrolled at three different teacher education institutions in Belgium and the Netherlands, 42 of whom also underwent newcomer education courses.ResultsThe study examined the factorability, reliability, and validity of the NTSE scale and showed that the scale is reliable (a = 0.97) and has good convergent and criterion validity. The results also demonstrated that participation in a study module for newcomer educators corresponded with an increase in partakers' NTSE scores, and the extent of the module was related to the degree of increase.DiscussionThe proposed scale performed well in the context where it was tested, but further international research is needed to determine its generalizability to different countries and time frames.

A Cross-Sectional Study on Inequity and Unmet Needs in Conducting Systematic Reviews (SRMA) and Meta-Analysis Among Medical Students and Junior Doctors.

Systematic reviews and meta-analyses allow a transparent, rigorous, and replicable analysis to summarize the results of multiple related studies and are considered top of the evidence-based medicine study hierarchy. The COVID-19 pandemic has shed light on the unmet educational needs of students worldwide, notably those from underprivileged backgrounds. This cross-sectional study aimed to ascertain students' and junior doctors' attitudes on their current knowledge, confidence and preparedness of appraising and conducting systematic reviews and meta-analysis internationally. A free online webinar was held in May 2021 by the senior author and a pre-event questionnaire was distributed. Responses collected were used for analysis anonymously to ascertain students' knowledge, experience, and confidence in preparing a systematic review and meta-analysis using a 1-5 Likert scale using IBM SPSS 26.0. Associations were examined using Chi-square and crosstabs analysis. Out of 2004 responses from 104 countries included in the analysis, the majority of delegates were from lower middle-income countries and were not familiar with the PRISMA checklist (59.2% and 81.1% respectively of the total number of participants). The majority had never attended any formal training (83%) and felt their medical institute gave them minimal advice (72.5%) in preparing systematic reviews. Among those who had attended formal training, the proportion was significantly higher in those belonging to high and upper middle-income countries combined (20.3%) than lower and lower-middle-income countries combined (15%). This study highlights gaps that need addressing to enhance the knowledge of medical students and junior doctors performing systematic reviews and meta-analyses. Clear disparities are found in country income and the level of education. Future large-scale studies are needed to understand the rationale of working on online research projects and the opportunities available to medical students and junior doctors that may lead to medical curriculum changes.

Jordanian Nurses' Perceived Disaster Preparedness: Factors Influencing Successful Planning.

Current disaster knowledge, skills, and preparedness levels need to be evaluated to guide plans to strengthen disaster readiness. This study aimed to explore the Jordanian staff nurses' perception regarding their familiarity, attitudes, and practices for disaster preparedness (DP) to reduce the negative impacts of disasters. This is a cross-sectional, quantitative, descriptive study. The study was conducted on nurses working at governmental and private hospitals in Jordan. A convenience sample of 240 currently working nurses was recruited to participate in the study. The nurses were somewhat familiar with their role in DP (2.9 ± .84). The nurses' overall attitude towards DP was 2.2 ± 0.38, indicating that respondents had medium attitude levels. A low practice level for DP (1.59 ± 0.45) was also observed. Among the studied demographic variables, there was a significant relationship between experience and prior training with improved familiarity and practices. This indicates a need for strengthening nurses' practical skills as well as their theoretical knowledge. However, there is only a significant difference between attitude scale scores and disaster preparedness training (f = 10.120; p=0.002). The study findings support the need for more training (academic and/or institutional) to increase and improve nursing disaster preparedness locally and globally.

Ready or not: Emergency preparedness in residential care facilities for the elderly (RCFE) in California.

This study examined the results of an electronic survey of residential care facilities for the elderly (RCFE) in California in 2021 to provide insight on key elements of emergency plans and facility preparedness for the COVID-19 pandemic and future emergencies. Surveys were distributed to RCFE administrators using publicly available emails found on the California Health and Human Services Open Data Portal. Responses from 150 facility administrators included data on their perception of current and future facility preparedness for COVID-19 and other emergency scenarios, items included in facility evacuation/shelter-in-place plans, and hazard vulnerability analyses and training practices of facility staff. Descriptive analyses were performed on collected data. The majority of results were from small facilities serving less than seven residents (70.7 percent). Prior to COVID-19, more than 90 percent of respondents included disaster drills, evacuation plans, and emergency transportation in their emergency preparedness plan. The majority of facilities added pandemic planning, vaccine distribution, and quarantine guidelines elements into their plans during COVID-19. Approximately half of facilities reported conducting proactive hazard vulnerability analyses. Around 75 percent of RCFEs felt well prepared for fires and infectious disease outbreaks, had mixed preparedness levels for earthquakes and floods, and felt least prepared for landslides and active shooter emergencies. During the pandemic, perceptions of preparedness rose, with 92 percent stating they felt very prepared currently and almost 70 percent felt very prepared for future pandemics. Preparedness of these essential facilities and their residents can continue to improve by conducting regular proactive hazard vulnerability analyses, improving communication lines and mutual aid agreements with local and state organizations, and preparing for critical emergencies such as landslides and active shooter scenarios. This can help to ensure adequate resources and investments are provided to care for older adults during emergencies.

A National Survey of Hospital Cyber Attack Emergency Operation Preparedness

Introduction:Cyberattacks on healthcare systems are increasing in frequency and severity. Hospitals need to integrate cybersecurity preparedness into their emergency operations planning and response in order to mitigate adverse outcomes during increasingly likely cyber events. No data currently exists regarding the level of preparedness of US hospital systems for cybersecurity attacks. We surveyed hospital emergency managers to assess cybersecurity preparedness for these events.Method:Fifty-seven emergency managers representing hospitals across the US participated in an online Qualtrics survey regarding current preparedness and response procedures for cybersecurity hazards.Results:Survey responses between April 2019 and May 2021 demonstrated that a majority of hospital systems surveyed included cybersecurity disasters in their HVA (82.4%, 47/57), and most ranked it as one of their top five priorities (57.4%, 27/47). However, over half denied specifically mentioning cybersecurity in their EOPs (52.6%, 30/57). Fourteen of the 57 hospital systems (24.5%) endorsed previously activating an Emergency Response for a cybersecurity incident unrelated to Information Technology (IT) failure.Conclusion:The survey results suggest that American hospitals are currently underprepared for cybersecurity disasters. We emphasize the importance of prioritizing cybersecurity in HVAs and implementing specific EOP annexes for cybersecurity emergencies.

Study on the costs and benefits of establishing a unified regulatory guidance for emergency preparedness of small modular reactors in China

Small modular reactors (SMRs) are rapidly developed worldwide in recent years for their potential extensive applications. China is very active in promoting SMR design and construction. However, the current emergency preparedness (EP) guidance in China is developed based on the characteristics of large water-cooled reactors, and they are only partially applicable to SMRs. In our previous work, we have fully demonstrated from a technical perspective that it is feasible for China to establish a unified EP framework for all SMR designs based on the dose and consequence of an accident spectrum. Therefore, this paper will comprehensively discuss the costs and benefits of establishing a unified EP guidance for all SMR designs in China. Uncertainty analysis is also conducted for variables with great uncertainty. Through the study in this paper, it can be concluded that developing a new unified EP regulatory guidance for all SMR designs in China is cost beneficial in most cases. In addition, it will also bring other benefits that are hard to be quantified, such as the consistency of supervision, the clarity of the EP plan, and the improved engagement of all stakeholders during SMR development. In a word, it would always be beneficial to establish a new unified EP regulatory guidance for all SMR designs in the long term.

The Impact of Previous Disasters on Hospital Disaster Surge Capacity Preparedness in Finland

Introduction:In a disaster, the number of victims and severity of injuries may overwhelm the treatment capacity of the local hospital. Surge capacity is the hospital’s ability to receive and treat an increased number of patients. This study aimed to explore if a past disaster or mass casualty incident (MCI) affects local hospital surge capacity preparedness.Method:The current hospital preparedness plans (HPPs) of University and central hospitals receiving surgical emergency patients in Finland were collected (n=28). The HPPs were read and analyzed using the World Health Organization (WHO) hospital emergency checklist tool with eight key components and 67 action items. The scores of key components were compared by percentage of the maximum score. The surge capacity score was compared between the hospitals that had been exposed to a disaster or MCI with those who had not. The effective level was considered as 70% of total points.Results:The overall median score of all key components was 76% (range 24%). The highest score was in command and control (median 93%, range 29%) and the lowest in post-disaster preparedness (median 50%, range 90%). The median surge capacity score was 65% (range 39%). There has been 12 disasters or MCIs during the past 25 years in Finland, all anthropogenic. There was no statistical difference between the surge capacity score of the hospitals with a history of a disaster or MCI compared to those without (65% for both, p=0.735).Conclusion:In Finland, the overall hospital preparedness level is effective with command and control being the best covered area. Surge capacity preparedness was below the effective level and it was not affected by a past disaster or MCI. Present-day challenges with the lack of resources in the health care system, more attention should be drawn to the surge capacity aspect in hospital preparedness plans.