An integrated vulnerability-resilience framework for climate risk assessment in depopulating urban landscapes

Military humanitarian efforts in pediatric surgery and ethical considerations.

Local women's organisations assume essential roles during disasters in hazard-prone, rural poor communities, especially when government capacities are overwhelmed and non-government resources are required to meet affected people's needs. Yet, they are often deprioritised as international actors' partners of choice in the well-established humanitarian system of the Philippines. This paper illustrates how they navigate vertical social ties with international humanitarian organisations to enhance their resilience in disaster preparedness, response, and recovery. It examines whether strengthening the linking social capital of local women's organisations with international humanitarian non-governmental organisations can: improve women's ability to access resources in disasters; challenge the power dynamic in such a way that women are able to engage meaningfully in decision making and attain an equal footing in the partnership; and increase the capacity of women to build community resilience as an outcome of improved access and meaningful engagement. The study engaged 10 leaders of the National Rural Women's Coalition (PKKK) in semi-structured interviews and applied a social constructionist, feminist standpoint framework to the analysis. It found that rural women navigate asymmetrical power dynamics in creative ways and value partnership behaviours that demonstrate equitability and true accompaniment.

Towards generative location awareness for disaster response: A probabilistic cross-view geolocalization approach

Remote sensing has rapidly advanced with the integration of deep learning, enabling more accurate and scalable detection of land use and land cover (LULC) changes, particularly with the increasing availability of Sentinel-1 and Sentinel-2 multispectral imagery. This review traces the evolution of classical machine learning approaches toward modern deep learning architectures, including Convolutional Neural Networks (CNNs), encoder-decoder models, Siamese and dual-stream networks, attention-based frameworks, and, more recently, Transformer-based models. Recent developments in Earth observation foundation models, trained on large-scale, multimodal datasets, have introduced new capabilities, including zero-shot inference, cross-sensor transferability, and improved generalization across diverse geographic regions. Despite these advances, significant challenges remain. The fusion of multimodal data, including optical, SAR, and ancillary sources, is complicated by differences in spatial, spectral, and temporal characteristics. Furthermore, domain adaptation, label noise, and limited geographic transferability continue to constrain the robustness of change detection pipelines. The quantification of uncertainty and model interpretability has also become increasingly important for operational applications in urban planning, agriculture, ecosystem monitoring, and disaster response. In addition, the growing computational and environmental costs of large-scale model pretraining underscore the need for more sustainable AI practices. Future research should therefore focus on advancing the Earth observation foundation and generative models, developing temporal AI methods for long-term sequence analysis, and promoting responsible, energy-efficient geospatial artificial intelligence. Integrating advances in remote sensing, machine learning, and environmental science will be essential for building practical, scalable, and reliable planetary monitoring systems.

This study investigates the barriers that limit women’s ability to receive and act upon early warning messages during disasters. It focuses on the intersection of socio-economic and cultural factors in coastal Odisha, India, with particular reference to Cyclone Fani . Using a mixed-method, exploratory design, data were collected in two phases from 211 women and from 173 stakeholders, including community volunteers, health workers, NGO staff, and government responders. Through surveys, focus group discussions, and interviews, the study identifies religious beliefs, socio-economic inequalities, communication barriers, and gendered risk perceptions as critical barriers to effective warning dissemination and preparedness. A Force Field Analysis (FFA) was applied to map and evaluate the relative strength of the barriers and facilitators influencing women’s disaster response behaviour. Factors such as grassroots volunteering, trained personnel, and strong neighbourhood networks emerged as key facilitators. Findings reveal that although most women received early warnings, behavioural and socio-cultural constraints limited their preparedness actions. These barriers underscore that early warning access and action are not merely technical challenges but are rooted in structural inequalities. The paper concludes that integrating behavioural and socio-cultural understanding into policy design is crucial for advancing inclusive disaster preparedness. By adopting behaviourally informed Early Warning Systems, Odisha and similar disaster-prone contexts can strengthen community responses to warning information and enable marginalized women to become active participants in resilience building.

Nurses play a pivotal role in disaster response processes; to manage these processes effectively, they require not only technical skills but also robust psychological resilience. Elucidating the relationship between psychological resilience and disaster preparedness is crucial for strengthening the preparedness of psychiatric nurses. This study was conducted to determine the predictive role of psychological resilience on disaster preparedness among psychiatric nurses. This descriptive and cross-sectional study was conducted with 140 psychiatric nurses. Data were collected using a "Personal Information Form," the "Psychological Preparedness for Disaster Threat Scale," and the "Brief Resilience Scale." Descriptive statistics, Pearson correlation analysis, simple linear regression, independent samples t-test, and one-way analysis of variance (ANOVA) were employed for data analysis. The mean disaster preparedness score of the participants was 62.77 ± 13.79. Psychological resilience was a positive and significant predictor of disaster preparedness (β = 0.272, p = 0.001), explaining 6.7% of the variance. Disaster preparedness scores were significantly higher among nurses who had received formal disaster training (p = 0.003) and among those with five years or more of professional experience (p = 0.028). Nurses working exclusively on night shifts had lower disaster preparedness scores than those working day shifts or rotating shifts (p = 0.024); however, this finding should be interpreted cautiously due to the very small number of participants in the night-shift-only group. Although psychological resilience is a significant internal resource associated with nurses' disaster preparedness, it is not solely sufficient. Healthcare institutions should integrate psychological empowerment programs with applied and simulation-based disaster training and ensure that such training is accessible to all personnel regardless of shift schedules. Further studies with larger and more balanced shift groups are needed to clarify the role of shift schedules in disaster preparedness. Not applicable.

Decision-making framework for response and management of environmental disasters (FRaMED).

Spatial planning plays a pivotal role in shaping the health and well-being of urban populations. Since 2016, most Chinese cities have incorporated health-related elements into their Territorial Spatial Planning (TSP) 2035 Schemes as part of national healthy city initiatives. It is essential to examine how health is represented in these statutory planning documents and whether the level of attention varies across cities. We developed an analytical framework for healthy city planning by synthesizing international scholarly literature and governmental policy documents. Using this framework, the TSP 2035 Schemes of 36 major Chinese cities were examined through a mixed-method design combining thematic dimension analysis, keyword network analysis, and disparity measures. All 36 cities have placed healthy city development on their planning schemes, focusing primarily on eight dimensions: (1) green and open space, (2) climate change and disaster response, (3) physical education (PE) facilities and public services, (4) environmental pollution prevention and control, (5) medical and health services, (6) elderly dimension, (7) health equity, and (8) healthy travel. Of these dimensions, green and open space along with climate change and disaster response receive the most emphasis. Notable healthy city keywords include 'park', 'green space', 'healthcare', 'livability', 'sports', 'resilience', 'pollution control', 'disaster prevention', 'walking', and 'jogging'. Cross-city comparisons reveal substantial disparities: cities with higher administrative status generally articulated more extensive and more diverse health-related planning content, whereas many lower-tier cities pay relatively little attention to equity-sensitive dimensions. Health has become a visible component of statutory planning discourse in China, but its integration remains selective and uneven across cities. The results suggest that China's healthy city development has reached an intermediate stage of "health promotion and education", and in terms of health-spatial planning integration, China has moved beyond a narrow environmental health orientation, yet important gaps remain in equity-sensitive and people-centered dimensions. Recommendations include strengthening legislation to support healthy city planning, improving the openness and transparency of TSP 2035 Schemes, and more differentiated policy support across cities.

ABSTRACT Natural disasters cause significant loss of life and heavily affect social, psychological, and economic well-being. Effective disaster management requires timely, adequate responses. Turkey, frequently exposed to disasters, needs strong management strategies. This retrospective study examines psychosocial service records to evaluate small-scale disaster responses in Samsun, emphasising temporary resettlement and survivors’ psychosocial well-being. Psychological well-being was analysed using Maslow’s hierarchy of needs as an analytical framework. Findings show mixed experiences: while survivors appreciated shelter, service quality, and social support, challenges such as poor food, lack of privacy, internet issues, and limited social activities dominated. Psychosocial analysis revealed that 93% did not use available psychological support, likely due to stigma, despite PTSD symptoms. These results underscore the need for social work practitioners to implement more engaging psychological interventions, guided by CSWE competencies, and for disaster initiatives to include systematic impact evaluation. Such measures can enhance survivor recovery, self-actualisation, and professional disaster practice.

Background/Aims: The increasing complexity of disasters requires effective integration of nurses into Civil Defense (CD) systems. Despite their crucial role, the competencies needed to operate within these multi-agency frameworks remain fragmented and insufficiently defined. The main aim of the study was to map nursing competencies for disaster response within the CD context, identifying essential skills, contextual variations, and barriers to application. Methods: A scoping review was conducted following the JBI methodology and reported according to PRISMA-ScR guidelines. Major databases (PubMed, CINAHL, Scopus, Embase) were searched without time limits, resulting in the inclusion of 27 studies published between 2011 and 2025. Results: 12 core competency domains were identified. Clinical care was the most cited competency (70% of studies), followed by communication (63%), leadership (60%), triage (48%), and psychosocial support (48%). The lack of specific training emerged as the primary individual barrier (44%), while the absence of standardized curricula was the leading systemic obstacle (41%). Competency requirements varied significantly based on the hazard type and organizational setting. Conclusions: Disaster nursing is emerging as an essential specialized field in response to the increasing frequency of climate-related events and global conflicts. There is an urgent need to move beyond purely clinical training to integrate "organizational literacy" and psychological resilience, harmonizing educational pathways with national CD policies and competency-based disaster preparedness programs.

Hurricane‐related flooding can mobilize microbial and chemical contaminants, while limited well testing and uneven disaster response capacity leave many households relying on private wells at elevated risk, particularly during the early recovery phase when contamination risk is acute. To address this challenge, we propose a data‐driven framework for quantifying post‐hurricane private well contamination risk. The framework produces a numerical risk score by integrating 78 geospatial variables across three modules representing hazard, physical vulnerability, and social capacity. The score is constructed using a hybrid approach that combines supervised and unsupervised learning to generate interpretable indices grounded in theory and calibrated to real‐world data. We applied the framework to western North Carolina following Hurricane Helene and evaluated its performance using post‐hurricane well testing data from the North Carolina Department of Health and Human Services together with community‐informed assessments in two counties. Higher risk scores were significantly associated with increased total coliform contamination (p = 0.006, Wilcoxon rank‐sum test), demonstrating the value of the framework for identifying areas with elevated contamination risk. These findings suggest that the framework can help identify areas with elevated contamination risk following extreme weather events, although predictive performance remains moderate and further systematic evaluation is needed. The framework is designed to be transferable and can be adapted to other storms and regions where geospatial and well testing data are available. Overall, this work provides a practical, data‐informed tool to support disaster preparedness, prioritize well testing, and protect private well users after extreme weather events.

Pre-hospital Emergency Medical Services (EMS) providers serve a critical function in disaster response. While technical preparedness remains essential, psychological resilience is equally vital for sustaining performance amidst stressful conditions. This research endeavored to assess disaster readiness and resilience among EMS providers in Tehran Province, Iran, and to identify the factors associated with resilience. A cross-sectional analytical study was conducted in 2025, involving 467 pre-hospital EMS providers, using online self-administered questionnaires. Data collection encompassed demographics, Persian Version of the Disaster Nursing Readiness Evaluation Index (F-DNREI), and Disaster Resilience Measurement Tool. Descriptive statistics, correlation analyses, and multiple linear regression were employed to identify factors associated with resilience. Participants' mean disaster readiness score was 95.88 ± 10.62, whereas resilience mean score was 44.81 ± 9.50, with only 3.85% classified as highly resilient. Resilience was significantly correlated with readiness (r = 0.562, p < 0.001) and was positively associated with work experience, higher education, and prior attendance at a disaster management workshop. In the final multivariable regression model, age was excluded due to near-perfect collinearity with work experience, disaster readiness, holding a bachelor's degree, and prior workshop participation; these variables were retained as independent predictors of disaster resilience (R² = 0.606). Despite adequate disaster readiness, resilience was low, indicating a critical gap between technical preparedness and psychological adaptability. Education, experience, and prior training emerged as significant factors associated with resilience. Based on these observational associations, integrating simulation-based training with resilience-enhancement and psychosocial-support components warrants evaluation as a potential strategy to strengthen both readiness and adaptive capacity. Future research should examine these dynamics in real emergency scenarios.

Hurricanes and flooding pose serious challenges to the stability of the blood supply, particularly in vulnerable regions such as Florida. We aimed to describe and evaluate the preparedness, response and recovery strategies of a large blood centre over the past decade, with a focus on Hurricane Irma (2017). Drawing on the centre's Business Continuity Plan, after-event reports and disaster response data, we examined how operations were disrupted and how the blood supply was maintained under extreme conditions. Combined, these storms resulted in tens of millions of dollars in losses through cancelled blood drives, damage to facilities, interruptions in operations and widespread breakdowns in communications, logistics and supply chains. At the same time, emergency coordination with hospitals, community partners and public agencies helped sustain blood availability when it was most needed. The experience with Hurricane Irma illustrates the complexity of maintaining resilience during large-scale disasters and highlights both the strengths and the vulnerabilities of existing preparedness measures. Over the decade, lessons learned from these events have been integrated into the centre's planning, leading to continuous improvements and a more robust framework for future emergencies. Yet critical gaps remain that will require new resources, stronger interorganizational networks, expanded research and ongoing data analysis to close. As climate change intensifies the frequency and severity of hurricanes, the urgency of addressing these vulnerabilities grows. Strengthening preparedness and resilience will be essential to safeguard the blood supply against the storms yet to come.

The aim of this study was to examine the effect of nurses’ moral sensitivity on their disaster response self-efficacy. The study was conducted with 273 nurses between August and November 2023. Data was collected using the Descriptive Information Form, Moral Sensitivity Questionnaire (MSQ) and Disaster Response Self-Efficacy Scale (DRSES). A weak but statistically significant negative correlation was found between MSQ scores and disaster response self-efficacy, indicating that higher moral sensitivity was associated with higher self-efficacy (r = -0.153, p = 0.011). Regression analysis indicated that moral sensitivity significantly predicted disaster response self-efficacy (β = −0.153, p < 0 .05). Ethical sensitivity of nurses was effective on their disaster response self-efficacy.

From FOB to PICU: military trauma systems that changed pediatrics.

Aim: To re-examine the 1996 airplane crash near Dubrovnik as a historical-forensic case study, focusing on the diplomatic purpose of the mission, the circumstances of the accident, and the Croatian institutional response in search, recovery, identification, and commemoration.Methods: This study used a narrative historical-forensic approach based on official aviation investigation reports, Croatian police and forensic documentation, U.S. congressional and governmental materials, contemporary reports, and commemorative sources. The analysis integrated aviation findings with medico-legal, institutional, diplomatic, and memorial contexts.Results: The CT-43A crash occurred during a U.S. diplomatic and economic mission undertaken shortly after the end of the Homeland War, with the aim of supporting reconstruction, stability, and renewed partnership in Croatia and Bosnia and Herzegovina. Aviation investigation findings attributed the accident to a combination of command failure, aircrew error, and an improperly designed non-precision approach procedure. Croatian police, rescue, medical, and forensic personnel responded under difficult terrain and weather conditions, secured the site, recovered the victims, performed preliminary identification procedures, and cooperated closely with IFOR/NATO and U.S. authorities. The response reflected the operational maturity Croatian forensic institutions had developed during the Homeland War and immediate post-war period.Conclusion: Three decades later, the CT-43A airplane crash should be understood not only as an aviation disaster, but also as a forensic, diplomatic, and commemorative event. The case demonstrates how professional disaster response, international cooperation, and historical-forensic documentation can contribute to institutional memory and shared Croatian–American remembrance.

Existing studies on tourism in flood-prone areas primarily focus on risk, disaster response, and vulnerability, with limited attention to how long-term environmental adaptation is integrated into tourism practices. This study addresses this gap by examining how communities in the Sena trough of Ayutthaya reinterpret seasonal water overflow as a foundation for community-based tourism and local resilience. The Sena trough, a low-lying floodplain within the Chao Phraya River basin, experiences predictable annual inundation that shapes settlement patterns, agriculture, and everyday life. Rather than treating these seasonal water conditions as disasters, local communities frame them as “water overflow,” a cyclical environmental condition embedded in local ecological and cultural systems. Using a qualitative case study approach, the research draws on field observations conducted between 2020 and 2024, supported by spatial analysis of flood-prone areas and validation discussions with local actors. The findings show how adaptive practices such as stilt housing, flood-adapted agriculture, canal-based mobility, and seasonal aquaculture have been translated into tourism experiences including boat tours, homestays, and participatory agricultural activities. These findings demonstrate how environmental adaptation, community resilience, and community-based tourism function as an integrated process, in which everyday adaptive practices are translated into experiential and economic activities. The study contributes to tourism geography by showing how long-term environmental adaptation can be operationalized as tourism, extending conventional perspectives that treat resilience as reactive rather than process-based.

Inefficiencies within the structures, processes, and resources associated with mental health and psychosocial support (MHPSS) can lead to adverse individual and collective health outcomes among disaster survivors. Therefore, accurately identifying the barriers to implementing these interventions is essential for strengthening the disaster response system. This study aimed to explore and extract the key challenges and recommendations related to MHPSS in disasters within the national health system in Iran. This study was conducted in December 2024 using a qualitative research design and a directed content analysis approach. Participants consisted of 20 experts in mental health, disaster management, and health policy, selected through purposive sampling. Data were collected via semi-structured, in-depth interviews, and the trustworthiness of the findings was ensured using Lincoln and Guba's criteria. Nine major challenge domains were identified. At the macro governance level, a limited recognition of the importance of MHPSS and insufficient attention to the long-term psychosocial consequences of disasters were reported. Within the domains of organization and coordination, the absence of a unified command and the presence of parallel activities across agencies were identified. Structural constraints included the lack of formally approved organizational structures, inadequate infrastructure, and the absence of a clear framework for the management and integration of volunteers. In the area of human resources, key challenges comprised a shortage of psychiatrists, misalignment between workforce capacity and assigned responsibilities, and insufficient attention to the motivation and welfare of responders. Training and research gaps were noted, including insufficient pre-disasters training and limited context-specific applied research. In addition, ineffective risk communication and limited consideration of cultural and social dimensions were identified as prominent obstacles to delivering effective MHPSS interventions. MHPSS in disasters is confronted with complex and intersectoral challenges, the resolution of which requires a coordinated and evidence-informed approach. Enhancing policymakers' awareness, ensuring sustainable financial resources, developing needs based training programs, leveraging local human resources, and incorporating cultural considerations can substantially improve the effectiveness of MHPSS services during crises and provide a foundation for future policymaking and planning in the health system.

The Field Trip to Fukushima Course (Harvard T.H. Chan School of Public Health, GHP549, Winter Session 2026) built on the inaugural 2025 course to offer an educational experience for graduate students across Harvard, examining ongoing recovery challenges in Fukushima following Japan's 2011 triple disaster of an earthquake, tsunami, and nuclear meltdown. Students learned directly from stakeholders spanning local, prefectural, and national levels across a range of sectors, mainly in Fukushima and Tokyo. Organized into three groups (Radiation and Environmental Health, Disaster Preparedness and Health Systems Resilience, and Community Recovery and Social Impact), students presented their results at Fukushima Medical University on January 20, 2026. The Radiation and Environmental Health group proposed establishing a Japan-led task force on nuclear disaster response and preparedness, presented in a theater-style format. The Disaster Preparedness and Health Systems Resilience group applied a social capital framework and recommended community strengthening through Disaster Welfare Assistance Teams in the acute phase and community buckwheat farming in long-term recovery. The Community Recovery and Social Impact group designed a LINE account for information dissemination and community building among young people. Building on its inaugural year, the course offered insights into how field-based, interdisciplinary learning can contribute to graduate education in disaster preparedness, recovery, and community resilience.