Gaps In Preparedness Research Articles

Perceptions and understanding of family pediatricians regarding the new Italian Type 1 Diabetes screening program

AimsItaly is the first country to implement a nationwide Type 1 Diabetes (T1D) screening program aimed at reducing cases of diabetic ketoacidosis and potentially delaying disease progression through early interventions. This study assesses the knowledge, perceptions, and willingness of family pediatricians (FPs) to participate in this program. MethodsAn anonymous online survey was conducted among 113 FPs in the Friuli Venezia Giulia region, an area not included in the initial pilot study. The survey evaluated their knowledge, readiness, and concerns regarding the screening program. ResultsOf the 62 respondents (55% response rate), 84% expressed a willingness to participate in the screening program, although most reported limited knowledge about it. The key concerns included family anxiety, identifying individuals at risk of diabetes, and uncertainty regarding follow-up procedures. While FPs acknowledged the potential benefits of reducing ketoacidosis, 75% emphasized the need for more training and support. ConclusionsWhile FPs are largely willing to participate in the T1D screening program, significant gaps in knowledge and preparedness remain. Addressing these gaps through comprehensive education and clear follow-up protocols is crucial for the successful nationwide implementation of the program in 2025.

The Impact of Community-Based Health Education on Maternal Health Outcomes in Rural Southeast Asia

Community-based health education has emerged as an effective strategy to improve maternal health outcomes, particularly in underserved rural areas with limited access to health services. These programs address critical gaps in prenatal care, birth preparedness, and postnatal health practices, empowering women to make informed decisions about their health and well-being. This research aims to determine the impact of culturally tailored community-based health education programs on maternal health outcomes in rural areas of Southeast Asia, with a focus on improving access to prenatal care, birth readiness, and postnatal care practices. Methods A mixed methods approach was used, integrating quantitative health records analysis with qualitative insights from interviews with participants in targeted rural communities. This dual methodology provided a comprehensive understanding of the program's effectiveness and cultural relevance. Results showed that regular health education sessions significantly improved maternal health outcomes. Communities exposed to these programs reported higher rates of attendance at antenatal check-ups, increased skilled attendance during delivery, and better adherence to postpartum care recommendations. These improvements were instrumental in reducing maternal and newborn mortality and improving overall health in this population. This research implicates the important role of culturally sensitive health education in bridging maternal health disparities in rural areas of Southeast Asia. By integrating local customs and beliefs into health messages, these programs foster community trust and engagement, thereby increasing their acceptance and effectiveness.

Understanding seismic hazard resilience in Montenegro: A qualitative analysis of community preparedness and response capabilities

Abstract Enhancing resilience against seismic hazards in earthquake-prone regions is essential for reducing the devastating impacts of disasters. Seismic resilience refers to a community’s ability to withstand and recover from earthquake impacts, while preparedness gaps are the areas where current measures are insufficient to effectively respond to or mitigate earthquake damage. This study focuses on Montenegro – a region with frequent seismic activity – aiming to assess resilience levels, identify critical gaps in preparedness, and evaluate the effectiveness of existing response strategies. Using qualitative methods, including semi-structured interviews, the research gathered insights from residents of Montenegro’s most vulnerable cities: Nikšić, Podgorica, Bar, Kotor, Cetinje, Budva, Herceg Novi, and Berane. Participants, chosen for their first-hand experience with significant earthquake impacts, provided valuable perspectives on various aspects of resilience, from local government response to individual preparedness. This research revealed significant disparities in resilience across communities: for instance, approximately 62.5% of the respondents highlighted inadequate education as a barrier to effective earthquake preparedness, and only 37.5% reported awareness of basic earthquake response procedures. Furthermore, while some communities, such as urban areas with accessible services, reported higher preparedness levels, rural areas showed deficiencies, with 50% of the respondents from these areas identifying a lack of organized drills and limited public awareness initiatives. These findings underscore the urgent need for community-specific preparedness programs and enhancements in both structural resilience and public education to bolster community readiness effectively. Also, findings highlight the need for customized preparedness programs tailored to specific community needs, alongside improvements in structural safety measures and educational outreach. The study underscores the importance of a comprehensive approach involving detailed risk assessments, community-focused preparedness training, and stronger public awareness initiatives. Furthermore, the study calls for enhanced local government capabilities to sustain proactive response measures, including rapid mobilization of emergency resources and regular disaster simulations, to build long-term resilience across communities.

Teacher perspectives and barriers in implementing inclusive education for Indian children with special needs: A pilot study

AbstractInclusive education is crucial for integrating children with special needs into mainstream educational settings. This pilot study explores the attitudes of teachers in India toward providing inclusive education to children with disabilities, and the challenges they face. As the Indian education system continues to evolve, there are significant gaps in teacher preparedness and the availability of resources, especially given the socio‐cultural and economic diversity of the country. The study aims to assess the perspectives of 30 primary and secondary school teachers regarding their experiences with inclusive education, focusing on their attitudes, challenges, and the resources available for supporting students with special needs. A mixed‐methods approach was employed, utilising surveys and interviews to gather both quantitative and qualitative data. The results indicate that while many teachers hold a positive attitude toward inclusive education, they face numerous challenges in its implementation, including a lack of specialised training, insufficient support services and inadequate teaching materials. Teachers expressed particular difficulty in supporting students with severe disabilities due to the lack of behavioural and psychological services in schools. This study emphasises the importance of continued teacher training and infrastructure improvements to foster effective inclusive education. It also highlights the need for policy changes, such as the integration of the Samagra Shiksha scheme and recognition of the 2016 Rights of Persons with Disabilities Act, to support teachers in overcoming the barriers they face. The findings from this pilot study will inform a larger, more comprehensive study, and provide the foundation for future reforms of inclusive education in India.

The repercussions of enacting the IMO 2020 regulation for mitigating ship emissions in Malaysian waters

ABSTRACT The IMO 2020 regulations, introduced by the International Maritime Organization (IMO), came into effect on January 1, 2020, with the primary goal of reducing sulphur oxide emissions from ships by capping the allowable sulphur content in marine fuels at 0.50%. This measure aims to minimize the harmful environmental and health impacts of sulphur emissions, which contribute to air pollution and acid rain. However, the implementation of these regulations has posed considerable challenges for Malaysia’s maritime sector, particularly due to increased operational costs and difficulties in complying with the stringent requirements. This study critically analyses the challenges associated with the enforcement of IMO 2020 regulations in Malaysia, focusing on regulatory compliance. By conducting a comprehensive review of existing literature and integrating insights from key stakeholders and regulatory authorities, this research evaluates the current state of implementation. The findings reveal that the enforcement of IMO 2020 in Malaysia has been suboptimal, largely due to gaps in regulatory execution and industry preparedness. For Malaysia to fully align with international standards and contribute to the preservation of a sustainable maritime ecosystem, concerted efforts are essential to enhance enforcement mechanisms and ensure compliance with global emission reduction targets.

Pregnancy Preparedness and Complication Preparedness of Pregnant Women in Prenatal Clinics of Tertiary Hospitals

This study assesses the level of Birth Preparedness and Complication Readiness (BPACR) among pregnant women attending antenatal clinics at a tertiary care center. Conducted through an analytical cross - sectional approach from August to October 2023 at Rajarajeswari Medical College Hospital, Bengaluru, it involved 194 participants who were 32 weeks gestation or more. The research utilized a questionnaire covering sociodemographic characteristics, knowledge of birth preparedness, and complication readiness, with data analyzed using descriptive statistics. Results indicated a low BPACR index with significant gaps in awareness and preparedness for childbirth and emergency situations. Only a fraction of participants had initiated antenatal care in the first trimester, and a majority were unaware of severe preeclampsia signs. The study underscores the need for enhanced education and awareness programs at both community and health center levels to improve birth preparedness and complication readiness among pregnant women.

Machine learning for anxiety and depression profiling and risk assessment in the aftermath of an emergency

Background & objectivesMental health disorders pose an increasing public health challenge worsened by the COVID-19 pandemic. The pandemic highlighted gaps in preparedness, emphasizing the need for early identification of at-risk groups and targeted interventions. This study aims to develop a risk assessment tool for anxiety, depression, and self-perceived stress using machine learning (ML) and explainable AI to identify key risk factors and stratify the population into meaningful risk profiles. MethodsWe utilized a cohort of 9291 individuals from Northern Spain, with extensive post-COVID-19 mental health surveys. ML classification algorithms predicted depression, anxiety, and self-reported stress in three classes: healthy, mild, and severe outcomes. A novel combination of SHAP (SHapley Additive exPlanations) and UMAP (Uniform Manifold Approximation and Projection) was employed to interpret model predictions and facilitate the identification of high-risk phenotypic clusters. ResultsThe mean macro-averaged one-vs-one AUROC was 0.77 (± 0.01) for depression, 0.72 (± 0.01) for anxiety, and 0.73 (± 0.02) for self-perceived stress. Key risk factors included poor self-reported health, chronic mental health conditions, and poor social support. High-risk profiles, such as women with reduced sleep hours, were identified for self-perceived stress. Binary classification of healthy vs. at-risk classes yielded F1-Scores over 0.70. ConclusionsCombining SHAP with UMAP for risk profile stratification offers valuable insights for developing effective interventions and shaping public health policies. This data-driven approach to mental health preparedness, when validated in real-world scenarios, can significantly address the mental health impact of public health crises like COVID-19.

Transition From Graduate Medical Education to Independent Practice: A Scoping Review.

This study examines the gaps in early career physician readiness for independent practice after graduating from their final graduate medical education (GME) program. The authors conducted a literature search of 4 online databases (PubMed, Scopus, Health Business Elite, and Education Resources Information Center) using the following terms: population terms (GME, fellow, resident, and others), early career terms (onboarding, hiring, early career, ready, and others), readiness terms (readiness, preparedness, knowledge, skills, competence), and independence terms (attending, physician, independent practice). The databases were searched on March 12, 2024, for articles that explored GME graduate gaps in readiness for independent practice; assessment tools, curricula, or curricular need aimed at gaps in early career physician readiness; or an area where GME graduates need more knowledge and skills. They extracted specific gaps in preparedness and categorized them using existing competency frameworks. The search returned 116 articles addressing gaps in preparedness for independent practice among recent GME graduates. Surgery yielded more articles than any other specialty (43 [37%]). Overall, 192 individual gaps were extracted; the greatest number of gaps came from patient care (75 [39%]) followed by personal and professional development (44 [23%]). The most frequently identified gaps were procedural independence (10 occurrences), practice management (9 occurrences), and billing (7 occurrences). Despite advances in GME, learners still struggle when transitioning to independent practice. Personal and professional development is a useful categorization for many gaps and should be considered for inclusion as a GME competency. Systematic assessment of new-to-practice attendings could help stakeholders better understand the true outcomes of GME programs. Concerted investment by specialty societies may drive greater understanding and innovative solutions. Additional study could help address the challenges in the GME-to-practice transition.

Development and Evaluation of a Direct Care Hospitalist Service Internal Medicine Sub-internship Rotation.

Direct Care Hospitalist Services (DCHS) can increase internal medicine (IM) sub-internship rotation availability while providing hospitalists additional teaching opportunities. Implement and evaluate a DCHS sub-internship. Urban Academic Medical School. IM sub-interns, hospitalists. One to two sub-interns were paired with three hospitalists on 3 weeks of day service and five nights in an apprenticeship model. Sub-interns admitted and followed patients on days and cross-covered and admitted on nights. DCHS sub-intern rotation satisfaction and skills preparedness were surveyed over 2 years. Sub-interns rotating on resident-covered service (RCS) were surveyed in year 2, and results compared to DCHS. Hospitalists were surveyed year 1 to rate satisfaction. Year 2 DCHS cross-cover paging data was tabulated to evaluate clinical content. DCHS and RCS sub-interns rated satisfaction and preparedness similarly. DCHS sub-interns rated time management (3.86 vs 4.33, p = 0.19) and calling consults (4.4 vs 4.8, p = 0.56) lower, but cross-cover higher (4.14 to 3.67, p = 0.34) than RCS. DCHS sub-interns averaged 39.4 (SD 4.1) nightly cross-cover pages with most related to acute symptoms (46%). Hospitalists were highly satisfied with their rotation experience. Sub-interns were highly satisfied with DCHS sub-internship. Future work will target gaps in preparedness for urgent patient care issues.

Global Health Security: Preparing For Future Pandemics

The interconnectedness of modern societies and global mobility has amplified the risk of infectious disease outbreaks escalating into pandemics. Global health security involves proactive efforts to detect, prevent, and respond to emerging health threats before they become widespread crises. Historical pandemics like the Black Death and the Spanish flu highlight the catastrophic consequences of uncontained outbreaks. Despite advancements in healthcare infrastructure, the COVID-19 pandemic has exposed gaps in preparedness, emphasizing the need for enhanced global surveillance, cross-sectoral collaboration, and technological innovations. This paper explores the historical context of pandemics, key components of pandemic preparedness, and the role of global coordination and technology in mitigating future health threats. It calls for stronger international collaboration and investment in healthcare systems to ensure resilience in the face of future pandemics. Keywords: Global health security, pandemic preparedness, pandemic response, historical pandemics, COVID-19, global surveillance.

An Analytical Study of Knowledge, Attitudes and Practices regarding NEXT among the Medical Students of G.S. Medical College, Hapur, U.P., India

The National Exit Test (NEXT) is a newly introduced licensing examination in India, aiming to standardize medical education and ensure quality assurance. There is no clarity regarding NEXT among MBBS students. To assess the knowledge, attitudes, and practices of medical students regarding NEXT and identify areas for improvement. A cross-sectional study was conducted among 200 medical students of different batches using a pretested questionnaire, with a response rate of 100% (200 respondents). The study revealed significant gaps in knowledge (36% aware of NEXT resources) and preparedness (32% joined preparatory classes), with students expressing uncertainty and negativity towards NEXT. The study highlights the need of clear guidelines , targeted interventions, including orientation programs and standardized preparation resource material to support students in navigating the challenges of NEXT

Combining biosafety expert’s evaluation and workers’ perception regarding the Biological Risks in Biomedical laboratories of Public Hospitals in Athens, Greece

Objectives: The aim of the present study was by combining an expert’s evaluation and laboratory workers’ perception, to review the biological risks in biomedical laboratories of public hospitals in Athens, Greece. It was also to evaluate how they are managing the biological materials, the level of safety awareness and training of the personnel, and to propose mitigation measures according to the existing risks, based on the local legislation and the international Biosafety guidelines. Materials and Methods: A total of 36 biosafety level-2 (BSL2) biomedical laboratories in 20 public hospitals were assessed for their biosafety containment specifics and compliance with biosafety practices. The study was designed as a cross-sectional study, with a checklist and a detailed health and safety (H&S) questionnaire, focused on biosafety and biorisk management. An expert biosafety officer observed and filled in a checklist for each biomedical laboratory (n=36) of the 20 hospitals. Laboratory staff (medical laboratory doctors, medical laboratory technologists, laboratory assistants, biologists and biochemists; n = 415) filled in a specific to biosafety H&S question­naire in each of these laboratories. Results: Both the results from the checklists and the questionnaires showed that in a significant percentage of laboratories there are the following deficiencies: restricted access and signage at the entrance, autoclaves in the laboratory area, ability to use the washbasins hands-free, biorisk management system, written risk assessments, biosafety manuals, standard operating procedures (SOPs), assigned biosafety officers, protocols about the use of Personal Protective Equipment (PPE), insufficient biosafety training programs, accidents reporting, eyewash emergency shower system, first aid kits and emergency telephone numbers. On the positive site laboratory procedures are separated from management, sanitary and rest areas, laboratory surfaces and floors are easy to clean and disinfect, good laboratory Practices followed for all procedures, waste management is in compliance with the current Greek legislation and there are sufficient PPE available. Conclusion: In the laboratories studied there are significant shortcomings in containment and administrative controls, in the application of Greek and EU biosafety legislation, and in the proper management of biological agents and materials in general. This emphasizes the importance of closing key gaps in biosafety and emergency preparedness, in the biomedical laboratories. Using the results of this study, actions should be developed, applied and enforced, in compliance with the local and European legislation and guidelines. This could enhance the safety of these facilities, and the laboratory professionals, the community and the environment could be better protected from possible harmful biological agents and the possibility of Laboratory acquired infections (LAIs). This study also demonstrated the value of the laboratory workers participation in the risk evaluation, despite their propensity to over or under-estimate the risk level of the possible hazards. That fact should be considered in future studies when enhancing hospital staff.

Migrant and refugee communities strengthening disaster resilience

This paper presents insights from a community-led initiative in South Australia aimed at enhancing disaster resilience in culturally and linguistically diverse (CALD) migrant and refugee communities. Anchored in the principles of community cohesion, empowerment and informed action, the project addresses socio-cultural dynamics and communication barriers. A series of workshops and forums, tailored to account for cultural sensitivity, showed strengthened community collaboration, skills development and increased awareness of the psychosocial effects of disasters, prompting proactive strategies that consider the unique vulnerabilities and strengths of CALD communities. Participant testimonials noted increased community spirit and practical application of acquired knowledge, including understanding local hazard risk profiles and trust-building with emergency services organisations. The findings demonstrate the importance of mitigating access challenges, integrating diverse community perspectives into resilience- building activities and ensuring the inclusivity of management policies. Highlighting the significance of strengths-based community-driven approaches in emergency and disaster management, particularly for marginalised groups, this initiative found that engaging communities as active contributors enables more resilient and self-efficacious populations that effectively bridge cultural and linguistic gaps in preparedness.

SHEA position statement on pandemic preparedness for policymakers: introduction and overview.

Throughout history, pandemics and their aftereffects have spurred society to make substantial improvements in healthcare. After the Black Death in 14th century Europe, changes were made to elevate standards of care and nutrition that resulted in improved life expectancy.1 The 1918 influenza pandemic spurred a movement that emphasized public health surveillance and detection of future outbreaks and eventually led to the creation of the World Health Organization Global Influenza Surveillance Network.2 In the present, the COVID-19 pandemic exposed many of the pre-existing problems within the US healthcare system, which included (1) a lack of capacity to manage a large influx of contagious patients while simultaneously maintaining routine and emergency care to non-COVID patients; (2) a "just in time" supply network that led to shortages and competition among hospitals, nursing homes, and other care sites for essential supplies; and (3) longstanding inequities in the distribution of healthcare and the healthcare workforce. The decades-long shift from domestic manufacturing to a reliance on global supply chains has compounded ongoing gaps in preparedness for supplies such as personal protective equipment and ventilators. Inequities in racial and socioeconomic outcomes highlighted during the pandemic have accelerated the call to focus on diversity, equity, and inclusion (DEI) within our communities. The pandemic accelerated cooperation between government entities and the healthcare system, resulting in swift implementation of mitigation measures, new therapies and vaccinations at unprecedented speeds, despite our fragmented healthcare delivery system and political divisions. Still, widespread misinformation or disinformation and political divisions contributed to eroded trust in the public health system and prevented an even uptake of mitigation measures, vaccines and therapeutics, impeding our ability to contain the spread of the virus in this country.3 Ultimately, the lessons of COVID-19 illustrate the need to better prepare for the next pandemic. Rising microbial resistance, emerging and re-emerging pathogens, increased globalization, an aging population, and climate change are all factors that increase the likelihood of another pandemic.4.

Ocular injury first aid knowledge among primary school teachers in Qassim province: A cross-sectional study

Ocular injuries, a leading cause of monocular blindness, can be prevented through appropriate protective measures. This study evaluates the current state of knowledge and practices among primary school teachers in Qassim Province, Saudi Arabia, emphasizing the importance of first aid in ocular injury prevention. To assess knowledge and practices regarding ocular injuries and first aid among primary school teachers in Qassim province, Saudi Arabia. This cross-sectional study was conducted between September and December 2023 in public schools across the Qassim region in Saudi Arabia. Information was collected using a self-administered questionnaire that assessed teachers’ knowledge and practices about ocular injuries first aid. Out of 986 teachers surveyed (99.6% response rate), 67.3% reported encountering ocular injuries in students. The most common injuries were eye trauma (62.5%) and foreign bodies (15.90%). The study revealed gaps in knowledge and preparedness, particularly in managing chemical burns, lacerations, and scratched eyes. Only 53.5% sought medical help in ocular emergencies, while a notable proportion needed more awareness of appropriate first aid measures. The study reveals a significant gap in Qassim Province primary schoolteachers’ knowledge of ocular injury first aid, necessitating urgent educational interventions to improve the handling of eye injuries. It emphasizes incorporating eye injury first aid into ongoing professional development, ensuring schoolteachers are prepared to effectively manage such potentially vision-threatening situations.

Planning For Resilience: Examining Gaps in Cyclone Preparedness and Impacts on Marginalized Communities in India's East coast cities

Cyclones and associated storm surges pose a major threat to coastal communities in India, especially along the Bay of Bengal where their intensity is higher. This paper examines cyclone resilience planning in four coastal cities - Visakhapatnam, Puri, Rameshwaram, and Velankanni. A multi-dimensional analysis is undertaken to focus on disaster preparedness, tourism economy contributions, socio-economic inclusion, and sustainability principles. The key objective is to study the integration of cyclone resilience with equitable, tourism-based development to strengthen vulnerable communities through conceptual modeling. The research methodology employs a mixed methods approach combining literature review, secondary data analysis of resilience infrastructure and tourism statistics, and conceptual model development. Findings highlight continued infrastructure and preparedness gaps alongside persisting socio-economic disparities limiting resilience access for marginalized groups. While progress is visible on early warnings, shelters, and evacuations, constraints exist regarding storm-proofing of amenities, customized enterprise support, secure housing, and risk financing tools. The study concludes that resilient, sustainable outcomes require planning processes that engage tourism-dependent communities through bottom-up participation. Coupled with hazard-resilient land use standards, customized livelihood protection schemes, resilient affordable housing programs, and coherent governance; tourism-centric coastal cities can enhance capacities to absorb cyclone impacts and enable inclusive rebuilding. Key Words: Cyclone resilience, Coastal city planning, Socio-economic vulnerabilities, Tourism economies

Ecology of emergency care in lower-tier healthcare providers in Ghana: an empirical data-driven Bayesian network analytical approach

The healthcare landscape in Ghana is primarily composed of lower-tier providers, which serve as the initial point of contact for most medical emergencies. This study aimed to assess the emergency care preparedness and readiness of primary healthcare providers using a robust evaluation approach. A multicentre retrospective cross-sectional study was conducted on 460 healthcare facilities using the standardised Health Facilities Emergency Preparedness Assessment Tool (HeFEPAT). Data were analysed via Bayesian Belief network. Emergency preparedness was associated with facility location, type, ownership, and in-charge personnel. Over 70% of facilities lacked specialised emergency/critical care personnel. Although 65% of in-charges reported protocol knowledge, only 7.8% could execute cardiopulmonary resuscitation. 90% of facilities lacked onsite defibrillators, and over 80% had no cerebrovascular accident medications. Road traffic accident protocols were largely unavailable, with an estimated 53% probability of lacking such protocols. Private-owned facilities were more likely to lack protocols for road traffic accidents (76% vs 20% probability) and general acute care (62% vs 32%) compared to government-owned facilities. Significant gaps in emergency preparedness were identified across the studied health facilities, indicating limited capacity to manage critical situations effectively. Urgent investments in emergency medicine training, essential resources, and evidence-based protocols are needed. Standardised emergency preparedness assessments should be implemented for accreditation and quality improvement. Further research can inform the development of national guidelines and targeted interventions to strengthen emergency response capacities.

A multisectoral approach to developing a state-level foreign animal disease response plan: the Ohio African Swine Fever Response Plan Workshop.

Foreign animal disease (FAD) preparedness is a high priority for state and federal governments to ensure the protection of the nation's livestock industry. Highly contagious diseases such as African swine fever (ASF) have been the focus of recent advancements in FAD preparedness, including the development of disease-specific response plans. At the state level, FAD response plans provide a framework to help ensure a rapid and coordinated response that considers the resources and realities of that state; however, preparing a comprehensive plan requires collaboration across multiple agencies and sectors that can be difficult to operationalize. To initiate systematic state-level ASF response plan writing and identify gaps in preparedness, university and industry stakeholders partnered with the Ohio Department of Agriculture and USDA to develop the Ohio African Swine Fever Response Plan Workshop. A linear planning model was used to implement the workshop in May 2021. All planning and workshop activities were conducted fully virtually, prompted by public health restrictions in response to COVID-19. Sixty-four participants, representing multiple sectors and stakeholder groups including state/federal/industry animal health officials, emergency management, environmental protection, and academia, contributed to the workshop. Spanning 3 days, participants identified current response capabilities and areas requiring additional planning for an effective state-level response. The workshop generated recommendations from a multisectoral perspective for subcommittees tasked with developing standard operating procedures for the Ohio ASF Response Plan. The methodology and resources used to plan, implement, and evaluate the workshop are described to provide a model for state-level response planning.

Understanding Barriers and Facilitators to Disaster Preparedness in Federally Qualified Health Centers in the United States: A Mixed Methods Study.

Severe weather events exacerbate existing health disparities due to poorly managed non-communicable diseases (NCDs). Our objective is to understand the experiences of staff, providers, and administrators (employees) of Federally Qualified Health Centers (FQHCs) in Puerto Rico and the US Virgin Islands (USVI) in providing care to patients living with NCDs in the setting of recent climate-related extreme events. We used a convergent mixed-methods study design. A quantitative survey was distributed to employees at 2 FQHCs in Puerto Rico and the USVI, assessing experience with disasters, knowledge of disaster preparedness, the relevance of NCDs, and perceived gaps. Qualitative in-depth interviews explored their experience providing care for NCDs during recent disasters. Quantitative and qualitative data were merged using a narrative approach. Through the integration of quantitative and qualitative data, we recognize: (1) significant gaps in confidence and preparedness of employees with a need for more training; (2) challenges faced by persons with multiple NCDs, especially cardiovascular and mental health disorders; and (3) most clinicians do not discuss disaster preparedness with patients but recognize their important role in community resilience. With these results, we recommend strengthening the capacity of FQHCs to address the needs of their patients with NCDs in disasters.

Urban Environment and People’s Perception on Risk Reduction in Fire Related Hazards in Srinagar City

This study aims to understand people’s risk perception to environmental hazards especially that of fires in context to an urban area. The fire is one of the major disasters in an urban environment but evidence of the effectiveness of education interventions against fire risks is limited. Fires start in three main ways i.e. accidents (misuse of appliances), deliberate ignition and equipment failure (electrical malfunction) and produce smoke and toxic gases which could be extremely fatal to those exposed to it hence the need for prevention and protection from spreading fires by delaying ignition period to allow people more time to escape and for the fire brigade to arrive at the incident. Urban disasters especially fires have tended to receive a baffling lack of response from aid agencies indicating major gaps in urban preparedness. Srinagar city is faced with inadequacy in responding to fire disasters of high magnitude and rescue teams have failed in many of the occasions to live up to expectations. The study area (Srinagar City, J & K) which is urban in nature and character has recorded highest number of fire incidents in last so many years, claiming dozens of lives and damaging property worth crores. The present study is an attempt to assess the people’s risk perception to fire hazards and their prevention, mitigation and preparedness measures in residential, commercial, educational and health related buildings. For this purpose both primary as well as secondary data has been used. The overall scenario reveals that the perception of selected respondents gives a very poor result, as more than 40 % of them either have no knowledge about the fire fighting equipment or lack their use during fire incidents. Factor identification has been done on prior knowledge upon which emphasis was on people’s perception, preparedness and mitigation measures adopted by different stakeholders.