Public health staff had few plans or protocols to guide them and often found themselves improvising and problem-solving with new organizations in the context of an overburdened health care system (Disaster Med Public Health Preparedness. 2016;10:436-442).
Power outages threaten public health. While outages will likely increase with climate change, an aging electrical grid, and increased energy demand, little is known about their frequency and distribution within states. Here, we characterize 2018–2020 outages, finding an average of 520 million customer-hours total without power annually across 2447 US counties (73.7% of the US population). 17,484 8+ hour outages (a medically-relevant duration with potential health consequences) and 231,174 1+ hour outages took place, with greatest prevalence in Northeastern, Southern, and Appalachian counties. Arkansas, Louisiana, and Michigan counties experience a dual burden of frequent 8+ hour outages and high social vulnerability and prevalence of electricity-dependent durable medical equipment use. 62.1% of 8+ hour outages co-occur with extreme weather/climate events, particularly heavy precipitation, anomalous heat, and tropical cyclones. Results could support future large-scale epidemiology studies, inform equitable disaster preparedness and response, and prioritize geographic areas for resource allocation and interventions.
Purpose Many nurses are trained inadequately in emergency preparedness (EP), preventing them from effectively executing response roles during disasters, such as chemical, biological, radiological, nuclear, and explosive (CBRNE) events. Nurses also indicate lacking confidence in their abilities to perform EP activities. The purpose of this article is to describe the phased development of, and delivery strategies for, a CBRNE curriculum to enhance EP among nursing professionals. The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) and the National Center for Disaster Preparedness at Columbia University's Earth Institute led the initiative. Methods Curriculum development included four phases. In Phases I and II, nursing staff at 20 participating NYC hospitals conducted 7,177 surveys and participated in 20 focus groups to identify training gaps in EP. In Phase III, investigators developed and later refined the CBRNE curriculum based on gaps identified. In Phase IV, 22 nurse educators (representing 7 of the original 20 participating hospitals) completed train‐the‐trainer sessions. Of these nurse educators, three were evaluated on their ability to train other nurses using the curriculum, which investigators finalized. Findings The CBRNE curriculum included six modules, a just‐in‐time training, and an online annual refresher course that addressed EP gaps identified in surveys and focus groups. Among the 11 nurses who were trained by three nurse educators during a pilot training, participant knowledge of CBRNE events and response roles increased from an average of 54% (range 45%–75%) on the pre‐test to 89% (range 80%–90%) on the posttest. Conclusions By participating in nursing CBRNE training, nurses increased their knowledge of and preparedness to respond to disasters. The train‐the‐trainer curriculum is easily adaptable to meet the needs of other healthcare settings. Clinical Relevance The CBRNE curriculum can be used to train nurses to better prepare for and more effectively respond to disasters.
This study characterizes trends in the frequency and characteristics of terrorist attacks in child-serving educational institutions around the world, examining the specific vulnerabilies of children and schools with regard to terrorist violence, as well as the various impacts that violence has on children, communities, and societies. Following the analysis of available data on terrorist attacks against educational institutions, vulnerabilities, and impacts, the study concludes with a discussion of what still needs to be understood in the intersection of child vulnerability and terrorism, and provides recommendations for improving resilience to terrorist attacks against child-serving educational institutions.One would like to think that certain truths or values would be universally understood as rules of engagement, formally declared or otherwise. The sanctity of children's well-being should be unquestioned, regardless of the issues at stake in the larger conflict. Sadly, history shows that this understanding is neither universally shared nor uniformly valued.
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