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Background Disasters may result in mass casualties and an imbalance between health care demands and supplies. This imbalance necessitates the prioritization of the victims based on the severity of their condition. Contributing factors and their effect on decision-making is a challenging issue in disaster triage. The present study seeks to address criteria for ethical decision-making in the prioritization of patients in disaster triage. Methods This conventional content analysis study was conducted in 2017. Subjects were selected from among Iranian experts using purposeful and snowball sampling methods. Data were collected using semi-structured interviews and were analyzed by the content analysis. Results Efficient and effective triage and priority-oriented triage were the main categories. These categories summarized a number of medical and nonmedical factors that should be considered in the prioritization of the victims in disaster triage. Conclusion A combination of measures should be considered to maximize the benefits of the prioritization of causalities in disasters. None of these measures alone would suffice to explain all aspects of ethical decision-making in disaster triage. Further investigations are needed to elaborate on these criteria in decision-making.

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Introduction: Considering the unexpected events that may occur in disasters, breastfeeding and risks of the artificial feeding need more investigations in such severe conditions. To review the literature regarding to the status of breastfeeding practices during and after disasters.We conducted a narrative review to support and investigate breastfeeding in austere conditions of disasters. Furthermore, the consequences of depriving infants from breast milk were studied.  Methods: The electronic databases of PubMed, Scopus, and Science Direct were explored and English articles published in 2000-2014 over breastfeeding in disasters were extracted and reviewed. Results: According to the findings, despite the frequent emphasizes on breastfeeding, natural and manmade disasters are strong contributors to its disruption. Uncontrolled distribution of the artificial milk should be avoided, since it is associated with lower rate of breastfeeding. Artificially-fed infants are more prone to diarrheal diseases and malnutrition, particularly in disaster situations, which healthy water is not available for preparing the artificial milk. Conclusion: Healthcare workers should encourage mothers to continue lactation in austere conditions of disasters and monitor distribution of the artificial formula strictly.

Background: This study examined the effectiveness of two educational methods on nurses' skills and commitment to implementing evidence-based practice (EBP). Method: Ninety nurses were randomly assigned to three groups. Participants in the workshop group took part in a 2-day training course, participants in the multimedia group received educational content through video, and participants in the control group did not receive any training content. The nurses' skills and commitment to implement EBP were assessed at baseline and 1 month after the teaching sessions. Results: The EBP skills of nurses in the intervention groups were significantly enhanced compared with nurses in the control group ( p < .05). Mean scores in the multimedia group were slightly better than in the workshop group; however, this difference was not statistically significant. Commitment to EBP implementation did not change significantly over time among the groups ( p > .05). Conclusion: Different methods of training can be useful in improving nurses' EBP skills; however, the participants' commitment to implement EBP did not change considerably. Because of its cost effectiveness, the multimedia method should be considered for use in nurse training. [ J Contin Educ Nurs . 2020;51(4):167–173.]

Background:The role of society and people in disaster risk management is prominent. However, using this potential and increasing the people's role have always been a challenge. The purpose of this study was to find community-based management challenges in disaster risk reduction. Materials and Methods:This study was conducted with the qualitative approach and in the form of content analysis. Participants were selected purposefully and by snowball sampling out of 17 professors and managers in the field of incidents and disasters. Data were recorded and collected through semi-structured interviews. The records were transcribed and then analyzed. Results:Results included 2 main themes of egocentrism and management helplessness (failure) and 5 main categories, including inadequate attention to the nature of the risk reduction process, inadequate community resilience, ignoring social capital, inadequate planning and training, and incorrect organization, as well as 13 subcategories.Conclusion: Firstly, managers should accept the community as a major hub of the process to harness the power of community. Secondly, using capable and trained managers familiar with the concepts, literature, and challenges in the field of disasters increase participation of people in disaster risk management. A B S T R A C T

Background: Disasters are medically defined as events in which the demands for patients' care far exceed the available resources. In such situations, triage and rationing of limited resources are inevitable. A decision regarding triage needs not only scientific guidelines but also an ethical framework and supporting policies. This study aims to provide a comprehensive review of the criteria for ethical decision-making in disasters triage. Materials and Methods: Medline (Via pubMed.com), Scopus, Web of Science, and ProQuest databases will be searched from 1990 to July 2017 using a defined search strategy. Other search resources include Google Scholar, World Health Library, Global Ethics Library, Gray Literature Report website, and World Health Organization (WHO), which will be searched using a modified search strategy. The manual search will be conducted in two journals with the highest number of retrieved titles in the Scopus search and the reference list of selected articles. Study selection, quality assessment, and data extraction will be done by the first author, and the second reviewer will check the results, and probable disagreements will be resolved through discussion and review by a third reviewer. Results: This systematic review will identify all factors a triage officer should be considered when he or she would like to make an ethical decision. Conclusion: Transparency and consistency are two main procedural ethical values of disaster triage. The result of this review could be used to make a consistent decision in disaster triage.