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The ongoing conflict in Sudan has severely disrupted the health professions education, notably in dentistry. This study aims to explore the impact of the armed conflict on dental education and training. A mixed-method cross-sectional study encompassed 29 dental schools in Khartoum, Darfur, Kordofan States, and Merowe City. Five key informants from the Sudanese Medical Specialization Board, the Human Resource Development Administration, and a university offering clinical dental master's programs were interviewed. Quantitative data on attacks against dental schools were collected through a structured Google form, and qualitative data on postgraduate training were obtained through semi-structured key informant interviews. Findings reveal that 79.3% of dental schools faced military assaults, with 73.9% experiencing looting and 60.9% repurposed as military bases. Notably, 44.8% of schools shifted to online education,3.4% collaborated with other universities, and 27.6% adopted a combined approach. Key informants' interviews unveiled disruptions in specialty training and housemanship, limiting access to crucial training facilities. The primary proposed solution was overseas training. Recurrently emphasized strategies to enhance the resilience of the training system included establishing dental centers in all states, collaborating with external training bodies, and anticipating and preparing for potential disasters. The adverse effects of the conflict on both undergraduate and postgraduate dental education are discernible, manifested through resource limitations, a shortage of dental materials and supplies within training facilities, and direct disruptions to clinical training due to attacks on healthcare institutions. The imperative need for urgent interventions is underscored to alleviate these consequences and safeguard the continuity of educational and training efforts. [ABSTRACT FROM AUTHOR]

As the Duwamish Valley community in Seattle, Washington, U.S.A. and other environmental justice communities nationally contend with growing risks from climate change, there have been calls for a more community-centered approach to understanding impacts and priorities to inform resilience planning. To engage community members and identify climate justice and resilience priorities, a partnership of community leaders, government-based practitioners, and academics co-produced a survey instrument and collected data from the community using the Seattle Assessment for Public Health Emergency Response (SASPER), an approach adapted from the Centers for Disease Control and Prevention's Community Assessment for Public Health Emergency Response (CASPER). In addition, we conducted a process and outcome project evaluation using quantitative survey data collected from volunteers and qualitative semi-structured interviews with project team members. In October and November 2022, teams of volunteers from partner organizations collected 162 surveys from households in the Duwamish Valley. Poor air quality, extreme heat, and wildfires were among the highest reported hazards of concern. Most Duwamish Valley households agreed or strongly agreed that their neighborhood has a strong sense of community (64%) and that they have people nearby to call when they need help (69%). Forty-seven percent of households indicated willingness to get involved with resilience planning, and 62% of households said that they would use a Resilience Hub during an emergency. Survey volunteers evaluated their participation positively, with over 85% agreeing or strongly agreeing that they learned new skills, were prepared for the survey, and would participate in future assessments. The evaluation interviews underscored that while the SASPER may have demonstrated feasibility in a pre-disaster phase, CASPER may not meet all community/partner needs in the immediate disaster response phase because of its lack of focus on equity and logistical requirements. Future research should focus on identifying less resource intensive data collection approaches that maintain the rigor and reputation of CASPER while enabling a focus on equity. [ABSTRACT FROM AUTHOR]

This study proposes an extendable modelling framework for Digital Twin-Oriented Complex Networked Systems (DT-CNSs) with a goal of generating networks that faithfully represent real-world social networked systems. Modelling process focuses on (i) features of nodes and (ii) interaction rules for creating connections that are built based on individual node's preferences. We conduct experiments on simulation-based DT-CNSs that incorporate various features and rules about network growth and different transmissibilities related to an epidemic spread on these networks. We present a case study on disaster resilience of social networks given an epidemic outbreak by investigating the infection occurrence within specific time and social distance. The experimental results show how different levels of the structural and dynamics complexities, concerned with feature diversity and flexibility of interaction rules respectively, influence network growth and epidemic spread. The analysis revealed that, to achieve maximum disaster resilience, mitigation policies should be targeted at nodes with preferred features as they have higher infection risks and should be the focus of the epidemic control. [ABSTRACT FROM AUTHOR]

Teachers play a pivotal role, both as educators and community leaders at the heart of any communities. This study seeks to address: "How do community-based interventions influence teacher resilience and well-being in the context of disaster education, and consequently, how does this affect overall community resilience?" Employing the rigorous PRISMA systematic review approach, we examined relevant studies, emphasizing the relationship between teacher resilience, well-being, and the efficacy of community-based disaster education interventions. 47 studies met the specific inclusion criteria and were included in in-depth analysis. This study identified a set of key interventions that have demonstrably boosted teacher resilience and well-being. There was a discernible positive relationship between teacher resilience and the effectiveness of community disaster education initiatives. The relationship between teacher resilience, their well-being, and effective community-based disaster education interventions is intricate and multifaceted. Enhanced teacher resilience contributes substantially to the success of disaster education programs. The interplay between teacher and community resilience emerged as a complex, symbiotic relationship, with teacher well-being acting as a cornerstone for effective community-based interventions. Reinforcing teacher resilience and well-being is integral to the success of community-based disaster education initiatives. Ensuring their well-being not only enhances educational outcomes but also fortifies community resilience. Teachers play a pivotal role in not only educating the younger generation but also in enhancing community resilience. Thus, any strategy aimed at supporting community resilience must integrate comprehensive measures to ensure the well-being and resilience of teachers. This nexus between education and community resilience emphasizes the necessity for integrated, holistic, and community-centric approaches to disaster management. [ABSTRACT FROM AUTHOR]

Heatwaves pose an important risk for population health and are associated with an increased demand for emergency care. To find factors causing such overload, an online Delphi study included 15 experts in emergency medicine, disaster medicine, or public health. One open-ended question was delivered in the first round. After content analysis, the obtained statements were sent to the experts in two rounds to be rated on a 7-point linear scale. Consensus was defined as a standard deviation ≤ 1.0. Thirty-one statements were obtained after content analysis. The experts agreed on 18 statements, mostly focusing on the input section of patient processing and identifying stakeholders, the population, and primary care as targets of potential interventions. Additional dedicated resources and bed capacity were deemed important as per throughput and output sections, respectively. These findings could be used in the future to implement and test solutions to increase emergency healthcare resilience during heatwaves and reduce disaster risk due to climatic change. [ABSTRACT FROM AUTHOR]

Under the background of global climate change, rainstorm and flood disasters have become the most serious cataclysm. Under the circumstances of an increasingly severe risk situation, it is necessary to enhance urban disaster resilience. Based on the disaster resilience process of prevention, absorption, and enhancement, and considering the safety factors such as personnel, facility, environment and management, this paper forms a dual dimension of the urban disaster resilience assessment model covering the key elements of urban disaster response and the core capacity of urban disaster recovery. Furthermore, if taking into account the characteristics of rainstorm and flood disasters, the paper screens the key indicators to build up an assessment index system of an urban rainstorm and flood disaster. The practical application was implemented in Beijing to have an assessment of the ability to recover from rainstorm and flood disasters in all districts of Beijing. And then, some pertinent suggestions for enhancing the resilience of Beijing to rainstorm and flood disasters were proposed. [ABSTRACT FROM AUTHOR]

Drawing upon the concept of longitudinal multiplexity and the Institutional Collection Action (ICA) framework, this article conducts a longitudinal observation of online emergency collaborative networks (ECNs) built and sustained among organizational actors within Shenzhen and Hong Kong in response to Typhoon Mangkhut. In addition to investigating the multiplex relationships among three types of online ECNs (i.e., preparedness networks, response networks, recovery networks), this article takes a comparative approach to examining how the structural constraints imposed by distinct emergency management systems (EMSs) influence the network formation and evolution as the disaster evolves over time. Findings obtained from a series of inferential network analyses reveal that preexisting online collaborative ties formed at the disaster preparedness stage are important for increasing organizations' tendency to build and sustain online collaborations during disaster response and recovery. Moreover, the decentralized EMS in Hong Kong exhibits more effectiveness in facilitating online network changes during both transitional periods. These findings demonstrate a pressing need for emergency researchers and frontline communication managers to understand the dynamic relationships among online ECNs across different disaster phases and further explore potential opportunities to facilitate online emergency collaboration on a broader scale. [ABSTRACT FROM AUTHOR]

Although the COVID-19 pandemic has impacted the psychological wellbeing of some people, there is evidence that many have been much less affected. The Ecological Model of Resilience (EMR) may explain why some individuals are not resilient whilst others are. In this study we test the EMR in a comparison of UK survey data collected from the COVID-19 Psychological Research Consortium (C19PRC) longitudinal study of a representative sample of the United Kingdom (UK) adult population and data from an Italian arm of the study. We first compare data from the third wave of the UK arm of the study, collected in July/August 2020, with data from an equivalent sample and stage of the pandemic in Italy in July 2020. Next, using UK longitudinal data collected from C19PRC Waves 1, 3 and 5, collected between March 2020 and April 2021 we identify the proportion of people who were resilient. Finally, we examine which factors, drawn from the EMR, predict resilient and non-resilient outcomes. We find that the 72% of the UK sample was resilient, in line with the Italian study. In the cross-sectional logistic regression model, age and self-esteem were significantly associated with resilience whilst death anxiety thoughts, neuroticism, loneliness, and Post Traumatic Stress Disorder (PTSD) symptoms related to COVID-19 were significantly associated with Non-Resilient outcomes. In the longitudinal UK analysis, at Wave 5, 80% of the sample was Resilient. Service use, belonging to wider neighbourhood, self-rated health, self-esteem, openness, and externally generated death anxiety were associated with Resilient outcomes. In contrast, PTSD symptoms and loneliness were associated with Non-Resilient outcomes. The EMR effectively explained the results. There were some variables which are amenable to intervention which could increase resilience in the face of similar future challenges. [ABSTRACT FROM AUTHOR]

We assessed food insecurity, dietary diversity and the right to adequate food among households in communities in Eastern Uganda that were affected by major landslides in 2010 and 2018. A prospective cohort study was applied to select 422 households during May-August (the food-plenty season) of 2019. In January-March (the food-poor season) of 2020, 388 households were re-assessed. Socio-demographic, food security, dietary diversity and right to adequate food data were collected using structured questionnaires. Four focus groups discussions and key informant interviews with 10 purposively sampled duty-bearers explored issues of food insecurity, dietary and the right to adequate food. The affected households had significantly higher mean (SE) food insecurity scores than controls, both during the food plenty season: 15.3 (0.5) vs. 10.8 (0.5), and during food-poor season: 15.9 (0.4) vs. 12.5 (0.0). The affected households had significantly lower mean (SE) dietary diversity scores than controls during the food plenty season: 5.4 (0.2) vs. 7.5 (0.2) and during the food poor season: 5.2 (0.2) vs. 7.3 (0.1). Multivariate analyses showed that the disaster event, education and main source of livelihood, were significantly associated with household food security and dietary diversity during the food-plenty season whereas during the food-poor season, the disaster event and education were associated with household food security and dietary diversity. During both food seasons, the majority of affected and control households reported to have consumed unsafe food. Cash-handout was the most preferred for ensuring the right to adequate food. Comprehension and awareness of human rights principles and state obligations were low. The severity of food-insecurity and dietary diversity differed significantly between the affected and control households during both food seasons. Moreover, the right to adequate food of landslide victims faced challenges to its realization. There is need for policy and planning frameworks that cater for seasonal variations, disaster effects and right to adequate food in order to reduce landslide victims' vulnerability to food insecurity and poor dietary diversity. In the long-term, education and income diversification program interventions need to be integrated into disaster recovery programs since they are central in enhancing the resilience of rural livelihoods to shocks and stressors on the food system. [ABSTRACT FROM AUTHOR]

Cloud computing has now evolved as an unavoidable technology in the fields of finance, education, internet business, and nearly all organisations. The cloud resources are practically accessible to cloud users over the internet to accomplish the desired task of the cloud users. The effectiveness and efficacy of cloud computing services depend on the tasks that the cloud users submit and the time taken to complete the task as well. By optimising resource allocation and utilisation, task scheduling is crucial to enhancing the effectiveness and performance of a cloud system. In this context, cloud computing offers a wide range of advantages, such as cost savings, security, flexibility, mobility, quality control, disaster recovery, automatic software upgrades, and sustainability. According to a recent research survey, more and more tech-savvy companies and industry executives are recognize and utilize the advantages of the Cloud computing. Hence, as the number of users of the Cloud increases, so did the need to regulate the resource allocation as well. However, the scheduling of jobs in the cloud necessitates a smart and fast algorithm that can discover the resources that are accessible and schedule the jobs that are requested by different users. Consequently, for better resource allocation and job scheduling, a fast, efficient, tolerable job scheduling algorithm is required. Efficient Hybrid Job Scheduling Optimization (EHJSO) utilises Cuckoo Search Optimization and Grey Wolf Job Optimization (GWO). Due to some cuckoo species' obligate brood parasitism (laying eggs in other species' nests), the Cuckoo search optimization approach was developed. Grey wolf optimization (GWO) is a population-oriented AI system inspired by grey wolf social structure and hunting strategies. Make span, computation time, fitness, iteration-based performance, and success rate were utilised to compare previous studies. Experiments show that the recommended method is superior. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has highlighted a need for better understanding of countries' vulnerability and resilience to not only pandemics but also disasters, climate change, and other systemic shocks. A comprehensive characterization of vulnerability can inform efforts to improve infrastructure and guide disaster response in the future. In this paper, we propose a data-driven framework for studying countries' vulnerability and resilience to incident disasters across multiple dimensions of society. To illustrate this methodology, we leverage the rich data landscape surrounding the COVID-19 pandemic to characterize observed resilience for several countries (USA, Brazil, India, Sweden, New Zealand, and Israel) as measured by pandemic impacts across a variety of social, economic, and political domains. We also assess how observed responses and outcomes (i.e., resilience) of the COVID-19 pandemic are associated with pre-pandemic characteristics or vulnerabilities, including (1) prior risk for adverse pandemic outcomes due to population density and age and (2) the systems in place prior to the pandemic that may impact the ability to respond to the crisis, including health infrastructure and economic capacity. Our work demonstrates the importance of viewing vulnerability and resilience in a multi-dimensional way, where a country's resources and outcomes related to vulnerability and resilience can differ dramatically across economic, political, and social domains. This work also highlights key gaps in our current understanding about vulnerability and resilience and a need for data-driven, context-specific assessments of disaster vulnerability in the future. [ABSTRACT FROM AUTHOR]

Background: Social media addiction, a recently emerged term in medical science, has attracted the attention of researchers because of its significant physical and psychological effects on its users. The issue has attracted more attention during the COVID era because negative emotions (e.g., anxiety and fear) generated from the COVID pandemic may have increased social media addiction. Therefore, the present study investigates the role of negative emotions and social media addiction (SMA) on health problems during and after the COVID lockdown. Methods: A survey was conducted with 2926 participants aged between 25 and 45 years from all eight divisions of Bangladesh. The data collection period was between 2nd September– 13th October, 2020. Partial Least Square Structural Equation Modelling (PLS-SEM) was conducted for data analysis by controlling the respondents' working time, leisure time, gender, education, and age. Results: Our study showed that social media addiction and time spent on social media impact health. Interestingly, while anxiety about COVID increased social media addition, fear about COIVD reduced social media addition. Among all considered factors, long working hours contributed most to people's health issues, and its impact on social media addiction and hours was much higher than negative emotions. Furthermore, females were less addicted to social media and faced less health challenges than males. Conclusion: The impacts of negative emotions generated by the COVID disaster on social media addiction and health issues should be reconsidered. Government and employers control people's working time, and stress should be a priority to solve people's social media addiction-related issues. [ABSTRACT FROM AUTHOR]

This study examines current household disaster preparedness and identifies its predictors in South Korea. A structured online survey was administered to 1,243 participants quota-sampled by age and population from each administrative district. Based on the socio-ecological model, interpersonal factors (general characteristics, prior disaster experience, anxiety, dispositional optimism, perceived disaster risk, and disaster preparedness knowledge), institutional factor (front-line preparedness), community factor (community resilience), public policy factor (governmental preparedness), and household disaster preparedness were measured. The data were analyzed using descriptive statistics, Mann–Whitney U test, Kruskal–Wallis test, Bonferroni test, Pearson's correlation coefficients, and multiple regression. The predictors of household disaster preparedness were occupation, economic status, prior disaster experience, anxiety, disaster preparedness knowledge, front-line preparedness, and community resilience. The most potent predictor of household disaster preparedness was community resilience. Our finding that community resilience, a community factor, has a greater impact on household disaster preparedness than personal factors calls for programs that promote such resilience. Further, continuous public education and campaigns are needed to increase public awareness of household disaster preparedness and to improve the public's competency to prepare for potential disasters. This study raises the need for community programs for residents to increase household disaster preparedness knowledge and improve their competencies related to disaster response. This study is significant in highlighting the importance of community factors in improving household disaster preparedness amid the need to prepare for various types of disasters. [ABSTRACT FROM AUTHOR]

Disasters, from hurricanes to pandemics, tremendously impact human lives and behaviors. Physical closeness to family post-disaster plays a critical role in mental healing and societal sustainability. Nonetheless, little is known about whether and how family colocation alters after a disaster, a topic of immense importance to a post-disaster society. We analyze 1 billion records of population-scale, granular, individual-level mobile location data to quantify family colocation, and examine the magnitude, dynamics, and socioeconomic heterogeneity of the shift in family colocation from the pre- to post-disaster period. Leveraging Hurricane Florence as a natural experiment, and Geographic Information System (GIS), machine learning, and statistical methods to investigate the shift across the landfall (treated) city of Wilmington, three partially treated cites on the hurricane's path, and two control cities off the path, we uncover dramatic (18.9%), widespread (even among the partially treated cities), and enduring (over at least 3 months) escalations in family colocation. These findings reveal the powerful psychological and behavioral impacts of the disaster upon the broader populations, and simultaneously remarkable human resilience via behavioral adaptations during disastrous times. Importantly, the disaster created a gap across socioeconomic groups non-existent beforehand, with the disadvantaged displaying weaker lifts in family colocation. This sheds important lights on policy making and policy communication to promote sustainable family colocation, healthy coping strategies against traumatic experiences, social parity, and societal recovery. [ABSTRACT FROM AUTHOR]

Most U.S. public health agencies rely upon closed points of dispensing (PODs) to aid in medical countermeasure (MCM) distribution. However, few studies have focused on how to assess closed POD preparedness and none have examined best practices for managing sites once they have been recruited. This study involved qualitative interviews with U.S. disaster planners to elucidate their approaches and challenges to managing, sustaining, and assessing existing closed POD sites. In all, 16 disaster planners participated. Common management practices included frequent communication with sites, providing formal and informal training, and assisting with POD exercises. Very few jurisdictions reported doing formal assessments of closed POD sites. The largest challenges identified were staff turnover and keeping sites engaged, sometimes leading to sites voluntarily withdrawing or needing to be removed from being a closed POD. Frequent communication and building partnerships with closed POD site personnel were recommended to maintain and sustain existing sites. Formal and informal assessments will provide assurance of deployment readiness. Closed POD management is a challenging, but essential process to ensure readiness to deploy. Practices outlined by this study can be implemented to enhance closed POD network management at other jurisdictions. This should increase the ability to distribute MCMs rapidly during a future event, contributing to stronger community resilience. Public health officials should continue expanding and improving closed POD networks to enable MCM delivery and minimize morbidity and mortality related to mass casualty events. [ABSTRACT FROM AUTHOR]

Background and aim: Despite the significant mental health challenges the COVID-19 pandemic and its associated government measures have presented, research has shown that the majority of people have adapted and coped well. The aim of this study was i) to determine the proportion of people with mental stability and volatility during the pandemic in a North West England city region sample and ii) to establish group differences in psychosocial variables. Mental stability and volatility refer to the extent to which individuals reported change in levels of common mental health symptoms over the course of 12 weeks. No change in mental health over the 12 weeks reflected mental stability whilst change in mental health reflected mental volatility. Method: A two-wave-online survey (N = 163) was used to explore the psychological and social impact of the pandemic on relatively disadvantaged neighbourhoods within the region. The data collected represents 12 weeks of individual pandemic experience between mid-June and mid-December 2020. A three-level composite common mental health change variable was created combining self-reported anxiety and depression to group stable, volatile, and very volatile individuals in terms of the changeability of their mental health. Kruskal-Wallis with post-hoc tests were used to determine how people with mental stability and volatility differed on factors categorised within an ecological framework of resilience (individual, community, societal, and COVID-19 specific). Results: Individuals categorised as 'stable' in terms of mental health symptoms (63.6%) had better mental and physical health; were more tolerant of uncertainty; and reported higher levels of resilience and wellbeing compared to 'very volatile' people (19.8%). These individuals also reported feeling less socially isolated, experienced a greater sense of belonging to their community which was more likely to fulfil their needs, and were more likely to have access to green space nearby for their recommended daily exercise. 'Stable' individuals did not report worrying any more during the pandemic than usual and tolerated uncertainty better compared to those in the 'volatile' group. Implications: The majority of participants in this sample were mentally stable and coping well with the challenges presented by the pandemic. The resilience of these individuals was related to key place-based factors such as a strong sense of community and useable local assets. The data showcase the role of place-based social determinants in supporting resilience and thereby highlight key preventative measures for public mental health during times of international crisis. [ABSTRACT FROM AUTHOR]

Natural disasters can have devastating and long-lasting effects on a community's emotional well-being. These effects may be distributed unequally, affecting some communities more profoundly and possibly over longer time periods than others. Here, we analyze the effects of four major US hurricanes, namely, Irma, Harvey, Florence, and Dorian on the emotional well-being of the affected communities and regions. We show that a community's emotional response to a hurricane event can be measured from the content of social media that its population posted before, during, and after the hurricane. For each hurricane making landfall in the US, we observe a significant decrease in sentiment in the affected areas before and during the hurricane followed by a rapid return to pre-hurricane baseline, often within 1-2 weeks. However, some communities exhibit markedly different rates of decline and return to previous equilibrium levels. This points towards the possibility of measuring the emotional resilience of communities from the dynamics of their online emotional response. [ABSTRACT FROM AUTHOR]

Objectives: To explore if the COVID-19 pandemic revealed differences across racial groups in coping, resilience, and optimism, all of which have implications for health and mental well-being. Methods: We collect data obtained from four rounds of a national sample of 5,000 US survey respondents in each round from April 2020 to February 2021. Using logistic regression and fixed effects models, we estimate the pandemic impacts on COVID-19 related concerns, social distancing behaviors, and mental health/life satisfaction and optimism for racial/income groups. Results: Despite extreme income and health disparities before and during the COVID-19 outbreak, Blacks and Hispanics remain more resilient and optimistic than their White counterparts. Moreover, the greatest difference in resilience, optimism and better mental health—is found between poor Blacks and poor Whites, a difference that persists through all four rounds. Conclusions: These deep differences in resilience have implications for the long-term mental health of different population groups in the face of an unprecedented pandemic. Better understanding these dynamics may provide lessons on how to preserve mental health in the face of public health and other large-scale crises. [ABSTRACT FROM AUTHOR]

This study aimed to determine the relationship between the level of panic and the various media disaster information modalities available during and after a natural disaster event. The method used was a Mix Methods Research Approach, which is a combination of qualitative descriptive and quantitative exploratory approaches. There were 150 respondents for the three research locations at Palu City, Sigi Regency and Donggala Regency. Respondents were selected by considering the event conditions experienced, physical damage to their house and their educational background. Media sources of disaster information analyzed were TV, internet, mobile phone (WA/SMS), radio, mosque/church, surau, community leaders and word of mouth. The data used was Likert scale analyses for perception tested with Rank Spearman Correlation. The results showed that the most significant panic level (α<0.01) was when the internet was not working, cellphones could not be used, and radio broadcasts could not be received. The most effective sources of disaster information in promoting a resilience attitude were guidance and advice from community leaders and ecological communication that was built from word of mouth. The exposure to natural disasters was shown to unite peoples' hearts in friendship. despite some did not communicate with each other before the disaster, some were even hostile. As many as 78.6% of respondents admitted that the affection between them as victims actually appeared when natural disasters destroyed the joints of their lives, even amongst those who did not communicate with each other, or were even hostile, before the disaster. Out of ecological communication, a "strong hug due to natural disasters" was born. [ABSTRACT FROM AUTHOR]

The need for resilient health systems is recognized as important for the attainment of health outcomes, given the current shocks to health services. Resilience has been defined as the capacity to "prepare and effectively respond to crises; maintain core functions; and, informed by lessons learnt, reorganize if conditions require it". There is however a recognized dichotomy between its conceptualization in literature, and its application in practice. We propose two mutually reinforcing categories of resilience, representing resilience targeted at potentially known shocks, and the inherent health system resilience, needed to respond to unpredictable shock events. We determined capacities for each of these categories, and explored this methodological proposition by computing country-specific scores against each capacity, for the 47 Member States of the WHO African Region. We assessed face validity of the computed index, to ensure derived values were representative of the different elements of resilience, and were predictive of health outcomes, and computed bias-corrected non-parametric confidence intervals of the emergency preparedness and response (EPR) and inherent system resilience (ISR) sub-indices, as well as the overall resilience index, using 1000 bootstrap replicates. We also explored the internal consistency and scale reliability of the index, by calculating Cronbach alphas for the various proposed capacities and their corresponding attributes. We computed overall resilience to be 48.4 out of a possible 100 in the 47 assessed countries, with generally lower levels of ISR. For ISR, the capacities were weakest for transformation capacity, followed by mobilization of resources, awareness of own capacities, self-regulation and finally diversity of services respectively. This paper aims to contribute to the growing body of empirical evidence on health systems and service resilience, which is of great importance to the functionality and performance of health systems, particularly in the context of COVID-19. It provides a methodological reflection for monitoring health system resilience, revealing areas of improvement in the provision of essential health services during shock events, and builds a case for the need for mechanisms, at country level, that address both specific and non-specific shocks to the health system, ultimately for the attainment of improved health outcomes. [ABSTRACT FROM AUTHOR]

Self-aid and mutual assistance among victims are critical for resolving difficulties in the immediate aftermath of a disaster, but individual facilitative factors for such resolution processes are poorly understood. To identify such individual factors in the background (i.e., disaster damage and demographic) and personality domains considering different types of difficulty and resolution, we analyzed survey data collected in the 3-year aftermath of the 2011 Great East Japan Earthquake and Tsunami. We first identified major types of difficulty using a cluster analysis of 18 difficulty domains and then explored individual factors that facilitated six types of resolution (self-help, request for help, help from family, help from an acquaintance, help through cooperation, and public assistance) of these difficulty types. We identified general life difficulties and medico-psychological difficulties as two broad types of difficulty; disaster damage contributed to both types, while some personality factors (e.g., neuroticism) exacerbated the latter. Disaster damage hampered self-resolution and forced a reliance on resolution through cooperation or public assistance. On the other hand, some demographic factors, such as being young and living in a three-generation household, facilitated resolution thorough the family. Several personality factors facilitated different types of resolution, primarily of general life difficulties; the problem-solving factor facilitated self-resolution, altruism, or stubbornness resolutions through requests, leadership resolution through acquaintance, and emotion-regulation resolution through public assistance. Our findings are the first to demonstrate the involvement of different individual, particularly personality, factors in survival in the complex social dynamics of this disaster stage. They may contribute to disaster risk mitigation, allowing sophisticated risk evaluation and community resilience building. [ABSTRACT FROM AUTHOR]

Background: In addition to their educational role, resilient schools have a good capacity in response to disasters. Due to the large student population, the schools can be a safe and secure environment during disasters, in addition to maintaining their performance after. Given the role and importance of the schools, the impact of culture and environment on resilience, without any indigenous and comprehensive tool for measuring the resilience in Iran, the study aimed to design and psychometrically evaluate the measurement tools. Method: This study was conducted using a mixed-method sequential explanatory approach. The research was conducted in two main phases of production on items based on hybrid model and the psychometric evaluation of the tool. The second phase included validity (formal, content and construction) and reliability (multiplex internal similarity, consistency and reliability). Result: The integration of systematic and qualitative steps resulted in entering 91 items into the pool of items. After formal and content validity, 73 items remained and 44 were omitted in exploratory factor analysis. A questionnaire with 5 factors explained 52.08% of total variance. Finally, after the confirmatory factor analysis, the questionnaire was extracted with 29 questions and 5 factors including "functional", "architectural", "equipment", "education" and "safety". Internal similarity and stability in all factors were evaluated as good. Conclusion: The result showed that the 29-item questionnaire of school resilience in emergencies and disasters is valid and reliable, that can be used to evaluate school resilience. On the other hand, the questionnaire on assessment of school resilience in disasters enables intervention to improve its capacity. [ABSTRACT FROM AUTHOR]

Considering the importance of psychological variables on health-related processes, this study investigated the role of resilience and coping strategies in relation to health. The aim of this research was to explore the underlying association between these aspects for the better understanding of the effect of psychosocial variables on mental health in cancer. This information could lead to the design of adapted psychological interventions in cancer. Participants with different diagnosis of cancer were recruited (N = 170). They came from the Spanish Association Against Cancer of Biscay. Resilience was measured with the 10 items Connor-Davidson Resilience Scale, coping with the Cognitive Emotion Regulation Questionnaire and mental health was measured as a global indicator through the SF-12 and the GHQ-12. A structural equation model (SEM) was conducted to test the effects between the constructs. Results showed that resilience and coping were significantly associated. Results reflected an absence of significant correlation between adaptive and disadaptive coping strategies. Resilience was the factor that most correlated with health outcomes (β = –.45, p <.001). However, disadaptive coping strategies did not correlate with resilience or mental health indicators. Findings in this study underscore the positive contribution of high levels of resilience and an adaptive coping on participants´ level of health. Disadaptive coping strategies did not reflect any positive relation with resilience or health indicators. Thus, promoting resilience and adaptive coping could be a significant goal for psychosocial and educational interventions in people with cancer. [ABSTRACT FROM AUTHOR]

The increased exposure of pastoralist communities in East Africa to climatic shocks has focused attention on the resilience of these communities. Although many social scientists directly or indirectly infer versions of homo-economic agents, increasing evidence in development behavioral economics, indicates that such assumptions may be misplaced. Despite on-going advances in the science concerning the effects of stress on dynamic changes in short-term cognitive capacity, there remains limited understanding of the effects of changes in cognitive capacity on economic decision making. The present research empirically evaluates the drivers of short-term changes in cognitive capacity–cognitive ability and heuristic use–and its effect on crop and livestock expenditure among predominantly poor Kenyan agro-pastoralists. Three rounds of cognition and survey data from Samburu, Kenya is analysed. The primary data was collected at the end of the 2015–16 East African drought and covers an 11-month period between October 2016 and September 2017. Dynamic panel estimation, employing maximum likelihood, is used on balanced and unbalanced data. Results indicate that fluid intelligence and heuristic use, along with literacy and stressors, affect crop expenditure. Perceptions of scarcity, relative to prior expectations, are also identified as an important determinant of short-term changes in cognitive ability. These results underscore the importance of better understanding the effects of short-term changes in cognitive capacity on economic expenditure among the poor. [ABSTRACT FROM AUTHOR]

Background: Cohort studies represent rich sources of data that can be used to link components of resilience to a variety of health-related outcomes. The Adolescent to Adult Health (Add Health) cohort study represents one of the largest data sets of the health and social context of adolescents transitioning into adulthood. It did not however use validated resilience scales in its data collection process. This study aimed to retrospectively create and validate a resilience indicator using existing data from the cohort to better understand the resilience of its participants. Methods: Questions asked of participants during one Add Health data collection time period (N = 15,701) were matched to items on a well-known and widely validated resilience scale called the Connor Davidson Resilience Scale. Factor analysis and psychometric analyses were used to refine and validate this novel Adolescent to Adult Health Resilience Instrument. Construct validity utilized participants' answers to the 10 item Center for Epidemiologic Studies Depression Scale, which has been used to validate other resilience scales. Results: Factor analysis yielded an instrument with 13 items that showed appropriate internal consistency statistics. Resilience scores in our study were normally distributed with no ceiling or floor effects. Our instrument had appropriate construct validity, negatively correlating to answers on the depression scale (r = -0.64, p<0.001). We also found demographic differences in mean resilience scores: lower resilience scores were seen among women and those who reported lower levels of education and household income. Conclusions: It is possible to retrospectively construct a resilience indicator from existing cohort data and achieve good psychometric properties. The Adolescent to Adult Health Resilience Instrument can be used to better understand the relationship between resilience, social determinants of health and health outcomes among young adults using existing data, much of which is publicly available. [ABSTRACT FROM AUTHOR]

Background: Hurricanes Katrina and Sandy were two of the most significant disasters of the 21st century that critically impacted communities and the health of their residents. Despite the assumption that disasters affect access to healthcare, to our knowledge prior studies have not rigorously examined availability of healthcare providers following disasters. Objective: The objective of this study was to examine availability of healthcare providers following large-scale hurricanes. Methods: Using historical data on healthcare providers from the National Plan and Provider Enumeration System and county-level population characteristics, we conducted a quasi-experimental study to examine the effect of large-scale hurricanes on healthcare provider availability in the short-term and long-term. We separately examined availability of primary care physicians, medical specialists, surgeons, and nurse practitioners. A difference-in-differences analysis was used to control for time variant factors comparing county-level health care provider availability in affected and unaffected counties the year before Hurricanes Katrina and Sandy, to five years after each storm. Results: Counties affected by Hurricane Katrina compared to unaffected locales experienced a decrease of 3.59 primary care physicians per 10,000 population (95% CI: -6.5, -0.7), medical specialists (decrease of 5.9 providers per 10,000 (95% CI: -11.3, -0.5)), and surgeons (decrease of 2.1 (95% CI: -3.8, -0.37)). However, availability of nurse practitioners did not change appreciably. Counties affected by Hurricane Sandy exhibited less pronounced changes. Changes in availability of primary care physicians, nurse practitioners, medical specialists, and surgeons were not statistically significant. Conclusion: Large-scale hurricanes appear to affect availability of healthcare providers for up to several years following impact of the storm. Effects vary depending on the characteristics of the community. Primary care physicians and medical specialists availability was the most impacted, potentially having long-term implications for population health in the context of disaster recovery. [ABSTRACT FROM AUTHOR]

Background: Resilience engineering has been advocated as an alternative to the management of safety over the last decade in many domains. However, to facilitate metrics for measuring and helping analyze the resilience potential for emergency departments (EDs) remains a significant challenge. The study aims to redesign the Hollnagel's resilience assessment grid (RAG) into a custom-made RAG (ED-RAG) to support resilience management in EDs. Methods: The study approach had three parts: 1) translation of Hollnagel's RAG into Chinese version, followed by generation of a tailored set of ED-RAG questions adapted to EDs; 2) testing and revising the tailored sets until to achieve satisfactory validity for application; 3) design of a new rating scale and scoring method. The test criteria of the ED-RAG questionnaire adopted the modified three-level scoring criteria proposed by Bloom and Fischer. The study setting of the field test is a private regional hospital. Results: The fifth version of ED-RAG was acceptable after a field test. It has three sets of open structured questions for the potentials to respond, monitor, and anticipate, and a set of structured questions for the potential to learn. It contained 38 questions corresponding to 32 foci. A new 4-level rating scale along with a novel scaling method can improve the scores conversion validity and communication between team members and across investigations. This final version is set to complete an interview for around 2 hours. Conclusions: The ED-RAG represents a snapshot of EDs'resilience under specific conditions. It might be performed multiple times by a single hospital to monitor the directions and contents of improvement that can supplement conventional safety management toward resilience. Some considerations are required to be successful when hospitals use it. Future studies to overcome the potential methodological weaknesses of the ED-RAG are needed. [ABSTRACT FROM AUTHOR]

Measuring disaster resilience is a key component of successful disaster risk management and climate change adaptation. Quantitative, indicator-based assessments are typically applied to evaluate resilience by combining various indicators of performance into a single composite index. Building upon extensive research on social vulnerability and coping/adaptive capacity, we first develop an original, comprehensive disaster resilience index (CDRI) at municipal level across Italy, to support the implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030. As next, we perform extensive sensitivity and robustness analysis to assess how various methodological choices, especially the normalisation and aggregation methods applied, influence the ensuing rankings. The results show patterns of social vulnerability and resilience with sizeable variability across the northern and southern regions. We propose several statistical methods to allow decision makers to explore the territorial, social and economic disparities, and choose aggregation methods best suitable for the various policy purposes. These methods are based on linear and non-liner normalization approaches combining the OWA and LSP aggregators. Robust resilience rankings are determined by relative dominance across multiple methods. The dominance measures can be used as a decision-making benchmark for climate change adaptation and disaster risk management strategies and plans. [ABSTRACT FROM AUTHOR]

Background: Lesotho and Swaziland experience intense, recurring drought resulting in disaster situations. Despite the recurrence of drought, both its influence on rural subsistence communities’ support systems and the actions that enable structures of resilience remain poorly understood. Each incidence of drought stimulates a disaster resilience discussion that stalls without achievement of positive results until the next disaster. This study has examined the influence of recurring drought on communities’ inherent resilience and proposes an evidence-based framework to enhance community resilience. Methods: Data were collected from 16 focus group discussions (N = 197) in the Highveld, Midveld and Lowveld agro-ecological regions of Swaziland and Lesotho. Themes and subthemes have been identified, defined, categorised and narrated using structuration theory as a guide. Results: Resilience activities were found to be characterised by knowledgeability and changes in behaviour in adapting and applying appropriate actions, all of which were enhanced by institutional support. The effectiveness of institutional support hinged on harnessing communities’ knowledge, social groups, value systems, connectedness, participation, decision-making and collectivism. Conclusion: Large-scale interventions to build and strengthen resilience are urgently needed in order to maintain cohesiveness and development gains, especially because rural subsistence farmers make up the majority of these two countries’ populations. Policies that integrate resilience with national development planning must be urgently developed and executed. [ABSTRACT FROM AUTHOR]