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BackgroundCameroon is amongst the worst affected countries by road traffic injuries with an estimated 1443 disability-adjusted life years per 100,000 population. There have been very limited reports on the crucial prehospital response to road traffic injuries in Cameroon. This study aimed to identify prehospital factors associated with RTI mortality in Cameroon.MethodsWe included patients enrolled between June 2022 and March 2023 in the Cameroon Trauma Registry. Information about prehospital factors and demographic data was obtained from patients or their proxies. We examined the association of prehospital care factors like care at the crash scene and type of transportation during crash with final patient outcome. We used Chi-squared test to investigate the association between selected independent variables and mortality. A multivariable logistic regression model was built to identify independent predictors of dying from an RTI.ResultsRTIs constituted 69.5% (n = 3203) of all injuries in the Cameroon Trauma Registry. Only 20.7% (n = 102) of 4 + wheel vehicle occupants had seatbelts on and just 2.7% (n = 53) of motorcycle riders were wearing helmets during the collision. Only 4.9% (n = 156) of patients received any form of scene care. In-hospital mortality was 4.3% (n = 139) and was associated with male sex (AOR = 1.7, 95%CI = 1.08-2.80), crashing on a motorcycle (AOR = 2.08, 95%CI = 1.1-3.67) and scene care (AOR = 0.25, 95%CI = 0.04-0.80).ConclusionsReceiving any type of care at the scene such as bleeding control or being placed in the recovery position by bystanders is associated with improved survival. Improving on existing informal prehospital care responses should be a priority in Cameroon.

In this article, we address the practical needs for the rapid processing and application of aerial photogrammetry remote sensing images, proposing a method based on high-performance computing technology to achieve the real-time, dynamic orthorectified visualization of aerial remote sensing images. This method differs from traditional orthorectification processing and application workflows, utilizing high-performance parallel computing capabilities to directly achieve orthorectification based on raw aerial images. In this paper, we also compare and analyze four different real-time orthorectified visualization schemes to meet various application needs, evaluating the efficiency and accuracy of the proposed method. Finally, experimental results with unmanned aerial vehicle (UAV) flight image data indicate that this method is feasible, with real-time computational results meeting practical application requirements in terms of effect and performance. [ABSTRACT FROM AUTHOR]

After natural disasters such as earthquakes, floods, or wars occur, cellular communication networks often sustain significant damage or become impaired. In these critical situations, first responders must coordinate with other rescue teams to communicate essential information to central command and survivors. To address this challenge, we have developed a reliable and rapidly deployable wireless ad hoc system for post-disaster management using Data Distribution Service (DDS) middleware, specifically RTI-DDS, named R-RDSP. The R-RDSP further enhances these metrics, achieving a 14.5% improvement in end-to-end delay and a 20.24% improvement in round-trip delay over the RDSP scheme. The R-RDSP system consists of three main modules: client, relay, and server. Each module connects to others via an ad hoc network, ensuring direct device-to-device communication without relying on existing infrastructure. The client module collects and sends the victim's location and emergency messages. The relay modules forward these messages across the ad hoc networks, ensuring minimal delay and high reliability. Finally, the server module receives the messages, processes them, and coordinates the response. Leveraging RTI-DDS for reliable message distribution, the system demonstrates robust performance even under challenging network conditions. [ABSTRACT FROM AUTHOR]

Background: US nursing homes were ground zero for COVID-19 and nursing home leaders faced multiple challenges to keep residents and staff safe. Understanding the leader’s role and their use of external resources to rapidly respond to the pandemic is important to better prepare for the next infectious disease outbreak emergency. The purpose of this study is to describe Missouri nursing home leaders’ use of external resources to manage challenges encountered during the pandemic. Methods: This qualitative descriptive study uses data from semi-structured interviews conducted with leaders from 24 Midwestern nursing homes between March 2022 and March 2023. Interviews were transcribed verbatim and analyzed using Dedoose software. Directed content analysis, guided by Donabedian’s Structure, Process, Outcome framework, was used for analysis. Interviews were conducted as part of a larger mixed-methods study focused on developing knowledge and recommendations to improve US nursing homes’ capacity to respond to infectious disease outbreaks. Results: Forty-three interviews were conducted across the 24 homes. Participants included administrators (n = 24), nurse leaders (n = 19), and infection preventionists (n = 16). Six sub-categories of external resources/support were used by leaders to manage challenges during the pandemic:1) corporate support and communications, 2) statewide resources, 3) community-based resources, 4) health care coalitions focused on emergency response planning, 5) existing affiliations with local organizations i.e., hospitals, and 6) community members and families. Corporate support was a primary resource; however, it was limited to chain-based homes. Leaders from standalone homes seemed most reliant on statewide agencies, existing affiliations, and other community-based resources due to their lack of corporate connections. Health care coalitions were few, but when available, helped nursing homes prepare for the pandemic onset. Family and community members were vital despite being off-site from nursing homes at the pandemic onset. Conclusion: Leaders played a pivotal role in accessing and using external resources to manage challenges during the pandemic. Statewide and community-based agencies and existing affiliations were particularly critical for standalone homes who otherwise had little to no means of support. Federal, state and local agencies must consider opportunities to build multi-agency regional collaborations, local health care coalitions and community-based partnerships that include nursing homes as member. Finally, community members and family were important in providing support, thus closing visitation is a double-edged sword that needs careful, future consideration. [ABSTRACT FROM AUTHOR]

Climate change has increasingly impacted developing and underdeveloped nations, with Bangladesh's coastal areas experiencing significant effects such as storm surges, salinity, cyclones, and droughts. These regions, heavily reliant on agriculture, face economic challenges exacerbated by climatic events, making adaptation to climate change a critical concern for coastal inhabitants. This study aims to understand the obstacles and adaptive mechanisms employed by the Munda indigenous people in southeastern coastal Bangladesh to protect their livelihoods. Employing both qualitative and quantitative methodologies, including focus group discussions (FGDs) and thematic analyses, we assessed the community's challenges and adaptation strategies. FGDs revealed that public life is frequently disrupted, salinity poses a major threat to agriculture and drinking water, and the cropping pattern, fish production, livestock, infrastructure, industry, biodiversity, health, and human settlement are adversely affected. Notably, there is a significant lack of adequate healthcare. Quantitative analysis using the χ2 test showed that 33.2% of participants believe climate change affects their happiness, 85.1% stored 72 h of water and food, and 59.3% had hygiene and sanitation supplies. This research underscores the necessity of adaptive measures such as rainwater harvesting, organic fertilizer usage, community disaster preparedness education, effective communication systems, and social security implementation to mitigate climate change's adverse effects. The findings offer valuable insights for the government, nongovermental organizations (NGOs), policymakers, civil society, and stakeholders in developing suitable climate adaptation strategies to ensure sustainable livelihoods in coastal Bangladesh. [ABSTRACT FROM AUTHOR]

Urban waterlogging is one of the major "diseases" faced by cities, posing a great challenge to the healthy and sustainable development of cities. The traditional geographic knowledge graph struggles to capture dynamic changes in urban waterlogging over time. Therefore, the objective of this study is to analyze the time, events, properties, geographic objects, and activities associated with urban waterlogging emergency responses from the geographic spatial and temporal processes perspective and to construct an urban waterlogging emergency knowledge graph by combining top-down and bottom-up approaches. We propose a conceptual model of urban waterlogging emergency response ontology based on spatiotemporal processes by analyzing the basic laws and influencing factors of urban waterlogging occurrence and development. Secondly, we describe the construction process of the urban waterlogging emergency response knowledge graph from knowledge extraction, knowledge fusion, and knowledge storage. Finally, the knowledge graph was visualized using 159 urban waterlogging events in China from 2020–2022, with a quality assessment indicating 81% correctness, 65.5% completeness, and 95% data conciseness. The results show that this method can effectively express the spatiotemporal process of an urban waterlogging emergency response and can provide a reference for the spatiotemporal modeling of the knowledge graph. [ABSTRACT FROM AUTHOR]

The current literature mainly uses hub capacity or transport route selection to manage the congestion of emergency multimodal transport and pays less attention to transshipment scheduling. This paper proposes an integrated optimization problem of transport routes and transshipment sequences (ITRTSP) and constructs a hybrid flow shop scheduling model to describe it. Based on this model, a recursive method is proposed to calculate the minimum waiting times that cargoes consume in queues at hubs, given the transport routes and transshipment sequences. Furthermore, a memetic algorithm is designed with route selection as the outer layer and transshipment sequence selection as the inner layer for solving ITRTSP. Compared with existing achievements, the model and algorithms can quantify the dependency between transshipment sequence selection and emergency transport time in multimodal transport network settings. The model and algorithms are applied to solve some real-scale examples and compared with the first-come-first-served (FCFS) rule commonly used in the current literature. The results indicate that the makespan is reduced by up to approximately 4.2%, saving 33.68 h. These findings demonstrate that even with given hub capacities and transport routes, congestion can still be managed and the schedule optimized through transshipment scheduling, further improving emergency transport efficiency. [ABSTRACT FROM AUTHOR]

Based on the background of Jiaxing City’s preliminary completion of institutional reform and revision of earthquake emergency plans, this paper deeply analyzes the current situation of earthquake emergency work faced by Jiaxing City. It proposes a strategic path for building and improving the earthquake emergency system in Jiaxing City from eight aspects, including reconstructing and strengthening collaborative emergency systems, improving emergency plans, and guiding social participation. The goal is to enhance the emergency response capacity of Jiaxing City in response to sudden earthquake events, while also hoping to provide valuable reference and inspiration for other cities in the Yangtze River Delta region with similar geographical and socio-economic characteristics in the construction of earthquake emergency systems.

Background: The healthcare sector witnessed the occurrences and impacts of disruptions on supply chains during the coronavirus disease (COVID-19) pandemic. Consequently, it is essential to strengthen institutional medical supply chain systems by addressing the key attributes of strategic stockpile plan renewal: flexibility, traceability and transparency, perseverance and responsiveness, global independence, and equitable access. Aim and objective: To establish a resilient supply chain integrated into the emergency management cycle by proposing a sustainable 5P Strategic Medical Stockpile model. Settings: Online evidence, available literature, and lessons learned during the COVID-19 response in the Emirate of Abu Dhabi. Methods: This review employed a systematic methodology of identification, selection, assessment, synthesis, and interpretation of data from peer-reviewed articles, review reports, and response frameworks spanning the years 2012 to 2020. Additionally, media reports and announcements were analyzed to determine the implications of COVID-19 on the supply chain from 2020 to 2022. Recommendations are formulated in response to the identified shortcomings revealed during the review process, as well as considering experiences and lessons resulting from responses to address COVID-19 in the Abu Dhabi Health Sector. Results: Our analysis revealed a deficiency in effective operational protocols for building a robust supply chain. The experience gained from responding to COVID-19 has highlighted deficiencies such as unclear issues with stockpiles, inadequate resources, insufficient planning, the absence of established procedures, and a lack of performance monitoring. The pandemic had a tremendous impact on health systems and medical supply chains worldwide. Our suggested model necessitates aligning responses with national contingency protocols. Accountability may fluctuate during each phase of an emergency, depending on decision-making authority and jurisdictional capabilities. Conclusion: The proposed 5P model can support policymakers, health regulators, institutions, and professionals in formulating strategies to establish a resilient stockpile system that serves as a medical supply chain buffer when supplies are not instantly accessible. [SJEMed 2024; 5(2.000): 073-080]

Abstract The application of multimodal deep learning for emergency response and recovery, specifically in disaster social media analysis, is of utmost importance. It is worth noting that in real-world scenarios, sudden disaster events may differ from the training data, which may require the multimodal network to predict them as unknown classes instead of misclassifying them to known ones. Previous studies have primarily focused on model accuracy in a closed environment and may not be able to directly detect unknown classes. Thus, we propose a novel multimodal model for categorizing social media related to disasters in an open-world environment. Our methodology entails utilizing pre-trained unimodal models as encoders for each modality and performing information fusion with a cross-attention module to obtain the joint representation. For open-world detection, we use a multitask classifier that encompasses both a closed-world and an open-world classifier. The closed-world classifier is trained on the original data to classify known classes, whereas the open-world classifier is used to determine whether the input belongs to a known class. Furthermore, we propose a sample generation strategy that models the distribution of unknown samples using known data, which allows the open-world classifier to identify unknown samples. Our experiments were conducted on two public datasets, namely CrisisMMD and MHII. According to the experimental results, the proposed method outperforms other baselines and approaches in crisis information classification.

Abstract Background Cameroon is amongst the worst affected countries by road traffic injuries with an estimated 1443 disability-adjusted life years per 100,000 population. There have been very limited reports on the crucial prehospital response to road traffic injuries in Cameroon. This study aimed to identify prehospital factors associated with RTI mortality in Cameroon. Methods We included patients enrolled between June 2022 and March 2023 in the Cameroon Trauma Registry. Information about prehospital factors and demographic data was obtained from patients or their proxies. We examined the association of prehospital care factors like care at the crash scene and type of transportation during crash with final patient outcome. We used Chi-squared test to investigate the association between selected independent variables and mortality. A multivariable logistic regression model was built to identify independent predictors of dying from an RTI. Results RTIs constituted 69.5% (n = 3203) of all injuries in the Cameroon Trauma Registry. Only 20.7% (n = 102) of 4 + wheel vehicle occupants had seatbelts on and just 2.7% (n = 53) of motorcycle riders were wearing helmets during the collision. Only 4.9% (n = 156) of patients received any form of scene care. In-hospital mortality was 4.3% (n = 139) and was associated with male sex (AOR = 1.7, 95%CI = 1.08–2.80), crashing on a motorcycle (AOR = 2.08, 95%CI = 1.1–3.67) and scene care (AOR = 0.25, 95%CI = 0.04–0.80). Conclusions Receiving any type of care at the scene such as bleeding control or being placed in the recovery position by bystanders is associated with improved survival. Improving on existing informal prehospital care responses should be a priority in Cameroon.

The application of multimodal deep learning for emergency response and recovery, specifically in disaster social media analysis, is of utmost importance. It is worth noting that in real-world scenarios, sudden disaster events may differ from the training data, which may require the multimodal network to predict them as unknown classes instead of misclassifying them to known ones. Previous studies have primarily focused on model accuracy in a closed environment and may not be able to directly detect unknown classes. Thus, we propose a novel multimodal model for categorizing social media related to disasters in an open-world environment. Our methodology entails utilizing pre-trained unimodal models as encoders for each modality and performing information fusion with a cross-attention module to obtain the joint representation. For open-world detection, we use a multitask classifier that encompasses both a closed-world and an open-world classifier. The closed-world classifier is trained on the original data to classify known classes, whereas the open-world classifier is used to determine whether the input belongs to a known class. Furthermore, we propose a sample generation strategy that models the distribution of unknown samples using known data, which allows the open-world classifier to identify unknown samples. Our experiments were conducted on two public datasets, namely CrisisMMD and MHII. According to the experimental results, the proposed method outperforms other baselines and approaches in crisis information classification. [ABSTRACT FROM AUTHOR]

This review explores the impact of telemedicine, mobile health (mHealth) applications, and point-of-care ultrasound in disaster scenarios. A comprehensive literature review was conducted using databases such as PubMed, MEDLINE, and Google Scholar to identify relevant studies on technology in disaster medicine. The findings indicate that telemedicine significantly enhances communication and coordination among emergency teams, mHealth applications improve patient tracking and triage, and point-of-care ultrasound provides rapid and accurate diagnostics in disaster settings. These technological advancements have contributed to efficient and effective disaster response efforts, highlighting the critical role of technology in modern disaster medicine.

ObjectiveTo identify the key issues in emergency response to public health emergencies in the Yangtze River Delta region, and to provide a basis for the formulation of relevant policies.MethodLiterature on emergency response to public health emergencies in the Yangtze River Delta region was systematically reviewed and collected, and 18 main problems were identified after collecting and organizing the problems. A questionnaire survey and cluster analysis were used to identify the key issues.ResultsThe study of 18 major problems revealed that "insufficient reserve of emergency medical supplies", "insufficient financial investment to meet the needs of emergency response", "lack of a sound mechanism for the deployment of supplies, resulting in the untimely deployment of materials", were the key issues of emergency response to public health emergencies in the Yangtze River Delta region.ConclusionFuture development of the emergency response system in the Yangtze River Delta region should focus on accelerating the integration process of the Yangtze River Delta, establishing and improving information systems, optimizing the material storage and deployment network, prioritizing the fund investment and utilization mechanism, and improving the effectiveness of public health emergency response.

Sarah Al-Shammari,1 Ahmed M Al-Wathinani,2 Mohammed A Abahussain,2 Nawaf A Albaqami,1 Mohammad A Alhallaf,2 Hassan Farhat,3,4 Krzysztof Goniewicz5 1Day Surgery Unit, Royal Commission Hospital, Jubail Industrial City, Al Jubail 31961, Saudi Arabia; 2Department of Emergency Medical Services, Prince Sultan Bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, Saudi Arabia; 3Ambulance Service, Hamad Medical Corporation, Doha, Qatar; 4Faculty of Medicine Ibn El Jazzar, University of Sousse, 4000, Sousse, Tunisia & Faculty of Sciences, University of Sfax, Sfax, Tunisia; 5Department of Security, Polish Air Force University, 08-521 D&eogon;blin, PolandCorrespondence: Ahmed M Al-Wathinani, Email ahmalotaibi@ksu.edu.saIntroduction: This study aimed to evaluate disaster preparedness and management among an inter-professional team at the Royal Commission Hospital (RCH) in Jubail, Saudi Arabia.Methods: Conducted between May and July 2023, this cross-sectional study involved healthcare providers in both patient-facing and non-patient-facing roles. Participants responded to a comprehensive online questionnaire comprising 22 questions across seven sections covering aspects of emergency response, disaster management, and infection control. The study targeted a minimum sample size of 500 participants, successfully garnering responses from 512 individuals.Results: Of the 512 participants, 59.9% (n=312) were healthcare providers in patient-facing roles, and 40.1% (n=209) were in non-patient-facing roles. The results revealed notable disparities in awareness and preparedness between these two groups. Healthcare providers demonstrated higher awareness levels compared to their non-patient-facing counterparts. For instance, 76.9% of healthcare providers were aware of the hospital’s emergency response plan compared to 56.2% of non-healthcare providers (χ² = 52.165, p < 0.001). Similar disparities were observed in understanding the term “disaster” (86.5% vs 54.1%, χ² = 27.931, p < 0.001), and awareness of a command center (73.4% vs 45.2%, χ² = 42.934, p < 0.001).Discussion: These findings underscore the critical need for enhancing awareness, education, and preparedness within healthcare facilities, emphasizing an integrated approach that includes both healthcare and non-healthcare staff. By addressing these gaps, healthcare facilities can significantly improve their emergency response efficiency, disaster management capabilities, and infection control measures, thereby enhancing the overall safety and quality of patient care.Keywords: disaster preparedness, emergency response, inter-professional collaboration, healthcare management, infection control, emergency medicine training, patient safety, cross-sectional analysis

Urban communities have long been pivotal in wealth creation and technological innovation. In the contemporary context, their modus operandi is intricately tied to a diverse array of critical infrastructure systems (CISs). These systems—encompassing utilities, transportation, communication, and more—are indispensable for daily life; however, historical lessons underscore that the ever-growing interdependence among modern CISs has sapped their robustness. Furthermore, this vulnerability is compounded by the intensifying natural hazards catalysed by climate change, leaving urban communities with eroded resilience. Against this backdrop, pilot studies have harnessed breakthroughs in artificial intelligence (AI) to chart a new course toward resilient urban communities. This paper illuminates AI-driven resilience by reviewing the latest research in key aspects including (1) the limitation of state-of-the-art resilience assessment frameworks; (2) emergency response as a novel blueprint featuring swift response following catastrophes; (3) efficient loss assessment of CISs using AI algorithms; and (4) machine-learning-enabled autonomous emergency response planning. The remaining challenges and hardships faced on the journey toward resilient urban communities are also discussed. The findings could contribute to the ongoing discourse on enhancing urban resilience in the face of increasingly frequent and destructive climate hazards. [ABSTRACT FROM AUTHOR]

Many cities across the United States (U.S.) face threats from natural hazards, and as climate change continues to worsen, cities will face increased risks. Emergency management helps cities to mitigate these risks and adapt to shifting threats. Based on the Rockefeller City Resilience Framework and City Resilience Index Driver 3, Indicator 3.4, the scope of this research was to develop an emergency management maturity model and explore emergency management capacity for future disasters based on an assessment of five cities across the U.S. With the resulting data, a city's score would serve as an evaluation of the emergency response indicator (Indicator 3.4) in order to eventually enter the City Resilience Index. The cities selected were Buffalo, New York; Honolulu, Hawaii; Memphis, Tennessee; New Orleans, Louisiana; and Saint Paul, Minnesota, based on their hazard/risk factors. It should be noted that these scores were intended to compare resilience in a city over time and identify unique areas in which the cities could improve emergency management and were not meant to rank the cities against each other. An interesting find was the overlap between the counties and cities regarding policy data, creating a new avenue for research in local level emergency management. [ABSTRACT FROM AUTHOR]

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The frequency of natural disasters has increased recently, posing a huge threat to human society. Rapid, accurate, authentic, and comprehensive acquisition and transmission of disaster information are crucial in emergency response. In this paper, we propose a design scheme for an aerial remote sensing platform based on real-time satellite communication. This platform mainly includes a civilian heavy-duty unmanned aerial vehicle, ground observation system with the self-developed orthographic image stabilization device, wireless communication system with an airborne mobile communication device using Ku band, ground satellite information receiving station, and data processing and application analysis system. The image stabilization capability of the ground observation system and the communication capability of the wireless communication system were verified through ground and flight tests respectively. The results showed that the stability accuracy of the platform was better than the theoretical threshold, the system transmission rate was not less than 2 M bandwidth, the data packet loss rate was low, and the time delay was not more than 2 s. The images captured in the experiment were clear, with a resolution of less than 1cm and an overlap rate of more than 70%. These all results meet the emergency observation requirement, which indicates that the aerial remote sensing platform based on real-time satellite communication has great potential for application in natural disaster emergency response. [ABSTRACT FROM AUTHOR]

Unmanned Aerial Vehicles (UAVs) play a pivotal role in disaster management and emergency response for ensuring safety of our society. In this respect, lightweight deep learning models are necessary for video and image processing onboard of UAVs for real-time applications. In this study, a useful feature extraction module known as "multi-block" is designed to effectively capture information across multiple imagery scales for facilitate lightweight deep learning models. The multi-block module incorporates depthwise convolution layers with diverse kernel sizes to ensure robust feature extraction. Then, pointwise convolution is leveraged to capture the correlation between different spatial locations and channels. Evaluated with the Aerial Image Database for Emergency Response (AIDER), the proposed multi-block module demonstrates a reliable performance pertaining to its feature extraction capabilities for undertaking aerial image classification tasks in disaster management. [ABSTRACT FROM AUTHOR]

Introduction: In urban areas exposed to high-magnitude earthquakes, the drinking water supply would be severely damaged, and domestic services would be disrupted for a large part of the population in the event of an earthquake. The Lima-Callao metropolitan area in Peru, South America, is expected to experience an 8.8 Mw earthquake, and it is estimated that approximately 90% of the population would not have immediate access to emergency water in the case of such an event. The main objective of this paper is to define criteria for a spatial analysis method to guide the design criteria for an Emergency Water Supply System (EWaSS). Methods: This paper combines territorial, urban resilience and participatory approaches and presents the results of an interdisciplinary research with social impact. Thus, it examines the urban territory at macro-, meso- and micro scales; physical-spatial variables indicating risk levels and possible public spaces to implement the system; and socio-spatial variables regarding the population, risk perception and participation in management to strengthen urban resilience. Normative tools and the Geographic Information System are used to spatialize and systematize quantitative and qualitative information. Results and discussion: The EWaSS is an alternative for safe water supply in a post-disaster situation that would provide immediate and autonomous operation during the first 72 h of the emergency. The results show the physical-spatial and social viability of urbanized areas and the system design criteria that guide local actors in making decisions at the three levels of emergency management. [ABSTRACT FROM AUTHOR]

Industrial fires at facilities including waste management sites, warehouses, factories, chemical works, and fuel storage depots are relatively frequent occurrences. Often, these fires occur adjacent to urban communities and result in ground-level airborne pollutant concentrations that are well above guideline values. Land, water, livestock, and crops may also be contaminated by the emissions and by firefighting activities. Moreover, impacted communities tend to have a higher proportion of minority ethnic populations as well as individuals with underlying health vulnerabilities and those of lower socio-economic status. Nevertheless, this is an aspect of air quality that is under-researched, and so this review aims to highlight the public health hazards associated with industrial fires and the need for an effective, coordinated, public health response. We also review the range of monitoring techniques that have been utilised in such fires and highlight the role of dispersion modelling in predicting plume trajectories and in estimating population exposure. We recommend establishing 1 h guideline values for particulate matter to facilitate timely public health interventions, and we highlight the need to review regulatory and technical controls for sites prone to fires, particularly in the waste sector. [ABSTRACT FROM AUTHOR]

Summary: Drones, unmanned aerial systems, are of growing interest to organizations involved in disaster risk reduction, particularly in post-disaster emergency response. Despite the potential benefits of drones, their use is not well established and practical challenges need to be understood. This study examines the role of drones in disaster management by analyzing various applications of drones in response to the Noto Peninsula earthquake in January 2024. Drones were used on the ground in a variety of new ways, including transport of emergency supplies, restore of cellphone communications, and inspect on damaged facilities. Several issues were identified, including the need to incorporate drone capabilities into disaster management plans, develop appropriate laws and regulations, establish public-private coordination mechanisms, address technological limitations due to advances in technology, and implement training programs specifically for drone operators. Collaboration among government agencies, private organizations, and industry associations in disaster response highlighted the importance of fostering partnerships and mobilizing collective expertise in disaster management. The study concludes by highlighting the important role that drones can play in enhancing emergency response efforts and mitigating the impact of future disasters.

The study aims to review and discuss the outcomes of emergency preparedness training programs among nursing students.

Abstract Objective Given the frequency of disasters worldwide, there is growing demand for efficient and effective emergency responses. One challenge is to design suitable retrospective charts to enable knowledge to be gained from disasters. This study provides comprehensive understanding of published retrospective chart review templates for designing and updating retrospective research. Methods We conducted a systematic review and text analysis of peer-reviewed articles and grey literature on retrospective chart review templates for reporting, analysing, and evaluating emergency responses. The search was performed on PubMed, Cochrane, and Web of Science and pre-identified government and non-government organizational and professional association websites to find papers published before July 1, 2022. Items and categories were grouped and organised using visual text analysis. The study is registered in PROSPERO (374,928). Results Four index groups, 12 guidelines, and 14 report formats (or data collection templates) from 21 peer-reviewed articles and 9 grey literature papers were eligible. Retrospective tools were generally designed based on group consensus. One guideline and one report format were designed for the entire health system, 23 studies focused on emergency systems, while the others focused on hospitals. Five papers focused specific incident types, including chemical, biological, radiological, nuclear, mass burning, and mass paediatric casualties. Ten papers stated the location where the tools were used. The text analysis included 123 categories and 1210 specific items; large heterogeneity was observed. Conclusion Existing retrospective chart review templates for emergency response are heterogeneous, varying in type, hierarchy, and theoretical basis. The design of comprehensive, standard, and practicable retrospective charts requires an emergency response paradigm, baseline for outcomes, robust information acquisition, and among-region cooperation.

Abstract Background The COVID-19 pandemic had a disproportionate impact on the health and wellbeing of people who use drugs (PWUD) in Canada. However less is known about jurisdictional commonalities and differences in COVID-19 exposure and impacts of pandemic-related restrictions on competing health and social risks among PWUD living in large urban centres. Methods Between May 2020 and March 2021, leveraging infrastructure from ongoing cohorts of PWUD, we surveyed 1,025 participants from Vancouver (n = 640), Toronto (n = 158), and Montreal (n = 227), Canada to describe the impacts of pandemic-related restrictions on basic, health, and harm reduction needs. Results Among participants, awareness of COVID-19 protective measures was high; however, between 10 and 24% of participants in each city-specific sample reported being unable to self-isolate. Overall, 3–19% of participants reported experiencing homelessness after the onset of the pandemic, while 20–41% reported that they went hungry more often than usual. Furthermore, 8–33% of participants reported experiencing an overdose during the pandemic, though most indicated no change in overdose frequency compared the pre-pandemic period. Most participants receiving opioid agonist therapy in the past six months reported treatment continuity during the pandemic (87–93%), however, 32% and 22% of participants in Toronto and Montreal reported missing doses due to service disruptions. There were some reports of difficulty accessing supervised consumption sites in all three sites, and drug checking services in Vancouver. Conclusion Findings suggest PWUD in Canada experienced difficulties meeting essential needs and accessing some harm reduction services during the COVID-19 pandemic. These findings can inform preparedness planning for future public health emergencies.

Introduction/aim: This paper aims to present the methodology for creating educational content/scenarios on a ship simulator (bridge simulator) that will serve officers of river units in developing the ability to react when performing regular and military tactical tasks on the ships of the River Flotilla. Also, training on the simulator aims to train officers of river units using modern information technologies. Methods: The paper uses simulation methods, experimental methods, case studies, and operational research. Results: Specific educational content/scenarios were created, also specific methodology was developed and the principles were clearly defined according to which content/scenarios are created on the ship simulator. Conclusion: By using the ship simulator, in different teaching scenarios, cadets of river units as well as members of river units are trained and acquire the ability to react adequately in real situations in the shortest possible time.

Recently, frequent flood disasters in China have seriously threatened economic development and public safety. This paper addresses the need for a dynamic urban flood emergency knowledge management system in emergency management departments and the lack of systematic knowledge among emergency managers regarding urban flood control. A multimodal knowledge graph-based urban flood emergency knowledge management model was constructed to enhance the decision-making capabilities of emergency management departments, improve the efficiency of public emergency evacuation, and reduce losses from urban flood disasters by analyzing the shortcomings of the existing emergency management system. An intelligent and dynamic flood emergency knowledge management model was built. This paper integrates multimodal knowledge graph technology to establish a multimodal emergency knowledge management framework for urban flood control. It develops and simulates the proposed model's application scenarios for urban flood emergency evacuation using the Flocking algorithm on the NetLogo platform. Through simulation experiments, the practicality and effectiveness of the model in real flood disaster situations were examined, particularly in simulating crowd evacuation behavior. The study found that the model significantly improves the accuracy of information and decision-making speed during emergency responses and supports emergency management departments in conducting targeted and personalized emergency decisions. This research provides a scientific basis for emergency management departments to optimize their emergency response strategies to flood disasters and serves as a reference and example for the application of multimodal knowledge graph technology in emergency management. [ABSTRACT FROM AUTHOR]

The Internet of Things (IoT) is a growing network of interconnected devices used in transportation, finance, public services, healthcare, smart cities, surveillance, and agriculture. IoT devices are increasingly integrated into mobile assets like trains, cars, and airplanes. Among the IoT components, wearable sensors are expected to reach three billion by 2050, becoming more common in smart environments like buildings, campuses, and healthcare facilities. A notable IoT application is the smart campus for educational purposes. Timely notifications are essential in critical scenarios. IoT devices gather and relay important information in real time to individuals with special needs via mobile applications and connected devices, aiding health-monitoring and decision-making. Ensuring IoT connectivity with end users requires long-range communication, low power consumption, and cost-effectiveness. The LPWAN is a promising technology for meeting these needs, offering a low cost, long range, and minimal power use. Despite their potential, mobile IoT and LPWANs in healthcare, especially for emergency response systems, have not received adequate research attention. Our study evaluated an LPWAN-based emergency response system for visually impaired individuals on the Hazara University campus in Mansehra, Pakistan. Experiments showed that the LPWAN technology is reliable, with 98% reliability, and suitable for implementing emergency response systems in smart campus environments. [ABSTRACT FROM AUTHOR]

This research sought to determine whether there was a direct relationship between muscle power, muscle endurance and emergency response times among young adults. While performance capability remains an essential component for emergency teams, this study showed how some physical fitness factors might alter initial emergency response time and lessen the effects of the disaster. Engagement in preparedness exercises, particularly those emphasizing physical activity, offers advantageous health outcomes and enhances disaster response efficacy. These improvements in readiness directly impact the overall outcomes of such disasters. The sample consisted of 21 students, comprising both male and female participants of the same age. Following the American College of Sports Medicine's (ACSM) Exercise Preparticipation Health Screening Questionnaire for Exercise Professionals, the participants were separated into two groups: the physically active group and the physically inactive group. The study's main objective was to determine whether muscle power and muscle endurance of the participants could influence their fire emergency response movement time to a safe location. Additionally, the study sought to find out whether physically active participants responded more quickly than physically inactive ones. The findings of this study indicate a relationship between emergency response time and measurements of muscle endurance and muscle power. Participants who were physically active had shorter movement time to safe location (p = 0.023), performed better on the standing broad jump test (p = 0.001), and muscle endurance test (p = 0.004). Although performance ability is a key component for emergency teams, this study demonstrated how some factors of physical fitness can affect initial emergency response time and help mitigate the effects of the disaster in young adults. [ABSTRACT FROM AUTHOR]

Objective: Given the frequency of disasters worldwide, there is growing demand for efficient and effective emergency responses. One challenge is to design suitable retrospective charts to enable knowledge to be gained from disasters. This study provides comprehensive understanding of published retrospective chart review templates for designing and updating retrospective research. Methods: We conducted a systematic review and text analysis of peer-reviewed articles and grey literature on retrospective chart review templates for reporting, analysing, and evaluating emergency responses. The search was performed on PubMed, Cochrane, and Web of Science and pre-identified government and non-government organizational and professional association websites to find papers published before July 1, 2022. Items and categories were grouped and organised using visual text analysis. The study is registered in PROSPERO (374,928). Results: Four index groups, 12 guidelines, and 14 report formats (or data collection templates) from 21 peer-reviewed articles and 9 grey literature papers were eligible. Retrospective tools were generally designed based on group consensus. One guideline and one report format were designed for the entire health system, 23 studies focused on emergency systems, while the others focused on hospitals. Five papers focused specific incident types, including chemical, biological, radiological, nuclear, mass burning, and mass paediatric casualties. Ten papers stated the location where the tools were used. The text analysis included 123 categories and 1210 specific items; large heterogeneity was observed. Conclusion: Existing retrospective chart review templates for emergency response are heterogeneous, varying in type, hierarchy, and theoretical basis. The design of comprehensive, standard, and practicable retrospective charts requires an emergency response paradigm, baseline for outcomes, robust information acquisition, and among-region cooperation. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic had a disproportionate impact on the health and wellbeing of people who use drugs (PWUD) in Canada. However less is known about jurisdictional commonalities and differences in COVID-19 exposure and impacts of pandemic-related restrictions on competing health and social risks among PWUD living in large urban centres. Methods: Between May 2020 and March 2021, leveraging infrastructure from ongoing cohorts of PWUD, we surveyed 1,025 participants from Vancouver (n = 640), Toronto (n = 158), and Montreal (n = 227), Canada to describe the impacts of pandemic-related restrictions on basic, health, and harm reduction needs. Results: Among participants, awareness of COVID-19 protective measures was high; however, between 10 and 24% of participants in each city-specific sample reported being unable to self-isolate. Overall, 3–19% of participants reported experiencing homelessness after the onset of the pandemic, while 20–41% reported that they went hungry more often than usual. Furthermore, 8–33% of participants reported experiencing an overdose during the pandemic, though most indicated no change in overdose frequency compared the pre-pandemic period. Most participants receiving opioid agonist therapy in the past six months reported treatment continuity during the pandemic (87–93%), however, 32% and 22% of participants in Toronto and Montreal reported missing doses due to service disruptions. There were some reports of difficulty accessing supervised consumption sites in all three sites, and drug checking services in Vancouver. Conclusion: Findings suggest PWUD in Canada experienced difficulties meeting essential needs and accessing some harm reduction services during the COVID-19 pandemic. These findings can inform preparedness planning for future public health emergencies. [ABSTRACT FROM AUTHOR]

Background: The healthcare sector witnessed the occurrences and impacts of disruptions on supply chains during the coronavirus disease (COVID-19) pandemic. Consequently, it is essential to strengthen institutional medical supply chain systems by addressing the key attributes of strategic stockpile plan renewal: flexibility, traceability and transparency, perseverance and responsiveness, global independence, and equitable access. Aim and objective: To establish a resilient supply chain integrated into the emergency management cycle by proposing a sustainable 5P strategic medical stockpile model. Settings: Online evidence, available literature, and lessons learned during the COVID-19 response in the Emirate of Abu Dhabi. Methods: This review employed a systematic methodology of identification, selection, assessment, synthesis, and interpretation of data from peer-reviewed articles, review reports, and response frameworks spanning the years 2012–2020. In addition, media reports and announcements were analyzed to determine the implications of COVID-19 on the supply chain from 2020 to 2022. Recommendations are formulated in response to the identified shortcomings revealed during the review process, as well as considering experiences and lessons resulting from responses to address COVID-19 in the Abu Dhabi Health Sector. Results: Our analysis revealed a deficiency in effective operational protocols for building a robust supply chain. The experience gained from responding to COVID-19 has highlighted deficiencies such as unclear issues with stockpiles, inadequate resources, insufficient planning, the absence of established procedures, and a lack of performance monitoring. The pandemic had a tremendous impact on health systems and medical supply chains worldwide. Our suggested model necessitates aligning responses with national contingency protocols. Accountability may fluctuate during each phase of an emergency, depending on decision-making authority and jurisdictional capabilities. Conclusion: The proposed 5P model can support policymakers, health regulators, institutions, and professionals in formulating strategies to establish a resilient stockpile system that serves as a medical supply chain buffer when supplies are not instantly accessible. [ABSTRACT FROM AUTHOR]

Global and national authorities have not historically approached animal health emergencies through a gendered lens. Yet these events almost certainly have gendered dimensions, such as differential engagement of women or men depending on their culturally accepted or assigned roles for animal care: risk of exposure to zoonoses; and access to emergency resources during response and recovery. Despite the role that gender seems to play with respect to animal health emergencies, little research has been conducted to better understand such dynamics, and little policy has been promulgated to address it in a way that optimizes response while ensuring equitableoutcomes. This piece summarizes 3 key themes that emerged from a panel discussion on gender and animal health emergencies at the World Organisation for Animal Health Global Conference on Emergency Management in April 2023. These themes were differential gendered exposure to pathogens; a lack of equitable gender representation in animal health decision-making; and enhancement of pathways for recognizing gender in national and international actions in preparing for, detecting, and responding to animal health emergencies. Beyond increasing opportunities for women to engage in leadership, the animal health and veterinary communities will benefit from connecting practitioners with gender experts to develop more integrative approaches to emergency preparedness and management. Animal health professionals should also advocate for further research to elucidate gender-specific dynamics in human populations in the context of animal emergencies and the promulgation of evidence-based policies. Such transformative efforts will lead to better outcomes for all people who depend on and provide care for animals. [ABSTRACT FROM AUTHOR]

Introduction/aim: This paper aims to present the methodology for creating educational content/scenarios on a ship simulator (bridge simulator) that will serve officers of river units in developing the ability to react when performing regular and military tactical tasks on the ships of the River Flotilla. Also, training on the simulator aims to train officers of river units using modern information technologies. Methods: The paper uses simulation methods, experimental methods, case studies, and operational research. Results: Specific educational content/scenarios were created, also specific methodology was developed and the principles were clearly defined according to which content/scenarios are created on the ship simulator Conclusion: By using the ship simulator, in different teaching scenarios, cadets of river units as well as members of river units are trained and acquire the ability to react adequately in real situations in the shortest possible time. [ABSTRACT FROM AUTHOR]

Remote sensing techniques have emerged as an essential tool for conducting damage assessments and are commonly used to improve disaster recovery planning and community resilience policies. The objective of this study was to use aerial imagery data and LiDAR to identify the hardest hit areas, quantify the extent of damages, and compare pre- and post-storm beach morphology conditions in Estero Island, Florida, relating to Hurricane Ian in 2022. This study identified >2400 structures that were impacted by Hurricane Ian, with 170 structures suffering extensive damage. Clustering of heavily damaged buildings was observed on the northern and central portions of the island, with lower levels of damage clustered on the southern part. Among the 'severely damaged' and 'destroyed' structures were seven mobile home subdivisions. The total assessed value of the heavily damaged structures was estimated at over USD 200 million. The results also indicated substantial post-storm debris and sand deposition across the entire island. Remote sensing provides advanced techniques that can help prioritize emergency response efforts after catastrophic impacts from a natural disaster. [ABSTRACT FROM AUTHOR]

In the context of emergency response applications, real-time situational awareness is vital. Unmanned aerial vehicles (UAVs) with imagers have emerged as crucial tools for providing timely information in such scenarios. Convolutional neural networks (CNN) are effective in image processing. However, the deployment of CNN models in UAVs faces significant challenges. The CNN models involve large number of parameters and energy-costly floating-point computations beyond the memory and power available on-board the UAVs. To address these challenges, we propose a co-design optimization approach for deploying the EmergencyNet CNN model on resource-constrained UAVs. Our strategy includes channel-wise pruning to reduce the size and optimize the network architecture. Additionally, we apply additive powers-of-two (APoT) quantization to further compress the model and enhance computational efficiency. Using channel-wise network pruning we derive TinyEmergencyNet that is only 155KB in memory size and 50% smaller than EmergencyNet. This proposed approach is evaluated on Aerial Image Disaster Event Recognition (AIDER) dataset. We have achieved an F1-score of 93.6% with 4-bit APoT quantization that closely approaches the full precision (32-bit) accuracy of 94%. Furthermore, hardware-friendly bit-shifting operations as a result of APoT quantization present an added advantage in hardware accelerator implementations. This work pioneers the joint application of channel-wise pruning and non-uniform APoT quantization on EmergencyNet, presenting a suitable solution tailored for UAV-based emergency response applications. [ABSTRACT FROM AUTHOR]

Emergency response plans for tunnel vehicle accidents are crucial to ensure human safety, protect critical infrastructure, and maintain the smooth operation of transportation networks. However, many decision-support systems for emergency responses still rely significantly on predefined response strategies, which may not be sufficiently flexible to manage unexpected or complex incidents. Moreover, existing systems may lack the ability to effectively respond effectively to the impact different emergency scenarios and responses. In this study, semantic web technologies were used to construct a digital decision-support system for emergency responses to tunnel vehicle accidents. A basic digital framework was developed by analysing the knowledge system of the tunnel emergency response, examining its critical elements and intrinsic relationships, and mapping it to the ontology. In addition, the strategies of previous pre-plans are summarised and transformed into semantic rules. Finally, different accident scenarios were modelled to validate the effectiveness of the developed emergency response system.

Objective: To estimate risk of being unvaccinated against COVID-19 by experience of intimate partner violence (IPV). Methods: Among 3,343 partnered individuals in a community-based U.S. cohort, we quantified emotional and physical IPV experienced between March and December 2020 and estimated risk of being unvaccinated against COVID-19 through June 2021 by experience of IPV. Experience of recent IPV was defined as endorsement of more frequent or severe IPV since the start of the pandemic or report of any past-month IPV in at least one of four follow-up surveys conducted by the end of December 2020. We created a three-level composite variable – no experience of IPV, experience of emotional but not physical IPV, and experience of physical IPV. Results: Cisgender women, non-binary, or transgender individuals who reported experiencing emotional, but not physical, IPV and those who reported experiencing physical IPV were both at significantly higher risk of being unvaccinated for COVID-19 compared to those who reported experiencing no IPV (ARRemotional violence: 1.28 [95 % CI: 1.09 – 1.51]; ARRphysical violence: 1.70 [95 % CI: 1.41 – 2.05]). Cisgender men who reported experiencing physical IPV were also at significantly higher risk of being unvaccinated for COVID-19 (ARRphysical violence: 1.52 [95 % CI: 1.15 – 2.02]). Conclusions: IPV may increase the risk of low vaccine uptake. Results highlight the need to incorporate IPV prevention and support into public health responses, with targeted resources and consideration for reducing barriers to public health interventions among those impacted.

Nepal has a health care system that is complicated by access, affordability, and availability. The geographical difficulty makes the health care reach to public more difficult. Nepal being a disasterprone country, it makes very important to strengthen the disaster preparedness up to the mark before the disaster strikes. During disaster and public health emergencies, the healthcare system quickly becomes overwhelmed or structural damage makes it non-functional, which necessitate the prior identification of Alternate Care Site by health service providers. Incorporating the identification of Alternate Care Sites into the Hospital Disaster Preparedness Plan represents a crucial transition from theoretical discussion to practical implementation for strengthening healthcare facilities. . This paper discusses the concept of Alternate Care site and its implementation in Nepal’s health emergency preparedness for disaster and public health emergencies.

Introduction: A full-scale simulation exercise is a comprehensive drill designed to replicate a real-world emergency scenario, thereby identifying the strengths and weaknesses in current practices. The overarching goal is to enhance healthcare system resilience through improved protocols, as highlighted in this systematic review tailored for researchers. The study aims specifically to assess the impact of full-scale simulations on enhancing hospital disaster plans. Methodology: Following PRISMA guidelines, this systematic review investigates the impact of full-scale simulation exercises on hospital disaster preparedness. The focus was on hospital staff involved in disaster and emergency preparedness training. The primary intervention was the execution of full-scale simulation exercises, and our research included various study designs, including randomised controlled trials and observational study designs. A comprehensive electronic database search was conducted, spanning PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials, from inception until October 9, 2023. The risk of bias was assessed using NIH tools. Results: The literature search yielded 2398 results, with 28 publications finally included in the systematic review. Summarising a broad range of disaster preparedness simulation exercises with a specific focus on full-scale simulation (FSS), the studies consistently demonstrated a positive impact on participants' skills, as well as identifying safety issues in hospital settings. Moreover, they revealed that simulations effectively addressed crucial areas for improvement in disaster response, including communication breakdowns, equipment deficiencies, and flaws in emergency plans. The studies utilised a multidimensional approach to evaluation metrics, encompassing non-technical skills, communication, teamwork, decision-making, and operational readiness. The exercises varied in duration from 30 minutes to multi-day simulations, covering a diverse range of disaster scenarios, such as mass casualties, viral epidemics, large aviation accidents, and terrorist attacks. Conclusion: Full-scale simulation exercises are a preparatory learning tool to test facility and staff readiness for complex emergencies. This systematic review focused on the different exercise scenarios used to address critical aspects of disaster response such as communication breakdowns, equipment deficiencies, and flaws in emergency plans. The scenarios and their duration were varied, and involved a multidimensional approach to evaluation. Such exercises enhance critical thinking and problem-solving skills, increase familiarity with potential emergencies, and build confidence in making judgments in real-world situations. In our opinion, there is a need for further programs that align simulation exercises with community resources for better preparedness in the face of public health disasters.

Abstract Background In early October 2021, thousands of residents in Carson, California began complaining of malodors and headaches. Hydrogen sulfide (H2S), a noxious odorous gas, was measured at concentrations up to 7000 parts per billion (ppb) and remained above California’s acute air quality standard of 30 ppb for a month. Intermittent elevations of H2S continued for 3 months. After 2 months of malodor in this environmental justice community, a government agency attributed the H2S to environmental pollution from a warehouse fire. Research has yielded conflicting results on the health effects of H2S exposure at levels that were experienced during this event. This research fills a critical need for understanding how people perceive and experience emergent environmental health events and will help shape future responses. Methods Through a community-academic partnership, we conducted 6 focus groups with 33 participants who resided in the Carson area during the crisis. We sought to understand how this incident affected residents through facilitated discussion on topics including information acquisition, impressions of the emergency response, health symptoms, and ongoing impacts. Results The majority of participants were women (n = 25), identified as Latina/o (n = 19), and rent their homes (n = 21). Participants described difficulty obtaining coherent information about the emergency, which resulted in feelings of abandonment. Most participants felt that local government and healthcare providers downplayed and/or disregarded their concerns despite ongoing odors and health symptoms. Participants described experiencing stress from the odors’ unknown health effects and continued fear of future odor incidents. Residents sought to take control of the crisis through information sharing, community networking, and activism. Participants experienced longer term effects from this event, including increased awareness of pollution and reduced trust in local agencies. Discussion This study demonstrates the necessity of clear, comprehensive, and prompt responses by relevant decisionmakers to chemical emergencies to appropriately address residents’ fears, curb the spread of misinformation, and minimize adverse health effects. Participant responses also point to the benefit of supporting horizontal community networks for improved information sharing. By engaging directly with community members, researchers and disaster responders can better understand the various and complex impacts of chemical disasters and can improve response.

Abstract Background In April 2021, the province of Ontario, Canada, was at the peak of its third wave of the COVID-19 pandemic. Intensive Care Unit (ICU) capacity in the Toronto metropolitan area was insufficient to handle local COVID patients. As a result, some patients from the Toronto metropolitan area were transferred to other regions. Methods A spreadsheet-based Monte Carlo simulation tool was built to help a large tertiary hospital plan and make informed decisions about the number of transfer patients it could accept from other hospitals. The model was implemented in Microsoft Excel to enable it to be widely distributed and easily used. The model estimates the probability that each ward will be overcapacity and percentiles of utilization daily for a one-week planning horizon. Results The model was used from May 2021 to February 2022 to support decisions about the ability to accept transfers from other hospitals. The model was also used to ensure adequate inpatient bed capacity and human resources in response to various COVID-related scenarios, such as changes in hospital admission rates, managing the impact of intra-hospital outbreaks and balancing the COVID response with planned hospital activity. Conclusions Coordination between hospitals was necessary due to the high stress on the health care system. A simple planning tool can help to understand the impact of patient transfers on capacity utilization and improve the confidence of hospital leaders when making transfer decisions. The model was also helpful in investigating other operational scenarios and may be helpful when preparing for future outbreaks or public health emergencies.

Firefighting is an occupation with high injury risks, particularly when conducting fireground operations. The fire service generally quantifies the job demands of firefighting through tracking emergency call volume across 24 h shifts; however, volume alone does not account for the specific work completed in response to different call types. Utilization of external (i.e., objective work) and internal (i.e., intrinsic responses to work) training load measures have the potential to quantify the multifaceted workload demands of responses to medical and fire emergencies and inform injury prevention strategies. Therefore, the purpose of this study was to utilize training load measures to quantify the workloads across emergency call types. For medical emergencies and fire emergencies, the external load and the physiological, perceived, and cumulative internal loads were quantified. The results indicate that the magnitude of objective work required for fire emergency responses that include fire suppression and/or auto-extrication is approximately three times greater than that of medical and other fire emergency (i.e., no suppression or extrication) responses. Further, in response to the objective work for fire suppression and/or auto-extrication calls, the intrinsic workloads are six times more physiologically and perceptually demanding than—as well as double, cumulatively—those of medical and other fire emergency responses.