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Background: Duty to care is both an integral concept in health care and a fundamental nursing obligation. But nurses' perceptions of duty to care can be moderated by their experiences in the practice setting. Research examining nurses' perceptions of their duty to care during the COVID-19 pandemic could shed light on how the pandemic is affecting the nursing workforce. Purpose: This study aimed to examine nurses' sense of duty to care during the early months of the pandemic, using the Nash Duty to Care Scale (NDCS), and to compare the high-scoring nurses with the low-scoring nurses. Methods: This quantitative study used a descriptive, cross-sectional design. It was conducted among licensed RNs enrolled at two accredited nursing programs in the Northeast region of the United States. Data were collected via a demographics questionnaire and the NDCS. A two-step cluster procedure was used to categorize participants into two groups: those with high perceived duty to care (HPDC) and those with low perceived duty to care (LPDC). Independent t tests were performed to compare NDCS results between the two groups. Results: Nearly two-thirds (61%) of the participants had total NDCS scores indicating an HPDC, while 39% had scores indicating an LPDC. Of the NDCS's four subscales, perceived obligation and perceived risk were the most important in separating participants into the low- and high-scoring groups. Conclusions: This study adds to the literature about the components that affected nurses' perceived duty to care and willingness to report to work during the early months of the pandemic. Just as nurses have a duty to care, health care organizations have an obligation to provide a safe working environment so that nurses can fulfill that duty without sacrificing personal safety. The study findings may guide health care leaders, systems, and organizations regarding how to create safer work environments that support the nurse's duty to care during disasters. This study aimed to examine nurses' sense of duty to care during the early months of the pandemic, using the Nash Duty to Care Scale, and to compare the high-scoring nurses with the low-scoring nurses. [ABSTRACT FROM AUTHOR]

The increasing vulnerability of the population from frequent disasters requires quick and effective responses to provide the required relief through effective humanitarian supply chain distribution networks. We develop scenario-robust optimization models for stocking multiple disaster relief items at strategic facility locations for disaster response. Our models improve the robustness of solutions by easing the difficult, and usually impossible, task of providing exact probability distributions for uncertain parameters in a stochastic programming model. Our models allow decision makers to specify uncertainty parameters (i.e., point and probability estimates) based on their degrees of knowledge, using distribution-free uncertainty sets in the form of ranges. The applicability of our generalized approach is illustrated via a case study of hurricane preparedness in the Southeastern United States. In addition, we conduct simulation studies to show the effectiveness of our approach when conditions deviate from the model assumptions. [ABSTRACT FROM AUTHOR]

Declarations and terminations of public health emergencies are performative utterances that shift the balance of governmental power and can change our world. They can provide and then extinguish the ability to provide grants andfunding, deploy the military, waive and modiht regulatory requirements, and curtail civil liberties, many times with limited legislative oversight. But public health emergency laws at every level are inconsistent at best and are being legislated in a reactionary manner that may limit the ability to effectively respond in juture public health emergencies. With such high stakes and during a time when executive agency authority is evolving, appropriate guidance on the felicity conditions for these performative utterances is thus urgently needed. Instead of simply accepting lengthy unfettered executive public health emergency powers or enacting strict legislative limitations on executive authority that could hinder an efective public health response in the future, this Article focuses on a singular first step in calling for a diverse, multi-disciplinary team of scholars and stakeholders to examine the existing web of public health emergency legislation and provide input and guidance on felicity conditions for declaring, continuing, and terminating specific public health emergencies that build in mechanisms for accountability and relevant, appropriate checks and balances. [ABSTRACT FROM AUTHOR]

Community structure analysis compared city characteristics and newspaper coverage of state/local government responses to COVID-19 in 25 major U.S. cities, sampling all 250+ word articles from 4/4/20 to 7/6/20. The resulting 588 articles were coded for "prominence" and "direction" (favorable/unfavorable/balanced-neutral coverage), then combined into each newspaper's composite "Media Vector" (range=0.3552 to −0.5197, or 0.8749). Twenty-one of 25 newspapers (84%) displayed unfavorable coverage of local COVID-19 responses. Pearson correlations and regression analysis confirmed a muscular "violated way of life" pattern, when a community perceives itself as threatened by a "biological threat or a threat to a cherished way of life." Political and belief system polarization (in particular percent Evangelical and percent voting Republican) were strongly associated with unfavorable coverage of local pandemic responses, compared to more favorable responses linked to percent voting Democratic or percent Catholic. Vulnerability (percent uninsured) was also linked to negative coverage. Conversely, two different measures of access to healthcare (percent municipal spending on health and welfare, and physicians/100,000) were significantly linked to favorable coverage of the same local government efforts. Community structure theory's grass roots "bottom up" expectations linking community demographics to variations in reporting on critical issues were robustly confirmed. [ABSTRACT FROM AUTHOR]

The Strategic National Stockpile (SNS) is a national system maintained by the US federal government to deliver medical supplies during emergencies. In the past, the SNS has been used to mitigate public health consequences of tragedies, such as Hurricane Katrina and Ebola outbreaks. However, challenges in maintaining and utilizing the SNS for patient safety are prevalent. This article canvasses ways in which the SNS is accessed and suggests needed changes in the wake of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Scientific evidence suggests that nonpharmaceutical interventions (NPIs) effectively curb the spread of COVID-19 before a pharmaceutical solution. Implementing these interventions also significantly affects regular socioeconomic activities and practices of social, racial, and political justice. Local governments often face conflicting goals during policymaking. Striking a balance among competing goals during a global pandemic is a fine science of governance. How well state governments consume the scientific evidence and maintain such a balance remains less understood. This study employs a set of Bayesian hierarchical models to evaluate how state governments in the United States use scientific evidence to balance the fighting against the spread of COVID-19 disease and socioeconomic, racial, social justice, and other demands. We modeled the relationships between five NPI strategies and COVID-19 caseload information and used the modeled result to perform a balanced governance evaluation. The results suggest that governmental attitude and guidance effectively guide the public to fight back against a global pandemic. The more detailed spatiotemporally varying coefficient process model produces 612,000 spatiotemporally varying coefficients, suggesting all measures sometimes work somewhere. Summarized results indicate that states emphasizing NPIs fared well in curbing the spread of COVID-19. With over 1 million deaths due to COVID-19 in the United States, we feel the balance scale likely needs to tip toward preserving human lives. Our evaluation of governance policies is hence based on such an argument. This study aims to provide decision support for policymaking during a national emergency. [ABSTRACT FROM AUTHOR]

Background: The coronavirus (COVID-19) pandemic presented a significant stressor on the public health system in the United States. While we know the immediate effects of the pandemic on public health programming, no literature has examined the resultant long-term impact on programmatic capacity for sustainability. This paper aims to identify the impact that the COVID-19 pandemic had on state tobacco control program's capacity for sustainability. Methods: From December 2018 to January 2022, we conducted 46 technical assistance calls with tobacco control program employees from 11 states. Calls were audio recorded and professionally transcribed. We analyzed calls (n = 20) that took place during the COVID-19 pandemic. Thematic analysis focused on the impact the COVID-19 pandemic had on tobacco control program's capacity for sustainability. Results: We identified six domains of sustainability that were impacted by COVID-19: (1) funding stability; (2) organizational capacity; (3) partnerships; (4) communication; (5) strategic planning; and (6) program adaptation. Conclusions: Our study is the first to identify the impact of the pandemic on capacity for sustainability of tobacco control programs. Having an understanding of COVID-19's influence on these sustainability domains could help with future public health programming during significant public health events and emergency preparedness. ClinicalTrials.gov Identifier: NCT03598114. Registration date: Retrospectively registered 02-07-2018. [ABSTRACT FROM AUTHOR]

Disaster events, such as floods, wildfires, and earthquakes, increasingly cause damage to livelihoods, the economy, and the environment. Preparing for disasters is noted as one of the most effective ways to adapt and increase resilience to these events, but research has shown that many people in the United States have not adopted recommended household preparedness actions. Moreso, there is currently no geospatial data set or tool for mapping geographic variation in disaster preparedness behavior, despite the availability of appropriate survey data. Using the Federal Emergency Management Agency National Household Survey from 2017 to 2020, we develop a multilevel regression and poststratification model that provides estimates at the state, county, and zip-code tabulation area scales of several preparedness actions and a general disaster preparedness index. Results show regional and state-level variation among preparedness levels, with the Southeast and Utah being generally more prepared than other regions of the United States. Additionally, we introduce an online interactive mapping tool for these results that practitioners, academics, and the public can use to identify preparedness levels in their area of interest. The outcomes of this study can be used to inform future work in hazard risk assessment and to further develop comparisons between risk perceptions and hazard preparedness. Finally, findings from this study contribute to the suite of geospatial models and methods used to assess the human dimensions of hazard risk and resilience. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study aimed to describe the experiences of nurse leaders during the 1st wave of the COVID-19 pandemic to enhance understanding in preparation for future disasters. BACKGROUND: The COVID-19 pandemic has posed significant challenges to the healthcare system globally. Nurse leaders play an essential part and have a significant impact on the efficacy of disaster management in future emergent situations. METHODS: The parent study conducted interviews with 100 nurses in the United States across specialty areas. This article presents a subgroup analysis of interview data from 13 self-identified nurse leaders. The research team used qualitative descriptive methodology and thematic analysis to identify patterns within the data. RESULTS: Five themes were identified for effective nurse leadership during an emerging pandemic: 1) responsiveness; 2) anticipating needs; 3) care innovations; 4) collaboration; and 5) adaptability. CONCLUSION: Supporting nurse leaders to exhibit effective leadership during periods of crisis is imperative to increase preparedness for future health events, protect population health, and create a pipeline of future nursing leadership. Involving nursing in developing and reforming policy is integral. [ABSTRACT FROM AUTHOR]

This study sought to describe the impact of the COVID-19 pandemic on community pharmacy practice and its workforce. Interviews were conducted with 18 key informants from pharmacy associations and community pharmacists representing chain and independent pharmacy organizations across the United States from January to May 2022. Interview notes were analyzed using a rapid content analysis approach. Four themes resulted: (a) patient care at community pharmacies focused on fulfilling COVID-19 response needs; (b) pharmacists' history as immunizers and scope of practice expansions facilitated COVID-19 response efforts; (c) workforce supply shortages impeded COVID-19 response efforts and contributed to burnout; and (d) maintaining community pharmacy workforce's readiness will be critical to future emergency preparedness and response efforts. Formalizing scope of practice expansion policies and reimbursement pathways deployed during the COVID-19 pandemic could facilitate the community pharmacy workforce's ability to address ongoing public health needs and respond to future public health emergencies. [ABSTRACT FROM AUTHOR]

Throughout the COVID-19 pandemic, public officials in the United States – from the President to governors, mayors, lawmakers, and even school district commissioners – touted unproven treatments for COVID-19 alongside, and sometimes as opposed to, mask and vaccine mandates. Utilising the framework of ‘pharmaceutical messianism’, our article focuses on three such cures – hydroxychloroquine, ivermectin, and monoclonal antibodies – to explore how pharmaceuticals were mobilised within politicised pandemic discourses. Using the states of Utah, Texas, and Florida as illustrative examples, we make the case for paying attention to pharmaceutical messianism at the subnational and local levels, which can very well determine pandemic responses and outcomes in contexts such as the US where subnational governments have wide autonomy. Moreover, we argue that aside from the affordability of the treatments being studied and the heterodox knowledge claiming their efficacy, the widespread uptake of these cures was also informed by popular medical (including immunological) knowledge, pre-existing attitudes toward ‘orthodox’ measures like vaccines and masks, and mistrust toward authorities and institutions identified with the ‘medical establishment’. Taken together, our case studies affirm the recurrent nature of pharmaceutical messianism in times of health crises – while also refining the concept and exposing its limitations. [ABSTRACT FROM AUTHOR]

Integrated healthcare agencies were particularly impacted early on during the COVID-19 pandemic by having to treat infected patients without interventions and vaccines. A phenomenological qualitative approach was taken to examine experiences of social workers in managerial positions handling the pandemic in these agencies. Data were collected before vaccines were authorized for emergency use. Purposive and snowball sampling was used to recruit participants. Data analysis followed a constant comparison strategy. Themes identified included: 1) response to the pandemic with limited information; 2) transition to remote work and telehealth; 3) management of social workers; and 4) preparation for post-pandemic. [ABSTRACT FROM AUTHOR]

Purpose: When emergencies or disasters arise, individuals who use augmentative and alternative communication (AAC) are particularly vulnerable. It is critical that individuals who use AAC are supported to make decisions that impact their own lives and are able to communicate during such a crisis. Preparedness efforts that include a plan around communication needs and supports are necessary for ensuring that individuals who use AAC are able to understand options that ensure personal safety and express their needs during a time of crisis. Method: Qualitative methods were used to identify and describe the experiences of two young adults who use AAC and their caregivers when engaging in person-centered planning intervention sessions to complete the activities of the United States Society for Augmentative and Alternative Communication (USSAAC) emergency/disaster preparedness toolkit. Pre-intervention interviews and subjective, objective, assessment, and plan (SOAP) notes taken after each intervention session were done to describe their preparedness and experiences completing the toolkit. Themes were identified to describe participant experiences and change in their perceived preparedness. Results: Five themes and 18 subthemes emerged from the pre-intervention interviews and the SOAP notes across 14 intervention sessions that captured each participant and their caregiver's awareness of needs, barriers in emergency situations, challenges in completing the toolkit, and actions during person-centered planning with the toolkit (e.g., personalizing communication boards, making a go bag, and scheduling visits with local emergency agencies). Conclusions: This study highlights the need for preparedness activities that are person-centered and account for the communication support needs of individuals who use AAC if faced with an emergency/disaster. Outcomes suggest that these methods were feasible and supported positive change in perceived preparedness in the young adults who used AAC and their caregivers. [ABSTRACT FROM AUTHOR]

School closures during the COVID-19 pandemic compromised access to essential meals for many children. In response, a public/private partnership known as the Emergency Meals-to-You program was established to deliver meals in affected rural areas of the United States. This study builds on this using a scorecard approach adapted from the United Nations Ten Essentials for Making Cities Resilient to identify and prioritize actions for strengthening food system resilience. A pilot food system resilience scorecard facilitated data collection from five workshops with professionals familiar with the program, emergency management, public health, or food systems. Data analysis and interpretation identified nine priority actions. These included integrating the food sector and schools within emergency management, mapping local food sector capacities, working with schools to receive de-identified data about nutritional, allergy and other health needs, developing disaster plans for sustaining food access at the school district level, and protecting ecosystem services and agricultural areas. There is an urgent need to embed the food sector and schools within emergency management. These systems are local, designed to coordinate complicated tasks in crises, multidisciplinary, and are used in many countries. Providing a ready-made framework for locally driven initiatives to strengthen food systems now and into the future. [ABSTRACT FROM AUTHOR]

Introduction: Based on the threat posed by the Asian longhorned beetle (Anoplophora glabripennis Motschulsky), many countries including the United States have adopted policies of eradication. The eradication of infestations that cover hundreds of square kilometers can require multiple visual surveys of millions of individual trees. At these scales, eradication may take several decades and span multiple beetle generations. During this period the infestation of new trees adds spatially-explicit risk to the landscape while surveys and the removal of infested trees reduce it. Methods: To track dynamic risk on the landscape we have developed the Asian Longhorned Beetle Hazard Management and Monitoring Tool. The geospatial tool combines data documenting; the locations, levels of infestation, and dates of detection of infested trees; the locations, methods, and timing of survey and host removal activities; and a reconstruction of beetle movement within the infested landscape to generate annual spatial estimates of infestation risk based on the combination of beetle dispersal and survey and host removal activities. Results: The analyses of three eradication programs highlight similar patterns in risk through time with risk peaking at the time infestations are detected and declining as management activities slow beetle spread and reduce risk through surveys. However, the results also highlight differences in risk reduction among the eradication programs associated with differences in beetle dispersal among infestations and the size of the infested landscape, highlighting the importance of applying local information to structure eradication programs. Discussion: The Asian Longhorned Beetle Hazard Management andMonitoring Tool provides a quantitative repeatable approach to tracking changes in infestation risk using local beetle behavior andmanagement efforts. In addition to this, the tool may provide a structure to optimize eradication efforts by allowingmanagers to estimate expected risk reduction based on proposed survey and host removal strategies. [ABSTRACT FROM AUTHOR]

The article calls for a social work response to climate change. It discusses the environmental and economic impact of climate change. It refers to ecosocial work as a possible intervention that includes advocacy and policy change to reduce greenhouse gas and carbon emissions, community education and awareness, crisis intervention, mental health support and access to resources, community organizing and resilience building, and identifying and securing resources and services.

In the face of anthropogenic climate change, the ability of communities to reduce the heat-health burden remains a significant public health issue. This research is the first to identify cooling centers across the southeastern United States, providing a resource for stakeholders. The study evaluates the spatial relationship of these venues for heat-vulnerable populations. Using a survey and publicly available data, researchers identified 1,433 cooling centers, though significant variability exists across states and local jurisdictions. Of the nine states examined, Tennessee was the only location with a health system–supported cooling center network. Only 36 percent of the Southeast's population lives within a fifteen-minute drive of a cooling center. In most states, less than 10 percent of vulnerable populations (elderly, non-white, below poverty) are within this driveshed. Most cooling centers were found in urban environments, although heat vulnerability is not exclusively a city issue. Further research is needed to strengthen cross-agency collaboration and evaluate the effectiveness of cooling centers in areas of both high and low population density. Some states have integrated heat as part of hazard mitigation plans, but additional research is needed to explore how these plans go beyond hazard identification and strengthen vulnerable communities' ability to mitigate heat risk. [ABSTRACT FROM AUTHOR]

High temporal and spatial resolution precipitation datasets are essential for hydrological and flood modeling to assist water resource management and emergency responses, particularly for small watersheds, such as those in Hawai'i in the United States. Unfortunately, fine temporal (subdaily) and spatial (<1 km) resolutions of rainfall datasets are not always readily available for applications. Radar provides indirect measurements of the rain rate over a large spatial extent with a reasonable temporal resolution, while rain gauges provide "ground truth." There are potential advantages to combining the two, which have not been fully explored in tropical islands. In this study, we applied kriging with external drift (KED) to integrate hourly gauge and radar rainfall into a 250 m × 250 m gridded dataset for the tropical island of O'ahu. The results were validated with leave-one-out cross validation for 18 severe storm events, including five different storm types (e.g., tropical cyclone, cold front, upper-level trough, kona low, and a mix of upper-level trough and kona low), and different rainfall structures (e.g., stratiform and convective). KED-merged rainfall estimates outperformed both the radar-only and gauge-only datasets by 1) reducing the error from radar rainfall and 2) improving the underestimation issues from gauge rainfall, especially during convective rainfall. We confirmed the KED method can be used to merge radar with gauge data to generate reliable rainfall estimates, particularly for storm events, on mountainous tropical islands. In addition, KED rainfall estimates were consistently more accurate in depicting spatial distribution and maximum rainfall value within various storm types and rainfall structures. Significance Statement: The results of this study show the effectiveness of utilizing kriging with external drift (KED) in merging gauge and radar rainfall data to produce highly accurate, reliable rainfall estimates in mountainous tropical regions, such as O'ahu. The validated KED dataset, with its high temporal and spatial resolutions, offers a valuable resource for various types of rainfall-related research, particularly for extreme weather response and rainfall intensity analyses in Hawai'i. Our findings improve the accuracy of rainfall estimates and contribute to a deeper understanding of the performance of various rainfall estimation methods under different storm types and rainfall structures in a mountainous tropical setting. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To estimate excess health care costs in the 12 months following COVID-19 diagnosis. STUDY DESIGN: Retrospective cohort study using Blue Cross Blue Shield of Rhode Island claims incurred from January 1, 2019, to March 31, 2022, among commercial and Medicare Advantage members. METHODS: Difference-in-differences analyses were used to compare changes in health care spend between the 12 months before (baseline period) and the 12 months after (post period) COVID-19 diagnosis for COVID-19 cases and contemporaneous matched controls without COVID-19. RESULTS: Overall, there were 7224 commercial and 1630 Medicare Advantage members with a COVID-19 diagnosis on/before March 31, 2021, each with a matched control, yielding a sample of 14,448 commercial and 3260 Medicare Advantage members. Among commercial members, 51.9% were aged 25 to 54 years and 54.0% were female. Among Medicare Advantage members, 94.2% were 65 years or older and 62.0% were female. Among commercial members, from the baseline period to the post period, total health care spend increased $41.61 (7.7%) per member per month (PMPM) more among COVID-19 cases compared with their matched controls. Among Medicare Advantage members, the difference-in-differences was greater, with spend increasing $97.30 (13.1%) PMPM more among cases compared with controls. The difference-in-differences was greatest for outpatient and professional services (both populations) and prescription services (Medicare Advantage only). CONCLUSIONS: COVID-19 diagnosis was associated with excess health care spend PMPM over the subsequent 12 months, highlighting the importance of societal preparations to support individuals' long-term health care needs following COVID-19 and as a part of future pandemic preparedness. [ABSTRACT FROM AUTHOR]

Objective: To compare mortality trends in patients requiring Extracorporeal Membrane Oxygenation (ECMO) support between the first quarters of 2019 and 2020 and determine whether these trends might have predicted the severe acute respiratory syndrome coronavirus-2 (SARS)-Cov-2 pandemic in the United States. Methods: We analyzed 5% Medicare claims data at aggregate, state, hospital, and encounter levels using MS-DRG (Medicare Severity-Diagnosis Related Group) codes for ECMO, combining state-level data with national census data. Necessity and sufficiency relations associated with change in mortality between the 2 years were modeled using qualitative comparative analysis (QCA). Multilevel, generalized linear modeling was used to evaluate mortality trends. Results: Based on state-level data, there was a 3.36% increase in mortality between 2019 and 2020. Necessity and sufficiency evaluation of aggregate data at state and institutional levels did not identify any association or combinations of risk factors associated with this increase in mortality. However, multilevel and generalized linear models using disaggregated patient-level data to evaluate institution mortality and patient death, identified statistically significant differences between the first (p =.019) and second (p =.02) months of the 2 years, the first and second quarters (p <.001 and p =.042, respectively), and the first 6 months (p <.001) of 2019 and 2020. Conclusion: Mortality in ECMO patients increased significantly during the first quarter of 2020 and may have served as an early warning of the SARS-Cov-2 pandemic. Granular data shared in real-time may be used to better predict public health threats. [ABSTRACT FROM AUTHOR]

Limited research on food systems and food insecurity (FI) following disasters finds contextual differences in post-disaster food systems that shape dimensions of FI. Measurement limitations make it difficult to address FI and develop effective practices for disaster-affected communities. To develop, validate, and test a Disaster Food Security Framework (DFSF). Mixed-methods approach was used, including in-depth interviews to understand lived experiences during disasters; expert panel input to validate DFSF designed using responses from in-depth interviews; and quantitative testing of robustness of DFSF using the coronavirus disease 2019 pandemic as a disaster example. The in-depth interviews included participants from Vermont (n = 5), North Carolina (n = 3), and Oklahoma (n = 2) who had been living in those states during Hurricane Irene (2011), Hurricane Florence (2018), the Moore tornadoes (2013), and coronavirus disease 2019 pandemic (2020). The expert panel consisted of researchers and practitioners from different US geographical regions and food-related disciplines (n = 18). For the quantitative testing survey, data from 4 US states (New York, New Mexico, Vermont, and Maryland; n = 3,228) from the National Food Access and COVID Research Team was used. The outcomes from the in-depth interviews were dimensions of disaster FI, those from the expert panel was a content validity ratio, and those from the quantitative testing was the number of items and components to be included. Inductive and deductive reasoning were using when reporting on the in-depth interviews and expert panel results, including frequencies. The quantitative testing was conducted using multiple correspondence analysis. The in-depth interviews revealed four dimensions of FI: availability (supply and donation), accessibility (economic, physical, and social), acceptability (preference and health), and agency (infrastructure and self-efficacy). The panel of experts reported high content validity for the DFSF and its dimensions (content validity ratio >0.42), thus giving higher credibility to the DFSF. Multiple correspondence analysis performed on 25 food-related variables identified one component with 13 indicators representing three of the four dimensions: availability, acceptability, and accessibility, but not agency. [ABSTRACT FROM AUTHOR]

The U. S. Department of Homeland Security launched the Ready public service campaign in 2003 to educate and provide the resources for the American people to prepare, respond, and mitigate emergencies and disasters. The web site provides tools for creating an emergency plan, and ways to stay informed and get involved in community preparedness. The goal of the web site and the campaign is to utilize public involvement to ease and lesson the affects of an emergency or disaster. [ABSTRACT FROM AUTHOR]

How to enhance community resilience to natural disasters is a major question for researchers and policymakers. Although researchers agree that sport generates community benefits, few scholarly efforts in sport management have been invested in understanding the sport–resilience association. This paper attempted to address whether and how sport clusters—the clustering of sport industries—are associated with community resilience across locations. To achieve this, geographically weighted regression and visualization techniques were applied to macro-level data regarding community resilience and the clustering of 13 separate sport industries across 3,108 counties in the contiguous United States. The results indicate that, overall, the clustering of eight sport industries was significantly associated with community resilience and demonstrates the existence of spatially heterogeneous associations in magnitudes and signs of community resilience in sport clusters. The findings of this paper have the potential to help community sport scholars and policymakers implement location-specific resilience policies through sport industry development. [ABSTRACT FROM AUTHOR]

Disasters have always occurred in libraires, generally confined to regional areas, or singular buildings. However, COVID-19 has affected libraries across the globe. This research looks at the effect COVID-19 had on libraries' in the United States disaster planning. It seeks to understand if disaster plans were created in preparation or created in response to a disaster. This research showed that even as the COVID-19 pandemic continued, libraries were beginning to discuss revising their disaster plans to reflect the lessons learned. However, it is too soon to know the lasting impact that the pandemic will have on disaster planning in libraries. [ABSTRACT FROM AUTHOR]

The manuscript reports the results of a study that explored what facilitates and hinders local emergency management program pursuit of accreditation by the Emergency Management Accreditation Program (EMAP). This research question is of significance for several reasons, including, (1) leading national emergency management organizations have endorsed The Emergency Management Standard promulgated by EMAP; (2) very few programs are accredited; and, (3) there are only two studies related to accreditation in emergency management and neither examines accreditation in a local context. Analysis of semi-structured interview data from local emergency management program leaders representing some of the largest municipalities in the United States revealed a variety of key themes regarding what facilitates or hinders accreditation pursuit. The complexity of these themes and the context which produces them suggests that widespread accreditation at the local level is not likely in the near future even though many leaders valued the Standard and accreditation. This conclusion is discussed and a variety of avenues that might be pursued if more accreditation of local programs were the goal is offered. [ABSTRACT FROM AUTHOR]

Strategic planning is a critical element in the strategic management of any public organization, including local emergency management agencies (EMAs). However, while the importance of strategic planning in emergency management is well founded, even codified in the national standards, little is known empirically about its actual use, and even less is known about the impacts of the planning process on local programs. As such, this study examined the strategic planning practices of county-level EMAs throughout the United States, focusing on the strategic planning process and its underlying dimensions. A composite index for strategic planning comprehensiveness was developed, based on five planning process dimensions, and then analyzed to gauge its relative impacts on local program quality. The findings revealed that the strategic planning process had a direct and significant impact on the quality of local emergency management programs, with the regression model explaining about 60 % of the variance in the local program quality index scores. [ABSTRACT FROM AUTHOR]

During April 30-August 4, 2023, smoke originating from wildfires in Canada affected most of the contiguous United States. CDC used National Syndromic Surveillance Program data to assess numbers and percentages of asthma-associated emergency department (ED) visits on days with wildfire smoke, compared with days without wildfire smoke. Wildfire smoke days were defined as days when concentrations of particulate matter (particles generally ≤2.5 μm in aerodynamic diameter) (PM2.5) triggered an Air Quality Index ≥101, corresponding to the air quality categorization, "Unhealthy for Sensitive Groups." Changes in asthma-associated ED visits were assessed across U.S. Department of Health and Human Services regions and by age. Overall, asthma-associated ED visits were 17% higher than expected during the 19 days with wildfire smoke that occurred during the study period; larger increases were observed in regions that experienced higher numbers of continuous wildfire smoke days and among persons aged 5-17 and 18-64 years. These results can help guide emergency response planning and public health communication strategies, especially in U.S. regions where wildfire smoke exposure was previously uncommon. [ABSTRACT FROM AUTHOR]

Introduction: We sought to examine the practice patterns of pain management in the emergency room (ER) for renal colic and the impact of opioid prescriptions on return ER visits and persistent opioid use. Methods: TriNetX is a collaborative research enterprise that collects real-time data from multiple health care organizations within the United States. The Research Network obtains data from electronic medical records and the Diamond Network provides claims data. We queried the Research Network for adults who visited the ER for urolithiasis, stratified by receipt of oral opioid prescriptions, to calculate the risk ratio (RR) of patients returning to the ER within 14 days and persistent opioid use ≥6 months from the initial visit. Propensity score matching was performed to control for confounders. The analysis was repeated in the Diamond Network as a validation cohort. Results: There were 255,447 patients in the research network who visited the ER for urolithiasis, of whom 75,405 (29.5%) were prescribed oral opioids. Black patients were less likely to receive opioid prescriptions than other races (p < 0.001). After propensity score matching, patients who were prescribed opioids had an increased risk of a return ER visit (RR 1.25, confidence interval [95% CI] 1.22–1.29, p < 0.001) and persistent opioid use (RR 1.12, 95% CI 1.11–1.14, p < 0.001) compared with patients who were not prescribed opioids. These findings were confirmed in the validation cohort. Conclusions: A significant proportion of patients presenting to the ER for urolithiasis receive opioid prescriptions, which carries a markedly increased risk of return ER visits and long-term opioid use. [ABSTRACT FROM AUTHOR]

This study investigates characteristics and trends of children <18 years old treated in United States emergency departments (EDs) for consumer product-related eye injuries. Data from the National Electronic Injury Surveillance System for January 1, 1997 through December 31, 2019 were analyzed. During the 23-year study period, an estimated 1,453,283 children were treated for consumer product-related eye injuries, averaging 63,186 children annually. Overall, the eye injury rate per 100,000 children <18 years old increased initially from 82.64 in 1997 to 104.53 in 2001 (p =.0492) and then decreased by 32.1% to 70.95 in 2019 (p <.0001). Almost two-thirds (64.5%) were boys and 32.1% were <5 years old. Overall, 2.6% of patients were admitted, but injuries involving non-powder firearms and golf had the highest admission rates (18.8% and 14.7%, respectively). Compared with other product categories, children were more frequently admitted if they had an eye injury associated with non-powder firearms (18.8% admitted; OR: 10.92, 95% CI: 8.67–13.76) or golf (14.7% admitted; OR: 6.59, 95% CI: 3.51–12.34). Contact with a non-chemical product was the leading mechanism of eye injury in all age groups, except children <5 years old, in which the leading mechanism was contact with a chemical product (34.2%). Corneal abrasion (36.5% overall) was the most frequent diagnosis across all age groups. Although the rate of consumer product-related pediatric eye injuries treated in US EDs has decreased since 2001, these injuries remain common among children. Therefore, increased prevention efforts are needed. [ABSTRACT FROM AUTHOR]

Background Despite research on large urban areas in the context of COVID-19, evidence on how these settings impact migrants is still limited. Objective To explore exacerbating and mitigating factors of large urban areas on migrants' vulnerabilities during the COVID-19 pandemic. Methods We conducted a systematic review of peer-reviewed studies published between 2020 and 2022, focused on migrants (foreign-born individuals who have not been naturalized in the host country, regardless of legal immigration status) in urban areas with a population >500 000. After screening 880 studies, 29 studies were included and categorized within the following thematic framework: (i) pre-existing inequities, (ii) governance strategies, (iii) urban design and (iv) engagement of civil society organizations (CSOs). Results Exacerbating factors include pre-existing inequities (e.g. unemployment, financial instability and barriers to healthcare access), exclusionary government responses (e.g. ineligibility for relief funds or unemployment benefits) and residential segregation. Mitigating community-level factors include the engagement of CSOs to fill institutional and governmental gaps through service provision and use of technology. Conclusions We recommend increased attention to pre-existing structural inequities faced by migrants, more inclusive governance strategies and partnerships between government and CSOs to improve the design and delivery of services to migrants in large urban areas. More research is needed on how urban design can be utilized to mitigate COVID-19 impacts on migrant communities. The factors identified in this systematic review should be considered as part of migrant-inclusive emergency preparedness strategies to address the disproportionate impact of health crises on migrant communities. [ABSTRACT FROM AUTHOR]

In the past 20 years of the Global War on Terror, the US has seen substantial improvements in its system of medical delivery in combat. However, throughout that conflict, enemy forces did not have parity with the weaponry, capability, or personnel of the US and allied forces. War against countries like China and Russia, who are considered near-peer adversaries in terms of capabilities, will challenge battlefield medical care in many different ways. This article reviews the experience of a medical team, Global Surgical and Medical Support Group, that has been providing assistance, training, medical support, and surgical support to Ukraine since the Russian invasion began in February 2022. The team has extensive experience in medicine, surgery, austere environments, conflict zones, and building partner nation capacities. This article compares and contrasts the healthcare systems of this war against the systems used during the Global War on Terror. The lessons learned here could help the US anticipate challenges and successfully plan for the provision of medical care in a future conflict against an adversary with capabilities close to its own. [ABSTRACT FROM AUTHOR]

This research sought to identify differences in perceived stress and personal resilience across gender, race, and different types of stressors (such as rent or mortgage stress) among a sample of United States residents experiencing the COVID‐19 pandemic. It used a cross‐sectional, convenience sampling design for primary survey data collected over 10 weeks starting in April 2020 (n=374). Independent t‐tests and binary logistic regression were performed to determine statistically significant differences between gender and race for perceived stress and personal resilience and to pinpoint key contributing factors. Results indicate women exhibited higher levels of stress, with non‐IPV (intimate partner violence) reporting women evidencing higher levels of resilience than IPV reporting women. Racial minority women were more likely to experience nutritional stress, whereas White women were more likely to worry about rent or mortgage stress. These findings provide insight into disparate impacts across vulnerable populations at the start of a crisis with implications for improving pre‐ and post‐disaster interventions. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic illuminated shortcomings in the ability of community hospitals in the United States to respond to crises of this nature. This has led to questions about the effectiveness of community hospital disaster preparedness. A study of hospital preparedness in New York State in 2017 revealed a number of barriers to preparedness. Among the most significant are economic barriers, given that disaster preparedness is not a reimbursable cost like patient care. The economic challenges have been exacerbated by a decline in federal disaster preparedness funding in recent years. Reflecting on previous writings, the author provides several options for overcoming these barriers to ensure hospitals are better prepared for future disasters. [ABSTRACT FROM AUTHOR]

Recent scholarship has explored the impact of interest groups on policy in the United States. However, little remains known about lobbying efforts and their effects in emergency management. Through analysis of a large data set of declared political activities from 1999 to 2020, we describe lobbying efforts in disaster planning and emergencies. Our findings suggest that lobbying efforts and expenditure are positively associated with appropriations (but not disaster incidence or severity), that corporations and trade associations are the organizations most involved in lobbying and that many of these efforts appear to be aimed at impacting legislation and the procurement of public funds for recovery efforts. We also find that only a minuscule number of lobbying efforts are related to socially vulnerable populations or social equity concerns. Collectively, these insights raise important questions about this process, demonstrating the need for further research to better understand lobbying and emergency management in the United States across all phases of the disaster life cycle. [ABSTRACT FROM AUTHOR]

During times of a pandemic, government emergency response webpages are an important communication channel and if properly managed, will mitigate pandemic impacts. Guided by the Crisis and Emergency Risk Communication (CERC) framework and web interactivity literature, this study examined the information content and interactivity of U.S. state governments' COVID-19 homepages when many states declared stay-at-home orders in March or April of 2020. Using a web archive service, we retrieved 48 state governments' COVID-19 homepages. Three coders coded these pages for the presence or absence of information content on five dimensions (timely updates, sensemaking information, efficacy information, targeted guidance, and anti-stigma communication) and interactivity on four dimensions (accessibility, navigability, media richness, and engagement). Results revealed that a large proportion of state governments' COVID-19 homepages provided timely information facilitating people's understanding of the pandemic. Yet, there were some information gaps regarding how to cope with the pandemic or its related problems, such as mental stress and social discrimination. While many COVID-19 homepages allowed easy navigation, page engagement and accessibility seemed inadequate. U.S. state governments' COVID-19 homepages could be a good source for sensemaking. Practitioners and researchers should explore how to better harness interactive Internet technologies and present information that fosters people's efficacy to manage through the pandemic. [ABSTRACT FROM AUTHOR]

The article reports on the evaluation of national COVID-19 surveillance data sources and indicators in the U.S. to ensure continuous monitoring of cases after the expiration of the public health emergency declaration on May 11, 2023. Other topics include how the data sources can help in the monitoring of the impact of the prevention and control strategies against COVID-19 to public health.

Emotions are touchstones of humans' everyday life experiences. Maps of emotions inform a variety of research from urban planning and disaster response to marketing studies. Emotions are most often shown on maps with colors. Previous research suggests that humans have subjective associations between colors and emotions that impact objective task performance. Thus, a mismatch between the emotion associated with a color and the emotion it represents may bias the viewer's attention, perception, and understanding of the map. There are no guidelines that can help cartographers and designers choose matching colors to display spatial emotional data. This study aimed to address this gap by suggesting cognitively congruent color palettes-color sets matched to emotions in a way that is aligned with color-emotion associations. To obtain the set of candidate congruent colors and identify appropriate color-to-emotion assignments, two user experiments were conducted with participants in the United States. In the first, participants picked a representative color for 23 discrete emotions. In the second experiment, for each candidate color from a set derived from the results of the first experiment, participants selected the best-matching emotions. The probability of the emotion being selected served as a measure of how representative the color is of that emotion. Due to the many-to-many nature of associations between colors and emotions, suitable color choices were incorporated into a dynamic palette generation tool. This tool solves the color assignment problem and produces a suitable color palette depending on the combination of selected emotions. [ABSTRACT FROM AUTHOR]

Objectives. To examine commonalities and gaps in the content of local US heat action plans (HAPs) designed to decrease the adverse health effects of extreme heat. Methods. We used content analysis to identify common strategies and gaps in extreme heat preparedness among written HAPs in the United States from jurisdictions that serve municipalities with more than 200 000 residents. We reviewed, coded, and analyzed plans to assess the prevalence of key components and strategies. Results. All 21 plans evaluated incorporated data on activation triggers, heat health messaging and risk communication, cooling centers, surveillance activities, and agency coordination, and 95% incorporated information on outreach to at-risk populations. Gaps existed in the specific applications of these broad strategies. Conclusions. Practice-based recommendations as well as future areas of research should focus on increasing targeted strategies for at-risk individuals and expanding the use of surveillance data outside of situational awareness. (Am J Public Health. 2023;113(5):559–567. https://doi.org/10.2105/AJPH.2022.307217) [ABSTRACT FROM AUTHOR]

The emergence of COVID-19 pandemic has had significant impacts on human lives as well as economic and social stability. The United States has a complicated history with biosecurity. The September 11th terror attacks uncovered various weaknesses in the national biosecurity infrastructure that have persisted into the current pandemic. This study explores the implications of framing the infectious disease biothreat as a security threat to improve our capabilities while protecting against the potential accelerated threat of bioterrorism in the post-COVID-19 era. To counter the increasing biothreats, the United States must invest in revamping the biodefense infrastructure to increase our resilience to various biothreats. [ABSTRACT FROM AUTHOR]

With climate change and the resulting rise in temperatures, wildfire risk is increasing all over the world, particularly in the Western United States. Communities in wildland–urban interface (WUI) areas are at the greatest risk of fire. Such fires cause mass evacuations and can result in traffic congestion, endangering the lives of both citizens and first responders. While existing wildfire evacuation research focuses on social science surveys and fire spread modeling, they lack data on traffic operations during such incidents. Additionally, traditional traffic data collection methods are unable to gather large sets of data on historical wildfire events. However, the recent availability of connected vehicle (CV) data containing lane-level precision historical vehicle movement data has enabled researchers to assess traffic operational performance at the region and timeframe of interest. To address this gap, this study utilized a CV dataset to analyze traffic operations during a short-notice evacuation event caused by a wildfire, demonstrating that the CV dataset is an effective tool for accurately assessing traffic delays and overall traffic operation conditions during the selected fire incident. The findings also showed that the selected CV dataset provides high temporal coverage and similar travel time estimates as compared to an alternate method of travel time estimation. The study thus emphasized the importance of utilizing advanced technologies, such as CV data, to develop effective evacuation strategies and improve emergency management. [ABSTRACT FROM AUTHOR]

The American Public Health Association (APHA) and prominent U.S. health organizations have acknowledged racism as a central cause of health inequality. In the midst of the COVID-19 pandemic, the U.S. confronts an additional public health crisis: mass impairment from Long COVID. Occupational segregation and institutionalized racism have made working-class Black, Indigenous, and people of color (BIPOC) more likely to experience Long COVID. Medical gatekeepers also prevent equal access to health: BIPOC face more obstacles in their search for disability accommodations and social support. To provide health equity to the Long COVID community, Disability Studies must confront racialized understandings of chronic pain and the consequences of these meanings by centering the lived experiences of BIPOC living with chronic pain. [ABSTRACT FROM AUTHOR]

When the coronavirus pandemic struck the United States, the country demonstrated significant shortfalls in preparedness and response. Diagnostic testing came late and was inadequate. Desperate for ventilators and personal protective equipment, states were thrust into a chaotic competition over the limited supplies. The network of federal, state, and local officials who had trained together on how to respond to a pandemic was torn as the Trump administration created the Coronavirus Task Force. And to top it off, the federal government had failed for decades to develop an efficient and well-resourced biodefense system to monitor and respond to biological threats like a pandemic virus. [ABSTRACT FROM AUTHOR]

In 2020, an estimated 424,300 youth were arrested and nearly 128,000 youth were detained in the United States, with disproportionately higher rates for minoritized youth when compared to White youth.1 Although the number of youth in detention facilities has decreased since the late 1990s, a staggering number of children and adolescents enter the justice system each year. This remains a critical issue for child and adolescent psychiatrists. By the time youth enter juvenile detention, individual mental health needs are already exceptionally high. [ABSTRACT FROM AUTHOR]

Illicit opioids, consisting largely of fentanyl, novel synthetic opioids, and adulterants, are the primary cause of drug overdose fatality in the United States. Xylazine, an alpha-2 adrenergic agonist and veterinary tranquilizer, is being increasingly detected among decedents following illicit opioid overdose. Clinical outcomes in non-fatal overdose involving xylazine are unexplored. Therefore, among emergency department patients with illicit opioid overdose, we evaluated clinical outcome differences for patients with and without xylazine exposures. This multicenter, prospective cohort study enrolled adult patients with opioid overdose who presented to one of nine United States emergency departments between 21 September 2020, and 17 August 2021. Patients with opioid overdose were screened and included if they tested positive for an illicit opioid (heroin, fentanyl, fentanyl analog, or novel synthetic opioid) or xylazine. Patient serum was analyzed via liquid chromatography quadrupole time-of-flight mass spectroscopy to detect current illicit opioids, novel synthetic opioids, xylazine and adulterants. Overdose severity surrogate outcomes were: (a) cardiac arrest requiring cardiopulmonary resuscitation (primary); and (b) coma within 4 h of arrival (secondary). Three hundred and twenty-one patients met inclusion criteria: 90 tested positive for xylazine and 231 were negative. The primary outcome occurred in 37 patients, and the secondary outcome occurred in 111 patients. Using multivariable regression analysis, patients positive for xylazine had significantly lower adjusted odds of cardiac arrest (adjusted OR 0.30, 95% CI 0.10–0.92) and coma (adjusted OR 0.52, 95% CI 0.29–0.94). In this large multicenter cohort, cardiac arrest and coma in emergency department patients with illicit opioid overdose were significantly less severe in those testing positive for xylazine. [ABSTRACT FROM AUTHOR]

Flooding causes more financial and physical destruction in the United States than any other natural hazard. To stem flood losses, local floodplain managers make decisions on how best to mitigate, prepare, and respond to flood hazards. Using quantitative and qualitative data gathered from interviews with 200 floodplain managers in the United States, this study explores the extent to which local communities are concerned about floods, perceptions of communities' ability to mitigate, prepare, and respond to floods, as well as the factors contributing to communities' perceptions of their ability to mitigate, prepare, and respond to floods. Findings indicate that floodplain managers generally perceived their communities to be very or somewhat concerned and prepared for floods. Floodplain managers also perceived their communities' ability to mitigate and respond to floods as being good. Lastly, the findings show that participation in the Federal Emergency Management Agency's Community Rating System was positively associated with floodplain managers' perceptions of their community's ability to mitigate, prepare, and respond to floods. [ABSTRACT FROM AUTHOR]

Objective: Public Health Reports (PHR) is the oldest public health journal in the United States and has reported on viral epidemics since the 19th century. We describe the creation and analysis of a collection of historic PHR articles on emerging viral epidemics in the United States to inform public health response to COVID-19 and future epidemics. Methods: We searched databases from 1878 through 2021 using custom search strings and conducted a manual search for articles published under previously used names for PHR. We evaluated all articles based on inclusion/exclusion criteria and coded the final list for virus/disease, article type, public health emergency preparedness and response capabilities from the Centers for Disease Control and Prevention (CDC), and PubMed citation count. Results: We identified 349 relevant articles including 130 commentaries/reviews/editorials, 79 epidemiologic reports, 75 research articles, and 65 case study/practice articles. The collection focused on influenza (n = 244), COVID-19 (n = 75), dengue (n = 14), and other emerging viruses, such as Zika and Ebola (n = 25). The collection included 48 articles on health disparities/health of various disadvantaged populations, highlighting such disparities as race and ethnicity (n = 22), socioeconomic status (n = 17), and age (n = 15). When we categorized articles by CDC public health emergency preparedness and response capabilities, we found that 207 addressed surveillance and epidemiologic investigation, 36 addressed community preparedness, and 28 addressed medical countermeasure dispensing and administration. The articles addressing surveillance and epidemiologic investigation, nonpharmaceutical interventions, and community preparedness had the most PubMed citations (799, 334, and 308, respectively). Conclusions: PHR 's historic articles on US emerging viral epidemics covered a range of virus/disease types, emergency preparedness and response capabilities, and contribution types and were widely cited in the scholarly literature. This publicly available and continuously updated collection is a valuable resource for pandemic planning and response. [ABSTRACT FROM AUTHOR]