Anticipating and planning for the urgent response to large-scale disasters is critical to increase the probability of survival in these events. These incidents present various challenges that complicate the response, such as unfavorable weather conditions, difficulties in accessing affected areas, and the geographical spread of the victims. Furthermore, local socioeconomic factors such as insufficient prevention education, limited disaster assets, and inadequate coordination between public and private emergency services may complicate these situations. In large-scale emergencies, multiple hotspots are usually observed, which requires efforts to coordinate the strategic allocation of human and material resources in different geographical areas. Therefore, the precise management of these resources based on the specific needs of each area becomes fundamental. To address these complexities, this paper proposes a methodology that models these scenarios as an optimization problem, focusing on the location and allocation of resources in mass casualty incidents. The proposed case study is Mexico City in a post-earthquake scenario, using voluntary geographic information, open government data, and historical data from the September 19, 2017 earthquake. Additionally, it is assumed that the resources that require optimal location and allocation are ambulances, which focus on medical issues that affect the survival of victims. The designed solution involves the use of a metaheuristic optimization technique, along with a parameter tuning technique, to find configurations that perform at different instances of the problem, i.e., different hypothetical scenarios that can be used as a reference for future possible situations. Finally, the objective is to present the different solutions graphically, accompanied by relevant information to facilitate the decision-making process of the authorities responsible for the practical implementation of these solutions.

Background: To investigate any associations between new clinical policies implemented because of the COVID-19 pandemic and harm to patients. Methods: Retrospective data collection of incidents and complaints reported through Datix®, and the Patient Liaison Service respectively. The setting was the Family Health division in a University teaching hospital in the UK. Primary and secondary outcome measures included; Proportion of incidents reported on Datix from 23/3/20 to 25/5/20, compared to the period from 23/3/19 to 29/5/19. COVID-19 related incidents and complaints and association with newly published guidelines or pathways from 23/3/20 to 29/5/20. Results: There was no significant difference in the proportion of overall patient activity resulting in incidents reported on Datix in 2020 (2.08%) compared to 2019 (2.09%), with 98% resulting in no/low harm in 2020. Three incident categories had increases in relative proportions of incidents including terms “COVID” or “Corona” compared to incidents that did not; “Child death”, “delay/failure to treatment and procedure” and “information governance”. One of the child deaths was a miscarriage and we were unable to link the second child death to a change in clinical policy at this stage. We were only able to link 2 COVID-19 associated incidents with a pathway or procedural change (one to the Children's Emergency Department admission pathway and the second to the introduction of virtual antenatal clinics). Eighteen complaints related to COVID-19 were logged. However, at this stage, we are unable to link any of these to a published change in clinical policy. Conclusions: Practice in the division was overall deemed to be safe in the designated period, with only 2 COVID-19 related incidents clearly related to a change in pathways and procedures. Continued surveillance and improved metrics for monitoring the impact of changes to pathways and procedures should be sought with the sustained presence of COVID-19 in clinical areas.

With the global outbreak of COVID-19, the panic buying incidents triggered by the variants of the Omicron strain have severely affected the normal social order. This paper considers the complex interest game and interactive relationship among multiple subjects in the mass panic buying event caused by rumors and constructs a three-party evolution game model of local government, rumor-monger, and public. Based on the theory of evolution game, the evolutionary process of the strategy selection of game subjects is studied, and the strategy selection of the three-game subjects under different scenarios is compared and analyzed. Taking the example of the montmorillonite powder panic buying caused by the XBB virus strain rumor in China, the evolutionary game model constructed in this study is simulated and analyzed. The study shows that: the evolution process of the mass panic buying event is characterized by six stages: the initial stage E1(0,0,0); the outbreak stage E3(0,1,0);the spread stage E7(0,1,1);the climax stage E8(1,1,1);the relief stage E5(1,1,0);and the recovery stage E4(1,0,0); there are four stable points in the evolutionary game of the three game subjects, namely (no intervention, no rumor, no panic buying), (no intervention, rumor, no panic buying), (intervention, no rumor, no panic buying), and (intervention, rumor, no panic buying), and the strategy of government intervention will be adjusted according to the strategy selection of the public and the rumor-monger; under the mechanism of reward and punishment of the higher-level government, increasing the punishment and reward intensity of the higher-level government will promote the local government to intervene in the rumor-mongering event faster, but increasing the reward intensity has a more significant impact on the intervention behavior of the local government than punishment, and increasing punishment intensity has a more significant impact on the non-rumor-mongering behavior of the rumor-monger than reward; the parameters of social risk-bearing cost, risk transmission coefficient, rumor-mongering income and cost, and public drug purchase cost have different degrees of influence on the evolutionary behavior of game subjects. This study provides new ideas for effectively responding to mass panic buying events in the context of public emergencies.

Nurses and paramedics play a pivotal role when Mass Casualty Incidents (MCI) occur, yet they often feel unprepared for such events. Implementation strategies for training activities, including Virtual Reality (VR) and Augmented Reality (AR) simulations, offer realistic and immersive learning experiences, enhancing skills and competencies for nursing students. The aim of this work was to investigate the adopted tools in studies on VR&AR simulations for training nursing and paramedic students in managing MCI. A scoping review was performed following the PRISMA-ScR statement, and the search strategy was conducted through five electronic databases from December 2022 to March 2023. Of 162 records identified, 27 full-text were screened and, six studies were included in this review. These studies involved students who were assigned to different training methods, including immersive VR simulation, written instruction, and traditional lecture. VR&AR and immersive simulation generally show promising evidences in enhancing practical skills and knowledge in MCI management. VR&AR showed to be promising in disaster education and preparedness training, offering different levels of immersiveness and engagement, encouraging active and experential learning. Further research is needed to determine their long-term effectiveness. The choice of training method should consider program goals, target population, and available resources.