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We thank all First Nations delegates in the room today for their contributions to the knowledge in this field. Today we have an impressive lineup of 6 esteemed presenters who will share their insights and research in this field.

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As we proceed with this session. I kindly request the presenters to adhere to the time limits. To ensure a smooth flow I will provide a two-minute warning followed by a one-minute warning and I will have to conclude each presentation at 12 min.

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All questions and remarks should be asked at the end of presentations. So with that being said, let's dive into our first presentation.

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Please join me welcoming our first presenter.

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Turn back here. And then just.

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Right. And I'm going to start my own timer here to be on track. Good afternoon.

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And my name is Tricia Walkendorf. I am a faculty member in the Department of Sociology and Criminal Justice at the University of Delaware.

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I also direct the Disaster Research Center and it's my pleasure to join with you this afternoon to talk a little bit about our findings related to the impacts of COVID.

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19 on Delawareans living with HIV. I want to acknowledge my co-author Nancy Rios Contreras at Chapman University as well as Christopher Thorpe, who's a PhD student in political science at the University of Delaware who helped with the data collection for this project.

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A bit of background and context for those of you who are not familiar with the United States Delaware is the second smallest state in the US.

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And geographically it has about just under a million people and in the context of when we conducted the study in early 2,021.

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60,000 Delawareans have tested positive for Covid-nineteen since the start of the pandemic.

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1,100 people had died from kovat related causes but of course we know that those are under estimates given the fact that testing was not widely available in the early months of the pandemic and not everybody got tested.

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In the summer of 2,020, the disaster research center conducted a broader study looking in Delaware at the impacts of Covid-nineteen.

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The disaster research center conducted a broader study looking in Delaware at the impacts of Covid-nineteen and the Delaware HIV Consortium approached us to do a study to look specifically at the impact of the clients who they serve, specifically Delawareans living with HIV in greatest need for economic and health care assistance.

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Those who qualify for benefits supported by the Ryan White program and I can talk a little bit about more that program in the Q&A if you have questions.

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So this was about we interviewed 55 people. This was about 12% of their client database. We did this by Zoom and telephone interviews.

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The interviews lasted between 30 min and 150 min. It was a semi-structured interview guide and participants received $100 gift card for participating.

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The impacts of people that were affected by Covid-nineteen, many of you are familiar with the research and have even seen some presentations here at the conference.

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I'm not going to go into those broad findings. Most of them apply here for this specific group.

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But I am going to highlight some of the unique experiences that impacted Delawareans living with HIV in more precarious economic circumstances.

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I want to start off with this quote from one of our interviewees highlighting that these decisions were ones that could cost you your life.

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Or someone else's life. People took this seriously. And so a question is, what do participants, who did participants trust regarding Covid-nineteen information.

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Trust was greatest with local leaders as opposed to state or federal leaders, but in particular with their doctors, with their nurses, with their case managers, upon whom they relied on routine care, both before the pandemic and during the pandemic.

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We found that it was therefore critical for these particular individuals to have accurate and up-to-date information that they could pass on.

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It shouldn't have been simply located at a state level or at a federal level. Moreover, there were significant impacts as medical appointments were delayed or canceled, the inability to have in person visits with case managers that also resulted in a delay in providing information or correcting misinformation.

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Some of you who are outside of the United States may not be familiar with Dr. Anthony Fauci, but he played a central role in the American response.

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He was during the pandemic and previously the director of the National Institute of Allergies and Infectious Diseases.

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But he had also served for many years advising presidents on global HIV and AIDS issues.

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He may not have been a household name to many people in the US prior to the pandemic, but the people who we spoke with knew him, knew him really well and trusted the information that he provided because they trusted him as a source of information for HIV.

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And AIDS, that they trusted him to speak to the issues in an accurate way. So the communication that was coming on about Covid-nineteen was also trusted by them.

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Consortium clients had significant economic hardships even before the pandemic occurred. So for an example of the people who we spoke with, 21% of households had 25% of them had household incomes, not individual incomes, but household incomes that were below $10,000 US a year.

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55% of them had household incomes before 20,000 a year and 86% below 40,000 per year and 86% below 40,000 per year.

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So any loss in income, any economic hardship affected these individuals significantly. On top of that, they had additional funds that they needed to expend on cleaning supplies, personal protective equipment, choosing less risky transportation.

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So not taking public transportation because they didn't want the exposure and instead opting for Uber for lift for taxis or paying someone they knew $2030 to transfer them to a medical appointment.

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Economic hardships would have been even greater if not for drawing on savings, receiving extensive support from others in their network, working multiple jobs, sometimes taking on a second job, sometimes taking on a third job, which also of course increased their exposure to others and their chances of contracting H, Covid-nineteen as

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well. As this individual said, everything since March fifteenth has been turned upside down. Various jobs are a stopgap to a slow leaking hole in the boat.

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Receiving assistance from case management and other support organizations was absolutely essential in their survival, particularly for those who were in smaller networks and had fewer people to draw on for support.

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I'm just gonna in the interest of time skip over the challenges here. I can talk about any of those in the Q&A if you have questions that I know otherwise I'm going to go over.

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So most participants reported a strong increase in anxiety, stress, and depression. Many of them had relied on or in need of mental health support before the pandemic and this was much more difficult to accomplish to achieve as in-person opportunities to meet and talk to someone were cancelled and not made available and they did not find that online Zoom group

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meetings did the trick for them. It was not sufficient. So what was really important were the random check-in calls and I say random because the case managers could not always be in touch with them.

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Even when we are sitting up the inner interviews, voicemail boxes were full, people were not able to have their phone connected for a time period.

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But when a case manager was able to check in on another issue. That was sometimes the only communication that they had with somebody who was outside of their household if somebody was in their household at all.

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It was really important for mental health. As this person said, it's scary, you know, because people are dying.

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You know, I had to fight with HIV before and AIDS and I didn't want to have that.

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I didn't know if I would be able to have that fight in me again. That was many years ago.

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I had to fight. I didn't know if I had to fight this battle with Covid-nineteen.

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Many participants reported a deterioration in their physical health. 13% of the people we spoke with reported missing medication during that first period of the pandemic.

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20% reported missing routine HIV lab testing. So these can have really serious consequences for somebody who is HIV positive.

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20% of the immune compromised individuals we spoke with had had close contact with a person diagnosed with Covid-nineteen.

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Many more new people who had fallen seriously ill. A lot of people knew multiple people who had passed away from COVID related causes.

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So it was really important in thinking about their health. This was very much on their mind. Experiences with virtual medical appointments were mixed.

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For some people, this was a great solution. It saved them time. They didn't have to sit in the waiting room.

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They didn't have to take time off work. In order to go to an appointment. It also saved money in terms of transportation and it limited their exposure.

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For others though, this was really challenging. They described that communication was not as good in having discussions with their health care professionals.

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They doubted a physician's ability to really make proper assessment of weight loss, of dehydration of changes in their skin condition over in a virtual environment.

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And for some people, this actually wasn't virtual. They themselves needed to go to a social service organization to get help with the technology to get proper Wi-Fi or connectivity to have a virtual visit.

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So it was virtual for the physician, but it wasn't virtual for them because they were still going somewhere waiting, having that experience.

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In both our larger study as well as in this study, people indicated that they were worried or anxious about kovat.

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But in the HIV study, people really used the word fear and afraid in a way that wasn't used in the earlier study that we conducted.

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They really described us as a life or death situation for them. And for those who they care about. Some research actually suggests that having the motion response, be it anxiousness or even anger can lead people to more information-seeking and protective action adoption.

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But fear is actually not found to be one of those cases. That's very different from what we found.

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We found that for the people who we talked with fear actually primed them to take protective action, be it wearing masks, engaging in avoidance behavior, timing their visits to grocery stores, taking their own supplies with them.

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To clean grocery carts to visit friends and more. As this person said, it's a sacrifice worth taking.

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Protective measures and isolating. Because I'm looking at the light at the end of the tunnel.

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I'm looking at the end of the road and I would rather be here healthy than not.

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Many really made this connection between HIV, the AIDS epidemic as well as with Covid-nineteen and I just want to leave you with with 2 things because I know that I'm out of time.

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Really seeing that this idea of fear being important, remembering their own experiences of people dying of misconception and misinformation, seeing that in the early stages of the COVID pandemic, but also recognizing that the same protective strategies would be helpful.

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We heard over and over again, you know, what's the difference? We're a mask or we're a condom.

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Many people said that. And it also led to this attitude of resilience in the face of another deadly crisis.

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So I will close with this quote. I learned to make do. That's just how I am.

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I've always been myself. My parents threw me out of the house I guess for being gay and all that so I told them you know I'm not going to cry about it I'm going to show these people what I can do.

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I just don't deal with nobody. I'm great. That's why this little thing, the pandemic-related challenges, is a small thing to a giant what I've been through.

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Thank you very much.

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Thank you so much and for our next presenter.

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And then.

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Okay. Alright. Hello, can you hear me? Okay. All right.

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So hi everyone. My name is Ronnie Frazier. I'm a PhD candidate at the University of Delaware.

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And I'm going to present to you about the compound nature of the pandemic and hurricane response.

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Which is the case study of maternal child health. In Louisiana and I worked on this project with Dr.

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Sarah Dion who's a core faculty member at the Disaster Research Center from the University of Delaware.

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To, I'm going to talk to you about why we study maternal and infant issues in disasters.

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Give a brief description about Hurricane Ida and our methodology for the project. Provide key descriptive findings and then how this relates to our other in-progress work.

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So really why do we study maternal child health and disasters? So first specifically pregnant Pregnant and maternal issues, women were who were pregnant or had moderate to severe Covid-nineteen infection were more likely to require a C-section, deliver pre-term diarrhoea on

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time of birth. Lose the pregnancy or have an infant die during the newborn period and then the effects of kovat 19 were part among women of color and women with pre-existing conditions with diabetes is particularly troubling in terms of the pandemic.

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And then we also see issues with maternal child health for her hurricane and storm related areas. So for example, Hurricane Ida.

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They had to evacuate critically ill infants from the NICU. You also see that women are more likely to die in the pandemic and then having multiple to die in the pandemic and then having multiple compound issues in other storm response.

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And so for Hurricane Ida, it made landfall in Louisiana along the coast in 2021 and it had it was a category 4 storm with sustained winds of 150 miles per hour or storm with sustained winds of 150 miles per hour or 241 kilometers per hour or 241 kilometers per hour and it

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had storm surge as high as 241 kilometers per hour and it had storm surge as high as 10 feet and it was particularly important in the history of Louisiana because it was particularly important in the history of Louisiana because it made landfall in the sixteenth and it was particularly important in the history of Louisiana because it made landfall on the sixteenth anniversary of Hurricane

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Katrina. Which was one of the most devastating storms in the United States. Just far.

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So we launched a quantitative Y based survey the Aquatrix after the landfall of Hurricane Ida and we knew systematic social media recruitment methods targeting mother and parenting pages.

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We focused on a wide range of areas that were potentially influenced by the storm in different ways. Whether evacuees or specific direct hits.

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Such as Baton Rouge, New Orleans, Hammond, Panchitula, so along the coast, but also more inland as well.

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And we're looking at birthing and then feeding vaccine decision making and health care access and then decision-making regarding evacuation.

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So the majority of our participants were white. Had a higher bachelor's figure more. We had a range of ages of children that were involved.

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So we had 12 months or older. We also had some that were less than 2 months at the time the survey was taken and we had different styles of infant feeding so breasts had about 25% at the breast only.

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Bottle said, 20% and then solid or complementary foods was 40% which reflects the different ages that we had in the sample.

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So some key findings that we found, we see that most of our respondents relied heavily on social support systems in the United States.

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Whether that be direct direct support from the women, infants and children, the WIC program which in the United States supports infants and women with direct monetary funds to buy food, nutritious food, SNAP, which is supplemental assistance program, which is general where they can access food and then disaster supplemental nutrition assistance which

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is the same as the previous program, but in a disaster. They open up more funds. So a lot of our participants were enrolled in either one or more of these programs relating to the intersectionality.

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So even though a lot of our participants were white and had a bachelor's degree and more we saw there was a lot of issues with intersectionality still with access to food and funding.

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We also found that 98% lost power. 77 lost power for more than 5 days or more.

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Which represents a significant amount of time especially if they had other issues going on. We also had 40% lost potable water and of 70% lost potable water for more than 5 days.

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So for families that are relying on formula feeding, this is particularly of concern because they don't have access to clean water or it's more challenging to get clean and potable water for the formula.

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We also found that 74% relocated or sought shelter due to Hurricane Ida. And 51 had to experience disruptions to childcare, 80% of which lost child care for 5 or more days.

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Again, a suit particular concern because they might not be able to return to work. Or have other return to normal activities.

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And then 40% had lost access or had disrupted access to medical care for themselves. So similar to what Dr.

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Walkendorf mentioned. We had access to OBJI and appointments, pediatrician, pharmacy.

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Some of these children were dealing with problems issues like medical issues prior to this storm and were unable to access care.

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And so some quotes that we pulled out, the fact that it was the Katrina anniversary really messed me up.

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I tested positive before COVID-19 hit before Ida hit and I was unable to shop for last-minute items, stress and the husband was quarantined at the time and a lot of stress in the pregnancy.

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Played a role. And then support groups they weren't able to access a lot of the the groups that they wish they had before.

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And then for infant feeding, we had disruptions and infant feeding so they had to decrease solid foods because they couldn't afford to purchase the items or they didn't have access to the items.

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And then they add to start baby formula due to lack of electricity for pumping and that affected the storm affected their milk supplies which we usually relate to stress.

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And so starting formula again can be a concern in an environment where you don't necessarily have easy access to potable water or you have decreased amounts of potable water available when you have to share it among all of the family unit.

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They're relying on prepackaged and fast food options, which usually can be prolonged for a period of time.

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So affecting the long-term nutritional and healthy healthiness of the child. And then we had families that had comorbidities of

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Face paralysis they had to actually feed in the vehicle because they had to have a pump in order to feed the child due to electricity and then

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And then we saw that affected choices on where they were to evacuate, whether that be friends or family or in Airbnb, they were to evacuate, whether that be friends or family or an Airbnb or family or an Airbnb in this case the Airbnb so they could bring the best milk with

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them and just some things that we are working on now and some policy implications. So we deployed for Hurricane Ian which happened in last year in the Florida in the state of Florida in the United States looking at families and infants with and young children.

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So we're looking at the results for that now and where the policy implications for this work is really to increase better integration between emergency management services and maternal child health which historically have been disparate and separate.

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And then targeted outreach for marginalized communities prior to the storm to talk about safe eating practices during major events.

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And then comprehensive mental health services as we found that it was kind of a secondary afterthought besides the primary health of the child but really long term for the parents that we have worked with.

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It's a big, especially in this case with that being the sixteenth anniversary at the time of landfall was particularly important for the families.

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And just when acknowledge the University of Delaware Research Foundation and thank you.

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Thank you so much and for our next presenter.

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And we've got now.

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Alex who've changed your hair. I know, right? Much better here, I suppose. Yeah.

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Okay, so I'm Tracy and Wu. I'm not edx career again where he's Alex is a better storyteller but I got better visionable glasses.

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So, okay, but you guys are stuck with me for the next 10 min. I'm gonna talk about our project, for the next 10 min. I'm gonna talk about our project, during Hurricane Laura and the COVID.

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19. I'm gonna talk about our project, during Hurricane Laura and the COVID.

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19 issues in emergency management,

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Okay, so, that's the outline of my study and I'm going to talk a little bit about the context setting the contacts and then the approach that we use to talk about this issue and then the findings and the discussion and conclusion.

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Okay, so as you can probably already know that Hurricane Laura happened back in 2,020 during August twentys to August the 20 seventh and that's the track of hurricane Laura from National Hurricane Center and So it is resulting a lot of damage as you can see on the PowerPoints and direct deaths from in

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the states as well and and total indirect as there was 34 people and 26 in Louisiana in 8 in Texas.

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More than half 1 million people were ordered to evacuate in around the Gulf Coast in those 2 states.

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And another thing that was happening during the same time was Covid-nineteen. I'm sure you guys probably know that and at the beginning of August, COVID was actually the peak in those 2 areas in terms of people get infected.

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And then it's in going down but you don't have a Condora is still a major issue during the time.

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So we originally had this idea earlier in 2,020 actually so before the hurricane season our colleagues was we were talking among ourselves so because there was actually a COVID start happening.

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During believe it was April and March in United States and we were like so what is going to happen during the hurricane season if people actually have to evacuate and because the protective action for these 2 very different, hazards are very different.

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Like for COVID you have to social distance, you have to isolate but for your vacation you can never you have to evacuate and go to shelters.

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So that was the spark of interest for our research team. It's a, it's a very big study actually.

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We did a lot of surveys in those 2 areas. And we did the interviews with emergency managers, public health workers and in those 2 areas as well.

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And we also design interviews with our house or survey participant afterwards after they did the survey. So today because of time and many kind of just focus on the findings from images management managers interviews and if we have a little bit time in the end I want to show you guys on our household findings as well but if we don't have you can always

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find me we can talk about that Okay, so we have major 3 research questions how the COVID-19 affect the planning efforts for the hurricane season and how the COVID.

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19 affect their vacation efforts associate with HECK and Laura and how did or COVET.

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19 affect shouting operations in response to Hurricane Laura. And we did some thematic analysis, but we better while we were putting together the paper, we think instead of coding that thing one thing to think 3, we actually told them that time one time 2, time 2, and time one focus on the planning effort and

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time to focus on the evacuation, whatever that was happening on the ground and then time to focus more on the sheltering.

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Issues. So it's, it's portrait study in nature for our interview parts, quantitative.

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Qualitative parts and with the same I structured interviews and during January to July, 2,021 about 6 months after the event and we did purpose of our sampling and conjugate with the snowball sampling as well.

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We eventually, we interviewed 33 public health experts, providers, images managers, shelter managers, etc. And 1619 of them from Texas and 16 of them from Louisiana.

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And of course we did Zone interviews and the interviews will last about 23 to 69 min long and average time for those interviews at 15 min.

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We came in to expect we only have like 30 min in a few time then but they actually go on and on and start talking a lot of stuff that's happened.

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During the time. Okay, and we did the inductive open coding, schematic analysis and that on the On the left side of the PowerPoint we have our interview guide some of the stuff that we covered.

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Okay, so, some of the findings we have here and during a time one planning phase, some major findings that we have here is that remote planning also one that they had to do.

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During COVID. So it's very unlike the previous day vacation planning process. Everybody had to do that remotely and not every single one of them was actually tech savvy.

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Back in the time back in 2,020. And then we start formulate Zoom and everything. So a lot of those guys folks had a little bit of learning curve about how to actually plan this whole thing and how to actually plan this whole thing and how to communicate with each I sayholders about how to communicate with each stakeholders about a vacation

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and and sheltering and stuff. So. So they have some difficulty there for the remote planning.

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And another major thing that we found was that they didn't have any guidance plans at the hand at the time during kovat and hurricane Laura and some of the Texans Texas emergency managers will rely on the Ebola plans they had back in the days but it's a very different situation obviously.

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And something also talk about the FEMA actually had a. A plan for repository disease.

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Planning evacuation in the mid twentys and something we're using that but in large most of them didn't actually had a plan, a guided guidance plan there.

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So they actually kind of have to improvise and make the plans along the way. And in terms of risk information source, as you guys probably remember in the states and other countries as well, the protective action for COVIS keep changing over the time and the risk information also keep changing over the time so a lot of registration there for images and

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managers obviously and all they still try to follow CDC central disease control in United States guidelines but like I say they change a lot during over the times.

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So eventually a lot of them actually try to communicate with their local health experts or county or town health experts but those guys also get stuff from CDC anyways so there was a lot of confusion at the at the beginning during this planning phase.

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So speaking of evacuation when the evacuation was actually happening and they were trying to manage the evacuation.

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Again the remote management is again presented a lot of difficulty for them and some actually try to do some sort of hybrid model like some of the key players actually in the EOC wearing masks and some of the guys who are actually in the home in the office and the home office at some other places and try to zoom in and communicate and

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try to organize things. But as you can see, Zoom is not always perfect. Yeah, sometimes they just offline for some no reason and especially during hurricane evacuation in some of the towns actually have the the sail tower knocked off during the hurricane so there was a lot of difficulties there for them as well.

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And let's see what I have. Oh, this one's very interesting. So a lot of things actually have some sort of wishful thinking even the planning faces and early vacation stage because they were thinking that maybe Kobe will go down and not really presenting the issue in vacation or the hurricane Laura probably just turn to another direction so

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they have a lot of wish for thinking when we are talking to them when they were remembering what happened in early in the evacuation and but inevitably they have to evacuate people.

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There was a lot of, little confusing there or not confusing or, different countries have different stage, some they actually switch to non congregate shelter, the hotels and motels like last minutes to our couple hours before the vacation and sometimes I can a couple of days before the vacation.

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So there was a lot of material improvisation that happened in the underground trying to manage people who we should put them in the bus and how when we evacuate them to different places.

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So doing the sheltering, there were some interesting findings that we have in the interview as well. So let me see.

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So the first one that we hear is The major thing about the sheltering experience for the emergency managers in 2 different areas in Louisiana and Texas is that Texas Texas, Texas, images were mainly very frustrated with what was happening.

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They try to manage your sheltering and buses and all those. And well, okay. And, for Louisiana folks, they were actually quite happy when, when everything was settled.

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So during our interview they were like we we actually get did this we we were very proud of ourselves in Louisiana areas.

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But one thing that we found is in Louisiana they rely a lot of the personal connections between the hotels and the emergency managers and especially in Louisiana areas because it was sudden seriously hit.

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Some of the people actually went there and during that time because of COVID nobody was in the hotel so they were actually quite easy for them to actually manage people to there.

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But in Texas, the problem is in Houston area, they are at the afraid of floods in the previous experience in a hobby of obviously.

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So a lot of them actually have to go all the way to DARs, the place that's where I am right now to to evacuate.

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And with that and Texas use one thing that they call the virtual EOC. It's not like online systems they take your phone system so they have to call somebody and they can actually tell them who which hotel rooms have available rooms they can send people to there.

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So there was a lot of confusing there and there was a first Sunday lunch the system during 2,020.

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During Hurricane Laura so the Texans Texas images were not very happy about that and another thing I have to jump through one thing but I really want to talk about that.

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So in in both areas they presented they were talking about the hard time to actually manage the evades because it's all non-cungary sheltering.

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The evangelicals because it's all non-kungary sheltering. So everybody's in their rooms.

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So there was a lot of non-kungary sheltering. So everybody's in their rooms.

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So there was a lot of happening inside the room so the emergency manager for them is actually very hard for them to actually managing them and also because of social distancing stuff when they try to communicate with them they have to be very creative for example like a slip a piece of paper underneath the table and tell them to do things or things are like

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Reliances arrived or something like that. So there was a lot of difficult time for them to manage in their evacuees.

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And in the Texas guys they also see some of the fraud like people actually count to the sheltering count of dollars.

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During the weekends and then during the weekdays I went back to Gaveston to do their work and then next weekend they are back again.

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They're just telling the people that the house is now. Habitable but like obviously they were just trying to get a free trip to that us.

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So, so I have a lot of stuff there as well, so I feel free to contact us and that's concludes my presentation.

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See that's pretty cool.

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Thank you so much and as a reminder we will have ample time towards the end of all presentations to go over any questions that the audience may have.

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So our next presenter.

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Hey, good afternoon everyone. I'm Amabel and Bornas from Mineral State University, it's a illegal Institute of Technology in the Philippines.

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I like to acknowledge my co-author, EC Jubilee Akisha from the biology department of the same institute.

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Okay, so actually I changed the title. It's now weing but not ready, which is the result of the study about the preparedness of disaster preparedness among nurses in our city, Lden.

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So naturally even induced disasters are increasing in magnitude. And frequency we all know that as presented by a lot of sessions during this ISA Congress.

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The result often includes loss of lives and distraction of property. And these disasters have devastating consequences resulting in the loss of lives and distraction which require significant humanitarian assistance.

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Give it the management of the problem. It is imperative to prioritize disaster preparedness and response measures to mitigate the impact of disasters on individuals and communities.

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This includes investing in disaster risk reduction strategies, improving early warning systems and enhancing the capacity of the healthcare providers such as nurses to respond to disasters.

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By taking proactive steps to manage disaster risk, societies can reduce the impact of disasters and build resilience to future events.

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So this is data from Greg international about the global vets from natural disasters from 1,900 to 2,016.

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So the Philippines is vulnerable to natural disasters, specifically typhoons and earthquakes, due to its location in the Pacific Ring of Fire and the Typhoon Belt.

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This vulnerability was further emphasized in 2,011 when Taiwan Washi local name Sendong, hip, elegant city resulting in significant loss of life and damage to property and infrastructure.

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The disaster caught many people unprepared, highlighting the importance of disaster performance response. Measures in the region.

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Also, Typhoon Pablo happened in 2,012 just a year after Typhoon Sendong or Washi.

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Mr. Resulted also in devastating effects. So the report of the National Disaster Record Duction Management Council in the Philippines indicate that the impact of these typhoons was widespread with ineligency 30 out of the 44 barangies or villages being affected.

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The disaster had a significant impact on the local community highlighting But the importance of investing in disaster risk reduction measures and enhancing the capacity of health care providers such as nurses to respond to disasters in the region.

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So the experience of an again city serve as a reminder of the importance of disaster preparedness and such We also had Precence of covet 19 which also highlighted the impact of disruption of the health care system.

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And while the pandemic continues to affect many parts of the world, there is hope that the development of effective vaccines and treatments has mitigated the impact.

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So health care providers including nurses, play a critical role in responding to the pandemic. Providing care to those affected and helping the spread of the disease.

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So the pandemic also highlighted the importance of investing in global health systems and preparedness measures to better respond to emerging infectious diseases in the future.

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So emergency preparedness is essential for healthcare personnel, including nurses. To effectively respond to disasters and pandemics.

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So the term impacts emergency preparedness refers to a range of skills, knowledge and actions that are necessary to prepare for and response a variety of potential threats, including natural disasters, pandemics, and other emergencies.

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This is from Zlipsky. So, Nurse played a critical role in emergency preparedness and response and they are often on the front lines of caring for patients during disasters and pandemics.

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In many cases, the demand for emerging stuff is much greater than the demand for other healthcare professionals in underscoring the importance of preparing nurses to expand to emergencies.

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So, emerging nursing intervention plays a vital role such as prevention, preparedness, response and recovery to reduce the effects that occur during disasters or pandemic.

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In the early response stage it is necessary to save many lives and the World Health Organization emphasized that preparedness of healthcare workers in disaster situations.

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Nurses are the largest manpower group of health care of personnel and they need to be trained the equip themselves with the required competencies during disasters to rescue safe and safeguard nurses.

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Registered nurses in the country in the Philippines make up the largest percentage of health care personnel according to the third 1,013 year book.

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And there are at least 44,070 31 registered nurses in the country. Okay, so according to that's what's the reason for this research?

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So my co-author is a nurse also and a practitioner and he considered the impact of the disasters from the typhoon and covet 19 and how we saw that nurses were unprepared and so we wanted to see empirically if this really was true so he conducted this study.

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So basically, the objective is to determine the nurse's perceived OK, it's a self-perception or familiarity in 4 hospitals.

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With disaster protocols and their confidence in mitigating disaster situations. So, okay. Just go back to the framework

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Sorry. So in terms of materials and methods, this study correspondence of the study were nurses who were working in 4 hospitals with one public hospital and 3 hospitals with one public hospital and 3 private hospitals in the city.

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One public hospital and 3 private hospitals in the city. A total of 103 private hospitals in the city.

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A total of 100 Florence,-one respondents. Were included and we used, What questionnaire, which includes the emergency preparedness information questioner or the epic questionnaire.

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Questions about self-regulation and job satisfaction. So we use descriptive statistics and environmental statistics in this analysis of the data.

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Okay, we followed of course protocols from our institution and entrepreneur also found as well as following the COVET.

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19 health protocols since during the time it was still, there were still of course the pandemic.

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We had Google forms but our respondents wanted to fill up the printed questionnaires instead of answering the Google forms.

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Okay, so of the location of our research, for those in familiar, it's in elegant city, it's in the Philippines.

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In a northern Mindanao. And This is the Google map of Ligand City. So Ligand City is a first-class highly urban ICT in northern Minanal and according to the 2,020 sensors it has a population of 163,000 people and located within the Lano Del

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Norte region but administered separately. So I'll go directly to the resource because I have 2 min.

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Okay, so in terms of social profile they were mostly from Covid-nineteen ward.

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They were mostly from COVET. 19 ward ICU and, Covid-nineteen, COVID.

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19 ward, ICU and, other particularly surgical areas and the pharmacy.

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And ages were ranging from 20 to 63 years old and working from 2 months, those who just are ranging from 20 to 60 years old and working from 2 months due to just finished graduated at 47 years and working full-time up to 36 h per week.

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So most of them were of course female. Okay, and. Majority of them had BS nursing degrees.

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Okay, in terms of the profit at the hospitals. The 4 hospitals were between 5,250 bed capacities or small and into large and 80% had disaster trainings 65% offer of the hospitals offer disaster trainings.

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73% had participated in disaster training in the last 5 years and 53% said that they had cared for people during disaster event, particularly Typhoon Senda or Taiwan Washi and Taiwan Pablo and 55% were on duty during a disaster or a pandemic.

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And 80% have not worked in close disaster shelters or evacuation sites. They were in the hospital.

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48% have been trained about handling charge of course and 45% respondents were trained in charge for the last 5 years.

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So there were updated in terms of draining in these areas. And for the epic score, emergency preparedness, as you can see from the table, there are 5 areas already are not familiar.

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With particularly the incidents command system and the role in it, which is very important. Epidemiology and surveillance particularly with questions about COVID.

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And then community communication and connectivity. Who did they talk to in the command incident center because they're familiar with that so they don't know whom they should talk to when it comes to these disasters or events.

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Then psychological issues, they don't know how to deal with patients with psychological issues and accessing critical resources.

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So they're not familiar with that. In the 10 areas of the epic questionnaire. And then in the narcissism scale, this is a shortcut of the epic questionnaire and you can see that in terms of overall familiarity they are familiar and prepared.

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In that aspect, just short question. In terms of self regulation, this is the result. They have very high willingness.

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To participate in disaster issue or or events or pandemic or being involved in situations like this. However, based on the epic score, they are not familiar with some important aspects.

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In terms of job satisfaction, they are highly satisfactory with their job and very satisfied with their job.

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And then, okay. And climbers. So in terms of individual differences because I wanted to find out if there are differences in terms of age, whether the older nurses were more prepared and so there were differences in terms of age number of years of course the higher the number of years in the hospital then the more prepared already.

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Than previous disaster experience as well as healthcare climate. And in terms of the 2 questions. And only these factors were involved previous disaster experience and health care climate.

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And then the last minute, okay, these are suggestions from those participants to enhance education about this-preparedness response through map drills, disaster simulation activities, review on site practice.

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Emotional preparation because as mentioned they can't deal with psychological issues even themselves though and annual competencies for the nurses and incorporate disaster preparedness education in nursing schools.

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And increasing manpower in the healthcare system. Provision of safety equipment. In hazard bay during disasters.

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Pront and relevant information dissemination because as mentioned by the previous speaker that there were a lot of changes from CDC about Covid-nineteen.

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So of course they were problematic with that issue and at issues of being vigilant, aware and presence of mind.

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And. Yeah, this, this is the, what's that extension part of the project because my partner wanted to know if nurses are really prepared and so if nurses are really prepared and so if they are not then what can we do so this is our proposed project and so if they are not then what can

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we do? So if they are not, then what can we do? So this is our proposed project to to conduct training about the areas where they're not familiar with.

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Thank you and for our next presenter.

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Good afternoon. Good afternoon. So in the interest of time, I would just like to say thank you for having me in this particular session.

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Variety of scholars, top notch scholars from around the world. So I'm excited to be here and give you a little bit of information about what I am working on with one of my colleagues in Greece.

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So in an earlier presentation I was with a colleague here, Russell Dippy, and we discussed the whole notion of professionalization and how professionalization works in the field and is emergency management, a profession, organizationally, or is it just a group of people that are doing good.

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This particular presentation, the role of clinical sociology in disaster resilience, health and care, fosters a sense of how do we bridge together those clinicians, those practitioners who are If a lack of better words, licensed.

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Certified to work with emergency managers. At every stage of the disaster cycle at which stage shall the intervention take place, those types of issues.

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So again, my name is Dimon Miller from Rowan University, so Diddy from the universe of the Aegean in Greece.

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And I shall start. I should know how to do that. So please do not try to read everything here.

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This is not designed for you to read. However, when disasters disrupt the ontological security of individuals, people get basically I'm going to use this highly complex sociological word called kerfuffle.

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In essence, the disaster landscape. They are thrown out of their normality. They are thrown out of their normality.

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They are thrown out of their normality. They are thrown out of their normality. They tendre thrown out of their normality.

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They tend to suffer from in many cases primary and secondary trauma. And all too often we as clinicians I guess I forgot to say I'm also a license counselor in the state of New Jersey and Louisiana.

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I have kitchen at too late. All too often individuals from the clinical realm, interface at the very point of And individual experiencing a great deal of trauma in the immediate impact stage or in the rescue stage somewhere in immediate post-rescue.

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And so that loss of one's immediate notion of where they are, that whole disaster landscape throws them into an entirely different world, a world in which they are not ready.

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Their whole sense of security who they are what they are the whole world has been defined redefined and reified has now been thrown in utter disarray.

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So this particular presentation is going to talk about how do we integrate some of those ideas, quality of life, health, some of those concepts of promoting the clinical, the emergency management practitioner and the researcher, the research engagement.

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How do we get that interaction? How do we do that? Now I also will say. That this is from a larger body of work so this is I'm giving you a snapshot of a larger body of work that's coming out published later this year.

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Diagnosis in social fields, so Tidis and I, we are working about using the whole concept of of clinical sociology, mental health, diagnostics and using that that medical model and to see if it's appropriate and applying and into disasters.

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And so this. Slide gets to that idea that you are thrust into a disaster landscape. So when disasters occur your ontological security, your perception of hell, your whole schema is thrust into a newfound reality.

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Individuals who suffer from a primary or secondary trauma in disaster situation often postpone or even suspend certain practices critical to maintaining their quality of life, their quality of health, their quality of understanding.

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Who they are. Now why is this important? Well for so many people this is the very very foundation of resilience that they need to pull from that cultural understanding that place and space.

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When your place in space looks like this and you're trying to figure out where my house used to be here, I used to be in this area.

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This is where family took place. The whole notion of who you are, where you are. It can really sty me recovery.

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And as a clinician, I'm trying to figure out so you know you had this whole thing called clinical sociology.

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And so clinical sociology is that humanistic multidisciplinary specialization that seeks to improve the quality of one's life.

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One's understanding of life. Clinical sociologists, well at the very core. A assess situations and reduce problems through analysis and intervention.

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Now I'm not making this up. This is all from the American. Sociological association. But where I believe we have the opportunity to engage is by looking at the clinical disaster sociologist.

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What I bring to a disaster from a disastrous perspective as a social scientist merged with that as a clinician as a license clinician working in conjunction with a multidisciplinary team at the Meso Micro macro levels.

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At any stage of the disaster cycle is where we hope to bring about an understanding. So that's a disaster cycle and stage appropriate macrombezo micro interventions.

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Becomes the key. So we're talking about cultural restoration, we're not talking about cultural restoration over here in recovery.

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We're talking about folk or wrestler. We're talking about preparation. We're talking about response.

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We're talking about mitigation, but we're also talking about prevention. Reagan, we're talking about prevention, reasoning.

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We're talking about all of these different levels. Where do we ask clinical sociologists get involved? And let's go back here.

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Improving the quality of life. And we argue that Clinical sociologist.

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Whether we study at the Mezzo. Macro or in my case the micro level and function at the micro level, we have an opportunity to address processes.

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Terms of discrimination in terms of who sits at the table being inclusive those types of issues. So stage appropriate interventions ensure the need to ensure the needed actors are ready to engage as part of the incident command tree on.

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And so we're bringing in this whole concept of medical triage so that we are working there right alongside the planners in terms of triaging situations.

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The health experts, the mental health, the religious leaders, the cultural leaders and and Our colleagues, the emergency managers.

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Well, yes, it is very important to first and foremost save life, maintain breath. We here on the other side, many of us in this room, sociologists, were also engaged in the preservation of.

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The quality of life, the quality of experience, the interaction among individuals.

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So the Clinical Disaster sociology is an antilateral security in the disaster landscape. So this is kind of where my research comes and I know I'm going to start getting some.

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So understanding culture, space, place, gender roles and being able to truly look at the positionality of these types of things at every level of the problem.

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So this is kind of where we this is where it gets interesting. Now, this is in its initial stages and I will admit we are still, we're still working.

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We, my my colleague and I when I say we from Greece we are studying 2 train derailments that happened essentially you know within 2 weeks of each other.

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On my side, Ohio on his side the tempi collision the tempi collision in Greece in the north central state of Ohio in the United States, a train derailment.

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And what's interesting about these, I'm going to give you some brief. Overview. I mean, again, I, it's so much.

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I can, and I can go into the literature of Gil and Pico in Alaska and all of these people about Nautics and Latex and all these different things but for what we're doing now

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Very briefly the train crash in in Ohio, East Palestine, hazardous materials leaked out a train D railmid several rail cars burned from over over they burned burn burn they release toxins in the air in the soil in the water

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Many individuals were evacuated not only in the state of Ohio but in some of the surrounding states.

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And we talk about the train crash in Timpi. Tempi and evangelist most in the Thessaly area of Greece.

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Essentially you had a case of human error. Case of human error where over 50 individuals who were on their way to college Oh, I just, individuals who are on their way to college, young individuals in the prime of their lives, they were involved in a massive train derailment that was caused by well the blame was shifted on any individual who was

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arrested. And so forth. So where do we intervene? How do we work with families?

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And how do we promote engagement at what level and what stage? Then we problem with our model is right now we're working with disasters that have occurred.

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That's the problem. And so what I am doing in various communities. I'm going through and and where we are.

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We're really We're really at a point of seeing. The cascading effects. In and the reason why I'm arguing about the cascading effects in Timpi is primarily because of the

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Primarily because of the series of technological failures on top of other technological failures on top of other technological failures.

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And we also see cascading effects of the. Natural hazards. In fact, I'm sorry, the technological hazards, the oils, the chemicals leaching into the water systems and what we are finding out in our research is that we have to have different approaches for addressing.

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Mentally for addressing compounding disasters as opposed to pascading disasters. The literature used to call for this whole notion of natural disasters, acts of God, people would get through it and we just kind of grinned and bared whereas opposed technological disasters.

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And what we're finding is in the wake of technological disasters, we really need to nuance that compounding as opposed to cascading in terms of how we deal with counseling and how we deal with substance abuse client.

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Substance abuse is my area. I know I ran through this really fast. I have 0 min.

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However.

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Thank you. We're really looking forward to the question and answer portion which will be after this presentation which was pre-recorded and we'll get that playing now.

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So it looks like this is just the presentation and it is not the presentation with the audio and or video included with it.

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Sure.

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Would I would start it I would launch it and see if The audio catches up. Sometimes there's been The sound is on yeah

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Sure. So go ahead and advance it to the next slide and to see if

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Watch.

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Yeah, I think this is just the PowerPoint. Is the presenter online?

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And yeah, cause they, they're telling me on the right. Oh, Yeah, so let's come back to the beginning.

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The beginning of the presentation.

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Where did you see it?

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Let's see if it's this. Alright, that's what it was also.

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We are Alvaro Viiya and Niaki Rubio from the University of Tabas Country and we will like to present a paper that will start it with the beginning of the pandemic.

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And that we finished last year. It is called Discounted Death. The eruption of the Covid-nineteen in the Geriatric system of the community of Madrid and deals with the effect of the pandemic on nursing homes in this Spanish community.

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We did this complaining statical data. And we're on morality and morbidity rates in losing homes.

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With interviews and medical records, national public protocols and military reports from the unit. That manage this kind of institution.

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Our proposal was by seat of the realization that the after of the outbreak of the pandemic the Spanish national health system made a serious of decision on how to distribute resources to care for the Sikh.

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That in this decision the elderly in nursing home

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I'm so sorry. I think it was a dancing to the next PowerPoints live.

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And it wasn't like showing. So should I follow along?

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We are a lot of we had in Minaki Rubio from the It is good institution.

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Our proposal was by seat of the realization that the after of the outbreak of the pandemic, the Spanish National Health System made a serious decision on how to distribute resources to care for the Sikh.

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Yeah.

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That in this decision the elderly nursing homes were at the bottom of the list of potentials patients. Throw these planes and scales it was decided that the voting resources respirators I see you beds or hospital care was a futile effort.

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So that when the videos broke out in nursing homes. The elderly were often not referred to hospitals. And yet a few days later we thought even being diagonal seat or Auntie for In this regard, we propose it to focus on 3 points that we used to represent and analyze the phenomenon.

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The first was to label that truncated breath. Under this title we will analyze the condition of those people who were excluded by the national health system thrilled a selection protocol publish it.

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By the community of Madrid. They were excluded when they were still alive in favor of authority. Younger people or with a clean clinical record.

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With a resizing mask and individual protection equipment. Even dying in their residences without a transfer and with communicating their condition to their relatives.

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And also aunts did. Abandoning the corpses in the nursing homes without picking them up. Transferring them to massive marks.

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So as Ephema. And a public public pavilion for concerts and conventions and the yellow ice colors.

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Askarine Rink. And then losing track of them preventing their relatives from recovering them and booting.

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Them as they should have been. For this reason we think of them as that. That did not count in this sense that in the sense that they were not thrown of worthless lives are not correct in circumstances of abandonment and neglect.

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In those photos you can see the spaces we are referring to, the Ithima and the Ice Palace.

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The second was numberless did and high-end populations. Where we analyst, how to the community of Madrid.

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Concealed and left and recorded and undeterminated number of deaths due to the effect of the virus in the reports it's submitted to the state.

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To a statically tracks the progress of the pandemic. This happened in 3 different ways. The fear was to avoid aging the sick.

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By not performing tests of of course, autopsies on the Sicily. The few diagnostic resources, antigen and PC air tests.

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Were directed Direct to hospital and denied the nursing homes.

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As reported in interviews with Nursing Home workers and family members. The second was the loss of Gase reports in the bureaucratic transfer between instances.

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Losing homes, referral hospitals, gumselling understands. The state. And the last one, excluding a scouse of there that he says, contracted and contrasted in medical reports and medical history of the patients in favor of diffuse diagnosis, sukas, respiratory in sufficiency.

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Large part of the cases were not registered or were related to a category. That was not included in the office held aoting.

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They dared with compatible seenomatology. Andrei, Entrefore as Claudette from the accounts from the official account of the pandemic.

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We were able to see a report like this one where the professional, the real cows of the date.

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Suddenly, are they old people, from different diseases, but not for good, of course Alzheimer's, terror attacks, even cancer.

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And so they recorded it.

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The self called digging without a cone in the state facilities. 7 to reflect on the situation of Abandon, cause be the social distancing measure with the space of state as it starts.

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A professional environment where the day took place was paralyzed. The original Davos left thousands of people out of the sense.

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In a time and place we move it from witnesses. Who call very verify how the situation was being managed.

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There was an exclusion of external ion such as moneyitarian organization or family association. Wait in other circumstances will have been able to monitor how the situation was being, they have with.

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You sure? And the perception of COVID is 19. This control and urgent social problem. Event approach that dog into a cone this spriental dimension illness and the result was a profound institutional institutional The disease elderly were not in the media narrative in which there were only heroes.

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They held professional a type kind of victim patient treated in hospital in Maldives. The doctor who Dyer in Ceris.

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He's Spanish state played the role of as Persian or for all those affected mixing the suffering experience in a nursing home with a state of Europe shock.

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Avoiding giving concrete explanations. I've had a set of empirical tensions described in this presentation.

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We would like to propose the idea of discounted death displaying those laws. Simply occurring took place in a vacuum, a void.

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From the meaning that are usually attribute from the social science. We refer to that. Are assumed as inevitable from the place delegate to complaining the final process of life.

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I mean, and they were this that did not come. And the other hand Then, debated the main management of Yeah, I mean it's realistic.

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Yes, but were encountered. I'm finally, and that'd like it. And like this course to explain.

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Them symbolic and then we thought and a cone. These 3 processes were the result. Of 2 opposing and you may need Daria region on the other hand, the state region.

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He was the result of the tension between the conception of human life. soprano volume and need to maintain the full term or the functions of a state that at that time was facing a analysis collapse stagnant spaces.

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In other words, the hell not a system managed to resist at the cost of our loan in 8 more years.

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In our exercise or planet emissions. But has not been recognized. And the residents, and forcing them pray as the vice of Abandon.

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Erasing forms obeying Travis it by suffering. Of the birds of the dead. Leaves a abandoned, er, to, which were lost in a context of a spectral precariousness on Bermayan undocumented status.

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That year we published a paper in many current employee review. And when we discuss these topics in modern time.

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Alrighty, wonderful. I'll end this.

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And in the interest of time, I will ask for the Panelists or discussants to take a seat of front so we can serve our community session.

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And how we'll do this is we'll ask for folks who are interested in asking questions to come to the front and use that microphone that's being put in the middle so that our Zoom participants can hear and we will take it from there.

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Do we have any questions to start with? Yes.

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So cheat. So I'll throw one to demand. I state level incident in Australia uses what we call a level 3 incident management team.

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That's a hundred 40 odd people and positions. How many more do you want to add to it by bringing all your sociology, sociology people and health people, to that team?

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And where am I gonna put them?

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So to be quite simply and not tur as many as needed to make sure that the voices of those who are impacted are recognized and heard.

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In the incident command system that we use in the United States we have the ability and flexibility to break down add, multiply, divide at any given point in time.

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Getting them in the room might be a little difficult. I get that granted But also, I'm not just arguing what we, I should say, we are not just arguing.

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For individuals to be at. The time of the disaster impact fee and in the impact we're arguing that we should be included all the way around so that in planning there is this level of mental health trauma informed understanding so that's what we're arguing so if we need to bring in that cultural specialist.

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That individual that's in education if we need to bring in that person that knows about the monk community because we don't have any you know, individuals that know anything about the Mong or the the Native Americans or whatever the case may be, then we do that.

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Hope I asked you questions. I mean, Yeah, well, we'll tell them to bring their own chairs.

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Hi. Question for Demand as well. You have said that the problem is that These disasters are occurring now.

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So can you expand on that? What do you mean by that? Like, why is that a problem?

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So thank you again. So we are, we're in the nascent stages of our research in the sense that we have not been able to apply.

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To the mitigation stage. So when we're talking about, you know, now we're in the middle of going into a community where there's a train derailment and you're talking now and so now all of a sudden we're there's a train derailment and you're talking now and so now all of a sudden we're the clinicians

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we're here to help you and we hadn't had a chance to get with our incident command partners, our with this partners and all.

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And it's just it's just this hodgepodge. What I'm saying is we need to be more fourth.

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For thinking and more collaborative from the very beginning so that we have entra into those communities into those.

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Local governments into those native communities where wherever we were talking about we don't just need to show up when the flood has happened.

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When you show up when the earthquake is just happening. You need to be there. Before.

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It doesn't work.

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I am so punky from the Philippines from the sociology department. I saw the Philippines.

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Interest that I am interested basically of asking you about especially in the US when disaster like floods, typhoons are the use of occurrences.

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Or is there a policy? Government policy. Organizing or integrating the health aspects related to your topic.

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Into the practices of disaster in the cycle of disaster bases. In your specific context. Because in the Philippines we have that but in practice you know it always seems to be confusing because disasters come in different you know times when people are not ready.

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In those cases, we have plans, but in practice, in operations, it would always be, you know, topsy.

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So just guess something on that. I thank you so much.

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That's for both of you. We go down the list. So in the context of the looking at the individuals living with HIV.

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So in the context of the looking at the individuals living with HIV, the study that we did, the individuals living with HIV, the study that we did, one of the benefits of looking at the individuals living with HIV, the study that we did, one of the benefits was actually the fact that this is in Delaware and it being

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a very small state. I don't mean that just in terms of geography and population, but the, I mean, even if I think about the emergency management agency or the public health agency.

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There's so many disaster research center or former students in those people associated with kind of a small network where you run into the governor at your local coffee shop.

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Our president is from. Delaware. And so the ability in that context for those adjustments to be made for someone to actually pick up a phone, make a phone call, have those personal relationships.

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It I would say was much easier for them to push those ideas forward. I think something that would be, because this is really local, right?

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So this emphasis on case management of health professionals. The local aspect was important and I think there would be a lot of value in looking at a larger state if you're looking at New York or California or Texas.

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Where those are much more dispersed if an individual organization, how for them to reach out through their national organizations, volunteering and disasters.

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This isn't that. This is a routine organization. How to make that connection so they can do their job better.

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I think we'd be challenging a larger state versus what we have.

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I think I will add a little bit what Tricia just talked about. So in a planning process usually when they do pre-premning.

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What they officially or in theory have to do is to contact all the stakeholders so sometimes in the planning document they do have some sort of a agreements there with the health providers or nursing homes or things like that.

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But that's. The important thing for that is the ability of images and managers of whoever is in charge of the plane documents.

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So ability to actually pull that on. So sometimes they might have personal connections with those folks when they are in small towns, then much easier for them to do that.

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But if we are in a big city that's see the Houston's or New Orleans.

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They might be a little bit difficulty there but I always think that if they do drios and they do play brands.

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And chances are you get to know those people and when things really happening then you'll be easier for you to come communicate with those folks and help them help you to set up things.

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I said I don't like answer your question. If I could just add to that because I would really like to hone in just a little bit.

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From a policy standpoint. So in the aftermath of Hurricane Katrina and the St. Rita's nursing home tragedy where several elderly individuals succumb during the disaster.

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There were federal laws put forward specifically to address nursing homes specifically to address nursing homes as a direct result of St.

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Reader's. There are some federal guidelines that must be taken into consideration by emergency managers, also by when we talk about access and functional needs, when we talk about functional needs, we're talking about limited mobility, site, those types of issues.

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So there are some federal laws in place that must be a part of plans that must be followed if federal dollars are going to be accompanying that.

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Now that's a natural disaster and we tend to see that fold out in the aftermath of Katrina a little bit better.

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And I mean, my colleague Trish, me, correct me if I'm wrong that those tend to kind of work out a little bit better now.

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They're not great, but better. However, when you come to a technological disaster such as Ohio and the train derailment There was a fight.

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Who goes in? When do they go in? EPA didn't go in and FEMA didn't go in and it is the responsibility of the train company.

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And then the triumph come and say, well, no, no, this is environmental. This is the environment.

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And so, so. There becomes an issue. Who's land? Is it federal land?

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Is it state land? And meanwhile, all of these individuals are suffering from the trauma and then the cascading impacts of institutional neglect and so now you have not only a chemical spill but you also have a neglect your very institutions are neglecting you.

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So those are the things I guess I want to say when you deal with a technological disaster is very, very ill-defined because the feds are looking for the company.

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And then the company is saying, well, wait a minute, this is navigable waters. And this, the fans have to take care of this.

445
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You know, the spill happened in war. So now that's a federal issue. That's navigable water.

446
01:28:47.000 --> 01:28:59.000
And so anyway, I hope I answered your quiet all of us I think. Kinda.

447
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In the case of maternal child health, there's a disparate, they're separate really we see that maternal child health.

448
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There's a disparate, they're separate really. We see that maternal childhood is still considered health and human services, so it's not really taken into consideration as much in emergency operations and if it is it's limited to mass care so mostly focused on sheltering and evacuation support.

449
01:29:17.000 --> 01:29:27.000
But really we see after the initial evacuation they have they start changing patterns and infant feeding.

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So for example When you look at disaster donations, we see a lot of donations of infant formula, but really not a lot of lactation support and care.

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So we have a lot of families that switched to infant formula that don't have access to clean water.

452
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And we see that a lot in international context as well, but we still see this happening in the United States.

453
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And formula is significantly more expensive. So for families that are living on the margins of society, it perpetually keeps them reliant on these.

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Predatory infant feeding practices, which the donation groups don't necessarily purposefully perpetuate, but we still see it as an issue.

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Because they're separate in the in the US and international context. So that's just an example.

456
01:30:15.000 --> 01:30:40.000
Okay. So, I originally from Taiwan and when I was a kid I was a graduate student we actually I was actually involved with the project there in Taiwan try to help people to help local government to be better prepared or mitigate the risk and it's very different in Asian countries that they actually, the federal or the

457
01:30:40.000 --> 01:30:46.000
central government just tell you what to do and if you don't do it then we give you a file or fire you or whatever.

458
01:30:46.000 --> 01:30:53.000
But in a state very different like the amount was mentioned earlier if you don't do this we just don't give you the money.

459
01:30:53.000 --> 01:31:02.000
And sometimes, if you are from like, very rich areas and, or agencies that you might not get.

460
01:31:02.000 --> 01:31:07.000
So, so it's just a bit. But there.

461
01:31:07.000 --> 01:31:17.000
Go ahead ahead. I would like to ask a question of Dr. So Chris asked. Maybe your research.

462
01:31:17.000 --> 01:31:38.000
For the period of monkey pots. It was before that. Oh. That would not, my question was about the compounding phase that we had one more.

463
01:31:38.000 --> 01:32:01.000
Okay, I have a question for Dr. Walkendorf. Sorry. Did you find that there was this increase of social support or stopgap programs for them.

464
01:32:01.000 --> 01:32:12.000
So just one example. I had mentioned the Ryan White program. Brian White was a teenage boy when he contracted HIV.

465
01:32:12.000 --> 01:32:29.000
As a hemophiliac early on in a pandemic and so there is this program or this funding that is made available for various programs around the country and there are 7 Ryan White funded programs in the state.

466
01:32:29.000 --> 01:32:41.000
So the Delaware HIV consortium does not. Provide the housing vouchers and support but there's another program that does that they work in concert with and that was again absolutely essential.

467
01:32:41.000 --> 01:32:59.000
So some of the individuals talked about Let's say being evicted part way through and they weren't supposed to be aicted but they were evicted or there was they had already put in that they were changing their lease but then they couldn't get back in and you couldn't get housing.

468
01:32:59.000 --> 01:33:09.000
So having case management step in, their normal case managers even though that wasn't their responsibility. To make those connections was really important.

469
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So that's just one, example of a stop gap with them doing something that was out of their normal role, but connecting them with other organizations, knowing that that affected their clients.

470
01:33:22.000 --> 01:33:31.000
I actually had a question for you as well, Dr. Walkendorf. You mentioned that some of your participants displayed some avoidance behavior?

471
01:33:31.000 --> 01:33:53.000
Could you describe what that looked like in the context of the study? Yeah, so certainly not going out at all was one thinking about not having contact with family members, things that are that you're familiar with, was one, thinking about not having, contact with, family members, things that are, that you're familiar with, but it was also, to some degree isolating

472
01:33:53.000 --> 01:33:58.000
in the home. That, that you're familiar with, but it was also, to some degree isolating in the home.

473
01:33:58.000 --> 01:34:05.000
So even if somebody would be, I remember at the top of my head one and so she would purposely like not.

474
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Have contact with that person because they were not abiding by protective actions that were going out. So thinking about those kind of relationships and self-isolating as much as possible even in their home environment.

475
01:34:11.000 --> 01:34:21.000
Gotcha. Thank you.

476
01:34:21.000 --> 01:34:31.000
And then medical appointments too, but lots of examples of canceling that delaying procedures. Thank you.

477
01:34:31.000 --> 01:34:39.000
I also had a question for Amabel. I really enjoyed your presentation. I enjoyed everyone's presentation and I love the title Willing but Not Ready.

478
01:34:39.000 --> 01:34:52.000
One of the suggestions that we're listed on your slide included nurses and engaging in disaster simulation activities.

479
01:34:52.000 --> 01:34:55.000
Okay, thank you for the question. And that's your name. Yeah, that's your name.

480
01:34:55.000 --> 01:35:07.000
Actually, we have in our school we also have a nursing college and so I will be partnering with in our school we also have a nursing college and so I will be partnering with them in terms of the extension activities that I'll be doing in the phase 2.

481
01:35:07.000 --> 01:35:17.000
Partnering with them with regards to doing simulations and trainings in the areas where they are not familiar with.

482
01:35:17.000 --> 01:35:33.000
So in the curriculum also talked to be the Dean of the College of Nursing also and some of the respondents said that they are not very familiar with this epic criteria that were asked because these were not included in the curriculum.

483
01:35:33.000 --> 01:35:44.000
So we also talk about that and I think the same relation would be, there is a particular disaster like an earthquake but usually it's earthquake with flooding in our area.

484
01:35:44.000 --> 01:35:56.000
And so what would be done within the hospital scenario, for example the command incident center who would be the lead and so on and so forth and in the areas particularly with psychological problems.

485
01:35:56.000 --> 01:36:12.000
From patients with psychological problems. How will be that? So in the different areas of the epic I think they need to be covered so they would be familiar with what to do, it's better to be prepared because usually we try to.

486
01:36:12.000 --> 01:36:17.000
Some of the respondents even said that. Maybe this will not happen again, but it's better to be prepared.

487
01:36:17.000 --> 01:36:28.000
So and particularly these are first responders. These are our very important part of the community is a medical community.

488
01:36:28.000 --> 01:36:33.000
Awesome. Thank you so much.

489
01:36:33.000 --> 01:36:41.000
Okay, I also had a question for Ronnie. As I mentioned earlier, I do attend to Lane.

490
01:36:41.000 --> 01:36:54.000
As I mentioned earlier, I do a question for Ronnie. As I mentioned earlier, I do attend to Lane, which is in New Orleans, Louisiana, and I think 3 of the presentations incorporated some form of data collection in Louisiana, but I think this is super relevant to me because the month after I moved to New

491
01:36:54.000 --> 01:37:04.000
Orleans. Hurricane I had a hit right so it was really interesting to firsthand see what the evacuation process was the privileges associated with being able to evacuate.

492
01:37:04.000 --> 01:37:05.000
But I just had a methods question about the data. You mentioned that you did systematic social media recruitment.

493
01:37:05.000 --> 01:37:22.000
Could you describe like this recruitment method so I can understand it a little bit more? You had a very, I think your population was like 83% white woman.

494
01:37:22.000 --> 01:37:32.000
I'd like to hear about the recruitment methods. So we basically looked at Facebook groups as a way to.

495
01:37:32.000 --> 01:37:44.000
To gain access to groups from a remote standpoint we weren't deploying due to kovat 19 in terms of field work so we wanted to do systematic social media recruitment and essentially what we do is we look at available groups related to different themes in the topic area.

496
01:37:44.000 --> 01:37:56.000
So for example that would be parenting, pregnancy.

497
01:37:56.000 --> 01:38:05.000
Birthing, breastfeeding, different main keywords to I find these groups. And then the mostly the PI because they are a mother.

498
01:38:05.000 --> 01:38:11.000
Due to ethical concerns, they were the ones that entered the groups. And we would either gain access if it was a public group.

499
01:38:11.000 --> 01:38:27.000
In post or we would contact the group organizer in the PI for per perspective is a white woman middle age with a child.

500
01:38:27.000 --> 01:38:41.000
Why and do not have a child. So really just do the ethics. Due to ethics we tried and then if it was a group that was a specific indigenous woman, we targeted Homa, which has a tribal nation.

501
01:38:41.000 --> 01:38:55.000
We also looked at other. There is a Black Mothers group, we would contact the group organizer to see if they would allow access into the into the group.

502
01:38:55.000 --> 01:39:01.000
We didn't just. Gain sneak in or anything like that. And then they would open to participate.

503
01:39:01.000 --> 01:39:21.000
We did offer incentives for participation. And then. Yeah, there is limitations on the X because of how many people like utilize Facebook or different groups, but that at the time this because of how many people utilize Facebook or different groups, but at the time this was the easiest way to gain access to different groups in a remote geographic community

504
01:39:21.000 --> 01:39:34.000
during the pandemic. Oh, I'm so sorry. Follow up with that. It wasn't kovat.

505
01:39:34.000 --> 01:39:39.000
If it was in COVID, we probably would have deployed in a similar weeded. Delayed deployment for Hurricane Ian.

506
01:39:39.000 --> 01:39:49.000
So he probably would have went in earlier and looked at different groups. You probably would have started with the women infant and children field office.

507
01:39:49.000 --> 01:39:52.000
Those are usually located in different counties or parishes in Louisiana. That's where we started in Florida.

508
01:39:52.000 --> 01:40:10.000
They're really good access point to gain access to other families. We also, for Florida, worked with a women in recovery, like a drug recovery that have infants.

509
01:40:10.000 --> 01:40:20.000
So that's where we started. So probably different programs targeted for women or young families. In in Louisiana.

510
01:40:20.000 --> 01:40:37.000
We didn't and I probably would have targeted both southern Louisiana which was affected by the storm and then other parts that are not as they weren't necessarily on the camera as much outside of the New Orleans proper.

511
01:40:37.000 --> 01:40:44.000
Do what? Yes. So I have a question for. Okay.

512
01:40:44.000 --> 01:40:59.000
Are you okay? By Marvel. Is tied to the reporting that

513
01:40:59.000 --> 01:41:08.000
Thank you. Sorry about that. So you said something about the privileges associated with being able to evacuate.

514
01:41:08.000 --> 01:41:14.000
Can you explain that just a little bit? Just a notion of privilege and evacuation. Sure.

515
01:41:14.000 --> 01:41:27.000
So I think the easiest way I could do this is just to describe the circumstance while the day before Ida touched down, flights were thousands of dollars to lead the MSY New Orleans airport.

516
01:41:27.000 --> 01:41:41.000
Roads were packed. There was no gas locally and a lot of times you would speak to locals who have been in Louisiana or New Orleans in particular for generations and you'd say, okay, where are you going?

517
01:41:41.000 --> 01:41:45.000
What's your plan? And they're like, oh no, I'm staying here. I have 5 kids.

518
01:41:45.000 --> 01:41:53.000
I don't have a vehicle. I don't have money right now to fill a tank and go to a hotel indefinitely.

519
01:41:53.000 --> 01:42:14.000
I have to stay and essentially quote unquote like plug it out. You know, and this is me being very transparent and embarrassingly enough, like I was like obering from like my apartment to the airport because my mom had helped me out with getting a flight to go back to South Florida and I was speaking to my Uber driver and I think

520
01:42:14.000 --> 01:42:24.000
I almost came to a point of tears because I was like, here I am. I have this position of privilege where I am booking a ride to be essentially escorted to an airport.

521
01:42:24.000 --> 01:42:44.000
I'm going to hop on a plane and leave this this area that is so poverty-stricken that I have decided to dedicate at least 4 years of my doctoral research to to help improve and help immerse myself in this area and here I am just leaving as soon as There was notification of a hurricane and there is so much privilege associated with

522
01:42:44.000 --> 01:42:51.000
that that this is me just throwing out a number that I'm sure 90% of the residents of New Orleans do not have.

523
01:42:51.000 --> 01:43:01.000
Dance to your question. Sure. Thank you. Oh, thank you.

524
01:43:01.000 --> 01:43:16.000
And thank you for that question. Tristan, I am obsessed with qualitative research and I noticed that the coding process for your interviews you used an inductive open coding process.

525
01:43:16.000 --> 01:43:34.000
Could you tell me a little bit about that please. So, basically we have 2 coders going through the manuscript and the first code as well essentially go through them and try to code the things that we see in the transcripts.

526
01:43:34.000 --> 01:43:45.000
And then talk with the second coder and then together they were developing a coding scheme. And then for moving from there they will develop the things and time.

527
01:43:45.000 --> 01:43:52.000
Gotcha. And you guys used to do and vivo. And you, okay, awesome.

528
01:43:52.000 --> 01:44:02.000
Awesome. It's provided by the university. Yeah, I hear that I hear that Awesome.

529
01:44:02.000 --> 01:44:11.000
Do you have any follow-up questions for our speakers today?

530
01:44:11.000 --> 01:44:15.000
Any comments, concerns?

531
01:44:15.000 --> 01:44:26.000
Just want to just thank everyone for supporting us at whatever stage of research we're in. I just want to thank everyone for supporting us at whatever stage of research we're in.

532
01:44:26.000 --> 01:44:30.000
Some of us, like I said, we're in our nascent stages and trying to do things and some of us are a little bit further advanced.

533
01:44:30.000 --> 01:44:41.000
Thank you for sharing and asking questions and being a part of this session with us. Awesome.