Introduction: Since 2001, a burgeoning interest by health care professionals in the growing asymmetrical terrorist threat and its impact on health care preparation and response has seen significantly increased academic output around this nebulous subject. Despite this, there has failed to be a consolidation of this sub-specialty. Discussion: This editorial argues for the consolidation of the body of experience gathered since 2001 into an initiative called Counter-Terrorism Medicine (CTM). It proposes that previously discrete sub-specialty areas can be consolidated, with improvements in collective understanding, and can build on previous work to provide a non-political health care focused definition of terrorist events, based on the triad of Violence, Intent, and Heath Care Impact. It notes the importance this defining triad has in health care planning and response considerations. Finally, it defines the parameters of CTM within the larger specialty of Disaster Medicine (DM). Conclusion: There is a growing body of academic work on the health care implications of terrorism. The time is right to coalesce these into an initiative referred to as CTM and to consider this as a discrete part of DM.

Of all the above factors, a review of fatality data contained in the PACSID indicate that aspiration, asphyxiation, grain weight, and lateral pressure are most likely the primary cause of death for most entrapment victims. Research gaps found by this study include an understanding of the impact of lateral pressure on lung expansion and oxygen availability and consumption rate, and the need for more case studies to accurately determine cause of death.

Introduction:Cultural awareness can be defined as an understanding of the differences that exist between cultures. This understanding is a crucial first step towards the development of cultural sensitivity, a willingness to accept those differences as having equal merit, and becoming operationally effective when working within different cultures. The benefits of cultural awareness have become apparent in recent decades, including within governments, militaries, and corporations. Many organizations have developed cultural awareness training for their staffs to improve cross-cultural cooperation. However, there has not been a large movement toward cultural sensitivity training among non-governmental organizations (NGOs) who provide aid globally, across a number of countries and cultures. Cultural awareness can be a useful tool which enables an NGO to better serve the populations with which they engage.Problem:The goal of this study was to evaluate the presence of cultural awareness training for employees and volunteers working within international NGOs.Methods:Ten of the largest international NGOs were identified. Their websites were evaluated for any mention of training in cultural awareness available to their employees and volunteers. All ten were then contacted via their public email addresses to find out if they provide any form of cultural awareness training.Results:Of the ten NGOs identified, none had any publicly available cultural awareness training on their websites. One NGO dealt with cultural awareness by only hiring local staff, who were already a part of the prevalent culture of the area. None of the others who responded provided any cultural awareness training.Conclusion:Cultural awareness is a vital tool when working internationally. Large NGOs, which operate in a wide-range of cultures, have an obligation to act in a culturally aware and accepting manner. Most large NGOs currently lack a systematic, robust cultural awareness training for their employees and volunteers.

Introduction:Children represent a particularly vulnerable population in disasters. Disaster Risk Reduction refers to a systematic approach to identifying, assessing, and reducing risks of disaster through sets of interventions towards disaster causes and population vulnerabilities. Disaster Risk Reduction through the education of the population, and especially children, is an emerging field requiring further study.Aim:To test the hypothesis that an educational program on Disaster Risk Reduction can induce a sustained improvement in knowledge, risk perception, awareness, and attitudes toward preparedness behavior of children.Methods:A Disaster Risk Reduction educational program for students aged 10-12 was completed in an earthquake-prone region of Jordan (Madaba). Subject students (A) and control groups of similarly aged untrained children in public (B) and private (C) schools were surveyed one year after the program. Surveys focused on disaster knowledge, risk perception, awareness, and preparedness behavior. Likert scales were used for some questions and binary yes/no for others. Results were collated and total scores averaged for each section. Average scores were compared between groups and analyzed using SPSS.Results:Students who had completed the Disaster Risk Reduction program were found through Levene’s test to have statistically significant improvement in earthquake knowledge (5.921 vs. 4.55 vs. 5.125), enhanced risk perception (3.966 vs. 3.580 vs. 3.789), and improved awareness of earthquakes (4.652 vs. 3.293 vs. 4.060) with heightened attitudes toward preparedness behavior (8.008 vs. 6.517 vs. 7.597) when compared to untrained public and private school control groups, respectively.Discussion:Disaster Risk Reduction education programs can have lasting impacts when applied to children. They can improve students’ knowledge, risk perception, awareness, and attitudes towards preparedness. Further work is required to determine the frequency of re-education required and appropriate age groups for educational interventions.

Background: Cultural awareness is an important part of organizational success when interacting with multiple cultures. Research has shown a dearth of standardized cultural awareness training programs for non-governmental humanitarian organization staff. Purpose: This study aims to develop an expert-consensus set of cultural awareness competencies as the basis for development of humanitarian staff cultural awareness trainings. Methods: A modified Delphi process was selected. The first round of surveys collected a list of cultural awareness competencies from experts in the fields of non-governmental organization (NGO) operations and cultural awareness education and research. This collated list of competencies was then used as the basis of a survey obtaining ratings by the group on a five-point Likert scale. Competencies which achieved an average rating of 4.0 or higher were considered to be “important” for inclusion in future training programs. Results: A total of 67.9% of contacted experts agreed to participate, with 84.2% of those completing all rounds of the survey. This group developed a list of ten competencies, including: Cultural Awareness/Sensitivity and Intercultural Communication; Cultural Intelligence; Unconscious Bias/Diversity Awareness; a Universal Declaration of Ethical Principles; Gender and Lesbian, Gay, Bisexual, Transgender, Queer, and Other Sexual Identities (LGBTQ+) Issues and Safety; Analytical and Critical Thinking Skills; Negotiation; Program Mission; Power Dynamics; and Empathy. Conclusions: This study defined a set of ten expert-consensus cultural awareness competencies which can be a basis for future NGO staff training. Future work can both use these competencies to create educational programs and further define and expand the set of competencies based on analyses of their implementation.