ObjectivesTo assess hospital emergency nurses' self-reported knowledge, role awareness and skills in disaster response with respect to the Hajj mass gathering in Mecca.DesignCross-sectional online survey with primary data collection and non-probabilistic purposive sample conducted in late 2014.SettingAll 4 public hospitals in Mecca, Saudi Arabia.Participants106 registered nurses in hospital emergency departments.Main outcome measureAwareness, knowledge, skills and perceptions of emergency nurses in Mecca with regard to mass gathering disaster preparedness.ResultsAlthough emergency nurses' clinical role awareness in disaster response was reported to be high, nurses reported limited knowledge and awareness of the wider emergency and disaster preparedness plans, including key elements of their hospital strategies for managing a mass gathering disaster. Over half of the emergency nurses in Mecca's public hospitals had not thoroughly read the plan, and almost 1 in 10 were not even aware of its existence. Emergency nurses reported seeing their main role as providing timely general clinical assessment and care; however, fewer emergency nurses saw their role as providing surveillance, prevention, leadership or psychological care in a mass gathering disaster, despite all these broader roles being described in the hospitals' emergency disaster response plans. Emergency nurses' responses to topics where there are often misconceptions on appropriate disaster management indicated a significant knowledge deficit with only 1 in 3 nurses at best or 1 in 6 at worst giving correct answers. Respondents identified 3 key training initiatives as opportunities to further develop their professional skills in this area: (1) hospital education sessions, (2) the Emergency Management Saudi Course, (3) bespoke short courses in disaster management.ConclusionsRecommendations are suggested to help enhance clinical and educational efforts in disaster preparedness.

Milk fat globule membrane (MFGM) is one of the milk components that is produced by the lactating mammary glands and released to the milk in the form of vesicles. MFGM surrounds milk fat globule secreted by the milk producing cells and has a complex structure containing various lipids (e.g., triacylglycerides, phospholipids, and cholesterol), proteins and other macromolecules. Among the proteinaceous components of MFGM is lactadherin, also known as milk fat globule-EGF factor 8 protein (MFG-E8). Being one of the main proteins present in MFGM, lactadherin is related to milk secretion, has antimicrobial and antiviral effects, and plays important roles in the immune defense as one of the immune system molecules. Furthermore, lactadherin belongs to the family of secreted extracellular matrix proteins, and clearly can be considered as a multifunctional (or moonlighting) glycoprotein involved in regulation of many biological and physiological processes, such as angiogenesis, atherosclerosis, haemostasis, phagocytosis, and tissue remodeling. This review focuses on the similarities and differences of lactadherin among different species and describes the main functions of this protein, as well as its structure.