The causal effect of mental health on labor market outcomes: The case of stress-related mental disorders following a human-made disaster.

As disasters increase due to climate change, population density, epidemics, and technology, information is needed about postdisaster consequences for people's mental health and how stress-related mental disorders affect multiple spheres of life, including labor-market attachment. We tested the causal hypothesis that individuals who developed stress-related mental disorders as a consequence of their disaster exposure experienced subsequent weak labor-market attachment and poor work-related outcomes. We leveraged a natural experiment in an instrumental variables model, studying a 2004 fireworks factory explosion disaster that precipitated the onset of stress-related disorders (posttraumatic stress disorder, anxiety, and depression) among individuals in the local community (N = 86,726). We measured labor-market outcomes using longitudinal population-level administrative data: sick leave, unemployment benefits, early retirement pension, and income from wages from 2007 to 2010. We found that individuals who developed a stress-related disorder after the disaster were likely to go on sickness benefit, both in the short- and long-term, were likely to use unemployment benefits and to lose wage income in the long term. Stress-related disorders did not increase the likelihood of early retirement. The natural experiment design minimized the possibility that omitted confounders biased these effects of mental health on work outcomes. Addressing the mental health and employment needs of survivors after a traumatic experience may improve their labor-market outcomes and their nations' economic outputs.

A Scoping Review of Factors Associated with HIV Acquisition in the Context of Humanitarian Crises.

Humanitarian crises-natural or human-made events that can threaten communities' health, safety, security, and well-being-may affect the HIV epidemic dynamics. Common aspects of humanitarian crises such as poverty, powerlessness, disruptions to the health systems, and social instability can contribute to a person's vulnerability to HIV infection through increased risk behaviors and limited access to health services. Guided by the Joanna Briggs Institute methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) reporting guidelines, we conducted a scoping review of literature published in English between January 1990 and March 2022 to characterize the global evidence of modifiable and non-modifiable factors for HIV acquisition in the context of humanitarian crises. We systematically searched, screened, and synthesized literature from MEDLINE, Embase, Global Health (all accessed via Ovid), and Scopus, and also grey literature through websites of humanitarian agencies and relevant non-government organizations, the International AIDS Society's abstract databases, and Google Scholar. We considered studies presenting empirical data on HIV prevalence, incidence, or risk factors in humanitarian crises-affected populations, including refugees, asylum seekers, and internally displaced persons. Forty-nine studies met the inclusion criteria. The majority of studies were quantitative (n = 43, 87.8%) and cross-sectional (n = 37, 75.5%) in design. Most were single-country studies (n = 43, 87.8%) and conducted in Sub-Saharan Africa (n = 31, 63.3%). We identified 5 non-modifiable factors for HIV acquisition (i.e., age, gender, location, place of birth or origin, and ethnicity) and 60 modifiable factors that we further classified into five categories, namely 18 policy and structural, 9 sociocultural, 11 health and mental health, 16 sexual practice, and 6 humanitarian crisis-related traumatic event factors. Within the modifiable categories, factors that were most often investigated were education level, marital status, sexually transmitted infection diagnosis, condom use, and experience of rape or sexual trauma, respectively. Informed by the findings, we applied the social-ecological model to map the identified multidimensional factors associated with HIV acquisition at the levels of individual, social and sexual networks, community, public policy, and the context of humanitarian crises. The current review provides a comprehensive, global analysis of the available evidence on HIV prevalence, incidence, and risk factors in humanitarian crises and implications for potential programs and research. Future research is warranted to further understand the directionality of the non-modifiable and modifiable factors affecting HIV acquisition, and the multilevel barriers and facilitators to the uptake of HIV prevention strategies in the context of humanitarian crises. Such research can generate actionable evidence to inform the development of ethical, trauma-informed, and culturally appropriate HIV prevention interventions in humanitarian settings.

RESUMEN: Las crisis humanitarias (eventos naturales o provocados por el hombre que pueden amenazar la salud, la seguridad y el bienestar de las comunidades) pueden afectar la dinámica de la epidemia del VIH. Los aspectos comunes de las crisis humanitarias como la pobreza, la impotencia, las perturbaciones de los sistemas de salud y la inestabilidad social pueden contribuir a la vulnerabilidad de una persona a la infección por VIH a través del aumento de comportamientos de riesgo y el acceso limitado a los servicios de salud. Guiados por la metodología del Instituto Joanna Briggs para las revisiones de alcance y la extensión de las directrices para la presentación de elementos de informe preferidos para revisiones sistemáticas y metaanálisis para revisiones de alcance (PRISMA-ScR), llevamos a cabo una revisión de alcance de la literatura publicada en inglés entre enero de 1990 y marzo de 2022 para caracterizar la evidencia global de factores modificables y no modificables para la adquisición del VIH en el contexto de crisis humanitarias. Buscamos, seleccionamos y sintetizamos sistemáticamente literatura de MEDLINE, Embase, Global Health (todas accedidas a través de Ovid) y Scopus y literatura gris a través de sitios web de agencias humanitarias y organizaciones no gubernamentales relevantes, las bases de datos de resúmenes de la Sociedad Internacional del SIDA y Google Académico. Consideramos estudios que presentaban datos empíricos sobre la prevalencia, incidencia o factores de riesgo del VIH en poblaciones afectadas por crisis humanitarias, incluyendo las personas refugiadas, solicitantes de asilo y desplazadas internamente. Cuarenta y nueve estudios cumplieron los criterios de inclusión. La mayoría de los estudios fueron de diseño cuantitativo (n = 43, 87.8%) y transversal (n = 37, 75.5%). La mayoría fueron estudios de un solo país (n = 43, 87.8%) y realizados en África subsahariana (n = 31, 63.3%). Identificamos cinco factores no modificables para la adquisición del VIH (es decir, edad, género, ubicación geográfica, lugar de nacimiento u origen y grupo étnico) y 60 factores modificables que clasificamos en cinco categorías, a saber 18 políticos y estructurales, 9 socioculturales, 11 factores de salud y salud mental, 16 de práctica sexual y 6 de eventos traumáticos relacionados con crisis humanitarias. Dentro de las categorías modificables, los factores que se investigaron con mayor frecuencia fueron el nivel educativo, el estado civil, el diagnóstico de infecciones de transmisión sexual, el uso de condón y la experiencia de violación o trauma sexual, respectivamente. Informados por los hallazgos, aplicamos el modelo socioecológico para asignar los factores multidimensionales asociados con la adquisición del VIH identificados a los niveles individual, de redes sociales y sexuales, comunidad, políticas públicas y contexto de crisis humanitaria. La revisión presente proporciona un análisis integral y global de la evidencia disponible sobre la prevalencia, la incidencia y los factores de riesgo del VIH en crisis humanitarias y sus implicaciones para posibles programas e investigaciones. Se necesitan más investigaciones para comprender mejor la direccionalidad de los factores modificables y no modificables que afectan la adquisición de VIH, y las barreras y facilitadores multinivel para el uso de estrategias para la prevención del VIH en el contexto de las crisis humanitarias. Dicha investigación puede generar evidencia accionable para informar el desarrollo de intervenciones para la prevención del VIH que sean éticas, informadas sobre el trauma, y culturalmente apropiadas en entornos humanitarios.

Patterns of psychiatric admissions across two major health crises: L' Aquila earthquake and COVID-19 pandemic lockdown.

BACKGROUND: This study examined psychiatric hospitalisation patterns in San Salvatore Hospital in L' Aquila (Italy), during two major crises: the 2009 earthquake and the COVID-19 pandemic lockdown. The investigation spans two four-year periods, from 2008 to 2011 and from 2019 to 2022, with a focus on the trimester around the earthquake and the first wave/lockdown of the pandemic. METHODS: We analysed weekly psychiatric unit admissions of adults diagnosed with schizophrenia spectrum disorder, major depression, bipolar disorder, and alcohol/substance use disorder. Four-year periods around the Earthquake and COVID-19 Lockdown were divided into sixteen trimesters, and Generalised linear models were used to analyse the relationship between weekly hospitalisation frequency and trimesters by diagnosis using a Poisson distribution. RESULTS: A total of 1195 and 1085 patients were admitted to the psychiatric ward in the 2008-2011 and 2019-2022 periods, respectively. Weekly hospitalisations in the earthquake trimester were lower than during the previous one for all diagnoses (schizophrenia spectrum: -41.9%, p = 0.040; major depression: -56.7%, p = 0.046; bipolar disorder: -69.1%, p = 0.011; alcohol/substance use disorder: -92.3%, p = 0.013). This reduction persisted for 21, 18, and 33 months after the earthquake for schizophrenia spectrum, bipolar, and alcohol/substance use disorders, respectively. Contrarily, patterns of weekly admissions around the COVID-19 lockdown remained substantially stable in the short term. However, a consistent long-term hospitalisation increase for all diagnoses characterised the first half of 2022 (the cessation of anti-COVID-19 measures; schizophrenia spectrum: +68.6%, p = 0.014; major depression: +133.3%, p = 0.033; bipolar disorder: +180.0%, p = 0.034; alcohol/substance use disorder: +475.0%, p = 0.001). CONCLUSIONS: The present study indicated that exposure to major health crises can have both short- and long-term effects on psychiatric ward admission, holding significant implications for current and future major health emergency management strategies.

Disaster Plant Pathology: Smart Solutions for Threats to Global Plant Health from Natural and Human-Driven Disasters.

Disaster plant pathology addresses how natural and human-driven disasters impact plant diseases and the requirements for smart management solutions. Local to global drivers of plant disease change in response to disasters, often creating environments more conducive to plant disease. Most disasters have indirect effects on plant health through factors such as disrupted supply chains and damaged infrastructure. There is also the potential for direct effects from disasters, such as pathogen or vector dispersal due to floods, hurricanes, and human migration driven by war. Pulse stressors such as hurricanes and war require rapid responses, whereas press stressors such as climate change leave more time for management adaptation but may ultimately cause broader challenges. Smart solutions for the effects of disasters can be deployed through digital agriculture and decision support systems supporting disaster preparedness and optimized humanitarian aid across scales. Here, we use the disaster plant pathology framework to synthesize the effects of disasters in plant pathology and outline solutions to maintain food security and plant health in catastrophic scenarios. We recommend actions for improving food security before and following disasters, including (i) strengthening regional and global cooperation, (ii) capacity building for rapid implementation of new technologies, (iii) effective clean seed systems that can act quickly to replace seed lost in disasters, (iv) resilient biosecurity infrastructure and risk assessment ready for rapid implementation, and (v) decision support systems that can adapt rapidly to unexpected scenarios. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY 4.0 International license.

Natural disasters as a public health issue.

This paper explains why natural disasters are a public health issue. A case in point is the Masara landslide in Maco Town, the Philippines. Public health concerns are not just the physical but also the 'total well-being of persons'. Classifying natural calamities as a concern related to public health will give a sense of urgency on the matter and thereby encourage governments to act on the negative effects of climate change, especially in developing countries.

Risk and protective factors associated with substance use among Puerto Rican youths after Hurricane María: a cross-sectional study.

BACKGROUND: Identifying factors associated with post-disaster youth substance use is a crucial element of developing evidence-based prevention and intervention efforts. Hurricane María struck Puerto Rico in September of 2017 and the wide-spread impact from this disaster, including exposure to trauma, displacement, and disrupted social supports had the potential to negatively impact levels of substance use among youth across the archipelago. However, post-disaster substance use remains under-investigated in this context. The current study sought to identify risk and protective factors associated with substance use among Puerto Rican youth in the aftermath of Hurricane Maria. METHODS: Cross-sectional, secondary data analyses were conducted using school-based survey data collected at all schools in Puerto Rico between February 1 and June 29, 2018 (5-9 months after Hurricane María). Social supports, substance use, and trauma symptoms were assessed. An ordinal regression analysis was conducted to identify student factors associated with greater likelihood of post-disaster substance use. RESULTS: A total of 36,485 participants (50.7% female, grades 7-12), were included in an ordinal regression analysis that compared the likelihood of respondents endorsing high, low, or no substance use after Hurricane María based on reported adult social support, counselor/teacher social support, peer social support, ptsd symptomatology, and gender. Findings showed that, when compared to students that endorsed low or no substance use, those who reported having adult social support demonstrated a 58% reduction in odds (OR = 0.42, 95% CI: 0.34-0.53) of reporting high substance use after Hurricane María, while students who reported having teacher/counselor social support demonstrated a 21% reduction in odds (OR = 0.79, 95% CI: 0.69-0.89) of reporting high substance use. Additionally, those that reported having peer social support demonstrated a 31% increase in odds (OR = 1.31, 95% CI: 1.10 to 1.58) of reporting higher substance use, compared to those that reported low or no substance use. CONCLUSIONS: While social support was generally protective, prevention efforts to build positive family and community connections may be indicated. Evidence-based school screenings of substance use and trauma may help direct intervention to those most at risk for co-occurring issues.

The disaster liaison for pediatric and perinatal medicine: A new system in Japan.

BACKGROUND: Worldwide, children, newborns, and pregnant or postpartum women are vulnerable to disasters and emergency situations, and providing support to this population is of great concern. Japan is located in a disaster-prone area, so disaster response and risk reduction strategies are important priorities. METHODS: We introduce a system called the Disaster Liaison for Pediatric and Perinatal Medicine (DLPPM). This was created with a specific focus on perinatal children and pregnant women in Japan. We report the details of its activities, discuss its challenges, and draw on lessons learned for the further development of perinatal support systems, particularly for children. RESULTS: The lessons learned from the activities of the DLPPM include the following: (1) establish a support system for emergency specialists beyond those with pediatric and perinatal specialties; (2) mitigate the risk of indirect damage caused by primary disasters; and (3) establish a networking function linked to existing pediatric and perinatal medicine facilities. CONCLUSIONS: By establishing similar systems, we believe that it will be feasible to address pediatric and perinatal care needs in disaster response contexts in other countries and regions around the world.

Resist and recover: Introducing a spring theory for modeling disaster resilience.

This paper presents a new approach for quantitatively modeling the resilience of a system that has been disrupted by a sudden-impact event. It introduces a new theoretical model that explicitly incorporates representations of the enabling and inhibiting forces that are inherent within postdisruption recovery behavior. Based on a new, more comprehensive measure of resilience that is able to capture both negative and positive deviations in performance, a generic mass-spring system is then used to illustrate the applicability of the theoretical model. The interplay between the enabling and inhibiting forces that is revealed by the new model provides a new theoretical basis for understanding the complexity of resilience and disaster recovery. With the addition of the new resilience measure, it lends support for defining and characterizing a new type of resilient behavior: unstable resilience.

Managing menstruation during natural disasters: menstruation hygiene management during "super floods" in Sindh province of Pakistan.

Menstruation is part of women's normal life, which requires basic hygienic practices. Managing hygiene can be affected by several factors and situations such as natural disasters. Focusing on 'super flooding' in Pakistan's Sindh Province, we pay attention to how this 'natural disaster' has affected hygienic practices of menstrual cycle of women. The study meticulously examines the dynamics of menstrual hygiene management, encompassing the nuanced encounters with feelings of shame and embarrassment among girls and women situated in flood camps, schools, and community shelters. It also intends to highlight women's challenge and embarrassment to participate in the distribution process of essential resources such as pads. The insights garnered from this study hold potential relevance for various stakeholders, including policymakers, healthcare practitioners, and researchers, offering a nuanced comprehension of the intersection of menstrual hygiene, climate change, and well-being of women.

Natural disasters: a comprehensive study using EMDAT database 1995-2022.

INTRODUCTION: The frequency, intensity, and geographical reach of natural disasters, fueled in part by factors such as climate change, population growth, and urbanization, have undeniably been escalating concerns around the world. DESIGN AND METHODS: This is a retrospective analysis of natural disasters recorded in the Emergency Events Database from 1995 to 2022. RESULTS: Between 1995 and 2022, 11,360 natural disasters occurred, with a mean of 398 per year. Asia experienced the most disasters (4390) and the highest number of casualties (918,198). Hydrological disasters were the most common subgroup (4969), while geophysical disasters led in terms of deaths (770,644). Biological disasters caused the most injuries (2544), particularly in Africa. CONCLUSION: Recognizing the historical impacts of the various subtypes of natural disasters may help different regions better risk analyze and mitigate the unique risks associated with such events.

Nutritional status among earthquake survivors: a systematic review and meta-analysis.

OBJECTIVE: Earthquakes, as one of the most devastating natural disasters, have many consequences, including the collapse of buildings where food is produced, stored, and distributed, which can ensue with numerous nutritional problems. This study was to investigate the nutritional status of earthquake survivors. STUDY DESIGN: This was a systematic review and meta-analysis study. METHODS: The present review was conducted according to the PRISMA guideline. The data were collected by searching the data resources of PubMed, Scopus, Web of Science, Science Direct, Google Scholar, MagIran, and Scientific Information Database. Meta-analysis was conducted using the random effects model, and the I2 index was used to assess heterogeneity among studies. Publication bias was assessed using Begg's test. RESULTS: In this study, 342 studies were identified in the primary literature search, and after removing duplicates, 14 of which were finally selected for meta-analysis. Based on the results of the meta-analysis, the overall prevalence was obtained: 4.19% for wasting, 16.78% for stunting, 12.59% for underweight, and 28.06% for anemia after the earthquake. CONCLUSION: The results indicated that earthquake survivors are exposed to malnutrition. Therefore, it is recommended that adequate food and nutritional supplements are provided to all earthquake survivors.

Nurses' experiences of providing medical services during the Kermanshah earthquake in Iran: a qualitative study.

BACKGROUND: Nurses have always been at the forefront of providing services for victims of disasters. Using nurses' experiences in disaster planning can play an important role in improving their readiness to provide healthcare during disasters. The objective of this study is not only to understand the challenges but also to explore and document the broader spectrum of experiences encountered by nurses in these critical situations. By focusing on their experiences, we aim to contribute valuable insights to enhance disaster preparedness and healthcare delivery strategies. METHODS: This qualitative study employed the content analysis method to describe the experiences of 16 earthquake relief nurses in Kermanshah, Iran. Sampling was done purposefully and continued until data saturation was achieved. Initially, two unstructured interviews were conducted to shape the interview's main line and refine guide questions. Subsequently, the study involved semi-structured interviews and observation notes for a nuanced understanding of the participants' experiences. RESULTS: In the analysis of the interviews, 920 codes were obtained and the nurses' experiences were categorized into three main categories: personal experiences, operational experiences, and social and cultural experiences. These three categories covered 12 subcategories. CONCLUSION: Results of describing nurses' experiences in the Kermanshah earthquake showed that nurses need to plan and implement necessary measures to ensure pre-disaster preparedness to respond effectively to disasters such as earthquakes. Besides, it is necessary to prepare, train and practice these interventions regularly, periodically, and purposefully. They should be evaluated and updated if they are used in a real earthquake or practice and maneuver.

Maternal experiences of pregnant women affected by natural disasters: A modified grounded theory approach.

Pregnant women experience medical and psychological difficulties in their daily lives during disasters. Since the care provided to them in disaster situations is unclear, it is necessary to better understand their experiences. This study aims to identify the maternal experiences of pregnant women during natural disasters. This research employed a modified grounded theory approach. Twenty-three pregnant women, living in disaster-affected areas, were interviewed. The research methods were utilized and interpretive analysis was conducted, resulting in a diagram and storyline to describe the process. The characteristics of the maternal experiences fluctuated between "being unable to face pregnancy because of the disaster response" and "facing the fact of being pregnant." To maintain a fluctuation between their affected life and their pregnant life, it was necessary to control the weighting between "securing a safe and secure place," "encountering support based on pregnancy," and "signs from the fetus." Clarifying the maternal experiences of pregnant women living in disaster areas revealed a multilayered structure of categories and relationships. This study suggests that understanding the structure of fluctuations and control is critical for the nursing practice.

A scoping review on the associations between early childhood caries and sustainable cities and communities using the sustainable development goal 11 framework.

BACKGROUND: Early childhood caries (ECC) is a multifactorial disease in which environmental factors could play a role. The purpose of this scoping review was to map the published literature that assessed the association between the Sustainable Development Goal (SDG) 11, which tried to make cities and human settlements safe, inclusive, resilient and sustainable, and ECC. METHODS: This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. In July 2023, a search was conducted in PubMed, Web of Science, and Scopus using tailored search terms related to housing, urbanization, waste management practices, and ECC. Studies that solely examined ECC prevalence without reference to SDG11 goals were excluded. Of those that met the inclusion criteria, a summary highlighting the countries and regions where the studies were conducted, the study designs employed, and the findings were done. In addition, the studies were also linked to relevant SDG11 targets. RESULTS: Ten studies met the inclusion criteria with none from the African Region. Six studies assessed the association between housing and ECC, with findings suggesting that children whose parents owned a house had lower ECC prevalence and severity. Other house related parameters explored were size, number of rooms, cost and building materials used. The only study on the relationship between the prevalence of ECC and waste management modalities at the household showed no statistically significant association. Five studies identified a relationship between urbanization and ECC (urbanization, size, and remoteness of the residential) with results suggesting that there was no significant link between ECC and urbanization in high-income countries contrary to observations in low and middle-income countries. No study assessed the relationship between living in slums, natural disasters and ECC. We identified links between ECC and SDG11.1 and SDG 11.3. The analysis of the findings suggests a plausible link between ECC and SDG11C (Supporting least developed countries to build resilient buildings). CONCLUSION: There are few studies identifying links between ECC and SDG11, with the findings suggesting the possible differences in the impact of urbanization on ECC by country income-level and home ownership as a protective factor from ECC. Further research is needed to explore measures of sustainable cities and their links with ECC within the context of the SDG11.

Natural disasters, foreign direct investment, and women's rights in developing countries.

We examine the conditions under which women's economic and political status is less vulnerable in the aftermath of natural disasters. We theorize that women in natural disaster-hit countries that receive higher levels of foreign direct investment (FDI) are less susceptible to the gendered impacts of those disasters. Since FDI is vital to post-disaster economic recovery, countries grappling with natural disasters are motivated to uphold women's rights as a strategy to attract FDI. Furthermore, multinational corporations (MNCs)' operation and commitment to gender equality-based values and practices are also an impetus to address the deterioration in respect for women's rights. By conducting a time-series cross-sectional, ordered logistic analysis with random effects and using a comprehensive dataset on natural disasters and women's rights, including 107 developing countries from 1990 to 2011, we find that FDI mitigates natural disasters' adverse effects on women's economic rights but not their political rights.

Exploring the impact of recovery funding on the well-being and health workforce capability of rural practices during natural disasters and emergencies.

INTRODUCTION: This study examines the impact of funding provided to support the well-being of rural health practitioners and their practice staff following the 2019-2022 bushfires. OBJECTIVE: To assess the benefits and implications of grant funding for rural practices to aid recovery following bushfires in NSW, Australia. DESIGN: An explanatory sequential mixed method design consisted of a survey and a thematic analysis of semi-structured Interviews. FINDINGS: Five key themes emerged from analysis: (1) the disasters altered the role of the practice and therapeutic relationships; (2) the funding had a positive impact on access to professional development; (3) the training had a positive impact on staff well-being and resilience; (4) the professional development had a positive impact on rural practitioner's sense of capability; and (5) important elements of future grant opportunities. DISCUSSION: The findings indicate the importance of recovering funding to facilitate access to professional development for rural health practioners during natural disasters which improved their mental health and wellbeing, capability and support to clients. CONCLUSION: Recovery funding facilitated improvement in workforce capability, professional resilience, mental health and well-being in the face of natural disasters and emergencies. There was a link between training and maintaining the capability of rural health care practitioners and their practice staff. Capability was an important factor in the well-being and resilience of the health workforce and their ability to support clients.

Unveiling the heart of disaster nursing: A qualitative study on motivations, challenges, and lessons from the devastating 2023 Turkey earthquakes.

BACKGROUND: Turkey has faced a notable escalation in earthquake disasters in the last two decades. Despite initiating a health and disaster management system, nurses' pivotal roles and experiences in handling such crises have been disregarded. AIM: This qualitative study analyzed nurses' experiences before, during, and after deployment in response to the 2023 Turkey earthquakes to enhance disaster-response efforts. METHODS: This descriptive qualitative study was conducted between March and May 2023 using semistructured interviews with 15 nurses purposively  sampled among those who volunteered to work in the earthquake zone. The MIRACLE and COREQ guidelines were followed for reporting qualitative research. FINDINGS: The analysis exposed five main themes for pre-tasking: moral obligation, motivation, insufficient experience, balancing responsibilities, and preparation challenges. The peri-task themes include responsibilities, skills, bravery and characteristics, workload management, teamwork, and outcomes. Post-tasking has three themes: competence assessment, career goals and aspirations, and support. Training and coping with anxiety and stress are common themes for all phases. CONCLUSIONS: Disaster relief requires a comprehensive and coordinated response from healthcare organizations, government agencies, and support systems. Providing adequate training, ensuring safety protocols, offering mental health support, and fostering a fair and supportive work environment are crucial steps in mitigating the adverse effects on nurses and, by extension, the patient care process in earthquake-affected areas. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nurse training in disaster preparedness should cover various response methods and involve multiple disciplines. Managers can help by arranging drills, simulations, online courses, and workshops and promoting partnerships for improved collaboration. Psychological support should be included to address emotional challenges. Regularly updating response policies based on past experiences is crucial for preparedness and efficiency.

Kidney health for all: preparedness for the unexpected in supporting the vulnerable.

As the rate of natural disasters and other devastating events caused by human activities increases, the burden on the health and well-being of those affected by kidney disease has been immeasurable. Health system preparedness, which involves creating a resilient system that is able to deal with the health needs of the entire community during times of unexpected disruptions to usual care, has become globally important. In the wake of the COVID-19 pandemic, there is a heightened awareness of the amplification of negative effects on the renal community. Paradoxically, the complex medical needs of those who have kidney diseases are not met by systems handling crises, often compounded by an acute increase in burden via new patients as a result of the crisis itself. Disruptions in kidney care as a result of unexpected events are becoming more prevalent and likely to increase in the years to come. It is therefore only appropriate that the theme for this year's World Kidney Day will focus on Kidney Health for All: preparedness for the unexpected in supporting the vulnerable.

Prenatal exposure to a natural disaster and early development of psychiatric disorders during the preschool years: stress in pregnancy study.

BACKGROUND: Growing evidence shows an association between in utero exposure to natural disasters and child behavioral problems, but we still know little about the development of specific psychopathology in preschool-aged children. METHODS: Preschool children (n = 163, mean age = 3.19, 85.5% racial and ethnic minorities) and their parents (n = 151) were evaluated annually at ages 2-5 to assess the emergence of psychopathology using the Preschool Age Psychopathological Assessment (PAPA), a parent-report structured diagnostic interview developed for preschool-age children. Sixty-six (40.5%) children were exposed to Sandy Storm (SS) in utero and 97 (59.5%) were not. Survival analysis evaluated patterns of onset and estimated cumulative risks of psychopathology among exposed and unexposed children, in total and by sex. Analyses were controlled for the severity of objective and subjective SS-related stress, concurrent family stress, and demographic and psychosocial confounders, such as maternal age, race, SES, maternal substance use, and normative prenatal stress. RESULTS: Exposure to SS in utero was associated with a substantial increase in depressive disorders (Hazard Ratio (HR) = 16.9, p = .030), anxiety disorders (HR = 5.1, p < .0001), and attention-deficit/disruptive behavioral disorders (HR = 3.4, p = .02). Diagnostic rates were elevated for generalized anxiety disorder (GAD; HR = 8.5, p = .004), attention-deficit/hyperactivity disorder (ADHD; HR = 5.5, p = .01), oppositional-defiant disorder (ODD; HR = 3.8, p = .05), and separation-anxiety disorder (SAD; HR = 3.5, p = .001). Males had distinctively elevated risks for attention-deficit/disruptive behavioral disorders (HR = 7.8, p = .02), including ADHD, CD, and ODD, whereas females had elevated risks for anxiety disorders (HR = 10.0, p < .0001), phobia (HR = 2.8, p = .02) and depressive disorders (HR = 30.0, p = .03), including SAD, GAD, and dysthymia. CONCLUSIONS: The findings demonstrate that in utero exposure to a major weather-related disaster (SS) was associated with increased risk for psychopathology in children and provided evidence of distinct psychopathological outcomes as a function of sex. More attention is needed to understand specific parent, child, and environmental factors which account for this increased risk, and to develop mitigation strategies.

Depression and PTSD among Houston Residents who Experienced Hurricane Harvey and COVID-19: Implications for Urban Areas Affected by Multiple Disasters.

Little is known about the combined impact of the COVID-19 pandemic and other major disasters on mental health. Hurricane Harvey hit the Gulf Coast in 2017, resulting in substantial costs, significant levels of displacement, and approximately 100 deaths, and was followed in 2020 by the COVID-19 pandemic. We randomly sampled 1167 Houstonians from 88 designated super-neighborhoods and surveyed them about their demographics, event-specific traumas and stressors, and symptoms of current depression and post-traumatic stress disorder (PTSD). We estimated the prevalence of depression (5.8%) and PTSD (12.6%) more than three years after Hurricane Harvey, and assessed the relative influence of event-specific stressors and traumas on current mental health. Overall, we observed evidence for two key findings that are salient for residents of urban environments in the context of multiple disasters. First, stressors were primary influences on depression, whereas both stressors and traumas influenced PTSD. Second, the influences of stressors and traumas on depression and PTSD symptoms faded with time.