Position of the Society for Nutrition Education and Behavior: The Importance of Emergency-Related Food and Nutrition Education Before, During, and After a Disaster.

It is the position of the Society for Nutrition Education and Behavior that for effective recovery from and resilience to disasters, it is essential that impacted individuals and communities have access to safe, nutritious, and culturally and contextually appropriate foods and beverages, and receive emergency-related food and nutrition education before, during, and after a disaster. Despite the increasing number, duration, and intensity of disasters worldwide, there is relatively limited guidance for research, policy, and practice about addressing the emergency-related food and nutrition needs of affected populations. Although nutrition emergencies tend to be understudied, emerging efforts are working to advance food and nutrition security during disaster response and recovery. To help elevate the importance of emergency-related food and nutrition education before, during, and after a disaster, Society for Nutrition Education and Behavior, which represents the unique professional interests of nutrition educators worldwide, summarizes the relevant literature and puts forth recommendations for all those who are engaged in this work in the following 4 key areas: (1) improving communication and outreach, (2) fostering community engagement and locally-driven preparedness, (3) building the evidence base and translating the evidence into action, and (4) training current professionals and the next generation of public health leaders. Altogether, before, during, and after a disaster, those who engage in this work, among other allies, can help elevate the importance of nutrition education and other strategies to promote healthy eating behaviors through research, policy, and practice.

Longitudinal associations between post-traumatic stress and post-traumatic growth among older adults 11 years after a disaster.

AIMS: Previous studies have reported inconsistent findings regarding the association between post-traumatic stress (PTS) and post-traumatic growth (PTG). Three major issues could account for this inconsistency: (1) the lack of information about mental health problems before the disaster, (2) the concept of PTG is still under scrutiny for potentially being an illusionary perception of personal growth and (3) the overlooking of PTS comorbidities as time-dependent confounding factors. To address these issues, we explored the associations of PTS and PTG with trauma-related diseases and examined the association between PTS and PTG using marginal structural models to address time-dependent confounding, considering pre-disaster covariates, among older survivors of the 2011 Japan Earthquake and Tsunami. METHODS: Seven months before the disaster, the baseline survey was implemented to ask older adults about their health in a city located 80 km west of the epicentre. After the disaster, we implemented follow-up surveys approximately every 3 years to collect information about PTS and comorbidities (depressive symptoms, smoking and drinking). We asked respondents about their PTG in the 2022 survey (n = 1,489 in the five-wave panel data). RESULTS: PTG was protectively associated with functional disability (coefficient -0.47, 95% confidence interval (CI) -0.82, -0.12, P < 0.01) and cognitive decline assessed by trained investigators (coefficient -0.07, 95% CI -0.11, -0.03, P < 0.01) and physicians (coefficient -0.06, 95% CI -0.11, -0.02, P < 0.01), while PTS was not significantly associated with them. Severely affected PTS (binary variable) was associated with higher PTG scores, even after adjusting for depressive symptoms, smoking and drinking as time-dependent confounders (coefficient 0.35, 95% CI 0.24, 0.46, P < 0.01). We also found that an ordinal variable of the PTS score had an inverse U-shaped association with PTG. CONCLUSION: PTG and PTS were differentially associated with functional and cognitive disabilities. Thus, PTG might not simply be a cognitive bias among survivors with severe PTS. The results also indicated that the number of symptoms in PTS had an inverse U-shaped association with PTG. Our findings provided robust support for the theory of PTG, suggesting that moderate levels of psychological struggles (i.e., PTS) are essential for achieving PTG, whereas intense PTS may hinder the attainment of PTG. From a clinical perspective, interventions that encourage social support could be beneficial in achieving PTG by facilitating deliberate rumination.

Prevention, social emancipation, and paradigmatic transition: a 40-year interdisciplinary Brazilian trajectory on accidents and disasters. / Prevenção, emancipação social e transição paradigmática: uma trajetória interdisciplinar de 40 anos no Brasil sobre acidentes e desastres.

The article, in the form of an essay, systematizes a 40-year-long professional trajectory of interdisciplinary and socially engaged experiences around the analysis and prevention of accidents and disasters. This study was mainly developed within the scope of research and postgraduate studies in Public Health in Brazil, driven by the sanitarian movement and the construction of Brazilian Unified National Health System (SUS) in its search for democracy and social and health justices. Its empirical basis involved workers' health and environmental surveillance actions organized in networks led by SUS in conjunction with universities, unions, social movements, environmental nongovernmental organizations (NGO), and Public Prosecutors' Offices. Events of greater socio-environmental complexity in sectors such as steel, petrochemicals, mining, agribusiness, and energy forged the search for new epistemic and interdisciplinary references that encompassed two new justices, i.e., environmental and cognitive. This essay systematizes this trajectory of conceptual contributions in three movements from the 1980s to the present day (each corresponding to a socio-political and institutional context) to reflect on paradigmatic transition movements in the analysis and prevention of accidents and disasters from an interdisciplinary perspective. It ends by suggesting abyssal and emancipatory prevention to face different current crises, including environmental, health, democratic, and civilizing ones.

O artigo, na forma de ensaio, sistematiza uma trajetória profissional de experiências interdisciplinares e socialmente engajadas em torno da análise e prevenção de acidentes e desastres nos últimos 40 anos. O trabalho acadêmico se desenvolveu principalmente no âmbito da pesquisa e pós-graduação na saúde pública brasileira impulsionado pelo movimento sanitarista e a construção do Sistema Único de Saúde (SUS) em sua busca por democracia, justiça social e sanitária. A base empírica envolveu ações de vigilância em saúde dos trabalhadores e ambiental organizadas em redes protagonizadas pelo SUS em conjunto com universidades, sindicatos, movimentos sociais, organizações não governamentais (ONG) ambientalistas e Ministérios Públicos. Eventos de maior complexidade socioambiental em setores como siderurgia, petroquímico, mineração, agronegócio e energia forjaram a busca por novos referenciais epistêmicos e interdisciplinares que abarcam duas novas justiças: a ambiental e a cognitiva. Este artigo apresenta essa trajetória de contribuições conceituais em três movimentos a partir da década de 1980 até os dias atuais, cada qual correspondendo a um contexto sociopolítico e institucional, para pensar movimentos de transição paradigmática na análise e prevenção de acidentes e desastres numa perspectiva interdisciplinar. Finaliza-se com a sugestão de prevenção abissal e emancipatória para enfrentar diferentes crises da atualidade, como a ambiental, a sanitária, a democrática e a civilizatória.

El artículo, en forma de ensayo, sistematiza una trayectoria profesional de experiencias interdisciplinarias y socialmente comprometidas en torno al análisis y la prevención de accidentes y desastres en los últimos 40 años. El trabajo académico se desarrolló principalmente en el ámbito de la investigación y postgrado en Salud Colectiva brasileña, impulsado por el movimiento sanitario y la construcción del Sistema Único de Salud (SUS) en su búsqueda por democracia, justicia social y sanitaria. La base empírica involucró acciones de vigilancia en salud y ambiental de los trabajadores, organizadas en redes protagonizadas por el SUS en conjunto con universidades, sindicatos, movimientos sociales, organizaciones no gubernamentales ambientalistas y Ministerios Públicos. Los acontecimientos de mayor complejidad socioambiental en sectores como la siderurgia, el petroquímico, la minería, el agronegocio y la energía han llevado a la búsqueda de nuevas referencias epistémicas e interdisciplinarias que abarcaron dos nuevas formas de justicia, la ambiental y la cognitiva. El artículo sistematiza esa trayectoria de contribuciones conceptuales en tres movimientos a partir de la década de 1980 hasta los días actuales, cada cual, correspondiendo a un contexto sociopolítico e institucional, para pensar movimientos de transición paradigmática en el análisis y prevención de accidentes y desastres desde una perspectiva interdisciplinaria. Se finaliza con la sugerencia de prevención abisal y una prevención emancipadora para enfrentar diferentes crisis de la actualidad, como la ambiental, la sanitaria, la democrática y la de civilización.

Associations between housing and psychological damage by earthquake and modifiable risk factors for dementia in general older adults: Tohoku Medical Megabank community-based cohort study.

AIM: To evaluate the association between housing and psychological damage caused by the Great East Japan Earthquake (GEJE) and modifiable risk factors (MRFs) of dementia for general population of older adults. METHODS: This cross-sectional study enrolled 29 039 community-dwelling older adults (mean age 69.1 ± 2.9 years, 55.5% women). We evaluated disaster-related damage (by complete or not complete housing damage) and psychological damage (by post-traumatic stress reaction [PTSR]) after the GEJE using a self-report questionnaire. MRFs encompassed the presence of depression, social isolation, physical inactivity, smoking, and diabetes. We examined the association between disaster-related damage and MRFs using ordinary least squares and modified Poisson regression models adjusted for sociodemographic and health status variables. RESULTS: Complete housing damage and PTSR were identified in 2704 (10.0%) and 855 (3.2%) individuals, respectively. The number of MRFs was significantly larger for the individuals with complete housing damage (ß = 0.23; 95% confidence interval [CI]: 0.19-0.27) and PTSR (ß = 0.60; 95% CI: 0.53-0.67). Prevalence ratios (PRs) for depression and physical inactivity were higher in individuals with complete housing damage. The PRs for all domains of the MRFs were significantly higher in individuals with PTSR. CONCLUSIONS: Housing and psychological damage caused by the GEJE were associated with an increased risk factor of dementia. To attenuate the risk of dementia, especially among older victims who have experienced housing and psychological damage after a disaster, multidimensional support across various aspects of MRFs is required. Geriatr Gerontol Int 2024; 24: 509-516.

Protecting Caribbean patients diagnosed with cancer from compounding disasters.

Caribbean small island developing states are becoming increasingly vulnerable to compounding disasters, prominently featuring climate-related hazards and pandemic diseases, which exacerbate existing barriers to cancer control in the region. We describe the complexities of cancer prevention and control efforts throughout the Caribbean small island developing states, including the unique challenges of people diagnosed with cancer in the region. We highlight potential solutions and strategies that concurrently address disaster adaptation and cancer control. Because Caribbean small island developing states are affected first and worst by the hazards of compounding disasters, the innovative solutions developed in the region are relevant for climate mitigation, disaster adaptation, and cancer control efforts globally. In the age of complex and cascading disaster scenarios, developing strategies to mitigate their effect on the cancer control continuum, and protecting the health and safety of people diagnosed with cancer from extreme events become increasingly urgent. The equitable development of such strategies relies on collaborative efforts among professionals whose diverse expertise from complementary fields infuses the local community perspective while focusing on implementing solutions.

A data driven oil spill mapping using GMM clustering and damping ratio on X-Press Pearl ship disaster in the Indian Ocean.

The work presented in this paper is focused on the largest marine disaster to have occurred in the Indian Ocean due to the breakup of the container tanker ship X-Press Pearl. In order to identify the oil spill and its temporal evolution, a recently proposed damping ratio (DR) index is employed. To derive the DR, a data-driven GMM-EM clustering method optimized by stochastic ordering of the resulting classes in Sentinel 1 SAR time series imagery is proposed. A ship-born oil spill site is essentially considered to consist of three subsites: oil, open sea, and ship. The initial site probability densities were determined by using k-means clustering. In addition to the clustering method, two histogram-based approaches, namely contextual peak thresholding (CPT) and contextual peak ordering (CPO), were also formulated and presented. The improved histogram peak detection methods take into account spatial and contextual dependencies. The similarity of the marginal probability densities of the open sea and the oil classes makes it difficult to quantify the DR values to show the level of dampening. In the study, we show that reasonable class separability to correctly determine the σVV0,seaθ is possible by using GMM clustering. Resulting class separability's are also reported using JM and ML distances. The methods tested show the range of derived DR values stays significantly within similar ranges to each other. The outcomes were tested with the ground-based surveys conducted during the disaster for oil spill sites and other chemical compounds. The proposed methods are simple to execute, robust, and fully automated. Further, they do not require masking the oil or the selection of high-confidence water pixels manually.

After an Earthquake: The Comparison of Psychological Status of Resident and Earthquake Survivor Cancer Patients.

OBJECTIVE: Natural disasters such as earthquakes can have a significant impact on cancer treatment and care. The objective of the study was to evaluate the psychological effect of the earthquake on survivor cancer patients compared to regular cancer patients. METHODS: Cancer patients who were evacuated from earthquake sites and referred for the continuation of their treatment, as well as regular resident patients were included in the study. The resident cancer patients were compared with the study population as a control group. DASS-21 forms were filled based on patients' declarations. RESULTS: Forty-six patients were earthquake survivors and 55 were resident cancer patients. Stress scores were significantly higher in earthquake survivors (P = 0.021). In contrast, there was no difference in stratified groups due to DASS-21 categorization in stress scores while depression and anxiety subgroups had significant differences (P = 0.012; P < 0.001). Also, women significantly had a worse outcome in the depression and anxiety categories (P = 0.028; P = 0.021) while no difference was observed in men. CONCLUSION: Recent earthquakes in Turkey had psychological negative effects on oncology patients. The increased stress, depression, and anxiety levels were observed in earthquake survivors who were evacuated from the disaster zone and compared to the control group.

Anesthetic approach to trauma patients in the city hospital after the 2023 Maras earthquake.

BACKGROUND: The February 6, 2023, Kahramanmaras earthquake caused significant destruction across our country. More than 50,000 people lost their lives, thousands were injured, and health facilities were damaged. Victims were transferred to hospitals in other provinces for treatment. This study evaluates the anesthesia approach applied to the injured who were transferred to our tertiary hospital. METHODS: We retrospectively reviewed the data of patients who underwent surgery between February 6 and February 20, 2023. The study included earthquake victims who underwent emergency trauma surgery, aged 10 years and above. We recorded the date of admission to the hospital, demographic information, type of surgery, surgical site, anesthesia technique, preference for peripheral block, laboratory values, dialysis and intensive care needs, and survival rates. Data analysis was performed using the IBM® Statistical Package for the Social Sciences (SPSS®) Version 26.0. RESULTS: A total of 375 cases were included in the study. Of these, 323 patients underwent surgery for extremity injuries, and 35 for vertebral injuries. Among the extremity injuries, 61.6% were to the lower extremities, and 17.1% to the upper extremities. Debridement was performed on 147 patients, fasciotomy on 49 patients, and amputation on 33 patients. General anesthesia was applied to 352 patients, spinal anesthesia to 19 patients, and sedoanalgesia to four patients. Peripheral nerve block was performed on 33 patients. Dialysis treatment was administered to 105 patients. Twenty-six patients were lost during the treatment process. There were no intraoperative patient deaths. CONCLUSION: The predominance of extremity injuries among earthquake victims increases the inclination towards regional anesthesia. Incorporating Plan A blocks into basic anesthesia skills could enhance the preference for regional anesthesia in disaster situations. Furthermore, transferring the injured to advanced centers may reduce morbidity.

Metal and metalloid maternal transfer in a newborn West Indian manatee (Trichechus manatus) two years after the northeastern oil spill disaster of 2019 in Brazil.

A large-scale oil spill along the northeastern Brazilian coast in 2019-2020 severely impacted primary manatee habitats in Brazil. This study aimed to assess metal and metalloid contamination in a dead manatee calf found following this oil spill. Several elements were detected, including chromium, iron, nickel, lead, and vanadium, which are crude oil components, and thallium, a component of dispersants used to degrade and dissipate crude oil. The presence of these contaminants in the manatee calf is indicative of maternal exposure, metabolism, and newborn transference via placenta and lactation. This is the first report of mother-calf metal transfer in manatees, highlighting the species' vulnerability and potential long-term population dynamics effects, and the first report for several metals and metalloids in these animals, laying the foundation for future research efforts. These findings highlight the urgent need for continued environmental monitoring, ecotoxicological assessments, and conservation initiatives.

'Financial fallout' in the US biopharmaceutical industry: Maximizing shareholder value, regulatory capture, and the consequences for patients.

Patients are suffering the consequences of financialization - as shareholders demand high returns from pharmaceutical companies, pharmaceuticals squeeze profits out of top-selling products, and insurers charge higher premiums for limited coverage, the impact of financialization cascades across the value chain to compound the burden of cost for patients. This article offers a novel theoretical perspective and methods for understanding how "financial fallout" has impacted the pharmaceutical value chain, health systems, and patients. Financial fallout describes the cascade of consequences characteristic of and essential to industries reshaped by financialization. It characterizes how the effects of financialization have become so thoroughly engrained in industries and societies as to seem inevitable and how the consequences are also devastating, like the fallout that follows nuclear disasters. The research represented here examines how processes of financial fallout: 1) cascade across the pharmaceutical value chain from innovation to commercialization; 2) are enacted through 'regulatory capture' as regulations meant to safeguard the public from the exigencies of the market ultimately serve the interests of industry; and 3) have devastating consequences for patients who need access to life-saving therapies. The analysis is developed through the example of the market for monoclonal antibodies in the US, and the specific case of Keytruda - one of the top-selling monoclonal antibodies marketed for cancer therapy, which generated over 14 USD billion in revenue in 2020 and 17 billion in 2021. It traces how processes of financial fallout cascade down the value chain to impact health systems and compound the cost of care for patients. Financial fallout signals dire trends in providing health services and access to medicines. It diagnoses how our options for saving lives and improving health are overdetermined by and infused with the interests of financial capital.

Palliating Serious Illness During Disasters and Public Health Emergencies.

ABSTRACT: The increase in disasters and public health emergencies in recent years is a serious public health concern. The needs of suffering victims can be multifaceted, particularly the needs of those who are from systematically marginalized populations. Palliative care nurses play a vital role in mitigating the suffering of those affected by these events. Despite the acute need, there is a lack of nurses who specialize in hospice and palliative care and generalist nurses are not sufficiently prepared to provide palliative care during disasters and public health emergencies. Nurses and nursing students should use national and global resources and training opportunities to hone their palliative care skills as well as learn self-care skills to increase their resiliency. Outcomes from research and collaborative efforts should be used to educate the future nursing workforce and advocate for equitable delivery of quality palliative care for all people who are affected by disasters and public health emergencies.

The role of habitat heterogeneity and timescales on the recovery of reef epifaunal communities affected by a massive oil spill in the tropics.

From August 2019 to January 2020 the Brazilian Coast was impacted by the largest oil spill in the Tropical oceans ever since. Paiva Beach, one of the most preserved sandy beaches in the northeast tropical Brazilian coast, was among the most affected regions by the oil spill in October 2019. This area has important reef systems that harbor abundant macroalgal assemblages with very diverse epifaunal communities. The present study aims to evaluate the impacts of the 2019 oil spill on epifauna associated with the seaweed species Jania capillacea and Penicillus capitatus collected in Paiva Beach from July 2019 to October 2022, and use the interaction macroalgae/epifauna/timescale as a proxy to quantify the effects of oil spills on communities structure and recovery. The epifauna of both algae did not suffer severe changes in abundance immediately after the spill, however, the abundance of taxa like echinoderms, sea spiders (Pycnogonida) and peracarid crustaceans dropped during or soon after the event, whereas others, like sabellid worms, had strong increase in abundance, possibly related to the spill. Both phytal assemblages also had distinct temporal patterns in species diversity and abundance, the last being strongly correlated to amphipod abundance for some taxa. The epifauna of J. capillacea had a short-term tendency of decrease in taxonomic diversity, whereas the epifaunal communities of P. capitatus gained a few taxa in the months immediately after the disaster. The diversity profiles of both communities returned to pre-spill conditions a few months later, with a slower abundance recovery in J. capillacea. Local environmental characteristics like landscape heterogeneity, connectivity with other environments, and critical-species (mainly amphipods) were possibly the main buffering factors for the phytal communities after the oil spill.

Development and demonstration of a data visualization platform of short-term guidelines for ambient air levels of benzene during disaster response in Houston, Texas.

Industrial disasters have caused hazardous air pollution and public health impacts. Response officials have developed limited exposure guidelines to direct them during the event; often, guidelines are outdated and may not represent relevant elevated-exposure periods. The 2019 Intercontinental Terminals Company (ITC) fire in Houston, Texas led to large-scale releases of benzene and presented a public health threat. This incident highlights the need for effective response and nimble, rapid public health communication. We developed a data-driven visualization tool to store, display, and interpret ambient benzene concentrations to assist health officials during environmental emergencies. Guidance values to interpret risk from acute exposure to benzene were updated using recent literature that also considers exposure periodicity. The visualization platform can process data from different sampling instruments and air monitors automatically, and displays information publicly in real time, along with the associated risk information and action recommendations. The protocol was validated by applying it retrospectively to the ITC event. The new guidance values are 6-30 times lower than those derived by the Texas regulatory agency. Fixed-site monitoring data, assessed using the protocol and revised thresholds, indicated that eight shelter-in-place and 17 air-quality alerts may have been considered. At least one of these shelter-in-place alerts corresponded to prolonged, elevated benzene concentrations (~1000 ppb). This new tool addresses essential gaps in the timely communication of air pollution measurements, provides context to understand potential health risks from exposure to benzene, and provides a clear protocol for local officials in responding to industrial air releases of benzene. Integr Environ Assess Manag 2024;20:533-546. © 2023 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Integrated environmental assessment of iron ore tailings in floodplain soils and plants after the Fundão Dam disaster in Brazil.

Previous studies of the Doce River basin (Brazil) seem to be contradictory regarding the contamination of soils with potentially harmful elements (PHE). This research aimed to perform an integrated assessment of PHE in the soil-plant-tailing system from the area most affected by the iron waste after the Fundão Dam disaster in 2015. Different fractions of PHE (exchangeable, nonexchangeable, reducible, and pseudo-total) were determined on deposited iron waste (DIW), soil waste mixture (SWM), and control soil (CS) samples. Total contents of PHE in Poaceae were also determined, and Allium cepa bioassays were performed to determine DIW and CS cytotoxicity and/or genotoxicity to plants. The Fe and Mn contaminations were the only ones related to the deposition of DIW on floodplains, and other harmful element content (such as As, Hg, Ni, Cd, Cr, and Pb) was not found above baseline values for soils. In addition, a significant part of the Fe and Mn in DIW is readily available or subject to acidification and prolonged flood reduction processes. The high available content of Fe favored its excessive accumulation by Brachiaria. The DIW chemical conditions reduced biological functions of A. cepa under a controlled environment. However, more drastic effects, such as genetic damage, were not seen. The postdisaster action of covering DIW with CS resulted in undesirable enrichment of Pb on the floodplain soils. The integrated results allow the conclusion that the iron waste is not a time bomb for PHE contamination of soils between the Fundão and Risoleta Neves Hydroelectric Dam (~100 km away from Fundão). Integr Environ Assess Manag 2024;20:117-132. © 2023 SETAC.

Long-term Experience on Breast Cancer-related Lymphedema in the Coastal Area of Fukushima, Japan After the 2011 Triple Disaster.

BACKGROUND/AIM: Disasters can jeopardize breast cancer care and Japan's triple disaster in 2011 (earthquake, tsunami, and nuclear accident) is no exception. However, detailed information is lacking regarding the care of breast cancer related lymphedema (BCRL) following the disaster. We aimed to explore the process by which local patients become aware of BCRL, the problems faced, and the support they require. We also aimed to clarify the effects of the 2011 disaster on experiences related to lymphedema in the target population. PATIENTS AND METHODS: Patients who developed BCRL after breast cancer treatment were recruited from Iwaki city, a municipality located in the southern coastal region of Fukushima (N=16). In-depth, semi-structured, face-to-face interviews were conducted, and the obtained data were appraised using thematic analysis. RESULTS: Five themes related to BCRL were identified: 1) the process of becoming aware of BCRL, 2) troubles or worries/concerns due to BCRL, 3) information sources regarding BCRL management, 4) strategies to cope with BCRL, and 5) the adverse impacts of the 2011 disaster on BCRL management. CONCLUSION: Except for the disaster context, the themes are in line with those of previous studies conducted in the non-disaster context. Nonetheless, there were limited but non-negligible adverse effects of the 2011 disaster on long-term local BCRL management. The findings of this study demonstrate the necessity for individualizing coping strategies against BCRL among healthcare professionals in the Fukushima coastal area and beyond.

Cognitive Interview Validation of a Novel Household Hazard Vulnerability Assessment Instrument.

BACKGROUND: Weather and climate disasters are responsible for over 13 000 US deaths, worsened morbidity, and $1.7 trillion in additional costs over the last 40 years with profound racial disparities. OBJECTIVES: This project empirically generated items for a novel survey instrument of household hazard vulnerability with initial construct validation while addressing racial bias in the data collection process. METHODS: Cognitive interviews facilitated understanding regarding the performance of drafted survey questions with transdisciplinary expert panelists from diverse US regions on unique hazard/disaster/event items. To prevent representation bias in data collection, those with Black and/or African American racial, biracial, or multiracial identities were over-sampled. Interview video recordings were qualitatively analyzed using thematic and pattern coding. RESULTS: A cognitive process mapped to themes of disaster characteristics, resources, individual life facets, and felt effects was revealed. We identified 379 unique instances of linked terms as synonyms, co-occurring, compounding, or cascading events. Potential for racial bias in data collection was elucidated. Analysis of radiation exposure, trauma, and criminal acts of intent items revealed participants may not interpret survey items with these terms as intended. CONCLUSION: Potential for racial bias exists relative to water dam failure, evacuation, external flood, suspicious packages/substances, and transportation failure. Hazard terms that were not interpreted as intended require further revision in the validation process of individual or household disaster vulnerability assessments. Several commonalities in the cognitive process and mapping of disaster terms may be utilized in disaster and climate change research aimed at the individual and household unit of analysis.

Improving child nutrition in disasters by developing a modeled disaster preparedness nutrition education curriculum.

In contemporary global society, largely because of climate change and other natural and human-induced hazards, disasters are an almost daily occurrence. The nutritional impact of disasters on children results in long-term physical and mental health problems. As children are one of the most vulnerable demographic groups, they must be empowered with disaster preparedness nutrition knowledge, and the skills and motivation to survive, prevent/reduce malnutrition, and maintain good health during disasters. A disaster preparedness nutrition education program (DPNEP) was developed in this study to improve children's nutrition in daily life and during disasters through student-centered education. A consultative approach was used to synthesize the knowledge of a diverse group of four experts in disaster medicine and management, public health, education, and food and nutrition sciences to reach a consensus through discussion. A model DPNEP was developed by targeting grade 4 and 5 students and using interactive teaching methods. This can lead to the implementation of continuous nutrition education to empower children to make healthy food choices in daily life and reduce the risk of disaster-nutrition-related morbidity and mortality. Furthermore, once children acquire the necessary information, they are likely to share this knowledge with their families and communities, thereby enhancing society's resilience.

Telepathology in intraoperative frozen section consultation of breast cancer sentinel node biopsy in Fukushima, Japan following the 2011 triple disaster: diagnostic accuracy and required time during the early implementation phase.

In breast cancer surgery, some medical facilities lack the necessary resources to conduct sentinel lymph node biopsy and its intraoperative frozen section consultation. In the coastal rural area of Fukushima, Japan, which has suffered from physician undersupply following the 2011 triple disaster of earthquake, tsunami and nuclear disaster, we explored the feasibility of telepathology by evaluating the diagnostic accuracy in remote intraoperative frozen section consultation of sentinel lymph node biopsy and its required time. Although examination time has room for improvement, telepathology can be one possible solution in resource-limited areas.