COVID-19 disaster recovery capitals: A conceptual framework to guide holistic and strengths-based support strategies.

ISSUE ADDRESSED: The COVID-19 pandemic bears many similarities to other disasters such as bushfires, earthquakes and floods. It also has distinctive features including its prolonged and recurrent nature and the social isolation induced by pandemic responses. Existing conceptual frameworks previously applied to the study of disaster, such as the Recovery Capitals Framework (RCF), may be useful in understanding experiences of the COVID-19 pandemic and in guiding agencies and governments tasked with supporting communities. METHODS: This paper presents an analysis of interviews conducted with residents of the Australian state of Victoria in 2020-2021. The RCF was used to analyse how participant experiences and well-being were influenced by seven forms of capital-social, human, natural, financial, built, cultural and political-with particular focus on the interactions between these capitals. RESULTS: Social capital featured most prominently in participants' accounts, yet the analysis revealed important interactions between social and other capitals that shaped their pandemic experiences. The RCF supported a strengths-based and holistic analysis while also revealing how inequities and challenges were compounded in some cases. CONCLUSIONS: Findings can be leveraged to develop effective and innovative strategies to support well-being and disrupt patterns of compounding inequity. Applying the RCF in the context of COVID-19 can help to link pandemic research with research from a wide range of disasters. SO WHAT?: In an increasingly complex global landscape of cascading and intersecting disasters including pandemics, flexible and nuanced conceptual approaches such as the RCF can generate valuable insights with practical implications for health promotion efforts.

Effect of an Evidence-Based Nutrition Care Pathway for Cancer Patients Undergoing Gastrointestinal and Pelvic Surgery.

Malnutrition in gastrointestinal surgery is associated with poorer post-operative outcomes which may be mitigated by delivery of evidence-based nutrition care. This study reports on the development, implementation and evaluation of an evidence-based nutrition care pathway for lower gastrointestinal and pelvic cancer patients. A retrospective cohort study of 40 surgical lower gastrointestinal and pelvic cancer patients pre- and post-implementation of the pathway was conducted. Outcomes assessed were, care pathway adherence, weight change, time to post-operative commencement of nutrition, and post-operative length of stay. Post-implementation of the pathway there were significant improvements in the proportion of patients who received dietetic assessment and education pre-surgery (0% vs 55%, P < .001) at regular intervals during admission (35% vs. 90%, P < .001) and post-discharge (22.5% vs. 81.8%, P < .001). Mean weight change between admission and discharge reduced post-implementation (-3.5%, SD 4.7 vs, -5.6%, SD 4.7; P = 0.08). Post-operative length of stay remained similar (16 day, IQR 11-34.7 vs. 17.5 day, IQR 11.2-25; P = 0.71). Post-implementation a greater proportion of patients commenced oral or enteral nutrition within 24 h, post-operatively (75% vs. 57.5%, P = 0.1). The nutrition care pathway was an effective method for delivering evidence-based nutrition care, resulting in clinically but not statistically significant improvements in outcomes.

Individual and community experiences of posttraumatic growth after disaster: 10 years after the Australian Black Saturday bushfires.

OBJECTIVE: To understand longer-term posttraumatic growth (PTG) and how this is associated with individual and community bushfire experiences. METHOD: Survey data (n = 391) from the Beyond Bushfires and the 10-year Beyond Bushfires studies were analyzed. Multilevel modeling examined relationships between basic individual demographics, bushfire exposure, and community-level variables at 3-4 years after the fires, and PTG at 10 years using the short form of the PTG Inventory. RESULTS: Ten years after these Australian bushfires, being female, experiencing higher degrees of property loss, and stronger individual sense of community were the factors associated with PTG. Approximately 12% of the variance observed in PTG scores was attributable to differences in PTG across communities. Individuals from medium and high bushfire-affected communities reported significantly higher PTG relative to those in low bushfire-affected communities. While there was evidence of community differences in PTG, and individuals' own sense of community was positively and significantly associated with increased PTG, community-level cohesion scores were not found to be significantly related to PTG (although the trend was in the expected direction). CONCLUSIONS: PTG is evident in longer-term disaster recovery. While PTG appears to vary across communities, the findings suggest that it is an individual's own sense of community (rather than community-level cohesion) that is most closely related to this longer-term growth following a bushfire event. While PTG is currently understood as an outcome of individual-level perceptions, community-level experiences shape the potential for positive transformations to occur after disasters and warrant further investigation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Using social capital to address youth sexual and reproductive health and rights in disaster preparedness and response: A qualitative study highlighting the strengths of Pacific community organisations and networks.

In the Pacific region, youth sexual and reproductive health and rights (SRHR) are strongly influenced by sociocultural and structural factors, which limit access to SRHR information and services for youth. As climate-related disasters intensify in the Pacific, existing challenges to youth SRHR may increase the risk of worse SRHR experiences and outcomes for youth before, during and after disasters. Community-based models of SRHR service provision models increase accessibility for youth in non-disaster times, but there is limited evidence of how community organisations address youth SRHR in disaster contexts. We conducted qualitative interviews with 16 participants from community organisations and networks in Fiji, Vanuatu, and Tonga following the 2020 Tropical Cyclone (TC) Harold. Guided by the Recovery Capitals Framework (natural, built, political, cultural, human, social, and financial capitals), we explored how community organisations addressed challenges to facilitate access to youth SRHR information and services. Social capital in the form of peer networks and virtual safe spaces was used to navigate challenges in political, financial, and natural capitals. Existing relationships and trusted collaborations were crucial to address cultural taboos related to youth SRHR. Previous experiences of disasters and knowledge of contexts enabled participants to provide sustainable solutions to identified SRHR needs. The work conducted by community organisations and networks pre-disaster made it easier to identify and address youth SRHR risks following disasters. Our research offers a unique perspective into how social capitals were used to mitigate challenges to youth SRHR across natural, human, financial, cultural, built, and political capitals. Findings offer important opportunities to invest in existing community strengths, for transformative action to advance the SRHR of Pacific youth.

Public health implications of multiple disaster exposures.

Disasters are an important public health issue; however, there is scarce evidence to date on what happens when communities and populations experience more than one disaster. This scoping review identifies literature on the effects of multiple disasters published until Aug 2, 2021, 1425 articles were identified, of which 150 articles were included. We analysed direct and indirect public health implications of multiple disasters. Our analysis suggests that exposure to multiple disasters can affect mental health, physical health, and wellbeing, with some evidence that the potential risks of multiple disaster exposure exceed those of single disaster exposure. We also identified indirect public health implications of multiple disaster exposure, related to changes in health-care facilities, changes in public risk perception, and governmental responses to multiple disasters. We present findings on community recovery and methodological challenges to the study of multiple disasters, and directions for future research.

Evaluating the effectiveness of a nutrition assistant role in a head and neck cancer clinic.

AIM: Acute toxicities secondary to (chemo)radiation for head and neck cancer can substantially impact nutritional intake. Nutrition is usually managed by dietitians, although time constraints may limit capacity to sufficiently deal with complex nutritional issues. The aim of the present study was to determine the effectiveness of a nutrition assistant performing screening and intervention of patients in a multidisciplinary head and neck clinic. METHODS: A model of care was developed to guide nutrition assistant practice within the clinic, with training provided to nutrition assistants prior to the clinic's implementation. Outcomes, including amount of dietitian time managing high risk patients, weight change over the duration of treatment, timing of initiation of enteral feeding and patient satisfaction were compared with pre- and post-implementation of the nutrition assistant role. RESULTS: Ninety-one patients were included, 43 pre-implementation and 48 post-implementation. Overall, (n = 21, 44%) of patients met criteria for nutrition assistant screening or intervention. Mean weight change between groups was comparable both during (-5.6% vs -4.7%, P = 0.3) and post-radiotherapy (-6.6% vs -6.49%, P = 0.9). Following implementation of the role significant improvement was found for overall patient satisfaction (4.0 ± 1.1 vs 4.6 ± 0.61, P = 0.03), and the dimensions: patient-perceived benefit (3.8 ± 0.69 vs 4.4 ± 0.62, P < 0.01) and dietitian/nutrition-assistant interpersonal skills (3.91 ± 1.1 vs 4.6 ± 0.55, P = 0.02). CONCLUSIONS: The nutrition assistant role resulted in improved patient satisfaction and maintenance of nutritional outcomes demonstrating the effectiveness of this role in supporting the management of head and neck cancer patients within a multidisciplinary treatment clinic.