Natural disasters, livelihood, and healthcare challenges of the people of a riverine island in Bangladesh: A mixed-method exploration.

BACKGROUND: Bangladesh's islands, because of their geographical location, frequently encounter crises like floods and river erosion, which pose significant threats to the residents' well-being and livelihoods. To delve into the effects of these disasters on livelihood and healthcare challenges, a mixed-method study was undertaken in a riverine-island near a major river of Bangladesh. METHODOLOGY: Between February 15th and February 28th, 2023, a cross-sectional study was conducted on an island in Bangladesh. The quantitative method involved conducting a survey of 442 households, with a total of 2921 participants. Additionally, 10 in-depth interviews and 10 key-informant interviews were conducted using semi-structured guidelines. Qualitative interviews were audio-recorded, transcribed verbatim, and analyzed using a thematic analysis. Triangulation was employed in this study through the integration of qualitative and quantitative analysis, resulting in the presentation of findings that offer an in-depth comprehension of the phenomenon being investigated. RESULTS: River erosions and floods are common and recurring natural disasters that significantly impact the lives of the riverine island inhabitants. These disasters often disrupted their livelihoods, forced many residents to endure substandard living conditions or relocated during flood events. The island faced a low diagnostic prevalence of chronic diseases (e.g., 5.1% of adults were hypertension and 2.5% are diabetes) because of the absence of diagnostic facilities and a shortage of certified doctors. A significant number of chronic illness people in the community turned to alternative medicine sources (39.3%) such as homeopathy, Kabiraj, and Ayurvedic medicine, especially it gets increased during periods of natural disasters. Moreover, reproductive aged women revealed that 79.4% of them gave birth at home, with 6.0% of these home deliveries resulting in miscarriage or infant death. The destruction of crops, unstable job opportunities, an inadequate educational system, and a deficient healthcare delivery system exacerbated the hardships faced by the population affected by these disasters. CONCLUSION: The failure to seek treatment for chronic diseases and undiagnosed diseases is a significant health issue among the aging adults on the island. Island residents face the challenge of establishing effective prevention strategies for the well-being of older adults especially at the period of natural disasters. It is crucial for the government and non-governmental organizations (NGOs) to collaborate to prevent the negative effects of floods and river erosions. This should include efforts to enhance the quality of education, healthcare services, job opportunities, and financial assistance for rebuilding homes.

Experiences of pregnant people affected by natural disasters: a qualitative systematic review protocol.

OBJECTIVE: This qualitative systematic review will identify, appraise, and synthesize existing qualitative evidence regarding the experiences of pregnant people during a natural disaster to gain a deeper understanding of the complex factors influencing their experiences. INTRODUCTION: During natural disasters, pregnant people would benefit from health workers, including nurses, midwives, and other professionals, considering their needs and providing support to address complex factors, including family relationships, social support, and stress; however, little is known about the experiences of pregnant people during a natural disaster. This study is the first qualitative systematic review of the experiences of pregnant people during a disaster. INCLUSION CRITERIA: This review will include studies that focus on pregnant people's experiences of living in a disaster area during a natural disaster. It will include both published and unpublished qualitative studies, with data collected through interviews and observations, in either English or Japanese. METHODS: The databases and other sources to be searched include MEDLINE, CINAHL, and PsycINFO (in English); and CiNii and Ichushi-Web (in Japanese). Further, we will cross-check the reference lists of included studies with search outcomes to identify any additional studies suitable for analysis. The search for gray literature will be conducted using Google Scholar and ProQuest. We will use the recommended JBI approach for study selection, critical appraisal, data extraction, and data synthesis. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021265326.

Health Disparity, Natural Disaster, and COVID-19: Perspectives From a Bahamian American Nurse.

Trauma clusters are formed when 2 or more disasters occur simultaneously and/or consecutively. These disasters have the propensity to potentiate health disparities. The purpose of this article is to share thoughts about critical caring theory and how the theory can inform holistic nursing action when health disparity amplifies trauma clustering.

Strengthening Resilience and Adaptive Capacity to Disasters in Cancer Control Plans: Lessons Learned from Puerto Rico.

Patients with cancer are among the most vulnerable populations in the aftermath of a disaster. They are at higher risk of medical complications and death due to the collapse of or disruptions in the health care system, the community infrastructure, and the complexity of cancer care. The United Nations' Sendai Framework for Disaster Reduction states that people with life-threatening and chronic diseases should be considered in disaster plans to manage their risks. With extreme weather or disasters becoming more intense and frequent and with the high burden of cancer in the United States and its territories, it is important to develop region-specific plans to mitigate the impact of these events on the cancer patient population. After Hurricanes Irma and Maria hit Puerto Rico and the U.S. Virgin Islands in 2017, the need to develop and implement such plans for patients with cancer was evident. We describe ongoing efforts and opportunities for disseminating and implementing emergency response plans to maintain adequate cancer care for patients during and after disasters. While plans for patients with cancer should be housed within the emergency support function infrastructure of each jurisdiction, the Centers for Disease Control and Prevention's Comprehensive Cancer Control Plans provide excellent community-centered mechanisms to support these efforts.

Risk assessment for oil leakage under the common threat of multiple natural hazards.

Petroleum industry can create enormous wealth and employment opportunities, which is one of the pillars of the national economy. The transportation conditions of petroleum products are complex and changeable. The natural disaster-induced dangerous chemical leakage may damage the ecological environment, which leads to substantial economic losses. It significantly undermines the sustainable development agenda. Therefore, assessing the possibility of leakage and the potential environmental damages becomes a primary task to decision-makers to formulate maintenance plans. This paper evaluated the risk of an oil pipeline leakage under the regional geological disasters. Specifically, risk assessment indicators system was established considering the common threat of multiple natural hazards in the region. The sensitivities of the influence factors were determined using the combined GIS and the contribution rate model. The fuzzy analysis approach was used to process the expert's judgment to obtain a real-time disaster hazard. Meanwhile, in terms of the analysis of pipeline failure causes, the assessment system of disaster resistance ability was developed to determine the possibility of leakage. The leakage-induced environmental losses were quantified by monetary quantification. Finally, the level of environmental risk was determined using a 5 × 5 probability-currency matrix. Case results show that the risk level is medium, thereby appropriate maintenance measures need to be taken to reduce the risk. Overall, this study provides necessary help to prevent the leakage of petroleum products in transportation. Also, the environmental risk presented in the form of currency can promote non-environmental professional risk decision-makers better understand the degree of risk.

Spatial clustering of people with memories and responses six years after an earthquake in Cauquenes, Chile.

The occurrence of earthquakes can cause psychiatric problems expressed as unpleasant and uncontrollable memories of the event termed post-traumatic stress disorder (PTSD). Mapping the location of people and identifying their exposure and reactions to an earthquake can be extremely valuable from a public, mental health point of view. The main objective of this study was to examine people with respect to PTSD and healthy post-traumatic growth (PTG) after an earthquake searching for expression of geographic clustering that could be useful for a better understanding of mental health conditions. Geographic information systems analyses were performed to detect global and local geographic clustering. Investigating 171 randomly selected adults from Cauquenes, Chile, we demonstrated spatially clustered variables related to PTSD and PTG in Cauquenes six years after an earthquake. Urban and peri-urban areas had clear differences (hotspots/coldspots). The spatial identifications found should facilitate exploring the impact of mental health programmes in communities exposed to disasters like earthquakes, thereby improving their quality of life as well as reducing overall costs.

The Effects of Yoga in Helping Cancer Patients and Caregivers Manage the Stress of a Natural Disaster: A Brief Report on Hurricane Harvey.

Background: This small qualitative study reports on the experiences of patients and family caregivers who participated in a dyadic yoga pilot trial while undergoing cancer treatment in the midst of Hurricane Harvey. Our primary purpose was to determine if participants implemented components of the program to cope with the stressors associated with Hurricane Harvey and if they perceived benefits from the yoga practices. Methods: We administered brief semistructured interviews to the dyads participating in a dyadic yoga pilot trial. Participants (n = 5 dyads) were asked to discuss their experience with Hurricane Harvey, including factors that helped them cope with the event while receiving treatment. Result: Patients had a mean age of 55.6 years, were mostly non-Hispanic White, male, and had advance stage head and neck cancer. Caregivers had a mean age of 58 years and were mainly non-Hispanic White and female. Analyses of the interviews revealed 2 overarching themes: (1) the storm's negative impact and (2) the use of yoga to cope with the hurricane-related stressors. Conclusions: Patient-caregiver dyads experienced psychological distress during the storm and/or its aftermath. Dyads used yoga techniques to cope with these psychological stressors. Yoga served as a means of social support as dyads either participated in these activities together or with other family members.

Telehealth at the US Department of Veterans Affairs after Hurricane Sandy.

BACKGROUND: Like other integrated health systems, the US Department of Veterans Affairs has widely implemented telehealth during the past decade to improve access to care for its patient population. During major crises, the US Department of Veterans Affairs has the potential to transition healthcare delivery from traditional care to telecare. This paper identifies the types of Veterans Affairs telehealth services used during Hurricane Sandy (2012), and examines the patient characteristics of those users. METHODS: This study conducted both quantitative and qualitative analyses. Veterans Affairs administrative and clinical data files were used to illustrate the use of telehealth services 12 months pre- and 12 months post- Hurricane Sandy. In-person interviews with 31 key informants at the Manhattan Veterans Affairs Medical Center three-months post- Hurricane Sandy were used to identify major themes related to telecare. RESULTS: During the seven-month period of hospital closure at the Manhattan Veterans Affairs Medical Center after Hurricane Sandy, in-person patient visits decreased dramatically while telehealth visits increased substantially, suggesting that telecare was used in lieu of in-person care for some vulnerable patients. The most commonly used types of Veterans Affairs telehealth services included primary care, triage, mental health, home health, and ancillary services. Using qualitative analyses, three themes emerged from the interviews regarding the use of Veterans Affairs telecare post- Hurricane Sandy: patient safety, provision of telecare, and patient outreach. CONCLUSION: Telehealth offers the potential to improve post-disaster access to and coordination of care. More information is needed to better understand how telehealth can change the processes and outcomes during disasters. Future studies should also evaluate key elements, such as adequate resources, regulatory and technology issues, workflow integration, provider resistance, diagnostic fidelity and confidentiality, all of which are critical to telehealth success during disasters and other crises.

The effect of natural disasters on cancer care: a systematic review.

As the incidence of cancer and the frequency of extreme weather events rise, disaster mitigation is becoming increasingly relevant to oncology care. In this systematic Review, we aimed to investigate the effect of natural disasters on cancer care and the associated health effects on patients with cancer. We searched MEDLINE, Embase, Scopus, CINAHL, PsycINFO, Web of Science, and ScienceDirect for articles published between database inception and November 12, 2016. Articles identifying the effect of natural disasters on oncology services or the associated health implications for patients with cancer were included. Only articles published in English were included. Data extraction was done by two authors independently and then verified by all authors. The effects of disaster events on oncology services, survival outcomes, and psychological issues were assessed. Of the 4593 studies identified, only 85 articles met all the eligibility criteria. Damage to infrastructure, communication systems and medication, and medical record losses substantially disrupt oncology care. The effect of extreme weather events on survival outcomes is limited to only a small number of studies, often with inadequate follow-up periods. Natural disasters cause substantial interruption to the provision of oncology care. To the best of our knowledge, this is the first systematic Review to assess the existing evidence base on the health effects of natural disaster events on cancer care. We advocate for the consideration of patients with cancer during disaster planning.

Disaster in pregnancy: midwifery continuity positively impacts infant neurodevelopment, QF2011 study.

BACKGROUND: Research shows that continuity of midwifery carer in pregnancy improves maternal and neonatal outcomes. This study examines whether midwifery group practice (MGP) care during pregnancy affects infant neurodevelopment at 6-months of age compared to women receiving standard hospital maternity care (SC) in the context of a natural disaster. METHODS: This prospective cohort study included 115 women who were affected by a sudden-onset flood during pregnancy. They received one of two models of maternity care: MGP or SC. The women's flood-related objective stress, subjective reactions, and cognitive appraisal of the disaster were assessed at recruitment into the study. At 6-months postpartum they completed the Ages and Stages Questionnaire (ASQ-3) on their infants' communication, fine and gross motor, problem solving, and personal-social skills. RESULTS: Greater maternal objective and subjective stress predicted worse infant outcomes. Even when controlling for maternal stress from the flood, infants of mothers who were in the MGP model of maternity care performed better than infants of mothers in SC on two of the five ASQ-3 domains (fine motor and problem solving) at 6-months of age. Furthermore, infants in the SC model were more likely to be identified as at risk for delayed development on these domains than infants in the MGP model of care. CONCLUSIONS: Continuity of midwifery care has positive effects on infant neurodevelopment when mothers experience disaster-related stress in pregnancy, with significantly better outcomes on two developmental domains at 6 months compared to infants whose mothers received standard hospital care.

The effect of a community-based spiritual life review program on Indonesian elders' resilience

Objective: This quasi-experimental, pre-/post-test study aimed to examine the effect of a community-based spiritual life review program on the resilience of elders residing in a disaster-prone area. Method: Fifty-two participants who met the inclusion criteria were recruited from three villages in the Kutaraja sub-district in Banda Aceh, Indonesia. The participants were randomly assigned to an experimental group and a control group. The participants' names were listed and then randomly selected by a random number generator. The experimental group underwent a community-based spiritual life review program, which included a review of their spiritual lives, the appreciation of feelings, affirmation by the religious leader, a reevaluation of their lives, and a reconstruction of their lives to recognize their memories and present feelings. Results: The elderly resilience scores were evaluated four weeks after the program was implemented. The control group received the same program after the study was finished. The participants in the experimental group significantly improved their resilience levels after completing the program (p < .05). There was a slight increase in the resilience scores from the pre-test to the post-test in the experimental group compared with the control group (p < .05). Conclusions: Future studies should add implementation sessions and avoid photos that would induce participants' traumatic memories or experiences during the spiritual life review

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Responsibilities of the Occupational and Environmental Medicine Provider in the Treatment and Prevention of Climate Change-Related Health Problems.

: Workers are uniquely susceptible to the health hazards imposed by environmental changes. Occupational and environmental medicine (OEM) providers are at the forefront of emerging health issues pertaining to working populations including climate change, and must be prepared to recognize, respond to, and mitigate climate change-related health effects in workers. This guidance document from the American College of Occupational and Environmental Medicine focuses on North American workers health effects that may occur as a result of climate change and describes the responsibilities of the OEM provider in responding to these health challenges.

Permanent education in health to face natural disasters: an intervention research

This study has as a primary aim to analyze the Situational Strategic Plan (SSP) with regard to a Family Health team, as a device for Permanent Education in Health (PEH) in order to deal with natural disasters. The method to be used is intervention research which adopts a qualitative approach, in which we will use the SSP as a PEH device, in order to guide the Family Health team when it comes to planning the actions in health. The analysis of data will occur based on the observation of four stages of the SSP, and in accordance with the analysis of the content, seen as a set of techniques of communication analysis. It is expected that the implementation of the SSP will be capable of generating other guiding instruments that assist the teams in undertaking territorial actions to face natural disasters, in order to deal with such conditions in a more holistic and resolute manner...

Informe ultrarrápido de evaluación de tecnología sanitária: profilaxis antibiótica para la leptospirosis en caso de desastre natural (inundación) / Ultra-rapid report health technology assessment: antibiotic prophylaxis for leptospirosis in the event of a natural disaster (flood)

La leptospirosis es una zoonosis bacteriana causada por especies del género Leptospira que afectam a humanos y animales. Su reservorio lo constituyen los roedores y animales domésticos principalmente, y su transmisión ocurre por la contaminación de suelos y agua con la orina de estos animales. Su distribucción es amplia en países tropicales incluyendo la región del Caribe, América Central y paises de Amércia del Sur. La mayoría de las infecciones son subclínicas o leves, pero puede ocasionar cuadros clínicos graves e incluso fatales. Situaciones particularmente graves de riesgo de infección las constituyen las inundaciones, ya que aumenta el contacto con aguas contaminadas por la orina de los animales vectores. Se realizó un informe ultrarrápido de evaluación de tecnología sobre las profilaxis antibiótica para la leptospirosis en caso de inundación a pedido de las autoridades del Ministerio de Salud de la Provincia de Burenos Aires. Conclusiones: La evidencia analizada no permite determinar si existen beneficios claros en relación al uso de doxiciclina 200 ms semanal en forma profiláctica para evitar la infección por leptospirosis en caso de inundación, luego de la exposición al factor de risgo. En cambio sí se observó aumento de efectos adversos leves (náuseas y vómitos) con el empleo de dicho antibiótico. Se necesitan nuevos ensayos clínicos controlados y aleatorizados de alta calidad metodológica para poder esclarecer la efectividad de la quimioproflaxis de casos de leptospirosis epidémica relacionados a inundaciones. Intervención no recomienda evidencia heterogénea impide extraer conclusiones sobre beneficio clínico en este momento.

Teorias médicas e gestäo urbanas: a seca de 1877-79 em Fortaleza / Medical theories and urban management: Fortaleza`s 1877-79 drought

Apresenta-se e discute-se as idéias, práticas médicas e açöes administrativas adotadas durante a seca de 1877-79 em Fortaleza, capital da província do Ceará. A seca foi acompanhada de uma epidemia de varíola e do aumento da migraçäo da populaçäo sertaneja para a capital. Sem rede de serviços públicos capaz de atender à populaçäo de retirantes que se alojaram na cidade e nos arredores, a administraçäo municipal esforçou-se para implementar recomendaçöes dos médicos, baseadas nos modernos princípios de higienizaçäo. Demonstra-se, por meio da análise dos relatórios dos presidentes da província e dos inspetores de saúde pública, a influência daquelas teorias médicas sobre as práticas de reorganizaçäo urbana, numa situaçäo de calamidade como o de Fortaleza em 1877. (AU)

Progresso, calamidade e trabalho: pobreza e urbanidade incipiente na cidade em fins do oitocento / Progress, calamity and work: poverty and initial urbanity in the city in late XIX century

Trata da confrontaçäo ocorrida durante a Grande Seca de 1877 no Ceará. Utilizando as palavras progresso, calamidade e trabalho como janelas para o entendimento das várias sensibilidades geradas em torno da problemática da seca, procura compreender os sentidos atribuídos a elas, historicamente, pelos vários grupos estudados. (AU)

Nutritional status of children under 5 years of age in three hurricane-affected areas of Honduras

Hurricanes and other natural disasters can produce crop destruction, population displacement, infrastructure damage, and long-term public health consequences that include increased malnitrition among the affected populations. This paper presents the results of anthropometric measurements taken of 295 children under 5 years of age from three regions of Honduras that were affected by Hurricane Mitch, a major storm that struck Central America in the fall of 1998. The children in our study were sampled in three shelters in the capital city of Tegucigalpa; in the resettlement zone of Nueva Choluteca, Choluteca; and in the small urban area of Catacamas, Olancho. Our data indicated that, in comparison to the period before the hurricane, there was an elevated prevalence of wasting in all three of the study areas, and that there were also high levels of underweight in the Tegucigalpa and Nueva Choluteca study areas. There were statistically significant differences between the mean values of malnutrition indicators for Catacamas and those for the Tegucigalpa and Nueva Choluteca settlements. These differences suggest that resettled families were confronting a nutritional crisis in July and August of 1999, some 9 months after the hurricane struck (AU)