Barbarigenesis and the collapse of complex societies: Rome and after.

"Barbarism" is perhaps best understood as a recurring syndrome among peripheral societies in response to the threats and opportunities presented by more developed neighbors. This article develops a mathematical model of barbarigenesis-the formation of "barbarian" societies adjacent to more complex societies-and its consequences, and applies the model to the case of Europe in the first millennium CE. A starting point is a game (developed by Hirshleifer) in which two players allocate their resources either to producing wealth or to fighting over wealth. The paradoxical result is that a richer and potentially more powerful player may lose out to a poorer player, because the opportunity cost of fighting is greater for the former. In a more elaborate spatial model with many players, the outcome is a wealth-power mismatch: central regions have comparatively more wealth than power, peripheral regions have comparatively more power than wealth. In a model of historical dynamics, a wealth-power mismatch generates a long-lasting decline in social complexity, sweeping from more to less developed regions, until wealth and power come to be more closely aligned. This article reviews how well this model fits the historical record of late Antiquity and the early Middle Ages in Europe both quantitatively and qualitatively. The article also considers some of the history left out of the model, and why the model doesn't apply to the modern world.

Health Vulnerability Index for Disaster Risk Reduction: Application in Belt and Road Initiative (BRI) Region.

Despite the importance of health vulnerability in disaster risk assessment, most of the existing disaster vulnerability indicators only emphasize economic and social vulnerability. Important underlying health risks such as non-communicable disease are not included in vulnerability measures. A three-phase methodology approach was used to construct a disaster risk model that includes a number of key health indicators which might be missing in global disaster risk analysis. This study describes the development of an integrated health vulnerability index and explains how the proposed vulnerability index may be incorporated into an all-hazard based disaster risk index in the Belt and Road Initiative (BRI), also known as the "Silk Road Economic Belt", region. Relevant indicators were identified and reviewed in the published literature in PubMed/Medline. A two-stage dimension reduction statistical method was used to determine the weightings of relevant dimensions to the construction of the overall vulnerability index. The proposed final health vulnerability index included nine indicators, including the proportion of the population below 15 and above 65 years, under-five mortality ratio, maternal mortality ratio, tuberculosis prevalence, age-standardized raised blood pressure, physician ratio, hospital bed ratio, and coverage of the measles-containing-vaccine first-dose (MCV1) and diphtheria tetanus toxoid and pertussis (DTP3) vaccines. This proposed index, which has a better reflection of the health vulnerability in communities, may serve as a policy and implementation tool to facilitate the capacity-building of Health-Emergency Disaster Risk management (Health-EDRM).

Decision tool for climate disasters and infectious disease at sub-national level in India: Ensuring a paradigm shift in health planning from prevalence to vulnerability.

Climate change is considered as a distal determinant of public health which is increasing in importance. India, as an example, has a national action plan for climate change and human health. Sub-national (State) plans for climate change also exist, taking into account the health sector. The State of Bihar was selected for assessment because of its vulnerability (a function of exposure, sensitivity and adaptive capacity). A vulnerability framework was constructed by discussions with national and local-level specialists followed by weightage given by working in the field of climate and health with international exposure. A total of 15 districts were at a high risk of floods and these were considered for detailed analysis using the methodology for human development index as well as other examples in the field of environment. Climate health vulnerability index score were correlated with actual prevalence of flood mortality data of these 15 districts in year 2016. It was found that climate health vulnerability and flood mortality had negative low correlation of -0.25. In contrast for vector-borne diseases (VBD), both pre-flood and post-flood, the morbidity data had a correlation of 0.24 and 0.11 respectively. Possible reasons for a negative correlation for mortality could involve better preparedness by disaster district authorities. However, outbreak control is within the ambit of the health sector where a possible reason for decreased correlation coefficient in the post-flood period could be due to the impact on health facilities itself, thus leading to reduced reporting.

Fire risk reduction through a community-based risk assessment: reflections from Makola Market, Accra, Ghana.

This paper explores the level of vulnerability to the hazard of fire that exists in Makola Market in Accra, Ghana, and assesses how this threat can be reduced through a community-based risk assessment. It examines the perceptions of both market-stall occupants and primary stakeholders regarding the hazard of fire, and analyses the availability of local assets (coping strategies) with which to address the challenge. Through an evaluation of past instances of fire, as well as in-depth key stakeholder interviews, field visits, and observations, the study produces a detailed hazard map of the market. It goes on to recommend that policymakers consider short-to-long-term interventions to reduce the degree of risk. By foregrounding the essence of holistic and integrated planning, the paper calls for the incorporation of disaster mitigation measures in the overall urban planning process and for the strict enforcement of relevant building and fire safety codes by responsible public agencies.

Climate change. A global threat to cardiopulmonary health.

Recent changes in the global climate system have resulted in excess mortality and morbidity, particularly among susceptible individuals with preexisting cardiopulmonary disease. These weather patterns are projected to continue and intensify as a result of rising CO2 levels, according to the most recent projections by climate scientists. In this Pulmonary Perspective, motivated by the American Thoracic Society Committees on Environmental Health Policy and International Health, we review the global human health consequences of projected changes in climate for which there is a high level of confidence and scientific evidence of health effects, with a focus on cardiopulmonary health. We discuss how many of the climate-related health effects will disproportionally affect people from economically disadvantaged parts of the world, who contribute relatively little to CO2 emissions. Last, we discuss the financial implications of climate change solutions from a public health perspective and argue for a harmonized approach to clean air and climate change policies.

Evaluation of the preservation value and location of farm ponds in Yunlin County, Taiwan.

Farm ponds in Yunlin County first appeared in 1,622 and have played roles in habitation, production, the ecology, culture, and disaster reduction. Farm ponds largely disappeared with the development of urban areas and the industrial sector; thus, effective preservation of the remaining ponds is critical. The criteria to evaluate the preservation value of farm ponds is established by expert questionnaires which follow the Fuzzy Delphi Method (FDM) and Fuzzy Analytic Hierarchy Process (FAHP), and GIS, which are integrated into a spatial analysis of the remaining 481 farm ponds in Yunlin County. The results show that 28 ponds should be preserved to continue the cultural interaction between farm ponds and settlements; 36 ponds should preserved to connect coasts and streams, which are important habitats for birds; 30 ponds should be preserved to increase storage capacity, recharge groundwater, and reduce land subsidence; four ponds should be preserved as Feng-Shui ponds in front of temples in settlements or as recreation areas for local citizens; and four farms should be preserved (high priority) in agricultural production areas to support irrigation. In short, FAHP and GIS are integrated to evaluate the number and locations of farm ponds that provide water for habitation, production, the ecology, culture, and disaster reduction and maintain the overall preservation value in Yunlin County. The results could inform governmental departments when considering conservation policies.

Preventable disasters in the offshore oil industry: from Piper Alpha to Deepwater Horizon.

This article compares two industrial disasters in the offshore oil industry, the explosion and fire on Piper Alpha off the coast of Scotland in 1988, the world's worst offshore disaster, and the blowout and explosions on Deepwater Horizon in the Gulf of Mexico in 2010. It attempts to answer a simple question: Given the enormity of the first tragedy and the careful analysis of its circumstances and causes, why were the lessons of previous failure not learned by this globally organized industry, in the very heartland in the United States? The answer tells us much about the ability of corporate capital to configure regulatory regimes in its own interests and to do so in a manner that continues to threaten the safety and well-being of its employees and the wider environment.

High-fidelity simulation and emergency preparedness.

Ongoing threats of bioterrorism and the consequences of natural disasters require nurses entering the workforce to be competent in emergency preparedness. Nurses need to collaborate with multidisciplinary teams and use their critical thinking skills to provide safe nursing care during potentially chaotic public health emergencies. Using Institute of Medicine recommendations and Quality and Safety Education for Nurses competencies, the authors describe a public health emergency simulation exercise with undergraduate senior nursing students enrolled in a public health clinical course. Students applied chronic disease, mental health, and pharmacology knowledge acquired in previous nursing courses to an unfolding infectious disease outbreak while practicing their assessment, treatment, delegation, organizational, and leadership skills. The students' quantitative evaluation of the experience indicated that 90.36% thought the purpose of the experience was clear, 91.5% thought the importance of delivering safe care during a public health emergency was stressed, and 79.5% thought the presimulation briefing and postsimulation debriefing helped them understand and participate in the drill. Qualitatively, the students' reflections of the exercise indicated that although they initially felt overwhelmed and anxious, they realized the importance of participating in emergency preparedness and recognized their ability to apply nursing skills learned in previous courses.

Imagination, distributed responsibility and vulnerable technological systems: the case of Snorre A.

An influential approach to engineering ethics is based on codes of ethics and the application of moral principles by individual practitioners. However, to better understand the ethical problems of complex technological systems and the moral reasoning involved in such contexts, we need other tools as well. In this article, we consider the role of imagination and develop a concept of distributed responsibility in order to capture a broader range of human abilities and dimensions of moral responsibility. We show that in the case of Snorre A, a near-disaster with an oil and gas production installation, imagination played a crucial and morally relevant role in how the crew coped with the crisis. For example, we discuss the role of scenarios and images in the moral reasoning and discussion of the platform crew in coping with the crisis. Moreover, we argue that responsibility for increased system vulnerability, turning an undesired event into a near-disaster, should not be ascribed exclusively, for example to individual engineers alone, but should be understood as distributed between various actors, levels and times. We conclude that both managers and engineers need imagination to transcend their disciplinary perspectives in order to improve the robustness of their organisations and to be better prepared for crisis situations. We recommend that education and training programmes should be transformed accordingly.

The Prestige oil spill and its economic impact on the Galician fishing sector.

The sinking of the Prestige oil tanker on 18 November 2002 off the coast of Galicia, Spain, had important economic, environmental and social ramifications. The aim of this paper is to carry out an initial analysis of the costs related to a halt in fishing activities in Galicia between November 2002 and December 2003. This involves three different steps: an assessment of the cost of the preventative and palliative measures introduced by Spanish public administrations (compensation for affected fishermen and shellfish fisherman); an indirect evaluation of the implications of the disaster (via a study of data on production); and a direct appraisal of the economic impact of the event (reduction in income), using questionnaires completed by a representative sample of fishermen and shellfish fisherman. The results obtained from these three methods of estimating losses are compatible. By December 2003, losses to the Galician fishing sector stood at an estimated EUR 76 million.

[Oil spill identification by near-infrared spectroscopy].

Petroleum oil spill happens occasionally at sea. It's important to differentiate the exact products in order to carry out following actions to decrease harmfulness. In the present study, a rapid oil spill identification method by near infrared spectroscopy coupled with pattern recognition techniques is proposed. 56 simulated spilled oils of gasoline, diesel fuel and lubricating oil in marine were chosen to develop the method. Organic reagent of CCl4 was used to extract the oil. Pattern recognition techniques were established by principal component analysis (PCA) coupled with Mahalanobis' distance with the multiplicative signal correction (MSC) and Norris first derivative pretreatment. The study shows that PCA technique is a useful method to extract the main characteristics, and Mahalanobis' distance is an ellipsoidal boundary that circumscribes a data cluster. And oil spill samples with concentration above 0.4 microL x mL(-1) can be successfully identified by the method. The developed technique could be further applied to the identification of spilled oil in marine.

Conclusiones y recomendaciones de la tercera reunion nacional de autoridades de salud publica

Conclusiones y recomendaciones de la 3ra. Reunion Nacional de Autoridades de salud Publica : discursos de apertura y cierre y recomendaciones sobre saneamiento ambiental, emergencias sanitarias, financiamiento y recursos para la salud, atencion medica integrada, niveles de complejidad de servicios de atencion medica, segun modos de operacion y agentes efectores, obras y servicios sociales

Conclusiones y recomendaciones de la tercera reunion nacional de autoridades de salud publica

Conclusiones y recomendaciones de la 3ra. Reunion Nacional de Autoridades de salud Publica : discursos de apertura y cierre y recomendaciones sobre saneamiento ambiental, emergencias sanitarias, financiamiento y recursos para la salud, atencion medica integrada, niveles de complejidad de servicios de atencion medica, segun modos de operacion y agentes efectores, obras y servicios sociales