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1.
Indian Pediatr ; 61(3): 277-280, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38469846

RESUMO

Children face unique risks resulting from disasters and conflicts. Broadly, complex emergencies create new and augment existing health risks to children. Direct, conflict-related injuries and deaths - such as those resulting from exposure to chemical weapons and blast injuries - not only have immediate impact but also have long-term impacts on the health and wellbeing of children. Lapses in vaccination coverage, changes in vector patterns, and widespread malnutrition, contribute to new and re-emerging infectious diseases among children. Understanding risks resulting from disasters and conflicts is critical for implementing timely and appropriate public health programs to reduce the negative health effects on children.


Assuntos
Desastres , Desnutrição , Resiliência Psicológica , Criança , Humanos , Saúde da Criança , Saúde Pública
5.
Disaster Med Public Health Prep ; 18: e45, 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38466322

RESUMO

OBJECTIVE: The Kahramanmaras earthquakes struck the north-eastern part of Türkiye and Syria on February 6, 2023. It is well known that timely coordination and provision of emergency medical care in the field is particularly important to save lives after earthquakes. This study aimed to identify the challenges faced by medical responders on the ground. METHODS: This exploratory-descriptive qualitative study was conducted in Hatay, the province most affected by the earthquakes. Data were collected through in-depth semi-structured interviews and field observations, and then analyzed using thematic analysis approach. RESULTS: The study was carried out with 15 first responders from the medical profession. The study revealed 9 themes of challenges faced by medical responders: providing safety and security, human resources management, meeting personal needs, recording data, communication, patient transport, burial procedures, psychological acumen, and logistical problems. Some problems were resolved after 72 h and some continued until day 7. CONCLUSIONS: Inadequate organization of volunteer health workers, communication breakdowns, and logistical problems are some of the main challenges. To address these issues, satellite phones and radio systems can be promoted, as well as disaster-resilient logistical planning and better coordination of volunteers.


Assuntos
Planejamento em Desastres , Desastres , Terremotos , Humanos , Turquia , Pessoal Técnico de Saúde
6.
BMC Res Notes ; 17(1): 63, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38439090

RESUMO

OBJECTIVE: Field trips to disaster-affected areas (FTDAs) without a specific purpose, such as medical cooperation, are widely used in medical education. However, what medical students gain from FTDAs remains unclear. The present study aimed to clarify what medical students gain from FTDAs. Five medical students who had visited the Fukushima nuclear power plant in Japan participated in a semi-structured group interview to ask what they gained from such a visit. The narratives were analysed using open coding. RESULTS: The following four themes emerged: "Spirit of scientific inquiry", "Foundation for lifelong education and personal growth", "Broadened understanding of the medical profession", and "Importance of practicing medicine in the community setting". The ambiguity of medical students' specific roles in the field trip compared to the fieldwork may have encouraged them to make sense of the experience from their perspective. As a result, students may have gained a broader perspective of their future work and career through the FTDA. If medical educators can gain consensus from the residents of a disaster site, different disaster-affected areas can be potential sites for medical education using FTDAs.


Assuntos
Desastres , Educação Médica , Estudantes de Medicina , Humanos , Pesquisa Qualitativa , Consenso
7.
PLoS One ; 19(3): e0299956, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38457447

RESUMO

Extreme precipitation usually cause grievous losses&casualties, which varies greatly under different scenarios. This paper took Henan province as an example, it innovatively constructed three different extreme precipitation scenarios and built indicators system of social vulnerability from exposure, sensitivity and resilience based on MOVE framework. Social Vulnerability Indexs(SoVI) were then calculated by mathematical models under three different reoccurrence intervals. The results show that SoVI was low in the west and high in the north. High SoVI areas expanded to the middle and south as recurrence intervals increased. SoVI in each area of Henan province increased along with the recurrence intervals at different growth rates. The larger the recurrence interval was, the faster the SoVI increased. The results indicate SoVI is greatly affected by disaster levels, which need to be incorporated into social vulnerability. This study provides not only a new thought for social vulnerability assessment, but also a reference for the policymakers to formulate related risk management policies.


Assuntos
Desastres , Vulnerabilidade Social , China , Medição de Risco , Gestão de Riscos
8.
Ulus Travma Acil Cerrahi Derg ; 30(3): 167-173, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38506390

RESUMO

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.


Assuntos
Anestésicos , Desastres , Terremotos , Humanos , Estudos Retrospectivos , Hospitais Urbanos
12.
PLoS One ; 19(3): e0300931, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38512874

RESUMO

A uniaxial compression test was conducted on sandstone specimens at various inclination angles to determine the energy evolution characteristics during deformation and damage. Based on the principle of minimum energy dissipation, an intrinsic model incorporating the damage threshold was developed to investigate the mechanical properties of sandstone at different inclination angles, and the energy damage evolution during deformation and damage. This study indicated that when the inclination angle of the structural surface remained below 40°, sandstone exhibited varying mechanical properties based on different inclination angles. The peak strain was positively correlated with the inclination angle, whereas the compressive strength and modulus of elasticity showed negative correlations. From an energy perspective, the deformation and damage of sandstone under external loading entail processes of energy input, accumulation, and dissipation. Moreover, higher inclination angles of the structural surface resulted in a smaller absorbed peak strain and a reduced proportion of dissipated energy relative to the energy input, thereby affecting the evolution of energy damage throughout the process. As the inclination angle of the structural surface increased, the absorbed total strain at the peak value decreased, whereas the proportion of the dissipated energy increased. Additionally, the damage threshold and critical value of the rock specimens increased with the inclination angle. The critical value, a composite index comprising the peak strain, compressive strength, and elastic modulus, also increased accordingly. These findings can offer a novel perspective for analyzing geological disasters triggered by fissure zones within underground rock formations.


Assuntos
Desastres , Salicilatos , Força Compressiva , Módulo de Elasticidade , Elasticidade
13.
Pediatr Cardiol ; 45(4): 840-846, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38431885

RESUMO

Natural and human-provoked disasters pose serious health risks to children, particularly children and youth with special healthcare needs, including many cardiology patients. The American Academy of Pediatrics (AAP) provides preparedness recommendations for families, but little is known about recommendation adherence. Caregivers of children seen in a pediatric cardiology clinic network were recruited to complete an electronic survey. Participants self-reported child medical history and their household's implementation of AAP recommended disaster preparedness items. Families received a link to AAP resources and a child ID card. Data were analyzed using descriptive statistics with Fisher's exact and Wilcoxon rank sum tests. 320 caregivers participated in the study, of whom 124 (38.8%) indicated that their child has a diagnosed cardiac condition, and 150 (46.9%) indicated that their child had special healthcare needs. The average preparedness item completion rate was 70.7% for household preparedness, 40.1% for reunification preparedness, and 26.3% for community preparedness. Households of children with medical needs had similar rates of preparedness compared to overall rates. Of all respondents, 27.8% previously received disaster preparedness resources, 67.7% would like resources on discussing disaster preparedness, and 93.0% intend to talk with their household about disaster preparedness after completing the survey. These results demonstrate a gap between AAP recommendations and household-level disaster preparedness, including patients with cardiac conditions and those with special healthcare needs. Families expressed that they were interested in getting resources for disaster preparedness. Pediatric cardiologists may consider asking about disaster preparedness and providing disaster preparedness resources tailored to the needs of their patients.


Assuntos
Planejamento em Desastres , Desastres , Adolescente , Criança , Humanos , Estados Unidos , Planejamento em Desastres/métodos , Inquéritos e Questionários , Autorrelato , Instituições de Assistência Ambulatorial
14.
Environ Monit Assess ; 196(4): 386, 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38506980

RESUMO

Heavy rains and floods cause human, material, and economic damage in cities worldwide. The severity of flooding has intensified due to accelerating urbanization. While much of the existing research on flood hazards emphasizes simulation and assessment, the correlation between indicators has yet to be explored. This study employs the Tree Gaussian Process sensitivity analysis method. Through rigorous sampling and correlation analysis, the model identifies critical determinants. Significantly, factors such as the water supply penetration rate (Var3), water pipeline density in built-up areas (Var4), centralized treatment rate of sewage treatment plants (Var6), agricultural land for forestry (Var13), and urban, village, and industrial and mining land (Var15) stand out as primary influencers on the flood-affected populace. These variables reflect a city's flood management capability and its dedication to resource stewardship and ecological equilibrium, underscoring its critical role in flood risk assessment and strategic mitigation. The study further illuminates that the interplay of these variables can exacerbate flood consequences, suggesting a compounded impact when variables operate in tandem. Recognizing these synergistic effects reveals a more pronounced flood threat than previously estimated, indicating that viewing these factors in silos might underrepresent the risk involved.


Assuntos
Desastres , Inundações , Humanos , Cidades , Monitoramento Ambiental , Urbanização
15.
Global Health ; 20(1): 23, 2024 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-38515186

RESUMO

BACKGROUND: The Sendai Framework is the United Nations' most significant approach to reducing the risk of disasters from 2015 to 2030. This framework designed for all communities. However, communities should create operational and remedial strategies based on their unique circumstances. Considering the gaps in the implementation of Sendai framework strategies in Iran, as a developing country, the present study was designed. METHOD: This study was conducted by using a qualitative direct content analysis method to find out the expert's opinions on the implementation of the Sendai framework in Iran from 2021 to 2023. 35 experts in the focus group discussion and 9 experts in the interview were the participants of the study. RESULTS: Study findings were merged and reported as one main theme entitled Executive actions for implementing the Sendai Framework, four categories, and 37 codes. Eleven codes for the strategy of understanding disaster risk, 11 codes for the strategy of strengthening disaster risk governance to manage disaster risk, eight codes for the strategy of Investing in disaster risk reduction for resilience, and finally, seven codes for the strategy of enhancing disaster preparedness for effective response and to "Build Back Better" in recovery, rehabilitation, and reconstruction were identified as implementation solutions. CONCLUSION: The Sendai Framework has not provided any detailed implementation solutions because the countries' economic, social, level of development, etc., are different. The study's findings can be used as a guide for other developing countries.


Assuntos
Planejamento em Desastres , Desastres , Humanos , Irã (Geográfico) , Desenvolvimento Sustentável , Comportamento de Redução do Risco
16.
BMC Public Health ; 24(1): 806, 2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38486256

RESUMO

INTRODUCTION: Disasters such as earthquakes, conflict, or landslides result in traumatic injuries creating surges in rehabilitation and assistive technology needs, exacerbating pre-existing unmet needs. Disasters frequently occur in countries where existing rehabilitation services are underdeveloped, hindering response to rehabilitation demand surge events. AIMS: The primary aim of this scoping review is therefore to synthesize the evidence on rehabilitation and assistive technology preparedness and response of health systems in LMICs to the demand associated with disasters and conflict situations. A secondary aim was to summarize related recommendations identified in the gathered literature. METHODOLOGY: A scoping review was conducted using the Arksey and O'Malley framework to guide the methodological development. The results are reported in accordance with PRISMA-ScR. Four bibliographic databases were used: CINHAL, Cochrane, Pubmed, Scopus and. Key international organisations were also contacted. The search period was from 2010-2022. Eligible publications were categorized for analysis under the six World Health Organization health systems buildings blocks. RESULTS: The findings of this scoping review suggest that rehabilitation is poorly integrated into health systems disaster preparedness and response in LMICs. Of the 27 studies included in the scoping review, 14 focused on service delivery, 6 on health workforce, 4 on health information systems and 3 on the leadership and governance building block. No study focused on financing nor assistive technology. This review found the most frequently referenced recommendations for actions that should be taken to develop rehabilitation services in disasters to be: the provision early and multi-professional rehabilitation, including the provision of assistive technology and psychological support, integrated community services; disaster response specific training for rehabilitation professionals; advocacy efforts to create awareness of the importance of rehabilitation in disasters; and the integration of rehabilitation into disaster preparedness and response plans. CONCLUSION: Findings of this scoping review suggest that rehabilitation is poorly integrated into health systems disaster preparedness and response in LMIC's, largely due to low awareness of rehabilitation, undeveloped rehabilitation health systems and a lack of rehabilitation professionals, and disaster specific training for them. The paucity of available evidence hinders advocacy efforts for rehabilitation in disaster settings and limits the sharing of experiences and lessons learnt to improve rehabilitation preparedness and response. Advocacy efforts need to be expanded.


Assuntos
Planejamento em Desastres , Desastres , Medicina , Tecnologia Assistiva , Humanos , Países em Desenvolvimento
17.
BMC Health Serv Res ; 24(1): 285, 2024 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-38443888

RESUMO

BACKGROUND: Disasters are events that bring with them effects that contribute to the disruption of the normality of a population and thus highlight the vulnerabilities of the health system. In Mariana and Brumadinho, the collapse of the dam of ore tailings brought with it several impacts that were felt in the short term and will be felt in the medium and long term. And that by being intensely intertwined with issues of economic and productive nature, has as its meaning an uninterrupted result of its activities. METHODS: Through the DATASUS database, two specific variables were chosen to perform the analysis: the approved amount and the approved value. For this research, a methodological device, the segmented regression line, was used to observe the influences that the disasters that occurred in Mariana and Brumadinho had on the ambulatory health systems. RESULTS: The results of the segmented regression line show that, with Mariana, the amount approved continued to grow throughout the period, which shows that there was no change because of the disaster. There was a reduction in spending. In Brumadinho, regarding the amount approved, there was an upward trend in the disaster's month, which did not change immediately afterwards, and regarding expenditure, the growth pattern was maintained in all three periods. Corroborating this data, the relative and absolute base elements show an increase in the amount approved and in the number of services provided at various posts compared with Minas Gerais. CONCLUSIONS: Based on the findings, it was possible to understand that although disasters exert an influence that may have some effect on the health system, the lack of significance sometimes cannot be interpreted as a lack of impact on the disaster. The segmented regression line outlines some effects that are not conclusive but indicative of a numerical interpretation and a trend interpretation.


Assuntos
Assistência Ambulatorial , Desastres , Humanos , Brasil , Bases de Dados Factuais , Emoções
18.
Glob Chang Biol ; 30(3): e17221, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38450880

RESUMO

Communities interspersed throughout the Canadian wildland are threatened by fires that have become bigger and more frequent in some parts of the country in recent decades. Identifying the fireshed (source area) and pathways from which wildland fire may ignite and spread from the landscape to a community is crucial for risk-reduction strategy and planning. We used outputs from a fire simulation model, including fire polygons and rate of spread, to map firesheds, fire pathways and corridors and spread distances for 1980 communities in the forested areas of Canada. We found fireshed sizes are larger in the north, where the mean distances between ecumene and fireshed perimeters were greater than 10 km. The Rayleigh Z test indicated that simulated fires around a large proportion of communities show significant directional trends, and these trends are stronger in the Boreal Plains and Shields than in the Rocky Mountain area. The average distance from which fire, when spreading at the maximum simulated rate, could reach the community perimeter was approximately 5, 12 and 18 km in 1, 2 and 3 days, respectively. The average daily spread distances increased latitudinally, from south to north. Spread distances were the shortest in the Pacific Maritime, Atlantic Maritime and Boreal Plains Ecozones, implying lower rates of spread compared to the rest of the country. The fire corridors generated from random ignitions and from ignitions predicted from local fire history differ, indicating that factors other than fuel (e.g. fire weather, ignition pattern) play a significant role in determining the direction that fires burn into a community.


Assuntos
Desastres , Incêndios Florestais , Canadá , Simulação por Computador , Florestas
20.
Cad Saude Publica ; 40(3): e00237022, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38477725

RESUMO

Disasters cause changes in morbidity, mortality, and medicine use. Brazil is one of the main producers of mineral ores at great environmental cost. Mine tailings are stored in dams and ruptures have led to major disasters. We investigated the consumption of psychoactive medicines in the municipalities affected by the Fundão dam disaster in Minas Gerais State. An ecological study was carried out on drug consumption, estimated using public purchases in Minas Gerais and dispensing data from private retail pharmacies. Consumption (in number of defined daily doses/100,000 inhabitants per day) was analyzed descriptively in eight municipalities, stratified according to consumption level during a 25-month period. Six comparisons of mean consumption values for both data sets were done for pre- and post-disaster periods. The means of medicine consumption before and after the event were plotted and linear trends were added. Public purchase data evinced high consumption levels. Only pharmaceutical retail showed significant differences between the strata in the pre-disaster versus two post-disaster periods. Smaller municipalities showed an increase in consumption 15 months after the disaster. Clonazepam led the way in pharmaceutical retail consumption, followed by fluoxetine. Medicines showed an upward trend after the disaster. The high public provision may have stifled significant consumption patterns of psychoactive drugs; however, peak consumption were observed in private retail, suggesting a modification in use patterns after the disaster. The decrease in consumption immediately after the event was probably related to lower care-seeking behavior on the part of the population, and significant peaks after the disaster may reflect economic consequences of it.


Assuntos
Desastres , Medicina , Humanos , Brasil , Fluoxetina , Preparações Farmacêuticas
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