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2.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(8): 1199-1203, 2020 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-32867424

RESUMO

When wars, major disasters, or epidemics of the infectious diseases occur, existing medical facilities are usually unable to implement timely and effective treatment for patients, or the reception capacity is difficult to meet the surge in demand for health care. The makeshift emergency hospitals are built for patient reception, treatment and even isolation for infectious disease control. The makeshift hospitals have developed and improved in modern times, including mobile field hospitals, field tent hospitals and navy hospital ships equipped with advanced equipment and commonly used for military purposes, or temporary hospitals built in large public buildings and newly built hospitals in support of disaster relief and humanitarian operation. Makeshift hospitals have played an important role in response to many disasters and epidemics globally. This paper briefly summarizes the history, types, and applications of makeshift hospitals in disasters and epidemic responses.


Assuntos
Serviço Hospitalar de Emergência/organização & administração , Desastres , Epidemias/prevenção & controle , Humanos
3.
Am J Disaster Med ; 15(1): 7-22, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804382

RESUMO

Hospitals, which care for some of the most vulnerable individuals, have been impacted by disasters in the past and are likely to be affected by future disasters. Yet data on hospital evacuations are infrequent and outdated, at best. This goal of this study was to determine the characteristics and frequency of disasters in the United States that have resulted in hospital evacuations by an appraisal of the literature from 2000 to 2017. There were 158 hospital evacuations in the United States over 18 years. The states with the highest number of evacuations were Florida (N = 39), California (N = 30), and. Texas (N = 15). The reason for the evacuation was "natura" in 114 (72.2 percent), made-man "intentional" 14 (8.9 percent), and man-made "unintentional" or technological related to internal hospital infrastructure 30 (19 percent).The most common natural threats were hurricanes (N = 65) (57 percent), wildfires (N = 21) (18.4 percent), floods (N = 10) (8.8 percent), and storms (N = 8) (7 percent). Bombs/bomb threats were the most common reason (N = 8) (57.1 percent) for a hospital evacuation result-ing from a man-made intentional disaster, followed by armed gunman (N = 4) (28.6 percent). The most frequent infrastruc-ture problems included hospital fires/smoke (N = 9) (30 percent), and chemical fumes (N = 7) (23.3 percent). Of those that reported the duration and number of evacuees, 30 percent of evacuations lasted over 24 h and the number of evacuees was >100 in over half (55.2 percent) the evacuations. This information regarding hospital evacuations should allow hospital administrators, disaster planners, and others to better prepare for disasters that result in the need for hospital evacuation.


Assuntos
Planejamento em Desastres/organização & administração , Desastres/estatística & dados numéricos , Hospitais , Transferência de Pacientes/estatística & dados numéricos , Transporte de Pacientes/estatística & dados numéricos , Tempestades Ciclônicas , Fogo , Inundações , Administração Hospitalar , Humanos , Estados Unidos
4.
Am J Disaster Med ; 15(1): 25-31, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804383

RESUMO

BACKGROUND: Disasters or crises impact humans, pets, and service animals alike. Current preparation at the federal, state, and local level focuses on preserving human life. Hospitals, shelters, and other human care facilities generally make few to no provisions for companion care nor service animal care as part of their disaster management plan. Aban-doned animals have infectious disease, safety and psychologic impact on owners, rescue workers, and those involved in reclamation efforts. Animals working as first responder partners may be injured or exposed to biohazards and require care. DATA SOURCES: English language literature available via PubMed as well as lay press publications on emergency care, veterinary care, disaster management, disasters, biohazards, infection, zoonosis, bond-centered care, prepared-ness, bioethics, and public health. No year restrictions were set. CONCLUSIONS: Human clinician skills share important overlaps with veterinary clinician skills; similar overlaps occur in medical and surgical emergency care. These commonalities offer the potential to craft-specific and disaster or crisis-deployable skills to care for humans, pets (dogs and cats), service animals (dogs and miniature horses) and first-responder partners (dogs) as part of national disaster healthcare preparedness. Such a platform could leverage the skills and resources of the existing US trauma system to underpin such a program.


Assuntos
Bem-Estar do Animal/organização & administração , Planejamento em Desastres/organização & administração , Emergências , Serviços Médicos de Emergência , Animais de Estimação , Trabalho de Resgate/métodos , Animais , Gatos , Planejamento em Desastres/métodos , Desastres , Cães , Cavalos , Humanos
5.
Am J Disaster Med ; 15(2): 113-128, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804391

RESUMO

During the 2017-2018 listeriosis outbreak in South Africa (SA), the total number of cases reached 1,060. In this study, the disaster management response to the 2017-2018 South Africa listeriosis outbreak is analyzed. The hazard was in part the contamination of a brand of a ready-to-eat (RTE) "polony" with a strain of Listeria monocytogenes ST6. The initial phase of the 2017-2018 listeriosis outbreak was characterized by a rapid increase in the number of detected human cases. The listeriosis outbreak was officially proclaimed in December 2017, resulting in listeriosis being added to the list of notifiable diseases in SA. The delay between onset and proclamation was a result of the difficulty in identifica-tion of the actual number of cases of listeriosis in the country. The response to the disaster included the coordination of the National Department of Health, the National Institute of Communicable Diseases (NICD), businesses/producers of the contaminated brand of RTE products, and the public. Some of these activities led to the removal of the contami-nated products from the retail sector in March 2018, resulting in a decrease in the number of cases found in SA. In re-sponse to the outbreak, the National Department of Health formed a multisector incidence response team and imple-mented the Emergency Response Plan. Impacts of future listeriosis outbreaks could be mitigated by the adoption of international listeriosis guidelines such as the WHO/FAO and FDA. Practical steps in this context should include setting a limit of L. monocytogenes in RTE products. WHO/FAO and FDA listeriosis policies which are described "zero toler-ance" where a limit of < 100 L. monocytogenes cells/g at the moment of consumption is acceptable can be adopted. Additional resources must be provided for research into infectious doses and the various routes of human exposure.


Assuntos
Surtos de Doenças/prevenção & controle , Guias como Assunto , Legislação como Assunto , Listeria monocytogenes , Listeriose/epidemiologia , Formulação de Políticas , Desastres , Notificação de Doenças , Microbiologia de Alimentos , Humanos , Listeriose/diagnóstico , África do Sul
6.
J Emerg Manag ; 18(4): 311-322, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804399

RESUMO

The aim of this study is to establish procedures to protect the residents of the Umm al-Nasr border village from the dangers of wars and military violations by preparing emergency management procedures for emergency per-sonnel to protect the population and properties, as well as designing a model that simulates the Emergency Opera-tions Department in the northern Gaza Strip. In addition, a mathematical equation was designed to calculate the strength of the true steadfastness of the society to defend the community in the event of war. The researchers used the analytical descriptive approach and the interview with the officials in the municipality of the village. The most important results of this study were the preparation of the risk matrix for the village of Umm al-Nasr by identifying the risks and analyzing them, determining the consequences and probability of each disaster threatening the village, designing a model showing the emergency operations and the effective institutions, and how to link the operations and coordination between the central chamber and the emergency committee besides the working institutions. In the field of relief, rescue and shelter as well as preparing preparedness and response measures in the event of war threatening the village. This study recommended the proper planning of the emergency management through the preparation of effective preparedness measures that seek to preserve life and property, and to protect the fragile communities in the Gaza Strip, especially the community of Umm al-Nasr to strengthen its steadfastness in the economic, environmental, and health sectors.


Assuntos
Conflitos Armados , Planejamento em Desastres , Desastres , Emergências , Árabes , Humanos
7.
J Emerg Manag ; 18(4): 341-347, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804401

RESUMO

Since the Stafford Act of 1988, the process of obtaining a formal Major Disaster Declaration has been codified for national implementation, with tasks defined at the smallest levels of local government up to the President. The Disas-ter Mitigation Act of 2000 (DMA 2000) placed additional requirements on local government to plan for mitigation ac-tivities within their jurisdictions. The goal of DMA 2000 was to not only implement more mitigative actions at the local level, but also initiate a process by which local governments could set up ongoing conversations and collaborative efforts with neighboring jurisdictions to ensure continuous, proactive measures were taken against the impacts of disasters. Based on the increased attention paid to mitigation and planning activities, a reasonable expectation would be to see a decline in the number of major disaster declarations since DMA 2000. However, simple correlation analy-sis shows that since DMA 2000, the number of major disaster declarations continues to increase. This article is in-tended as a preliminary study to encourage more detailed analysis in the future of the impacts of federal policy on local-level disaster prevention.


Assuntos
Planejamento em Desastres/organização & administração , Desastres/prevenção & controle , Socorro em Desastres/organização & administração , Desastres/economia , Humanos , Governo Local , Política Pública
8.
J Emerg Manag ; 18(4): 349-354, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804402

RESUMO

This work is a companion paper to "Quantifying the Relationship Between Predisaster Mitigation Spending and Major Disaster Declarations for US States and Territories." Mitigation is a relatively new undertaking, especially for local jurisdictions, within the United States disaster policy. The Disaster Mitigation Act of 2000 (DMA 2000) requires local jurisdictions to plan for and implement mitigative strategies in order to access federal grant funding options for emergency management. After DMA 2000 went into effect in the mid-2000s, a supporting study by the Multi-Hazard Mitigation Council (MMC 2005) found that on average, mitigation projects yielded a benefit-cost ratio of 4:1 at the local level.1 This paper evaluates and compares predisaster mitigation spending and postdisaster assistance spend-ing at the state and FEMA Regional levels, hypothesizing that as mitigation spending increases, postdisaster spend-ing should decrease. The results however indicate the opposite, with most states showing increasing in both types of spending over time.


Assuntos
Planejamento em Desastres/economia , Desastres/economia , Organização do Financiamento/estatística & dados numéricos , Custos e Análise de Custo , Humanos , Governo Local , Estados Unidos
9.
Nat Commun ; 11(1): 4325, 2020 08 28.
Artigo em Inglês | MEDLINE | ID: mdl-32859917

RESUMO

Hospital systems play a critical role in treating injuries during disaster emergency responses. Simultaneously, natural disasters hinder their ability to operate at full capacity. Thus, cities must develop strategies that enable hospitals' effective disaster operations. Here, we present a methodology to evaluate emergency response based on a model that assesses the loss of hospital functions and quantifies multiseverity injuries as a result of earthquake damage. The proposed methodology can design effective plans for patient transfers and allocation of ambulances and mobile operating rooms. This methodology is applied to Lima, Peru, subjected to a disaster scenario following a magnitude 8.0 earthquake. Our results show that the spatial distribution of healthcare demands mismatches the post-earthquake capacities of hospitals, leaving large zones on the periphery significantly underserved. This study demonstrates how plans that leverage hospital-system coordination can address this demand-capacity mismatch, reducing waiting times of critically injured patients by factors larger than two.


Assuntos
Planejamento em Desastres/métodos , Terremotos , Emergências , Hospitais , Planejamento em Desastres/organização & administração , Desastres , Serviços Médicos de Emergência , Instalações de Saúde , Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Modelos Teóricos , Peru , Administração em Saúde Pública
10.
J Environ Radioact ; 222: 106375, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32791372

RESUMO

The purpose of this work is to highlight the effects of ionizing radiation on the genetic material in higher plants by assessing both adaptive processes as well as the evolution of plant species. The effects that the ionizing radiation has on greenery following a nuclear accident, was examined by taking the Chernobyl Nuclear Power Plant disaster as a case study. The genetic and evolutionary effects that ionizing radiation had on plants after the Chernobyl accident were highlighted. The response of biota to Chernobyl irradiation was a complex interaction among radiation dose, dose rate, temporal and spatial variation, varying radiation sensitivities of the different plants' species, and indirect effects from other events. Ionizing radiation causes water radiolysis, generating highly reactive oxygen species (ROS). ROS induce the rapid activation of detoxifying enzymes. DeoxyriboNucleic Acid (DNA) is the object of an attack by both, the hydroxyl ions and the radiation itself, thus triggering a mechanism both direct and indirect. The effects on DNA are harmful to the organism and the long-term development of the species. Dose-dependent aberrations in chromosomes are often observed after irradiation. Although multiple DNA repair mechanisms exist, double-strand breaks (DSBs or DNA-DSBs) are often subject to errors. Plants DSBs repair mechanisms mainly involve homologous and non-homologous dependent systems, the latter especially causing a loss of genetic information. Repeated ionizing radiation (acute or chronic) ensures that plants adapt, demonstrating radioresistance. An adaptive response has been suggested for this phenomenon. As a result, ionizing radiation influences the genetic structure, especially during chronic irradiation, reducing genetic variability. This reduction may be associated with the fact that particular plant species are more subject to chronic stress, confirming the adaptive theory. Therefore, the genomic effects of ionizing radiation demonstrate their likely involvement in the evolution of plant species.


Assuntos
Adaptação Fisiológica , Acidente Nuclear de Chernobyl , Desastres , Fenômenos Fisiológicos Vegetais , Monitoramento de Radiação , Radioatividade , Plantas , Radiação Ionizante
11.
J Environ Manage ; 272: 111086, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-32854890

RESUMO

The present study deals with bioavailability of trace metals in the Doce river continental shelf, southeast of Brazil. The bottom sediments of the study area were firstly sampled a few weeks before the biggest environmental disaster of Brazil, the collapse of the Fundão dam in November of 2015. The disaster released around 40 Mm3 of iron ore tailings into Doce river basin and an estimate of 10 Mm3 reached the river delta, having the adjacent continental shelf as the final destination. One year and a half later, on April of 2017, the continental shelf was sampled again. A total of 48 stations were evaluated concerning concentrations of trace metals (Zn, Cu, Pb, Ni, Cr) and other ancillary variables before and after the accident. Trace metals were determined through fractionation in order to assess mobility and establish the ecological risk through RAC index. Before the accident, trace metals mobility was Pb > Ni > Cu > Zn > Cr, with Pb Cu, Ni and posing high ecological risk (RAC>30%) in many stations. Differences in concentrations of metal from pre to post accident were significant, and the increase of trace metals was observed. The mobility order after the accident changed to: Cu > Pb > Ni > Zn > Cr. Metal fractionation showed remarkable changes after the accident, with elements such as Cu, Ni and Zn highly associated with reducible fractions originated from the tailings composition. Despite the decrease of RAC to medium risk after the accident in most stations, the bioavilability of Cu, Pb, Ni and Zn increased as show by their higher accumulation in the bioavailable fractions.


Assuntos
Desastres , Metais Pesados/análise , Poluentes Químicos da Água/análise , Disponibilidade Biológica , Brasil , Monitoramento Ambiental , Sedimentos Geológicos , Medição de Risco , Rios
12.
Glob Health Action ; 13(1): 1795963, 2020 12 31.
Artigo em Inglês | MEDLINE | ID: mdl-32762300

RESUMO

Managing a deadly pandemic in low- and middle-income countries (LMIC) is challenging. The task becomes tougher when there is an outbreak of an equally deadly disease. This is the present situation of Ghana, a low-resource country, that is confronted with the coronavirus disease 2019 (COVID-19) pandemic and cerebrospinal meningitis (CSM) outbreak. Apart from the resource constraint at both governmental and individual levels, such a situation affects the overall wellbeing of ordinary citizens as well as healthcare professionals, particularly those in high-risk areas. Perhaps, more than ever, we have to ensure equitable distribution of scarce healthcare resources in our effort to manage this 'twin disaster' of COVID-19 and CSM. We evaluated Ghana's situation (outbreak response) and recommended measures to help us navigate this conundrum of a public health crisis.


Assuntos
Infecções por Coronavirus/prevenção & controle , Desastres/prevenção & controle , Surtos de Doenças/prevenção & controle , Meningite/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/epidemiologia , Países em Desenvolvimento , Gana/epidemiologia , Alocação de Recursos para a Atenção à Saúde , Recursos em Saúde/provisão & distribução , Humanos , Meningite/epidemiologia , Pneumonia Viral/epidemiologia
13.
Waste Manag ; 114: 215-224, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32679479

RESUMO

Flood waste management is important for reducing the damage and secondary environmental pollution caused by delays in disaster recovery. One key issue related to flood waste management concerns estimating the precise quantity of waste to plan recovery strategies and policies. In this study, an advanced flood waste estimation technique was devised using data stratification. In total 90 flood cases in South Korea were sorted by three strata characteristics: administrative region (AR; equivalent to special city or province), urbanization rate (UR), and disaster type and coastal accessibility (DC). According to the results, such data stratification led to flood waste prediction improvement not only by the single-stage stratification but also by successive stratifications. Data stratification was effective both for identifying groups with similar contexts and for eliminating disparities in the dataset that impede accurate waste prediction. Among the stratification sequences tested, the order resulted in the most improvement in flood waste prediction was UR, AR, and DC. This stratification order yielded enhanced waste prediction in 74 cases. Since this study deals with a strategy to resolve gaps in disaster data, which is a crucial issue in many countries, it is envisaged that this strategy can be transferred to other countries.


Assuntos
Desastres , Gerenciamento de Resíduos , Cidades , Inundações , República da Coreia
17.
PLoS One ; 15(6): e0233888, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32603333

RESUMO

Urban development relies on many factors to remain viable, including infrastructure, services, and government provisions and subsidies. However, in situations involving federal or state level policy, development responds not just to one regulatory signal, but also to multiple signals from overlapping and competing jurisdictions. The 1982 U.S. Coastal Barrier Resources Act (CoBRA) offers an opportunity to study when and how development restrictions and economic disincentives protect natural resources by stopping or slowing urban development in management regimes with distributed authority and responsibility. CoBRA prohibits federal financial assistance for infrastructure, post-storm disaster relief, and flood insurance in designated sections (CoBRA units) of coastal barriers. How has CoBRA's removal of these subsidies affected rates and types of urban development? Using building footprint and real estate data (n = 1,385,552 parcels), we compare density of built structures, land use types, residential house size, and land values within and outside of CoBRA units in eight Southeast and Gulf Coast states. We show that CoBRA is associated with reduced development rates in designated coastal barriers. We also demonstrate how local responses may counteract withdrawal of federal subsidies. As attention increases towards improving urban resilience in high hazard areas, this work contributes to understanding how limitations on infrastructure and insurance subsidies can affect outcomes where overlapping jurisdictions have competing goals.


Assuntos
Conservação dos Recursos Naturais/métodos , Política Ambiental , Financiamento Governamental , Reforma Urbana/economia , Desastres , Inundações , Humanos , Seguro , Sudeste dos Estados Unidos
18.
Artigo em Inglês | MEDLINE | ID: mdl-32646034

RESUMO

Korea's Daegu Metropolitan City once had the second highest rate of COVID-19 infection after Wuhan in China. Following the outbreak, the government provided the first national disaster relief fund to citizens as financial aid. This study investigated whether the sense of regional belonging, pride, and mental health among 550 citizens of Daegu differed between the times before and after COVID-19, based on the presence or absence of the disaster relief fund. Frequency analysis, descriptive statistical analysis, and t-tests were conducted using the SPSS 25.0 program. Results showed that the sense of belonging was higher after COVID-19 than before, while pride was lower. Individuals who received the disaster relief fund showed higher levels of regional belonging and pride with statistical significance. The prevalence of melancholy and depression increased after COVID-19, but the presence or absence of the fund did not lead to a significant difference. Thus, in case of a future national disaster level, provision of the disaster relief fund can raise the sense of regional belonging and pride, in order to elicit communication among local residents toward overcoming difficulties. Furthermore, during challenging disaster situations, central and local governments should provide diverse programs for the citizens' mental health care.


Assuntos
Infecções por Coronavirus/psicologia , Desastres/economia , Pneumonia Viral/psicologia , Fatores Sociológicos , Adulto , Idoso , Betacoronavirus , Cidades , Infecções por Coronavirus/economia , Emoções , Feminino , Administração Financeira , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Pandemias/economia , Pneumonia Viral/economia , República da Coreia , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: covidwho-437287

RESUMO

In addition to top-down Health-Emergency and Disaster Risk Management (Health-EDRM) efforts, bottom-up individual and household measures are crucial for prevention and emergency response of the COVID-19 pandemic, a Public Health Emergency of International Concern (PHEIC). There is limited scientific evidence of the knowledge, perception, attitude and behavior patterns of the urban population. A computerized randomized digital dialing, cross-sectional, population landline-based telephone survey was conducted from 22 March to 1 April 2020 in Hong Kong Special Administrative Region, China. Data were collected for socio-demographic characteristics, knowledge, attitude and risk perception, and various self-reported Health-EDRM behavior patterns associated with COVID-19. The final study sample was 765. Although the respondents thought that individuals (68.6%) had similar responsibilities as government (67.5%) in infection control, less than 50% had sufficient health risk management knowledge to safeguard health and well-being. Among the examined Health-EDRM measures, significant differences were found between attitude and practice in regards to washing hands with soap, ordering takeaways, wearing masks, avoidance of visiting public places or using public transport, and travel avoidance to COVID-19-confirmed regions. Logistic regression indicated that the elderly were less likely to worry about infection with COVID-19. Compared to personal and household hygiene practices, lower compliance was found for public social distancing.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Comportamentos Relacionados com a Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adolescente , Adulto , Idoso , Atitude , China , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Desastres , Emergências , Serviço Hospitalar de Emergência , Feminino , Hong Kong/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Percepção , Pneumonia Viral/epidemiologia , Gestão de Riscos , Fatores Socioeconômicos , Adulto Jovem
20.
PLoS One ; 15(6): e0234381, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32555741

RESUMO

The objective of this paper is to empirically examine the impacts of infrastructure service disruptions on the well-being of vulnerable populations during disasters. There are limited studies that empirically evaluate the extent to which disruptions in infrastructure system services impact subpopulation groups differently and how these impacts relate to the wellbeing of households. Being able to systematically capture the differential experiences of sub-populations in a community due to infrastructure disruptions is necessary to highlight the differential needs and inequities that households have. In order to address this knowledge gap, this study derives an empirical relationship between sociodemographic factors of households and their subjective well-being impacts due to disruptions in various infrastructure services during and immediately after Hurricane Harvey. Statistical analysis driven by spearman-rank order correlations and fisher-z tests indicated significant disparities in well-being due to service disruptions among vulnerable population groups. The characterization of subjective well-being is used to explain to what extent infrastructure service disruptions influence different subpopulations. The results show that: (1) disruptions in transportation, solid waste, food, and water infrastructure services resulted in more significant well-being impact disparities as compared to electricity and communication services; (2) households identifying as Black and African American experienced well-being impact due to disruptions in food, transportation, and solid waste services; and (3) households were more likely to feel helpless, difficulty doing daily tasks and feeling distance from their community as a result of service disruptions. The findings present novel insights into understanding the role of infrastructure resilience in household well-being and highlights why it is so important to use approaches that consider various factors. Infrastructure resilience models tend to be monolithic. The results provide empirical and quantitative evidence of the inequalities in well-being impacts across various sub-populations. The research approach and findings enable a paradigm shift towards a more human-centric approach to infrastructure resilience.


Assuntos
Desastres , Populações Vulneráveis , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Tempestades Ciclônicas/história , Planejamento em Desastres , Feminino , Abastecimento de Alimentos , Disparidades nos Níveis de Saúde , História do Século XXI , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Eliminação de Resíduos , Resiliência Psicológica , Seguridade Social , Fatores Socioeconômicos , Inquéritos e Questionários , Texas , Transportes , Abastecimento de Água , Adulto Jovem
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