Effective population size of Culex quinquefasciatus under insecticide-based vector management and following Hurricane Harvey in Harris County, Texas.

Introduction: Culex quinquefasciatus is a mosquito species of significant public health importance due to its ability to transmit multiple pathogens that can cause mosquito-borne diseases, such as West Nile fever and St. Louis encephalitis. In Harris County, Texas, Cx. quinquefasciatus is a common vector species and is subjected to insecticide-based management by the Harris County Public Health Department. However, insecticide resistance in mosquitoes has increased rapidly worldwide and raises concerns about maintaining the effectiveness of vector control approaches. This concern is highly relevant in Texas, with its humid subtropical climate along the Gulf Coast that provides suitable habitat for Cx. quinquefasciatus and other mosquito species that are known disease vectors. Therefore, there is an urgent and ongoing need to monitor the effectiveness of current vector control programs. Methods: In this study, we evaluated the impact of vector control approaches by estimating the effective population size of Cx. quinquefasciatus in Harris County. We applied Approximate Bayesian Computation to microsatellite data to estimate effective population size. We collected Cx. quinquefasciatus samples from two mosquito control operation areas; 415 and 802, during routine vector monitoring in 2016 and 2017. No county mosquito control operations were applied at area 415 in 2016 and 2017, whereas extensive adulticide spraying operations were in effect at area 802 during the summer of 2016. We collected data for eighteen microsatellite markers for 713 and 723 mosquitoes at eight timepoints from 2016 to 2017 in areas 415 and 802, respectively. We also investigated the impact of Hurricane Harvey's landfall in the Houston area in August of 2017 on Cx. quinquefasciatus population fluctuation. Results: We found that the bottleneck scenario was the most probable historical scenario describing the impact of the winter season at area 415 and area 802, with the highest posterior probability of 0.9167 and 0.4966, respectively. We also detected an expansion event following Hurricane Harvey at area 802, showing a 3.03-fold increase in 2017. Discussion: Although we did not detect significant effects of vector control interventions, we found considerable influences of the winter season and a major hurricane on the effective population size of Cx. quinquefasciatus. The fluctuations in effective population size in both areas showed a significant seasonal pattern. Additionally, the significant population expansion following Hurricane Harvey in 2017 supports the necessity for post-hurricane vector-control interventions.

Social support and community embeddedness protect against post-disaster depression among immigrants: a Vietnamese American case study.

Immigrants often face increased vulnerabilities to disaster-related poor health and recovery, compared to mainstream populations. Little is known about Hurricane Harvey's impacts among the storm affected area's large Vietnamese American population. Our study documented diverse psychological experiences and recovery challenges 1 year post-storm among a sample of 120 Vietnamese Americans residing in the Houston, Texas area. Using linear regression modeling, we examined the association between social support and depressive symptom development among these storm-affected Vietnamese Americans. Social support encapsulating both social embeddedness and perceived support was measured by the Louisville Social Support Scale and depressive symptom development was measured by 18 items that assessed emotional distress. These items included loss of appetite, loss of concentration, exposure to persistent pain, and the exhibition of hopelessness, tiredness, sadness, frustration, discouragement, desperation, exhaustion, disgraced, anger, and craziness. We found adverse post-disaster health outcomes, as well as potential avenues to mitigate them, that should be taken into consideration in the design and implementation of inclusive disaster programs. A high level of social support lowered depressive symptomology among Vietnamese Americans post-Hurricane Harvey, even when accounting for Hurricane Harvey-related home damages and injuries/illness. The negative association between social support and depressive symptom development remained after accounting for both post-storm self-rated mental and physical health. Our results suggested that public health practitioners and emergency management entities should prioritize social support resources to foster mental well-being after hurricanes among Vietnamese Americans as future hurricanes are expected to be stronger and more prevalent along the United States Gulf Coast.

Adverse Health Outcomes Following Hurricane Harvey: A Comparison of Remotely-Sensed and Self-Reported Flood Exposure Estimates.

Remotely sensed inundation may help to rapidly identify areas in need of aid during and following floods. Here we evaluate the utility of daily remotely sensed flood inundation measures and estimate their congruence with self-reported home flooding and health outcomes collected via the Texas Flood Registry (TFR) following Hurricane Harvey. Daily flood inundation for 14 days following the landfall of Hurricane Harvey was acquired from FloodScan. Flood exposure, including number of days flooded and flood depth was assigned to geocoded home addresses of TFR respondents (N = 18,920 from 47 counties). Discordance between remotely-sensed flooding and self-reported home flooding was measured. Modified Poisson regression models were implemented to estimate risk ratios (RRs) for adverse health outcomes following flood exposure, controlling for potential individual level confounders. Respondents whose home was in a flooded area based on remotely-sensed data were more likely to report injury (RR = 1.5, 95% CI: 1.27-1.77), concentration problems (1.36, 95% CI: 1.25-1.49), skin rash (1.31, 95% CI: 1.15-1.48), illness (1.29, 95% CI: 1.17-1.43), headaches (1.09, 95% CI: 1.03-1.16), and runny nose (1.07, 95% CI: 1.03-1.11) compared to respondents whose home was not flooded. Effect sizes were larger when exposure was estimated using respondent-reported home flooding. Near-real time remote sensing-based flood products may help to prioritize areas in need of assistance when on the ground measures are not accessible.

Factors Associated With Poor Health Outcomes Among Vietnamese Americans After Hurricane Harvey, Houston, Texas, 2018-2019.

OBJECTIVE: Immigrants typically experience poor health outcomes after disasters but are often excluded in disaster studies. We assessed physical and mental health outcomes among Houston-area Vietnamese American residents after Hurricane Harvey and hurricane-related characteristics associated with poor health outcomes. METHODS: We conducted in-person structured surveys among 120 Vietnamese Americans from November 2018 through February 2019. We used the physical and mental component scores of the 12-Item Short-Form Health Survey to assess health outcomes. We used descriptive statistics for health outcomes and hurricane-related effects and examined the associations between hurricane-related characteristics and health outcomes. RESULTS: Overall mean (95% CI) physical and mental component scores were 39.8 (29.7-49.9) and 32.6 (27.6-37.6), respectively. The odds of poor physical health poststorm were significantly higher among participants reporting ≥5 versus <5 depressive symptoms (odds ratio [OR] = 3.04; 95% CI, 1.11-8.29; P = .03) and significantly lower among participants with versus without health insurance (OR = 0.25; 95% CI, 0.09-0.71; P = .01). The odds of experiencing poor mental health more than a year after the hurricane were significantly higher among those sustaining versus not sustaining a serious injury/illness because of the hurricane (OR = 3.34; 95% CI, 1.12-9.94; P = .03) and among those who were married/partnered versus not married/partnered (OR = 4.16; 95% CI, 1.32-13.07; P = .02). Receiving versus not receiving free health care services after the hurricane and having high versus low levels of acculturation protected against poor mental health (P < .05 for both). CONCLUSIONS: Our findings highlight the inequalities of postdisaster health outcomes in this immigrant population and emphasize the need for improved disaster recovery programs that account for these factors.

Determinants of exposure to endocrine disruptors following hurricane Harvey.

Hurricane Harvey was a category four storm that induced catastrophic flooding in the Houston metropolitan area. Following the hurricane there was increased concern regarding chemical exposures due to damage caused by flood waters and emergency excess emissions from industrial facilities. This study utilized personal passive samplers in the form of silicone wristbands in Houston, TX to both assess chemical exposure to endocrine disrupting chemicals (EDCs) immediately after the hurricane and determine participant characteristics associated with higher concentrations of exposure. Participants from the Houston-3H cohort (n = 172) wore a wristband for seven days and completed a questionnaire to determine various flood-related and demographic variables. Bivariate and multivariate analysis indicated that living in an area with a high Area Deprivation Index (ADI) (indicative of low socioeconomic status), identifying as Black/African American or Latino, and living in the Houston neighborhoods of Baytown and East Houston were associated with increased exposure to EDCs. These results provide evidence of racial/ethnic and socioeconomic injustices in exposure to EDCs in the Houston Metropolitan Area. Since the multiple regression models conducted did not fully explain exposure (0.047 < R2 < 0.34), more research is needed on the direct sources of EDCs within this area to create effective exposure mitigation strategies.

Does flooding get worse with subsiding land? Investigating the impacts of land subsidence on flood inundation from Hurricane Harvey.

As one of the most devastating tropical storms, 2017 Hurricane Harvey caused severe flooding and damage in Houston, Texas. Besides enormous rainfall amount, land subsidence might be another contributing factor to the Harvey flood. However, few studies have numerically quantified the evolvement of land subsidence over decades, largely due to the lack of reliable methods to realistically estimate land subsidence both continuously and at high spatial resolution. Therefore, this study aims to investigate retrospective changes of regional topology due to 117 years (1900 to 2017) of land subsidence and the consequent impacts on flood inundation. Based on continuous land subsidence, we conduct a series of simulations on the 2017 Hurricane Harvey in Brays Bayou, Texas using a hydrodynamic/hydraulic model. The results indicate that the overall change of flood depth caused by land subsidence is relatively minor with the flood water deepened by six centimeters per one meter of subsided land at the worst impacted location. The impact from land subsidence on flood depth exhibits strong nonlinearity in time, where effects from previous land subsidence hotspots could be altered by later continuing land subsidence. Spatially, changes in flood depth due to the land subsidence are not only heterogeneous but mixed with coexisting increased and reduced flood depths. The results of this study improve the understanding of the dynamic evolvement of flood inundation due to continuous land subsidence so that better planning can be initiated for sustainable urban development for coastal communities, which is imperative under ongoing climate change and sea level rise.

Associating Increased Chemical Exposure to Hurricane Harvey in a Longitudinal Panel Using Silicone Wristbands.

Hurricane Harvey was associated with flood-related damage to chemical plants and oil refineries, and the flooding of hazardous waste sites, including 13 Superfund sites. As clean-up efforts began, concerns were raised regarding the human health impact of possible increased chemical exposure resulting from the hurricane and subsequent flooding. Personal sampling devices in the form of silicone wristbands were deployed to a longitudinal panel of individuals (n = 99) within 45 days of the hurricane and again one year later in the Houston metropolitan area. Using gas chromatography−mass spectroscopy, each wristband was screened for 1500 chemicals and analyzed for 63 polycyclic aromatic hydrocarbons (PAHs). Chemical exposure levels found on the wristbands were generally higher post-Hurricane Harvey. In the 1500 screen, 188 chemicals were detected, 29 were detected in at least 30% of the study population, and of those, 79% (n = 23) were found in significantly higher concentrations (p < 0.05) post-Hurricane Harvey. Similarly, in PAH analysis, 51 chemicals were detected, 31 were detected in at least 30% of the study population, and 39% (n = 12) were found at statistically higher concentrations (p < 0.05) post-Hurricane Harvey. This study indicates that there were increased levels of chemical exposure after Hurricane Harvey in the Houston metropolitan area.

Primary Outcomes for Adults Receiving the Unified Protocol after Hurricane Harvey in an Integrated Healthcare Setting.

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) has demonstrated efficacy for treating anxiety and depression. However, there are limited effectiveness data when conducted in real-world settings with diverse populations, including those with trauma. We evaluated treatment outcomes in a naturalistic, community setting among 279 adults who received UP following Hurricane Harvey. We examined change in overall clinical severity, depression and anxiety symptoms, functional impairment, and baseline outcome predictors (i.e., demographic characteristics, impact from Hurricane Harvey, co-occurrence of depression and anxiety symptoms). Global clinical severity, depression and anxiety symptoms, and functional impairment decreased by end-of-treatment. Participants experienced global symptom improvement to a lesser degree than demonstrated in efficacy trials. Participants who experienced greater storm impact reported larger reductions in anxiety symptoms than those less impacted by Harvey. Further studies evaluating the effectiveness of the UP post-disaster and with diverse samples are needed.

Multi-scalar and multi-dimensional conceptions of social capital and mental health impacts after disaster: the case of Hurricane Harvey.

While much research investigates how social capital relates to mental health after disasters, less work employs a multi-scalar, multi-dimensional social capital framework. This study applies such a construct to an analysis of novel survey data of approximately 1,000 rural and urban Texans after Hurricane Harvey struck the United States in August 2017. On the individual level, it finds that greater social support is linked to fewer mental health impacts, but that greater civic and organisational engagement is connected to greater mental health impacts. At the community level, it finds that neither a density of bridging social capital organisations nor of bonding social capital organisations is associated with poorer mental health, although a greater number of bonding organisations is related to negative mental health impacts on rural residents. The paper concludes by focusing on how individual and community social capital relationships with mental health are contingent on measurement, scale, and rural or urban location.

Extreme Precipitation and Flooding Contribute to Sudden Vegetation Dieback in a Coastal Salt Marsh.

Climate extremes are becoming more frequent with global climate change and have the potential to cause major ecological regime shifts. Along the northern Gulf of Mexico, a coastal wetland in Texas suffered sudden vegetation dieback following an extreme precipitation and flooding event associated with Hurricane Harvey in 2017. Historical salt marsh dieback events have been linked to climate extremes, such as extreme drought. However, to our knowledge, this is the first example of extreme precipitation and flooding leading to mass mortality of the salt marsh foundation species, Spartina alterniflora. Here, we investigated the relationships between baseline climate conditions, extreme climate conditions, and large-scale plant mortality to provide an indicator of ecosystem vulnerability to extreme precipitation events. We identified plant zonal boundaries along an elevation gradient with plant species tolerant of hypersaline conditions, including succulents and graminoids, at higher elevations, and flood-tolerant species, including S. alterniflora, at lower elevations. We quantified a flooding threshold for wetland collapse under baseline conditions characterized by incremental increases in flooding (i.e., sea level rise). We proposed that the sudden widespread dieback of S. alterniflora following Hurricane Harvey was the result of extreme precipitation and flooding that exceeded this threshold for S. alterniflora survival. Indeed, S. alterniflora dieback occurred at elevations above the wetland collapse threshold, illustrating a heightened vulnerability to flooding that could not be predicted from baseline climate conditions. Moreover, the spatial pattern of vegetation dieback indicated that underlying stressors may have also increased susceptibility to dieback in some S. alterniflora marshes.Collectively, our results highlight a new mechanism of sudden vegetation dieback in S. alterniflora marshes that is triggered by extreme precipitation and flooding. Furthermore, this work emphasizes the importance of considering interactions between multiple abiotic and biotic stressors that can lead to shifts in tolerance thresholds and incorporating climate extremes into climate vulnerability assessments to accurately characterize future climate threats.

Polycyclic Aromatic Hydrocarbons in Houston Parks After Hurricane Harvey.

Unprecedented inland precipitation and catastrophic flooding associated with Hurricane Harvey potentially redistributed contaminants from industrial sites and transportation infrastructure to recreational areas that make up networks of green infrastructure, creeks, and waterways used for flood control throughout the Greater Houston Area. Sediment samples were collected in parks located near the Buffalo Bayou watershed 1 week after Hurricane Harvey made landfall and again 7 weeks later. Total concentrations of the U.S. Environmental Protection Agency's (EPA's) 16 priority polycyclic aromatic hydrocarbons (PAHs) were measured in each sample at both time points. Diagnostic ratios were calculated to improve understanding of potential sources of PAHs after flooding. Diagnostic ratios suggest vehicular traffic to be a potential source for PAHs in parks. Although the concentrations of PAHs in all samples were below EPA actionable levels, given that no background values were available for comparison, it is difficult to quantify the impact flooding from Hurricane Harvey had on PAH concentrations in Houston parks. However, given the high frequency of flooding in Houston, and the concentration of industrial facilities and transportation infrastructure adjacent to recreation areas, these data demonstrate that PAHs were still present after unprecedented flooding. This study may also serve as a baseline for future efforts to understand the environmental health impacts of disasters.

Assessing Patient Needs During Natural Disasters: Mixed Methods Analysis of Portal Messages Sent During Hurricane Harvey.

BACKGROUND: Patient portals play an important role in connecting patients with their medical care team, which improves patient engagement in treatment plans, decreases unnecessary visits, and reduces costs. During natural disasters, patients' needs increase, whereas available resources, specifically access to care, become limited. OBJECTIVE: This study aims to examine patients' health needs during a natural crisis by analyzing the electronic messages sent during Hurricane Harvey to guide future disaster planning efforts. METHODS: We explored patient portal use data from a large Greater Houston area health care system focusing on the initial week of the Hurricane Harvey disaster, beginning with the date of landfall, August 25, 2017, to August 31, 2017. A mixed methods approach was used to assess patients' immediate health needs and concerns during the disruption of access to routine and emergent medical care. Quantitative analysis used logistic regression models to assess the predictive characteristics of patients using the portal during Hurricane Harvey. This study also included encounters by type (emergency, inpatient, observation, outpatient, and outpatient surgery) and time (before, during, and after Hurricane Harvey). For qualitative analysis, the content of these messages was examined using the constant comparative method to identify emerging themes found within the message texts. RESULTS: Out of a total of 557,024 patients, 4079 (0.73%) sent a message during Hurricane Harvey, whereas 31,737 (5.69%) used the portal. Age, sex, race, and ethnicity were predictive factors for using the portal and sending a message during the natural disaster. We found that prior use of the patient portal increased the likelihood of portal use during Hurricane Harvey (odds ratio 13.688, 95% CI 12.929-14.491) and of sending a portal message during the disaster (odds ratio 14.172, 95% CI 11.879-16.907). Having an encounter 4 weeks before or after Hurricane Harvey was positively associated with increased use of the portal and sending a portal message. Patients with encounters during the main Hurricane Harvey week had a higher increased likelihood of portal use across all five encounter types. Qualitative themes included: access, prescription requests, medical advice (chronic conditions, acute care, urgent needs, and Hurricane Harvey-related injuries), mental health, technical difficulties, and provider constraints. CONCLUSIONS: The patient portal can be a useful tool for communication between patients and providers to address the urgent needs and concerns of patients as a natural disaster unfolds. This was the first known study to include encounter data to understand portal use compared with care provisioning. Prior use was predictive of both portal use and message sending during Hurricane Harvey. These findings could inform the types of demands that may arise in future disaster situations and can serve as the first step in intentionally optimizing patient portal usability for emergency health care management during natural disasters.

Using search-constrained inverse distance weight modeling for near real-time riverine flood modeling: Harris County, Texas, USA before, during, and after Hurricane Harvey.

Flooding poses a serious public health hazard throughout the world. Flood modeling is an important tool for emergency preparedness and response, but some common methods require a high degree of expertise or may be unworkable due to poor data quality or data availability issues. The conceptually simple method of inverse distance weight modeling offers an alternative. Using stream gauges as inputs, this study interpolated stream elevation via inverse distance weight modeling under 15 different model input parameter scenarios for Harris County, Texas, USA, from August 25th to September 15th, 2017 (before, during, and after Hurricane Harvey inundated the county). A digital elevation model was used to identify areas where modeled stream elevation exceeded ground elevation, indicating flooding. Imagery and observed high water marks were used to validate the models' outputs. There was a high degree of agreement (between 79 and 88%) between imagery and model outputs of parameterizations visually validated. Quantitative validations based on high water marks were also positive, with a Nash-Sutcliffe efficiency of in excess of .6 for all parameterizations relative to a Nash-Sutcliffe efficiency of the benchmark of 0.56. Inverse distance weight modeling offers a simple, accurate method for first-order estimations of riverine flooding in near real-time using readily available data, and outputs are robust to some alterations to input parameters.

Hospital Preparedness, Mitigation, and Response to Hurricane Harvey in Harris County, Texas.

OBJECTIVE: This case study documents Harris County hospitals' flood preparedness and mitigation efforts before Hurricane Harvey, their collective response experience during Hurricane Harvey, and their lessons learned in the storm's aftermath. METHODS: The case study was constructed using a survey of hospital emergency managers, semi-structured interviews with local agencies involved in public health, emergency management, and health care, and an analysis of news reports and other documents from a variety of government agencies, local organizations, and hospitals themselves. RESULTS: Harris County hospitals learned their most valuable lessons through their direct and repeated experience with flooding over the years, leading to improved preparedness before Hurricane Harvey. Hospital emergency response successes included infrastructure improvements, staff resilience, advanced planning, and pre-established collaboration. However, hospitals still experienced challenges with staff burnout, roadway flooding, and patient evacuation. CONCLUSIONS: Although the current state of hospital flood preparedness and mitigation is rather advanced and mature, it is advisable that Harris County takes steps to strengthen emergency management efforts in hospitals with fewer financial and staffing resources and less direct flood experience.

Chromophoric dissolved organic matter (CDOM) in a subtropical estuary (Galveston Bay, USA) and the impact of Hurricane Harvey.

The landfall of Hurricane Harvey in August 2017 provided the opportunity to study the impact of extreme freshwater discharge on chromophoric dissolved organic matter (CDOM) properties in a subtropical estuary (Galveston Bay, Texas). Both fluorescence spectroscopy (excitation-emission matrices) and a three-component parallel factor analysis (PARAFAC) model identified changes in CDOM properties. Comparing to Coble's peaks, component 1 was similar to peak C, component 2 to peak M, and component 3 to peak B. Results clearly show three periods with distinct CDOM properties: a dry season, a wet season, and Hurricane Harvey. The dry season was characterized by higher values of the spectral slope and fluorescence and biological indices. The wet season was characterized by high values of PARAFAC components 1 and 2 (humic-like) and the absorption coefficient at 350 nm. Some CDOM components were highly correlated with salinity, indicating conservative mixing. Component 3 (protein-like) had a low correlation to salinity, suggesting degradation or production processes in the bay. Silicates and NO3- + NO2- had negative relationships with salinity and a positive one with PARAFAC components 1 and 2. PARAFAC component 3 was correlated with dissolved oxygen and chlorophyll a, suggesting a relationship between CDOM fluorescent components and phytoplankton activity. High values of the humification index were observed immediately after Hurricane Harvey, indicating increased input of terrestrial organic matter into the bay. Hurricane Harvey increased CDOM levels and humification, and the variability and changes seem to be mostly due to freshwater discharge from the San Jacinto River and not the Trinity River. The influx of freshwater was sufficient to eliminate the salinity gradient in Galveston Bay and significantly change CDOM properties. Galveston Bay recovered quickly from the hurricane and associated flux of freshwater, returning to pre-hurricane CDOM characteristics in less than 2 months.

Fecal indicators, pathogens, antibiotic resistance genes, and ecotoxicity in Galveston Bay after Hurricane Harvey.

Unprecedented rainfall after Hurricane Harvey caused a catastrophic flood in the southern coast of Texas, and flushed significant floodwater and sediments into Galveston Bay, the largest estuary along the Texas Gulf Coast. This study investigated the immediate and long-term (6 months post-Harvey) fecal indicators, pathogenic bacteria, antibiotic resistance genes (ARGs), and ecotoxicity in the Galveston Bay. Dramatic decrease of salinity profile to zero, increased levels of fecal indicator bacteria and pathogenic bacteria, and detection of various ARGs were observed in the water and sediment samples collected 2 weeks post-Harvey. High levels of BlaTEM and cytotoxicity measured by yeast bioluminescent assay (BLYR) were also observed especially near the river mouths. While Vibrio spp. was dominant in water, much higher abundance of fecal indicator bacteria and pathogen were detected in the sediments. A decreasing trend of BlaTEM and cytotoxicity was observed in March 2018 samples, suggesting the Bay has returned to its pre-hurricane conditions 6 months post-Harvey. Interestingly, the abundance of fecal indicator bacteria and pathogens were shifted dramatically according to high-streamflow and low-streamflow seasons in the Bay. The data are useful to construct the model of risk assessment in coastal estuaries system and predict the effects of extreme flooding events in the future.

Resident perspectives of environmental health risk exposures after Hurricane Harvey.

This study examines what visitors to urban parks in Houston, TX, know about environmental health risks resulting from Hurricane Harvey, a category 4 storm that made landfall in August 2017 and dropped over 60 in. of rain in 8 days making it the most significant rainfall event in US history. Interviews were conducted with adult Houstonians using purposive sampling. In total, 27 interviews were conducted with 36 different participants. Interviews were audio-recorded, transcribed verbatim, and analyzed qualitatively using a phronetic iterative approach. This study found that park visitors lack sufficient knowledge about environmental health risks, yet they have strong desires to learn more about such risks. In particular, participants have clear opinions on what the content of the messages (i.e., concise, manageable, not fear-inducing) should be and how they would like to receive the information (i.e., conveniently accessible, from trusted local sources). Implications for health campaign interventions utilizing uncertainty theories are discussed.

Impact of flooding on urban soils: Changes in antibiotic resistance and bacterial community after Hurricane Harvey.

Major perturbations in soil and water quality are factors that can negatively impact human health. In soil environments of urban areas, changes in antibiotic-resistance profiles may represent an increased risk of exposure to antibiotic-resistant bacteria via oral, dermal, or inhalation routes. We studied the perturbation of antibiotic-resistance profiles and microbial communities in soils following a major flooding event in Houston, Texas, caused by Hurricane Harvey. The main objective of this study was to examine the presence of targeted antibiotic-resistance genes and changes in the diversity of microbial communities in soils a short time (3-5 months) and a long time (18 months) after the catastrophic flooding event. Using polymerase chain reaction, we surveyed fourteen antibiotic-resistance elements: intI1, intI2, sul1, sul2, tet(A) to (E), tet(M), tet(O), tet(W), tet(X), and blaCMY-2. The number of antibiotic-resistance genes detected were higher in short-time samples compared to samples taken a long time after flooding. From all the genes surveyed, only tet(E), blaCMY-2, and intI1 were prevalent in short-time samples but not observed in long-time samples; thus, we propose these genes as indicators of exogenous antibiotic resistance in the soils. Sequencing of the V3-V4 region of the bacterial 16S rRNA gene was used to find that flooding may have affected bacterial community diversity, enhanced differences among bacterial lineages profiles, and affected the relative abundance of Actinobacteria, Verrucomicrobia, and Gemmatimonadetes. A major conclusion of this study is that antibiotic resistance profiles of soil bacteria are impacted by urban flooding events such that they may pose an enhanced risk of exposure for up to three to five months following the hurricane. The occurrence of targeted antibiotic-resistance elements decreased eighteen months after the hurricane indicating a reduction of the risk of exposure long time after Harvey.

A Pilot Study on Playback Theatre as a Therapeutic Aid after Natural Disasters: Brain Connectivity Mechanisms of Effects on Anxiety.

BACKGROUND: Natural disasters can affect mental health and result in symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD). Playback Theatre (PT) is a form of improvisation where actors play-back personal stories told by audience members. Whether PT can be therapeutic in post-disaster settings is not known. METHOD: We used a series of PT performances and studied levels of depression, anxiety, and PTSD symptoms in a sample of 13 people affected by Hurricane Harvey that happened in Houston, TX, August 2017. Brain imaging, specifically resting state functional connectivity of the amygdala was also studied before and after the PT performances. RESULTS: Both anxiety (p = .001, Cohen's d = -1.25) and PTSD (p = .002, Cohen's d = -1.0) symptoms significantly decreased after a series of 4 PT performances from January 2019 - February 2019. Depression reduction was not significant. We performed resting state functional connectivity (RSFC) MRI before and after the series of performances. We used the right and left amygdala as seeds for RSFC analysis and found that the connectivity between the left amygdala and the bilateral supramarginal gyri was increased after PT. The bilateral supramarginal connectivity with the default mode and the saliency networks increased too, which correlated with reduction in anxiety scores. CONCLUSIONS: PT may offer a form of intervention for anxiety caused by disasters. An increase in left amygdala/supramarginal gyri connectivity may be the underlying mechanism.

Food Insecurity in the Post-Hurricane Harvey Setting: Risks and Resources in the Midst of Uncertainty.

Food insecurity is of heightened concern during and after natural disasters; higher prevalence is typically reported in post-disaster settings. The current study examines food insecurity prevalence and specific risk/resource variables that may act as barriers or advantages in accessing food in such a setting. Using a modified quota sample (n = 316), Hurricane Harvey survivors participated in face-to-face interviews and/or online surveys that assessed health, social and household factors, and sociodemographic characteristics. Using logistic regression analyses we find that social vulnerabilities, circumstantial risk, and social and psychological resources are important in determining the odds of food insecurity. Hispanic and/or Nonwhite survivors, renters, and those persons displaced during the natural disaster have higher food insecurity odds. Survivors with stronger social ties, higher levels of mastery, and a greater sense of connectedness to their community are found to have lower food insecurity odds. A more nuanced analysis of circumstantial risk finds that while the independent effects of displacement and home ownership are important, so too is the intersection of these two factors, with displaced-renters experiencing significantly higher odds than any other residence and displacement combinations, and particularly those who are homeowners not displaced during the disaster. Strategies for addressing differential risks, as well as practical approaches for implementation and education programming related to disaster recovery, are discussed.