A contribuição de terapeutas ocupacionais no domínio da gestão de risco e desastres: um protocolo de revisão de escopo / Contribution of occupational therapists to the field of risk and disaster management: a scoping review protocol

Resumo Introdução Desastres trazem consequências humanas, socioeconômicas e ambientais e agravam situações de vulnerabilidade. Tanto países centrais, altamente industrializados, como países com dificuldades econômicas estão sujeitos a esses eventos. No Brasil, a pandemia de COVID-19 e o rompimento de barragens evidenciam dificuldades em se antecipar e responder esses tipos de eventos. Ações da terapia ocupacional no campo das emergências e desastres são escassas na literatura, notadamente na esfera da prevenção. Objetivo Explorar as evidências da contribuição de terapeutas ocupacionais no domínio da gestão de risco e desastres a partir das características, prioridades e principais áreas de interesse da produção intelectual em terapia ocupacional. Método Uma pesquisa abrangente será conduzida nos periódicos Disasters, Hazards & Crisis in Public Policy, International Journal of Mass Emergencies and Disasters, and Risk, International Journal of Risk Reduction e Journal of Contingencies and Crisis Management, assim como nas bases de dados Occupational Therapy Literature Search Service (OTDBASE), PubMed e Web of Science. Critérios de inclusão Ações e experiências no âmbito da terapia ocupacional, notadamente aquelas de terapeutas ocupacionais na gestão de riscos e desastres, encontradas em estudos revisados por pares, que adotem métodos quantitativos, qualitativos e mistos, nos idiomas espanhol, inglês e português, sem restrição temporal. A abordagem preconizada pelo Joanna Briggs Institute (JBI) para seleção de estudos, avaliação crítica, extração e síntese de dados será utilizada.

Abstract Introduction Disasters bring human, socioeconomic, and environmental consequences and exacerbate situations of vulnerability. Both highly industrialized core countries and those facing economic difficulties are subject to these events. In Brazil, the COVID-19 pandemic and the collapse of dams highlight difficulties in anticipating and responding to these types of events. Actions of occupational therapy in the field of emergencies and disasters are scarce in the literature, notably in the sphere of prevention. Objective To explore the evidence of the contribution of occupational therapists in the field of risk management and disasters based on the characteristics, priorities, and main areas of interest of intellectual production in occupational therapy. Method A comprehensive search will be conducted in the journals Disasters, Hazards & Crisis in Public Policy, International Journal of Mass Emergencies and Disasters, and Risk, International Journal of Risk Reduction, and Journal of Contingencies and Crisis Management, as well as in the databases Occupational Therapy Literature Search Service (OTDBASE), PubMed, and Web of Science. Inclusion Criteria Actions and experiences in the field of occupational therapy, notably those of occupational therapists in risk and disaster management, found in peer-reviewed studies adopting quantitative, qualitative, and mixed methods, in Spanish, English, and Portuguese, without temporal restriction. The approach advocated by the Joanna Briggs Institute (JBI) for study selection, critical appraisal, and data collection and synthesis will be used.

Strategies to manage tree pest and disease outbreaks: a balancing act.

Tree diseases are one of the major threats to forests worldwide. As the frequency and severity of disease outbreaks increase, effective prevention and mitigation strategies are urgently needed. Emerging methods are available to tackle this issue, however, trade-offs and potential ecological consequences should be considered for successful forest preservation.

Urban rainstorm and waterlogging scenario simulation based on SWMM under changing environment.

Urban rainstorm and waterlogging occurred more frequently in recent years, causing huge economic losses and serious social harms. Accurate rainstorm and waterlogging simulation is of significant value for disaster prevention and mitigation. This paper proposed a numerical model for urban rainstorm and waterlogging based on the Storm Water Management Model (SWMM) and Geographic Information System (GIS), and the model was applied in Lianhu district of Xi'an city of China. Furthermore, the effects of rainfall characteristics, pipe network implementation level and urbanization level on waterlogging were explored from the perspectives of spatial distribution of waterlogging points, drainage capacity of pipe network and surface runoff generation and confluence. The results show that: (1) with the increase of rainfall recurrence period, the peak of total water accumulating volume, the average decline rate of water accumulating volume and the number of waterlogging nodes increase; (2) optimizing the pipe diameter can shorten the average overload time of the pipe network from the entire pipe network, but for a single pipe, optimizing the pipe diameter may lead to overloading of unoptimized downstream pipeline; (3) the lower the imperviousness, the less the number of waterlogging nodes and average time of water accumulating, and (4) the west, northwest and southwest areas are relatively affected by the imperviousness, only improving the underlying surface conditions has limited influence on waterlogging in the study area. This study can provide reference for urban waterlogging prevention and reduction and pipe network reconstruction.

Evaluación de síntomas neuropsiquiátricos para la detección temprana de trastorno neurocognoscitivo / Evaluation of neuropsychiatry symptoms for the early detection of neurocognitive disorder

RESUMEN INTRODUCCIÓN: El diagnóstico oportuno del trastorno neurocognitivo es de los principales retos en la atención de los trastornos neurocognitivos. Por esto, se han generado estrategias para la detección preclínica de la enfermedad, entre ellas las destinadas a evaluar síntomas neuropsiquiátricos (NPS) como la escala Mild Behavior Impairment - Checklist (MBI-C). MÉTODOS: Inicialmente se realizó una búsqueda en BVSalud, Medline y PsycNet, luego se realizó una búsqueda en bola de nieve. Se incluyeron términos referentes a deterioro comportamental leve (abarcando los NPS en etapas tempranas), deterioro cognitivo leve y términos específicos del MBI-C. RESULTADOS: La presencia de NPS se asocia con un aumento en la incidencia anual de demencia. Al evaluarlos con MBI-C, su puntuación se correlaciona con biomarcadores como una mayor atrofia cortical, la presencia de la proteína β-amiloide, así como disminución en funciones ejecutivas como la capacidad de enfocar la atención y la memoria de trabajo. DISCUSIÓN: Los hallazgos en la literatura sugieren la utilidad de MBI-C como marcador de neurodegeneración en estadios previos a la demencia, esto mediante la evaluación de su capacidad predictiva de forma independiente y al compararla con otros biomarcadores. CONCLUSIONES: MBI-C supone ser un instrumento de fácil aplicabilidad e interpretación, sostenible e incluyente. Sin embargo, quedan vacíos sobre la pertinencia de esta escala, por lo que surge la necesidad de investigar este tema.

ABSTRACT INTRODUCTION: Early diagnosis of neurocognitive disorder is the main challenge of dementia health attention. Therefore, strategies for preclinical detection of the disease have been created, like those intended to evaluate neuropsychiatric symptoms (NPS), like the Mild Behavior Impairment - Checklist (MBI-C). METHODS: Research was performed in BVSalud, Medline, and Psynet. Then a snowball sampling was done. The terms included were mild behavioral impairment (included NPS in initial stages), mild cognitive impairment, and specific terms of MBI-C. RESULTS: The presence of NPS increase the incidence of dementia, with an annual conversion rate of 9%. About MBI-C, the score has been related to biomarkers like worse brain atrophy in patients with Parkinson's Disease and a positive relationship with the presence of B-amyloid protein. Also, Creese and cols. show that mild behavioral impairment (measured by MBI-C) is associated with a faster decrease in attention and working memory. DISCUSSION: MBI-C utility as a neurodegenerative marker has been demonstrated to detect cognitive, neuropsychiatry, and functional symptoms that may precede dementia by evaluating its predictive capacity alone and comparing it to other biomarkers. CONCLUSION: MBI-C is easy to apply and interpret, is sustainable and inclusive. However, there are still gaps in the relevance of the scale, so there is the need to continue investigating this topic.

Injury prevention for yoga practicing college students / Prevenção de lesões para estudantes universitários praticantes de ioga / Prevención de lesiones en estudiantes universitarios practicantes de yoga

ABSTRACT Introduction: The research shows that most yoga students consider it a low-intensity and low-risk training, evidencing the lack of awareness related to prevention and safety methods, two causal factors of sports injuries. Added to this danger is the scarce literature scientifically reporting the prevention methods for college students practicing this activity. Objective: Study the prevention of injuries during yoga practice by college students, exploring the risk management of this activity. Methods: Patients admitted to a hospital, yoga practitioners, were volunteers in a questionnaire to raise the main injuries and their causes. Data such as time of practice, frequency, and recurrence of injuries were also cataloged. A preventive protocol was elaborated based on the data of the collected accidents and tested with another 50 volunteers divided equally into control and experimental groups. The control group received no interventions. The experimental group added 10 minutes of warm-up and stretching based on the elaborated protocol. Interventions were three times weekly for eight weeks. Risk mitigation data and FMS tests were collected and compared. Results: The total FMS test score in the experimental group increased from 12.5 to 16.2, with a significant impact. The total FMS test score of college students in the control group before the experiment was 12.5 to 14.3. Conclusion: Adding warm-up exercises combined with preparation activities by stretching and basic yoga movements before the start of activities can help athletes' physical condition and reduce the occurrence of sports injuries. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: As pesquisas mostram que a maioria dos estudantes praticantes de ioga a considera um treinamento de baixa intensidade e baixo risco, evidenciando a falta de consciência relacionada à prevenção e métodos de segurança, dois fatores causais de lesões esportivas. Soma-se a essa periculosidade a escassa literatura relatando cientificamente os métodos de prevenção aos estudantes universitários praticantes dessa atividade. Objetivo: Estudar a prevenção de lesões durante a prática do exercício de ioga pelos estudantes universitários, explorando a gestão de riscos dessa atividade. Métodos: Pacientes internados em um hospital, praticantes de ioga, foram voluntários em um questionário para levantar as principais lesões e suas causas. Dados como tempo de prática, frequência e reincidências de lesões também foram catalogadas. Um protocolo preventivo foi elaborado com base nos dados dos acidentes coletados e experimentado com outros 50 voluntários divididos igualmente em grupo controle e experimental. O grupo de controle não recebeu intervenções. O grupo experimental acrescentou 10 minutos de aquecimento e alongamento com base no protocolo elaborado. As intervenções foram de 3 vezes semanais, por 8 semanas. Dados de mitigação de riscos e teste FMS foram coletados e comparados. Resultados: A pontuação total do teste FMS no grupo experimental aumentou de 12,5 para 16,2, com impacto significativo. A pontuação total do teste FMS de estudantes universitários do grupo de controle antes do experimento foi de 12,5 para 14,3. Conclusão: A adição de exercícios de aquecimento combinados com atividades de preparação por alongamento e movimentos básicos de ioga antes do início das atividades pode auxiliar na condição física dos atletas e reduzir a ocorrência de lesões esportivas. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

Resumen Introducción: Las investigaciones muestran que la mayoría de los estudiantes que practican yoga lo consideran un entrenamiento de baja intensidad y bajo riesgo, lo que evidencia la falta de concienciación relacionada con los métodos de prevención y seguridad, dos factores causales de las lesiones deportivas. A este peligro se suma la escasa literatura que informe científicamente sobre los métodos de prevención para los universitarios que practican esta actividad. Objetivo: Estudiar la prevención de lesiones durante la práctica del ejercicio de yoga por los estudiantes universitarios, explorando la gestión de riesgos de esta actividad. Métodos: Los pacientes ingresados en un hospital, practicantes de yoga, fueron voluntarios en un cuestionario para plantear las principales lesiones y sus causas. También se catalogaron datos como el tiempo de práctica, la frecuencia y la recurrencia de las lesiones. Se elaboró un protocolo preventivo basado en los datos de los accidentes recogidos y se experimentó con otros 50 voluntarios divididos a partes iguales en grupo de control y grupo experimental. El grupo de control no recibió ninguna intervención. El grupo experimental añadió 10 minutos de calentamiento y estiramientos basados en el protocolo elaborado. Las intervenciones se realizaron 3 veces por semana durante 8 semanas. Se recopilaron y compararon los datos de mitigación de riesgos y la prueba FMS. Resultados: La puntuación total de la prueba FMS en el grupo experimental aumentó de 12,5 a 16,2, con un impacto significativo. La puntuación total en la prueba FMS de los estudiantes universitarios del grupo de control antes del experimento era de 12,5 a 14,3. Conclusión: La adición de ejercicios de calentamiento combinados con actividades de preparación mediante estiramientos y movimientos básicos de yoga antes del inicio de las actividades puede ayudar a la condición física de los deportistas y reducir la aparición de lesiones deportivas. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Factors Associated with Knowledge of Evacuation Routes and Having an Emergency Backpack in Individuals Affected by a Major Earthquake in Piura, Peru.

Information on the prevention of earthquakes in Peru, a high-risk country, is still emerging. We determined the frequency and factors associated with knowledge of evacuation routes and the use of emergency backpacks in people affected by a major earthquake. A cross-sectional study using secondary data was conducted from August-December 2021 on people that experienced the 6.1 magnitude earthquake that occurred in Piura, Peru on 30 July 2021. The outcome was self-reported knowledge of evacuation routes and the use of emergency backpacks. The association with self-reported earthquake preparation training, use of sources of information on earthquakes, and sociodemographic variables was investigated. A total of 69.5% of participants knew evacuation routes, and 46.3% had an emergency backpack. A higher frequency of knowledge of evacuation routes was associated with previous training (PR: 1.47; 95% CI: 1.15-1.87), use of the media (PR: 1.35; 95% CI: 1.06-1.72), having received information from the COEN (PR: 1.19; 95% CI: 1.02-1.40), and with a greater number of household members (PR: 1.03; 95% CI: 1.01-1.06). There is a high frequency of knowledge of evacuation routes among participants. However, basic notions of prevention culture are still needed. This research contributes to policy development on earthquake preparation at the community level.

Comparative Study on International Research Hotspots and National-Level Policy Keywords of Dynamic Disaster Monitoring and Early Warning in China (2000-2021).

For more than 20 years, disaster dynamic monitoring and early warning have achieved orderly and sustainable development in China, forming a systematic academic research system and top-down policy design, which are inseparable from the research of China's scientific community and the promotion of government departments. In the past, most of the research on dynamic disaster monitoring and early warning focused on specific research in a certain field, scene, and discipline, while a few studies focused on research review or policy analysis, and few studies combined macro and meso research reviews in academia with national policy analysis for comparative analysis. It is necessary and urgent to explore the interaction between scholars' research and policy deployment, which can bring theoretical contributions and policy references to the top-down design, implementation promotion, and academic research of China's dynamic disaster monitoring and early warning. Based on 608 international research articles on dynamic disaster monitoring and early warning published by Chinese scholars from 2000-2021 and 187 national policy documents published during this period, this paper conducts a comparative analysis between the knowledge maps of international research hotspots and the co-occurrence maps of policy keywords on dynamic disaster monitoring and early warning. The research shows that in the stage of initial development (2000-2007), international research articles are few and focused, and research hotspots are somewhat alienated from policy keywords. In the stage of rising development (2008-2015), after the Wenchuan earthquake, research hotspots are closely related to policy keywords, mainly in the fields of geology, engineering disasters, meteorological disasters, natural disasters, etc. Meanwhile, research hotspots also focus on cutting-edge technologies and theories, while national-level policy keywords focus more on overall governance and macro promotion, but the two are gradually closely integrated. In the stage of rapid development (2016-2021), with the continuous attention and policy promotion of the national government, the establishment of the Ministry of Emergency Management, and the gradual establishment and improvement of the disaster early warning and monitoring system, research hotspots and policy keywords are integrated and overlapped with each other, realizing the organic linkage and mutual promotion between academic research and political deployment. The motivation, innovation, integration, and transformation of dynamic disaster monitoring and early warning are promoted by both policy and academic research. The institutions that issue policies at the national level include the State Council and relevant departments, the Ministry of Emergency Management, the Ministry of Water Resources, and other national ministries and commissions. The leading affiliated institutions of scholars' international research include China University of Mining and Technology, Chinese Academy of Sciences, Wuhan University, Shandong University of Science and Technology, and other institutions. The disciplines involved are mainly multidisciplinary geosciences, environmental sciences, electrical and electronic engineering, remote sensing, etc. It is worth noting that in the past two to three years, research and policies focusing on COVID-19, public health, epidemic prevention, environmental governance, and emergency management have gradually increased.

Post-Traumatic Stress Disorder after the 6.1 Magnitude Earthquake in Piura, Peru: A Cross-Sectional Study.

In Peru, major disasters like the 2007 Pisco earthquake have produced high rates of post-traumatic stress. However, evidence is still needed to strengthen interventions. In 2021, a major earthquake struck Piura, in northern Peru. In this context, we aimed to assess the prevalence of PTSD and its associated factors. A cross-sectional study was conducted during August-September 2021 in people who experienced the 6.1 Piura earthquake on 30 July 2021. The questionnaire included the PCL-C, CD-RISC, ISI, HFIAS, and additional demographic data. Generalized linear models were used. The prevalence of PTSD was 20.3%. Household income was between PEN 2001 and 3000 (PR = 4.26, 95% CI: 1.08-16.75), smoking (PR = 2.49, 95% CI: 1.03-6.01), experience of a nervous breakdown (PR = 1.83, 95% CI: 1.09-3.09), moderate food insecurity (PR = 2.91, 95% CI: 1.10-7.73), and severe insomnia (PR = 8.25, 95% CI: 2.22-30.71) increased the prevalence of PTSD. One out of five individuals experienced post-traumatic stress symptoms after the 2021 earthquake in Piura, which varies depending on socioeconomic, psychosocial, and individual factors. Further research should strengthen these findings to ensure a fair and early mental health intervention against new seismic events in this and other Peruvian regions.

Construction and Evaluation of a Safe Community Evaluation Index System-A Study of Urban China.

A community is the basic unit of a city. Scientific and effective evaluations of the construction effect of safe communities can improve the construction capacity of community disaster prevention and mitigation; it is also the basis for improving urban public safety and realizing stable and sustainable urban operation. First, following the development framework of a safe community and taking two typical communities in Xi'an, China, as examples, based on the literature and expert opinions, the initial indicators of a safe community are determined. Second, based on existing data, the literature and expert opinions, a questionnaire is designed, and the reliability and validity of the questionnaire are tested by exploratory factor analysis. Third, the indicators for evaluating the construction ability of a safe community are selected. Finally, an evaluation model of the construction ability of safe communities is constructed by using the comprehensive weighting technique for order of preference by similarity to the ideal solution (TOPSIS), which is applied to the actual evaluation of eighteen representative communities in Xi'an. The main findings are as follows. (1) The sense of community security is the collective consciousness of community residents. It includes not only the security and feelings of community residents themselves, but also the cognition of the impact of social policies at the macro and micro-levels on community residents, their families, and even the whole community. (2) From the three levels of consciousness, technology, and policy as the starting points for the construction of the theoretical model of a safe community, organizational resilience, accessibility resilience, social environmental resilience, and capital resilience are found to be the main influencing factors in the construction of a safe community. (3) Using questionnaires and expert interviews to preliminarily screen evaluation indicators and using the comprehensive weighting TOPSIS method to build an evaluation model can effectively avoid the defects of traditional empirical research on the validity and reliability of methods. (4) The ranking of the eighteen representative communities in the empirical analysis is basically consistent with the selection results of the national comprehensive disaster reduction demonstration community, which indicates the effectiveness and accuracy of the indicators and algorithms.

[Management and impact of interventions to reduce COVID-19 cases in Costa RicaGestão e impacto das medidas de intervenção para reduzir os casos de COVID-19 na Costa Rica]. / Gestión e impacto de las medidas de intervención para la reducción de casos por COVID-19 en Costa Rica.

Objective: Assess the impact of interventions introduced in Costa Rica during 2020 and 2021 to control the COVID-19 pandemic. Methods: A Bayesian Poisson regression model was used, incorporating control or intervention measures as independent variables in the changes in reported case numbers per epidemiological week. Results: The results showed the relative and combined impact of containment policies and measures on the reduction of cases: mainly vehicular traffic restrictions, use of masks, and implementation of health guidelines and protocols. Evidence of impact was optimized and made available for decision-making by the country's health and emergency authorities. Several iterations were generated for constant monitoring of variations in impact at four different moments in the pandemic's spread. Conclusion: The simultaneous implementation of different mitigation measures in Costa Rica has been a driving force in reducing the number of COVID-19 cases.

Objetivo: Avaliar o impacto das intervenções realizadas na Costa Rica durante 2020 e 2021 para o controle da pandemia de COVID-19. Método: Foi utilizado um modelo Bayesiano de regressão de Poisson que incorporou as medidas de controle ou intervenção como variáveis independentes sobre a variação do número de casos por semana epidemiológica. Resultados: Os resultados evidenciaram o efeito relativo e conjunto que as políticas ou medidas de contenção tiveram na redução de casos, principalmente as restrições a veículos, o uso de máscaras e a implementação de diretrizes e protocolos de saúde. As evidências dos efeitos foram otimizadas e disponibilizadas às autoridades sanitárias e de emergência do país para auxiliar na tomada de decisão. Diversas iterações foram geradas para o monitoramento constante da variação nos efeitos em quatro momentos distintos do avanço da pandemia. Conclusão: A aplicação simultânea de diferentes medidas de mitigação na Costa Rica tem sido um agente promotor da diminuição de casos de COVID-19.

Programa de atención psicosocial y salud integral a víctimas del conflicto armado, Algeciras (Huila), Colombia, 2018 / Program of psychosocial care and integral health to victims of the armed conflict, Algeciras (Huila), Colombia, 2018

Resumen Introducción: En Colombia se estima que existen 7 675 032 víctimas del conflicto armado. Uno de los departamentos del país con mayor afectación de personas es Huila. Debido al impacto del conflicto sobre la salud, es necesario realizar la caracterización de la población para identificar las necesidades derivadas de este y orientar las intervenciones. Objetivo: Elaborar un programa de atención psicosocial y salud integral a víctimas del conflicto armado residentes en la cabecera municipal de Algeciras (Huila), Colombia. Métodos: Diseño cuantitativo cross-sectional con fase descriptiva retrospectiva. Se realizó búsqueda activa en el municipio para el reconocimiento de la población víctima del conflicto. Para el análisis se utilizó Excel 2016 y SPSS versión 24. Resultados: La prevalencia para la población víctima del conflicto armado fue del 80,0 %. El tipo de violencia al que estuvieron expuestos fue desplazamiento (51,0 %) con un periodo de afectación entre diez a veinte años (35,8 %). Según grupos de edad predominaron las edades entre los 30 a 34 años con un 11,7 %. Conclusiones: 1) La prevalencia estimada para la población víctima del conflicto armado puso de manifiesto el reto psicosocial para dar respuesta desde una pespectiva individual, familiar y comunitaria. 2) Las intervenciones planteadas estuvieron orientadas hacia la atención psicosocial y desarrollo de habilidades individuales y sociales, las cuales deben complementarse con acciones interinstitucionales e intersectoriales para el mejoramiento de los determinantes sociales de la salud.

Abstract Introduction: In Colombia it is estimated that a total of 7,675,032 victims exist due to the armed conflict. Huila is one of the departments in the country with the greatest impact on people. Due to the impact of the conflict on health, it is necessary to characterize the population in order to identify the needs derived from the conflict and to orient the interventions. Objective: To design a program of psychosocial attention and integral health to victims of the armed conflict whom are residents of Algeciras (Huila), Colombia. Methods: Quantitative-based cross-sectional with a retrospective descriptive phase. An active search was performed in the municipality to identify victims of the conflict amongst the population. Excel 2016 and SPSS version 24 were used for the analysis. Results: The prevalence of victims was 80.0 %. The type of violence experienced by victims was displacement (51.0%) with an affected period between ten to twenty years (35.8%). Regarding age groups, those aged between 30 to 34 years were predominately affected (11.7%). Conclusions: 1) The estimated prevalence of the victim population highlights the psychosocial challenge to provide an individual, family and community response. 2) The proposed practices are oriented towards psychosocial care and the development of individual and social skills, which must be complementary with inter-institutional and intersectoral actions for the improvement of social determinants of health.

A systematic review of spinal cord ischemia prevention and management after open and endovascular aortic repair.

OBJECTIVE: Spinal cord ischemia (SCI) is one of the most devastating complications after descending thoracic aortic (DTA) and thoracoabdominal aortic (TAA) repairs. Patients who develop SCI have a poor prognosis, with mortality rates reaching 75% within the first year after surgery. Many factors have been shown to increase the risk of this complication, including the extent of TAA repair, length of aortic and collateral network coverage, embolization, and reduced spinal cord perfusion pressure. As a result, a variety of treatment strategies have been developed. We aimed to provide an up-to-date review of SCI rates with associated treatment algorithms from open and endovascular DTA and TAA repair. METHODS: Using PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines, a literature review with the MeSH (medical subject headings) terms "spinal cord ischemia," "spinal cord ischemia prevention and mitigation strategies," "spinal cord ischemia rates," and "spinal cord infarction" was performed in the Cochrane and PubMed databases to find all peer-reviewed studies of DTA and TAA repair with SCI complications reported. The search was limited to 2012 to 2021 and English-language reports. MeSH subheadings, including diagnosis, complications, physiopathology, surgery, mortality, and therapy, were used to further restrict the included studies. Studies were excluded if they were not of humans, had not pertained to SCI after DTA or TAA operative repair, and if the study had primarily discussed neuromonitoring techniques. Additionally, studies with <40 patients or limited information regarding SCI protection strategies were excluded. Each study was individually reviewed by two of us (S.L. and A.D.) to assess the type and extent of aortic pathology, operative technique, SCI protection or mitigation strategies, rates of overall and permanent SCI symptoms, associations with SCI on multivariate analysis, and mortality. RESULTS: Of the 450 studies returned by the MeSH search strategy, 41 met the inclusion criteria and were included in the final analysis. For the endovascular DTA repair patients, the overall SCI rates ranged from 0% to 10.6%, with permanent SCI symptoms ranging from 0% to 5.1%. The rate of overall SCI after endovascular and open TAA repair was 0% to 35%. The permanent SCI symptom rate was reported by only one study of open repair at 1.1%. The permanent SCI symptom rate after endovascular TAA repair was 2% to 20.5%. CONCLUSIONS: The present review has provided an up-to-date review of the current rates of SCI and the prevention and mitigation strategies used during DTA and TAA repair. We found that a multimodal approach, including a bundled institutional protocol, staging of multiple repairs, preservation of the collateral blood flow network, augmented spinal cord perfusion, selective cerebrospinal fluid drainage, and distal aortic perfusion during open TAA repairs, appears to be important in reducing the risk of SCI.

Gestión e impacto de las medidas de intervención para la reducción de casos por COVID-19 en Costa Rica / Management and impact of interventions to reduce COVID-19 cases in Costa Rica / Gestão e impacto das medidas de intervenção para reduzir os casos de COVID-19 na Costa Rica

RESUMEN Objetivo. Evaluar el impacto de las intervenciones introducidas en Costa Rica durante 2020 y 2021 para el control de la pandemia por COVID-19. Método. Se empleó un modelo bayesiano de regresión de Poisson que incorporó las medidas de control o intervención como variables independientes sobre la modificación de la cantidad de casos por semana epidemiológica. Resultados. Los resultados evidenciaron el efecto relativo y conjunto que han tenido las políticas o medidas de contención en la reducción de casos, principalmente la restricción vehicular, el uso de mascarillas y la puesta en práctica de los lineamientos y protocolos sanitarios. Las evidencias de los efectos se optimizaron y se pusieron a disposición para la toma de decisiones de las autoridades sanitarias y de emergencia del país. Se generaron varias iteraciones para el monitoreo constante de la variación en los efectos en cuatro momentos distintos del avance de la pandemia. Conclusión. La aplicación simultánea de distintas medidas de mitigación en Costa Rica ha sido un agente promotor de la disminución de casos de COVID-19.

ABSTRACT Objective. Assess the impact of interventions introduced in Costa Rica during 2020 and 2021 to control the COVID-19 pandemic. Methods. A Bayesian Poisson regression model was used, incorporating control or intervention measures as independent variables in the changes in reported case numbers per epidemiological week. Results. The results showed the relative and combined impact of containment policies and measures on the reduction of cases: mainly vehicular traffic restrictions, use of masks, and implementation of health guidelines and protocols. Evidence of impact was optimized and made available for decision-making by the country's health and emergency authorities. Several iterations were generated for constant monitoring of variations in impact at four different moments in the pandemic's spread. Conclusion. The simultaneous implementation of different mitigation measures in Costa Rica has been a driving force in reducing the number of COVID-19 cases.

RESUMO Objetivo. Avaliar o impacto das intervenções realizadas na Costa Rica durante 2020 e 2021 para o controle da pandemia de COVID-19. Método. Foi utilizado um modelo Bayesiano de regressão de Poisson que incorporou as medidas de controle ou intervenção como variáveis independentes sobre a variação do número de casos por semana epidemiológica. Resultados. Os resultados evidenciaram o efeito relativo e conjunto que as políticas ou medidas de contenção tiveram na redução de casos, principalmente as restrições a veículos, o uso de máscaras e a implementação de diretrizes e protocolos de saúde. As evidências dos efeitos foram otimizadas e disponibilizadas às autoridades sanitárias e de emergência do país para auxiliar na tomada de decisão. Diversas iterações foram geradas para o monitoramento constante da variação nos efeitos em quatro momentos distintos do avanço da pandemia. Conclusão. A aplicação simultânea de diferentes medidas de mitigação na Costa Rica tem sido um agente promotor da diminuição de casos de COVID-19.

Adherencia a las conductas preventivas de la COVID-19 en mujeres trans colombianas

Introducción/Objetivo: Establecer el nivel de adherencia de un grupo de mujeres trans colombianas a las medidas de prevención ante el SARS-CoV-2. Método: Diseño transversal correlacional descriptivo de una sola etapa. Se administró un cuestionario en línea anónimo a 100 mujeres trans de Colombia. Los resultados fueron obtenidos utilizando métodos estadísticos tanto frecuentistas como bayesianos (a priori- a posteriori). Resultados: Cerca de las tres cuartas partes de las mujeres participantes reportaron un alto nivel de adherencia a las conductas preventivas. Los factores asociados fueron sentirse capaz de implementar las acciones de prevención y creer en la eficacia de ellas, para evitar contagiar a otros, los conflictos con otras personas y problemas legales. Conclusiones: La autoeficacia y los comportamientos gobernados por reglas están relacionados con la adherencia a las medidas de prevención. Abordar la adherencia en tiempos de COVID-19 implica incorporar de manera integral la magnitud de las inequidades e injusticias sociales y las respuestas en salud ante una situación que afecta a la humanidad de manera diversa y diferenciada.

Introduction/Objective: To establish the level of adherence of a group of Colombian trans women to SARS-CoV-2 prevention measures. Method: Single-stage descriptive correlational cross-sectional design. An anonymous online questionnaire was administered to 100 Colombian trans women. The results were obtained using both frequentist and bayesian (a priori-a posteriori) statistical methods. Results: About three-quarters of the participating women reported a high level of adherence to preventive behaviors. Associated factors were feeling able to implement the preventive actions and believing in their effectiveness, to avoid infecting others, conflicts with others, and avoiding legal problems. Conclusions: Self-efficacy and rule-governed behaviors are related to adherence to prevention measures. Addressing adherence in times of COVID-19 implies comprehensively incorporating the magnitude of social inequities and injustices and the health responses to a situation that affects humanity in a diverse and differentiated manner.

Comprehensive Risk Assessment of High Temperature Disaster to Kiwifruit in Shaanxi Province, China.

In recent years, the main kiwifruit producing region, central-south Shaanxi Province, has often suffered from the threat of extreme high temperatures. Assessing the risk of high-temperature disasters in the region is essential for the rational planning of agricultural production and the development of resilience measures. In this study, a database was established to assess the risk of a high-temperature disaster to kiwifruit. Then, four aspects, hazard, vulnerability, exposure and disaster prevention and mitigation capacity, were taken into account and 19 indexes were selected to make an assessment of the risk of a high-temperature disaster. At the same time, 16 indexes were selected for the assessment of the climatic suitability of kiwifruit in terms of light, heat, water, soil and topography, and were used as one of the indexes for exposure assessment. The analytic hierarchy process and the entropy weighting method were combined to solve the weights for each index. The results reveal that: (1) The Guanzhong Plain has a high climatic suitability for kiwifruit, accounting for 15.14% of the study area. (2) The central part of the study area and southern Shaanxi are at high risk, accounting for 22.7% of the study area. The major kiwifruit producing areas in Shaanxi Province (e.g., Baoji) are at a low risk level, which is conducive to the development of the kiwifruit industry. Our study is the first to provide a comprehensive assessment of the risk of a high-temperature disaster to the economic fruit kiwifruit, providing a reference for disaster resilience and mitigation.

Risk Management of COVID-19 in the Residential Educational Setting: Lessons Learned and Implications for Moving Forward.

With limited COVID-19-guidelines for institutions of higher education (IHEs), colleges and universities began the 2020-2021 academic year with varying approaches. We present a comprehensive COVID-19 prevention and mitigation approach at a residential university during the 2020-2021 academic year, along with campus SARS-CoV-2 transmission during this time. Risk management of COVID-19 was facilitated through (1) a layered approach of primary, secondary, and tertiary prevention measures; (2) a robust committee structure leveraging institutional public health expertise; (3) partnerships with external health entities; and (4) an operations system providing both structure and flexibility to adapt to changes in disease activity, scientific evidence, and public health guidelines. These efforts collectively allowed the university to mitigate SARS-CoV-2 transmission on campus and complete the academic year offering in-person learning on a residential campus. We identified 36 cases of COVID-19 among the 2037 in-person learners during the fall semester, 125 cases in the inter-semester break, and 169 cases among 2095 in-person learners during the spring semester. SARS-CoV-2 infection during the academic year was associated with gender (p = 0.04), race/ethnicity (p = 0.01), and sorority/fraternity membership (p < 0.01). Infection was not associated with undergraduate vs. graduate student status, Division I athlete status, or housing type (all p > 0.05). A multi-faceted public health approach was critical for reducing the impact of COVID-19 while carrying out the university's educational mission.

Endoscopy mitigation strategy with telemedicine and low-cost device use for COVID-19 prevention: A fourth-level Colombian center experience.

BACKGROUND AND STUDY AIMS: The COVID-19 outbreak has reorganized surgical team conditions regarding endoscopy. The number of interventions has been reduced, the number of healthcare professionals must be limited, and both the patients and physicians are more protected than ever. PATIENTS AND METHODS: In the highest peak of contagion in Colombia, endoscopy, colonoscopy, and esophagogastroduodenoscopy were performed using a low-cost disposable device. A total of 1388 procedures were performed. Every patient was assessed for symptoms via a telephone call, at the health center, and after the procedure, following specific attention routes. RESULTS: After procedure follow-up, no positive cases of COVID-19 were noted. CONCLUSION: The methodology reduced the risk of infection during the COVID-19 pandemic.

Livelihood resilience and strategies of rural residents of earthquake-threatened areas in Sichuan Province, China.

Natural disasters are increasing in frequency in China. Enhancing residents' livelihood resilience and adjusting their livelihood strategies have gradually become effective means of dealing with disaster risk. Therefore, it is of great significance to explore the livelihood strategies and livelihood resilience of rural residents in earthquake-stricken areas to help them cope with disaster risks. However, few studies have explored the correlation between residents' livelihood resilience and livelihood strategies from the perspective of residents' livelihood resilience. Based on a survey of 327 households in four districts and counties of Sichuan Province, China that were affected by the Wenchuan and Lushan earthquakes, we construct a framework for analyzing livelihood resilience and livelihood strategy selection. We comprehensively analyze the characteristics of livelihood resilience and livelihood strategy and explore their correlation using an ordinal multi-classification logistic regression model. The results show that: (1) Among 327 sample households, 90.21% were non-farming, 3.67% were part-time households and 6.12% were farming households. Residents' livelihood resilience is mainly based on their disaster prevention and mitigation capacity. (2) As far as the correlation between livelihood resilience and livelihood strategies is concerned, the stronger the buffer capacity in livelihood resilience, the more rural residents tend to engage in non-farming activities to obtain income. When other conditions remain unchanged, the logarithmic probability of choosing an agricultural livelihood strategy decreases by 21.814 for each unit of buffer capacity. From the perspective of residents' livelihood resilience, this study deepens our understanding of the relationship between livelihood resilience and livelihood strategy in earthquake-stricken areas. It also provides useful information for the formulation of policies to improve residents' resilience in disaster-threatened areas.

Key Factors and Coupling Relationships of Collaborative Governance for Disaster Prevention in China's Coastal Cities.

In order to discover the key factors for the successful implementation of the collaborative management of disaster prevention and mitigation in coastal cities and their causal coupling, based on the hypothesis, the main factor analysis method was used to analyze the key factors of the various subsystems of disaster prevention and mitigation, and to verify the correlation between the main factors and the successful implementation of coordinated governance for disaster prevention and mitigation in coastal cities. Interpretative structural model (ISM) is used to explore the coupling relationship between subsystems and key factors within each subsystem. The results show that there have 6 factors, including emergency organization coordination, plan construction coordination, monitoring and early warning coordination, information sharing coordination, emergency command coordination, and emergency resource coordination are positively related to the successful implementation of coastal city disaster prevention and mitigation collaborative governance; emergency rescue coordination and emergency decision-making coordination are not directly related to the successful implementation of disaster prevention and mitigation collaborative governance in coastal cities. When the main factors work together, the impact on the successful implementation of disaster prevention and mitigation collaborative governance in coastal cities is not obvious. There are obvious hierarchical relationships and clear influence paths between key factors within each main factor.

Research on the awareness of disaster prevention and the ability of self-rescue and mutual aid among children in Mianyang Area / 中国小儿急救医学

Objective:To investigate the current situation of children′s awareness of disaster prevention and self-rescue ability in Mianyang area, provide reference for the development of scientific training programs on children′s disaster knowledge, and improve children′s survival ability during the disaster occurence.Methods:Through literature review and expert consultation, the questionnaire was designed by ourselves.Multi-stage sampling method was used to investigate 2 162 cases from county (city) high school, junior high school and primary school in Mianyang area.Results:8.3% of children had weak disaster awareness.Children had a good understanding of disaster related knowledge, with the highest alarm call awareness rate of 91.8%, fire, flood, earthquake escape and earthquake warning score of 86.5%, 84.2%, 84.2%, 83.0%.Cardiopulmonary resuscitation and fire hydrant operation awareness rate was very low (58.8%, 57.4%). Even some children still chose improper escape behavior.The scores of early warning knowledge and first aid skill were correlated with gender and age.In knowledge of disaster precursors, using of fire extinguishers and hydrants, and first aid skills, the scores of boys were significantly higher than those of girls ( P<0.001). Except for fire-related knowledge, gas leakage escape and shelter awareness rate, the older the children were, the higher the scores were ( P<0.05). The scores of early warning, escape knowledge and first aid skills were correlated with the location of home, and the differences were significant ( P>0.001). More than 80.0% of children chose flashlights, food and water, and emergency kits, while 65.0% to 75.0% children thought it was not necessary to prepare a radio, telephone directory, and cash. Conclusion:Children′s awareness of disaster reduction and self-rescue ability are generally good, but there are still insufficient first-aid skills and improper choice of escape behavior.The education of disaster awareness and self-rescue ability should be strengthened in children′s basic education so as to reduce the casualties of children caused by disasters.