COVID-19: a review on SARS-CoV-2 origin, epidemiology, virology, clinical manifestations and complications with special emphasis on adverse outcome in Bhopal Gas Tragedy survivor.

After the global outbreak of coronaviruses caused diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS), an outbreak due to these viruses occurred in December, 2019 in Wuhan, Hubei Province, China and led to a worldwide spread. Coronavirus 2019 disease (COVID-19) has emerged as a serious global health emergency and spread from a person to another who has the virus. But the scope of an intermediate host is not known. Population at higher risk includes individuals in higher age group (>60 years) or with comorbidities such as diabetes, hypertension, cardiovascular disease and weaker immune system. Many unknown and underestimate risk factors could be responsible for adverse outcomes in COVID-19. These risk factors should be appropriately identified, addressed and necessary actions should be taken to mitigate the effect of COVID-19 pandemic. Bhopal gas tragedy was one of the world's worst industrial chemical leak disaster. The survivors of this incident still suffer from the various complications such as increased rate of cancers, chronic illness like tuberculosis, respiratory diseases, birth defects, nerve injury, growth retardations, gynecological illness and many more. The survivors of Bhopal gas tragedy are at higher risk of developing COVID-19 related adverse outcome. One of the possible explanations can be long term effect of methyl isocyanate (MIC). MIC exposure can lead to possible toxic effect on genetic, epigenetic and non-genetic factors. In this review, we aim to establish the scientific basis for adverse outcome in COVID-19 patients who are also victims of Bhopal gas tragedy.

Continuous post-disaster physical rehabilitation: a qualitative study on barriers and opportunities in Iran.

BACKGROUND: Internationally, inclusion of physical rehabilitation services during early disaster response is relatively new. The aim of the study was to gain an understanding of disaster relief physical rehabilitation in Iran. METHODS: A qualitative study design was employed and sixteen semi-structured interviews were conducted for data collection. Content analysis was used for data analysis. The participants in this study were purposively selected among people who experienced the Bam (2003) and Varzaghan (2012) earthquakes. RESULTS: Three main themes were explored including: indispensable intervention, barriers to continuous intervention and opportunities for intervention. Almost all participants reiterated the importance of effective physical rehabilitation services during disasters. Some participants mentioned significant barriers for delivering such services in the context of Iran. The lack of an effective responsible body, weak disaster-related competencies and under-prioritization by government were among other barriers. On a more positive note, some interviewees talked about national programs that could facilitate service delivery. CONCLUSIONS: Providing disaster relief physical rehabilitation has faced many barriers in Iran. However, there are some facilitators in the country that could help provide these services. Finally, the feasibility of post-disaster physical rehabilitation services delivery completely depends on the current national rehabilitation system.

Therapeutic group therapy improved self-efficacy of school age children

Objective: The survival of children against disaster can be seen from their confidence in their ability (self-efficacy). Self-efficacy can help children to determine their ability against disaster as preparedness. The proper intervention to increase self-efficacy as a protective factor is a therapeutic group therapy. The aim of this research is to measure the increase of self-efficacy of school age children against earthquake and Tsunami through therapeutic group therapy. Method: This research used quasi-experimental design with pre-post-tests with control group. The sample involved in this study is 69 children, where 35 of them are in the experimental group while the rest 34 children are in the control group consisting of school children at the IV and V graders of elementary school. Results: The result of the research showed that the self-efficacy of school children is improved significantly after being treated with therapeutic group therapy (p value < 0,05), those who were not treated with therapeutic group therapy have no significant improvement (p value > 0,05). Conclusions: This research is recommended to be conducted on school age children to improve their self-efficacy against disaster through health education

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Long-term Recovery From Hurricane Sandy: Evidence From a Survey in New York City.

OBJECTIVES: This study aimed to examine a range of factors influencing the long-term recovery of New York City residents affected by Hurricane Sandy. METHODS: In a series of logistic regressions, we analyzed data from a survey of New York City residents to assess self-reported recovery status from Hurricane Sandy. RESULTS: General health, displacement from home, and household income had substantial influences on recovery. Individuals with excellent or fair health were more likely to have recovered than were individuals with poor health. Those with high and middle income were more likely to have recovered than were those with low income. Also, individuals who had not experienced a decrease in household income following Hurricane Sandy had higher odds of recovery than the odds for those with decreased income. Additionally, displacement from the home decreased the odds of recovery. Individuals who applied for assistance from the Build it Back program and the Federal Emergency Management Agency had lower odds of recovering than did those who did not apply. CONCLUSIONS: The study outlines the critical importance of health and socioeconomic factors in long-term disaster recovery and highlights the need for increased consideration of those factors in post-disaster interventions and recovery monitoring. More research is needed to assess the effectiveness of state and federal assistance programs, particularly among disadvantaged populations. (Disaster Med Public Health Preparedness. 2018;12:172-175).

Fukushima Triple Disaster and the Road to Recovery: a Qualitative Exploration of Resilience in Internally Displaced Residents.

Six years after the March 2011 Triple Disaster, over 35,000 Japanese individuals remain in temporary housing. Evacuated residents, many of who are elderly, face mental health challenges. This study evaluates the well being of individuals living in temporary housing within Fukushima. Reactions to relocation were explored using Photovoice, a community-based participatory research method, in which a set of research questions are examined qualitatively through photographs and interviews. Seven participants (average age = 69.7) were provided cameras to answer a set of self-generated questions, a process that was repeated three times. An initial analysis found resilience among participants, which was explored using a theoretical framework of resiliency. Residents discussed how relocation has disrupted their lives and coping strategies they employ to ameliorate stressors. They were often optimistic and future-oriented, stating that they wanted to "live strong" after the disaster. These resilient mindsets were personified in action: all engaged in hobbies, critical for their emotional well being. Participants also emphasized the importance of community and familial support. The evidence of resilience in participants is encouraging, suggesting that these vulnerable elderly internally displaced residents are recovering from the disruption of relocation. These themes should be explored in larger temporary housing communities. Considering the number of relocated individuals today, understanding how to foster resilience could be used to inform the development of future temporary housing shelters.

Repetitive Transcranial Magnetic Stimulation for Phantom Limb Pain in Land Mine Victims: A Double-Blinded, Randomized, Sham-Controlled Trial.

UNLABELLED: We evaluated the effects of repetitive transcranial magnetic stimulation (rTMS) in the treatment of phantom limb pain (PLP) in land mine victims. Fifty-four patients with PLP were enrolled in a randomized, double-blinded, placebo-controlled, parallel group single-center trial. The intervention consisted of real or sham rTMS of M1 contralateral to the amputated leg. rTMS was given in series of 20 trains of 6-second duration (54-second intertrain, intensity 90% of motor threshold) at a stimulation rate of 10 Hz (1,200 pulses), 20 minutes per day, during 10 days. For the control group, a sham coil was used. The administration of active rTMS induced a significantly greater reduction in pain intensity (visual analogue scale scores) 15 days after treatment compared with sham stimulation (-53.38 ± 53.12% vs -22.93 ± 57.16%; mean between-group difference = 30.44%, 95% confidence interval, .30-60.58; P = .03). This effect was not significant 30 days after treatment. In addition, 19 subjects (70.3%) attained a clinically significant pain reduction (>30%) in the active group compared with 11 in the sham group (40.7%) 15 days after treatment (P = .03). The administration of 10 Hz rTMS on the contralateral primary motor cortex for 2 weeks in traumatic amputees with PLP induced significant clinical improvement in pain. PERSPECTIVE: High-frequency rTMS on the contralateral primary motor cortex of traumatic amputees induced a clinically significant pain reduction up to 15 days after treatment without any major secondary effect. These results indicate that rTMS is a safe and effective therapy in patients with PLP caused by land mine explosions.

Injuries and surgical needs of children in conflict and disaster: From Boston to Haiti and beyond.

Comprehensive care of patients in conflict and disaster requires coordination of medical, social, and public health agencies. Pediatric patients in these settings comprise a particularly vulnerable group subject to disruption of social networks and separation from family, inadequate surgical care due to lack of surgeon, anesthetist, and nursing specialization, and a general lack of advocacy within the global public health agenda. In the recent upswell of attention to the global surgical burden of disease and deficiencies in necessary infrastructure, the needs of pediatric surgical patients remain underappreciated and underemphasized amid calls for improvement in global surgical health. Experience in recent natural and man-made disasters has demonstrated that pediatric patients makeup a significant proportion of those injured, and has perhaps refocused our need to better characterize the surgical needs of children in conflict and disaster. In addition to treat such patients, we recognize the unmet challenges of improving pediatric emergency and surgical infrastructures in the low- and middle-income country settings where conflict and disaster occur most often, and continuing to advocate for vulnerable children worldwide and keep them out of harm's way.

Child Disaster Mental Health Services: a Review of the System of Care, Assessment Approaches, and Evidence Base for Intervention.

Several decades of research have informed our knowledge of children's reactions to disasters and the factors that influence their reactions. This article describes the system of care for child disaster mental health services using population risk to determine needed services and a stepped care approach built on assessment and monitoring to advance children to appropriate services. To assess the evidence base for disaster interventions, recent reviews of numerous child disaster mental health interventions are summarized.

Rehabilitation needs of the survivors of the 2013 Ya'an earthquake in China.

OBJECTIVE: To determine the physical, functional and psychosocial rehabilitation needs of the injured survivors of the 2013 earthquake in Ya'an, China. DESIGN: Cross-sectional survey. METHODS: A total of 143 injured survivors (80 males, 63 females, mean age 41.4 years (standard deviation (SD) 20.2)) were recruited for the study. A questionnaire was designed to collect their demographic and environmental information. Manual muscle testing and active range of motion (AROM) were used to assess physical function. The Modified Barthel Index was used to assess activities of daily living (ADL) and the Post-Traumatic Stress Disorder - Self Rating Scale was used to assess psychological status. The rehabilitation needs of the injured survivors were identified based on the assessment results. RESULTS: Physical problems of the back and lower limbs were more severe than those of the upper limbs, as measured by MMT and AROM. Various degrees of dependence in ADL were measured in 74.2% of subjects, and psychological distress was present in more than 50% of subjects. Rehabilitation training prescribed by local therapists included functional training (74.8%), exercises (49.0%), provision of splints (44.8%), etc. Psychological interventions were re-commended to most of the patients. There were high levels of need for assistive devices, and home and community modifications. CONCLUSION: There is a high level of need for early rehabilitation in hospital, followed by continued home and community rehabilitation services, particularly for injured survivors who are returning to villages with very limited resources.

[Special challenges in the highest-elevation acute-care hospital in Europe]. / L'hôpital le plus haut d'Europe face à des enjeux particuliers.

Oberengadin Hospital in Samedan is faced with particular challenges, as the highest-elevation acute-care hospital in Europe (1750 m = 5,740 ft above sea level). The factors responsible for this are elevation-related and meteorological/climatic influences, as well as seasonal variations in Südbünden's demographic structure due to tourism.

Cirugía Plástica en emergencias humanitarias: 20 años de experiencia con Médicos del Mundo / Plastic Surgery in humanitarian emergencies: a 20-year-experience period with Médicos del Mundo

En este artículo presento mi experiencia como cirujano plástico de la organización Médicos del Mundo en múltiples misiones de ayuda humanitaria quirúrgica: conflictos bélicos y emergencias tras desastres naturales, describiendo la dinámica de este tipo de misiones desde la movilización inicial hasta el fin de las mismas y desde una óptica tanto personal como de la organización para la que actúo. Las misiones se han llevado a cabo en 10 países de Europa, África y Asia, en las que se intervinieron quirúrgicamente más de 330 pacientes. El equipo quirúrgico desplazado está compuesto habitualmente por anestesista, cirujano ortopédico y cirujano plástico; una combinación adecuada para el tipo de patología encontrada tanto tras terremotos (fracturas abiertas, síndromes por aplastamiento, secuelas de síndromes compartimentales), como en conflictos bélicos (heridas por metralla, por arma de fuego, amputaciones traumáticas, quemaduras y pérdidas de sustancia). Todo ello sirve también para analizar la diferente ayuda humanitaria que la comunidad internacional ofrece en ambos escenarios (AU)

In this paper I present my experience as plastic surgeon working for Médicos del Mundo organization in multiple humanitarian aid surgical missions: war conflicts and emergencies after natural disasters, describing the dynamics of such missions from the initial mobilization until its final from both, a personal perspective and the organization for which I act. Missions were conducted in 10 countries of Europe, Africa and Asia, and more than 330 patients were operated. The displaced surgical team usually consists of anesthesiologist, orthopedic surgeon and plastic surgeon; a suitable combination for the type of pathology founded after earthquakes (open fractures, crush syndrome, sequelae of compartment syndrome) and war (shrapnel wounds, gunshot wounds, traumatic amputations, burns and loss of substance). The existing difference between the humanitarian aid given by the international community in both scenarios is also analyzed (AU)

Atuação da fisioterapia às vítimas da boate kiss: a experiência de um Hospital de Pronto-Socorro / Physical therapy treatment for the victims of nightclub kiss: the experience of an Emergency Hospital

Introdução: Este artigo trata-se de um relato do trabalho desenvolvido pela equipe de fisioterapeutas de um hospital de pronto-socorro aos pacientes vítimas de queimaduras decorrente da tragédia na Boate Kiss. Objetivo: Descrever as práticas de assistências fisioterapêuticas prestadas, de forma a permitir compartilhar experiências realizadas com esse perfil de paciente em nível hospitalar. Método: Por meio de discussões durante as reuniões da equipe de fisioterapia, foram coletados dados a respeito das atuações na assistência às vítimas da Boate Kiss que foram internadas no hospital. Resultados: Descrevemos, nesse trabalho, as principais atividades assistenciais da fisioterapia, de forma que tecemos, entre outras considerações, a necessidade de atuação o mais precoce possível como uma estratégia de evitar complicações tardias. Conclusão: Consideramos, também, que a reabilitação de uma lesão por queimadura é um processo longo e que não termina com a alta hospitalar.

Introduction: This article it is about a report by work done by the team of physiotherapists in a emergency hospital to the burn victims due to the tragedy in Nightclub Kiss. Objective: The objective was to describe the practice of physical therapy, in order to allow to share experiences with this profile of patients at the hospital level. Methods: Through discussions during the meetings of the physiotherapy team, data about the actuations in assisting victims of Nightclub Kiss who were hospitalized in the hospital were collected. Results: We hereby describe in this paper the main assistance activities of physiotherapy so that present work we make among other considerations, the need for action as early as possible as a strategy to prevent late complications. Conclusion: We also consider that the rehabilitation of a burn injury is a long process that does not end with discharge.

Life recovery after disasters: a qualitative study in the Iranian context.

INTRODUCTION: Planned and organized long-term rehabilitation services should be provided to victims of a disaster for social integration, economic self-sufficiency, and psychological health. There are few studies on recovery and rehabilitation issues in disaster situations. This study explores the disaster-related rehabilitation process. METHOD: This study was based on qualitative analysis. Participants included 18 individuals (eight male and ten female) with experience providing or receiving disaster health care or services. Participants were selected using purposeful sampling. Data were collected through in-depth and semi-structured interviews. All interviews were transcribed and content analysis was performed based on qualitative content analysis. RESULTS: The study explored three main concepts of recovery and rehabilitation after a disaster: 1) needs for health recovery; 2) intent to delegate responsibility; and 3) desire for a wide scope of social support. The participants of this study indicated that to provide comprehensive recovery services, important basic needs should be considered, including the need for physical rehabilitation, social rehabilitation, and livelihood health; the need for continuity of mental health care; and the need for family re-unification services. Providing social activation can help reintegrate affected people into the community. CONCLUSION: Effective rehabilitation care for disaster victims requires a clear definition of the rehabilitation process at different levels of the community. Involving a wide set of those most likely to be affected by the process provides a comprehensive, continuous, culturally sensitive, and family-centered plan.

Management of health care services for flood victims: the case of the shelter at Nakhon Pathom Rajabhat University Central Thailand.

BACKGROUND: In Central Thailand basic health care services were affected by a natural disaster in the form of a flood situation. Flood Relief Operations Centers were established from the crisis. Nakhon Pathom Rajabhat University and including the faculty of nursing volunteered to care for those affected and assist in re-establishing a functioning health care system. STUDY OBJECTIVES: The aim of this study was to make explicit knowledge of concept, lesson learned, and the process of management for re-establishing a health care service system at a flood victims at Relief Operations Center, Nakhon Pathom Rajabhat University. METHODS: We used a qualitative design with mixed methods. This involved in-depth interviews, focus group, observational participation and non-observational participation. Key informants included university administrators, instructors, leaders of flood victims and the flood victims. Data was collected during October-December, 2010. Data were analysed using content analysis and compared matrix. RESULTS: We found that the concept and principle of health care services management were community based and involved home care and field hospital services. We had prepared a management system that placed emphasise on a community based approach and holistic caring such as 24h Nursing Clinic Home, visits with family, a referral system, field hospital. The core of management was to achieve integrated instruction started from nursing students were practiced skills as Health promotion and nursing techniques practicum. CONCLUSIONS: Rules were established regarding the health care service system. The outcomes of Health Care Service at the Flood Relief Operations Center were direct and sincere help without conditions, administrations concerned and volunteer nursing students instructors, University Officer have sympathetic and charitable with flood victims and environment.

Clínica postraumática tras una catástrofe: Madrid, 11M-2004 / No disponible

En el presente artículo se describe, tras una breve aproximación al concepto de trauma, la atención psicológica prestada a la población infanto-juvenil tras los atentados del 11-M en Madrid, puesta en marcha por la Oficina de Salud Mental de la Comunidad de Madrid y en especial las características sociodemográficas y la sintomatología observada y la intervención realizada desde el Centro de Salud Mental de Alcalá de Henares (AU)

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