Economic Evaluation Approaches in the Field of Disaster Health Management.

BACKGROUND: Economic evaluation approaches are needed to establish useful interventions for saving lives, preventing economic damage, and saving recovery costs at the time of disasters. Thus, the present study is aimed to identify the studies that applied economic evaluation approaches/methods for evaluating the economic costs of disasters. METHODS: A scoping review was conducted to find the eligible studies and perform a comprehensive data analysis. RESULTS: Based on the findings, cost-effectiveness analysis, economic loss assessment, modeling, or mapping, as well as behavioral economic analysis were used as the economic evaluation approaches/methods. CONCLUSIONS: Applying economic evaluation approaches to illustrate the economic costs of disasters is highly recommended. Managing competing priorities and optimizing resources allocations to the most cost-effective interventions can be achieved by cost-effectiveness analysis. The results of economic loss assessment can be used as the basis of disaster preparedness and response planning. Economic modeling can be applied to compare different interventions and anticipate socio-economic effects of disasters. A behavioral economic approach can be effective for decision-making in the field of disaster health management. Further research is needed to identify the advantages and limitations of each economic evaluation method/approach in the field of health in disasters. Such research can preferably be designed as the systematic review and meta-analysis.

The necessity for an integrated Emergency Operations Center (EOC) among first responders: Lesson learned from two Iranian railway accidents.

Introduction: Several train accidents have occurred in Iran in the last twenty years, resulting in considerable loss of human lives. This study aims to investigate and analyze the response process and deficiencies thereof, of three responding organizations to two railway accidents in Iran. Methods: The study was performed in 2 stages to examine the challenges faced by the first responders in the said accidents. In the first stage, a descriptive statistical analysis was conducted to estimate the injuries and loss of human lives. In the second stage, qualitative description (QD) was performed. Technical reports, official documents, and interviews contributed to the sources of primary data. Study participants were members of first responders who were interviewed. Results: The lack of key components like coordination, information-sharing, a single unified command between responders from different organizations, a lack of relief and rescue railway train, and poor inter-organizational interactions in the deployment of relief teams, were found to be the most important challenges. Discussion and conclusion: The analysis of these two accidents showed that the lack of an integrated emergency operations center (EOC) among the organizations involved in the emergency response appears to be the obvious cause of initial confusion and disruption in the response phase which caused a delay which proved fatal. Designing and developing an integrated response plan among responding organizations, preparing an information sharing network, centralized deployment of forces to the site of the accident, strengthening inter-organizational interactions in the form of an incident command system, designing, launching, and using rescue trains on rail routes and use of air emergency facilities in areas with poor accessibility can reduce mortality in future in similar kind of accidents.

Comparison of health-related quality of life (HRQoL) among healthy, obese and chronically ill Iranian children.

BACKGROUND: Health-related quality of life (HRQoL) has frequently been compared between both healthy and obese children and healthy and chronically ill children; however, there is glaring lack of evidence regarding comparison of HRQoL in obese children with their counterparts with chronic diseases. Therefore, this study aimed to compare HRQoL among healthy, obese and chronically ill children. METHODS: This cross sectional study was conducted among 802 children (8-12 years) who were recruited via convenience sampling method. Participants were 98 healthy, 102 obese and 602 chronically ill children with six groups of chronic conditions including different types of cancer, rheumatoid arthritis, chronic gastrointestinal, kidney, neurologic and respiratory diseases. HRQoL was assessed using the Iranian version of the PedsQL questionnaire and both reports including child self-report and parent proxy-report were obtained. To compare subscales and total scores of HRQoL among healthy, obese and six groups of chronically ill children, the general linear model was used. RESULTS: Mean self-reported HRQoL total scores were 73.7 ± 13.3 and 74.6 ± 11.8 in girls and boys respectively; based on the parents' reports, mean HRQoL total scores were 71.6 ± 15.4 and 71.4 ± 13.0 in girls and boys respectively. From the prespectives of both children and parents, HRQoL total score was significantly lower in obese girls compared to both healthy girls and girls with chronic gastrointestinal, kidney, neurologic and respiratory diseases. Considering both children's and parents' reports, HRQoL total score was significantly lower in obese boys compared to both healthy boys and boys with chronic respiratory diseases. In terms of subscales of HRQoL, the impairment of HRQoL in obese children, compared to their counterparts with other chronic diseases, was more common in social functioning and physical functioning subscales, specifically in girls. CONCLUSION: Obese children reported poorer HRQoL compared to their healthy counterparts, as well as their counterparts with chronic diseases. Current findings emphasize the important impact of childhood obesity on the perceived health of these children, particularly in the social dimension, underscoring thereby the designing, planning and implementation of health promotion programs for prevention and treatment of childhood obesity.

A model based on equations of kinetics to study nitrogen dioxide behavior within a plasma discharge reactor.

In this work, a zero-dimensional kinetics model is used to study the temporal behavior of different species such as charged particles, radicals and excited states inside a Dielectric Barrier Discharge plasma reactor. It is shown that, the reactor significantly reduces the concentration of nitrogen monoxide as an environmental pollutant. After a drastic increase, a decrease in the concentration of the NO2 molecules inside the reactor is seen. Nitrogen monoxide molecules with a very low concentration are produced inside the reactor and its quick conversion to other products is proved. The obtained results are compared with the existing experimental and simulation findings, whenever possible.