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Artigo em Inglês | MEDLINE | ID: mdl-30764531


Identification and profiling of current and emerging disaster risks is essential to inform effective disaster risk management practice. Without clear evidence, readiness to accept future threats is low, resulting in decreased ability to detect and anticipate these new threats. A consequential decreased strategic planning for mitigation, adaptation or response results in a lowered resilience capacity. This study aimed to investigate threats to the health and well-being of societies associated with disaster impact in Oceania. The study used a mixed methods approach to profile current and emerging disaster risks in selected countries of Oceania, including small and larger islands. Quantitative analysis of the International Disaster Database (EM-DAT) provided historical background on disaster impact in Oceania from 2000 to 2018. The profile of recorded events was analyzed to describe the current burden of disasters in the Oceania region. A total of 30 key informant interviews with practitioners, policy managers or academics in disaster management in the Oceania region provided first-hand insights into their perceptions of current and emerging threats, and identified opportunities to enhance disaster risk management practice and resilience in Oceania. Qualitative methods were used to analyze these key informant interviews. Using thematic analysis, we identified emerging disaster risk evidence from the data and explored new pathways to support decision-making on resilience building and disaster management. We characterized perceptions of the nature and type of contemporary and emerging disaster risk with potential impacts in Oceania. The study findings captured not only traditional and contemporary risks, such as climate change, but also less obvious ones, such as plastic pollution, rising inequality, uncontrolled urbanization, and food and water insecurity, which were perceived as contributors to current and/or future crises, or as crises themselves. The findings provided insights into how to improve disaster management more effectively, mainly through bottom-up approaches and education to increase risk-ownership and community action, enhanced political will, good governance practices and support of a people-centric approach.

Planejamento em Desastres/organização & administração , Gestão de Riscos/organização & administração , Planejamento em Desastres/métodos , Prova Pericial , Feminino , Humanos , Entrevistas como Assunto , Masculino , Oceania , Percepção , Pesquisa Qualitativa , Medição de Risco , Gestão de Riscos/métodos
Confl Health ; 12: 16, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29686727


Evidence of use of toxic gas chemical weapons in the Syrian war has been reported by governmental and non-governmental international organizations since the war started in March 2011. To date, the profiles of victims of the largest chemical attacks in Syria remain unknown. In this study, we used descriptive epidemiological analysis to describe demographic characteristics of victims of the largest chemical weapons attacks in the Syrian war. We analysed conflict-related, direct deaths from chemical weapons recorded in non-government-controlled areas by the Violation Documentation Center, occurring from March 18, 2011 to April 10, 2017, with complete information on the victim's date and place of death, cause and demographic group. 'Major' chemical weapons events were defined as events causing ten or more direct deaths. As of April 10, 2017, a total of 1206 direct deaths meeting inclusion criteria were recorded in the dataset from all chemical weapons attacks regardless of size. Five major chemical weapons attacks caused 1084 of these documented deaths. Civilians comprised the majority (n = 1058, 97.6%) of direct deaths from major chemical weapons attacks in Syria and combatants comprised a minority of 2.4% (n = 26). In the first three major chemical weapons attacks, which occurred in 2013, children comprised 13%-14% of direct deaths, ranging in numbers from 2 deaths among 14 to 117 deaths among 923. Children comprised higher proportions of direct deaths in later major chemical weapons attacks, forming 21% (n = 7) of 33 deaths in the 2016 major attack and 34.8% (n = 32) of 92 deaths in the 2017 major attack. Our finding of an extreme disparity in direct deaths from major chemical weapons attacks in Syria, with 97.6% of victims being civilians and only 2.4% being combatants provides evidence that major chemical weapons attacks were indiscriminate or targeted civilians directly; both violations of International Humanitarian Law (IHL). Identifying and quantifying chemical weapons violations requires inter-disciplinary collaboration to inform international policy, humanitarian intervention and legal action.

Artigo em Inglês | MEDLINE | ID: mdl-28757595


The Syrian conflict has displaced five million individuals outside their country with Lebanon hosting the largest numbers per capita. Around 24% of Syrian refugees fleeing to Lebanon are women of reproductive age (15-49). Yet, a better understanding of the sexual and reproductive health needs of Syrian refugee women in Lebanon is required to improve provided services. Eleven focus group discussions were conducted in four regions of Lebanon with 108 Syrian refugee women of reproductive age. Thematic analysis was used to examine the data. Interviewed women were mainly adults. They believed that, in Lebanon, they were subjected to early marriage compared to the norm in Syria due to their financial situation and uncertainty. Cost was reported as the main barrier to use contraception in Lebanon but some Syrian refugee women were not aware of free services covering sexual and reproductive health. In general, marriage, pregnancy, and family planning behavior of Syrian refugee women in Lebanon slightly differed from those in Syria pre-conflict in terms of age of marriage, conception subsequent to marriage, and contraception method. Hence, interventions to increase awareness of subsidized sexual and reproductive health services, including free contraceptives at primary health care centers, and those targeting protection from early marriage of Syrian refugee women in Lebanon are strongly recommended.

Anticoncepção/estatística & dados numéricos , Casamento/estatística & dados numéricos , Refugiados/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Líbano , Pessoa de Meia-Idade , Pesquisa Qualitativa , Saúde Reprodutiva/estatística & dados numéricos , Síria , Saúde da Mulher/estatística & dados numéricos , Adulto Jovem
Artigo em Inglês | MEDLINE | ID: mdl-28075363


Due to the conflict that started in spring 2014 in Eastern Ukraine, a total of 1.75 million internally displaced persons (IDPs) fled the area and have been registered in government-controlled areas of the country. This paper explores perceived health, barriers to access to healthcare, caring practices, food security, and overall financial situation of mothers and young children displaced by the conflict in Ukraine. This is a qualitative study, which collected data through semi-structured in-depth interviews with nine IDP mothers via Skype and Viber with a convenience sample of participants selected through snowball technique. Contrary to the expectations, the perceived physical health of mothers and their children was found not to be affected by conflict and displacement, while psychological distress was often reported. A weak healthcare system, Ukraine's proneness to informal payments, and heavy bureaucracy to register as an IDP were reported in our study. A precarious social safety net to IDP mothers in Ukraine, poor dietary diversity, and a generalized rupture of vaccine stocks, with halted or delayed vaccinations in children were identified. Increasing social allowances and their timely delivery to IDP mothers might be the most efficient policy measure to improve health and nutrition security. Reestablishment and sustainability of vaccine stocks in Ukraine is urgent to avoid the risks of a public health crisis. Offering psychological support for IDP mothers is recommended.

Saúde da Criança/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Nível de Saúde , Saúde Materna/estatística & dados numéricos , Refugiados/psicologia , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Entrevistas como Assunto , Saúde Pública , Pesquisa Qualitativa , Ucrânia , Adulto Jovem
Sci Rep ; 5: 11972, 2015 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-26153115


Floods and storms are climate-related hazards posing high mortality risk to Caribbean Community (CARICOM) nations. However risk factors for their lethality remain untested. We conducted an ecological study investigating risk factors for flood and storm lethality in CARICOM nations for the period 1980-2012. Lethality--deaths versus no deaths per disaster event- was the outcome. We examined biophysical and social vulnerability proxies and a decadal effect as predictors. We developed our regression model via multivariate analysis using a generalized logistic regression model with quasi-binomial distribution; removal of multi-collinear variables and backward elimination. Robustness was checked through subset analysis. We found significant positive associations between lethality, percentage of total land dedicated to agriculture (odds ratio [OR] 1.032; 95% CI: 1.013-1.053) and percentage urban population (OR 1.029, 95% CI 1.003-1.057). Deaths were more likely in the 2000-2012 period versus 1980-1989 (OR 3.708, 95% CI 1.615-8.737). Robustness checks revealed similar coefficients and directions of association. Population health in CARICOM nations is being increasingly impacted by climate-related disasters connected to increasing urbanization and land use patterns. Our findings support the evidence base for setting sustainable development goals (SDG).

Desastres , Agricultura , Região do Caribe , Clima , Conservação dos Recursos Naturais , Bases de Dados Factuais , Inundações , Humanos , Modelos Logísticos , Razão de Chances , Fatores de Risco , População Urbana
PLoS One ; 7(9): e45927, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23029321


The hypothesis that Neanderthals exploited birds for the use of their feathers or claws as personal ornaments in symbolic behaviour is revolutionary as it assigns unprecedented cognitive abilities to these hominins. This inference, however, is based on modest faunal samples and thus may not represent a regular or systematic behaviour. Here we address this issue by looking for evidence of such behaviour across a large temporal and geographical framework. Our analyses try to answer four main questions: 1) does a Neanderthal to raptor-corvid connection exist at a large scale, thus avoiding associations that might be regarded as local in space or time?; 2) did Middle (associated with Neanderthals) and Upper Palaeolithic (associated with modern humans) sites contain a greater range of these species than Late Pleistocene paleontological sites?; 3) is there a taphonomic association between Neanderthals and corvids-raptors at Middle Palaeolithic sites on Gibraltar, specifically Gorham's, Vanguard and Ibex Caves? and; 4) was the extraction of wing feathers a local phenomenon exclusive to the Neanderthals at these sites or was it a geographically wider phenomenon?. We compiled a database of 1699 Pleistocene Palearctic sites based on fossil bird sites. We also compiled a taphonomical database from the Middle Palaeolithic assemblages of Gibraltar. We establish a clear, previously unknown and widespread, association between Neanderthals, raptors and corvids. We show that the association involved the direct intervention of Neanderthals on the bones of these birds, which we interpret as evidence of extraction of large flight feathers. The large number of bones, the variety of species processed and the different temporal periods when the behaviour is observed, indicate that this was a systematic, geographically and temporally broad, activity that the Neanderthals undertook. Our results, providing clear evidence that Neanderthal cognitive capacities were comparable to those of Modern Humans, constitute a major advance in the study of human evolution.

Comportamento Animal , Fósseis , Homem de Neandertal/psicologia , Passeriformes/anatomia & histologia , Aves Predatórias/anatomia & histologia , Animais , Cognição , Plumas/anatomia & histologia , Paleontologia