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1.
Bogotá; Organización Panamericana de la Salud; dic. 05, 2020. 7 p.
Não convencional em Espanhol | LILACS | ID: biblio-1140276

RESUMO

A la fecha Colombia reporta 1.334.089 casos (9.297 casos nuevos en las últimas 24h) con un incremento nacional del 0,7% en las últimas 24h y 37.117 defunciones (183 las últimas 24 Horas) con un aumento nacional del 0,5% en las últimas 24h. Los departamentos y distritos que presentaron los aumentos relativos más altos de COVID-19 en los últimos 7 días fueron: Caldas 11,9% (2.070), Quindío 11,5% (1.397), Tolima 11,5% (2.445), Norte Santander 10,3% (2.075), Boyacá 9,3% (1.302), Casanare 9,0% (504), Cartagena 8,7% (2.044), Risaralda 7,8% (1.297), Santa Marta 7,3% (765), Santander 7,1% (2.658). La tasa de incidencia nacional es de 2.648,5 casos por cada 100.000 habitantes; los departamentos y/o distritos que superan la tasa nacional son en su orden: Bogotá (4.905,8), Amazonas (3.992,7), Barranquilla (3.590,0), San Andrés (3.433,7), Caquetá (3.275,8), Antioquia (3.247,0), Quindío (3.157,9), Cartagena (3.107,4), Huila (2.713,3), Meta (2.686,8). La tasa de mortalidad nacional es de 736,9 muertes por cada millón de habitantes; se observa una tasa de mortalidad mayor a la nacional en: Amazonas (1.556,6), Barranquilla (1.375,7), Caquetá (1.169,2), Bogotá (1.110,5), Santa Marta (943,2), Córdoba (904,3), Santander (893,5), Huila (870,3), Norte Santander (865,9), Quindío (831,8), Valle del Cauca (778,9).


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Pneumonia Viral/mortalidade , Infecções por Coronavirus/mortalidade , Tempestades Ciclônicas/estatística & dados numéricos , Pandemias/prevenção & controle , Desastres Naturais/mortalidade , Colômbia/epidemiologia
2.
Bogotá; Organización Panamericana de la Salud; nov. 23, 2020. 14 p.
Não convencional em Espanhol | LILACS | ID: biblio-1129658

RESUMO

Según el reporte informativo N°170 del IDEAM la habitual temporada de lluvias que se registra cada año para esta época, sumado a la influencia del Fenómeno La Niña y a una actividad ciclónica muy activa, ha generado que las lluvias de este segundo semestre del 2020 hayan aumentado considerablemente. Estas precipitaciones han generado que departamentos como Antioquia, Bolívar, Chocó, La Guajira, Magdalena, Norte de Santander y el Archipiélago de San Andrés, Providencia y Santa Catalina hayan tenido situaciones de emergencia más complejas.


Assuntos
Humanos , Pneumonia Viral/epidemiologia , Infecções por Coronavirus/epidemiologia , Tempestades Ciclônicas/estatística & dados numéricos , Pandemias/estatística & dados numéricos , Colômbia/epidemiologia
3.
Am J Public Health ; 110(10): 1466-1471, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32816548

RESUMO

Objectives. To review the trends in pregnancy outcomes after Hurricane Katrina and assess effects of the disaster on research and public health related to pregnant women.Methods. We reexamined the 2004-2006 vital statistics data from Alabama, Louisiana, and Mississippi, assessing what the risk of adverse pregnancy outcomes in the population would have been under varying risk scenarios.Results. We saw a reduction in number of births as well as in low birth weight and preterm birth. If the number of births had stayed constant and the relative higher risk in the "missing" births had been between 17% and 100%, the storm would have been associated with an increased risk instead of a decrease. Because the relative decline in births was larger in Black women, the higher risk in the "missing" births required to create a significant increase associated with the storm was generally not as great as for White women.Conclusions. Higher exposure to Katrina may have produced a reduction in births among high-risk women in the region rather than increasing adverse outcomes among those who did give birth.


Assuntos
Coeficiente de Natalidade , Resultado da Gravidez , Medição de Risco , Alabama/epidemiologia , Coeficiente de Natalidade/etnologia , Coeficiente de Natalidade/tendências , Tempestades Ciclônicas/estatística & dados numéricos , Feminino , Humanos , Recém-Nascido , Louisiana/epidemiologia , Mississippi/epidemiologia , Gravidez , Resultado da Gravidez/epidemiologia , Resultado da Gravidez/etnologia , Saúde Pública
4.
Public Health Rep ; 135(4): 511-523, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32539542

RESUMO

OBJECTIVES: Although research shows that public health is substantially affected during and after disasters, few studies have examined the health effects of Hurricane Harvey, which made landfall on the Texas coast in August 2017. We assessed disparities in physical health, mental health, and health care access after Hurricane Harvey among residents of the Houston-The Woodlands-Sugar Land, Texas, metropolitan statistical area (ie, Houston MSA). METHODS: We used structured survey data collected through telephone and online surveys from a population-based random sample of Houston MSA residents (n = 403) collected from November 29, 2017, through January 6, 2018. We used descriptive statistics to describe the prevalence of physical health/mental health and health care access outcomes and multivariable generalized linear models to assess disparities (eg, based on race/ethnicity, socioeconomic status, disability) in health outcomes. RESULTS: Physical health problems disproportionately affected persons who did not evacuate (odds ratio [OR] = 0.41; 95% confidence interval [CI], 0.19-0.87). Non-Hispanic black persons were more likely than non-Hispanic white persons to have posttraumatic stress (OR = 5.03; 95% CI, 1.90-13.10), as were persons in households that experienced job loss post-Harvey (vs did not experience job loss post-Harvey; OR = 2.89; 95% CI, 1.14-7.32) and older persons (OR = 1.04; 95% CI, 1.01-1.06). Health care access was constrained for persons whose households lost jobs post-Harvey (vs did not lose jobs post-Harvey; OR = 2.73; 95% CI, 1.29-5.78) and for persons with disabilities (vs without disabilities; OR = 3.19; 95% CI, 1.37-7.45). CONCLUSIONS: Our findings underscore the need to plan for and ameliorate public health disparities resulting from climate change-related disasters, which are expected to occur with increased frequency and magnitude.


Assuntos
Tempestades Ciclônicas/estatística & dados numéricos , Pessoas com Deficiência/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Classe Social , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e Questionários , Texas , Adulto Jovem
5.
West J Emerg Med ; 21(3): 586-594, 2020 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-32421505

RESUMO

INTRODUCTION: Hurricanes have increased in severity over the past 35 years, and climate change has led to an increased frequency of catastrophic flooding. The impact of floods on emergency department (ED) operations and patient health has not been well studied. We sought to detail challenges and lessons learned from the severe weather event caused by Hurricane Harvey in Houston, Texas, in August 2017. METHODS: This report combines narrative data from interviews with retrospective data on patient volumes, mode of arrival, and ED lengths of stay (LOS). We compared the five-week peri-storm period for the 2017 hurricane to similar periods in 2015 and 2016. RESULTS: For five days, flooding limited access to the hospital, with a consequent negative impact on provider staffing availability, disposition and transfer processes, and resource consumption. Interruption of patient transfer capabilities threatened patient safety, but flexibility of operations prevented poor outcomes. The total ED patient census for the study period decreased in 2017 (7062 patients) compared to 2015 (7665 patients) and 2016 (7770) patients). Over the five-week study period, the arrival-by-ambulance rate was 12.45% in 2017 compared to 10.1% in 2016 (p < 0.0001) and 13.7% in 2015 (p < 0.0001). The median ED length of stay (LOS) in minutes for admitted patients was 976 minutes in 2015 (p < 0.0001) compared to 723 minutes in 2016 and 591 in 2017 (p < 0.0001). For discharged patients, median ED LOS was 336 minutes in 2016 compared to 356 in 2015 (p < 0.0001) and 261 in 2017 (p < 0.0001). Median boarding time for admitted ED patients was 284 minutes in 2016 compared to 470 in 2015 (p < 0.0001) and 234.5 in 2017 (p < 0.001). Water damage resulted in a loss of 133 of 179 inpatient beds (74%). Rapid and dynamic ED process changes were made to share ED beds with admitted patients and to maximize transfers post-flooding to decrease ED boarding times. CONCLUSION: A number of pre-storm preparations could have allowed for smoother and safer ride-out functioning for both hospital personnel and patients. These measures include surplus provisioning of staff and supplies to account for limited facility access. During a disaster, innovative flexibility of both ED and hospital operations may be critical when disposition and transfer capibilities or bedding capacity are compromised.


Assuntos
Defesa Civil , Tempestades Ciclônicas/estatística & dados numéricos , Serviço Hospitalar de Emergência , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Gestão de Mudança , Defesa Civil/métodos , Defesa Civil/organização & administração , Defesa Civil/normas , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/tendências , Acesso aos Serviços de Saúde/organização & administração , Hospitalização/estatística & dados numéricos , Humanos , Melhoria de Qualidade , Estudos Retrospectivos , Texas/epidemiologia
6.
Proc Natl Acad Sci U S A ; 117(19): 10429-10434, 2020 05 12.
Artigo em Inglês | MEDLINE | ID: mdl-32341144

RESUMO

Extreme climate events such as droughts, cold snaps, and hurricanes can be powerful agents of natural selection, producing acute selective pressures very different from the everyday pressures acting on organisms. However, it remains unknown whether these infrequent but severe disruptions are quickly erased by quotidian selective forces, or whether they have the potential to durably shape biodiversity patterns across regions and clades. Here, we show that hurricanes have enduring evolutionary impacts on the morphology of anoles, a diverse Neotropical lizard clade. We first demonstrate a transgenerational effect of extreme selection on toepad area for two populations struck by hurricanes in 2017. Given this short-term effect of hurricanes, we then asked whether populations and species that more frequently experienced hurricanes have larger toepads. Using 70 y of historical hurricane data, we demonstrate that, indeed, toepad area positively correlates with hurricane activity for both 12 island populations of Anolis sagrei and 188 Anolis species throughout the Neotropics. Extreme climate events are intensifying due to climate change and may represent overlooked drivers of biogeographic and large-scale biodiversity patterns.


Assuntos
Lagartos/anatomia & histologia , Seleção Genética/fisiologia , Animais , Biodiversidade , Evolução Biológica , Clima , Mudança Climática/estatística & dados numéricos , Tempestades Ciclônicas/estatística & dados numéricos , Desastres/estatística & dados numéricos , Ecossistema , Ilhas , Filogenia , Filogeografia , Dinâmica Populacional/estatística & dados numéricos , Dedos do Pé/anatomia & histologia
8.
Disaster Med Public Health Prep ; 14(1): 150-154, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32148222

RESUMO

The 2017 Atlantic hurricane season was especially memorable for 3 major hurricanes-Harvey, Irma, and Maria-that devastated population centers across Texas, Florida, and Puerto Rico, respectively. Each storm had unique hazard properties that posed distinctive challenges for persons living with type 1 diabetes (T1D). Diabetes care specialists and educators took on leadership roles for coordinating care and establishing insulin supply lifelines for people with T1D living in the hardest-hit neighborhoods affected by these extreme storms. Strategies and resources were customized for each population. Diabetes specialists strategized to provide mutual support and shared insulins and supplies across sites.


Assuntos
Tempestades Ciclônicas/estatística & dados numéricos , Diabetes Mellitus Tipo 1/terapia , Administração dos Cuidados ao Paciente/normas , Diabetes Mellitus Tipo 1/epidemiologia , Florida/epidemiologia , Humanos , Liderança , Administração dos Cuidados ao Paciente/métodos , Administração dos Cuidados ao Paciente/estatística & dados numéricos , Porto Rico/epidemiologia , Texas/epidemiologia
9.
Disaster Med Public Health Prep ; 14(1): 119-124, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32014082

RESUMO

OBJECTIVE: The aim of this study is to determine the response of home-based primary care programs to the fall 2017 Atlantic hurricane season. METHODS: This study examines the experiences of 9 Veterans Health Administration (VHA) Home-Based Primary Care (HBPC) programs in their responses to Hurricanes Harvey, Irma, and Maria. Thirty-four phone interviews with HBPC leadership and staff were conducted from April to July 2018. RESULTS: The total census of impacted HBPC programs was 3118. No program reported loss of life due to these hurricanes. Early preparedness was key to an effective program response. Response included prompt tracking of the patients. In the most affected areas, respondents noted limited resources to support basic patient needs. CONCLUSIONS: Medically complex patients served by programs such as the VHA's HBPC program represent a subset of the population, yet they have an outsized impact on health care resources that could be exacerbated by inadequate disaster preparedness. HBPC programs serve a unique role in supporting the "older old." They are tasked with supporting disaster preparedness activities of patients. Understanding what is involved in actualizing their requirements shows communities how to effectively engage with these programs.


Assuntos
Tempestades Ciclônicas/estatística & dados numéricos , Agências de Assistência Domiciliar/estatística & dados numéricos , Agências de Assistência Domiciliar/organização & administração , Humanos , Pesquisa Qualitativa , Estados Unidos , United States Department of Veterans Affairs/organização & administração , United States Department of Veterans Affairs/estatística & dados numéricos
10.
J Am Assoc Nurse Pract ; 32(2): 103-105, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32015275

RESUMO

Hurricane Michael made landfall in Florida's northwest Gulf Coast on October 10, 2018, causing massive destruction. It was the first Category 5 storm in recorded history to make landfall in the northeast Gulf Coast and the third most destructive hurricane to hit the continental United States. The health care infrastructure collapsed due to the severe damage to two main acute care hospitals, several heath care facilities, and clinics, resulting in large staff layoffs with many physicians relocating out of the area due to lack or support. With many schools and business destroyed, nearly 3,000 children left the school system along with their families. Ultimately, there were not enough living spaces for first responders and recovery crews, so posthurricane recovery efforts were gravely affected. Here are the stories of four nurse practitioners (NPs) who stepped up and recreated themselves to provide needed health care to several communities ravaged by Hurricane Michael. NPs, as skilled and trusted health care providers, are well-prepared to address the pressing life-threatening needs often associated with disasters such as hurricanes, thus ultimately making a difference in health outcomes in affected communities. It is a testimony for NPs across the state of Florida to be able to practice to their full extent of their education and preparation.


Assuntos
Planejamento em Desastres/métodos , Profissionais de Enfermagem/tendências , Tempestades Ciclônicas/estatística & dados numéricos , Planejamento em Desastres/tendências , Florida , Humanos , Médicos/provisão & distribução , Médicos/tendências
11.
Disaster Med Public Health Prep ; 14(1): 125-129, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32000882

RESUMO

OBJECTIVE: Hurricane Harvey, which made landfall in Texas on August 24, 2017, caused catastrophic damage that resulted in the closure of many schools and school districts across 4 states. We evaluated the underlying reasons and characteristics of the unplanned school closures to gain insight on how communities may cope with recommended preemptive closures as an intervention for pandemic influenza. METHODS: Information was extracted from news articles, school websites, and Twitter and Facebook posts previously collected through daily systematic searches of Google, Google News, and Lexis-Nexis. This information was sorted into predefined categories describing the characteristics that may be associated with unplanned school closures that occur during a natural disaster. RESULTS: Across Texas, Louisiana, Kentucky, and Tennessee, there were 3026 unplanned closures. Sixty-three percent of the closures occurred in Texas. The main reasons for the closures were flooding, power outages, and structural damage. The closed schools in Texas were sometimes used as shelters or as locations for providing food or other resources. CONCLUSION: School closures associated with Hurricane Harvey were attributed to both the effects of the hurricane and use for resource allocation. These findings can help inform preparedness planning and response for future hurricane seasons and other large-scale emergencies.


Assuntos
Tempestades Ciclônicas/estatística & dados numéricos , Instituições Acadêmicas/classificação , Inundações/estatística & dados numéricos , Humanos , Kentucky , Louisiana , Instituições Acadêmicas/estatística & dados numéricos , Tennessee , Texas , Estados Unidos
12.
Disaster Med Public Health Prep ; 14(1): 111-118, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31996271

RESUMO

OBJECTIVE: When 2017 Hurricane Harvey struck the coastline of Texas on August 25, 2017, it resulted in 88 fatalities and more than US $125 billion in damage to infrastructure. The floods associated with the storm created a toxic mix of chemicals, sewage and other biohazards, and over 6 million cubic meters of garbage in Houston alone. The level of biohazard exposure and injuries from trauma among persons residing in affected areas was widespread and likely contributed to increases in emergency department (ED) visits in Houston and cities receiving hurricane evacuees. We investigated medical surge resulting from these evacuations in Dallas-Fort Worth (DFW) metroplex EDs. METHODS: We used data sourced from the North Texas Syndromic Surveillance Region 2/3 in ESSENCE to investigate ED visit surge following the storm in DFW hospitals because this area received evacuees from the 60 counties with disaster declarations due to the storm. We used the interrupted time series (ITS) analysis to estimate the magnitude and duration of the ED surge. ITS was applied to all ED visits in DFW and visits made by patients residing in any of the 60 counties with disaster declarations due to the storm. The DFW metropolitan statistical area included 55 hospitals. Time series analyses examined data from March 1, 2017-January 6, 2018 with focus on the storm impact period, August 14-September 15, 2017. Data from before, during, and after the storm were visualized spatially and temporally to characterize magnitude, duration, and spatial variation of medical surge attributable to Hurricane Harvey. RESULTS: During the study period overall, ED visits in the DFW area rose immediately by about 11% (95% CI: 9%, 13%), amounting to ~16 500 excess total visits before returning to the baseline on September 21, 2017. Visits by patients identified as residing in disaster declaration counties to DFW hospitals rose immediately by 127% (95% CI: 125%, 129%), amounting to 654 excess visits by September 29, 2017, when visits returned to the baseline. A spatial analysis revealed that evacuated patients were strongly clustered (Moran's I = 0.35, P < 0.0001) among 5 of the counties with disaster declarations in the 11-day window during the storm surge. CONCLUSIONS: The observed increase in ED visits in DFW due to Hurricane Harvey and ensuing evacuation was significant. Anticipating medical surge following large-scale hurricanes is critical for community preparedness planning. Coordinated planning across stakeholders is necessary to safeguard the population and for a skillful response to medical surge needs. Plans that address hurricane response, in particular, should have contingencies for support beyond the expected disaster areas.


Assuntos
Tempestades Ciclônicas/estatística & dados numéricos , Mapeamento Geográfico , Capacidade de Resposta ante Emergências/normas , Adolescente , Adulto , Cidades/estatística & dados numéricos , Feminino , Substâncias Perigosas/efeitos adversos , Substâncias Perigosas/análise , Humanos , Masculino , Distribuição de Poisson , Vigilância da População/métodos , Capacidade de Resposta ante Emergências/estatística & dados numéricos , Texas/epidemiologia
13.
Disaster Med Public Health Prep ; 14(1): 10-17, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31359852

RESUMO

In 2017, Cuba was pummeled by Hurricane Irma, one of the strongest and most devastating Atlantic basin hurricanes in history. Twelve of Cuba's 15 provinces and 90 percent of the population were affected, and there was island-wide loss of electrical power. Despite the significant damage, ongoing economic hardships, and the political realities that required Cuba to handle the situation without response support from other nations, Cuba's recovery was swift and effective. Cuba's disaster self-sufficiency and timely response to Hurricane Irma was grounded on 5 decades of disaster planning coupled with ongoing evolution of disaster risk reduction and management strategies. While the central command center, with local dispatch response teams, and mandated citizen engagement are features unique to Cuba's political structure, in this study, we highlight 5 defining attributes of Cuba's hurricane response that can constructively inform the actions of other island and coastal nations vulnerable to Atlantic tropical cyclones. These attributes are: (1) actively learning and incorporating lessons from past disaster events, (2) integrating healthcare and public health professionals on the frontlines of disaster response, (3) proactively engaging the public in disaster preparedness, (4) incorporating technology into disaster risk reduction, and (5) infusing science into risk planning. In terms of hurricane response, as a geopolitically isolated nation, Cuba has experienced particular urgency when it comes to protecting the population and creating resilient infrastructure that can be rapidly reactivated after the onslaught of storms of ever-increasing intensity. This includes planning for worsening future disaster scenarios based on a clear-eyed appreciation of the realities of climate change.


Assuntos
Participação da Comunidade/métodos , Tempestades Ciclônicas/estatística & dados numéricos , Saúde Pública/métodos , Defesa Civil/métodos , Participação da Comunidade/psicologia , Cuba , Fontes de Energia Elétrica/normas , Fontes de Energia Elétrica/estatística & dados numéricos , Eletricidade , Falha de Equipamento , Humanos , Saúde Pública/tendências
14.
Disaster Med Public Health Prep ; 14(1): 71-79, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31452492

RESUMO

OBJECTIVES: This study empirically examines preparedness with a kit, medication, and a disaster plan on disaster outcomes including perceived recovery, property damage, and use of medical or mental health services. METHODS: Using a cross-sectional, retrospective study design, 1114 households in New York City were interviewed 21-34 months following Super Storm Sandy. Bivariate associations were examined and logistic regression models fit to predict the odds of disaster outcomes given the level of preparedness. RESULTS: Respondents with an evacuation plan were more likely to report not being recovered (odds ratio [OR] = 2.4; 95% confidence interval [CI]: 1.5-3.8), property damage (OR = 1.4; 95% CI: 1.1-1.9), and use of medical services (OR = 2.3; 95% CI: 1.1-4.5). Respondents reporting a supply of prescription medication were more likely to report using mental health (OR = 3.5; 95% CI: 1.2-9.8) and medical services (OR = 2.3; 95% CI: 1.1-4.8). CONCLUSIONS: Having a kit, plan, and medication did not reduce risk of adverse outcomes in Superstorm Sandy in this sample. Disaster managers should consider the lack of evidence for preparedness when making public education and resource allocation decisions. Additional research is needed to identify preparedness measures that lead to better outcomes for more efficient and effective response and recovery.


Assuntos
Defesa Civil/normas , Tempestades Ciclônicas/estatística & dados numéricos , Características da Família , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Defesa Civil/estatística & dados numéricos , Estudos Transversais , Tempestades Ciclônicas/prevenção & controle , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque , Razão de Chances , Estudos Retrospectivos , Inquéritos e Questionários
15.
Disaster Med Public Health Prep ; 14(1): 63-70, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31455463

RESUMO

OBJECTIVE: The aim of this study was to describe individuals seeking care for injury at a major emergency department (ED) in southern Puerto Rico in the months after Hurricane Maria on September 20, 2017. METHODS: After informed consent, we used a modified version of the Natural Disaster Morbidity Surveillance Form to determine why patients were visiting the ED during October 16, 2017-March 28, 2018. We analyzed visits where injury was reported as the primary reason for visit and whether it was hurricane-related. RESULTS: Among 5 116 patients, 573 (11%) reported injury as the primary reason for a visit. Of these, 10% were hurricane-related visits. The most common types of injuries were abrasions, lacerations, and cuts (43% of all injury visits and 50% of hurricane-related visits). The most common mechanisms of injury were falls, slips, trips (268, 47%), and being hit by/or against an object (88, 15%). Most injury visits occurred during the first 3 months after the hurricane. CONCLUSIONS: Surveillance after Hurricane Maria identified injury as the reason for a visit for about 1 in 10 patients visiting the ED, providing evidence on the patterns of injuries in the months following a hurricane. Public health and emergency providers can use this information to anticipate health care needs after a disaster.


Assuntos
Tempestades Ciclônicas/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Adolescente , Adulto , Idoso , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Estudos Transversais , Serviço Hospitalar de Emergência/organização & administração , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Vigilância da População/métodos , Porto Rico/epidemiologia , Ferimentos e Lesões/epidemiologia
16.
Disaster Med Public Health Prep ; 14(1): 130-138, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31429397

RESUMO

Meteorological and even human-made disasters are increasing every year in frequency and magnitude. The passage of a disaster affects a society without distinction, but groups with social vulnerability (low socioeconomic status, chronic medical, or psychological conditions, limited access to resources) face the most significant impact. As a result, psychological and behavioral symptoms (eg, depression and anxiety) can ensue, making the immediate response of mental health services crucial. Secondary data from a database of a temporary healthcare unit were analyzed. A total of 54 records were reviewed to collect information; univariate and bivariate analyses were done. The purpose of this article is to present our experience regarding the incorporation of a mental health services model, with its respective benefits and challenges, into a temporary healthcare unit, after Hurricane Maria in 2017.


Assuntos
Defesa Civil/métodos , Tempestades Ciclônicas/estatística & dados numéricos , Prestação Integrada de Cuidados de Saúde/tendências , Serviços de Saúde Mental/tendências , Defesa Civil/estatística & dados numéricos , Prestação Integrada de Cuidados de Saúde/métodos , Planejamento em Desastres , Humanos , Serviços de Saúde Mental/estatística & dados numéricos , Porto Rico
17.
Disaster Med Public Health Prep ; 14(1): 28-33, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31304898

RESUMO

OBJECTIVE: Describe the lived experience of a grassroots, non-governmental disaster medical team (DMT) through a research lens and share practical lessons learned, based on the DMT's experience to support and inform future response teams. METHODS: Forty-five days after Hurricane Maria, a non-governmental DMT provided primary medical care via community based pop-up clinics and home visitations in 5 different areas of Puerto Rico. Observational data, photo images, and debriefing notes were collected and documented in the response team's daily activity log. Field notes were coded using a descriptive coding method and then categorized into 2 domains specific to public health and medical diagnosis. RESULTS: Medical aid was provided to nearly 300 (N = 296) residents. Field note observations identified exhaustion related to living conditions and the exacerbation of underlying conditions such as reactive airway diseases, diabetes, hypertension, and depression due to the compounding effects of multiple post-disaster triggers. During home visitations, feelings of sadness and helplessness were identified secondary to natural disaster trauma and current living conditions. CONCLUSION: Our non-governmental DMT displayed similar characteristics demonstrated by federal DMTs post natural disaster. A number of strategic lessons learned emerged from the public health intervention important to future non-governmental DMTs.


Assuntos
Tempestades Ciclônicas/estatística & dados numéricos , Medicina de Desastres/métodos , Equipe de Assistência ao Paciente/tendências , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Instituições de Assistência Ambulatorial/organização & administração , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Tempestades Ciclônicas/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente/estatística & dados numéricos , Porto Rico
18.
Disaster Med Public Health Prep ; 14(1): 56-62, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31218986

RESUMO

OBJECTIVE: To determine the extent of service disruption among home health agencies impacted by Hurricane Harvey. METHODS: Structured interviews with optional open-ended questions were conducted with home health agencies in and around Houston, Texas. A random sample of 277 agencies was selected and contacted via telephone during the study period, from February to May of 2018. RESULTS: Only 45% of 122 participating agencies indicated that their offices were open during Hurricane Harvey, and three-fourths reported that home visits were disrupted. The length of disruption varied: 7% reported a disruption of 1 day or less and 46% indicated a disruption of 1 week or longer. Disruption occurred even though nearly all (99%) of the agencies had-and close to all (92%) of them activated-an emergency preparedness plan. CONCLUSIONS: Although most of the participating home health agencies activated their emergency preparedness plan, significant disruption in home health services occurred. While agencies are required to have clear, detailed plans in place, gaps in effective implementation of emergency preparedness plans remain.


Assuntos
Tempestades Ciclônicas/estatística & dados numéricos , Agências de Assistência Domiciliar/estatística & dados numéricos , Agências de Assistência Domiciliar/organização & administração , Agências de Assistência Domiciliar/tendências , Humanos , Entrevistas como Assunto/métodos , Pesquisa Qualitativa , Inquéritos e Questionários , Texas/epidemiologia
19.
Disaster Med Public Health Prep ; 14(1): 23-27, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31221231

RESUMO

OBJECTIVE: Using validated psychological assessment instruments, this study examined the psychological distress associated with potential language barriers experienced by over 135 000 Puerto Rican residents who either temporarily or permanently migrated to the continental United States with the landfall of Hurricane Maria in 2017. METHODS: Participants were Puerto Rican residents (n = 107) who remained in Puerto Rico (control) or left the island for at least 3 months because of Hurricane Maria (migrants). Participants completed an online survey in their preferred language (Spanish or English), which assessed self-reported English language proficiency, Kessler Psychological Distress Scale (K6), Posttraumatic Stress Disorder Checklist for DSM 5, Patient Health Questionnaire 9-item depression scale, and the Generalized Anxiety Disorder 7-item scale. It was hypothesized that migrants with lower self-reported English proficiency would have comparatively higher indices of post-disaster distress than those with a higher proficiency. RESULTS: Dividing the migrant group by preferred language for questionnaire completion, the Fisher's exact test showed significant differences in prevalence of severe mental distress, as defined by K6 scores above 13, between the Spanish-preferring migrants (30.4%), English-preferring migrants (0%), and controls (9.6%). CONCLUSION: Our results support a possible correlation between decreased language proficiency in post-disaster migrants and a higher risk factor for severe mental distress.


Assuntos
Ansiedade/etiologia , Tempestades Ciclônicas/estatística & dados numéricos , Patologia da Fala e Linguagem/classificação , Estresse Psicológico/etiologia , Migrantes/psicologia , Adulto , Idoso , Ansiedade/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Psicometria/instrumentação , Psicometria/métodos , Porto Rico , Patologia da Fala e Linguagem/estatística & dados numéricos , Estresse Psicológico/psicologia , Inquéritos e Questionários , Migrantes/estatística & dados numéricos
20.
Disaster Med Public Health Prep ; 14(1): 49-55, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31221233

RESUMO

OBJECTIVES: Hurricane Harvey left a path of destruction in its wake, resulting in over 100 deaths and damaging critical infrastructure. During a disaster, public health surveillance is necessary to track emerging illnesses and injuries, identify at-risk populations, and assess the effectiveness of response efforts. The Centers for Disease Control and Prevention (CDC) and American Red Cross collaborate on shelter surveillance to monitor the health of the sheltered population and help guide response efforts. METHODS: We analyzed data collected from 24 Red Cross shelters between August 25, 2017, and September 14, 2017. We described the aggregate morbidity data collected during Harvey compared with previous hurricanes (Gustav, Ike, and Sandy). RESULTS: Over one-third (38%) of reasons for visit were for health care maintenance; 33% for acute illnesses, which includes respiratory conditions, gastrointestinal symptoms, and pain; 19% for exacerbation of chronic disease; 7% for mental health; and 4% for injury. The Red Cross treated 41% of clients within the shelters; however, reporting of disposition was often missed. These results are comparable to previous hurricanes. CONCLUSION: The capacity of Red Cross shelter staff to address the acute health needs of shelter residents is a critical resource for local public health agencies overwhelmed by the disaster. However, there remains room for improvement because reporting remained inconsistent.


Assuntos
Tempestades Ciclônicas/estatística & dados numéricos , Planejamento em Desastres/estatística & dados numéricos , Abrigo de Emergência/estatística & dados numéricos , Vigilância da População/métodos , Planejamento em Desastres/métodos , Planejamento em Desastres/tendências , Humanos , Cruz Vermelha/organização & administração , Texas/epidemiologia
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