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1.
J Forensic Odontostomatol ; 2(38): 47-56, 2020 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-33174537

RESUMO

BACKGROUND: Forensic Odontology (FO) still strives for recognition in some countries such as Pakistan. Natural and man-made disasters, along with child abuse cases and age estimation for child marriages and juvenile imprisonments in Pakistan justify its applicability. AIMS: This study investigated the awareness, information, training, practice and interest in FO in dental professionals in Pakistan. Another aim was to design tools to deliver primary knowledge about FO and emphasize the importance of dental records. METHODOLOGY: A 10 question paper-based survey was distributed among 560 dental professionals and postgraduates of 14 public dental institutes/hospitals in Pakistan. The results were quantitatively analyzed by graphs using Microsoft Excel (version 16.22). An educational video and an information leaflet were produced after the survey was undertaken to explain the scope of FO and the importance of dental records respectively. RESULTS: 476 dentists (51%♀, 49 %♂) aged 20 - 50+ years responded and 98.53% confirmed that FO was not taught in the dental schools. 66% were aware of the field and 62% were only informed. 99% were not trained and 89.7% were not working in this field; however, 89% were interested in training within Pakistan. Considering dental charts, 60.92% do not produce detailed charts but 55% maintain them and the majority do so manually. Radiographs were the most stored type. CONCLUSIONS: Most dentists are aware of the existence of FO, but they need to acknowledge the significance of dental record keeping and encourage implementation of FO. Regardless of the absence of any governing body for FO and negligible education, training and implementation in Pakistan, this field is gradually progressing. The authorities should introduce detailed guidelines for recording, managing and storing dental records. They should ensure the future acknowledgement of this subject in the education system and assign forensic odontologists to the Disaster Victim Identification (DVI) team.


Assuntos
Maus-Tratos Infantis , Registros Odontológicos , Adolescente , Adulto , Criança , Vítimas de Desastres , Odontologia Legal , Humanos , Pessoa de Meia-Idade , Paquistão , Adulto Jovem
3.
Australas Psychiatry ; 28(6): 636-638, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32683892

RESUMO

OBJECTIVE: If the narrative of "coronavirus" has an underlying theme, it may perhaps for some be one of survival, whilst for others, the theme might be suffering. The recurring motif of survival has continued throughout history, yet for the first time the sum of all fears has amounted to a run on the bare essentials. This paper seeks to offer an alternative formulation of "panic buying," with references to literature, philosophy, and contemporary neurobiology. CONCLUSION: The bare essentials disappeared perhaps as part of some self-fulfilling prophecy: the supermarkets became bare because others inadvertently lead us to believe they would become bare. The contagion model of emotional propagation provides a psychological model of how "panic buying" by an individual might lead to the replication of panic in an observer. The Polyvagal Theory further informs us of how the threat posed by the pandemic primes our limbic system to perceive danger, and explains how witnessing others engaging in fight-flight responses might evoke a fearful affect in an observer. In the end, it is perhaps through Nietzsche's study of classical tragedy that we may find some meaning to the pandemic, allowing our collective lived experience to serve as a template for growth.


Assuntos
Infecções por Coronavirus/psicologia , Vítimas de Desastres/psicologia , Medo , Neurobiologia , Pânico , Pneumonia Viral/psicologia , Sobrevida/psicologia , Betacoronavirus , Ajustamento Emocional , Humanos , Pandemias , Teoria Psicológica , Psicologia Social
4.
Environ Health Prev Med ; 25(1): 19, 2020 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-32527213

RESUMO

BACKGROUND: In areas affected by the tsunami of the great East Japan Earthquake, smoking behavior may have deteriorated due to high stress and drastic changes in living environment. Surveys were conducted to reveal changes in smoking behaviors among victims. METHODS: A population-based random-sample home-visit interview survey of victims in Iwate and Miyagi Prefectures affected by the tsunami disaster was conducted in 2012 (n = 1978), while a population-based nationwide survey was conducted in 2013 (n = 1082). A panel survey in 2014 was conducted with respondents of the 2012 survey (n = 930). Multiple logistic regression analysis was performed to reveal factors related to smoking status after the disaster. RESULTS: There was high smoking prevalence of both sexes in the tsunami disaster area (current smoking rate in coastal area, 50.0% for male, 21.4% for female; inland area, 34.7% for male, 7.6% for female). Low prevalence of male quitters was observed (quitter rate in coastal area, 20.8% for male, 8.0% for female; inland area, 23.4% for male, 5.5% for female). The prevalence of nicotine-dependent people assessed by FTND (Fagerström Test for Nicotine Dependence) in the coastal area was also higher than in the inland area or other areas of Japan. Smoking behavior among victims worsened after the disaster and did not improve 3 years from the disaster. Post-disaster factors related to smoking were living in coastal area, complete destruction of house, and living in temporary housing. CONCLUSIONS: Smoking prevalence and the level of nicotine dependence of tsunami victims were still high even 3 years after the disaster. It is important to emphasize measures for smoking control in the disaster areas for an extended time period.


Assuntos
Vítimas de Desastres/estatística & dados numéricos , Terremotos , Fumar/epidemiologia , Tsunamis , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Adulto Jovem
6.
BMC Public Health ; 20(1): 625, 2020 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-32375725

RESUMO

BACKGROUND: Women, with more vulnerabilities and less access to resources, are often seen as victims of natural disasters. Therefore, the present study aimed to investigate the experiences of rural women with damages resulting from an earthquake in Iran. METHODS: In this research, a qualitative approach, as well as the conventional content analysis was employed. The study population consisted of rural women residing in the earthquake-stricken areas of Sarpol-e Zahab and Salas-e Babajani counties in Kermanshah Province, Iran. Semi-structured interviews were used for data collection. Moreover, sampling was purposeful, theoretical saturation was achieved by conducting 22 interviews, and the data analysis process was performed according to the steps proposed by Graneheim and Lundman. For the strength and transferability of the research, Lincoln and Guba's Evaluative Criteria were used. RESULTS: There were seven categories regarding the experiences of rural women after the earthquakes including neglecting the health needs; tension in the family and marital relations; gender inequality in the provision of assistance; feeling insecure; ignoring the ruling culture of the region; concealing needs for fear of stigmatization, and incoherent mourning as well as two categories regarding their reactions to and interaction with the earthquake consequences including positive and negative interactions. CONCLUSIONS: Paying more attention to the needs of rural women, taking the culture governing the village into account at the time of service delivery, and helping them with positive adaptations are some indispensable measures that should be taken.


Assuntos
Vítimas de Desastres/psicologia , Desastres , Terremotos , População Rural , Adulto , Cultura , Feminino , Identidade de Gênero , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Irã (Geográfico) , Casamento/psicologia , Pesquisa Qualitativa , Socorro em Desastres/estatística & dados numéricos , Fatores Socioeconômicos , Adulto Jovem
7.
Chin J Traumatol ; 23(4): 243-248, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32418712

RESUMO

PURPOSE: To explore the epidemiological and clinical profile of patients admitted to the trauma and emergency department (TED) of a tertiary care hospital due to tropical cyclone Fani and highlight the challenges faced by the hospital in this natural disaster. METHODS: A retrospective study was conducted in the TED in the affected zone. Data of all victims affected by the cyclone Fani on May 3, 2019 were obtained from disaster records and medical case sheets. All patients except death on admission were included. Clinical variables included anatomical sites and severity of injuries which was assessed by revised trauma score (RTS) and injury severity score (ISS). Trauma injury severity score (TRISS) was also calculated. RESULTS: Of 75 patients, 74 were included and the other one was brought dead and thus excluded. The age, median ± interquartile range (IQ), was 41.0 (27.7-53.0) years. The male to female ratio was 2:1. Most of the wounded were transported by the police control room vans on day 1: first 10 h, 50.0%; 10-24 h, 20.3%. The median ± IQ range of RTS, ISS and TRISS were 20 (14-28), 7.84 (7.841-7.841), and 97.4 (91.6-98.9), respectively. Simple external injury was the dominant injury type. Polytrauma (ISS >15) was seen in 67% cases and spine injury in 14% cases (7% cervical and 7% thoracolumbar). Injury causes included sharp flying objects (broken pieces of glasses and asbestos) in 31% cases, followed by fall of trees in 20.3%. Twenty-four patients were discharged after primary treatment, 30 admitted to the indoor-trauma ward or intensive care unit and 20 deferred or transferred to another center. There was no in-house mortality. Challenges were related to electricity failure, mobile network breakdown, infrastructure collapse, and delay in expertise repair from outside due to airport/railway closure. CONCLUSION: In cyclonic storm like Fani, sharp flying objects, fall of trees/poles and collapsing walls constitute the common mode of injuries causing harm to more than one body regions. Polytrauma was seen in the majority of patients though external injury was the commonest. The affected hospital had the uphill task of treating hospitalized patients as well as disaster victims.


Assuntos
Tempestades Ciclônicas , Planejamento em Desastres , Vítimas de Desastres/estatística & dados numéricos , Serviço Hospitalar de Emergência , Traumatismo Múltiplo/epidemiologia , Traumatismo Múltiplo/etiologia , Centros de Atenção Terciária , Centros de Traumatologia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índices de Gravidade do Trauma , Adulto Jovem
8.
Leg Med (Tokyo) ; 46: 101713, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32442862

RESUMO

An evaluation of a Rapid DNA system was performed using buccal swab samples and mock Disaster Victim Identification (DVI) samples collected postmortem. The allelic ladder success rate was 90% and samples analyzed simultaneously with this allelic ladder were used for further analysis. Sample success rate of the Rapid DNA system for buccal swab samples, and blood and muscle DVI samples were calculated. Success rates of buccal swab samples were 100% and 75% using cassettes preloaded with all reagents suitable for high- and low-DNA content samples, respectively. Success rates of fresh DVI samples were 80% to 100%. Success rates of putrefied DVI samples varied widely between 0% and 20% and 50% to 80% depending on cassette and sample types. Conventional DNA analysis was performed for comparison with the results of the Rapid DNA system. DNA quantity and degradation of human DNA were measured using quantitative polymerase chain reaction. DVI samples that yielded more than 1 ng/µL of DNA when extracted with conventional protocols were suitable for analysis using cassettes for both high- and low-DNA content samples. DVI samples with less than 0.1 ng/µL of DNA were suitable only for analysis using cassettes for low-DNA content samples. All alleles called and exported by the Expert system software implemented in the Rapid DNA system were concordant with allele calls made by conventional capillary electrophoresis DNA analysis.


Assuntos
Impressões Digitais de DNA/métodos , Vítimas de Desastres , Medicina Legal/métodos , Mucosa Bucal , DNA/análise , Humanos , Manejo de Espécimes
10.
Nurs Ethics ; 27(4): 911-923, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32264790

RESUMO

BACKGROUND: Ethical care provided by nurses to earthquake victims is one of the main subjects in nursing profession. OBJECTIVES: Given the information gap in this field, the present study is an attempt to explore the nurses' experience of ethical care provided to victims of an earthquake. RESEARCH DESIGN AND METHOD: A hermeneutic phenomenological study was performed. The participants were 16 nurses involved in providing care to the injured in Kermanshah earthquake, Iran. They were selected using purposeful sampling, and in-depth and semi-structured interviews were carried out. The transcribed interviews were analyzed based on the hermeneutic approach using the analysis method proposed by Diekelmann et al. ETHICAL CONSIDERATIONS: The study was approved by the Research Council and Ethics Committee of Urmia University of Medical Sciences, Iran. FINDINGS: Data analyses revealed four themes and 10 sub-themes that illustrated nurses' experience of ethical care during earthquake. The themes were (1) Respecting humanistic values (sacrifice, stepping beyond task description, and voluntary work), (2) Commitment to ethics (honesty, confidentiality, and trustworthiness), (3) Respecting dignity of victims (respecting cultural values, maintaining privacy, having humanistic perspective, and effective communication), and (4) Spiritual support (helping patients to do religious rituals Psychological support). CONCLUSION: The results showed the nurses' experience with providing care to earthquake victims. The findings underlined ethics and ethical values in providing nursing care during disasters. It is suggested that special courses on the importance of nursing ethics in critical situations be incorporated into nursing curriculums and in-service educations.


Assuntos
Atitude do Pessoal de Saúde , Vítimas de Desastres , Terremotos , Enfermeiras e Enfermeiros/psicologia , Cuidados de Enfermagem/ética , Recursos Humanos de Enfermagem no Hospital/psicologia , Adulto , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
11.
PLoS One ; 15(3): e0229958, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32168332

RESUMO

BACKGROUND: Social support plays an important role in adolescents' mental health and well-being, and even more so for disaster survivors. To measure the level of social support, one needs an appropriate tool to produce valid and reliable results; therefore, we aimed to measure the invariance across gender groups, and analyze the construct validity and reliability of the Indonesian version of the Multidimensional Scale of Perceived Social Support (MSPSS), a social support measurement tool which was theoretically constructed and has been well validated in many countries with various cultures and backgrounds. METHODS: A school-based assessment was conducted in junior and senior high schools in a post-disaster setting in Yogyakarta Province, Indonesia. We analyzed 299 adolescent survivors of a volcanic eruption, aged 12~18 years who completed a 12-item Indonesian version of the MSPSS. RESULTS: The factorial validity confirmed the three-factor structure of the scale (Family, Friends, and Significant Others) which met all of the criteria of parameter indices and provided evidence of high internal consistency reliability. The three-level measurement of invariance, which consisted of configural, metric, and scalar invariance, also performed very well across gender groups with our data and corresponded to the recommended parameters. Our composite reliability values were all fine (>0.7) and indicated that the items in the same construct were strongly correlated and reliable. CONCLUSIONS: The Indonesian version of the MSPSS was shown to be a valid, reliable, theoretically constructed, and applicable instrument for adolescent disaster survivors.


Assuntos
Adaptação Psicológica , Vítimas de Desastres/psicologia , Psicometria , Sobreviventes/psicologia , Adolescente , Criança , Feminino , Humanos , Indonésia/epidemiologia , Masculino , Apoio Social
13.
Int J Qual Health Care ; 32(2): 149-155, 2020 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-31909791

RESUMO

Quality issue: Improving quality of care has become a global health priority to improve health outcomes and strengthen health systems, particularly in the context of achieving universal health coverage. Initial assessment: The delivery of quality essential health services in settings of extreme adversity, such as fragile, conflict-affected, vulnerable or disaster contexts, has been identified as a high priority globally to address the massive level of need. Choice of solution: This paper provides an action framework to systematically address the quality of health services for state and non-state actors working in such settings. The framework is designed to be practical, comprehensible and simple in adoption and implementation. It describes challenges, a set of medical needs and population priorities, a menu of quality-related interventions, and a hierarchy of health system levels defining the roles and responsibilities of key actors. Conclusion: Optimizing the use of limited resources in delivering the best quality possible in 'the hardest of the hard settings' is imperative.


Assuntos
Assistência à Saúde/normas , Qualidade da Assistência à Saúde , Populações Vulneráveis , Conflitos Armados , Assistência à Saúde/métodos , Países em Desenvolvimento , Vítimas de Desastres , Humanos , Refugiados
14.
Am J Disaster Med ; 15(4): 275-282, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33428198

RESUMO

OBJECTIVE: To determine whether victim behavior and interaction with triage personnel would conform to expected actions as dictated by the Simple Triage and Rapid Treatment (START) triage methodology, which emphasizes that victims will accept their assigned -triage category. METHODS: In total, 105 volunteers were recruited to complete a 32-question survey after portraying victims in a triage-focused mass casualty incident (MCI) simulation. Questions included sociodemographic characteristics, willingness to follow commands of first responders, and willingness to help first responders. The authors examined whether the outcomes differed by demographics, healthcare experience, or disaster exposure of participants. RESULTS: The survey response rate was 90 percent (95/105). The mean age of participants was 31 years (58 percent women). Half of respondents indicated that they would ask responders to change their triage color if they disagreed with it and 75 percent would ask first responders to change their friend or family members' triage colors. Twenty-one percent of victims reported that they would alter their own triage tag to receive treatment faster and 38 percent would alter a friend or family member's triage color. The youngest (<20 years) and oldest (>40 years) respondents were most likely to act maladaptively. CONCLUSION: Triage algorithms rely upon -victims following the instructions of rescuers. This study suggests that maladaptive behavior by some victims should be anticipated.


Assuntos
Planejamento em Desastres , Socorristas , Incidentes com Feridos em Massa , Adulto , Vítimas de Desastres , Feminino , Humanos , Inquéritos e Questionários , Triagem
16.
J Anthropol Sci ; 96: 69-89, 2019 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-31782750

RESUMO

The scientific study of the victims of the 79 AD Vesuvius eruption began with the first discovery in the 1980s of hundreds of skeletons of people who had taken refuge in the suburban area of Herculaneum. Hundreds of human victims were found crowding the beach and a series of waterfront chambers, fixated into a final posture by the first of the deadly incoming pyroclastic currents. The towns of Herculaneum, Pompeii and other Roman settlements up to 20 kilometers away were suddenly hit and overwhelmed by successive ash-avalanches, fast moving clouds of hot volcanic ash and gases known as pyroclastic surges, capable of killing all residents who were not yet evacuated. Given the impossibility of access to the skeletal remains of the Pompeiians locked within the plaster casts and the sparse occasional finds of victims elsewhere, most of the anthropological studies focused on the victims discovered in Herculaneum. The first investigations were carried out to detect the biological and pathological features of these people. More recent multidisciplinary studies on the victims' skeletons and their volcanological context shed light on the dynamic impacts of the 79 AD Plinian eruption on the area around the volcano and on its inhabitants. The effects of the high temperatures of the surges as suffered by the remaining resident population were revealed, with crucial implications for the present-day risk of a similar outcome to around three million people living close to the volcano, including metropolitan Naples.


Assuntos
Vítimas de Desastres/história , Erupções Vulcânicas/história , Adulto , Osso e Ossos/anatomia & histologia , Criança , Feminino , História Antiga , Humanos , Itália/etnologia , Masculino , Paleontologia , Adulto Jovem
17.
Psychiatriki ; 30(3): 193-203, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31685451

RESUMO

Electromagnetic radiation influences in many ways humans and animals, while earthquakes are known to be related with electromagnetic phenomena. We recently showed that large earthquakes reduced admissions of psychiatric patients, whereas small earthquakes were associated with increased number of admissions. Our aim was to examine the effect of seismic-related electromagnetic activity on two chronic and severe psychiatric disorders varying in terms of etiology and treatment, i.e. bipolar disorder and schizophrenia. Retrospective data concerning monthly admission rates of patients diagnosed with schizophrenia or bipolar disorder in the Psychiatric Unit of the University Hospital of Heraklion, Crete, Greece between 2008 and 2010 were analyzed in relation to the number of earthquakes with small (≥2) or larger magnitude in the Crete region in Greece. Results showed a marked reduction of acute admissions during a storm of large earthquakes, which was greater in patients with bipolar disorder (91.2%) than schizophrenia patients (52.4%). In addition there was a significant increase of admissions during a period of frequent small earthquakes, primarily among patients with bipolar disorder. The results suggest that electrostatic fields that accompany large earthquakes may have a protective effect on psychiatric disorders, particularly on bipolar disorder. These findings are consistent with the ameliorating effect of electromagnetic fields used in Electroconvulsive therapy (ECT) and Transcranial Magnetic Stimulation (TMS) in patients with bipolar disorder. Future studies focusing on the underlying mechanisms may lead to more specific treatments of psychiatric disorders.


Assuntos
Transtorno Bipolar/epidemiologia , Vítimas de Desastres/psicologia , Terremotos/estatística & dados numéricos , Esquizofrenia/epidemiologia , Campos Eletromagnéticos , Feminino , Grécia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Admissão do Paciente/estatística & dados numéricos , Estudos Retrospectivos
18.
Artigo em Inglês | MEDLINE | ID: mdl-31398907

RESUMO

Changes in levels and patterns of physical activity might be a mechanism to assess and inform disaster recovery through the lens of wellbeing. However, few studies have examined disaster impacts on physical activity or the potential for physical activity to serve as an indicator of disaster recovery. In this exploratory study, we examined daily bicycle and pedestrian counts from four public bicycle/pedestrian trails in Houston, before and after Hurricane Harvey landfall, to assess if physical activity returned to pre-Harvey levels. An interrupted time series analysis was conducted to examine the immediate impact of Harvey landfall on physical activity; t-tests were performed to assess if trail usage returned to pre-Harvey levels. Hurricane Harvey was found to have a significant negative impact on daily pedestrian and bicycle counts for three of the four trails. Daily pedestrian and bicycle counts were found to return to pre-Harvey or higher levels at 6 weeks post-landfall at all locations studied. We discuss the potential for further research to examine the trends, feasibility, validity, and limitations of using bicycle and pedestrian use levels as a proxy for disaster recovery and wellbeing among affected populations.


Assuntos
Ciclismo/estatística & dados numéricos , Tempestades Ciclônicas/estatística & dados numéricos , Vítimas de Desastres/estatística & dados numéricos , Desastres/estatística & dados numéricos , Exercício Físico , Pedestres/estatística & dados numéricos , Recuperação de Função Fisiológica , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Texas
19.
Washington, D.C.; PAHO; 2019-08-21.
em Inglês | PAHO-IRIS | ID: phr-51484

RESUMO

[Description of the Course]. The Mass Casualty Management course is a didactic, multi-sectoral training course consisting of five days of lectures, field exercises and role-playing. It is designed to sharpen the response skills of mass casualty responders, helping them to more effectively manage events in human and/or other resources-challenged areas. On day six, it culminates in a series of practical field exercises, held at night, to underscore nocturnal challenges. Upon successful completion of the course, students will be eligible for a certificate in Mass Casualty Management, issued through the Ministry of Health or the National Disaster Office, in collaboration with the Pan American Health Organization. The course will be of value to all persons likely to be involved in a community’s response to a mass casualty event: police officers; fire officers; medical staff; first responders; ambulance service personnel; Coast Guard and the military; airport/airline employees; disaster managers; paramilitary and non-governmental organizations (NGOs), such as Red Cross volunteers; and security staff.


Assuntos
Incidentes com Feridos em Massa , Recursos Humanos em Desastres , Cursos de Capacitação , Avaliação de Risco e Mitigação , Vítimas de Desastres , América
20.
PLoS One ; 14(7): e0220016, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31318948

RESUMO

BACKGROUND: In 2015, an earthquake killing 9,000 and injuring 22,000 people hit Nepal. The Tribhuvan University Teaching Hospital (TUTH), a reference tertiary hospital, was operational immediately after the earthquake. We studied the profile of earthquake victims admitted in TUTH and assessed what factors could influence hospital length of stay. METHODS: An earthquake victim dataset was created based on patient records, with information on sex, age, date of admission and discharge, diagnosis, and surgical intervention. We performed an initial descriptive overview of the earthquake victims followed by a time-to-event analysis to compare length of hospital stay in different groups, using log rank test and cox regression to calculate Hazard Ratios. RESULTS: There were in total 501 admitted victims, with the peak of admissions occurring on the fifth day after the earthquake. About 89% had injury as main diagnosis, mostly in lower limbs, and 66% of all injuries were fractures. Nearly 69% of all patients underwent surgery. The median length of hospital stay was 10 days. Lower limb and trunk injuries had longer hospital stays than injuries in the head and neck (HR = 0.68, p = 0.009, and HR = 0.62 p = 0.005, respectively). Plastic surgeries had longer hospital stays than orthopaedic surgeries (HR = 0.57 p = 0.006). Having a crush injury and undergoing an amputation also increased time to discharge (HR = 0.57, p = 0.013, and HR = 0.65 p = 0.045 respectively). CONCLUSIONS: Hospital stay was particularly long in this sample in comparison to other studies on earthquake victims, indirectly indicating the high burden TUTH had to bear to treat these patients. To strengthen resilience, tertiary hospitals should have preparedness plans to cope with a large influx of injured patients after a large-scale disaster, in particular for the initial days when there is limited external aid.


Assuntos
Vítimas de Desastres/estatística & dados numéricos , Terremotos , Hospitalização , Centros de Atenção Terciária , Adolescente , Adulto , Criança , Pré-Escolar , Demografia , Vítimas de Desastres/história , Feminino , História do Século XXI , Humanos , Lactente , Recém-Nascido , Masculino , Registros Médicos , Pessoa de Meia-Idade , Nepal/epidemiologia , Modelos de Riscos Proporcionais , Adulto Jovem
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