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1.
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
2.
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
3.
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
4.
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
5.
J Trauma Stress ; 32(2): 196-205, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30913348

RESUMO

A large body of research has linked disaster exposure to adverse mental and physical health outcomes. Few studies, however, have explored the cumulative impact of exposure to multiple disasters. Participants (N = 8,366) from the National Institute of Environmental Health Sciences Gulf Long-Term Follow-Up Study were classified as having been exposed to both, either, or neither Hurricane Katrina and the Deepwater Horizon oil spill (DHOS). Participants also reported on a range of mental and physical health symptoms. Logistic regression models found that participants who were exposed to both disasters had significantly higher odds of probable generalized anxiety disorder, odds ratio (OR) = 1.72, 95% CI [1.52, 1.96]; major depression, OR = 1.53, 95% CI [1.32, 1.77]; and posttraumatic stress disorder, OR = 2.51, 95% CI [2.03, 3.10], than participants who were exposed to only one disaster, ps < .001. Additionally, a linear regression model found that participants who were exposed to both disasters had significantly more physical health symptoms at the time of the spill than those who were exposed to only one disaster, B = 0.99, SE = .20, p < .001. The results indicate that cumulative disaster exposure confers enhanced risk for adverse mental and physical health outcomes. The findings demonstrate that screening for prior exposure among disaster-affected individuals might identify those at greatest risk for adverse health outcomes.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Vítimas de Desastres/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto , Tempestades Ciclônicas , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Poluição por Petróleo , Escalas de Graduação Psiquiátrica , Sudeste dos Estados Unidos/epidemiologia , Texas/epidemiologia
6.
Disaster Med Public Health Prep ; 13(1): 38-43, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30841950

RESUMO

OBJECTIVES: Two Category 5 storms, Hurricane Irma and Hurricane Maria, hit the U.S. Virgin Islands (USVI) within 13 days of each other in September 2017. These storms caused catastrophic damage across the territory, including widespread loss of power, destruction of homes, and devastation of critical infrastructure. During large scale disasters such as Hurricanes Irma and Maria, public health surveillance is an important tool to track emerging illnesses and injuries, identify at-risk populations, and assess the effectiveness of response efforts. The USVI Department of Health (DoH) partnered with shelter staff volunteers to monitor the health of the sheltered population and help guide response efforts. METHODS: Shelter volunteers collect data on the American Red Cross Aggregate Morbidity Report form that tallies the number of client visits at a shelter's health services every 24 hours. Morbidity data were collected at all 5 shelters on St. Thomas and St. Croix between September and October 2017. This article describes the health surveillance data collected in response to Hurricanes Irma and Maria. RESULTS: Following Hurricanes Irma and Maria, 1130 health-related client visits were reported, accounting for 1655 reasons for the visits (each client may have more than 1 reason for a single visit). Only 1 shelter reported data daily. Over half of visits (51.2%) were for health care management; 17.7% for acute illnesses, which include respiratory conditions, gastrointestinal symptoms, and pain; 14.6% for exacerbation of chronic disease; 9.8% for mental health; and 6.7% for injury. Shelter volunteers treated many clients within the shelters; however, reporting of the disposition (eg, referred to physician, pharmacist) was often missed (78.1%). CONCLUSION: Shelter surveillance is an efficient means of quickly identifying and characterizing health issues and concerns in sheltered populations following disasters, allowing for the development of evidence-based strategies to address identified needs. When incorporated into broader surveillance strategies using multiple data sources, shelter data can enable disaster epidemiologists to paint a more comprehensive picture of community health, thereby planning and responding to health issues both within and outside of shelters. The findings from this report illustrated that managing chronic conditions presented a more notable resource demand than acute injuries and illnesses. Although there remains room for improvement because reporting was inconsistent throughout the response, the capacity of shelter staff to address the health needs of shelter residents and the ability to monitor the health needs in the sheltered population were critical resources for the USVI DoH overwhelmed by the disaster. (Disaster Med Public Health Preparedness. 2019;13:38-43).


Assuntos
Tempestades Ciclônicas/estatística & dados numéricos , Abrigo de Emergência/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Vigilância da População/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Vítimas de Desastres/estatística & dados numéricos , Abrigo de Emergência/organização & administração , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Cruz Vermelha/organização & administração , Ilhas Virgens Americanas/epidemiologia
7.
Disaster Med Public Health Prep ; 13(4): 745-752, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30859933

RESUMO

OBJECTIVE: The current study compares the measures of sleep quality and intensity of insomnia based on the clustering analysis of variables including dysfunctional beliefs and attitudes about sleep, experiential avoidance, personality traits of neuroticism, and complications with emotion regulation among the individuals struck by an earthquake in Kermanshah Province. METHODS: This study is a cross-sectional study that was carried out among earthquake victims of Kermanshah Province (western Iran) in 2017. Data were gathered starting 10 days after the earthquake and lasted for 2 weeks; of 1,200 standard questionnaires distributed, 1,001 responses were received, and the analysis was performed using 999 participants. The data analysis was carried out using a cluster analysis (K-mean method). RESULTS: Two clusters were identified, and there is a significant difference between these two clusters in regard to all of the variables. The cluster with higher mean values for the selected variables shows a higher intensity of insomnia and a lower sleep quality. CONCLUSIONS: Considering the current results, it can be concluded that variables of dysfunctional attitudes and beliefs about sleep, experiential avoidance, the personality traits of neuroticism, and complications with emotion regulation are able to identify the clusters where there is a significant difference in regard to sleep quality and the intensity of insomnia. (Disaster Med Public Health Preparedness. 2019;13:745-752).


Assuntos
Vítimas de Desastres/psicologia , Terremotos/estatística & dados numéricos , Distúrbios do Início e da Manutenção do Sono/classificação , Adolescente , Adulto , Idoso , Análise por Conglomerados , Cognição , Estudos Transversais , Vítimas de Desastres/estatística & dados numéricos , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Personalidade , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Inquéritos e Questionários
10.
Psychoneuroendocrinology ; 100: 131-136, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30326460

RESUMO

Orexigenic hormones are a group of hormones that can up-regulate appetite. Current studies have shown that orexigenic hormones also play important roles in stress responses and may be implicated in regulation of fear memory. However, these conclusions lack evidence from human studies. In this study, we examined associations between orexigenic hormone genes and fear-related mental disorders by investigating main, G × E, and G × G effects of ghrelin and orexin gene single nucleotide polymorphisms (SNPs) on human posttraumatic stress disorder (PTSD) symptoms in 1134 Chinese earthquake survivors. SNPs Leu72Met of the GHRL gene (rs696217), Ile408Val of the HCRTR1 gene (rs2271933) and Val308Ile of the HCRTR2 gene (rs2653349) were genotyped. None of the SNPs showed significant main or G × E effects. However, a significant interaction effect between GHRL rs696217 and HCRTR1 rs2271933 was found to predict the PTSD Checklist (PCL-5) total score (P = 0.007). Further analysis revealed different interaction patterns in males and females. For females, the rs2271933 G allele was associated with an increased PCL-5 total score (B = 2.59, P = 0.024) when the rs696217 genotype TT/TG was present. For males, the rs696217 T allele is associated with an increased PCL-5 total score (B = 3.62, P = 0.040) when the rs2271933 genotype GG/GA was present. These current findings expand our knowledge of physiological function of the orexigenic hormone system, and suggest its involvement in development of fear-related mental disorders such as PTSD.


Assuntos
Grelina/genética , Receptores de Orexina/genética , Polimorfismo de Nucleotídeo Único , Transtornos de Estresse Pós-Traumáticos/genética , Adulto , Alelos , Grupo com Ancestrais do Continente Asiático/genética , Estudos de Casos e Controles , Vítimas de Desastres/psicologia , Vítimas de Desastres/estatística & dados numéricos , Terremotos , Epistasia Genética , Medo/fisiologia , Medo/psicologia , Feminino , Frequência do Gene , Predisposição Genética para Doença , Genótipo , Humanos , Masculino , Projetos Piloto , Dados Preliminares , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/patologia
11.
Disaster Med Public Health Prep ; 13(3): 533-538, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30417805

RESUMO

OBJECTIVE: Although dentists are valuable assets in identification teams during disaster events, forensic dentistry is not used effectively in the identification studies conducted in Turkey, and the importance of dental data is ignored. The aim of this study was to determine the level of knowledge of dentists regarding their duties and responsibilities during major disasters. METHODS: This descriptive study was conducted between December 2015 and June 2016. Registered dentists (n=20.280) of the Turkish Dental Association were invited to complete the organization's online survey. A total of 539 dentists participated in the volunteer workshop. Data were analyzed using SPSS, version 22.0 (IBM Corp, Armonk, NY). The chi-square analysis was used to evaluate the knowledge level of dentists by group regarding disaster victim identification (DVI) - the process and procedure of recovering and identifying victims of major disasters (eg, earthquake, terrorist attack). RESULTS: The dentists included in the study consisted of 320 (59.4%) females and 219 (40.6%) males with a mean age of 37.4±12.6 years. The number of specialists and general dentists were 249 (45.6%) and 297 (54.4%), respectively; 249 (69.71%) dentists who had knowledge about forensic dentistry stated that they received this information during their formal training. The percentage of dentists who were aware of the existence of an organization of a disaster response operation in Turkey was 74.2%, but only 20.5% (n=110) had knowledge about DVI. We found that 92.9% (n=104) of these dentists believed that dentists should be included in the team for the identification of disaster victims. On the other hand, only half (52.3%) of the dentists with knowledge of DVI wanted to work on the identification teams. The majority (99.1%) considered DNA analysis to be the safest method for identification. CONCLUSION: Our findings show that, although dentists know about the identification process, they do not have enough relevant knowledge. (Disaster Med Public Health Preparedness. 2019;13:533-538).


Assuntos
Odontólogos/normas , Medicina de Desastres/métodos , Antropologia Forense/métodos , Papel Profissional/psicologia , Adulto , Odontólogos/psicologia , Odontólogos/estatística & dados numéricos , Medicina de Desastres/estatística & dados numéricos , Vítimas de Desastres/estatística & dados numéricos , Feminino , Antropologia Forense/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Turquia
12.
Disaster Med Public Health Prep ; 13(4): 672-676, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30575495

RESUMO

OBJECTIVES: We quantified an absolute imbalance of the medical risks and the support needs for children at each disaster-based hospital in Kanagawa immediately following the occurrence of a large earthquake by using the risk resource ratio (RRR) and need for medical resources (NMR). METHODS: The RRR and NMR of 33 disaster-based hospitals were estimated through dividing the estimated number of pediatric victims by the number of critically patients. We calculated the ratio of the NMR of each hospital. RESULTS: The total number of pediatric victims in Kanagawa was estimated at 8,391. The total number of vacant beds for pediatric victims was 352. The median RRR and NMR of the total number of pediatric victims were 27 and 224. The median RRR and NMR of the number of critically ill pediatric patients were 27 and 12. CONCLUSIONS: The absolute imbalance of the RRR and NMR for children in Kanagawa was quantified. This suggests that we might embark on preparedness strategies for children in advance. (Disaster Med Public Health Preparedness. 2018;13:672-676).


Assuntos
Vítimas de Desastres/estatística & dados numéricos , Terremotos/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/normas , Pediatria/estatística & dados numéricos , Criança , Pré-Escolar , Defesa Civil/normas , Defesa Civil/estatística & dados numéricos , Terremotos/mortalidade , Feminino , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Japão , Masculino , Pediatria/métodos , Inquéritos e Questionários
14.
Int J Infect Dis ; 74: 100-108, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30053579

RESUMO

OBJECTIVES: The rapid emergence of carbapenem-resistant Acinetobacter baumannii is a global health concern. A comparative genomic analysis was performed on two ST85 A. baumannii strains harboring blaNDM-1 and blaOXA-94 collected in Lebanon from Syrian Civil War victims. METHODS: Genome sequencing data of ACMH-6200 and ACMH-6201 were used for in silico extraction of multilocus sequence types (MLST), resistance genes, and virulence factors. Plasmids were genetically mapped in silico and using PCR-based replicon typing (PBRT). The genetic environment of blaNDM-1 and blaOXA-94 was determined, and whole-genome single nucleotide polymorphism (wgSNP) analysis in comparison with 41 publicly available A. baumannii genomes was performed. RESULTS: Tn125 carrying blaNDM-1 was truncated by the insertion of ISAba14 downstream of dct, generating ΔTn125. blaOXA-94 was upstream of ISAba13 and ISAba17. Resistance to ceftazidime could be attributed to AmpC cephalosporinase encoded by blaADC-25, and to blaNDM-1 on plasmids. GyrA (S83L) and ParC (S80L) substitutions conferred resistance to fluoroquinolones. wgSNP analysis separated the isolates based on their sequence types. CONCLUSIONS: The role of refugees in the transmission of antimicrobial resistance in developing countries is understudied. As such, this study sheds light on the correlation between population mobility and the importation of drug-resistant pathogens. It also highlights the manifold mechanisms underlying antibiotic resistance in A. baumannii.


Assuntos
Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/genética , Proteínas de Bactérias/genética , beta-Lactamases/genética , Infecções por Acinetobacter/epidemiologia , Acinetobacter baumannii/classificação , Acinetobacter baumannii/efeitos dos fármacos , Acinetobacter baumannii/isolamento & purificação , Antibacterianos/farmacologia , Conflitos Armados/estatística & dados numéricos , Proteínas de Bactérias/metabolismo , Mapeamento Cromossômico , Vítimas de Desastres/estatística & dados numéricos , Fluoroquinolonas/farmacologia , Genoma Bacteriano , Genômica , Humanos , Líbano , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Filogenia , Plasmídeos/genética , Plasmídeos/metabolismo , Síria/epidemiologia , beta-Lactamases/metabolismo
15.
J Emerg Manag ; 16(1): 61-66, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29542101

RESUMO

A number of recent incidents in the United States resulted in a large number of citizens reporting to the Emergency Room seeking reassurance that they were okay. These citizens are being referred to in the medical community as the "Worried Well." We conducted a review of a transportation incident involving a chemical release and fire, which resulted in over 100 people reporting to the local emergency room for evaluation. Few, if any of the patients seen in the hospital had a potential exposure to the chemical or combustion byproducts. It is probable that stress hormones released by the sympathetic nervous system caused the symptoms experienced by the majority of the patients. This review suggest the need for better coordination between incident command and the hospital, including more timely situation reports including parameters such as the wind direction and potential downwind pollutant levels, to assist the physicians and nurses more appropriately manage these "Worried Well."


Assuntos
Vazamento de Resíduos Químicos/psicologia , Planejamento em Desastres/organização & administração , Serviços Médicos de Emergência , Incidentes com Feridos em Massa , Adulto , Medicina de Desastres/métodos , Vítimas de Desastres/psicologia , Vítimas de Desastres/estatística & dados numéricos , Serviços Médicos de Emergência/métodos , Serviços Médicos de Emergência/normas , Feminino , Humanos , Masculino , Melhoria de Qualidade , Estados Unidos
16.
Disaster Med Public Health Prep ; 12(3): 366-372, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28851475

RESUMO

As older persons make up an ever greater proportion of the world's population, a range of concerns are being voiced by policy-makers, program managers, and care providers about best or optimal practices for serving this population's needs during all stages of disasters. Given that age-related vulnerabilities are common in late life, this article describes existing systems of care in the United States for the provision of disaster mental health services. Second, it evaluates the evidence for disaster treatment interventions with this subgroup of the population. Third, it synthesizes the findings of recent studies focusing on screening, assessment, and treatment approaches. To advance our current system of care and to adequately respond to the mental health needs of older persons, it is advantageous to periodically review progress, identify current gaps and unmet needs, and describe opportunities for improvement. (Disaster Med Public Health Preparedness. 2018; 12: 366-372).


Assuntos
Vítimas de Desastres/estatística & dados numéricos , Geriatria/normas , Serviços de Saúde Mental/normas , Qualidade da Assistência à Saúde/normas , Geriatria/estatística & dados numéricos , Humanos , Programas de Rastreamento/métodos , Programas de Rastreamento/normas , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estados Unidos
17.
Disaster Med Public Health Prep ; 12(2): 172-175, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-28831946

RESUMO

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).


Assuntos
Tempestades Ciclônicas , Vítimas de Desastres/reabilitação , Saúde Pública/métodos , Vítimas de Desastres/estatística & dados numéricos , Nível de Saúde , Habitação/normas , Habitação/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , Modelos Logísticos , Cidade de Nova Iorque , Saúde Pública/estatística & dados numéricos , Fatores Socioeconômicos , Inquéritos e Questionários
18.
J Ment Health ; 26(4): 373-384, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28635439

RESUMO

BACKGROUND: The psychological impact of disasters has been well-documented; less attention has been paid to factors affecting the wellbeing of those exposed to disasters as occupational groups. AIMS: To conduct a systematic literature review identifying social and occupational factors affecting the wellbeing of disaster-exposed employees; to use these factors to identify recommendations for potential interventions. METHOD: Four electronic literature databases were searched; reference lists of relevant papers were hand-searched. RESULTS: A total of 18 005 papers were found, 571 full texts were read and 36 included in the review. The psychological impact of disasters on employees was associated with pre-disaster factors (experience/training; income; life events/health; job satisfaction), peri-disaster factors (exposure; peri-traumatic experiences; perceptions of safety; injury), social factors (organisational support; social support generally) and post-disaster factors (impact on life). CONCLUSIONS: It is important to build a resilient workforce outside of a crisis. Pre-disaster training in recognising signs of distress, understanding vulnerability factors such as those described above, which may put certain employees at greater risk of distress and how to support colleagues may be useful. Further research into the effectiveness of post-disaster interventions is needed.


Assuntos
Vítimas de Desastres/psicologia , Desastres , Resiliência Psicológica , Adaptação Psicológica , Estudos Transversais , Vítimas de Desastres/estatística & dados numéricos , Humanos , Apoio Social
19.
Index enferm ; 26(1/2): 113-117, ene.-jun. 2017. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-167079

RESUMO

Objetivo principal: Estimar el impacto en mortalidad de los desastres en España y sus tendencias epidemiológicas entre 1950 y 2012. Metodología: Estudio observacional retrospectivo con análisis de tendencias mediante análisis de regresión y suavizado exponencial. Resultados principales: Se estudiaron 284 desastres ocurridos en España entre 1950 y 2012. 57% fueron desastres tecnológicos, 39% desastres naturales (64% biológicos) y 4% deliberados (atentados terroristas). Aumentaron significativamente (p<0,05) la frecuencia total de desastres, los naturales, los tecnológicos y los subgrupos de desastres biológicos, climatológicos y de transporte. Disminuyó significativamente (p<0,05) la mortalidad total por desastres y la más alta por episodio fue por tecnológicos. Conclusión principal: España tiene un patrón mixto de desastres, con predominio de los tecnológicos. Aumentaron la frecuencia de episodios, específicamente biológicos, climatológicos y de transporte. La mortalidad está condicionada por los eventos de alto impacto


Objective: To estimate the impact on mortality due to disasters in Spain since1950 to 2012 and its epidemiological trends. Methods: Retrospective observational study with trend analysis by regression analysis and exponential smoothing. Results: We studied 284 events during the period. 57% were technological disasters (81% transport accidents), 39% were natural disasters (64% biological disasters) and 4% deliberated events. We found a significant (p<0,05) increasing trend in the total number of disasters, as well in natural and technological disaster groups, and also in the biological, climatological and transport accident subgroups. Technological disasters show highest average mortality per episode. Decreasing mortality trend was found significant (p<0,05). Conclusions: Spain showed a mixed pattern of disaster type although technological ones are the most frequent. There is an upward trend of disaster frequency, especially in biological, climatological and transport accident subgroups. Mortality is determined by high-impact events


Assuntos
Humanos , Vítimas de Desastres/estatística & dados numéricos , Impacto de Calamidades , Emergências em Desastres/métodos , Registros de Mortalidade/estatística & dados numéricos , Política Nacional de Vigilância Sanitária , Estudos Retrospectivos
20.
Disaster Med Public Health Prep ; 11(5): 568-572, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28393744

RESUMO

OBJECTIVE: After large-scale disasters, victim identification frequently presents a challenge and a priority for responders attempting to reunite families and ensure proper identification of deceased persons. The purpose of this investigation was to determine whether currently commercially available facial recognition software can successfully identify disaster victims with facial injuries. METHODS: Photos of 106 people were taken before and after application of moulage designed to simulate traumatic facial injuries. These photos as well as photos from volunteers' personal photo collections were analyzed by using facial recognition software to determine whether this technology could accurately identify a person with facial injuries. RESULTS: The study results suggest that a responder could expect to get a correct match between submitted photos and photos of injured patients between 39% and 45% of the time and a much higher percentage of correct returns if submitted photos were of optimal quality with percentages correct exceeding 90% in most situations. CONCLUSIONS: The present results suggest that the use of this software would provide significant benefit to responders. Although a correct result was returned only 40% of the time, this would still likely represent a benefit for a responder trying to identify hundreds or thousands of victims. (Disaster Med Public Health Preparedness. 2017;11:568-572).


Assuntos
Vítimas de Desastres/classificação , Traumatismos Faciais/complicações , Reconhecimento Facial , Software/normas , Vítimas de Desastres/estatística & dados numéricos , Humanos , Incidentes com Feridos em Massa/estatística & dados numéricos
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