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Siddik MA, Islam ARMT. A systematic review of cyclonic disaster: Damage-loss, consequences, adaptation strategies, and future scopes. Heliyon 2024; 10:e33345. [PMID: 39021972 PMCID: PMC11252950 DOI: 10.1016/j.heliyon.2024.e33345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 06/11/2024] [Accepted: 06/19/2024] [Indexed: 07/20/2024] Open
Abstract
Tropical cyclones have direct and indirect repercussions in many coastal areas worldwide. In coastal regions, several studies have identified the driving factors of cyclonic hazards and their associated impacts. However, previous studies have focused little on cyclone-induced damage and loss, consequences, and adaptation strategies. As a result, it is critical to explore the global focus areas of cyclone-related studies. This review systematically examined cyclone-induced damage and loss, its consequences, adaptation strategies in coastal regions, and associated research gaps. Results revealed eight main types of cyclone-induced damages and losses. About 46 % of studies focused on vegetation damages, followed by water and sanitation (11 %), crop damages (8 %), income or business losses (8 %), health and injuries (8 %), land use and land cover changes (8 %), infrastructural damages (5 %), and mixed damages and losses (5 %). These damages and losses led to further consequences, including disruption of biocenoses, fish death because defoliated leaves carried carbon into the water, changes in forest structure and composition, loss of timber plantation confidence, hampering the steady supply of safe drinking water, raising drinking water costs, unsanitary circumstances, an increase in infectious diseases, a decrease in protein consumption, and business and supply chain interruptions. Approximately 35 % of the studies addressed one or more of the thirteen adaptation strategies identified in this review. Most of these studies documented the use of natural regeneration and tree planting as responses to vegetation damage and water purification and the distribution of emergency-safe water in response to water and sanitation damage. The findings have led to a proposal for an adaptation framework for cyclone-induced damage and loss. This review recommended investigating cyclone-induced land use and land cover change, damage to vegetation functional traits and patterns, health and injuries, service networks, and infrastructural damages.
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Affiliation(s)
- Md. Abubakkor Siddik
- Dr. Wazed Research and Training Institute, Begum Rokeya University, Rangpur, 5404, Bangladesh
- Department of Emergency Management, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh
| | - Abu Reza Md. Towfiqul Islam
- Department of Disaster Management, Begum Rokeya University, Rangpur, 5404, Bangladesh
- Department of Development Studies, Daffodil International University, Dhaka, 1216, Bangladesh
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Aydin S, Kazci O, Ece B, Kantarci M. Earthquakes from a radiological perspective: what is demanded from the radiologists, and what can we do? A pictorial review. Diagn Interv Radiol 2024; 30:30-41. [PMID: 37095695 PMCID: PMC10773182 DOI: 10.4274/dir.2023.232157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/03/2023] [Indexed: 04/26/2023]
Abstract
Earthquakes are among the most destructive and unpredictable natural disasters. Various diseases and ailments, such as bone fractures, organ and soft-tissue injuries, cardiovascular diseases, lung diseases, and infectious diseases, can develop in the aftermath of severe earthquakes. Digital radiography, ultrasound, computed tomography, and magnetic resonance imaging are significant imaging modalities utilized for the quick and reliable assessment of earthquake-related ailments to facilitate the planning of suitable therapy. This article examines the usual radiological imaging characteristics observed in individuals from quake-damaged regions and summarizes the strengths and functionality of imaging modalities. In such circumstances, where quick decision-making processes are life-saving and essential, we hope this review will be a practical reference for readers.
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Affiliation(s)
- Sonay Aydin
- Erzincan Binali Yıldırım University Faculty of Medicine, Department of Radiology, Erzincan, Turkey
| | - Omer Kazci
- Ankara Training and Research Hospital, Clinic of Radiology, Ankara, Turkey
| | - Bunyamin Ece
- Kastamonu University Faculty of Medicine, Department of Radiology, Kastamonu, Turkey
| | - Mecit Kantarci
- Erzincan Binali Yıldırım University Faculty of Medicine, Department of Radiology, Erzincan, Turkey
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Saeed H, Hamid S, Zoukar I, Khiami A, Al Hawat L, Khoja M, Khawatmy H, Abdalnour H, Dashash M. Post-quake call for action: developing core competencies matrix for Syrian health workers in emergency time. Confl Health 2024; 18:5. [PMID: 38178240 PMCID: PMC10768459 DOI: 10.1186/s13031-023-00567-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 12/28/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND The recent earthquake in Syria has caused widespread devastation, leading to extensive damage and loss of life. Considering the diverse range of disasters and conflicts that have affected Syrian society, health workers must possess essential competencies to effectively manage various types of disasters, including earthquakes. Therefore, this study was undertaken to identify the specific competencies required by Syrian health workers to respond efficiently and effectively to earthquakes. METHODS An exploratory qualitative study was conducted at the Medical Education Program MEP of the Syrian Virtual University SVU. Nine members of the research team of the MEP, who represent various health specializations in medicine, dentistry, nursing, and pharmacy, accepted to take part in this study. Among these, three members have been actively involved in providing health care in hospitals and the field during the Syrian earthquake on 6 February 2023. The Delphi process was adopted to identify competencies. Health workers involved in earthquake response were categorized into nine groups including medical doctors, dentists, pharmacists, nurses, psychological support professionals, medical students, allied healthcare professionals, on-site disaster teams, and managers. The final list was accepted if it achieved more than 80% agreement among the participants in the first, second, and final rounds. RESULTS The study identified 74 competencies (12 knowledge items, 35 skills, and 27 attitudes) essential for health workers to respond effectively to earthquakes. They are categorized into five domains: "Preparing the team for the rescue process during and, after earthquakes, Implementation of the rescue process, Education and psychological support, Research, and development". CONCLUSION A list of earthquake competencies was identified for health workers. It is hoped that this list will enhance a country's resilience and will enable decision-makers to support health workers in acquiring these competencies within a very strained health system in Syria and other countries.
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Affiliation(s)
- Hani Saeed
- Medical Education Program, Syrian Virtual University, Damascus, Syria
- Faculty of Nursing, Latakia, Syria
| | - Sulaf Hamid
- Medical Education Program, Syrian Virtual University, Damascus, Syria
- Pediatric Dentistry Department, Qasyoun Private University for Science and Technology, Damascus, Syria
| | - Imad Zoukar
- Medical Education Program, Syrian Virtual University, Damascus, Syria
- Department of Pediatrics, Damascus Hospital, Damascus, Syria
| | - Adel Khiami
- Medical Education Program, Syrian Virtual University, Damascus, Syria
- Research Department, Demonstration Training and Research Oral Health Center (DTROHC), Ministry of Education, Damascus, Syria
| | - Lama Al Hawat
- Medical Education Program, Syrian Virtual University, Damascus, Syria
| | - Mohammed Khoja
- Medical Education Program, Syrian Virtual University, Damascus, Syria
| | - Hossam Khawatmy
- Medical Education Program, Syrian Virtual University, Damascus, Syria
| | - Hani Abdalnour
- Medical Education Program, Syrian Virtual University, Damascus, Syria
- Department of Neurosurgery, Faculty of Medicine, Damascus University, Damascus, Syria
| | - Mayssoon Dashash
- Medical Education Program, Syrian Virtual University, Damascus, Syria.
- Department of Pediatric Dentistry, Faculty of Dentistry, Damascus University, Damascus, Syria.
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Hu XZ, Ursano RJ, Benedek D, Li X, Zhang L. Association of 5-HTTLPR With Post-Traumatic Stress Disorder in US Service Members. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2024; 8:24705470241245497. [PMID: 38682050 PMCID: PMC11055429 DOI: 10.1177/24705470241245497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/21/2024] [Indexed: 05/01/2024]
Abstract
Objective Post-traumatic stress disorder (PTSD) is a mental disorder that manifests after exposure to a stressful traumatic event, such as combat experience. Accumulated evidence indicates an important genetic influence in the development of PTSD. The serotonin transporter (5-HTT) gene has been identified as a candidate for PTSD and a polymorphism of the serotonin transporter-linked promoter region (5-HTTLPR) is associated with the disorder in the general population. However, whether it is associated with PTSD in active military service members has not been investigated. This study aimed to investigate the relationship between 5-HTTLPR and PTSD in service members. Methods Leucocyte genomic DNA was extracted from service members, including those with PTSD (n = 134) or without PTSD (n = 639). The 5-HTTLPR polymorphism was detected by means of 2 stages of TaqMan fluorescent PCR assay. PTSD symptoms and symptom severity were assessed using the PTSD Checklist (PCL), a 17-item, DSM-based, self-report questionnaire with well-established validity and reliability. PTSD was determined based on endorsement of DSM-IV criteria and a PCL total score ≥ 44. Results Significant differences in biallele distribution were observed between PTSD and controls (χ2 = 7.497, P = .024). The frequency of SS, SL, and LL genotypes in the PTSD group was 0.17, 0.56, and 0.27 respectively, compared to the frequencies of 0.27, 0.43, and 0.29 in non-PTSD controls. Carriers of the L allele had higher scores for reexperiencing and arousal symptoms on the PCL, compared to SS homozygote carriers (P < .05). The triallele genotypes showed no significant differences in distribution between the PTSD and control groups (P > .05) and no relationship with PTSD symptom severity. The interaction of triallelic genotypes of 5-HTTLPR and traumatic life events was associated with re-experiencing, avoidance, and arousal (P < .05 for all). Multiple regression analysis revealed significant correlations between both biallelic and triallelic genotypes of 5-HTTLPR, the interaction of the number of stressful lifetime events, and 5-HTTLPR genotypes with PCL total score (P < .001). Conclusion Our findings suggested that 5-HTT might play a minor role in PTSD, and the interaction between 5-HTTLPR and the environment had effects on PCL score, complementing and emphasizing 5-HTT for PTSD, especially in the military population.
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Affiliation(s)
- Xian-Zhang Hu
- Center for the Study of Traumatic Stress, Department of Psychiatry, USUHS, Bethesda, MD, USA
- Henry M Jackson Foundation for the Advancement of Military Medicine
| | - Robert J. Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, USUHS, Bethesda, MD, USA
| | - David Benedek
- Center for the Study of Traumatic Stress, Department of Psychiatry, USUHS, Bethesda, MD, USA
| | - Xiaoxia Li
- Center for the Study of Traumatic Stress, Department of Psychiatry, USUHS, Bethesda, MD, USA
- Henry M Jackson Foundation for the Advancement of Military Medicine
| | | | - Lei Zhang
- Center for the Study of Traumatic Stress, Department of Psychiatry, USUHS, Bethesda, MD, USA
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Valente M, Zanellati M, Facci G, Zanna N, Petrone E, Moretti E, Barone-Adesi F, Ragazzoni L. Health System Response to the 2023 Floods in Emilia-Romagna, Italy: A Field Report. Prehosp Disaster Med 2023; 38:813-817. [PMID: 37753631 PMCID: PMC10694460 DOI: 10.1017/s1049023x23006404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/11/2023] [Accepted: 08/20/2023] [Indexed: 09/28/2023]
Abstract
In May 2023, the Italian region Emilia-Romagna was hit by intense rainfall, which caused extensive floods in densely populated areas. On May 4, 2023, a 12-month state of emergency was declared in the region with the activation of response and recovery plans. This field report provides an overview of the health response to the floods, paying particular attention to the measures put in place to ensure care for displaced populations and raising interesting points of discussion regarding the role of the health system during extreme weather events (EWEs). The considerations that emerge from this report underline the need for a primary care approach to disasters, especially when these occur in areas with a high prevalence of elderly resident population, and underscore the importance of integration of different levels of care.
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Affiliation(s)
- Martina Valente
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
- Department for Sustainable Development and Ecological Transition, Università del Piemonte Orientale, 13100, Vercelli, Italy
| | | | - Giulia Facci
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
- Department of Translational Medicine, Università del Piemonte Orientale, 28100, Novara, Italy
| | - Nicola Zanna
- Azienda AUSL Ferrara, Ferrara, Emilia-Romagna, Italy
| | | | - Erika Moretti
- Azienda AUSL Ferrara, Ferrara, Emilia-Romagna, Italy
| | - Francesco Barone-Adesi
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
- Department of Translational Medicine, Università del Piemonte Orientale, 28100, Novara, Italy
| | - Luca Ragazzoni
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
- Department for Sustainable Development and Ecological Transition, Università del Piemonte Orientale, 13100, Vercelli, Italy
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Al-qbelat RM, Subih MM, Malak MZ. Effect of Educational Program on Knowledge, Skills, and Personal Preparedness for Disasters Among Emergency Nurses: A Quasi-Experimental Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580221130881. [PMID: 36281566 PMCID: PMC9608037 DOI: 10.1177/00469580221130881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Continuous nursing education has a significant correlation with increasing knowledge, improving skills, and personal preparedness for disasters among nurses which leads to a decrease in mortality rate and enhances the quality of care. However, there is limited literature evaluating the effect of educational programs on the knowledge, skills, and personal preparedness for disaster preparedness among emergency nurses at Arab countries including, Jordan. This study evaluated the effect of an educational program on knowledge, skills, and personal preparedness for disasters among emergency nurses. A quasi-experimental study and one-group pretest-posttest design was used. A convenience sample was adopted to recruit registered nurses who are working in emergency rooms in the private and government health sectors in Jordan (N = 50). This study was conducted between May and June 2021. The intervention included an educational program consisting of 5 topics about disasters. The participants attended this program for 8 h over 1 week via Zoom application. There were significant differences between the pre-post educational intervention for knowledge (t = 4.79, P ≤ .001), skills (t = 6.66, P ≤ .001), and personal preparedness (t = 9.56, P ≤ .001) for disasters. These findings suggested the importance of implementing continuous education and training programs for emergency nurses about disasters due to increasing frequency of disasters worldwide.
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Affiliation(s)
| | | | - Malakeh Z. Malak
- Al-Zaytoonah University of Jordan, Amman, Jordan,Malakeh Z. Malak, Community Health Nursing, Faculty of Nursing, A-Zaytoonah University of Jordan, Airport Street, P.O. Box: 130 Amman 11733, Jordan. Emails: ;
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Rodríguez-Alejandro O, Torres-Lugo NJ, Mangual-Pérez D, Colón-Miranda R, Sánchez-Fernández H, López-Ventosa J, Pagán-Molderhauer C, Ramírez N, Otero-López A. Orthopaedic trauma epidemiology after Hurricane Maria in the Puerto Rico Trauma Centre. INTERNATIONAL ORTHOPAEDICS 2022; 46:1447-1453. [PMID: 35460368 DOI: 10.1007/s00264-022-05409-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/15/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Hurricane Maria is the most devastating natural phenomenon in the recent history of Puerto Rico. Due to its destructive path through the island, the Puerto Rico Trauma Center (PRTC) remained the only hospital managing orthopaedic trauma in the immediate post-disaster period. We investigated the impact of this hurricane on the orthopaedic trauma epidemiology in the PRTC. METHODS We evaluated the admissions by the orthopaedic surgery service in terms of demographics, mechanisms of injury, and orthopaedic diagnoses for two months after the impact of Hurricane Maria (HM) on September 20, 2017. We compared our study group with the same two month period for two years prior (2015 and 2016) and after (2018 and 2019) as control periods. A p value of < 0.05 was considered statistically significant. RESULTS We included 384 admissions from September 20 to November 20, 2017. The majority were males (63%) and had an average age of 54 years. The most-reported mechanism of injury was fall from standing height (FFSH), showing a significant increment compared with the control periods. Contrarily, motor vehicle accidents (MVA) showed a significant reduction. Among the orthopaedic diagnoses, the hip + pelvis category showed a significant decline within the study group. CONCLUSIONS This study highlighted the impact of HM on the orthopaedic trauma epidemiology at the PRTC. Our findings provide valuable evidence to healthcare institutions to better prepare to manage the potential changes in the orthopaedic trauma epidemiology after a major atmospheric event.
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Affiliation(s)
- Omar Rodríguez-Alejandro
- Department of Orthopaedic Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Norberto J Torres-Lugo
- Department of Orthopaedic Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
| | - Danny Mangual-Pérez
- Department of Orthopaedic Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Roberto Colón-Miranda
- Department of Orthopaedic Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Héctor Sánchez-Fernández
- Department of Orthopaedic Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - José López-Ventosa
- School of Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | | | - Norman Ramírez
- Department of Orthopaedic Surgery, Mayagüez Medical Centeu, Mayagüez, Puerto Rico
| | - Antonio Otero-López
- Department of Orthopaedic Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
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Velin L, Donatien M, Wladis A, Nkeshimana M, Riviello R, Uwitonze JM, Byiringiro JC, Ntirenganya F, Pompermaier L. Systematic media review: A novel method to assess mass-trauma epidemiology in absence of databases-A pilot-study in Rwanda. PLoS One 2021; 16:e0258446. [PMID: 34644363 PMCID: PMC8513851 DOI: 10.1371/journal.pone.0258446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 09/27/2021] [Indexed: 12/23/2022] Open
Abstract
Objective Surge capacity refers to preparedness of health systems to face sudden patient inflows, such as mass-casualty incidents (MCI). To strengthen surge capacity, it is essential to understand MCI epidemiology, which is poorly studied in low- and middle-income countries lacking trauma databases. We propose a novel approach, the “systematic media review”, to analyze mass-trauma epidemiology; here piloted in Rwanda. Methods A systematic media review of non-academic publications of MCIs in Rwanda between January 1st, 2010, and September 1st, 2020 was conducted using NexisUni, an academic database for news, business, and legal sources previously used in sociolegal research. All articles identified by the search strategy were screened using eligibility criteria. Data were extracted in a RedCap form and analyzed using descriptive statistics. Findings Of 3187 articles identified, 247 met inclusion criteria. In total, 117 MCIs were described, of which 73 (62.4%) were road-traffic accidents, 23 (19.7%) natural hazards, 20 (17.1%) acts of violence/terrorism, and 1 (0.09%) boat collision. Of Rwanda’s 30 Districts, 29 were affected by mass-trauma, with the rural Western province most frequently affected. Road-traffic accidents was the leading MCI until 2017 when natural hazards became most common. The median number of injured persons per event was 11 (IQR 5–18), and median on-site deaths was 2 (IQR 1–6); with natural hazards having the highest median deaths (6 [IQR 2–18]). Conclusion In Rwanda, MCIs have decreased, although landslides/floods are increasing, preventing a decrease in trauma-related mortality. By training journalists in “mass-casualty reporting”, the potential of the “systematic media review” could be further enhanced, as a way to collect MCI data in settings without databases.
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Affiliation(s)
- Lotta Velin
- Department of Biomedical and Clinical Sciences, Center for Teaching & Research in Disaster Medicine and Traumatology (KMC), Linköping University, Linköping, Sweden
- * E-mail:
| | | | - Andreas Wladis
- Department of Biomedical and Clinical Sciences, Center for Teaching & Research in Disaster Medicine and Traumatology (KMC), Linköping University, Linköping, Sweden
| | | | - Robert Riviello
- Brigham and Women’s Hospital, Boston, MA, United States of America
- Department of Global Health and Social Medicine, Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States of America
| | | | | | - Faustin Ntirenganya
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- University Teaching Hospital in Kigali, Kigali, Rwanda
| | - Laura Pompermaier
- Department of Biomedical and Clinical Sciences, Center for Teaching & Research in Disaster Medicine and Traumatology (KMC), Linköping University, Linköping, Sweden
- Department of Global Health and Social Medicine, Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States of America
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Rowinski A, von Schreeb J. Decontamination of Surgical Instruments for Safe Wound Care Surgeries in Disasters: What are the Options? A Scoping Review. Prehosp Disaster Med 2021; 36:645-650. [PMID: 34550059 PMCID: PMC8459170 DOI: 10.1017/s1049023x2100090x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 06/23/2021] [Accepted: 07/10/2021] [Indexed: 11/10/2022]
Abstract
International guidelines stipulate that autoclavation is necessary to sterilize surgical equipment. World Health Organization (WHO) guidelines for decontamination of medical devices require four levels of decontamination: cleaning, low- and high-level disinfection, as well as sterilization. Following disasters, there is a substantial need for wound care surgery. This requires prompt availability of a significant volume of instruments that are adequately decontaminated. Ideally, they should be sterilized using an autoclave, but due to the resource-limited field context, this may be impossible. The aim of this study was therefore to identify whether there are portable and less resource-demanding techniques to decontaminate surgical instruments for safe wound care surgery in disasters. A scoping review was chosen, and searches were performed in three scientific databases, grey literature, and included data from organizations and journals. Articles were scanned for decontamination techniques feasible for use in the resource-scarce disaster setting given that: they achieved at least high-level disinfected instruments, were portable, and did not require electricity. A total of 401 articles were reviewed, yielding 13 articles for inclusion. The study identified three techniques: pressure cooking, boiling, and liquid chemical immersion, all achieving either sterilized or high-level disinfected instruments. It was concluded that besides autoclaves, there are less resource-demanding decontamination techniques available for safe wound surgery in disasters. This study provides systematic information to guide optimal standard setting for sterilization of surgical material in resource-limited disaster settings.
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Affiliation(s)
- Anna Rowinski
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Johan von Schreeb
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Coventry CA, Dominguez L, Read DJ, Trelles M, Ivers RQ, Montazerolghaem M, Holland AJA. Comparison of Operative Logbook Experience of Australian General Surgical Trainees With Surgeons Deployed on Humanitarian Missions: What Can Be Learnt for the Future? JOURNAL OF SURGICAL EDUCATION 2020; 77:131-137. [PMID: 31451427 DOI: 10.1016/j.jsurg.2019.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 07/28/2019] [Accepted: 08/02/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE General surgical training in Australia has undergone considerable change in recent years with less exposure to other areas of surgery. General surgeons from many high-income countries have played important roles in assisting with the provision of surgical care in low- and middle-income countries during sudden-onset disasters (SODs) as part of emergency medical teams (EMTs). It is not known if contemporary Australian general surgeons are receiving the broad surgical training required for work in EMTs. DESIGN Logbook data on the surgical procedures performed by Australian general surgical trainees were obtained from General Surgeons Australia (GSA) for the time period February 2008 to February 2017. Surgical procedures performed by Médecins sans Frontières (MSF) surgeons during 5 projects in 3 SODs (the 2010 Haiti earthquake, the 2013 Philippines typhoon and the 2015 Nepal earthquake) were obtained from previously published data for 6 months following each disaster. SETTING AND PARTICIPANTS This was carried out at the University of Sydney with input from MSF Operational Centre Brussels and GSA. RESULTS Australian general surgical trainees performed a mean of 2107 surgical procedures (excluding endoscopy) during their training (10 6-month rotations). Common procedures included abdominal wall hernia repairs (268, 12.7%), cholecystectomies (247, 11.8%), and specialist colorectal procedures (242, 11.5%). MSF surgeons performed a total of 3542 surgical procedures across the 5 projects analyzed. Common procedures included Caesarean sections (443, 12.5%), wound debridement (1115, 31.5%), and other trauma-related procedures (472, 13.3%). CONCLUSIONS Australian general surgical trainees receive exposure to both essential and advanced general surgery but lack exposure to specialty procedures including the obstetric and orthopedic procedures commonly performed by MSF surgeons after SODs. Further training in these areas would likely be beneficial for general surgeons prior to deployment with an EMT.
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Affiliation(s)
- Charles A Coventry
- The Children's Hospital at Westmead Clinical School, The University of Sydney School of Medicine, Sydney, NSW, Australia.
| | - Lynette Dominguez
- Médecins sans Frontières- Operational Centre Brussels, Brussels, Belgium
| | - David J Read
- National Critical Care and Trauma Response Centre, Darwin, NT, Australia
| | - Miguel Trelles
- Médecins sans Frontières- Operational Centre Brussels, Brussels, Belgium
| | - Rebecca Q Ivers
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | | | - Andrew J A Holland
- The Children's Hospital at Westmead Clinical School, The University of Sydney School of Medicine, Sydney, NSW, Australia; Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney, NSW, Australia
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11
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Navarro-Mateu F, Escámez T, Quesada MP, Alcaráz MJ, Vilagut G, Salmerón D, Huerta JM, Chirlaque MD, Navarro C, Kessler RC, Alonso J, Martínez S. Modification of the risk of post-traumatic stress disorder (PTSD) by the 5-HTTLPR polymorphisms after Lorca's earthquakes (Murcia, Spain). Psychiatry Res 2019; 282:112640. [PMID: 31727442 PMCID: PMC7436333 DOI: 10.1016/j.psychres.2019.112640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 10/13/2019] [Accepted: 10/24/2019] [Indexed: 11/26/2022]
Abstract
Information of the modulation effect of the serotonin transporter gene-linked polymorphic region (5-HTTLPR) on post-traumatic stress disorder (PTSD) after earthquakes is scarce and contradictory. A cross-sectional face-to-face interview survey of a representative sample of the adults was carried out after the Lorca (Spain) earthquakes (May 11, 2011). Socio-demographic variables, DSM-IV diagnostic assessment and earthquake-related stressors were obtained from the Composite International Diagnostic Interview (CIDI). The triallelic and biallelic classification of the 5-HTTLPR polymorphism were genotyped from buccal swabs. Multivariate logistic regression models were used to predict PTSD, including interaction terms to explore gene-environment (G x E) interactions. The vast majority (83%, n = 341) of the Lorca survey respondents (n = 412, 71% response rate) were genotyped. Both classifications of the 5-HTTLPR genotype were in Hardy-Weinberg equilibrium. Prior lifetime PTSD was the only variable that remained a significant predictor after adjustments. There were no significant main effects of earthquake related stressors or 5-HTTLPR. However, G x E interactions of 5-HTTLPR with high emotional impact and prior lifetime anxiety disorders were statistically significant. These results provide new evidence of the modulation effect of the 5-HTTLPR polymorphisms on PTSD risk. This information might characterize people at higher risk of developing PTSD after an earthquake exposure.
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Affiliation(s)
- Fernando Navarro-Mateu
- Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM). Servicio Murciano de Salud. Murcia, Spain; Departamento de Psicología Básica y Metodología, Universidad de Murcia. Murcia, Spain; CIBER in Epidemiology & Public Health (CIBERESP). Madrid, Spain; IMIB-Arrixaca. Murcia, Spain.
| | - Teresa Escámez
- IMIB-Arrixaca. Murcia, Spain.,BIOBANC-MUR. IMIB Arrixaca. Murcia, Spain.,Spanish Biobaks Platform, ISCIII. Madrid, Spain
| | | | - Mª José Alcaráz
- Fundación para la Formación e Investigación Sanitarias (FFIS) de la Región de Murcia. Murcia, Spain
| | - Gemma Vilagut
- CIBER in Epidemiology & Public Health (CIBERESP). Madrid, Spain.,IM-Institut Hospital del Mar dÍnvestigacions Médiques. Barcelona, Spain
| | - Diego Salmerón
- CIBER in Epidemiology & Public Health (CIBERESP). Madrid, Spain.,IMIB-Arrixaca. Murcia, Spain.,Departamento de Ciencias Sociosanitarias. Universidad de Murcia. Murcia, Spain
| | - José Mª Huerta
- CIBER in Epidemiology & Public Health (CIBERESP). Madrid, Spain.,IMIB-Arrixaca. Murcia, Spain.,Department of Epidemiology, Murcia Health Council, Murcia, Spain
| | - M. Dolores Chirlaque
- CIBER in Epidemiology & Public Health (CIBERESP). Madrid, Spain.,IMIB-Arrixaca. Murcia, Spain.,Departamento de Ciencias Sociosanitarias. Universidad de Murcia. Murcia, Spain.,Department of Epidemiology, Murcia Health Council, Murcia, Spain
| | - Carmen Navarro
- CIBER in Epidemiology & Public Health (CIBERESP). Madrid, Spain.,IMIB-Arrixaca. Murcia, Spain.,Departamento de Ciencias Sociosanitarias. Universidad de Murcia. Murcia, Spain.,Department of Epidemiology, Murcia Health Council, Murcia, Spain
| | - Ronald C. Kessler
- Department of Health Care Policy. Harvard Medical School. Boston, USA
| | - Jordi Alonso
- CIBER in Epidemiology & Public Health (CIBERESP). Madrid, Spain.,IM-Institut Hospital del Mar dÍnvestigacions Médiques. Barcelona, Spain.,Departamento de Salud y Ciencias Experimentales, Universidad Pompeu Fabra, Barcelona, Spain
| | - Salvador Martínez
- Instituto de Neurociencias UMH-CSIC. Alicante, Spain.,CIBER in Mental Health (CIBERSAM). Madrid, Spain
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Langdon S, Johnson A, Sharma R. Debris Flow Syndrome: Injuries and Outcomes after the Montecito Debris Flow. Am Surg 2019. [DOI: 10.1177/000313481908501004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
On January 9, 2018, a catastrophic debris flow devastated Montecito, California. A 30-foot wall of boulders, mud, and debris ran down the hillsides at 15 miles per hour injuring dozens and causing 21 prehospital deaths. A retrospective review was conducted of the victims from the debris flow presenting to Cottage Health. Injury patterns, procedures performed, complications, length of stay, and outcomes were analyzed. Twenty-four patients were evaluated; 15 were admitted. Of the patients admitted, the most common presenting symptoms were soft tissue injuries (100%), hypothermia (67%), craniofacial injuries (67%), corneal abrasions (53%), and orthopedic injuries (47%), as well as loss of an immediate family member during the incident (73%). Procedures included skin irrigation (93%), operative soft tissue debridement (47%), body orifice irrigation due to mud impaction (40%), and orthopedic repair of fractures and ligaments (40%). All survived to discharge. “Debris flow syndrome” can be defined as a pattern of injuries, including soft tissue injuries, hypothermia, craniofacial trauma, corneal abrasions, orthopedic injuries, and mud impaction. Managing the debris flow syndrome requires co-ordinated and specialized care.
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Affiliation(s)
- Sarah Langdon
- Santa Barbara Cottage Hospital, Santa Barbara, California
| | | | - Rohit Sharma
- Santa Barbara Cottage Hospital, Santa Barbara, California
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Coventry CA, Holland AJA, Read DJ, Ivers RQ. Australasian general surgical training and emergency medical teams: a review. ANZ J Surg 2019; 89:815-820. [PMID: 31066168 DOI: 10.1111/ans.15158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/24/2019] [Accepted: 02/26/2019] [Indexed: 01/09/2023]
Abstract
Emergency medical teams (EMTs) have provided surgical care in sudden-onset disasters in low- and middle-income countries. General surgeons have been heavily involved in many EMTs due to their traditional broad set of surgical skills and experience. With the increased subspecialization of general surgical training in many high-income countries, including Australia and New Zealand, finding general surgeons with adequately broad experience is becoming more challenging. Furthermore, it is now considered standard for EMTs deploying to a sudden-onset disaster to have undergone credentialing, demonstrating sufficient training of their deployed members. The purpose of this review was to highlight the challenges and potential solutions facing those involved in training and recruiting general surgeons for EMTs in Australasia.
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Affiliation(s)
- Charles A Coventry
- Children's Hospital at Westmead Clinic School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Andrew J A Holland
- Children's Hospital at Westmead Clinic School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - David J Read
- National Critical Care and Trauma Response Centre, Darwin, Northern Territory, Australia
| | - Rebecca Q Ivers
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, New South Wales, Australia
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