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Achbani A, Bouchriti Y, Sine H, Kharbach A, Boukrim M, Rida J, Ait Ougjij A, Sine H. Key Takeaways From the Al Haouz Earthquake, Morocco, 2023. Disaster Med Public Health Prep 2024; 18:e88. [PMID: 38712626 DOI: 10.1017/dmp.2024.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Affiliation(s)
- Abderrahmane Achbani
- Population Health and Nursing Sciences, Higher Institute of Nursing and Technical Health Professions, Marrakech, Morocco
- Laboratory of Cell Biology and Molecular Genetics (LBCGM), Department of Biology, Faculty of Sciences, University Ibn Zohr, Agadir, Morocco
| | - Youssef Bouchriti
- High Institute of Nursing Professions and Technical Health, Agadir, Morocco
| | - Hayat Sine
- Clinical Epidemiology and Medico-Surgical Sciences, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Ahmed Kharbach
- Laboratory of Cell Biology and Molecular Genetics (LBCGM), Department of Biology, Faculty of Sciences, University Ibn Zohr, Agadir, Morocco
- High Institute of Nursing Professions and Technical Health, Agadir, Morocco
- Laboratory of Biostatistics, Clinical Research and Epidemiology, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
| | - Mohamed Boukrim
- Population Health and Nursing Sciences, Higher Institute of Nursing and Technical Health Professions, Marrakech, Morocco
| | - Jamila Rida
- Research Laboratory of Innovation in Health Sciences, Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco
| | - Abdellatif Ait Ougjij
- Neuroscience Department of Life Sciences, Laboratory of Biological Engineering, Faculty of Sciences and Technics, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - Hasnaa Sine
- Population Health and Nursing Sciences, Higher Institute of Nursing and Technical Health Professions, Marrakech, Morocco
- Laboratory of Cell Biology and Molecular Genetics (LBCGM), Department of Biology, Faculty of Sciences, University Ibn Zohr, Agadir, Morocco
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Tayfur İ, Bayramoğlu B, Şimşek P, Gunduz A. Medical Response to the February 6, 2023, Earthquakes in Hatay: Challenges Faced in the Deadliest Disaster in the History of Türkiye. Disaster Med Public Health Prep 2024; 18:e45. [PMID: 38466322 DOI: 10.1017/dmp.2024.21] [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] [Indexed: 03/12/2024]
Abstract
OBJECTIVE The Kahramanmaraş earthquakes struck the north-eastern part of Türkiye and Syria on February 6, 2023. It is well known that timely coordination and provision of emergency medical care in the field is particularly important to save lives after earthquakes. This study aimed to identify the challenges faced by medical responders on the ground. METHODS This exploratory-descriptive qualitative study was conducted in Hatay, the province most affected by the earthquakes. Data were collected through in-depth semi-structured interviews and field observations, and then analyzed using thematic analysis approach. RESULTS The study was carried out with 15 first responders from the medical profession. The study revealed 9 themes of challenges faced by medical responders: providing safety and security, human resources management, meeting personal needs, recording data, communication, patient transport, burial procedures, psychological acumen, and logistical problems. Some problems were resolved after 72 h and some continued until day 7. CONCLUSIONS Inadequate organization of volunteer health workers, communication breakdowns, and logistical problems are some of the main challenges. To address these issues, satellite phones and radio systems can be promoted, as well as disaster-resilient logistical planning and better coordination of volunteers.
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Affiliation(s)
- İsmail Tayfur
- University of Health Sciences, Sancaktepe Şehit Prof. Dr. İlhan Varank Education and Research Hospital, Department of Emergency Medicine, Istanbul, Türkiye
- Karadeniz Technical University, Institute of Health Sciences, Department of Disaster Medicine, Trabzon, Türkiye
| | - Burcu Bayramoğlu
- University of Health Sciences, Sancaktepe Şehit Prof. Dr. İlhan Varank Education and Research Hospital, Department of Emergency Medicine, Istanbul, Türkiye
| | - Perihan Şimşek
- Karadeniz Technical University, Institute of Health Sciences, Department of Disaster Medicine, Trabzon, Türkiye
- Trabzon University, School of Applied Sciences, Department of Emergency Aid and Disaster Management, Trabzon, Türkiye
| | - Abdülkadir Gunduz
- Karadeniz Technical University, Institute of Health Sciences, Department of Disaster Medicine, Trabzon, Türkiye
- Karadeniz Technical University, Faculty of Medicine, Department of Emergency Medicine, Trabzon, Türkiye
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Ozel M, Tatliparmak AC, Cetinkaya R, Sizlanan A, Ak R, Yilmaz S. Earthquake-related isolated blunt thoracic trauma patients: A special population study in the emergency department. Am J Emerg Med 2024; 75:148-153. [PMID: 37950983 DOI: 10.1016/j.ajem.2023.10.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/13/2023] Open
Abstract
OBJECTIVE The objective of this study is to compare patients with severe and mild blunt thoracic trauma, who survived an earthquake and presented to the emergency department (ED), in order to identify factors influencing the severity of trauma in earthquake-related thoracic injuries. METHODS This retrospective, cross-sectional, observational comparative study included patients with isolated thoracic injuries due to the February 6th Kahramanmaraş earthquake. The patients were categorized into severe and mild groups based on chest trauma scoring (CTS), and their characteristics were compared. RESULTS The study included 53 patients, with 43 (88.1%) classified as having mild thoracic trauma and 10 (18.9%) classified as having severe thoracic trauma. There was no significant difference in the duration of entrapment between the groups (p = 0.824). The incidence of hemothorax, pneumothorax, rib fractures, and pneumomediastinum did not differ significantly between the two groups (p > 0.05). However, severe thoracic trauma was associated with a higher rate of lung contusion compared to the mild group (p = 0.045). The severe group exhibited significantly higher median scores for lung contusion, rib fractures, and total CTS compared to the mild group (p < 0.001). The mortality rate was significantly higher in the severe group (40%, n = 4) compared to the mild group (2.3%, n = 1) (p = 0.003). CONCLUSION The duration of entrapment did not significantly affect the severity of thoracic injuries in earthquake-related blunt thoracic trauma. However, lung contusion was found to be a more prominent feature in these injuries compared to other clinical conditions such as hemothorax and pneumothorax. These findings highlight the distinct clinical implications of earthquake-related thoracic trauma and may have implications for management strategies in these cases.
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Affiliation(s)
- Mehmet Ozel
- University of Health Sciences, Dept. of Emergency Medicine, Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | | | - Remzi Cetinkaya
- University of Health Sciences, Dept. of Emergency Medicine, Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | - Ahmet Sizlanan
- University of Health Sciences, Department of Thoracic Surgery, Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | - Rohat Ak
- University of Health Sciences, Dept. of Emergency Medicine, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Sarper Yilmaz
- University of Health Sciences, Dept. of Emergency Medicine, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey.
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Zhou Z, Yao L, Hou S, Zhou Y, Zhao C, Bai S, Li N, Li T, Zhang Y. Measuring the Capability of Biological Incident Rescue Teams in China: A Fuzzy Analytic Hierarchy Process Based Model - Tianjin Municipality, China, 2022-2023. China CDC Wkly 2023; 5:922-926. [PMID: 37970068 PMCID: PMC10630905 DOI: 10.46234/ccdcw2023.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/08/2023] [Indexed: 11/17/2023] Open
Abstract
Introduction The swift advancement of biotechnology has presented both opportunities and challenges to our society, thrusting biosafety to the forefront of concern. Consequently, the evaluation of rescue capabilities in the event of a bioterrorism incident becomes of paramount importance. Currently, there is a notable absence of specific measurement criteria and a comprehensive evaluation system. This paper aims to establish a systematic approach towards assessing emergency response capabilities in the context of bioterrorism incidents. Methods We employed an enhanced Delphi methodology to establish an index evaluation framework. Subsequently, the weight of the judgment matrix was ascertained via the application of the fuzzy comprehensive evaluation approach. This led to the creation of a fuzzy comprehensive evaluation model for bioterrorism rescue capability. Results A modified Delphi study was conducted involving 11 experts across two rounds, achieving a response rate of 100%. The Kendall coordination coefficients recorded in the first and second rounds were 0.303 and 0.632, respectively (P<0.05). Upon comprehensive analysis involving score, coefficient of variation, and full score ratio, we distinguished five primary indicators and 25 secondary indicators. Subsequently, an evaluation model was developed based on the Analytic Hierarchy Process (AHP) tailored to assess the response to a rescue from bioterrorism. Discussion The expert panel confirmed consensus on all aspects of the model, validating its comprehensive content. The succeeding course of action involves converting the assessment model to a measurable scale, affirming its functionality, and implementing it in practical evaluation tasks to further enhance the capabilities of the biological incident rescue team.
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Affiliation(s)
- Zichen Zhou
- College of Management and Economy, Tianjin University, Tianjin, China
| | - Lulu Yao
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
| | - Shike Hou
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
| | - Yan Zhou
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Chao Zhao
- Center for Biosafety Research and Strategy, Tianjin University, Tianjin, China
| | - Song Bai
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
| | - Nan Li
- College of Management and Economy, Tianjin University, Tianjin, China
| | - Tiantian Li
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
| | - Yongzhong Zhang
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
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Tahernejad S, Ghaffari S, Ariza-Montes A, Wesemann U, Farahmandnia H, Sahebi A. Post-traumatic stress disorder in medical workers involved in earthquake response: A systematic review and meta-analysis. Heliyon 2023; 9:e12794. [PMID: 36685451 PMCID: PMC9850193 DOI: 10.1016/j.heliyon.2023.e12794] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/01/2022] [Accepted: 01/01/2023] [Indexed: 01/05/2023] Open
Abstract
Introduction Medical workers involved in responding to the earthquake are exposed to frightening scenes and witness dead bodies and severely injured moaning people, predisposing them to multiple mental health consequences. This study was aimed to determine the prevalence of Post-Traumatic Stress Disorder (PTSD) after earthquakes among medical workers using a systematic review and meta-analysis. Materials and methods The review study was performed following PRISMA guidelines, and the study's protocol was registered in PROSPERO with the code CRD42022333069. The data resources of Google Scholar, Science Direct, Web of Science, PubMed, and Scopus were searched to specify the related studies. To perform meta-analysis, the random effects model was utilized, and the I2 index was considered to assess heterogeneity between studies. The STATA software was used for data analysis. Results In the initial data resources search, 1399 articles were identified. From these articles, 13 were finally chosen for meta-analysis and quality assessment. The meta-analysis results indicated that the prevalence of post-earthquake PTSD among medical workers involved in the earthquake response was 16.37% (95% CI: 11.63-21.11, I2 = 97.33%, p = 0 < 0.001). Conclusion The medical workers involved in response to the earthquake have a relatively high risk of PTSD in the short and long term. Therefore, medical workers involved in response to disasters should undergo screening for mental health disorders before and after disasters and receive the necessary training with regard to stress management, psychological resilience, and how to express their feelings and emotions.
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Affiliation(s)
- Somayeh Tahernejad
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Sina Ghaffari
- Department of Occupational Health Engineering and Safety at Work, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Ulrich Wesemann
- Department of Psychiatry, Psychotherapy and Psychotraumatology, Bundeswehr Hospital, Berlin, Germany
| | - Hojjat Farahmandnia
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Sahebi
- Non-Communicable Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran,Corresponding author.
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Wang Z, Wang F. Well-being Effects of Natural Disasters: Evidence from China's Wenchuan Earthquake. JOURNAL OF HAPPINESS STUDIES 2022; 24:563-587. [PMID: 36531932 PMCID: PMC9741708 DOI: 10.1007/s10902-022-00609-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
UNLABELLED This study finds that the Wenchuan earthquake in 2008, one of China's most catastrophic earthquakes, substantially decreased victims' subjective well-being even after incorporating the offsetting effects of post-disaster relief programs. This net well-being impact lasted for nearly 10 years and was on average equivalent to a loss of 67% of the average equivalized household income. Although the post-disaster measures largely restored income, health, and employment, they failed to prevent well-being losses due to family dissolution, as reflected in the higher rates of divorce and widowhood after the earthquake. We find that rural populations, older adults, the less educated, and residents without social insurance were more vulnerable to the earthquake shock. This study uses six waves of a nationally representative dataset of China and a difference-in-differences approach to identify the short- and long-term causal well-being effects of the Wenchuan earthquake. Deeper analyses on mechanisms and heterogeneity suggest that post-disaster policies should focus more on aspects beyond economic factors and on the well-being of disadvantaged populations in particular. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10902-022-00609-z.
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Affiliation(s)
- Zou Wang
- Institute of Regional and Urban Economics, School of Applied Economics, Renmin University of China, Beijing, China
| | - Fei Wang
- School of Labor and Human Resources, Renmin University of China, Beijing, China
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Li S, Guo C, Chan SSS. ICD-11 Posttraumatic Stress Disorder and Complex PTSD Among Hospital Medical Workers in China: Impacts of Wenchuan Earthquake Exposure, Workplaces, and Sociodemographic Factors. Front Psychiatry 2022; 12:735861. [PMID: 35111084 PMCID: PMC8801437 DOI: 10.3389/fpsyt.2021.735861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 12/09/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Previous studies address posttraumatic stress disorder (PTSD) following disasters as a public health issue. However, few studies investigate the long-term effect of disaster exposure on PTSD among hospital medical workers (HMWs). OBJECTIVES This study aimed to study the prevalence of ICD-11 PTSD and complex PTSD (CPTSD) among exposed and non-exposed HMWs 11 years after the Wenchuan earthquake in China, to identify the factors associated with PTSD and CPTSD scores, and to examine the factor structures of PTSD and CPTSD models. METHODS A cross-sectional study was conducted using a self-administered online questionnaire. Two thousand fifty-nine valid samples were collected from four hospitals in 2019. Descriptive statistical analysis, multivariate regression models, and confirmatory factor analysis (CFA) were performed. RESULTS The prevalence of PTSD and CPTSD was 0.58 and 0.34%, respectively. The unexposed group reported higher PTSD and CPTSD scores than the exposed group. The type of workplace and marital status were significantly associated with the PTSD and CPTSD scores of HMWs. The CFA results indicate that both the correlated first-order model and the correlated two-layer model were a good fit to explain the structure of PTSD and CPTSD. CONCLUSION These findings suggest that few HMWs who were exposed to the Wenchuan earthquake suffered from PTSD or CPTSD 11 years following the disaster. However, psychological support was still necessary for all HMWs, especially for unmarried HMWs who were Working in smaller hospitals. Further research is required to analyze mental health status using ICD-11 PTSD and CPTSD to provide ongoing evidence to help HWMs cope effectively with the challenges of future disasters.
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Affiliation(s)
- Sijian Li
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Chunlan Guo
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- World Health Organization Collaborating Center for Community Health Services, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Sunshine S. S. Chan
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Li S, Gillani AH, Ibrahim MIM, Omer S, Fang Y. Should We Focus More on Teaching and Training Disaster Management in Health-care Colleges? An Insight into the Students' Knowledge, Attitude, and Readiness to Practice. J Pharm Bioallied Sci 2022; 14:147-156. [PMID: 36506724 PMCID: PMC9728062 DOI: 10.4103/jpbs.jpbs_420_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/04/2021] [Accepted: 08/04/2021] [Indexed: 12/15/2022] Open
Abstract
Background The critical aspects of risk management for students are providing knowledge, building positive attitudes, and readiness to practice. Our study aimed to assess Chinese health-care university students' knowledge (K), attitude (A), and readiness to practice (rP) regarding disaster medicine and preparedness. Materials and Methods A survey was carried out using a self-administered disaster medicine and preparedness questionnaire. Three main outcome measures were K (22 items), A (16 items), and rP (11 items). Responses were scored and classified as high, moderate, and low. Descriptive and inferential statistics were performed for data analysis. Results A total of 769 valid questionnaires were collected. The associations between K, A, and rP scores was significant, i.e., K-A scores (r = 0.449, P = 0.000), K-rP scores (r = 0.312, P = 0.000), and A-rP scores (r = 0.656, P = 0.000). Multiple linear regression analysis indicated direct low-to-moderate effects of gender, age, attitude, and knowledge on readiness to practice (R 2 = 0.198; P < 0.001). Conclusions The study discovered that most of the students had a moderate level of knowledge, moderate level of attitude, high level of readiness to practice, and a moderate level of total KArP. K, A, and rP were significantly correlated, and K and A were predictors for rP among the health-care students. The findings indicate the importance of health-care colleges for building students' knowledge, attitudes, and readiness to practice disaster medicine and preparedness before joining the profession.
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Affiliation(s)
- Shi Li
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, Shaanxi, China,Center for Drug Safety and Policy Research, Xian Jiaotong University, Xi'an, Shaanxi, China,Shaanxi Centre for Health Reform and Development Research, Xian Jiaotong University, Xi'an, Shaanxi, China
| | - Ali Hassan Gillani
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, Shaanxi, China,Center for Drug Safety and Policy Research, Xian Jiaotong University, Xi'an, Shaanxi, China,Shaanxi Centre for Health Reform and Development Research, Xian Jiaotong University, Xi'an, Shaanxi, China
| | - Mohamed Izham Mohamed Ibrahim
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar,Address for correspondence: Prof. Mohamed Izham Mohamed Ibrahim, Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar. E-mail:
| | - Sumaira Omer
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, Shaanxi, China,Center for Drug Safety and Policy Research, Xian Jiaotong University, Xi'an, Shaanxi, China,Shaanxi Centre for Health Reform and Development Research, Xian Jiaotong University, Xi'an, Shaanxi, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, Shaanxi, China,Center for Drug Safety and Policy Research, Xian Jiaotong University, Xi'an, Shaanxi, China,Shaanxi Centre for Health Reform and Development Research, Xian Jiaotong University, Xi'an, Shaanxi, China
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Whittaker G, Wood GA, Oggero G, Kett M, Lange K. Meeting AT needs in humanitarian crises: The current state of provision. Assist Technol 2021; 33:3-16. [PMID: 34951828 DOI: 10.1080/10400435.2021.1934612] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Humanitarian coordination systems increasingly recognize and aim to respond to the needs of people with disabilities within populations affected by crises, spurred on by the UN Convention on the Rights of Persons with Disabilities (CRPD) which was adopted in 2006. Many agencies state their aim to meet the requirements of the CRPD using a "twin track" approach: ensuring the inclusion of people with disabilities in mainstream provision, alongside targeted support for their needs, which may include the need for Assistive Technology (AT). However, there is very little evidence of AT provision in humanitarian settings, which is a specific and urgent need for many people including the elderly and people with disabilities, and an implicit requirement of Article 11 of the CRPD and World Health Assembly resolution on improving access to assistive technology. There is also little evidence of effective mechanisms for AT provision in humanitarian settings. This is despite high and growing levels of unmet AT need in crises, and despite the legally binding requirement in the CRPD to provide AT for those who need it. AT provision faces unique challenges in humanitarian settings. This paper discusses the evidence available in the literature for the scale and quality of AT provision interventions in crises, and what is known about the challenges and facilitators of provision. We conducted a search of the academic literature and retained literature that reported on any form of AT provision following crisis, where international humanitarian response was in place, published in English between January 2010 and June 2020. We found very few examples in that academic literature of systematic and coordinated AT provision at the acute stage of crisis, and even less in the preparedness and post-acute stages. However, it is difficult to assess whether this is the result of insufficient academic attention or reflects a lack of provision. The small body of academic literature that describes AT provision in humanitarian settings paints a picture of small-scale provision, specialized to single types of impairments, and delivered by predominantly by NGOs. We also conducted a search of the gray literature, using the same inclusion criteria, in two countries: Afghanistan and South Sudan (case studies forthcoming). This gray literature provided supplementary evidence of the types of AT providers and AT provision available in those protracted crises. There are very few examples of how AT services can be scaled up (from a very low baseline) and maintained sustainably within a strengthened health system. The literature also describes more examples of provision of assistive products for mobility over assistive products for other impairments. If the paucity of literature on AT provision in humanitarian settings is a reflection of the scale of provision, this implies a deficiency in humanitarian response when it comes to providing people with AT needs with the essential products and services to which they have a right, and which will enable their access to basic, life-saving assistance. We conclude by providing recommendations for urgent actions that the AT and humanitarian community must take to fill this critical gap in the provision of essential products and services for a potentially marginalized and excluded group.
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Affiliation(s)
- Golnaz Whittaker
- Humanitarian Section, UNICEF Office of Research Innocenti, Florence, Italy
| | - Gavin Adam Wood
- Humanitarian Section, UNICEF Office of Research Innocenti, Florence, Italy
| | - Giulia Oggero
- Access to Assistive Technology and Medical Devices Unit, WHO, Geneva, Switzerland
| | - Maria Kett
- Institute of Epidemiology and Healthcare, UCL, London; and Global Disability Innovation Hub, London, UK
| | - Kirstin Lange
- Disability Section, Programme Division, UNICEF, New York, USA
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Establishment of disaster medical assistance team standards and evaluation of the teams' disaster preparedness: An experience from Taiwan. J Formos Med Assoc 2021; 121:815-823. [PMID: 34657769 DOI: 10.1016/j.jfma.2021.08.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 07/26/2021] [Accepted: 08/24/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND/PURPOSE Taiwan set up disaster medical assistance teams (DMATs) after the Chi-Chi earthquake, but these teams lack unified standards. METHODS This study was divided into two phases. Phase I was a Delphi study conducted in 2019 with 26 experts who were invited to establish Taiwan's DMAT standards by modifying the World Health Organization Emergency Medical Team (WHO EMT) type I fixed standards. Phase II was a cross-sectional study conducted in 2020. A questionnaire was used to evaluate the disaster preparedness of DMATs by standards set in phase I. RESULTS In phase I, Taiwan's DMAT standards were established after three rounds of Delphi consensus, with a response rate of 88.5%. The major departures from the WHO EMT standards were the exclusion of obstetric care, mental health, rehabilitation, and laboratory and blood transfusion standards and the addition of an ultrasound standard. During phase II, a total of 32 teams were invited, and the response rate was 96.9%. The overall standard achievement rate was 56.9%, and the three lowest achievement rates corresponded to sanitation (22.6%), medical malpractice insurance (25.8%), and pharmacy and drug supply (25.8%). The national DMATs, official DMATs, DMATs funded by government, and DMATs with ≥10 years of experience had significantly higher achievement rates for partial or overall standards. CONCLUSION Using localized standards to evaluate the disaster preparedness of each team, DMATs were found to have many shortcomings mainly due to the lack of unified government announcement standards, legal protection, and adequate financial support.
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Hu S, Yang J. Assault associated with intergenerational and historical traumas and mental health concern in China. Asian J Psychiatr 2021; 61:102682. [PMID: 33992854 DOI: 10.1016/j.ajp.2021.102682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 04/20/2021] [Accepted: 05/07/2021] [Indexed: 12/19/2022]
Affiliation(s)
- Shaohua Hu
- Department of Psychiatry, the Frist Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China; The Key Laboratory of Mental Disorder's Management in Zhejiang Province, Hangzhou, China; Brain Research Institute, Zhejiang University, Hangzhou, China
| | - Jianzhong Yang
- Department of Psychiatry, the Second Affiliated Hospital of Kunming, Medical University, Kunming Yunnan, 650101, China.
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Lu B, Zeng W, Li Z, Wen J. Risk factors of post-traumatic stress disorder 10 years after Wenchuan earthquake: a population-based case-control study. Epidemiol Psychiatr Sci 2021; 30:e25. [PMID: 33729117 PMCID: PMC8061289 DOI: 10.1017/s2045796021000123] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 02/04/2021] [Accepted: 02/15/2021] [Indexed: 02/05/2023] Open
Abstract
AIMS To investigate the prevalence of post-traumatic stress disorder (PTSD) symptoms in the hard-hit areas 10 years after the Wenchuan earthquake, and explore the risk factors of long-term PTSD among Wenchuan earthquake survivors. METHODS A matched case-control study was conducted. The involving participants were from the hard-hit areas 10 years after the Wenchuan earthquake. The collected information includes demographic characteristics, socioeconomic status, behaviour habits, earthquake exposure, perceived social support, physical health and mental health. Mental health status was measured using the PTSD Checklist-Civilian Version (PCL-C). Respondents with PCL-C score ⩾38 were classified as cases, and then the cases and controls were matched based on age (±3 years) and community location according to a ratio of 1:3. RESULTS We obtained 86 cases and 258 controls. After controlling for confounding factors, it was found that lower income (OR 2.42; 95% CI 1.16-5.03), chronic diseases (OR 3.00; 95% CI 1.31-6.88) and death of immediate families in the earthquake (OR 7.30; 95% CI 2.36-22.57) were significantly associated with long-term PTSD symptoms. CONCLUSION Even 10 years after the Wenchuan earthquake, the survivors in the hard-hit areas still suffered from severe mental trauma. Low income, chronic diseases and death of immediate families in the earthquakes are significantly associated with long-term PTSD symptoms. Interventions by local governments and health institutions to address these risk factors should be undertaken to promote the health of survivors.
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Affiliation(s)
- Bingqing Lu
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu610041, China
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu610041, China
| | - Wenqi Zeng
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu610041, China
| | - Zhuyue Li
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu610041, China
| | - Jin Wen
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu610041, China
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Fang J, Hou H, Lu C, Pang H, Deng Q, Ye Y, Pan L. A new scheduling method based on sequential time windows developed to distribute first-aid medicine for emergency logistics following an earthquake. PLoS One 2021; 16:e0247566. [PMID: 33621257 PMCID: PMC7901742 DOI: 10.1371/journal.pone.0247566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/09/2021] [Indexed: 11/19/2022] Open
Abstract
After an earthquake, affected areas have insufficient medicinal supplies, thereby necessitating substantial distribution of first-aid medicine from other supply centers. To make a proper distribution schedule, we considered the timing of supply and demand. In the present study, a "sequential time window" is used to describe the time to generate of supply and demand and the time of supply delivery. Then, considering the sequential time window, we proposed two multiobjective scheduling models with the consideration of demand uncertainty; two multiobjective stochastic programming models were also proposed to solve the scheduling models. Moreover, this paper describes a simulation that was performed based on a first-aid medicine distribution problem during a Wenchuan earthquake response. The simulation results show that the methodologies proposed in this paper provide effective schedules for the distribution of first-aid medicine. The developed distribution schedule enables some supplies in the former time windows to be used in latter time windows. This schedule increases the utility of limited stocks and avoids the risk that all the supplies are used in the short-term, leaving no supplies for long-term use.
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Affiliation(s)
- Jiaqi Fang
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
| | - Hanping Hou
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
| | - Changxiang Lu
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
| | - Haiyun Pang
- School of Economics and Management, Zhejiang University of Science and Technology, Hangzhou, Zhejiang, China
| | - Qingshan Deng
- Department of Radiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yong Ye
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lingle Pan
- College of Emergency Management, Zhejiang College of Security Technology, Wenzhou, Zhejiang, China
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Sun H, Liu J, Han Z, Jiang J. Stochastic Petri Net Based Modeling of Emergency Medical Rescue Processes during Earthquakes. JOURNAL OF SYSTEMS SCIENCE AND COMPLEXITY 2021; 34:1063-1086. [PMID: 33456273 PMCID: PMC7801775 DOI: 10.1007/s11424-020-9139-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 02/22/2020] [Indexed: 06/12/2023]
Abstract
The post-disaster emergency medical rescue (EMR) is critical for people's lives. This paper presents a stochastic Petri net (SPN) model based on the process of the rescue structure and a Markov chain model (MC), which is applied to the optimization of the EMR process, with the aim of identifying the key activities of EMR. An isomorphic MC model is developed for measuring and evaluating the time performance of the EMR process during earthquakes with the data of the 2008 Wenchuan earthquake. This paper provides a mathematical approach to simulate the process and to evaluate the efficiency of EMR. Simultaneously, the expressions of the steady state probabilities of this system under various states are obtained based on the MC, and the variations of the probabilities are analyzed by changing the firing rates for every transition. Based on the concrete data of the event, the authors find the most time consuming and critical activities for EMR decisions. The model results show that the key activities can improve the efficiency of medical rescue, providing decision-makers with rescue strategies during the large scale earthquake.
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Affiliation(s)
- Huali Sun
- School of Management, Shanghai University, Shanghai, 200444 China
| | - Jiaguo Liu
- School of Maritime Economics and Management, Dalian Maritime University, Dalian, 116026 China
| | - Ziqiang Han
- School of Political Science and Public Administration, Shandong University, Qingdao, 266237 China
| | - Juan Jiang
- School of Management, Shanghai University, Shanghai, 200444 China
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Abstract
The availability of resources and their concentration in the place of greatest need, will not allow us to successfully overcome a medical surge without the energy required to activate these resources and activities, and increase their quantities if necessary, that is why the staff and management of healthcare institutions are forced to making ethical crisis decisions about who wins and who loses. This study highlights the versatility of the concept of ‘energy’ by attributing it to money or financial resources, which are highly essential in dealing with surges as the healthcare system adopts the appropriate capacity level. This study considers the means (space, staff, supplies, and specific resources) at the disposal of healthcare institutions for the control of diseases as economic resources to identify ways for enhancing their capacity, especially during periods of medical surges such as that caused by the coronavirus disease (COVID-19). The medical resources are dependent on ‘energy’, albeit not in the strictest sense of the term. The article, thus, points out that while limited resources are the norm in economic theory, a medical surge provides an opportunity to sufficiently extend the resources within the health system capacity through increased funding.
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Should the Government Be Allowed to Take Control over Your Car as Part of a Disaster Management Plan? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217780. [PMID: 33114374 PMCID: PMC7663635 DOI: 10.3390/ijerph17217780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 12/20/2022]
Abstract
Introduction: With the Safety Ensuring Lives Future Deployment and Research in Vehicle Evolution (SELF DRIVE) Act in the United States, there is a growing interest in autonomous vehicles (AVs). One avenue of innovation would be to use them to mobilize and coordinate response efforts during natural disasters. This study uses an earthquake response in an urban, developed setting as a hypothetical example case study. In this hypothetical scenario, private AVs would be mobilized to help rescue victims from collapsed structures. Methods: A Markov model compared an intervention arm with AVs to a status quo arm using a hypothetical cohort of American earthquake victims. The three possible health states were trapped but alive, rescued and alive, and dead. The cycle length of the Markov model was 6 h. Results: The cost of deploying AVs was $90,139 relative to $87,869 in status quo arm. Using AVs produced an incremental cost of $2269 (95% credible interval (CI) = $−12,985–$8959). Victims have 7.33 quality-adjusted life years (QALYs) in the intervention arm compared to 7.20 QALYs in the status quo arm, resulting in an incremental gain of 0.13 (95% CI = −0.73–2.19) QALYs. The incremental cost-effectiveness ratio (ICER) was $16,960/QALY gained (95% CI = cost-saving–$69,065/QALY). Discussion: The mobilization of private AVs in the setting of an earthquake has the potential to save money and reduce the loss of life. AVs may advance emergency management competencies.
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Ceferino L, Mitrani-Reiser J, Kiremidjian A, Deierlein G, Bambarén C. Effective plans for hospital system response to earthquake emergencies. Nat Commun 2020; 11:4325. [PMID: 32859917 PMCID: PMC7455727 DOI: 10.1038/s41467-020-18072-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 07/27/2020] [Indexed: 11/09/2022] Open
Abstract
Hospital systems play a critical role in treating injuries during disaster emergency responses. Simultaneously, natural disasters hinder their ability to operate at full capacity. Thus, cities must develop strategies that enable hospitals' effective disaster operations. Here, we present a methodology to evaluate emergency response based on a model that assesses the loss of hospital functions and quantifies multiseverity injuries as a result of earthquake damage. The proposed methodology can design effective plans for patient transfers and allocation of ambulances and mobile operating rooms. This methodology is applied to Lima, Peru, subjected to a disaster scenario following a magnitude 8.0 earthquake. Our results show that the spatial distribution of healthcare demands mismatches the post-earthquake capacities of hospitals, leaving large zones on the periphery significantly underserved. This study demonstrates how plans that leverage hospital-system coordination can address this demand-capacity mismatch, reducing waiting times of critically injured patients by factors larger than two.
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Affiliation(s)
- Luis Ceferino
- Department of Civil and Environmental Engineering, Stanford University, Stanford, CA, USA. .,The Andlinger Center for Energy and the Environment, Princeton University, Princeton, NJ, USA.
| | - Judith Mitrani-Reiser
- Materials and Structural Systems Division, Engineering Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, USA
| | - Anne Kiremidjian
- Department of Civil and Environmental Engineering, Stanford University, Stanford, CA, USA
| | - Gregory Deierlein
- Department of Civil and Environmental Engineering, Stanford University, Stanford, CA, USA
| | - Celso Bambarén
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
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18
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Tang W, Xu D, Xu J. The mediating role of alexithymia between earthquake exposure and psychopathology among adolescents 8.5 years after the wenchuan earthquake. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2020.109881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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19
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Precision Augmentation of Medical Surge Capacity for Disaster Response. Emerg Med Int 2020; 2020:5387043. [PMID: 32257446 PMCID: PMC7102446 DOI: 10.1155/2020/5387043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 02/12/2020] [Indexed: 11/18/2022] Open
Abstract
Background In recent years, serious injuries associated with extreme climate, earthquakes, terrorism, and other natural and man-made disasters have occurred frequently throughout the world. A surge in medical demand that extends beyond local medical surge capacity in mass casualty incidents following major disasters is common. Materials and Methods. We reviewed and analyzed emergency medical rescue efforts after major disasters in recent years to elaborate the precision strategy of augmenting medical surge capacity for disaster response. Results Precision augmentation of medical surge capacity for disaster response can be achieved through several measures. These include (1) release of internal capacity through precision launching or through upgrading the levels of response, (2) precision support for medical surge capacity from external efforts, (3) centralized response, and (4) altering standards of care. We should adopt precision augmentation of medical surge capacity according to the specific situation. Conclusions Augmentation of medical surge capacity as a basic strategy can be used to achieve effective disaster response. In disaster response, due to the complexity of disaster medical capacity amplification, it is important to select the appropriate medical capacity strategy accurately according to the actual disaster situation.
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Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry 2020; 7:300-302. [PMID: 32085840 PMCID: PMC7128328 DOI: 10.1016/s2215-0366(20)30073-0] [Citation(s) in RCA: 884] [Impact Index Per Article: 221.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Li Duan
- Department of Psychiatry, the First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Gang Zhu
- Department of Psychiatry, the First Affiliated Hospital of China Medical University, Shenyang 110001, China; Central Laboratory, the First Affiliated Hospital of China Medical University, Shenyang 110001, China.
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21
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Liu S, Lu L, Bai ZZ, Su M, Qi ZQ, Zhang SY, Chen Y, Ao BY, Cui FZ, Lagarde E, Lii K. Post-Traumatic Stress and School Adaptation in Adolescent Survivors Five Years after the 2010 Yushu Earthquake in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214167. [PMID: 31671736 PMCID: PMC6861989 DOI: 10.3390/ijerph16214167] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 10/22/2019] [Accepted: 10/27/2019] [Indexed: 11/16/2022]
Abstract
(1) Background: The devastating Ms 7.1 earthquake struck Yushu city, China, in 2010, leading to serious consequences and damage in the central Tibetan Plateau. This study aimed to assess school adaptation and post-traumatic stress disorder (PTSD) symptoms of adolescent survivors five years after the Yushu earthquake. (2) Methods: A large-scale, school-based mental health survey was conducted 5 years after the earthquake among Tibetan students in the city of Yushu using the Adolescent’s School Adaptation Scale (ASAS) and the PTSD Checklist. (3) Results: A total of 1976 questionnaires were collected. A total of 30.7% of Tibetan adolescents had poor school adaptation and 19.5% were estimated as having probable PTSD. Logistic regression showed that females (OR = 0.73, 95% CI: 0.60–0.89), senior students (OR = 0.48, 95% CI: 0.39–0.59), and those who participated in post-disaster reconstruction (OR = 0.68, 95% CI: 0.54–0.85) were less likely to have poor school adaptation, while a positive association was observed among those buried under a collapsed building (OR = 1.47, 95% CI: 1.04–2.09) and those who experienced bereavement (OR = 1.77, 95% CI: 1.27–2.45). Students who had experienced bereavement were also more likely to have PTSD (OR = 1.60, 95% CI: 1.12–2.28). (4) Conclusions: The post-traumatic effects of the Yushu earthquake on Tibetan adolescents were severe and long-lasting. Sustainable long-term mental health services to help adolescents to restructure their mental health are necessary.
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Affiliation(s)
- Shou Liu
- Department of Public Health, Medical College, Qinghai University, Qinghai 810001, China.
- Department of Statistics, University of California, Riverside, 337 Olmsted Hall, UCR, Riverside, CA 92521, USA.
| | - Li Lu
- Team IETO, Bordeaux Population Health Research Center, UMR U1219, INSERM, Université de Bordeaux, 33076 Bordeaux, France.
| | - Zheng-Zhong Bai
- Department of Public Health, Medical College, Qinghai University, Qinghai 810001, China.
| | - Min Su
- School of Public Administration, Inner Mongolia University, Inner Mongolia 010021, China.
| | - Zheng-Qing Qi
- Department of Public Health, Medical College, Qinghai University, Qinghai 810001, China.
| | - Shi-Yu Zhang
- Department of Public Health, Medical College, Qinghai University, Qinghai 810001, China.
| | - Yuan Chen
- Department of Public Health, Medical College, Qinghai University, Qinghai 810001, China.
| | - Bing-Yu Ao
- Department of Public Health, Medical College, Qinghai University, Qinghai 810001, China.
| | - Feng-Zhen Cui
- Department of Public Health, Medical College, Qinghai University, Qinghai 810001, China.
| | - Emmanuel Lagarde
- Team IETO, Bordeaux Population Health Research Center, UMR U1219, INSERM, Université de Bordeaux, 33076 Bordeaux, France.
| | - Kehshin Lii
- Department of Statistics, University of California, Riverside, 337 Olmsted Hall, UCR, Riverside, CA 92521, USA.
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Injury Patterns and Medical Evacuation of Patients in Chifeng Tornado in China, August 11, 2017. Disaster Med Public Health Prep 2019; 14:590-595. [PMID: 31637987 DOI: 10.1017/dmp.2019.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To study injury patterns and medical rescue operations related to tornadoes that occur in rural areas, this study investigated the data pertaining to the 2017 Chifeng tornado (China). METHODS Medical records of 52 tornado-related patients were investigated. Data were collected from 3 local hospitals that received all the tornado victims. RESULTS A total of 148 injuries were diagnosed. Tornado-related injuries were mainly caused by collapsed houses (51.9%) and direct physical trauma caused by the tornado (38.5%). Most injuries occurred outdoors (63.5%). The head (20.3%) and thorax (14.8%) were most 2 frequent anatomical injury sites. Soft-tissue injuries (43.9%) and contusions and lacerations (37.3%) were the 2 most common injury types. On evaluating the Abbreviated Injury Scale scores, a score of 1 was the most common (66.2%), and a score of 6 was not recorded. CONCLUSIONS A trailing phenomenon in the distribution of time to admission among the victims of a particular tornado in China was observed. The delivery is timely compared with nondisaster situation. There was a statistically significant difference of injury causes between outdoor and indoor patients. Helmets should be used by potential tornado victims. Basement units capable of functioning as shelters should be built in villages.
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Xue Z, Yang Z, Sun H, Ren J, Sun M, Li J, Zhang A, Zheng P, Pan P, Dou J, Shen L, Chen Y, Li K, Feng T, Lv Y, Bi C, Jin L, Wang Z, Yao Y. Epidemiological analysis of respiratory and intestinal infectious diseases in three counties of Sichuan: the baseline survey of Disaster Mitigation Demonstration Area in western China. PeerJ 2019; 7:e7341. [PMID: 31372321 PMCID: PMC6659668 DOI: 10.7717/peerj.7341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 06/24/2019] [Indexed: 11/26/2022] Open
Abstract
Background Natural disasters can indirectly induce epidemics of infectious diseases through air and water pollution, accelerated pathogen reproduction, and population migration. This study aimed to explore the epidemiological characteristics of the main infectious diseases in Sichuan, a province with a high frequency of natural disasters. Methods Data were collected from the local Centers for Disease Control infectious disease reports from Lu, Shifang and Yuexi counties from 2011 to 2015 and from the baseline survey of the Disaster Mitigation Demonstration Area in Western China in 2016. Principal component regression was used to explore the main influencing factors of respiratory infectious diseases (RIDs). Results The incidence rates of RIDs and intestinal infectious diseases (IIDs) in 2015 were 78.99/100,000, 125.53/100,000, 190.32/100,000 and 51.70/100,000, 206.00/100,000, 69.16/100,000 in Lu, Shifang and Yuexi respectively. The incidence rates of pulmonary tuberculosis (TB) was the highest among RIDs in the three counties. The main IIDs in Lu and Shifang were hand-foot-mouth disease (HFMD) and other infectious diarrhea; however, the main IIDs in Yuexi was bacillary dysentery. The proportions of illiterate and ethnic minorities and per capita disposable income were the top three influencing factors of RIDs. Conclusions TB was the key point of RIDs prevention among the three counties. The key preventable IIDs in Lu and Shifang were HFMD and other infectious diarrhea, and bacillary dysentery was the major IIDs in Yuexi. The incidence rates of RIDs was associated with the population composition, the economy and personal hygiene habits.
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Affiliation(s)
- Zhiqiang Xue
- Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | | | - Hui Sun
- UNICEF Office for China, BeiJing, China
| | - Jinghuan Ren
- Chinese Center for Disease Control and Prevention, BeiJing, China
| | - Mengzi Sun
- Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Jiagen Li
- Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Anning Zhang
- Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Pingping Zheng
- Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Pan Pan
- Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Jing Dou
- Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Li Shen
- Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yang Chen
- Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Kexin Li
- Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Tianyu Feng
- Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yaogai Lv
- Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Chunli Bi
- Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Lina Jin
- Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Zhe Wang
- Chinese Center for Disease Control and Prevention, BeiJing, China
| | - Yan Yao
- Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
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Subacute Phase After an Earthquake: An Even More Important Period. Disaster Med Public Health Prep 2019; 13:1011-1016. [PMID: 31115282 DOI: 10.1017/dmp.2019.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
An earthquake is a very common natural disaster. Numerous studies have focused on the acute phase, but studies concerning the subacute phase after an earthquake were very limited. This aroused more attention being paid to medical relief in the subacute phase, and this study elaborated on the division of the medical relief period and the definition of medical relief targets. More importantly, major types of disease were analyzed by reviewing the relevant published studies, which were identified by searching electronic databases. Findings suggested that the clear division of medical relief stage is vital for determining the priority of medical aid and allocating medical resources scientifically, and all concerned populations should be targeted for medical assistance. The focus of acute phase is injury (64.2%), and the subacute phase is disease (27.8% respiratory disease, 22.9% common disease, 12.5% wound/injury, 10.5% skin disease, 8.7% gynecological and pediatric disease, 8.5% digestive disease). However, due to the limited available studies, the included articles perhaps did not reflect the actual proportion of each type of disease. More studies are needed to better understand the proportion of different diseases in each phase of an earthquake.
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Zhou L, Zhang P, Zhang Z, Fan L, Tang S, Hu K, Xiao N, Li S. A Bibliometric Profile of Disaster Medicine Research from 2008 to 2017: A Scientometric Analysis. Disaster Med Public Health Prep 2019; 13:165-172. [PMID: 29717685 PMCID: PMC7113417 DOI: 10.1017/dmp.2018.11] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
ABSTRACTThis study analyzed and assessed publication trends in articles on "disaster medicine," using scientometric analysis. Data were obtained from the Web of Science Core Collection (WoSCC) of Thomson Reuters on March 27, 2017. A total of 564 publications on disaster medicine were identified. There was a mild increase in the number of articles on disaster medicine from 2008 (n=55) to 2016 (n=83). Disaster Medicine and Public Health Preparedness published the most articles, the majority of articles were published in the United States, and the leading institute was Tohoku University. F. Della Corte, M. D. Christian, and P. L. Ingrassia were the top authors on the topic, and the field of public health generated the most publications. Terms analysis indicated that emergency medicine, public health, disaster preparedness, natural disasters, medicine, and management were the research hotspots, whereas Hurricane Katrina, mechanical ventilation, occupational medicine, intensive care, and European journals represented the frontiers of disaster medicine research. Overall, our analysis revealed that disaster medicine studies are closely related to other medical fields and provides researchers and policy-makers in this area with new insight into the hotspots and dynamic directions. (Disaster Med Public Health Preparedness. 2019;13:165-172).
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Affiliation(s)
- Liang Zhou
- Research Institute of Field Surgery, Daping Hospital, Army Medical University, Chongqing, China
| | - Ping Zhang
- Research Institute of Field Surgery, Daping Hospital, Army Medical University, Chongqing, China
| | - Zhigang Zhang
- Research Institute of Field Surgery, Daping Hospital, Army Medical University, Chongqing, China
| | - Lidong Fan
- Research Institute of Field Surgery, Daping Hospital, Army Medical University, Chongqing, China
| | - Shuo Tang
- Research Institute of Field Surgery, Daping Hospital, Army Medical University, Chongqing, China
| | - Kunpeng Hu
- Research Institute of Field Surgery, Daping Hospital, Army Medical University, Chongqing, China
| | - Nan Xiao
- Research Institute of Field Surgery, Daping Hospital, Army Medical University, Chongqing, China
| | - Shuguang Li
- Research Institute of Field Surgery, Daping Hospital, Army Medical University, Chongqing, China
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Prevalence and Determinants of PTSD 3 Years After an Earthquake in Iran. Community Ment Health J 2019; 55:542-547. [PMID: 30796682 DOI: 10.1007/s10597-019-00384-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 02/15/2019] [Indexed: 10/27/2022]
Abstract
Post-Traumatic Stress Disorder (PTSD) is one of the most debilitating and costly mental health problems that can develop following exposure to natural disasters. Nevertheless, much remains unknown about how to best address PTSD and other mental health needs in disaster-stricken areas, particularly in rural and under-resourced areas. The present study is a population-based cross-sectional study conducted in rural areas that were affected by a destructive earthquake in Iran. The aim of the research is to explore the prevalence and determinants of PTSD among survivors 3 years after the earthquake. A multi-stage cluster random sampling technique was used to obtain a sample of 600 respondents between the ages of 18- and 87-years-old in affected areas. In the present sample, 224 individuals (37.3%) reported some PTSD symptoms. Factors associated with an increased likelihood of developing PTSD included being in a severely-stricken (as opposed to moderately-stricken) village and being female. However, there were no significant associations between PTSD and age groups, marital status, profession, and educational status. These results underscore the need for improved psychosocial interventions following disasters.
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Chan EYY, Man AYT, Lam HCY. Scientific evidence on natural disasters and health emergency and disaster risk management in Asian rural-based area. Br Med Bull 2019; 129:91-105. [PMID: 30753325 PMCID: PMC6413858 DOI: 10.1093/bmb/ldz002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 01/04/2019] [Accepted: 01/11/2019] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Disaster epidemiological studies indicate that Asia has the highest frequency of natural disasters. Rural communities are heavily impacted by natural disasters and have different healthcare needs to urban ones. Referencing Asian countries, this paper's objective is to provide an overview of health impacts and the current evidence for designing programmes and policies related to rural health emergency and disaster risk management (health-EDRM). SOURCES OF DATA This paper uses published English-only reports and papers retrieved from PubMed, Google Scholar, Embase, Medline and PsycINFO on rural disaster and emergency responses and relief, health impact and disease patterns in Asia (January 2000-January 2018). AREAS OF AGREEMENT Earthquakes are the most studied natural disasters in rural communities. The medical burden and health needs of rural communities were most commonly reported among populations of extreme age. Most of the existing research evidence for rural interventions was reported in China. There lacks published peer-reviewed reports of programme impacts on personal and community preparedness. AREAS OF CONTROVERSY There is a lack of evidence-based health-EDRM interventions to evaluate implementation effectiveness in rural areas despite vast volumes of health-related disaster literature. GROWING POINTS Climate change-related disasters are increasing in frequency and severity. Evidence is needed for disaster risk reduction interventions to address the health risks specific to rural populations. AREAS TIMELY FOR DEVELOPING RESEARCH To support global policy development, urgent evidence is needed on the intervention effectiveness, long-term health outcomes, local and cultural relevance as well as sustainability of health relief produced by Health-EDRM programmes in rural areas.
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Affiliation(s)
- E Y Y Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, Division of Global Health and Humanitarian Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- François-Xavier Bagnoud Center for Health & Human Rights, Harvard University, Boston, MA, USA
| | - A Y T Man
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, Division of Global Health and Humanitarian Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - H C Y Lam
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, Division of Global Health and Humanitarian Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Sweileh WM. A bibliometric analysis of health-related literature on natural disasters from 1900 to 2017. Health Res Policy Syst 2019; 17:18. [PMID: 30744641 PMCID: PMC6371570 DOI: 10.1186/s12961-019-0418-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 01/20/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Worldwide, natural disasters have caused a large number of deaths and considerable morbidity. Nevertheless, limited information is available on how the health-related literature on natural disasters has evolved. The current study aims to assess the growth and pattern of health-related literature on natural disasters. METHOD A bibliometric method was implemented using Scopus database for the period from 1900 to 2017. Keywords used in the search strategy were obtained from the classifications of natural disasters presented by the Centre for Research on the Epidemiology of Disasters. The health component was determined by selecting the health-related subject areas in Scopus. RESULTS In total, 9073 documents were retrieved. The annual number of publications showed a noticeable sharp increase after 2004. The retrieved documents received 97,605 citations, an average of 10.8 per document. The h-index of the retrieved documents was 113. Author keywords with the highest occurrence were 'earthquakes' followed by 'disaster medicine', 'disaster planning', 'tsunami', 'mental health', 'disaster preparedness', 'PTSD', 'emergency preparedness', and 'public health'. Authors from the United States of America contributed to 3127 (34.5%) publications and ranked first, followed by those from Japan (700; 7.7%) and China (636; 7.0%). When research output was standardised by Gross Domestic Product per capita, India ranked first, followed by China and the United States. The United Kingdom had the highest percentage of documents with international authors, followed by those from Switzerland and Canada. The Prehospital and Disaster Medicine journal published the most articles (636; 7.0%). The Sichuan University and its affiliated hospital contributed to 384 (7.0%) documents and ranked first in the field. CONCLUSION The current baseline information on health-related literature on natural disasters showed that this field is growing rapidly but with inadequate international research collaboration. Research collaboration in this field needs to be strengthened to improve the global response to natural disasters in any place in the world. There is a need to expand the research focus in this field to include communicable and non-communicable diseases. Finally, the health effects of other natural disasters, such as floods, droughts and disease outbreaks, need to be addressed.
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Affiliation(s)
- Waleed M Sweileh
- Department of Physiology, Pharmacology/Toxicology, Division of Biomedical Sciences, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
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Michaud J, Moss K, Licina D, Waldman R, Kamradt-Scott A, Bartee M, Lim M, Williamson J, Burkle F, Polyak CS, Thomson N, Heymann DL, Lillywhite L. Militaries and global health: peace, conflict, and disaster response. Lancet 2019; 393:276-286. [PMID: 30663597 DOI: 10.1016/s0140-6736(18)32838-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 11/20/2017] [Accepted: 11/01/2018] [Indexed: 11/17/2022]
Abstract
Many countries show a growing willingness to use militaries in support of global health efforts. This Series paper summarises the varied roles, responsibilities, and approaches of militaries in global health, drawing on examples and case studies across peacetime, conflict, and disaster response environments. Militaries have many capabilities applicable to global health, ranging from research, surveillance, and medical expertise to rapidly deployable, large-scale assets for logistics, transportation, and security. Despite this large range of capabilities, militaries also have limitations when engaging in global health activities. Militaries focus on strategic, operational, and tactical objectives that support their security and defence missions, which can conflict with humanitarian and global health equity objectives. Guidelines-both within and outside militaries-for military engagement in global health are often lacking, as are structured opportunities for military and civilian organisations to engage one another. We summarise policies that can help close the gap between military and civilian actors to catalyse the contributions of all participants to enhance global health.
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Affiliation(s)
- Joshua Michaud
- Henry J Kaiser Family Foundation, Washington, DC, USA; Johns Hopkins University School of Advanced International Studies, Washington, DC, USA.
| | - Kellie Moss
- Henry J Kaiser Family Foundation, Washington, DC, USA
| | - Derek Licina
- US Army Regional Health Command - Pacific, Honolulu, HI, USA
| | - Ron Waldman
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | - Maureen Bartee
- Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Matthew Lim
- US Naval Medical Research Center, Silver Spring, MD, USA
| | | | - Frederick Burkle
- Harvard Humanitarian Initiative, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Christina S Polyak
- US Military HIV Research Program, Bethesda, MD, USA; The Henry Jackson Foundation, Bethesda, MD, USA
| | - Nicholas Thomson
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Centre for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - David L Heymann
- Chatham House Royal Institute of International Affairs, London, UK; London School of Hygiene & Tropical Medicine, London, UK
| | - Louis Lillywhite
- Chatham House Royal Institute of International Affairs, London, UK
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The Impact of Earthquake on Poverty: Learning from the 12 May 2008 Wenchuan Earthquake. SUSTAINABILITY 2018. [DOI: 10.3390/su10124704] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
How to combine disaster prevention and mitigation, post-disaster reconstruction and poverty alleviation has become a new hot issue. On 12 May 2008, a major earthquake devastated the Wenchuan area in Sichuan Province in the heartland of China. After ten-years have passed, it is a good time to review what we learned from the Great Wenchuan earthquake. The impact of Wenchuan earthquake on poverty-stricken counties, poverty-stricken villages, and poverty-stricken households was analyzed. Suggestions for improving the method of combining disaster prevention, post-disaster reconstruction, and poverty alleviation were proposed. The results from this research could serve as an important reference for formulation of the poverty alleviation and development program after a major earthquake.
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A Rapid Public Health Needs Assessment Framework for after Major Earthquakes Using High-Resolution Satellite Imagery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061111. [PMID: 29848956 PMCID: PMC6025284 DOI: 10.3390/ijerph15061111] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/21/2018] [Accepted: 05/25/2018] [Indexed: 11/24/2022]
Abstract
Background: Earthquakes causing significant damage have occurred frequently in China, producing enormous health losses, damage to the environment and public health issues. Timely public health response is crucial to reduce mortality and morbidity and promote overall effectiveness of rescue efforts after a major earthquake. Methods: A rapid assessment framework was established based on GIS technology and high-resolution remote sensing images. A two-step casualties and injures estimation method was developed to evaluate health loss with great rapidity. Historical data and health resources information was reviewed to evaluate the damage condition of medical resources and public health issues. Results: The casualties and injures are estimated within a few hours after an earthquake. For the Wenchuan earthquake, which killed about 96,000 people and injured about 288,000, the estimation accuracy is about 77%. 242/294 (82.3%) of the medical existing institutions were severely damaged. About 40,000 tons of safe drinking water was needed every day to ensure basic living needs. The risk of water-borne and foodborne disease, respiratory and close contact transmission disease is high. For natural foci diseases, the high-risk area of schistosomiasis was mapped in Lushan County as an example. Finally, temporary settlements for victims of earthquake were mapped. Conclusions: High resolution Earth observation technology can provide a scientific basis for public health emergency management in the major disasters field, which will be of great significance in helping policy makers effectively improve health service ability and public health emergency management in prevention and control of infectious diseases and risk assessment.
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Evaluation of Use of Prosthesis, Mobility, and Quality of Life in Young and Adult Persons with Unilateral Above-Knee Amputation 7 Years after the 2008 Sichuan Earthquake. ACTA ACUST UNITED AC 2018. [DOI: 10.1097/jpo.0000000000000173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Investigating Lushan Earthquake Victims' Individual Behavior Response and Rescue Organization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14121556. [PMID: 29232912 PMCID: PMC5750974 DOI: 10.3390/ijerph14121556] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 11/14/2017] [Accepted: 11/22/2017] [Indexed: 11/29/2022]
Abstract
Research concerning the impact of earthquake victims’ individual behavior and its association with earthquake-related injuries is lacking. This study examined this relationship along with effectiveness of earthquake rescue measures. The six most severely destroyed townships during the Lushan earthquake were examined; 28 villages and three earthquake victims’ settlement camp areas were selected as research areas. Inclusion criteria comprised living in Lushan county for a longtime, living in Lushan county during the 2013 Lushan earthquake, and having one’s home destroyed. Earthquake victims with an intellectual disability or communication problems were excluded. The earthquake victims (N (number) = 5165, male = 2396) completed a questionnaire (response rate: 94.7%). Among them, 209 were injured (5.61%). Teachers (p < 0.0001, OR (odds ratios) = 3.33) and medical staff (p = 0.001, OR = 4.35) were more vulnerable to the earthquake than were farmers. Individual behavior was directly related to injuries, such as the first reaction after earthquake and fear. There is an obvious connection between earthquake-related injury and individual behavior characteristics. It is strongly suggested that victims receive mental health support from medical practitioners and the government to minimize negative effects. The initial reaction after an earthquake also played a vital role in victims’ trauma; therefore, earthquake-related experience and education may prevent injuries. Self-aid and mutual help played key roles in emergency, medical rescue efforts.
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Schenk EJ, Yuan J, Martel LD, Shi GQ, Han K, Gao X. Risk factors for long-term post-traumatic stress disorder among medical rescue workers appointed to the 2008 Wenchuan earthquake response in China. DISASTERS 2017; 41:788-802. [PMID: 27982458 DOI: 10.1111/disa.12222] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study aims to determine the risk factors for clinically-significant post-traumatic stress disorder (PTSD) among Chinese medical rescue workers one year after the response to the Wenchuan earthquake on 12 May 2008. A sample of 337 medical workers who performed response work within the first three months of the event completed an online questionnaire, which included information on demographics, social support, the management and organisation of the disaster response, and an assessment of PTSD. Symptoms consistent with PTSD were prevalent in 17 per cent of the rescue workers. Those who developed PTSD symptoms were more likely to have been injured, experienced a water shortage, been disconnected from family and friends during the response, and have passive coping styles and neurotic personalities. Factors that cannot be changed easily, such as personality traits, should be evaluated prior to deployment to ensure that rescue workers at higher risk of PTSD are provided with adequate support before and during deployment.
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Affiliation(s)
- Ellen J Schenk
- MPH was a graduate student at the Department of Global Health, Rollins School of Public Health, Emory University, United States at the time when most of the work on this manuscript was conducted and is currently a doctoral student at the Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - Jun Yuan
- MA.Sc is a trainee with the Chinese Field Epidemiology Training Program and an epidemiologist at the Guangzhou Center for Disease Control and Prevention, China
| | - Lise D Martel
- PhD is the Guinea Country Director at the Center for Global Health, Centers for Disease Control and Prevention, United States
| | - Guo-Qing Shi
- MPH is a mentor with the Chinese Field Epidemiology Training Program, China
| | - Ke Han
- MPH is a trainee with the Chinese Field Epidemiology Training Program, China
| | - Xing Gao
- MD PhD is a Representative (in China) with the China-US Collaborative Program on Emerging and Re-emerging Infectious Diseases, Centers for Disease Control and Prevention, United States
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Liu X, Yang H, Tang B, Liu Y, Zhang L. Health status of adolescents in the Tibetan plateau area of western China: 6 years after the Yushu earthquake. Health Qual Life Outcomes 2017; 15:152. [PMID: 28755656 PMCID: PMC5534242 DOI: 10.1186/s12955-017-0727-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 07/21/2017] [Indexed: 01/19/2023] Open
Abstract
Background An earthquake struck Yushu in Qinghai province of China on April 14, 2010, causing 2698 deaths and 12,135 injuries.The present study aimed to assess the health status, and associated determinants, of child survivors in the epicenter of the Yushu earthquake 6 years after the event. Methods A cross-sectional survey was performed among students from two junior schools in Yushu County. Descriptive statistics, t-tests, ANOVA, Wilcoxon rank sum tests, Kruskal-Wallis H tests and stepwise linear regression analysis were used for data analysis. Results The mean scores onmental component summary (MCS)and physical component summary (PCS) were 42.13 (SD 7.32) and 42.04 (SD 8.07), respectively. Lower PCS in the aftermath of an earthquake was associated with being trapped/in danger, injured to self, receiving no escape training while lowerMCS in the aftermath of an earthquake was associated with a lower grade level, not living with parents, fear during the earthquake, death in the family, and not receiving psychological counseling after the earthquake. Conclusions In conclusion, the results of the present study help to expand our knowledge regarding the health status of child survivors 6 years after the Yushu earthquake. Our study provides evidence-based suggestions for specific long-term health interventions in such vulnerable populations.
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Affiliation(s)
- Xu Liu
- Department of HealthService, Faculty of HealthService, Second Military Medical University, 800Xiangyin Road, Shanghai, 200433, China
| | - Hongyang Yang
- Department of Medical Affairs, The General Hospital of the PLA Rocket Force, Beijing, China
| | - Bihan Tang
- Department of HealthService, Faculty of HealthService, Second Military Medical University, 800Xiangyin Road, Shanghai, 200433, China
| | - Yuan Liu
- Department of HealthService, Faculty of HealthService, Second Military Medical University, 800Xiangyin Road, Shanghai, 200433, China
| | - Lulu Zhang
- Department of HealthService, Faculty of HealthService, Second Military Medical University, 800Xiangyin Road, Shanghai, 200433, China.
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Evaluating the Evacuation and Rescue Capabilities of Urban Open Space from a Land Use Perspective: A Case Study in Wuhan, China. ISPRS INTERNATIONAL JOURNAL OF GEO-INFORMATION 2017. [DOI: 10.3390/ijgi6070227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chen Y, Qiu J, Yang A, Yuan D, Zhou J. Epidemiology and management of splenic injury: An analysis of a Chinese military registry. Exp Ther Med 2017; 13:2102-2108. [PMID: 28565815 DOI: 10.3892/etm.2017.4208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Accepted: 12/23/2016] [Indexed: 01/24/2023] Open
Abstract
In China, there have been few meta-analyses of the epidemiology and management of splenic injury. Due to the success of Chinese military hospitals in the domestic treatment of splenic injury, the present study conducted a systematic review of such cases, identifying a high occurrence rate of splenic trauma, as well as a number of strategies of managing splenic injury in China. Data were collected from sixteen Chinese military hospitals between July 2000 and March 2009, and retrospectively reviewed. It was observed that between July 2000 and March 2009 a total of 7,807 patients (84.32% male and 15.68% female) with splenic injury were admitted to hospital. The mean duration of hospital stay was 17.9±18.6 days and the gender distribution of splenic injury over the successive years did not differ significantly (P>0.05, c=0.034). However, there was a significant difference in the gender distribution of splenic injury patients in different months (P<0.05, c=0.063). In addition, admission numbers for splenic injury were highest in September, October and November. It was also found that splenic injury may occur at all ages, though patients of working age (20-50 years), which comprises 85.59% of patients, the highest proportion of all recorded cases. Associations between mortality rate and each management strategy were as follows: Operative management, 0.11% and non-operative management, 0.15%. Furthermore, multivariate analysis demonstrated that transfusion, New Injury Severity Score and management strategies were all correlated with mortality rate. Thus, despite a lack of data for inpatients from civilian hospitals, the present study has, in part, identified the epidemiology and management strategies of splenic injury in China. These findings may supplement those from previous analyses of splenic injury in other countries and regions.
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Affiliation(s)
- Yong Chen
- State Key Laboratory of Trauma, Burns and Combined Injury, Department 4, Research Institute of Surgery, Daping Hospital, The Third Military Medical University, Chongqing 400042, P.R. China
| | - Jun Qiu
- State Key Laboratory of Trauma, Burns and Combined Injury, Department 4, Research Institute of Surgery, Daping Hospital, The Third Military Medical University, Chongqing 400042, P.R. China
| | - Ao Yang
- State Key Laboratory of Trauma, Burns and Combined Injury, Department 4, Research Institute of Surgery, Daping Hospital, The Third Military Medical University, Chongqing 400042, P.R. China
| | - Danfeng Yuan
- State Key Laboratory of Trauma, Burns and Combined Injury, Department 4, Research Institute of Surgery, Daping Hospital, The Third Military Medical University, Chongqing 400042, P.R. China
| | - Jihong Zhou
- State Key Laboratory of Trauma, Burns and Combined Injury, Department 4, Research Institute of Surgery, Daping Hospital, The Third Military Medical University, Chongqing 400042, P.R. China
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Abstract
AbstractDisaster can strike people in any community at any time anywhere in the world. Disasters occur with high frequency, take on multiple forms, and exert wide influence, typically causing property damage, injuries, and death. As the world’s largest developing country, China incurs great costs when a disaster hits. After the Wenchuan earthquake in 2008, the Chinese government focused its attention on the construction of an emergency response system, the creation of disaster prevention and mitigation systems, and the development of a disaster medicine program. Here, we describe the current status of disaster medicine in China, focusing on the following four aspects: the Emergency Management System, Education & Training, Rescue Practices, and Research. We also discuss the future of disaster medicine in China. (Disaster Med Public Health Preparedness. 2018;12:157–165)
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How Prepared Are Hospitals' Emergency Management Capacity? Factors Influencing Efficiency of Disaster Rescue. Disaster Med Public Health Prep 2016; 12:176-183. [PMID: 27189920 DOI: 10.1017/dmp.2016.25] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES In light of government investment over the past decade, we explored the capacity for disaster response in Heilongjiang Province, identifying the factors that affect response capacity. METHODS We surveyed 1257 medical staff in 65 secondary and tertiary hospitals in Heilongjiang province to explore their perceptions of disaster management capacity using a cross-sectional multistage, stratified cluster sampling method. RESULTS All tertiary hospitals (100%) and most secondary hospitals (93%) have documented disaster management plans that are regularly reviewed. In secondary hospitals, drills were less prevalent (76.7%) but the occurrence of simulated training exercises was closer to tertiary hospitals (86.0%). We noted that 95.4% of all hospitals have leadership groups responsible for disaster preparedness capacity building, but only 10.8% have a stockpiled network of reserve supplies. CONCLUSIONS Although response capacity has improved in Heilongjiang Province, vulnerabilities remain. We recommend that priorities should be targeted at preparedness capacity building, in terms of reliable and relevant operational response plans, the expansion of existing response mechanisms to oversee local education and scenario training, and to ensure there is sufficient access to protective equipment and materials, either held in reserve, or alternatively by activating resilient supply chain mechanisms. (Disaster Med Public Health Preparedness. 2018;12:176-183).
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Kang P, Lv Y, Hao L, Tang B, Liu Z, Liu X, Liu Y, Zhang L. Psychological consequences and quality of life among medical rescuers who responded to the 2010 Yushu earthquake: A neglected problem. Psychiatry Res 2015; 230:517-23. [PMID: 26476590 DOI: 10.1016/j.psychres.2015.09.047] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 07/16/2015] [Accepted: 09/29/2015] [Indexed: 10/23/2022]
Abstract
A comprehensive study was conducted 8 months after the 2010 Yushu earthquake to assess the prevalence of posttraumatic stress disorder (PTSD) among medical rescuers and the rescuers' quality of life. Additionally, the study examines differences between local and supporting forces, as well as the relationship between PTSD and lower quality of life (QoL), and the risk factors for both. A total of 338 rescuers (including 123 local rescuers and 215 supporting ones) were randomly selected from Yushu County (the epicenter) and Xining City using multistage systematic sampling. Two standardized instruments, the PTSD Checklist-Civilian Version (PCL-C) and the Chinese version of the WHOQOL-BREF, were used to evaluate the prevalence of PTSD and obtain the rescuers' QoL. Being between 40 and 50 years old, a nurse, Tibetan, having been in serious danger or having received mental health training before this earthquake were significantly and independently associated with PTSD symptoms. Compared with supporting rescuers, local rescuers were more likely to develop PTSD and to report a lower QoL. Additional mental health services and training should be available to at-risk medical rescuers and groups to ensure they are adequately prepared for relief efforts and to maintain their mental health after assistance in disaster relief.
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Affiliation(s)
- Peng Kang
- Department of Military Health Management, College of Military Health Management, Second Military Medical University, Shanghai 200433, China
| | - Yipeng Lv
- Department of Military Health Management, College of Military Health Management, Second Military Medical University, Shanghai 200433, China
| | - Lu Hao
- Office of Teaching and Training, Division of Graduate, Second Military Medical University, Shanghai 200433, China
| | - Bihan Tang
- Department of Military Health Management, College of Military Health Management, Second Military Medical University, Shanghai 200433, China
| | - Zhipeng Liu
- Department of Military Health Management, College of Military Health Management, Second Military Medical University, Shanghai 200433, China
| | - Xu Liu
- Department of Military Health Management, College of Military Health Management, Second Military Medical University, Shanghai 200433, China
| | - Yuan Liu
- Department of Military Health Management, College of Military Health Management, Second Military Medical University, Shanghai 200433, China
| | - Lulu Zhang
- Department of Military Health Management, College of Military Health Management, Second Military Medical University, Shanghai 200433, China.
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Abstract
BACKGROUND When disaster strikes, the number of patients requiring treatment can be overwhelming. In low-income countries, resources to assist the injured in a timely fashion may be limited. As a consequence, necrosis and wound infection in disaster patients is common and frequently leads to adverse health outcomes such as amputations, chronic wounds, and loss of life. In such compromised health care environments, low-tech and cheap wound care options are required that are in ready supply, easy to use, and have multiple therapeutic benefits. Maggot debridement therapy (MDT) is one such wound care option and may prove to be an invaluable tool in the treatment of wounds post-disaster. DISCUSSION This report provides an overview of the wound burden experienced in various types of disaster, followed by a discussion of current treatment approaches, and the role MDT may play in the treatment of complex wounds in challenging health care conditions. Maggot debridement therapy removes necrotic and devitalized tissue, controls wound infection, and stimulates wound healing. These properties suggest that medicinal maggots could assist health care professionals in the debridement of disaster wounds, to control or prevent infection, and to prepare the wound bed for reconstructive surgery. Maggot debridement therapy-assisted wound care would be led by health care workers rather than physicians, which would allow the latter to focus on reconstructive and other surgical interventions. Moreover, MDT could provide a larger window for time-critical interventions, such as fasciotomies to treat compartment syndrome and amputations in case of life-threatening wound infection. RECOMMENDATIONS There are social, medical, and logistic hurdles to overcome before MDT can become widely available in disaster medical aid. Thus, research is needed to further demonstrate the utility of MDT in Disaster Medicine. There is also a need for reliable MDT logistics and supply chain networks. Integration with other disaster management activities will also be essential. CONCLUSIONS In the aftermath of disasters, MDT could play an important role facilitating timely and efficient medical treatment and improving patient outcomes. Existing social, medical, and logistic barriers will need to be overcome for MDT to be mainstreamed in Disaster Medicine.
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The Technical Efficiency of Earthquake Medical Rapid Response Teams Following Disasters: The Case of the 2010 Yushu Earthquake in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:15390-9. [PMID: 26690182 PMCID: PMC4690927 DOI: 10.3390/ijerph121214991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 10/19/2015] [Accepted: 11/30/2015] [Indexed: 11/16/2022]
Abstract
Purpose: Performance assessments of earthquake medical rapid response teams (EMRRTs), particularly the first responders deployed to the hardest hit areas following major earthquakes, should consider efficient and effective use of resources. This study assesses the daily technical efficiency of EMRRTs in the emergency period immediately following the 2010 Yushu earthquake in China. Methods: Data on EMRRTs were obtained from official daily reports of the general headquarters for Yushu earthquake relief, the emergency office of the National Ministry of Health, and the Health Department of Qinghai Province, for a sample of data on 15 EMRRTs over 62 days. Data envelopment analysis was used to examine the technical efficiency in a constant returns to scale model, a variable returns to scale model, and the scale efficiency of EMRRTs. Tobit regression was applied to analyze the effects of corresponding influencing factors. Results: The average technical efficiency scores under constant returns to scale, variable returns to scale, and the scale efficiency scores of the 62 units of analysis were 77.95%, 89.00%, and 87.47%, respectively. The staff-to-bed ratio was significantly related to global technical efficiency. The date of rescue was significantly related to pure technical efficiency. The type of institution to which an EMRRT belonged and the staff-to-bed ratio were significantly related to scale efficiency. Conclusions: This study provides evidence that supports improvements to EMRRT efficiency and serves as a reference for earthquake emergency medical rapid assistance leaders and teams.
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Shen WF, Jiang LB, Jiang GY, Zhang M, Ma YF, He XJ. Development of the science of mass casualty incident management: reflection on the medical response to the Wenchuan earthquake and Hangzhou bus fire. J Zhejiang Univ Sci B 2015; 15:1072-80. [PMID: 25471837 DOI: 10.1631/jzus.b1400225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE In this paper, we review the previous classic research paradigms of a mass casualty incident (MCI) systematically and reflect the medical response to the Wenchuan earthquake and Hangzhou bus fire, in order to outline and develop an improved research paradigm for MCI management. METHODS We searched PubMed, EMBASE, China Wanfang, and China Biology Medicine (CBM) databases for relevant studies. The following key words and medical subject headings were used: 'mass casualty incident', 'MCI', 'research method', 'Wenchuan', 'earthquake', 'research paradigm', 'science of surge', 'surge', 'surge capacity', and 'vulnerability'. Searches were performed without year or language restriction. After searching the four literature databases using the above listed key words and medical subject headings, related articles containing research paradigms of MCI, 2008 Wenchuan earthquake, July 5 bus fire, and science of surge and vulnerability were independently included by two authors. RESULTS The current progresses on MCI management include new golden hour, damage control philosophy, chain of survival, and three links theory. In addition, there are three evaluation methods (medical severity index (MSI), potential injury creating event (PICE) classification, and disaster severity scale (DSS)), which can dynamically assess the MCI situations and decisions for MCI responses and can be made based on the results of such evaluations. However, the three methods only offer a retrospective evaluation of MCI and thus fail to develop a real-time assessment of MCI responses. Therefore, they cannot be used as practical guidance for decision-making during MCI. Although the theory of surge science has made great improvements, we found that a very important factor has been ignored-vulnerability, based on reflecting on the MCI response to the 2008 Wenchuan earthquake and July 5 bus fire in Hangzhou. CONCLUSIONS This new paradigm breaks through the limitation of traditional research paradigms and will contribute to the development of a methodology for disaster research.
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Affiliation(s)
- Wei-feng Shen
- Department of Emergency Medicine, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
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Tang B, Ge Y, Liu Z, Liu X, Kang P, Liu Y, Zhang L. Health-related quality of life for medical rescuers one month after Ludian earthquake. Health Qual Life Outcomes 2015; 13:88. [PMID: 26108679 PMCID: PMC4479311 DOI: 10.1186/s12955-015-0286-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 06/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An earthquake struck Ludian in Yunnan province of China on August 3, 2014, resulting in 3143 injuries, 617 deaths, and 112 missing persons. Our study aimed at estimating the quality of life and associated determinants among medical rescuers after Ludian earthquake. METHODS A cross-sectional survey was performed among personnel from three hospitals that assumed rescue tasks in Ludian earthquake. Descriptive statistics, t-tests, ANOVA and stepwise linear regression analysis were used for data analysis. RESULTS The mean scores on the physical component summary (PCS) and mental component summary (MCS) were 49.86 (SD = 6.01) and 35.85(SD = 6.90), respectively. Lower PCS in the aftermath of an earthquake was associated with non-military medical rescuers, elderly age, and being trapped/in danger while lower MSC in the aftermath of an earthquake was associated with non-military medical rescuers, young age, being female, being trapped/in danger and low education degree. CONCLUSIONS In conclusion, our study demonstrates that medical rescuers are at risk for a lower HRQoL after exposure to Ludian earthquake. The results of this study help expand our knowledge of health-related quality of life among medical rescuers after the Ludian earthquake.
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Affiliation(s)
- Bihan Tang
- Institute of Military Health Management, Second Military Medical University, 800 Xiangyin Rd, Shanghai, 200433, China.
| | - Yang Ge
- Institute of Military Health Management, Second Military Medical University, 800 Xiangyin Rd, Shanghai, 200433, China.
| | - Zhipeng Liu
- Institute of Military Health Management, Second Military Medical University, 800 Xiangyin Rd, Shanghai, 200433, China.
| | - Xu Liu
- Institute of Military Health Management, Second Military Medical University, 800 Xiangyin Rd, Shanghai, 200433, China.
| | - Peng Kang
- Institute of Military Health Management, Second Military Medical University, 800 Xiangyin Rd, Shanghai, 200433, China.
| | - Yuan Liu
- Institute of Military Health Management, Second Military Medical University, 800 Xiangyin Rd, Shanghai, 200433, China.
| | - Lulu Zhang
- Institute of Military Health Management, Second Military Medical University, 800 Xiangyin Rd, Shanghai, 200433, China.
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Mochalski P, Unterkofler K, Teschl G, Amann A. Potential of volatile organic compounds as markers of entrapped humans for use in urban search-and-rescue operations. Trends Analyt Chem 2015. [DOI: 10.1016/j.trac.2015.02.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Xu M, Liang Z, Xu Y, Wang J. Chinese vaccine products go global: vaccine development and quality control. Expert Rev Vaccines 2015; 14:763-73. [PMID: 25697690 DOI: 10.1586/14760584.2015.1012503] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Through the continuous efforts of several generations, China has become one of the few countries in the world that is capable of independently addressing all the requirements by the Expanded Program on Immunization. Regulatory science is applied to continuously improve the vaccine regulatory system. Passing the prequalification by WHO has allowed Chinese vaccine products to go global. Chinese vaccine products not only secure disease prevention and control domestically but also serve the needs for international public health. This article describes the history of Chinese vaccine development, the current situation of Chinese vaccine industry and its contribution to the prevention and control of infectious diseases. We also share our experience of national quality control and vaccine regulation during the past decades. China's experience in vaccine development and quality control can benefit other countries and regions worldwide, including the developing countries.
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Affiliation(s)
- Miao Xu
- Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products, National Institutes for Food and Drug Control, No.2, Tiantan Xili, Dongcheng District, Beijing 100050, People's Republic of China
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Du Y, Ding Y, Li Z, Cao G. The role of hazard vulnerability assessments in disaster preparedness and prevention in China. Mil Med Res 2015; 2:27. [PMID: 26605045 PMCID: PMC4657270 DOI: 10.1186/s40779-015-0059-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 10/22/2015] [Indexed: 11/10/2022] Open
Abstract
China is prone to disasters and escalating disaster losses. Effective disaster mitigation is the foundation for efficient disaster response and rescue and for reducing the degree of hazardous impacts on the population. Vulnerability refers to the population's capacity to anticipate, cope with, and recover from the impact of a hazardous event. A hazard vulnerability assessment (HVA) systematically evaluates the damage that could be caused by a potential disaster, the severity of the impact, and the available medical resources during a disaster to reduce population vulnerability and increase the capacity to cope with disasters. In this article, we summarized HVA team membership, content (disaster identification, probability and consequences), and methods and procedures for an HVA that can be tailored to China's needs. We further discussed the role of epidemiology in an HVA. Disaster epidemiology studies the underlying causes of disasters to achieve effective disaster prevention and reduction. In addition, we made several recommendations that are already in practice in developed countries, such as the U.S., for future implementation in China and other developing countries. An effective HVA plan is crucial for successful disaster preparedness, response, and recovery.
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Affiliation(s)
- Yan Du
- Department of Epidemiology, Second Military Medical University, 800 Xiangyin Road, Shanghai, 200433 People's Republic of China
| | - Yibo Ding
- Department of Epidemiology, Second Military Medical University, 800 Xiangyin Road, Shanghai, 200433 People's Republic of China
| | - Zixiong Li
- Department of Epidemiology, Second Military Medical University, 800 Xiangyin Road, Shanghai, 200433 People's Republic of China
| | - Guangwen Cao
- Department of Epidemiology, Second Military Medical University, 800 Xiangyin Road, Shanghai, 200433 People's Republic of China
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Nakagawa J, Ehrenberg JP, Nealon J, Fürst T, Aratchige P, Gonzales G, Chanthavisouk C, Hernandez LM, Fengthong T, Utzinger J, Steinmann P. Towards effective prevention and control of helminth neglected tropical diseases in the Western Pacific Region through multi-disease and multi-sectoral interventions. Acta Trop 2015; 141:407-18. [PMID: 23792012 DOI: 10.1016/j.actatropica.2013.05.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 04/22/2013] [Accepted: 05/21/2013] [Indexed: 12/13/2022]
Abstract
Neglected tropical diseases (NTDs) cause serious health, social and economic burdens in the countries of the World Health Organization Western Pacific Region. Among the NTDs, helminth infections are particularly prominent with regard to the number of infected individuals and health impact. Co-endemicity is common among impoverished and marginalized populations. To achieve effective and sustainable control of helminth NTDs, a deeper understanding of the social-ecological systems governing their endemicity and strategies beyond preventive chemotherapy are required to tackle the multiple causes of infection and re-infection. We discuss the feasibility of implementing multi-disease, multi-sectoral intervention packages for helminth NTDs in the Western Pacific Region. After reviewing the main determinants for helminth NTD endemicity and current control strategies, key control activities that involve or concern other programmes within and beyond the health sector are discussed. A considerable number of activities that have an impact on more than one helminth NTD are identified in a variety of sectors, suggesting an untapped potential for synergies. We also highlight the challenges of multi-sectoral collaboration, particularly of involving non-health sectors. We conclude that multi-sectoral collaboration for helminth NTD control is feasible if the target diseases and sectors are carefully selected. To do so, an incentive analysis covering key stakeholders in the sectors is crucial, and the disease-control strategies need to be well understood. The benefits of multi-disease, multi-sectoral approaches could go beyond immediate health impacts by contributing to sustainable development, raising educational attainment, increasing productivity and reducing health inequities.
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Affiliation(s)
- Jun Nakagawa
- World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines
| | - John P Ehrenberg
- World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines
| | - Joshua Nealon
- World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines
| | - Thomas Fürst
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; University of Basel, P.O. Box, CH-4003 Basel, Switzerland
| | - Padmasiri Aratchige
- World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines
| | - Glenda Gonzales
- World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines
| | - Chitsavang Chanthavisouk
- World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines
| | - Leda M Hernandez
- Infectious Disease Office, National Centre for Disease Prevention and Control, Department of Health, Sta. Cruz, 1000 Manila, Philippines
| | - Tayphasavanh Fengthong
- Department of Hygiene and Health Promotion, Ministry of Health, P.O. Box 1232, Vientiane, Lao People's Democratic Republic
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; University of Basel, P.O. Box, CH-4003 Basel, Switzerland
| | - Peter Steinmann
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; University of Basel, P.O. Box, CH-4003 Basel, Switzerland.
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Professionalization of anesthesiologists and critical care specialists in humanitarian action: a nationwide poll among italian residents. Prehosp Disaster Med 2014; 30:16-21. [PMID: 25499144 DOI: 10.1017/s1049023x14001320] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Over the last decades, humanitarian crises have seen a sharp upward trend. Regrettably, physicians involved in humanitarian action have often demonstrated incomplete preparation for these compelling events which have proved to be quite different from their daily work. Responders to these crises have included an unpredictable mix of beginner-level, mid-level, and expert-level providers. The quality of care has varied considerably. The international humanitarian community, in responding to international calls for improved accountability, transparency, coordination, and a registry of professionalized international responders, has recently launched a call for further professionalization within the humanitarian assistance sector, especially among academic-affiliated education and training programs. As anesthetists have been involved traditionally in medical relief operations, and recent disasters have seen a massive engagement of young physicians, the authors conducted, as a first step, a poll among residents in Anesthesia and Critical Care Medicine in Italy to evaluate their interest in participating in competency-based humanitarian assistance education and in training incorporated early in residencies. METHODS The Directors of all the 39 accredited anesthesia/critical care training programs in Italy were contacted and asked to submit a questionnaire to their residents regarding the objectives of the poll study. After acceptance to participate, residents were enrolled and asked to complete a web-based poll. RESULTS A total of 29 (74%) of the initial training programs participated in the poll. Out of the 1,362 questionnaires mailed to residents, 924 (68%) were fully completed and returned. Only 63(6.8%) of the respondents voiced prior participation in humanitarian missions, but up to 690 (74.7%) stated they were interested in participating in future humanitarian deployments during their residency that carried over into their professional careers. Countrywide, 896 (97%) favored prior preparation for residents before participating in humanitarian missions, while the need for a specific, formal, professionalization process of the entire humanitarian aid sector was supported by 889 (96.2%). CONCLUSIONS In Italy, the majority of anesthesia/critical care residents, through a formal poll study, affirmed interest in participating in humanitarian assistance missions and believe that further professionalization within the humanitarian aid sector is required. These results have implications for residency training programs worldwide.
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