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Kovačić Petrović Z, Peraica T, Blažev M, Kozarić-Kovačić D. Association between prolonged stress caused by COVID-19 pandemic and earthquakes and quality of life, anxiety, depression, psychoactive substances, and problematic alcohol use in adult Croatian population. Front Psychiatry 2024; 15:1295977. [PMID: 38487575 PMCID: PMC10937337 DOI: 10.3389/fpsyt.2024.1295977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 02/12/2024] [Indexed: 03/17/2024] Open
Abstract
Background The prolonged stress experience caused by the COVID-19 pandemic and two earthquakes led to increased alcohol and psychoactive substance use (PSU) accompanied by a decrease in mental wellbeing and quality of life (QoL) in the Croatian population. Our aim was to determine the relationship between alcohol and PSU and mental health outcomes including anxiety and depression, and QoL. Methods A cross-sectional online survey conducted from September 30 to October 27, 2021, included 1,118 Croatian adults (220 men and 898 women; mean age, 35.1 ± 12.3 years) recruited through non-probabilistic convenience sampling. The survey consisted of a self-reported questionnaire on PSU, the CAGE Alcohol Questionnaire, the Hospital Anxiety Depression Scale, and the World Health Organization Quality of Life (WHOQoL)-BREF. Structural equation modeling was used to evaluate the association between PSU, problematic alcohol use (PAU), mental health outcomes, and QoL. Results The model demonstrated a good fit and indicated that PSU increase, PAU, and anxiety and depression symptoms significantly explained all QoL domains (p < 0.001 for all). Both PSU increase and PAU during prolonged stress were directly associated with decreased QoL. These relationships were also indirectly mediated through increased anxiety and depression symptoms. Conclusion These results showed the need to direct public health interventions and treatment interventions during and after long-term stress (pandemics and earthquakes) to reduce the negative impact on substance use and QoL by reducing depression and anxiety, which ultimately may contribute to better wellbeing and rapid recovery of individuals affected by prolonged stress.
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Affiliation(s)
- Zrnka Kovačić Petrović
- Department of Psychiatry and Psychological Medicine, University of Zagreb School of Medicine, Zagreb, Croatia
- Department of Addiction, University Hospital Vrapče, Zagreb, Croatia
| | - Tina Peraica
- Department of Psychiatry, Referral Center for Stress-related Disorders of the Ministry of Health, University Hospital Dubrava, Zagreb, Croatia
- Department of Forensic Sciences, University of Split, Split, Croatia
| | - Mirta Blažev
- Ivo Pilar Institute of Social Sciences, Zagreb, Croatia
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Kartol A, Üztemur S, Yaşar P. Development and validation of the Earthquake Obsession Scale. DEATH STUDIES 2024:1-9. [PMID: 38372351 DOI: 10.1080/07481187.2024.2317177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Earthquakes are natural disasters that are very destructive and whose timing is unknown. These disasters can have a very negative effect on people's mental health, and their effects can last for many years. This study examined the psychometric properties of a scale to measure earthquake obsession. Data were collected from adults living in different provinces of Türkiye (N = 732), who completed the new scale, Doomscrolling Scale, Death Distress Scale, and Mental Well-Being Scale. The Earthquake Obsession Scale (EOS) had a two-factor structure, good internal consistency reliability, and convergent and discriminant validity. Correlational analysis revealed that earthquake obsession was positively associated with doomscrolling and death anxiety, and negatively associated with well-being. Mediation analysis indicated that doomscrolling and death distress mediated the relationship between earthquake obsession and well-being. The results emphasized the potential of earthquake obsession to affect daily life negatively and revealed its relationship with psychological variables.
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Affiliation(s)
- Aslı Kartol
- Department of Psychological Counseling and Guidance, Nizip Faculty of Education, Gaziantep University, Gaziantep, Türkiye
| | - Servet Üztemur
- Department of Social Studies Education, Faculty of Education, Anadolu University, Eskişehir, Türkiye
| | - Pınar Yaşar
- Department of Psychological Counseling and Guidance, Gaziantep University, Gaziantep, Türkiye
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Kovačić Petrović Z, Peraica T, Blažev M, Tomašić L, Kozarić-Kovačić D. Quality of Life During the First Three Waves of the COVID-19 Pandemic and Two Earthquakes in Croatia. J Nerv Ment Dis 2023; 211:919-926. [PMID: 37094571 DOI: 10.1097/nmd.0000000000001660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
ABSTRACT In a cross-sectional study, we measured the impact of the first three COVID-19 pandemic waves and two earthquakes, occurring during the same period in Croatia, on the quality of life (QoL) of the general adult population. An online survey consisting of sociodemographic questions, questions related to COVID-19 and earthquake stressors, the World Health Organization Quality of Life (WHOQoL)-BREF scale, Impact of Event Scale, and Patient Health Questionnaire 4 was completed by 220 men and 898 women (mean age, 35.1 ± 12.3 years). In a series of regressions, we examined the association among five blocks of predictors and six dependent QoL variables, four domain scores, and two global scores. Both WHOQoL-BREF global and domain scores after the prolonged stress were significantly predicted by anxiety, depression, stress symptoms, and sociodemographic characteristics. COVID-19-related stressors predicted significantly physical and psychological health, social relationships, and environmental QoL, whereas earthquake-related stressors predicted health satisfaction, physical and psychological health, and environmental QoL.
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Affiliation(s)
- Zrnka Kovačić Petrović
- Department of Psychiatry and Psychological Medicine, University of Zagreb School of Medicine, and Department of Addiction, University Psychiatric Hospital, Zagreb
| | | | | | - Lea Tomašić
- University Psychiatric Hospital Vrapče, Zagreb, Croatia
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Adams GG, MacMillan L, Smith T, Sharp A, Casagrande R. Meta-Analysis on the Health Effects Resulting from Evacuation or Relocation. Disaster Med Public Health Prep 2023; 17:e538. [PMID: 37994037 DOI: 10.1017/dmp.2023.55] [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: 11/24/2023]
Abstract
OBJECTIVE Evacuation and relocation are key actions used to protect the public in response to natural or technological disasters, but there are inherent risks to both. Unfortunately, these risks have not been fully quantified, which limits the ability of emergency managers and the public to effectively balance the risks and benefits of evacuation or relocation. This work provides quantitative data on the risks of health effects from displacement following evacuation or relocation. METHODS Researchers performed a literature review and meta-analysis of published studies and quantified risks of 14 different health effects, including both physical and socio-behavioral outcomes, from studies of 9 different disaster types. RESULTS The findings show statistically significant increases in 9 of the 14 health effects in displaced populations, indicating an increased likelihood of experiencing detrimental health effects compared with nondisplaced populations. A pooled analysis of all negative health effects found an odds ratio of 1.49 (95% confidence interval: 1.24-1.79), which shows a significant relationship between displacement and negative health outcomes. CONCLUSIONS These findings demonstrate that evacuated or relocated populations have an increased risk of experiencing negative health effects associated with displacement. The broad number of disaster types included mean that findings are applicable to any emergency evacuation or relocation.
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Affiliation(s)
| | | | - Todd Smith
- US Nuclear Regulatory Commission, Washington, DC, USA
| | - Amy Sharp
- US Nuclear Regulatory Commission, Washington, DC, USA
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Harville EW, Pan K, Beitsch L, Uejio CK, Lichtveld M, Sherchan S, Timuta C. Hurricane Michael and Adverse Social and Mental Health Risk Factors. Matern Child Health J 2023; 27:680-689. [PMID: 36781693 DOI: 10.1007/s10995-023-03596-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES To assess changes in mental health and social risk factors in pregnant women in counties affected by Hurricane Michael (October 2018). METHODS Data from the Universal Perinatal Risk Screen (UPRS) and vital statistics for the state of Florida were obtained. Prenatal risk factors (unplanned pregnancy, mental health services, high stress, use of tobacco or alcohol, young children at home or with special needs, trouble paying bills) were compared in the year before and year after Hurricane Michael in affected counties (n = 18,887). Log-Poisson regression with robust variance was used for binary outcomes, adjusting for maternal age, race, BMI, and education. RESULTS A smaller proportion of pregnant women were screened in the months after the hurricane. No changes were seen in overall scores. The proportion referred was lower in the 1 month after Michael compared to that in 1 month before Michael (RR 0.78, 95% CI = 0.71, 0.86), but greater in the year after (RR = 1.07, 95% CI: 1.04, 1.10). Most individual risk factors on the screener did not change significantly, except having an illness that required ongoing medical care was less common in the short term (3 months after vs. 3 months before: aRR = 0.76, 95% CI: 0.66, 0.87), and more common in the longer term (1 year after vs. 1 year before, aRR = 1.09, 95% CI: 1.02, 1.18). Birth certificate data suggested smoking during pregnancy was higher among women who experienced Michael during their pregnancies (aRR = 1.15, 95% CI: 1.01, 1.32). DISCUSSION Perinatal screening and referral declined in the short-term aftermath of Hurricane Michael.
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Affiliation(s)
- E W Harville
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St. #8318, 70112, New Orleans, LA, USA.
| | - K Pan
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St. #8318, 70112, New Orleans, LA, USA
| | - L Beitsch
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - C K Uejio
- Department of Geography, College of Social Sciences and Public Policy, Florida State University, Tallahassee, FL, USA
| | - M Lichtveld
- Department of Environmental Health Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
- Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - S Sherchan
- Department of Environmental Health Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - C Timuta
- Florida Association of Healthy Start Associations, Tallahassee, FL, USA
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Min YS, Kim SY, Choi SK, Ahn YS. The Effect of Prior Mental Health on Persistent Physical Symptoms after Exposure to a Chemical Disaster. Healthcare (Basel) 2023; 11:healthcare11071004. [PMID: 37046932 PMCID: PMC10094456 DOI: 10.3390/healthcare11071004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023] Open
Abstract
A styrene monomer (SM) oil vapor leak occurred at a chemical plant in Seosan, South Korea on 17 May 2019. A bad odor developed, and many residents complained of various symptoms and visited nearby medical institutions. We analyzed the demographic and clinical characteristics of patients treated at local hospitals and clinics for symptoms related to SM exposure, and identified factors affecting symptom persistence in any organ. Data were collected by the main Seosan office, and 1201 (33.0%) subjects agreed to participate in this study. We used the Assessment of Chemical Exposure toolkit of the Agency for Toxic Substances and Disease Registry. Logistic regression was performed to determine whether mental health symptoms prior to the accident were risk factors for symptom persistence. The strongest risk factor for persistence of at least one symptom in any organ was a preexisting mental health symptom (odds ratio [OR] = 5.47, 95% confidence interval [CI]: 2.57–11.65). Persistent symptoms of the nervous (OR = 1.54), musculoskeletal (OR = 1.92), and gastrointestinal (OR = 1.45) systems were observed. Prior mental health symptoms are risk factors for persistent physical symptoms after a chemical disaster. After a disaster, management of individuals with preaccident mental symptoms or disease is needed.
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Affiliation(s)
- Young-Sun Min
- Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, Cheonan 31151, Republic of Korea;
| | - Soo-Young Kim
- Affiliated Clinic, LG Energy Solution, Cheongju 28122, Republic of Korea
| | - Sun-Kyeong Choi
- Department of Preventive Medicine and Genomic Cohort Institute, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea;
| | - Yeon-Soon Ahn
- Department of Preventive Medicine and Genomic Cohort Institute, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea;
- Correspondence:
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Van Baelen L, Gremeaux L, Antoine J, Bruggeman H, Gisle L, Plettinckx E, De Ridder K. COVID-19 and people who use drugs: Impact of the pandemic on general anxiety and depressive disorders among adults in Belgium. J Affect Disord 2021; 295:946-953. [PMID: 34706467 PMCID: PMC8441094 DOI: 10.1016/j.jad.2021.08.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 07/31/2021] [Accepted: 08/25/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND During previous pandemics people who use drugs (PWUD) were categorized among the most vulnerable. In the current study, firstly, we wanted to evaluate the impact of the COVID-19 crisis on the prevalence of anxiety and depressive disorders among PWUD. Furthermore, we wanted to compare the prevalence of these disorders with that of members from the general population who did not use drugs. METHODS We used a matched cohort design based on two separate repeated cross-sectional online surveys (April and November 2020) among PWUD and the general population. Results of GAD-7 and PHQ-9 were used as outcome variables. We calculated absolute and relative risks for matched pairs for both affective disorders, and logistic regression to compare affective disorders over both waves for PWUD. RESULTS In April, the prevalence of affective disorders was similar for PWUD and the general population. In November, the risks for anxiety disorders increased with 64% for PWUD compared to non-PWUD (RR = 1.64, 95%CI 1.42-1.88), whereas the risks for depressive disorders more than doubled (RR = 2.29, 95%CI 1.97-2.67). Having a job and being male were protective factors for PWUD for both anxiety and depressive disorders. LIMITATIONS As this study used self-reported data, GAD-7 and PHQ-9 give an indication of the presence of anxiety and depression which might differ from a clinician's judgement. CONCLUSIONS PWUD might be disproportionally affected by COVID-19. Health care providers should be attentive to substance use as an indicator for increased risk of mental health problems.
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Affiliation(s)
- Luk Van Baelen
- Department of Epdemiology and public health, Sciensano, Rue Juliette Wytsmanstraat, 14, Brussels 1050, Belgium.
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Dückers MLA, Baliatsas C, Spreeuwenberg P, Verheij RA, Reifels L, Yzermans CJ. Immediate and long-term health impact of exposure to gas-mining induced earthquakes and related environmental stressors. Eur J Public Health 2021; 31:715-721. [PMID: 33496336 PMCID: PMC8514061 DOI: 10.1093/eurpub/ckaa244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Little is known about the public health impact of chronic exposure to physical and social stressors in the human environment. Objective of this study was to investigate the immediate and long-term health effects of living in an environment with gas-mining induced earthquakes and related stressors in the Netherlands. METHODS Data on psychological, somatic and social problems recorded routinely in electronic health records by general practitioners during a 6-year period (2010-2015) were combined with socioeconomic status and seismicity data. To assess immediate health effects of exposure to ML≥1.5 earthquakes, relative risk ratios were calculated for patients in the week of an earthquake and the week afterwards, and compared to the week before the earthquake. To analyse long-term health effects, relative risks of different groups, adjusted for age, sex and socioeconomic status, were computed per year and compared. RESULTS Apart from an increase in suicidality, few immediate health changes were found in an earthquake week or week afterwards. Generally, the prevalence of health problems was higher in the mining province in the first years, but dropped to levels equal to or even below the control group in subsequent years, with lower relative risks observed in more frequently exposed patients. CONCLUSIONS From a public health perspective, the findings are fascinating. Contrary to our expectation, health problems presented in general practice in the earthquake province decreased during the study period. More frequently exposed populations reported fewer health issues to general practitioners, which might point at health adaptation to chronic exposure to stressors.
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Affiliation(s)
- Michel L A Dückers
- Nivel—Netherlands Institute for Health Services Research, Utrecht, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
- Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Christos Baliatsas
- Nivel—Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Peter Spreeuwenberg
- Nivel—Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Robert A Verheij
- Nivel—Netherlands Institute for Health Services Research, Utrecht, The Netherlands
- Tilburg School of Social and Behavioral Sciences (TRANZO), Tilburg University, Tilburg, The Netherlands
| | - Lennart Reifels
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - C Joris Yzermans
- Nivel—Netherlands Institute for Health Services Research, Utrecht, The Netherlands
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Increased alcohol use during the COVID-19 pandemic: The effect of mental health and age in a cross-sectional sample of social media users in the U.S. Prev Med 2021; 145:106422. [PMID: 33422577 PMCID: PMC9063034 DOI: 10.1016/j.ypmed.2021.106422] [Citation(s) in RCA: 97] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 01/03/2021] [Accepted: 01/05/2021] [Indexed: 01/16/2023]
Abstract
The COVID-19 pandemic has triggered a public health crisis of unprecedented scale. Increased alcohol use has been extensively documented during other crises, particularly among persons with anxiety and depression. Despite COVID-19's differential impact by age, the association of age, mental health and alcohol use during the pandemic has not been explored. This study aimed to examine whether age modified the association of anxiety and depressive symptoms with alcohol use during the COVID-19 pandemic. Two online surveys were administered to U.S. adult social media users in March and April 2020. Generalized linear models were conducted in 2020 among 5850 respondents (52.9% female; 22.0% aged 18-39 years, 47.0% aged 40-59 years, and 31.0% aged ≥60 years) to examine if age modified the association of anxiety and depression symptomatology and alcohol use. Overall, 29% of respondents reported increased alcohol use. Adjusted odds ratios of reporting increased alcohol use were 1.41 (95% CI = 1.20-1.66) among respondents with anxiety symptoms and 1.64 (95% CI = 1.21-2.23) among those with depressive symptoms compared to those without such symptoms. Whereas respondents aged 18-39 years had the highest probability of reporting increased alcohol use, the probability of older persons (40-59 and ≥60 years) reporting increased drinking was much greater among those with symptoms of anxiety and depression, compared to those without symptoms. These findings warrant age-differentiated public health messaging on the risks of excessive alcohol use and scale-up of substance use services for middle-aged and older adults with symptoms of depression and anxiety.
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Conrad RC, Hahm H“C, Koire A, Pinder-Amaker S, Liu CH. College student mental health risks during the COVID-19 pandemic: Implications of campus relocation. J Psychiatr Res 2021; 136:117-126. [PMID: 33588225 PMCID: PMC8635290 DOI: 10.1016/j.jpsychires.2021.01.054] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 01/10/2021] [Accepted: 01/29/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE During the COVID-19 pandemic, many universities evacuated their campuses, requiring students to vacate on campus residences. The psychological outcomes of students who relocated during the pandemic remains unknown. We examined mandated relocation experiences related to self-reported worry, grief, loneliness, and depressive, generalized anxiety, and post-traumatic stress disorder (PTSD) symptoms among college students during the COVID-19 pandemic. METHODS We analyzed cross-sectional survey data obtained from April 9 to August 4, 2020 on 791 young adults (ages 18-30 years) who were enrolled at a U.S. university. The CARES 2020 Project (COVID-19 Adult Resilience Experiences Study) is an online survey of young adults' mental health during the COVID-19 pandemic. Recruitment relied on snowball sampling. Participants were asked if they were required to relocate from campus and among those who did, their experiences in moving. COVID-19-related worry and grief, loneliness, and depressive, anxiety, and PTSD symptoms were assessed. RESULTS Approximately one-third of students reported being mandated to relocate. Students mandated to relocate reported more COVID-19-related grief, loneliness, and generalized anxiety symptoms compared to those who did not even after controlling for the severity level of local COVID-19 outbreaks. Students who had to leave behind valuable personal belongings reported more COVID-19-related worries, grief, and depressive, generalized anxiety, and PTSD symptoms. CONCLUSIONS Students who were mandated to relocate reported worse psychological outcomes compared to students who were not mandated to relocate. Our findings have implications for addressing the psychological impact of evacuating college campuses during public health emergencies and other disasters.
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Affiliation(s)
- Rachel C. Conrad
- Department of Psychiatry, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA,Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
| | - Hyeouk “Chris” Hahm
- School of Social Work, Boston University, 264 Bay State Rd, Boston, MA, 02215, USA
| | - Amanda Koire
- Department of Psychiatry, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA,Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
| | - Stephanie Pinder-Amaker
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA,McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA
| | - Cindy H. Liu
- Department of Psychiatry, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA,Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA,Department of Newborn Medicine, 221 Longwood Avenue, Brigham and Women's Hospital, Boston, MA, 02115, USA,Corresponding author. Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
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Yzermans CJ, Baliatsas C, Van der Velden PG, Dückers MLA. The experience of sudden loss of a colleague or neighbor following the MH17 plane crash in the Ukraine: a qualitative interview study. BMC Psychol 2020; 8:16. [PMID: 32046782 PMCID: PMC7014754 DOI: 10.1186/s40359-020-0379-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 01/21/2020] [Indexed: 11/20/2022] Open
Abstract
Background The literature on loss and traumatic grief after disasters provides findings on the impact of losing a partner, child or close friend on partners, parents and friends. However, little attention has been given to the broader everyday social environment of deceased persons. The present study constitutes a qualitative exploration of the impact on colleagues and neighbors following the MH17 airplane disaster in the Ukraine, July 2014. Methods Eighteen structured interviews were conducted with eleven colleagues and seven neighbors. The interviews focused on the relation(−ship) with the victim, on the disaster, the first days and weeks hereafter, and the status one and a half years after the crash. Results Especially for colleagues and neighbors with an intensive, long-lasting relation and ties based on friendship and trust, the impact of the sudden death was large. The MH17 disaster was considered a special event, different from, for instance, an “ordinary” accident. It was actively covered by the media and a recurrent conversation topic in meetings with other people. In the workplace, employers and less involved colleagues show empathy for a limited period of time, but grief has an expiration date – a moment where it gets more difficult to others or influences productivity. The appreciation for rituals in the workplace or in the neighborhood varies. Conclusions The interviews indicate a “hierarchy of bereavement”. People are not part of the typical inner circle, but feel “affected” and experience little social recognition and acknowledgment, particularly in the longer term. As such, colleagues and neighbors may experience loneliness and/or isolation. Generally, there is no need to consult a practitioner, despite the experience of health complaints such as intrusive dreaming and lack of sleep.
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Affiliation(s)
- C Joris Yzermans
- Nivel - Netherlands Institute for Health Services Research, P.O. Box 1568, 3500, BN, Utrecht, The Netherlands
| | - Christos Baliatsas
- Nivel - Netherlands Institute for Health Services Research, P.O. Box 1568, 3500, BN, Utrecht, The Netherlands
| | - Peter G Van der Velden
- CentERdata, and Tilburg University's Network on Health and Behavior (Nethlab), Tilburg, The Netherlands
| | - Michel L A Dückers
- Nivel - Netherlands Institute for Health Services Research, P.O. Box 1568, 3500, BN, Utrecht, The Netherlands. .,ARQ National Psychotrauma Centre, Diemen, The Netherlands.
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van der Velden PG, Muffels RJA, Peijen R, Bosmans MWG. Wages and employment security following a major disaster: A 17-year population-based longitudinal comparative study. PLoS One 2019; 14:e0214208. [PMID: 30925173 PMCID: PMC6440641 DOI: 10.1371/journal.pone.0214208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 03/08/2019] [Indexed: 11/30/2022] Open
Abstract
Objectives The effects of disasters on mental health are well documented, but very little is known about the short to long-term effects of human-made disasters on wage and employment security careers of the affected residents. Methods Residents affected by a major fireworks disaster (May 13, 2000) in a Dutch residential area were all anonymously identified, based on postal codes of the affected area. To gain insight in these effects, data were derived from Statistics Netherlands that records all individual demographic, gross annual wages and employment security data of the entire Dutch population since 1999. A quasi-experimental matched control group design was used by constructing two pair-wise matched groups of non-affected residents of the city of Tilburg and the general Dutch population. Matching was based on nine demographic variables such as gender, age, education level and gross annual wage in 1999 (Ntotal = 12,648). The effects of the disaster on wage and employment security from 1999 to 2016 among the total group and among those with low wages in 1999, were assessed using fixed-effects panel regression analyses. Results Affected residents had significant lower gross annual wages in the medium and long term than the non-affected groups from the Netherlands, but differences were (very) small. Compared to the Tilburg group the significant differences were trivial in the medium term. Among the low-wage groups, no relevant differences were found between affected and non-affected residents. With respect to employment security, no or trivial differences were found between the total group of affected and matched comparison groups. Among those with low wages in 1999, in 2001 and especially 2002 affected residents worked fewer weeks per year than non-affected from Tilburg. In 2002 the difference with the Tilburg group was above moderate. Conclusions These results speak to the resilience of affected residents, given the mental health problems and PTSD-symptomatology they suffered from, as shown in previous research.
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Affiliation(s)
- Peter G. van der Velden
- CentERdata, Tilburg, The Netherlands
- Tilburg University’s Network on Health and Labor (NETHLAB), Tilburg, The Netherlands
- Intervict, Tilburg University, Tilburg, The Netherlands
- * E-mail: ,
| | - Ruud J. A. Muffels
- Tilburg University’s Network on Health and Labor (NETHLAB), Tilburg, The Netherlands
- TRANZO, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Department of Sociology, Tilburg School of Social and Behavioral Sciences, Tilburg University, The Netherlands
| | - Roy Peijen
- Department of Sociology, Tilburg School of Social and Behavioral Sciences, Tilburg University, The Netherlands
- Tilburg Institute of Governance (TIG), Tilburg University, The Netherlands
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Iqbal U, Li YCJ, Tang KP, Chien HC, Yang YT, Hsu YHE. A positive legacy of trauma? A study on the impact of natural disasters on medical utilization. Int J Qual Health Care 2019; 31:64-69. [PMID: 29982715 DOI: 10.1093/intqhc/mzy130] [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: 01/20/2018] [Revised: 03/11/2018] [Accepted: 05/27/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The impact of natural disasters on medical utilization is largely unknown and often overlooked how it affects bereaving and non-bereaving survivors. The aim of this study is to determine the medical utilization between both survivor groups and long-term effects. STUDY DESIGN A 10-year 1999-2009 population-based retrospective study by using the National Health Insurance claim database and the Household Registration database from the Department of Health, Executive Yuan, Taiwan. SETTINGS Taiwan 1999 Chi-Chi earthquake-affected areas. PARTICIPANTS A total of 49 834 individuals which included 1183 bereaving survivors and 48 651 non-bereaving earthquake survivors. INTERVENTION(S) None. MAIN OUTCOME MEASURES Medical utilization of bereaving and non-bereaving survivors. RESULTS The results showed that bereaving survivors had significantly more outpatient visits before the earthquake, within 3-month period and 1 year after earthquake (odds ratio (OR) = 1.11, 1.16 and 1.08). However, after 1 year after earthquake their outpatient visits were not significantly different from non-bereaving, and even significantly less in some years. Inpatient visits of bereaving survivors had similar trend to outpatient visits, i.e. visits were more both before earthquake and within 3-month period after earthquake (OR = 1.59 and 1.89), however, they were not significantly higher than non-bereaving survivors for the following years of the study. CONCLUSION Our study reveals that compared to non-bereaving survivors, bereaving survivors slightly had higher medical utilization in the beginning stage of earthquake, i.e. for the first 3-month period or 1 year after earthquake. However, there were no differences between these two groups in medical utilization including outpatient and inpatient visits in long run.
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Affiliation(s)
- Usman Iqbal
- The Master Program in Global Health and Development of Taipei Medical University, 250 WuHsing St., Taipei, Taiwan.,International Center for Health Information Technology (ICHIT), Taipei Medical University, 250 WuHsing St., Taipei, Taiwan
| | - Yu-Chuan Jack Li
- International Center for Health Information Technology (ICHIT), Taipei Medical University, 250 WuHsing St., Taipei, Taiwan.,Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, 250 WuHsing St., Taipei, Taiwan
| | - Kung-Pei Tang
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, 250 WuHsing St., Taipei, Taiwan
| | - Hui-Chen Chien
- Center for General Education, Taipei Medical University, 250 WuHsing St., Taipei, Taiwan
| | - Ya-Ting Yang
- Center for General Education, Taipei Medical University, 250 WuHsing St., Taipei, Taiwan.,Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Hampton House, 624 N Broadway, Baltimore, MD, USA
| | - Yi-Hsin Elsa Hsu
- Executive Master Program of Business Administration in Biotechnology, College of Management, Taipei Medical University, 250 WuHsing St., Taipei, Taiwan.,School of Health Care Administration, Taipei Medical University, 250 WuHsing St., Taipei, Taiwan
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Jacobs J, Oosterbeek M, Tummers LG, Noordegraaf M, Yzermans CJ, Dückers MLA. The organization of post-disaster psychosocial support in the Netherlands: a meta-synthesis. Eur J Psychotraumatol 2019; 10:1544024. [PMID: 30815232 PMCID: PMC6383614 DOI: 10.1080/20008198.2018.1544024] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 10/11/2018] [Accepted: 10/12/2018] [Indexed: 11/24/2022] Open
Abstract
Background: Despite numerous calls for a more evidence-based provision of post-disaster psychosocial support, systematic analyses of post-disaster service delivery are scarce. Objective: The aim of this review was to evaluate the organization of post-disaster psychosocial support in different disaster settings and to identify determinants. Methods: We conducted a meta-synthesis of scientific literature and evaluations of post-disaster psychosocial support after 12 Dutch disasters and major crises between 1992 and 2014. We applied systematic search and snowballing methods and included 80 evaluations, as well as grey and scientific documents. Results: Many documents focus on the prevalence of mental health problems. Only a few documents primarily assess the organization of post-disaster psychosocial support and its determinants. The material illustrates how, over the course of two decades, the organizational context of post-disaster psychosocial support in the Netherlands has been influenced by changes in legislation, policy frameworks, evidence-based guidelines, and the instalment of formal expertise structures to support national and local governments and public services. Recurring organizational issues in response to events are linked to interrelated evaluation themes such as planning, training, registration, provision of information and social acknowledgement. For each evaluation theme, we identify factors helping or hindering the psychosocial support organization during the preparedness, acute and recovery phases. Conclusions: The meta-synthesis illustrates that psychosocial service delivery has grown from a monodisciplinary to a multidisciplinary field over time. Suboptimal interprofessional collaboration poses a recurring threat to service quality. Despite the development of the knowledge base, post-disaster psychosocial support in the Netherlands lacks a systematic and critical appraisal of its functioning. Further professionalization is coupled with the strengthening of evaluation and learning routines.
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Affiliation(s)
- Jurriaan Jacobs
- Impact - National Knowledge and Advice Centre for Psychosocial Care Concerning Critical Incidents, Arq Psycho Trauma Expert Group, Diemen, The Netherlands.,Utrecht School of Governance, Utrecht University, Utrecht, The Netherlands
| | - Marjolaine Oosterbeek
- Impact - National Knowledge and Advice Centre for Psychosocial Care Concerning Critical Incidents, Arq Psycho Trauma Expert Group, Diemen, The Netherlands
| | - Lars G Tummers
- Utrecht School of Governance, Utrecht University, Utrecht, The Netherlands
| | - Mirko Noordegraaf
- Utrecht School of Governance, Utrecht University, Utrecht, The Netherlands
| | - C Joris Yzermans
- NIVEL - Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Michel L A Dückers
- Impact - National Knowledge and Advice Centre for Psychosocial Care Concerning Critical Incidents, Arq Psycho Trauma Expert Group, Diemen, The Netherlands.,NIVEL - Netherlands Institute for Health Services Research, Utrecht, The Netherlands
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15
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Gorji HA, Jafari H, Heidari M, Seifi B. Cancer Patients During and after Natural and Man-Made Disasters: A Systematic Review. Asian Pac J Cancer Prev 2018; 19:2695-2700. [PMID: 30360593 PMCID: PMC6291047 DOI: 10.22034/apjcp.2018.19.10.2695] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 09/13/2018] [Indexed: 11/27/2022] Open
Abstract
Background: Disasters affect all social functions. In particular, hospitals must mobilize their resources for response to mass injuries. This process can affected treatment of cancer patients and may resulted in delayed care. Considering the importance of continuity of care for cancer patients, the aim of this systematic review was to identify challenges and preparedness measures for cancer patients during and after disasters. Materials and Methods: This systematic review that was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines between January 2000 to December 2017. The keywords searched included: “disaster,” “emergency,” “crisis,” “disruptive event,” “technological disaster,” “natural disaster,” “cancer,” “cancer patient,” “chronic disease,” “continuity of care,” and “patient with chronic disease. “The Google Scholar, ISI Web of Science, Science Direct, PubMed and Scopus databases were searched. Results: After screening and review of article eligibility, seven were included in the study. The selected articles were compared from several aspects. The results showed that most publications concerned all of the chronic diseases or all types of cancers. In addition breast cancer appeared a field of interest in disaster studies. Cancer studies in disaster management usually concentrated less on technological disasters. Conclusion: In aftermath of disasters, the concentration on measures to provide services for injuries and food, water and shelter, results in many challenges for cancer patients. Thus the health system must prepare cancer patients and caregivers for better responses to disasters. In addition, surge capacity must be considered in hospitals and other medical facilities to guarantee continuity of care.
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Affiliation(s)
- Hasan Abolghasem Gorji
- School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
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16
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Kusama T, Aida J, Sugiyama K, Matsuyama Y, Koyama S, Sato Y, Yamamoto T, Igarashi A, Tsuboya T, Osaka K. Does the Type of Temporary Housing Make a Difference in Social Participation and Health for Evacuees of the Great East Japan Earthquake and Tsunami? A Cross-Sectional Study. J Epidemiol 2018; 29:391-398. [PMID: 30344193 PMCID: PMC6737186 DOI: 10.2188/jea.je20180080] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background Although the majority of survivors of the huge Great East Japan Earthquake and Tsunami evacuated to two types of temporary housings, prefabricated housing and rented housing, health effects of these different environments were unclear. We examined whether prevalent social participation in prefabricated housing brought larger health benefits than in rented housing using the largest health survey data of the disaster survivors. Methods This cross-sectional study used a 2012 survey by the Miyagi Prefectural Government, in which almost all of evacuees were targeted (response rate: 61.6%). Self-rated health (SRH) and psychological distress measured via K6 score were the dependent variables, and social participation was the independent variable. Odds ratios of the social participation on health variables were estimated using logistic regression models. To assess the contribution of social participation, the population attributable fraction (PAF) was estimated. Results The participants lived in prefabricated and rented housing numbered 19,726 and 28,270, respectively. Participants in prefabricated housing had poorer SRH and K6 than those in rented housing. The proportions of participants engaging in social participation of prefabricated and rented housing were 38.2% and 15.4%, respectively. The absence of social participation was significantly associated with poor SRH and K6 among participants in both housing types. The PAFs of social participation with good SRH were 39.5% in prefabricated housing and 14.4% in rented housing. For K6, the PAFs were 47.1% and 19.5% in prefabricated and rented housing, respectively. Conclusion Compared to the residents in rented housing, residents in prefabricated housing had more frequent opportunities for social participation, which was associated with larger health benefits.
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Affiliation(s)
- Taro Kusama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry.,Miyagi Prefectural Government Office
| | - Kemmyo Sugiyama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Yusuke Matsuyama
- Department of Global Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU).,Japan Society for the Promotion of Science
| | - Shihoko Koyama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry.,Division of Community Oral Health Science, Department of Community Medical Supports, Tohoku Medical Megabank Organization
| | - Yukihiro Sato
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry.,Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University
| | - Takafumi Yamamoto
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Ayaka Igarashi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Toru Tsuboya
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry.,Disaster Medical Science Division, Disaster Related Oral Health, International Research Institute of Disaster Science
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Trip H, Tabakakis K, Maskill V, Richardson S, Dolan B, Josland H, McKay L, Richardson A, Cowan L, Hickmott B, Houston G. Psychological health and resilience: the impact of significant earthquake events on tertiary level professional students. A cross-sectional study. Contemp Nurse 2018; 54:319-332. [PMID: 30045677 DOI: 10.1080/10376178.2018.1503549] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND The effect of natural disasters internationally is linked to intensity and duration and the impact of these events for tertiary level professional students is not clearly understood. Following a 7.1 magnitude earthquake in New Zealand in 2010 (with aftershocks lasting 27 months) a number of tertiary nursing students experienced significant disruption to their studies. AIM To compare the psychological health, resilience and the impact on learning for three cohorts of students engaged in tertiary nursing education during this time. METHOD A cross-sectional survey design and convenience sampling was used for three cohorts of learners. An online survey was completed (n = 290) and included: Depression Anxiety and Stress Scale; PTSD Checklist; Work and Social Adjustment Scale; Connor-Davidson Resilience Scale. RESULTS Statistically significant differences were found across the psychometric scales with regard to relationship status. Whilst an increase in self-reported physical and mental health issues prior to and following the earthquakes were noted, mitigating factors were also identified. CONCLUSIONS In order to support psychological health amongst nursing students, tertiary education systems need to plan for sustainable learning. The importance of facilitating future orientation within organisations is necessary to develop resilience amongst staff and students, which, in turn, will enable on-going education during significant disaster events.
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Affiliation(s)
- Henrietta Trip
- a Centre for Postgraduate Nursing Studies , University of Otago , P O Box 4345, Christchurch 8140 , New Zealand
| | - Kosta Tabakakis
- b Research and Enterprise , University of Otago , P O Box 4345, Christchurch 8140 , New Zealand
| | - Virginia Maskill
- a Centre for Postgraduate Nursing Studies , University of Otago , P O Box 4345, Christchurch 8140 , New Zealand
| | - Sandra Richardson
- a Centre for Postgraduate Nursing Studies , University of Otago , P O Box 4345, Christchurch 8140 , New Zealand.,c Emergency Department , Canterbury District Health Board (CDHB) , Private Bag 4710, Christchurch 8140 , New Zealand
| | - Brian Dolan
- d Service Improvement, CDHB , Private Bag 4710, Christchurch 8140 , New Zealand.,e Health Service 360 , Oak Tree House, Farnell Drive, Stratford Upon Avon , CV37 9DJ , United Kingdom.,f Oxford Institute of Nursing, Midwifery and Allied Health Research , Oxford Brookes University, & University of Salford , Maxwell Building, 43 Crescent, Salford M5 4WT , United Kingdom
| | - Heather Josland
- g Department of Nursing, Midwifery & Allied Health , Ara Institute of Canterbury , 130 Madras Street, P O Box 540, Christchurch 8140 , New Zealand
| | - Lisa McKay
- g Department of Nursing, Midwifery & Allied Health , Ara Institute of Canterbury , 130 Madras Street, P O Box 540, Christchurch 8140 , New Zealand
| | - Anna Richardson
- g Department of Nursing, Midwifery & Allied Health , Ara Institute of Canterbury , 130 Madras Street, P O Box 540, Christchurch 8140 , New Zealand
| | - Lois Cowan
- g Department of Nursing, Midwifery & Allied Health , Ara Institute of Canterbury , 130 Madras Street, P O Box 540, Christchurch 8140 , New Zealand
| | - Becky Hickmott
- h Workforce Development, CDHB , 32 Oxford Terrace, Christchurch 8140 , New Zealand
| | - Gail Houston
- i Specialist Mental Health Service, Hillmorton Hospital , Private Bag 4733, CDHB, Christchurch 8140 , New Zealand
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18
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Cong Z, Nejat A, Liang D, Pei Y, Javid RJ. Individual relocation decisions after tornadoes: a multi-level analysis. DISASTERS 2018; 42:233-250. [PMID: 28771783 DOI: 10.1111/disa.12241] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study examines how multi-level factors affected individuals' relocation decisions after EF4 and EF5 (Enhanced Fujita Tornado Intensity Scale) tornadoes struck the United States in 2013. A telephone survey was conducted with 536 respondents, including oversampled older adults, one year after these two disaster events. Respondents' addresses were used to associate individual information with block group-level variables recorded by the American Community Survey. Logistic regression revealed that residential damage and homeownership are important predictors of relocation. There was also significant interaction between these two variables, indicating less difference between homeowners and renters at higher damage levels. Homeownership diminished the likelihood of relocation among younger respondents. Random effects logistic regression found that the percentage of homeownership and of higher income households in the community buffered the effect of damage on relocation; the percentage of older adults reduced the likelihood of this group relocating. The findings are assessed from the standpoint of age difference, policy implications, and social capital and vulnerability.
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Affiliation(s)
- Zhen Cong
- PhD is an Associate Professor at the Department of Human Development and Family Studies, Texas Tech University, United States
| | - Ali Nejat
- Assistant Professor at the Department of Civil, Environmental and Construction Engineering, Texas Tech University, United States
| | - Daan Liang
- PhD is a Professor at the Department of Construction Engineering, National Wind Institute, Texas Tech University, United States
| | - Yaolin Pei
- PhD student at the Department of Human Development and Family Studies, Texas Tech University, United States
| | - Roxana J Javid
- Assistant Professor at the Department of Engineering Technology, Savannah State University, United States
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An International Comparison of the Instigation and Design of Health Registers in the Epidemiological Response to Major Environmental Health Incidents. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2018; 23:20-28. [PMID: 27870717 DOI: 10.1097/phh.0000000000000489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Epidemiological preparedness is vital in providing relevant, transparent, and timely intelligence for the management, mitigation, and prevention of public health impacts following major environmental health incidents. A register is a set of records containing systematically collected, standardized data about individual people. Planning for a register of people affected by or exposed to an incident is one of the evolving tools in the public health preparedness and response arsenal. OBJECTIVE We compared and contrasted the instigation and design of health registers in the epidemiological response to major environmental health incidents in England, France, Italy, the Netherlands, and the United States. DESIGN Consultation with experts from the 5 nations, supplemented with a review of gray and peer-reviewed scientific literature to identify examples where registers have been used. SETTING Populations affected by or at risk from major environmental health incidents in England, France, Italy, the Netherlands, and the United States. METHODS Nations were compared with respect to the (1) types of major incidents in their remit for considering a register; (2) arrangements for triggering a register; (3) approaches to design of register; (4) arrangements for register implementation; (5) uses of registers; and (6) examples of follow-up studies. RESULTS Health registers have played a key role in the effective public health response to major environmental incidents, including sudden chemical, biological, radiological, or nuclear, as well as natural, more prolonged incidents. Value has been demonstrated in the early and rapid deployment of health registers, enabling the capture of a representative population. CONCLUSION The decision to establish a health register must ideally be confirmed immediately or soon after the incident using a set of agreed criteria. The establishment of protocols for the instigation, design, and implementation of health registers is recommended as part of preparedness activities. Key stakeholders must be aware of the importance of, and protocols for, establishing a register.Agencies will find value in preparing and implementing registers as part of an effective public health response to major environmental incidents, including sudden chemical, biological, radiological, or nuclear incidents, as well as natural, more prolonged incidents.
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Application of a Theoretical Model Toward Understanding Continued Food Insecurity Post Hurricane Katrina. Disaster Med Public Health Prep 2017; 12:47-56. [PMID: 28758601 DOI: 10.1017/dmp.2017.35] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Disaster recovery efforts focus on restoring basic needs to survivors, such as food, water, and shelter. However, long after the immediate recovery phase is over, some individuals will continue to experience unmet needs. Ongoing food insecurity has been identified as a post-disaster problem. There is a paucity of information regarding the factors that might place an individual at risk for continued food insecurity post disaster. METHODS Using data from a sample (n=737) of households severely impacted by Hurricane Katrina, we estimated the associations between food insecurity and structural, physical and mental health, and psychosocial factors 5 years after Hurricane Katrina. Logistic regression models were fit and odds ratios (OR) and 95% CI estimated. RESULTS Nearly one-quarter of respondents (23%) reported food insecurity 5 years post Katrina. Marital/partner status (OR: 0.7, CI: 0.42, 0.99), self-efficacy (OR: 0.56, CI: 0.37, 0.84), sense of community (OR: 0.7, CI: 0.44, 0.98), and social support (OR: 0.59, CI: 0.39, 0.89) lowered the odds of food insecurity and explained most of the effects of mental health distress on food insecurity. Social support, self-efficacy, and being partnered were protective against food insecurity. CONCLUSIONS Recovery efforts should focus on fostering social-support networks and increased self-efficacy to improve food insecurity post disaster. (Disaster Med Public Health Preparedness. 2018;12:47-56).
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Association between housing type and γ-GTP increase after the Great East Japan Earthquake. Soc Sci Med 2017; 189:76-85. [PMID: 28787629 DOI: 10.1016/j.socscimed.2017.07.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 07/19/2017] [Accepted: 07/22/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND It has been reported that alcohol consumption increases after natural disasters, with an impact on health. However, the impact of relocation upon drinking behavior has been unclear. The aim of this study was to clarify the association between housing type and the impact of alcohol consumption on health after the Great East Japan Earthquake (GEJE) of 2011. METHODS We analyzed 569 residents living in devastated areas of Ishinomaki city, who had undergone assessment of their γ-GTP levels at health check-ups in both 2010 and 2013, and had given details of the type of housing they occupied in 2013. The housing types were categorized into five groups: "same housing as that before the GEJE", "prefabricated temporary housing", "privately rented temporary housing/rental housing", "homes of relatives", and "reconstructed housing". We used fixed-effect regression analysis to examine the association between housing type after the GEJE and changes in γ-GTP after adjustment for age, BMI, housing damage, number of people in household, smoking status, presence of illness, psychological distress, and social network. RESULTS The mean age of the participants was 71.5 years and 46.2% of them were men. The proportion of individuals who drank heavily, and suffered from psychological distress and insomnia, was highest among those living in privately rented temporary housing/rental housing. Compared with individuals who continued to occupy the same housing as those before the GEJE, the effect of change in γ-GTP was significantly higher in individuals who had moved to privately rented temporary housing/rental housing (b = 9.5, SE = 4.4, p < 0.05). CONCLUSION Our present findings reveal that disaster victims who have moved to privately rented temporary housing/rental housing are at highest risk of negative health effects due to alcohol drinking.
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Adhikari RP, Upadhaya N, Paudel S, Pokhrel R, Bhandari N, Cole L, Koirala S. Psychosocial and Mental Health Problems of Older People in Postearthquake Nepal. J Aging Health 2017; 30:945-964. [DOI: 10.1177/0898264317702056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To identify community perceptions on psychosocial and mental health problems of older people in postearthquake situation in Nepal. Method: A qualitative methodology was adopted to explore the experience and opinions of older people, social workers, school teachers, health workers, and nongovernmental organization workers on the psychosocial and mental health problems of older people in Nepal, using key informant interviews. Results: Major local vocabulary for older peoples’ psychosocial and mental health problems were “bichalan” (variation in mood and feeling), “ekohoro” (becoming single minded), “athmabiswasko kami” (low self-esteem), and “bina karan rune” (crying without any reason). The major causes attributed to older people’s problems were physical injury, disability, family conflict, and economic problems. Forgetfulness, tiredness, loss of concentration, restlessness, and isolation were observed in older people since the 2015 earthquake. Discussion: The findings suggest that earthquake had negative impact on older people’s psychosocial well-being; however, little support or treatment options have been made available to these individuals. The tailor-made community-based psychosocial and mental health programs for older people are needed.
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Affiliation(s)
- Ramesh P. Adhikari
- Padma Kanya Multiple Campus, Tribhuvan University, Kathmandu, Nepal
- Transcultural Psychosocial Organization, Kathmandu, Nepal
| | | | | | - Ruja Pokhrel
- Transcultural Psychosocial Organization, Kathmandu, Nepal
| | | | | | - Suraj Koirala
- Transcultural Psychosocial Organization, Kathmandu, Nepal
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Horikoshi N, Iwasa H, Kawakami N, Suzuki Y, Yasumura S. Residence-related factors and psychological distress among evacuees after the Fukushima Daiichi nuclear power plant accident: a cross-sectional study. BMC Psychiatry 2016; 16:420. [PMID: 27881162 PMCID: PMC5121974 DOI: 10.1186/s12888-016-1134-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 11/17/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Relocation following a disaster can impact the psychological well-being of evacuees. This study investigated the associations between residence-related factors and psychological distress among evacuees living in temporary housing after the Fukushima Daiichi Nuclear Power Plant accident. METHODS Data from 525 participants living in temporary housing were collected. Associations between residence-related factors (frequent relocation, dissatisfaction with the residence, and plan to move to permanent housing) and psychological distress were measured. The psychological distress of evacuees was measured using the Japanese version of the 6-item Kessler scale (K6). We used a cut-off score of five to identify cases with psychological distress, the basis of Kessler's 6 items for psychological distress. RESULTS Multivariate logistic regression analysis (n = 418) showed that frequent relocation (OR = 2.05, 95% CI: 1.14-3.66, p = 0.016) and dissatisfaction with the residence (OR = 2.48, 95% CI: 1.60-3.83, p < 0.001) was significantly associated with psychological distress. After stratifying by gender, dissatisfaction with the residence was associated with psychological distress, and a plan to move to permanent housing was significantly associated with psychological distress in women (OR = 1.93, 95% CI: 1.03-3.63, p = 0.041). CONCLUSIONS Frequent relocation and dissatisfaction with the residence were associated with psychological distress among evacuees following the Fukushima nuclear disaster. Evacuees should be provided with comfortable living spaces, and steps should be taken to reduce repeated relocation of evacuees. Thus, particular attention should be paid to women with a plan to move to permanent housing within this context.
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Affiliation(s)
- Naoko Horikoshi
- Department of Public Health, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima, 960-1295, Japan.
| | - Hajime Iwasa
- Department of Public Health, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295 Japan ,Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015 Japan
| | - Norito Kawakami
- Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654 Japan
| | - Yuriko Suzuki
- National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo, 187-8553 Japan
| | - Seiji Yasumura
- Department of Public Health, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295 Japan
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Nakaya N, Nakamura T, Tsuchiya N, Narita A, Tsuji I, Hozawa A, Tomita H. Prospect of future housing and risk of psychological distress at 1 year after an earthquake disaster. Psychiatry Clin Neurosci 2016; 70:182-9. [PMID: 26661684 DOI: 10.1111/pcn.12377] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 10/30/2015] [Accepted: 12/09/2015] [Indexed: 11/30/2022]
Abstract
AIM Since the Great East Japan Earthquake in 2011, many of the affected have been forced to live in temporary housing or at a relative's house. Special attention needs to be paid to the negative health impacts resulting from such changes in living conditions. This study examined the association between future housing prospects and the risk of psychological distress 1 year after the earthquake. METHODS In 2012, a questionnaire was completed by a cross-sectional study of people aged 20 years or older living in Shichigahama Town, Miyagi, northeastern Japan, an area that had been severely inundated by the tsunami. Future housing prospects post-earthquake were classified into four categories: already settled in permanent housing, moving to new housing, under consideration, or unable to make any plans. Psychological distress was evaluated using the Kessler 6 scale, defined as ≥5 points out of 24. We performed multiple logistic regression analyses adjusted for potential confounding factors. RESULTS Of the 3614 individuals studied, subjects whose future housing was under consideration (odds ratio [OR] = 2.1, 95% confidence interval [CI] = 1.6-2.7, P < 0.01) and those who were unable to make any future housing plans (OR = 1.9, 95%CI = 1.4-2.5, P < 0.01) exhibited a significantly higher risk of psychological distress compared with subjects who had already settled in permanent housing. CONCLUSION In this study, subjects whose future housing prospects were under consideration and those who were unable to make any future housing plans were at a higher risk of psychological distress 1 year after the earthquake disaster.
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Affiliation(s)
- Naoki Nakaya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Tomohiro Nakamura
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Naho Tsuchiya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Akira Narita
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Ichiro Tsuji
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Hiroaki Tomita
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
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Airway symptoms and lung function among male workers in an area polluted from an oil tank explosion. J Occup Environ Med 2015; 56:953-8. [PMID: 25153304 DOI: 10.1097/jom.0000000000000201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess whether working in an industrial harbor where an oil tank exploded was associated with more airway symptoms and lower lung function in men 1.5 years later. METHODS In a cross-sectional study of 180 men, 18 to 67 years old, airway symptoms and lung function among men who worked in the industrial harbor at the time of the explosion was compared with those of working men with residence more than 20 km away. Regression analyses are adjusted for smoking, occupational exposure, atopy, recent infection, and age. RESULTS Exposed men had significantly more upper (ORirritated nose = 2.89 [95% confidence interval = 1.31 to 6.37]) and lower (ORdyspnea uphill = 3.79 [95% confidence interval = 1.69 to 8.46]) airway symptoms, and some indication of more reversible airway obstruction than unexposed workers. CONCLUSIONS Men working in an area with an oil tank explosion had more airway symptoms and indication of more airway obstruction 1.5 years after the event.
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Binder SB, Baker CK, Barile JP. Rebuild or Relocate? Resilience and Postdisaster Decision-Making After Hurricane Sandy. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2015; 56:180-96. [PMID: 25903679 DOI: 10.1007/s10464-015-9727-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Hurricane Sandy struck the east coast of the United States on October 29, 2012, devastating communities in its path. In the aftermath, New York implemented a home buyout program designed to facilitate the permanent relocation of residents out of areas considered to be at risk for future hazards. While home buyout programs are becoming popular as policy tools for disaster mitigation, little is known about what factors influence homeowners to participate in or reject these programs. This study used mixed methods to assess the relationship between community resilience and the relocation decision in two heavily damaged communities in which the majority of residents made different decisions regarding whether or not to pursue a buyout. The sample was composed of residents from Oakwood Beach and Rockaway Park, both working-class communities in New York City, who participated via a community survey (N = 133) and/or in-depth interviews (N = 28). Results suggested that community resilience moderated the relationship between community of residence and the buyout decision, leading to opposite responses on the buyout decision. Contextual community factors, including the history of natural disasters, local cultural norms, and sense of place, were instrumental in explaining these different responses. Implications for disaster policy are discussed.
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Affiliation(s)
- Sherri Brokopp Binder
- Department of Psychology, University of Hawai`i at Mānoa, 2530 Dole Street, Sakamaki, C-400, Honolulu, HI, 96822, USA,
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Stratta P, de Cataldo S, Bonanni RL, Rossi A. Community mental health service utilization after the L'Aquila earthquake. Community Ment Health J 2015; 51:504-8. [PMID: 25540028 DOI: 10.1007/s10597-014-9822-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 12/11/2014] [Indexed: 11/29/2022]
Abstract
This study investigated the use of the facilities for the mental health by the population affected by the L'Aquila (Italy) 2009 earthquake. The data about the activities of the Mental Health Centre of L'Aquila during the years from 2008 to 2010 were obtained by the service Information System. In the months following the event the percentage of referrals was reduced. Failure to use specialized facilities after disasters should not be seen as reassuring. It is conceivable that a relevant rate of frank or sub-threshold psychopathology is present that the traditional mental health facilities may not be able to intercept.
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Affiliation(s)
- Paolo Stratta
- National Mental Health Care Service (NMHCS), L'Aquila, Italy,
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Khan Y, Fazli G, Henry B, de Villa E, Tsamis C, Grant M, Schwartz B. The evidence base of primary research in public health emergency preparedness: a scoping review and stakeholder consultation. BMC Public Health 2015; 15:432. [PMID: 25925775 PMCID: PMC4415223 DOI: 10.1186/s12889-015-1750-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 04/16/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Effective public health emergency preparedness and response systems are important in mitigating the impact of all-hazards emergencies on population health. The evidence base for public health emergency preparedness (PHEP) is weak, however, and previous reviews have noted a substantial proportion of anecdotal event reports. To investigate the body of research excluding the anecdotal reports and better understand primary and analytical research for PHEP, a scoping review was conducted with two objectives: first, to develop a thematic map focused on primary research; and second, to use this map to inform and guide an understanding of knowledge gaps relevant to research and practice in PHEP. METHODS A scoping review was conducted based on established methodology. Multiple databases of indexed and grey literature were searched based on concepts of public health, emergency, emergency management/preparedness and evaluation/evidence. Inclusion and exclusion criteria were applied iteratively. Primary research studies that were evidence-based or evaluative in nature were included in the final group of selected studies. Thematic analysis was conducted for this group. Stakeholder consultation was undertaken for the purpose of validating themes and identifying knowledge gaps. To accomplish this, a purposive sample of researchers and practicing professionals in PHEP or closely related fields was asked to complete an online survey and participate in an in-person meeting. Final themes and knowledge gaps were synthesized after stakeholder consultation. RESULTS Database searching yielded 3015 citations and article selection resulted in a final group of 58 articles. A list of ten themes from this group of articles was disseminated to stakeholders with the survey questions. Survey findings resulted in four cross-cutting themes and twelve stand-alone themes. Several key knowledge gaps were identified in the following themes: attitudes and beliefs; collaboration and system integration; communication; quality improvement and performance standards; and resilience. Resilience emerged as both a gap and a cross-cutting theme. Additional cross-cutting themes included equity, gender considerations, and high risk or at-risk populations. CONCLUSIONS In this scoping review of the literature enhanced by stakeholder consultation, key themes and knowledge gaps in the PHEP evidence base were identified which can be used to inform future practice-oriented research in PHEP.
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Affiliation(s)
- Yasmin Khan
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON, M5G 1V2, Canada.
- Division of Emergency Medicine, Department of Medicine, University of Toronto, 2075 Bayview Ave, C753, Toronto, ON, M4N 3M5, Canada.
| | - Ghazal Fazli
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON, M5G 1V2, Canada.
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Bonnie Henry
- British Columbia Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada.
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
| | - Eileen de Villa
- Peel Public Health, 7120 Hurontario Street, P.O Box 667 - RPO Streetsville, Mississauga, ON, L5M 2C2, Canada.
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada.
| | - Charoula Tsamis
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON, M5G 1V2, Canada.
| | - Moira Grant
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON, M5G 1V2, Canada.
| | - Brian Schwartz
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON, M5G 1V2, Canada.
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada.
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Masedu F, Mazza M, Di Giovanni C, Calvarese A, Tiberti S, Sconci V, Valenti M. Facebook, quality of life, and mental health outcomes in post-disaster urban environments: the l'aquila earthquake experience. Front Public Health 2014; 2:286. [PMID: 25566527 PMCID: PMC4273552 DOI: 10.3389/fpubh.2014.00286] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 12/07/2014] [Indexed: 11/15/2022] Open
Abstract
Background: An understudied area of interest in post-disaster public health is individuals’ use of social networks as a potential determinant of quality of life (QOL) and mental health outcomes. A population-based cross-sectional study was carried out to examine whether continual use of online social networking (Facebook) in an adult population following a massive earthquake was correlated with prevalence of depression and post-traumatic stress disorders (PTSD) and QOL outcomes. Methods: Participants were a sample of 890 adults aged 25–54 who had been exposed to the L’Aquila earthquake of 2009. Definition of “user” required a daily connection to the Facebook online social network for more than 1 h per day from at least 2 years. Depression and PTSD were assessed using the Screening Questionnaire for Disaster Mental Health. QOL outcomes were measured using the World Health Organisation Quality of Life BREF (WHOQOL-BREF) instrument. Logistic regression was carried out to calculate the prevalence odds ratios (POR) for social network use and other covariates. Results: Two hundred and twenty one of 423 (52.2%) men, and 195 of 383 (50.9%) women, had been using Facebook as social network for at least 2 years prior to our assessment. Social network use correlated with both depression and PTSD, after adjusting for gender. A halved risk of depression was found in users vs. non-users (POR 0.50 ± 0.16). Similarly, a halved risk of PTSD in users vs. non-users (POR 0.47 ± 0.14) was found. Both men and women using online social networks had significantly higher QOL scores in the psychological and social domains of the WHOQOL-BREF. Conclusion: Social network use among adults 25–54 years old has a positive impact on mental health and QOL outcomes in the years following a disaster. The use of social networks may be an important tool for coping with the mental health outcomes of disruptive natural disasters, helping to maintain, if not improve, QOL in terms of social relationships and psychological distress.
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Affiliation(s)
- Francesco Masedu
- Section of Environmental Medicine and Clinical Epidemiology, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila , L'Aquila , Italy
| | - Monica Mazza
- Section of Neuropsychology, Department of Life, Health and Environmental Sciences, University of L'Aquila , L'Aquila , Italy
| | - Chiara Di Giovanni
- Department of Mental Health, Local Health Agency of the National Health System , L'Aquila , Italy
| | - Anna Calvarese
- Department of Mental Health, Local Health Agency of the National Health System , L'Aquila , Italy
| | - Sergio Tiberti
- Section of Environmental Medicine and Clinical Epidemiology, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila , L'Aquila , Italy
| | - Vittorio Sconci
- Department of Mental Health, Local Health Agency of the National Health System , L'Aquila , Italy
| | - Marco Valenti
- Section of Environmental Medicine and Clinical Epidemiology, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila , L'Aquila , Italy ; Department of Mental Health, Local Health Agency of the National Health System , L'Aquila , Italy
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Tracy M, Morgenstern H, Zivin K, Aiello AE, Galea S. Traumatic event exposure and depression severity over time: results from a prospective cohort study in an urban area. Soc Psychiatry Psychiatr Epidemiol 2014; 49:1769-82. [PMID: 24816599 PMCID: PMC6684030 DOI: 10.1007/s00127-014-0884-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 04/14/2014] [Indexed: 01/30/2023]
Abstract
PURPOSE A substantial proportion of adults experience traumatic events each year, yet little is known about the effects of different types of traumatic events on depression severity over time. We prospectively assessed the effects of traumatic event exposure during a 1-year period on changes in depression severity during that period among a representative sample of adults living in Detroit, Michigan in the United States. METHODS We used data from 1,054 participants in the first two waves of the Detroit Neighborhood Health Study (2008-2010). Depression severity was measured with the Patient Health Questionnaire-9 (PHQ-9). Negative binomial regression was used to estimate the effect of traumatic event exposure on depression severity at Wave 2, adjusting for Wave 1 PHQ-9 score and potential confounders. RESULTS The mean depression severity score at Wave 2 among those exposed to at least one traumatic event during follow-up was 1.71 times higher than among those with no traumatic event exposure [95 % confidence interval (CI) 1.27-2.29]. Also positively associated with depression severity at Wave 2 (vs. no traumatic events) were assaultive violence (mean ratio 2.49, 95 % CI 1.41-4.38), injuries and other directly experienced shocking events (mean ratio 2.59, 95 % CI 1.62-3.82), and three or more traumatic events (mean ratio 2.58, 95 % CI 1.62-4.09). CONCLUSIONS Violence, injuries, and other directly experienced traumatic events increase depression severity and may be useful targets for interventions to alleviate the burden of depression in urban areas.
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Affiliation(s)
- Melissa Tracy
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th St., Room 515, New York, NY, 10032, USA,
| | - Hal Morgenstern
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA,Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA,Department of Urology, School of Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Kara Zivin
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI 48109, USA,Department of Veterans Affairs, Ann Arbor, MI 48113, USA
| | - Allison E. Aiello
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Sandro Galea
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th St., Room 515, New York, NY 10032, USA
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Sato Y, Aida J, Takeuchi K, Ito K, Koyama S, Kakizaki M, Sato M, Osaka K, Tsuji I. Impact of Loss of Removable Dentures on Oral Health after the Great East Japan Earthquake: A Retrospective Cohort Study. J Prosthodont 2014; 24:32-6. [DOI: 10.1111/jopr.12210] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2014] [Indexed: 11/30/2022] Open
Affiliation(s)
- Yukihiro Sato
- Department of International and Community Oral Health; Tohoku University Graduate School of Dentistry; Sendai Japan
| | - Jun Aida
- Department of International and Community Oral Health; Tohoku University Graduate School of Dentistry; Sendai Japan
| | - Kenji Takeuchi
- Department of International and Community Oral Health; Tohoku University Graduate School of Dentistry; Sendai Japan
- Section of Preventive and Public Health Dentistry; Division of Oral Health, Growth and Development; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - Kanade Ito
- Department of International and Community Oral Health; Tohoku University Graduate School of Dentistry; Sendai Japan
| | - Shihoko Koyama
- Department of International and Community Oral Health; Tohoku University Graduate School of Dentistry; Sendai Japan
| | - Masako Kakizaki
- Division of Epidemiology; Department of Public Health and Forensic Medicine; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Mari Sato
- Center for Community Health; Tohoku University Graduate School of Medicine; Sendai Japan
- Department of Women's Health Nursing; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Ken Osaka
- Department of International and Community Oral Health; Tohoku University Graduate School of Dentistry; Sendai Japan
- Tohoku University International Research Institute of Disaster Science; Sendai Japan
| | - Ichiro Tsuji
- Division of Epidemiology; Department of Public Health and Forensic Medicine; Tohoku University Graduate School of Medicine; Sendai Japan
- Center for Community Health; Tohoku University Graduate School of Medicine; Sendai Japan
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Abstract
INTRODUCTION Planned and organized long-term rehabilitation services should be provided to victims of a disaster for social integration, economic self-sufficiency, and psychological health. There are few studies on recovery and rehabilitation issues in disaster situations. This study explores the disaster-related rehabilitation process. METHOD This study was based on qualitative analysis. Participants included 18 individuals (eight male and ten female) with experience providing or receiving disaster health care or services. Participants were selected using purposeful sampling. Data were collected through in-depth and semi-structured interviews. All interviews were transcribed and content analysis was performed based on qualitative content analysis. RESULTS The study explored three main concepts of recovery and rehabilitation after a disaster: 1) needs for health recovery; 2) intent to delegate responsibility; and 3) desire for a wide scope of social support. The participants of this study indicated that to provide comprehensive recovery services, important basic needs should be considered, including the need for physical rehabilitation, social rehabilitation, and livelihood health; the need for continuity of mental health care; and the need for family re-unification services. Providing social activation can help reintegrate affected people into the community. CONCLUSION Effective rehabilitation care for disaster victims requires a clear definition of the rehabilitation process at different levels of the community. Involving a wide set of those most likely to be affected by the process provides a comprehensive, continuous, culturally sensitive, and family-centered plan.
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Ni J, Reinhardt JD, Zhang X, Xiao M, Li L, Jin H, Zeng X, Li J. Dysfunction and post-traumatic stress disorder in fracture victims 50 months after the Sichuan earthquake. PLoS One 2013; 8:e77535. [PMID: 24204861 PMCID: PMC3812228 DOI: 10.1371/journal.pone.0077535] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 09/03/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the effectiveness of a rehabilitation intervention on physical dysfunction (PDF) and post-traumatic stress disorder (PTSD) in fracture victims 50 months after the Sichuan earthquake of 2008 and to identify risk factors for PTSD. METHODS This is a retrospective cohort study. Four hundred and fifty-nine earthquake-related fracture victims from Mianzhu city, Sichuan Province who did not qualify for disability pension participated. Two hundred and forty-five subjects received regular rehabilitation and 214 did not. Muscle strength, joint range of motion (ROM),sensory function, and sit-to-stand balance capacity were evaluated to assess PDF. The PTSD Checklist-Civilian Version (PCL-C) was administered to screen for PTSD. An ordinary least square regression was used to predict PTSD, and a logistic regression was used to predict PDF. In addition a Least Angle Regression (LARS) was carried out for PTSD to study the effects of rehabilitation and PDF at the same time. RESULTS Unadjusted and adjusted group differences in physical dysfunction (p<0.01) and PTSD prevalence (p<0.05) were significant in favor of the rehabilitation group. In addition, being female, average or above family income, having witnessed death and fearfulness were found risk factors for PTSD symptoms 50 months after the earthquake. Both PDF and rehabilitation were selected predictors by LARS demonstrating opposite effects. CONCLUSION PDF and PTSD were significantly reduced by the rehabilitation intervention. Future medical intervention strategies should consider rehabilitation in order to assist survivors in dealing with both physical and psychological effects of natural disaster.
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Affiliation(s)
- Jun Ni
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Rehabilitation Medicine, The Affiliated Hospital of Nantong University, Nantong, China
- Caring For Children Foundation, Hong Kong, China
| | - Jan D. Reinhardt
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu and Hong Kong Polytechnical University, China
- Committee for Rehabilitation Disaster Relief, International Society for Physical and Rehabilitation Medicine, Geneva, Switzerland
- Department of Human Functioning Science, Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Xia Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Caring For Children Foundation, Hong Kong, China
- Committee for Rehabilitation Disaster Relief, International Society for Physical and Rehabilitation Medicine, Geneva, Switzerland
| | - Mingyue Xiao
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Caring For Children Foundation, Hong Kong, China
| | - Ling Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Caring For Children Foundation, Hong Kong, China
| | - Hong Jin
- Mianzhu County People’s Hospital, Sichuan, China
| | - Xianmin Zeng
- Shifang County People’s Hospital, Sichuan, China
| | - Jianan Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Committee for Rehabilitation Disaster Relief, International Society for Physical and Rehabilitation Medicine, Geneva, Switzerland
- * E-mail:
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Homish GG, Frazer BS, McCartan DP, Billittier AJ. Emergency Mental Health: Lessons Learned From Flight 3407. Disaster Med Public Health Prep 2013; 4:326-31. [DOI: 10.1001/dmp.2010.33] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
ABSTRACTEmergency mental health (EMH), a field that is often not well represented when considering emergency preparedness, is nonetheless a vital component to any disaster response. Emergency mental health issues must be considered not only for victims of disasters and their families, friends, and coworkers but also for both on-scene and off-scene responders and members of the community who may have witnessed the disaster. This article describes the EMH preparation for and response to the crash of Continental Airlines flight 3407 in western New York on February 12, 2009, killing all 49 crew and passengers on board and 1 person on the ground. It describes aspects of the response that went as planned and highlights areas for improvement. The lessons learned from this EMH preparation and response can be used to inform future planning for disaster response.(Disaster Med Public Health Preparedness. 2010;4:326-331)
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Post-Tsunami Medical Care: Health Problems Encountered in the International Committee of the Red Cross Hospital in Banda Aceh, Indonesia. Prehosp Disaster Med 2012. [DOI: 10.1017/s1049023x00015806] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractIntroduction:When the Tsunami struck Asia on 26 December 2004, Aceh, Indonesia suffered more damage than did any other region. After the Tsunami, many humanitarian organizations provided aid in Aceh. For example, the International Committee of the Red Cross (ICRC), along with the Indonesian and Norwegian Red Cross opened a field hospital in Banda Aceh on 16 January 2005. This study describes the illnesses seen in the out-patient department/casualty department (OPD/CD) of the ICRC hospital nine weeks after the Tsunami. It describes the percentage of people seen for problems directly related to the Tsunami, and includes a basic screening for depression and post-traumatic stress disorder (PTSD).Methods:A prospective, five-day study was performed from 01–05 March 2005. Patients registering in the ICRC field hospital in Banda Aceh were considered for the study. Data collected included: (1) age; (2) gender; (3) diagnosis in the OPD/CD; and (4) whether or not the problem was related directly to the Tsunami. Seven basic questions were asked to screen for depression and PTSD symptoms.Results:Twelve percent of the problems seen in the OPD/CD nine weeks after the Tsunami still were related directly to the Tsunami. Sixty-three percent of patients in the study were male. The medical problems included: (1) urological (19%); (2) digestive (16%); (3) respiratory (12%); and (4) musculoskeletal (12%). Although <2% of patients were diagnosed with a mental health problem, 24% had at least four or more of the seven depression/PTSD symptoms addressed in the study.Conclusions:Post-earthquake and post-tsunami health problems and medical needs differ from those found in conflict zones. After the Tsunami, both surgical and primary healthcare teams were needed. Many problems were chronic medical problems, which may be indicative of the lack of healthcare infrastructure before the Tsunami. The findings suggest that mental health issues must be taken into consideration for future planning. The ethical issues of performing research in complex emergencies also need further development at the international level.
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McKinney N, Houser C, Meyer-Arendt K. Direct and indirect mortality in Florida during the 2004 hurricane season. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2011; 55:533-46. [PMID: 20924612 DOI: 10.1007/s00484-010-0370-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Revised: 09/14/2010] [Accepted: 09/20/2010] [Indexed: 05/17/2023]
Abstract
Previous studies have shown that natural disasters, and hurricanes in particular, have led to more deaths than those usually documented in short post-storm surveys. Such indirect deaths, thought to be related to dietary, stress or pre-existing medical conditions, can exceed the number of direct deaths and may persist for weeks or even months beyond the event itself. In the present study, cumulative sum of deviations plots are used to quantify the number of direct and indirect deaths resulting from Hurricanes Charley, Frances, Ivan and Jeanne that made landfall in Florida in 2004. Results suggest that there was an elevated mortality for up to 2 months following each storm, resulting in a total of 624 direct and indirect deaths attributable to the storm. Trauma-related deaths that can be associated directly with the storm account for only ∼4% of the total storm-related mortality, while indirect mortality accounts for most storm-related deaths. Specifically, a large percentage of the elevated mortality was associated with heart (34%) and cancer-related deaths (19%), while diabetes (5%) and accident-related deaths (9%) account for a smaller but still significant percentage of the elevated mortality. The results further suggest that the elevated mortality was the result of additional deaths that would not have otherwise occurred within that 5 month period, and not simply a clustering of deaths that were inevitable between 1 August and 31 December 2004. The elevated mortality identified in this study is significantly greater than the official count of 31 direct and 113 indirect deaths resulting from the four hurricanes combined. This suggests a need for improved mortality counts and surveillance in order to better evaluate and identify effective prevention policies, and to identify preventable deaths.
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Affiliation(s)
- Nathan McKinney
- Department of Environmental Studies, University of West Florida, Pensacola, FL 32514, USA
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Nijrolder I, van der Velden PG, Grievink L, Yzermans CJ. Symptom attribution and presentation in general practice after an extreme life event. Fam Pract 2011; 28:260-6. [PMID: 21247957 DOI: 10.1093/fampra/cmq114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A serious life event is likely to shape attributions relating to symptoms experienced afterwards. While they may play an important role in prognosis and seeking care, such perceptions have hardly been studied among survivors of a disaster. OBJECTIVE To investigate the association between self-reported health problems that have been attributed to an extreme life event and the symptoms presented to GPs. METHODS A two-wave longitudinal survey (2-3 weeks and 18 months) among survivors of a fireworks disaster was combined with a continuous morbidity surveillance in general practice. Symptoms attributed to the disaster reported in an open-ended question in the two waves were analysed using descriptive statistics. Differences in presented symptoms over time were analysed using logistic multilevel analysis. RESULTS More than half of the respondents reported health problems, which were, in their opinion, related to the disaster. Psychological problems were most frequently reported in association with the disaster, and in contrast to physical attributed symptoms, presentation of these problems in general practice decreased over time. In the total sample, musculoskeletal symptoms were less frequently presented in the longer term. Survivors who attributed symptoms to the disaster at both waves or after 18 months only most often presented such symptoms to the GP. CONCLUSION Survivors attributed psychological problems and physical symptoms to the disaster at short-term and midterm post-disaster. Most of these survivors presented such symptoms to the GP. Attribution of symptoms to an extreme life event such as a disaster may therefore require special attention from the GP.
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Affiliation(s)
- Iris Nijrolder
- NIVEL-Netherlands Institute for Health Services Research, Utrecht, The Netherlands
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Surveying the Ashes: Experience from the 2007 Peloponnese Wildfires Six Months after the Disaster. Prehosp Disaster Med 2011; 26:79-89. [DOI: 10.1017/s1049023x11000094] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractIntroduction: Major disasters disrupt the infrastructure of communities and have lasting psychological, economic, and environmental effects on the affected areas. The psychological status and community effects of the devastating 2007 wildfires on the Peloponnese Peninsula of Greece were assessed six months following the disaster.Methods:Adult inhabitants, 18–65 years of age, living in villages affected by the wildfires were selected randomly and compared with a demographically similar group living in neighboring villages that were unaffected by the fires. Regions were chosen based on the extent of fire damage in that area. There were 409 participants in the fire group, and 391 in the control group. Participants completed a questionnaire that included the SCL-90-R symptom checklist, a subjective perception of health status, and a series of items assessing views about current problems, personal values, and trust in different institutions.Results:The fire group scored significantly higher on psychological distress compared to the control group. Both groups viewed their health status in the previous year as better than at the present time. There were few significant differences between groups in the designation of regional problems, attitudes, and values. In the total sample, 41.6% listed unemployment, and 15.0% listed poverty as the most important problem in their region. The Church was indicated as the most trusted institution by 36.7% of the group and the Government by 13.3%. A total of 30.2% did not have a trusted institution.Conclusions:The hardiness and resilience of the fire-impacted group was evident. However, an improvement in economic conditions is needed to maintain the health and enhance the quality of life of the population living in the Peloponnese region. This improvement likely would have a positive effect on the attitude of trust in government institutions.
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Abstract
A number of studies have shown a range of symptoms resulting from exposure to natural disasters such as flooding. Among these consequences, individuals may experience symptoms of post-traumatic stress disorder (PTSD), depression and anxiety. The aim of this study was to examine the psychological impact of flooding in the UK. A cross-sectional survey was used to investigate the psychological symptoms associated with the aftermath of the flood amongst adults living in the affected communities. A questionnaire battery including the Harvard Trauma Questionnaire (trauma and symptoms associated with PTSD), Hopkins Symptom Checklist (anxiety and depression), Coping Strategies Questionnaire and a range of questions addressing sociodemographic characteristics and factors relating to the flood was administered to households in flood-affected areas. Four hundred and forty four completed questionnaires were returned. 27.9% of participants met criteria for symptoms associated with PTSD, 24.5% for anxiety and 35.1% for depression. Females had higher mean scores on PTSD, anxiety and depression than males. Most frequently reported coping strategies were rational, detached and avoidant, with the least frequent being emotional coping. Having to vacate home following flood, previous experience of flooding and poor health were associated with greater psychological distress. Detached coping appeared to be related to less distress. Although it is not possible to determine whether the symptoms were a direct consequence of the flood, symptoms of distress are a significant issue amongst communities affected by environmental events warranting further attention to prevent chronic distress.
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Affiliation(s)
- Victoria Mason
- Department of Psychological Sciences, University of Worcester, Henwick Grove, Worcester, UK.
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Korteweg HA, van Bokhoven I, Yzermans CJ, Grievink L. Rapid Health and Needs assessments after disasters: a systematic review. BMC Public Health 2010; 10:295. [PMID: 20515478 PMCID: PMC2889870 DOI: 10.1186/1471-2458-10-295] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Accepted: 06/01/2010] [Indexed: 11/28/2022] Open
Abstract
Background Publichealth care providers, stakeholders and policy makers request a rapid insight into health status and needs of the affected population after disasters. To our knowledge, there is no standardized rapid assessment tool for European countries. The aim of this article is to describe existing tools used internationally and analyze them for the development of a workable rapid assessment. Methods A review was conducted, including original studies concerning a rapid health and/or needs assessment. The studies used were published between 1980 and 2009. The electronic databasesof Medline, Embase, SciSearch and Psychinfo were used. Results Thirty-three studies were included for this review. The majority of the studies was of US origin and in most cases related to natural disasters, especially concerning the weather. In eighteen studies an assessment was conducted using a structured questionnaire, eleven studies used registries and four used both methods. Questionnaires were primarily used to asses the health needs, while data records were used to assess the health status of disaster victims. Conclusions Methods most commonly used were face to face interviews and data extracted from existing registries. Ideally, a rapid assessment tool is needed which does not add to the burden of disaster victims. In this perspective, the use of existing medical registries in combination with a brief questionnaire in the aftermath of disasters is the most promising. Since there is an increasing need for such a tool this approach needs further examination.
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Affiliation(s)
- Helena A Korteweg
- National Institute for Public Health and the Environment, Postbus 1 3720 BA, Bilthoven, The Netherlands
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ten Veen PMH, Morren M, Yzermans CJ. The influence of news events on health after disaster: a longitudinal study in general practice. J Trauma Stress 2009; 22:505-15. [PMID: 19960548 DOI: 10.1002/jts.20462] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This study investigates the influence of local and international news events on utilization of health services resources and health complaints as presented by victims of a fireworks depot disaster. It was hypothesized that victims (N = 2,854) will show more utilization and health complaints to their general practitioner (GP) in the week after 11 local news reports of events relating to the specific index trauma and 6 unrelated disasters reported in international print news, than the week before. Health data of victims and matched controls were extracted from electronic medical records, covering 4-years postdisaster. Especially local news events concerning the cause of the disaster were associated in both victims and controls with an increase of GP utilization and health complaints, including medically unexplained physical symptoms, chronic diseases, and psychological problems. No difference between victims and controls were found.
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Affiliation(s)
- Petra M H ten Veen
- Netherlands Institute for Health Services Research, Utrecht, The Netherlands
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van den Berg B, Yzermans CJ, van der Velden PG, Stellato RK, Brunekreef B, Lebret E, Grievink L. Risk factors for unexplained symptoms after a disaster: a five-year longitudinal study in general practice. PSYCHOSOMATICS 2009; 50:69-77. [PMID: 19213975 DOI: 10.1176/appi.psy.50.1.69] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Medically unexplained symptoms (MUS) are a common reason to seek medical care. When presented to the general practitioner (GP), more than three-quarters of symptoms such as stomach ache, headache, and pain in bones and muscles cannot be explained by a medical disorder. OBJECTIVE The authors examined the course of MUS presented to the GP in the 1 year before the disaster and in the 4 years after a disaster in order to study the risk factors for MUS. METHOD Data were extracted from the electronic medical records of survivors and from a questionnaire (N=1,216). RESULTS Although the mean number of MUS was significantly increased statistically in the first 2 years post-disaster, the increase was not clinically significant. CONCLUSION The authors identified several important risk factors, such as immigrant status and psychological problems, that are easy for GPs to recognize. Despite this, the sensitivity of the regression model was relatively low.
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Affiliation(s)
- Bellis van den Berg
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
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Uscher-Pines L. Health effects of relocation following disaster: a systematic review of the literature. DISASTERS 2009; 33:1-22. [PMID: 18498372 DOI: 10.1111/j.1467-7717.2008.01059.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This paper reviews the literature on the effects of post-disaster relocation on physical and mental heath, and develops a conceptual framework to guide future research. Forty articles were selected for full-text review and incorporation into the conceptual framework. Twenty-four articles were reviewed for results and methodology. These overwhelmingly tracked mental health outcomes. Only four (16 per cent) focused on physical health. Eight of ten showed an association between relocation and psychological morbidity. Certain outcomes (such as mortality, injury and cardiovascular disease risk factors) revealed inconsistent results, but these were rarely studied. Despite the frequency of post-disaster relocation and evidence of its effect on psychological morbidity, there is a relative paucity of studies; the few examples in the literature reveal weak study designs, inconsistent results, and inattention to physical health impacts and the challenges facing vulnerable populations. Further research guided by theory is needed to inform emergency preparedness and recovery policy.
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Affiliation(s)
- Lori Uscher-Pines
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, USA.
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Minimizing the Impact of Complex Emergencies on Nutrition and Geriatric Health: Planning for Prevention is Key. HANDBOOK OF CLINICAL NUTRITION AND AGING 2009. [PMCID: PMC7121257 DOI: 10.1007/978-1-60327-385-5_29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Complex emergencies (CEs) can occur anywhere and are defined as crisis situations that greatly elevate the risk to nutrition and overall health (morbidity and mortality) of older individuals in the affected area. In urban areas with high population densities and heavy reliance on power-driven devices for day-to-day survival, CEs can precipitate a rapid deterioration of basic services that threatens nutritionally and medically vulnerable older adults. The major underlying threats to nutritional status for older adults during CEs are food insecurity, inadequate social support, and lack of access to health services. The most effective strategy for coping with CEs is to have detailed, individualized pre-event preparations. When a CE occurs, the immediate relief efforts focus on establishing access to food, safe water, and essential medical services.
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Kim SC, Plumb R, Gredig QN, Rankin L, Taylor B. Medium-term post-Katrina health sequelae among New Orleans residents: predictors of poor mental and physical health. J Clin Nurs 2008; 17:2335-42. [PMID: 18705709 DOI: 10.1111/j.1365-2702.2008.02317.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To assess the medium-term post-Katrina mental and physical health of New Orleans residents and to determine demographic, social and environmental factors that predict poor mental and physical health. BACKGROUND Major disasters can have a negative impact on the health of survivors for prolonged periods. Although the initial and short-term impacts of Hurricane Katrina have been well described, the medium-term impacts have not been studied as thoroughly. DESIGN Cross-sectional survey. METHODS A convenience sample (n = 222) of residents in Gentilly area of New Orleans completed questionnaires between 16 and 18 December 2006. Multivariate logistic regression and multiple regression models were employed to determine predictors of poor mental and physical health. RESULTS Poor mental health was reported by 52% of the respondents. Pre-Katrina depression [odds ratio (OR) = 19.1], post-Katrina depression (OR = 7.2), poor physical health (OR = 5.6), feeling unsafe from crime (OR = 4.3) and female gender (OR = 2.6) were significant predictor variables of poor mental health. Twenty-four percent of the variance in number of days of poor mental health was explained by the independent variables (R(2) = 0.24; p < 0.001). Poor physical health was reported by 48% of the respondents. Poor mental health (OR = 3.9), lack of money to buy food (OR = 2.7) and pre-Katrina arthritis (OR = 2.6) were significant predictor variables of poor physical health. Twenty-three percent of the variance in number of days of poor physical health was explained by the independent variables (R(2) = 0.23; p < 0.001). CONCLUSIONS Approximately half of the New Orleans residents continue to experience poor mental and physical health 15 months after Katrina. The results support focusing post-Katrina efforts to protect residents from crime, improve mental health services to the depressed and improve food supply to the poor. RELEVANCE TO CLINICAL PRACTICE Identifying predictors of poor mental and physical health may help clinicians and policy makers to focus their efforts in ameliorating the post-disaster health sequelae.
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Affiliation(s)
- Son Chae Kim
- School of Nursing, Point Loma Nazarene University, San Diego, CA 92106, USA.
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Soeteman RJH, Yzermans CJ, Spreeuwenberg P, Lagro-Janssen TALM, van den Bosch WJHM, van der Zee J. Changes in the pattern of service utilisation and health problems of women, men and various age groups following a destructive disaster: a matched cohort study with a pre-disaster assessment. BMC FAMILY PRACTICE 2008; 9:48. [PMID: 18755036 PMCID: PMC2553410 DOI: 10.1186/1471-2296-9-48] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2008] [Accepted: 08/28/2008] [Indexed: 11/10/2022]
Abstract
Objectives Female gender and young age are known risk factors for psychological morbidity after a disaster, but this conclusion is based on studies without a pre-disaster assessment. The aim of this study in family practice was to investigate if these supposed risk factors would still occur in a study design with a pre-disaster measurement. Methods A matched cohort study with pre-disaster (one year) and post-disaster (five years) data. Community controls (N = 3164) were matched with affected residents (N = 3164) on gender, age and socioeconomic status. Main outcome measures were utilization rates measured by family practice attendances and psychological, musculoskeletal and digestive health problems as registered by the family practitioner using the International Classification of Primary Care (ICPC). Results Affected residents of female and male gender and in five age groups all showed increases in utilization rates in the first post-disaster year and in psychological problems when compared to their pre-disaster baseline levels. The increases showed no statistically significant changes, however, between women and men and between all age groups. Conclusion Gender and age did not appear to be disaster-related risk factors in this study in family practice with a pre-disaster base line assessment, a comparison group and using existing registries. Family practitioners should not focus specifically on these risk groups.
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Affiliation(s)
- Rik J H Soeteman
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
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Bongers S, Janssen NAH, Reiss B, Grievink L, Lebret E, Kromhout H. Challenges of exposure assessment for health studies in the aftermath of chemical incidents and disasters. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2008; 18:341-359. [PMID: 18461091 DOI: 10.1038/jes.2008.23] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2007] [Accepted: 03/07/2008] [Indexed: 05/26/2023]
Abstract
Exposure assessment during and after acute chemical incidents and disasters is essential for health studies that may follow. During chemical incidents, the focus usually lies on risk assessment and afterward attention shifts toward possible (long-term) health effects. This may lead to insufficient available data on exposure to study the association between exposure and health outcome, and collection of additional exposure data is often required. Literature on health studies conducted after several chemical incidents was reviewed to obtain better insight on the needs of health studies. Four different types of scenarios were distinguished based on when exposure data were collected and the exposure data used for health studies. These four scenarios gave insight on exposure data needed for conclusive health studies and when different methods of exposure data collection should be used. Literature indicated that adequate and rapid exposure assessment during chemical incidents is vital for health studies, because data that are not collected during or directly after an incident may be irretrievably lost. Poor exposure assessment is not always the only problem in health studies. Problems in health studies including poor exposure assessment may be prevented when the general design and needs of health studies are taken into account when designing contingency plans. Together with measures that will help facilitate funding, design, and coordination of health studies, disaster management programs should, among others, prepare for methods that lead to a swift identification of released substances, determination of concentrations and dispersion of released substances, designing basic questionnaire outlines, and rapid evaluation of the usefulness and necessity of employing biological sampling.
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Affiliation(s)
- Sim Bongers
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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Fassaert T, van Dulmen S, Schellevis F, van der Jagt L, Bensing J. Raising positive expectations helps patients with minor ailments: a cross-sectional study. BMC FAMILY PRACTICE 2008; 9:38. [PMID: 18590520 PMCID: PMC2459169 DOI: 10.1186/1471-2296-9-38] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2007] [Accepted: 06/30/2008] [Indexed: 11/10/2022]
Abstract
BACKGROUND Consultations for minor ailments constitute a large part of the workload of general practitioners (GPs). As medical interventions are not always available, specific communication strategies, such as active listening and positive communication, might help GPs to handle these problems adequately. This study examines to what extent GPs display both strategies during consultations for minor ailments and investigates how each of these relate to the patients' perceived health, consultation frequency and medication adherence. METHODS 524 videotaped consultations between Dutch GPs and patients aged 18 years or older were selected. All patients presented a minor ailment, and none of them suffered from a diagnosed chronic illness. The observation protocol included the validated Active Listening Observation Scale (ALOS-global), as well as three domains of positive communication, i.e. providing reassurance, a clear explanation, and a favourable prognosis. Patients completed several questionnaires before, immediately after, and two weeks after the consultation. These included measures for state anxiety (STAI), functional health status (COOP/WONCA charts) and medication adherence (MAQ). Consultation frequency was available from an ongoing patient registration. Data were analysed using multivariate regression analyses. RESULTS Reassurance was related to patients' better overall health. Providing a favourable prognosis was linked to patients feeling better, but only when accompanied by a clear explanation of the complaints. A clear explanation was also related to patients feeling better and less anxious, except when patients reported a low mood pre-visit. Active listening alone was positively associated with patients feeling worse. Among patients in a good mood state, active listening was associated with less adherence. CONCLUSION To some extent, it seems helpful when GPs are at the same time clear and optimistic about the nature and course of minor ailments. Yet, it does not seem helpful always and in all cases, e.g. when patients feel low upon entering the consulting room. Although communication strategies might to some extent contribute to the management of minor ailments, the results of this observational study also indicate that it is important for a physician to pay attention to the mood of the patient who enters the consulting room.
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Affiliation(s)
- Thijs Fassaert
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.
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van den Berg B, Grievink L, van der Velden PG, Yzermans CJ, Stellato RK, Lebret E, Brunekreef B. Risk factors for physical symptoms after a disaster: a longitudinal study. Psychol Med 2008; 38:499-510. [PMID: 17892620 DOI: 10.1017/s003329170700133x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Although symptoms such as fatigue, headache and pain in bones and muscles are common after disasters, risk factors for these symptoms among disaster survivors have rarely been studied. We examined predisposing, precipitating and perpetuating factors for these physical symptoms among survivors of a man-made disaster. In addition, we examined whether risk factors for physical symptoms differ between survivors and controls. METHOD Survivors completed a questionnaire 3 weeks (n=1567), 18 months and 4 years after the disaster. Symptoms and risk factors were measured using validated questionnaires. A comparison group was included at waves 2 and 3 (n=821). Random coefficient analysis (RCA) was used to study risk factors for symptoms. RESULTS Female gender [beta (beta)=1.0, 95% confidence interval (CI) 0.6-1.4], immigrant status (beta=1.0, 95% CI 0.6-1.4) and pre-disaster psychological problems (beta=0.8, 95% CI 0.1-1.4) were predisposing factors for symptoms. Although disaster-related factors were predictors, the relationship between symptoms and disaster-related factors was not very strong and the magnitude of this association was reduced when perpetuating factors were added. Intrusions and avoidance, depression, anxiety and sleeping problems were important perpetuating factors for physical symptoms among survivors and mediated the association between traumatic stress and physical symptoms. Risk factors for symptoms were comparable between survivors and controls. CONCLUSIONS The results indicate that health-care workers should be alert for physical symptoms among female survivors, immigrant survivors and individuals with a high level of psychological problems both before and after a disaster.
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Affiliation(s)
- B van den Berg
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.
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van der Velden PG, Yzermans CJ, Kleber RJ, Gersons BPR. Correlates of mental health services utilization 18 months and almost 4 years postdisaster among adults with mental health problems. J Trauma Stress 2007; 20:1029-39. [PMID: 18157885 DOI: 10.1002/jts.20273] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The authors assess the correlates of mental health services utilization (MHS) after a disaster among adults with mental health problems. Data of a three-wave longitudinal study among adult survivors of a fireworks disaster (T1: 2-3 weeks, T2: 18 months, T3: almost 4 years postdisaster) were linked with their electronic medical records (N = 649). Multivariate logistic regression analyses showed that triple comorbidity of PTSD and high levels of anxiety and depression symptoms were positively associated with self-reported MHS utilization at T2 (n = 270) and T3 (n = 216). Private insurance, predisaster psychological problems, and relocation were associated with MHS utilization at T2 while female gender, being single, and migrant status was associated with MHS utilization at T3. Receiving treatment at T2 was positively associated with receiving treatment at T3, as opposed to medium optimism at T2.
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