"Out of our control": living through Cyclone Yasi

[Human Caring at Different Stages After Disasters]

Disasters, including natural disasters and man-made ones, occur rather frequently in recent years. Disasters bring destruction to the resources and expectations of local residents and cause varying degrees of physical and mental damage to the victims, some of whom suffered persistent post-traumatic stress disorder (PTSD). Human caring is the essence and core of nursing. Giving consideration to the needs and wishes of patients, the nursing staff respect the personal values of patients, give patients sincere attention and care, satisfy the reasonable needs of patients, protect the dignity of patients, stimulate patients' positive inner drive, alleviate their physical and mental pain, and facilitate the smooth recovery of patients. However, very few studies have been done to look into the human caring at various stages after a disaster hit and there is little relevant guidance available. Herein, we examined the characteristics and needs of victims of disasters in the post-disaster response stage and recovery stage and elaborated on specific and feasible measures for the implementation of human caring after disasters, including prehospital emergency care, which includes on-the-site emergency care and transportation of patients, in-hospital treatment, which includes an environment of human caring and human caring for patients and their families, especially for the special-needs populations, and post-hospital recovery stage, which includes post-hospital continuing and community-based human caring. We intend to provide guidance and reference for the practice of human caring when major disasters occur.

Severe cyclones and sex-specific birth outcomes in Queensland, Australia: An interrupted time-series analysis

OBJECTIVES

A male is less adaptable to biological stressors than a female fetus with consequent higher morbidity and mortality. Adverse birth outcomes increase and male livebirths decrease after environmental disasters, economic crises, and terrorist events. We hypothesized the ratio of male to female livebirths would decrease in areas affected by severe tropical cyclones (TCs) in Queensland, Australia. Additionally, in male livebirths, there would be an increase in preterm and low birthweight births. Lastly, we hypothesized that the pregnancy stage at which exposure occurred would modify the association between TC exposure and observed outcomes.

METHODS

Interrupted time series analysis was used to analyze Queensland administrative birth records from July 2007 to June 2018 for significant changes in the sex ratio at birth, measured as the proportion of male livebirths. Adjusted generalized linear models were fitted to births in areas affected by two category five TCs: cyclones Yasi (February 2011) and Marcia (February 2015). To explore male mortality and morbidity risk, additional analysis was conducted on the proportion of male stillborn, low birthweight, and preterm births. The association between estimated pregnancy stage during the TC and the proportion of male births was also analyzed.

RESULTS

Contrary to our hypothesis, increases in the proportion of male livebirths were observed following early-pregnancy exposure to cyclone Yasi and mid-pregnancy exposure to Marcia, although the latter was not statistically significant. No significant changes were observed in proportions of male stillborn, low birthweight, and preterm births.

CONCLUSIONS

This study found a significant association between severe TCs and sex ratio at birth. The stage of pregnancy at which maternal stressors were experienced modified this association. Among people exposed in early to mid-pregnancy, the proportion of male births was higher. This may be because of differential loss of females in utero. Studying sex differences in birth outcomes provides insight into in utero vulnerabilities associated with environmental stressors. Climate change is increasing the intensity and frequency of natural disasters. Understanding fetal vulnerability to environmental stressors will provide crucial information supporting early life health interventions that mitigate the immediate and long-term effects.

Social network responses to victims of potentially traumatic events: A systematic review using qualitative evidence synthesis

Background

A substantial number of qualitative studies examined how adult victims of potentially traumatic events (PTEs) experienced support provided by family members, friends, colleagues, and other significant others in the informal network. Importantly, the large majority of qualitative studies focused on the perceived support of victims of specific events such as sexual offences, partner violence, homicide, accidents and disasters. Although it is likely that across specific PTEs there are similarities as well as differences in experienced support from the informal network, to date no systematic review synthesized the results of qualitative studies on support from the informal network following various types of PTEs. The aim of the present systematic review is to fill this gap in the scientific knowledge, which is also highly relevant for victim services, policymakers, and the informal network.

Methods

A literature search of qualitative studies was conducted using the electronic databases of PubMed, Web of Science, CINAHL, Psych INFO, Scopus, Criminal Justice Abstracts and Picarta. The quality of the identified studies was assessed with the Consolidated Criteria for Reporting Qualitative research (COREQ) checklist, followed by analysis of the results of the identified studies using Qualitative Evidence Synthesis.

Findings

Seventy-five papers were included in the synthesis, involving 2799 victims of PTEs such as accidents, disasters, homicide, intimate partner violence (IPV), and sexual offences. Saturation was only achieved for IPV. Overall, four major categories of perceived social support were identified, namely, support perceived as supportive, supportive but insufficient, unsupportive, and absent from informal support providers, which included friends, family, neighbors, (if applicable) offender’s family, religious group members, work/school colleagues, fellow victims, the local community, and the social network in general. Across the PTE groups, there were similarities in experiencing positive forms of support (particularly empathy and sharing experiences) as well as negative forms of support (abandonment, avoidance, lack of empathy, and not experiencing support despite victim’s request for help). There were also differences across PTE groups, in particular, victims of sexual and intimate partner violence mentioned a number of other supportive (mobilizing support, no unsupportive responses) and non-supportive (e.g., justification or normalization of violence and minimizing responses) responses.

Conclusions

The review showed that different actors within the social informal network can play an important role in providing support after victims experience violence, homicide, accidents, and disasters. However, the review revealed that the large majority of qualitative studies were aimed at victims of IPV, and only for this type of PTE was saturation achieved. This indicates that, although this synthesis identified several similarities and differences, it is still too early to draw more definitive conclusions on similarities and differences in experienced social support after various PTEs and that future qualitative studies focusing on other PTEs are much needed.

Knowledge and Attitudes Among Hospital Pharmacists About COVID-19

Objectives

Coronavirus (COVID-19) cases and deaths related to the virus have been reported all over the world. Pharmacists play an important role in conveying accurate information about COVID-19 to the community. The aim of this study was to evaluate the knowledge and attitudes among hospital pharmacists about COVID-19.

Materials and Methods

A questionnaire was distributed to pharmacists participating in the 7th National Hospital and Institution Pharmacists Congress. The questions included in this questionnaire were created using the Turkish COVID-19 Scientific Committee guideline (COVID-19 Guideline).

Results

Analysis of 237 questionnaires (72.6% completed by women) showed that the media (television, newspaper), internet (nonscientific resources), internet (scientific resources), and social media were the most popular sources of information (60.3%, 53.6%, 53.2%, and 41.4%, respectively). The participants' age and the source of information that they used had an important influence on their knowledge of and attitudes towards COVID-19 infection. The majority of the participants (72.6%) stated that they were not wearing any kind of mask. Transmission of the disease by airborne route was well known by the participants (91.1%), as well as the main symptoms such as fever (92.4%), cough (84.4%), and dyspnea (60.3%). The participants were aware of the risk groups for COVID-19 infection such as advanced age (84.8%) and having comorbidities (80.2%). Washing hands with soap (92.0%), using hand disinfectants (80.6%), and avoiding contact with sick people (81.9%) were popular answers for protection from the disease, but wearing an N95 mask was also mentioned by 59.1% of the participants. Prevention of the disease by rinsing the nose with saline solution was believed in by 43.9% of the participants.

Conclusion

Classical media and social media affect the attitudes of both the public and health professionals. Using media tools for accurate information is one of the basic conditions for preventing and controlling the spread of the disease.

A scoping review of post-disaster social support investigations conducted after disasters that struck the Australia and Oceania continent

This scoping review provides a summary of research findings on social support dynamics in the wake of disasters that occurred on the continent of Australia and Oceania between 1983 and 2013. Forty-one studies, quantitative and qualitative, were summarised, investigating different facets of post-disaster supportive interactions. All inquiries assessed disasters resulting from natural hazards, with the majority of them conducted following events in Australia and New Zealand. The review revealed similar patterns of post-disaster social support dynamics that routinely unfold after disastrous incidents all over the world. Consistent with the disaster mental health literature, the documentation of social support mobilisation and social support deterioration processes was common. Salutary direct effects of supportive behaviours on post-disaster psychological distress were also highly evident. Most studies, however, posed research questions or hypotheses that lacked empirical or theoretical grounding. In conclusion, the review offers several recommendations on how to advance research on post-disaster social support.

A Systematic Review of Techniques Employed for Determining Mental Health Using Social Media in Psychological Surveillance During Disasters

During disasters, people share their thoughts and emotions on social media and also provide information about the event. Mining the social media messages and updates can be helpful in understanding the emotional state of people during such unforeseen events as they are real-time data. The objective of this review is to explore the feasibility of using social media data for mental health surveillance as well as the techniques used for determining mental health using social media data during disasters. PubMed, PsycINFO, and PsycARTICLES databases were searched from 2009 to November 2018 for primary research studies. After screening and analyzing the records, 18 studies were included in this review. Twitter was the widely researched social media platform for understanding the mental health of people during a disaster. Psychological surveillance was done by identifying the sentiments expressed by people or the emotions they displayed in their social media posts. Classification of sentiments and emotions were done using lexicon-based or machine learning methods. It is not possible to conclude that a particular technique is the best performing one, because the performance of any method depends upon factors such as the disaster size, the volume of data, disaster setting, and the disaster web environment.

Site Selection Models in Natural Disaster Shelters: A Review

Constructing natural disaster shelters is important for disaster emergency management, and site selection models provide a feasible technique and method. This paper presents site selection models for natural disaster shelters. A synthesis of the types, objectives, constraints, methods of solutions, targeted disasters and applications of different site selection models for natural disaster shelters is investigated. Shelter location models can be classified as single-objective models, multiobjective models and hierarchical models, according to the objective and hierarchy type. Minimizing the evacuation distance or time, shelter construction cost or number, and the total risk are the general objectives of the models. Intelligent optimization algorithms are widely used to solve the models, instead of the Geographic Information System (GIS) method, due to the complexity of the problem. The results indicate that the following should be the main focuses of future works: How to set a model that can be applied for determining the shelter locations of multiple disasters; how to consider the uncertainty in the models; how to improve the existing algorithms or models to solve large-scale location-allocation problems; and how to develop a new resource-saving model that is consistent with the concept of sustainable development, as advocated by shelter planners and policy makers, which can be applied in real situations. This study allows those undertaking shelter location research to situate their work within the context of shelter planning.

"We expect seniors to be able to prepare and recover from a cyclone as well as younger members of this community": Emergency Management's Expectations of Older Adults Residing in Aging, Remote Hamlets on Australia's Cyclone-Prone Coastline

OBJECTIVE

To investigate the extent to which older residents feel they can remain "self-reliant" during future natural disasters and to compare the findings with the viewpoints of local policy-makers and with those charged with caring for the elderly both on a day-to-day basis and in times of crisis.

METHODS

This study used an array of non-probability snowballing techniques to seek the participation of senior citizens over the age of 65 years, emergency services officers, community health carers, and local government disaster managers located in aging, remote, coastal Australian communities vulnerable to cyclones and storm surges. All respondents participated in either a face-to-face personal interview or a focus group, with senior citizens also completing a self-administered questionnaire.

RESULTS

This research found a discrepancy between policy expectations and the experiences of both the elderly and those who care for them, as well as a lack of understanding with regard to the term "self-reliant."

CONCLUSIONS

These results highlight the inability of older adults in aging, remote, coastal Australian communities to remain "self-reliant" in the future, impacting both disaster management policies and the future capacity of these communities to remain resilient. (Disaster Med Public Health Preparedness. 2018;12:14-18).

‘The trauma of the cyclone has changed us forever’: self-reliance, vulnerability and resilience among older Australians in cyclone-prone areas

The combination of population ageing and climate change is creating a new threat for many Australian coastal hamlets vulnerable to the impact of tropical cyclones. Increasingly, elderly people are facing future tropical cyclones alone, without support from family and friends, relying instead on already stretched government and authority resources, despite Emergency Management Australia's (EMA) policy expectation that all citizens must be self-reliant. This research explored the future self-reliance and disaster resilience of coastal hamlets through the lens of the Social Cognitive Theory by outlining the findings from focus groups, personal interviews and questionnaires involving participants over 65 years of age, residing in townships previously impacted by Cyclone Larry (in 2006) and Cyclone Yasi (in 2011). Participants recalled a lack of social support following the cyclones, a fear of evacuating their homes, as well as the trauma of recovering from such intense destruction. Respondents were also concerned about the physical, cognitive and financial impacts of ageing on their ability to prepare and recover from future cyclones, frightened that experiences from the past might be repeated in the future, contributing to feelings of isolation, frustration and the loss of community, and a rethinking of ageing in the place of their choice. These considerations impact on the dependence EMA has that all citizens will remain self-reliant when faced with a natural hazard and should be considered when making future policy decisions in relation to more isolated coastal townships.

Scenario-Based Multi-Objective Optimum Allocation Model for Earthquake Emergency Shelters Using a Modified Particle Swarm Optimization Algorithm: A Case Study in Chaoyang District, Beijing, China

The correct location of earthquake emergency shelters and their allocation to residents can effectively reduce the number of casualties by providing safe havens and efficient evacuation routes during the chaotic period of the unfolding disaster. However, diverse and strict constraints and the discrete feasible domain of the required models make the problem of shelter location and allocation more difficult. A number of models have been developed to solve this problem, but there are still large differences between the models and the actual situation because the characteristics of the evacuees and the construction costs of the shelters have been excessively simplified. We report here the development of a multi-objective model for the allocation of residents to earthquake shelters by considering these factors using the Chaoyang district, Beijing, China as a case study. The two objectives of this model were to minimize the total weighted evacuation time from residential areas to a specified shelter and to minimize the total area of all the shelters. The two constraints were the shelter capacity and the service radius. Three scenarios were considered to estimate the number of people who would need to be evacuated. The particle swarm optimization algorithm was first modified by applying the von Neumann structure in former loops and global structure in later loops, and then used to solve this problem. The results show that increasing the shelter area can result in a large decrease in the total weighted evacuation time from scheme 1 to scheme 9 in scenario A, from scheme 1 to scheme 9 in scenario B, from scheme 1 to scheme 19 in scenario C. If the funding were not a limitation, then the final schemes of each scenario are the best solutions, otherwise the earlier schemes are more reasonable. The modified model proved to be useful for the optimization of shelter allocation, and the result can be used as a scientific reference for planning shelters in the Chaoyang district, Beijing.