The impact of earthquakes in Latin America on the continuity of HIV care: A retrospective observational cohort study

Objectives

As earthquakes occur frequently in Latin America and can cause significant disruptions in HIV care, we sought to analyze patterns of HIV care for adults at Latin American clinical sites experiencing a significant earthquake within the past two decades.

Study design

Retrospective clinical cohort study.

Methods

Adults receiving HIV care at sites experiencing at least a "moderate intensity" (Modified Mercalli scale) earthquake in the Caribbean, Central and South America network for HIV epidemiology (CCASAnet) contributed data from 2003 to 2017. Interrupted Time Series models were fit with discontinuities at site-specific earthquake dates (Sept. 16, 2015 in Chile; Apr. 18, 2014 and Sept. 19, 2017 in Mexico; and Aug. 15, 2007 in Peru) to assess clinical visit, CD4 measure, viral load lab, and ART initiation rates 3- and 6-months after versus before earthquakes.

Results

Comparing post-to pre-earthquake periods, there was a sharp drop in median visit (incidence rate ratio [IRR] = 0.79, 95% confidence interval [CI]: 0.68-0.91) and viral load lab (IRR = 0.78, 95% CI: 0.62-0.99) rates per week, using a 3-month window. CD4 measurement rates also decreased (IRR = 0.43; 95% CI: 0.37-0.51), though only using a 6-month window.

Conclusions

Given that earthquakes occur frequently in Latin America, disaster preparedness plans must be more broadly implemented to avoid disruptions in HIV care and attendant poor outcomes.

From Tragedy to Resilience in a University Hospital: Characteristics of Patients in the Aftermath of the 2023 Turkey Earthquake

OBJECTIVE

This study focuses on adults affected by the February 2023 Turkey earthquakes, aiming to uncover demographic and clinical traits.

METHODS

A retrospective analysis of data from adult patients who sought emergency care between February 6 and February 21, 2023, following the earthquakes, was conducted.

RESULTS

Among 3072 patients, 1544 (50.3%) of whom were women, trauma (31.1%) was the most prevalent cause of emergency department presentations. The median age of all patients was 44 y (interquartile range [IQR] 31-61 y). Hatay province accounted for 65.2% of trauma patients as origin. Most of the patients (66.8%) presented to the emergency department by their own means, while this was opposite for trauma patients, of whom 54.5% was transferred by means of Ambulance Service. Half of the total trauma patients were rescued from the debris, and 75.9% sustained limb injuries. Crush syndrome affected 24.7%, and emergency hemodialysis was performed on 9.1%, whereas emergency surgery was performed on 22.8% of all trauma cases. Overall, 10.2% of trauma patients lacked any identification. The rate of emergency department admittions due to respiratory and cardiovascular diseases was higher at the time of the earthquake compared with the previous year (P < 0.001).

CONCLUSIONS

The insights gained from this study hold valuable implications for disaster response strategies, emphasizing the importance of preparedness, timely intervention, and comprehensive patient care.

An enhanced drought forecasting in coastal arid regions using deep learning approach with evaporation index

Coastal arid regions are similar to deserts, where it receives significantly less rainfall, less than 10 cm. Perhaps the world's worst natural disaster, coastal area droughts, can only be detected using reliable monitoring systems. Creating a reliable drought forecast model and figuring out how well various models can analyze drought factors in coastal arid regions are two of the biggest obstacles in this field. Different time-series methods and machine-learning models have traditionally been utilized in forecasting strategies. Deep learning is promising when describing the complex interplay between coastal drought and its contributing variables. Considering the possibility of enhancing our understanding of drought features, applying deep learning approaches has yet to be tried widely. The current investigation employs a deep learning strategy. Coastal Drought indices are commonly used to comprehend the situation better; hence the Standard Precipitation Evaporation Index (SPEI) was used since it incorporates temperatures and precipitation into its computation. An integrated coastal drought monitoring model was presented and validated using convolutional long short-term memory with self-attention (SA-CLSTM). The Climatic Research Unit (CRU) dataset, which spans 1901-2018, was mined for the drought index and predictor data. To learn how LSTM forecasting could enhance drought forecasting, we analyzed the findings regarding numerous drought parameters (drought severity, drought category, or geographic variation). The model's ability to predict drought intensity was assessed using the Coefficient of Determination (R2), the Root Mean Square Error (RMSE), and the Mean Absolute Error (MAE). Both the SPEI 1 and SPEI 3 examples had R2 values more than 0.99 for the model. The range of predicted outcomes for each drought group was analyzed using a multi-class Receiver Operating Characteristic based Area under Curves (ROC-AUC) method. The research showed that the AUC for SPEI 1 was 0.99 and for SPEI 3, 0.99. The study's results indicate progress over machine learning models for one month in advance, accounting for various drought conditions. This work's findings may be used to mitigate drought, and additional improvement can be achieved by testing other models.

Evaluation of the demographic characteristics and general health status of earthquake survivors affected by the 2023 Kahramanmaraş earthquake; a section from Gaziantep Nurdağı district

BACKGROUND

An earthquake with a magnitude of 7.7 occurred in Pazarcık District of Turkey at 04.17 on February 6, 2023 and another earthquake of 7.6 occurred at 13.24 on the same day. This is the second largest earthquake to have occurred in Turkey. The aim of this study is to investigate the earthquake-related level of knowledge, attitudes and behaviours, general health and psychological status of survivors who were affected by the 2023 Kahramanmaraş Earthquake and who were living in Nurdağı District of Gaziantep after the earthquake.

METHODS

Data of 2317 individuals older than 18 years of age who were living in earthquake neighbourhoods, tents and containers in Nurdağı District of Gaziantep were examined. Variables were evaluated to find out the demographic characteristics and general health status of earthquake victims. General Health Questionnaire (GHQ-12) was used to find out psychological states of earthquake victims.

RESULTS

The rate of injuries was 14.2% and leg and foot injuries were the most common with 44.2%. The relationship between injury status; and age, marital status, and being trapped under debris was revealed (p < 0.05). Mean GHQ-12 score of the survivors was 3.81 ± 2.81 and 51.9% experienced psychological distress. In the evaluation with logistic regression, it was found that female gender, being injured in the earthquake, loss of first degree and second degree relatives (with a higher rate in loss of first degree relative), having a severely damaged -to be demolished house and having a completely destroyed house were correlated with higher level of psychological distress (p < 0.05).

CONCLUSION

General characteristics, injury prevalence and affecting factors of earthquake survivors were evaluated in the present study. Psychological distress was found in victims. For this reason, providing protective and assistive services to fight the destructive effects of earthquake is vital. Accordingly, increasing the awareness of people residing in earthquake zones regarding earthquakes is exceptionally important.

Exposure to earthquakes and development of ischemic heart disease

BACKGROUND

The evidence regarding the effect of earthquake exposure on the development of cardiovascular diseases is limited. This study evaluated the association between the 2016 Gyeongju earthquake, which had a magnitude of 5.8, and over 600 subsequent aftershocks occurring within a year in Korea, with the development of ischemic heart disease (IHD) among residents of Gyeongju.

METHODS

Ten years (2010-2019) of medical records from a randomly selected cohort of residents (n = 540,858) in Gyeongju and 3 control cities were acquired from the national health insurance service. Employing difference-in-difference and meta-analyses, the risks of IHD development of Gyeongju residents before (reference: Sep 2014 to Aug 2015; period 1: Sep 2015 to Aug 2016) and after (period 2: Sep 2016 to Aug 2017; period 3: Sep 2017 to Aug 2018; period 4: Sep 2018 to Aug 2019) the earthquake were estimated.

RESULTS

The monthly average incidence of IHD in Gyeongju was 39.5 persons (per 1,000,000) for reference period and 38.4 persons for period 1. However, the number increased to 58.5 persons in period 2, and 49.8 persons in period 3, following the earthquake. The relative risk (RR) [with a 95% confidence interval] of developing IHD among Gyeongju residents increased by 1.58 times (1.43, 1.73) in period 2, 1.33 times (1.21, 1.46) in period 3, and 1.15 times (1.04, 1.27) in period 4, in comparison to both the control cities and the pre-earthquake reference period. The increase in RR was particularly noticeable among women, adults aged 25-44, and individuals with lower incomes.

CONCLUSIONS

The major earthquake in Korea was associated with an increase in the development of IHD among local residents. Individuals exposed to earthquakes may benefit from cardiovascular health surveillance.

Impact of extreme weather events on mental health in South and Southeast Asia: A two decades of systematic review of observational studies

Extreme weather events in South and Southeast Asia exert profound psychosocial impacts, amplifying the prevalence of mental illness. Despite their substantial consequences, there is a dearth of research and representation in the current literature. We conducted a systematic review of observational studies published between January 1, 2000, and January 20, 2024, to examine the impact of extreme weather events on the mental health of the South and Southeast Asian population. Quality assessment of the included studies was conducted using the Newcastle-Ottawa Scale (NOS) quality appraisal checklist. The search retrieved 70 studies that met the inclusion criteria and were included in our review. Most were from India (n = 22), and most used a cross-sectional study design (n = 55). Poor mental health outcomes were associated with six types of extreme weather events: floods, storm surges, typhoons, cyclones, extreme heat, and riverbank erosion. Most studies (n = 41) reported short-term outcome measurements. Findings included outcomes with predictable symptomatology, including post-traumatic stress disorder, depression, anxiety, general psychological distress, emotional distress and suicide. Limited studies on long-term effects showed higher mental disorders after floods and typhoons, while cyclone-exposed individuals had more short-term distress. Notably, the review identified over 50 risk factors influencing mental health outcomes, categorized into six classes: demographic, economic, health, disaster exposure, psychological, and community factors. However, the quantitative evidence linking extreme weather events to mental health was limited due to a lack of longitudinal data, lack of control groups, and the absence of objective exposure measurements. The review found some compelling evidence linking extreme weather events to adverse mental health in the South and Southeast Asia region. Future research should focus on longitudinal study design to identify the specific stressors and climatic factors influencing the relationship between climate extremes and mental health in this region.

Meta-analyses of motivational factors of response to natural disaster

Response behavior of individuals is of critical importance to decrease chances of injury and death as well as ameliorate costs in property and infrastructure damage in natural disasters. Plenty of studies have examined which factors motivate individuals to respond to natural disasters. However, a systematic overview of the key motivating factors of various response behaviors is lacking. This study conducts a series of meta-analyses using data of 53,713 samples from 87 studies (77 papers) conducted in 27 different countries and regions to examine how 17 motivational factors were associated with individuals' response to natural disasters. The results indicate self-efficacy, outcome efficacy, attitudes, subjective norms, and information acquisition show the strongest effects on response behavior. Contrarily, the impact of negative affects like fear, depression, and anxiety on victims is minimal, despite the common assumption that they are significant related to response behaviour. In addition, current studies have disproportionally focused on studying risk perception, experience and information acquisition, earthquake and hurricane, and evacuation and preparation, while attention given to other types of motivational factors, disasters and response behaviors is lacking.

The impact of the 2021 flood on the outpatient care in the North Rhine region, Germany: a cross-sectional study

BACKGROUND

In the summer of 2021, heavy precipitation led to extreme flooding across Western Europe. In Germany, North Rhine-Westphalia and Rhineland-Palatinate were particularly affected. More than 180 people lost their lives, and over 700 were left injured and traumatized. In the North Rhine district alone, more than 120 practices were only able to operate to a limited extent or had to close their practices completely. The aim of this study was to assess the impact of the 2021 flood on the outpatient care in the North Rhine region.

METHODS

The cross-sectional study was conducted in January 2022 in practices affected by the flood in the North Rhine region. For this purpose, 210 affected practices were identified using a list of the Association of Statutory Health Insurance Physicians for North Rhine (KVNO) and via telephone and/or e-mail. These practices were forwarded a questionnaire that addressed, among other things, the local accessibility of the practices before and after the flood, possibilities of patient care in different premises and received support.

RESULTS

A total of 103 practices (49.1%) returned the completed questionnaire, of which 1/4 were general practitioners. 97% of the practices reported power failure, more than 50% water supply damage and nearly 40% the loss of patient records. 76% of the participating practices stated that they needed to close their practice at least temporarily. 30 doctors took up patient care in alternative premises. The average number of patients seen by doctors per week before the flood was 206.5. In the first week working in alternative premises, doctors saw an average of 66.2 patients (-50.3%). Especially elderly/geriatric patients and patients with disabilities were identified as particularly vulnerable in terms of access to health care after the flood.

CONCLUSIONS

The flood had a significant negative impact on outpatient care. We determined not only a high number of closed practices and a large decrease in patient numbers but also differences in patient care assessment depending on the type of alternative premises. To address outpatient care disruptions after extreme weather events more effectively, appropriate measures should be implemented pre-emptively.

Crisis-related stimuli do not increase the emotional attentional blink in a general university student population

Crises such as natural disasters or pandemics negatively impact the mental health of the affected community, increasing rates of depression, anxiety, or stress. It has been proposed that this stems in part from crisis-related stimuli triggering negative reactions that interrupt daily life. Given the frequency and prominence of crisis events, it is crucial to understand when crisis-related stimuli involuntarily capture attention and trigger increased stress and distraction from obligations. The emotional attentional blink (EAB) paradigm-in which emotional distractors hinder report of subsequent targets in streams of rapidly displayed stimuli-allows examination of such attentional capture in a rapidly changing dynamic environment. EABs are typically observed with generally disturbing stimuli, but stimuli related to personal traumas yield similar or greater effects, indicating strong attentional capture by stimuli related to individual trauma history. The current study investigated whether a similar comparable or increased crisis-related EAB exists within a community affected by large-scale crisis. Specifically, effects of conventional emotional distractors and distractors related to recent crises were compared using EABs in university students without a mental health diagnosis. Experiment 1 used images related to Hurricane Harvey, evaluating a crisis 4 years prior to data collection. Experiment 2 used words related to the COVID pandemic, evaluating an ongoing crisis at the time of data collection. In both experiments, the conventional EAB distractors yielded strong EABs, while the crisis-related distractors yielded absent or weak EABs in the same participants. This suggests that crisis-related stimuli do not have special potency for capturing attention in the general university student population. More generally, crises affecting communities do not necessarily yield widespread, strong reactivity to crisis-related stimuli.

Critical healthcare for older adults post Hurricane Ian in Florida, United States

We highlight critical public healthcare inadequacies for older adult populations resulting in fatalities after Hurricane Ian. We summarize whether a fatality was a result of the storm directly, indirectly, or not at all. Massive destruction from Ian eliminated critical life-sustaining health care for the week following the hurricane. This disproportionately affected the older adult population, with most elder deaths attributed to a lack of some form of health care. To prevent further unnecessary deaths following a disaster event, we recommend that public health policy practitioners, medical practitioners, and state officials consider how to provide managed opt-in emergency care services, mobile elderly care until restoration of power and services, and revisions to community-based critical care provider building codes to include generators and fuel. We offer this viewpoint to generate discussion among public health and emergency planners.

Sleep Disturbances and Delayed Sleep Timing are Associated with Greater Post-Traumatic Stress Symptoms in Youth Following Hurricane Harvey

Sleep patterns following a natural disaster are associated with mental health difficulties, but research in youth samples has been limited to subjective reports of sleep. Participants (N = 68, 8-17 years old) completed an assessment 6-9 months after Hurricane Harvey, which included subjective measures of sleep, chronotype, hurricane-related post-traumatic stress symptoms, and one week of actigraphy. Prior to the hurricane, parents provided reports on emotional symptoms. Controlling for age, sex, socioeconomic status, participation time, and pre-hurricane emotional symptoms, subjective sleep disturbances and an eveningness chronotype were associated with greater post-traumatic stress, with the strongest effects observed for re-experiencing, negative cognitions/mood, and arousal/reactivity symptoms. Later sleep timing as measured by actigraphy was associated with greater arousal/reactivity symptoms and shorter sleep duration was associated with greater avoidance symptoms. As extreme weather-related events are expected to become more frequent and severe, these findings contribute to models of youth risk and resilience.

Modeling the power system resilience in China under different natural disasters

A good understanding of the power system resilience is necessary for optimizing the investment strategies and supporting the emergency rescue, but the existing quantitative estimation results based on real outage events are still lacked due to the data limitations. Therefore, this study first establishes a unified framework to measure the power system resilience under different natural disasters, by integrating the electricity performance curve with the dynamic inoperability input-output model. Then, a database of 285 Chinese historical big power outage events caused by natural disasters is established, and the city-level power system resilience values are estimated. Finally, a benefit analysis is conducted for improving the power system resilience. Our major findings are that: (1) Electricity system recoveries quickest from hail (23.05 h), while restores slowest from snowstorm (117.31 h). (2) China's city electricity system is the most resilient to the thunderstorm, while is the least resilient to the earthquake. (3) Enhancing the power system resilience will significantly reduce the requirements for rescue resources, and the saved emergency rescue cost ranges from 0.57 million yuan to 12.08 million yuan with 1% reduction of initial inoperability.

Challenges and perspectives in applying the environmental sensitivity index to pipelines: a review on the prevention and management of oil spills disasters

The oil spill environmental sensitivity index is a key tool for preventing and dealing with environmental disasters caused by oil spills. This study aims to review the available literature on the subject and highlight the importance of methodological advances to improve how the index is applied in continental areas, especially in regions crossed by pipelines. Most current mapping techniques focus on coastal areas and fail to consider the stretches of land that are vulnerable to geodynamic natural disasters. In this context, the need to implement environmental sensitivity indices specific for pipelines has become urgent. This study also presents an overview of the main accidents around the world and a detailed analysis of the history of Brazilian disasters related to oil spills along continental stretches, with a focus on pipelines and natural disasters. In addition, this work highlights the importance of carrying out new research in mountainous areas of Brazil and is aimed at preventing Natechs (natural hazard triggering technological disasters) and improving contingency plans. As a result, several pathways have been identified, which involves the necessity of resolving gaps in terrestrial environmental sensitivity mapping methodologies, particularly as applied to pipelines. Furthermore, solutions must be capable of integrating terrestrial, fluvial, coastal, and maritime environmental sensitivity mapping techniques. Moreover, the need to implement dynamic risk monitoring systems in real time is critical to help manage such a complex problem.

Components of Health Surveillance System in Natural Disasters that Affect Military Health Services: A Systematic Review

Background

Military health surveillance system, as the first responder in natural disasters, plays an important role in public health. This study aimed to identify those components of the health surveillance system, which influence military health services in natural disasters.

Methods

Five databases of Medline, SCOPUS, Web of Science, ProQuest, Cochrane Library, and search engines of Scholar Google, scienceopen.com, openGery.eu, and WHO.int were reviewed from Jan 1990 to Jan 2022. Due to the heterogeneity of the included studies, various JBI quality assessment tools were applied and the extracted data were analyzed by meta-synthesis method.

Results

Out of 6538 retrieved studies, after the duplicates and irrelevant studies identified in screening stage were removed, 174 studies extracted from the electronic search of databases and 16 studies retrieved from the manual search of other sources were reviewed based on the study inclusion criteria. Finally, 24 studies with inclusion criteria were selected for data extraction. Ten criteria of monitoring, detecting, data collection and reporting, tracking, type of surveillance system, operational readiness, coordination and interaction, feasibility, flexibility, and acceptability were identified as effective components in the surveillance system of military health services. The identified components were classified into two main categories of structural and operational components.

Conclusion

The structural components of the military health surveillance system describe the important infrastructural features of the health surveillance system to preparing for natural disasters; and the operational components explains the effective functional features of military health surveillance system in response of natural disasters. The results of this study help policymakers in military health services implement a more effective health surveillance system in natural disasters.

The specter of cholera in Libya and North Africa: Natural disasters and anthropization threaten human health during recent years

Introduction

According to data from the World Health Organization (WHO), in the last year cholera has re-emerged in various areas of the planet, particularly in Africa. The resurgence of this disease is closely linked to poor hygiene, which is sometimes the result of wars or environmental disasters, as in Lebanon and Syria since autumn 2022 and today in Libya.

Discussion

The spread of cholera is chiefly caused by the presence of contaminated water, in environments with inadequate hygiene and sanitation. Another cause, however, is the lack of access to adequate vaccination and treatment campaigns.

Method

In this short paper, the authors highlight the possibility of a resurgence of epidemic cholera in Libya, especially in light of the consequences of the devastating cyclone Daniel and the simultaneous collapse of two dams upstream of the city of Derna. They also highlight the concern that cholera and other infectious diseases may also spread in Morocco, which was hit by a severe earthquake on 8 September last. The focus of the paper is the awareness that the spread of epidemic diseases is very often linked to human actions, which may trigger or exacerbate the effects of natural disasters.

Conclusions

Since these events have devastating effects both on the environment and on people and their psychophysical balance, it is evident that we need to devote greater attention to the health of the planet, to which the health and survival of the human species is strictly and inextricably linked. Indeed, disasters related to phenomena of anthropization facilitate the spread of infectious diseases, placing a heavy burden on local and global health organizations and the health of entire populations. A change of course is therefore essential, in that human actions must be aimed at limiting rather than aggravating the spread of diseases.

Gender Disparities in First Authorship at Three Medical Universities in an Area Affected by the Great East Japan Earthquake

The Great East Japan Earthquake that occurred on March 11, 2011, was one of the largest natural disasters in modern times. Publication in medical journals is important aspects of the academic promotion process, and is thus important for all scientists. However, little is known about whether and how substantial natural disasters affect gender disparities in academic productivity in disaster-affected areas. We hypothesized that the Great East Japan Earthquake widened the existing disparities in scientific publishing between male and female researchers. To test this hypothesis, this retrospective observational study using existing databases was conducted. We extracted from the MEDLINE database all types of biomedical articles published from March 11, 2007, to March 11, 2015, by three medical universities in a disaster-affected area of Japan. Differences in the proportion of female first authorship during the 4 years before and after the Great East Japan Earthquake were compared. A total of 5,873 papers were analyzed. The proportion of female first authors significantly declined after the Great East Japan Earthquake (20.5% vs. 14.1%; odds ratio 0.64; 95% confidence interval 0.56-0.73). A similar trend was identified across all prespecified subgroups, including clinical department; original article; public medical university; and prestigious journal with impact factor >6. Reference data from two medical universities minimally affected by the Great East Japan Earthquake showed the opposite trend. These results collectively suggest that large natural disasters can reinforce existing gender disparities in first authorship in biomedicine.

Does age matter in genetics? The role of ADCYAP1R1 in sex-specific risk for posttraumatic stress disorder in trauma-exposed preadolescent children

Following trauma exposure, children are a vulnerable population and at risk for developing posttraumatic stress disorder (PTSD). A large body of research has demonstrated the impactful role of genetics in vulnerability for PTSD in adult samples; yet very little research has examined genetic risk for PTSD in children. It is unknown whether genetic associations identified in adults are true for children; replication of findings from adult samples is needed in child samples. This study investigated an estrogen-responsive variant (ADCYAP1R1) that has been well-established to confer sex-specific risk for PTSD in adult samples, but is hypothesized to function differently in children, potentially due to pubertal changes in the estrogen system. Participants were children (n = 87; 57% female) ages 7 to 11 exposed to a natural disaster. Participants were assessed for trauma exposure and symptoms of PTSD. Participants provided a saliva sample, which was genotyped for the ADCYAP1R1 rs2267735 variant. In girls, the ADCYAP1R1 CC genotype was associated with PTSD (OR = 7.30). In boys, evidence for the opposite effect emerged, with the CC genotype attenuating risk for PTSD (OR = 8.25). When investigating specific PTSD symptom clusters, an association between ADCYAP1R1 and arousal emerged. This study is the first to investigate the relationship between ADCYAP1R1 and PTSD in trauma-exposed children. Findings for girls mirrored prior research on adult women, whereas findings for boys diverged from prior research on adult men. These potential differences between children and adults in genetic vulnerability for PTSD underscore the need for more genetic studies in child samples.

Unique challenges posed by fire disturbance to water supply management and transfer agreements in a headwaters region

As a headwaters region, Colorado is a critical source of water for surrounding states and Mexico. But fuel densification and shifts in hydrometeorological processes, such as climate aridification and precipitation sharpening, are causing increasingly severe and erratic wildfire behavior and post-disturbance geomorphic hazards in and downstream of its forested source water areas. Human development patterns and inter and intra-state water rights agreements further complicate resource management. This is prompting land managers to consider progressive planning and management tools to mitigate fire-related degradation of water supply and irrigation systems. This narrative review examines aspects of Colorado's geography, demography, and hydrology that make its water supply systems and transfer agreements particularly vulnerable to landscape disturbance and then provides hazard mitigation recommendations. Readers are introduced to Colorado's water supply portfolio including how water is moved, stored, treated, and consumed; why those systems are vulnerable to wildfire disturbance; and how risk can be reduced before and after fires occur. Lessons learned are applicable to other source water areas facing similar challenges. By synthesizing our review findings, we identified numerous research and programmatic gaps including the need for more interdisciplinary studies; a lack of explicit research into how disturbance-driven hydromodification may hinder the ability of headwater regions to exercise their water rights and fulfill water transfer agreements (crucial for reducing potential future water conflict); an unresolved debate regarding the potential effects of forest treatments on water yield; and the need for additional funding to roll out tools and educational programs to communities experiencing severe wildfire activity for the first time.

Social group connections support mental health following wildfire

PURPOSE

As environmental disasters become more common and severe due to climate change, there is a growing need for strategies to bolster recovery that are proactive, cost-effective, and which mobilise community resources.

AIMS

We propose that building social group connections is a particularly promising strategy for supporting mental health in communities affected by environmental disasters.

METHODS

We tested the social identity model of identity change in a disaster context among 627 people substantially affected by the 2019-2020 Australian fires.

RESULTS

We found high levels of post-traumatic stress, strongly related to severity of disaster exposure, but also evidence of psychological resilience. Distress and resilience were weakly positively correlated. Having stronger social group connections pre-disaster was associated with less distress and more resilience 12-18 months after the disaster, via three pathways: greater social identification with the disaster-affected community, greater continuity of social group ties, and greater formation of new social group ties. New group ties were a mixed blessing, positively predicting both resilience and distress.

CONCLUSIONS

We conclude that investment in social resources is key to supporting mental health outcomes, not just reactively in the aftermath of disasters, but also proactively in communities most at risk.

Risk perception of compound emergencies: A household survey on flood evacuation and sheltering behavior during the COVID-19 pandemic

Compound hazards are derived from independent disasters that occur simultaneously. Since the outbreak of COVID-19, the coupling of low-probability high-impact climate events has introduced a novel form of conflicting stressors that inhibits the operation of traditional logistics developed for single-hazard emergencies. The competing goals of hindering virus contagion and expediting massive evacuation have posed unique challenges for community safety. Yet, how a community perceives associated risks has been debated. This research utilized a web-based survey to explore the relationship between residents' perceptions of conflicting risks and emergency choices made during a historic compound event, the flooding in 2020 in Michigan, US that coincided with the pandemic. After the event, postal mail was randomly sent to 5,000 households living in the flooded area, collecting 556 responses. We developed two choice models for predicting survivors' evacuation options and sheltering length. The impact of sociodemographic factors on perceptions of COVID-19 risks was also examined. The results revealed greater levels of concern among females, democrats, and the economically inactive population. The relationship between evacuation choice and concern about virus exposure was dependent upon the number of seniors in the household. Concern about a lack of mask enforcement particularly discouraged evacuees from extended sheltering.

Meal plans for meeting the reference values using food items available in shelters

BACKGROUND

We have suggested "Revised Nutritional Reference Values for Feeding at Evacuation Shelters" (Revised RV) as a daily nutritional recommendation for meals served at evacuation shelters where poor diets had been reported. Since there are no meal examples to satisfy the Revised RV, our objectives were, for the future meal provision, to develop nutritionally adequate meal plans using the foods served at shelters in the past and to examine if the Revised RV could be met by changing combination of foods available.

METHODS

In this case study using secondary data, we analyzed food weights of 86 meals served and recorded at 12 shelters after the heavy rains in July 2020. We obtained these data from Kumamoto Prefecture that was damaged and asked us dietary assessment for nutrition assistance. Foods were classified into 3 types according to the check mark in the record sheets: food aid (commercial packaged food), boxed meal, and hot meal service. We counted serving frequency of each food and analyzed nutritional differences by their combinations. Menus were devised by choosing foods that were served more frequently or were more nutritious among those served at shelters. The target values for one meal were set at 1/3 of the Revised RV for energy, protein, vitamins B₁, B₂, and C, and salt.

RESULTS

None of the meals served in the shelters satisfied the target. We created 2 menus using food aid only: (#1 curry doughnut, milk with long shelf-life, and orange jelly) and (#2 salmon rice ball, ham and cheese sandwich, and vegetable juice); 1 menu by combination of boxed meal and food aid: (#3 boxed meal and vegetable juice); and 2 menus by combination of hot meal service and food aid: (#4 chicken meatball soup, packaged tofu, soy sauce, preprocessed white rice, and bottled green tea) and (#5 bamboo shoots rice, chicken and vegetable miso soup, and bottled green tea). Planned menus generally contained more energy, protein, and vitamins and less salt than the meals served. Their vitamin C contents were especially higher.

CONCLUSION

Nutritionally adequate meals could be planned by changing the combination of foods available in shelters.

Latent class analysis of post-traumatic stress disorder symptoms following exposure to Hurricane Ike

BACKGROUND

There is substantial heterogeneity in how people react to potentially traumatic events (PTEs). Although some literature has explored this heterogeneity, there are only a few studies identifying factors associated with it within the disaster literature.

OBJECTIVE

The current investigation identified latent classes of post-traumatic stress disorder (PTSD) symptoms and differences between these classes after exposure to Hurricane Ike.

METHODS

Adults living in Galveston and Chambers County, Texas, (n = 658) completed a battery of measures during an interview conducted two to five months after Hurricane Ike. Latent class analysis (LCA) was performed to identify latent classes of PTSD symptoms. Additionally, gender, age, racial or ethnic minority status, depression severity, anxiety severity, quality of life, perceived need for services, and disaster exposure were examined to explore class differences.

RESULTS

LCA supported a 3-class model with low (n = 407, 61.9%), moderate (n = 191, 29.0%), and high PTSD symptoms (n = 60, 9.1%). Women appeared most at-risk for a moderate-severity presentation as compared to a low-severity presentation. Further, racial or ethnic minority groups appeared most at-risk for a high-severity presentation as compared to a moderate-severity presentation. Overall, the high symptom class had the poorest well-being, the most perceived need for services, and the highest exposure to the disaster, followed by the moderate symptom class, and finally the low symptom class.

CONCLUSIONS

PTSD symptom classes appeared to be differentiated primarily by overall severity as well as important psychological, contextual, and demographic dimensions.

Creation of the first regional medical resource map for use in a disaster

Background

Japan is located on the Pacific Ring of Fire and experiences frequent earthquakes. In addition, as the climate is changing due to global warming, heavy rains have caused frequent floods recently. Following the occurrence of disasters, citizens often experience confusion regarding access to healthcare services. Moreover, health professionals often face uncertainty regarding the availability of medical services in their local area. The Tokyo Kita city Pharmacist Association (KPA) independently developed the pharmacist safety confirmation (PSC) and pharmacy status confirmation (PSTC) systems to provide information regarding pharmaceutical resources during a disaster. These systems are very useful; however, they only provide information about pharmacies. Using this system as a base, a regional medical resource (RMR) map was created in cooperation with the Medical Association and Dental Association to provide useful medical resource information for clinicians and citizens during a disaster.

Objectives

The study aimed to assess the effectiveness and reliability of the RMR map.

Methods

The PSC and PSTC systems were originally invented by the KPA. The systems were employed in the event of actual earthquakes and flood damages and have produced positive results. An RMR map was created as a new resource map system by updating the software and platform of PSC and PSTC, and its reliability and efficacy were verified using drills. Drills were conducted seven times from 2018 to 2021.

Results

Out of the 527 member facilities, 450 were registered. The response rate ranged from 49.4% to 73.8% and the system successfully created useful maps.

Conclusion

This is the first report on the creation of an effective RMR map that can be used for helping people during disasters in Japan.

Public opinion changing patterns under the double-hazard scenario of natural disaster and public health event

In the context of the COVID-19 epidemic, a "double-hazard scenario" consisting of a natural disaster and a public health event occurring simultaneously is likely to arise. Focusing on this double-hazard scenario, this study developed a new opinion dynamics model that verifies the effect of opinion dynamic in practical applications and extends the realistic meaning of the logic matrix. The new model can be used to quickly identify changing trends in public opinion about two co-occurring public safety events in China, helping the government to better anticipate and respond to these real double-hazard scenarios. The new model was tested with three real double-hazard scenarios involving natural disasters and public health events in China and the simulation results were analyzed. Using visualization and Pearson correlation coefficients to analyze more than a million items of network-wide public opinion data, the new model was found to show a good fit with reality. The study finally found that in China, public attention to both natural hazards and public health events was greater when these public safety events co-occurred (double-hazard scenario) than when they occurred separately (single-hazard scenarios). These results verify the coupling phenomenon of different disasters in a multi-hazard scenario at the information level for the first time, which is greatly meaningful for multi-hazard research.

Classification modeling of intention to donate for victims of Typhoon Odette using deep learning neural network

The need for stability in the economy for world development has been a challenge due to the COVID-19 pandemic. In addition, the increase of natural disasters and their aftermath have been increasing causing damages to infrastructure, the economy, livelihood, and lives in general. This study aimed to determine factors affecting the intention to donate for victims of Typhoon Odette, a recent super typhoon that hit the Philippines leading to affect 38 out of 81 provinces of the most natural disaster-prone countries. Determining the most significant factor affecting the intention to donate may help in increasing the engagement of donations among other people to help establish a more stable economy to heighten world development. With the use of deep learning neural network, a 97.12% accuracy was obtained for the classification model. It could be deduced that when donors understand and perceive both severity and vulnerability to be massive and highly damaging, then a more positive intention to donate to victims of typhoons will be observed. In addition, the influence of other people, the holiday season when the typhoon happened, and the media as a platform have greatly contributed to heightening the intention to donate and control over the donor's behavior. The findings of this study could be applied and utilized by government agencies and donation platforms to help engage and promote communication among donors. Moreover, the framework and methodology considered in this study may be extended to evaluate intention, natural disasters, and behavioral studies worldwide.

Effects of 2018 Japan floods on healthcare costs and service utilization in Japan: a retrospective cohort study

BACKGROUND

Floods and torrential rains are natural disasters caused by climate change. Unfortunately, such events are more frequent and are increasingly severe in recent times. The 2018 Japan Floods in western Japan were one of the largest such disasters. This study aimed to evaluate the effect of the 2018 Japan Floods on healthcare costs and service utilization.

METHODS

This retrospective cohort study included all patients whose receipts accrued between July 2017 and June 2019 in Hiroshima, Okayama, and Ehime prefectures using the National Database of Health Insurance Claims. We used Generalized Estimating Equations (GEEs) to investigate yearly healthcare costs during the pre-and post-disaster periods, quarterly high-cost patients (top 10%), and service utilization (outpatient care, inpatient care, and dispensing pharmacy) during the post-disaster period. After the GEEs, we estimated the average marginal effects as the attributable disaster effect.

RESULTS

The total number of participants was 5,534,276. Victims accounted for 0.65% of the total number of participants (n = 36,032). Although there was no significant difference in pre-disaster healthcare costs (p = 0.63), post-disaster costs were $3,382 (95% CI: 3,254-3,510) for victims and $3,027 (95% CI: 3,015-3,038) for non-victims (p < 0.001). The highest risk difference among high-cost patients was 0.8% (95% CI: 0.6-1.1) in the fourth quarter. In contrast, the highest risk difference of service utilization was in the first quarter (outpatient care: 7.0% (95% CI: 6.7-7.4), inpatient care: 1.3% (95% CI: 1.1-1.5), and dispensing pharmacy: 5.9% (95% CI: 5.5-6.4)).

CONCLUSION

Victims of the 2018 Japan Floods had higher medical costs and used more healthcare services than non-victims. In addition, the risk of higher medical costs was highest at the end of the observation period. It is necessary to estimate the increase in healthcare costs according to the disaster scale and plan for appropriate post-disaster healthcare service delivery.

A timely method for post-disaster assessment and coastal landscape survey using drone and satellite imagery

To mitigate floods and storm surges, coastal communities across the globe are under the pressure of high-cost interventions, such as coastal barriers, jetties, and renourishment projects, especially in areas prone to hurricanes and other natural disturbances. To evaluate the effectiveness of these coastal projects in a timely fashion, this methodology is supported by a Geographic Information System that is instaneously fed by regional and local data obtained shortly (24 h) after the disturbance event. Our study assesses the application of 3D models based on aerophotogrammetry from a Phantom 4 RTK drone, following a methodological flowchart with three phases. The Digital Elevation Models (DEMs) based on aerophotogrammetry obtained from a Phantom 4 RTK drone presented a low margin of error (± 5 cm) to dispense Ground Control Points. This technique enables a rapid assessment of inaccessible coastal areas due, for instance, to hurricane impacts. Evaluation of DEMs before and after the disturbance event allows quantifying the magnitudes of shoreline retreat, storm surges, difference in coastal sedimentary volumes, and identifying areas where erosion and sediment accretion occur. Orthomosaics permit the individualization and quantification of changes in vegetation units/geomorphological areas and damages to urban and coastal infrastructure. Our experience monitoring coastal dynamics in North and South America during the last decade indicates that this methodology provides an essential data flow for short and long-term decision-making regarding strategies to mitigate disaster impacts.•Permanent and regional monitoring with spatial-temporal analysis based on satellite/aerial images and lidar data prior to the event.•Local DEMs based on drone aerophotogrammetry after the event.•Integration of regional and local planialtimetric/environmental data.

Latent profiles of psychological status among populations cumulatively exposed to a flood and the recurrence of the COVID-19 pandemic in China

Henan Province in Central China was hit by unprecedented, rain-triggered floods in July 2021 and experienced a recurrence of the COVID-19 pandemic. The current study aims to identify the latent profiles of psychological status and acceptance of change among Henan residents who have been cumulatively exposed to these floods and the COVID-19 pandemic. A total of 977 participants were recruited. Latent profile analysis (LPA) was used to explore underlying patterns of psychological status (i.e., perceived risk of the COVID-19 pandemic, post-traumatic stress symptoms, anxiety and rumination) and acceptance of change. The predictors were evaluated with multinomial logistic regression. LPA identified four patterns of psychological status and acceptance of change: high distress/high acceptance (5.1%), moderate distress/moderate acceptance (20.1%), mild distress/mild acceptance (45.5%), and resilience (29.3%). The additive impact of the floods and COVID-19 pandemic and negative emotion during the floods were the risk factors, while flood coping efficacy, trust, and a closer psychological distance change were the protective factors. The present study therefore provides novel evidence on psychological status after both a natural disaster and a major public health event. The cumulative effects of the floods and the COVID-19 pandemic may have heightened the risk of post-disaster maladaptation. A complex relationship between psychological outcomes and acceptance of change was also found. The findings of this study thus provide a foundation for both disaster management and psychological assistance for particular groups.

CEO's Childhood Experience of Natural Disaster and CSR Activities

Interest in the drivers of firms' corporate social responsibility (CSR) is growing. However, little is known about the influence of a CEO's childhood experience of natural disasters on CSR. Using archival data, we explore this relationship by offering three mechanisms that may account for how the CEO's childhood experience of natural disaster is related to their CSR. More specifically, while prior research has established a positive relationship based on the post-traumatic growth theory, we show that the dual mechanisms of prosocial values and a CEO's risk aversion explain the positive relationship. We further find that the positive relationship is stronger (1) when CEOs have longer career horizons and (2) when community social capital is high. This study contributes to both research and managerial implications on the topics of CEO's childhood experience and CSR. In particular, this study advances the upper echelon theory by revealing that a CEO's childhood experience of natural disaster is a useful yet relatively underexplored variable that can help explain the substantial variations in firms' CSR. Moreover, we emphasize that a CEO's career horizons and level of community social capital are important variables that further amplify the effect of a CEO's childhood experience of natural disaster on the firm's CSR commitment.

The psychological impact of the Turkey-Syria earthquake on children: addressing the need for ongoing mental health support and global humanitarian response

This letter aims to explore the potential impact of the Turkey-Syria earthquake on the psychological well-being of the affected children and adolescents. It emphasises the crucial importance of prompt identification and management of emerging mental health disorders in this vulnerable population. The letter draws on existing research evidence to highlight the need for suitable mental health interventions to mitigate the anticipated suffering of many children and adolescents affected by the earthquake. A comprehensive overview of the mediating factors which may play a role in the extent of the impact of an earthquake on the mental health of children is discussed. A range of appropriate strategies and interventions are recommended and the call for continued global support is renewed. We have concluded that major earthquakes can potentially contribute to the development of mental health disorders among children and adolescents. However, by providing timely and effective support, it is possible to prevent long-term psychological consequences and facilitate early recovery. We propose the urgent implementation of effective mental health interventions in the aftermath of the Turkey-Syria earthquake to foster the recovery and resilience of the affected young population.

Chlorinated persistent organic pollutants in human breast milk in the Miyagi Prefecture disaster-affected area 1 year after the Great East Japan Earthquake of 2011

BACKGROUND

In the Great East Japan Earthquake of 11 March 2011, an earthquake and accompanying tsunami struck the Tohoku region of northeastern Japan. Buildings collapsed and the tsunami spread waste, including hazardous materials. This study aimed to determine the concentrations of persistent organic pollutants (POPs) in the breast milk of mothers living in the disaster-affected area of Sendai 1 year after the earthquake. Temporal trends in the POPs concentrations were evaluated by comparison with previous studies.

METHODS

One hundred breast milk samples were obtained from lactating mothers at a hospital in Sendai in 2012. The results were compared with those from other years to examine whether there were changes in the POPs concentrations after the earthquake. We measured polychlorinated biphenyls (PCBs) and organochlorine pesticides, such as chlordanes, using gas chromatography-mass spectrometer (GC-MS) with negative chemical ionization, and dichlorodiphenyl trichloroethane (DDT) and its metabolites using GC-MS with electron impact ionization.

RESULTS

The mean total PCBs (11 congeners), total chlordane, and total DDT concentrations were 76.2 ng/g lipid, 39.8 ng/g lipid, and 73.5 ng/g lipid, respectively. For the samples collected in 2012, the concentrations of POPs in breast milk showed minimal changes compared with results from previous years for samples collected at the same hospital in Sendai.

CONCLUSIONS

Our study demonstrates that 1 year after the earthquake and tsunami, the concentrations of chlorinated POPs in breast milk had not changed substantially.

Impact of the 2021 north american winter storms on children with epilepsy

Purpose

In February 2021 a series of winter storms caused power outages for nearly 10 million people in the United States, Northern Mexico and Canada. In Texas, the storms caused the worst energy infrastructure failure in state history, leading to shortages of water, food and heat for nearly a week. Impacts on health and well-being from natural disasters are greater in vulnerable populations such as individuals with chronic illnesses, for example due to supply chain disruptions. We aimed to determine the impact of the winter storm on our patient population of children with epilepsy (CWE).

Methods

We conducted a survey of families with CWE that are being followed at Dell Children's Medical Center in Austin, Texas.

Results

Of the 101 families who completed the survey, 62% were negatively affected by the storm. Twenty-five percent had to refill antiseizure medications during the week of disruptions, and of those needing refills, 68% had difficulties obtaining the medications, leading to nine patients-or 36% of those needing a refill-running out of medications and two emergency room visits because of seizures and lack of medications.

Conclusions

Our results demonstrate that close to 10% of all patients included in the survey completely ran out of antiseizure medications, and many more were affected by lack of water, heat, power and food. This infrastructure failure emphasizes the need for adequate disaster preparation for vulnerable populations such as children with epilepsy for the future.

Integrated operations for natural disaster management: A systematic Review

Background: This study aimed to conduct a systematic review of models describing the integrated logistics operations performed as a response to natural disasters, with the hope to identify the challenges and limitations of healthcare systems in natural disaster management. Methods: A systematic literature search was carried out in PubMed/Medline, Scopus, Google Scholar, and bibliographies of retrieved articles using MeSH headings and keywords such as natural disaster, logistics, model. A total of 98 publications were identified through the search process. Seven potentially relevant articles met the inclusion criteria. The key demographic, clinical, and pathological information of all qualified studies were extracted from the full-text articles. Results: Among the seven included studies, six had either model data or considerations on distribution methods. Storage, human resources, infrastructures, primary priority items, coordination of organizations, and information and communication with the media were also the focus of studies. The articles were mainly from Iran (n=2), the United States (n=2), and Indonesia (n=2). The models presented in the studies has mainly focused on a specific aspect of disaster management, such as smart government development, use of military services, people with logistic training and/or medical team model. Conclusion: This study systematically highlighted the crucial points that should be considered in managing natural disasters including human resources, infrastructure, storage, priority items, distribution, access system, coordination of organizations, information, and communication with the media. In this regard, we prepared a comprehensive comparison of possible models and logistics.

Association between low back pain and functional disability in the elderly people: a 4-year longitudinal study after the great East Japan earthquake

BACKGROUND

Functional disability is a major health issue in an aging population. Low back pain (LBP) is a common health concern that can lead to functional disability in the elderly; nonetheless, their association has not yet been clarified. This study aimed to examine the association between LBP and functional disability in the elderly, with a focus on its dose-dependent effects.

METHODS

This study used the 4-year longitudinal data of people living in disaster-affected areas after the Great East Japan Earthquake (aged ≧65, n = 914). LBP and physical function were assessed at 2, 4, and 6 years after the disaster. Multivariate logistic regression analyses were performed to assess the association between LBP and low physical function, as well as the effect of preceding LBP on the onset of low physical function.

RESULTS

LBP was significantly associated with low physical function, and the association became stronger as the duration of LBP increased. Adjusted odds ratios (95% confidence intervals) were 1.27 (0.79-2.06) in "< 2 years," 1.95 (1.01-3.77) in "≥2 years and <4 years," and 2.34 (1.35-4.06) in "≥4 years" (p for trend = 0.009). Additionally, preceding LBP was significantly associated with the onset of low physical function, and the effect became prominent as the duration of LBP increased. Adjusted odds ratios (95% confidence intervals) were 2.28 (1.19-4.37) in "< 2 years" and 2.82 (1.35-5.90) in "≥2 years" (p for trend = 0.003).

CONCLUSIONS

LBP is associated with physical disability among the elderly in a dose-dependent manner. Therefore, prevention and treatment of LBP are important for preventing functional disability.

Impact of the 2018 Japan Floods on benzodiazepine use: a longitudinal analysis based on the National Database of Health Insurance Claims

PURPOSE

Natural disaster has an impact on mental health. The 2018 Japan Floods, which took place in July 2018 were one of the largest water disasters in Japan's recorded history. We aimed to evaluate the change in the number of benzodiazepine prescriptions by physicians before and after the disaster.

METHODS

A retrospective cohort study based on the National Database of Health Insurance Claims was conducted in the flood-stricken areas between July 2017 and June 2019. The subjects were divided between victims and non-victims according to certification by local governments. Members of both groups were then categorized into three groups based on their pre-flood use of benzodiazepines: non-user, occasional user, and continuous user. Difference-in-differences (DID) analysis with a logistic regression model was conducted to estimate the effect of the disaster among victims by comparing the occurrence of benzodiazepine prescriptions before and after the disaster.

RESULTS

Of 5,000,129 people enrolled, 31,235 were victims. Among all participants, the mean prescription rate for benzodiazepines in victims before the disaster (11.3%) increased to 11.8% after the disaster, while that in non-victims (8.3%) decreased to 7.9%. The DID analysis revealed that benzodiazepine prescription among victims significantly increased immediately after the disaster (adjusted ratio of odds ratios (ROR) 1.07: 95% confidence interval 1.05-1.11), and the effect of the disaster persisted even 1 year after the disaster (adjusted ROR 1.2: 95% confidence interval 1.16-1.24).

CONCLUSION

The flood increased the number of benzodiazepines prescriptions among victims, and the effect persisted for at least 1 year.

Primary Outcomes for Adults Receiving the Unified Protocol after Hurricane Harvey in an Integrated Healthcare Setting

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) has demonstrated efficacy for treating anxiety and depression. However, there are limited effectiveness data when conducted in real-world settings with diverse populations, including those with trauma. We evaluated treatment outcomes in a naturalistic, community setting among 279 adults who received UP following Hurricane Harvey. We examined change in overall clinical severity, depression and anxiety symptoms, functional impairment, and baseline outcome predictors (i.e., demographic characteristics, impact from Hurricane Harvey, co-occurrence of depression and anxiety symptoms). Global clinical severity, depression and anxiety symptoms, and functional impairment decreased by end-of-treatment. Participants experienced global symptom improvement to a lesser degree than demonstrated in efficacy trials. Participants who experienced greater storm impact reported larger reductions in anxiety symptoms than those less impacted by Harvey. Further studies evaluating the effectiveness of the UP post-disaster and with diverse samples are needed.

The Effects of Maternal Disaster Exposure on Adolescent Mental Health 12 Years Later

Natural disasters adversely impact children's mental health, with increased parent or child exposure and subsequent parental distress predicting poorer outcomes. It remains unknown, however, whether the psychological consequences of disasters for children persist long-term, and if so, why and for whom. We therefore examined the effects of mothers' exposure to Hurricane Katrina on adolescent children's mental health 12 years later, distinguishing between direct effects of disaster exposure and effects mediated by maternal distress, and evaluating moderation by child age and gender. Data were from a 2003-2018 study of young, low-income, primarily African American mothers living in New Orleans when Hurricane Katrina occurred in 2005 (n = 328). Mothers rated their mental health about one year pre-Katrina and one, four, and 12 years afterwards. They reported on an adolescent child's (ages 10-17, mean = 14.46) internalizing and externalizing symptoms 12 years post-Katrina using the Strengths and Difficulties Questionnaire. Path analytic models adjusting for mothers' pre-disaster distress showed that, whereas the direct effects of maternal hurricane exposures on child mental health were not significant, the indirect effects were. Specifically, mothers who experienced more Katrina-related stressors had higher distress thereafter, which predicted poorer child outcomes. Results did not differ significantly by child age. Gender differences are discussed. Findings suggest that disasters can affect child mental health for many years, even for those who were very young or not yet born at the time, due to parents' disaster-related distress. Addressing parents' mental health needs in the aftermath of disasters may improve child well-being long-term.

The Mental Health Consequences of Hurricane Matthew on Haitian Children and Youth: An Exploratory Study

Haiti has experienced many major natural disasters in the past decade that included Hurricane Matthew which led to mass damage to property, a depletion of basic resources, human fatalities and injuries, and mental health consequences that affected the poorest. The current study focused on the psychological effects of Hurricane Matthew on Haitian children and adolescents. Children display heightened depression, and PTSD symptoms in the aftermath of disasters (Hausman et al., Journal of Family Psychology 34:836-845, 2020), however, the researchers anticipated that children living in orphanages would display more severe mental health symptoms than those living with their families, because of their additional stressor of family loss. Using a convenience sample, quantitative data was collected using several instruments, in a survey format, that were individually administered to a sample of 77 adolescents. Participants had high depressive scores and reported multiple adverse events and limited access to basic needs. In comparing subgroups, we found children who were in orphanages reported significantly fewer adverse childhood experiences than those living with their families. This is likely because orphanages in Haiti consistently provide children with a safe and stable environment, buffering them against the traumatic effects of disasters. In contrast, children living with their families reported witnessing or experiencing interpersonal violence, neglect and abuse in addition to disaster-related stress. Before addressing the issues faced by disaster-affected children in Haiti, the systemic issues that maintain the socio-economic deprivation of so many citizens must be addressed. An important step is for policymakers to collaborate with mental health providers to develop community interventions that are low-cost and easily accessible. These interventions must consider and incorporate the social context and cultural patterns of help-seeking and treatment utilization in Haiti.

Elemental analysis of hair provides biomarkers of maternal hardship linked to adverse behavioural outcomes in 4-year-old children: The QF2011 Queensland Flood Study

BACKGROUND

Exposure to adverse experiences during pregnancy, such as a natural disaster, can modify development of the child with potential long-term consequences. Elemental hair analysis may provide useful indicators of cellular homeostasis and child health. The present study investigated (1) if flood-induced prenatal maternal stress is associated with altered hair elemental profiles in 4-year-old children, and (2) if hair elemental profiles are associated with behavioural outcomes in children.

METHODS

Participants were 75 children (39 boys; 36 girls) whose mothers were exposed to varying levels of stress due to a natural disaster (2011 Queensland Flood, Australia) during pregnancy. At 4 years of age, language development, attention and internalizing and externalizing problems were assessed and scalp hair was collected. Hair was analyzed by inductively coupled plasma mass spectrometry (ICP-MS) for 28 chemical elements.

RESULTS

A significant curvilinear association was found between maternal objective hardship and copper levels in boys, as low and high maternal objective hardship levels were associated with the highest hair copper levels. Mediation analysis revealed that low levels of maternal objective hardship and high levels of copper were associated with lower vocabulary scores. Higher levels of maternal objective hardship were associated with higher magnesium levels, which in turn were associated with attention problems and aggression in boys. In girls, high and low maternal objective hardship levels were associated with high calcium/potassium ratios.

CONCLUSION

Elemental hair analysis may provide a sensitive biomonitoring tool for early identification of health risks in vulnerable children.

Sustainability efficiency of climate change and global disasters based on greenhouse gas emissions from the parallel production sectors - A modified dynamic parallel three-stage network DEA model

This study employed dynamic three-stage network data envelopment analysis (DEA), considering parallel production in the agricultural and industrial sectors, to assess the impact of greenhouse gas emissions on the climate change and natural disaster stages. The results revealed the following: (1) The dynamic overall efficiencies of more countries are decreasing than are increasing. The seven countries with the poorest overall efficiency ranking (Myanmar, Vietnam, Thailand, Bangladesh, the Philippines, Pakistan, and India) are mostly located in Southeast Asia. (2) The number of countries that maintained low efficiency over the long term is greater than those that retained high efficiency over the long term. Myanmar, Mexico, India, the Philippines, Thailand, and Vietnam maintained efficiency scores below 0.5, whereas South Korea, Japan, China, and New Zealand maintained efficiency scores above 0.8. (3) More than one-third of countries exhibited declines in efficiency over time, and half were European countries. Less than one-third of countries maintained their efficiency, and less than one-third of countries gradually improved. (4) Approximately half of the countries' efficiency scores were lower than the global average. The efficiency scores of the industrial sector exhibited a greater room for improvement on the input factors than did those of the agricultural sector. (5) Total factor energy efficiency analysis revealed that methane emissions and CO₂ emissions have a similar level but large room for improvement across countries. Improving input factors in the production stage can ultimately mitigate inefficiencies in the climate change and natural disaster stages. There are still other important factors related to climate change, such as sea surface temperature, forest areas, or air pollution indicators, that could be considered in future research. The occurrence of global disasters could also be discussed in groups according to the region where the countries are located in the future.

Increased prescriptions for irritable bowel syndrome after the 2018 Japan Floods: a longitudinal analysis based on the Japanese National Database of Health Insurance Claims and Specific Health Checkups

Background

The frequency and intensity of natural disasters are increasing worldwide, which makes our understanding of disaster-related diseases more important than ever. Natural disasters cause mental stress and infectious diarrhea, but the causal relationship between disasters and a potential consequence of these conditions, irritable bowel syndrome (IBS), is unreported. The 2018 Japan Floods, which took place in July 2018 was one of the largest water disasters in Japan’s recorded history. We investigate the change of drug prescriptions for IBS between disaster-suffers and non-sufferers throughout the disaster period to examine the relationship.

Methods

This is a retrospective cohort study based on the Japanese National Database of Health Insurance Claims and Specific Health Checkups in flood-stricken areas between July 2017 and June 2019. We included subjects older than 15 years of age who had visited a medical institution or been hospitalized in the hardest-hit areas of the disaster. Ramosetron, polycarbophil calcium, and mepenzolate bromide (IBS drugs) approved solely for the treatment of IBS in Japan were analyzed. The monthly rate of prescriptions for IBS drugs was compared between municipality-certified disaster victims and non-victims using a controlled interrupted time series analysis. For those who were not prescribed IBS drugs before the disaster (non-users), the occurrence of an IBS drug prescription after the disaster was evaluated using a multivariable logistic regression analysis adjusted for gender and age.

Results

Of 5,287,888 people enrolled, 32,499 (0.61%) were certified victims. The prescription rate for IBS drugs among victims increased significantly by 128% immediately after the disaster, while it was stable among non-victims. The trend for the post-disaster prescription rate among victims moved upward significantly when compared to non-victims (0.01% per month; 95% confidence interval (CI) 0.004–0.015; P = 0.001). Among non-users, the occurrence of an IBS drug prescription for victims was 0.71% and was significantly higher than non-victims (0.35%, adjusted odds ratio 2.05; 95% CI 1.81–2.32).

Conclusions

The 2018 Japan Floods increased the rate of prescriptions for IBS drugs, suggesting that the disaster caused or worsened IBS among victims.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12876-022-02342-6.

Sleep disturbance is associated with neck pain: a 3-year longitudinal study after the Great East Japan Earthquake

Background

Neck pain is a common health problem in the general population as well as in people after natural disasters. Sleep disturbances are gaining attention as risk factors for musculoskeletal pain; however, the association between sleep disturbance and neck pain has not been clarified. The present study aimed to clarify the association between sleep disturbance and neck pain, especially focusing on the effect of the duration of sleep disturbance, after the Great East Japan Earthquake.

Methods

This study used 3-year longitudinal data obtained from individuals (n = 2,059) living in disaster-affected areas after the Great East Japan Earthquake. Sleep disturbance and neck pain were investigated at 4, 5, 6, and 7 years after the disaster. Multivariate logistic regression analyses were used for the assessment.

Results

Sleep disturbance was significantly associated with neck pain, and the association was stronger as the duration of sleep disturbance increased (adjusted odds ratios [95% confidence intervals]: 1.84 [1.23–2.75] for “ < 1 year”; 2.41 [1.53–3.81] for “ ≥ 1 year and < 2 years”; 2.80 [2.09–3.76] for “ ≥ 2 years”). Furthermore, preceding sleep disturbance was significantly associated with the onset of neck pain, and the association was stronger as the duration of sleep disturbance increased (adjusted odds ratios [95% confidence intervals]: 1.86 [1.08–3.20] for “ < 1 year”; 2.39 [1.22–4.70] for “ ≥ 1 year and < 2 years”; 3.00 [1.94–4.65] for “ ≥ 2 years”).

Conclusions

Sleep disturbance is associated with neck pain, and long-lasting sleep disturbance strengthens the association. Clinicians should consider this association to effectively treat patients with neck pain, especially those affected by natural disasters.

Effects of the 2018 Japan Floods on long-term care insurance costs in Japan: retrospective cohort study

BACKGROUND

Climate change has increased the frequency and severity of torrential rains and floods around the world. Estimating the costs of these disasters is one of the five global research priorities identified by WHO. The 2018 Japan Floods hit western Japan causing extensive destruction and many deaths, especially among vulnerable elderly. Such affected elderly would need long-term care due to the various health problems caused by the disaster. A Long-Term Care Insurance (LTCI) system provides care services in Japan. The aim of this study was to evaluate the effect of the 2018 Japan Floods on LTCI costs and service utilization.

METHODS

The participants of this retrospective cohort study were all verified persons utilizing LTCI services in Hiroshima, Okayama and Ehime prefectures. The observation period was from 2 months before to 6 months after the disaster. We used Generalized Estimating Equations (GEEs) to examine the association between disaster status (victims or non-victims) and the monthly total costs of LTCI service (with gamma-distribution/log-link) by residential environment (home or facility). Among home residents, we also examined each service utilization (home-based service, short-stay service and facility service), using the GEEs. After the GEEs, we estimated Average Marginal Effects (AME) over all observation periods by months as the attributable disaster effect.

RESULTS

The total number of participants was 279,578. There were 3024 flood victims. The disaster was associated with significantly higher total costs. The AME for home residents at 2 months after was $214 (Standard Error (SE): 12, p < 0.001), which was the highest through the observation period. Among facility residents, the AME immediately after the disaster increased by up to $850 (SE: 29, p < 0.001). The service utilization among home residents showed a different trend for each service. The AME of home-based services decreased by up to - 15.2% (SE:1.3, p < 0.001). The AME for short-stay service increased by up to 8.2% (SE: 0.9, p < 0.001) and the AME for facility service increased by up to 7.4% (SE: 0.7, p < 0.001), respectively.

CONCLUSIONS

The 2018 Japan Floods caused an increase in LTCI costs and the utilization of short-stay and facility services, and a decrease in utilization of home-based services.

Registered nurses: can our supply meet the demand during a disaster?

BACKGROUND

Death and destructions are often reported during natural disasters; yet little is known about how hospitals operate during disasters and if there are sufficient resources available for hospitals to provide ongoing care during these catastrophic events. The purpose of this study was to determine if the State of New Jersey had a supply of registered nurses (RNs) that was sufficient to meet the needs of hospitalized patients during a natural disaster - Hurricane Sandy.

METHODS

Secondary data were used to forecast the demand and supply of New Jersey RNs during Hurricane Sandy. Data sources from November 2011 and 2012 included the State Inpatient Databases (SID), American Hospital Association (AHA) Annual Survey on hospital characteristics and staffing data from New Jersey Department of Health. Three models were used to estimate the RN shortage for each hospital, which was the difference between the demand and supply of RN full-time equivalents.

RESULTS

Data were available on 66 New Jersey hospitals, more than half of which experienced a shortage of RNs during Hurricane Sandy. For hospitals with a RN shortage in ICUs, a 20% increase in observed RN supply was needed to meet the demand; and a 10% increase in observed RN supply was necessary to meet the demand for hospitals with a RN shortage in non-ICUs.

CONCLUSION

Findings from this study suggest that many hospitals in New Jersey had a shortage of RNs during Hurricane Sandy. Efforts are needed to improve the availability of nurse resources during a natural disaster.

Infant and young child feeding during natural disasters: A systematic integrative literature review

BACKGROUND

As climate change worsens, the frequency and intensity of natural disasters continues to increase. These extreme weather events particularly affect the physical and mental health of vulnerable groups such as mothers and infants. From low-income to high income countries, poorly organised disaster response can negatively impact infant and young child feeding practices.

AIM

To examine challenges and supportive strategies for infant and young child feeding during natural disasters to inform further research and guide disaster recommendations and practice.

METHODS

A comprehensive search strategy explored the electronic databases PubMed, CINAHL and Cochrane Library. Screening, data extraction and analysis were conducted using Covidence. Quality assessment was conducted using the Mixed Methods Appraisal Tool (MMAT). Studies were analysed using thematic analysis.

FINDINGS

This review included 13 studies (4 mixed methods, 1 critical ethnography, 2 quasi-experimental studies, 4 descriptive studies, 1 qualitative study, 1 evidence gap map analysis). Breastfeeding facilitators during natural disaster contexts are privacy for breastfeeding, community and family support, adaptation of professional breastfeeding support to the local context and pre-existing breastfeeding practice. Breastfeeding challenges during natural disasters include decreased breastfeeding self-efficacy, lack of knowledge and resources and over-reliance on formula baby milks. Formula baby milk feeding challenges during natural disasters are the lack of access to resources required for hygienic formula baby milk preparation as well as the lack of availability of formula baby milk in some contexts.

CONCLUSION

This systematic integrative review demonstrates that interventions which facilitate optimal infant and young child feeding in natural disaster contexts must be culturally and socially appropriate; increasing women's knowledge of optimal breastfeeding and safe formula baby milk feeding practices as well as breastfeeding self-efficacy.

On the stability of risk and time preferences amid the COVID-19 pandemic

We elicited incentivized measures of risk and time preferences from a sample of undergraduate students in Athens, Greece, in waves that preceded and overlapped with the COVID-19 pandemic. We exploited the timing of several events that occurred in the course of the pandemic (e.g., first occurrence of cases and deaths, curfew, relaxation of curfew etc.) and estimated structural parameters for various theories of risk and time preferences comparing these with pre-pandemic estimates. We find no effect between the different waves or other key events of the pandemic, despite the fact that we have about 1000 responses across all waves. Overall, our subjects exhibit intertemporal stability of risk and time preferences despite the significant effect of the COVID-19 pandemic on public health and the global economy.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10683-021-09727-6.

Storm Alex: acute stress responses in the pediatric population

INTRODUCTION

On 2 October 2020, a violent storm (Alex) reached the French Riviera and caused significant damage in three inhabited valleys in the hinterland of the city of Nice. Entire populations were exposed to prolonged stress (no means of communication, electricity nor water) and were particularly at risk of suffering from psychological consequences. We first hypothesized that a majority of children would experience an acute stress reaction. However, we also hypothesized that their clinical expression would differ depending on their developmental age. Thus, we aimed to evaluate, according to the child's level of development, the presence of acute stress symptoms.

METHODS

Consecutive interviews with the child/adolescent and his/her parents were conducted by child and adolescent psychologists and psychiatrists to assess symptomatology following storm Alex (from day 1 to day 3). Each interview assessed nine classes of symptoms that have been compared according to age-groups.

RESULTS

116 children have been evaluated (0.2-17.6 years, mean 9.1). The 0-5-years-old showed more agitation as well as developmental regression than children aged 6-11 (p = .011, p = .045) and 12-18 years (p < .001, p < .001). Anxiety was reported more frequently among the 6-11 years old than the 0-5 years children (p = .018). Overall, the interviewed children presented at least one manifestation of acute stress after the storm (94% for the 0-5 years; 83% for the 6-11 years and 74% for the 12-18 years).

DISCUSSION

The results highlight the high rate of acute stress symptoms in a natural disaster context, their specificity depending on children's age. Therefore; it emphasizes the need to develop, improve and validate specific assessment tools. Scheduled follow-up evaluations will help to understand, after a natural disaster, the long-term stress response in children, paving the way for targeting early, intensive, specific and multidisciplinary symptomatic treatment approaches.Trial registration: ClinicalTrials.gov identifier: NCT04850924.

HIGHLIGHTS

Acute stress symptoms in children and adolescents are very frequent in the context of exposure to a natural disaster with specifications depending on the developmental age.

The impact of natural disasters on the spread of COVID-19: a geospatial, agent-based epidemiology model

Background

Natural disasters and infectious diseases result in widespread disruption to human health and livelihood. At the scale of a global pandemic, the co-occurrence of natural disasters is inevitable. However, the impact of natural disasters on the spread of COVID-19 has not been extensively evaluated through epidemiological modelling.

Methods

We create an agent-based epidemiology model based on COVID-19 clinical, epidemiological, and geographic data. We first model 35 scenarios with varying natural disaster timing and duration for a COVID-19 outbreak in a theoretical region. We then evaluate the potential effect of an eruption of Vesuvius volcano on the spread of COVID-19 in Campania, Italy.

Results

In a majority of cases, the occurrence of a natural disaster increases the number of disease related fatalities. For a natural disaster fifty days after infection onset, the median increase in fatalities is 2, 59, and 180% for a 2, 14, and 31-day long natural disaster respectively, when compared to the no natural disaster scenario. For the Campania case, the median increase in fatalities is 1.1 and 2.4 additional fatalities per 100,000 for eruptions on day 1 and 100 respectively, and 60.0 additional fatalities per 100,000 for an eruption close to the peak in infections (day 50).

Conclusion

Our results show that the occurrence of a natural disaster in most cases leads to an increase in infection related fatalities, with wide variance in possible outcomes depending on the timing of the natural disaster relative to the peak in infections and the duration of the natural disaster.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12976-021-00151-0.

The effect of the 2018 Japan Floods on cognitive decline among long-term care insurance users in Japan: a retrospective cohort study

BACKGROUND

The July 2018 Japan Floods caused enormous damage to western Japan. Such disasters can especially impact elderly persons. Research has shown that natural disasters exacerbated a decline in cognitive function, but to date, there have been no studies examining the effects of this disaster on the elderly. The object of this study was to reveal the effect of this disaster in terms of cognitive decline among the elderly.

METHODS

Study participants were certified users of the long-term care insurance (LTCI) system in Hiroshima, Okayama, and Ehime prefectures from May 2018 to June 2018. The observation period was from July 2018 to December 2018. Our primary outcome was cognitive decline after the disaster using a dementia symptomatology assessment. In addition to a crude model, a multivariate Cox proportional hazards model was used to assess the cognitive decline of victims, adjusting for age classification, gender, the level of dementia scale before the disaster occurred, residential environment, whether a participant used facilities shut down after the disaster, and population density. After we confirmed that the interaction term between victims and residential environment was statistically significant, we stratified them for the analysis.

RESULTS

The total number of participants was 264,614. Victims accounted for 1.10% of the total participants (n = 2,908). For the Cox proportional hazards model, the hazard ratio of the victims was 1.18 (95% confidential interval (CI): 1.05-1.32) in the crude model and 1.12 (95% CI: 1.00-1.26) in the adjusted model. After being stratified by residential environment, the hazard ratio of home victims was 1.20 (95% CI: 1.06-1.36) and the hazard ratio of facility victims was 0.89 (95% CI: 0.67-1.17).

CONCLUSIONS

This study showed that elderly living at home during the 2018 Japan Floods were at risk for cognitive decline. Medical providers, care providers, and local governments should establish a system to check on the cognitive function of elderly victims and provide necessary care support.

Resident perspectives of environmental health risk exposures after Hurricane Harvey

This study examines what visitors to urban parks in Houston, TX, know about environmental health risks resulting from Hurricane Harvey, a category 4 storm that made landfall in August 2017 and dropped over 60 in. of rain in 8 days making it the most significant rainfall event in US history. Interviews were conducted with adult Houstonians using purposive sampling. In total, 27 interviews were conducted with 36 different participants. Interviews were audio-recorded, transcribed verbatim, and analyzed qualitatively using a phronetic iterative approach. This study found that park visitors lack sufficient knowledge about environmental health risks, yet they have strong desires to learn more about such risks. In particular, participants have clear opinions on what the content of the messages (i.e., concise, manageable, not fear-inducing) should be and how they would like to receive the information (i.e., conveniently accessible, from trusted local sources). Implications for health campaign interventions utilizing uncertainty theories are discussed.