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PubMed2000

Impact of the earthquake of September 26, 1997 in Umbria, Italy on the socioenvironmental and psychophysical conditions of an elderly population.

The consequences of natural disasters on the social and health status of older people have not been deeply considered. The aim of this study was to evaluate the socioenvironmental and psychophysical conditions of an elderly population after a devastating earthquake. A randomly selected group of 332 older people (> or =64 years) was selected among 1548 eligible subjects living in the city of Nocera Umbra four months after an earthquake of 5.6 magnitude on the Richter scale. Three geriatricians evaluated the study subjects by means of a structured interview, and standardized scales, which considered physical and mental status, mood and anxiety, and self-perception of well-being, as well as the characteristics of family composition and social interactions. Of the study subjects, 11.1% lived alone, and 33.4% with the spouse only. Most were self-sufficient in the basic activities of daily life. Musculoskeletal diseases and hypertension were the most frequently observed pathologies in this geriatric population. In addition, 47.9% of the subjects lived in temporary houses; this group more frequently suffered from hypertension, and had a higher score of comorbidity as measured by Cumulative Illness Rating Scale (CIRS) compared to people who remained at home. People living in the pre-fabricated huts also showed a higher score on the Geriatric Depression Scale and the Hamilton scale for anxiety, and complained more often of their health status, evaluated as self-perception of well-being, when compared to the home dwellers. Although all the studied subjects suffered from the discomforts caused by the earthquake, the precariousness of living in temporary houses, whose structural characteristics do not take the needs of elderly subjects into account, could justify the higher distress experienced by persons housed in the huts. These observations suggest that, after natural disasters, emergency programs should be more adapted to elderly people, whose needs and expectations are often different from those of young adults.

Activities of Daily Living↗
PubMedDate not supplied

[Evaluation of the psychological consequences of environmental catastrophes: a feasibility study based on the 1992 floods in the Vaucluse].

Scientific studies of environmental disasters, whether human or natural in origin, have shown that the psychological impact of such events may be considerable and long-lasting. Several natural disasters have occurred in France, but their impact on public psychological health has not been assessed. In September 1992, there was a major flood in southeast France (Vaucluse), which caused 38 deaths. Four years later, we performed a pilot cross-sectional study to assess the feasibility of a larger epidemiological study to assess the psychological impact of this flood. Two affected towns were chosen for this study: Vaison-la-Romaine (VLR), where the flood was very sudden and 29 people were killed, and Bédarrides, where the water level rose more slowly. In Bédarrides, households were randomly selected from a list of victims (n = 100) and in Vaison-la-Romaine, households were randomly selected from the telephone directory (n = 140). Exposure to the flood was assessed by a series of questions, the answers to which were used to calculate an exposure score. The questionnaire also included psychometric scales for post-traumatic stress disorder (QE-PTSD), anxiety (Spielberger State-Trait Anxiety Inventory) and depression (Beck Depression Inventory). In Bédarrides, the participation rate was high: 69% of the selected households were successfully contacted and found to be eligible for inclusion and 74% agreed to a face-to-face interview. In Vaison-la-Romaine, 51% of the selected households were contacted and eligible and 50% agreed to the face-to-face interview. Our survey showed that exposure was multidimensional and that it was possible to calculate an exposure score suitable for the analysis of exposure-effect relationships. The PTSD scale was completed well by the interviewees, several of whom did not fill in the depression and anxiety scales correctly. However, analysis of the responses obtained showed that these tools had a high level of internal consistency. Cross-correlations between the various psychological scales used in this study were highly significant (p < 10-4). There was some degree of association between some psychometric scales and exposure. This pilot study shows that a cross-sectional study of the long-term psychological consequences of an environmental disaster could be carried out several years after the event but that the feasibility of such a study depends ultimately on its acceptance by the public and the relevant authorities. It underlines the need to collect exposure data immediately after the event and enabled us to identify and to adapt the tools required for this kind of evaluation. It should encourage public health decision-makers to support such evaluation and to improve the psychological and social support available to people exposed to floods.

Anxiety↗
PubMedDate not supplied

Nursing students' perceptions about disaster nursing.

Man-made or natural disasters are occurring more frequently in the United States and around the world. It is important that all nurses in all specialties be prepared to care for people affected by disasters. This article reports a descriptive study that sought to explore nursing students' perceptions about disaster nursing and to use the findings to suggest recommendations for building the discipline of disaster nursing. Results of this study indicate that nursing students had the following gaps of knowledge regarding disaster nursing: (1) an incomplete definition of disaster nursing; (2) lack of recognition about the importance of knowing community resources, having mock disaster drills, and utilizing disaster planning models; and (3) lack of perception that all nurses could play a significant role in disaster situations. The authors recommend that disaster nursing be taught by nursing faculty as a specialty in nursing programs.

Adult↗
PubMedDate not supplied

Field triage in disasters.

In man-made and natural disasters, prehospital providers and their emergency medical services systems may find it necessary to shift their triage methodology from a daily operational framework of treating the most severely injured patient first and providing the highest level of care for each patient to the concept of providing the greatest good for the greatest number of casualties. In a scenario where there are an overwhelming number of casualties, this shift will be necessary, both to identify critically injured patients who can benefit from immediate, life-saving interventions and to preserve prehospital and hospital resources. This report examines triage issues as they apply to mass casualty events.

Disasters↗
PubMed2006

Providing critical care during a disaster: the interface between disaster response agencies and hospitals.

OBJECTIVE: Recent natural disasters have highlighted shortfall areas in current hospital disaster preparedness. These include the following: 1) insufficient coordination between hospitals and civil/governmental response agencies; 2) insufficient on-site critical care capability; 3) a lack of "portability" of acute care processes (i.e., patient transport and/or bringing care to the patient); 4) education shortfalls; and 5) the inability of hospitals to align disaster medical requirements with other competing priorities. CONCLUSIONS: Definition of the roles and responsibilities of a hospital during a disaster requires additional planning precision beyond the prehospital response phase. Planners must also better define plans for circumstances when or if a hospital is rendered unusable. Disaster medical training of hospital personnel has been inadequate. This article details the specifics of these issues and outlines various potential approaches to begin addressing and formulating remedies to these shortfalls.

Critical Care↗
PubMed2005

The east coast Big Flood, 31 January-1 February 1953: a summary of the human disaster.

The Big Flood was the worst natural disaster to befall Britain during the twentieth century, and the scale of its human impact was due to the lack of adequate disaster preparedness. The 307 deaths on land were caused by drowning or from the effects of exposure. Two-thirds occurred in four clusters along the shoreline and mainly comprised inhabitants of post-war prefabricated buildings, bungalows and chalets, with the highest mortality among the elderly. The emergency response was spontaneous and community led, with the main search and rescue completed before central government became involved. No individuals or agencies were blamed for the neglected state of the flood defences or the absence of warnings, along with the post-war shortage of adequate housing, which were the main causes of vulnerability. The media played a limited role, and television was in its infancy. Mental health impacts were either self-limiting or failed to be articulated in a society recovering from the Second World War. The major mitigating factors included the empathetic response of people, locally and nationally, as well as the availability of armed forces personnel based in East Anglia, whose actions played a decisive part in the battle against the sea. The major legacies of the Big Flood were a coastal flood forecasting system, a more scientific approach to sea defences and the building of the Thames barrier.

Computer Simulation↗
PubMed2006

The pediatrician and disaster preparedness.

For decades, emergency planning for natural disasters, public health emergencies, workplace accidents, and other calamities has been the responsibility of government agencies on all levels and certain nongovernment organizations such as the American Red Cross. In the case of terrorism, however, entirely new approaches to emergency planning are under development for a variety of reasons. Terrorism preparedness is a highly specific component of general emergency preparedness. In addition to the unique pediatric issues involved in general emergency preparedness, terrorism preparedness must consider several additional issues, including the unique vulnerabilities of children to various agents as well as the limited availability of age- and weight-appropriate antidotes and treatments. Although children may respond more rapidly to therapeutic intervention, they are at the same time more susceptible to various agents and conditions and more likely to deteriorate if they are not monitored carefully. This article is designed to provide an overview of key issues for the pediatrician with respect to disaster, terrorism, and public health emergency preparedness. It is not intended to be a complete compendium of didactic content but rather offers an approach to what pediatricians need to know and how pediatricians must lend their expertise to enhance preparedness in every community. To become fully and optimally prepared, pediatricians need to become familiar with these key areas of emergency preparedness: unique aspects of children related to terrorism and other disasters; terrorism preparedness; mental health vulnerabilities and development of resiliency; managing family concerns about terrorism and disaster preparedness; office-based preparedness; hospital preparedness; community, government, and public health preparedness; and advocating for children and families in preparedness planning.

Bioterrorism↗
PubMed1993

The power of volunteers in disaster relief.

Hurricane Andrew, one of the worst natural disasters in American history, brought out the spirit of caring in medical personnel as volunteers from all over the country came to aid the hurricane's victims. The following is an example of how one massive relief effort can make a difference in thousands of lives.

Disaster Planning↗
PubMed1999

[Repeated amenorrhea in an adolescent girl in the course of flood disaster in Kłodzko Region, July 1997].

OBJECTIVES: A natural disaster has been defined as a disruption of human ecology that exceeds the capacity of the community to function normally. DESIGN: After the flood disaster in Kłodzko Region, July 1997, the major problem in female adolescents was observed: secondary amenorrhea. MATERIALS AND METHODS: 17 female adolescents, aged 13-18, which injured from the flood disaster with secondary amenorrhea were investigated. A control random group consists of 17 girls diagnosed before oral contraception. Diagnostic work-up includes history, physical and psychological examinations, hormonal profiles, transvaginal ultrasonography, color Doppler analysis of utero-ovarian arterial blood flow. RESULTS: FSH, LH, E2 plasma levels and LH/FSH ratio were significantly lower in the amenorrheic group compared to normal girls. Prolactin serum levels after metoclopramid administration were significantly higher in the amenorrheic group. Lower impedance to blood flow in the intraovarian arteries have been shown. Psychosomatic disorders related to hypothalamic amenorrhoea were diagnosed. CONCLUSIONS: Psychosocial stress observed during the flood disaster caused hypogonadotropic hypogonadism amenorrhoea in the female adolescents.

Adolescent↗
PubMed1989

Veterinary services in disasters and emergencies.

Potential man-made or natural disasters could overwhelm the residual medical and surgical capacity. Veterinarians have the training and experience to augment physicians in caring for human casualties, and dispersed veterinary hospitals constitute survivable facilities that are equipped to provide medical and surgical care. Veterinarians can also serve public health and preventive medicine and maintain the health of agricultural livestock as food sources. Civil defense planning must include veterinarians so that these valuable medical care resources can be used to save lives that might otherwise be lost.

Civil Defense↗
PubMed1994

Psychological response to disaster: implications for Hawaii.

Given the frequency of natural disasters in Hawaii, it is important for practitioners to be aware of the numerous resulting psychological responses and risk factors, especially those unique to Hawaii. Practical guidelines are presented for practitioners, both in providing leadership during the disaster and in screening for psychopathology thereafter.

Disaster Planning↗
PubMedDate not supplied

An analysis of Disaster Medical Assistance Team (DMAT) deployments in the United States.

OBJECTIVE: To determine the prevalence and types of disasters on which Disaster Medical Assistance Teams (DMAT) teams have been deployed. METHODS: This descriptive study used the websites of the 42 DMAT teams in the United States with information confirmed by NDMS websites for a historical analysis of DMAT team deployment. All 42 DMAT teams were included in the analysis from 1985 through 2002. One DMAT team did not have a website, so they were contacted by phone. RESULTS: From 1985 through 2002 DMAT teams were deployed for 50 disasters: 41 natural (41/50=82%), and 9 man-made disasters (9/50=18%). Of the 41 natural disasters, there were 17 hurricanes/tropical storms (17/41=41.6%), 10 floods (10/41=24.3%), 7 earthquakes (7/41=17.0%), 4 fires (4/41=9.8%), 2 blizzards/ice storms (2/41=4.9%), and 1 tornado (1/41=2.4%). Of the 9 man-made disasters, there were 3 terrorist attacks (3/9=33.3%), 2 epidemics (2/9=22.2%), 2 plane crashes (2/9=22.2%), 1 fire (1/9=11.1%) and 1 relief mission (1/9=11.1%). Of the 8 disasters outside of the United States, there were 4 earthquakes (4/8=50%), 2 tropical storms (2/8=25%), 1 wildfire (1/8=12.5%) and 1 relief mission (1/8=12.5%). There were also numerous "stand-by" deployments. CONCLUSION: The majority (over 80%) of DMAT team deployments from 1985 through 2002 were for natural disasters, although there has been an increase in "man-made" disasters in recent years with terrorist attacks being the most frequent man-made disaster. DMAT teams have also been deployed on missions outside the United States, most often responding to earthquakes and secondly for hurricanes/tropical storms. There has been a prevalence of "water-related" natural disasters including hurricanes/tropical storms and floods, which accounted for three fourths of all natural disasters (25/34=73.5%) and about two thirds of all (natural and man-made) disasters (25/43=59.5%) in the United States over an 18 year period. Recent events including hurricane Katrina suggest that our finding of a prevalence of "water-related" natural disasters is a reliable trend. In the future, DMAT teams need to be prepared to function in a variety of disasters, both natural and man-made, although resources and planning must include "water-related" disasters because they comprise the majority of disasters in the United States.

Disasters↗
PubMed2001

Disaster mitigation and preparedness: the case of NGOs in the Philippines.

The Philippines is very vulnerable to natural disasters because of its natural setting, as well as its socio-economic, political and environmental context--especially its widespread poverty. The Philippines has a well-established institutional and legal framework for disaster management, including built-in mechanisms for participation of the people and NGOs in decision-making and programme implementation. The nature and extent of collaboration with government in disaster preparedness and mitigation issues varies greatly according to their roots, either in past confrontation and political struggles or traditional charity activities. The growing NGO involvement in disaster management has been influenced by this history. Some agencies work well with local government and there is an increasing trend for collaborative work in disaster mitigation and preparedness. Some NGOs, however, retain critical positions. These organisations tend to engage more in advocacy and legal support for communities facing increased risk because of development projects and environmental destruction. Entry points into disaster mitigation and preparedness vary as well. Development-oriented agencies are drawn into these issues when the community members with whom they work face disaster. Relief organisations, too, realise the need for community mobilisation, and are thus drawn towards development roles.

Community Participation↗
PubMed2001

The potential impacts of climate variability and change on health impacts of extreme weather events in the United States.

Extreme weather events such as precipitation extremes and severe storms cause hundreds of deaths and injuries annually in the United States. Climate change may alter the frequency, timing, intensity, and duration of these events. Increases in heavy precipitation have occurred over the past century. Future climate scenarios show likely increases in the frequency of extreme precipitation events, including precipitation during hurricanes, raising the risk of floods. Frequencies of tornadoes and hurricanes cannot reliably be projected. Injury and death are the direct health impacts most often associated with natural disasters. Secondary effects, mediated by changes in ecologic systems and public health infrastructure, also occur. The health impacts of extreme weather events hinge on the vulnerabilities and recovery capacities of the natural environment and the local population. Relevant variables include building codes, warning systems, disaster policies, evacuation plans, and relief efforts. There are many federal, state, and local government agencies and nongovernmental organizations involved in planning for and responding to natural disasters in the United States. Future research on health impacts of extreme weather events should focus on improving climate models to project any trends in regional extreme events and as a result improve public health preparedness and mitigation. Epidemiologic studies of health effects beyond the direct impacts of disaster will provide a more accurate measure of the full health impacts and will assist in planning and resource allocation.

Climate↗
PubMed2005

Tsunami insight to mangrove value.

The recent tsunami in the Indian Ocean is the latest and most devastating natural disaster to highlight the value of mangrove forest and other natural defences in protecting vulnerable coastal communities.

Asia↗
PubMed1998

Flood disaster preparedness: a retrospect from Grand Forks, North Dakota.

Natural disasters often come without warning. The clinical, financial, and business risks can be enormous. Grand Forks' (ND) healthcare systems experienced a flooding disaster of unprecedented proportions in April of 1997. Planned and practiced disaster and evacuation procedures can significantly reduce a healthcare facilities' risk to life, health, and safety. This article retrospectively analyzes disaster preparation and the complete evacuation of the facilities' patients.

Disaster Planning↗
PubMed1979

An emergency medical system approach to disaster planning.

The increasing prevalence of terrorist attacks and natural disasters has mandated that more emphasis be placed on emergency disaster planning. The report focuses on the 1976 Courthouse bombing in Boston, which generated 20 casualties. Ambulance response by Boston's Emergency Medical Service system was made in 2.5 minutes and all victims were transported from the scene within 20 minutes. Successful management of this incident employed several important principles of disaster planning. These include the initial medical response, staging at the scene, and hospital notification. Additionally, the concept of triage as an integral part of disaster planning is explained with examples of the on-site medical stabilization and treatment of casualties. The importance of these concepts in practice and the necessity of close coordination of ambulance response and the responses of other emergency agencies, i.e., Police and Fire, were clearly demonstrated in the disaster which resulted from the Courthouse bombing.

Adult↗