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PubMed2003

Therapeutic effects of two antidepressant agents in the treatment of posttraumatic stress disorder (PTSD).

Posttraumatic stress disorder (PTSD) is a psychiatric disorder characterised by an acute emotional response to a traumatic event or situation involving severe environmental stress (natural disasters, wars, epidemics, rape, assaults, physical torture, catastrophic illness or accident), which may be identified in cognitive, affective or sensory motor activities. The objective was to perform a pilot clinical trial designed to compare the effects of older (tricyclic) and newer "second-generation" (selective inhibitors of serotonin uptake) antidepressants in the treatment of PTSD. A total of 20 hospitalised chronic military combat Bosnian veterans with PTSD symptoms were randomly assigned into two groups of 10 patients each. One group was treated with amitriptyline hydrochloride (AMYZOL) 75 mg/day as a representative of older antidepressants and the other with fluoxetine hydrochloride 60 mg/day (OXETIN) as a representative of newer antidepressants. Those drugs were administered by mouth two or three times-a-day in equally divided doses for at least 8 weeks. Favourable response was achieved in 70% of patients treated with amitriptyline hydrochloride and 60% of patients treated with fluoxetine hydrochloride. Amitriptyline hydrochloride was more effective in the treatment of acute PTSD symptoms (emotional numbing, startle reaction, nightmares, flashbacks, intrusive thoughts, vulnerability, poor impulse control or irritability and explosiveness). Fluoxetine hydrochloride showed a greater efficacy in the treatment of chronic PTSD symptoms (avoidance and numbing symptoms, hyperarousal, nightmares and a feeling of guilt).

Journal Article↗
PubMed1996

Special challenges of maintaining wild animals in captivity in North America.

The maintenance of wild animals in captivity in North America is regulated by a number of different laws and government agencies in each country. Member institutions of zoo and aquarium associations in Canada, the United States of America and Mexico experience an extra tier of regulation in the form of industry standards, which are sometimes stricter than those imposed by government. Climate, natural disasters and harmful pest species all contribute to the challenge of keeping animals in certain locales. Vigilance against zoonotic disease transmission is maintained through industry and government-mandated sanitation standards, which are fortified by reporting regulations of local, regional and Federal health agencies. Current controversies in the keeping of particular taxa in North America include the threat to non-human primate breeding programmes precipitated by strict new import regulations, the fear of herpesvirus B infection, and commercial airline transport bans. Successive human fatalities among elephant handlers have prompted the industry and governments to re-examine the manner in which these potentially dangerous creatures are maintained in captivity.

Animal Husbandry↗
PubMed2002

Risk management of international trade: emergency preparedness.

Emergency preparedness and management are among the most important and critical issues facing animal health in the world today. The goals of a country for an animal health emergency management (AHEM) system should include the following: --being prepared to detect and manage an outbreak of a foreign animal disease --preventing the introduction of foreign and emerging animal pathogens --having an appropriate response system for control and eradication of the disease --having a system for recovery from animal health emergencies, including natural disasters. An AHEM system can no longer be limited to a single organisation within a country. In the event of a serious threat to the animal agriculture of a country, broader and more comprehensive participation is required. If not properly planned for, animal health emergencies can rapidly become national disasters. Therefore, it is essential that the central government of a country work towards these goals through partnerships with other Federal and State/Provincial/District organisations, academic institutions and national animal industries.

Animal Diseases↗
PubMed1995

Self-perceived traumatic stress in college: a survey.

Most studies of Posttraumatic Stress Disorder have involved war veterans and victims of natural disasters and violent crime. To evaluate the incidence at college, 179 college students' responses were examined. Analysis indicated that there was a high frequency of self-perceived traumatic stress in this sample; 42% reported traumatic events, whereas only 6% would meet strict diagnostic criteria. Automobile accidents, deaths, and harassment were events perceived as traumatic. Most students turned to themselves or friends for treatment. Apparently traumatic events are more prevalent on campus than previously thought and (with the exception of rape) are rarely covered in prevention programs. College health authorities should be aware of the high incidence of perceived trauma, inform college students of potential stressors, and provide appropriate treatment.

Adolescent↗
PubMedDate not supplied

Parents' struggles to rebuild family life after Hurricane Andrew.

The purpose of this phenomenological study was to gain a deeper understanding of the meaning of parents' everyday experiences after a major natural disaster. In-depth interviews were conducted with 13 parents who lived in the hurricane-damaged area. The essence of being a parent emerged as "struggling to rebuild family life." The struggles were superimposed on top of ongoing issues such as divorce and job responsibilities. Parents described feelings of being thankful to be alive, being overwhelmed, being limited by environmental aftereffects, being responsible for children, balancing needs and roles, constantly changing amidst uncertainty, and finding meaning in the disaster. Study findings support the need for nursing interventions that address family needs, support strengths, and involve parents as active decision makers.

Adaptation, Psychological↗
PubMed1992

Acute renal failure in the Armenian earthquake.

A destructive earthquake devastated northwestern Armenia on December 7, 1988. The size of the affected area (radius of 50 miles), the time of the day when it occurred (11:41 a.m.), deficiencies in the design and construction of buildings, and inadequate initial rescue and relief capabilities resulted in one of the most lethal and traumatic natural disasters of the century. A large but unknown number (estimated at 225 to 385) of the extricated victims who had sustained crush injury developed myoglobinuric acute renal failure requiring dialytic support. The limited number (8-10 dialysis machines) of antiquated dialysis facilities available locally were overwhelmed. International dialysis relief efforts resulted in meeting the immediate acute needs and provided the motivation and elements of the more efficient system for the future delivery of maintenance dialysis.

Acute Kidney Injury↗
PubMed1997

Earthquake consequences and measures for reduction of seismic risk.

Earthquakes are one of the most destructive of all natural disasters. This article discusses the consequences of earthquakes on material property. In addition, measures for the control and reduction of the consequences of earthquakes are described. Emphasis is placed on appropriate preparation by the general population and the need for a rapid and efficient response of governmental agencies. Finally, the experience of the staff of the Institute of Earthquake Engineering and Engineering Seismology in minimizing the consequences of earthquakes is described.

Delivery of Health Care↗
PubMedDate not supplied

Malaria on the move: human population movement and malaria transmission.

Reports of malaria are increasing in many countries and in areas thought free of the disease. One of the factors contributing to the reemergence of malaria is human migration. People move for a number of reasons, including environmental deterioration, economic necessity, conflicts, and natural disasters. These factors are most likely to affect the poor, many of whom live in or near malarious areas. Identifying and understanding the influence of these population movements can improve prevention measures and malaria control programs.

Agriculture↗
PubMed2004

PTSD symptoms in elementary school children after Typhoon Rusa.

PURPOSE: A natural disaster negatively affects children's emotional and behavioral adjustment. The purpose of this paper was to examine the prevalence, symptoms, and correlates of PTSD after the occurrence of Typhoon Rusa. METHOD: 261 elementary school children living in Kimcheon, which was a devastated rural area in South Korea by Typhoon Rusa, were selected. Data were collected 4 months after the disaster using the PTSD Reaction Index categories recommended by Frederick, severity of PTSD. RESULT: 12.3% of the children had either moderate or severe PTSD symptoms; 22.7% reported mild symptoms; and the remaining 65% had sub-clinical symptoms of PTSD. The most frequent symptom was recurrent fear(67.0%). 13% to 17.2% of children exhibited difficulty in concentration, sleep disturbance, and guilt feeling. The regression model of severity of PTSD was composed of the level of exposure to traumatic experiences, grade in school, gender, negative coping style, and social support, and explained 34.3% for PTSD symptoms. Exposure to traumatic experiences was the strongest factor of all predictors. CONCLUSION: Emotional support from friends and coping style were correlated with PTSD severity. School-based interventions that emphasizes coping with disaster related problems and problem-solving may prove to be useful, and may aid in building close and supportive ties with teachers, classmates, and friends.

Adaptation, Psychological↗
PubMed2006

Natural course of posttraumatic stress disorder: a 20-month prospective study of Turkish earthquake survivors.

OBJECTIVE: A 20-month prospective follow-up of survivors of the severe earthquake in Turkey in 1999 examined the natural course of posttraumatic stress disorder (PTSD) and the contribution of different symptom clusters to the emergence of PTSD. METHOD: Subjects were randomly sampled in a suburb of Istanbul that was severely affected by the earthquake. A total of 464 adults were assessed with a self-report instrument for PTSD symptoms on 3 consecutive surveys that were administered 1 to 3, 6 to 10, and 18 to 20 months following the earthquake. RESULTS: The prevalence of PTSD was 30.2% on the first survey and decreased to 26.9% and 10.6% on the second and third surveys, respectively. Female subjects showed initially higher (34.8%) PTSD rates compared with male subjects (19.1%). However, gender differences disappeared by the time of the third survey due to high spontaneous remission rates in female subjects. Low levels of chronic and delayed-onset PTSD were observed. A major contribution of the avoidance symptoms to PTSD diagnosis was identified by statistical analysis. CONCLUSIONS: Initial PTSD following an earthquake may be as prevalent as in other natural disasters, but high rates of spontaneous remission lead to low prevalence 1.5 years following the earthquake. Initial avoidance characteristics play a major role in the emergence of PTSD.

Adult↗
PubMed1984

The Ash Wednesday bushfires in Victoria.

The Ash Wednesday bushfires were one of the worst natural disasters in Australia's history. This paper documents observations of human reactions to the disaster started immediately after the bushfires. Two frameworks were used for classification of observations: biopsychosocial and temporal. Biological, psychological and social reactions in adults and children are described as they occurred before, during, immediately after, and two months after the disaster. Some reactions in animals are noted. Victims of the bushfires were seen to have reacted during the various phases of the experience in a predictable way: during the acute danger, when survival was paramount, and immediately afterward, the usual patterns of hierarchical structure within families and in the wider community broke down and new social structures emerged. These reverted to previously existing patterns in the ensuing months. Feelings of disorientation, unreality and anger at outside agencies, which were viewed as hostile and unhelpful, were commonplace. The findings have implications for the development of everyday stress reactions and clinical syndromes presenting to clinical practitioners. Lastly, the role of intervention for disaster reactions is examined and its usefulness noted.

Aged↗
PubMedDate not supplied

Sydney hailstorms: the health role in the recovery process.

We highlight the involvement of community health, public health and mental health staff in the recovery period after a natural disaster (hailstorm and ensuing wind and rain over three weeks) which, despite causing relatively few deaths or severe injuries, affected 20,000 families and caused damage estimated at $1.5 billion. Many families were given information and advice, and 383 individuals were referred for health assessment and management by doctors and other healthcare workers over an eight-month recovery period.

Australia↗
PubMed2006

Potential impact of AUSFTA on Australia's blood supply.

Australia is largely self-sufficient in its supply of safe, fresh blood products because of the goodwill of non-remunerated, volunteer donors, plus rigorous testing and processing standards. CSL Limited is the sole provider of plasma fractionation services in Australia, enjoying exclusive rights under the Plasma Fractionation Agreement with the Australian Government. In the Australia-United States Free Trade Agreement (AUSFTA), Australia agreed to review its current contract with CSL Limited, and to recommend to the states and territories that the process be opened up to overseas tender. Overseas tenders for off-shore fractionation services are likely to be highly competitive due to their low manufacturing costs and accumulated expertise. Off-shore fractionation could compromise the safety of Australia's blood supply through delays in processing and transportation, issues related to quality control, and even the siphoning of stock to overseas markets. This could compromise the long-term care of Australian patients and create a serious national security risk in the event of a terrorist attack or natural disaster. Australia's AUSFTA obligation to recommend changes does not equate to an obligation to actually proceed. The states and territories should carefully consider whether such changes would be in our national interest. The long-term security of the Australian people in the current security environment is dependent on continuance of an on-shore fractionation plant and appropriate back-up facilities.

Australia↗
PubMed2005

Iranian military forces in the Bam earthquake.

The earthquake that struck Bam, Iran, in December 2003 was one of the most catastrophic natural disasters in recent years. Medical and assistance activities conducted by Iranian military forces in this event are discussed in light of the special capabilities of the military forces in search and rescue missions. Among the most significant activities of the Iranian military forces in this event are the following: reporting the first news about the event, starting search and rescue missions in the first hour after the disaster by the 1st Brigade of Bam as the first assisting force, setting up two field hospitals as the first Iranian field hospitals in the disaster area, transporting 937 assistance, medical, and health care personnel to the disaster area in the first day, setting up 23 field emergency and 13 field assistance centers in the area, running 8 post-hospital care centers throughout the country, and playing a significant role in airlifting 11,792 casualties to different hospitals around the country. Based on the recent experience and the exclusive abilities of military forces, a special role for these forces in search and rescue missions should be considered.

Disasters↗
PubMed2006

Planning for avian influenza.

Avian influenza, or influenza A (H5N1), has 3 of the 4 properties necessary to cause a serious pandemic: It can infect people, nearly all people are immunologically naive, and it is highly lethal. The Achilles heel of the virus is the lack of sustained human-human transmission. Fortunately, among the 124 cases reported through 30 May 2006, nearly all were acquired by direct contact with poultry. Unfortunately, the capability for efficient human-human transmission requires only a single mutation by a virus that is notoriously genetically unstable, hence the need for a new vaccine each year for seasonal influenza. Influenza A (H5N1) is being compared to another avian strain, the agent of the "Spanish flu" of 1918-1919, which traversed the world in 3 months and caused an estimated 50 million deaths. The question is, are we ready for this type of pandemic? The answer is probably no. The main problems are the lack of an effective vaccine, very poor surge capacity, a health care system that could not accommodate even a modest pandemic, and erratic regional planning. It's time to get ready, and in the process be ready for bioterrorism, natural disasters, and epidemics of other infectious diseases.

Antiviral Agents↗
PubMed2003

Crush injury and crush syndrome: a consensus statement.

Crush syndrome remains rare in European practice but is common in areas of civil disorder and where society has given way to civil war or natural disaster. Clinicians in the west are becoming increasingly involved in such situations and there is no reason to believe that the few instances due to conventional causes, such as an elderly person collapsing or road traffic accidents, will cease. Therefore, it is important that clinicians who deal rarely with crush syndrome have access to appropriate guidelines. This consensus report seeks to provide such advice.

Adult↗
PubMed1993

Earthquake!

Who in their right mind would see a natural disaster as an opportunity? One agency does see earthquakes as opportunities to improve its service to rural and hard-to-reach patients. This earthquake preparedness plan is an ongoing process, evaluated and updated even when there isn't a call for true preparedness.

California↗