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PubMed1980

A case-control study of hypertensive women in a post-disaster community: Wyoming Valley, Pennsylvania.

Among 396 female flood victims participating in a five-year post-disaster survey, 31 cases were identified who developed hypertension during that time period. A case-control study of hypertension was carried out utilizing age and ponderal index as matching criteria. The purpose of the study was to assess risk factors for hypertension associated with the early recovery period. Pairwise matching yielded 29 case-control pairs for analysis. Such factors as property loss, financial difficulties, physical work, use of alcohol, and perceived distress--all associated with the recovery period--were significantly associated with hypertension. Two mental health dimensions--somatization and anxiety--and the respondent's perceived effect of the flood on health assessed at the time of the survey also demonstrated significant positive correlations with hypertension.

Adult↗
PubMed1982

The stress of post-disaster body handling and victim identification work.

Personnel involved with the recovery and identification of bodies following the Mount Erebus aircrash were interviewed and tested. They gave information about the stressors of the assignment and their reactions to them. The outcome revealed that about a third of the subjects experienced some transient problems initially, and about one-fifth after three months. At a 20-month follow-up there was still some evidence of subjects being under stress. In this study, disaster stress was seen as a complex interaction between environmental and task stressors, job competency, perceptual and emotional defenses, management and follow-up support. It was suggested that levels of stress might be reduced if emotional de-briefing were introduced as a routine matter, alongside logistic de-briefing at the end of any similar operation. The procedure would help to ventilate any negative feelings there might be and to offer additional help should it be needed.

Adult↗
PubMed1987

Exploring the impact of a natural disaster on the health and psychological well-being of older adults.

The failure of researchers to consider the temporal dimensions of the stress process may be at least partially responsible for the disappointing empirical findings from research on stress and health. We argue that careful consideration must be given to the time lag between the occurrence of a stressor and initial symptom development, as well as the length of time that is required for symptoms to abate. Using a synthetic cohort design, we examine the length of time needed for symptoms to dissipate following a natural disaster (Hurricane Alicia). Findings from a random community survey of older adults suggest that the major effects of the storm diminish in about 16 months. Significant gender differences were found in this adjustment process. The implications of these findings for stress research are discussed.

Adaptation, Psychological↗
PubMed2006

Caring for children and adolescents in the aftermath of natural disasters.

The recent Southeast Asia tsunami confronted countries with the challenge to provide mental healthcare to children and adolescents who experienced loss, displacement and disruption of daily lives. The region that was affected is resource poor, however a great deal could be learned about the needed approaches to care, and the cautions that had to be exercised to avoid doing harm. The experience highlights the need to enhance the capacities for appropriate needs assessment, diagnosis, triage and post-disaster support in terms of schooling and employment.

Adolescent↗
PubMed2006

Dissociating veridicality, consistency, and confidence in autobiographical and event memories for the Columbia shuttle disaster.

A total of 449 students were tested for their event memories and autobiographical memories of hearing about the Columbia shuttle disaster of 1st February 2003. Four different groups were tested 2, 18, 27, or 51 days after the event. All participants were then re-tested after 5 months (second session) and again after 1 year (third session) from the first interview. Dissociations between consistency and confidence and between event and autobiographical memories were found. Consistency and confidence in event memories, but not in autobiographical memories, were affected by time. In contrast, repeated testing selectively enhanced autobiographical memories, in accordance with the narrative and rehearsal hypothesis of Neisser and Harsh (1992). For event memories, veridicality was inversely correlated to consistency, which in turn was inversely correlated to confidence, and mainly based on omissions. As regards veridicality, the analyses showed an increase of false memories at long time delays. Results are discussed with reference to recent studies contrasting autobiographical and event memories.

Disasters↗
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↗
PubMedDate not supplied

Psychosocial response to disaster: the attacks on the Stark and the Cole.

The terrorist attack on the USS Cole on 12 October 2000 was remarkably similar to the 1987 attack on the USS Stark. This article discusses the psychosocial consequences of the attacks on the families and crews of the ships and the community response of the Navy to the attacks, particularly that of the Navy Family Service Centers. The impact of the attacks is compared to the impact of natural and man-made disasters on communities while the impact on the crew is examined in light of combat psychiatry and post-traumatic stress disorder (PTSD). Events such as these are very likely to produce PTSD despite early intervention efforts. Following the attack on the Stark greater attention was given to the grief of family members than to the trauma of the crew, while the crew of the Cole has received longer-term psychiatric assistance than in previous similar episodes.

Disasters↗
PubMed1989

Psychological symptoms in older adults following natural disaster: nature, timing, duration, and course.

Using a prospective design with five follow-up intervals, the study addressed questions regarding the timing of onset, duration, course, and nature of psychological reaction to natural disaster. As participants in a statewide panel study, more than 200 older adults were interviewed both before and after two distinct floods occurred in southeastern Kentucky in 1981 and 1984. Exposure to these incidents, which differed in overall intensity, was assessed at both the individual and community levels. Personal loss was associated with short-term increases in negative affect, limited to one year postflood. Longer-term effects were more dependent on the level of community destruction. Exposure to high levels of community destruction was related to decreased positive affect up to two years postdisaster, whereas exposure to high levels of both community destruction and personal loss was predictive of increased negative affect for two years.

Aged↗
PubMed1988

Preventive social work in perceived environmental disasters.

A modified social support network intervention model is presented that can prevent extreme or inappropriate public response to exposure to perceived environmental toxins and other perceived technological disasters. Social workers in public health and environmental health settings may find this model useful as a basis for preexposure community intervention.

Community Psychiatry↗
PubMed1990

The Lockerbie disaster and other aircraft breakups in midair.

This is a review of the experiences and activities of various specialty groups that constituted the organization developed to investigate the Lockerbie air disaster. Circumstances surrounding other aircraft midair breakup crashes are also discussed.

Accidents, Aviation↗
PubMed2002

Lessons learned from the Marmara disaster: Time period under the rubble.

OBJECTIVE: To investigate the effect of the time period under the rubble on morbidity and mortality of the crush-syndrome patients after the catastrophic Marmara earthquake that struck northwestern Turkey in August 1999. DESIGN: Observational study. SETTING: Consecutive admissions to emergency and intensive care units of 35 reference hospitals that treated the renal victims. METHODS: Analysis of questionnaires obtained from these hospitals. PATIENTS: A total of 539 of 639 crush-syndrome patients whose time under the rubble was identified in the questionnaires. RESULTS: Mean time under the rubble was 11.7 +/- 14.3 hrs (median, 8 hrs; interquartile range, 6 hrs; range, 0.5-135 hrs). The highest number of patients was entrapped within the 5-8 hrs time stratum, and by the end of 48 hrs, 97% of the victims had been rescued. Nondialyzed victims spent a longer duration under the rubble than dialyzed ones (15.9 +/- 23.1 hrs [median, 7 hrs; interquartile range, 8.5 hrs] vs. 10.3 +/- 9.5 hrs [median, 8 hrs; interquartile range, 6 hrs), p <.001)]. Likewise, in the strata of longer time under the rubble, the percentage of survivors was higher (p =.07). Time under the rubble correlated positively with the number of amputated extremities (p <.001) and admission platelet count (p <.001), and it correlated negatively with admission serum albumin (p <.001). The victims entrapped for >50 hrs (n = 6) were characterized by lower figures of admission blood urea nitrogen (p =.04), serum creatinine (p =.003), hemodialysis sessions, and duration of hemodialysis support (p =.005, for both analyses) compared with victims whose time under the rubble was shorter. CONCLUSION: Rescue efforts should continue at least for 5 days after the disaster. Time under the rubble is not an adverse prognostic indicator of survival or renal dysfunction for the patients of crush syndrome, probably because only the victims with mild or moderate injuries can survive under the rubble for longer durations.

Adolescent↗
PubMed1991

Children and disaster: age, gender, and parental effects on PTSD symptoms.

Psychiatric reports of 179 children aged 2 to 15 who were exposed to the Buffalo Creek dam collapse in 1972 were rated for post-traumatic stress disorder (PTSD) symptoms 2 years after the disaster. Age and gender effects and the impact of the level of exposure and parental functioning were examined according to a conceptual model addressing factors contributing to adaptation to a traumatic event. Results showed fewer PTSD symptoms in the youngest age group and higher symptom levels for girls than boys. Approximately 37% of the children were given a "probable" diagnosis of PTSD. Multiple regression analysis showed that life threat, gender, parental psychopathology, and an irritable and/or depressed family atmosphere all contributed to the prediction of PTSD symptomatology in the children.

Adaptation, Psychological↗
PubMed1992

Malignant memories. Reluctance to utilize mental health services after a disaster.

This report describes the reluctance of individuals exposed to a man-made disaster to utilize formal mental health services. Measures were obtained in an initial screening 6 months after a shooting for 24 exposed school personnel. Data from the initial screening were compared for those who did not participate in a follow-up screening 12 months later (N = 11) and those who did (N = 13). Follow-up nonparticipants reported: more posttraumatic stress disorder symptoms, especially avoidance; recall of life threat during the event; feeling depressed; and an increase in positivity toward victims but not about their work or mental health professionals. The authors conclude that some individuals may avoid formal mental health services because they serve as cues for malignant memory retrieval and discuss implications for service delivery.

Adult↗
PubMed1995

Effects of a natural disaster on immigrants and host population.

The psychosocial effects of the 1989 Newcastle earthquake on 250 immigrants from non-English-speaking backgrounds (NESB) were compared with a matched sample of 250 Australian-born subjects. The NESB subjects had higher levels of both general (General Health Questionnaire-12) and event-related (Impact of Event Scale) psychological morbidity. Furthermore, NESB females had the highest levels of distress, particularly those who were older on arrival in Australia and those who experienced high levels of disruption. The results suggest that NESB immigrants, particularly women, appear to be more at risk for developing psychological distress following a natural disaster. However, level of exposure and an avoidance coping style contributed more substantially to psychological distress than ethnicity.

Adaptation, Psychological↗
PubMed1988

The role of a regional trauma system in the management of a mass disaster: an analysis of the Keystone, Colorado, chairlift accident.

On December 14, 1985, the Teller chairlift at the Keystone, Colorado, ski area collapsed, throwing 60 of the 372 people aboard to the ground from heights up to 50 feet. Initial triage and management of the victims was carried out by the local ski patrol, the on-duty physician at the area's Snake River Health Services Clinic, and by volunteer physicians and nurses present at the scene. Thirty-three people required immediate evacuation to hospitals, most of them being transported 75 miles by helicopter air ambulance to level I and II trauma centers in the Denver metropolitan area. Eighteen of these air-evacuated patients were in serious or critical condition. Less seriously injured victims were treated at local medical facilities. The scene evacuation was carried out by helicopter and ground vehicles in accordance with an existing disaster plan coordinated by the Colorado Trauma Institute (CTI). The unique problems posed by a mass casualty incident in a remote mountain location are emphasized by this tragedy. Patient salvage due to the efficacy of a regionally organized trauma system is clearly demonstrated.

Adolescent↗
PubMedDate not supplied

Mass casualty disaster nursing course.

In light of ongoing threats to homeland security, nursing students must be introduced to content related to disaster nursing and the management of mass casualties. The author describes course content and activities to help nursing faculty teach this material.

Curriculum↗
PubMed2001

Braced for disaster.

Organized disaster or mass casualty incident planning is typically limited to prehospital, ED, OR, and ICU personnel. Such planning can be transferred to acute care situations as well.

Acute Disease↗
PubMed2001

What to do before disaster strikes.

The key to averting disaster or minimizing its effects is a solid data security plan. Learn the types of data risks that exist, how to develop a plan to counteract them, and your role in ensuring the safety of health and patient data.

Disaster Planning↗