Management of helicopter medical transport in 36 patients with critical cardiac disease / 中华危重病急救医学

Objective:To summarize the management experience of helicopter medical transport in patients with critical heart disease, so as to provide reference for transport of patients with critical heart disease under the background of major natural disasters.Methods:The clinical and transport data of 36 critically ill cardiac patients in Fuwai Central China Cardiovascular Hospital from 16:30 on July 21 to 19:30 on July 22, 2021 due to historically rare heavy rainstorms were collected. All 36 critically ill cardiac patients were transported by helicopter. The safe transportation was implemented under the measures of quickly forming a transport leadership and coordination group, clarifying responsibilities and division of labor, doing a good job in the pretreatment of the patient's condition, pipeline assessment and mechanical circulation support (MCS) equipment, simulating and practicing the transfer process, improving the safety of the transfer implementation process, and effectively handing over with the target hospital. The gender, age, disease type, MCS, transport and outcome of patients were collected.Results:Thirty-six patients with cardiac critical illness were from adult extracardiac intensive care unit (ICU), adult cardiac care unit (CCU), children's CCU, comprehensive ICU and department of neurology. There were 24 males and 12 females; age (50.93±20.86) years old. There were 12 patients using respirator, 7 patients needing MCS, 2 of whom needed both extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon pump (IABP), and 7 patients with post-cardiac surgery. The total distance of transportation of 36 patients was 1 638.4 km, the transit time was 10.5 hours, one way flight time of helicopter was about 8 minutes, and the average transport time per patient was about 17.5 minutes. The vital signs of 36 patients during transport were basically stable, without complications, and all of them reached the target hospital safely.Conclusion:Under the seamless connection of the rapid establishment of the transfer leadership coordination group, assessment of the patient's condition and pretreatment, the simulation of the transfer process, and the effective handover with the receiving hospital, the use of helicopter for medical transport for critically ill heart patients is feasible and safe, which can buy valuable time for saving patients' lives and further treatment.

Funcionalidad familiar y satisfacción con la vida post desastre natural en una comunidad de San Antonio del Pedregal, Perú / Family functionality and satisfaction with life after natural disaster in a community of San Antonio del Pedregal, Perú / Funcionalidade familiar e satisfação com a vida pós-desastre natural em uma comunidade de San Antonio del Pedregal, Perú

Los desastres naturales, aparte de las pérdidas económicas que generan, también pueden afectar el funcionamiento familiar y la satisfacción con la vida debido a los eventos adversos que se experimentan. Por ello, el principal objetivo de la investigación fue determinar la relación que existe entre la funcionalidad familiar y la satisfacción con la vida en la comunidad de San Antonio del Pedregal - Sector 1 en Lurigancho-Chosica, Perú; una de las zonas más afectadas por la presencia de huaicos (grandes aluviones frecuentes en las alturas andinas) desde la década de 1980 y que recientemente ha experimentado los efectos adversos del fenómeno del Niño de 2017. La investigación se desarrolló bajo el enfoque cuantitativo, con alcance correlacional y diseño no experimental de corte transversal; además, la muestra de estudio estuvo conformada por 180 personas. Los resultados indican que, a pesar de los eventos vividos, las personas muestran un moderado funcionamiento familiar y se encuentran satisfechas con sus vidas. Las mujeres presentaron mayor puntaje en ambas variables en comparación con los varones, los mayores de 60 años reportaron mayor funcionalidad familiar y los menores de 30 años mostraron mejores resultados en la satisfacción con la vida.(AU)

Natural disasters, apart from economic losses, can also affect family functioning and life satisfaction due to the adverse events that are experienced. Therefore, the main purpose of the research was to know the relation between the family functionality and satisfaction with life in the community of San Antonio del Pedregal - Sector 1 in Lurigancho-Chosica, Peru; one of the geographical areas most affected by the presence of huaicos (frequent large floods in the Andean highlands) since the 1980s and that has recently experienced the adverse effects of the El Niño phenomenon of 2017. The research was correlational and transversal; furthermore, the study sample consisted of 180 local people. The results indicate that, despite the events experienced, people show moderate family functioning and are satisfied with their life. Women had a higher score in both variables compared to men, those over 60 years of age reported greater family functionality, and those under 30 years of age showed better results in life satisfaction.(AU)

Os desastres naturais, além das perdas econômicas, também podem afetar o funcionamento da família e a satisfação com a vida devido aos eventos adversos vivenciados. Portanto, o objetivo principal da investigação foi conhecer a relação entre a funcionalidade da família e a satisfação com a vida na comunidade de San Antonio del Pedregal - Setor 1 em Lurigancho-Chosica, Peru; uma das áreas geográficas mais afetadas pela presença de huaicos (grandes inundações frequentes no planalto andino) desde a década de 1980 e que recentemente experimentou os efeitos adversos do fenômeno El Niño de 2017. A investigação foi correlacional e transversal; além disso, a amostra do estudo foi composta por 180 pessoas locais. Os resultados indicam que, apesar dos eventos vivenciados, as pessoas apresentam funcionamento familiar moderado e estão satisfeitas com a vida. As mulheres obtiveram pontuação mais elevada em ambas as variáveis em relação aos homens, as maiores de 60 anos relataram maior funcionalidade familiar e as menores de 30 anos apresentaram melhores resultados na satisfação com a vida.(AU)

Generating Subjective Theories After a Disaster: The Role of Personality / Generando Teorías Subjetivas Después del Desastre: El Rol de la Personalidad

Abstract The role of people's beliefs in their perception of disasters has been scarcely studied. This study, we analyzed how people who experienced an earthquake and a subsequent tsunami employ subjective theories (ST) to explain their traumatic experience. This study aimed to interpret the explanations developed by a group of people about the earthquake and tsunami that took place in Chile in 2015. Thirteen episodic interviews were conducted as part of a qualitative case study. The participants' theories were grouped into four categories: the impact of personality on one's reaction to hardships; the existence of a link between personality and coping styles; the limited influence of personality on one's way of coping with difficulties; and changes in personality after experiencing hardships. These findings are discussed analyzing whether the participants' explanations could foster personal growth and psychological well-being after the catastrophe.

Resumen El rol de las creencias en la experiencia del desastre ha sido poco investigado. En este estudio se analizó cómo personas que experimentaron un terremoto y posterior tsunami, utilizan teorías subjetivas (TS) para explicar la experiencia traumática. El propósito de este estudio fue interpretar las explicaciones que algunas personas elaboraron respecto al terremoto y tsunami vivido en la zona norte de Chile el año 2015. Se realizaron trece entrevistas episódicas, en el marco de un estudio de caso con metodología cualitativa. Como hallazgos interesantes de las teorías surgen cuatro categorías: implicancias de la personalidad en la reacción ante dificultades; existencia de relación entre personalidad y estilo de afrontamiento; poca importancia de la personalidad al momento de afrontar dificultades, y cambio en la personalidad luego de experimentar una dificultad. Estos hallazgos se discuten analizando si estas explicaciones podrían favorecer -o no- el crecimiento y bienestar psicológico posterior a la catástrofe.

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.

Changes in smoking behavior among victims after the great East Japan earthquake and tsunami

BACKGROUND@#In areas affected by the tsunami of the great East Japan Earthquake, smoking behavior may have deteriorated due to high stress and drastic changes in living environment. Surveys were conducted to reveal changes in smoking behaviors among victims.@*METHODS@#A population-based random-sample home-visit interview survey of victims in Iwate and Miyagi Prefectures affected by the tsunami disaster was conducted in 2012 (n = 1978), while a population-based nationwide survey was conducted in 2013 (n = 1082). A panel survey in 2014 was conducted with respondents of the 2012 survey (n = 930). Multiple logistic regression analysis was performed to reveal factors related to smoking status after the disaster.@*RESULTS@#There was high smoking prevalence of both sexes in the tsunami disaster area (current smoking rate in coastal area, 50.0% for male, 21.4% for female; inland area, 34.7% for male, 7.6% for female). Low prevalence of male quitters was observed (quitter rate in coastal area, 20.8% for male, 8.0% for female; inland area, 23.4% for male, 5.5% for female). The prevalence of nicotine-dependent people assessed by FTND (Fagerström Test for Nicotine Dependence) in the coastal area was also higher than in the inland area or other areas of Japan. Smoking behavior among victims worsened after the disaster and did not improve 3 years from the disaster. Post-disaster factors related to smoking were living in coastal area, complete destruction of house, and living in temporary housing.@*CONCLUSIONS@#Smoking prevalence and the level of nicotine dependence of tsunami victims were still high even 3 years after the disaster. It is important to emphasize measures for smoking control in the disaster areas for an extended time period.

Reconstrução em Movimento: Impactos do Terremoto de 2010 em Imigrantes Haitianos / Reconstruction in Movement: 2010 Earthquake Impacts on Haitian Immigrants / Reconstrucción en Movimiento: Impactos del Terremoto de 2010 en Inmigrantes Haitianos

A cultura oferece rituais e discursos que orientam o indivíduo, inclusive nos acontecimentos que excedem as possibilidades imediatas de representação psíquica, os eventos traumáticos. Em janeiro de 2010, o Haiti foi atingido por um terremoto com proporções catastróficas. A dificuldade do país em responder ao ocorrido, que agravou a situação precária da maioria de sua população, levou muitos haitianos a emigrarem, sendo o Brasil um dos destinos ­ ainda que provisório. O processo migratório, principalmente nas migrações involuntárias, implica em diversas mudanças e pode levar o sujeito a um estado de vulnerabilidade psíquica, pois muito daquilo que o orientava em sua existência é ameaçado pelo contato com a cultura diferente. O objetivo principal deste estudo foi analisar quais os impactos psicológicos do terremoto que, além de levar a experiência do imprevisível pelo evento em si, foi seguido de uma migração necessária para a continuidade e reconstrução da vida. De natureza qualitativa e exploratória, o procedimento de coleta de informações se deu por meio de entrevistas semiestruturadas. Aplicou-se a análise de conteúdo das narrativas, orientada pelo olhar psicanalítico e etnopsiquiátrico. Os resultados demonstram que a lembrança traumática, as perdas de pessoas próximas, a casa, o trabalho e a educação foram acrescidos às dificuldades de uma migração que, apesar de facilitada legalmente, é vivida com dificuldade de integração pela maioria desses sujeitos. Em contrapartida, o desejo de reconstrução da história individual e coletiva apresenta-se como importante força na vida dessas pessoas que, mesmo a distância, procuram compartilhar projetos com os conterrâneos....(AU)

Culture provides rituals and discourses that guide the individual, including in events that exceed the immediate possibilities of psychological representation, the traumatic ones. In January 2010 Haiti was hit by an earthquake with catastrophic proportions. The difficulty that the country had to respond to what happened aggravated the precarious situation of the majority of its population, leading many Haitians to emigrate, with Brazil as one of the destinations - albeit temporary. The migration process, especially in the involuntary migration, involves several changes and can lead the individual to a mental state of vulnerability, once much of what guided one in his or her existence is threatened by the contact with a different culture. The aim of this study was to analyze which are the psychological impacts due an earthquake that, in addition to bringing the experience of the unpredictable event itself, was followed by a migration required for the continuity and reconstruction of life. From qualitative and exploratory nature, the procedure to collect data was performed through semi-structured interviews. Content analysis of the narratives was carried out, guided by the psychoanalytic and ethnopsychiatric approaches. The results show that the traumatic memory, the loss of close persons, home, work and education were added to the difficulties of a migration that, although legally facilitated, is experienced with difficulty to integration for the majority of these individuals. On the other hand, the desire for reconstruction of individual and collective history presents itself as a major force in the lives of people who, even distant, seek to share projects with their compatriots....(AU)

La cultura ofrece rituales y discursos que orientan al sujeto, inclusive en los eventos traumáticos, que son acontecimientos que exceden las posibilidades inmediatas de representación psíquica. En enero de 2011, Haití fue tomado por un terremoto con proporciones catastróficas. La dificultad del país en responder a lo ocurrido agravó la situación precaria de la mayor parte de su populación, motivando la emigración de muchos haitianos, siendo Brasil uno de los destinos ­ aunque provisorio. El proceso migratorio, principalmente el de las migraciones involuntarias, implica diversas mudanzas y puede llevar al sujeto a un estado de vulnerabilidad psíquica, puesto que aquello que lo orientaba en su existencia es amenazado por el contacto con una cultura diferente. El objetivo principal de este estudio fue analizar cuáles son los impactos psicológicos del terremoto que, más allá de llevar la experiencia de lo imprevisible por el evento en sí, fue seguido de una migración necesaria para la continuidad y reconstrucción de vida. De naturaleza cualitativa y exploratoria, el procedimiento de colecta de informaciones en este estudio fue realizado por medio de entrevistas semiestructuradas. Fue aplicado el análisis de contenidos a los discursos, orientado por las perspectivas psicoanalítica y etnopsiquiátrica. Los resultados demuestran que la recordación de eventos traumáticos, la pérdida de personas cercanas, casa, trabajo y educación fueron acrecentadas a las dificultades de una migración que, a pesar de ser facilitada legalmente, es experimentada con dificultad de integración por la mayoría de los participantes de este estudio. En contrapartida, el deseo de reconstrucción de la historia individual y colectiva aparece como una importante fuerza en la vida de estas personas que, aún en la distancia, buscan compartir proyectos con los coterráneos....(AU)

Disaster Debris Management during the 2014-2015 Malaysia Flood Incident

@#Introduction: Flood is a natural disaster cause by heavy rainfall and high tide phenomenon. In the event of flood, substantial amount of wastes tend to be moved away and washed with mud that cause the task of waste recovering extremely challenging. The objective of the study was to assess flood victims participation, duration and major problem arise during post flood waste clean-up activity together with respondent’s knowledge and psychological importance in the recovery process. Methods: A cross sectional survey using interview and self-administered questionnaire was conducted involving 150 flood victims in Kuala Krai, Kelantan, who were heavily affected by the recent flood. Results: Respondents participation in the clean-up process was high (N = 126, 84%). Average 1 to 3 months were taken for the clean-up activity. Majority of the respondents had low and moderate satisfaction on the cleaning service provided by the authority (N = 84, 56%). Major problem arises from the past flood waste clean up activity was the biased waste removal process (N = 124, 83%), victims have to find alternative ways for disposal (N = 108, 72%) and the temporary disposal site were located near to the housing area that creates discomfort (N = 105, 70%). The correlation test obtained significant relationship between knowledge and education level (X2 = 0.203, p=0.013). But no significant relationship was obtained between knowledge with gender, age, monthly income, duration of clean-up process, respondents participation and satisfaction. Conclusion: Disaster debris management and disposal is critically important to support the victims in their recovery process.

Terremotos y salud en México: atención de la emergencia en el Istmo de Tehuantepec / Earthquakes and health in Mexico: emergency care in the Isthmus of Tehuantepec

Resumen El día 7 de septiembre del 2017 se registró un sismo de intensidad 8.2 grados en la escala de Richter, con mayor afectación en la región del Istmo de Tehuantepec. El mecanismo de respuesta por parte del sector salud fue implementado de manera inmediata a través del Operativo para la Seguridad en Salud. Las acciones prioritarias estuvieron enfocadas en el restablecimiento de la capacidad local de atención médica, en la identificación de enfermedades prevalentes y en llevar a cabo acciones de salud pública. Sin embargo, pese a las experiencias obtenidas en 1985, aún se vislumbra escasez de planeación y asignación de responsabilidades.

Abstract On September 7, 2017, an earthquake measuring 8.2 on the Richter scale recorded, with the greatest impact in the Isthmus of Tehuantepec region. The response mechanism by the health sector implemented immediately through the Health Security Operative. The priority actions were focused on restoring the local capacity of medical attention, in the identification of prevalent diseases, and in carrying out public health actions. However, despite the experiences obtained in 1985, there is still a glimpse of a shortage of planning and assignment of responsibilities.

Estimation of the National Burden of Disease and Vulnerable Population Associated with Natural Disasters in Korea: Heavy Precipitation and Typhoon

BACKGROUND: Despite its growing significance, studies on the burden of disease associated with natural disasters from the perspective of public health were few. This study aimed at estimating the national burden of disease associated with typhoons and torrential rains in Korea. METHODS: During the period of 2002–2012, 11 typhoons and five torrential rains were selected. Mortality and morbidities were defined as accentual death, injury and injury-related infection, and mental health. Their incidences were estimated from National Health Insurance Service. Case-crossover design was used to define the disaster-related excess mortality and morbidity. Disability-adjusted life years (DALYs) were directly assessed from excess mortality and morbidity. RESULTS: The burden of disease from typhoons increased with the intensity, with 107.7, 30.6, and 36.6 DALYs per 100,000 per event for strong, moderate, and weak typhoons, respectively. Burden of disease from torrential rains were 56.9, 52.8, and 26.4 DALYs per 100,000 per event for strong, moderate, and weak episodes, respectively. Mental disorders contributed more years lived with disability (YLDs) than did injuries in most cases, but the injury-induced YLDs associated with strong typhoon and torrential rain were higher than those of lower-intensity. The elderly was the most vulnerable to most types of disaster and storm intensities, and males younger than 65 years were more vulnerable to a strong torrential rain event. CONCLUSION: The intensity of torrential rain or typhoon was the strongest determinant of the burden of disease from natural disasters in Korea. Population vulnerable may vary depending on the nature and strength of the disasters.

Factores socio-demográficos, crecimiento y sintomatología postraumática en sobrevivientes del terremoto de Chile del 2010 / Socio-demographic factors, posttraumatic growth and symptoms in survivors of Chile earthquake 2010

El propósito de este estudio es evaluar la relación entre factores socio-demográficos y del evento con la sintomatología postraumática (SPT) y el crecimiento postraumático (CPT) en personas que perdieron su hogar en el terremoto de Chile del 27 de febrero de 2010. Con este fin, se seleccionaron 351 personas adultas, entre 18 y 84 años, de las cuales 63,2% eran mujeres. Se aplicó el Inventario de Crecimiento Postraumático y la Escala de Impacto de Evento Revisada, además de un cuestionario socio-demográfico. Se evidencia en el estudio la relación significativa con la SPT o el CPT de elementos tales como sexo, edad, ingresos económicos, cambio de comuna tras el sismo y la razón de la pérdida de la vivienda Se presentan los resultados y argumenta su alcance para la promoción y prevención de salud en sobrevivientes de desastres naturales.

The purpose of this study is to evaluate the relationship that socio-demographic and event factors share with post-traumatic symptomatology (PTSD) and posttraumatic growth (PTG) in people who lost their home in the earthquake that hit Chile on february 27th, 2010. To this end, 351 adults from 18 to 84 years old were selected, of whom 63.2% were women. For this study, the Posttraumatic Growth Inventory (PTGI) and the revised Impact of Event Scale (IES) were applied, in addition to a socio-demographic questionnaire. This study shows that elements such as gender, age, economic income, change of location after the earthquake, and the reason behind the loss of housing bear a significant relation with PTSD or PTG. Results are presented, and their consequences for health promotion and prevention in survivors of natural disasters are discussed. Keywords: posttraumatic

Funcionalidad familiar y satisfacción con la vida post desastre natural en una comunidad de San Antonio del Pedregal, Perú

Los desastres naturales, aparte de las pérdidas económicas que generan, también pueden afectar el funcionamiento familiar y la satisfacción con la vida debido a los eventos adversos que se experimentan. Por ello, el principal objetivo de la investigación fue determinar la relación que existe entre la funcionalidad familiar y la satisfacción con la vida en la comunidad de San Antonio del Pedregal - Sector 1 en Lurigancho-Chosica, Perú; una de las zonas más afectadas por la presencia de huaicos (grandes aluviones frecuentes en las alturas andinas) desde la década de 1980 y que recientemente ha experimentado los efectos adversos del fenómeno del Niño de 2017. La investigación se desarrolló bajo el enfoque cuantitativo, con alcance correlacional y diseño no experimental de corte transversal; además, la muestra de estudio estuvo conformada por 180 personas. Los resultados indican que, a pesar de los eventos vividos, las personas muestran un moderado funcionamiento familiar y se encuentran satisfechas con sus vidas. Las mujeres presentaron mayor puntaje en ambas variables en comparación con los varones, los mayores de 60 años reportaron mayor funcionalidad familiar y los menores de 30 años mostraron mejores resultados en la satisfacción con la vida.

Natural disasters, apart from economic losses, can also affect family functioning and life satisfaction due to the adverse events that are experienced. Therefore, the main purpose of the research was to know the relation between the family functionality and satisfaction with life in the community of San Antonio del Pedregal - Sector 1 in Lurigancho-Chosica, Peru; one of the geographical areas most affected by the presence of huaicos (frequent large floods in the Andean highlands) since the 1980s and that has recently experienced the adverse effects of the El Niño phenomenon of 2017. The research was correlational and transversal; furthermore, the study sample consisted of 180 local people. The results indicate that, despite the events experienced, people show moderate family functioning and are satisfied with their life. Women had a higher score in both variables compared to men, those over 60 years of age reported greater family functionality, and those under 30 years of age showed better results in life satisfaction.

Os desastres naturais, além das perdas econômicas, também podem afetar o funcionamento da família e a satisfação com a vida devido aos eventos adversos vivenciados. Portanto, o objetivo principal da investigação foi conhecer a relação entre a funcionalidade da família e a satisfação com a vida na comunidade de San Antonio del Pedregal - Setor 1 em Lurigancho-Chosica, Peru; uma das áreas geográficas mais afetadas pela presença de huaicos (grandes inundações frequentes no planalto andino) desde a década de 1980 e que recentemente experimentou os efeitos adversos do fenômeno El Niño de 2017. A investigação foi correlacional e transversal; além disso, a amostra do estudo foi composta por 180 pessoas locais. Os resultados indicam que, apesar dos eventos vivenciados, as pessoas apresentam funcionamento familiar moderado e estão satisfeitas com a vida. As mulheres obtiveram pontuação mais elevada em ambas as variáveis ​​em relação aos homens, as maiores de 60 anos relataram maior funcionalidade familiar e as menores de 30 anos apresentaram melhores resultados na satisfação com a vida.

Significados y vulnerabilidad social ante el terremoto y tsunami del 27 de febrero del 2010: la dimensión subjetiva desde los "damnificados" / Meanings and social vulnerability to 27F earthquake and tsunami: subjective dimension of Chilean victims

El presente estudio tuvo como objetivo conocer los significados y experiencias de 14 personas damnificadas por el desastre del 27F pertenecientes a la comuna de Constitución, Chile. Para esto se utilizó un diseño cualitativo de corte fenomenológico. Para la selección de participantes se empleó un muestreo intencionado. En cuanto a la producción de datos, se aplicó la técnica de entrevistas en profundidad cuyo producto fue analizado con la estrategia de codificación de la teoría fundamentada. Los resultados se dividen en dos temas principales: a) nos quedamos con lo puesto: (sobre)viviendo en la incertidumbre; y b) desorganización institucional vs. apoyo civil. Se identificaron subcategorías en cada tema de análisis, las cuales son ilustradas por los datos narrativos. Asimismo, se discuten y valoran las implicancias en la incorporación de la subjetividad de los afectados al proceso de comprensión psicosocial en la investigación sobre los desastres socio-naturales.

The present study aimed to understand meanings and shared experiences of 14 persons from Constitución (Chile) affected by the natural disaster on 27 February (27F). In order to achieve this goal, phenomenological qualitative design was used, selecting a purposive sampling comprised of people affected by the 27F earthquake and tsunami. Qualitative data collection was produced via in-depth interviews which were analyzed through strategies of codification based on grounded theory. The results are split into two main subjects: A) We lost everything: Surviving under uncertain conditions. B) Institutional disorganization vs. civil society. Five subcategories were identified inside each category of analysis and are illustrated by their narrative stories. Additionally, implications connected with the incorporation of that subjectivity experienced by victims to the process of psychosocial understanding (framed into the research of socio-natural disaster) is discussed and assessed.

The Record-Setting Flood of 2014 in Kelantan: Challenges and Recommendations from an Emergency Medicine Perspective and Why the Medical Campus Stood Dry

Floods are considered an annual natural disaster in Kelantan. However, the record-setting flood of 2014 was a ‘tsunami-like disaster’. Hospital Universiti Sains Malaysia was the only fully functioning hospital in the state and had to receive and manage cases from the hospitals and clinics throughout Kelantan. The experiences, challenges, and recommendations resulting from this disaster are highlighted from an emergency medicine perspective so that future disaster preparedness is truly a preparation. The history of how the health campus was constructed with the collaboration of Perunding Alam Bina and Perkins and Willis of Chicago is elaborated.

Post-Traumatic Stress Disorder And Its Associated Factors Among School-Going Children Exposed To A Tsunami Disaster In Malaysia

Posttraumatic stress disorder (PTSD) is a psychiatric diagnosis made when someone including children who experiences traumatic stressor. Those who are exposed to a more severe trauma have highest level of PTSD. The aim of this study was to measure the prevalence of PTSD and its associated factors among 219 children who were affected by a form of natural disaster which is the tsunami waves in a rural area in Malaysia. A cross sectional study was carried out among children aged 10-12 years 6 months after the traumatic event. Child Posttraumatic Stress Disorder –Reaction Index (CPTSD-RI) was used as a screening instrument which was answered by the affected children through a self-administered questionnaire. Forty six percent of these children had PTSD symptoms; 31.1% of these children had mild, 11.4% had moderate, 3.7% had severe PTSD and none had very severe PTSD. Result also showed that 91.8% had re-experiencing symptoms, 28.3% had numbing/avoidance symptoms and 49.3% had hyperarousal symptoms. Children with low social support (Adj OR = 2.3 (95% CI: = 1.3- 4.2)), and children who experienced deaths among someone close to them (Adj OR = 3.7 (95% CI =1.2 - 11.5)) were more likely to have symptoms of PTSD. This showed that children are at higher risk of developing PTSD as early as 6 months after the event and thus early intervention should be offered to them. Future longitudinal study can be carried out among affected children to assess whether these PTSD symptoms persist over time.

Propiedades psicométricas de la escala de síntomas de TEPT para niños (CPSS) en población chilena afectada por el terremoto y tsunami del 27-F de 2010 / Psychometric properties of the children's posttraumatic symptoms scale in the earthquake and tsunamis chileans' victims

Existen pocos instrumentos para la evaluación de sintomatología postraumática en niños/as y adolescentes en Latinoamérica. El presente estudio analiza las propiedades psicométricas de la child PTSD Symptom Scale CPSS (Foa, Johnson, Feeny y Treadwell, 2001), en niños y niñas víctimas de un desastre natural. Se realizan los análisis psicométricos habituales, incluyendo un análisis factorial exploratorio y uno confirmatorio. Se analiza la convergencia de la escala CPSS con el diagnóstico de TEPT a través de la entrevista estructurada DISC-IV Una estructura de tres factores de primer orden fue la que mostró mejor ajuste en el análisis confirmatorio. La escala mostró alta consistencia interna. Un puntaje de 24 o más puntos permite obtener una sensibilidad de 82 por ciento y especificidad de 88 por ciento respecto del diagnóstico de TEPT con el DISC-IV Estas positivas cualidades psicométricas indican la utilidad de la escala para ser usada en chile con niños/ as y adolescentes expuestos a desastres naturales.

There are not many instruments about evaluation of post Traumatic symptomatology in Latin-American children and adolescents. The current study analyzes the psychometric properties of the child PTSD Symptom Scale CPSS (Foa, Johnson, Feeny y Treadwell, 2001), among young victims of a natural disaster. Regular psychometric analyses were carried out, including an exploratory and confirmatory factor analysis of the instrument. The structured interview DISC-IV was used as a criterion test. An structure of three first order factors showed the best fit. The scale presented high internal consistency. A score of 24 or more points allowed a sensitivity of 82 percent and a specificity of 88 percent according to DISC-IV. These positive psychometric qualities indicate the utility of this scale to be used in chilean children and adolescents.

Relación entre los cambios del ambiente laboral ocasionados postevento sísmico del 27 febrero 2010 y la presencia de ansiedad y estrés laboral en el profesional de enfermería / Relationship between the change of work environment caused by 27 february 2010 seismic post-event and the presence of anxiety and stress in professional nursing

Objetivo: Determinar la relación entre síntomas de ansiedad y estrés laboral en el profesional de enfermería de dos establecimientos hospitalarios de la Provincia de Ñuble con los cambios en el ambiente laboral postevento sísmico. Método: Estudio cuantitativo, correlacional, en 64 profesionales de enfermería. Se aplicó el Maslach Burnout Inventory, la escala de Ansiedad y Depresión de Goldberg y un cuestionario para identificar los cambios en el ambiente laboral postevento sísmico. Resultados: El 56,25% de los sujetos presentó síntomas de ansiedad, un 59,38% de depresión, el 84,38% un nivel medio de estrés. La modificación del espacio físico fue el cambio más estresante. El cambio en la calidad de los insumos utilizados, patología de los usuarios y en el flujograma de atención se asocian estadísticamente con la presencia de ansiedad en los profesionales de enfermería. Conclusión: El evento sísmico ocasionó diversas modificaciones en el ambiente laboral, cuyos cambios pueden ser relacionados con la generación de ansiedad en el profesional de enfermería, que es un pilar fundamental de todas las atenciones de salud; por tanto, en la medida que tengan buena salud mental sus prestaciones serán más efectivas, eficaces y oportunas, incrementando la calidad en la atención a los usuarios.

Objective: Determine the relationship between symptoms of anxiety and occupational stress in nursing professionals of two hospitals of the Province of Ñuble with changes in the work environment by seismic post-event. Method: quantitative and correlational study in 64 nurses. The Maslach Burnout Inventory, the Anxiety and Depression Scale of Goldberg and a questionnaire to identify changes in the work environment in seismic post-event, were applied. Results: 56.25% of the subjects had symptoms of anxiety, 59.38% of depression, 84.38% an average stress level. Modification of the physical space was the most stressful change. The change in the quality of supplies used, pathology of user and attention flowchart, associate statistically with the presence of anxiety in nurses. Conclusion: The seismic event caused several changes in the work environment, and those changes can be related to the generation of anxiety in the nursing professional, who is a cornerstone of all health care, therefore, as having good mental health their services will be more effective, efficient and timely, increasing the quality of care to users.

Bases conceptuales para la gestión integral del riesgo / Conceptua bases for integrated risk management

La formulación de bases conceptuales para una gestión integral del riesgo, parte de la identificación de las dinámicas de los desastres socio-naturales en los países en vía de desarrollo, de la definición de los elementos estructurales y su espacialización en el territorio de Pamplona, además de la formulación y aplicación de una metodología de recolección y análisis de información en el contexto específico diversos sitios de Pamplona evidenciados con una mayor amenaza y vulnerabilidad, a eventos de remoción en masa. Los lineamientos propuestos están soportados en la representación del sentido colectivo y de los intereses de los actores sociales del desarrollo, se fundamentan en la adaptabilidad, la habitabilidad y la incertidumbre, y son esenciales para la determinación de acciones de intervención en diferentes escalas de aproximación al territorio, las cuales, deben ser llevadas a una negociación de intereses en niveles de ejecución real y posible.

The formulation of conceptual bases for a comprehensive risk management, starts from the identification of the dynamics of social-natural disasters in developing countries, from the definition of structural elements and its spatialization in the territory of Pamplona, and from the formulation and implementation of a collecting and analyzing information methodology in the specific context in a variety of areas in Pamplona evidenced with more threat and vulnerability to landslide events. The proposed guidelines are supported on the representation of collective consciousness and the interests of social actors of development, based on the adaptability, habitability and uncertainty, and are the essence for the determination of intervention actions at different scales of approximation to the territory, which must be brought to a negotiation of interests in levels of real and possible performance.

Infectious diseases in the aftermath of monsoon flooding in Pakistan

Pakistan is ranked 9th in terms of flood-affected countries worldwide. In the summer of 2010, the northern province of Khyber-Pakhtunkhwa received more than 312 mm of rain in a 56 hour period. This resulted in over 1 600 deaths across the region. In addition, over 14 million people were directly affected by this record-breaking deluge. Flood affected regions serve as ideal breeding grounds for pathogens, leading to the spread of diseases. The poor standards of hygiene in camps set up for individuals displaced by the floods also contribute to this. It is essential that those involved in relief efforts are aware of the epidemiology of diseases that have historically seen a sudden upsurge after natural disasters. Keeping this in mind, we conducted a simple review of literature. An extensive literature search was conducted using the PubMed data base and online search engines. Articles published in the last 20 years were considered along with some historical articles where a background was required. Seven major diseases were identified to increase substantially in the aftermath of natural disasters. They were then classified into acute and sub-acute settings. Diarrhea, skin & eye infections and leptospirosis were identified in the acute setting while malaria, leishmaniasis, respiratory infections and hepatitis were identified in the sub-acute setting.

The sinking of the MV Doña Paz - A critique on maritime disaster preparedness in the Philippines: An analysis of the event

OBJECTIVE: To discuss the various factors contributory to the fatalities that resulted from the sinking of the MV Dona Paz. METHODS: Review of the pre-disaster, disaster and post-disaster events surrounding the sinking of the MV Dona Paz, as well as the subsequent response by the government and responsible agencies to the disaster. RESULTS: The Sinking of the MV Dona Paz, along with the loss of more than 4,000 precious lives, is but a footnote in the long litany of misfortunes plaguing the Philippine maritime industry. A closer look into the events and circumstances leading to this tragedy demonstrates a confluence of equipment and system inadequacy on one hand and human error and lack of preparedness on the other. CONCLUSION: Multiple factors account for the occurence of this tragedy, along with other maritime disaster incidents dotting the long maritime history of the Philippines. A cursory analysis of these factors may lead to recommendations that can prevent similar occurrences in the future and mitigate damage to property and loss of life. The policy implications of these findings are discussed in a subsequent paper.

The sinking of the MV Doña Paz - A critique on maritime disaster preparedness in the Philippines: Policy implications

OBJECTIVE: To discuss the various factors contributory to maritime disaster preparedness in the Philippines, in the context of the sinking of the MV Dona Paz and formulate recommendations to address these factors. METHOD: Review of the state of maritime preparedness in the pre-disaster setting and the post-disaster response following the sinking of the MV Dona Paz by the government and responsible agencies. A scrutiny of the state of preparedness of concerned agencies and subsequent response to the disaster was conducted with the objective of formulating recommendations which may lead to prevention and mitigate loss of lives. RESULTS: Multiple factors accounted for the occurrence of this tragedy. These factors include an inherent risk due to the geography of shipping industry and its labor force. Economic conditions prevent both the industry and government agencies from upgrading vessels and communications equipment. Lack of enforcement of existing regulations allows vessels to sail overloaded and at times manned by less-than-qualified crew. Delayed response and deficient post-disaster medical response may have led to a disproportionately high mortality. CONCLUSIONS: The systems inadequacies of the Philippine maritime disaster response mechanism are highlighted by the Dona Paz tragedy. Many of the factors contributing to the disproportionately high incidence of maritime disasters in the Philippines and the resulting loss of limb may be preventable. Recommendations on regulation and enforcement, disaster preparedness, search and rescue, and medical response are discussed.