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 prevalence of psychological distress during pregnancy in Miyagi Prefecture for 3 years after the Great Eas t Japan Earthquake

BACKGROUND@#To examine changes in psychological distress prevalence among pregnant women in Miyagi Prefecture, which was directly affected by the Great East Japan Earthquake and tsunami, and compare it with the other, less damaged areas of Japan.@*METHODS@#This study was conducted in conjunction with the Japan Environment and Children`s Study. We examined 76,152 pregnant women including 8270 in Miyagi Regional Center and 67,882 in 13 other regional centers from the all-birth fixed data of the Japan Environment and Children's Study. We then compared the prevalence and risk of distress in women in Miyagi Regional Center and women in the 13 regional centers for 3 years after the disaster.@*RESULTS@#Women in the Miyagi Regional Center suffered more psychological distress than those in the 13 regional centers: OR 1.38 (95% CI, 1.03-1.87) to 1.92 (95% CI, 1.42-2.60). Additionally, women in the inland area had a consistently higher prevalence of psychological distress compared to those from the 13 regional centers: OR 1.67 (95% CI, 1.18-2.38) to 2.19 (95% CI, 1.60-2.99).@*CONCLUSIONS@#The lack of pre-disaster data in the Japan Environment and Children's Study made it impossible to compare the incidence of psychological distress before and after the March 2011 Great East Japan Earthquake. However, 3 years after the Great East Japan Earthquake, the prevalence of pregnant women with psychological distress did not improve in Miyagi Regional Center. Further, the prevalence of mental illness in inland areas was consistently higher than that in the 13 regional centers after the disaster.

Tracing the genetic root of Trinket cattle: an endangered cattle population of a small isolated island of Nicobar group of islands

Trinket cattle are the inhabitant of a small island called Trinket, which is one of the picturesque islands of Andaman. This herd is thought to be of Danish leftover during their dynasty in Nicobar archipelago. When the island was abandoned by foreign invaders, indigenes utilized the animals for the purpose of meat. As a result, the cattle became semi-feral in nature. After the Great Sumatra earthquake and tsunami of Indian Ocean in 2004, Trinket island was left abandoned by indigenes and the cattle became totally feral in nature. To trace the genetic root of the cattle, this study has been undertaken based on the sequence information of the mitochondrial D-loop and cytochrome b gene. The genomic DNA was extracted from the blood samples of the Trinket cattle and was used for amplification of mitochondrial markers, and the sequence information was generated by Sanger sequencing. The analysis of sequence information revealed that the Trinket cattle belongs to Bos indicus (I) haplotype, sub-haplotype I2. The presence of I2 sub-haplotype in Trinket cattle may be due to the expansion of this I2 haplotype towards Southeast Asian countries. This is a novel input for the formulation of breeding strategy towards conservation of eco-friendly sustainable livestock in the isolated island ecosystem.

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.

Ultrasound cardiography examinations detect victims' long-term realized and potential consequences after major disasters: a case-control study

BACKGROUND@#An increase in cardiovascular diseases has been reported following major disasters. Previous work has shown that ultrasonographic findings from ultrasound cardiography examination (UCG) increased until the 44th month after the tsunami caused by the Great East Japan Earthquake. The present study conducted UCG among victims in the tsunami disaster area and investigated the frequency of disaster-related cardiovascular diseases and changes over time until the 55th month after the disaster.@*METHODS@#The subjects were residents of temporary housing complexes and neighboring housing in Watari-gun, Miyagi Prefecture, Japan. There were 207 subjects in the 18th month, 125 in the 30th month, 121 in the 44th month, and 106 in the 55th month after the disaster. Data were collected through UCG and self-report questionnaire.@*RESULTS@#Significant changes were observed among subjects with clinical findings from the UCG, which increased over the study period-from 42.0 to 60.8, 72.7, and 73.6% beginning in the 18th month after the disaster (p < 0.0001).@*CONCLUSIONS@#It is possible that the UCG can become a useful examination to visualize the potential impact of a major disaster on the cardiac function of victims. Victims with clinical findings continued increasing not only during the acute phase after a disaster but also in the long term. We therefore need to keep this in mind, and note that it is important to establish a support system to control cardiovascular diseases from the early stage of disaster.@*TRIAL REGISTRATION@#UMIN; ID000029802. R000034050 . 2 November 2017.

Factors associated with social support in child-rearing among mothers in post-disaster communities

BACKGROUND@#Natural disasters have long-term negative impacts on the health and socioenvironmental conditions of a population, affecting the physical environment as well as the relationships within the community, including social networks. Mothers in post-disaster communities may have difficulty receiving social support not only from family members and relatives but also from members of their community, such as people in their neighborhoods. This study focused on mothers with infants and preschool-aged children in post-disaster communities. The associations of social support with sociodemographic characteristics and socioenvironmental conditions related to child-rearing among mothers in post-disaster communities were assessed.@*METHODS@#An anonymous self-administered questionnaire survey was conducted in October 2015 in 988 households in areas affected by the Great East Japan Earthquake and Tsunami. The data collected on sociodemographic and socioenvironmental characteristics included the presence of pre-disaster acquaintances in the neighborhood and social support for child-rearing. The associations of sociodemographic and socioenvironmental characteristics with social support were examined.@*RESULTS@#We analyzed 215 completed questionnaires from mothers living in different houses from those they lived in before the disaster to reflect continuous relationships with people from the pre-disaster communities. Social support was significantly associated with infant sex, extended family, support obtained from relatives not living together, pre-disaster acquaintances, use of child support resources, and no perceived difficulties in child-rearing. In addition, the presence of pre-disaster acquaintances was associated with categories of mental/physical place of comfort and child-rearing support, with adjusted odds ratios of 1.88 (95% CI 1.03-3.44) and 2.84 (95% CI 1.46-5.52) compared with mothers who did not have any pre-disaster acquaintances.@*CONCLUSIONS@#Factors associated with the obtainment of social support in child-rearing among mothers in post-disaster communities were attributed not only to mothers themselves and family members but also to socioenvironmental factors such as the presence of pre-disaster acquaintances. The presence of pre-disaster acquaintances promoted rich social support in child-rearing in post-disaster communities. When reconstructing a community following changes in residence location after a disaster, the pre-disaster relationships among the community dwellers should be considered from the viewpoint of child-rearing support.

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

Síntomas del trastorno por estrés postraumático en la comuna chilena de Cobquecura, 2010 / Post-trauma stress syndrome observed in Chilean commune of Cobquecura 2010

Objetivo: estimar síntomas del trastorno por estrés postraumático en habitantes de la Comuna de Cobquecura, Chile después del terremoto de 2010. Métodos: se utilizó un diseño no experimental de tipo descriptivo. Para recoger los datos se aplicó la Escala de Davidson, que mide percepción de síntomas relacionados con estrés postraumático. Resultados: el 58,5 por ciento de los entrevistados presentaba estrés postraumático con dificultades para elaborar la situación vivida, ya sea por la reexperimentación, la evitación de hablar acerca del suceso o la sobrevigilancia referida a los estímulos. A lo anterior debe agregarse que el 41,5 por ciento del resto de la población no alcanzaron el umbral mínimo para clasificarlo como trastorno por estrés postraumático según la validación y confiabilidad que entrega la Escala de Davidson. Sin embargo esto no implica que no tuvieran un grado de estrés postrauma. Conclusiones: se podría haber esperado un porcentaje más alto de la población con estrés postraumático dado que se encontraban en la zona del epicentro, sin embargo, Cobquecura resistió el terremoto de buena manera, sin víctimas fatales y no fue afectado por tsunami, por ende la población regresó rápidamente a su funcionamiento normal después del evento. Esto se refleja en el hecho de que los participantes notificaron pocos daños materiales causados por el terremoto(AU)

Objective: to determine post-trauma stress disorder symptoms in inhabitants of Cobquecura community after 2010 earthquake. Methods: non-experimental descriptive-type design was used to collect data as well as Davidson Trauma Scale was applied to measure symptoms related with post traumatic stress. Results: in the study population, 58.5 percent of the interviewed people presented with post traumatic stress, having difficulties in describing the situation that they had lived, whether for the re-experimentation, avoiding any talk about the event, or due to excessive surveillance of stimuli. It must be added that the remaining 41.5 percent of the inhabitants did not reach the minimum threshold to be classified as post traumatic stress disorder individuals, according to the validation and the reliability of Davidson Trauma Scale. However, this does not imply that they did not suffer post-trauma stress. Conclusions: a higher percentage of population with post trauma stress could have been expected, since this community was located in the epicentre area. Cobquecura withstood the earthquake; there were neither fatal victims nor tsunami, so people returned rapidly to their normal life after the event. This is mainly revealed in the fact that the participants reported few material damages caused by the earthquake(AU)

An outbreak of hepatitis A virus among children in a flood rescue camp: A post‑disaster catastrophe.

We report an outbreak of acute viral hepatitis among children in a flood rescue camp at Rudraprayag district of Uttarakhand State, India. In May 2013, there was a disastrous natural calamity, The Himalayan Tsunami in Himalayan and Sub‑Himalayan region of Uttarakhand. More than 5700 people were feared dead, and thousands were sheltered in different rescue camps. A linkage was hypothesised between the infected individuals and the common water sources feared of being contaminated faecally. Aetiological agent of the present outbreak was HAV that is emerging in an outbreak form in India, emphasizing a definite need for formulating mandatory vaccination and proper control strategies. The report exemplifies the basic problems encountered after a natural calamity.

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.

Trauma symptoms in children after the tsunami.

Limited research has examined factors associated with psychological distress following natural disasters among non-Western child populations. Conditions associated with trauma-related symptoms following the 2004 tsunami in a sample of 265 Sri Lankan child survivors (53.6% female, aged 3 to 17) were examined retrospectively. Multivariate regression analyses identified pre-traumatic conditions (female gender, prior health) and peri-traumatic conditions (loss of family, complete property loss) as being associated with increased trauma-related symptoms. Findings can be applied to the identification of children most at risk of developing trauma-related symptoms following a natural disaster from a non-Western population to aid development of culturally-appropriate interventions.

Assessment of well water quality in Tsunami affected regions of south-west coast of Kerala, India.

The quality of well waters, based on 23 parameters of water, at 12 stations of south-west coast of Kerala, India, was assessed during monsoon, 2009 and summer, 2010, to determine their suitability for drinking and other domestic purposes. The stations selected were grouped into four regions viz. least, slightly, moderately and severely affected ones based on the severity of 2004 Asian Tsunami at each station. The depths of wells showed variations depending on the seasons and on their distance from the seacoast. The average water temperatures during monsoon and summer seasons were 28.5oC and 30.2oC respectively. The pH of well waters were below 6.5 in least and slightly affected regions and above this value in moderately and severely affected regions. In all the four regions, the well water parameters of electrical conductivity, hardness, fluoride, free chlorine, copper, zinc, calcium and nickel were below, and phosphorus, lead, iron cadmium and manganese were above the standard permissible levels set for them in drinking water. The values of salinity, sodium and potassium in the well waters of moderately and severely affected regions, and the values of nitrate-nitrogen, nitrate and magnesium in the well waters of severely affected regions were above the permissible limits set for them in drinking water. Water quality index calculated on the basis of drinking water standards revealed that the well waters of least and slightly affected regions were moderately polluted in both monsoon and summer seasons and the same of moderately affected region were excessively polluted during monsoon and severely polluted during summer seasons, whereas the well waters of severely affected regions were severely polluted in both seasons. Suitable recommendations were made to improve the quality of well waters of least and slightly affected regions.

Intervención de salud mental en niños expuestos a desastre natural / Mental health intervention in children exposed to natural disasters

Introduction: this study is part of the mental health intervention, conducted by a child psychiatry team for children exposed to the february 2010 earthquake/tsunami in a community of the VII Region that was strongly affected by the natural disaster. Objective: to describe the intervention and evaluate the effectiveness of the strategies implemented for both children and teachers. Methodology: interventions are described and classified in three categories. (1) Case report and child care consulting, referred by their teacher. (2) Psychoeducational workshops for teachers of the intervened school. (3) Self-Care day aimed at professionals of the same school. The evaluation is done through an anonymous survey designed to measure the effectiveness of the intervention. Results: 33 children were evaluated and treated, the most common diagnoses were adaptive disorders (8/33) and ADHD (11/33), and only 3 patients met the criteria for post-traumatic stress disorder (PTSD). Intervention implementation included psychoeducation for parents (100 percent), coordination with schools and local health network (100 percent), counseling (70 percent) and drug prescription (45 percent). Only 45 percent of the cases evaluated had symptoms triggered or exacerbated by the earthquake/tsunami. Regarding teacher evaluation (N: 11), 100 percent described the intervention as "very good". 90 percent considered it appropriate to the needs at the moment and as a contribution to their educational work. Conclusions: after events of this nature, many interventions take place to support the affected population. It is important to have more scientific information about the effectiveness of such interventions to prevent the development of post-traumatic psychopathology.

Introducción: este trabajo forma parte de la intervención de salud mental, realizada por un equipo de psiquiatría infantil para niños expuestos al terremoto/maremoto de febrero de 2010, en una comunidad de la VII Región fuertemente afectada por el desastre natural. Objetivos: describir la intervención realizada y evaluar la efectividad de las estrategias implementadas tanto a niños como a profesores. Metodología: se describe las intervenciones realizadas, clasificadas en 3 categorías: 1) Consultoria de casos clínicos y atención de niños derivados por sus profesores. 2) Talleres psicoeducativos a profesores de la escuela intervenida. 3) Jornada de autocuidado, dirigida a los profesionales de la misma escuela. La evaluación se realiza a través de encuesta anónima a los profesores diseñada para cuantificar la efectividad de la intervención. Resultados: se evaluaron y trataron 33 niños, los diagnósticos más frecuentes fueron Trastornos adaptativos (8/33) y Déficit atencional (11/33); sólo 3 casos cumplían criterios de Trastorno por Estrés Postraumático(TEPT). Las intervenciones utilizadas incluyeron psicoeducación a padres (100 por ciento), coordinación con colegios y red de salud municipal (100 por ciento), apoyo psicológico (70 por ciento) y farmacológico (45 por ciento). Sólo en el 45 por ciento de los casos evaluados la sintomatología se había desencadenado o agravado con el terremoto/maremoto. En relación a la evaluación de profesores (n: 11), 100 por ciento consideró la intervención como "muy buena". Un 90 por ciento la consideró adecuada a las necesidades y constituyó un aporte a su quehacer educativo. Conclusiones: tras eventos como éste, se realizan variadas intervenciones de apoyo a la población afectada. Es importante contar con mayor información científica acerca de la efectividad de dichas intervenciones para prevenir el desarrollo de psicopatología postraumática.

Thinking of nuclear disaster caused by earthquake and tsunami in Fukushima / 中国医学装备

On March 11, 2011 eastern Japan was struck by magnitude 9.0 earthquake and an enormous tsunami which together killed over 20,500 people and resulted in the evacuation of over 320,000 people from the devastated areas. This paper introduces the damage sustained by the Fukushima-Daiichi nuclear power plant during this major natural disaster, as well as the protection of the public protection measures;nuclear accident in Fukushima is worth pondering for future energy development planning and response in Japan and around the world.

Efecto de las estrategias de afrontamiento al estrés en los síntomas de estrés post-traumático en sobrevivientes de un terremoto. Hacia un modelo explicativo del estrés post-traumático / The effects of stress coping strategies in post-traumatic stress symptoms among earthquake survivors: an explanatory model of post-traumatic stress

Se determinó el efecto de las estrategias de afrontamiento (WOC) en los síntomas de estrés post-traumático (PTSD) ante un evento estresante común para 304 personas (Chile, terremoto 27 de febrero de 2010), mediante la aplicación del ways of coping questionnaire y de la davidson scale of trauma. Los resultados muestran 4 modelos de regresión lineal múltiple significativos que explican el total y los 3 tipos de síntomas del PTSD a partir de las WOC evitación y resolución de problemas. Sin embargo, un primer modelo integrado mediante ecuaciones estructurales no obtuvo buenos índices de ajuste. Se concluye con un modelo integrado alternativo que presenta muy buenos índices de ajuste. Finalmente se entregan explicaciones basadas en neuroimágenes y covert conditioning, además de reflexiones sobre prevención y prevalencia del PTSD.

The effect of the ways of coping (WOC) in post-traumatic stress disorder (PTSD) symptoms in a stressing event common to a sample of 304 people (Chile, earthquake february, 27 2010) was determined through the application of the ways of coping questionnaire and the davidson scale of trauma. The results show 4 significant regression multiple linear models explaining the total and the 3 types of PTSD symptoms through WOC such as avoidance and problem solution. However, a first integrated model through structural equations did not attain good fit indexes. The study has been concluded with an alternative integrated model presenting very good adjustment indexes (CMIN/DF=.058, RMSEA=.000, NFI=.999, CFI=.999 and PNFI=.100). Finally, explanations based on neuroimages and covert conditioning are provided along with reflections on the prevention and prevalence of the PTSD.

Relevancia y prevalencia del estrés post-traumático post-terremoto como problema de salud pública en Constitución, Chile / The relevance and prevalence of post-traumatic stress after an earthquake: public health problem in Constitucion, Chile

Objetivos Según investigaciones previas, después del terremoto y tsunami del 27 de febrero de 2010 (27-F), se espera un aumento de la prevalencia del estrés post-traumático (TEPT). Esta investigación pretende mostrar la importancia de este problema, identificando la prevalencia del TEPT en la ciudad de Constitución, una de las más afectadas por el 27-F. Método Mediante la escala Short Posttraumatic Stress Disorder Rating Interview (SPRINT-E), se midió la cantidad de síntomas intensos de TEPT en dos muestras: apoderados de un colegio municipal y personal de la red de atención primaria. Resultados La prevalencia del TEPT en ambos grupos es mayor a lo esperado: 36 % en el grupo de apoderados (en el cual se esperaba un 23 %) y 20 % en el de funcionarios (en el cual se esperaba un 15 %). Conclusiones Se reflexiona respecto del grave problema de salud mental pública presente en esta ciudad en particular y en todas las zonas afectadas en general. También se discute respecto de la factibilidad de resolver este problema de salud pública, mediante los recursos disponibles en la red de salud. Si bien su resolución es compleja, es posible apoyar iniciativas científicas de investigación aplicada, como la que actualmente está llevando a cabo la Facultad de Psicología de la Universidad de Talca.(AU)

Objectives An increase in the prevalence of post-traumatic stress disorder (PTSD) is expected following the February 27th 2010 (F-27) earthquake and tsunami, according to previous research; the current research was aimed at showing the importance of this problem by identifying PTSD prevalence in Constitucion, one of the Chilean cities most affected by F-27. Methods The number of severe PTSD symptoms was measured in two samples taken from staff from a local school and a primary care network, using the short post-traumatic stress disorder rating interview (SPRINT-E) scale. Results PTSD prevalence was higher than expected in both groups: 36 % in the local school staff (where 23 % was expected) and 20 % for primary care network staff (15 % was expected). Conclusions The article deals with PTSD prevalence, reflecting on the serious public mental health problem affecting this city in particular and all affected areas in general. It also discusses the feasibility of solving this public health problem by using available health network resources. While its resolution is complex, initiatives in applied research can always be supported, such as those currently being conducted by the University of Talca's psychology faculty.(AU)

Tsunami, post-tsunami malaria situation in Nancowry group of islands, Nicobar district, Andaman and Nicobar Islands.

Background & objectives: Due to tsunami in 2004 a large proportion of population in Nicobar group of Islands become homeless, and in 2006 large scale labour migration took place to construct the houses. In 2008, a significant increase in malaria incidence was observed in this area. Therefore, in March 2008, the situation of malaria was assessed in Nancowry Islands in Nicobar District to study the reasons for the observed upsurge in the number of cases, and to suggest public health measures to control the infection. Methods: The methods included a retrospective analysis of long term trend in the behaviour of malaria over the years from 2001 to 2008, analysis of the acute malaria situation, and rapid fever and malaria parasitemia survey along with environmental component. Mass radical therapy (MRT) and post-intervention parasitemia survey were carried out. The malaria situation in the aftermath of MRT was analysed. Results: During the post tsunami year (2005) there was a large increase in the incidence of malaria and this trend continued till 2008. The percentage of Plasmodium falciparum increased from 23 to 53 per cent from 2006 to 2007 that coincides with the labour influx from mainland. The study showed that Nancowry was highly endemic, with high transmission setting, and high risk area for malaria. Though, more number of migrant labourers suffered fever (75 vs 20%) and sought malaria treatment over past month but parasitemia survey showed higher point prevalence of malaria among native tribes (7.4 vs 6.5%). Post-MRT, there was a decline in the occurrence of malaria, though it did not last long. Interpretation & conclusions: The study findings suggest that the migrant workers hailing from non-endemic or moderately endemic settings became victims of malaria in epidemic proportion in high endemic and high transmission setting. To find out the reasons for deterioration of malaria situation at Nancowry in the aftermath of tsunami requires further research.

Impact of the Great East Japan Earthquake and tsunami on health, medical care and public health systems in Iwate Prefecture, Japan, 2011

PROBLEM: The Great East Japan Earthquake was one of the largest earthquakes ever recorded in global history. The damage was spread over a wide area, with the worst-hit areas being Iwate, Miyagi and Fukushima prefectures. In this paper we report on the damage and the impact of the damage to describe the health consequences among disaster victims in Iwate Prefecture. CONTEXT: In Iwate Prefecture the tsunami claimed 4659 lives, with 1633 people missing. In addition to electricity, water and gas being cut off following the disaster, communication functions were paralysed and there was a lack of gasoline. ACTION: Medical and public health teams from Iwate Prefecture and around the country, including many different specialists, engaged in a variety of public health activities mainly at evacuation centres, including medical and mental health care and activities to prevent infectious diseases. OUTCOME: Given the many fatalities, there were relatively few patients who required medical treatment for major injuries. However, there were significant medical needs in the subacute and chronic phases of care in evacuation centres, with great demand for medical treatment and public health assistance, measures to counteract infection and mental health care. DISCUSSION: By referring to past experiences of national and international large-scale disasters, it was possible to respond effectively to the health-related challenges. However, there are still challenges concerning how to share information and coordinate overall activities among multiple public health response teams. Further examination will be required to ensure better preparedness in response to future disasters.

Health care response to the tsunami in Taro District, Miyako City, Iwate Prefecture

PROBLEM: In the Taro District (population: 4434), the great tsunami of 11 March 2011 destroyed the central region including the clinic, the sole medical facility (one physician, 13 nurses and other staff) in the district, and many citizens were forced to live in evacuation centres. CONTEXT: The Taro District experienced massive damage during the tsunamis of 1896 and 1933. Since then countermeasures to tsunamis have been implemented. The great tsunami on 11 March 2011 caused catastrophic damage to the lowlying areas where approximately 2500 people lived; 1609 buildings were completely destroyed, and approximately 200 people died or were missing across the district. ACTION: The Taro National Health Insurance Clinic, the sole medical facility in the Taro District, was required to play a central role in a variety of activities to care for residents in severely affected areas. First of all, evacuees needed to move to neighbouring hospitals or safer evacuation centres because lifeline services were cut off to the first evacuation centre. Then, the clinic staff worked in a temporary clinic; they visited the evacuation centres to assess the public health and medical situation, cared for wounded residents, managed infection control and encouraged a normal lifestyle where possible. Additional medical, pharmaceutical and logistical support was received from outside the district. OUTCOME: There was no noticeably severe damage to health, although there was manifestation of and deterioration in lifestyle-related diseases (e.g. diabetes, hypertension, obesity). Health care activities gradually returned to their pre-disaster levels. At the end of July 2011, the evacuation centres closed, and all evacuees moved to temporary accommodations. Discussion: Isolated rural health practitioners were required to be involved in a wide variety of activities related to the disaster in addition to their routine work: e.g. preventive health (public health and safety activities), routine medical care, acute medical care, psychological care, post-mortems and recovery of medical facilities. Although the whole health care system returned to near-normal six months after the disaster, it is important to plan how to develop more resilient medical systems to respond to disasters, especially in rural areas. This article describes my experience and lessons learnt in responding to this disaster.