Presença de risco de transtorno do estresse pós-traumático em policiais militares feridos por arma de fogo / Presence of risk of posttraumatic stress disorder in military police officers wounded by firearms / Presencia de riesgo de trastorno de estrés postraumático en policías militares heridos por armamiento de fuego

Este estudo teve como objetivo identificar o risco de desenvolvimento de transtorno de estresse pós-traumático (TEPT), bem como sua associação com pensamentos ou tentativas suicidas e a saúde mental de policiais militares feridos por arma de fogo, na Região Metropolitana de Belém (RMB), nos anos de 2017 a 2019. A pesquisa contou com a participação de 30 entrevistados, que responderam o Inventário Demográfico e a Lista de verificação de TEPT para o DSM-5 (PCL-5). Para análise dos dados, utilizou-se a técnica estatística Análise Exploratória de Dados e a técnica multivariada Análise de Correspondência. Os resultados revelaram a existência de risco de desenvolvimento do transtorno de forma parcial ou total em uma expressiva parcela da população entrevistada, tendo homens como maioria dos sintomáticos, com média de 38 anos, exercendo atividades operacionais e vitimados em via pública quando estavam de folga do serviço. O ferimento deixou a maioria com sequelas, com destaque para dores crônicas, limitações de locomoção e/ou mobilidade e perda parcial de um membro. E, ainda, policiais sintomáticos apresentaram comportamentos suicidas, relatando já terem pensado ou tentado tirar a própria vida. Desta forma, conclui-se que policiais militares são expostos constantemente a traumas inerentes a sua profissão. Quando há ameaça de vida, como nos casos de ferimentos por arma de fogo, são suscetíveis a sequelas físicas decorrente do ferimento, somadas a sequelas mentais tardias, como o surgimento de sintomatologias de TEPT e ideação suicida.(AU)

This study aimed to identify the risk of developing post-traumatic stress disorder (PTSD) and its associations around suicidal thoughts or attempts and mental health in military police officers injured by firearms, in the Metropolitan Region of Belem (RMB), from 2017 to 2019. The research had the participation of 30 respondents who answered the Demographic Inventory and the PTSD checklist for DSM-5 (PCL-5). For data analysis, we used the statistical technique Exploratory Data Analysis and the multivariate technique Correspondence Analysis. The results revealed the existence of risk of developing partial or total disorder in a significant portion of the interviewed population, with men as most of the symptomatic individuals, with mean age of 38 years, developing operational activities and victimized on public roads when they were off duty. The injuries left most of them with sequelae, especially chronic pain, limited locomotion and/or mobility, and partial loss of a limb. In addition, symptomatic officers showed suicidal behavior, such as reporting they had thought about or tried to take their own lives. Thus, we conclude that military policemen are constantly exposed to traumas inherent to their profession. When their lives are threatened, as in the case of firearm wounds, they are susceptible to physical sequelae resulting from the injury, in addition to late mental sequelae, such as the appearance of PTSD symptoms and suicidal ideation.(AU)

Este estudio tuvo como objetivo identificar el riesgo de desarrollo de trastorno de estrés postraumático (TEPT) y sus asociaciones con pensamientos o tentativas suicidas y la salud mental en policías militares heridos por armamiento de fuego, en la Región Metropolitana de Belém (Brasil), en el período entre 2017 y 2019. En el estudio participaron 30 entrevistados que respondieron el Inventario Demográfico y la Lista de verificación de TEPT para el DSM-5 (PCL-5). Para el análisis de datos se utilizaron la técnica estadística Análisis Exploratoria de Datos y la técnica multivariada Análisis de Correspondencia. Los resultados revelaron que existen riesgos de desarrollo de trastorno de estrés postraumático de forma parcial o total en una expresiva parcela de la población de policías entrevistados, cuya mayoría de sintomáticos eran hombres, de 38 años en media, que ejercen actividades operacionales y fueron victimados en vía pública cuándo estaban de día libre del servicio. La lesión dejó la mayoría con secuelas, especialmente con dolores crónicos, limitaciones de locomoción y/o movilidad y la pierda parcial de un miembro. Aún los policías sintomáticos presentaran comportamiento suicida, tales como relataran qué ya pensaron o tentaron quitar la propia vida. Se concluye que los policías militaran se exponen constantemente a los traumas inherentes a su profesión. Cuando existe amenaza de vida, como en los casos de heridas por armamiento de fuego, son expuestos a secuelas físicas transcurridas de la herida, sumado a secuelas mentales tardías, como el surgimiento de sintomatologías de TEPT y la ideación suicida.(AU)

Engajamento com o trabalho e exaustão emocional de profissionais da socioeducação / Engagement with work and emotional exhaustion of socio-education professionals / Comprometimiento con el trabajo y agotamiento emocional de profesionales de la socioeducación

Buscou-se compreender a percepção dos profissionais das medidas socioeducativas acerca do seu engajamento e exaustão com o trabalho. Para isso, realizou-se um estudo qualitativo, descritivo e exploratório, por meio de uma entrevista semiestruturada a três integrantes da equipe técnica e dois coordenadores de segurança (idades entre 28 e 57 anos). A análise dos dados foi conduzida com o auxílio do software Iramuteq, que gerou cinco classes temáticas: a) rotina das unidades socioeducativas e as demandas do trabalho dos profissionais; b) gestão de conflitos nas unidades, da mediação à polícia; c) recursos pessoais e institucionais relacionados ao exercício da profissão; d) aspectos relacionados ao contexto de trabalho; e, por último, e) indicadores de esgotamento laboral, adversidades e adoecimento profissional. Os participantes descreveram diversas demandas relacionadas à exaustão física e psicológica (e.g. equipe reduzida, insalubridade, baixo salário e fragilidade do vínculo empregatício), mas também ressaltaram a relevância social de sua prática profissional junto aos adolescentes e o relacionamento positivo entre os profissionais como fatores que justificam o seu engajamento e permanência nas instituições socioeducativas. Conclui-se evidenciando que os contextos têm influência direta na saúde desses profissionais, o que sublinha a importância de se olhar para suas condições de trabalho e para aspectos ligados à saúde mental, promovendo, desse modo, avanços na realidade socioeducativa.(AU)

The aim was to understand the perception of professionals of socio-educational measures about their engagement and exhaustion with work. To that end, a qualitative, descriptive, and exploratory study was carried out by means of a semi-structured interview with three members of the technical team and two safety coordinators (ages between 28 and 57 years). Data analysis was conducted with the help of the IRAMUTEQ software, which generated five thematic classes: a) routine of socio-educational units and work demands of professionals; b) conflict management in the units, from mediation to the police; c) personal and institutional resources related to the exercise of the profession; d) aspects related to the work context; and, lastly, e) indicators of labor exhaustion, adversity, and occupational illness. Participants described several demands related to physical and psychological exhaustion (e.g. reduced team, insalubrity, low salary, and fragility of the employment relationship), but also emphasized the social relevance of their professional practice with adolescents and the positive relationship among professionals as factors that justify their engagement and permanence in socio- educational institutions. It is concluded that the contexts have a direct influence on the health of these professionals, which highlights the importance of looking at their working conditions and aspects related to mental health, thus promoting advances in the socio-educational reality.(AU)

Se procuró comprender la percepción de los profesionales que trabajan con medidas socioeducativas sobre su comprometimiento y el agotamiento en el trabajo. Para esto, se realizó un estudio cualitativo, descriptivo y exploratorio, por medio de una entrevista semiestructurada a tres integrantes del equipo técnico y dos coordinadores de seguridad (edades entre 28 y 57 años). El análisis de los datos fue conducido en el software IRAMUTEQ, que generó cinco clases temáticas: a) rutina de las unidades socioeducativas: demandas del trabajo de los profesionales; b) manejo de conflictos en las unidades: desde la mediación hasta la policía; c) recursos personales e institucionales relacionados al ejercicio de la profesión; d) aspectos relacionados al contexto del trabajo; e) indicadores de agotamiento laboral, adversidades y enfermedad del profesional. Los participantes describieron diversas demandas relacionadas al agotamiento físico y psicológico (por ej.: equipo reducido, insalubridad, bajos sueldos y fragilidad del vínculo laboral), pero también destacaron la importancia social de su práctica profesional junto a los adolescentes y el vínculo positivo entre los profesionales como factores que justifican su comprometimiento y permanencia en las instituciones socioeducativas. Se concluye que los contextos influyen directamente en la salud de estos profesionales, lo que rescata la importancia de verificar sus condiciones de trabajo y los aspectos relacionados a la salud mental, promoviendo, de este modo, avances en la realidad socioeducativa.(AU)

Knowledge of emergency preparedness among nurses in Machakos level five Hospital in Machakos County, Kenya

BACKGROUND An emergency is an unexpected event that disrupts normal operations within a health facility and requires immediate interventions to address it. Knowledge of emergency preparedness is an important role of clinical nursing to enhance patient outcomes. This study aimed to determine the types of emergencies received at Machakos Level 5 Hospital (ML5H) and to assess the nurses' level of knowledge on emergency preparedness. MATERIALS AND METHOD This was a descriptive cross-sectional research design. The study was conducted at Machakos Level 5 Hospital, Machakos County, Kenya. The sample included 132 nurses working at ML5H, who were randomly selected and consented to participate in the study. Data was collected using a self-administered questionnaire and an observation checklist. Data were coded and entered into SPSS version 25 software and the analysis included descriptive statistical tests. RESULTS A little more than a half (56%) of the nurses were found to have adequate knowledge of emergency preparedness; 65% had attended training on emergency preparedness and 63% indicated that training had enhanced their competence. CONCLUSION A higher proportion of nurses reported not participating in emergency drills that could be used to improve their knowledge and skills in emergency preparedness. The results of the study indicate that there is a need to enhance the knowledge of nurses' on emergency preparedness.

Sufficient informed consent to medical treatment of adults legal and ethical perspectives from Malawi

This special communication discusses the current legal and ethical requirements for informed consent to medical treatment of adults in Malawi. It analyzes the scope of the laws and code of ethics on professional discipline, including criminal privilege for surgeries and clarifies when insufficient disclosures entitle patients to compensation under civil law. Inconsistencies and uncertainties in the law are made apparent. It evaluates to which degree disclosure standards of other Commonwealth jurisdictions (e.g. the case of Montgomery) would be suitable for the health care setting of a country like Malawi that is characterized by shortages of resources, high illiteracy rates and a communitarian cultural context. Doctor-patient communication is not alien to African culture and part of sufficient informed consent. In order to balance the need for efficiency in health care delivery, accountability for quality care, fairness and effective patient-doctor communication the authors suggest to adopt the reasonable patient test only, if a defence of heavy workload on case-to-case basis is introduced at the same time. This does not dispense the need for organisational diligence on part of the institutional health care provider within its capacity

Experiencia organizativa del Centro de Investigaciones Científicas de la Defensa Civil en el diagnóstico de la COVID-19 / Organizational experience of the Civil Defense Scientific Research Center in the diagnosis of COVID-19

El enfrentamiento a la epidemia de la COVID-19 en Cuba, ha requerido el desarrollo de nuevas capacidades para su diagnóstico en los laboratorios de biología molecular de diferentes instituciones científicas y de salud. El objetivo de este trabajo es mostrar la experiencia del Centro de Investigaciones Científicas de la Defensa Civil en la organización del diagnóstico de la COVID-19. Se revisaron documentos rectores del trabajo del centro, su programa de bioseguridad y los reportados por la Organización Mundial de la Salud para el enfrentamiento a la pandemia. Se expone la experiencia de la estructura adoptada por la entidad para asegurar el diagnóstico de forma ininterrumpida, las funciones del grupo de dirección y la secuencia de las actividades desarrolladas. Se destaca la capacitación del personal en la gestión de riesgos biológicos y las medidas de prevención adoptadas. El uso adecuado de los medios de protección colectivos e individuales, la manipulación segura de las muestras biológicas y la cooperación con otras entidades, han permitido el cumplimiento de la tarea encomendada, sin la ocurrencia de accidentes que comprometan la salud del personal que labora en el diagnóstico, ni afectaciones a la comunidad y al medio ambiente(AU)

Facing the COVID-19 epidemic in Cuba has required the development of new capacities for its diagnosis in the molecular biology laboratories of different scientific and health institutions. The objective of this work is to show the experience of the Cuban Civil Defense Scientific Research Center in organizing the diagnosis of COVID-19. Guiding documents for the Center's work, its biosafety program, and those reported by the World Health Organization for dealing with the pandemic were reviewed. The experience of the structure adopted by the entity to ensure an uninterrupted diagnosis, the functions of the Steering Group and the sequence of activities carried out is exposed; highlighting the training of personnel in the management of biological risks and the prevention measures adopted. The proper use of collective and individual protection means, the safe handling of biological samples and cooperation with other entities, have allowed the fulfillment of the entrusted task, without the occurrence of accidents that compromise the health of the personnel working in the diagnosis, nor effects on the community and the environment(AU)

Discursos sobre o risco no contexto da gestão de emergências e desastres / Discourse on risk in the context of emergency and disaster management / Discursos sobre el riesgo en el contexto de la gestión de emergencias y desastres

Este artigo tem como objetivo compreender e discutir os conceitos de risco produzidos no contexto do Sistema Nacional de Proteção e Defesa Civil (Sinpdec). Esse sistema é a instituição brasileira que concentra maior parte das intervenções sobre riscos no contexto das emergências e desastres. Trata-se de uma pesquisa de orientação qualitativa, fundamentada pelas perspectivas de discurso desenvolvidas por Foucault e pela Psicologia Discursiva. Foram realizadas 36 entrevistas. semiestruturadas, sendo 21 com trabalhadores e trabalhadoras, e 15 com usuários e usuárias. Chamou-nos a atenção que o conjunto de termos encontrados coloca o risco como algo socialmente negativo, que pode provocar danos. Observou-se, além disso, que, no Sinpdec, o risco é fortemente associado aos fenômenos da natureza, fator que limita, no interior do sistema, a problematização das questões políticas e sociais que envolvem a temática. Esperamos que esta pesquisa possa contribuir para a ampliação de sentidos sobre o risco que circunscrevem o contexto estudado.

The aim of this article is to understand and to foster the debate on the concepts of risk elaborated in the context of the National System of Civil Protection and Defense (Sistema Nacional de Proteção e Defesa Civil - Sinpdec). The research, which has a qualitative grounding, is based on discourse perspectives developed by Michel Foucault and the English School of Discursive Psychology. In total, 36 semi-structured interviews were conducted, 21 being with workers and 15 with users. The terms which were found drew our attention since they situated risk as something negative from a social perspective, and that can cause harm. It was also observed that within Sindpec, risk is strongly associated with natural phenomena - this is a limiting factor which, within the system, can restrain the problematization of the political and social questions surrounding the issue. We hope that the research will contribute to the broadening of meanings about risk in this context.

Este artículo tiene por objetivo comprender y discutir los conceptos de riesgos producidos en el contexto del Sistema Nacional de Protección y Defensa Civil (Sinpdec), la institución brasileña que concentra gran parte de las intervenciones sobre riesgos en el contexto de emergencias y desastres. Se trata de una investigación de orientación cualitativa, fundamentada por las perspectivas del discurso desarrolladas por Michel Foucault y por la Psicología Discursiva. Fueron realizadas 36 entrevistas. semi estructuradas, 21 con trabajadores y trabajadoras y 15 con usuarios y usuarias. Nos llamó la atención que el conjunto de términos encontrados establece el riesgo como algo socialmente negativo que puede provocar daños. Se observó, además de eso, que en el Sinpdec el riesgo está fuertemente asociados a los fenómenos de la naturaleza, factor que limita, en el interior del sistema, la problematización de las cuestiones políticas y sociales relacionadas a la temática. Esperamos que la investigación contribuya a la expansión de los significados sobre el riesgo en el contexto estudiado.

Lesotho COVID-19 emergency preparedness and response project (P173939) - Mafeteng hospital operations: environmental and social management plan (ESMP) operations phase

An outbreak of the coronavirus disease (COVID-19) caused by the 2019 novel coronavirus (SARS-CoV-2) has been spreading rapidly across the world since December 2019, following the diagnosis of the initial cases in Wuhan, China. On March 11, 2020, the World Health Organization (WHO) declared a global pandemic. As of January 6, 2021, the outbreak has resulted in more than 86 million global cases and more than 1.8 million global deaths.1 and 3206 cases in Lesotho with 65 deaths. In order to respond to this global pandemic, the Government of Lesotho (GoL) will implement a Lesotho COVID-19 Emergency Preparedness and Response Project (EPRP), with World Bank (WB) financial support. The Lesotho COVID-19 Emergency Preparedness and Response Project (EPRP), with US$ 7.5 million total budget, comprises of two main components, Emergency COVID-19 Response (US$6.675 million), and Project Implementation and Monitoring & Evaluation (US$0.825 million).

Análise da percepção de risco dos estudantes participantes do Projeto Agente Mirim de Defesa Civil / Risk perception analysis of students participating in the Junior Civil Defense Agent

Atualmente, a Defesa Civil (DC) de Blumenau, em Santa Catarina, na Bacia Hidrográfica do Rio Itajaí (BHRI) realiza ações de educação ambiental para Gestão de Risco de Desastres (GRD) por meio de projetos, dentre eles o Agente Mirim de Defesa Civil (AMDC). O objetivo dessa pesquisa foi analisar como o projeto AMDCsubsidia a implementação da Lei Federal no. 12.608/2012, por meio da análise da percepção de risco dos estudantes durante sua participação. Para isso, foram utilizadas cinco ferramentas aplicadas em sete momentos no decorrer do ano letivo de 2016. Os resultados revelam que os estudantes ao ingressarem no projeto, trazem consigo conceitos básicos sobre ações de defesa civil e constroem novos conhecimentos sobre riscos de desastres. Conclui-se que as práticas educativas empregadas no projeto AMDC possibilitam a construção de conhecimentos, procedimentos e atitudes, capacitando os estudantes nos processos de prevenção, mitigação e preparação frentes aos riscos de desastres conforme enfatizado pela Lei Federal no. 12.608/2012.

Currently the Civil Defense (CD) of Blumenau, Santa Catarina, in the Itajaíriver basin conducts environmental education actions for Disaster Risk Management (DRM) through projects, among them the "Junior Civil Defense Agent" (JCDA). The objective of this research was to analyze how the JCDA project subsidizes the implementation of Federal Law nº. 12.608/2012, by analyzing the students' perception of risk during their participation. To this end, five tools were applied at seven times during the 2016 school year. The results show that students entering the project bring with them basic concepts about civil defense actions and build new knowledge about disaster risks. It is concluded that the educational practices employed in the JCDA project enable the construction of knowledge, procedures and attitudes, enabling students in disaster prevention, mitigation and preparedness processes as emphasized by Federal Law nº. 12.608/2012.

Preparação e resposta a desastres do Brasil na pandemia da COVID-19 / Preparación y respuesta a desastres de Brasil en la pandemia de COVID-19 / Disaster preparedness and response in Brazil in the face of the COVID-19 pandemic

Resumo Como a crise em saúde pública causada pela pandemia da COVID-19 ajuda a compreender o funcionamento do Sistema Nacional de Proteção e Defesa Civil (SINPDEC) nas fases de preparação e resposta a desastres em saúde no Brasil? A resposta a essa pergunta se dará por meio do seguinte objetivo geral: compreender o funcionamento do SINPDEC no enfrentamento à COVID-19, com ênfase na atuação do Ministério da Saúde (MS), órgão gestor de combate às ameaças em saúde. Para tanto, três objetivos específicos serão explorados: caracterizar a (doença) COVID-19 como evento em saúde pública com potencial causador de desastre, situar os conceitos de preparação e resposta na literatura de governança de desastres e identificar previsões legais e funcionamento da gestão de desastres no Brasil. A despeito das tensões decisórias no âmbito político, a burocracia profissional brasileira conseguiu garantir a ativação do sistema de governança de desastres relativa às fases de preparação e resposta. Contudo, sua ativação não foi suficiente para aplacar a crise, cujo agravamento expõe falhas nas fases de prevenção e mitigação de desastres, bem como a falta de uma resposta ao desastre em âmbito federativo.

Resumen ¿Cómo la crisis de salud pública causada por la pandemia de COVID-19 ayuda a comprender el funcionamiento del Sistema Nacional de Protección y Defensa Civil (SINPDEC) en las fases de preparación y respuesta a desastres de salud en Brasil? La respuesta a esta pregunta se dará mediante el siguiente objetivo general de investigación: comprender el funcionamiento del SINPDEC en el afrontamiento a la COVID-19, con énfasis en el trabajo del Ministerio de Salud, organismo gestor del combate contra las amenazas a la salud. Con este fin, se explorarán tres objetivos específicos: caracterizar la COVID-19 como un evento de salud pública con el potencial de causar un desastre; situar los conceptos de preparación y respuesta en la literatura sobre gestión de desastres; e identificar las predicciones legales y el funcionamiento de la gestión de desastres en Brasil. Se argumenta que, a pesar de las tensiones políticas en la toma de decisiones, la burocracia profesional brasileña logró garantizar la activación del sistema de gestión de desastres relacionado con las fases de preparación y respuesta. Sin embargo, su activación no fue suficiente para aplacar la crisis, cuyo empeoramiento expone fallas en las fases de prevención y mitigación de desastres, así como la falta ‒e importancia‒ de una respuesta al desastre en ámbito federativo.

Abstract This article aims to understand how the National System of Protection and Civil Defense functions in response to COVID-19, with emphasis on the work of the Ministry of Health, which is the body responsible for tackling health threats. Three specific objectives were used: the first characterizes COVID-19 as a public health event that can represent a disaster; the second situates the concepts of preparedness and response in the disaster governance literature; the third identifies the jurisprudence and the functioning of disaster management in Brazil. The findings show that, despite the political decision-making tensions, the Brazilian professional bureaucracy managed to guarantee the activation of the disaster governance system related to the preparation and response phases. However, its activation was not enough to allay the crisis. The severity of the pandemic exposed flaws in the phases of disaster prevention and mitigation, as well as the lack of coordinated government response.

Discursos (sobre)viver nos territórios em risco da região metropolitana do Recife / Discourses (about) living in territories at risk of the metropolitan region of Recife / (Discursos (sobre)vivir en los territorios en riesgo de la región metropolitana de Recife

A presente pesquisa objetiva analisar e debater os discursos produzidos por usuárias(os) do Sistema Nacional de Proteção e Defesa Civil, residentes na Região Metropolitana do Recife, no que diz respeito à vida nos territórios em risco. O estudo está inserido no conjunto de pesquisas que buscam compreender os fenômenos socioculturais que envolvem a questão do risco, e suas implicações para os processos de subjetivação das pessoas nos contextos marcados por emergências e desastres. Desenvolvemos uma metodologia qualitativa, como referenciais epistêmico-metodológicos adotamos os estudos foucaultianos sobre discurso e a Psicologia Discursiva de origem inglesa. Realizamos entrevistas semiestruturadas com a participação de três homens e doze mulheres usuárias(os) da defesa civil e beneficiárias(os) do auxílio-moradia. Os discursos produzidos ressaltaram um território marcado por um sistema de gerenciamentos de riscos deficitário e pouco efetivo, sendo que a pobreza e a dificuldade de acesso a serviços públicos básicos são demandas centrais das pessoas que nele habitam. Identificamos também estratégias de resistência, que mesmo fragilizadas, buscam suprir a ausência efetiva do Estado nesses espaços. A questão social é uma temática central no contexto pesquisado, produz marcas profundas naquilo que se define como risco e, por conseguinte, na vida das pessoas que habitam os territórios permeados por ele...(AU)

This study analyzes the discussions produced by users of the National System for Civil Protection and Defense by residents of Recife's Metropolitan Region regarding survival in territories at risk. It is part of a set of projects which seek to understand socio-cultural phenomena where the matter of risk is involved and its implications for processes of how people interiorize emergencies and disasters in their respective contexts. A qualitative methodological approach was adopted. We used Foucault's study on discourse and the English school of Discursive Psychology as epistemic-methodological frameworks. Semi-structured interviews were conducted with the participation of 12 women and 3 men who were end-users of civil defense and beneficiaries of housing assistance. The generated discussions indicated a territory marked by a system of risk management which was deficient and very ineffective, as poverty and difficult access to basic public services are demands pertaining to people who live there. We also identified strategies for resistance which, even when they became fragile, sought to overcome the state's lack of presence in these scenarios. Social issues constitute a central subject for the context analyzed, as they have a profound impact upon what is defined as risk and for the people who live in territories permeated by this risk...(AU)

La presente investigación objetiva analizar y debatir los discursos producidos por usuarias/os del Sistema Nacional de Protección y Defensa Civil, residentes en la Región Metropolitana de Recife, en lo que se refiere a la vida de las personas en territorios en riesgo. El estudio está insertado en un conjunto de investigaciones que buscan comprender los fenómenos socioculturales que involucran las cuestiones de riesgo, y sus implicaciones para los procesos de subjetivación de las personas en los contextos marcados por emergencias y desastres. Desarrollamos una metodología cualitativa, como referencias epistémico-metodológicas, y adoptamos los estudios foucaultianos sobre discurso y la Psicología Discursiva de origen inglesa. Realizamos entrevistas semiestructuradas con la participación de tres hombres y doces mujeres usuarios/as de defensa civil y beneficiarios/as del programa auxilio vivienda. Los discursos producidos apuntan un territorio marcado por un sistema de gerenciamientos de riesgos deficiente y poco efectivo, siendo que la pobreza y la dificultad al acceso de servicios públicos básicos son las demandas centrales de las personas donde habitan. Identificamos también estrategias de resistencia, que aun fragilizadas buscan suprimir la ausencia efectiva del Estado en esos lugares. La cuestión social es una temática central del contexto encuestado, produciendo marcas profundas en lo que se define como riesgo y, por consiguiente, en la vida de las personas que habitan en los territorios impregnados por estos riesgos...(AU)

Indonesian nurses' perception of disaster management preparedness / 中华创伤杂志(英文版)

PURPOSE@#Using a quantitative approach, this study aims to assess Indonesian nurses' perception of their knowledge, skills, and preparedness regarding disaster management.@*METHODS@#This study was a descriptive comparison in design. The research samples are Indonesian nurses working in medical services and educational institutions. The variables of nurses' preparedness to cope with disaster victims were measured using the Disaster Preparedness Evaluation Tool (DPET), which was electronically distributed to all nurses in Indonesia. Data were analyzed using a statistical descriptive one-way Analysis of Variance (ANOVA) and t-test with a significance level of 95%.@*RESULTS@#In total, 1341 Indonesian nurses completed this survey. The average scores of preparedness to cope with disasters, the ability to recover from disaster, and evaluation of disaster victims were 3.13, 2.53, and 2.46, respectively. In general, nurses surveyed in this study are less prepared for disaster management, and do not understand their roles both during the phase of disaster preparedness, and when coping with a post-disaster situation.@*CONCLUSION@#Nurses' preparedness and understanding of their roles in coping with disasters are still low in Indonesia. Therefore, their capacity in preparedness, responses, recovery, and evaluation of disasters needs improvement through continuing education. The efforts needed are significant due to potential disasters in Indonesia and adequate nurses resources.

A responsabilidade do Estado na perspectiva da legislação da Defesa Civil e de lideranças comunitárias / The responsibility of the State from the perspective of Civil Defense legislation and community leaders / La responsabilidade del Estado en vista de la legislación de la Defensa Civil y de los liderazgos comunitarios

Esta pesquisa buscou compreender a responsabilidade do Estado na gestão de risco de desastres sob a perspectiva de lideranças comunitárias do M'Boi Mirim. Tendo em vista que a região conta com 50 das 407 áreas de risco do município de São Paulo, estando entre os piores índices de exclusão e vulnerabilidade da cidade, e que compete às prefeituras gerenciar áreas de risco, verifica-se a importância de compreender a responsabilidade do Estado neste contexto. Foram analisadas entrevistas de três lideranças comunitárias da região. Desta análise emergiram diversos elementos que contribuem para a situação da região: a inércia do poder público, as dificuldades de diálogo entre população e autoridades governamentais e a diversidade de atores que interferem na solução das questões encontradas, como secretarias municipais que não conversam entre si, políticos que atuam de acordo com seus próprios interesses e a onipresença do tráfico. Verificou-se, ainda, que as lideranças tinham uma perspectiva crítica tanto com relação às ações ou inércia do governo como também com relação à responsabilidade da população.

The aim of this research was to understand the State's responsibility in the disaster risk management in the M'Boi Mirim regions from the perspective of the community leaders. The relevance of the focus on governmental responsibility stems from three issues: that 50 of the 407 areas of risk in the São Paulo municipality are located in this region; that it has one of the worst indicators of vulnerability in the city and that it is a duty of the municipal government to manage areas of risk. Interviews were carried out with three community leaders. Results indicate that various factors contribute to the disaster risk in the region: governmental inertia; the difficult dialogue between population and government authorities and the diversity of actors that interfere in the solution of the problem, such as lack of communication between municipal departments, politicians that act on behalf of their own interests and the omnipresence of drug trafficking. Results also indicate that community leaders have a critical view regarding governmental actions as well as the responsibility of the population.

Esta investigación buscó comprender la responsabilidad del Estado en la gestión del riesgo de desastres desde la perspectiva de líderes comunitarios del barrio M'Boi Mirim. La región cuenta con 50 de las 407 zonas de riesgo del municipio de San Pablo, tiene uno de los peores índices de exclusión y vulnerabilidad de la ciudad, y dado que compete a las alcaldías gestionar estas áreas de riesgo, se ve la importancia de comprender la responsabilidad del estado en este contexto. Se analizaron las entrevistas de tres líderes comunitarios de la región. De este análisis surgieron diversos elementos que contribuyeron para la situación de la región: la inercia del poder público, las dificultades de diálogo entre la población y las autoridades gubernamentales, y la diversidad de agentes que interfieren en la solución de las cuestiones encontradas, por ejemplo, secretarias municipales que no se comunican entre sí, políticos que actúan de acuerdo a sus propios intereses y la omnipresencia del tráfico. De la misma manera, se observó que los lideres tienen una perspectiva critica con relación a las acciones o inercia, así como también con relación a la responsabilidad de la población.

Availability and safety of blood transfusion during humanitarian emergencies

Background: Availability and safety of blood transfusion is a major concern in countries affected by humanitarian emergencies. These emergencies increase demand for blood transfusion and make its delivery challenging and complex. Nevertheless, there is a lack of information on emergency preparedness and response capacity of blood transfusion services and on the challenges in meeting patients' needs.

Aims: To assess availability and safety of blood transfusion during humanitarian emergencies.

Methods: We searched PubMed and Index Medicus for the World Health Organization Eastern Mediterranean Region for data on availability and safety of blood transfusion during humanitarian emergencies. We also gathered information through a survey and during a regional consultation in Tunisia.

Results: We found 24 publications on disaster from 5 countries in the Region and 16 publications on disaster preparedness and blood transfusion in casualties and severe trauma outside the Region. However, none dealt with availability and safety of blood transfusion during humanitarian emergencies. Armed conflicts and terrorism, flooding and earthquakes are the most frequent emergencies with 10–85% of the injured requiring blood transfusion. There are gaps in emergency preparedness and response, including human resources, transport and cold chain, supply of consumables and maintenance of equipment, power supply, and finances.

Conclusions: There is a need to integrate blood transfusion services in the overall national emergency preparedness and response, and provide assistance to affected countries to address identified gaps. Recommendations for individual countries need to be tailor made, along the lines of the regional strategic framework for blood safety and availability

La disciplina Preparación para la Defensa en la formación de estudiantes de Medicina / The discipline Preparation for Defense in the training of medical students

Fundamento: las instituciones médicas tienen definido su encargo social, para ello conciben la formación de estudiantes de Medicina con un sólido sistema de conocimientos. Objetivo: caracterizar la disciplina Preparación para la Defensa en la formación de estudiantes de Medicina por la significación especial de esta en su formación integral. Métodos: se desarrolló una investigación descriptiva con predominio de métodos cualitativos en la Universidad de Ciencias Médicas de Pinar del Río, de enero a febrero 2015. Se utilizaron métodos de los niveles teórico, entre ellos: el analítico-sintético, inductivo-deductivo, histórico-lógico y el abstracto a lo concreto; y empíricos: el análisis documental del plan de estudio de la disciplina Preparación para la Defensa, y la encuesta a los estudiantes para indagar sobre el tema. Resultados: la disciplina Preparación para la Defensa declara un sistema de conocimientos, habilidades y valores que garantizan el desempeño de los estudiantes de la carrera de Medicina. La mayoría de los alumnos la consideraron pertinente, y todos reconocieron su valor para la formación integral del profesional ante situaciones de contingencia. Se constató la necesidad de establecer nexos de continuidad con materias de la disciplina Medicina General Integral. Conclusiones: se identificaron las fotalezas de la disciplina para formar modos de actuación positivos en los futuros médicos ante situaciones de contingencias, y se aprecia que sus contenidos pueden enriquecerse con otras materias del currículo a partir de la identificación de los núcleos de contenidos que tienen potencialidades para la integración disciplinar.

Background: the medical institutions have a well defined social commitment, for this, the training of Medicine students is conceived with a solid knowledge system. Objective: to characterize the discipline Preparation for Defense in the training of medical students because of the special significance of this in their comprehensive formation. Methods: a descriptive research was developed with predominance of the qualitative methods in Pinar del Río University of Medical Sciences, from January to February of 2015. Methods of the theoretical level were used, among them, The analytic-synthetic, inductive-deductive, historical-logical and the abstract-concrete; And empirical ones: documentary analysis of the curriculum of the discipline Preparation for Defense and the survey to students to inquire about the subject. Results: the discipline Preparation for Defense declares a system of knowledge, skills and values ??that guarantee the performance of medical students. Most of the students considered it interesting, and all recognized its value for the comprehensive formation of the professional in situations of contingency. It was verified the need to establish continuity links with subjects of the Comprehensive General Medicine discipline. Conclusions: the potentialities of the discipline were identified to form positive ways of performance in future doctors in situations of contingencies, and it is appreciated that their contents can be enriched with other subjects of the curriculum through the identification of the core contents that have potentialities for disciplinary integration.

Middle East Respiratory Syndrome Outbreak and Responsiveness of the Pharmacy Programs on the Pharmacy Practice Education

BACKGROUND: Pharmacy curriculum change was made from a 4-year program to a 2+4 year program in year 2009 in Korea. The change has resulted in more educational exposures on patient-centered practice environments for about 1,400 hours in the last year of the professional pharmacy program. When the Middle East Respiratory Syndrome (MERS) outbreak hit Seoul and suburban areas and propagated to other provinces in Korea, emergency response to avoid student infection in the pharmacy practice sites became an urgent issue. While other health professional programs such as medicine and nursing had activated emergency preparedness manuals, timely and clear guidelines were not disseminated to all pharmacy programs and protective measures largely relied on individual pharmacy program. METHODS: A survey was developed by the Committee on Pharmacy Practice Experience Programs in the Korean College of Clinical Pharmacy to document the status of pharmacy programs during the Korea MERS outbreak in 2015. The 10-question survey was distributed to the pharmacy practice experience coordinators to 34 out of 35 pharmacy schools in Korea by emails. RESULTS: Our findings showed that 82.4% of the program coordinators (28/34) responded to the survey, 96.4% of the programs did not have emergency preparedness manuals, administrative meetings were held in 89.3% of the pharmacy programs, the rotation schedules were modified or withheld in 53.6% of schools, and the changes were mostly observed from the programs classified as MERS outbreak regions. CONCLUSION: Further needs in establishing the emergency preparedness manual should be explored for pharmacy education stakeholders.

Public health emergency preparedness and response to emerging infectious diseases

No abstract available.

Public health emergency preparedness and response in Korea

Infectious disease control and prevention in Korea are handled based on laws such as the Framework Act on the Management of Disasters and Safety and the Infectious Disease Control and Prevention Act. To fill the gaps in the national public health system that were identified during the 2015 Middle East respiratory syndrome outbreak in Korea, Korea has strengthened its capacity to prepare for and respond to public health emergency. The objectives are to prevent, promptly detect, and rapidly respond to imported infectious diseases; to fully mobilize public health and medical resources; to revise governance enhancing the role of the centralized decision-making structures; and to improve health care facilities to prevent health care-associated infections.

Role of the local government in infectious disease-related public health emergency preparedness and response

In public health emergency arising from an infectious disease epidemic, the local government is responsible for protecting the community residents by containing the spread of the disease. Such role requires close collaboration with the central government and health care institutions. Preparedness capabilities of the local government include biosurveillance, community resilience, countermeasures and mitigation, incident management, information management, and surge management. During the epidemic of Middle East respiratory syndrome in Korea, local governments exercised great efforts in contact management, patient identification, and patient management. Korea Ministry of Health and Welfare is promoting for the local governments to prepare the infectious disease emergency preparedness plan by providing a common framework. Community preparedness involves the roles of health care institutions in order to protect the residents' health. Hospitals and primary care clinics need to maintain sufficient levels of preparedness to secure safe environment and to provide sustainable service during the emergency situations.