Regeneración de un bosque secundario afectado por el Huracán Otto en Costa Rica / Regeneration of a secondary forest affected by Hurricane Otto in Costa Rica

Resumen Introducción: Se han realizado múltiples estudios en bosques afectados por huracanes, pero la información obtenida para Costa Rica es escasa, o nula en el caso de impactos directos como lo fue Otto, por lo que es necesario ampliar el conocimiento que se tiene acerca de los efectos de estos fenómenos en bosques tropicales y los mecanismos de recuperación de estos biomas. Consecuentemente se vuelve necesario identificar la vulnerabilidad de los ecosistemas a largo plazo y cuantificar las pérdidas que se generan a diferentes escalas, producto de los intensos eventos pluviales y los fuertes vientos. Objetivo: Determinar el comportamiento y estado de la recuperación en un bosque secundario afectado directamente por el huracán Otto en Boca Tapada, Pital, San Carlos, Costa Rica. Métodos: Se establecieron 10 unidades de muestreo de 20 x 50 m distribuidas de forma sistemática dentro de un bosque secundario afectado por el huracán Otto en Boca Tapada de San Carlos. Se evaluó la condición actual del bosque, se identificaron las especies que más daño recibieron por consecuencia de los fuertes vientos, así como las que poseen capacidad de recuperarse a través de rebrotes. Se realizó un sobrevuelo con un vehículo no tripulado, y se construyó un ortomosaico que fue posteriormente digitalizado y clasificado de acuerdo con el estado de la cobertura forestal presente en tres tiempos evaluados, condición inicial, después del aprovechamiento forestal y la condición al momento de realizado el muestreo. Se comparó la densidad poblacional, diversidad y área basal con lo presentado para un bosque primario aledaño al sitio de estudio, que también fue afectado por el paso del huracán Otto. Resultados: Se obtuvo que un 69.5 % de los individuos con d ≥ 5 cm se encuentran en buen estado, un 20.3 % fue descopado y un 12.7 % inclinado sin exposición de raíces. La familia que más riqueza de especies aporta es Fabaceae, esta misma es la que más abundancia de individuos dañados posee y la que presentó mayor cantidad de especies con capacidad de rebrotar. La especie que más daños sufrió fue Couma macrocarpa (Euphorbiaceae). El área de cobertura boscosa inicial fue afectada en un 7,63 % por el aprovechamiento forestal, y en un 44.25 % por el paso del huracán Otto. Se determinó que existen diferencias significativas en la diversidad de especies (P = 0.0004; α = 0.05) y en la densidad de individuos (P = 0.0011; α = 0.05), el bosque secundario es quien posee la mayor media. No se presentaron diferencias significativas en los valores de área basal (P = 0.6951; α = 0.05). Conclusiones: Un 30,5 % de la masa forestal fue afectada por el paso del huracán Otto y la familia Fabaceae representa un papel importante en la recuperación del bosque. Además, el aprovechamiento forestal en un bosque puede aumentar el riesgo de afectación por el paso de huracanes y el bosque secundario posee mayor diversidad de especies y mayor densidad de individuos que el bosque primario.

Abstract Introduction: Multiple studies have been carried out in forests affected by hurricanes, but the information obtained for Costa Rica is scarce or null, in the case of direct impacts such as Otto, so it is necessary to expand the existing knowledge about the effects of these phenomena on tropical forests and the recovery mechanisms of these biomes. Consequently, it is necessary to identify the vulnerability of ecosystems in long term and quantify the losses that are generated at different scales, as a result of the intense events of rain and strong winds. Objective: Determining behavior and recovery status in a secondary forest directly affected by Hurricane Otto in Boca Tapada, Pital, San Carlos, Costa Rica. Methods: Ten 20 x 50 m sampling units were systematically distributed within a secondary forest affected by Hurricane Otto in Boca Tapada, San Carlos. The current condition of the forest was evaluated, the species that received the most damage due to high winds were identified, as well as those that have the capacity to recover through regrowths. An overflight was carried out with an unmanned aerial vehicle and an orthomosaic was constructed, subsequently digitized, and classified according to the state of the forest cover presented in three evaluated moments, initial condition, after logging and the condition at the time of sampling. Population density, diversity, and basal area, were compared to data obtained in an adjacent primary forest also affected by the passage of Hurricane Otto. Results: It was obtained that 69.5 % of individuals with d ≥ 5 cm are in good condition, 20.3 % were broken in the tree canopy and 12.7% inclined without exposure of the roots. The family that provided the greatest species richness is Fabaceae, which is the same with the greatest abundance of damaged individuals and the one with the highest number of species with the ability to resprouting. The species that suffered the most damage was Couma macrocarpa (Euphorbiaceae). The initial area of forest cover was reduced by 7.63 % due to logging and 44.25 % due to Hurricane Otto. It was determined that there are significant differences in species diversity (P = 0.0004; α = 0.05) and in the density of individuals (P = 0.0011; α = 0.05). The secondary forest has the highest average in both cases. There are no significant differences in the values of the basal area (P = 0.6951; α = 0.05). Conclusions: 30.5 % of the forest mass was affected by the passage of Hurricane Otto and the Fabaceae family plays an important role in forest recovery. In addition, forest harvesting in a forest can increase the risk of being affected by the passage of hurricanes and the secondary forest has a greater diversity of species and a higher density of individuals than the primary forest.

Reporte de Situacion Emergencia por Huracan IOTA y temporada de lluvias Colombia No. 09: 05 de diciembre 2020 / Emergency Situation Report for Hurricane IOTA and rainy season Colombia No. 09: December 05, 2020

A la fecha Colombia reporta 1.334.089 casos (9.297 casos nuevos en las últimas 24h) con un incremento nacional del 0,7% en las últimas 24h y 37.117 defunciones (183 las últimas 24 Horas) con un aumento nacional del 0,5% en las últimas 24h. Los departamentos y distritos que presentaron los aumentos relativos más altos de COVID-19 en los últimos 7 días fueron: Caldas 11,9% (2.070), Quindío 11,5% (1.397), Tolima 11,5% (2.445), Norte Santander 10,3% (2.075), Boyacá 9,3% (1.302), Casanare 9,0% (504), Cartagena 8,7% (2.044), Risaralda 7,8% (1.297), Santa Marta 7,3% (765), Santander 7,1% (2.658). La tasa de incidencia nacional es de 2.648,5 casos por cada 100.000 habitantes; los departamentos y/o distritos que superan la tasa nacional son en su orden: Bogotá (4.905,8), Amazonas (3.992,7), Barranquilla (3.590,0), San Andrés (3.433,7), Caquetá (3.275,8), Antioquia (3.247,0), Quindío (3.157,9), Cartagena (3.107,4), Huila (2.713,3), Meta (2.686,8). La tasa de mortalidad nacional es de 736,9 muertes por cada millón de habitantes; se observa una tasa de mortalidad mayor a la nacional en: Amazonas (1.556,6), Barranquilla (1.375,7), Caquetá (1.169,2), Bogotá (1.110,5), Santa Marta (943,2), Córdoba (904,3), Santander (893,5), Huila (870,3), Norte Santander (865,9), Quindío (831,8), Valle del Cauca (778,9).

Reporte de situacion emergencia por huracan IOTA y temporada de lluvias Colombia No. 05: 23 de Noviembre 2020 / Emergency situation report due to hurricane IOTA and rainy season Colombia No. 05: 23 November 2020

Según el reporte informativo N°170 del IDEAM la habitual temporada de lluvias que se registra cada año para esta época, sumado a la influencia del Fenómeno La Niña y a una actividad ciclónica muy activa, ha generado que las lluvias de este segundo semestre del 2020 hayan aumentado considerablemente. Estas precipitaciones han generado que departamentos como Antioquia, Bolívar, Chocó, La Guajira, Magdalena, Norte de Santander y el Archipiélago de San Andrés, Providencia y Santa Catalina hayan tenido situaciones de emergencia más complejas.

Tropical cyclone Fani-perspective from the trauma and emergency department of an affected tertiary hospital / 中华创伤杂志(英文版)

PURPOSE@#To explore the epidemiological and clinical profile of patients admitted to the trauma and emergency department (TED) of a tertiary care hospital due to tropical cyclone Fani and highlight the challenges faced by the hospital in this natural disaster.@*METHODS@#A retrospective study was conducted in the TED in the affected zone. Data of all victims affected by the cyclone Fani on May 3, 2019 were obtained from disaster records and medical case sheets. All patients except death on admission were included. Clinical variables included anatomical sites and severity of injuries which was assessed by revised trauma score (RTS) and injury severity score (ISS). Trauma injury severity score (TRISS) was also calculated.@*RESULTS@#Of 75 patients, 74 were included and the other one was brought dead and thus excluded. The age, median ± interquartile range (IQ), was 41.0 (27.7-53.0) years. The male to female ratio was 2:1. Most of the wounded were transported by the police control room vans on day 1: first 10 h, 50.0%; 10-24 h, 20.3%. The median ± IQ range of RTS, ISS and TRISS were 20 (14-28), 7.84 (7.841-7.841), and 97.4 (91.6-98.9), respectively. Simple external injury was the dominant injury type. Polytrauma (ISS >15) was seen in 67% cases and spine injury in 14% cases (7% cervical and 7% thoracolumbar). Injury causes included sharp flying objects (broken pieces of glasses and asbestos) in 31% cases, followed by fall of trees in 20.3%. Twenty-four patients were discharged after primary treatment, 30 admitted to the indoor-trauma ward or intensive care unit and 20 deferred or transferred to another center. There was no in-house mortality. Challenges were related to electricity failure, mobile network breakdown, infrastructure collapse, and delay in expertise repair from outside due to airport/railway closure.@*CONCLUSION@#In cyclonic storm like Fani, sharp flying objects, fall of trees/poles and collapsing walls constitute the common mode of injuries causing harm to more than one body regions. Polytrauma was seen in the majority of patients though external injury was the commonest. The affected hospital had the uphill task of treating hospitalized patients as well as disaster victims.

Posttraumatic symptomatology of a rural Filipino population in Merida, Leyte in the wake of Super Typhoon Yolanda (Haiyan)

Objectives@#The goal of the research was to provide local data on the varieties of posttraumatic symptomatology among survivors of Super typhoon Haiyan in a rural community in Merida, Leyte.@*Methodology@#This is a single point non-invasive study of Filipino survivors of typhoon Yolanda who came from Merida, Leyte, involving administration of a symptom checklist i.e. Post Traumatic Stress Disorder Checklist- Civilian version (PCL-C) to assess the occurrence of posttraumatic symptoms in the selected group of volunteers with no history of psychiatric illness. The PCL-C was given as part of a community screening for symptoms of PTSD conducted three months after the typhoon. There were two ways of scoring the PTSD Checklist- Civilian version (PCL-C) - either by computing for the total severity score or by scoring each response category just like one would in the Diagnostic and Statistical Manual (DSM IV TR) criteria. The sum of all PCL-C item scores indicated the severity of Post Traumatic Stress Disorder (PTSD). A score of 30 and above represented the occurrence of PTSD. T-test was used to determine differences in the severity scores of those who met the criteria for PTSD using the total "severity scoring method" and those who did not.@*Results@#A total of 29 respondents took part in the study where the majority were female (28/29 or 96.55%). The results showed that Filipinos suffered more re-experiencing symptoms but less avoidance symptoms compared to the DSM IV-TR criteria. Nine of 29 (31.03%) respondents were assessed as having Post Traumatic Stress Disorder (PTSD) based on the total "severity score method': However, none fulfilled the PTSD DSM IV TR criteria when the response "category scoring method" was used. Those who met the severity criteria had significantly higher scores in items 1 (Repeated, disturbing memories, thoughts, or images of a stressful experience from the past?), 3 (Suddenly acting or feeling as if a stressful experience were happening again?), 5 (Having physical reactions when something reminded you of a stressful experience from the past?), 6 (Avoid thinking about or talking about a stressful experience from the past or avoid having feelings related to it?) and 13 (Trouble falling or staying asleep?).@*Conclusion@#There seems to be a difference in how the Filipinos experience trauma compared to Western models such as described in the Diagnostic Symptom Manual (DSM IV TR) criteria though caution is warranted in interpreting the results due to the small sample size and the predominance of female respondents.

Medical needs documented by Emergency Medical Services (EMS) responders to areas affected by Typhoon Haiyan in the Philippines: Implications on disaster response policy

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Despite existing disaster preparedness policies in the Philippines, there has not been any validated assessment of the quality of disaster medical response, which would require reliable aggregate data on patient diagnoses and management.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> This mixed-methods study documented the diagnoses, triage classification and case management of patients seen by Philippine EMS groups who responded to the Typhoon Haiyan disaster in the Philippines in November and December 2013, as well as difficulties associated in gathering these data, using the Utstein-style Template for Uniform Data Reporting of Acute Medical Response in Disasters as framework.</p><p style="text-align: justify;"><strong>METHODS:</strong> Three hundred (300) individuals vetted by EMS organizations were invited to answer a survey modeled after the Utstein-style template, and submit tallies of patients seen. Out of 52 responses received, policy recommendations were subsequently generated on concerns assessed by the template using the nominal group technique.</p><p style="text-align: justify;"><strong>RESULTS:</strong> The submitted data yielded a total of 41,202 patients with information on age, sex, and diagnosis; 19,193 with triage classification; and 27,523 with information on case management. The focus group discussion underlined the absence of a standard communication and information management system. Participants recommended establishing such a system and highlighted the role of the Department of Health - Health Emergency Management Bureau in coordinating disaster medical response efforts and information management.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> This study underlines the importance of effective communication, and multisectoral coordination, to generate reliable data and thus, facilitate resource allocation for disaster medical response.</p>

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.

Effect of typhoons on the Korean national emergency medical service system

OBJECTIVE: While the effect of typhoons on emergency medicine has been evaluated, data are scarce on their effects on the emergency medical service (EMS). This study evaluated the effect of typhoons on EMS patients and performance. METHODS: The study period was January 2010 to December 2012. Meteorological data regarding typhoons were provided by the Korean Meteorological Administration. EMS data were retrieved from the EMS database of the national emergency management agency. The database includes ambulance run sheets, which contain clinical and operational data. In this case-crossover study, the cases and controls were EMS calls on the day of typhoon warnings and calls one week prior to the typhoon warnings, respectively. RESULTS: During the study period, 11 typhoons affected Korea. A total of 14,521 cases were selected for analysis. Overall, there were no obvious differences between the case and control groups. However, there were statistically significant differences in age, place, and time requests. There were fewer patients between 0 and 15 years of age (P=0.01) and more unconscious patients (P=0.01) in the case group. The EMS operational performance, as measured by the times elapsed between call to start, call to field, and call to hospital did not differ significantly. There was also no significant difference in the time from hospital arrival between the cases (28.67, standard deviation 16.37) and controls (28.97, standard deviation 28.91) (P=0.39). CONCLUSION: Typhoons did not significantly affect the EMS system in this study. Further study is necessary to understand the reasons for this finding.

Three years after Typhoon Ondoy until Habagat rains: Prevalence of acute stress disorder and post-traumatic stress disorder among residents of Barangay Tumana, Marikina: A cross-sectional analytical study

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> This study aimed to determine the prevalence of Acute Stress Disorder and Post Traumatic Stress Disorder among residents of Barangay Tumana, Marikina exposed to Typhoon Ondoy in September 2009 and Habagat rains in August 2012.</p><p style="text-align: justify;"><strong>METHODOLOGY:</strong> The Acute Stress Disorder Scale (ASDS) and Impact of Events Scale-Revised (IESR) were administered to 212 subjects. Trauma history was also obtained. When screened positive for Acute Stress Disorder (ASD) and/or Post Traumatic Stress Disorder (PTSD), a confirmatory diagnosis was done through psychiatric clinical interview.</p><p style="text-align: justify;"><strong>RESULTS:</strong> The study showed a prevalence rate of 10% for ASD and 5% for PTSD. Co-morbid ASD and PTSD were seen in 4% of the subjects. Frequency and type of prior traumatic events were not significantly different among subjects who were positive or negative for ASD/PTSD diagnoses.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> There was a significant prevalence of ASD/PTSD diagnoses among residents exposed to Typhoon Ondoy and Habagat, thus the need for developing a means of early detection and immediate therapeutic intervention in Filipino communities exposed to natural disasters.</p>

Notifiable diseases under Philippine integrated disease surveillance and response (PIDSR) among patients seen at the Eastern Visayas Regional Medical Center (EVRMC) before and after super typhoon Yolanda

@#<p style="text-align: justify;"><strong>INTRODUCTION:</strong> Typhoon Haiyan, or Typhoon "Yolanda" in the Philippines, caused catastrophic damage last November 8, 2013 in the islands of Leyte. As of April 17, 201, NDRRMC confirmed 6,300 fatalities across the country and around 5,877 were from Eastern Visayas. The actual death toll remained unclear although it is being claimed to be about 10,000 in Tacloban City alone.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> This study aimed to determine the transmission of notifiable diseases under PIDSR as to increase in morbidity, deaths and case fatality rates among patients consulted and/or admitted at EVRMC before and after ST Yolanda.</p><p style="text-align: justify;"><strong>MATERIALS AND METHODS:</strong> This is a descriptive study which included all patients who sought consultation and/or admission in EVRMC with clinical diagnosis of any notifiable disease under the PIDSR reference list.</p><p style="text-align: justify;"><strong>RESULTS:</strong> A cumulative total of 8,299 patients with notifiable diseases sought and/or admission between November 2012 - October 2013 and November 2013 - October 2014. Of which, 3,873 or 46.67% were cases before Super Typhoon Yolanda while 4,426 or 53.33% were cases a year after. Patients below 14 years old were mostly affected after the disaster. There were few patients, 70 years old and above who sought consultation and/or admission. As to occurrence between sexes, there were more females affected than males after the disaster which comprised of 51.4% of the total. As to geographic distribution, there were more cases coming from the 1st district of Leyte including Tacloban City comprising 61.58% compared to its occurrence prior to the disaster.  As to the number of cases under Category I, an increased cases of measles from 2 cases to 356 or an increase of 99.44% after the disaster. Notifiable diseases under Category II comprised 91.53% of the total post disaster with an increase of 12.5% from the total cases the previous year. Acute watery diarrhea had the highest number of patients affected then, was followed by Dengue fever,  27.43% and Acute bloody diarrhea, 2.35%. Chikungunya increased from 10 cases the previous year to 33. As to deaths, there was no increase under Category I but, under Category II, an increase of 26.1% after the typhoon was observed. Among these, were Acute watery diarrhea, Dengue fever, Influenza like illness and Measles after disaster.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> During calamities, everything is affected, from infrastructure, agriculture and most of all the people. Transmission of different infectious diseases occur because of displacement of the population, lack of safe water supply and sanitation facilities and, lack of available health care services.</p>

Prevalence of psychosocial distress among flood victims in selected urban barangays in Manila

OBJECTIVES: This study was conducted to estimate the prevalence of psychosocial problems among residents of four flood-prone barangays in Manila located along the Maricaban-Malibay creek in Pasay City and were reported to have experienced 10-15 feet-deep flood waters simultaneously caused by Typhoon Maring and the southwest monsoon in August 2013.METHODOLOGY: A stratified two-stage random cluster sampling method, adapted from the Community Assessment for Public Health Emergency Response (CASPER) Toolkit, was employed in the syudy. The first stage of sampling used street clusters, with more or less of the same size, as the primary sampling unites (PSU) and households as secondary sampling units (SSU) to select the households that will be included in the survey. Since the clusters were more or less of the same size, they ahd equal chances of being selected in the study if the probability of selection is proportionate to size (PPS). Seven houses were then randomly chosen from the 30 selected clusters. All of the househol heads from the 210 selected households were given several copies of the self-administered questionnairescalled the Self-Reporting Questionnaire-20 (SRQ-20), a screening tool developed by WHO, to determine the psychosocial condition of the household members 12-65 years.RESULTS: The prevalence of psychosocial distress in this population was estimated at 17% (95%CI=13.7-20.3%). The residents of the study barangays were in their rehabilitation phase i.e., three months post disaster when data was collected for this study. The study also characterized the households in the sample according to socio-economic status, presence of members with special needs, and presence of children 0-5 years ol. In the aftermath of the disaster, 46.84% of the respondents had positive answer on the group of questions about decreased energy, 49.8% on somatic symptoms,25.89% on depressive thoughts and 40.91% on depressive moods.There was a higher prevalence of these 4 factors among females, those separated, with low socioeconomic status and low educational attainment.CONCLUSION: The estimated prevalence of psychosocial distress was 17% (95%CI=13.7%-20.3%), In the aftermath of the disaster, 46.8% of the respondents had positive answer on the group of questions about decreased energy, 49.8% on somatic symptoms, 25.9% on depressive thoughts and 40.9% on depressive moods.

Prevalence of psychosocial distress among flood victims in selected urban barangays in Manila

OBJECTIVES: This study was conducted to estimate the prevalence of psychosocial problems among residents of four flood-prone barangays in Manila located along the Maricaban-Malibay creek in Pasay City and were reported to have experienced 10-15 feet-deep flood waters simultaneously caused by Typhoon Maring and the southwest monsoon in August 2013.METHODOLOGY: A stratified two-stage random cluster sampling method, adapted from the Community Assessment for Public Health Emergency Response (CASPER) Toolkit, was employed in the syudy. The first stage of sampling used street clusters, with more or less of the same size, as the primary sampling unites (PSU) and households as secondary sampling units (SSU) to select the households that will be included in the survey. Since the clusters were more or less of the same size, they ahd equal chances of being selected in the study if the probability of selection is proportionate to size (PPS). Seven houses were then randomly chosen from the 30 selected clusters. All of the househol heads from the 210 selected households were given several copies of the self-administered questionnairescalled the Self-Reporting Questionnaire-20 (SRQ-20), a screening tool developed by WHO, to determine the psychosocial condition of the household members 12-65 years.RESULTS: The prevalence of psychosocial distress in this population was estimated at 17% (95%CI=13.7-20.3%). The residents of the study barangays were in their rehabilitation phase i.e., three months post disaster when data was collected for this study. The study also characterized the households in the sample according to socio-economic status, presence of members with special needs, and presence of children 0-5 years ol. In the aftermath of the disaster, 46.84% of the respondents had positive answer on the group of questions about decreased energy, 49.8% on somatic symptoms,25.89% on depressive thoughts and 40.91% on depressive moods.There was a higher prevalence of these 4 factors among females, those separated, with low socioeconomic status and low educational attainment.CONCLUSION: The estimated prevalence of psychosocial distress was 17% (95%CI=13.7%-20.3%), In the aftermath of the disaster, 46.8% of the respondents had positive answer on the group of questions about decreased energy, 49.8% on somatic symptoms, 25.9% on depressive thoughts and 40.9% on depressive moods.

Rapid Health Needs Assessment after Typhoons Bolaven and Tembin Using the Public Health Assessment for Emergency Response Toolkit in Paju and Jeju, Korea 2012

Following natural disasters, rapid health needs assessments are required to quickly assess health status and help decision making during the recovery phase. The Korean Centers for Disease Control and Prevention (KCDC) developed the Public Health Assessment for Emergency Response (PHASER) Toolkit which was optimized for a weather disaster in Korea. The goal of this study is to assess public health needs following the 2012 typhoons Bolaven and Tembin in both urban and rural areas in Korea. We conducted pilot trials using the PHASER toolkit to assess health needs following typhoons Bolaven and Tembin in Paju and Jeju during summer 2012. We sampled 400 households in Jeju and 200 households in Paju using a multistage cluster sampling design method. We used a standardized household tracking sheet and household survey sheet to collect data on the availability of resource for daily life, required health needs, clinical results and accessibility of medical services. The primary outcomes were clinical results and accessibility of medical service after the typhoons. We completed surveys for 190 households in Paju and 386 households in Jeju. Sleeping disorders were identified in 6.8% (95% confidence interval [CI], 2.8%–10.8%) surveyed in Paju and 17.4% (95% CI, 12.8%–22.0%) in Jeju. We used the PHASER toolkit to assess healthcare needs rapidly after 2 typhoons in Korea. Sleeping disorders were frequently identified in both Paju and Jeju following the 2 typhoons.

Leptospirosis outbreak after a heavy rainfall typhoon in the Philippines: Clinical features, outcome and prognostic factors for mortality

@#<p style="text-align: justify;"><strong>BACKGROUND AND OBJECTIVES:</strong> In September 2009, Metro Manila was hit by a heavy rainfall typhoon Ketsana inundating several cities of Metro Manila causing an outbreak of leptospirosis. We analyzed the prognostic factors associated with mortality among leptospirosis patients admitted after the typhoon at nine tertiary hospitals from September to November 2009.<br /><strong>METHODS:</strong> We reviewed the charts of patients with probable and confirmed leptospirosis. Confirmed leptospirosis was based on any of the following: positive leptospiral culture of blood or urine, single high leptospira microagglutination titer (MAT) of 1:1600 or a fourfold rise in MAT antibody titers or seroconversion. Patients with negative serology or cultures but with history of wading in floodwaters plus any of the following signs and symptons: fever, headache, myalgia, conjunctival suffusion, diarrhea and abdominal pain, jaundice, oliguria and changes in sensorium were considered probable cases. <br /><strong>RESULTS:</strong> We analyzed 332 probable and 259 confirmed leptospirosis patients. Mean age was 37.95± 14.09, mostly males (80.2%). Almost all patients (98%) waded in floodwaters. Majority had moderate to severe form of leptospirosis (83%). Acute renal failure was the most common complication (87.1%). Mortality was 11.3% mostly due to pulmonary hemorrhage. On multivariate analysis of confirmed and probable cases, the factors independently associated with mortality were pulmonary hemorrhage (OR 2.75, 95% CI 1.46 to 5.20), severity of the disease (OR 3.85, 95% CI 1.60 to 9.26), thrombocytopenia (OR 3.16, 95% CI 1.22-8.16), duration of illness before admission (OR 0.88, 95% CI 0.78-0.99) and age (OR 1.03, 95% CI 1.00-1.06).<br /><strong>CONCLUSION:</strong> Pulmonary hemorrhage remains a poor prognostic factor and strong predictor of mortality among patients with severe leptospirosis. Early consult through heightened awareness of the public and prompt recognition of leptospirosis among clinicians can decrease the risk for progression to complications of leptospirosis and mortality. <br /><br /> </p>

Psychosocial Interventions for Children and Adolescents after a Disaster: A Systematic Literature Review (1991–2015)

OBJECTIVES: The aim of this systematic literature review is to analyze the psychosocial interventions for children and adolescents after disasters. METHODS: We conducted a review of the extant research literature from 1991 to 2015 via a comprehensive search of the MEDLINE, EMBASE, Cochrane CENTRAL, PubMed and PsyclNFO databases. The keywords employed in this research included: ‘child’, ‘adolescent’, ‘youth’, ‘disaster’, ‘posttraumatic’, ‘psychosocial’, ‘therapy’ and ‘intervention’. The researchers followed the PRISMA guidelines. A total of 850 articles were screened for their eligibility and fifty-nine were found to meet the study criteria. The final data analysis was performed based on the disaster type, study design, type of intervention, sample size, age, school grade, number of sessions, setting of intervention delivery, providers, approach and parent involvement. RESULTS: Countries worldwide have experienced various kinds of disasters, including earthquakes, hurricanes, vessel accidents, tornados, tsunamis, volcanic eruptions, war, fire, terrorism, and traffic accidents. The types of psychosocial intervention that were conducted after these disasters included: psychological first aid, psychological debriefing, psychoeducation, trauma focused cognitive behavior therapy, eye movement desensitization reprocessing, prolonged exposure therapy, group play therapy and arts therapy, project interventions, school-based interventions and web-based interventions. CONCLUSION: The findings of the systematic literature review suggest that an appropriate psychosocial intervention could be utilized as evidence-based mental health treatment for children and adolescents after disasters.

Hurricane katrina: influence on the male-to-female birth ratio

This study was carried out in order to ascertain whether or not Hurricane Katrina and related factors [i.e. the amount of rainfall] influenced the male-to-female birth ratio [M/F]. Monthly births by gender for the affected states [Alabama, Florida, Louisiana and Mississippi] for January 2003 to December 2012 were obtained from the Centers for Disease Control and Prevention [CDC Wonder, Atlanta, Ga., USA]. Precipitation data was obtained from the US National Weather Service. Ordinary linear logistic regression was used for trend analysis. A p value

Review of Disaster Mental Health System in Japan / 신경정신의학

Mental health is one of the most important issues for disaster survivors, and many studies have reported higher rates of mental health problems after disasters. Because Japan has experienced frequent earthquakes, tsunami, typhoons, and volcanoes, mental health problems have been a matter of great concern after disasters in Japan. To serve the psychiatric services after the Hanshin-Awaji (Kobe) earthquake, 'Hyogo institute for traumatic stress' was established. And when the disaster caused by the great east Japan earthquake and tsunami occurred, 'National information center of disaster mental health' and 'Disaster psychiatric assistance team' had the important role of reducing mental health problems.

Experience of a Medical Assistance for Disaster Caused by a Typhoon of Haiyan in the Philippines

PURPOSE: On November 8, 2013, Typhoon Haiyan attacked the Philippines, causing damage to many houses and trees as well as loss of many lives. A medical team from our hospital and university was sent to Philippines in order to provide medical assistance. We wish to describe our experiences of disaster medicine and discuss problems and improvement points. METHODS: We analyzed the characteristics of patients who received medical treatment administered by us at Tagobon city in the Philippines for five days. RESULTS: We provided medical services to 951 patients for five days. Most patients visited us for medical treatment not trauma. Almost all chief complaints were associated with respiratory, gastrointestinal, dermatologic, and ophthalmologic symptoms. We mainly treated the patients with medications. CONCLUSION: During the subacute period after the disaster, most patients complained of medical and dermatologic problems due to lack of sanitation rather than traumatic complications. Medical assistance for disaster should be administered appropriately according to the types of diseases that occurduring each period after disaster.

Efectos del Huracán Paloma sobre los pastos marinos del archipiélago Jardines de la Reina, Cuba / Hurricane Paloma’s effects on seagrasses along Jardines de la Reina archipelago, Cuba

Seagrasses are one of the most important coastal ecosystems since they promote organic matter flow, nutrient cycling, food availability and refuge. Until now, reports on damages caused by storms and hurricanes on seagrass beds are uncommon and highly variable. The seagrass meadows of the East end of Jardines de la Reina archipelago were surveyed from Nov. 29th to Dec. 5th of 2008, in order to determinate the effects from the passing of Hurricane Paloma: a category three storm on the Saffir-Simpsom scale. A rapid field assessment of the affected areas was carried out using the manta tow technique. In six sites, seagrass was quantitatively evaluated using a 15cm diameter core (four sampling units per site) and shoot density was calculated. Remote sensing techniques were used to estimate seagrass cover. To estimate the percentage of affected areas, a Region of Interest (ROI) was first created over a Landsat image. The percentage of seagrass affected within the ROI was estimated through direct georeferentiation of the contours of the damaged area and with a comparison to the total seagrass extension. To find possible explanations for damages, a false colour image was created using the near infrared band, to highlight the differences between emerged and submerged zones. The direction of winds was estimated using ArcGis 9.2 creating circular buffers, from the centre of the hurricane and generating lines tangent to the buffers. Seagrass in the region was dominated by the angiosperm Thalassia testudinum. Regional mean density was 1 321±721 shoots/m², a value regarded as high for the Caribbean area. Seagrass meadows were partly affected by sediment accumulation on the shoots of T. testudinum and uprooting rhizomes. The 7.6km² disturbed area represented 1% of the total seagrass area. Other sites, closer to the centre of the hurricane, did not show any damages on the marine vegetation. The keys location with respect to the hurricane track was the most likely cause of the effects. To the North of the affected area there is an opening among the keys where the generation of waves, currents and turbulence could have occurred. Three years after the hurricane event, both vegetation cover loss and silt re-colonization by macroalgae species were observed within the affected area, by showing a patchily-vegetated landscape. This site is currently undergoing a temporal succession whose assessment demands a monitoring scheme, that will provide interesting information to document its future evolution and responsiveness against upcoming natural or anthropogenic events.

Las descripciones de disturbios naturales, provocados por tormentas o huracanes, sobre las comunidades de pastos marinos son altamente variables. Del 29 de noviembre al 5 de diciembre 2008 se determinaron los efectos del huracán Paloma, categoría tres en la escala Saffir-Simpsom, sobre los pastos marinos del extremo oriental del Archipiélago Jardines de la Reina. Se llevó a cabo una evaluación rápida de campo mediante recorridos con arrastre (manta tow) y se muestreo cuantitativamente en seis sitios. Se utilizaron técnicas de teledetección para estimar la extensión de los pastos. La densidad media regional fue de 1 321±721vástagos/m², valor considerado como alto para la zona del Caribe. El pasto marino sufrió afectaciones parciales provocadas por acumulación de sedimentos sobre los vástagos de Thalassia testudinum o desenterramiento de rizomas. El área bajo disturbios fue de 7.6km² que representa el 1% del total de pastos marinos. Sitios más cercanos al ojo del huracán no mostraron afectaciones en la vegetación marina. La distribución de los cayos con respecto a la trayectoria del huracán se define como la causa más probable del patrón de afectación observado. Después de tres años del paso del huracán, la evolución del área afectada apunta hacia una pérdida de vegetación y re-colonización del sedimento por especies de macroalgas, se observa un paisaje con vegetación por parches. El sitio se encuentra en una sucesión temporal, por lo que se hace oportuno evaluar el área afectada mediante un programa de monitoreo para documentar su evolución futura y ante nuevos episodios naturales y/o antrópicos.