Scrambling For Safety In The Eye Of Dorian: Mental Health Consequences Of Exposure To A Climate-Driven Hurricane.

As climate change alters the behavior of Atlantic hurricanes, these storms are trending stronger, wetter, and slower moving over coastal and island populations. Hurricane Dorian exemplified all three attributes. Dorian's destructive passage over the Abaco Islands, Bahamas, on September 1, 2019, exposed residents of its capital, Marsh Harbour, to a prolonged encounter with the storm's core. After Dorian's fierce front eyewall and towering storm surge tore apart shanty town habitats and eviscerated concrete homesites, residents desperately sought refuge during the brief respite when Dorian's eye passed directly overhead. The category 5 winds then resumed abruptly and Dorian continued its relentless destruction. This article focuses on the storm's mental health consequences, drawing on observations of on-site clinicians as well as findings from previous research on the mental health effects of Atlantic hurricanes and the transformation of hurricane hazards resulting from climate change. To protect island and coastal populations against climate-driven storms, disaster planning policy should emphasize resilience-focused prevention and mitigation strategies. In the aftermath of these events, health system response should include community outreach, case finding, and evidence-based interventions that optimize the use of mental health professionals.

Outcomes of treatment in men with prostate cancer at the cancer centre Bahamas.

PURPOSE: This is a first report from The Bahamas of management and long-term outcomes in men with non-metastatic prostate cancer treated with radiotherapy, with or without androgen deprivation therapy, from 2004 to 2016. METHODS: Patients were characterized by baseline factors, stratified by risk groups using tumor stage (clinical T-stage), prostate-specific antigen (PSA) test result and Gleason grade, and sorted by treatment combinations (by radiation volume and use of androgen deprivation). RESULTS: Overall, 205/216 men were Afro-Caribbean. Median age was 66. There were 18 low-, 77 intermediate-, and 121 high-risk patients, treated with prostate-only versus pelvis plus prostate radiotherapy, many receiving 2 years of androgen suppression. Time to commence radiation was about 6 months from initial diagnosis. In those not relapsing, global PSA nadir was reached in 4 years and was under 1.0, reduced from a mean at baseline of 31. At 10 years, disease-free experience (32 relapses) was 68% and overall survival was 87%, although only 2/12 deaths were related to prostate cancer. This experience compares favorably with recently published outcomes from other countries using very similar treatments. CONCLUSIONS: This study establishes benchmark statistics from diagnosis to long-term follow-up. Outcomes in Bahamian men are consistent with expectations from risk-stratified guidelines followed in developed countries.