Psychological impact of the Spring 2019 flood among adult population of Iran.

BACKGROUND: From March to April 2019, a flood occurred in several regions of Iran. The most affected provinces were Golestan, Lorestan, and Khuzestan. AIMS: The present study aimed to determine the prevalence and determinants of psychological distress and depression among the affected adult population 6 months after the event. METHODS: A cross-sectional household survey with face-to-face interview was carried out on a random sample of 1,671 adults aged above 15 years living in the flood-affected areas from August to September 2019. We applied GHQ-28 and PHQ-9 for the assessment of psychological distress and depression, respectively. RESULTS: The prevalence of psychological distress and depression were 33.6% (95% CI [29.5, 37.7]) and 23.0% (95% CI [19.4, 26.7]), respectively. Determinants of psychological distress were a history of mental disorders (Adjusted odds ratio [AOR] = 4.7), primary (AOR = 2.9) or high school (AOR = 2.4) education (vs. university), no compensation received (AOR = 2.1), high damage to assets (AOR = 1.8), the house flooded more than 1 m (AOR = 1.8), female gender (AOR = 1.8), and limited access to health care services (AOR = 1.8). Determinants of depression were unemployment (AOR = 5.3) or being a housewife (AOR = 2.7), a history of mental disorders (AOR = 4.1), high damage to assets (AOR = 2.5), no compensation received (AOR = 2.0), the house flooded more than 1 m (AOR = 1.8), limited access to health care services (AOR = 1.8), and high wealth index (AOR = 1.7). CONCLUSION: The results of this study revealed a high prevalence of psychological distress and depression in the flood-affected adult population. The high-risk group, particularly flood victims who had a history of mental disorders, and those exposed to severe damages of flood, should be prioritized for screening, and mental health services.

Association between housing damage, present bias and delayed-onset post-traumatic stress symptoms among older adults 9 years after a natural disaster.

BACKGROUND: Previous studies suggest that experience of natural disasters may heighten present bias. Research also suggests that impaired self-control (in particular, heightened present bias) could be linked to delayed-onset post-traumatic stress symptoms (PTSS) among survivors of natural disasters. We examined a hypothesis that the association between disaster experiences and delayed-onset PTSS is mediated through present bias among older survivors of the 2011 Japan earthquake and tsunami. METHODS: The baseline survey was conducted for older adults who lived in a city located 80 km west of the epicentre 7 months before the disaster. Approximately 2.5 and 8.5 years after the disaster, we surveyed older survivors to assess the trajectory of PTSS (2230 participants). We implemented analyses by three analytical groups: (1) resilient versus delayed-onset, (2) resilient versus improved and (3) resilient versus persistent. RESULTS: Logistic regression models showed that major housing damage was linked to raised present bias in all analytical groups (OR 2.47, 95% CI 1.04 to 5.87; OR 2.75, 95% CI 1.20 to 6.29; OR 2.65, 95% CI 1.15 to 6.10, respectively). The present bias, however, was significantly associated with only delayed-onset PTSS (OR 2.05, 95% CI 1.14 to 3.69). In the group of resilient versus delayed onset, housing destruction was also associated with delayed-onset PTSS (OR 2.44, 95% CI 1.11 to 5.37), and the association was attenuated by present bias (OR 2.36, 95% CI 1.07 to 5.18). CONCLUSIONS: Present bias could mediate the association between housing damage and delayed-onset PTSS among older survivors of a natural disaster.

Comparison of body pressure distribution in healthy subjects between bubble wrap and an emergency mattress laid on a cardboard bed: a randomized controlled crossover trial.

Background: It has been pointed out that the poor environment of evacuation shelters causes health problems and disaster-related deaths among evacuees, and we are concerned that their environment will deteriorate, particularly during a large-scale disaster due to a shortage of daily necessities. In Japan, evacuees usually slept on floors with futons until the Great East Japan Earthquake, but cardboard beds were installed in evacuation shelters. Previous studies have suggested that cardboard beds can reduce cold air transmission from the floor. We have reported that a cardboard bed can have a low-contact pressure dispersion capacity and cannot reduce musculoskeletal strain, unlike a futon or mattress. In the Great East Japan Earthquake, 33% of disaster-related deaths were reported to have been caused by physical or mental fatigue due to living in evacuation shelters. When a large-scale disaster such as the Nankai Trough Earthquake generates huge numbers of evacuees, the supply of mattresses for evacuees will be very difficult. Therefore, we considered potential alternatives that could be produced in large quantities over a short period. Bubble wrap, with very lightweight and waterproofing, could be a good candidate for mattress replacement. This study aimed to investigate the improvement in body pressure distribution and pressure-sensing area when using bubble wrap. Methods: Twenty-seven healthy subjects allocated to sequences A and B with different intervention order were laid in supine and lateral positions on a cardboard bed without a mattress, bubble wrap, or air mattress: the mattress-body contact pressure and contour areas were measured, and subjective firmness and comfort during these conditions were also investigated using the visual analog scale (VAS). Acquired data were analyzed using a linear mixed-effects model and Bonferroni's post-hoc test, and P < 0.05 was considered statistically significant. Results: The mattress-body contact pressure and contour area showed significant differences with and without air mattresses. With the air mattresses, the pressure in the supine position decreased by 34%, and that in the lateral position decreased by 13%. However, the four-fold bubble wrap did not improve the mattress-body contact pressure and contour area; the change ratios were within 5% compared to the cardboard bed. However, there were significant differences in subjective firmness and comfort using the VAS among all experimental positions. Conclusion: Our study showed that bubble wrap could not significantly improve body pressure concentration and may not be a satisfactory substitute for air mattresses. Because of the improvement in subjective firmness and comfort with the bubble wrap, using it for an extended period may affect the incidence of back pain in evacuees. Finally, we hypothesize that the body pressure dispersion of the bubble wrap may be improved by changing the air-filling rate and the size of the air bubbles.

The Suicidal Ideation of Disaster Victims: A Nationwide Cross-Sectional Study.

Purpose: Various natural and human made disasters occur worldwide. This study aimed to identify the factors affecting suicidal ideation in victims of disasters such as typhoons, heavy rainfall, fires, and earthquakes. Methods: Data were obtained from a long-term survey on life changes among disaster victims conducted in 2019 by the National Disaster Management Research Institute. The study included 2234 victims of natural and social disasters occurring in Korea between 2012 and 2018. Suicidal ideation was assessed using the Korean version of the Composite International Diagnostic Interview developed by the World Health Organization. The participants' demographic characteristics, disaster-related characteristics, physical characteristics, psychological characteristics, and social characteristics were analyzed as the influencing factors. The data were analyzed using the chi-square test, t-test, and logistic regression. Results: Of the 2234 subjects in this study, 32 were disaster victims who had experienced suicidal ideation, accounting for 1.4%. The results showed that the factors affecting suicidal ideation included disaster-related injury/disease, depression, and social support. The odds ratio of suicidal ideation was higher when there was injury/disease (OR=1.89, 95% CI=0.07-0.48), with higher depression levels (OR=1.31, 95% CI=1.18-1.47) and with lower social support (OR=0.94, 95% CI=0.90-0.99). Conclusion: This study identifies the significant influencing factors of suicidal ideation in disaster victims, which were as follows: disaster-related injury or disease, depression, and social support. Our study's findings would contribute to screening high-risk groups of suicidal ideation and developing effective support, interventions, and suicide prevention programs for disaster victims. Furthermore, to prevent suicide and promote the healthy recovery of disaster victims, mental health care services aimed at suicide prevention should be reinforced and the victims should be provided with psychological support and treatment without financial burden.

Development of nutrient-based nutritional standards for foodservice at shelters during disasters in the Republic of Korea.

BACKGROUND/OBJECTIVES: In times of disaster, simplified and minimized nutritional standards are necessary for a quick response to provide nutritious relief food. This study aimed to develop nutrient-based nutritional standards for foodservice at shelters during disasters in the Republic of Korea (South Korea). SUBJECTS/METHODS: The standards were developed in 2 phases. First, nutrients to be included in the standards were selected. Initial candidates were selected considering 3 aspects: preceding standards, insufficient intake during disasters, and inadequate intake among South Koreans. Final selection was made by excluding nutrients for 3 reasons: nutrients for which there is no deficiency concern in South Korea, nutrients whose intake data were not available, or nutrients whose values presented by Dietary Reference Intakes for Koreans are difficult to achieve based on the current diet among South Koreans. Second, the reference values of energy and the selected nutrients were calculated. The reference values for the entire population who were 1-year-old and over were calculated by multiplying the estimated energy requirements or the recommended nutrient intake and the proportion of each age and sex group. Respective reference values were also calculated for 4 different age groups (1-5, 6-11, 12-64, and ≥ 65-year-old). RESULTS: The standards for the entire population were 2,000 kcal for energy, 55 g for protein, 650 µg retinol activity equivalents for vitamin A, 95 mg for vitamin C, 1.1 mg for thiamin, 1.3 mg for riboflavin, 14 mg niacin equivalents for niacin, 350 µg dietary folate equivalents for folic acid, 750 mg for calcium, and 11 mg for iron. Four additional standards corresponding to each age group were developed. CONCLUSIONS: The nutritional standards during disasters were developed for South Korea, including energy and 9 nutrients with reference values for the entire population and 4 different age groups. The standards will contribute to maintaining the health of disaster evacuees in South Korea.

Association between Dietary Diversity and Sociopsychological Factors and the Onset of Dyslipidemia after the Great East Japan Earthquake: Fukushima Health Management Survey.

This study aimed to clarify the relationship between the onset of low-density lipoprotein hypercholesterolemia (hyper-LDLemia), high-density lipoprotein hypocholesterolemia (hypo-HDLemia), and hyper-triglyceridemia (hyper-TGemia) and lifestyle/socio-psychological factors among Fukushima evacuation area residents after the Great East Japan Earthquake. Participants included 11,274 non-hyper-LDLemia, 16,581 non-hypo-HDLemia, and 12,653 non-hyper-TGemia cases in the Fiscal Year (FY) 2011. In FY2011, these participants underwent a health checkup and responded to a mental health and lifestyle survey. The onset of each disease was followed through FY2017. The evacuation experience was positively associated with the risk of hyper-LDLemia, hypo-HDLemia, or hyper-TGemia. Conversely, the middle high dietary diversity score was negatively associated with the onset of hyper-TGemia. Moreover, low sleep satisfaction was positively associated with hypo-HDLemia and hyper-TGemia. The "almost never" exercise habit was positively associated with hypo-HDLemia. Current smoking and audible nuclear power plant explosions were positively associated with the risk of hyper-TGemia. Drinking habits exhibited a negative association with the onset of hyper-LDLemia, hypo-HDLemia, and hyper-TGemia. The results of this study indicate the need for continuous improvement in lifestyle, as well as efforts to eliminate the impact of disasters to prevent the onset of dyslipidemia among disaster evacuees.

Psychological Distress in Responders and Nonresponders in a 5-year Follow-up Health Survey: The RIAS Study.

BACKGROUND: People with poor health or mental conditions are generally unwilling to participate in the health examinations, and no studies have directly examined the relationship of psychological distress among disaster survivors with participation status to date. The present study thus examined psychosocial differences according to the respondent status in a 5-year follow-up survey among participants in the prospective health surveys on survivors of the Great East Japan Earthquake and Tsunami Disaster study in Iwate Prefecture, Japan. METHODS: We analyzed data from 10,203 Japanese survivors aged ≥18 years (mean age, 65.6 years; 38.0% men) and who underwent health examinations at baseline in 2011. Participants were classified into responders and nonresponders according to their 2015 health examination participation status. Psychological distress was evaluated using the Kessler 6 scale and categorized as none, mild, and severe. Multinominal logistic regression was used to examine the risk of psychological distress in relation to participation status. RESULTS: In the 2015 survey, 6,334 of 6,492 responders and 1,686 of 3,356 nonresponders were analyzed. The most common reasons for nonparticipation in the survey were participated in other health examinations, examined at a hospital, and did not have time to participate. Nonresponse in males was associated only with mild psychological stress, whereas nonresponse in females was associated with mild and severe psychological distress. CONCLUSION: Nonresponders in the follow-up survey had a higher risk of psychological distress than responders. Continuous monitoring of the health of nonresponders and responders may help to prevent future health deterioration.

Correlation between Spiritual Intelligence and Clinical Competency in Students Who Are Children of War Victims.

Objective: Providing effective and correct care to patients requires clinical competence. One of the important components in clinical competence is spiritual intelligence the purpose of the study was to consider the correlation between clinical competence and spiritual intelligence in students who are children of victims of war of Hamadan University of Medical Sciences in 2019. Method : The cross-sectional study was carried out on 145 Martyrs' and War Veterans' Students of medical, nursing, midwifery, and paramedical schools. Sampling was done through census of students of operating room, anesthesia, medicine, nursing, midwifery, laboratory science, and radiology. The data collection tools were Kazdin et al's (1986) Spiritual Intelligence questionnaire and Liu et al's (2009) Clinical Competency Assessment questionnaire. Data were analyzed by SPSS 23 software. Results: The results of data analysis showed a direct, positive, and significant linear relationship between spiritual intelligence and clinical competence of all students (P < 0.05). According to the students' self-report, the highest mean score of clinical competency of the students was related to medical students with a mean score of 37 and the lowest to the laboratory students with a mean score of 30 (P =0.012). In addition, the results showed that the highest mean score of spiritual intelligence belonged to nursing students with a score of 48 (good spiritual intelligence) and the lowest to radiology students with a score of 39 (moderate spiritual intelligence) (P =0.019). Conclusion: We found that there is a direct and positive correlation between spiritual intelligence and clinical competence, so it seems that promoting spiritual intelligence may be associated with an increase in clinical competence.

Estimation of Health-Related Quality of Life Losses Owing to a Technological Disaster in Brazil Using EQ-5D-3L: A Cross-Sectional Study.

OBJECTIVES: In 2015, a dam collapsed at Samarco iron ore mine in the municipality of Mariana, Brazil, and contaminated more than 600 km of watercourses and destroyed almost 1600 acres of vegetation. Nineteen people died and more than 600 families lost their homes. This study aimed to estimate health-related quality of life (HRQoL) losses owing to this disaster. METHODS: We collected data from a probabilistic sample of 459 individuals aged 15 years or older. Household face-to-face interviews were conducted in December 2018. Pre-event data were not available for this population, so respondents were asked to evaluate at present and in retrospect their health status using EQ-5D-3L. The Minas Gerais societal value sets for EQ-5D-3L health preferences, estimated in 2011, were used to calculate utility losses. The health loss estimation from EQ-5D will form the basis for the calculation of compensation payments for the victims. RESULTS: Approximately 74% of the study population suffered some HRQoL loss. On average, EQ-5D index values decreased from 0.95 to 0.76. The greatest effects were observed for the anxiety/depression dimension, followed by pain/discomfort. Before the tragedy, the proportion of individuals with severe anxiety/depression and pain/discomfort was equal to 1% rising to 23% and 11%, respectively. CONCLUSIONS: Catastrophic losses owing to the Samarco disaster were found. The EQ-5D-3L instrument showed feasibility and sensitiveness to measure HRQoL losses owing to a negative health shock in a low-income Brazilian population.

Perú y la memoria global de las víctimas de covid-19 / Peru and global remembrance of covid-19 victims

Resumen El cambio en la relación con las víctimas a causa del coronavirus es una de las consecuencias más perturbadoras y menos explorada de todos los aspectos entre los cuales la covid-19 ha alterado nuestras vidas en el último año. Este ensayo examina las estrategias que los peruanos han desarrollado para compensar la imposibilidad de participar en funerales y entierros debido a las medidas de distanciamiento social. La incorporación de plataformas digitales permitieron recrear rituales funerarios y permitir el duelo necesario en circunstancias adversas. El ensayo concluye que es necesario erigir un memorial a las víctimas de la covid-19 como una manera de concientizar a la población y futuras generaciones sobre la necesidad de preparación ante una eventual próxima pandemia.

Abstract The change in relationships with the victims of coronavirus is one of the most disturbing and least explored consequences of all the ways in which covid-19 has altered our lives over the last year. This essay examines the various strategies Peruvians have developed to compensate for the inability to attend funerals and burials in person due to government-imposed social distancing measures. The use of digital platforms, mainly social media, made it possible to recreate funeral rites and allowed the necessary grieving under adverse circumstances. Using a comparative approach, the essay concludes that it is necessary to erect a memorial to the victims of covid-19 as a way of raising public awareness, and that of future generations, about the need to prepare for an eventual future pandemic.

The Lived Experience of Victims of Catastrophic Coastal Erosion: A cycle of impact, consequence and recovery.

OBJECTIVES: Environmental hazards are part of the Earth's natural cycle and are ongoing within human history. When vulnerable situations meet environmental hazards, disasters occur where human and natural costs could be enormous. This study aimed to explore the experiences of the victims of coastal erosion during the monsoon season. METHODS: Seven victims of catastrophic coastal erosion in the Kollam District of Kerala, India, were interviewed from December 2013 to February 2014. The study followed Edmond Husserl's descriptive phenomenological method. RESULT: These interviews constituted the primary data source. Three main themes with eleven subthemes emerged from these data. The main themes were impact, consequences and recovery. The subthemes were living in constant fear, escaping from the catastrophe; cataclysmic sea waves and their tumultuous behaviour, instant damage and destruction, the epoch of losses; agony and suffering; homelessness-helplessness-sleeplessness mixed with fear; government aid only in dreams; haunting memories; never-ending daily needs; first home and native land; and the desire to go back to the site of the disaster. CONCLUSION: From the derived themes, a phenomenon associated with coastal erosion evolved. The phenomenon is termed "Catastrophic coastal erosion: A cycle of impact, consequences, and recovery."

Association between post-traumatic stress disorder symptoms and bone fractures after the Great East Japan Earthquake in older adults: a prospective cohort study from the Fukushima Health Management Survey.

BACKGROUND: It has been reported that psychological stress affects bone metabolism and increases the risk of fracture. However, the relationship between bone fractures and post-traumatic stress disorder (PTSD) is unclear. This study aimed to evaluate the effects of disaster-induced PTSD symptoms on fracture risk in older adults. METHODS: This study evaluated responses from 17,474 individuals aged ≥ 65 years without a history of fractures during the Great East Japan Earthquake who answered the Mental Health and Lifestyle Survey component of the Fukushima Health Management Survey conducted in 2011. The obtained data could determine the presence or absence of fractures until 2016. Age, sex, physical factors, social factors, psychological factors, and lifestyle factors were subsequently analyzed. Survival analysis was then performed to determine the relationship between the fractures and each factor. Thereafter, univariate and multivariate Cox proportional hazard models were constructed to identify fracture risk factors. RESULTS: In total, 2,097 (12.0%) fractures were observed throughout the follow-up period. Accordingly, univariate and multivariate Cox proportional hazard models showed that PTSD symptoms (total PTSD checklists scoring ≥ 44) [hazard ratio (HR): 1.26; 95% confidence interval (CI): 1.10-1.44; P = 0.001], history of cancer (HR: 1.49; 95% CI: 1.24-1.79; P < 0.001), history of stroke (HR: 1.25; 95% CI: 1.03-1.52; P = 0.023), history of heart disease (HR: 1.30; 95% CI: 1.13-1.50; P < 0.001), history of diabetes (HR: 1.23; 95% CI: 1.09-1.39; P < 0.001), current smoking (HR: 1.29; 95% CI: 1.02-1.63; P = 0.036), and high dissatisfaction with sleep or no sleep at all (HR: 1.33; 95% CI: 1.02-1.74; P = 0.035) promoted a significant increase in fracture risk independent of age and sex. CONCLUSIONS: The present study indicates that disaster-induced PTSD symptoms and insomnia contribute to increased fracture risk among older adults residing in evacuation areas within the Fukushima Prefecture.

Persistent mental health impacts of disaster. Five-year follow-up after the 2011 great east Japan earthquake and tsunami: Iwanuma Study.

Few studies have tracked the long-term mental health outcomes following major disaster. We sought to document the trajectories of depressive symptoms and post-traumatic stress symptoms (PTSS) in the aftermath of the 2011 Great East Japan earthquake and tsunami. A cohort of community-dwelling older adults were followed for 5.5 years after the disaster at 3 waves (2010, 2013 and 2016). Depressive symptoms were measured by the Geriatric Depression Scale Short Form, while PTSS was assessed by the Screening Questionnaire for Disaster Mental Health. We examined the trajectories of mental illness symptoms based on the probabilities of persistence, recovery, and delayed onset. Among people without pre-disaster depressive symptoms, 13.6% had developed depressive symptoms 2.5 years after the disaster. Of these, half of those had recovered and half had persisted at the 5.5 year follow-up. 11.1% of survivors reported post-traumatic stress symptoms in 2013; of these, 58% recovered by 2016, while 4.8% experienced delayed onset. Job loss was associated with persistent PTSS (OR 2.03; 95%CI 1.01-4.12) while a drop in subjective economic status predicted delayed onset of PTSS (OR 2.13; 1.34-3.39). However, disaster-related experiences were unrelated to the trajectory of depressive symptoms at 5.5 years. The probabilities of remission (58%) and delayed onset (5%) of PTSS are consistent with prior disaster research. The experience of job loss and drop in subjective economic status appeared to exert a lingering influence on the persistence or delayed onset of PTSS. Depressive symptoms after the disaster had remitted in roughly half of the survivors after 5.5 years.

Mitigating Psychological Impact: The Experience of Korean Disaster Management.

The psychological impact of disasters has not been adequately addressed in Korea. This research aims to evaluate how Korea should improve its management of the psychological impact of disasters toward the ultimate goal of effective disaster management. Qualitative content analysis is the main method applied. Nonprofessional management is compared with professional management by considering governments, psychology specialists, disaster victims, and local communities. The main finding is that Korea must change its current management style from nonprofessional to professional. Neighboring nations need to implement supplementary measures toward adopting a systematic approach that considers all phases of the disaster management cycle, emergency planning, and a long-term approach. The value of this study lies in its comprehensive examination of the issue of psychological impact from the perspective of disaster management in Korea.

Asociación entre tiempo de atención pre hospitalaria y la mortalidad hospitalaria en víctimas de accidentes de tránsito / Association Between Pre-Hospital Care Time And Hospital Mortality In Victims Of Traffic Accidents

Introduccion: Los accidentes de tránsito (AT) se encuentran como la primera prioridad en investigación de salud en el Perú, Según la Organización Mundial de la Salud (OMS) se estima que los costos económicos por impacto de vehículos y lesiones por AT son de 1% y 1.5% del Producto Nacional Bruto (PNB) en países de bajos y medianos ingresos; En el Perú es aproximadamente el 1.5 ­ 2% del Producto Bruto Interno (PBI). Objetivo: Determinar si existe asociación entre el tiempo de atención prehospitalaria y la mortalidad hospitalaria en víctimas de accidentes de tránsito. Métodos: Se realizó una revisión sistemática mediante la búsqueda bibliográfica de artículos relacionados en fuentes de indexación tales como PubMed y BIREME. Resultados: Los retrasos en las transferencias de pacientes al hospital y la falta Sistema Médico de Emergencia (SME) pre hospitalarios se asociaron significativamente con un aumento de la mortalidad (P: 0.000) así mismo la necesidad de un SME como proveedor de atención prehospitalaria fue predictor significativo de mortalidad en emergencia con un odds ratio [OR] ajustado 2.19; IC del 95% [1.88­2.55], y en las primeras 24 horas de ingreso con un OR ajustado 2.31; IC del 95% [ 1.95­2.73]. Conclusión: El tiempo de atención pre hospitalaria en accidentes de tránsito se encuentra significativamente asociada a la mortalidad hospitalaria, por ello, se propone estudiar factores asociados al largo tiempo de atención pre hospitalaria.

Introduction: Traffic accidents (AT) are the first priority in health research in Peru, According to the World Health Organization (WHO) it is estimated that the economic costs of vehicle impact and injuries due to AT are 1 % and 1.5% of the Gross National Product (GNP) in low and middle income countries; In Peru it is approximately 1.5 - 2% of the Gross Domestic Product (GDP). Objective: To determine if there is an association between the time of prehospital care and hospital mortality in victims of traffic accidents. Methods: A systematic review was carried out through the literature search of related articles in indexing sources such as PubMed and BIREME. Results: Delays in the transfer of patients to the hospital and the lack of pre-hospital Emergency Medical System (SME) were significantly associated with an increase in mortality (P: 0.000) and the need for an SME as a prehospital care provider was significant predictor of emergency mortality with an adjusted odds ratio [OR] 2.19; 95% CI [1.88­2.55], and in the first 24 hours of admission with an adjusted OR 2.31; 95% CI [1.95­2.73]. Conclusion: The time of pre-hospital care in traffic accidents is significantly associated with hospital mortality, therefore, it is proposed to study factors associated with the longtime of pre-hospital care.

PTSD symptom profiles among Louisiana women affected by the 2010 Deepwater Horizon Oil Spill: A latent profile analysis.

BACKGROUND: Few prior studies have investigated the latent class structure of PTSD using DSM-5 symptoms. METHODS: To describe latent PTSD profiles among women who resided in Deepwater Horizon Oil Spill (DHOS)-affected coastal Louisiana communities, we used data from women enrolled in The Women and Their Children's Health (WaTCH) Study. Latent profile analysis was performed on the 20-item PTSD Checklist for DSM-5 (PCL-5) and model fit statistics for 2-class through 6-class solutions were compared. The pseudo-class draws method was employed on the best class solution to compare key covariates (including demographics, mental health indicators, DHOS exposure indicators, and trauma exposures) across classes. RESULTS: Among 1997 women (mean age 46.63 ± 12.14 years, 56.8% white, mean trauma categories 6.09 ± 2.98, 9.55% previously diagnosed with PTSD), model fit statistics supported a five-class solution: low symptoms (mean PCL-5 = 4.10), moderate without mood alterations (mean = 19.73), moderate with mood alterations (mean = 34.24), severe without risk-taking (mean = 55.75), and severe with risk-taking (mean = 53.80). Women in the low-symptom class were significantly more likely to be white, have finished high school, have an income of at least $40,001 per year, be married or living with a partner, and endorse fewer trauma categories than women in the four symptomatic classes. Women with moderate to severe symptoms often had co-morbid depressive symptoms and no prior PTSD diagnosis. LIMITATIONS: This study was limited by use of self-reported data and one-time assessment of PTSD symptoms. DISCUSSION: Five distinct latent profiles of DSM-5 PTSD symptoms consisted of notably different individuals. Most affected women did not report prior PTSD diagnosis. Future research and practice identifying and addressing barriers to care for trauma-affected women in these communities is warranted.

Factors associated with Quality of Life among Disaster Victims: An Analysis of the 3(rd) Nationwide Panel Survey of Disaster Victims

PURPOSE: The purpose of this study is to assess socio-demographic, disaster-related, physical health-related, psychological, and social factors that may adversely affect disaster victims' QoL (Quality of Life). METHODS: A cross sectional study was designed by using the secondary data. From the 3rd Disaster Victims Panel Survey (2012~2017), a total of 1,659 data were analyzed by using descriptive statistics including frequency, percentage, t-test, ANOVA, and multivariate linear regression. RESULTS: Older people with lower health status lacking financial resources prior to a disaster were more at risk of low levels of QoL. Lower levels of perceived health status, resilience, and QoL were reported by disaster exposed individuals, while their depression was higher than the depression in the control group of disaster unexposed ones. Resilience, social and material supports were positively associated with QoL whereas depression and PTSD (Post-Traumatic Stress Disorders) were negatively associated. CONCLUSION: These findings suggest that psychological symptoms and loss due to disasters can have adverse impacts on the QoL of disaster victims in accordance with their prior socio-demographic background. They also indicate that targeted post-disaster community nursing intervention should be considered a means of increased social support as well as physical and mental health care for disaster victims.

Guía para la enseñanza del apoyo vital avanzado ante múltiples víctimas. Consenso para el proyecto de formación e investigación en apoyo vital. Cienfuegos, 2018 / Guideline for teaching advanced life support in the presence of mass casualty. Consensus for the project of training and research in life support. Cienfuegos, 2018

Fundamento: en situaciones de desastres, cuando el número de enfermos o lesionados es alto y los recursos limitados, la atención médica precisa de cambios de estructura y procesos si se quiere salvar un número elevado de personas. El personal de salud debe estar entrenado para enfrentar esta situación cada vez más frecuente. El "Proyecto para la formación e investigación en apoyo vital en emergencias y desastres" puede ser un marco académico para lograrlo. Objetivo: actualizar, para el proyecto, las guías y estrategia docente para la enseñanza del apoyo vital ante víctimas múltiples. Métodos: taller nacional realizado el 10-11 de julio del 2018 en Cienfuegos, con 13 expertos y cuatro informantes clave. Se utilizaron la técnica de tormenta de ideas y de grupo nominal, cuestionario semiestructurado y revisión documental previa. Resultados: se proponen para la enseñanza del apoyo vital en situaciones de desastres, tanto en el pregrado como el posgrado: los objetivos, aspectos didácticos, estrategia docente, contenidos, alcance, habilidades a desarrollar, futuras investigaciones y áreas para la colaboración interinstitucional. Se definió la estructura de un curso prototipo para la enseñanza del tema y las principales consideraciones para su ejecución. Conclusiones: las propuestas académicas para el curso "Apoyo vital avanzado ante víctimas múltiples" permiten la preparación de los profesionales de la salud para brindar asistencia médica en situaciones de desastres, con escasos recursos y en ambientes complejos.

Foundation: in disaster situations, when the number of patients or injured is high and the resources are limited, medical care requires changes of structures and processes if it is aimed to save most of the persons involved. Health personnel should be trained to face this situation becoming more frequent each time. Objective: to update, for the project, the guidelines and strategies for teaching life support in the presence of mass casualty. Methods: national workshop developed in July 10th and 11th in Cienfuegos, with 13 experts and four key informers. The techniques of brain storming and nominal group, semi-structured and previous documentary review. Results: objectives, specific aspects, teaching strategy, contents, scope of the abilities, skills to develop, future research, and areas for inter-institutional collaboration were proposed for teaching life support in situations of disaster. Conclusion: academic proposals for the course "Life support in the presence of mass casualty¨ allow preparing health professionals to offer medical assistance in situations of disasters with limited resources in complex environments.

Perceived social support levels among university students following the 2011 earthquake in Van, Turkey.

OBJECTIVE: To evaluate the perceived social support levels of students after an earthquake. METHODS: This cross-sectional, descriptive study was conducted between June and July 2012 in Van, Turkey, following an earthquake in the region. Sample comprised students at the midwifery and nursing department of Yuzuncu Yil University, Turkey. Data was collected using a questionnaire including student information and the multidimensional scale of perceived social support inventory. Quantitative data was analysed using SPSS 17. RESULTS: Of the 650 subjects, 461(70.9%) migrated away from the city following the earthquake, while 189(29%) stayed back, and, of them, 98(52%) students stayed in tents and 52(27.5%) in containers. The mean perceived social support level of students was 58.9±17.9 and the level of perceived social support increased as respondents' age, class and economic status increased (p<0.05). CONCLUSIONS: Perceived social support was found to be affected by variables such as university year, age and relation with friends, economic status and migration status after the earthquake.