Mental Health Impact of Hosting Disaster Refugees: Analyses from a Random Sample Survey Among Haitians Living in Miami

Después de la tormenta: Collective trauma following Hurricane Maria in a northeastern Puerto Rican community in the United States

Hurricane Maria was the largest disaster in Puerto Rico's history, affecting Puerto Rican communities throughout the United States. We conducted focus groups using a grounded theory approach with adults displaced from Puerto Rico to a northeastern community 12 (n = 5) and 17 months (n = 7) postdisaster. Key informant interviews were also conducted with nine community advocates working with displaced hurricane survivors. Emerging themes reflect narrative and social identity processes following collective trauma. Findings emphasize the need for timely and long-term disaster responses that build on community strengths without leaving communities to cope on their own. We discuss how incorporating group storytelling in postdisaster research is a culturally sensitive practice that can promote resiliency among survivors.

Symptoms of posttraumatic stress disorder, depression, anxiety and other mental health problems following the 2010 earthquake in Haiti: A systematic review and meta-analysis

BACKGROUND

The 2010 earthquake in Haiti caused significant human and material damages, thousands of deaths and injuries, and 1.5 million homeless. This systematic review and meta-analysis aims to synthesize research on the prevalence and factors associated with PTSD, depression, anxiety symptoms, and other mental health problems among survivors.

METHODS

We searched six databases and retained 50 articles for the systematic review, 28 of which were included in three random effects meta-analyses on the prevalence of PTSD, depression, and anxiety symptoms in survivors.

RESULTS

Following the earthquake, more than one out of four individuals (28.44%,CI 95%,17.68%-42.37%; k = 24) reported severe symptoms of PTSD, one out of three reported severe symptoms of depression (32.16%,CI 95%,23.60%-42.11%; K=14), and one out of five reported severe symptoms of anxiety (20.49%,CI 95%,15.74%-26.24%;k=5). Studies revealed important rates of other mental health problems (including psychological distress and disturbance, suicidal ideations, and increased alcohol consumption) in survivors. Females were 41.38% more likely than males to experience severe symptoms of PTSD (OR = 1.41,CI 95%,1.22-1.64). Time was a moderator for depression and anxiety but not for PTSD, while the average age of participants only moderated depression.

LIMITATIONS

The studies included are observational and most used self-reported measures.

CONCLUSIONS

In a global context where natural disasters tripled since 1980, this first systematic review showed that human and material damages associated with the earthquake were sufficiently traumatic to induce severe symptoms of PTSD, depression, anxiety, and other mental health problems. Clinical and research implications are discussed.

PROSPERO REGISTRATION NUMBER

CRD42018115430.

Primary Health Care Center (PHCC) Location-Allocation with Multi-Objective Modelling: A Case Study in Idleb, Syria

The Syrian crisis began on 15 March 2011. It is one of the bloodiest and complicated conflicts in the world today. Although almost eight years have passed over this tragedy, civilians continue to suffer from conflicts and destructions in the area. As a result, this situation disregards human life and the number of people in need increases day by day. Particularly, people who have to live in the conflict area encounter troubles with regard to health, shelter, food and other needs. Thus, we have focused on identifying the Primary Health Care Center (PHCC) locations within Idleb Governorate in Syria. Data is extracted from a sample containing 23 sub-districts in the governorate and a total of 338 communities. We have formulated a mixed integer-weighted goal programming model and combined it with a Geographic Information System-GIS (ArcMap). The model is solved via an optimization package and moreover, sensitivity analyses are conducted to achieve a more in-depth study. Our aim was to have 60 PHCCs out of 77 available candidate PHCCs and the model located 42 PHCCs in total, by allocating 379,080 people, with a total cost of USD 1,000,353 and a cash for work amounting to USD 163,549. Accordingly, the model’s outputs and sensitivity analyses are expected to help decision-makers in case of such disasters.

Are performance measurement systems useful? Perceptions from health care

BACKGROUND

Prior literature identified the use of Performance Measurement Systems (PMS) as crucial in addressing improved processes of care. Moreover, a strategic use of PMS has been found to enhance quality, compared to non-strategic use, although a clear understanding of this linkage is still to be achieved. This paper deals with the test of direct and indirect models related to the link between the strategic use of PMS and the level of improved processes in health care organizations. Indirect models were mediated by the degree of perceived managerial discretion.

METHODS

A PLS analysis on a survey of 97 Italian managers working for health care organizations in the Lombardy region was conducted. The response rate was 77.6%.

RESULTS

The strategic use of PMS in health care organizations directly and significantly (p < 0.001) enhances performance in terms of improved processes. Perceived managerial discretion is positively and significantly (p < 0.001) affected by the strategic use of PMS, whereas the mediation effect is non-significant.

CONCLUSIONS

This study contributes to the literature investigating the design and implementation of a non-financial measurement tool, such as the non-financial information included into a balanced scorecard (BSC), in health care organizations. Managers in health care organizations can benefit from the strategic use of PMS to effectively allocate their time to strategic opportunities and threats, which might arise and affect organizational, output-related performance, such as improving processes.