Exploring Volunteer Pharmacists' Experiences in Responding to 2023 Türkiye Earthquakes: A Qualitative Phenomenological Study

OBJECTIVE

Pharmacists are vital in disaster response efforts, dispensing essential medications, managing pharmacy services, consulting, and educating survivors regarding their medications. Their contributions, however, are often underrepresented in scientific literature. This study aimed to explore the experiences of pharmacists who provided pharmacy services to meet the pharmaceutical needs of the survivors after 2 major earthquakes in Türkiye in 2023.

METHODS

This study adopted a phenomenological approach. Data were collected using semi-structured interviews. Purposive sampling was used to invite pharmacists who provided pharmacy services to survivors. Interview transcripts were analyzed following an inductive, reflexive thematic analysis.

RESULTS

In total, 15 pharmacists were interviewed. Four main overarching themes "response to the earthquake," "preparedness for the earthquake," "experiences during service delivery," and "mental and physical experiences" were developed.

CONCLUSIONS

From participants' experiences, it is essential to expand the clinical responsibilities of pharmacists and train them in providing wound care, administering immunization, and prescribing. Pharmacists should be integrated as essential members of disaster health teams. International health organizations, nongovernmental organizations, and governments are encouraged to work collaboratively and develop disaster management plans including pharmacists in early responders. This might help mitigate the deficiencies and overcome challenges in health-care systems to provide effective patient-centered care by health professionals and respond effectively to disasters.

Earthquake Experiences of Nursing Students Residing in Earthquake Zone, the Disaster of the Century: A Qualitative Study

This study was carried out to examine the experiences of nursing department students regarding earthquakes with a phenomenological approach. The type of research is phenomenological research, one of the qualitative research methods. The research was carried out with 22 nursing students who experienced the earthquake in the Turkey earthquake on February 6, 2023. The data were collected using the "Semi-Structured Interview Form". In this study, "earthquake experience" was discussed as a phenomenon, and the data obtained from the phenomenon after content analysis were evaluated in five themes as follows: Experiences during the earthquake, experiences after the earthquake, search-rescue operations, social support and daily life after the earthquake. It was seen that they acted with the instinct of protection during the earthquake and then tried to shelter and communicate. The study reveal that the disaster preparedness and competencies of nursing students should be increased.

A comparative study of earthquake disaster management laws between USA and Indonesia

The frequent occurrence of disasters because of Indonesia's geographical location within the Ring of Fire calls for effective disaster-management efforts. With the issuance of Law No. 24 of 2007 on Disaster Management, the Indonesian National Disaster Management Agency (Badan Nasional Penanggulangan Bencana or BNPB) was subsequently established. Keeping in mind previous disasters in Indonesia which occur in different regions, that is, Palu and Aceh Tsunami, Cianjur earthquake, and Mount Merapi, Indonesia's disaster-management law is general and lacks technical guidelines in addressing the needs of the various regions and the different contours of geography. This article aims to analyse existing Indonesian regulatory and agency problems in disaster management by conducting a normative and comparative approach between the disaster management policy in the United States of America (USA) and Indonesia. The authors chose the USA's disaster-management policy in particular as most comparative studies on disaster management law do not involve the USA despite the State's ability to provide a comprehensive and consistent policy in the midst of the decentralisation of responsibilities with the numerous states. The authors conclude that according to existing disaster-management laws in USA and Indonesia, the government is obligated to fulfil its citizens' rights in the event of natural disasters. Furthermore, noting the issues that exist within the Indonesian disaster-management system, Indonesia can adopt the best practices of the USA to improve its disaster-management system. Among others, Indonesia can learn from the USA in the fields of accountability and transparency amongst agencies, the development of Early Warning Systems, an improved system of interagency cooperation, as well as the provision of specific disaster-management assistance.

Contribution

The findings of this study are expected to serve as evaluation material and to improve government effectiveness in dealing with natural disasters.

Assessment of Nutritional Composition of Turkish Red Crescent Menus After the M7.8 and M7.6 Earthquakes in Kahramanmaraş, Türkiye

OBJECTIVE

This study aims to evaluate the nutritional content and quality of the Turkish Red Crescent (TRC) menus delivered to earthquake victims after the 2023 earthquakes in Kahramanmaraş, Türkiye.

METHODS

The menus of general, search-rescue, diabetes, and celiac were obtained from the TRC following the magnitudes of 7.8 and 7.6 Kahramanmaraş earthquakes. The nutrient content of the menus was evaluated with the Nutrient Rich Food (NRF20.3) score. In addition, the menus' energy, macronutrient, and micronutrient contents were compared with the dietary reference intake values of the Türkiye Dietary Guideline-2022, European Food Safety Authority, and Food and Drug Administration.

RESULTS

The general menu was insufficient to meet the daily requirements of vitamin D, vitamin K, vitamin C, calcium, and potassium for earthquake victims. The sodium, phosphorous, and omega-6/omega-3 ratios were much higher than the recommended intakes. The NRF20.3 score of the diabetes menu was significantly higher than the search-rescue and celiac menus (P < 0.05). The energy content of the search-rescue menu was significantly higher than that of other menus (P < 0.05).

CONCLUSION

The several nutritional risks were determined in TRC menus for earthquake victims who suffered from the Kahramanmaraş earthquakes. Several supplementation programs can be applied to the earthquake regions to obtain strength immunity and effectively challenge posttraumatic stress symptoms.

Recovering the status quo: tipping points and earthquake aftermaths in colonial India

Scholars of disaster politics debate how far natural hazards cause or catalyse political change. This paper builds on recent scholarship on tipping points and social contracts to argue that two case studies of historical earthquakes in 1930s British-colonised India invite a focus on the dynamics of cooperation and conflict between state and non-state actors. Officials of the colonial state and its nationalist rivals cooperated after one earthquake even though they otherwise bitterly opposed each other. Cooperation broke down after the second event, just one year later. Yet, in both cases, officials and nationalist leaders shared a broad vision for Indian society, which pushed both sides actively to seek to recover the social and economic status quo ante, preventing potential tipping points from crystallising. These case studies reveal how and why highly fraught social contracts can survive major disasters. The colonial state's transient and reactive approach to disaster governance continued to impact on post-independence India.

Methane Emissions from Non-producing Oil and Gas Wells and the Potential Role of Seismic Activity: A Case Study in Northeast British Columbia, Canada

Increasing seismic activity due to fluid injections for oil and gas production may be contributing to leakage along non-producing oil and gas wells and emitting methane, a potent greenhouse gas. However, the extent to which nearby seismicity may drive or exacerbate methane emissions and cause well integrity issues is unknown. Therefore, we analyze field evaluations at 448 non-producing oil and gas wells in Northeast British Columbia (NEBC) and geospatially analyze oil and gas well and fluid injection data alongside locations of 3515 earthquakes from 2001 to 2021 and 130 faults. Through analysis of ground and helicopter-based field evaluations of non-producing wells in NEBC, we show that methane emission rates of non-producing wells average at 8301 mg/h/well but vary by 10 orders of magnitude. We find that higher methane emission rates (milligrams of methane/h/well) are observed at wells with larger flowing pressures at the wellhead during completion (kPa) and with shorter distances (m) to earthquakes, particularly at plugged wells. These results imply that seismicity may increase the likelihood of non-producing well integrity issues and methane leakage, thereby also exacerbating groundwater contamination and environmental degradation risks.

Experiences of Operating Room Professionals During the 2020 Izmir Earthquake: A Qualitative Approach

OBJECTIVE

In the aftermath of earthquakes, the availability of emergency units and operating rooms (OR) in hospitals can make a difference in the survival of those injured. OR professionals' experience during earthquakes is vital for ensuring safe and effective surgical procedures. This study was conducted to explore perceptions and describe the experiences of OR professionals, aiming to improve OR processes during and after earthquakes.

METHODS

This phenomenological study employed semi-structured interviews to collect qualitative data from 16 OR professionals who experienced the earthquake. Purposeful sampling was utilized for face-to-face interviews, and MAXQDA20 was used for content analysis.

RESULTS

The primary themes included workplace perspectives, during-earthquake experiences, ethical considerations, and post-earthquake experiences. The workplace was described as unique, dynamic, stressful, and disciplined. Participants experienced fear and panic during the earthquake. Abandoning patients was deemed unethical, resulting in ethical quandaries for professionals when their safety was at risk.

CONCLUSION

Participants displayed responsibility and ethical conduct while remaining with the patients during the tremor. Implementing practices is crucial in mitigating fear and chaos and improving information management. As such, it is highly recommended that hospital disaster plans incorporate the active participation of OR professionals.

The Support to Mitigate the Impact of Suicide for Disaster Aid Workers of the 2011 Great East Japan Earthquake

Suicide substantially impacts disaster-affected communities due to pre-existing psychosocial effects caused by the disaster. Following the Great East Japan Earthquake of 2011, local disaster aid workers had overworked for months, and many workers eventually died by suicide. Although many workplaces suffered this dual damage, there is limited literature on psychosocial postvention in this context. This study reports the activities of individual/group postventions provided to these aid workers. The bereaved person expressed grief for the loss of their colleagues and anger for not being protected. The postvention observed unusual and distinctive group dynamics. It was essential for mental health professionals to address 2 types of traumatic exposures in the group programs -trauma from the disaster and their colleagues' deaths due to suicide. These postvention programs might be beneficial in maintaining aid workers' mental health and helping them cope with the loss of their colleagues.

Using Distributed Temperature Sensing for Long-Term Monitoring of Pockmark Activity in the Gulf of Patras (Greece): Data Processing Hints and Preliminary Findings

Patras Gulf pockmark field (Western Greece) is a tectonically controlled field that has been activated at least twice by strong earthquakes (M5.4, 14 July 1993 and M6.4, 8 June 2008), and episodic gas seepages have been recorded in the past using geophysical means. A distributed temperature sensor (DTS) system was deployed inside a shallow pockmark and along an active fault at the northern end of the field. This ongoing experiment represents the first long-term monitoring ever conducted on gas-bearing pockmarks and active faults by the DTS system. For now, we have acquired and analyzed data regarding about 1.56 years. One of the primary objectives of this study is to establish methodological queues for data processing and analysis, including spectral analysis and incomplete data treatment techniques, to be standardized for use in further stages of the experiment. Spectral analysis was proven capable of separating the temperature footprint of background environmental components, such as sea-atmosphere heat flux, tides, and winds/waves, from high-frequency temperature residuals. Those residuals represent unusual events that might be correlated to seismicity. Monitoring the causal relationship between seismic activity and seabed water temperature changes in the field was thus attempted. No significant local earthquakes occurred during the monitoring period. Although the relation between seismicity and irregular seabed water temperature events was not systematic, we postulate that four thermal events have a causative link with the local seismicity. The DTS system constitutes a low-cost monitoring system, and the promising preliminary results of this experiment suggest that it is worth testing for a longer period.

Pediatric Emergency Response in a Non-Epicenter Hospital during the 2023 Turkey-Syria Earthquake: A Retrospective Study of 125 Cases in the First 20 Days

BACKGROUND The 2023 Turkey-Syria earthquakes affected a large population. Ankara Mamak State Hospital, a non-epicenter hospital, was also making efforts to treat earthquake patients. This retrospective study was conducted from this non-epicenter hospital during the 2023 Turkey-Syria earthquake and aimed to evaluate the emergency response to 125 pediatric patients identified in the first 20 days. MATERIAL AND METHODS The cases were scanned from the hospital's electronic registry system by age and diagnosis code. We recorded the demographic data of patients under the age of 18 years, the day they arrived, the provinces they left, their diagnoses, treatments, consultations, characteristics of trauma in traumatic cases, and outcomes of all children in a non-epicenter hospital. We detected 125 pediatric cases in the first 20 days. RESULTS There were 125 pediatric patients under the age of 18 who arrived to the Emergency Department (ED). On the 6th day, the number of cases peaked. Their mean age was 7.9±5.6 years (minimum: 0, maximum: 18) and 52.8% were males. Most cases had non-traumatic internal disease (81.6%) and were most (97.6%) were discharged from the ED. While soft-tissue injury was the most common diagnosis in traumatic cases (69.9%), there were more (56.5%) extremity injuries according to the affected body zone. CONCLUSIONS After major disasters, there may be an increased number of pediatric patients taken to hospitals far from the disaster area. For this reason, non-epicenter hospitals should be prepared to provide an adequate number of health care workers and sufficient supplies and equipment.

Disaster Preparedness and Hospital Safety in State Hospitals in Lima (Peru)

INTRODUCTION

Peru's health infrastructures, particularly hospitals, are exposed to disaster threats of different natures. Traditionally, earthquakes have been the main disaster in terms of physical and structural vulnerability, but the coronavirus disease 2019 (COVID-19) pandemic has also shown their functional vulnerability. Public hospitals in Lima are very different in terms of year constructed, type of construction, and number of floors, making them highly vulnerable to earthquakes. In addition, they are subject to a high demand for care daily. Therefore, if a major earthquake were to occur in Lima, the hospitals would not have the capacity to respond to the high demand.

OBJECTIVE

The aim of this study was to analyze the Hospital Safety Index (HSI) in hospitals in Lima (Peru).

MATERIALS AND METHODS

This was a cross-sectional observational study of 18 state-run hospitals that met the inclusion criteria; open access data were collected for the indicators proposed by the Pan American Health Organization (PAHO) Version 1. Associations between variables were calculated using the chi-square test, considering a confidence level of 95%. A P value less than .05 was considered to determine statistical significance.

RESULTS

The average bed occupancy rate was 90%, the average age was 70 years, on average had one bed per 25,126 inhabitants, and HSI average score was 0.36 with a vulnerability of 0.63. No association was found between HSI and hospital characteristics.

CONCLUSION

Most of the hospitals were considered Category C in earthquake and disaster safety, and only one hospital was Category A. The hospital situation needs to be clarified, and the specific deficiencies of each institution need to be identified and addressed according to their own characteristics and context.

The earthquakes in Turkey and their effects on nursing and community health

BACKGROUND

Severe damage was experienced in 10 provinces in Turkey, and the north of Syria, with the earthquakes that hit Kahramanmaraş at midnight and afternoon on February 6, 2023.

AIM

The authors aimed to give brief information to the international nursing community about the situation related to earthquakes in the aspects of nurses.

CONCLUSION

These earthquakes caused traumatic processes in the affected regions. Many people, including nurses and other healthcare professionals, died or were injured. The results demonstrated that the required preparedness had not been applied. Nurses went to these areas voluntarily or on assignment and cared for individuals with injured. The universities in the country passed to distance education because of the shortage of safe places for victims. This situation also negatively influenced nursing education and clinical practice by interrupting in-person education one more time after the COVID-19 pandemic.

IMPLICATIONS FOR NURSING AND NURSING POLICY

Since the outcomes show a need for well-organized health and nursing care, policymakers may consider getting nurses' contributions to the disaster preparedness and management policy-making processes.

Association between problematic Internet use and specific Internet activities and COVID-19- and earthquake-related stress, anxiety, and depression symptoms among Croatian young adults

Background

During the COVID-19 pandemic and concomitant earthquakes in Croatia in 2020, increased Internet use (IU) and Internet-based addictive behaviors were associated with decreasing mental well-being. We determined the changes in IU, problematic IU (PIU), and problematic specific Internet activities in young adults during the prolonged stress caused by the pandemic and earthquakes, age differences in PIU and differences in perceived source of stress (pandemic or earthquakes), and association between PIU and increase in specific Internet activities and stress, anxiety, and depression symptoms in young adults.

Methods

A cross-sectional online survey conducted from September 30, 2021 to October 17, 2021 included 353 young adults aged 22.6 ± 2.1 years, 382 early adults aged 32.1 ± 4.4 years, and 371 middle-aged adults aged 49.0 ± 6.5 years. Data on sociodemographic characteristics, stressors (without perceived stressors, only pandemic-related stressor, only earthquake-related stressor, and both pandemic and earthquake-related stressors), PIU and IU were collected with a self-report questionnaire. The Impact of Event Scale and the Hospital Anxiety Depression Scale were used to evaluate mental symptoms. PIU and problematic specific Internet activities were assessed using Tao et al.'s criteria. Data were anaylzed with paired-sample Wilcoxon test, McNemar's and Pearson's chi-square tests, and structural equation modeling.

Results

In 17% of young adults, we found increased PIU (OR = 5.15, 95% CI [2.82, 10.18]), problematic social media use (OR = 2.77, 95% CI [1.56, 5.14]), and uncontrolled online shopping (OR = 5.75, 95% CI [1.97, 22.87]) (p < 0.001 for all). PIU and problematic social media use were more common among young adults (60.8%), as well as problematic online gaming (25.9%). Problematic social media use was more frequent among young adults reporting pandemic stress than among those without perceived stress (69.9% vs. 43.2%). Increased online gaming predicted more severe avoidance symptoms (p = 0.041), increased social media use predicted more severe depression symptoms (p = 0.017), increased online shopping predicted more severe intrusion (p = 0.013) and anxiety symptoms (p = 0.001). PIU predicted more severe intrusion (p = 0.008), avoidance (p = 0.01), anxiety (p < 0.001), and depression (p = 0.012) symptoms.

Conclusion

Different effects of the pandemic and earthquakes on IU could reflect a different effect of various stressors on Internet behavior of young adults. Type of problematic Internet behavior may predict for the type of mental health problem.

Substance use disorders after natural disasters: a narrative review

Natural disasters significantly impact individuals and communities, including damage to infrastructure, injuries, loss of life, and psychological distress. Factors contributing to the development of substance use disorders (SUDs) during and after these events include trauma and stress, disruption of social support networks, availability of substances, and lack of access to mental health services. This paper aims to draw attention to the relationship between SUDs and natural disasters. Thus, we reviewed the literature by following SANRA guidelines. Prevention and intervention strategies to reduce the risk of SUDs during and after natural disasters are providing mental health services, strengthening social support networks, limiting access to substances, and providing education and training to healthcare providers, emergency responders, and community members. Considering the mental health needs of individuals affected by natural disasters is essential to mitigate the risk of SUDs and other mental health conditions.

Antimicrobial-Resistant Infections after Turkey/Syria Earthquakes, 2023

Increased rates of multidrug-resistant microbes have been reported after earthquakes. After the 2023 earthquakes in Turkey and Syria, the number of associated highly drug-resistant pathogens and nosocomial transmission will probably surge in hospitals treating injured patients. It is not too late to act to prevent antimicrobial-resistant infections from compounding these tragedies.

Tsallis q-Statistics in Seismology

Non-extensive statistical mechanics (or q-statistics) is based on the so-called non-additive Tsallis entropy. Since its introduction by Tsallis, in 1988, as a generalization of the Boltzmann-Gibbs equilibrium statistical mechanics, it has steadily gained ground as a suitable theory for the description of the statistical properties of non-equilibrium complex systems. Therefore, it has been applied to numerous phenomena, including real seismicity. In particular, Tsallis entropy is expected to provide a guiding principle to reveal novel aspects of complex dynamical systems with catastrophes, such as seismic events. The exploration of the existing connections between Tsallis formalism and real seismicity has been the focus of extensive research activity in the last two decades. In particular, Tsallis q-statistics has provided a unified framework for the description of the collective properties of earthquakes and faults. Despite this progress, our present knowledge of the physical processes leading to the initiation of a rupture, and its subsequent growth through a fault system, remains quite limited. The aim of this paper was to provide an overview of the non-extensive interpretation of seismicity, along with the contributions of the Tsallis formalism to the statistical description of seismic events.

Kidney transplantation during mass disasters - from COVID-19 to other catastrophes A Consensus Statement by the DESCARTES Working Group and Ethics Committee of the ERA

Mass disasters are characterized by a disparity between health care demand and supply, which hampers complex therapies like kidney transplantation. Considering scarcity of publications on previous disasters, we reviewed transplantation practice during the recent COVID-19 pandemic, and dwelled upon this experience for guiding transplantation strategies in the future pandemic and non-pandemic catastrophes. We strongly suggest continuing transplantation programs during mass disasters, if medical and logistic operational circumstances are appropriate. Postponing transplantations from living donors and referral of urgent cases to safe regions or hospitals are justified. Specific preventative measures in anticipated disasters (such as vaccination programs during pandemics or evacuation in case of hurricanes or wars) may be useful to minimize risks. Immunosuppressive therapies should consider stratifying risk status and avoiding heavy immune suppression in patients with a low probability of therapeutic success. Discharging patients at the earliest convenience is justified during pandemics, whereas delaying discharge is reasonable in other disasters, if infrastructural damage results in unhygienic living environments for the patients. In the outpatient setting, telemedicine is a useful approach to reduce the patient load to hospitals, to minimize the risk of nosocomial transmission in pandemics and the need for transport in destructive disasters. If it comes down to save as many lives as possible, some ethical principles may vary in function of disaster circumstances, but elementary ethical rules are non-negotiable. Patient education is essential to minimize disaster-related complications and to allow for an efficient use of health care resources.

The Impact of Earthquakes on Public Health: A Narrative Review of Infectious Diseases in the Post-Disaster Period Aiming to Disaster Risk Reduction

Earthquakes are among the most impressive natural phenomena with very high potential to set off a chain of effects that significantly affects public health through casualties and injuries. Related disasters are attributed not only to the strong ground motion and coseismic phenomena but also to secondary effects, comprising mainly landslides and tsunamis, among others. All these can create harsh conditions favorable for the emergence of infectious diseases that are capable of causing additional human and economic losses and disruption of the emergency and recovery process. The present study comprises an extensive narrative review of the existing literature on the earthquake-triggered infectious diseases recorded worldwide, along with their symptoms, causative pathogens, associated risk factors, most vulnerable population groups, and prevention strategies. Respiratory, gastrointestinal, and vector-borne diseases, as well as wound and skin infections, are mainly recorded among the earthquake-affected population. Measures for effectively preventing earthquake-triggered infectious diseases are also proposed. One of the widely proposed measures is the establishment of a proper disease surveillance system in order to immediately and effectively identify the pre- and post-disaster occurrence of infectious diseases. This approach significantly contributes to disease trends monitoring, validation of early warning, and support of the emergency response and recovery actions.

A Discrete Elements Study of the Frictional Behavior of Fault Gouges

A series of discrete elements simulations is presented for the study of fault gouges' frictional response. The gouge is considered to have previously undergone ultra-cataclastic flow and long-time consolidation loading. We explore the effect of different particle characteristics such as size, polydispersity, and also shearing velocities on gouge's response under the conditions met in the seismogenic zone. Monte-Carlo analyses suggest that the local stick-slip events disappear when averaging over a large number of numerical samples. Moreover, the apparent material frictional response remains almost unaffected by the spatial randomness of particles' position and by the particle's size distribution. On the contrary, the mean particle size controls the formation and thickness of the observed shear bands, which appear after the peak friction is met. Furthermore, the apparent friction evolution fits well to an exponential decay law with slip, which involves a particle size dependent critical slip distance. For the studied conditions and depth, the shearing velocity is found to play a secondary role on the apparent frictional response of the gouge, which highlights the importance of analyses involving multiphysics for studying the rheology of fault gouges. Besides improving the understanding of the underlying physics of the problem, the above findings are also useful for deriving pertinent constitutive models in the case of modeling with continuum theories.

Demand-supply balance of disaster medical care in Osaka City based on damage estimation for a Nankai Trough megathrust earthquake: A geographic information system-based analysis

Aim

Studies have not fully examined whether the medical care system would be able to manage the high number of casualties due to a Nankai Trough earthquake, whose probability of recurrence in the next 30 years is ~70%. This study assessed the demand-supply balance of the disaster medical care system in Osaka city by integrating the data on damage estimation and disaster coping hospitals using a geographic information system.

Methods

We obtained data on the distribution of casualties in two cases, high and low rates of evacuation from the tsunami, and available beds in Osaka city calculated from operating data of each disaster coping hospital. We expanded these data on a geographic information system and investigated the balance of medical care.

Results

The total number of available beds in the disaster medical care facilities was 5,559, and the shortage with evacuation rates being either low or high, would be 47,631 and 1,487, respectively. With a low evacuation rate, bed shortage is a common occurrence in coastal areas. With a high evacuation rate, bed shortage decreases, and problems with medical care arise in the eastern area of Osaka city.

Discussion

In the case of a low evacuation rate, greater bed shortage was found along the coast of Osaka Bay where the probabilities of flooding are high. In the case of a high evacuation rate, however, the number of casualties was much lower. A shortage of medical care did not occur along the coast, but in the eastern part of Osaka city.

Problematic Internet Use, Anxiety, Depression, and Stress Symptoms in Adults with COVID-19 Pandemic and Earthquake Experience: Insights from Croatian Online Survey

In 2020, Croatia was hit by the COVID-19 pandemic and two earthquakes. As previous research showed that Internet use (IU) increased during the COVID-19 pandemic, we carried out an online survey to determine the levels of problematic Internet use (PIU) and problematic specific Internet activities before and during the prolonged stress caused by the COVID-19 pandemic as well as earthquakes. We also determined the correlation between the PIU and specific Internet activities and anxiety, depression, and stress symptoms. According to the responses of 1,118 participants from all Croatian regions, PIU increased by 14.1 percent (odds ratio [OR] 6.2), problematic social media use by 12.6 percent (OR 4.8), and uncontrolled online shopping by 5.3 percent (OR 5.8) in comparison with presurvey period. The PIU increase was significantly higher in participants reporting only pandemic-related stress than in those reporting both pandemic- and earthquake-related stress. Problematic social media use increased in those reporting only pandemic-related stress and both pandemic- and earthquake-related stress. The strongest correlation between PIU and problematic social media use and anxiety, depression, intrusion, and avoidance symptoms was found among those reporting both pandemic- and earthquake-related stress. The correlation between psychiatric measures and PIU and problematic specific Internet activities varied depending on the source of experienced or perceived stress. Our findings show the relationship between the problematic stress-related Internet behaviors, different types of stressors, and their impact on the overall PIU and problematic specific Internet activities in situations of prolonged stress.

A Systematic Review of Structural Health Monitoring Systems to Strengthen Post-Earthquake Assessment Procedures

Structural health monitoring (SHM) is vital to ensuring the integrity of people and structures during earthquakes, especially considering the catastrophic consequences that could be registered in countries within the Pacific ring of fire, such as Ecuador. This work reviews the technologies, architectures, data processing techniques, damage identification techniques, and challenges in state-of-the-art results with SHM system applications. These studies use several data processing techniques such as the wavelet transform, the fast Fourier transform, the Kalman filter, and different technologies such as the Internet of Things (IoT) and machine learning. The results of this review highlight the effectiveness of systems aiming to be cost-effective and wireless, where sensors based on microelectromechanical systems (MEMS) are standard. However, despite the advancement of technology, these face challenges such as optimization of energy resources, computational resources, and complying with the characteristic of real-time processing.

The viewpoints of residents of Kerman, Iran regarding the challenges and barriers of preparing households against earthquakes: A theory-guided qualitative content analysis

Introduction

Earthquakes cause a lot of damage and casualties. For various reasons, most households are not prepared for earthquakes. This study aims to identify the challenges and barriers to households' preparedness against earthquakes from the viewpoint of Kerman residents.

Methods

This qualitative-directed content analysis study was conducted from December 2021 to May 2022 in the city of Kerman in southeast Iran. Data was collected by purposive sampling through in-depth and semi-structured individual face-to-face interviews with 48 households.

Results

After multiple rounds of analyzing and summarizing the data based on the social-cognitive theory and taking into consideration similarities and differences, five main categories and 19 subcategories created based on the results of data analysis and including (1) Challenges related to cognitive factors (2) Challenges related to behavioral factors (3) Challenges related to the physical environment (4) Challenges related to the social environment and (5) Challenges related to financial factors.

Conclusion

Although the participants listed many challenges and barriers in different fields, in order to overcome the barriers and challenges of preparing households for an earthquake, the support of the authorities and the cooperation of the residents are necessary.

Pathways to post-traumatic growth and post-traumatic stress following the Canterbury earthquakes in a cohort of 40-year-olds

OBJECTIVE

To report on post-traumatic growth and post-traumatic stress following the Canterbury earthquakes and to quantify the relationships between exposure to the earthquakes, post-traumatic growth and post-traumatic stress.

METHOD

The Christchurch Health and Development Study is a longitudinal birth cohort study of New Zealanders aged 40 years at the time of latest assessment in 2017. A total of 455 participants were exposed to the Canterbury earthquakes and assessed in 2012 and 2017. Post-traumatic growth was measured in 2017 using the Post-traumatic Growth Inventory. Earthquake-related post-traumatic stress was measured in 2012 using post-traumatic stress disorder items from the Diagnostic Interview Schedule. Post-traumatic growth and post-traumatic stress were modelled using measures of earthquake impact and subjective measures of earthquake consequences (peri-traumatic stress and disruption distress).

RESULTS

There was an indirect relationship between earthquake impact and post-traumatic growth. This was mediated via disruption distress. There was also an indirect relationship between earthquake impact and post-traumatic stress. This was mediated via peri-traumatic stress and disruption distress. Post-traumatic growth and post-traumatic stress were not significantly related.

CONCLUSIONS

Measurement of post-traumatic growth and post-traumatic stress is required for a holistic understanding of disaster consequences. Subjective assessment of distress following disasters is required to predict their psychological effects.

Factors Associated with Knowledge of Evacuation Routes and Having an Emergency Backpack in Individuals Affected by a Major Earthquake in Piura, Peru

Information on the prevention of earthquakes in Peru, a high-risk country, is still emerging. We determined the frequency and factors associated with knowledge of evacuation routes and the use of emergency backpacks in people affected by a major earthquake. A cross-sectional study using secondary data was conducted from August-December 2021 on people that experienced the 6.1 magnitude earthquake that occurred in Piura, Peru on 30 July 2021. The outcome was self-reported knowledge of evacuation routes and the use of emergency backpacks. The association with self-reported earthquake preparation training, use of sources of information on earthquakes, and sociodemographic variables was investigated. A total of 69.5% of participants knew evacuation routes, and 46.3% had an emergency backpack. A higher frequency of knowledge of evacuation routes was associated with previous training (PR: 1.47; 95% CI: 1.15-1.87), use of the media (PR: 1.35; 95% CI: 1.06-1.72), having received information from the COEN (PR: 1.19; 95% CI: 1.02-1.40), and with a greater number of household members (PR: 1.03; 95% CI: 1.01-1.06). There is a high frequency of knowledge of evacuation routes among participants. However, basic notions of prevention culture are still needed. This research contributes to policy development on earthquake preparation at the community level.

Optimizing Earthquake Nowcasting With Machine Learning: The Role of Strain Hardening in the Earthquake Cycle

Nowcasting is a term originating from economics, finance, and meteorology. It refers to the process of determining the uncertain state of the economy, markets or the weather at the current time by indirect means. In this paper, we describe a simple two-parameter data analysis that reveals hidden order in otherwise seemingly chaotic earthquake seismicity. One of these parameters relates to a mechanism of seismic quiescence arising from the physics of strain-hardening of the crust prior to major events. We observe an earthquake cycle associated with major earthquakes in California, similar to what has long been postulated. An estimate of the earthquake hazard revealed by this state variable time series can be optimized by the use of machine learning in the form of the Receiver Operating Characteristic skill score. The ROC skill is used here as a loss function in a supervised learning mode. Our analysis is conducted in the region of 5° × 5° in latitude-longitude centered on Los Angeles, a region which we used in previous papers to build similar time series using more involved methods (Rundle & Donnellan, 2020, https://doi.org/10.1029/2020EA001097; Rundle, Donnellan et al., 2021, https://doi.org/10.1029/2021EA001757; Rundle, Stein et al., 2021, https://doi.org/10.1088/1361-6633/abf893). Here we show that not only does the state variable time series have forecast skill, the associated spatial probability densities have skill as well. In addition, use of the standard ROC and Precision (PPV) metrics allow probabilities of current earthquake hazard to be defined in a simple, straightforward, and rigorous way.

A comparative examination of the health status of earthquake-affected and non-earthquake-affected adolescents in Yushu

Background

Yushu, Qinghai Province, which is located in the remote Tibetan Plateau in western China, was struck by a disastrous earthquake in 2010.

Methods

This study aimed to compare the health status of adolescents who had (Exp-Group) and had not (Non-Group) experienced the Yushu earthquake, 7 years after it occurred; additionally, group-specific predictors of health status were identified. A cross-sectional study was adopted among students from two junior schools in Yushu, whereby two groups were compared. Descriptive statistics, t-tests, Wilcoxon rank-sum tests, Kruskal-Wallis H tests, and stepwise linear regression were used to analyze data.

Results

Exp-Group scored higher than Non-Group on Physiological Component Summary (PCS) but not on Mental Component Summary (MCS). Among Exp-Group participants, lower PCS scores were predicted for "house damaged," "injured," "family member injured," and "family member or friend dead." Lower MCS scores were predicted by "family member or friend dead." Among Non-Group participants, PCS scores were predicted by "residence" and "family member or friend dead." Lower MCS scores were predicted by "not living with parents."

Conclusion

Lower PCS and MCS scores of Exp-Group adolescents mainly contributed to earthquake-related injuries, while lower PCS and MCS scores of Non-Group are related to poor living conditions and the fact of the left-behind child.

Role of Atmospheric Temperature and Seismic Activity in Spring Water Hydrogeochemistry in Urumqi, China

Springs offer insight into the sources and mechanisms of groundwater recharge and can be used to characterize fluid migration during earthquakes. However, few reports provide sufficient annual hydrochemical and isotopic data to compare the variation characteristics and mechanisms with both atmospheric temperature and seismic effects. In this study, we used continuous δ²H, δ¹⁸O, and major ion data from four springs over 1 year to understand the groundwater origin, recharge sources, circulation characteristics, and coupling relationships with atmospheric temperature and earthquakes. We found that (1) atmospheric temperatures above and below 0 °C can cause significant changes in ion concentrations and water circulation depth, resulting in the mixing of fresh and old water in the aquifer, but it cannot cause changes in δ²H and δ¹⁸O. (2) Earthquakes of magnitude ≥ 4.8 within a 66 km epicentral distance can alter fault zone characteristics (e.g., permeability) and aggravate water-rock reactions, resulting in significant changes in δ²H, δ¹⁸O, and hydrochemical ion concentrations. (3) Hydrogen and oxygen isotopes are the most sensitive precursory seismic indicators. The results of this study offer a reference for the establishment of long-term hydrochemical and isotopic monitoring, with the potential for use in earthquake forecasting.

Post-Traumatic Stress Disorder after the 6.1 Magnitude Earthquake in Piura, Peru: A Cross-Sectional Study

In Peru, major disasters like the 2007 Pisco earthquake have produced high rates of post-traumatic stress. However, evidence is still needed to strengthen interventions. In 2021, a major earthquake struck Piura, in northern Peru. In this context, we aimed to assess the prevalence of PTSD and its associated factors. A cross-sectional study was conducted during August-September 2021 in people who experienced the 6.1 Piura earthquake on 30 July 2021. The questionnaire included the PCL-C, CD-RISC, ISI, HFIAS, and additional demographic data. Generalized linear models were used. The prevalence of PTSD was 20.3%. Household income was between PEN 2001 and 3000 (PR = 4.26, 95% CI: 1.08-16.75), smoking (PR = 2.49, 95% CI: 1.03-6.01), experience of a nervous breakdown (PR = 1.83, 95% CI: 1.09-3.09), moderate food insecurity (PR = 2.91, 95% CI: 1.10-7.73), and severe insomnia (PR = 8.25, 95% CI: 2.22-30.71) increased the prevalence of PTSD. One out of five individuals experienced post-traumatic stress symptoms after the 2021 earthquake in Piura, which varies depending on socioeconomic, psychosocial, and individual factors. Further research should strengthen these findings to ensure a fair and early mental health intervention against new seismic events in this and other Peruvian regions.

Rescue Robots for the Urban Earthquake Environment

Robotics have important applications in the field of disaster medical rescue. The deployment of urban rescue robots at the earthquake site can help shorten response time, improve rescue efficiency and keep rescue personnel away from danger. This discussion introduces the performance of some robots in actual rescue scenarios, focuses on the current research status of robots that can provide medical assistance, and analyzes the merits and shortcomings of each system. Based on existing studies, the limitations and development directions of urban rescue robots are also discussed.

Profile and Outcome of Victims of an Earthquake in an Aging Society: A Population-Based Descriptive Study of the Earthquake in Osaka, Japan, on June 18, 2018

OBJECTIVE

The aim of this study is to reveal the characteristics and outcomes of patients injured in a major earthquake and who were transported to a hospital by ambulance.

METHODS

This study was a retrospective descriptive epidemiological study including all patients who were injured after a major earthquake struck Osaka Prefecture on June 18, 2018, and were transported to a hospital by ambulance. The main outcome was the prognosis at each hospital's emergency department.

RESULTS

In total, 214 patients were included in the analysis. Their median age was 74 years (IQR, 54-82); 53 (24.8%) were men and 161 (75.2%) were women. The median time from ambulance call to arrival at the scene was 10 min (IQR, 7-15), and the median time from ambulance call to the hospital arrival was 37 min (IQR, 30-51). Ninety-seven patients (45.3%) were admitted to a hospital, 114 patients (53.3%) were discharged home to and from the emergency department, and 3 patients (1.4%) died. Among the patients discharged to home from the emergency department, the most common pathological condition was head bruising in 16 patients.

CONCLUSIONS

This study revealed the profile of injured patients transported by ambulances after an earthquake that struck an aging society.

A Safe Home? A Qualitative Study into the Experiences of Adolescents Growing Up in the Dutch Area Impacted by Earthquakes Induced by Gas Extraction

For decades, the Netherlands has experienced minor earthquakes due to gas extraction. This study aims to obtain insight into the experiences of adolescents and the impact of these earthquakes on their well-being and living environment. Focus groups were held with 24 adolescents, and interviews were held with 3 adolescents (N = 27; M = 15 years). Through qualitative analysis, we identified six themes. The adolescents shared experiences of anxiety related to the earthquakes and their consequences and considered these to be a normal part of their life. Anxiety and feelings of endangerment not only related to their own experiences but were also connected to the impact of earthquakes on their social environment, such as the restoration of buildings. Several sources of support (e.g., talking, social cohesion) were mentioned to deal with the negative consequences of the earthquakes. A lack of trust in the government was an additional main theme, with adolescents mentioning several needs, potentially relevant to policymakers in the Netherlands. Growing up in the gas extraction area of Groningen had many consequences on the adolescents in the study, who felt inhibited from expressing feelings of anxiety and fear. To support their needs, interventions at the individual, family, educational, societal, and policy levels are recommended.

Hospital Evacuation Implications After the 2016 Kumamoto Earthquake

During the 2016 Kumamoto earthquake, 10 hospitals took responsibility for complete evacuation, in what has become regarded as one of the largest evacuations of patients in 1 seismic disaster. We aimed to examine the reasons for evacuation and to assess hospital vulnerability as well as preparedness for the earthquake. A multidisciplinary team conducted semi-structured interviews with the hospitals 6 months after the earthquake. The primary reasons for the decision to evacuate hospitals were categorized into 3: 1) Concern for structural safety (4 facilities), 2) Damage to the facility water system (7 facilities), and 3) Cessation of regional water supply (5 facilities).All hospitals decided on immediate evacuation within 30 hours and could not wait for structural engineers to inspect the affected buildings. Damage to sprinklers or water facilities caused severe water shortages and flood, thus requiring weeks to resume inpatient care. The earthquake revealed the vulnerability of rapid building-inspection systems, aging buildings, and water infrastructure.

Health System Disruption at the Primary Health Center Level Affected by Earthquake, Tsunami, and Liquefaction in 3 Districts of Central Sulawesi, Indonesia

OBJECTIVES

An earthquake followed by tsunami and liquefaction on September 28, 2018, in Central Sulawesi caused health system disruptions. This study aimed to know health system disruption at the primary health center (PHC) level due to the disaster in 3 districts (Palu, Sigi, Donggala) of Central Sulawesi.

METHODS

This was a qualitative study conducted in March 2019 involving 36 PHCs. Data were collected through interview of PHC officers using a structured questionnaire. Variables included disruption of management, budget, human resources, drug supply, Early Warning Alert and Response System (EWARS) of epidemic prone disease (EPD), human resource migration, health facility damage, and health facility access. Descriptive analysis was conducted to define disruption for a 1-y projection.

RESULTS

Health system disruptions in Palu affected management, budget, human resources, EWARS, health facility damage, and health access; occurred within 1-2 mo; and were projected to become better after 6 mo. Problems in Sigi were management, human resources, drug supply, EPD, and EWARS for 1 mo after disaster and were projected to be better after 2 mo. The problems in Donggala were health services access, management, human resources for 1 mo after the disaster and were projected to be normal after 2 mo.

CONCLUSIONS

Health system disruptions occurred in Central Sulawesi Province at the PHC level within 1-2 mo and were projected to become better after 3 mo in most PHCs.

Mutual Impacts of the COVID-19 Pandemic and the Recent Earthquakes: A Scoping Review of the Lessons Learned

OBJECTIVE

The aim of this study was to review the articles dealing with the mutual impacts of the coronavirus disease 2019 (COVID-19) pandemic and the recent earthquakes to elicit the various scopes of the lessons learned including the challenges, the successful measures, and the recommendations.

METHODS

To detect the relevant studies published between February 1, 2020, and June 9, 2021, PubMed, Web of Science, Scopus, and Google Scholar were searched. Having considered specific inclusion/exclusion criteria, 18 studies were included.

RESULTS

Seven major earthquakes have occurred concurrently or before the pandemic era in Albania, Croatia, Haiti, Great East Japan, Mexico, Nepal, and Utah. Thematic analysis revealed 5 themes for the "challenges" (management inefficiency, increased life-threatening, economic, socially related, and dual psychological challenges); 4 themes for the "efficient response measures" (health-care services measures, government measures, community-based cooperative activities, and disaster management response); and 3 major themes with 7 sub-themes for the "recommendations" including "the mitigation phase" (identifying probable natural disasters), "the preparedness phase" (preparing necessary equipment), and "the response phase" (mental care response measures, health-care-related COVID-19 measures, economic improvement measures, recognizing community-based capabilities, and government-related boosting measures).

CONCLUSIONS

It is suggested that these scopes of the mutual impacts of the COVID-19 pandemic and the earthquakes be studied in systematic reviews.

Role of Community Health Volunteers Since the 2015 Nepal Earthquakes: A Qualitative Study

OBJECTIVE

Nepal female community health volunteers (FCHVs) were the first available health personnel in communities during the 2015 Nepal earthquakes. This study explored the facilitating factors and barriers of the FCHVs during health emergencies.

METHODS

In-depth interviews with 24 FCHVs and 4 health managers from 2 districts in Nepal (Gorkha and Sindhupalchowk) were conducted using semi-structured interview guides. The qualitative data were analyzed using thematic analysis methods.

RESULTS

FCHVs were the first responders to provide services after the earthquakes and were well accepted by the local communities. Different models of supervision existed, and differences in the workload and remuneration offered to FCHVs were described. A wide range of disaster-related knowledge and skills were required by FCHVs, and lack of prior training was an issue for some respondents. Furthermore, lack of access to adequate medical supplies was a major barrier for FCHVs in the 2015 earthquakes. The 5 identified themes were discussed.

CONCLUSION

Providing regular disaster response training for FCHVs and strong leadership from the public sector with sustained investments will be essential for increasing the capacities of community health workforces to prepare for and reduce the impacts of future health emergencies in resource-poor settings.

Post-traumatic growth of people who have experienced earthquakes: Qualitative research systematic literature review

Introduction

Earthquakes can have a variety of physical, emotional, and social effects on the people who experience them. Post-traumatic Growth (PTG) results from people attempting to reconstruct their lives after experiencing a traumatic event. We intend to inform the local community of the importance of disaster psychology by identifying and analyzing the literature on post-traumatic growth experiences of subjects who experienced earthquakes.

Methods

This study applied a systematic review of qualitative research published from January 1, 2012 to January 31, 2021 to understand PTG in people who have experienced earthquakes. The search expressions "Post-traumatic Growth", "Earthquake", "Qualitative" were applied to CINAHL, EMBASE, PubMed, PsycInfo, KISS, RISS, and NDSL databases. Initially, 720 papers were found; after removal of duplicates, 318 remained. After a review of titles and abstracts, 186 papers that did not meet the selection criteria of this study were removed. After a further examination of the remaining 132 papers, the researchers removed 65 papers that did not match the research topic. Lastly, of the remaining 67 papers, detailed review eliminated quantitative papers that did not match this study (25), articles that were not original (19), articles in which results were not PTG (8), articles that were not related to this study (3), articles that were not written in English (2), or articles that had mixed topics (2). Eight papers remained.

Results

The results of this study show that the PTG in people who have experienced earthquakes can be classified into three categories: "Change in self-perception", "Change of interpersonal relationships", and "Spiritual change". They can be further classified into eight subcategories: "Reviewing one's existence", "Acceptance", "Discovering strengths by working through adversity", "Gratitude for life", "Changes in personal relations", "Changes in social relations", "Accepting the existence of God", and "A breakthrough to overcome difficulties".

Discussion

These results can be used as basic data for a positive psychological understanding for those who have experienced earthquake trauma.

Psychological distress in children and adolescent disaster survivors

BACKGROUND

This study aimed to clarify the association between mental and behavioral changes and subsequent psychological distress among children and adolescents living in areas affected by the 2011 Great East Japan Earthquake.

METHODS

We conducted a two-wave study, with waves 1 and 2 occurring in 2011 and 2014, respectively. Data of 462 respondents aged 9-14 years during wave 1 and who participated in both surveys were used in the present analysis. A factor analysis was performed using the mental and behavioral changes reported by respondents in wave 1. Psychological distress was defined as a score of ≥5 on the six-item Kessler Psychological Distress Scale, as measured in wave 2. With the factors generated in this analysis set as independent variables, the odds ratios (OR) (95% confidence intervals, 95% CIs) for psychological distress were calculated using logistic regression, adjusting for age, sex, house damage, living environment, and loss of family or friends.

RESULTS

Psychological distress was present in 108 (23.4%) of the respondents. The factor analysis yielded three factors describing mental and behavioral changes: interpersonal issues, brain fog, and anxiety and panic. Of these, interpersonal issues were significantly associated with subsequent psychological distress, with an OR of 2.59 (95% CI 1.58-4.25). This association did not change even when stratified by age and sex.

CONCLUSIONS

This study suggests that interpersonal issues are a significant predictor of psychological distress in children and adolescents living in areas affected by a large-scale disaster.

Associations Between the 2011 Great East Japan Earthquake and Tsunami and the Sleep and Mental Health of Japanese People: A 3-Wave Repeated Survey

PURPOSE

Large-scale natural disasters have an enormous physical and mental impact, immediately after they occur, on people living near the central disaster areas. It is known that, in the early stages, a seismic disaster triggers high rates of symptoms for insomnia, depression, and anxiety. However, little information is available about their medium- to long-term clinical outcomes. In this study, we conducted a repeated cross-sectional nationwide questionnaire survey to clarify changes in the prevalence of insomnia and its background factors after the Great East Japan Earthquake, a huge earthquake with a moment magnitude of 9.0 that occurred on March 11, 2011.

METHODS

We conducted a repeated cross-sectional survey in November 2009 (pre-earthquake, 1224 participants), July 2011 (4 months post-earthquake, 1259 participants), and August 2012 (18 months post-earthquake, 1289 participants) using stratified random sampling from 157 Japanese sites.

RESULTS

Compared to 2009, the prevalence of insomnia statistically increased nationwide immediately post-disaster (11.7% vs 21.2%; p < 0.001) but significantly decreased in 2012 compared to immediately after the earthquake (10.6% vs 21.2%; p < 0.001). In 2011, insomnia was most frequent in the central disaster area. Multivariable logistic regression models demonstrated the association between the following factors and increased risk of insomnia: being a woman (odds ratio [OR] 1.48, 95% confidence interval [CI]: 1.00-2.19), being employed in 2009 (OR 1.74, 95% CI: 1.15-2.62), and being of younger age group (20-64 years) in 2011 (OR 1.64, 95% CI: 1.12-2.42) and 2012 (OR 2.50 95% CI: 1.47-4.23). Post-earthquake, the prevalence of insomnia symptoms in men increased, while the gender difference decreased and was no longer statistically significant. Additionally, insomnia was associated with psychological distress (scores ≥5 on the Kessler Psychological Distress Scale) in 2011 and 2012.

CONCLUSION

This study demonstrated that the prevalence of insomnia was significantly higher after the earthquake. Moreover, individuals with insomnia were more likely to experience psychological distress after the earthquake that continued until 2012.

Disasters and 'conditions of possibility': rethinking causation through an analysis of earthquakes in Nepal

What causes a disaster's aftermath? Scholars have increasingly turned to historical approaches that link outcomes to pre-disaster sociopolitical dynamics. Disasters lead to 'critical junctures' that 'trigger' events that unfold in the wake of the initial phenomenon. This paper argues that the 'critical junctures' paradigm shares limitations with 'path dependency' theory from which it is derived, namely a tendency towards historicism-a functionalist teleology better able to explain continuity than change. As an alternative, this analysis draws on Michel Foucault's understanding of 'conditions of possibility' as a way of rethinking agency/causation, moving away from individual subjects, events, or even historical conditions towards, instead, the new, radically destabilised 'epistemological field' emerging in the disaster's aftermath. This paper examines a series of devastating earthquakes in Nepal to consider how post-disaster 'epistemological fields' present new 'conditions of possibility' within which new ideas, actions, and outcomes become thinkable and possible in ways that pre-disaster historical conditions could not have predicted.

The Role of Emergency Medical Services in Earthquake Response: Integrating the ABC Approach of Israel's Magen David Adom

Throughout history, earthquakes have caused devastation and loss of life. Emergency medical services (EMS) plays a vital role in the response to any mass-casualty incident or disaster. Magen David Adom, Israel's premier EMS organization, has a unique strategy known as the ABC approach to earthquake response. It involves thousands of salaried workers and trained volunteers who are prepared to respond to an earthquake based on the extent of the disaster. Depending on the amount of destruction, they will be working locally or available to help in other areas. A Level A earthquake causes local destruction and minimal casualties. Any EMS responders in that area as well as in surrounding areas will be available to help. Furthermore, all responders will need to work automatically and autonomously. A Level B earthquake causes extensive destruction, and all responders in the region will be busy caring for the victims. Anyone available outside of the region will come and help. A Level C earthquake is completely devastating, and all workers nationwide will be involved in responding to the catastrophe. The role of EMS responders using the ABC approach to earthquake response, as described here, may be integrated in part or whole in other EMS systems.

Active Faulting and Deep-Seated Gravitational Slope Deformation in Carbonate Rocks (Central Apennines, Italy): A New "Close-Up" View

Active faulting and deep-seated gravitational slope deformation (DGSD) are common geological hazards in mountain belts worldwide. In the Italian central Apennines, kilometer-thick carbonate sedimentary sequences are cut by major active normal faults that shape the landscape, generating intermontane basins. Geomorphological observations suggest that the DGSDs are commonly located in fault footwalls. We selected five mountain slopes affected by DGSD and exposing the footwall of active seismogenic normal faults exhumed from 2 to 0.5 km depth. Field structural analysis of the slopes shows that DGSDs exploit preexisting surfaces formed both at depth and near the ground surface by tectonic faulting and, locally, by gravitational collapse. Furthermore, the exposure of sharp scarps along mountain slopes in the central Apennines can be enhanced either by surface seismic rupturing or gravitational movements (e.g., DGSD) or by a combination of the two. At the microscale, DGSDs accommodate deformation mechanisms similar to those associated with tectonic faulting. The widespread compaction of micro-grains (e.g., clast indentation), observed in the matrix of both normal faults and DGSD slip zones, is consistent with clast fragmentation, fluid-infiltration, and congruent pressure-solution active at low ambient temperatures (<60°C) and lithostatic pressures (<80 MPa). Although clast comminution is more intense in the slip zones of normal faults because of the larger displacement accommodated, we are not able to find microstructural markers that allow us to uniquely distinguish faults from DGSDs.

Quality of Life in Lower-Limb Amputees 10 Years After the 2008 Sichuan Earthquake: A Cross-Sectional Study

OBJECTIVE

The aim of this study was to investigate the long-term outcome of quality of life (QOL) in the lower-limb amputees 10 years after the 2008 Sichuan earthquake.

METHODS

In the cross-sectional study, 66 lower-limb amputees were recruited. The prosthetics-related QOL was assessed using the Prosthetic Evaluation Questionnaire (PEQ) in terms of the scales of utility, appearance, sounds, residual limb health, perceived response, frustration, social burden, ambulation, and well-being. The score of each PEQ subscale was calculated and compared among the cohorts with different demographic characteristics.

RESULTS

The PEQ scores showed that the scales of sounds, residual limb health, and frustration were still low in the lower-limb amputees 10 years after the 2008 Sichuan earthquake. The comparison of PEQ scales among cohorts with different demographic characteristics indicated that the potential demographic risk factors, namely, age, marital status, educational level, living independence, and comorbidity, were associated with prosthesis-related QOL.

CONCLUSIONS

The prosthesis-related QOL of the lower-limb amputees 10 years after the 2008 Sichuan earthquake has been partly documented in this study. The potential demographic risk factors associated with QOL of amputees were also identified. These findings could enhance the understanding of prosthesis-related QOL of lower-limb amputees sustained in an earthquake and facilitate the optimization of post-disaster rehabilitation strategies.

Neural response to trauma-related and trauma-unrelated negative stimuli in remitted and persistent pediatric post-traumatic stress disorder

INTRODUCTION

Most youths who suffer from post-traumatic stress disorder (PTSD) lose their diagnosis in the first 1-2 years. However, there are few studies on this brain mechanism, and the heterogeneity of the findings is partially due to the different stimuli applied and the mixed trauma history. Therefore, the use of trauma-related/unrelated stimuli to study the remittance mechanism of earthquake-induced PTSD could advance our knowledge of PTSD and inspire future treatment.

METHODS

Thirteen youths with PTSD, 18 remitted participants, and 18 control participants underwent functional magnetic resonance imaging (fMRI), while viewing trauma-related pictures, trauma-unrelated negative pictures, and scrambled pictures.

RESULTS

Under trauma-unrelated condition, the neural activity of the left hippocampus in the remitted group was between the two other groups. Under trauma-related condition, the PTSD and the remitted group exhibited higher neural activity in the right middle occipital gyrus than controls. The remitted group showed higher neural activity in the right parahippocampal gyrus and right lingual gyrus under trauma-related condition than trauma-unrelated condition, while no significant difference was found in PTSD group.

CONCLUSION

PTSD status-related group differences are mainly reflected in the left hippocampus under the trauma-unrelated condition, while the hyperactivity in the right middle occipital gyrus under trauma-related condition could be an endophenotype for PTSD.

Highly Dissipative Materials for Damage Protection against Earthquake-Induced Structural Pounding

It is a common situation that seismic excitations may lead to collisions between adjacent civil engineering structures. This phenomenon, called earthquake-induced structural pounding, may result in serious damage or even the total collapse of the colliding structures. Filling the gap between two buildings erected close to one another by using visco-elastic materials can be considered to be one of the most effective methods to avoid seismic pounding. In this paper, a new polymer-metal composite material made of polyurethane and closed-cell aluminum foam is proposed as a pounding energy absorber for protection against earthquake hazards. The composite was created in two versions, with and without an adhesive interface. A series of experiments which reflect the conditions of seismic collision were performed: quasi-static compression, dynamic uniaxial compression and low-cycle dynamic compression with 10 loops of unloading at 10% strain. The composite material's behavior was observed and compared with respect to uniform material specimens: polymer and metal foam. The experimental results showed that the maximum energy absorption efficiency in the case of the new material with the bonding layer was improved by 34% and 49% in quasi-static and dynamic conditions, respectively, in comparison to a sole polymer bumper. Furthermore, the newly proposed composites dissipated from 35% to 44% of the energy absorbed in the cyclic procedure, whereas the polymer specimen dissipated 25%. The capacity of the maintenance of the dissipative properties throughout the complete low-cycle loading was also satisfactory: it achieved an additional 100% to 300% of the energy dissipated in the first loading-unloading loop.

Medical Problems and Concerns with Temporary Evacuation Shelters after Great Earthquake Disasters in Japan: A Systematic Review

Japan has repeatedly suffered from natural disasters. A number of temporary evacuation shelters have been opened for the benefit of evacuees. Although the operation of such evacuation shelters has improved after the Great Hanshin-Awaji Earthquake (1995), a number of operational difficulties were encountered during the Great East Japan Earthquake in 2011 and the Kumamoto Earthquake in 2016. A systematic literature review was conducted to identify the medical concerns encountered in temporary evacuation shelters by focusing on unsanitary environment, food and nutrition, and shortage of medication. Actual sanitary conditions have been found to be below the standards stipulated by the Japanese government as per international guidelines. Food aid in evacuation shelters was neither nutritionally balanced, nor was the distribution to different shelters balanced. Furthermore, evacuees with chronic diseases feared that there may be a shortage of medication. Crowding in evacuation shelters increased the risk of outbreaks of infectious diseases (e.g., tuberculosis). Malnutrition and shortage of medication exacerbated the risk of deterioration of chronic diseases (e.g., diabetes mellitus, hypertension) among evacuees. Therefore, it is recommended that healthcare professionals should be promptly deployed to evacuation shelters, to promote sanitary control and education, as well as address limited space availability, and food and medication shortage.

Reports on progress in physics the complex dynamics of earthquake fault systems: new approaches to forecasting and nowcasting of earthquakes

Charles Richter's observation that 'only fools and charlatans predict earthquakes,' reflects the fact that despite more than 100 years of effort, seismologists remain unable to do so with reliable and accurate results. Meaningful prediction involves specifying the location, time, and size of an earthquake before it occurs to greater precision than expected purely by chance from the known statistics of earthquakes in an area. In this context, 'forecasting' implies a prediction with a specification of a probability of the time, location, and magnitude. Two general approaches have been used. In one, the rate of motion accumulating across faults and the amount of slip in past earthquakes is used to infer where and when future earthquakes will occur and the shaking that would be expected. Because the intervals between earthquakes are highly variable, these long-term forecasts are accurate to no better than a hundred years. They are thus valuable for earthquake hazard mitigation, given the long lives of structures, but have clear limitations. The second approach is to identify potentially observable changes in the Earth that precede earthquakes. Various precursors have been suggested, and may have been real in certain cases, but none have yet proved to be a general feature preceding all earthquakes or to stand out convincingly from the normal variability of the Earth's behavior. However, new types of data, models, and computational power may provide avenues for progress using machine learning that were not previously available. At present, it is unclear whether deterministic earthquake prediction is possible. The frustrations of this search have led to the observation that (echoing Yogi Berra) 'it is difficult to predict earthquakes, especially before they happen.' However, because success would be of enormous societal benefit, the search for methods of earthquake prediction and forecasting will likely continue. In this review, we note that the focus is on anticipating the earthquake rupture before it occurs, rather than characterizing it rapidly just after it occurs. The latter is the domain of earthquake early warning, which we do not treat in detail here, although we include a short discussion in the machine learning section at the end.

Prevalence and Characteristics of Earthquake-Related Head Injuries: A Systematic Review

OBJECTIVE

We conducted a systematic review to determine the prevalence and characteristics of earthquake-associated head injuries for better disaster preparedness and management.

METHODS

We searched for all publications related to head injuries and earthquakes from 1985 to 2018 in MEDLINE and other major databases. A search was conducted using "earthquakes," "wounds and injuries," and "cranio-cerebral trauma" as a medical subject headings.

RESULTS

Included in the analysis were 34 articles. With regard to the commonly occurring injuries, earthquake-related head injury ranks third among patients with earthquake-related injuries. The most common trauma is lower extremity (36.2%) followed by upper extremity (19.9%), head (16.6%), spine (13.1%), chest (11.3%), and abdomen (3.8%). The most common earthquake-related head injury was laceration or contusion (59.1%), while epidural hematoma was the most common among inpatients with intracranial hemorrhage (9.5%) followed by intracerebral hematoma (7.0%), and subdural hematoma (6.8%). Mortality rate was 5.6%.

CONCLUSION

Head injuries were found to be a commonly occurring trauma along with extremity injuries. This knowledge is important for determining the demands for neurosurgery and for adequately managing patients, especially in resource-limited conditions.