Scoping Review of PTSD Treatments for Natural Disaster Survivors

This scoping review explores the current research on PTSD interventions for Natural Disaster survivors. It includes fourteen randomized control trials (RCTs). The included interventions were, pharmaceuticals, nutraceuticals, herbal supplements, CBT, yoga, narrative exposure therapy, acupuncture stimulation, web-based interventions, and a multimodal art and meditation program. CBT is considered the standard of care for general PTSD treatment and was also found to be effective for the treatment of natural disaster-related PTSD symptoms. However, higher-level clinical evidence is needed. There are inconsistencies with the use of pharmaceuticals, nutraceuticals, and herbal supplements, while there is insufficient clinical evidence to effectively determine the efficacy of yoga, acupuncture, art, and narrative exposure therapies. Factors like the availability of resources, cultural sensitivity, and values and preferences impact the effectiveness of interventions used to treat PTSD in natural disaster survivors. Clinical studies in this field need to be further expanded regardless of the study type.

Climate change as a threat multiplier to environmental reproductive justice

Legacies of racial capitalism and colonialism drive present day racial disparities in perinatal health outcomes. Climate change amplifies existing social inequalities associated with environmental exposures and reproductive health, of which BIPOC (Black, Indigenous, and people of color) communities bear a disproportionate burden. Through case studies, this article summarizes three examples of climate justice issues with reproductive healthcare outcomes: traffic related air pollution exposure, chemical exposures in personal care products and plastics, and natural disaster frequency. We advocate for incorporation of climate justice and environmental health impact into medical school curriculum, increased prenatal screening for environmental toxins, and physician engagement with local environmental issues.

Parental Influence on Child Mental Health Post-Hurricane Harvey

Purpose

Many children who face natural disasters experience significant mental health consequences. Parents play a prominent role in the likelihood of child mental health outcomes after a weather-related disaster. This study aimed to examine the relationship between parent risk factors and children's psychological well-being post Hurricane Harvey.

Methods

Parents (n = 140) completed a survey that measured hurricane exposure, parental depression and anxiety, parenting behaviors, and assistance given and received during or after Hurricane Harvey. Additionally, parents were asked to complete questionnaires assessing one of their children's post-disaster psychosocial functioning and distress.

Results

Results indicated that heightened parent anxiety was significantly associated with an increased risk for emotional symptoms, conduct problems, and hyperactivity-inattention symptoms in children. Additionally, inconsistency in parental discipline was significantly associated with an increased risk of child conduct problems. Further, higher numbers of assistance types received by parents-a proxy indicator of resource loss-was associated with higher child emotional distress scores.

Conclusions

Broader systems-level interventions that address parents' physical and emotional needs may help mitigate maladaptive reactions in children and facilitate greater post-disaster psychosocial adjustment.

Cancer Incidence in Volcanic Areas: A Systematic Review

Background:

There are more than 1,000 active volcanoes worldwide with inhabitants within 100 km of them. Volcanoes spill several toxic metals and spew pollution through gasses, causing soil and water contamination. The dangerously active volcanoes place the nearby population at risk for volcanic hazards. This review aimed to determine whether people living in these volcanic areas have higher risk of cancer and more attention should be given to this danger.

Methods:

A systematic literature search was conducted of PUBMED, Science Direct, SCOPUS, Proquest, and Google Scholar, and from citation searching. We assessed the quality of the studies and extracted the incidence rate of cancer in the volcanic areas compared to non-volcanic areas.

Results:

The search identified 360 articles, with 11 studies meeting our selection criteria. The results reported the incidence of cancer in children was predominantly in volcanic areas with girls suffering as much as 1.4 per 100,000 per year. The highest cancer age standardized incidence rates for females, males, and overall calculation in volcanic areas were reported as 31.7/100,000/year in Catania, 10.34/100,000/year in Furnas, and 38.3/100,000/year in Catania-Messina-Enna for thyroid cancer. We observed the increasing incidence of carcinoma for some types of cancer in volcanic areas.

Conclusion:

Cancer incidence in volcanic areas was higher than non-volcanic areas and it is caused by multifactorial conditions. The concentrations of hazardous elements of volcanic products vary among volcanoes and are related to the harmful risk for the inhabitants. The negative effects of volcanic products to human health should be given more consideration.

Estimation of the National Burden of Disease and Vulnerable Population Associated with Natural Disasters in Korea: Heavy Precipitation and Typhoon

BACKGROUND

Despite its growing significance, studies on the burden of disease associated with natural disasters from the perspective of public health were few. This study aimed at estimating the national burden of disease associated with typhoons and torrential rains in Korea.

METHODS

During the period of 2002-2012, 11 typhoons and five torrential rains were selected. Mortality and morbidities were defined as accentual death, injury and injury-related infection, and mental health. Their incidences were estimated from National Health Insurance Service. Case-crossover design was used to define the disaster-related excess mortality and morbidity. Disability-adjusted life years (DALYs) were directly assessed from excess mortality and morbidity.

RESULTS

The burden of disease from typhoons increased with the intensity, with 107.7, 30.6, and 36.6 DALYs per 100,000 per event for strong, moderate, and weak typhoons, respectively. Burden of disease from torrential rains were 56.9, 52.8, and 26.4 DALYs per 100,000 per event for strong, moderate, and weak episodes, respectively. Mental disorders contributed more years lived with disability (YLDs) than did injuries in most cases, but the injury-induced YLDs associated with strong typhoon and torrential rain were higher than those of lower-intensity. The elderly was the most vulnerable to most types of disaster and storm intensities, and males younger than 65 years were more vulnerable to a strong torrential rain event.

CONCLUSION

The intensity of torrential rain or typhoon was the strongest determinant of the burden of disease from natural disasters in Korea. Population vulnerable may vary depending on the nature and strength of the disasters.

Designing a model of patient tracking system for natural disaster in Iran

CONTEXT

Disaster patient tracking consists of identifying and registering patients, recording data on their medical conditions, settings priorities for evacuation of scene, locating the patients from scene to health care centers and then till completion of treatment and discharge.

AIM

The aim of this study was to design a model of patient tracking system for natural disaster in Iran.

MATERIALS AND METHODS

This applied study was conducted in two steps in 2016. First, data on disaster patient tracking systems used in selected countries were collected from library-printed and electronic references and then compared. Next, a preliminary model of disaster patient tracking system was provided using these systems and validated by Delphi technique and focus group. The data of the first step were analyzed by content analysis and those of the second step by descriptive statistics.

RESULTS

Analysis of the comments of key information persons in three Delphi rounds, consisting of national experts, yielded three themes, i.e., content, function, and technology, ten subthemes, and 127 components, with consensus rate of over 75%, to provide a disaster patient tracking system for Iran.

CONCLUSION

In Iran, there is no comprehensive process to manage the data on disaster patients. Offering a patient tracking system can be considered a humanitarian and effective measure to promote the process of identifying, caring for, evacuating, and transferring patients as well as documenting and following up their medical and location conditions from scene till completion of the treatment.

Cognitive behavioral therapy for young people after l'aquila earthquake

Objective:

Cognitive behavior therapy (CBT) emerges as the best validated therapeutic approach for children and adolescents who experienced trauma-related symptoms, particularly associated with anxiety or mood disorders. The aim of this study was to evaluate the CBT efficacy among young people exposed to L’Aquila earthquake, in 2009.

Methods:

one year after the disaster, 39 young subjects as a case group (CBT treated) and 24 as a comparison group (no CBT treated) were evaluated with the Impact of Event Scale Revised (IES-R), the General Health Questionnaire-12 items (GHQ-12) and the Brief Cope. CBT was conducted in 12 sessions (once per week for 3 months). After CBT intervention, both groups were evaluated again with the same psychometric instruments.

Results:

our results show a significantly decrease in post traumatic symptoms and psychological distress severity in CBT group. It was attributable to an improvement in each of three PTSD dimensions (intrusion, avoidance, and arousal) and in the total score of IES-R (p< 0.04). Among CBT treated group, subjects that adopted “planning/problem solving” coping strategies (p < .02) and “religiosity” (p < .045) show higher improvement in psychological distress.

Conclusions:

our findings show the efficacy of CBT and the influence of individual coping strategies in the improvement of posttraumatic stress symptoms and psychological distress among young people seeking help from an outpatients service for young people with psychiatric problems (the SMILE) after the catastrophic disaster in L’Aquila.

Malnutrition of children in the Democratic People's Republic of North Korea

Natural disasters have caused extensive damage to crops and to infrastructure in the Democratic People's Republic of North Korea (DPRK). The international community has responded by providing emergency food aid. To improve understanding of the magnitude of food deficiency in the DPRK. The World Food Programme (WFP) conducted a nutritional assessment survey in August 1997. The survey measured the height and weight of a total of 3984 children <7 y of age in 40 government-selected institutions. Additional information was obtained on institutional access to food and on the care, treatment and parental support of a subsample of severely malnourished and nonmalnourished children. The prevalence of acute malnutrition (wasting), based on weight-for-height Z-score < -2, varied from 0 to 32.7% among institutions, and the prevalence of chronic malnutrition (stunting), based on height-for-age < -2 Z-score varied from 0.6 to 74.1%. The findings from this survey indicate the presence of areas with severe acute or chronic malnutrition in the DPRK.

Decline in sex ratio at birth after Kobe earthquake

We investigated the possible association between the Kobe earthquake (January 1995) and the sex ratio among live-born infants after the catastrophe. A significant decline in the sex ratio (0.501) of Hyogo Prefecture in October 1995 was observed 9 months after the Kobe earthquake as compared with an expected value of 0.516 in the period from January 1993 to January 1996 (P = 0.04; one-tailed). Simultaneously, a reduction in fertility of approximately 6% was also observed, compared with the month of October 2 years previously. Thus, the acute stress resulting from a great natural catastrophe can be a cause of a low sex ratio at birth 9 months later.

Flood control embankments contribute to the improvement of the health status of children in rural Bangladesh

Every year, Bangladesh experiences major floods that inundate about one-third of the country. Therefore, flood control projects that comprise earthen dikes and irrigation/drainage systems are built along the major rivers to protect the people living in low-lying areas, stabilize the river banks and improve agricultural productivity. However, the adverse effects of these projects are regularly emphasized, such as environmental degradation and reduction of fishing supplies. The Demographic Surveillance System of the International Centre for Diarrhoeal Diseases Research, Bangladesh (ICDDR,B) was used to assess the effect of a flood control programme on the mortality of 0-4-year-old children residing in the Matlab study area. Adjusted mortality rates were used in comparing four adjacent child populations residing either inside or outside a flood-control embankment and according to the type of health services provided in this area. Between the periods 1983-86 and 1989-92, the crude child mortality in the total study area decreased by 37%, from 185.9 per 1000 live births to 117.9 per 1000 live births. Following the construction of the embankment, death rates outside were up to 29% higher in 1-4-year-old children and 9% higher for 0-4-year age group compared to the flood-protected area (P < 0.001). Simultaneously, in the same study area, health interventions contributed to a 40% reduction in mortality among children less than 5 years of age in all causes of deaths (P < 0.001). Migration patterns and the effect of distances to the hospital are discussed.

Breakdown of China's policy of restricting population movement

"A notable distinction between population movement in China and that in other countries is that the former has been regulated by administrative authority.... In this paper, population movement forced by administrative power is referred to as policy-induced movement, whereas that caused by economic factors or disasters is regarded as spontaneous movement....This paper will analyze China's population movement over a forty-five-year period since the early 1950s by comparing policy-induced and spontaneous movement patterns."

Population geography of calamity: the sixteenth and seventeenth century Yucatan

"This historical demography for Yucatan [Mexico] at the time of Spanish contact presents a number of problems. There were multiple Maya-Spaniard contacts before the Spaniards established a continuous presence after the protracted conquest of the Yucatan. The area of Yucatan that was controlled by the Spanish at any one time is not precisely known, and Yucatan offered ¿refuge' areas where the indigenous population could avoid Spanish control and counts. These issues are addressed here by considering different regions of the Yucatan and using a numerical computer simulation to generate new estimates of population that result from migration, warfare, agricultural calamity, and epidemics."

Socio-economic influences on gender inequalities in child health in rural Bangladesh

OBJECTIVE

To investigate gender inequalities in child growth and nutritional status in relation to socio-economic status in Bangladesh.

DESIGN

A 16-month longitudinal study of child growth measuring anthropometric and socio-economic status.

SETTING

A rural area of Jamalpur district, northern Bangladesh.

SUBJECTS

1366 children from 2 to 6 years of age.

METHODS

Child height and weight were measured monthly. Morbidity, food intake and health-seeking behaviours were assessed fortnightly. Multivariable analyses were performed on the growth and nutritional status of male and female children in relation to socio-economic factors including father's occupation, parental education, birth order and family size.

RESULTS

There was no evidence of gender bias in farming and trading/employee households but landless female children had significantly poorer height-for-age (P < 0.001) and weight-for-age (P < 0.001) than their male counterparts. During a period of natural disaster, a statistically significant interaction was observed between father's occupation and sex (P < 0.05) such that the combination of being female and being landless was more detrimental to nutritional status than either variable alone. Over the following 16-months, catch-up-growth was apparent in landless female children who grew significantly more in height-for-age (P < 0.001) and weight-for-age (P < 0.001) than their male counterparts.

CONCLUSIONS

Gender inequalities in health in Bangladesh varied significantly according to occupational status, such that the effect of sex was dependent upon occupation. These effects were statistically significant during the period of natural disaster but became insignificant as local conditions improved. This demonstrates both temporal and socio-economic variation in gender inequalities in health.

A demographic profile of the Marathwada earthquake victims

"[The] Marathwada earthquake, one of the worst natural calamities in India so far, happened to be a factor in the loss of thousands of human and animal lives and the destruction of a vast stretch of natural environment. In this study an attempt has been made to enlist the quake affected victims and to analyse their demographic characteristics in terms of their distribution at district level."

Environmental concerns and international migration

"This article focuses on international migration occurring as a result of environmental changes and processes. It briefly reviews attempts to conceptualize environment-related migration and then considers the extent to which environmental factors have been and may be significant in initiating migration. Following is an examination of migration as an independent variable in the migration-environment relationship. Finally, ethical and policy dimensions are addressed."

[Demographic impact of the Chernobyl nuclear power station disaster]

"The article deals with the impact of the Chernobyl [nuclear] disaster on demographic development of the areas [of Belarus] damaged through the disaster. Data are given related to population size, sex and age population structure, migration, morbidity, mortality and fertility based on monitoring surveys." (SUMMARY IN ENG)

Effects of biosocial variables on changes in nutritional status of rural Bangladeshi children, pre- and post-monsoon flooding

This study examined the effects of biosocial variables on changes in nutritional status of rural Bangladeshi children, aged less than 2 years, pre- and post-1987 monsoon flooding. Nutritional status was measured by weight for age: variables included were age, sex, sickness during 2 weeks preceding the survey, intake of vitamin A capsules, socioeconomic status of household, and mother's education. A multivariate logistic regression analysis revealed an adverse effect of flood on nutrition and the effect was dependent on sex of child and intake of vitamin A. After the flood the proportion of severely malnourished children was significantly greater among those who had not taken vitamin A. For boys the proportion with severe malnutrition increased after the flood and the increase was greater than for girls; however, boys always had a lower risk of severe malnutrition than girls.

The social implications of population displacement and resettlement: an overview with a focus on the Arab Middle East

"Recent decades have witnessed a global increase in the collective displacement of populations as a result of natural disasters, wars and development projects. The social implications of displacement, and its corollary process of resettlement, are explored in this article, with a focus on the Arab world....[The author suggests that] an approach which emphasizes the relation between the causes and consequences of displacement, examines cases in their historical contexts, and selects the appropriate unit of analysis is essential in developing an adequate framework of analysis."

Risk factors for mortality in the Bangladesh cyclone of 1991

Cyclones continue to pose a dangerous threat to the coastal populations of Bangladesh, despite improvements in disaster control procedures. After 138,000 persons died in the April 1991 cyclone, we carried out a rapid epidemiological assessment to determine factors associated with cyclone-related mortality and to identify prevention strategies. A nonrandom survey of 45 housing clusters comprising 1123 persons showed that mortality was greatest among under-10-year-olds (26%) and women older than 40 years (31%). Nearly 22% of persons who did not reach a concrete or brick structure died, whereas all persons who sought refuge in such structures survived. Future cyclone-associated mortality in Bangladesh could be prevented by more effective warnings leading to an earlier response, better access to designated cyclone shelters, and improved preparedness in high-risk communities. In particular, deaths among women and under-10-year-olds could be reduced by ensuring that they are given special attention by families, neighbours, local authorities, and especially those in charge of early warnings and emergency evacuation.

Famine-affected, refugee, and displaced populations: recommendations for public health issues

During the past three decades, the most common emergencies affecting the health of large populations in developing countries have involved famine and forced migrations. The public health consequences of mass population displacement have been extensively documented. On some occasions, these migrations have resulted in extremely high rates of mortality, morbidity, and malnutrition. The most severe consequences of population displacement have occurred during the acute emergency phase, when relief efforts are in the early stage. During this phase, deaths--in some cases--were 60 times the crude mortality rate (CMR) among non-refugee populations in the country of origin (1). Although the quality of international disaster response efforts has steadily improved, the human cost of forced migration remains high. Since the early 1960s, most emergencies involving refugees and displaced persons have taken place in less developed countries where local resources have been insufficient for providing prompt and adequate assistance. The international community's response to the health needs of these populations has been at times inappropriate, relying on teams of foreign medical personnel with little or no training. Hospitals, clinics, and feeding centers have been set up without assessment of preliminary needs, and essential prevention programs have been neglected. More recent relief programs, however, emphasize a primary health care (PHC) approach, focusing on preventive programs such as immunization and oral rehydration therapy (ORT), promoting involvement by the refugee community in the provision of health services, and stressing more effective coordination and information gathering. The PHC approach offers long-term advantages, not only for the directly affected population, but also for the country hosting the refugees. A PHC strategy is sustainable and strengthens the national health development program.

Survival of classic cholera in Bangladesh

During the present cholera pandemic the El Tor biotype of Vibrio cholerae has completely displaced the classic biotype, except in Bangladesh. We studied the distribution of these two biotypes in twenty-four rural districts during epidemics in 1988-89; there was clustering of the classic biotype in the southern region and of the El Tor biotype in all other regions. These findings suggest that the southern coastal region is now (and may always have been) the habitat of classic cholera. The selective distribution of V cholerae O1 biotypes in Bangladesh may have been affected by ecological changes occurring in the country.

Famine and man: lessons from the Irish past, a guide to the future?

"The intention of the present study was to examine such information as is available on the Ethiopian famine of the 1980s, and to compare it with known sequelae of the Irish Famine [of the mid-nineteenth century]. From this comparison it may be possible to determine if features common to all disasters of this nature are identifiable, and ultimately, whether the information gained can be employed to prevent their recurrence and further large-scale loss of life."

Impacts of river bank erosion on population displacement in the lower Brahmaputra (Jamuna) floodplain

"This study has attempted to focus on dimensions and impacts of displacement by river bank erosion in the lower Brahmaputra (Jamuna) floodplain of Bangladesh. Based on a survey of 547 randomly selected households, it was observed that about two thirds of the floodplain inhabitants were displaced at least once in their life time." The socioeconomic consequences are discussed, and implications for development planning are considered.

Spatial patterns of out-migration in Maharashtra: 1961-71

In view of the importance of migration in Maharashtra state. India an attempt is made to identify the areas of out-migration, and to assess the probable causes for it. The analysis is confined to the decade 1961-1971 and based on secondary data, with the taluka as the unit of analysis. The total number of births and deaths in each taluka for the period of study was complied and enabled the natural increase of population to be computed. A comparison of this with the actual increase as indicated by the census made it possible to identify the areas of out-migration. The study revealed that the out-migration talukas were located in 3 areas and that the relative significance of out-migration varied. The analysis indicated that the causes of out-migration were probably unfavorable relief efforts, susceptibility to drought, closure of household industries, and the 'pull' effect of metropolitan centers like Bombay.