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On February 6, 2023, a strong earthquake (7.8 Richter scale) shook southwestern Türkiye, and also affected areas in northwest Syria, resulting in over 50 000 fatalities and more than 100 000 injured in Türkiye, in addition to the displacement of approximately 3 million people. In response to an international request for assistance from the Turkish government, the United Kingdom (UK) government deployed an Emergency Medical Team (EMT) Type 1 to provide outpatient care. This report describes the type of medical conditions treated at the facility from 1 week to 3 months post-earthquake. Consultations and diagnoses were recorded using standardized UK EMT patient records and reported through the WHO Minimum Data Set (MDS) format. A total of 7048 patient consultations were documented during the deployment.
The majority of cases involved infectious conditions, primarily respiratory illnesses, rather than trauma. Noncommunicable diseases (NCDs), such as cardiovascular diseases and diabetes, were also prevalent, particularly among adults and older patients. The report outlines some recommendations to better adapt data collection in order to improve EMT preparedness for future earthquake responses.
The scoping review aims to provide an overview of the existing literature to inform an understanding of pharmacists’ roles, skills, and knowledge requirements for Emergency Medical Teams responding to disasters or humanitarian crises.
Methods
The methodology utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines, with methodology adapted by the Joanna Briggs Institute. Six databases were searched for sources published after 2000: PubMed, Mednar, Scopus, Defense Technical Information Centre, LILACS, and CINAHL. A manual search of grey literature was conducted to discover additional sources of information outside of the electronic databases.
Results
Of the 427 initial studies and reports, 36 were selected for inclusion. Five key themes on role requirements were identified: supply chain management; establishment and operationalization of pharmacies; stakeholder communication, collaboration, and liaison; direct patient care; and response management and coordination. Each theme was delineated into subthemes linked with requisite skills and knowledge.
Conclusions
This scoping review identifies key roles, skills, and knowledge requirements of pharmacist contributions to Emergency Medical Teams responding to disasters or emergencies.
This study aims to assess the quality of life (QoL) of earthquake survivors who experienced 2 major earthquakes in Türkiye on February 6, 2023, with different measurement tools.
Methods
The study was conducted in 2 centers with a total of 467 participants. For QoL measurement, face-to-face Euroqol EQ-5D-5L, Euroqol Visual Analog Scale (EQ-VAS), and Nottingham Health Profile (NHP) measurement tools were used.
Results
On the EQ-5D-5L scale, most of the participants stated that they struggled the most with the anxiety/Depression dimension. In NHP, the highest mean score is in the Emotional Reaction section. Females and the 55+ age group were found to have worse QoL. A linear and moderate correlation was found between the EQ-5D-5L index value and the EQ-VAS score; an inverse, weak, or moderate correlation was found between the EQ-VAS score and the sections of the NHP scores; an inverse and strong correlation was found between the Nottingham Health Profile Distress (NHP-D) score and the EQ-5D-5L index value.
Conclusions
The findings obtained with the measurement tools used in this study reveal various dimensions affecting the QoL of different cohorts. In addition, the study provides important evidence for policies to be developed to increase post-earthquake QoL.
This methodological study aimed to adapt the DLS, introduced for individuals aged 18-60 years, to those aged 60 years and older and to determine its psychometric properties.
Methods
We collected the data between December 15, 2021 and April 18, 2022. We carried out the study with a sample of 60 years and older living in the city center of Burdur, Turkey. The sample was selected using snowball sampling, a non-probability sampling technique. We collected the data using a questionnaire booklet covering an 11-item demographic information form and the DLS. We utilized reliability and validity analyses in the data analysis. The analyses were performed on SPSS 23.0, and a P value < 0.05 was considered statistically significant.
Results
The mean age of the participants was found to be 68.29 (SD = 6.36). The 61-item measurement tool was reduced to 57 items by removing a total of 4 items from the scale. We also calculated Cronbach’s α values to be 0.936 for the mitigation/prevention subscale, 0.935 for the preparedness subscale, 0.939 for the response subscale, and 0.945 for the recovery/rehabilitation subscale.
Conclusions
As adapted in this study, the DLS-S can be validly and reliably used for individuals aged 60 years and older.
Treatment interruptions in disaster victims are concerning, owing to an increase in natural disasters and the growing elderly population with chronic conditions. This study examined the temporal trends in treatment interruptions among victims of 2 recent major heavy rain disasters in Japan: West Japan heavy rain in 2018 and Kumamoto heavy rain in 2020.
Methods
Data for this study were derived from the national standardized medical data collection system called the “Japan Surveillance in Post-Extreme Emergencies and Disasters.” Joinpoint regression analysis was performed to examine the daily trends in treatment interruptions reported soon after each disaster onset.
Results
A total of 144 and 87 treatment interruption cases were observed in the heavily affected areas of the West Japan heavy rain in 2018 and Kumamoto heavy rain in 2020, respectively. In both disasters, a high number of treatment interruption cases were observed on the first day after the disaster. Joinpoint regression analysis showed that trends in the percentage of treatment interruptions differed between the 2 disasters at different disaster scales.
Conclusions
The findings suggest the importance of a prompt response to treatment interruptions in the immediate aftermath of a disaster and consideration of the specific characteristics of the disaster when planning for disaster preparedness and response.
A useful way to prepare the public for disasters is to teach them where to get information. The purpose of this study is to evaluate the readability and appropriateness of the content of websites prepared for the public on disaster preparedness.
Methods
In September-October 2022, we evaluated 95 disaster preparedness websites (intended for the public) using the Ateşman Readability Index, JAMA criteria, DISCERN, and a new researcher-created content comparison form. Evaluation scores were compared according to information sources.
Results
Of the websites included in the research, 45.2% represented government institutions (GIG), 38.0% non-profit organizations (NPOG), 8.4% municipal organizations (MOG), and 8.4% other organizations (OG). Those which scored above average on the websites were 36.8% on the content evaluation, 51.6% on the DISCERN scale, 53.7% on the Ateşman Readability Index, and 55.8% on the JAMA criteria. The content evaluation form showed that the scores of the websites belonging to the MOG were higher than the scores of the other websites. Others group websites also scored higher than altered websites on the JAMA criteria.
Conclusions
The study revealed that websites created to increase public knowledge on disaster preparedness are not good enough in terms of readability, quality, and content.
Risk is a central concept in modern regulatory studies. In Chapter 2, the general idea of ’risk’ is introduced. The chapter helps readers grasp its scientific and practical relevance for regulation. The chapter also offers an overview of the importance of risk in scholarly work and policy-making. The chapter emphasizes the extensive and diverse nature of risk studies across different academic disciplines including ’technical’ quantitative methods and sociological critique. It explains how risk identification, risk assessment, and risk management are conventionally understood and highlights their shortcomings and complexities. Additionally, it discusses the trend of ’riskification’ – the tendency to frame a growing number of issues in the language of risk.
This paper delves into the influence of network media on the efficacy of emergency response during natural disasters. Given the frequent occurrence of disasters that pose significant risks to urban areas, effective emergency response mechanisms are paramount. Leveraging the Data Envelopment Analysis (DEA) model, this study assesses disaster response efficiency by analyzing network information. It explores the distinct characteristics of disaster response across different types of natural disasters and their various occurrence stages. To this end, three emblematic disasters are chosen for empirical analysis: the 2021 Zhengzhou heavy rainstorm, the 2022 Super Typhoon Chaba, and the 2022 Luding earthquake. Our findings reveal disparities in response efficiency among these disaster types, with Zhengzhou’s rainstorm response demonstrating the highest efficiency, followed by the Super Typhoon Chaba, and the Luding earthquake yielding the lowest efficiency. Furthermore, this study meticulously discusses the pivotal factors that shape response efficiency, encompassing government decision-making, emergency rescue operations, and social assistance. By pinpointing optimal response strategies tailored to distinct disaster stages, this paper underscores its contribution toward augmenting disaster response efficiency and fostering urban safety and disaster preparedness.
from
Part II
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The Practice of Experimentation in Sociology
Davide Barrera, Università degli Studi di Torino, Italy,Klarita Gërxhani, Vrije Universiteit, Amsterdam,Bernhard Kittel, Universität Wien, Austria,Luis Miller, Institute of Public Goods and Policies, Spanish National Research Council,Tobias Wolbring, School of Business, Economics and Society at the Friedrich-Alexander-University Erlangen-Nürnberg
Vignette experiments are vignettes are brief descriptions of social objects including a list of varying characteristics, on the basis of which survey respondents state their evaluations or judgments. The respondents’ evaluations typically concern positive beliefs, normative judgments, or their own intentions or actions. Using a study on the gender pay gap and an analysis of trust problems in the purchase of used cars as examples, we discuss the design characteristics of vignettes. Core issues are the selection of the vignettes that are included out of the universe of possible combinations, the type of dependent variables, such as rating scales or ranking tasks, the presentation style, differentiating text vignettes from a tabular format, and issues related to sampling strategies.
Floods often displace people and exacerbate their access to finance, affecting the livelihood of daily wage workers in least-developed countries. In August 2017, Nepal experienced the heaviest rainfall in more than 60 years, severely flooding about 80 per cent of the land in the southern part of the country. Using the two-way fixed effects approach and an event study design, we evaluate the impact of severe flooding on the wages of agricultural workers. We show that the 2017 floods resulted in a 9–10 per cent decrease in cash wages among agricultural households while in-kind wages of agricultural laborers increased significantly after the floods, implying that in-kind wages helped mitigate the adverse effects of floods on cash wages. We also investigate changes in assistance, loan-seeking behavior, loan repayment, and collection behavior as mechanisms leading to the risk-mitigating behavior by farmers.
We are members of Students’ Education, Empowerment and Development in Mental Health, a group of medical students and psychiatrists from around the globe under the Psychiatry, Medicine and Primary Care Section of the World Psychiatric Association. In this article, we put forward recommendations to help improve the mental health response in disaster-prone regions such as Türkiye. We recommend a three-step multi-tiered mental health response system that could significantly help to address the immediate, short-term and long-term mental health needs of communities directly affected by a disaster. The recommendation draws from the relevant literature and, most importantly, from our lived experiences of living in earthquake-prone countries.
States of emergency do not only imply a significant change in the balance of powers between the three branches of government, they are also very frequently declared: between 1985 and 2014, at least 137 countries were subject to at least one such event. Our analysis shows that it is crucial to distinguish between states of emergency declared as a consequence of a natural disaster from those declared as a consequence of political turmoil. Distinguishing between the costs of declaring an emergency and its benefits, we find that the less costly it is to declare an emergency, the more emergencies will be called on the grounds of natural disasters but not on the grounds of political turmoil. This is, hence, more evidence that constitutions matter. Finally, emergencies based on political turmoil are more likely to be declared if an economic crisis is hitting the country, large natural disasters are more likely to lead to a state of emergency when more powers are allocated to the legislature, and results suggest that even military coup governments are subject to constitutional constraints.
Previous studies have reported inconsistent findings regarding the association between post-traumatic stress (PTS) and post-traumatic growth (PTG). Three major issues could account for this inconsistency: (1) the lack of information about mental health problems before the disaster, (2) the concept of PTG is still under scrutiny for potentially being an illusionary perception of personal growth and (3) the overlooking of PTS comorbidities as time-dependent confounding factors. To address these issues, we explored the associations of PTS and PTG with trauma-related diseases and examined the association between PTS and PTG using marginal structural models to address time-dependent confounding, considering pre-disaster covariates, among older survivors of the 2011 Japan Earthquake and Tsunami.
Methods
Seven months before the disaster, the baseline survey was implemented to ask older adults about their health in a city located 80 km west of the epicentre. After the disaster, we implemented follow-up surveys approximately every 3 years to collect information about PTS and comorbidities (depressive symptoms, smoking and drinking). We asked respondents about their PTG in the 2022 survey (n = 1,489 in the five-wave panel data).
Results
PTG was protectively associated with functional disability (coefficient −0.47, 95% confidence interval (CI) −0.82, −0.12, P < 0.01) and cognitive decline assessed by trained investigators (coefficient −0.07, 95% CI −0.11, −0.03, P < 0.01) and physicians (coefficient −0.06, 95% CI −0.11, −0.02, P < 0.01), while PTS was not significantly associated with them. Severely affected PTS (binary variable) was associated with higher PTG scores, even after adjusting for depressive symptoms, smoking and drinking as time-dependent confounders (coefficient 0.35, 95% CI 0.24, 0.46, P < 0.01). We also found that an ordinal variable of the PTS score had an inverse U-shaped association with PTG.
Conclusion
PTG and PTS were differentially associated with functional and cognitive disabilities. Thus, PTG might not simply be a cognitive bias among survivors with severe PTS. The results also indicated that the number of symptoms in PTS had an inverse U-shaped association with PTG. Our findings provided robust support for the theory of PTG, suggesting that moderate levels of psychological struggles (i.e., PTS) are essential for achieving PTG, whereas intense PTS may hinder the attainment of PTG. From a clinical perspective, interventions that encourage social support could be beneficial in achieving PTG by facilitating deliberate rumination.
This chapter uses medieval chronicles and annals to explore how river disasters were understood and remembered, and how people chose to tell stories about rivers. A focus on floods brings up issues of risk and resilience, and how floods were interpreted by medieval people. The chapter also focuses on how rivers are connected to other memorable and historic events and why they were such powerful stories. The chapter then turns to the ways that rivers were incorporated into monastic memory and to stories of foundation, and how holy sites were seen as revealed by God and the saints. The chapter ends with a case study focused on St. Sturm and the monastery of Fulda, with a focus on the role of rivers in the house’s history.
This chapter explores the ways that rivers could shift from cultural and economic resource to sites of risk. Beginning with a close reading of the early medieval historian Gregory of Tours, it argues that as a bishop, Gregory saw rivers both as sites of regular and significant economic and cultural risk and of potential religious salvation. This balance between practical and religious response and representation weaves through the chapter, which draws heavily on hagiographical accounts and historical sources to explore cultural constructions of “risk.” Rivers were sources of economic and political instability, and threats to cultural memory and cohesion. Floods, shipwrecks, drought, and other disasters are found throughout medieval narrative, and form the basis of this chapter’s analysis. Finally, this chapter argues that medieval authors also saw rivers as connected to existential threats: the “Flood,” sin, demons, and the dissolution of memory and cultural identity. Paired with these fears, those same rivers became sources of salvation and markers of sanctity.
Climate change is leading to more frequent and intense natural disasters, with developing countries particularly at risk. However, most research concerning mental health and natural disasters is based in high-income country settings. It is critically important to provide a mental health response to such events, given the negative psychosocial impacts they elicit. The aim of this systematic review is to explore the barriers and facilitators to implementing mental health and psychosocial support (MHPSS) following natural disasters in developing countries. Eight databases were searched for relevant quantitative and qualitative studies from developing countries. Only studies reporting barriers and/or facilitators to delivering MHPSS in response to natural disasters in a low- or middle-income country were included and full texts were critically appraised using the McGill University Mixed Methods Appraisal Tool. Reported barriers and facilitators were extracted and analysed thematically. Thirty-seven studies were included in the review, reflecting a range of natural disaster settings and developing countries. Barriers to implementing MHPSS included cultural relevance, resources for mental health, accessibility, disaster specific factors and mental health stigma. Facilitators identified included social support, cultural relevance and task-sharing approaches. A number of practical approaches can be used to facilitate the implementation of MHPSS in developing country settings. However, more research is needed on MHPSS in the developing country natural disaster context, especially in Africa, and international policies and guidelines need to be re-evaluated using a decolonial lens.
Menstruation is part of women’s normal life, which requires basic hygienic practices. Managing hygiene can be affected by several factors and situations such as natural disasters. Focusing on ‘super flooding’ in Pakistan’s Sindh Province, we pay attention to how this ‘natural disaster’ has affected hygienic practices of menstrual cycle of women. The study meticulously examines the dynamics of menstrual hygiene management, encompassing the nuanced encounters with feelings of shame and embarrassment among girls and women situated in flood camps, schools, and community shelters. It also intends to highlight women’s challenge and embarrassment to participate in the distribution process of essential resources such as pads. The insights garnered from this study hold potential relevance for various stakeholders, including policymakers, healthcare practitioners, and researchers, offering a nuanced comprehension of the intersection of menstrual hygiene, climate change, and well-being of women.
This study explored community supervision officers’ perceptions of the individual, community, and organizational challenges confronted by program participants after Hurricane María and their recommendations for future emergency management.
Methods:
A qualitative content analysis was conducted for nine focus group with community supervision officers in Puerto Rico. Participants were asked about their perceptions of how the mental health and drug abuse of persons on parole or probation were affected and the measures taken to address these concerns in disaster response.
Results:
Narratives expose vulnerabilities experienced by those supervised and the aggregated challenges that impact retention in health and rehabilitative services, all of which can detract from successful sentence completion. The disaster response categories call for a more adaptable approach to overseeing procedures in light of the difficulties involved and recognizing the support of the supervised population who have contributed to community initiatives.
Conclusion:
Findings will contribute to informing planning, preparedness, and responses that mitigate the adverse consequences this vulnerable population may experience when exposed to future disaster hazards. Addressing emergency preparedness in this setting provides an opportunity to enact reforms in community supervision and improve access to services needed to enable the successful reintegration of individuals into their communities.
It is often argued that governments take advantage of extreme events to expand their power to the detriment of the political opposition and citizens at large. Violations of constitutional constraints are a clear indication of such opportunistic behaviour. We study whether natural disasters, conflicts and other extreme events systematically diminish governments' compliance with constitutional constraints. Our results indicate that governments are most likely to overstep their competences or disregard their responsibilities during civil conflicts, at the onset of international sanctions or following successful coups d’état. Interestingly, Cold War interventions by the United States that installed or supported a political leader led to a decrease in constitutional compliance in the target country, whereas Soviet interventions had no such effect. In contrast, banking crises and natural disasters, which threaten societies at large, but not necessarily the political elite, do not cause a significant decline in constitutional compliance.
The goal of this nationally representative, cross-sectional study is to evaluate the trends in routine checkup within the last year associated with exposure to a hurricane. We compared Puerto Rico (2017 Hurricane Irma, Hurricane Maria), Texas (2017 Hurricane Harvey), and Florida (2017 Hurricane Irma, Hurricane 2018 Michael) with states that had a category 1-2 hurricane make landfall from 2014 to 2019: Georgia, Louisiana, Mississippi, North Carolina, and South Carolina. We found that states impacted by a major hurricane in 2017 had a drop in routine checkup while the states that experienced a category 1-2 landfall did have a change in that year. By the following year, all states reported an increase in routine checkup suggesting that the disruption in routine care was temporary.