Psychological effects of earthquakes in children: prospects for brief behavioral treatment

Background  Treatment of child earthquake survivors is a relatively less investigated issue in disaster research. A review of the evidence on the mental health effects of earthquakes, risk factors, and findings from treatment studies may provide useful insights into effective treatment of traumatized children. Data sources  Studies of child and adolescent earthquake survivors included the PILOTS database (electronic index for literature on psychological trauma) and relevant evidence from various studies of adult earthquake survivors. Results  Evidence points to elevated rates of posttraumatic stress disorder (PTSD), depression, and earthquake-related fears in children and adolescents. Traumatic stress appears to be mediated by loss of control over fear induced by exposure to unpredictable and uncontrollable earthquakes. This implies that interventions enhancing sense of control over fear are likely to be most effective. Recent studies indeed show that a control focused behavioral treatment (CFBT) involving mainly encouragement for self-exposure to feared situations is highly effective in facilitating recovery from earthquake trauma. Evidence also suggests that CFBT can be delivered through booklets and similar media. Conclusions  Pilot studies suggest that CFBT has promise in effective treatment of PTSD in children. Further research is needed to confirm these preliminary findings and to develop self-help tools for children.     

汶川大地震后3个月四川省北川和理县6～23月龄婴幼儿的营养状况

目的 调查分析四川省北川、理县两个地震重灾区6～23月龄婴幼儿的营养状况.方法 测量了北川县擂鼓镇、曲山镇和理县杂谷脑镇、薛城镇和朴头乡478名6～23月龄婴幼儿的身长、体重和血红蛋白(Hb)水平,6～11、12～17、18～23月龄段婴幼儿分别为190、144、144名;分别计算年龄别体重(WAZ)、年龄别身长(HAZ)、身长别体重(WHZ);分析低体重率、生长迟缓率、消瘦率、贫血率情况.结果 6～23月龄男童和女童WAZ平均值分别为-0.97～-0.13、-0.67～-0.23,HAZ平均值分别为-1.23～-0.31、-1.25～-0.38;北川18～23月龄婴幼儿的WAZ(-0.89±1.16)和HAZ(-1.20±1.60)与6～11和12～17月龄婴幼儿差异具有统计学意义(WAZ分别为-0.32±0.92、-0.47±1.00,HAZ分别为-0.58±0.98、-0.68±1.34;F值分别为7.161、4.584,P值均＜0.05);理县18～23月龄婴幼儿的WAZ(-0.65±1.03)和HAZ(-1. 11±1.15)与6～11和12～17月龄的婴幼儿的差异具有统计学意义(WAZ分别为-0.23±0.93、-0.58±0.52,HAZ分别为-0.51±1.55、-0.80±1.19;F值分别为3.156、4.345,P值均＜0.05).北川和理县18～23月龄婴幼儿低体重率分别为15.6%(12/77)和9.1%(6/66);生长迟缓率分别为26%(20/77)和24.2%(16/66).北川18～23月龄婴幼儿的消瘦率达到了9.1%(7/77).北川、理县婴幼儿贫血率分别高达49.6%(123/248)和78.8%(178/226).中度贫血率达到7.7%(19/248)和19.9%(45/226).结论 震后北川、理县6～23月龄婴幼儿生长发育状况不佳;贫血率较高.18～23月龄婴幼儿的营养不良更为严重,应采用有针对性的营养干预.     

Risk,science and blood: The politics of the haemophilia crisis in Ireland

With Ireland's blood supply compromised in the 1980s, the impact upon its haemophiliac community was unprecedented. Thus far, academic attention has focused on apportioning blame and identifying administrative failure: what the government knew about Human Immunodeficiency Virus (HIV), Acquired Immune Deficiency Syndrome (AIDS) and Hepatitis C; and when the blood supply was compromised. Our task is to explain why the crisis emerged. We maintain it was not an issue of risk management, but risk assessment. Prior to the 1970s, decisions about risk were refracted through government channels (ministers, civil servants and medico-scientific experts, i.e. the realm of the political/legal). By the 1980s, risk assessment/management were separated and Government was predisposed to accept market decisions (the realm of the economic/legal). Here intervention is recognised as legitimate only if a risk is established and, even then, it must be proportionate. A balance must be struck between competing objectives: safety, innovation, cost, competitiveness and free trade. Crucially, this reform precluded a precautionary approach.     

Increase in West Nile neuroinvasive disease after Hurricane Katrina

After Hurricane Katrina, the number of reported cases of West Nile neuroinvasive disease (WNND) sharply increased in the hurricane-affected regions of Louisiana and Mississippi. In 2006, a >2-fold increase in WNND incidence was observed in the hurricane-affected areas than in previous years.     

Preparing for Disaster: Response Matrices in the USA and UK

Disasters, whether man-made or naturally occurring, require complex responses across multiple government agencies and private sector elements, including the media. These factors mandate that, for effective disaster management and because of the unpredictability of such events, response structures must be in place in advance, ready to be activated on short notice, with lines of responsibility clearly delineated and mechanisms for coordination of efforts already established. Disaster response experiences in the USA and the UK were reviewed at a conference convened by the New York Academy of Medicine and the Royal Society of Medicine in June 2007. Lessons to be drawn from these comparisons were sought. The importance of careful advance planning, clear delineation of spheres of responsibility and response roles, effective mechanisms for communication at all levels, and provision for adequate communication with the public were all identified as key elements of effective response mechanisms.

Tsunami-related injury in Aceh Province,Indonesia

Abstract

The Asian tsunami, of December 2004, caused widespread loss of life. A series of surveys were conducted to assess tsunami-related mortality and injury, risk factors, care seeking and injury outcomes.

Three surveys of tsunami-affected populations, in seven districts of Aceh province, were conducted between March and August 2005. Surveys employed a two-stage cluster design and probability proportional to size sampling methods.

Overall, 17.7% (95% confidence interval (CI)=16.8–18.6) of the population was reported as dead/missing1 1. See Doocy et al. (2007a Doocy, S., Gorokhovich, Y., Burnham, G., Balk, D. and Robinson, C. 2007a. Tsunami mortality estimates and vulnerability mapping in Aceh, Indonesia. American Journal of Public Health, 97(S1): 146–151. [Crossref], [PubMed] , [Google Scholar], b Doocy, S., Rofi, A., Moodie, C., Spring, E., Bradley, S., Burnham, G. and Robinson, C. 2007b. Tsunami mortality in Aceh Province, Indonesia. Bulletin of the World Health Organisation, 85(2): 273–278.  [Google Scholar]) for a complete discussion of tsunami mortality. and 8.5% (95% CI=7.9–9.2) had been injured. Odds of mortality were 1.41% (95% CI=1.27–1.58) times greater in females than in males; risk of injury was opposite, with an odds of injury of 0.81 (95% CI=0.61–0.96) for females in comparison to males. Mortality was greatest among the oldest and young population sub-groups, and injuries were most prevalent among middle-aged populations (20–49). An estimated 25,572 people were injured and 3682 (1.2%) suffered lasting disabilities.

While mortality was particularly elevated among females and among the youngest and oldest age groups, injury rates were the greatest among males and the working-age population, suggesting that those are more likely to survive the tsunami were also more likely to be injured.     

云南突发事件的特点：2007年云南19次突发事件的回顾性分析

目的分析云南省影响较大的突发事件的特点。方法统计和分析2007年云南省卫生厅共处置的19次在云南省内影响较大的突发事件的资料。结果19次影响较大的突发事件中,报告发病4311例,死亡100例,其中公共卫生事件9次（47．37％）,事故灾难6次（31．58％）,自然灾害3次（15．79％）,社会安全事件1次（5．26％）。结论2007年云南省影响较大的突发事件以公共卫生事件为主,事故灾难、自然灾害的危害性也很大。