Global risk of big earthquakes has not recently increased

The recent elevated rate of large earthquakes has fueled concern that the underlying global rate of earthquake activity has increased, which would have important implications for assessments of seismic hazard and our understanding of how faults interact. We examine the timing of large (magnitude M≥7) earthquakes from 1900 to the present, after removing local clustering related to aftershocks. The global rate of M≥8 earthquakes has been at a record high roughly since 2004, but rates have been almost as high before, and the rate of smaller earthquakes is close to its historical average. Some features of the global catalog are improbable in retrospect, but so are some features of most random sequences--if the features are selected after looking at the data. For a variety of magnitude cutoffs and three statistical tests, the global catalog, with local clusters removed, is not distinguishable from a homogeneous Poisson process. Moreover, no plausible physical mechanism predicts real changes in the underlying global rate of large events. Together these facts suggest that the global risk of large earthquakes is no higher today than it has been in the past.     

Psychology of earthquake-induced stress cardiomyopathy, myocardial infarction and non-cardiac chest pain

Aims: To compare psychological factors in patients presenting to hospital with earthquake‐induced stress cardiomyopathy, myocardial infarction (MI) and non‐cardiac chest pain. We hypothesised that patients with stress cardiomyopathy and non‐cardiac chest pain would be more psychologically vulnerable than those with MI. Methods: Cardiology admitting staff in the week following the September 2010 Christchurch earthquake prospectively identified patients with earthquake‐precipitated chest pain. Males were excluded. All consenting women met diagnostic criteria for one of the three conditions. Patients underwent a semistructured interview with a senior clinical psychologist who was blind to the cardiac diagnosis. Premorbid psychological factors, experience of the earthquake and psychological response were assessed using a range of validated tools. Results: Seventeen women were included in the study, six with stress cardiomyopathy, five with MI and six with non‐cardiac chest pain. Earthquake experiences were notably similar across the groups. Patients with non‐cardiac chest pain scored high on the hospital anxiety and depression scale, the health anxiety questionnaire, the Eysenck neuroticism scale and the Impact of Event scale. Women with stress cardiomyopathy scored as the most psychologically robust. Depression and extroversion scores were the same across groups. Conclusion: Our hypothesis was incorrect. Women with non‐cardiac chest pain following an earthquake have higher anxiety and neuroticism scores than women with either MI or stress cardiomyopathy. Stress cardiomyopathy following an earthquake is not specific to psychologically vulnerable women. The psychology of natural disaster‐induced stress cardiomyopathy may differ from that of sporadic cases.     

Lessons from the 2015 earthquake(s) in Nepal: implication for rehabilitation

Purpose: There has been an increase in the number of natural disasters in recent history, and the rate of disability is increasing among survivors. The most recent major natural disaster was the earthquake(s) that occurred in Nepal on 25 April 2015 and 12 May 2015. In total, more than 8500 people were killed and over 18?500 people were left injured. This article aims to demonstrate the role of rehabilitation professionals in post-disaster relief and beyond in Nepal. Method: This is an experiential account of physiotherapists present during the earthquake and participating in the post-disaster relief. Results: Rehabilitation professionals played an important role in the acute phase post-disaster by providing essential services and equipment. However, discharge planning emerged as an important role for rehabilitation providers in the early days of post-disaster and signaled a relatively new and innovative function that facilitated the heavy imbalance between little supply and tremendous demand for care. In the coming years, rehabilitation will need to support local initiatives that focus on minimizing the long-term effects among people with a newly acquired disability. Conclusions: Rehabilitation serves an important role across the continuum in post-disaster relief from the initial stages to the months and years following an event.

• Implications for Rehabilitation

• Driven by medical advances in acute field medicine, the relative proportion of casualties following natural disasters is decreasing, while relative rates of disability are rising among survivors.

• In post-disaster settings, the growing number of people with newly acquired disabilities will be added to the existing proportion of the population who lived with disabilities, creating a significant growth in the total number of people with disabilities (PWDs) in communities that are often ill prepared to provide necessary services.

• Rehabilitation interventions in the initial stages of emergency humanitarian response can minimize the long-term effects among people with newly acquired disabilities through early activation and prevention of secondary effects.

• Rehabilitation providers thus appear to have an important mediating effect on outcomes of disabilities in the early stages, but must also be strong partners with PWDs to advocate for social and political change in the long term.

     

抗震救灾行动中卫生装备保障能力建设的分析与研究

目的:分析抗震救灾行动中卫生装备保障的特点,思考提升卫生装备保障能力的主要对策.方法:总结灾区救援环境恶劣、对自我保障能力要求高、保障任务繁重、工作重点突出、形势复杂、协同配合难度大、人员受限、技术配备要求高等特点,分析研究相应对策.结果:卫生装备保障队伍应当加强装备配备,完善物资管理,加强应急训练,提高保障能力.结论:研究和思考抗震救灾行动中卫生装备保障能力建设具有很强的现实意义.     

《基层地震灾害紧急救援队能力分级测评》地方标准研究与编制

地震应急救援能力评估是一个多内容、多层次、多环节的系统工程,我国开展应急救援能力评估的时问较短,大部分研究还处于理论探索阶段,尚未形成成熟和稳定的理论框架与评估模型.根据我国的地震应急救援实际来看,我国地震应急管理系统的评估工作还很薄弱,特别缺乏对地震救援队救援能力进行细化研究.但是,大量丰富且适用的评估决策理论为地震...     

Antimicrobial susceptibility of clinical isolates from earthquake victims in Wenchuan

On 12 May 2008, an earthquake measuring 8.0 on the Richter scale struck Wenchuan County, Sichuan, China. Between 12 May and 11 June, 1823 victims were hospitalized in West China Hospital. These patients were severely injured, and most of their wounds were contaminated. Here, the results of bacteriological identification and antibiotic susceptibility testing of 725 non-duplicate isolates from earthquake victims are presented. Gram-negative bacilli were most frequently isolated (71.3%). Only 18.9% of isolates were Gram-positive bacteria; Candida spp. accounted for 9.7%, and Gram-negative cocci for 0.1%. After anaerobic culture, four Clostridium sordellii strains and one Clostridium bifermentans strain were isolated from deep wounds. Specimen culture from earthquake victims revealed a spectrum of pathogens and antibiotic susceptibilities that was different from that usually encountered in West China Hospital, especially concerning methicillin-resistant Staphylococcus aureus , extended-spectrum β-lactamase producers, and multidrug-resistant (MDR) non-fermenting Gram-negative bacilli. The pathophysiology of the injuries in earthquake victims was different from that in the patients who were not earthquake victims. A combination of environmental bacteria with a high proportion of Gram-negative bacteria was often observed in the earthquake victims. Approximately 26% of all earthquake victims were shown to be carriers of MDR microorganisms. Therefore, appropriate microbiological assessment upon admission, and identification of patients to be put in quarantine, is of paramount importance.     

特大地震灾害后平武南坝镇应急卫生快速评估分析

目的了解特大地震后重灾区主要公共卫生问题和需求，确定救灾防疫工作重点和干预策略。方法采用访谈法和调查法，了解当地概况、历史疫情、卫生资源、震灾影响、群众安置、人畜尸体处理、饮用水卫生、饮食卫生、环境卫生、疾病监测体系、灾民与救援部队人员健康状况、卫生处置以及外部需求等，对灾区现场进行全面快速卫生学评估。结果评估结果表明，特大地震灾害后，平武县南坝镇生态环境被破坏；卫生资源受重创且运行困难；环境卫生条件恶化；蝇密度高；生活饮用水、食品卫生存在较大隐患；疾病监测体系亟待建立：急需外部专业防疫力量的援助。结论特大地震灾区初始阶段，生活饮用水、食品卫生与环境消杀以及完善的症状监测体系是确保大灾之后无大疫的关键环节。     

A case of recurrent earthquake stress cardiomyopathy with a differing wall motion abnormality

We present the case of a Caucasian woman who survived two major earthquakes, presenting on each occasion with stress cardiomyopathy, but with a different pattern of regional wall motion abnormality on the second occasion. The first Christchurch earthquake struck on September 4, 2010. At 7.1 on the Richter scale, it was larger than the major Haiti quake, but miraculously there were no direct fatalities. In the week following, eight women meeting modified Mayo criteria for stress cardiomyopathy presented to Christchurch Hospital. The second Christchurch earthquake was on February 22, 2011. It measured 6.4 on the Richter scale and caused 180 direct fatalities. In the week following this earthquake, 24 women were admitted with stress cardiomyopathy. One patient presented after both earthquakes. This 76-year-old woman first presented on September 4 with 10 hours of chest pain. Electrocardiogram showed inferolateral deep T-wave inversion and QT prolongation. TnI peaked at 0.81 μg/L. Coronary angiography demonstrated diffuse atheroma with a moderate mid LAD lesion that was stented at the time. Echocardiography showed a classic takotsubo pattern. Her follow-up echocardiogram on September 28 was normal and she was completely well at that point. However, during the second earthquake of February 22, she again developed chest pain and shortness of breath. TnI peaked at 1.3 μg/L. Echocardiogram showed a midwall variant takotsubo with apical sparing. She was discharged from hospital on the 25th, planning to leave Christchurch for a new home in another city, but returned for follow-up echocardiogram on July 27. This was normal.     

Risk factors for the development of PTSD and depression among child and adolescent victims following a 7.4 magnitude earthquake

Objective. PTSD and major depression occur frequently following traumatic exposure, both as separate disorders and concurrently. Although much of Turkey is under threat of severe earthquakes, risk factors for developing psychiatric disorders among Turkish children have not yet been studied. The aim of the study was to examine risk factors for PTSD and depression develpoment in children. Method. A total of 160 survivors (102 girls and 58 boys) severely impacted by Turkey's 7.4-magnitude quake participated in a psychiatric interview 6–20 weeks after the disaster. The mean age was 14.43. Logistic regression was used to test effects of pre-disaster, disaster-related and post-disaster factors on diagnoses, yielding odds ratios (OR). Results. CAPS indicated that 96 (60%) had PTSD, and psychiatric interview found 49 (31%) with depression. Children diagnosed with PTSD were more likely to have witnessed death (OR=2.47) and experienced an extreme parental reaction (OR=3.45). Children with depression were more likely to be male (OR=4.48), have a higher trait anxiety score (OR=1.12 for every additional point), sustain injury (OR=4.29), and have lost a family member in the quake (OR=10.96). Focusing on the 96 children with PTSD, those with comorbid depression were more likely male, have a higher trait anxiety score, and have lost of family member. Conclusions. Mental health professionals should offer support to children witnessing death or losing a family member in a disaster. The ability of the family to remain calm and reassuring also may be a key factor in preventing PTSD.     

地震伤员外科救治医护人员的压力水平和特质应对方式

目的:探讨在地震灾害发生后的早期,救治伤员的外科医护人员的压力水平及特质应对方式。方法:在汶川大地震后第14天,方便选取成都市参加收治地震伤员的某医院外科医护人员37名,同期选取某医院精神科医护人员44名为对照组,用自制地震相关问题筛查表、心理健康自评问卷及特质应对方式问卷进行测查。结果:外科医护人员的心理健康自评问卷和消极应对方式因子得分均高于对照组[(9.3±4.7)vs.(3.2±3.9),(29.8±6.2)vs.(26.1±7.1),均P0.05];外科医护人员的心理健康自评问卷得分与消极应对因子得分呈正相关(r=0.50,P=0.002);外科医护人员年龄与急性应激水平正相关(R2=0.168,P=0.012)。结论:震后外科医护人员有较高水平的急性应激反应,尤其以年长者、具有消极应对倾向者为甚,建议加强医疗资源的合理调配和心理知识宣传,以提高外科医护人员自身心理健康水平。