Health Risks in Disaster Responders: A Conceptual Framework

2019 ◽  
Vol 34 (02) ◽  
pp. 209-216
Author(s):  
Jyoti Khatri ◽  
Gerard Fitzgerald ◽  
Meen B. Poudyal Chhetri

Introduction:Disasters cause severe disruption to socio-economic, infrastructural, and environmental aspects of community and nation. While the impact of disasters is strongly felt by those directly affected, they also have significant impacts on the mental and physical health of relief/recovery workers and volunteers. Variations in the nature and scale of disasters necessitate different approaches to risk management and hazard reduction during the response and recovery phases.Method:Published articles (2010-2017) on the quantitative and quantitative relationship between disasters and the physical and mental health of relief/recovery workers and volunteers were systematically collected and reviewed. A total of 162 relevant studies were identified. Physical injuries and mental health impacts were categorized into immediate, short-term, and chronic conditions. A systematic review of the literature was undertaken to explore the health risks and injuries encountered by disaster relief workers and volunteers, and to identify the factors contributing to these and relating mitigation strategies.Results:There were relatively few studies into this issue. However, the majority of the scrutinized articles highlighted the dependence of nature and scope of injuries with the disaster type and the types of responders, while the living and working environment and socio-economic standing also had significant influence on health outcomes.Conclusion:A conceptual framework derived from the literature review clearly illustrated several critical elements that directly or indirectly cause damage to physical and mental health of disaster responders. Pre-disaster and post-disaster risk mitigation approaches may be employed to reduce the vulnerability of both volunteers and workers while understanding the identified stressors and their relationships.Khatri KC J, Fitzgerald G, Poudyal Chhetri MB. Health risks in disaster responders: a conceptual framework. Prehosp Disaster Med. 2019;34(2):209–216

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Odone ◽  
B Frascella ◽  
G Vigezzi ◽  
G Gaetti ◽  
V Gianfredi

Abstract Population ageing presents both challenges and opportunities for societies around the world. Increasing statutory retirement age and limiting exits to early retirement are frequent policy responses to population ageing, but this is unlikely to have the desired impact if the complex relationships that link work, retirement and health remains unknown. In this context, we designed and are currently conducting the multi-partner project on pension reforms and spatial-temporal patterns in healthy ageing, funded by Fondazione Cariplo. The project involves a multi-disciplinary research team from University Vita-Salute San Raffaele, Bocconi University and the Unit of Epidemiology of the Regional Health Service of ASL TO3. In this first presentation we will first describe the project design, its general aim and specific objectives, then we will present a proposed conceptual framework on the association between retirement and health and its determinants. The framework is the first deliverable of the project and is the results of a comprehensive review of the available evidence and consultation with experts in the field. In particular we conducted a scoping review to retrieve, pool and critically appraise the relevant evidence on the impact of retirement and transition to retirement on physical and mental health and their determinants. We summarized the evidence collected in a conceptual framework that attempt to quantify how health and retirement are bi-directionally linked, how health is central to the timing of retirement, how labor-associated determinants condition employment cessation, how and retirement have varying effects on risk factors for physical and mental health and the role of confounding factors and mediators. Towards the end of the presentation we will outline an extensive stakeholder mapping carried out for the purposes of the project at the national and European level


2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e49-e49
Author(s):  
Sarah Gander ◽  
Sarah Campbell ◽  
Kate Flood ◽  
Bryn Robinson

Abstract Background It is well-documented that children facing social disparities, trauma and toxic stress will experience a disproportionate number of negative physical and mental health outcomes across their lifespan. A common manifestation of this is the increasing prevalence of behaviour-related diagnoses in school-aged children. Regardless of whether a child suffers from a true behaviour disorder, or if they are displaying symptoms that relate to complex and challenging social conditions, they require a thoughtful, collaborative and inclusive approach to their care. Community Social Pediatrics adopts such an approach. Objectives The objective of the current study is to examine and understand the experiences of children and their families during the referral and treatment process for pediatric behavioural referrals in our local region. We will also explore the perspective of service providers on the challenges and strengths of the current system. Design/Methods A focus group (n=8) using semi-structured group interviews was conducted with caregivers whose children were in various stages of care/treatment regarding behavorial issues in the region surrounding Saint John, NB. Questions focused on: experiences in the system; efficacy of services; the child’s experience; wait times; and system cohesion. Qualitative thematic analysis was used to analyze the data. Through a strategic planning exercise (n=26), we were able to engage service providers and experts in this area to delineate the challenges and strengths that they perceive in the current system, and to provide insights they have into working with families. Results The major themes identified by families were defined by positive interactions, negative interactions, barriers, their own behavioural responses to the system and the impact on the child. Families’ positive experiences were associated with respectful and effective communication, integrated wrap-around services, assistance with navigation, and a child-centred approach. Negative experiences were rooted in feeling stigmatized by service providers, lack of communication between service providers, and inadequate mental health services for children. A number of system and personal barriers were identified. The service providers echoed these issues: provide equitable and efficient access to services; understand the needs of the family; strengthen relationships with partners and clients; and create a supportive working environment. Conclusion Consultation with families and service providers identified a number of issues in how children access and engage with community services. Community Social Pediatrics seeks to impact health at the community level and addresses the needs of children in a way that reflects the social context of their lives, community and society. Assessment and care procedures that are delivered through this model aim to remove barriers, reduce fragmentation and increase collaboration and communication across the entire care team.


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044463
Author(s):  
Danielle Borg ◽  
Kym Rae ◽  
Corrine Fiveash ◽  
Johanna Schagen ◽  
Janelle James-McAlpine ◽  
...  

IntroductionThe perinatal–postnatal family environment is associated with childhood outcomes including impacts on physical and mental health and educational attainment. Family longitudinal cohort studies collect in-depth data that can capture the influence of an era on family lifestyle, mental health, chronic disease, education and financial stability to enable identification of gaps in society and provide the evidence for changes in government in policy and practice.Methods and analysisThe Queensland Family Cohort (QFC) is a prospective, observational, longitudinal study that will recruit 12 500 pregnant families across the state of Queensland (QLD), Australia and intends to follow-up families and children for three decades. To identify the immediate and future health requirements of the QLD population; pregnant participants and their partners will be enrolled by 24 weeks of gestation and followed up at 24, 28 and 36 weeks of gestation, during delivery, on-ward, 6 weeks postpartum and then every 12 months where questionnaires, biological samples and physical measures will be collected from parents and children. To examine the impact of environmental exposures on families, data related to environmental pollution, household pollution and employment exposures will be linked to pregnancy and health outcomes. Where feasible, data linkage of state and federal government databases will be used to follow the participants long term. Biological samples will be stored long term for future discoveries of biomarkers of health and disease.Ethics and disseminationEthical approval has been obtained from the Mater Research Ethics (HREC/16/MHS/113). Findings will be reported to (1) QFC participating families; (2) funding bodies, institutes and hospitals supporting the QFC; (3) federal, state and local governments to inform policy; (4) presented at local, national and international conferences and (5) disseminated by peer-review publications.


2021 ◽  
pp. 014303432110250
Author(s):  
Celeste Simões ◽  
Anabela C. Santos ◽  
Paula Lebre ◽  
João R. Daniel ◽  
Cátia Branquinho ◽  
...  

Resilience is an individual’s ability to adapt successfully to and persevere during and after significant challenges. Resilience programmes based on a socioemotional learning approach have been associated with an increase in protextive factors (e.g., prosocial competencies), improvements in physical and mental health, and a decrease in internalised and externalised symptoms. The present study aimed to evaluate the impact of the RESCUR curriculum implemented in Portuguese schools on students’ academic, behavioural, and socioemotional outcomes, based on child and teacher reports. Participants included 1,084 children (53.2% male) aged 3-15 ( M = 7.24, SD = 2.31). A quasi-experimental study compared outcomes for an experimental intervention group (AIG) with a waiting list control group (WG). The results showed the RESCUR programme decreased mental health difficulties while increasing both prosocial behaviours and well-being. In addition, academic performance increased for those in preschool after implementation. Both teachers and children consistently reported positive behavioural changes in resilience-related competencies after implementing RESCUR. Our findings contribute to the recent research on the potential of RESCUR to address key socioemotional competencies and improve relevant protextive factors. Study limitations and future recommendations are addressed.


Author(s):  
Emily Shoesmith ◽  
Lion Shahab ◽  
Dimitra Kale ◽  
Daniel S. Mills ◽  
Catherine Reeve ◽  
...  

The coronavirus disease 2019 (COVID-19) pandemic presents an opportunity to explore the role of animals as sources of emotional and physical support during a period when most of the population is experiencing social and environmental challenges. We investigated how companion animal owners perceived the influence of human–animal interaction on their physical and mental health during the first COVID-19 lockdown phase in the U.K., and what concerns they had regarding their animals at this time. We also explored the impact of participants’ interaction with non-companion animals during this phase. A cross-sectional online survey of U.K. residents aged over 18 was conducted between April and June 2020. The final item of the survey invited open-ended free-text responses, allowing participants to describe any experiences and/or perceptions of their human–animal relationships during the COVID-19 lockdown phase. A qualitative thematic analysis of responses was undertaken. Four main themes related to the following aspects of human–animal interactions during the COVID-19 lockdown phase were identified: the positive impact of animal ownership during the COVID-19 lockdown (e.g., amelioration of wellbeing and mental health), concerns relating to animal ownership during the COVID-19 lockdown (e.g., concerns over animals carrying the COVID-19 virus), grief and loss of an animal during the COVID-19 lockdown and the impact of engaging with non-companion animals during the COVID-19 lockdown. The findings complement and extend previous insights into the impact of human–animal interaction with both companion and non-companion animals. They also highlight the challenges of caring for an animal during the lockdown phase and indicate the need to consider the development of further targeted support strategies, such as “day care” for the companion animals of key workers in this context.


Author(s):  
Patricia Nayna Schwerdtle ◽  
Kate Baernighausen ◽  
Sayeda Karim ◽  
Tauheed Syed Raihan ◽  
Samiya Selim ◽  
...  

Background: Climate change influences patterns of human mobility and health outcomes. While much of the climate change and migration discourse is invested in quantitative predictions and debates about whether migration is adaptive or maladaptive, less attention has been paid to the voices of the people moving in the context of climate change with a focus on their health and wellbeing. This qualitative research aims to amplify the voices of migrants themselves to add nuance to dominant migration narratives and to shed light on the real-life challenges migrants face in meeting their health needs in the context of climate change. Methods: We conducted 58 semi-structured in-depth interviews with migrants purposefully selected for having moved from rural Bhola, southern Bangladesh to an urban slum in Dhaka, Bangladesh. Transcripts were analysed using thematic analysis under the philosophical underpinnings of phenomenology. Coding was conducted using NVivo Pro 12. Findings: We identified two overarching themes in the thematic analysis: Firstly, we identified the theme “A risk exchange: Exchanging climate change and health risks at origin and destination”. Rather than describing a “net positive” or “net negative” outcome in terms of migration in the context of climate change, migrants described an exchange of hazards, exposures, and vulnerabilities at origin with those at destination, which challenged their capacity to adapt. This theme included several sub-themes—income and employment factors, changing food environment, shelter and water sanitation and hygiene (WaSH) conditions, and social capital. The second overarching theme was “A changing health and healthcare environment”. This theme also included several sub-themes—changing physical and mental health status and a changing healthcare environment encompassing quality of care and barriers to accessing healthcare. Migrants described physical and mental health concerns and connected these experiences with their new environment. These two overarching themes were prevalent across the dataset, although each participant experienced and expressed them uniquely. Conclusion: Migrants who move in the context of climate change face a range of diverse health risks at the origin, en route, and at the destination. Migrating individuals, households, and communities undertake a risk exchange when they decide to move, which has diverse positive and negative consequences for their health and wellbeing. Along with changing health determinants is a changing healthcare environment where migrants face different choices, barriers, and quality of care. A more migrant-centric perspective as described in this paper could strengthen migration, climate, and health governance. Policymakers, urban planners, city corporations, and health practitioners should integrate the risk exchange into practice and policies.


2021 ◽  
Vol 33 (2) ◽  
pp. 130-136
Author(s):  
William Cabin

There is significant data on the adverse impact of COVID-19 on persons who were poor, minorities, had compromised physical or mental health, or other vulnerabilities prior to the COVID-19 pandemic. A significant portion of the overall Medicare population has such vulnerabilities. The Medicare home health beneficiary population is even more vulnerable than the overall Medicare population based on gender, race, income level, living alone status, and number of chronic conditions. A literature review indicates there is only 1 study on the impact of COVID-19 in Medicare home health on home care workers and none on the impact on home health beneficiaries. The current study is a qualitative study based on interviews of a convenience sample of 48 home care nurses from 9 different home health agencies in New York City between April 1 and August 31, 2020. Six major themes emerged: need for social service supports increased; loneliness and depression increased among patients; physical and mental health conditions became exacerbated; substance use and abuse increased; evidence of domestic violence against patients increased; and there was a limited amount of staff and equipment to care for patients.


2021 ◽  
Vol 8 (1) ◽  
pp. e000987
Author(s):  
Nicola J Roberts ◽  
Carol A Kelly ◽  
Kate A Lippiett ◽  
Emma Ray ◽  
Lindsay Welch

BackgroundNurses have been at the forefront of the pandemic response, involved in extensive coordination of services, screening, vaccination and front-line work in respiratory, emergency and intensive care environments. The nature of this work is often intense and stress-provoking with an inevitable psychological impact on nurses and all healthcare workers. This study focused on nurses working in respiratory areas with the aim of identifying and characterising the self-reported issues that exacerbated or alleviated their concerns during the first wave of the COVID-19 pandemic.MethodsAn online survey was developed consisting of 90 questions using a mixture of open-ended and closed questions. Participant demographic data were also collected (age, gender, ethnicity, number of years qualified, details of long-term health conditions, geographical location, nursing background/role and home life). The online survey was disseminated via social media and professional respiratory societies (British Thoracic Society, Primary Care Respiratory Society, Association of Respiratory Nurse Specialists) over a 3-week period in May 2020 and the survey closed on 1 June 2020.ResultsThe study highlights the experiences of nurses caring for respiratory patients during the first wave of the pandemic in early 2020. Concerns were expressed over the working environment, the supply and availability of adequate protective personal equipment, the quality of care individuals were able to deliver, and the impact on mental health to nurses and their families. A high number provided free-text comments around their worries and concerns about the impact on their household; these included bringing the virus home, the effect on family members worrying about them, mental health and the impact of changing working patterns, and managing with children. Although both formal and informal support were available, there were inconsistencies in provision, highlighting the importance of nursing leadership and management in ensuring equity of access to services.ConclusionsSupport for staff is essential both throughout the pandemic and afterwards, and it is important that preparation of individuals regarding building resilience is recognised. It is also clear that psychological support and services for nurses and the wider healthcare team need to be available and quickly convened in the event of similar major incidents, either global or local.


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