Characteristics of Physician Relocation Following Hurricane Katrina

2007 ◽  
Vol 1 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Kusuma Madamala ◽  
Claudia R. Campbell ◽  
Edbert B. Hsu ◽  
Yu-Hsiang Hsieh ◽  
James James
Keyword(s):  
Hurricane Katrina ◽  
Gulf Coast ◽  
General Medicine ◽  
Lessons Learned ◽  
Bivariate Analysis ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Factors Associated ◽  
The Us ◽  
The Impact

ABSTRACTIntroduction: On August 29, 2005, Hurricane Katrina made landfall along the US Gulf Coast, resulting in the evacuation of >1.5 million people, including nearly 6000 physicians. This article examines the relocation patterns of physicians following the storm, determines the impact that the disaster had on their lives and practices, and identifies lessons learned.Methods: An Internet-based survey was conducted among licensed physicians reporting addresses within Federal Emergency Management Agency–designated disaster zones in Louisiana and Mississippi. Descriptive data analysis was used to describe respondent characteristics. Multivariate logistic regression was performed to identify the factors associated with physician nonreturn to original practice. For those remaining relocated out of state, bivariate analysis with χ2 or Fisher exact test was used to determine factors associated with plans to return to original practice.Results: A total of 312 eligible responses were collected. Among disaster zone respondents, 85.6% lived in Louisiana and 14.4% resided in Mississippi before the hurricane struck. By spring 2006, 75.6% (n = 236) of the respondents had returned to their original homes, whereas 24.4% (n = 76) remained displaced. Factors associated with nonreturn to original employment included family or general medicine practice (OR 0.42, 95% CI 0.17–1.04; P = .059) and severe or complete damage to the workplace (OR 0.24, 95% CI 0.13–0.42; P < .001).Conclusions: A sizeable proportion of physicians remain displaced after Hurricane Katrina, along with a lasting decrease in the number of physicians serving in the areas affected by the disaster. Programs designed to address identified physician needs in the aftermath of the storm may give confidence to displaced physicians to return. (Disaster Med Public Health Preparedness. 2007;1:21–26)

Characteristics of Physician Relocation Following Hurricane Katrina

2009 ◽  
Vol 95 (1) ◽  
pp. 6-12
Author(s):  
Kusuma Madamala ◽  
Claudia R. Campbell ◽  
Edbert B. Hsu ◽  
Yu-Hsiang Hsieh ◽  
James James
Keyword(s):  
Hurricane Katrina ◽  
Gulf Coast ◽  
General Medicine ◽  
The United States ◽  
Lessons Learned ◽  
Bivariate Analysis ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Factors Associated ◽  
The Impact

ABSTRACT Introduction: On Aug. 29, 2005, Hurricane Katrina made landfall along the Gulf Coast of the United States, resulting in the evacuation of more than 1.5 million people, including nearly 6000 physicians. This article examines the relocation patterns of physicians following the storm, determines the impact that the disaster had on their lives and practices, and identifies lessons learned. Methods: An Internet-based survey was conducted among licensed physicians reporting addresses within Federal Emergency Management Agency-designated disaster zones in Louisiana and Mississippi. Descriptive data analysis was used to describe respondent characteristics. Multivariate logistic regression was performed to identify the factors associated with physician nonreturn to original practice. For those remaining relocated out of state, bivariate analysis with x2 or Fisher exact test was used to determine factors associated with plans to return to original practice. Results: A total of 312 eligible responses were collected. Among disaster zone respondents, 85.6 percent lived in Louisiana and 14.4 percent resided in Mississippi before the hurricane struck. By spring 2006, 75.6 percent (n = 236) of the respondents had returned to their original homes, whereas 24.4 percent (n = 76) remained displaced. Factors associated with nonreturn to original employment included family or general medicine practice (OR 0.42, 95 percent CI 0.17–1.04; P = .059) and severe or complete damage to the workplace (OR 0.24, 95 percent CI 0.13–0.42; P &lt; .001). Conclusions: A sizeable proportion of physicians remain displaced after Hurricane Katrina, along with a lasting decrease in the number of physicians serving in the areas affected by the disaster. Programs designed to address identified physician needs in the aftermath of the storm may give confidence to displaced physicians to return.

Hurricane Katrina: an environmental perspective

2006 ◽  
Vol 364 (1845) ◽  
pp. 2099-2115 ◽  
Author(s):  
Ewen McCallum ◽  
Julian Heming
Keyword(s):  
Hurricane Katrina ◽  
Observational Studies ◽  
Gulf Coast ◽  
Theoretical Modelling ◽  
Loss Of Life ◽  
The Us ◽  
Hurricane Season ◽  
The Usa ◽  
The Impact ◽  
National Hurricane Center

On 29 August 2005, Hurricane Katrina hit the Gulf Coast of the USA to become one of the worst natural disasters in the country's history. The forecasts and official warnings of the event issued by the US National Hurricane Center up to 60 h ahead were excellent and largely based on an ‘ensemble’ of model and statistical guidance. The Met Office Global Model is highlighted as one of the best performers for Hurricane Katrina. The active 2005 Atlantic hurricane season has fuelled the debate on the impact of climate change on tropical cyclones. Some recent publications have suggested that this impact is already apparent, while others are more cautious. Inconsistencies remain among many of the theoretical, modelling and observational studies. Despite the excellent warnings, there was a tragic loss of life as a result of Hurricane Katrina which has led to political questions concerning complex socio-economic issues, the state of flood defences and how to coordinate the reaction to and mitigate the impact of such monumental natural hazards.

Hospitalization Rates Among Dialysis Patients During Hurricane Katrina

2012 ◽  
Vol 27 (4) ◽  
pp. 325-329 ◽  
Author(s):  
David Howard ◽  
Rebecca Zhang ◽  
Yijian Huang ◽  
Nancy Kutner
Keyword(s):  
Hurricane Katrina ◽  
Large Scale ◽  
Service Use ◽  
Hospital Admissions ◽  
Gulf Coast ◽  
The United States ◽  
Time Varying ◽  
Dialysis Patients ◽  
Hospitalization Rates ◽  
The Impact

AbstractIntroductionDialysis centers struggled to maintain continuity of care for dialysis patients during and immediately following Hurricane Katrina's landfall on the US Gulf Coast in August 2005. However, the impact on patient health and service use is unclear.ProblemThe impact of Hurricane Katrina on hospitalization rates among dialysis patients was estimated.MethodsData from the United States Renal Data System were used to identify patients receiving dialysis from January 1, 2001 through August 29, 2005 at clinics that experienced service disruptions during Hurricane Katrina. A repeated events duration model was used with a time-varying Hurricane Katrina indicator to estimate trends in hospitalization rates. Trends were estimated separately by cause: surgical hospitalizations, medical, non-renal-related hospitalizations, and renal-related hospitalizations.ResultsThe rate ratio for all-cause hospitalization associated with the time-varying Hurricane Katrina indicator was 1.16 (95% CI, 1.05-1.29; P = .004). The ratios for cause-specific hospitalization were: surgery, 0.84 (95% CI, 0.68-1.04; P = .11); renal-related admissions, 2.53 (95% CI, 2.09-3.06); P < .001), and medical non-renal related, 1.04 (95% CI, 0.89-1.20; P = .63). The estimated number of excess renal-related hospital admissions attributable to Katrina was 140, representing approximately three percent of dialysis patients at the affected clinics.ConclusionsHospitalization rates among dialysis patients increased in the month following the Hurricane Katrina landfall, suggesting that providers and patients were not adequately prepared for large-scale disasters.Howard D, Zhang R, Huang Y, Kutner N. Hospitalization rates among dialysis patients during Hurricane Katrina. Prehosp Disaster Med. 2012;27(4):1-5.

scholarly journals Analisis Perbedaan Posisi Meneran Miring Kiri dan Setengah Duduk Pada Ibu Bersalin Dengan Lama Kala II Di RSUD Dr. H. Moch Anshari Saleh Banjarmasin

2019 ◽  
pp. 39-46
Author(s):  
Dewi Pusparani Sinambela ◽  
St. Hateriah
Keyword(s):  
Univariate Analysis ◽  
Data Retrieval ◽  
Bivariate Analysis ◽  
P Value ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Long Time ◽  
Second Stage Labor

Latar Belakang: Lama Kala II dalam persalinan yaitu jangka waktu mulai dari serviks berdilatasi penuh sampai dengan kelahiran bayi tidak boleh melebihi 2 jam pada primigravidan dan 1 jam pada multigravida. Pemilihan posisi melahirkan sangat dianjurkan untuk memberikan rasa nyaman pada ibu, posisi dapat membantu penurunan janin ke dasar panggul dan mempercepat proses persalinan. Dari data yang diperoleh bulan Januari 2018 jumlah persalinan kala II lama sebanyak 0,30% dari 240 persalinan normal.Tujuan: Menganalisis Perbedaan Posisi Meneran Miring Kiri dan Setengah Duduk Pada Ibu Bersalin Dengan Lama Kala II.Metode: Jenis penelitian ini adalah Analisis kuantitatif. Rancangan penelitian menggunakan quasi eksperiment. Populasi penelitian semua ibu bersalin di RSUD Dr. H. Moch Anshari Saleh Banjarmasin. Pengambilan sebanyak 30 responden. Pengambilan data dilakukan dengan menggunakan ceklist. Analisa data yang dilakukan adalah Analisa Univariat dan Analisa Bivariat dengan uji Fisher Exact Test.Hasil: Responden yang menggunakan posisi meneran miring kiri 15 orang (50%) dan setengah duduk sebanyak 15 orang (50%). Jumlah responden primipara yang mengalami persalinan kala II 60 menit sebanyak 12 orang (40,0%), primipara yang mengalami kala II 60 menit sebanyak 2 orang (6,7%) dan responden multipara yang mengalami kala II 30 menit sebanyak 16 orang (53,3%), multipara yang mengalami kala II 30 menit sebanyak 0 orang (0%) dari hasil uji Fisher Exact Test dengan nilai p sebesar 0,483.Simpulan: Tidak ada perbedaan posisi miring kiri dengan posisi setengah duduk terhadap kemajuan persalinan kala II di RSUD Dr. H. Moch. Anshari Saleh Banjarmasin. Kata Kunci: Lama Kala II, Persalinan, Posisi Meneran.   Analysis of Different Left and Half Posisition Straining on Mother with Second Duration of Labour In RSUD Dr. H. Moch Anshari Saleh BanjarmasinABSTRACT Background: The duration of second stage of labor is the period from the full dilated cervix to the birth of the baby should not exceed 2 hours in primigravida and 1 hour in multigravida. Position selection is very beneficial for giving comfort to the mother, the position can help lower the fetus to the pelvic floor and improve labor. From the data obtained in January 2018 the number of prolonged second stage deliveries was 0.30% of 240 normal deliveries.Objective: Analyze the Differences in Position Meniring Left and Half Seated at the Maternity with Long Time II.Method: This type of research is quantitative analysis. The study design used quasi experiment. The study population of all mothers giving birth at Dr. RSUD H. Moch Anshari Saleh Banjarmasin. Taking as many as 30 respondents. Data retrieval is done using a checklist. Data analysis performed was Univariate Analysis and Bivariate Analysis with Fisher Exact Test.Results: Respondents who used the left oblique piercing position were 15 people (50%) and half sat as many as 15 people (50%). The number of primiparous respondents who increased labor at second time 60 minutes was 12 people (40.0%), primipara who added second stage 60 minutes as many as 2 people (6.7%) and multiparous respondents who used second time 30 minutes as many as 16 people (53.3%), multiparas who replaced time II 30 minutes as many as 0 people (0%) from the results of the Fisher Exact Test with a p value of 0.483.Conclusion: There was no difference in left oblique position with sitting position towards the progress of second stage labor in Dr. Hospital. H. Moch. Ansari Saleh Banjarmasin.  Keywords : Second Duration, Labour, Straining Position 

The Library as Lifeboat

2016 ◽  
pp. 494-515 ◽  
Author(s):  
Michael R. Mabe
Keyword(s):  
Emergency Management ◽  
Natural Disasters ◽  
Hurricane Katrina ◽  
Disaster Relief ◽  
Lessons Learned ◽  
Hurricane Irene ◽  
Management Professionals ◽  
Chesterfield County ◽  
The Impact ◽  
Effective Reaction

According to Hurricane Katrina: Lessons Learned (2006), emergency management professionals realized first-hand that preplanning and coordination is essential when mounting an effective reaction to natural disasters. This chapter describes how leaders in Chesterfield County, VA learned similar lessons in 2001 during Hurricane Irene. In comparison to Katrina the amount of damage caused by Irene was minimal but the impact on county leaders was severe. Based on lessons learned during Irene and an unexpected wind storm nine months later, Chesterfield County leaders now include the Chesterfield County Public (CCPL) in their official disaster relief plans. When activated, CCPL will serve as an information hub, double as a daytime relief shelter and participate in mass feeding if necessary. Selected library branches are available to be used as overnight relief shelters for mass care when the activation of a standard sized shelter facility is not warranted. These changes have made a notable difference.

scholarly journals Risk of small for gestational age babies in preterm delivery due to pregnancy-induced hypertension

2019 ◽  
Vol 28 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Rima Irwinda ◽  
Budi Iman Santoso ◽  
Raymond Surya ◽  
Lidia Firmiaty Nembo
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Preterm Births ◽  
Secondary Data ◽  
Large For Gestational Age ◽  
Fisher Exact Test ◽  
Pregnancy Induced Hypertension ◽  
Exact Test ◽  
Induced Hypertension ◽  
The Impact

BACKGROUND Pregnancy-induced hypertension (PIH) causes high maternal morbidity and mortality worldwide. This study aims to assess the impact of PIH on fetal growth according to gestational age in preterm deliveries.METHODS A prospective cohort study using secondary data was undertaken in Ende District, East Nusa Tenggara, Indonesia from September 2014 to August 2015. The t-test was performed to compare mean birth weight based on gestational week between normotensive and PIH women, continued by linear regression. The chi-square or Fisher exact test was also conducted to determine the probability of birthing small for the gestational age (SGA) and large for gestational age (LGA) babies between normotensive and PIH women.RESULTS A total of 1,673 deliveries were recorded in Ende Hospital over the 1-year study period, among which 182 cases involved preterm births. The PIH group had lower birth weight than normotensive women at each gestational age starting from 32–35 weeks (p=0.004; 95% CI 150.84–771.36). Normotensive women at gestational ages of 32 (p=0.05; 95% CI 0.01–0.83), 34 (p=0.37; 95% CI 0.01–4.12), and 36 (p=0.31; 95% CI 0.02–2.95) weeks had a lower risk of birthing SGA babies than PIH women; LGA babies were recorded at gestational ages of 33 (p=1.00; 95% CI 0.07–37.73) and 35 (p=0.31; 95% CI 0.34–63.07) weeks.CONCLUSIONS Poor perfusion of the uteroplacental is one of the reasons behind intrauterine growth restriction, which results in SGA babies born to PIH women.

scholarly journals Attributing differences in the fate of lateral boundary ozone in AQMEII3 models to physical process representations

2018 ◽  
Vol 18 (23) ◽  
pp. 17157-17175
Author(s):  
Peng Liu ◽  
Christian Hogrefe ◽  
Ulas Im ◽  
Jesper H. Christensen ◽  
Johannes Bieser ◽  
...  
Keyword(s):  
Turbulent Mixing ◽  
Dry Deposition ◽  
Gulf Coast ◽  
Vertical Mixing ◽  
Primary Role ◽  
Southeastern Us ◽  
The Us ◽  
Vertical Grid ◽  
Vertical Turbulent Mixing ◽  
The Impact

Abstract. Increasing emphasis has been placed on characterizing the contributions and the uncertainties of ozone imported from outside the US. In chemical transport models (CTMs), the ozone transported through lateral boundaries (referred to as LB ozone hereafter) undergoes a series of physical and chemical processes in CTMs, which are important sources of the uncertainty in estimating the impact of LB ozone on ozone levels at the surface. By implementing inert tracers for LB ozone, the study seeks to better understand how differing representations of physical processes in regional CTMs may lead to differences in the simulated LB ozone that eventually reaches the surface across the US. For all the simulations in this study (including WRF∕CMAQ, WRF∕CAMx, COSMO-CLM∕CMAQ, and WRF∕DEHM), three chemically inert tracers that generally represent the altitude ranges of the planetary boundary layer (BC1), free troposphere (BC2), and upper troposphere–lower stratosphere (BC3) are tracked to assess the simulated impact of LB specification. Comparing WRF∕CAMx with WRF∕CMAQ, their differences in vertical grid structure explain 10 %–60 % of their seasonally averaged differences in inert tracers at the surface. Vertical turbulent mixing is the primary contributor to the remaining differences in inert tracers across the US in all seasons. Stronger vertical mixing in WRF∕CAMx brings more BC2 downward, leading to higher BCT (BCT=BC1+BC2+BC3) and BC2∕BCT at the surface in WRF∕CAMx. Meanwhile, the differences in inert tracers due to vertical mixing are partially counteracted by their difference in sub-grid cloud mixing over the southeastern US and the Gulf Coast region during summer. The process of dry deposition adds extra gradients to the spatial distribution of the differences in DM8A BCT by 5–10 ppb during winter and summer. COSMO-CLM∕CMAQ and WRF∕CMAQ show similar performance in inert tracers both at the surface and aloft through most seasons, which suggests similarity between the two models at process level. The largest difference is found in summer. Sub-grid cloud mixing plays a primary role in their differences in inert tracers over the southeastern US and the oceans in summer. Our analysis of the vertical profiles of inert tracers also suggests that the model differences in dry deposition over certain regions are offset by the model differences in vertical turbulent mixing, leading to small differences in inert tracers at the surface in these regions.

Reaching vulnerable populations in the disaster-prone US Gulf Coast: Communicating across the crisis lifecycle

2019 ◽  
Vol 14 (2) ◽  
pp. 121-136
Author(s):  
Elizabeth L. Petrun Sayers, PhD ◽  
Andrew M. Parker, PhD ◽  
Rajeev Ramchand, PhD ◽  
Melissa L. Finucane, PhD ◽  
Vanessa Parks, MA ◽  
...  
Keyword(s):  
Hurricane Katrina ◽  
Vulnerable Populations ◽  
News Media ◽  
Gulf Coast ◽  
Multinomial Logistic Regression ◽  
Geographic Region ◽  
Unique Challenge ◽  
Response Strategies ◽  
The Us ◽  
Channel Preferences

Delivering risk and crisis communication to US Gulf Coast residents poses a unique challenge to individual and organizational responders. The region has endured several natural and man-made disasters, spanning Hurricane Katrina, the Deepwater Horizon oil spill, and more recently Hurricanes Harvey and Irma. In the future, the US Gulf Coast is expected to remain susceptible to a range of disasters. At the same time, the region is experiencing a growing population, struggles with systemic disparities between residents, and is home to major energy, tourism, fishing, and shrimping industries. Engaging in pre-crisis planning with vulnerable populations, and assessing response strategies, can help the region prepare for future disasters. In support of understanding vulnerabilities in the US Gulf Coast, the authors conducted a survey in 2016 of n = 2,520 adult residents of the targeted geographic region. The authors examine how demographic characteristics affect communication channel preferences (ie, television, Internet, print [newspapers, magazines], radio, word-of-mouth, or another specified channel) and trust in sources (ie, the national news media, local news media, business leaders and organizations, religious leaders and institutions, academics and academic institutions, friends and family, and doctors) in the US Gulf Coast. Weighted prevalence estimates or similar summary statistics (mean, standard deviation) are provided for both outcomes. Findings for channel preferences and trust in sources are examined by sex, race/ethnicity, age, and education. Weighted multinomial logistic regression is used in a multivariate model. Weighted linear regression is used to examine differences in trust in each source of information. Results highlight significant differences in channel preferences and trust across respondents. The authors also place these results in context to more readily accessible national estimates of these outcomes, emphasizing takeaways for the region.

Network-centric emergency response: The challenges of training for a new command and control paradigm

2006 ◽  
Vol 4 (2) ◽  
pp. 57 ◽  
Author(s):  
Lt. Col. Mark Stanovich, USMCR
Keyword(s):  
Emergency Response ◽  
New Technology ◽  
Modern Society ◽  
Armed Forces ◽  
Lessons Learned ◽  
Technological Innovations ◽  
Incident Command ◽  
Us Military ◽  
The Us ◽  
The Impact

The last two decades have seen technological innovations that have revolutionized the collection and transfer of information, permitting access to and dissemination of massive amounts of data with unprecedented speed and efficiency. These innovations have been incorporated into virtually every aspect of modern society, from personal communications, to commercial and business processes, to governmental function and military operations. The concept of network-centric warfare (NCW) grew out of these new capabilities and has been a prominent topic in strategic and operational discussions in the US military since the late 1990s.In recent years, the concepts behind NCW have been increasingly applied to emergency response, particularly as responders prepare for an increasingly complex threat spectrum in a post-9/11 world. As emergency responders adopt the technological innovations and organizational concepts that enable network-centric operations, attention should be paid to the lessons learned by the US armed forces in the application of the network-centric approach to war-fighting. Emergency operations centers (EOCs), incident command centers (ICCs), and field personnel will require extensive training and experimentation to sort out the impact of this new technology. They must develop protocols and procedures to leverage maximum advantage, while avoiding the undesirable and damaging effects of that technology improperly applied. Because most emergency response organizations lack the vast training resources of the US military, they must be innovative and adaptable in taking advantage of every opportunity to train their personnel in the assimilation of this new technology.

scholarly journals HUBUNGAN STATUS OBESITAS TERHADAP HIPERTENSI DI PUSKESMAS SUNGKAI KABUPATEN BANJAR

2018 ◽  
Vol 5 (1) ◽  
pp. 60-68
Author(s):  
Zaleha Zaleha
Keyword(s):  
Public Health ◽  
Waist Circumference ◽  
Health Center ◽  
Bivariate Analysis ◽  
Fisher Exact Test ◽  
Chi Square ◽  
Exact Test ◽  
Public Health Center ◽  
Matched Study ◽  
And Control

Hypertension is becoming more prevalent in Indonesia.The risk of Hypertension increase with the development of obesity. A limited number of studies in Indonesia have examined relationship between obesity indicator and hypertension. The objective of the study conducted to know related between several obesity indicator and hypertension of patients at Sungkai Public Health Center in Banjar District. The study was observasional analityc with case control matched study. Subjects this study consisted of 60 subjects that were collected consecutively and devided into two group, case and control with comparison case and control 1 : 1. Blood pressure. Body Mass Index   (BMI), Waist Circumference (WC) and Waist to Hip Ratio (WHR) were obtained, Chi Square Test or Fisher Exact Test  was used to bivariate analitytic with α = 0,05. The Odds Ratio (OR) was calculated to predict the risk of each obesity indicator to hypertension.This study showed that BMI was significantly related with essensial hypertension in bivariate analysis (OR=3,1). The nonsignificant correlation (p > 0,05) identified for Waist Circumference and Waist Hip Ratio. Obesity indicator related to essential hypertension of patients at Sungkai Public Health Center in Banjar District was BMI

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