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The Enduring Health Challenges of Afghan Immigrants and Refugees in Iran: A Systematic Review

July 21, 2017 · Review

Introduction

Iran is the third country in the world with the highest number of registered refugees with the majority coming from Afghanistan. They suffer major health and social risks yet their health status has never been comprehensively determined.

Methods

This systematic review of the literature highlights major disparities among documented immigrants in health access, communicable and non-communicable diseases and the increasingly desperate plight of undocumented immigrants.

Results

Comparing with Iranian population, the findings suggest the higher prevalence of most diseases among Afghan immigrants and refugees. This highlights the importance of increasing the migrants’ access to health services from both public health as well as human rights perspectives.

Discussion

Although the Iranian government has taken new initiatives to overcome this challenge, certain issues have still remained unaddressed. Potential solutions to improve this process are discussed.

Risk Criteria in Hospital Site Selection: A Systematic Review

May 1, 2017 · Review

Introduction: Hospitals should be safe and remain functional in emergencies and disasters as it is mentioned in the Sendai Framework. Proper selection of a hospital location has a direct effect on survival of affected population in disasters as well as cost and benefit of the hospital in non-emergency situation. Different studies applied different criteria for Hospital Site Selection (HSS). The present study through a systematic review aimed to find out a categorized criteria list that have been used for (HSS) in the literature.

Methods: In accordance with the PRISMA statement, “PubMed”, “ScienceDirect”, “Google Scholar”, and “Scopus” were searched up to end of 2015. All English Articles that were published in peer-reviewed journals and had discussed site selection criteria for hospitals were included. Out of 41 articles, 15 met the inclusion criteria in which 39 general criteria for HSS were applied. These criteria were categorized in six main groups including cost, demand, environmental, administrative, disaster risk, and “other” concerns through a focus group discussion.

Results: Accordingly, the application percentage of cost, demand, environmental, administrative, disaster risk, and “other” concerns in the articles was 100, 93.3, 53.3, 33.3, 20.0, and 13.3 respectively. The least devoted attention was to disaster risk issues.

Discussion: Few researchers applied risk related criteria for HSS. Further consideration of “risk of hazards” and “burden of diseases” in comprehensive studies, is recommended for HSS to guide the decision makers for building more resilient hospitals. Keywords   Hospital, Site selection, Systematic review, Disaster risk

Mass Casualty Decontamination in a Chemical or Radiological/ Nuclear Incident: Further Guiding Principles

September 15, 2016 · Review

This short report presents a response to an article written by Cibulsky et al. (2016). The paper by Cibulsky et al. presents a useful and timely overview of the evidence surrounding the technical and operational aspects of mass casualty decontamination. It identifies three priority targets for future research, the third of which is how casualties’ needs can be met in ways that best support compliance with and effectiveness of casualty decontamination. While further investigation into behavioural, communication and privacy issues during mass decontamination is warranted, there is now a substantial body of research in this area which is not considered in detail in the succinct summary provided by Cibulsky et al. (2016). In this short report, we summarise the available evidence around likely public behaviour during mass decontamination, effective communication strategies, and potential issues resulting from a lack of privacy. Our intention is to help further focus the research needs in this area and highlight topics on which more research is needed.

Leveraging Social Computing for Personalized Crisis Communication using Social Media

March 24, 2016 · Review
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Introduction: The extensive use of social media in modern life redefines social interaction and communication. Communication plays an important role in mitigating, or exacerbating, the psychological and behavioral responses to critical incidents and disasters. As recent disasters demonstrated, people tend to converge to social media during and following emergencies. Authorities can then use this media and other computational methods to gain insights from the public, mainly to enhance situational awareness, but also to improve their communication with the public and public adherence to instructions.

Methods: The current review presents a conceptual framework for studying psychological aspects of crisis and risk communication using the social media through social computing.

Results: Advanced analytical tools can be integrated in the processes and objectives of crisis communication. The availability of the computational techniques can improve communication with the public by a process of Hyper-Targeted Crisis Communication.

Discussion: The review suggests that using advanced computational tools for target-audience profiling and linguistic matching in social media, can facilitate more sensitive and personalized emergency communication.

Availability and Diversity of Training Programs for Responders to International Disasters and Complex Humanitarian Emergencies

June 23, 2014 · Review

Introduction: Volunteers and members of relief organizations increasingly seek formal training prior to international field deployment. This paper identifies training programs for personnel responding to international disasters and complex humanitarian emergencies, and provides concise information – if available- regarding the founding organization, year established, location, cost, duration of training, participants targeted, and the content of each program.

Methods: An environmental scan was conducted through a combination of a peer-reviewed literature search and an open Internet search for the training programs. Literature search engines included EMBASE, Cochrane, Scopus, PubMed, Web of Science databases using the search terms “international,” “disaster,” “complex humanitarian emergencies,” “training,” and “humanitarian response”. Both searches were conducted between January 2, 2013 and September 12, 2013.

Results: 14 peer-reviewed articles mentioned or described eight training programs, while open Internet search revealed 13 additional programs. In total, twenty-one training programs were identified as currently available for responders to international disasters and CHE. Each of the programs identified has different goals and objectives, duration, expenses, targeted trainees and modules. Each of the programs identified has different goals and objectives, duration, expenses, targeted trainees and modules. Seven programs (33%) are free of charge and four programs (19%) focus on the mental aspects of disasters. The mean duration for each training program is 5 to 7 days. Fourteen of the trainings are conducted in multiple locations (66%), two in Cuba (9%) and two in Australia (9%). The cost-reported in US dollars- ranges from $100 to $2,400 with a mean cost of $480 and a median cost of $135. Most of the programs are open to the public, but some are only available by invitation only, such as the International Mobilization Preparation for Action (IMPACT) and the United Nations Humanitarian Civil-Military Coordination (UN-CMCoord) Field Course.

Conclusions: A variety of training programs are available for responders to disasters and complex humanitarian emergencies. These programs vary in their objectives, audiences, modules, geographical locations, eligibility and financial cost. This paper presents an overview of available programs and serves as a resource for potential responders interested in capacity-building training prior to deployment.

The Human Impact of Tsunamis: a Historical Review of Events 1900-2009 and Systematic Literature Review

April 16, 2013 · Review

Introduction.
Although rare, tsunamis have the potential to cause considerable loss of life and injury as well as widespread damage to the natural and built environments. The objectives of this review were to describe the impact of tsunamis on human populations in terms of mortality, injury, and displacement and, to the extent possible, identify risk factors associated with these outcomes. This is one of five reviews on the human impact of natural disasters.

Methods.
Data on the impact of tsunamis were compiled using two methods, a historical review from 1900 to mid 2009 of tsunami events from multiple databases and a systematic literature review to October 2012 of publications. Analysis included descriptive statistics and bivariate tests for associations between tsunami mortality and characteristics using STATA 11.

Findings.
There were 255,195 deaths (range 252,619-275,784) and 48,462 injuries (range 45,466-51,457) as a result of tsunamis from 1900 to 2009. The majority of deaths (89%) and injuries reported during this time period were attributed to a single event –the 2004 Indian Ocean tsunami. Findings from the systematic literature review indicate that the primary cause of tsunami-related mortality is drowning, and that females, children and the elderly are at increased mortality risk. The few studies that reported on tsunami-related injury suggest that males and young adults are at increased injury-risk.

Conclusions.
Early warning systems may help mitigate tsunami-related loss of life.

The Human Impact of Volcanoes: a Historical Review of Events 1900-2009 and Systematic Literature Review

April 16, 2013 · Review

Introduction.
More than 500 million people live within the potential exposure range of a volcano. The risk of catastrophic losses in future eruptions is significant given population growth, proximities of major cities to volcanoes, and the possibility of larger eruptions. The objectives of this review are to describe the impact of volcanoes on the human population, in terms of mortality, injury, and displacement and, to the extent possible, identify risk factors associated with these outcomes. This is one of five reviews on the human impact of natural disasters.

Methods.
Data on the impact of volcanoes were compiled using two methods, a historical review of volcano events from 1900 to 2009 from multiple databases and a systematic literature review of publications ending in October 2012. Analysis included descriptive statistics and bivariate tests for associations between volcano mortality and characteristics using STATA 11.

Findings.
There were a total of 91,789 deaths (range: 81,703-102,372), 14,068 injuries (range 11,541-17,922), and 4.72 million people affected by volcanic events between 1900 and 2008. Inconsistent reporting suggests this is an underestimate, particularly in terms of numbers injured and affected. The primary causes of mortality in recent volcanic eruptions were ash asphyxiation, thermal injuries from pyroclastic flow, and trauma. Mortality was concentrated with the ten deadliest eruptions accounting for more than 80% of deaths; 84% of fatalities occurred in four locations (the Island of Martinique (France), Colombia, Indonesia, and Guatemala).

Conclusions.
Changes in land use practices and population growth provide a background for increasing risk; in conjunction with increasing urbanization in at risk areas, this poses a challenge for future volcano preparedness and mitigation efforts.

The Human Impact of Floods: a Historical Review of Events 1980-2009 and Systematic Literature Review

April 16, 2013 · Review

Background.
Floods are the most common natural disaster and the leading cause of natural disaster fatalities worldwide. Risk of catastrophic losses due to flooding is significant given deforestation and the increasing proximity of large populations to coastal areas, river basins and lakeshores. The objectives of this review were to describe the impact of flood events on human populations in terms of mortality, injury, and displacement and, to the extent possible, identify risk factors associated with these outcomes. This is one of five reviews on the human impact of natural disasters

Methods.
Data on the impact of floods were compiled using two methods, a historical review of flood events from 1980 to 2009 from multiple databases and a systematic literature review of publications ending in October 2012. Analysis included descriptive statistics, bivariate tests for associations and multinomial logistic regression of flood characteristics and mortality using Stata 11.0.

Findings.
There were 539,811 deaths (range: 510,941 to 568,680), 361,974 injuries and 2,821,895,005 people affected by floods between 1980 and 2009. Inconsistent reporting suggests this is an underestimate, particularly in terms of the injured and affected populations. The primary cause of flood-related mortality is drowning; in developed countries being in a motor-vehicle and male gender are associated with increased mortality, whereas female gender may be linked to higher mortality in low-income countries.

Conclusions.
Expanded monitoring of floods, improved mitigation measures, and effective communication with civil authorities and vulnerable populations has the potential to reduce loss of life in future flood events.

The Human Impact of Earthquakes: a Historical Review of Events 1980-2009 and Systematic Literature Review

April 16, 2013 · Review

Introduction.
Population growth and increasing urbanization in earthquake-prone areas suggest that earthquake impacts on human populations will increase in the coming decades. Recent large earthquakes affecting large populations in Japan, Haiti, Chile and New Zealand are evidence of this trend and also illustrate significant variations in outcomes such damage and mortality levels. The objectives of this review were to describe the impact of earthquakes on human populations in terms of mortality, injury and displacement and, to the extent possible, identify risk factors associated with these outcomes. This is one of five reviews on the human impact of natural disasters.

Methods.
Data on the impact of earthquakes were compiled using two methods, a historical review from 1980 to mid 2009 of earthquake events from multiple databases and a systematic literature review of publications, ending in October 2012. Analysis included descriptive statistics and bivariate tests for associations between earthquake mortality and characteristics using STATA 11.

Findings.
From 1980 through 2009, there were a total of 372,634 deaths (range 314,634-412,599), 995,219 injuries (range: 845,345-1,145,093), and more than 61 million people affected by earthquakes, and mortality was greatest in Asia. Inconsistent reporting across data sources suggests that the numbers injured and affected are likely underestimates. Findings from a systematic review of the literature indicate that the primary cause of earthquake-related death was trauma due to building collapse and, the very young and the elderly were at increased mortality risk, while gender was not consistently associated with mortality risk.

Conclusions.
Strategies to mitigate the impact of future earthquakes should include improvements to the built environment and a focus on populations most vulnerable to mortality and injury.

The Human Impact of Tropical Cyclones: a Historical Review of Events 1980-2009 and Systematic Literature Review

April 16, 2013 · Review

Background.
Cyclones have significantly affected populations in Southeast Asia, the Western Pacific, and the Americas over the past quarter of a century. Future vulnerability to cyclones will increase due to factors including population growth, urbanization, increasing coastal settlement, and global warming. The objectives of this review were to describe the impact of cyclones on human populations in terms of mortality, injury, and displacement and, to the extent possible, identify risk factors associated with these outcomes. This is one of five reviews on the human impact of natural disasters.

Methods.
Data on the impact of cyclones were compiled using two methods, a historical review from 1980 to 2009 of cyclone events from multiple databases and a systematic literature review of publications ending in October 2012. Analysis included descriptive statistics and bivariate tests for associations between cyclone characteristics and mortality using Stata 11.0.

Findings.
There were 412,644 deaths, 290,654 injured, and 466.1 million people affected by cyclones between 1980 and 2009, and the mortality and injury burden was concentrated in less developed nations of Southeast Asia and the Western Pacific. Inconsistent reporting suggests this is an underestimate, particularly in terms of the injured and affected populations. The primary cause of cyclone-related mortality is drowning; in developed countries male gender was associated with increased mortality risk, whereas females experienced higher mortality in less developed countries.

Conclusions.
Additional attention to preparedness and early warning, particularly in Asia, can lessen the impact of future cyclones.

Dealing with disaster databases – What can we learn from health and systematic reviews?

October 7, 2011 · Review

There is an increasing move towards facilitating the use of research findings in policy and practice relating to disaster risk reduction and response. One of the key issues is the quality of the evidence available to decision-makers. Disaster databases, as a key resource, represent a tremendous investment of effort and goodwill. However, their usefulness is limited by the variability in how they are compiled, differences in the output they produce, a general lack of comparability and standardization, and the fact that they might produce different results due to the ways they have been created or by chance. One possible solution to this, which has been applied successfully in evidence synthesis in health care is the systematic review. In this study we attempt to show how the systematic review process may be applied to information and data that is held in disaster databases. We demonstrate that systematic reviews of disaster databases can be achieved in a technical sense and the potential value of such reviews, but also discuss the practical difficulties that arise.

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