地震前后汶川映秀镇居民卫生防疫意识调查

目的:研究地震前和地震后15 d、30 d汶川映秀镇居民卫生防疫意识的变化,为开展震后群众防疫工作提供科学依据.方法:自行设计卫生防疫意识调查表,对灾民进行问卷调查,应用χ2检验决定差异显著性. 结果:完成有效问卷121份.统计表明震后映秀灾民接受卫生宣教的人数显著增加(P=0.000).理想的饮用水源由震前的山泉水和自来水转变为瓶装水和山泉水.认为粪便应该灭蝇处理的人比例显著上升(P=0.001).认为生活垃圾应该掩埋或焚烧的比例以及便后应洗手的比例都显著上升.当可能出现疫情时,选择提醒他人注意或积极上报的意识较震前显著上升(P=0.001).多数居民选择使用药物喷洒进行蚊蝇防制.对自身疾病关注度加大,等待医疗队送医送药或自己随意服药的意识加强. 结论:映秀镇居民在震后经过卫生宣教后卫生防疫意识较震前提高,但对医疗和消毒服务有过度依赖.     

Stress imparted by the great 2004 Sumatra earthquake shut down transforms and activated rifts up to 400?km away in the Andaman Sea

The origin and prevalence of triggered seismicity and remote aftershocks are under debate. As a result, they have been excluded from probabilistic seismic hazard assessment and aftershock hazard notices. The 2004 M = 9.2 Sumatra earthquake altered seismicity in the Andaman backarc rift-transform system. Here we show that over a 300-km-long largely transform section of the backarc, M≥4.5 earthquakes stopped for five years, and over a 750-km-long backarc section, the rate of transform events dropped by two-thirds, while the rate of rift events increased eightfold. We compute the propagating dynamic stress wavefield and find the peak dynamic Coulomb stress is similar on the rifts and transforms. Long-period dynamic stress amplitudes, which are thought to promote dynamic failure, are higher on the transforms than on the rifts, opposite to the observations. In contrast to the dynamic stress, we calculate that the mainshock brought the transform segments approximately 0.2 bar (0.02 MPa) farther from static Coulomb failure and the rift segments approximately 0.2 bar closer to static failure, consistent with the seismic observations. This accord means that changes in seismicity rate are sufficiently predictable to be included in post-mainshock hazard evaluations.     

地震后野外条件下医疗救治围手术期麻醉管理

目的:总结地震后野外条件下医疗救治的围手术期麻醉管理经验.方法:回顾分析长海医院抗震救灾医疗队在野外条件下实施的89例患者麻醉临床资料,总结围手术期麻醉管理经验.结果:气管插管全麻1例,氯胺酮咪达唑仑静脉麻醉复合局部麻醉16例,硬膜外阻滞59例,臂丛神经阻滞13例.所有患者均平稳度过围手术期,无明显呼吸抑制,血流动力学稳定,未出现少尿等并发症.结论:在野外条件下实施麻醉,以保证安全、减少患者痛苦和精神创伤、减少麻醉并发症为原则,麻醉方法的选择需因人而异、合理应用.     

灾后防疫非朝夕之功，科学防疫是重中之重

地震灾后传染病的流行受基础设施被破坏的程度、地理和气候等自然因素和人为因素的影响.水源污染、病媒密度增加、环境卫生恶劣以及当地及输入性病原体是地震后消化道、虫媒和呼吸道传染病的主要危险因素.灾区防疫工作应针对传染源、传播途径和易感人群等3个关键环节展开.同时应重视过度"消杀灭"对生态环境的破坏.对灾民进行卫生教育和重建当地卫生防疫力量是长期控制疫病的关键.本文以映秀灾区防疫工作为基础,就目前灾后防疫工作存在的问题进行分析,并提出了10条建议,供后期防疫工作借鉴.     

基于城市现代化特点的破坏性地震应急医学救援面临的困难与对策

目的旨在分析城市现代化进程特点及给应急医学救援带来的困难,进而研究城市破坏性地震灾害应急医学救援对策措施。方法通过文献回顾、史料查阅、访谈座谈等方式查找破坏性地震下城市应急医学救援体系遭遇的医疗资源挤兑等困境。结果在城市人口密度极大、城市交通网络发达等特点下,遭遇破坏性地震给应急医学救援带来批量伤病员、转运受阻,指挥不畅等困难。结论提出通过加强应急医学救援队伍建设、充分利用民间力量,提高空中医疗救援力量建设、加强群众的自救互救能力以及注重舆情造成的社会信任危机等措施应对城市破坏性地震应急医学救援对策建议。     

地震灾害后患者的营养护理方法与技巧探讨

目的探讨地震伤患者的营养护理方法与技巧。方法对我院收治的1934例地震伤患者,进行持续不断的营养评估、诊断、计划、实施和检测,并及时修正营养计划与措施,实施个体化的营养护理。结果1934例地震伤患者经过合理的营养支持护理后,体重减轻6例,营养不良3例,切口感染1例,尿路感染1例。其余1923例营养状况良好,无并发症发生。结论科学合理的营养护理方法和技巧,可直接影响地震伤患者转归,促进伤口愈合,减少并发症及致残率和死亡率。     

Early psychological distress among sufferers after the 2011 Northern Nagano Prefecture Earthquake

We surveyed 3078 sufferers in Tsunan (Niigata), an intermediate and mountainous area of Japan, after the 2011 Northern Nagano Prefecture Earthquake. More subjects reported fear of the earthquake or related anxiety symptoms and insomnia in Tsunan than in the control group. Female sex and older age were found to be risk factors for poor psychological outcome. Those with risk factors should be carefully followed up.     

The impact of the Canterbury earthquakes on successful school leaving for adolescents

Objective : To examine the impact of the Canterbury earthquakes on the important adolescent transition period of school leaving. Method : Local and national data on school leaving age, attainment of National Certificate of Educational Achievement (NCEA) standards, and school rolls (total registered students for schools) were examined to clarify long‐term trends and delineate these from any impacts of the Canterbury earthquakes.  Results : Despite concerns about negative impacts, there was no evidence for increased school disengagement or poorer academic performance by students as a consequence of the earthquakes. Conclusion : Although there may have been negative effects for a minority, the possibility of post‐disaster growth and resilience being the norm for the majority meant that negative effects on school leaving were not observed following the earthquakes. A range of post‐disaster responses may have mitigated adverse effects on the adolescent population. Implications for Public Health : Overall long‐term negative effects are unlikely for the affected adolescent population. The results also indicate that similar populations exposed to disasters in other settings are likely to do well in the presence of a comprehensive post‐disaster response.     

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.