Stress during the rebuilding phase influenced mental health following two Queensland flood disasters more than the event itself

It has long been known that disasters can have mental health consequences such as increased rates of PTSD, depression and anxiety. While some research has shown that secondary stressors during the aftermath of a disaster can influence psychological outcomes, this aspect of the disaster experience has not been widely studied. This paper reports on two studies that investigated which aspects of the experience of being flooded were most predictive of mental health outcomes. The first study was a qualitative study of adults whose homes had been inundated in the Mackay flood of 2008 (n=16). Thematic analysis of interviews conducted 18-20 months post-flood found that stressors during the flood aftermath such as difficulties and delays during the rebuilding process and a difficult experience with an insurance company were nominated as the most stressful aspect of the flood by the majority of participants. The second study surveyed Mackay flood survivors three and a half years post-flood, and Brisbane 2011 flood survivors 7-9 months post-flood (n=158). Findings indicated aftermath stress contributed to mental health outcomes over and above the contribution of perceived trauma, objective flood severity, prior mental health, self-efficacy and demographic factors. The implications of these results for the provision of community recovery services following natural disasters are discussed, including the need to provide effective targeting of support services throughout the lengthy rebuilding phase; a possible role for co-ordinating tradespeople; and training for insurance company staff aimed at minimising the incidence of insurance company staff inadvertently adding to disaster victims’ stress.

Cold water immersion: Practices, trends and avenues of effect

Cold water immersion and ice baths are popular methods of recovery used by athletes. From the simple wheelie bin with water and ice, to the inflatable baths with complex water cooling units to recovery sessions in the ocean, the practice of cold water immersion is wide and varied. Research into cold water immersion was conducted as early as 1963 when Clarke1 examined the influence of cold water on performance recovery after a sustained handgrip exercise. Research has been conducted to understand how cold water immersion might affect the body’s physiological systems and how factors such as water temperature and the duration of immersion might enhance recovery after training and/or competition. Despite this research activity, how are we to know if research is being put into practice? In more serious situations, where guidelines and policies need to be standardised for the safe use of a product, one would expect that there is a straight forward follow-on from research into practice. Although cold water immersion may not need the rigor of testing compared to drug treatments, for example, the decision on whether to use cold water immersion in specific situations (e.g. after training or competition) may rest with one or two of the staff associated with the athlete/team. Therefore, it would be expected that these staff are well-informed on the current literature regarding cold water immersion.

Designing environments for recovery

There’s growing evidence that psychosis is linked to the physical environments that we live in. Good environments are the ones that allow people to step back, relax and feel secure, while engaging in interesting and meaningful activity. Bad environments don’t allow respite: they keep people on their toes and somehow magnify meaninglessness and hollow rules and unreasonable demands. They may also be bleak and even unfair or outright scary. But don’t expect everyone to notice the bad environments: recent studies demonstrate that patients with psychosis are far more likely to notice even subtle negative features in the environment than people without symptoms. The same patients are also less likely to notice the good things an environment has to offer – but that doesn’t mean they shouldn’t be provided.

Recovery after an Ironman triathlon: Sustained inflammatory responses and muscular stress

Ultra-endurance exercise, such as an Ironman triathlon, induces muscle damage and a systemic inflammatory response. As the resolution of recovery in these parameters is poorly documented, we investigated indices of muscle damage and systemic inflammation in response to an Ironman triathlon and monitored these parameters 19 days into recovery. Blood was sampled from 42 well-trained male triathletes 2 days before, immediately after, and 1, 5 and 19 days after an Ironman triathlon. Blood samples were analyzed for hematological profile, and plasma values of myeloperoxidase (MPO), polymorphonuclear (PMN) elastase, cortisol, testosterone, creatine kinase (CK) activity, myoglobin, interleukin (IL)-6, IL-10 and high-sensitive C-reactive protein (hs-CRP). Immediately post-race there were significant (P < 0.001) increases in total leukocyte counts, MPO, PMN elastase, cortisol, CK activity, myoglobin, IL-6, IL-10 and hs-CRP, while testosterone significantly (P < 0.001) decreased compared to prerace. With the exception of cortisol, which decreased below prerace values (P < 0.001), these alterations persisted 1 day post-race (P < 0.001; P < 0.01 for IL-10). Five days post-race CK activity, myoglobin, IL-6 and hs-CRP had decreased, but were still significantly (P < 0.001) elevated. Nineteen days post-race most parameters had returned to prerace values, except for MPO and PMN elastase, which had both significantly (P < 0.001) decreased below prerace concentrations, and myoglobin and hs-CRP, which were slightly, but significantly higher than prerace. Furthermore, significant relationships between leukocyte dynamics, cortisol, markers of muscle damage, cytokines and hs-CRP after the Ironman triathlon were noted. This study indicates that the pronounced initial systemic inflammatory response induced by an Ironman triathlon declines rapidly. However, a low-grade systemic inflammation persisted until at least 5 days post-race, possibly reflecting incomplete muscle recovery.

Factors influencing vulnerability and positive post-disaster response following the Mackay 2008 and Brisbane 2011 floods

This project investigated which aspects of being flooded most affected mental health outcomes. It found that stress in the aftermath of the flood, during the clean-up and rebuilding phase, including stress due to difficulties with insurance companies, was a previously overlooked risk factor, and social support and sense of belonging were the strongest protective factors. Implications for community recovery following disasters include providing effective targeting of support services throughout the lengthy rebuilding phase; the need to co-ordinate tradespeople; and training for insurance company staff aimed at minimising the incidence of insurance company staff inadvertently adding to disaster victims' stress.

The trajectory of minor stroke recovery for men and their female spousal caregivers: Literature review

Title The trajectory of minor stroke recovery for men and their female spousal caregivers: literature review Aim This paper is a report of a narrative review to examine the current state of knowledge regarding the impact of minor stroke on male patients and their female spousal caregivers’ recovery trajectory and quality of life. Background Minor stroke survivors are often discharged early in the recovery process. The perception of the healthcare community that these patients and their female spousal caregivers will experience an uneventful recovery may lead to inadequate preparation for the postdischarge period. Methods A range of databases was searched to identify papers addressing ‘minor stroke’, ‘transitions’, ‘quality of life’, ‘chronic disease’, ‘caregivers’ and ‘spouse caregivers’, including AARP Ageline, AMED, CINAHL, Evidence Based Medicine Reviews, MEDLINE and PsychInfo. Papers published in English from 1990 to December 2006 were included. Thirty-four papers were in the final data set. Results Minor stroke survivors and their female spousal caregivers may experience major challenges in adaptations postdischarge. The trajectory of minor stroke recovery may necessitate a re-evaluation of life plans, rethinking of priorities and integration of resulting disabilities into current and emerging life situations for both stroke survivors and their female spousal caregivers. In many cases these adaptations are compounded by transitions associated with the normal ageing process. Conclusion While there is extensive literature on stroke recovery and the role of caregivers in general, there is little available describing the recovery of minor stroke survivors in relation to the normal ageing process. Further research is needed examining recovery from a transitional perspective, to support nurses and other health professionals discharge planning.

Does Australia need laws for 'Biotrespass' to protect organic farmers?

The supreme court of Western Australia handed down a landmark decision yesterday, on genetically modified crop liability. The ruling in Marsh v Baxter is an enormous win for the agricultural biotechnology industry, and has disappointed organic farmers and their advocates.

SOTrain: A new program for training supervisors and operators in Australian sugar factories

The provision of effective training of supervisors and operators is essential if sugar factories are to operate profitably and in an environmentally sustainable and safe manner. The benefits of having supervisor and operator staff with a high level of operational skills are reduced stoppages, increased recovery, improved sugar quality, reduced damage to equipment, and reduced OH&S and environmental impacts. Training of new operators and supervisors in factories has traditionally relied on on-the-job training of the new or inexperienced staff by experienced supervisors and operators, supplemented by courses conducted by contractors such as Sugar Research Institute (SRI). However there is clearly a need for staff to be able to undertake training at any time, drawing on the content of online courses as required. An improved methodology for the training of factory supervisors and operators has been developed by QUT on behalf of a syndicate of mills. The new methodology provides ‘at factory’ learning via self-paced modules. Importantly, the training resources for each module are designed to support the training programs within sugar factories, thereby establishing a benchmark for training across the sugar industry. The modules include notes, training guides and session plans, guidelines for walkthrough tours of the stations, learning activities, resources such as videos, animations, job aids and competency assessments. The materials are available on the web for registered users in Australian Mills and many activities are best undertaken online. Apart from a few interactive online resources, the materials for each module can also be downloaded. The acronym SOTrain (Supervisor and Operator Training) has been applied to the new training program.

Predicting the need for adaptive radiotherapy in head and neck cancer

Background and purpose Adaptive radiotherapy (ART) can account for the dosimetric impact of anatomical change in head and neck cancer patients; however it can be resource intensive. Consequently, it is imperative that patients likely to require ART are identified. The purpose of this study was to find predictive factors that identify oropharyngeal squamous cell carcinoma (OPC) and nasopharyngeal carcinoma (NPC) patients more likely to need ART. Materials and methods One hundred and ten patients with OPC or NPC were analysed. Patient demographics and tumour characteristics were compared between patients who were replanned and those that were not. Factors found to be significant were included in logistic regression models. Risk profiles were developed from these models. A dosimetric analysis was performed. Results Nodal disease stage, pre-treatment largest involved node size, diagnosis and initial weight (categorised in 2 groups) were identified as significant for inclusion in the model. Two models were found to be significant (p = 0.001), correctly classifying 98.2% and 96.1% of patients respectively. Three ART risk profiles were developed. Conclusion Predictive factors identifying OPC or NPC patients more likely to require ART were reported. A risk profile approach could facilitate the effective implementation of ART into radiotherapy departments through forward planning and appropriate resource allocation.

Effects of cold water immersion and active recovery on hemodynamics and recovery of muscle strength following resistance exercise

Cold water immersion (CWI) and active recovery (ACT) are frequently used as post-exercise recovery strategies. However, the physiological effects of CWI and ACT after resistance exercise are not well characterized. We examined the effects of CWI and ACT on cardiac output (Q), muscle oxygenation (SmO2) and blood volume (tHb), muscle temperature (Tmuscle ) and isometric strength after resistance exercise. On separate days, 10 men performed resistance exercise, followed by 10 min CWI at 10°C or 10 min ACT (low-intensity cycling). Q (7.9±2.7 l) and Tmuscle (2.2±0.8ºC) increased, whereas SmO2 (-21.5±8.8%) and tHb (-10.1±7.7 μM) decreased after exercise (p<0.05). During CWI, Q ̇(-1.1±0.7 l) and Tmuscle (-6.6±5.3ºC) decreased, while tHb (121±77 μM) increased (p<0.05). In the hour after CWI, Q ̇and Tmuscle remained low, while tHb also decreased (p<0.05). By contrast, during ACT, Q ̇(3.9±2.3 l), Tmuscle (2.2±0.5ºC), SmO2 (17.1±5.7%) and tHb (91±66 μM) all increased (p<0.05). In the hour after ACT, Tmuscle and tHb remained high (p<0.05). Peak isometric strength during 10 s maximum voluntary contractions (MVCs) did not change significantly after CWI, whereas it decreased after ACT (-30 to -45 Nm; p<0.05). Muscle deoxygenation time during MVCs increased after ACT (p<0.05), but not after CWI. Muscle reoxygenation time after MVCs tended to increase after CWI (p=0.052). These findings suggest firstly that hemodynamics and muscle temperature after resistance exercise are dependent on ambient temperature and metabolic demands with skeletal muscle, and secondly, that recovery of strength after resistance exercise is independent of changes in hemodynamics and muscle temperature.

Framework for assessing the influence of critical infrastructure interdependencies in post-disaster reconstruction management

Due to ever increasing climate instability, the number of natural disasters affecting society and communities is expected to increase globally in the future, which will result in a growing number of casualties and damage to property and infrastructure. Such damage poses crucial challenges for recovery of interdependent critical infrastructures. Post-disaster reconstruction is a complex undertaking as it is not only closely linked to the well-being and essential functioning of society, but also requires a large financial commitment. Management of critical infrastructure during post-disaster recovery needs to be underpinned by a holistic recognition that the recovery of each individual infrastructure system (e.g. energy, water, transport and information and communication technology) can be affected by the interdependencies that exist between these different systems. A fundamental characteristic of these interdependencies is that failure of one critical infrastructure system can result in the failure of other interdependent infrastructures, leading to a cascade of failures, which can impede post-disaster recovery and delay the subsequent reconstruction process. Consequently, there is a critical need for developing a holistic strategy to assess the influence of infrastructure interdependencies, and for incorporating these interdependencies into a post-disaster recovery strategy. This paper discusses four key dimensions of interdependencies that need to be considered in a post-disaster reconstruction planning. Using key concepts and sub-concepts derived from the notion of interdependency, the paper examines how critical infrastructure interdependencies affect the recovery processes of damaged infrastructures.

Inter-organisational characteristics of resilience in a post-disaster recovery context

During post-disaster recovery, an infrastructure system may be subject to a number of disturbances originating from several other interdependent infrastructures. These disturbances might result in a series of system failures, thereby having immediate impact on societal living conditions. The inability to detect signs of disturbance from one infrastructure during recovery might cause significant disruptive effects on other infrastructure via the interconnection that exist among them. In such circumstances, it clearly appears that critical infrastructures' interdependencies affect the recovery of each individual infrastructure, as well as those of other interdependent infrastructure systems. This is why infrastructure resilience needs to be improved in function of those interdependencies, particularly during the recovery period to avoid the occurrence of a ‘disaster of disaster’ scenario. Viewed from this perspective, resilience is achieved through an inter-organisational collaboration between the different organisations involved in the reconstruction of interdependent infrastructure systems. This paper suggests that to some extent, the existing degree of interconnectedness between these infrastructure systems can also be found in their resilience ability during post-disaster recovery. For instance, without a resilient energy system, a large-scale power outage could affect simultaneously all the interdependent infrastructures after a disaster. Thus, breaking down the silos of resilience would be the first step in minimizing the risks of disaster failures from one infrastructure to cascade or escalate to other interconnected systems.

Community Resilience: Fostering Recovery, Sustainability, and Growth

In this chapter, the authors define community resilience and identify the components that predict it will occur. Three dimensions are highlighted: recovery, sustainability, and growth. Their discussion focuses on communities like those of Sudanese refugees who have experienced forced migration, emphasizing the importance that community plays to future adaptation. They show through their report on their research that community collaboration, shared identity, and empowerment increase bonding and bridging capital that promote the well-being of people under stress. They argue that an emphasis on community resilience places value on the social connections, policies, programs, and community context necessary for resilience in different cultures and contexts.

Building resilient communities: Creating effective multi-channel communication during disaster response and recovery

Our aim is to examine evidence-based strategies to motivate appropriate action and increase informed decision-making during the response and recovery phases of disasters. We combine expertise in communication, consumer psychology and marketing, disaster and emergency management, and law. This poster presents findings from a social media work package, and preliminary findings from the focus group work package on emergency warning message comprehension.