Floods and human health : a systematic review

Floods are the most common type of disaster globally, responsible for almost 53,000 deaths in the last decade alone (23:1 low- versus high-income countries). This review assessed recent epidemiological evidence on the impacts of floods on human health. Published articles (2004–2011) on the quantitative relationship between floods and health were systematically reviewed. 35 relevant epidemiological studies were identified. Health outcomes were categorized into short- and long-term and were found to depend on the flood characteristics and people's vulnerability. It was found that long-term health effects are currently not well understood. Mortality rates were found to increase by up to 50% in the first year post-flood. After floods, it was found there is an increased risk of disease outbreaks such as hepatitis E, gastrointestinal disease and leptospirosis, particularly in areas with poor hygiene and displaced populations. Psychological distress in survivors (prevalence 8.6% to 53% two years post-flood) can also exacerbate their physical illness. There is a need for effective policies to reduce and prevent flood-related morbidity and mortality. Such steps are contingent upon the improved understanding of potential health impacts of floods. Global trends in urbanization, burden of disease, malnutrition and maternal and child health must be better reflected in flood preparedness and mitigation programs.

Outsourcing and cutting choice in private hospital menus – does it impact on patient foodservice satisfaction?

Patient satisfaction with foodservices is multidimensional. It is well recognised that food and other aspects of foodservice delivery are important elements of patients overall perception of the hospital experience. This study aimed to determine whether menu changes in 2008 at an acute private hospital, considered negative by the dietetic staff, would affect patient satisfaction with the foodservice. Changes to the menu, secondary to the refurbishment of the foodservice facilities decreased the number of choices at breakfast from six to four, and altered the dessert menu to include a larger proportion of commercially produced products. The Acute Care Hospital Foodservice Patient Satisfaction Questionnaire (ACHFPSQ) was utilised to assess patient satisfaction with the menu changes, as it has proven accuracy and reliability in measuring patient satisfaction. Results of the survey (n=306) were compared to data with previous ACHFPSQ surveys conducted annually since 2003. Data analysed included overall foodservice satisfaction and four dimensions of foodservice satisfaction: food quality, meal service quality, staff/service issues and the physical environment. Satisfaction targets were set at 4 (scale 1–5) for each foodservice dimension. Analysis showed that despite changes to the menu, overall foodservice satisfaction rated high, with a score of 4.3. Eighty-six percent of patients rated the foodservice as either ‘very good’ or ‘good’. The four foodservice dimensions were rated highly (4.2–4.8). Findings were consistent with previous survey results, demonstrating a high level of patient satisfaction across all dimensions of the foodservice, despite changes to the menu. The annual ACHFPSQ was of value to this practice question.

Implications of lipid biology for the pathogenesis of schizophrenia

Objective: Preclinical and clinical data suggest that lipid biology is integral to brain development and neurodegeneration. Both aspects are proposed as being important in the pathogenesis of schizophrenia. The purpose of this paper is to examine the implications of lipid biology, in particular the role of essential fatty acids (EFA), for schizophrenia. Methods: Medline databases were searched from 1966 to 2001 followed by the crosschecking of references. Results: Most studies investigating lipids in schizophrenia described reduced EFA, altered glycerophospholipids and an increased activity of a calcium-independent phospholipase A2 in blood cells and in post-mortem brain tissue. Additionally, in vivo brain phosphorus-31 Magnetic Resonance Spectroscopy (31P-MRS) demonstrated lower phosphomonoesters (implying reduced membrane precursors) in first- and multi-episode patients. In contrast, phosphodiesters were elevated mainly in first-episode patients (implying increased membrane breakdown products), whereas inconclusive results were found in chronic patients. EFA supplementation trials in chronic patient populations with residual symptoms have demonstrated conflicting results. More consistent results were observed in the early and symptomatic stages of illness, especially if EFA with a high proportion of eicosapentaenoic acid was used. Conclusion: Peripheral blood cell, brain necropsy and 31P-MRS analysis reveal a disturbed lipid biology, suggesting generalized membrane alterations in schizophrenia. 31P-MRS data suggest increased membrane turnover at illness onset and persisting membrane abnormalities in established schizophrenia. Cellular processes regulating membrane lipid metabolism are potential new targets for antipsychotic drugs and might explain the mechanism of action of treatments such as eicosapentaenoic acid.

Assessment of the health impacts of the 2011 summer floods in Brisbane

Background: During December 2010 and January 2011, torrential rainfall in Queensland resulted in the worst flooding in over 50 years. We carried out a community-based survey to assess the health impacts of this flooding in the city of Brisbane. Methods: A community-based survey was conducted in 12 flood-affected electorates using postal questionnaires. A random sample of residents in these areas was drawn from electoral rolls. Questions examined sociodemographic information, the direct impact of flooding on the household, and perceived flood-related health impacts. Outcome variables included perceived flood-related effects on overall and respiratory health, along with mental health outcomes measured by psychosocial distress, reduced sleep quality and probable post-traumatic stress disorder (PTSD). Multivariable logistic regression was used to examine the association between flooding and health outcome variables, adjusted for current health status and socioeconomic factors. Results: 3000 residents were invited to participate in this survey, with 960 responses (32%). People whose households were directly impacted by flooding had a decrease in perceived overall health (OR 5.3, 95% CI: 2.8–10.2), along with increases in psychological distress (OR 1.9, 1.1–3.5), decreased sleep quality (OR 2.3, 1.2–4.4), and probable PTSD (OR 2.3, 1.2–4.5). Residents were also more likely to increase usage of both tobacco (OR 6.3, 2.4–16.8) and alcohol (OR 7.0, 2.2–22.3) after flooding. Conclusions: There were significant impacts of flood events on residents’ health, in particular psychosocial health. Improved support strategies may need to be integrated into existing disaster management programs to reduce flood-related health impacts.

Court Based Psychiatric Assessment: A Case for an Integrated and Diversionary Public Health Role

This article describes a follow-up study of 232 individuals who underwent psychiatric assessment by a Criminal Justice Mental Health Team (CJMHT) in 2001/2002, and also draws upon in-depth interviews conducted with 26 of the cohort. At assessment many people are identified with substance misuse problems, as homeless and with a history of psychiatric contact but in the main their problems are of insufficient severity to merit diversion to psychiatric hospital. The study mapped service contact, housing and offending in the 12 months following assessment and compared this to the 12 months prior to assessment, and found increased levels of service contact but also increased levels of offending and no decrease in homelessness. Thus assessment by the CJMHT brought few discernible advantages for the majority of clients. This was also the perception of the 26 clients who were interviewed. Their own perceptions of their lifestyle and the support that they deemed most valuable are described to identify means of enhancing the efficacy of court assessment.

Green Exercise in the UK Countryside: Effects on Health and Psychological Well-being and Implications for Policy and Planning

There is evidence that contact with the natural environment and green space promotes good health. It is also well known that participation in regular physical activity generates physical and psychological health benefits. The authors have hypothesised that ‘green exercise’ will improve health and psychological well-being, yet few studies have quantified these effects. This study measured the effects of 10 green exercise case studies (including walking, cycling, horse-riding, fishing, canal-boating and conservation activities) in four regions of the UK on 263 participants. Even though these participants were generally an active and healthy group, it was found that green exercise led to a significant improvement in self-esteem and total mood disturbance (with anger-hostility, confusion-bewilderment, depression-dejection and tension-anxiety all improving post-activity). Self-esteem and mood were found not to be affected by the type, intensity or duration of the green exercise, as the results were similar for all 10 case studies. Thus all these activities generated mental health benefits, indicating the potential for a wider health and well-being dividend from green exercise. Green exercise thus has important implications for public and environmental health, and for a wide range of policy sectors.

Health status and use of health services among recently arrived men with refugee backgrounds: A comparative analysis of urban and regional settlement in South-east Queensland

Approximately one-third of refugee and humanitarian entrants to Australia are adult men. Many of these men and their families settle in regional areas. Little is known about the health status of refugee men and the use of health services, and whether or not there are differences between those living in urban and regional areas. This paper reports on the cross-sectional differences in health status and use of health services among a group of 233 recently arrived refugee men living in urban and regional areas of South-east Queensland. Overall, participants reported good levels of subjective health status, moderate to good levels of well-being, and low prevalence of mental illness. Men living in urban areas were more likely to have a longstanding illness and report poorer health status than those settled in regional areas. In contrast, men living in regional areas reported poorer levels of well-being in the environment domain and were more likely to visit hospital emergency departments. Targeted health promotion programs will ensure that refugee men remain healthy and develop their full potential as members of the Australian community. Programs that facilitate refugees’ access to primary health care in regional areas may promote more appropriate use of hospital emergency departments by these communities.

Amphiphilic silicone archtectures via anaerobic thiol - ene chemistry

Despite broad application, few silicone-based surfactants of known structure or, therefore, surfactancy have been prepared because of an absence of selective routes and instability of silicones to acid and base. Herein the synthesis of a library of explicit silicone-poly(ethylene glycol) (PEG) materials is reported. Pure silicone fragments were generated by the B(C(6)F(5))(3)-catalyzed condensation of alkoxysilanes and vinyl-functionalized hydrosilanes. The resulting pure products were coupled to thiol-terminated PEG materials using photogenerated radicals under anaerobic conditions.