Altered hippocampal microstructure and function in children who experienced Hurricane Irma.
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SUBMITTER: Conley MI
PROVIDER: S-EPMC8206237 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectivesNursing home residents are especially vulnerable to adverse outcomes after a hurricane. Prior research suggests that emergency department (ED) visits increase among community-residing older adults after natural disasters. However, little is known about the impact of hurricanes on the large population of older adults residing in assisted living (AL) settings, particularly the influence of storms on the rates and causes of ED visits. We examined whether rates of ED use for injuries and other medical reasons increased after Hurricane Irma in 2017 among AL residents in Florida.DesignRetrospective cohort study.Setting and participantsSamples of 30,358 Medicare fee-for-service beneficiaries in 2016 and 28,922 beneficiaries in 2017 who resided in Florida AL communities.MeasuresThe number of injury-related and other medical visits per 1,000 person-days within 30 and 90 days of September 1 in 2016 and 2017. We adjusted for age, race, sex, and chronic conditions using linear regression with AL fixed effects. We compared the top 10 primary diagnoses resulting in an ED visit between 2016 and 2017.ResultsAdjusted rates of injury-related visits were 12.5% higher at 30 days but did not differ at 90 days. Other medical visits were 12% higher at 30 days in 2017 than in 2016 and 7.7% higher at 90 days. Heart failure was a leading cause of ED visits within 90 days of September 1 in 2017, unlike in 2016.Conclusions and implicationsIncreased attention should be paid to AL communities in disaster preparedness and response efforts given the increased likelihood of ED visits following a hurricane.
| S-EPMC8035167 | biostudies-literature
Project description:Mangroves buffer inland ecosystems from hurricane winds and storm surge. However, their ability to withstand harsh cyclone conditions depends on plant resilience traits and geomorphology. Using airborne lidar and satellite imagery collected before and after Hurricane Irma, we estimated that 62% of mangroves in southwest Florida suffered canopy damage, with largest impacts in tall forests (>10 m). Mangroves on well-drained sites (83%) resprouted new leaves within one year after the storm. By contrast, in poorly-drained inland sites, we detected one of the largest mangrove diebacks on record (10,760 ha), triggered by Irma. We found evidence that the combination of low elevation (median = 9.4 cm asl), storm surge water levels (>1.4 m above the ground surface), and hydrologic isolation drove coastal forest vulnerability and were independent of tree height or wind exposure. Our results indicated that storm surge and ponding caused dieback, not wind. Tidal restoration and hydrologic management in these vulnerable, low-lying coastal areas can reduce mangrove mortality and improve resilience to future cyclones.
| S-EPMC8238932 | biostudies-literature
Project description:ObjectivesTo examine the effect of Hurricane Irma on staff-related financial expenditures and daily direct-care nurse staffing levels.DesignRetrospective cohort study.SettingSeptember 3-24, 2017 in the state of Florida, United States. Hurricane Irma made landfall on September 10, 2017.ParticipantsSix hundred and fifty-three nursing homes (NHs), 81 evacuated facilities, and 572 facilities that sheltered-in-place.MeasurementsThis study used data from Payroll-Based Journaling (PBJ), Certification and Survey Provider Enhanced Reports (CASPER), and Florida's health providers' emergency reporting system. PBJ provided estimates of daily direct-care nurse staffing levels for registered nurses, licensed practical nurses, and certified nursing assistants. CASPER reported facility-level characteristics such as profit status, chain membership, and special care unit availability. Florida's emergency reporting system identified evacuation status during Hurricane Irma. Linear mixed-effects models were used to estimate the unique contribution of evacuation status on daily staffing increases over time from September 3 to 10.ResultsAmong all facilities, we found significant increases in staffing for licensed practical nurses (p = 0.02) and certified nursing assistants (p < 0.001), but not for registered nurses (p = 0.10) before Hurricane Irma made landfall. From 1 week before landfall to 2 weeks after landfall (September 3-24), an additional estimated $2.41 million was spent on direct-care nurse staffing. In comparison to facilities that sheltered-in-place, evacuated facilities increased staffing levels of all nurse types (all p < 0.001). At landfall, evacuated facilities spent an estimated $93.74 on nurse staffing per resident whereas facilities that sheltered-in-place spent $76.10 on nurse staffing per resident.ConclusionNHs face unprecedented challenges during hurricanes, including maintaining adequate direct-care nurse staffing levels to meet the needs of their residents. NHs that evacuated residents had an increase in direct-care nurse staffing that was greater than that seen in NHs that sheltered-in-place.
| S-EPMC8373745 | biostudies-literature
Project description:In early September 2017, Irma was the most powerful hurricane that struck the northern Caribbean over the last 100 years. In the 21st century, the stronger types of tropical cyclones will likely increase in frequency due to the climate change and internal climate variability. Lessons to anticipate the response of mangroves to this intensification can be learned from this extreme event. Here, we analysed damages caused in mangrove forests of the Saint Martin Island. Mangroves of this island were previously degraded due to historic human pressures and recent over-urbanisation. Forest inventories and time series of very high resolution satellite images revealed that approximately 80% of the mangrove area was damaged by the hurricane. Results highlighted distinct rates of forest recovery. Early and rapid recoveries were largely observed in most study sites. However, some mangroves were still unable to recover fourteen months after the disturbance. The human-induced degradation of the ecosystem prior to the hurricane is hypothesised to be the main factor controlling the absence of forest recovery. We suggest that human-degraded mangroves will be weakened in the face of such extreme events. We advocate to preserve and restore mangroves in order to guarantee all the valuable ecosystem services they provided.
| S-EPMC6908650 | biostudies-literature
Project description:ImportanceNursing home residents are at heightened risk for morbidity and mortality following an exposure to a disaster such as a hurricane or the COVID19 pandemic. Previous research has shown that nursing home resident mortality related to disasters is frequently underreported. There is a need to better understand the consequences of disasters on nursing home residents and to differentiate vulnerability based on patient characteristics.ObjectiveTo evaluate mortality and morbidity associated with exposure to Hurricane Irma, a Category 4 storm that made landfall on September 10, 2017, in Cudjoe Key, Florida, among short-stay (<90-day residence) and long-stay (≥90-day residence) residents of nursing homes.Design, setting, and participantsCohort study of Florida nursing home residents comparing residents exposed to Hurricane Irma in September 2017 to a control group of residents residing at the same nursing homes over the same time period in calendar year 2015. Data were analyzed from August 28, 2019, to July 22, 2020.ExposureResidents who experienced Hurricane Irma were considered exposed; those who did not were considered unexposed.Main outcome and measuresOutcome variables included 30-day and 90-day mortality and first hospitalizations after the storm in both the short term and the long term.ResultsA total of 61 564 residents who were present in 640 Florida nursing home facilities on September 7, 2017, were identified. A comparison cohort of 61 813 residents was evaluated in 2015. Both cohorts were mostly female (2015, 68%; 2017, 67%), mostly White (2015, 79%; 2017, 78%), and approximately 40% of the residents in each group were over the age of 85 years. Compared with the control group in 2015, an additional 262 more nursing home deaths were identified at 30 days and 433 more deaths at 90 days. The odds of a first hospitalization for those exposed (vs nonexposed) were 1.09 (95% CI, 1.05-1.13) within the first 30 days after the storm and 1.05 (95% CI, 1.02-1.08) at 90 days; the odds of mortality were 1.12 (95% CI, 1.05-1.18) at 30 days and 1.07 (95% CI, 1.03-1.11) at 90 days. Among long-stay residents, the odds of mortality for those exposed to Hurricane Irma were 1.18 (95% CI, 1.08-1.29) times those unexposed and the odds of hospitalization were 1.11 (95% CI, 1.04-1.18) times those unexposed in the post 30-day period.Conclusions and relevanceThe findings of this study suggest that nursing home residents are at considerable risk to the consequences of disasters. These risks may be underreported by state and federal agencies. Long-stay residents, those who have resided in a nursing home for 90 days or more, may be most vulnerable to the consequences of hurricane disasters.
| S-EPMC7539118 | biostudies-literature
Project description:Extreme climatic events (ECEs) are increasing in frequency and intensity and this necessitates understanding their influence on organisms. Animal behaviour may mitigate the effects of ECEs, but field studies are rare because ECEs are infrequent and unpredictable. Hurricane Irma made landfall in southwestern Florida where we were monitoring white-tailed deer (Odocoileus virginianus seminolus) with GPS collars. We report on an opportunistic case study of behavioural responses exhibited by a large mammal during an ECE, mitigation strategies for reducing the severity of the ECE effects, and the demographic effect of the ECE based on known-fate of individual animals. Deer altered resource selection by selecting higher elevation pine and hardwood forests and avoiding marshes. Most deer left their home ranges during Hurricane Irma, and the probability of leaving was inversely related to home range area. Movement rates increased the day of the storm, and no mortality was attributed to Hurricane Irma. We suggest deer mobility and refuge habitat allowed deer to behaviourally mitigate the negative effects of the storm, and ultimately, aid in survival. Our work contributes to the small but growing body of literature linking behavioural responses exhibited during ECEs to survival, which cumulatively will provide insight for predictions of a species resilience to ECEs and improve our understanding of how behavioural traits offset the negative impacts of global climate change.
| S-EPMC6939277 | biostudies-literature
Project description:ImportanceExposure to hurricanes is associated with increased mortality and morbidity in nursing home (NH) residents, but the factors contributing to these outcomes are less understood. One hypothesized pathway could be power outages from hurricanes that expose NH residents to excess ambient heat.ObjectiveTo determine the association of power loss from Hurricane Irma with hospitalization and mortality in NH residents in Florida.Design setting and participantsThis retrospective cohort study of NH residents residing in Florida when Hurricane Irma landed on September 10, 2017, assessed mortality at 7 and 30 days after the storm and hospitalization at 30 days after the storm. The analysis was conducted from May 2, 2021, to June 28, 2021. All NH residents residing in Florida at landfall were eligible (N = 67 273). We excluded those younger than 65 years, missing power status information, or who were evacuated (13 178 [19.6%]).ExposureWe used state-administered surveys to determine NH power outage status. Exposed residents experienced a power outage poststorm, whereas unexposed residents did not experience a power outage poststorm.Main outcomes and measuresWe used Medicare claims to assess mortality and hospitalization after Hurricane Irma landfall using generalized linear models with robust standard errors.ResultsIn the aftermath of Hurricane Irma, 27 892 residents (18 510 women [66.4%]; 3906 [14.0%] Black, 1651 [5.9%] Hispanic, and 21 756 [78.0%] White individuals) in 299 NHs were exposed to power loss and 26 203 residents (17 620 women [67.2%]; 4175 [15.9%] Black, 1030 [3.9%] Hispanic, and 20 477 [78.1%] White individuals) in 292 NHs were unexposed. Nursing homes that lost power were similar in size, quality star rating, and type of ownership compared with NHs that did not lose power. Power loss was associated with an increased adjusted odds of mortality among all residents within 7 days (odds ratio [OR],1.25; 95% CI,1.05-1.48) and 30 days (OR, 1.12; 95% CI,1.02-1.23) poststorm and hospitalization within 30 days, although only among residents aged 65 to 74 years (OR, 1.16; 95% CI, 1.03-1.33).Conclusions and relevanceIn this cohort study, power loss was associated with higher odds of mortality in all affected NH residents and hospitalization in some residents. The benefits and costs of policies that require NHs to have emergency alternate power sources should be assessed.
| S-EPMC8796882 | biostudies-literature
Project description:ObjectivesTo investigate the factors associated with whether assisted living communities (ALCs) in Florida evacuated or sheltered in place for Hurricane Irma in 2017, focusing on license type as a proxy for acuity of care.DesignCross-sectional study using data collected by the state through its emergency reporting system and a post-hurricane survey.Setting and participantsAnalyses included all 3112 ALCs in the emergency reporting system. A subset of 1880 that completed the survey provided supplementary data.Methodsχ2 tests were used to examine differences between ALC characteristics (license type, size, payment, profit status, rural location, geographical region, and being under an evacuation order) and whether they evacuated. Logistic regression was used to test associations between characteristics and evacuation status.ResultsOf 3112 ALCs, 560 evacuated and 2552 sheltered in place. Bivariate analysis found significant associations between evacuation status and evacuation order, license type (mental health care), payment, and region. In the adjusted analysis, medium and larger ALCs were 43% (P < .001) and 53% (P < .001) less likely to evacuate than ALCs with fewer than 25 beds. Compared with ALCs in the Southeast, nearly every region was more likely to evacuate, with the highest likelihood in the Central West (odds ratio 1.76, 95% confidence interval 1.35‒2.30). ALCs under an evacuation order were 8 times more likely to evacuate (P < .001). We found no relationship between evacuation status and having a license to provide higher care.Conclusions and implicationsPrior research highlighting harm associated with evacuation has led to recommendations that long-term care facilities carefully consider resident impairment in evacuation decision-making. Evidence that small ALCs are more likely to evacuate and that having a higher-care license is not associated with evacuation likelihood shows research is needed to understand how ALCs weigh resident risks in decisions to evacuate or shelter in place.
| S-EPMC7396303 | biostudies-literature
Project description:The impacts of hurricane-related disasters in agricultural communities include extensive losses of fields, orchards, and livestock, the recovery of which could span many years. Agricultural Extension Agents (EAs) try to manage and mitigate these losses, while simultaneously overseeing emergency shelter operations. These non-professional emergency responders face numerous potential stressors, the outcomes of which are minimally known. This study examined the short- and long-term medical and behavioral outcome of 36 University of Florida Agricultural Extension Agents within two months and one year after Hurricane Irma, Florida, USA, taking into consideration personal/home and work-related hurricane impacts. Regression analyses indicated that combined home and work hurricane impacts were associated with greater anxiety, depression, and medical symptoms controlling for age and number of prior hurricane experiences within two months of landfall. One year later, depression symptoms increased as well as the use of negative disengagement coping strategies for which stability of the work environment was protective. The findings suggest that advanced training in emergency response, organization and time management skills, time off and temporary replacement for personally impacted EAs, and workplace stability, including enhanced continuity of operations plans, represent critical elements of health prevention and early intervention for this occupational group.
| S-EPMC7038044 | biostudies-literature
Project description:BACKGROUND:In September 2017, the Hurricane Irma devastated the islands of Saint-Martin and Saint-Barthelemy (French West Indies). This was a particularly distressing time for the local healthcare staff in charge of rescuing the population. The aim of this study was to identify the explanatory factors of post-traumatic distress and burnout in hospital staff. METHODS:An anonymous questionnaire was sent to all 509 hospital workers of Saint-Martin and Saint-Barthelemy. Post-traumatic distress and burnout was assessed using the Post-Traumatic Stress Disorder Checklist (PCL-S) and Copenhagen Burnout Inventory (CBI) scales. Bivariate and multivariate analyses were used to determine the explanatory variables for these two psychological disorders. RESULTS:Two hundred and sixty-two questionnaires were completed (response rate of 51.7%). The explanatory factors of post-traumatic distress were female gender (OR = 12.93, 95% CI: 2.70-232.10), electricity shortages (OR = 2.92, 95% CI: 1.13-8.19) and home damage (OR = 1.16, 95% CI [1.02-1.33]). In parallel, the explanatory factors of burnout were post-traumatic distress (OR: 10.42, 95% CI: 4.72-25.58), female gender (OR = 2,41, 95% CI: 1.24-5.02) and paramedical staff (OR = 2,53, 95% CI: 1.15-6.21). In the multivariate analysis, only burnout was significantly associated with post-traumatic distress (OR = 9.26, 95% CI: 4.11-23.14). CONCLUSIONS:Six months after Irma, post-traumatic distress among hospital staff was strongly linked to burnout. This study revealed the lack of electricity as a new factor related to post-traumatic distress. It also suggested that psychological intervention should be strengthened.
| S-EPMC7064261 | biostudies-literature