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This study explores how loneliness affects earthquake risk perception and preparedness behaviors among older adults in Japan. Aging is often accompanied by increased vulnerability to natural disasters, and loneliness is hypothesized to compromise effective preparedness. Using the Japanese Older Adult Preparedness Model (JOAPM), which integrates the Protective Action Decision Model (PADM) and cultural context, we examine how loneliness influences both perceived earthquake risk and protective behaviors.
Methods
An online survey conducted in April 2024 gathered responses from adults aged 55 and older across 4 earthquake-prone Japanese prefectures. Measures included demographics, disaster experience, loneliness (UCLA Loneliness Scale), risk perception, and preparedness actions such as household adjustments. Regression and mediation analyses assessed the direct and indirect effects of loneliness on preparedness.
Results
Findings show that loneliness has a significant negative direct effect on disaster preparedness. However, it also slightly increases risk perception, which in turn has a positive relationship with preparedness behaviors, suggesting a modest indirect pathway. Overall, the direct negative effect of loneliness outweighs the indirect benefit.
Conclusion
The results highlight the complex role of psychosocial factors in disaster readiness, suggesting that interventions should address information dissemination, self-efficacy, and the emotional isolation experienced by older adults in high-risk areas.
Building collapses, debris removal, new construction, and increased stove use for heating have elevated air pollution in regions affected by the February 6, 2023, Kahramanmaraş earthquake. This study examines the relationship between carbon monoxide (CO) poisoning and air pollution in these areas 1 year after the disaster.
Methods
A retrospective analysis of 151 patients from 10 hospitals in 8 cities was conducted, including data on demographics, clinical symptoms, sources of CO exposure, vital signs, laboratory findings, air pollution levels, and outcomes.
Results
Indoor stove use was the primary source of CO exposure. The average Air Quality Index (AQI) was 55 (IQR 44-56), and particulate matter (PM2.5) levels averaged 17.5 μg/m3 (IQR 10-27), exceeding EPA (Environmental Protection Agency) thresholds. AQI levels post-earthquake were significantly higher than pre-earthquake in Kahramanmaraş (AQI1 = 48.5 [IQR 48-55], AQI2 = 55 [IQR 55-80]; P = 0.007), Hatay (AQI1 = 40.5 ± 13.7, AQI2 = 56 [IQR 51-60.5]; P <0.001), and Gaziantep (AQI1 = 44 [IQR 41-56], AQI2 = 55 [IQR 54-55.5]; P = 0.014). Leukocytosis (P = 0.004) and myocardial injury (P <0.001) in CO poisoning cases varied significantly across provinces.
Conclusions
In conclusion, elevated AQI and PM2.5 levels likely worsened myocardial injury in CO poisoning cases due to combined outdoor and indoor pollution effects. These findings emphasize the need for air quality monitoring and mitigation in disaster regions.
To assess the iodine status of pregnant women from disadvantaged groups in Kahramanmaraş Province 1 year after the earthquake, including factors affecting iodine status.
Methods
510 healthy pregnant women were included in the study. A questionnaire was given to pregnant women after the earthquake to assess changes in diet and other social factors. Thyroid function, autoantibodies, thyroglobulin, urinary iodine concentration (UIC), creatinine (Cr) levels, and ultrasound were measured. Thyroid ultrasound was also performed to assess thyroid volume.
Results
The median UIC of the participants was 91.27 μg/g Cr (Q1-Q3 = 62.53-142.86). The rate of low iodine status (<150 μg/g Cr) was 77.3% and the incidence of goiter was 19.2%. After the earthquake, 69% of pregnant women lived in urban areas and 31% in rural areas. 11.8% of the areas where they lived were moderately damaged, 11.4% severely damaged, and 5.9% completely destroyed. 15.1% were still living in temporary shelters 1 year after the earthquake. The risk of low UIC was 2.2 times higher for those living in temporary shelters after the earthquake.
Conclusions
Temporary shelters after the earthquake were the main risk factor for low iodine status. We need to support these groups after disasters and reduce the number of people living in temporary shelters.
The aim was to document sociodemographic and clinical data of patients with musculoskeletal injuries who applied to the Physical Medicine and Rehabilitation clinic after the earthquake, to share experiences, and thus contribute to preparation for subsequent disasters.
Methods
The study was planned as retrospective, cross-sectional, and analytic. A total of N = 230 earthquake victims, 105 (45.7%) males and 125 (54.3%) females, aged between 1 and 79, were included in our study.
Results
Regarding injury location, the lower extremity was primarily affected with N = 125 (54.3%). The number of amputated patients was N = 29 (12.6%), and the most common location was transfemoral amputation with N = 14 (6.1%) patients. The number of fractures was N = 130 (56.5%), and the most common fracture site was the lower extremity in N = 66 (28.7%) patients. N = 162 (70.4%) of the patients had soft tissue injuries. There was peripheral nerve damage in N = 76 (33%) of the earthquake victims; the most frequently damaged nerve was the peroneal nerve in N = 36 (15.7%) patients. A vertebral fracture was present in N = 9 (3.9%) patients, and the most frequently fractured vertebra was the lumbar vertebra in 11 (4.8%) patients.
Conclusion
Defining the profiles of patients with musculoskeletal injuries in the early period, determining their needs, and including them in the rehabilitation program will ensure successful functional gain.
To describe the results of the Federal Center for Disaster Medicine field hospital work in an outpatient setting in Aleppo, Syria, during the delayed period after the earthquake (from days 33 to 67) for 35 days.
Methods
A retrospective analysis of routinely collected patient data from March 10 to April 13, 2023, was conducted. Descriptive statistics were used to summarize patient demographics, disease spectrum (according to ICD-10), and procedures.
Results
6812 patients were examined and consulted by various specialists. Of all patients, 40.6% were under the age of 18. In adults, the most commonly diagnosed conditions were diseases of the musculoskeletal system (27.1%), eye diseases (12.0%), circulatory diseases (10.1%), and respiratory diseases (10.0%). Among children, the most common reasons for admission were infectious diseases (68.9%), with respiratory tract infections being the most frequent (48.0%). Surgical interventions were performed in 150 cases; 61 patients required hospitalization.
Conclusions
During disasters, the needs of the population for various types of medical care vary significantly. The main causes of variability, in our opinion, are the time period of work from the disaster onset; the situation in the country and in the healthcare system, preceding the disaster; the climatic conditions during work; and the local endemicity of diseases.
This study included postpartum women who survived the earthquake that occurred on February 6, 2023, with epicenters in Kahramanmaraş, and assessed their experiences, psychosocial needs using a qualitative research method. The findings were organized under 5 key themes: “psychological processes experienced during and after the earthquake,” “experiences related to pregnancy and childbirth,” “biopsychosocial problems experienced after the earthquake,” “experiences related to s workers,” and “expectations and needs of earthquake-affected mothers.” Codes were established for women that were specific to their emotional responses following the earthquake: fear, sorrow, anxiety, difficulty in controlling anger, hopelessness, exhaustion, and inability to experience the mourning process; concerning their emotional reactions at the moment of the earthquake: extreme fear, helplessness, shock, and grief response; and regarding the traumatic effects of the earthquake: post-traumatic growth and post-traumatic stress disorder. During and after an earthquake, pregnant and postpartum women have biopsychosocial needs such as shelter, food, clothing, hygiene, support, and care, and these needs should be prioritized. Early psychological interventions should be provided to help women deal with the negative traumatic experiences they encounter during this process. Relevant institutions should create individual care-focused support systems and early intervention to deliver comprehensive care following earthquake.
Faulting within rocks and sediment creates some of the most dramatic landscapes (Fig. 10.1). A favorite trip for many visitors to the Western United States follows the route from San Francisco to Las Vegas, or from San Francisco to Phoenix, where much of the mountainous scenery along these routes has been formed by faulting. Because of this faulting, the high alpine landscapes contrast greatly with the desert landforms in the lowlands below. After reading this chapter, you will be able to take this excursion and understand the stunning geomorphology of these faulted landscapes, and others.
Earthquakes cause significant mortality and morbidity, particularly through crush injuries and their complications. This study aimed to evaluate whether systemic immune inflammation index (SII) and Pan-immune inflammatory values (PIV) obtained from complete blood count parameters can predict intensive care needs, dialysis requirements, and mortality in patients with crush injuries following earthquake.
Methods
We retrospectively analyzed data from 76 patients with crush injuries admitted to a university hospital following the earthquake. Blood samples were collected upon admission. SII and PIV were calculated and compared with conventional laboratory markers for their ability to predict clinical outcomes.
Results
Intensive care unit (ICU) admission was required in 40.8% of patients, and 21.1% required dialysis. In ROC analysis, an SII value above 1372 predicted ICU admission with 67.7% sensitivity and 66.7% specificity (P < .001), while an SII value above 1735 predicted dialysis requirement with 75.0% sensitivity and 73.3% specificity (P < .001). Similarly, a PIV value above 1345 predicted ICU admission with 74.2% sensitivity and 73.3% specificity (P < .001), and a value above 1906 predicted dialysis requirement with 81.3% sensitivity and 78.3% specificity (P < .001).
Conclusions
Complete blood count-derived inflammatory markers may serve as accessible, early indicators to complement clinical assessment for resource allocation following earthquake-related crush injuries, particularly in resource-limited disaster settings. These tools may aid in patient triage and care planning when comprehensive laboratory testing is limited.
This chapter focuses on how urban development relates to earthquake risk. It draws connections between earthquakes and floods, then introduces key technical concepts (e.g., magnitude v. intensity, liquefaction, structural response to shaking). It presents the urban development and disaster histories of Kobe (Japan; including the 1995 earthquake) and Christchurch (New Zealand; including the 2010–2011 Canterbury earthquake sequence), assessing and comparing them using the Urban Risk Dynamics framework. Findings resonate with themes from the flood chapters. Urbanization often involves modifying lands (e.g., draining wetlands, expanding waterfronts, constructing islands), which are susceptible to ground failure in earthquakes. While newer structures are less prone to damage because of technological and building code advances, many older buildings are concentrated in neighborhoods that are hotspots of physical and social vulnerability. Postdisaster reconstruction and recovery accelerate prior trends. Catastrophic events trigger learning and instigate diversification in risk reduction strategies. Retreat from hazard lands is possible, as exemplified in Christchurch’s residential red zone.
The study was conducted to assess the psychological resilience and stress symptoms in health care workers following the 2023 Kahramanmaraş earthquake.
Methods
The study was completed with a sample size of 313 health care workers who experienced the earthquake and was carried out in a descriptive and correlational design. The Sociodemographic Data Form, Brief Psychological Resilience Scale (BPRS), and Traumatic Stress Symptom Scale-5 (TSSS-5) were used.
Results
The study found that 39.6% of health care workers were diagnosed with post-traumatic stress disorder, 41.2% of participants considered leaving their jobs after the earthquake, and 79.9% reported a decrease in job motivation (slight or a lot). It was determined that there was a negative correlation between the participants’ BPRS scores and TSSS-5 scores (r:-0.523, P = 0.00).
Conclusions
In accordance with the findings of our study, it can be posited that traumatic stress symptoms diminished as the level of psychological resilience increased in health care workers who experienced the earthquake.
The purpose of this study is to determine the effects of the perceived trauma levels of women at reproductive age after earthquakes on their menstruation cycle.
Methods
This descriptive and correlational study was conducted between March 17, 2023, and April 17, 2023, after the earthquakes that happened in Turkey on February 6, 2023 and affected 11 cities. The study was conducted with 355 women. Data were collected using an online questionnaire form prepared via Google Forms. Data collection was performed using a Participant Information Form and the Post-Earthquake Trauma Level Determination Scale.
Results
According to the multiple regression analysis results, the significant predictors of perceived trauma levels after the earthquakes included the severity of dysmenorrhea (β-coefficient = 0.164, P = .007), characteristics of vaginal discharge (β-coefficient = 0.136, P = .027), and itching in the perineum (β-coefficient = −0.220, P = .001). These variables explained 12.4% of the total variance in the perceived trauma levels of the participants.
Conclusions
The perceived trauma levels of women after the earthquakes had significant effects on the severity of dysmenorrhea, characteristics of vaginal discharge, and itching in the perineum. Health professionals should not overlook the effects of women’s perceived trauma levels on their menstruation cycles after earthquakes and evaluate the issue considering these aspects.
The present study was conducted to determine self-management and influencing factors in dialysis patients who experienced the earthquake.
Methods
The study was conducted descriptively with 125 patients receiving dialysis in a city affected by the earthquake in Türkiye. Data were collected with the “Personal Information Form” and the “Chronic Illness Self-Management Scale” (CISMS). Kolmogorov-Smirnov, Mann Whitney U, Kruskall Wallis, Spearman Correlation tests, Wilcoxon, and Linear Regression were used in the statistical analysis.
Results
The study found that 9.6% of the patients were trapped under the rubble in the earthquake, 71.2% lost a relative, 43.8% changed dialysis centers, 36.8% missed dialysis sessions, and 51.2% could not comply with the diet after the earthquake. Women (p < 0.001), those with secondary school or lower educational levels (p < 0.05), those with another chronic disease, and those who lost a relative in the earthquake had lower health care maintenance efficacy (p < 0.05). The treatment adherence of those who adhered to the diet was higher than those who did not (p < 0.05).
Conclusion
It was determined that the level of self-stigma of the patients after the earthquake was low, their treatment adherence was high, and there were many variables affecting their self-management.
Türkiye is a country with many seismic fault lines and has experienced major earthquakes throughout its history. In history, 2 major earthquakes occurred in Kahramanmaraş province in 1544 and 1795, causing serious destruction and damage. On February 6, 2023, 2 major earthquakes of 7.7 Mw and 7.6 Mw occurred, centered in Kahramanmaraş (Elbistan and Pazarcık). This great disaster affected 11 cities (about 14 million people), mostly Kahramanmaraş, Hatay, and Malatya. According to the latest official report, it resulted in 50 783 deaths and more than 122 000 injuries.1,2
Disasters can have catastrophic effects on people’s physical, mental, and psychosocial status, as well as public health. Many people undoubtedly suffer from short- and long-term disabilities as a result of the disaster once the first shock wears off [1]. Two devastating earthquakes caused extensive damage in southern and central Türkiye and northern and western Syria in February 2023, resulting in thousands of deaths and injuries. It is estimated that approximately 15 million people were affected. Since there is a possibility that people affected by the earthquake will continue their lives with disabilities, it is important to make an early assessment and make preliminary preparations in this respect. With this preparation and rehabilitation carried out in the early period, it is aimed at helping individuals adapt more quickly to both personal and social life and to increase their independence in daily life.
On February 6, 2023, 7.7 and 7.6 magnitude earthquakes struck southeastern Türkiye, affecting 11 provinces and causing significant losses. This study aims to assess the mental health status of survivors in the twelfth month after the earthquake.
Methods
A cross-sectional study was conducted using an online survey with the virtual snowball sampling method. The survey included sociodemographic data, previous traumas, earthquake-related experiences, and the Post-Earthquake Trauma Level Determining Scale (PETLDS) and Hospital Anxiety and Depression Scale.
Results
The study included 2544 participants. The mean PETLDS score was 58.14±18.18, indicating that the participants were highly traumatized. Among them, 59.5% had high levels of post-traumatic symptoms, 44.2% had high anxiety, and 61% had high depression symptoms. 35.77% of participants displayed a co-occurrence of post-traumatic stress along with anxiety and depression. Female gender was the strongest predictor of high-level trauma and anxiety, while a history of psychiatric disorder was the strongest predictor of depression. Multiple logistic regression analysis indicated that symptoms were predicted by low income, low education level, smoking, comorbid chronic diseases, past traumatic experiences, the loss or injury of a loved one due to the earthquake, personal injury, temporary displacement, and damage to homes and workplaces.
Conclusions
The findings suggest that one year after the earthquake, mental health problems are prevalent among survivors, highlighting the need for urgent psychiatric interventions.
This study aimed to investigate the relationship between pre-earthquake and earthquake-related characteristics and post-earthquake trauma levels of individuals affected by the February 6, 2023 Kahramanmaraş earthquakes.
Methods
The study is in survey design, one of the quantitative research methods. The participants consist of individuals affected by the earthquake and staying in temporary accommodation centers (student dormitories) in Konya province. A survey including a personal information form and a scale for determining the Post-Earthquake Trauma Levels was administered face to face to 334 volunteer participants.
Results
Adults aged 30-46, those trapped under debris, those injured in the earthquake, those who lost a family member, a relative, a neighbour or a friend, and those who received psychological support after the earthquake are in the risk group in terms of high post-earthquake trauma levels.
Conclusions
The findings reveal the groups in which the traumatic effects of earthquakes on adults are high. It is important to prepare intervention programs by considering the needs of these groups in psychosocial interventions to be carried out after the earthquake.
We aimed to reveal the psychological effects of old and young individuals after the earthquake by looking at their post-traumatic stress disorder (PTSD) and depression situations.
Methods
Data collected by face-to-face survey method were analyzed. The 4 provinces (Hatay, Kahramanmaraş, Adıyaman, and Gaziantep) most affected by the 7.7 and 7.6 magnitude earthquakes centered in Kahramanmaraş, Turkey on February 6, 2023 were included in the study. Peritraumatic distress inventory, impact of events scale, and Beck depression inventory were applied to 300 people (150 old, 150 young).
Results
The presence of peritraumatic stress was observed in 94% (282 people), PTSD symptoms in 90% (270 people) and moderate to severe depression in 36.7% (110 people). When younger were compared with those elders, it was concluded that there was no significant difference in terms of presence of peritraumatic distress (49.6% vs. 50.4%, P=0.627), PTSD (49.6% vs. 50.4%, P=0.620) and moderate to severe depression (45.5% vs. 54.5%, P=0.258).
Conclusions
We found similar rates of PTSD and depression symptoms in older and younger adults exposed to earthquakes. Policies need to be developed to ensure psychological well-being after an earthquake disaster in the adult population regardless of age group.
A minority of earthquake-exposed individuals develop post-traumatic stress disorder (PTSD), often alongside comorbid depression and anxiety symptoms. No systematic review has examined psychological interventions for adults with substantial earthquake-related PTSD symptoms.
Aims
To synthesise studies evaluating psychological interventions for adult earthquake-related PTSD and conduct meta-analyses estimating overall effect sizes.
Method
The review was pre-registered with PROSPERO (CRD42023441020). PsycINFO, MEDLINE, EMBASE, CINAHL and Scopus were searched for studies (last search conducted July 2024). Randomised controlled trials (RCTs), non-randomised and non-controlled studies evaluating psychological interventions for adults with substantial earthquake-related PTSD symptoms were eligible. Outcomes were PTSD, depression and anxiety symptoms. Narrative syntheses and meta-analyses summarised study findings. The Mixed Methods Appraisal Tool guided quality assessments.
Results
Sixteen studies were identified (eight RCTs, four non-randomised and four non-controlled studies), representing 1315 participants receiving psychological intervention. Interventions included cognitive behavioural therapy (CBT), specific CBT variants, eye movement desensitisation and reprocessing, interpersonal psychotherapy and an internet-based intervention focusing on social cognitive theory. Studies generally reported statistically and clinically significant improvements associated with psychological interventions. Among studies included in meta-analyses, overall effect size was 2.11 (95% CI = 0.92, 3.31) for PTSD symptoms and 1.01 (95% CI = 0.50, 1.52) for depression symptoms.
Conclusions
Psychological interventions are associated with good outcomes among adults with earthquake-related PTSD. The most evidence currently exists for CBT-based interventions, which are recommended as first-line treatments. Efficient intervention options, including single-session and group-based treatments, also show promise and are recommended for addressing widespread treatment need.