灾害流行病学经典研究.ppt

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1、Classic Studies on Disaster Epidemiology,Knowledge review,1,Application of disaster epidemiological,2,Study methods of disaster epidemiological,3,Examples,4,Summary,5,Contents,Part one,Knowledge review,“an encounter between forces of harm and a human population in harms way, influenced by the ecolog

2、ical context, in which demands exceed the coping capacity of the disaster-affected community” Unforeseen/sudden situation or event that causes great damage, destruction and human suffering, and which overwhelms local capacity, necessitating a request to national or international level for external a

3、ssistance (EM-DAT Glossary)Exposure of a vulnerable human population to a hazard in a way that the impact exceeds the coping capacity of the affected community.,Disaster,Is the basic science of public health.“The study of the distribution and determinants of health-related states or events in specif

4、ied populations, and the application of this study to control health problems.” The study of the distribution, determinants, and effects of health states or events in defined populations, and the application of this study to optimize population health.,Epidemiology,The study of the distribution, det

5、erminants, and effects of health states or events in populations affected by (natural) disasters, and the application of this study to prevent disaster situations, mitigate the health effects of disasters, control the adverse health effects of disasters and optimize the health of disaster affected p

6、opulations in the long run.,Disaster Epidemiology,Part two,Application of disaster epidemiological,With the development of disaster epidemiology, the use of disaster epidemiology is also expanding, which is summed up mainly in the following two aspects.,Application of disaster epidemiology,Applicati

7、on of disaster epidemiology,Firstly, we should make the analysis of the causes and consequences of disasters. The focus is on the disasters themselves and the related diseases and deaths. The in-depth study of the causes of disasters is crucial for making preventive measures.,Application of disaster

8、 epidemiology,Secondly, we need to study the possible mechanisms and measures to reduce the burden of disasters when disasters happen. The most direct application of epidemiological methods is to establish sensitive monitoring system, and to understand the exact number of casualties and possible eme

9、rgency situations of infectious diseases.,Part three,Study methods of disaster epidemiological,Because of the wide scope of disaster epidemiology, different research methods need to be applied to achieve different research purposes, and many methods are needed to be applied in combination. The main

10、epidemiological methods of disaster epidemiology include the following three kinds 1.Descriptive epidemiology 2. Analytical epidemiology 3. Evaluation epidemiology,Study methods of disaster epidemiological,1.Descriptive epidemiology It applies the method of descriptive epidemiology to identify the d

11、istribution of disease and health status of victims, and describes their frequency and distribution characteristics in time, space and human life.2. Analytical epidemiology A comparative investigation between patients and non patients is made to identify risk factors or protective factors for a dise

12、ase, and discuss why and why some events occur. In the analysis of disaster epidemiology, it is necessary to apply the classical mathematical and statistical methods.,Study methods of disaster epidemiological,3. Evaluation epidemiology It has a scientific evaluation of the damage and harm caused by

13、the disaster, the effect, effect and benefit of various preventive measures taken against the health of the victims.,Study methods of disaster epidemiological,Part four,Examples,Example one,Earthquake Injuries Related Housing in a Guatemalan Village,A simple description,Researcher study the patterns

14、 of death and serious injury in the villages of Santa Maria Cauque and to relate them to the different types of construstion employed in the town.The collapse of adobe dwellings was the main cause of death and injury following the earthquake in Guateemala.As it has been in other areas of Latin Ameri

15、ca Epidemiologic study of the relation between house construction and health effects following earthquake can provide clues for the prevention of death and injury in areas of the world prone to these natural disasters.,Methods,Using cross sectional study. It is one of the types of descriptive epidem

16、iology.Including two surveys: 1.Survey of Death and Serious Injury 2.The Within House survey,Main conclusions,1.The age-specific mortality rates were high for the young and the old. But low for those of middle age.2.The risk of injury was greater to women than to men for almost all age group.3.The r

17、isk of the earthquake-related trauma is greatest to the young and the elderly.4.Houses designed with light walls, such as cornstalk walls, reinforced with a rigid frame are more resilient and earthquake-proof than unreinforced load-bearing wall structures such as adobe.,Example two,East Bengal Cyclo

18、ne of November, 1970,A simple description,Two medical relief assessment were carried out in the sourthern coastal region of East Bengal affected by the cyclone and tide bore of Novermber,1970.The first, a rapid 18-site survey, documented the adequacy of existing water supplies and absence of signifi

19、cant post-cyclone mobidity or exceptional levels of epidemic diseases.The second, wider in scope, was done 2 months later, Seventy-nine unions in the nine most affected thanas were visited.,Methods,First survey 1. Using cross sectional study. 2.Plotting affected areas and selecting sampling sitesSec

20、ond survey 1. Using cross sectional study. 2.Using cluster sampling ensure uniform coverage of the most severely affected area. 3.Using the family as the basic unit of study.,Results,First survey1.Food, clothing, and shelter were needed most; water, fieldhospitals, and vaccinations were far less urg

21、ent.Second survey1.More than half of the deaths were of children under ten.2.Males fared better than females in all but youngest age-groups.3.Post-cyclone morbidity and mortality were both relatively low.4.Greatest destruction occurred along the coast and fits the pattern of cyclone mortality.,Resul

22、ts,Second survey5. It was impossible to assess the degree of rehabilitation achieved, since we lacked detailed data on the levels of destruction at the time of the cyclone.6. .and so on.,Discussion,1.New relief capacities need are rapid , accurate methods of assessing the extent of damage and immedi

23、ate medical and supportive needs of an area.2.Disasters with long-term relief and rehabilitative consequences require continued monitoring and repeated reassessments long after the initial relief phase has ended.,Example three,Lessons for Epidemiology from the Ethiopian Famines,Prombles,1. Ethiopia

24、s food exports actually rose during the famine period.2. No food balance data were ready in time to predict famine.3. By the mid 1973 the famine was at its peak. Information about it is extremely scarce, and epidemiology data virtually non-existant.4. Numerous foreign angencies were failed to react

25、the famine with horrified derision.,Reasons,1.When an emergency was at last declared in the muted tones, both government and at least two major relief agencies miscalculated the severity and timing of the problem.2.When the crises had passed, the “hidden famine” became an international media event,

26、sustained by immense publicity about starvation in the agricultural areas.,Lessons,1.The lessons for agencies and epidemiologists alike, lie in their fixation with starvation as if this represented the disease rather than the symptom. If both epidemiological pratice and agency response take as a con

27、ceptual model of famine an equation which links drought with crop failure and animal deaths, and this in turn with human starvation, then their approach is bound to fail.2.We could be drawn from the behavior of the donor agencies.,Summary,We do know that: Until they realise both the need for timely

28、and reliable information, and for action based on it, all famine epidemiology will remain an academic exercise of no practical use.,In my opinion, to finish a correct study on disaster epidemiologywe need:1. Correct understanding of research object 2.Suitable and right study methods3.In time and rapid4.Enough and reliable information5.And so on .,Summary,

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