The gap between the life expectancy of the richest and poorest sectors of society in England is increasing, according to new research from Imperial College London.
The research, published in the journal Lancet Public Health, also reveals that the life expectancy of England’s poorest women has fallen since 2011, in what researchers say is a “deeply worrying” trend.
The study, funded by the Wellcome Trust, analysed Office for National Statistics data on all deaths recorded in England between 2001 and 2016—7.65 million deaths in total.
The results revealed the life expectancy gap between the most affluent and most deprived sectors of society increased from 6.1 years in 2001 to 7.9 years in 2016 for women, and from 9.0 to 9.7 years in men.
The life expectancy of women in the most deprived communities in 2016 was 78.8 years, compared to 86.7 years in the most affluent group. For men, the life expectancy was 74.0 years among the poorest, compared to 83.8 years among the richest.
The results also revealed that the life expectancy of women in the poorest sectors of society has dropped by 0.24 years since 2011.
Professor Majid Ezzati, senior author of the research from Imperial’s School of Public Health, said: “Falling life expectancy in the poorest communities is a deeply worrying indicator of the state of our nation’s health, and shows that we are leaving the most vulnerable out of the collective gain.
“We currently have a perfect storm of factors that can impact on health, and that are leading to poor people dying younger. Working income has stagnated and benefits have been cut, forcing many working families to use foodbanks. The price of healthy foods like fresh fruit and vegetables has increased relative to unhealthy, processed food, putting them out of the reach of the poorest.”
He added: “The funding squeeze for health and cuts to local government services since 2010 have also had a significant impact on the most deprived communities, leading to treatable diseases such as cancer being diagnosed too late, or people dying sooner from conditions like dementia.”
The research team also analysed the illnesses that contributed to the widening life expectancy gap. Although they found that people in the poorest sectors died at a higher rate from all illnesses, a number of diseases showed a particularly stark difference between rich and poor.
The diseases that led to particularly large loss of longevity in the poor compared to the rich were newborn deaths and children’s diseases, respiratory diseases, heart disease, lung and digestive cancers, and dementias. In 2016, children under five years old from the poorest sectors of society were 2.5 times as likely to die as children from affluent families.
“This study suggests the poor in England are dying from diseases that can be prevented and treated,” said Professor Ezzati. “Greater investment in health and social care in the most deprived areas will help reverse the worrying trends seen in our work. We also need government and industry action to eradicate food insecurity and make healthy food choices more affordable, so that the quality of a family’s diet isn’t dictated by their income.”
The team conducted their analysis by using information on the where each death occurred, which was matched to small areas of England known as lower super output areas by the Office of National Statistics. These lower super output areas, which each have a population of around 1,500 people, are given a score of deprivation from the Office of National Statistics (called an Index of Multiple Deprivation). The research team point out this means the comparisons are based on a community’s deprivation and affluence, and not that of individuals.
Reliance on carers makes nursing home residents especially vulnerable to sex abuse. Credit: shutterstock.com
We don’t often think of older women being victims of sexual assault, but such assaults occur in many settings and circumstances, including in nursing homes. Our research, published this week in the journal Legal Medicine, analysed 28 forensic medical examinations of female nursing home residents who had allegedly been victims of sexual assault in Victoria over a 15-year period.
The cases were examined by Clinical Forensic Medicine – a division of the Victorian Institute of Forensic Medicine – between January 1, 2000 and December 31, 2015.
The majority of the alleged victims had some form of cognitive or physical impairment. All 14 perpetrators who were reported were male, half of whom were staff and half other residents. The majority of case reports didn’t indicate whether the alleged victim had received treatment for the assault.
The most frequent alleged sexual contact was vaginal contact or penetration. Injuries weren’t reported for every case. Where present, they consisted of bruising, skin tears, redness and swelling.
The physical examination was often limited because of the cognitive status (in 38%) of the individuals, physical issues (in 31%), lack of cooperation (23%), and poor examination conditions (23%). Data on alleged victims’ behaviour was commonly missing.
These information gaps highlight the difficulty of examination which is essential to a detailed investigation. A better understanding of the context and setting of the assault, which is usually available when younger women are victims, is essential to inform prevention efforts.
Eliminating sexual assault in nursing homes is a major challenge which starts with acknowledging it exists and recognising the scale of this abuse.
Much higher than we think
Sexual assault is considered the most hidden, as well as least acknowledged and reported, form of elder abuse. This makes it difficult to accurately estimate its prevalence.
Prior to 2007, it was estimated there were around 20,000 unreported cases of elder abuse, neglect and exploitation in Victoria. Between 2009-10 and 2014-2015 the published number of sexual assaults among older people rose from around 280 to 430 reports nationally (information about each jurisdiction was not available).
In 2015–2016 The Australian Department of Health was notified of 396 reports of alleged or suspected unlawful sexual contact of residents in nursing homes in Australia.
Based on these statistics, we expected Victoria would have 80-120 sexual assaults of residents reported in nursing homes per year (equating to approximately 1,200 assaults during the study period). The 28 cases reported to the forensic investigation team over a 15 year period suggests under-recognition and under-reporting.
Nursing home residents are particularly vulnerable to sexual assault due to their dependency on caregivers, health problems, and the co-housing of residents, sometimes with potentially dangerous older individuals with sexual assault backgrounds.
Negative stereotypes such as that older people aren’t sexual beings, their greater dependency on others, potential divided loyalty to staff members or residents are unique barriers to reporting, detecting, and preventing sexual assault in nursing homes. Despite severe health consequences, efforts to prevent and address elder abuse remain inadequate.
In the majority of cases we examined, signs of general or genital injury were not found. Further, post-assault victim responses, such as agitation, distress and confusion may mirror symptoms of cognitive impairment. This can create difficulties for nursing home staff in distinguishing between the usual behaviour or a response to trauma, such as sexual assault.
Also, nursing home victims of sexual assault tend to be ignored by staff who often don’t believe the accusations. Although we could not determine who or what prompted reporting, what is known is that sexual assaults are unlikely to have a witness, though witnesses appear to be crucial to ensure successful prosecution.
Sexual assault, in any setting or age group, is one of the most difficult crimes to prosecute due to the required elements of intent and lack of consent. But this is made all the more complicated when it comes to nursing home residents.
Awareness is crucial
Staff must be aware of the existence of sexual assault in nursing homes. It is their duty as care providers to report alleged or suspected sexual assault in a timely manner. More education, training and research is needed to address the knowledge gaps around incidence, levels of reporting, nature of investigations, responses required to better assist the victim, and the interventions needed to prevent sexual assault.
Without a clear understanding of the alleged victim and incident characteristics, we will struggle to combat sexual assaults in nursing homes. There is an urgent need to better use the existing data held by the the Department of Health to understand the full extent of sexual assault in nursing homes. The Royal Commission is an opportunity to consider the development of tailored policies, staff training and legislation.
A new scientific study of forecasts and alternative scenarios for life expectancy and major causes of death in 2040 shows all countries are likely to experience at least a slight increase in lifespans. In contrast, one scenario finds nearly half of all nations could face lower life expectancies.
The rankings of nations’ life expectancies offer new insights into their health status.
For example, China, with an average life expectancy of 76.3 years in 2016, ranked 68th among 195 nations. However, if recent health trends continue it could rise to a rank of 39th in 2040 with an average life expectancy of 81.9 years, an increase of 5.6 years.
In contrast, the United States in 2016 ranked 43rd with an average lifespan of 78.7 years. In 2040, life expectancy is forecast to increase only 1.1 years to 79.8, but dropping in rank to 64th. By comparison, the United Kingdom had a lifespan of 80.8 years in 2016 and is expected to increase to 83.3, raising its rank from 26th to 23rd in 2040.
In addition, the study, published today in the international medical journal The Lancet, projects a significant increase in deaths from non-communicable diseases (NCDs), including diabetes, chronic obstructive pulmonary disease (COPD), chronic kidney disease, and lung cancer, as well as worsening health outcomes linked to obesity.
However, there is “great potential to alter the downward trajectory of health” by addressing key risk factors, levels of education, and per capita income, authors say.
“The future of the world’s health is not pre-ordained, and there is a wide range of plausible trajectories,” said Dr. Kyle Foreman, Director of Data Science at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, and lead author on the study. “But whether we see significant progress or stagnation depends on how well or poorly health systems address key health drivers.”
The top five health drivers that explain most of the future trajectory for premature mortality are high blood pressure, high body mass index, high blood sugar, tobacco use, and alcohol use, Foreman said. Air pollution ranked sixth.
In addition to China, several other nations are expected in 2040 to increase substantially in their rankings in terms of life expectancy, including:
Syria is expected to rise most in rank globally—from 137th in 2016 to 80th in 2040 -likely, according to the authors, due to a conservative model for conflict;
Nigeria from 157th to 123rd; and
Indonesia from 117th to 100th
In contrast, Palestine is expected to drop the most in its life expectancy ranking—from 114th in 2016 to 152nd in 2040. Moreover, several high-income nations are forecast to drop substantially in their rankings, including:
United States, dropping the most for high-income countries, from 43rd in 2016 to 64th in 2040;
Canada from 17th to 27th ;
Norway from 12th to 20th ;
Taiwan (Province of China) from 35th to 42nd ;
Belgium from 21st to 28th ;
Netherlands from 15th to 21st ;
The rankings also find that Spain is expected to place first in the world in 2040 (average lifespan of 85.8 years), a rise from fourth in 2016 (average lifespan of 82.9 years). Japan, ranked first in 2016 (average lifespan 83.7 years), will drop to second place in 2040 (average lifespan 85.7 years).
Rounding out the top 10 for 2040 are:
Singapore (average lifespan 85.4 years) ranked third, as compared to 83.3 years in 2016 and ranking also of third
Switzerland (average lifespan 85.2 years), as compared to 83.3 years in 2016 and ranking of second
Portugal (average lifespan 84.5 years), as compared to 81.0 years in 2016 and ranking of 23rd
Italy (average lifespan 84.5 years), as compared to 82.3 years in 2016 and ranking of seventh
Israel (average lifespan 84.4 years), as compared to 82.1 years in 2016 and ranking of 13th
France (average lifespan 84.3 years), as compared to 82.3 years in 2016 and ranking also of eighth
Luxembourg (average lifespan 84.1 years) as compared to 82.2 years in 2016 and ranking of 10th
Australia (average lifespan 84.1 years), as compared to 82.5 years in 2016 and ranking of fifth.
Among those top 10 nations, even their ‘worse’ scenarios in 2040 remain above 80 years. In stark contrast, the bottom-ranked nations, which include Lesotho, Swaziland, Central African Republic, and South Africa, the “better” and “worse scenarios” in 2040 range from a high of 75.3 years in South Africa (“better” scenario) to a low of 45.3 years in Lesotho (“worse scenario”), a 30-year difference.
“Inequalities will continue to be large,” said IHME Director Dr. Christopher Murray. “The gap between the ‘better’ and ‘worse’ scenarios will narrow but will still be significant. In a substantial number of countries, too many people will continue earning relatively low incomes, remain poorly educated, and die prematurely. But nations could make faster progress by helping people tackle the major risks, especially smoking and poor diet.”
In a “worse” scenario, life expectancy decreases in nearly half of all countries over the next generation. Specifically, 87 countries will experience a decline, and 57 will see an increase of one year or more. In contrast, in the “better” scenario, 158 countries will see life expectancy gains of at least five years, while 46 nations may see gains of 10 years or more.
The future shift toward increased premature mortality from NCDs and injuries and away from communicable diseases is apparent by the changing proportions of the top 10 causes of premature death.
In 2016, four of the top 10 causes of premature mortality were NCDs or injuries; in contrast, in 2040, that number increases to eight. The eight NCD or injury causes in the top ten in 2040 are expected to be ischemic heart disease, stroke, COPD, chronic kidney disease, Alzheimer’s disease, diabetes, road injuries, and lung cancer.
The study is unprecedented in scope, Foreman said, and provides more robust statistical modeling and more comprehensive and detailed estimates of risk factors and diseases than previous forecasts from the United Nations and other population studies institutes.
IHME researchers leveraged data from the Global Burden of Disease (GBD) study to produce forecasts and alternative “better” and “worse” scenarios for life expectancy and mortality due to 250 causes of death for 195 countries and territories.
Researchers produced forecasts of independent drivers of health, including sociodemographic measurements of fertility, per capita income, and years of education, along with 79 independent drivers of health such as smoking, high body mass index, and lack of clean water and sanitation. They then used information on how each of these independent drivers affects specific causes of death to develop forecasts of mortality.
“The range of ‘better’ and ‘worse’ scenarios enables stakeholders to examine potential changes to improve health systems—locally, nationally, and globally,” Murray said. “These scenarios offer new insights and help to frame health planning, especially regarding long lag periods between initial investments and their impacts, such as in the research and development of drugs.”
In addition to calling attention to the growing importance of non-communicable diseases, the analysis exposes a substantial risk of HIV/AIDS mortality rebounding, which could undo recent life expectancy gains in several nations in sub-Saharan Africa.
Furthermore, while NCDs are projected to rise in many low-income countries, communicable, maternal, neonatal, and nutritional diseases are likely to remain among the leading causes of early death, thereby creating a “double burden” of disease.
The study is entitled “Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016-40 for 195 countries and territories.”
Natural disasters can bring out both the best and the worst in people, but you can reduce the panic and anxiety of adverse weather conditions by being prepared with tools and resources that can secure your safety. Balancing safety with being human is key, says Scot Conway, leadership trainer at Guardian Quest Martial Arts in Spring Valley, Calif. “Disaster preparedness includes getting back to your life and work as quickly as possible after the disaster,” he says. Protect and prepare your home and your family by having the essentials on hand.
Emergency Contact Information
When a natural disaster occurs, keep your family together as best you can, recommends Conway. “Put contact information and medical information on every member of your family,” he says. “In case you get separated, make sure a note with each person identifies any information a first responder might need to know.” It’s also crucial to have a list of emergency numbers for local family members, neighbors and close friends. Teach your children how to use 911 and create a plan for emergencies that includes specific procedures and tasks for each family member.
Bandages and Medical Supplies
A first-aid kit is a must-have for your home. You need bandages, disinfectant and triple antibiotic ointments for treating minor cuts, scrapes and wounds, says Brandon Maye, founder of Practical Applications, an independent security consulting firm in Jacksonville, Ala. “Small cuts and wounds can become debilitating if infected and must be treated properly if in a survival situation,” says Maye. Pack up a variety of bandage sizes, travel-size disinfectant wipes and ointments in a waterproof bag to have handy.
Flashlights
If a blackout occurs, a flashlight is essential, says Maye. “There is nothing worse than being caught in the dark without a flashlight except being caught in the dark with a flashlight that doesn’t work,” he says. Stock up on batteries and keep them near the flashlights in your home. If your house is multistory, keep a working flashlight on each level to avoid falling up or down stairs in the dark. Rechargeable flashlights are a handy tool, but always keep a battery-operated as a backup when the power is out.
Socks, Gloves and Hats
Regardless of the time of year, a warm, dry pair of socks can increase your comfort level during a natural disaster, says Maye. Pack a pair for each member of the family in case rain, snow or soot dampens their socks. In cooler weather, a poncho, hat and pair of gloves are also essential to keep the elements off your skin and avoid the risk of frostbite when temps are freezing. If you have room in your disaster-preparedness bag, toss in a pair of rain boots as an extra precaution from flooding areas.
Food
Ensure that you have the energy needed to survive a natural disaster. Lorraine Holmes Milton, Houston-based author of “Disaster Master Plan,” suggests gathering enough nonperishable food to feed your family for 72 hours. Holmes Milton recommends ready-to-eat meals, protein bars, fruit cups, peanut butter and jelly with crackers and canned meat. Juice boxes and bottled water are also essential to pack. “These nonperishable foods can be very beneficial during any emergency situation,” she says. Check your food stash monthly to ensure it has not expired and to swap out with fresh nonperishables.
Water and Purifying Tablets
Since you can’t predict the amount of time your family may be under distress during a natural disaster, be prepared with at least 1 gallon of water for each person for seven days, recommends Holmes Milton. Store additional water for bathing during a disaster. Just in case you don’t have enough bottled water packed, purchase water-purifying tablets to disinfect polluted or suspended water so it is safe for drinking.
Emergency Radio
When power is lost and cell phones are out of range, an emergency radio can provide you with life-saving instructions. An emergency radio tuned to NOAA Weather Radio All Hazards is what the American Red Cross recommends, says Holmes Milton. This radio receiver runs on minimal or no power and is designed to function even when you are isolated or affected by a power outage. The receiver broadcasts emergency information for your area. “Adhere to the disaster information on the emergency radio, especially the mandatory evacuations,” says Holmes Milton. “If the authority tells you to evacuate — evacuate.”
Power Inverters
Whether your area is affected by a tornado, hurricane, flood or blackout, having a backup power source during a disaster can help you communicate with others and power up medical machines and devices necessary to keep your family safe. Holmes Milton points out that power inverters can be used to charge your cell phones, laptops, oxygen machine or even a nebulizer for asthma patients. A power inverter converts DC power to AC, so you can use batteries or a car charger to restore power to appliances, electronics and medical machines during an emergency.
Fire-Starting Materials
In cold temperatures, you will need an alternative source of heat to stay warm and cook meals until the disaster abates. Fire-starting materials are essential tools you need in case of a natural disaster. Have dry wood stored near your home and a few newspapers, matches or lighters. In extreme cases, you may even have to get creative, says Maye. “Whether you use a steel wool and a 9-volt battery or a magnesium stick, the ability to start a fire in a survival situation can mean the difference in life and death,” he says.
Mobile Technology
A charged cell phone or electronic device with wireless access can help you communicate with family, friends and first responders; get critical instructions and information from emergency personnel and government officials; and "warn other individuals that there may be danger approaching," says engineering professor Pamela McCauley Bush, leader of University of Central Florida’s Human Factors in Disaster Management Research Team. “Mobile technology has been critical in supporting ‘information seeking’ in crisis events, facilitating public action, and serving as a source of functional and emotional support.”
As Hurricane Sandy threatens the East Coast, millions are wondering: Am I doing everything I can to prepare for a disaster? eHow has created a list of what you need to do ASAP — from collecting relevant emergency documents to creating a home first aid kit — to get ready to survive Mother Nature’s wrath and the challenges that follow.
Protect Your Home
Homeowners facing a hurricane should take preventative measures such as trimming dead branches from trees and readying windows.
When disaster strikes, the public water supply may be unavailable, leaving people with no water for drinking, bathing or cleaning. To avoid finding yourself in this situation, provide yourself and your household with an emergency water supply. Refilling gallon water jugs is a very inexpensive way to make sure you have water when you need it. Plan on storing at least 1 gallon per person per day for at least three days, and store the water correctly to ensure that your supply is safe.
Safe Types of Water Jugs
FEMA and the American Red Cross recommend storing water in the food-grade containers you originally purchased the water in, and they recommend leaving the containers sealed until you actually use the water. However, these two organizations also say that food-grade gallon jugs that originally contained water or soda are safe to refill for emergency water storage. High Density Polyethylene is considered food-grade plastic, and you can find the initials “HDPE” next to the recycling sign on containers made from this material.
Preparation of Water Jugs
To prepare jugs for refilling with water, thoroughly clean them with hot water and dishwashing soap. Rinse the jugs very well so you don’t leave any soap residue behind. Make a solution of 1 teaspoon liquid chlorine bleach to 1 quart water. Pour the solution into the water jug and swish it around until the solution has touched every part of the inside of the jug. Pour the bleach solution out of the jug, and rinse the jug with clean tap water. The bleach helps to kill any bacteria that may be present inside the jug.
Longevity of Safe Water Storage
If you fill your water jugs with city tap water, it has been treated with chlorine, and you don’t have to treat it yourself. If you fill your jugs with well water, add 2 drops of chlorine bleach to help your water to last for six months. No matter which kind of water you use originally or how you treat your water, FEMA recommends replacing the water in your refilled jugs every six months. To help you remember when to replace your water, use a permanent marker to write the date you filled the jug on the jug itself.
Storage of Water Jugs
Fluorescent light and sunlight degrade High Density Polyethylene, shortening its life, breaking down your water storage containers and causing them to crack and leak. To keep your water jugs intact, store them in a cool, dark place where they will not be subject to sunlight. Dark closets, cupboards, cellars and basements are good places to store your water supply.
Milk Jugs as Water Containers
Although gallon-sized milk jugs are handy and readily available, FEMA and the American Red Cross do not recommend refilling them with water for emergency water storage. Milk contains protein and fruit sugars that are very difficult to remove from the jug’s plastic. When these proteins and sugars remain in the jug, bacteria grows, making the water unsafe to drink.
What it takes to live comfortably depends on each individual. However, there are basic things every human needs to survive. Survival depends on physical and intangible elements that feed your body as well as your mind.
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Air
Perhaps the most critical element to survival is oxygen that allows us to breathe. Whether your problem is lack of air, poor air quality or a physical condition that limits your lung capacity, you will likely suffer brain damage or die if your supply of oxygen is cut off for longer than three minutes. People who sufferer from emphysema or severe bronchitis can attest to this.
Water
The human body is made up of about 70 percent water. You won’t last long without this vital substance. In extreme heat situations, you can become dehydrated and begin to experience problems within hours.
Food
Food, while not quite as critical as water, is also key to survival. People who have survived hunger strikes show that humans can live for some time without eating. However, without proper hydration, the body will only last between 40 and 70 days without food.
Sleep
If you lose a night’s sleep, you’ll probably be grouchy the next day. Continue that pattern for more than a night or two and you’ll grow more delirious. Without the proper amount of sleep for an extended period of time, your body’s processes like hormone production needed for proper body functions begin to shut down.
Shelter
Whether it’s a tent or a penthouse, having adequate shelter to protect you from the elements is key to survival. Regardless of income, human beings need some form of protection against wind, rain and snow to live. The most effective form of shelter is determined by your environment.
Security
Not only is it vital to have protection from weather elements, it’s also important to have security against attacks of any kind. Encounter one too many wild animals or maniacs with a gun and you won’t live long. Arming yourself in some way against attacks from human and animal predators or having someone who can protect you, provides a sense of security and leads to a longer life.
Health
Good health is not necessarily vital to survival but some level of general health is important. Good health will determine the quality of your life and usually leads to a longer life. A lifetime of healthy habits, including adequate exercise and consumption of nutritious foods, helps extend survival.
Income
Regardless of a society’s currency or unit of trading, a source of income is vital to survival. In some countries, you may not need a significant amount of money to survive due to lower costs of living but you still need some way of paying your bills. Even if ill and unable to work, generous friends and relatives or governmental support is critical. Before the advent of cash, people around the world used goods and services to barter and trade.
Companionship
Viewers who witnessed Tom Hanks create a friend named Wilson out of a volleyball in the movie “Castaway” saw the importance of companionship for survival. Being alone and having no one with whom to share your life might not kill you as quickly as hunger or dehydration but it will eventually erode your will to survive. Having the love and connection of at least a pet is critical.
Means of Communication
Cut yourself off from any way to communicate with the outside world and your survival will be limited. Communication is vital in general for companionship and helps you through rough times. Also, if you need assistance, calling for help is critical. Elderly people with physical problems know this and equip themselves with an automatic calling system when living alone.
Whether you are involved in a car accident or need to report another type of crime in Los Angeles, your first step is to call the Los Angeles Police Department (LAPD). If you are on the University of California-Los Angeles campus, you should call the UCLA police department. A police report is an official document that keeps track of any information related to a crime or other incident, including what happened and who was involved. By filing a police report, you involve the authorities and may help them identify and apprehend criminals.
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Things You’ll Need
Phone
Call 911 in an emergency. LAPD officers will go to the scene as quickly as possible (see References 2).
Call 877-ASK-LAPD for non-emergency calls. An example of this is an incident in which you hit a street sign with your car but nobody is injured. A police officer will respond to the call, but it may not be a top priority (see References 1, 2).
Visit a nearby police station and ask to file a report. (see References 1).
Answer the police officer’s questions as accurately and thoroughly as possible. Be prepared to give your contact information in case police have follow-up questions (see References 1).
Cyclones are among the most dangerous and most destructive natural disasters that can occur. They have been responsible for about 1.9 million deaths worldwide over the last two centuries, and it is estimated that 10,000 people are killed each year by these storms. Cyclones tend to do the most damage in coastal areas, where they have been known to alter the landscape and remove forest canopy.
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Strong Winds
The most prevalent and perhaps best understood effect of cyclones is strong wind. In fact, these strong winds tend to affect the other destructive agents of cyclones. Low-level winds will typically be stronger on the right side of a cyclone in the Northern Hemisphere, but the wind strength tends to be highly variable no matter where a cyclone hits. The strong winds of cyclones can cause damage over an area of 25 km in smaller systems and up to 500 km in larger systems. Winds have been known to destroy smaller buildings and knock out power for thousands of people.
Tornadoes
Tornadoes do not normally occur in the same tropical regions that cyclones usually affect, rather tornadoes generally come from the storms in coastal regions and on islands. They may be far more common than people once believed. Cyclone-spawned tornadoes are often not reported in regions such as the Caribbean, but some damage patterns suggest that they occur frequently. Tornadoes can attain wind speeds of up to 480 kph and can stretch more than 3 km. Cyclone tornadoes tend to occur in the outer edge of the eyewall cloud, in the right-front quadrant of the storm system.
Rainfall and Flooding
The thunderstorms produced in a cyclone system produce intense rainfall — causing massive flooding, mudslides and landslides. This flooding tends to be more severe and destructive inland due to poor preparedness. Although this rainfall can be very destructive and cost millions of dollars in damage, rain in smaller cyclone systems can actually be beneficial when it provides much needed rainfall to drier areas.
Storm Surges
A storm surge is an abnormal rise in water that occurs during a cyclone. Potentially disastrous surges occur in coastal areas with low-lying terrain that enables inundation. The storm surge is typically the most damaging effect of cyclones, historically resulting in 90 percent of tropical cyclone deaths. When combined with strong winds, storm surges can produce massive waves that can cause inland flooding and destruction.
Fractures of bones are often surgically repaired through the use of plates and screws. Complications from these medical devices may occur, including inhibited movement, loosening of the screws and inflammation of the bone, muscle and tendons. The removal of plates and screws has been shown to alleviate many of these complications.
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Irritation to Tendons
The insertion of surgical plates to facilitate the healing of bone can induce irritation to the tendons and cause additional fractures by drilling holes for the screws. A study published in the June 2011 issue of the “Journal of Orthopedic Trauma” investigated the effects of 2.7 mm smaller, low-profile locking plates to replace larger, 3.5 mm traditional plates. The surgeons chose matching pairs of radii, a bone of the lower arm, and simulated a fracture in each. The crux of the study was to compare the smaller plate to the larger and to test locking screws in comparison to unlocking screws. The study concluded that locking screws were not as beneficial in comparison to using smaller plates when torsion strength and bending were rated.
Range of Motion
A controversy among surgeons exists as to whether the use of surgical locking plates to treat humeral fractures of the upper arm is beneficial over nonsurgical treatments. A study appearing in the April 2011 issue of the “Journal of Shoulder and Elbow Surgery” compared the two treatment methods. The researchers investigated the outcomes of patients after one year and found no significant differences between the two for parameters of the study. However, the authors noted that the nonsurgical treatment offered a greater range of motion as compared to the surgical option.
Complications with Absorbable Plates and Screws
Absorbable plates and screws are used in reconstructive surgery of the cranium and mandible (head and jaw). A study published in the March 2011 issue of the “Journal of Craniofacial Surgery” investigated complications associated with these surgical devices. The authors reviewed 430 instances where absorbable plates and screws were used for surgery and found five cases in which the patients developed an inflammatory reaction to the materials and reported infection of the sinuses. The study reported that symptoms cleared upon the removal of the devices and no infections were reported for the following 12 months.
Irritation to Muscle Tissue
The use of a plate and screws is common for the treatment of fractures of the distal radius, the furthest point of the lower arm from the body, and wrist. A study included in the May 2001 issue of the “Journal of Hand Surgery” reported that complications arise from the use of plates by screws penetrating the extensor muscles. The researchers examined 46 cases of distal radius fractures and found that of the 230 screws used in the procedures, 59 had protruded from the plate by more than 0.5 mm. Of these 59, 18 had caused inflammation to the tendons of the extensor muscles.
Some geographical areas are prone to certain types of national disasters. In others, large-scale accidents can occur without such natural precedent. In both types of situations, critical lessons have to be learned for the future while, at the same time, the effects of that disaster must be minimized as much as possible. Disaster management frameworks must address all of these concerns reflexively.
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Identification
The causes and effects of disaster management may be seen as operating cyclically. Disaster management techniques are not bred or prompted by a single incident, but evolve gradually both as a response to previous events and in a preparatory way towards future emergencies. In this sense. those stakeholders involved in the development of disaster management include a broad number of actors including politicians, nongovernmental organizations (NGOs), civilian elements, academics and many others. Humanitarian agencies or organizations fit prominently among related NGOs.
Desired Effects
Disaster management is concerned with a set of practices that must limit the range and level of the disaster’s impact, not only on surrounding people, but on the physical landscape and local infrastructure. The first concept is mitigation, one that contains the impact of the disaster to minimal proportions through mechanisms such as structure inspections and building inspections. Mitigation is followed by emergency preparedness systems and personnel, response mechanisms and teams, and finally, recovery contingencies that help the local population return to a degree of normalcy in daily life.
Causes
Disaster management and specific tools can be initiated by a number of emergency events. The Urban Earthquake Vulnerability Reduction Project isolates five primary categories of emergency: water and climate-related (floods, tornadoes or hurricanes), geologically-related (earthquakes and dam destruction), chemical/industrial/nuclear, accident-related and finally, biologically related. Each of these requires its own specific approaches, organization, mitigation resources, strategies and tactics.
Assessing Vulnerability
To learn from past causes and lessen the devastation of future effects, disaster management analysts must look at an area and determine its level of vulnerability. This can be based on surrounding geological features (such as fault lines) as well as the layout of the area in terms of structures, infrastructure, roads and other criteria. Additionally, vulnerability levels can be established based on socioeconomic conditions, how well those conditions prepare them for response to an emergency and ultimately, how they are prepared to undergo recovery efforts.
Medical gauze is most often used as a protective guard for wounds or cuts. Because gauze comes in direct contact with open wounds, it is of utmost importance that the gauze used is sterile. All gauze is guaranteed sterile until it is removed from its packaging, but keeping it sterile when the packaging has been removed or compromised will ensure it is free of potentially harmful pathogens. Ultraviolet lights and iodine are the most effective methods of ensuring the gauze you use is free of dirt, bacteria and viruses.
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Things You’ll Need
Soap and water
Iodine
UV light chamber
Boiling water
Clean the wound with soap and water — or peroxide, if available — prior to applying the gauze. Sterile gauze will not prevent infection, if the wound itself has been contaminated.
Place the it in an ultraviolet chamber and leave it for an hour. This will kill any germs and contaminants on the surface of the gauze.
Float the gauze in a pot of boiling water, if you do not have access to an ultraviolet chamber. Allow the gauze to sit in the boiling water for 2 to 3 minutes. Remove it and place it on a surface that has been thoroughly cleaned with soap and water, to prevent re-contamination.
Put iodine on the gauze, once the it has been sterilized using boiling water or ultraviolet light. Immediately place the gauze iodine-side down on the wound.
