Planning for Long‐Term Recovery Before Disaster Strikes: Case Studies of 4 US Cities: A Final Project Report

Among the four phases along the hazard continuum -- preparedness, response, recovery, and mitigation -- the sub‐field of long‐term recovery has long been an outlier, an "orphan" when it comes to concerted policy attention and pre‐disaster planning. It's not that community residents or municipal and state government officials are unaware of the potential long‐term residual consequences of natural disasters. Since the attacks of September 11, 2001 and the subsequent creation of the Department of Homeland Security, the U.S. government has spent billions of dollars to upgrade and enhance the country's ability to detect and respond to major catastrophic events, whether man‐made or natural in origin. The country experienced catastrophic wildfires in 2003, 2007‐2008, and 2011, a regional electrical blackout affecting 9 states and part of Canada in 2003, major Midwest flooding in 2008 and again this year, Category 3 or greater hurricanes in 2004, 2005, and 2008, and significant tornado clusters in 2011 that claimed 529 lives and caused over $17 billion in damages. These hazards have struck virtually every region of the country, and the consequences are readily evident to emergency managers and local city and county. Although the ratio of uncovered to covered losses has declined over this three‐decade timeframe, from approximately 8:1 to 4:1, absolute dollar losses have escalated tremendously. This may represent gains in mitigation efforts to insure against losses in high‐risk areas, but the size and growth of uncovered losses suggest a growing recovery challenge. This difference between covered and uncovered losses reflects the absolute minimum investment required for affected areas to return to pre‐event conditions, much less build back to a better or higher standard. Furthermore, what this trend line cannot capture are those disaster consequences not so easily monetized -- diminished physical and mental health among an affected citizenry, loss of a sense of community and attachment to place, or large scale social disruptions or population displacements. Given the magnitude of the social investment needed to pursue long‐term recovery after a disaster, and the attention that other phases in the hazard continuum have experienced, why is recovery still a policy orphan, and what are the local implications for pre‐disaster planning for long‐term recovery

The effects of trauma exposure and posttraumatic stress disorder (PTSD) on the emotion-induced memory trade-off

Many past examinations of memory changes in individuals with posttraumatic stress disorder (PTSD) have focused on changes in memory for trauma. However, it is unclear if these mnemonic differences extend beyond the memory of the trauma to memory for other positive and negative information and if they are specific to individuals with PTSD or extend to other individuals who have experienced trauma. The present study examined the influences of trauma exposure and PTSD on an effect that may parallel tunnel memory in PTSD: the emotion-induced memory trade-off, whereby emotional aspects of an experience are remembered at the expense of the nonemotional context. Three groups of participants (25 with current PTSD, 27 who had experienced trauma but did not have current PTSD, and 25 controls who had neither experienced significant trauma nor met criteria for current PTSD) were shown complex visual scenes that included an item (positive, negative, or neutral) placed on a neutral background. Forty-five minutes later, participants underwent a recognition memory test for the items and backgrounds separately. An emotion-induced memory trade-off was said to occur when there was a significant difference in item and background memory for emotional scenes, but not for neutral scenes. Results indicated that people with PTSD, like the other groups, were more likely to remember positive and negative items than neutral items. Moreover, people with PTSD exhibited a memory trade-off comparable in magnitude to that exhibited by the non-trauma control group. In contrast, trauma-exposed people without a current diagnosis of PTSD did not show a trade-off, because they remembered items within scenes better than their accompanying contexts not only for emotional but also for neutral scenes. These results suggest that (1) the effect of emotion on memory for visual scenes is similar in people with PTSD and control participants, and (2) people who have experienced trauma, but do not have PTSD, may have a different way of attending to and remembering visual scenes, exhibiting less of a memory trade-off than either control participants or people with PTSD

Disaster Recovery: Guidance for Donors

This guidance paper goes above and beyond what donors can learn--or already have learned--from a handful of excellent guides developed by the philanthropic community since Hurricane Katrina. Much of this literature on "disaster philanthropy" has been directed at the most effective ways for donors and their agents to deliver assistance during unfolding crises and the immediate aftermath, and how donors and their agents can help provide food, water, clothing, shelter, sanitation, health care and self-governance for masses of displaced and traumatized people. Here, we discuss innovative and under-appreciated ways that donors can help American communities recover and rebuild resiliently from disasters. The goal is to give donors a fresh perspective on supporting local efforts not only to rebuild from disasters already sustained, but also to prepare to recover from potential disasters. In both cases, there are opportunities for donors to directly fund, or pool and leverage funds for a variety of recovery and rebuilding activities, programs and services

Topological organization of whole-brain white matter in HIV infection

Infection with human immunodeficiency virus (HIV) is associated with neuroimaging alterations. However, little is known about the topological organization of whole-brain networks and the corresponding association with cognition. As such, we examined structural whole-brain white matter connectivity patterns and cognitive performance in 29 HIV+ young adults (mean age = 25.9) with limited or no HIV treatment history. HIV+ participants and demographically similar HIV− controls (n = 16) residing in South Africa underwent magnetic resonance imaging (MRI) and neuropsychological testing. Structural network models were constructed using diffusion MRI-based multifiber tractography and T(1)-weighted MRI-based regional gray matter segmentation. Global network measures included whole-brain structural integration, connection strength, and structural segregation. Cognition was measured using a neuropsychological global deficit score (GDS) as well as individual cognitive domains. Results revealed that HIV+ participants exhibited significant disruptions to whole-brain networks, characterized by weaker structural integration (characteristic path length and efficiency), connection strength, and structural segregation (clustering coefficient) than HIV− controls (p < 0.05). GDSs and performance on learning/recall tasks were negatively correlated with the clustering coefficient (p < 0.05) in HIV+ participants. Results from this study indicate disruption to brain network integrity in treatment-limited HIV+ young adults with corresponding abnormalities in cognitive performance

Predisposing, Enabling, and Need Factors Associated with High Service Use in a Public Mental Health System

The purpose of this study was twofold: (1) To investigate the individual- and system-level characteristics associated with high utilization of acute mental health services according to a widely-used theory of service use—Andersen’s Behavioral Model of Health Service Use —in individuals enrolled in a large, public-funded mental health system; and (2) To document service utilization by high use consumers prior to a transformation of the service delivery system. We analyzed data from 10,128 individuals receiving care in a large public mental health system from fiscal years 2000–2004. Subjects with information in the database for the index year (fiscal year 2000–2001) and all of the following 3 years were included in this study. Using logistic regression, we identified predisposing, enabling, and need characteristics associated with being categorized as a single-year high use consumer (HU: >3 acute care episodes in a single year) or multiple-year HU (>3 acute care episodes in more than 1 year). Thirteen percent of the sample met the criteria for being a single-year HU and an additional 8% met the definition for multiple-year HU. Although some predisposing factors were significantly associated with an increased likelihood of being classified as a HU (younger age and female gender) relative to non-HUs, the characteristics with the strongest associations with the HU definition, when controlling for all other factors, were enabling and need factors. Homelessness was associated with 115% increase in the odds of ever being classified as a HU compared to those living independently or with family and others. Having insurance was associated with increased odds of being classified as a HU by about 19% relative to non-HUs. Attending four or more outpatient visits was an enabling factor that decreased the chances of being defined as a HU. Need factors, such as having a diagnosis of schizophrenia, bipolar disorder or other psychotic disorder or having a substance use disorder increased the likelihood of being categorized as a HU. Characteristics with the strongest association with heavy use of a public mental health system were enabling and need factors. Therefore, optimal use of public mental services may be achieved by developing and implementing interventions that address the issues of homelessness, insurance coverage, and substance use. This may be best achieved by the integration of mental health, intensive case management, and supportive housing, as well as other social services

Koinonia

In This IssueThe Fabric of Our Faithfulness: Part 1, David S. Guthrie What is the Sophomore Slump-and Why Should We Care?: Excerpted from Visible Solutions for Invisible Students: Helping Sophomores Succeed, by Laurie A. Schreiner & Jerry Pattengale Around CampusServant Leadership, Tess Bradley The 7 Be\u27s of Student Leader Supervision, Jesse Brown Spotlight on SpeakersJohn 7:53-8:11: The Politically Correct Version, Calvin Miller Regular FeaturesPresident\u27s Corner Editor\u27s Disk ACSD Business: Placement Services 2001, Conference Thoughts: Something Old...Something New..., Submissions Soughthttps://pillars.taylor.edu/acsd_koinonia/1031/thumbnail.jp

Ultrafine wools: comfort and handle properties for next-to-skin knitwear and manufacturing performance

This study aimed to quantify the skin comfort and handle properties of a range of wool fabrics produced from ultrafine wool (13.7&ndash;15.1 &micro;m) and in doing so determine if differences in fiber diameter and staple crimp frequency (5.3&ndash;7.1 crimps/cm) were important in these properties. The fabrics were evaluated using a range of subjective and objective measurement techniques, including the Wool ComfortMeter, the Wool HandleMeter and in wearer trials. This work indicated that single jersey fabrics made from ultrafine wool are approaching the limit of objective and subjective evaluation of next-to-skin comfort. The results from the Wool ComfortMeter, Wool HandleMeter and the wearer trial show that there were no significant effects that can be attributed to wool staple crimp (fiber curvature) in these ultrafine wool fabrics. The work also demonstrated a difference in the manufacturing response when knitted fabric made from wools of different fiber diameter (13.7&ndash;23.7 &micro;m), and using yarns of the same count, resulted in a progressively higher fabric mass per unit area as mean fiber diameter was progressively reduced

The Effect of Glucagon-Like Peptide-2 Receptor Agonists on Colonic Anastomotic Wound Healing

Background. Glucagon-like peptide 2 (GLP-2) is an intestinal specific trophic hormone, with therapeutic potential; the effects on intestinal healing are unknown. We used a rat model of colonic healing, under normoxic, and stress (hypoxic) conditions to examine the effect of GLP-2 on intestinal healing. Methods. Following colonic transection and reanastomosis, animals were randomized to one of six groups (n = 8/group): controls, native GLP-2, long-acting GLP-2 (GLP-2- MIMETIBODY, GLP-2-MMB), animals were housed under normoxic or hypoxic (11%  O2) conditions. Animals were studied five days post-operation for anastomotic strength and wound characteristics. Results. Anastomotic bursting pressure was unchanged by GLP-2 or GLP-2-MMB in normoxic or hypoxic animals; both treatments increased crypt cell proliferation. Wound IL-1β increased with GLP-2; IFNγ with GLP-2 and GLP-2-MMB. IL-10 and TGF-β were decreased; Type I collagen mRNA expression increased in hypoxic animals while Type III collagen was reduced with both GLP-2 agonists. GLP-2 MMB, but not native GLP-2 increased TIMP 1-3 mRNA levels in hypoxia. Conclusions. The effects on CCP, cytokines and wound healing were similar for both GLP-2 agonists under normoxic and hypoxic conditions; anastomotic strength was not affected. This suggests that GLP-2 (or agonists) could be safely used peri-operatively; direct studies will be required