Natural disasters in the history of the eastern Turk empire

This article analyzes the effect of climate extremes on the historical processes that took place (AD 536, 581, 601, 626 and 679) in the Eastern Turk Empire (AD 534–745) in Inner Asia. Climate extremes are sharp, strong and sometimes protracted periods of cooling and drought caused by volcanic eruptions that in this case resulted in a negative effect on the economy of a nomadic society and were often accompanied by famine and illness. In fact, many of these natural catastrophes coincided with the Black Death pandemics among the Eastern Turks and the Chinese living in the north of China. The Turk Empire can be split into several chronological periods during which significant events that led to changes in the course of history of the nomadic state took place: AD 534–545—the rise of the Turk Empire; AD 581–583—the division of the Turk Empire into theWestern and the Eastern Empires; AD 601–603—the rise of Qimin Qaghan; AD 627–630—the Eastern Turks are conquered by China; AD 679–687—the second rise of the Eastern Turk Empire. The research shows that there is clearly-discernable interplay between important historical events and climate extremes in the history of the Turk Empire. This interplay has led us to the conclusion that the climatic factor did have an impact on the historical processes that took place in the eastern part of Inner Asia, especially on the territories with a nomadic economy. © The Author(s) 2019

Volcanic Gases:Silent Killers

This is the accepted manuscript. The final version is available at http://link.springer.com/chapter/10.1007%2F11157_2015_14.Volcanic gases are insidious and often overlooked hazards. The effects of volcanic gases on life may be direct, such as asphyxiation, respiratory diseases and skin burns; or indirect, e.g. regional famine caused by the cooling that results from the presence of sulfate aerosols injected into the stratosphere during explosive eruptions. Although accounting for fewer fatalities overall than some other forms of volcanic hazards, history has shown that volcanic gases are implicated frequently in small-scale fatal events in diverse volcanic and geothermal regions. In order to mitigate risks due to volcanic gases, we must identify the challenges. The first relates to the difficulty of monitoring and hazard communication: gas concentrations may be elevated over large areas and may change rapidly with time. Developing alert and early warning systems that will be communicated in a timely fashion to the population is logistically difficult. The second challenge focuses on education and understanding risk. An effective response to warnings requires an educated population and a balanced weighing of conflicting cultural beliefs or economic interests with risk. In the case of gas hazards, this may also mean having the correct personal protection equipment, knowing where to go in case of evacuation and being aware of increased risk under certain sets of meteorological conditions. In this chapter we review several classes of gas hazard, the risks associated with them, potential risk mitigation strategies and ways of communicating risk. We discuss carbon dioxide flows and accumulations, including lake overturn events which have accounted for the greatest number of direct fatalities, the hazards arising from the injection of sulfate aerosol into the troposphere and into the stratosphere. A significant hazard facing the UK and northern Europe is a “Laki”-style eruption in Iceland, which will be associated with increased risk of respiratory illness and mortality due to poor air quality when gases and aerosols are dispersed over Europe. We discuss strategies for preparing for a future Laki style event and implications for society

Distress and quality of life characteristics associated with seeking surgical treatment for stress urinary incontinence

<p>Abstract</p> <p>Background</p> <p>Current research focuses on three variables in evaluating the impact of stress urinary incontinence (SUI) on daily living: severity of incontinence, distress or bother resulting from incontinence, and effect on health related quality of life (HRQoL). Understanding the impact of these variables is important as they are the driving force behind women seeking surgical treatment. Given the importance of HRQoL in determining need for treatment, as well as evaluating treatment success, this review provides an assessment of the degree to which HRQoL is impaired in women seeking surgical treatment.</p> <p>Methods</p> <p>PubMed searches for the terms "quality of life and distress and urinary incontinence" and "quality of life and bother and urinary incontinence" were performed with limits of English, human and female subjects through May 2008. All studies using validated instruments were included. No time limit was placed on the search.</p> <p>Results</p> <p>Of 178 articles retrieved, 21 met the inclusion criteria, and 17 reported methods of scoring. The studies used the Urogenital Distress Inventory (UDI) and the Incontinence Impact Questionnaire (IIQ). Wide ranges of mean and individual levels of severity of symptoms, UDI and IIQ scores were seen among women seeking surgical treatment. Fourteen studies reported baseline and post-surgical treatment distress and QoL data. Statistically significant improvements between baseline and post-surgical UDI and IIQ scores were reported in 12 studies. Reported cure rates ranged from 46% to 97%. Satisfaction with the procedure was reported in 4 studies and ranged from 84% to 91%. A minority of studies reported the relationship between reduction in symptoms and change in HRQoL.</p> <p>Conclusion</p> <p>HRQoL is the main reason women seek surgical treatment for incontinence and surgical treatment leads to a significant improvement in mean HRQoL scores. Assessment of HRQoL has proved less useful in identifying why individual women seek treatment for incontinence. Preliminary work has begun to characterize the interaction between severity of symptoms, distress or bother resulting from these urinary symptoms, impact on HRQoL, and treatment seeking behavior, but further research is needed. Greater standardization in the reporting of results of distress or bother and HRQoL would allow for comparison across studies.</p

Distress and quality of life characteristics associated with seeking surgical treatment for stress urinary incontinence

<p>Abstract</p> <p>Background</p> <p>Current research focuses on three variables in evaluating the impact of stress urinary incontinence (SUI) on daily living: severity of incontinence, distress or bother resulting from incontinence, and effect on health related quality of life (HRQoL). Understanding the impact of these variables is important as they are the driving force behind women seeking surgical treatment. Given the importance of HRQoL in determining need for treatment, as well as evaluating treatment success, this review provides an assessment of the degree to which HRQoL is impaired in women seeking surgical treatment.</p> <p>Methods</p> <p>PubMed searches for the terms "quality of life and distress and urinary incontinence" and "quality of life and bother and urinary incontinence" were performed with limits of English, human and female subjects through May 2008. All studies using validated instruments were included. No time limit was placed on the search.</p> <p>Results</p> <p>Of 178 articles retrieved, 21 met the inclusion criteria, and 17 reported methods of scoring. The studies used the Urogenital Distress Inventory (UDI) and the Incontinence Impact Questionnaire (IIQ). Wide ranges of mean and individual levels of severity of symptoms, UDI and IIQ scores were seen among women seeking surgical treatment. Fourteen studies reported baseline and post-surgical treatment distress and QoL data. Statistically significant improvements between baseline and post-surgical UDI and IIQ scores were reported in 12 studies. Reported cure rates ranged from 46% to 97%. Satisfaction with the procedure was reported in 4 studies and ranged from 84% to 91%. A minority of studies reported the relationship between reduction in symptoms and change in HRQoL.</p> <p>Conclusion</p> <p>HRQoL is the main reason women seek surgical treatment for incontinence and surgical treatment leads to a significant improvement in mean HRQoL scores. Assessment of HRQoL has proved less useful in identifying why individual women seek treatment for incontinence. Preliminary work has begun to characterize the interaction between severity of symptoms, distress or bother resulting from these urinary symptoms, impact on HRQoL, and treatment seeking behavior, but further research is needed. Greater standardization in the reporting of results of distress or bother and HRQoL would allow for comparison across studies.</p

Is complementary and alternative medicine (CAM) cost-effective? a systematic review

BACKGROUND: Out-of-pocket expenditures of over $34 billion per year in the US are an apparent testament to a widely held belief that complementary and alternative medicine (CAM) therapies have benefits that outweigh their costs. However, regardless of public opinion, there is often little more than anecdotal evidence on the health and economic implications of CAM therapies. The objectives of this study are to present an overview of economic evaluation and to expand upon a previous review to examine the current scope and quality of CAM economic evaluations. METHODS: The data sources used were Medline, AMED, Alt-HealthWatch, and the Complementary and Alternative Medicine Citation Index; January 1999 to October 2004. Papers that reported original data on specific CAM therapies from any form of standard economic analysis were included. Full economic evaluations were subjected to two types of quality review. The first was a 35-item checklist for reporting quality, and the second was a set of four criteria for study quality (randomization, prospective collection of economic data, comparison to usual care, and no blinding). RESULTS: A total of 56 economic evaluations (39 full evaluations) of CAM were found covering a range of therapies applied to a variety of conditions. The reporting quality of the full evaluations was poor for certain items, but was comparable to the quality found by systematic reviews of economic evaluations in conventional medicine. Regarding study quality, 14 (36%) studies were found to meet all four criteria. These exemplary studies indicate CAM therapies that may be considered cost-effective compared to usual care for various conditions: acupuncture for migraine, manual therapy for neck pain, spa therapy for Parkinson's, self-administered stress management for cancer patients undergoing chemotherapy, pre- and post-operative oral nutritional supplementation for lower gastrointestinal tract surgery, biofeedback for patients with "functional" disorders (eg, irritable bowel syndrome), and guided imagery, relaxation therapy, and potassium-rich diet for cardiac patients. CONCLUSION: Whereas the number and quality of economic evaluations of CAM have increased in recent years and more CAM therapies have been shown to be of good value, the majority of CAM therapies still remain to be evaluated