Limited research has been conducted to understand the relationship between heat wave warnings with public awareness and behavioral changes in the Asian population. The Hong Kong Observatory introduced the “very hot weather warning” in 2000 to alert the public of heatstroke and sunburn in Hong Kong. However, the population's behavioral responses to these weather alerts is unclear. Moreover, the relationship between perceived health risks and behavioral changes has not been examined. The goal of this study is to examine the health risk perceptions and behavioral changes following public heat wave warnings in Hong Kong.

A cross-sectional, population-based, telephone survey, using the last-birthday method was conducted within two weeks following a heat wave warning in 2009. A heat warning and a health study instrument, based on Intergovernmental Panel on Climate Change (IPCC) guidelines and related literature was developed and validated. Descriptive and multivariate logistic regression analyses were conducted.

The questionnaire was completed by 1,123 individuals whose socio-demographic characteristics were comparable to 2009 Hong Kong population census data. Of respondents, 83.6% were aware of the heat wave weather warning. Multivariate logistic regression of socio-demographic factors indicated that being female, those in middle age groups, and those with higher educational attainment was significantly associated with heat wave warning awareness. Among those aware of the public warning, the majority were unconcerned about potential adverse health effects, < 40% were aware of the community heat-related preparedness plans, and < 50% changed their behavior to mitigate the potential adverse health impacts of hot weather.

This is the first study to examine climate change and health behavioral responses in an urban Chinese population. Future research direction should further investigate correlations between awareness and health protective actions, as well as the drivers for health behavioral changes that mitigate the impact of climate change.

Disaster could greatly affect physical, psychological and social health of people affected. However, current crisis intervention protocols after natural or man-made disasters often overlook the psychosocial impact of crisis on victims. In its executive board meeting in 2005, WHO has called for action in implementing programs that can repair the psychological damage of war, conflict and natural disasters. Currently there are three main post-disaster psychological interventions available in the field: Critical Incidence Stress Management developed by Mitchell and Everly in 1980's; Psychological First Aid developed by the National Child Traumatic Stress Network and National Center for PTSD after millennium; and Mental Health First Aid developed by the Kitchener and Jorm after millennium.

A comparative descriptive analysis among the three different interventions was performed. Specific objectives, target populations, content, training duration, empirical evidence, instructor training and various adaptations were compared. Public health implications for implementation in disaster settings are discussed.

The study is among the first that provided a detail comparison among the different protocols available in the field. More importantly it discussed the empirical evidence that support the use of the specific protocols at different scenarios. Implication the results of the study could be used as a guidance for choosing psychological interventions immediately post-disasters by emergency responders, public health practitioners and academic researchers.

Psychological First Aid (PFA) has become the choice of mental health intervention and integration with the current disaster relief protocols during emergencies by the Institute of Medicine, NIMH and the WHO. It can be used during or immediately after disaster. People without mental health specialized training, including public health practitioners and emergency responders can learn and apply to everyone in need. Whilst being used extensively, few studies have evaluated the effectiveness of PFA and its field applicability.

A prospective randomized controlled study. 800 emergency medical responders were recruited. Participants were randomly assigned to the control/intervention arms to receive a one-day training of PFA based on the protocol developed by the National Child Traumatic Stress Network (2006). A pilot study was conducted to evaluate the screening tools and training material and all training was provided by trained clinical psychologist. Repeated measures analysis of covariance was used to evaluate the efficacy of PFA program in changes in various outcome measures between PFA intervention and control group. All analyses were conducted on the intent-to-treat and completer groups. Ethical approval was approved by the CUHK-NTEC Clinical Research Ethics Committee.

Preliminary results from the post-training and 3 month follow-up data indicated participants in the training group have reported a significantly more substantial knowledge in disaster mental health, improve self-efficacy in delivering help in times of emergencies, high frequency of actual helping behavior as well as better self-reported psychological well-being when compared with waitlist control group.

This study examines and reports findings of clinical effectiveness of PFA 3 months post training in Chinese emergency responders. Preliminary results provided empirical evidences on the effectiveness of the approach.

Unintentional household injuries are a major public health problem that affects large numbers of people. Various population-based surveys from the literature showed > 40% of households reporting an injury that required medical attention. However, there is a general lack in comprehensive population surveys to highlight the risk of post-injury, help-seeking behavior and its associated financial cost. This study is part of the urban, home-based injury epidemiological study series (2007–2010) in Hong Kong.

A population-based, cross-sectional, random telephone survey was conducted using the last birthday method in 2009. A study instrument was developed and validated based on the modified Chinese World Health Organization guidelines for injury and violence surveys.

The study population comprised of non-institutionalized, Cantonese-speaking Hong Kong residents (n = 6,570). Among the 39.4% self-reported injuries within the past 12 months, only 8.6% of injured people had sought medical care. Respondents tended to seek medical care from the private setting in the first episode of post-injury treatment. Among health seekers, 70% of the injured participants reported having to seek a second treatment and the care-seeking pattern shifted from private to public medical service delivery setting. Predictors of service preferences were identified and discussed.

Medical care seeking patterns post-unintentional household injury was identified. Medical and emergency services providers may wish to consider health service implications.

Natural disasters cannot be prevented but their human impact can be mitigated. Effective medical and public health mitigation and responses require multidisciplinary efforts and appropriate training. Whilst Asia is currently ranked as the most natural disaster prone area globally, limited disaster medical and public health response training opportunities are available in the region. Our paper reports efforts to identify the training gaps and ways to fill them to prepare frontline practitioners and academic researchers in disaster and medical humanitarian emergency relief efforts in Asia.

Grounded on the disciplinary principles of academic training in public health, emergency & disaster medicine and primary care, our paper reviews the current disaster related academic training offered in these disciplines and maps out the training and knowledge gaps in disaster mitigation and response for frontline practitioners and academic researchers. We suggest ways to fill such gaps.

A two-dimensional (clinical versus non-clinical), three-tier education training framework (Entrant level, Continuous medical education needs and Expertise level) is developed. Experiences and key training needs in Asia are highlighted.

The proposed framework identifies areas for comprehensive training for medical and public health practitioners who are interested to engage in medical disaster relief. The proposed framework also aims to strengthen mitigation and response capacities in health systems.

Knowledge about disasters plays an essential role in managing and responding to disasters and emergencies, especially among a group of health care professionals who are actively or will potentially be involved in disaster and emergency settings. A set of training materials that aims to enhance understanding of disasters and their impact of health has been developed. This project aims to examine the effectiveness of the disaster knowledge training to improve technical knowledge and perceptions of health impact of disasters in health care professionals and responders.

“Understanding Disasters” training was provided to 300 health care professionals during May to October. Each of the participated attendees filled a pre- and immediate post-training survey that contains socio-demographic information and 20 items measuring various knowledge of disasters.

287 individuals completed the questionnaires (95% response rate). Findings demonstrated that training may effectively enhance one's knowledge about disasters, especially by clarifying the myths and misunderstandings towards disasters. Respondents demonstrated an enhancement of knowledge in 70% of the questions (14/20). Of note, while the whole sample exhibited an enhancement in knowledge, non-clinical staff appeared to have more statistical significant gained in knowledge than clinical based trainee.

Although disasters cannot be controlled, human impacts of disaster can be mitigated if appropriate training might be offer. This study demonstrates that training program might be useful to enhance better understanding of health impact of disasters.

Sleep disturbances are common symptoms during the immediate and long-term aftermath of exposure of traumatic events. While stress affects sleep in all age groups, due to differences in physiological, psychological, and socio-behavorial risk factors, the clinical management of pediatric patients with sleep disturbances post-disaster might be different. This study aims to systematically review scientific literature on the clinical management of pediatric sleep disturbances post-disaster and its clinical implication in developing countries. Methods: A keyword-based, systematic review was conducted for scientific publication in academic and disaster literature databases (Medline, PUBMED, Academic Search Premier, Google Scholar, ELDIS, PsycINFO, PILOTS and RELIEFWEB) until October 2010. Abstracts of all the hits were inspected to remove non-relevant articles, and all relevant articles were reviewed and scored by two reviewers to determine relevancy before being included in the final study database. Quality, relevance, and applicability of the reported literature were examined critically with the EBM level of evidence and EPPHPPQ (2003) assessment tool.

The literature disproportionally emphasized the clinical effects and psychological impacts of traumatic events on pediatric patients, and most reported studies were reported as a subset within PTSD study literature. Management of younger children, gender differences, clinical effectiveness of cross-disciplinary management modalities, and experiences in middle- and low-income countries were extremely limited. While principles of sleep hygiene and clinical guidelines for management of adult sleep disturbance are available, the application of clinical effectiveness and appropriateness of these guidelines in pediatric population must be examined further.

Currently, there is limited literature on the acute management of pediatric sleep disturbances post-disaster in developing countries. Evidence-based studies are needed to identify the appropriate clinical approaches to support the pediatric population with sleep disturbances post-disaster.

China has one of the countries with highest occurrence of disasters and disasters are disproportionately affecting rural area of China where ethnic minorities are inhibiting. Limited studies have been conducted to examine how mental health of ethnic minorities in China might be affected by disasters. Through qualitative focus group study methods, this multi-site project examines the mental health impact of disasters in ethnic minority groups in rural China.

20 focus groups were conducted in rural Sichuan, Yunnan, Gansu and Hainan province of China to understand the mental health impact and coping of disasters during 2008–2010. Ethnic minority groups including Tai, Naxi, Li, Jiang and Hui affected by earthquake, flooding, mudslide, storm and snow storm were included for the focus group interviews. Guided questions were used and male and female participants participated separately in different groups. Focus groups were held at common area within the village and were all type recorded and transcribed for analyses. Saturation of data was reached and thematic analyses were conducted.

Whilst distress, including mood disturbance, sleep problems and heightened arousal after disaster occurrences, were reported among respondents, when compared with Han Chinese affected in disasters, ethnic minority respondents reported more resilience and coping capacity post disaster. Gender impact and gaps in mental health service were identified.

Study results disparities in resilience and coping behavior among different ethnic groups in China. More in-depth studies should be conducted to understand post disaster mental health needs and service utilization of ethnic minorities in China.

The Sichuan earthquake on 12 May 2008 with a magnitude of 8.0 killed > 87,000 people. The response of the Hong Kong Red Cross (HKRC) included a basic healthcare team to a small rural town called Yanmen three weeks after the earthquake. The objective of this study was to review HKRC's medical records to identify the disease pattern in the Chinese rural setting post earthquake.

A cross-sectional, record-based study of all patients treated by the HKRC basic healthcare team from 01 June to 19 June 2008. This retrospective study studied the medical records collected during the clinical consultations, and descriptive analysis was performed for the demographic and clinical information. Blood pressure measurement was classified according to the JNC-7 classification, and the age- and gender-specific prevalence of hypertension was sought.

A total of 2,034 cases were seen during the 19-day period with daily attendance ranging from 73 to 153 cases. Musculoskeletal, respiratory, and gastrointestinal problems were the top three categories and accounted for 30.4, 17.4, and 12.7% respectively. Trauma accounted for 5.4% of the cases attended, and 26.0% of the injuries were related to the earthquake. A total of 38.7% of the consultations were for medical problems that existed before the earthquake. A total of 43.4% patients with blood pressure measurements were above the recognized cutoff for hypertension.

Due to the impact and time phase post disaster, trauma, and injuries directly resulting from the earthquake did not contribute to a large number of cases. However, the management of chronic illness was an important issue, especially with the excessive prevalence of high blood pressure found in this study. Further studies to investigate the relationship between chronic diseases including hypertension and post-earthquake conditions are needed.

Limited information is available on the health outcomes of the rural older population in developing countries is affected by disasters. In October 2010, Hainan Province experienced severe flooding following heavy rains. Nearly four million people were affected and many had undergone resettlement. This study investigated the impacts of the flooding on people living in the disaster-affected rural communities. The findings were compared with baseline information collected in 2010 about health issues in rural villages in Hainan. Health outcome comparisons also were made between ethnic groups (Han versus Li).

A two-stage cluster-sampling, cross-sectional post-disaster study was conducted. The entire Hainan Island was categorized into ranks of different severity in rainfall amount and associated damage in October (most severe, intermediate, least severe). The county with the most rainfall and the most severe ranking and the one with least rainfall and the least severe ranking were identified. In each county, one Han and one Li village were chosen by using a computer-generated random number, so four villages were sampled in total. More than 100 individuals ≥ 50 years of age were interviewed by face-to-face survey. Data on disaster-related injuries, socio-demographic information, non-communicable disease, lifestyle, and mental health were collected.

Findings indicated the severity of impact was associated with self-reported health outcomes of older population. Gender and ethnic differences were found in reported health outcomes. Predictors of adverse post-disaster health outcomes in older populations in rural communities were identified.

The results demonstrated significant differences in the impacts of flooding in rural populations. Targeted services and interventions should be planned to address the disparity and meet the physical and mental health needs post-disaster.