Health in Emergencies and Disasters Quarterly
Volume:1 Issue: 3, Spring 2016

Recovery is a part of disaster management cycle during which repair and reconstruction takes place, and individuals, groups, and communities retake what they have lost and ideally the risk of future incidents reduces. Life recovery is a subjective and multidimensional issue influenced by various factors, whereas valid measurable indicators in evaluating the recovery after disasters are helpful. This article considers the related texts with the aim of reviewing the indicators of recovery after disasters. The examined issues are basics of recovery, recovery in the form of process, as well as components and dimensions of recovery.

Identification of the effective factors in reducing response time in prehospital emergency medical service (EMS) can assist in improving its services. This study aimed at reviewing the effect of applying global positioning system (GPS) on response time of Tehran EMS ambulances.
Of 132 Tehran EMS stations, 24 ones were randomly selected, and relevant data, including the response time of all missions in 2009 (without GPS) and in 2011 (with GPS) as well as number of daily calls to each dispatch center were extracted. The average number of daily calls in the call centers were categorized into 3 groups as follows: I) ≤10 calls, II) 10 to 15 calls, and III) >15 calls. The statistical analysis of the obtained data was carried out by paired t test.
The findings revealed that the average response times in 2009 for the 3 groups (I, II, and III) were 10.11, 11.25, and 10.92 minutes, respectively. These times recorded for groups (I, II, and III) in 2011 were 9.86, 10.71, and 11.58 minutes, respectively, which were significantly less than the response times recorded in 2009 (P This research has demonstrated that the application of GPS in the ambulances may be essential in the reduction of response time, especially in emergency stations with more average mission numbers

The safety of rehabilitation centers is of great importance to ensure the well-being of patients. The present study aimed to determine non-structural and functional vulnerability of state rehabilitation centers of Tehran City welfare organization in disasters using national standard instruments in 2014.
This study has a descriptive and cross-sectional design. A total of 17 rehabilitation centers affiliated with Tehran welfare organization are investigated. The vulnerability of centers was measured using 2 checklists of non-structural and functional vulnerability of the World Health Organization. The reliabilities of the non-structural and functional vulnerability instuments were 0.79 and 0.91, respectively, using the Cronbach α. The data were collected through observation and interview with authorities of centers and their staffs. The data analysis was performed through descriptive statistics and 1-sample t-test using SPSS 16.
Among 17 rehabilitation centers, the mean functional safety of 11 centers (64.7%) was high and showed low vulnerability and safety of 6 centers (35.3%) was average and showed average vulnerability. With regard to non-structural safety level, 9 centers (53% of centers) had high safety level and showed low vulnerability. Eight centers (47% of centers) had average safety level and showed average vulnerability. The results of 1-sample t test showed that at the significance level of 0.05, there was no significant difference between functional and non-structural safety of centers.
The functional and non-structural safety of state rehabilitation centers of Tehran welfare organization was above average and vulnerability of centers to disaster was average, too. We suggest that the required planning be performed to improve non-structural and functional safety quality of centers and reduce their vulnerability.

Air pollution is one of the most important factors threatening the health of citizens. It increases the prevalence of cardiovascular and respiratory diseases as well as emergency admissions to hospitals in the polluted metropolitan cities. The present study was conducted using Air Quality (AirQ) model and aimed to investigate the effects of air pollution on the number of emergency cardiovascular and respiratory patients admissions in Tehran hospitals during 2005-2014.
This was cross-sectional study. First, the needed hourly information was received from the Bureau of Air Quality Control, and the Environmental Protection Agency of Tehran City. Then, the information was validated according to WHO criteria, and the statistical indicators and the stages required to quantify the harmful effects of air pollutants were calculated by using appropriate application.
According to the results, the number of cases admitted to the emergency ward of hospitals due to heart diseases (by exposure to particulate matter) during the years 2005 to 2014 were respectively 1797, 1280, 1766, 1980, 2132, 2703, 2389, 2594, 2158, and 2291 cases, totaling 20990 persons, and for respiratory diseases (due to exposure to particulate matter) during the same years were respectively 4643, 3301, 4650, 5117, 5511, 6999, 6180, 6452, 5577, and 5922 cases, totaling 54352 people. Also, the number of cases admitted to the emergency wards of hospitals due to chronic obstructive pulmonary disease caused by exposure to emissions of pollutants such as sulfur dioxide, nitrogen dioxide, and ozone were respectively, 1806, 2454, and 2941 cases.
Air pollution in Tehran increases the load of emergency visits to hospitals and increases the risk of respiratory and heart diseases. Therefore, measures to reduce and control air pollution and to prepare, equip, and mobilize hospitals, particularly emergency wards, are among important priorities that should be pursued seriously by the authorities.

To reduce traffic injuries in the country, health professionals should have accurate estimates of road traffic deaths. Multiple and sometimes inconsistent statistics presented by organizations in charge create high degree of uncertainty for planners and decision makers. To achieve an accurate estimate, several methods are available. Of them, capture-recapture method seems to be an appropriate and affordable method regarding the reliability of the data sources. This study aimed to estimate the number of road traffic deaths in Kurdistan Province during 2004-2009, using capture-recapture method and based on 2 sources of data obtained from Death Registration System and Forensic Medicine Department.
All deaths due to road traffic accidents in Kurdistan Province were extracted during 2004-2009. These deaths were legally registered in Death Registration System and Forensic Medicine Department. Shared cases among these 2 sources were identified based on full name, age, gender, and date of death and finally the accurate number of deaths was calculated using the correct volume formula.
During study period, Forensic Medicine Department of the province had registered about 3289 cases of road traffic mortalities and Death Registration System had registered 3771 cases of death resulting from road traffic accidents. Using capture-recapture method, the number of deaths in the same years was estimated as 5726 people (5818-5634:CI95%). The proportion of mortality registered in the Death Registration System and Forensic Medicine Department of the province to the total estimated deaths were 65.8% and 57.4%, respectively and both systems together covered 85.4% of road traffic deaths, i.e. under-reporting of about 832 people.
The results of the present study indicate that none of 2 sources of Forensic Medicine Department and Death Registration System, per se or both, fully covered road traffic mortalities and using capture-recapture method can help estimate the actual number of deaths.

Infants are the most vulnerable people with special needs in natural disasters. Since midwives are responsible for providing reproductive health services to infants in disastrous situations, assessing their professional competence is of great importance.
This cross-sectional study was conducted in Tehran, Iran. A total of 361 midwives were selected by cluster sampling method. After giving their informed consents, they participated in the study and completed the researcher-made questionnaire about providing health services to infants in natural disasters. Midwives’ professional competence was investigated through self-assessment in terms of their perceived importance, knowledge, and skill. Then, the data were analyzed using SPSS.
Mean(SD) total score of professional competency of midwives in providing services to infants in disasters was 91.95(20.2) obtained from 3 subcategories: perceived importance, 39.83(9.55); knowledge, 22.5(5.06); and skill 30.16(6.86). There were significant relationships between the scores of professional competency of midwives with age (P=0.053), degree of education (P=0.028), the workplace (P=0.053), and experience in disaster (P=0.047). About 49.86% of midwives demonstrated middle level of professional competency. The lowest knowledge and skill score were reported in managing common neonatal problems such as asphyxia, sepsis, physical trauma, which requires referral and stability.
The average scores of professional competency of midwives to deliver reproductive health service to infants in disasters shows the necessity of related and integrated education. It is recommended that by holding training exercises and simulations, midwives be educated with regard to disasters and how to respond in these situations.

Stroke is a major cause of death and disability in the world and these complications can be decreased by competent emergency care. Emergency medical service (EMS) transfer half of the stroke patients to hospitals. This study aimed to determine diagnosis of status and transfer time of stroke patients by EMS to a main hospital (Valiasr) in Arak City.
This study was a descriptive analytic study and conducted on 43 patients with a diagnosis of stroke that transferred by EMS to Valiasr Hospital in Arak City. Data were collected through a checklist which contained information about age, sex, type of accident, response time, scene time, transfer time, and total time from inpatients records and Emergency Center statistics. Regarding data analysis, descriptive statistical tests were performed by SPSS 19.
The mean(SD) age of patients was 73.7(3.8) years and 51.2% of them were women. The stroke diagnosis by EMS technicians was correct in 15(34.9%) cases. In 20(46.5%) cases, the diagnosis was wrong and in 8(18.6%) cases, there were not any diagnosis. The most common non-stroke condition was confusion. The mean response time and arrival time to location, transfer time, and total time were 6.9, 16.9, 9.1, and 35.3 minutes, respectively. In patients with correct diagnosis and wrong or no diagnosis, these mean times were 7, 17.1, 3.9, and 35.7 minutes and 6.9, 16.8, 9.7, and 33.5 minutes, respectively.
The results of this study showed that an accurate diagnosis by EMS technicians could be an indicator for faster transfer of the patient to treatment center. It is recommended that more appropriate pre-hospital diagnosis tools of stroke be developed and handed to EMS staff, for more accurate diagnosis of strokes and their better treatment.