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Article ; Online: Pregnant Women’s Experiences during Hurricane Maria

Georgina Silva-Suarez / Silvia E. Rabionet / Carmen D. Zorrilla / Hulda Perez-Menendez / Solaritza Rivera-Leon

International Journal of Environmental Research and Public Health, Vol 18, Iss 8541, p

Impact, Personal Meaning, and Health Care Needs

2021 Volume 8541

Abstract: During a disaster, pregnant women are considered among the most vulnerable. Background: On 20 September 2017, the Caribbean was hit by a category 4 hurricane. The purpose of the study was to explore the impact on pregnant women during and after the ... ...

Abstract	During a disaster, pregnant women are considered among the most vulnerable. Background: On 20 September 2017, the Caribbean was hit by a category 4 hurricane. The purpose of the study was to explore the impact on pregnant women during and after the hurricane regarding access to health care, social services, and support systems. Methods: In-depth interviews were conducted to 10 women that were pregnant during the event. Qualitative inquiry based on the Interpretative Phenomenological Analysis framework was used to interpret the narratives. Results: Five major themes emerged: meaning of living through a disaster, fear, the dual burden of protecting themselves and their unborn baby, disruption in health care, and coping mechanisms. Despite the negative feelings, most participants experienced positive transformations. They narrated how they stayed calm and coped in order to protect their pregnancy. Their overall evaluation of the healthcare system was positive. The support of friends and family was crucial pre and post-disaster. Conclusions: The interviews provided a wealth of firsthand information of women experiencing a natural disaster while pregnant. The findings underscore the need to incorporate emotional support in the preparedness and response plans for pregnant women. Educating, empowering, and incorporating families and communities is vital in these efforts.
Keywords	hurricane ; natural disasters ; pregnant women ; prenatal stress ; pregnancy ; Medicine ; R
Subject code	360
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Impact of Hurricane Maria on Student Pharmacists and Their Perception of Their Academic Performance.

Silva-Suarez, Georgina / Reyes, Yarelis Alvarado / Rodriguez-Figueroa, Linnette / Rivera-Ortiz, Norymar / Loyselle, Juan Vargas- / Rabionet, Silvia E / Medina, Patricia / Lozada, Raquel / Ortiz, Blanca

American journal of pharmaceutical education

2020 Volume 84, Issue 9, Page(s) ajpe7808

Abstract: Objective. ...

Abstract	Objective.
MeSH term(s)	Academic Performance ; Adult ; Cyclonic Storms ; Female ; Humans ; Male ; Perception ; Pharmacists ; Puerto Rico ; Students, Pharmacy ; Young Adult
Language	English
Publishing date	2020-09-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	603807-4
ISSN	1553-6467 ; 0002-9459
ISSN (online)	1553-6467
ISSN	0002-9459
DOI	10.5688/ajpe7808
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: A Reminder From the Devastation Hurricane Maria Left Behind.

Lopez-Candales, Angel / Hernandez-Suarez, Dagmar F / Osterman-Pla, Anthony D / Conde-Santiago, José G

Cureus

2018 Volume 10, Issue 1, Page(s) e2038

Abstract: On September 20, 2017, Hurricane Maria hit Puerto Rico, causing an unprecedented humanitarian ...

Abstract	On September 20, 2017, Hurricane Maria hit Puerto Rico, causing an unprecedented humanitarian crisis on a level that none of us have experienced before. The following editorial intends to show a physician's perspective of the impact of this storm on healthcare, particularly in triggering cardiovascular events.
Language	English
Publishing date	2018-01-08
Publishing country	United States
Document type	Editorial
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.2038
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Effect of Hurricane Maria on HPV, Tdap, and meningococcal conjugate vaccination rates in Puerto Rico, 2015-2019.

Colón-López, Vivian / Díaz-Miranda, Olga L / Medina-Laabes, Diana T / Soto-Abreu, Roxana / Vega-Jimenez, Idamaris / Ortiz, Ana P / Suárez, Erick L

Human vaccines & immunotherapeutics

2021 Volume 17, Issue 12, Page(s) 5623–5627

Abstract: In September 2017, Hurricane Maria devastated the Caribbean region, among them the US territory ... analyze the impact of Hurricane Maria on vaccine initiation. Monthly initiation rates were estimated. Age ...

Abstract	In September 2017, Hurricane Maria devastated the Caribbean region, among them the US territory of Puerto Rico (PR). Vaccination distribution and uptake suffered from the impact. This study evaluated the trends in monthly vaccination initiation rates for human papilloma virus (HPV), Tdap and meningococcal conjugate (MenACWY) adolescent vaccines from 2015 to 2019, during which it was possible to observe and analyze the impact of Hurricane Maria on vaccine initiation. Monthly initiation rates were estimated. Age-standardized initiation rate ratio (SRR) and 95% CI were estimated. The analysis included 85,340 adolescents; 52.3% were male, and 47.7% were females. September 2017 showed HPV vaccine initiation had the lower rates of all the studied vaccines, with a rate of 75% after the disaster (from a rate of almost 90% in July 2017). Tdap and MenACWY vaccines rates remained above 90% in the same period. The SRR of HPV vaccine for September and October 2017 showed an estimated reduction of 5% and 8% in vaccine initiation rates, respectively for each month, when 2016 was the reference year (
MeSH term(s)	Adolescent ; Alphapapillomavirus ; Cyclonic Storms ; Diphtheria-Tetanus-acellular Pertussis Vaccines ; Female ; Humans ; Immunization Schedule ; Male ; Meningococcal Vaccines ; Papillomaviridae ; Papillomavirus Infections/epidemiology ; Papillomavirus Infections/prevention & control ; Papillomavirus Vaccines ; Puerto Rico/epidemiology ; Vaccination/methods
Chemical Substances	Diphtheria-Tetanus-acellular Pertussis Vaccines ; Meningococcal Vaccines ; Papillomavirus Vaccines
Language	English
Publishing date	2021-12-02
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2664176-8
ISSN	2164-554X ; 2164-5515
ISSN (online)	2164-554X
ISSN	2164-5515
DOI	10.1080/21645515.2021.2004809
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Article ; Online: Pregnant Women's Experiences during Hurricane Maria: Impact, Personal Meaning, and Health Care Needs.

Silva-Suarez, Georgina / Rabionet, Silvia E / Zorrilla, Carmen D / Perez-Menendez, Hulda / Rivera-Leon, Solaritza

International journal of environmental research and public health

2021 Volume 18, Issue 16

Abstract: During a disaster, pregnant women are considered among the most vulnerable.: Background: On 20 September 2017, the Caribbean was hit by a category 4 hurricane. The purpose of the study was to explore the impact on pregnant women during and after the ... ...

Abstract	During a disaster, pregnant women are considered among the most vulnerable. Background: On 20 September 2017, the Caribbean was hit by a category 4 hurricane. The purpose of the study was to explore the impact on pregnant women during and after the hurricane regarding access to health care, social services, and support systems. Methods: In-depth interviews were conducted to 10 women that were pregnant during the event. Qualitative inquiry based on the Interpretative Phenomenological Analysis framework was used to interpret the narratives. Results: Five major themes emerged: meaning of living through a disaster, fear, the dual burden of protecting themselves and their unborn baby, disruption in health care, and coping mechanisms. Despite the negative feelings, most participants experienced positive transformations. They narrated how they stayed calm and coped in order to protect their pregnancy. Their overall evaluation of the healthcare system was positive. The support of friends and family was crucial pre and post-disaster. Conclusions: The interviews provided a wealth of firsthand information of women experiencing a natural disaster while pregnant. The findings underscore the need to incorporate emotional support in the preparedness and response plans for pregnant women. Educating, empowering, and incorporating families and communities is vital in these efforts.
MeSH term(s)	Adaptation, Psychological ; Cyclonic Storms ; Delivery of Health Care ; Female ; Humans ; Pregnancy ; Pregnant Women ; Qualitative Research
Language	English
Publishing date	2021-08-12
Publishing country	Switzerland
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph18168541
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Article ; Online: Differential and persistent risk of excess mortality from Hurricane Maria in Puerto Rico: a time-series analysis.

Santos-Burgoa, Carlos / Sandberg, John / Suárez, Erick / Goldman-Hawes, Ann / Zeger, Scott / Garcia-Meza, Alejandra / Pérez, Cynthia M / Estrada-Merly, Noel / Colón-Ramos, Uriyoan / Nazario, Cruz María / Andrade, Elizabeth / Roess, Amira / Goldman, Lynn

The Lancet. Planetary health

2018 Volume 2, Issue 11, Page(s) e478–e488

Abstract: Background: Hurricane Maria struck Puerto Rico on Sept 20, 2017, devastating the island ...

Abstract	Background: Hurricane Maria struck Puerto Rico on Sept 20, 2017, devastating the island. Controversy surrounded the official death toll, fuelled by estimates of excess mortality from academics and investigative journalists. We analysed all-cause excess mortality following the storm. Methods: We did a time-series analysis in Puerto Rico from September, 2017, to February, 2018. Mortality data were from the Puerto Rico Vital Statistics System. We developed two counterfactual scenarios to establish the population at risk. In the first scenario, the island's population was assumed to track the most recent census estimates. In the second scenario, we accounted for the large-scale population displacement. Expected mortality was projected for each scenario through over-dispersed log-linear regression from July, 2010, to August, 2017, taking into account changing distributions of age, sex, and municipal socioeconomic development, as well as both long-term and seasonal trends in mortality. Excess mortality was calculated as the difference between observed and expected deaths. Findings: Between September, 2017, and February, 2018, we estimated that 1191 excess deaths (95% CI 836-1544) occurred under the census scenario. Under the preferred displacement scenario, we estimated that 2975 excess deaths (95% CI 2658-3290) occurred during the same observation period. The ratio of observed to expected mortality was highest for individuals living in municipalities with the lowest socioeconomic development (1·43, 95% CI 1·39-1·46), and for men aged 65 years or older (1·33, 95% CI 1·30-1·37). Excess risk persisted in these groups throughout the observation period. Interpretation: Analysis of all-cause mortality with vital registration data allows for unbiased estimation of the impact of disasters associated with natural hazards and is useful for public health surveillance. It does not depend on certified cause of death, the basis for the official death toll in Puerto Rico. Although all sectors of Puerto Rican society were affected, recovery varied by municipal socioeconomic development and age groups. This finding calls for equitable disaster preparedness and response to protect vulnerable populations in disasters. Funding: Forensic Science Bureau, Department of Public Safety, and Milken Institute School of Public Health of The George Washington University (Washington, DC, USA).
MeSH term(s)	Age Factors ; Cause of Death ; Cyclonic Storms/mortality ; Humans ; Natural Disasters/mortality ; Puerto Rico ; Sex Factors
Language	English
Publishing date	2018-10-12
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2542-5196
ISSN (online)	2542-5196
DOI	10.1016/S2542-5196(18)30209-2
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Differential and persistent risk of excess mortality from Hurricane Maria in Puerto Rico

Carlos Santos-Burgoa, ProfMD / John Sandberg, PhD / Erick Suárez, ProfPhD / Ann Goldman-Hawes, PhD / Scott Zeger, ProfPhD / Alejandra Garcia-Meza, MPH / Cynthia M Pérez, ProfPhD / Noel Estrada-Merly, MS / Uriyoan Colón-Ramos, ScD / Cruz María Nazario, ProfPhD / Elizabeth Andrade, DrPH / Amira Roess, PhD / Lynn Goldman, MD

The Lancet Planetary Health, Vol 2, Iss 11, Pp e478-e

a time-series analysis

2018 Volume 488

Abstract: Summary: Background: Hurricane Maria struck Puerto Rico on Sept 20, 2017, devastating the island ...

Abstract	Summary: Background: Hurricane Maria struck Puerto Rico on Sept 20, 2017, devastating the island. Controversy surrounded the official death toll, fuelled by estimates of excess mortality from academics and investigative journalists. We analysed all-cause excess mortality following the storm. Methods: We did a time-series analysis in Puerto Rico from September, 2017, to February, 2018. Mortality data were from the Puerto Rico Vital Statistics System. We developed two counterfactual scenarios to establish the population at risk. In the first scenario, the island's population was assumed to track the most recent census estimates. In the second scenario, we accounted for the large-scale population displacement. Expected mortality was projected for each scenario through over-dispersed log-linear regression from July, 2010, to August, 2017, taking into account changing distributions of age, sex, and municipal socioeconomic development, as well as both long-term and seasonal trends in mortality. Excess mortality was calculated as the difference between observed and expected deaths. Findings: Between September, 2017, and February, 2018, we estimated that 1191 excess deaths (95% CI 836–1544) occurred under the census scenario. Under the preferred displacement scenario, we estimated that 2975 excess deaths (95% CI 2658–3290) occurred during the same observation period. The ratio of observed to expected mortality was highest for individuals living in municipalities with the lowest socioeconomic development (1·43, 95% CI 1·39–1·46), and for men aged 65 years or older (1·33, 95% CI 1·30–1·37). Excess risk persisted in these groups throughout the observation period. Interpretation: Analysis of all-cause mortality with vital registration data allows for unbiased estimation of the impact of disasters associated with natural hazards and is useful for public health surveillance. It does not depend on certified cause of death, the basis for the official death toll in Puerto Rico. Although all sectors of Puerto Rican society were ...
Keywords	Environmental sciences ; GE1-350
Subject code	310
Language	English
Publishing date	2018-11-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Disaster Management in a Nephrology Service: Lessons Learned from Hurricane Maria.

Bonilla-Félix, Melvin / Suárez-Rivera, Marta

Blood purification

2018 Volume 47, Issue 1-3, Page(s) 199–204

Abstract: Background: Puerto Rico suffered a major humanitarian -crisis after Hurricane Maria. We describe ...

Abstract	Background: Puerto Rico suffered a major humanitarian -crisis after Hurricane Maria. We describe our experience with patients with renal disease in an academic medical center. Summary: A comprehensive emergency response plan should be developed, shared and discussed with the team and the patients prior to the hurricane. The needs of the staff should not be ignored to ensure their ability to participate as responders. Physical damage to facilities, lack of basic services, shortage of disposable products, and the inability to get to treatment centers are the most common threats. Preemptive dialysis can avoid serious complications. A contingency plan to move patients to another center should be prearranged in case the unit is rendered nonfunctional after the storm. Patients must receive preventive education about fluid and dietary restrictions and the possible use of potassium binding drugs if they cannot reach a dialysis unit. A list of alternative drugs that could be used if patients are not able to fill their medications is required. The Internet and social media proved to be an invaluable communication tool. A registry of patients with updated contact information, as well as contact information for relatives and a physical address where an emergency rescue team can be dispatched is essential. Water safety should be reinforced. Key Message: Our experience showed us that preparing for the worst is not enough. Advanced planning of a streamlined response is the best tactic to decrease harm.
MeSH term(s)	Cyclonic Storms ; Disaster Medicine/methods ; Disaster Medicine/organization & administration ; Disaster Medicine/standards ; Disaster Planning/methods ; Disaster Planning/organization & administration ; Disaster Planning/standards ; Humans ; Registries ; Renal Dialysis
Language	English
Publishing date	2018-12-05
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	605548-5
ISSN	1421-9735 ; 0253-5068
ISSN (online)	1421-9735
ISSN	0253-5068
DOI	10.1159/000494580
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Article: Adapt and Evolve: How our Internal Medicine Residency changed in Hurricane Maria.

Hernandez-Suarez, Dagmar F / Rodriguez-Ruiz, Christina / Malavé-Sánchez, Melanie / Mirabal-Arroyo, Javier E / Colón-Márquez, José A / Jiménez-Velázquez, Ivonne Z / Rassi-Stella, Nicole / Febles-Negrón, Arelis / Lopez-Candales, Angel

Puerto Rico health sciences journal

2018 Volume 37, Issue 1, Page(s) 3–4

MeSH term(s)	Cyclonic Storms ; Internal Medicine/education ; Internship and Residency/organization & administration ; Puerto Rico
Language	English
Publishing date	2018-03-16
Publishing country	Puerto Rico
Document type	Editorial ; Research Support, N.I.H., Extramural
ZDB-ID	639137-0
ISSN	0738-0658
ISSN	0738-0658
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Article ; Online: Records covered under the maria da penha law by the military police in border areas / Registros enquadrados na lei maria da penha realizados pela brigada militar em área de fronteira

Madeline Mazuí Guterres Suarez Mazuí / Marcia Adriana Poll / Cenir Gonçalves Tier / Letice Dalla Lana

Revista de Pesquisa : Cuidado é Fundamental Online, Vol

2021 Volume 12

Abstract: ... de Área de Fronteira (1º BPAF) enquadrados como violência contra a mulher na Lei Maria da Penha. MÉTODOS ... de Fronteira, 565 (18,26%) casos ocorreram devido a ações de violência contra a mulher enquadrada na Lei Maria ...

Abstract	OBJETIVO:caracterizar os atendimentos efetuados pela Brigada Militar do 1º Batalhão de Policiamento de Área de Fronteira (1º BPAF) enquadrados como violência contra a mulher na Lei Maria da Penha. MÉTODOS: Pesquisa do tipo documental, com busca aos Boletins de Atendimentos da Brigada Militar no período de 2014. RESULTADOS: Dos 3.094 atendimentos efetuados pela Brigada Militar do 1º Batalhão de Policiamento de Área de Fronteira, 565 (18,26%) casos ocorreram devido a ações de violência contra a mulher enquadrada na Lei Maria da Penha e 426 casos (13,76%) referiram-se a eventos de Furto Qualificado. Dos 565 casos notificados, 205 (36,30%) das mulheres vítimas de violência permaneceram sob medida protetiva no ano de 2014. Apenas 278 (49,20%) agressores foram encaminhados à Polícia Civil para fazer o registro da ocorrência. CONCLUSÃO: Conclui-se que, ao se conhecer a violência do município, novas práticas sociais e ações de saúde podem ser estruturadas.
Keywords	Violência contra a mulher ; Políticas Públicas ; Violência Doméstica ; Medicine ; R ; Nursing ; RT1-120
Language	English
Publishing date	2021-05-01T00:00:00Z
Publisher	Universidade Federal do Estado do Rio de Janeiro
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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