Daily Archives: 27 April 2024

Experts develop a blueprint to assist elderly individuals at risk of storm floods

Recent research findings suggest that emergency planners in Shanghai and New York City are under increasing scrutiny to safeguard elderly residents from the severe consequences of coastal flooding precipitated by storms and cyclones.

Both metropolises are acutely vulnerable to the ravages of storm-induced flooding, and a comparative analysis of their emergency management systems reveals marked disparities in their approaches to evacuating elderly individuals to safety.

Through an in-depth examination of emergency protocols within these cities, specialists have formulated a strategy for efficient evacuation that could potentially apply to other cities globally threatened by similar flood risks, including Mumbai, Bangkok, Jakarta, Ho Chi Minh City, Miami, and Tokyo.

This innovative research, featuring contributions from the University of Birmingham, was published in Nature Water. The authors urge emergency planning bodies to establish additional local shelters to expedite the safe evacuation of those in flood-prone areas.

The study points out the discrepancy in evacuation travel times, noting that trips to evacuation sites in New York City generally take less than 20 minutes. This starkly contrasts with Shanghai, where evacuating flood-threatened areas can extend up to 3 to 4 hours due to a scarcity of accessible shelters in vulnerable communities.

Professor Nigel Wright of the University of Birmingham remarked on the vulnerability of peripheral neighbourhoods in coastal cities to storm-induced flooding, highlighting that despite these areas’ lower population densities, they often house groups with special needs, including older adults.

The contrast in evacuation strategies for older adults in Shanghai and New York City underscores the importance of strategic, risk-informed evacuation planning against storm flooding. The study offers valuable insights into making operational emergency evacuation decisions and suggests a template for crafting flood management policies for major coastal cities worldwide.

The researchers also identified potential challenges in evacuating people from offshore islands, such as Shanghai’s Chongming Island, where emergency responders face difficulties promptly reaching evacuees. The centralisation of shelters and uneven distribution of vulnerable populations leave such high-risk neighbourhoods inadequately served during extreme flood events.

Amid the backdrop of increasing coastal population sensitivity to flood disasters, China and the United States are enhancing their emergency management strategies through better organisation and evacuation planning. The evolving nature of coastal flood risk necessitates further research into evacuation strategies, factoring in climate change, coastal urbanisation, and adaptation strategies.

The phenomenon of coastal flooding, exacerbated by storm surges, is a global issue. Incidents are becoming more frequent and severe due to factors such as climate-induced sea-level rise, changes in storm patterns, and human activities. Notable flood disasters in cities like Shanghai, New Orleans, New York City, and Macau highlight the acute vulnerability of coastal cities to such events.

Projections for the 136 largest coastal cities indicate a more than threefold increase in the population exposed to centennial coastal floods from 38.5 million in 2005 to 150 million by the 2070s, with potential economic damages escalating to more than ten times the current figures by 2050.

In Europe, without mitigative action, the expected annual exposure of individuals to coastal flooding could surge from 10,200 to 3.65 million by 2100, primarily affecting major urban areas due to rising sea levels and ongoing socioeconomic development.

More information: Jie Yin et al, Strategic storm flood evacuation planning for large coastal cities enables more effective transfer of elderly populations, Nature Water. DOI: 10.1038/s44221-024-00210-z

Journal information: Nature Water Provided by University of Birmingham

Patient-centered cardiovascular care is crucial for enhancing equity and outcomes

According to a new American Heart Association Scientific Statement published today in Circulation, adult cardiovascular care focusing on the patient can enhance individual experiences and medical outcomes.

Patient-centred care revolves around recognizing the patient as an individual and respecting their beliefs, preferences, and values. It merges the healthcare professional’s expertise with the patient’s health priorities, empowering patients through informed decision-making by providing clear information and fostering an active partnership among the patient, their family, and the healthcare team. Michael J. Goldfarb, M.D., M.Sc., chair of the scientific statement writing committee and associate professor of cardiology at the Jewish General Hospital and McGill University in Montreal, Quebec, emphasized that patient-centred care involves informed choices rather than allowing patients unrestricted freedom in their healthcare decisions.

Dr Goldfarb also highlighted the necessity for healthcare professionals managing adults with heart disease to acquire guidance and practical tools for integrating a person-centred approach into regular clinical practice. The statement outlines several critical components of patient-centred care, including shared decision-making, medication management, and focusing on patient-oriented outcomes.

Shared decision-making is characterized by a collaborative relationship based on trust, mutual respect, and open communication between patients, families, and healthcare professionals. Health professionals must accommodate their patients’ health literacy levels and provide transparent, straightforward information about risks, current health conditions, and the potential outcomes of different screening and treatment options, encouraging patients to engage in discussions about their health.

Although the effectiveness of medications in preventing and treating heart disease is well-documented, adherence issues are significant, with many patients not consistently taking their medications as prescribed. This can be due to various factors, including the complexity of medication regimes and the cost of drugs. Engaging patients in discussions about their medication can help improve adherence, reduce costs, and minimize side effects, possibly through the use of combination pills or substituting expensive medications with cheaper but equally effective alternatives.

The statement further stresses the importance of incorporating the patient’s physical, emotional, and social well-being assessments into managing their heart disease. This holistic view allows healthcare professionals to understand better the patient’s condition and the effects of treatments, recognizing changes that might not be apparent through standard medical examinations alone.

Dr. Goldfarb also pointed out that care outcomes significant to health professionals and health systems might only sometimes align with what is important to patients. For instance, while the length of hospital stay is a standard metric for care quality, patients might prioritize their overall quality of life and functional ability post-treatment more highly.

The statement also addresses the need to overcome barriers to implementing patient-centred care, particularly for populations burdened disproportionately by cardiovascular disease. This includes deploying culturally and linguistically appropriate services and considering social determinants of health such as economic stability and access to quality healthcare. Special attention is given to different demographics, such as older adults, women, individuals with behavioural and mental health issues, adults with congenital heart disease, and those with physical disabilities, emphasizing tailored approaches that consider their unique health needs and circumstances.

Moreover, the statement acknowledges the obstacles to patient-centred care stemming from patient, clinician, and health system-related factors. These include patients’ distrust or limited access to healthcare, clinicians’ time constraints and documentation demands, and health systems that may need more resources for team-based care.

In conclusion, while there are challenges to genuinely patient-centred care, the statement underscores that it is achievable and already practised to some extent. As highlighted by Dr Goldfarb, the ongoing development and incorporation of patient-centred outcome measures are vital for optimizing care for patients, their families, and caregivers.

More information: Michael J. Goldfarb et al, Patient-Centered Adult Cardiovascular Care: A Scientific Statement From the American Heart Association, Circulation. DOI: 10.1161/CIR.0000000000001233

Journal information: Circulation Provided by American Heart Association