International review of psychiatry
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The aim of this paper is to highlight the activities and observations of some NGOs and some dedicated researchers in the field of psychosocial consequences of disaster in Bangladesh, particularly in the coastal areas and the tornado-affected areas of the district of Tangile and Jamalpur during the last two decades. Some of the advantages of the non-governmental organizations' (NGOs) work in relief and development were their linkages with grass-roots people ensuring access to the community and community participation, the flexible approach of work, ability and willingness to learn from people and ability to connect people's lives with their realities. The most remarkable survey carried out by the Social Assistance and Rehabilitation for the Physically Vulnerable (SARPV-Bangladesh) after the 1996 tornado showed, on average, that women are more affected psychologically than men; 66% of the total sample in the disaster area were psychologically traumatized and required emergency services. ⋯ In developing countries like Bangladesh, limitations of mental health professionals and inadequate knowledge and practice about disaster mental health among the medical and paramedical staff, may lead to delays in the psychosocial management and rehabilitation of the survivors. To respond properly to a serious type of disaster like a cyclone or a tornado or recurrent devastating flood, the disaster mental health team should be aware of the socio-economic status, local culture, tradition, language and local livelihood patterns. Integration of the team with the network of various governmental and non-governmental organizations is essential to provide mental health services effectively.
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Myanmar as a country in South-East Asia is vulnerable to disasters including storms, floods, fire, earth fall, earthquakes, depending on the geographical nature and climate of the area. The National Health Committee (NHC) of Myanmar has formed under it an Emergency Healthcare Committee. ⋯ The experience of dealing with the tsunami has shown that psychosocial support to the affected community not only reduces its psychological distress but can also facilitate physical rehabilitation. Thus mental health and psychosocial aspects have been included in disaster preparedness and management plans of the MoH.
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This paper discusses the tsunami disaster in Sri Lanka with special reference to Buddhism, which is the majority religion in the island. The role of religious beliefs and of religion in general in strengthening coping skills is well known. ⋯ This paper provides an overview of the relationship between culture and traumatic experiences, with a brief discussion of the role of religion in mental health. It then goes on to explore some relevant Buddhist concepts and practices which can be used in clinical settings.
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Sleepwalking and night terrors are considered to be manifestations of the same nosologic continuum. It has been proposed that a sudden arousal from non-rapid eye movement (NREM) sleep is the cause of these disorders. Benign forms of NREM arousal parasomnias occur frequently in childhood and attenuate in teen years; however, they can persist into or begin in adulthood. ⋯ Post-arousal EEG activity reveals altered consciousness during sleepwalking and sleep terror episodes. Pathophysiology of NREM arousal parasomnias consists of predisposing factors, which may be a genetically determined tendency for deep sleep, facilitating factors which deepen sleep and increase slow wave sleep, and triggering factors which increase sleep fragmentation, such as stress, environmental or endogenous stimuli, and stimulants. Recently published data on low delta power in the first sleep cycle and slow decline of delta power in successive sleep cycles suggest a chronic inability to sustain slow wave sleep.
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Obstructive sleep apnea syndrome (OSAS) is a common disorder in adults and children, which is characterized by repetitive transient reversible upper airway obstructions during sleep. Due to disrupted sleep architecture and intermittent hypoxemia, OSAS leads to impaired daytime functioning in various neuropsychological and affective domains. The most common abnormalities are executive dysfunction, impaired vigilance, depression, and possibly anxiety and, in children, hyperactivity. ⋯ This persistent deficit, despite effective treatment, raises the possibility of a remaining subtle structural brain damage; such damage has been demonstrated through the use of sensitive functional and other neuroimaging techniques. Prefrontal cortical damage may underlie the cognitive dysfunction in OSAS. Early recognition and treatment may prevent this untoward effect of OSAS.