Our aim was to explore bereaved siblings' positive and negative memories and experiences of their brother's or sister's illness and death.

In our nationwide Swedish study, 174 of 240 (73%) bereaved siblings participated, and 70% responded to two open-ended statements, which focused on siblings' positive and negative memories and experiences of illness and death. The data were analyzed using systematic text condensation.

The bereaved siblings' responses were categorized into four different themes: (1) endurance versus vulnerability, (2) family cohesion versus family conflicts, (3) growth versus stagnation, and (4) professional support versus lack of professional support. The first theme expressed endurance as the influence that the ill siblings' strong willpower, good mood, and stamina in their difficult situation had on healthy siblings, whereas vulnerability was expressed as the feeling of emptiness and loneliness involved with having an ill and dying sibling. In the second theme, family cohesion was expressed as the bonds being strengthened between family members, whereas family conflicts often led siblings to feel invisible and unacknowledged. In the third theme, most siblings expressed the feeling that they grew as individuals in the process of their brother's or sister's illness and death, whereas others experienced stagnation because of the physical and mental distress they bore throughout this time, often feeling forgotten. In the last theme—professional support—most siblings perceived physicians and staff at the hospital as being warm, kind, and honest, while some siblings had negative experiences.

The study shows that bereaved siblings can have positive memories and experiences. The significance of the positive buffering effect on bereaved siblings' own endurance, personal growth, family cohesion, and social support should be noted. This knowledge can be valuable in showing healthcare professionals the importance of supporting the siblings of children with cancer throughout the cancer trajectory and afterwards into bereavement.

To demonstrate features of the mental health care during the acute phase of a disaster due to natural hazards in Japan. This report will discuss issues in devastated area of Chuetsu in Niigata Prefecture after an offshore earthquake.

The earthquake of 16 July 2007 had a magnitude 6.8. It injured 2,153 people, including 192 with severe injuries, and caused 14 deaths. The Tokyo Medical Association (TMA) deployed disaster medical relief teams on the day of the event, and performed mental care in internally displaced person (IDP) camps. Other mental care teams took over the mission three days after the event.

There were 27 medical teams was 27. They visited 88 IDP camps. Medical teams treated 2,288 cases during first four days. Forty-seven cases included psychiatric problems. Three of 13 refugees who had psychiatric symptoms needed new mediane. Four were under psychiatric treatment and could continue their treatment with their attending physicians.

Earthquake victims displayed the following characteristics during the acute phase: (1) poor adaptation in the elderly; (2) fluctuation of compliance for medications; (3) occult anxiety and complaints; and (4) unconsciousness of sleep disturbance.

The development and education of liaison methods about mental health care during the acute phase of a disaster is needed for emergency physicians and general surgeons of Disaster Medical Assistance Team and Medical Association relief teams that perform treatment during the acute phase of disaster. They must understand and have skills for triage of different mental health cases.

In 2003, a major power outage occurred in the midwest and northeast United States affecting some 50 million people. The power outages affected multiple systems in state and local municipalities and, in turn, affected public health.

Semi-structured interviews were conducted using open-ended questionnaires, with a convenience sample of state- and locally selected subject matter experts from Ohio, Michigan, and New York. Respondents were interviewed in groups representing one of five areas of interest, including: (1) emergency preparedness; (2) hospital and emergency medical services; (3) municipal environmental systems; (4) public health surveillance and epidemiology; and (5) psychosocial and behavioral issues. The reported positive and negative impacts of the power outage on public health, medical services, and emergency preparedness and response were documented. Responses were categorized into common themes and recommendations were formulated.

The amount of time that the respondents' locations were without power ranged from <1 hour to 52 hours. Many common themes emerged from the different locations, including communications failures, alternate power source problems, manpower and training issues, and psychosocial concerns. There was minimal morbidity and mortality reported that could be attributed to the event.

Power outages negatively impacted multiple municipal infrastructures, and affected medical services, emergency response, and public health efforts. Previous federal funding positively impacted public health and emergency response capabilities. Recommendations were made based upon the common themes identified by the respondents.

Recommendations may assist state and local health departments, medical service providers, and emergency responders in planning for future power outage problems.