We examined psychological outcomes in a sample of participants who evacuated from the World Trade Center towers on September 11, 2011. This study aimed to identify risk factors for psychological injury that might be amenable to change, thereby reducing adverse impacts associated with emergency high-rise evacuation.

We used data from a cross-sectional survey conducted 2 years after the attacks to classify 789 evacuees into 3 self-reported psychological outcome categories: long-term psychological disorder diagnosed by a physician, short-term psychological disorder and/or memory problems, and no known psychological disorder.

After nonmodifiable risk factors were controlled for, diagnosed psychological disorder was more likely for evacuees who reported lower “emergency preparedness safety climate” scores, more evacuation challenges (during exit from the towers), and evacuation-related physical injuries. Other variables associated with increased risk of psychological disorder outcome included gender (female), lower levels of education, preexisting physical disability, preexisting psychological disorder, greater distance to final exit, and more information sources during egress.

Improving the “emergency preparedness safety climate” of high-rise business occupancies and reducing the number of egress challenges are potential strategies for reducing the risk of adverse psychological outcomes of high-rise evacuations. Focused safety training for individuals with physical disabilities is also warranted. (Disaster Med Public Health Preparedness. 2017;11:326–336)

A lower glycaemic index (GI) diet is associated with a reduction in glycosylated Hb (HbA1c) in people with diabetes. Yet, little research has been conducted to determine the effects of specific goals regarding consumption of low GI (LGI) foods on diabetes outcomes. The present study evaluated a behavioural intervention on dietary intake, weight status and HbA1c, which included a goal to consume either six or eight servings of LGI foods daily.

A parallel two-group design was used. Following the 5-week intervention, participants were randomly assigned to the group of six (n 15) or eight (n 20) servings of LGI foods daily and followed up for 8 weeks. Dietary intake was assessed using the mean of 4 d food records.

A metropolitan community in the USA.

Individuals aged 40–65 years with type 2 diabetes of ≥1 year and HbA1c ≥ 7·0 % were eligible.

There was no significant difference between goal difficulty groups with regard to GI servings at the end of the study. However, mean consumption of LGI foods increased by 2·05 (se 0·47) and 1·65 (se 0·40) servings per 4184 kJ in the six (P < 0·001) and eight (P < 0·001) LGI serving groups, respectively. For all participants combined, there were significant decreases in mean HbA1c (−0·58 (se 0·21) %; P = 0·01), weight (−2·30 (se 0·78) kg; P = 0·01), BMI (−0·80 (se 0·29) kg/m2; P = 0·01) and waist circumference (−2·36 (se 0·81) cm; P = 0·01).

An intervention including a specific goal to consume six to eight servings of LGI foods daily can improve diabetes outcomes. Clinicians should help patients set specific targets for dietary change and identify ways of achieving those goals.