To evacuate or shelter in place: implications of universal hurricane evacuation policies on nursing home residents. (1/9)


Alert but less alarmed: a pooled analysis of terrorism threat perception in Australia. (2/9)


Onsite medical rounds and fact-finding activities conducted by Nippon Medical School in Miyagi prefecture after the Great East Japan Earthquake 2011. (3/9)

This report describes our onsite medical rounds and fact-finding activities conducted in the acute phase and medical relief work conducted in the subacute phase in Miyagi prefecture following the Great East Japan Earthquake and subsequent tsunami that occurred off northeastern Honshu on March 11, 2011. As part of the All-Japan Hospital Association medical team deployed to the disaster area, a Nippon Medical School team conducted fact-finding and onsite medical rounds and evaluated basic life and medical needs in the affected areas of Shiogama and Tagajo. We performed triage for more than 2,000 casualties, but in our medical rounds of hospitals, clinics, and nursing homes, we found no severely injured person but did find 1 case of hyperglycemia. We conducted medical rounds at evacuation shelters in Kesennuma City during the subacute phase of the disaster, from March 17 through June 1, as part of the Tokyo Medical Association medical teams deployed. Sixty-seven staff members (17 teams), including 46 physicians, 11 nurses, 3 pharmacists, and 1 clinical psychotherapist, joined this mission. Most patients complained of a worsening of symptoms of preexisting conditions, such as hypertension, respiratory problems, and diabetes, rather than of medical problems specifically related to the tsunami. In the acute phase of the disaster, the information infrastructure was decimated and we could not obtain enough information about conditions in the affected areas, such as how many persons were severely injured, how severely lifeline services had been damaged, and what was lacking. To start obtaining this information, we conducted medical rounds. This proved to be a good decision, as we found many injured persons in evacuation shelters without medication, communication devices, or transportation. Also, basic necessities for life, such as water and food, were lacking. We were able to evaluate these basic needs and inform local disaster headquarters of them. In Kesennuma City, we found that some evacuation shelters could not contact others even after 1 week after the earthquake. We realized from our experiences that, unlike our activities following more localized earthquake disasters, the first task following such large-scale disasters is to acquire information on basic life needs, including medication needs, and the number of persons requiring assistance. We must provide medical relief according to the unique characteristics of the disaster-affected areas as well as the specific nature of the disaster, in this case, a tsunami.  (+info)

The medical association activity and pediatric care after the earthquake disaster in Fukushima. (4/9)

On March 11, 2011, a gigantic earthquake struck eastern Japan. Utilities such as electricity, water, gas and telecommunication were interrupted. In Koriyama, the City Hall collapsed and government administration offices had to be moved to a nearby baseball stadium that had been designed to include facilities for use during a pandemic. An operations center was set up in this stadium. As members of the Koriyama Medical Association, we following the disaster protocol and set up our operations center in the Koriyama Medical Care Hospital. One large hospital with 280 inpatients and another hospital with 150 inpatients had been heavily damaged. Transfer of those patients to other hospitals without the use of telecommunications was extremely difficult. Many doctors in member hospitals and clinics went out of their way to cooperate throughout the crisis. Up to 5,000 people from the radiation evacuation zone were rushed to Koriyama. They stayed in schools and community centers, where we provided them with healthcare. Even in Koriyama, which is 60 km away from the Fukushima nuclear power plant, radiation levels were high, especially for the first few weeks. Citizens were advised to stay at home and keep their doors and windows closed. These drastic measures and frequent earthquake aftershocks were very stressful, especially for children. To help prevent children from developing posttraumatic stress disorder (PTSD), a project team composed of various groups caring for children was developed, and this team took action to protect children. Through these efforts we hoped to provide children with an appropriate environment to grow normally, even in a zone of persistent low-level radiation. We demonstrated once again that our members' long history of mutual assistance and cooperation with the administration was the main cornerstone to overcome the crisis.  (+info)

High prevalence of deep vein thrombosis in tsunami-flooded shelters established after the great East-Japan earthquake. (5/9)

High prevalence of deep vein thrombosis (DVT) in disaster shelters has been reported in the aftermath of earthquakes in Japan. Calf DVT was examined using sonography in the shelters after the Great East Japan earthquake on March 11, 2011. By the end of July 2011, 701 out of 8,630 evacuees suspected with calf DVT, judged by inspections or medical interviews, were examined in 32 shelters, and 190 evacuees were confirmed to have calf DVT. The prevalence of DVT was 2.20%, which was 200 times higher than the usual incidence in Japan. The DVT prevalence seemed to decrease with time. By the end of May, a significantly higher prevalence of DVT was found in tsunami-flooded shelters (109 of 3,871 evacuees; 2.82%) than in non-flooded shelters (53 of 3,155 evacuees; 1.68%). After June, its prevalence was still higher (18/541; 3.33%) in tsunami-flooded shelters than in non-flooded shelters (10/1063; 0.94%). The cause of the high prevalence of DVT was supposed to be dehydration due to the delay in supplying drinking water, vomiting, and diarrhea experienced by the evacuees because of a shortage of clean water to wash their hands. Dehydration was especially noticed in women because they restricted themselves of water intake to avoid using unsanitary toilet facilities. Moreover, crowded shelters restricted the mobility of elderly people, which would exacerbate the prevalence of DVT. Those deteriorated and crowded shelters were observed in tsunami-flooded areas. Therefore, long-term shelters should not be set up in flooded areas after tsunami.  (+info)

An overview of respiratory medicine during the Tsunami Disaster at Tohoku, Japan, on March 11, 2011. (6/9)


Estimation of the total population moving into and out of the 20 km evacuation zone during the Fukushima NPP accident as calculated using "Auto-GPS" mobile phone data. (7/9)

The first objective data showing the geographical locations of people in Fukushima after the Fukushima Dai-ichi nuclear power plant accident, obtained by an analysis of GPS (Global Positioning System)-enabled mobile phone logs, are presented. The method of estimation is explained, and the flow of people into and out of the 20 km evacuation zone during the accident is visualized.  (+info)

Protecting and improving breastfeeding practices during a major emergency: lessons learnt from the baby tents in Haiti. (8/9)