INUNDATION INSIDE A LEVEE OF THE YUURA RIVER DUE TO THE HEAVY RAIN IN JULY 2020 AND EVACUATION BEHAVIOR AT NURSING FACILITIES IN ASHIKITA TOWN

湯浦川の近くに立地する高齢者施設を対象に，被害状況や避難行動等についてインタビュー調査を行った．また，湯浦川の河口付近の氾濫進展状況を数値解析し，施設周辺の浸水過程を再現した．施設職員の証言内容と浸水過程，発表された防災情報を照合することで避難行動の特徴を検証した．職員が少ない夜間の災害対応において，多数の高齢者を少ない職員で避難誘導するには限界があるため，夜間を想定した避難計画や訓練が重要であることを確認した．さらに，感潮域に位置する高齢者施設においては，避難情報や防災気象情報に加え潮位情報を活用することで夜間帯の行動を回避できる可能性が示唆された

Survey on Evacuation Behavior at Nursing Facilities in Ashikita Town due to Heavy Rain in July 2020

The nursing facility C located near the Sashiki River was flooded due to Heavy Rain in July 2020. The survey method was an interview survey on the damage situation and evacuation behavior. In addition, a flood inundation analysis was conducted. Judging from both the execution and the process of flooding, facility C missed the timing of the evacuation action. The main reasons were that the event was beyond one’s expectation, information was not helpful, lack of manpower, flooded water rose fast. The lessons of this experience are action plan using information, nighttime emergency system, evacuation drills with multiple patterns. For the safety of elderly people, both an evacuation security plan and a business continuity plan (BCP) are needed. On the other hand, there are administrative issues related to wide-area evacuation. Deregulation of the long-term care insurance system and simplification of administrative procedures are desirable.令和2年7月豪雨により佐敷川の近くに立地する高齢者施設Cは浸水被害を受けた。高齢者施設Cを対象に，被害状況や避難行動に関するインタビュー調査と氾濫解析を実施した。避難行動と浸水の過程からみて，より安全な避難のタイミングを逃していた。主な理由として，想定外の出来事であったこと，情報が活用されなかったこと，マンパワーが足りなかったこと，浸水の速度が速かったことなどが考えられる。この教訓として，情報を活用した行動計画，夜間の緊急参集体制，複数のパターンによる避難訓練，などが挙げられる。また，高齢者の安全な生活のためには避難確保計画と事業継続計画（BCP）の両方が求められる。一方，広域避難に関する行政上の課題も明らかになった。この課題を解決するためには，自治体や福祉団体による計画策定支援が必要で，介護保険制度の規制緩和，行政手続きの簡略化が望まれる

Total transferrin in cerebrospinal fluid is a novel biomarker for spontaneous intracranial hypotension

Spontaneous intracranial hypotension (SIH) is caused by cerebrospinal fluid (CSF) leakage. Patients with SIH experience postural headaches, nausea, etc., due to CSF hypovolemia. Imaging studies and clinical examinations, such as radioisotope (RI) scintigraphy, are useful for diagnosing SIH. However, 20-30% of patients do not show typical morphology and clinical test results. We previously reported that CSF contains transferrin (Tf) isoforms:"brain-type" Tf derived from the choroid plexus and "serum-type" Tf derived from blood. We showed that both isoforms increased in the CSF of patients with SIH by Western blotting. In the present study, we demonstrate that conventional ELISA for quantifying total Tf is useful for diagnosing SIH more accurately than Western blotting. In addition, SIH with chronic subdural hematoma (CSDH) was also accurately diagnosed. Total Tf in the CSF can serve as a useful biomarker for diagnosing SIH with or without CSDH