The Great East Japan Earthquake Disaster: a compilation of published literature on health needs and relief activities, March 2011-September 2012

Objective: To provide an overview of the health needs following the Great East Japan Earthquake Disaster and the lessons identified. Methods: The relevant of peer review and grey literature articles in English and Japanese, and books in Japanese, published from March 2011 to September 2012 were searched. Medline, Embase, PsycINFO, and HMIC were searched for journal articles in English, CiNii for those in Japanese, and Amazon.co.jp. for books. Descriptions of the health needs at the time of the disaster were identified using search terms and relevant articles were reviewed. Findings: 85 English articles, 246 Japanese articles and 13 books were identified, the majority of which were experience/activity reports. Regarding health care needs, chronic conditions such as hypertension and diabetes were reported to be the greatest burden from the early stages of the disaster. Loss of medication and medical records appeared to worsen the situation. Many sub-acute symptoms were attributed to the contaminated sludge of the tsunamis and the poor living environment at the evacuation centres. Particularly vulnerable groups were identified as the elderly, those with mental health illnesses and the disabled. Although the response of the rescue activities was prompt, it sometimes failed to meet the on-site needs due to the lack of communication and coordination. Conclusion: The lessons identified from this mega-disaster highlighted the specific health needs of the vulnerable populations, particularly the elderly and those with non-communicable diseases. Further research is needed so that the lessons identified can be incorporated into future contingency plans in Japan and elsewhere

A systems engineering approach to resolving structural barriers to the implementation of demand response

A principal mechanism for achieving the policy goal of the reduction of greenhouse gas emissions is the widespread electrification of transport and heating coupled with the parallel de-carbonization of electricity generation. This requires a major expansion of renewable generation (principally wind) together with new nuclear and clean fossil. This paper reviews both the policy position within the UK and the implications for system balancing that large-scale intermittent generation, such as wind, presents to the System Operator (SO). One proposal for helping to maintain system balance is the use of Demand Response (DR) by the SO. It is by no means clear whether the existing industrial structure can provide the right incentives for the realization of significant DR capacity. This paper presents a method of classifying barriers and describes experience in developing a Systems Engineering methodology, using the Systems Modeling Language (SysML), as an approach to modeling the structural and operational aspects of the British system with the objective of understanding barriers to the implementation of DR

Medication supply for people evacuated during disasters.

© 2015 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.Medication loss is a major problem in disaster settings, and it is crucial for patients to bring their medication and healthcare items with them when they leave their homes during an evacuation. This article is based on a systematic literature review on medication loss, the objectives of which were to identify the extent and implications of medication loss, to identify the burden of prescription refill, and to make recommendations on effective preparedness. The review revealed that medication loss, prescription loss and refills, and the loss of medical aids are a significant burden on the medical relief teams. The medical aids are not limited to drugs, but include routine medications, medical/allergy records, devices for specific care and daily life, and emergency medications. One possible solution is to make a personal emergency pack and for people to carry this with them at all times. To ensure that patients are adequately prepared, stakeholders, especially health professionals, need to be actively involved in the preparation plans. Since our findings have little impact on disaster risk reduction unless shared broadly, we are now taking actions to spread our findings, such as presenting in conferences and via posters, in order to raise awareness among patients and healthcare professionals. As part of these activities, our findings were presented at the Evidence Aid Symposium on 20 September 2014, at Hyderabad, India

The Great East Japan Earthquake Disaster: distribution of hospital damage in Miyagi prefecture.

Copyright © 2014 World Association for Disaster and Emergency Medicine.Introduction: In catastrophic events, a key to reducing health risks is to maintain functioning of local health facilities. However, little research has been conducted on what types and levels of care are the most likely to be affected by catastrophic events.Problem: The Great East Japan Earthquake Disaster (GEJED) was one of a few megadisasters that have occurred in an industrialized society. This research aimed to develop an analytical framework for the holistic understanding of hospital damage due to the disaster.Methods: Hospital damage data in Miyagi Prefecture at the time of the GEJED were collected retrospectively. Due to the low response rate of questionnaire-based surveillance (7.7%), publications of the national and local governments, medical associations, other nonprofit organizations, and home web pages of hospitals were used, as well as literature and news sources. The data included information on building damage, electricity and water supply, and functional status after the earthquake. Geographical data for hospitals, coastline, local boundaries, and the inundated areas, as well as population size and seismic intensity were collected from public databases. Logistic regression was conducted to identify the risk factors for hospitals ceasing inpatient and outpatient services. The impact was displayed on maps to show the geographical distribution of damage.Results: Data for 143 out of 147 hospitals in Miyagi Prefecture (97%) were obtained. Building damage was significantly associated with closure of both inpatient and outpatient wards. Hospitals offering tertiary care were more resistant to damage than those offering primary care, while those with a higher proportion of psychiatric care beds were more likely to cease functioning, even after controlling for hospital size, seismic intensity, and distance from the coastline.Conclusions: Implementation of building regulations is vital for all health care facilities, irrespective of function. Additionally, securing electricity and water supplies is vital for hospitals at risk for similar events in the future. Improved data sharing on hospital viability in a future event is essential for disaster preparedness

Disaster-driven evacuation and medication loss: a systematic literature review

AIM: The aim of this systematic literature review was to identify the extent and implications of medication loss and the burden of prescription refill on medical relief teams following extreme weather events and other natural hazards. METHOD: The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Key health journal databases (Medline, Embase, PsycINFO, Maternity and Infant Care, and Health Management Information Consortium (HMIC)) were searched via the OvidSP search engine. Search terms were identified by consulting MeSH terms. The inclusion criteria comprised articles published from January 2003 to August 2013, written in English and containing an abstract. The exclusion criteria included abstracts for conferences or dissertations, book chapters and articles written in a language other than English. A total of 70 articles which fulfilled the inclusion criteria were included in this systematic review. RESULTS: All relevant information was collated regarding medication loss, prescription loss and refills, and medical aids loss which indicated a significant burden on the medical relief teams. Data also showed the difficulty in filling prescriptions due to lack of information from the evacuees. People with chronic conditions are most at risk when their medication is not available. This systematic review also showed that medical aids such as eye glasses, hearing aids as well as dental treatment are a high necessity among evacuees. DISCUSSION: This systematic review revealed that a considerable number of patients lose their medication during evacuation, many lose essential medical aids such as insulin pens and many do not bring prescriptions with them when evacuated.. Since medication loss is partly a responsibility of evacuees, understanding the impact of medication loss may lead to raising awareness and better preparations among the patients and health care professionals. People who are not prepared could have worse outcomes and many risk dying when their medication is not available

Cankerworms

Cankerworms, also known as inchworms, are in the order Lepidoptera and family Geometridae. Geometrid moth adults have slender bodies and relatively large, broad forewings (Figs. 1, 3). Both fall, Alsophila pometaria, and spring, Paleacrita vernata, cankerworms occur in Utah, with the fall cankerworm being most common

Modelling the human components of complex systems

Complex systems are specified, designed, built and tested by humans, all of whom are immersed in a cultural environment that colours their emotions, cognition, decisions and behaviours. This paper presents a brief overview of culture, its sources, its measurement and its effects on the performance of complex systems. This paper also describes a series of culture and personality modelling tools that the authors have developed for the purpose of assessing the match of individuals and teams to missions or tasks, based on their cultural backgrounds and/or personality traits

Working towards a holistic organisational systems model

This paper presents an integration effort combining a number of soft factors modelling tools and considers the potential impact of such an overall tool in a system of systems environment. The paper introduces the tools developed and how it is envisaged they will work together to provide a comprehensive, coherent output. It is suggested that a suite of interoperable tools of this form could aid the design and operation of organisational systems and ensure they are fit for purpose

Simulation of high-resolution domestic electricity demand based on a building occupancy model and its applicability to the study of demand side management

Alongside the well understood need to reduce overall electricity consumption, there is an increasing need to provide demand response: the ability to time shift electrical demand in accordance with available low-carbon generation including wind, marine and solar power. Many domestic loads can readily be employed to provide time shifting demand response in the range of minutes to hours and this concept is already the subject of numerous demonstrations worldwide. The modelling presented in this paper provides a basis for the quantification of the availability and impact of demand response in the domestic sector. In particular, this paper describes the development of a domestic electricity demand model capable of providing data with a one-minute time resolution and with which the operation of demand response may be assessed. The electricity demand model is constructed at the level of individual household appliances and their usage is based on surveyed time-use data. This provides for appropriate temporal diversity of energy use between simulated dwellings. Occupancy data allows the correlated usage of appliances to be represented within an actively occupied dwelling, as well as representing the sharing of appliances, such as lighting, in dwellings with multiple occupants. This paper summarises previously developed occupancy and lighting models and explains how the lighting model can be extended to create an integrated appliance model

Unbiased simulation of rare events in continuous time

For rare events described in terms of Markov processes, truly unbiased estimation of the rare event probability generally requires the avoidance of numerical approximations of the Markov process. Recent work in the exact and ε-strong simulation of diffusions, which can be used to almost surely constrain sample paths to a given tolerance, suggests one way to do this. We specify how such algorithms can be combined with the classical multilevel splitting method for rare event simulation. This provides unbiased estimations of the probability in question. We discuss the practical feasibility of the algorithm with reference to existing ε-strong methods and provide proof-of-concept numerical examples