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

Relationship Between Millennials and Brand Loyalty: Mediating Brand Loyalty Factors

The purpose of this study is to identify factors (brand elements) that mediate between Millennials and brand loyalty, and to test a theoretical model that includes these mediating factors in describing the relationship between millennials and brand loyalty. The study focused on the key factors that we identified and hypothesized to mediate the relationship between millennials and brand loyalty. The quantitative study surveyed two hundred and fifty-three (n=253) respondents randomly drawn. Structural Equation Modelling (SEM) was used to test a model of the relationship between the mediating factors, millennials and brand loyalty. All model fit parameters were well within acceptable bounds. The Comparative Fit Index (CFI) was 0.999, Root Mean Square Error of Approximation (RMSEA) was 0.018, and Standardized Root Mean Square Residual (SRMR) was 0.022. However, we believe that the model is over-fitting the data, and this is not surprising given that there are 22 variables and 253 data points. These results show promise, but require further investigation in a second phase of the inquiry. This study limited itself to surveying millennials, brand loyalty, and the seven mediating factors we identified and hypothesized to play a role in mediating between them. Based on this study, brand management strategies are proposed

School restrictions on outdoor activities and weight status in adolescent children after Japan's 2011 Fukushima Nuclear Power Plant disaster: a mid- to long-term retrospective analysis

Objective Radiation fears following Japan’s 2011 Fukushima nuclear disaster impacted levels of physical activity in local children. We assessed the post- versus pre-disaster weight status in school children, and evaluated to what extent school restrictions on outdoor activities that were intended to reduce radiation exposure risk affected child weight. Participants We considered children aged 13–15 years from four of the five secondary schools in Soma City (n=1,030, 99.1% of all children in the city), located in 35–50 km from the Fukushima nuclear plant, post- (2012 and 2015) and pre-disaster (2010). Methods Weight status, in terms of body mass index (BMI), percentage of overweight (POW), and incidence of obesity and underweight (defined as a POW ≥ 20% and ≤ -20%, respectively), were examined and compared pre- and post-disaster using regression models. We also constructed models to assess the impact of school restrictions on outdoor activity on weight status. Results After adjustment for covariates, a slight decrease in mean BMI and POW was detected in females in 2012 (-0.37, 95% CI: -0.68 to -0.06; and -1.97, 95% CI: -3.57 to -0.36, respectively). For male children, obesity incidence increased in 2012 (odds ratio for obesity: 1.45, 95% CI: 1.02 to 2.08). Compared to pre-disaster weight status, no significant weight change was identified in 2015 in either males or females. School restrictions on outdoor activities were not significantly associated with weight status. Conclusions Four years following the disaster, weight status has recovered to the pre-disaster levels for both males and females; however a slight decrease in weight in females, and a slight increased risk of obesity was observed in males one year following the disaster. Our findings could be used to guide actions taken during the early phase of a radiological disaster to manage the post-disaster health risks in adolescent children

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

Time variations in the deep underground muon flux

More than 35 million high-energy muons collected with the MACRO detector at the underground Gran Sasso Laboratory have been used to search for flux variations of different nature. Two kinds of studies were carried out: a search for the occurrence of clusters of events and a search for periodic variations. Different analysis methods, including the Scan Statistics test and the Lomb-Scargle spectral analysis have been applied to the data.Comment: 7 pages, 5 figures, accepted by EP