Factors related to evacuation intention when a Level 4 evacuation order was issued among people with mental health illnesses using group homes in Japan: A cross-sectional study.

This study aimed to identify factors related to the intention to evacuate in a disaster following a Level 4 evacuation order among people with mental health illnesses living in group homes in Japan. The participants were people with mental health conditions living in group homes in Ishikawa Prefecture, Japan. We created an original self-administered questionnaire and conducted a survey among this group. Of the 625 people with mental health conditions using group homes, 152 (24.3%) responded. Of these, 110 (5.9%) who provided valid data were included in the analysis. A total of 85 (77.3%) people said that they intended to evacuate in the event of a Level 4 evacuation order. We controlled for gender, age group, type of disability, experience of participating in disaster training, fear of contracting COVID-19 during evacuation, and earthquake and flood disaster experience as confounders. After controlling for these variables, the factors associated with intention to evacuate under a Level 4 evacuation order included not having emergency food prepared (odds ratio [OR] 3.81, 95% confidence interval [CI]: 1.03-14.08); believing that group home users would help them during disasters (OR 3.08, 95% CI: 1.04-9.12); and planning to ask the local government for help (OR 2.84, 95% CI: 1.01-8.01). Group home managers should be aware that people who do not believe that other group home residents would help them, and those not wishing to seek help from local government, may decide not to evacuate. Longitudinal studies across diverse regions are needed to identify factors that affect evacuation intention.

Effect of the 2024 Noto Peninsula earthquake on outpatient chemotherapy among cancer survivors in Japan: a retrospective study.

BACKGROUND: The study aim was to elucidate the effect of the 2024 Noto Peninsula earthquake on outpatient chemotherapy treatment of cancer survivors at Kanazawa Medical University Hospital (KMUH), Japan. METHODS: Medical and nursing records for January 4-31, 2024, from KMUH were retrospectively collected, and data for 286 participants were analyzed. RESULTS: Of the 286 participants, 95.1% were able to attend their first scheduled appointment. Of the 12 (4.2%) who could not attend because of the earthquake, 7 (58.3%) rescheduled their appointments. A total of 8 participants (2.8%) were unable to attend their second scheduled appointment in January, despite being able to attend their first appointment; 3 (37.5%) of these participants reported that they were unable to attend their appointments because of the effect of the earthquake. Chemotherapy was not administered to 53 (18.5%) participants who did attend, mainly owing to neutropenia, progressive disease, rash, and anemia. Evacuation information was available for 25 participants (8.7%); of these, 8 (28.6%) evacuated to their homes, 7 (25.0%) to public shelters, and 4 (14.3%) to apartments near the hospital. Disaster status information was obtained from 62 participants (21.7%), and indicated experiences such as home damage, water outages, and relying on transportation assistance from family to attend appointments. CONCLUSIONS: Most cancer survivors receiving chemotherapy at KMUH were able to maintain outpatient visits. However, a few could not attend because of the earthquake. Further studies are needed to provide more detailed information on the effect of disasters on cancer survivors and the potential factors underlying non-attendance at medical appointments.

Using Spatial Scan Statistics and Geographic Information Systems to Detect Monthly Human Mobility Clusters and Analyze Cluster Area Characteristics.

Introduction: This study evaluated the detection of monthly human mobility clusters and characteristics of cluster areas before the coronavirus disease 2019 (COVID-19) outbreak using spatial epidemiological methods, namely, spatial scan statistics and geographic information systems (GIS). Methods: The research area covers approximately 10.3 km2, with a population of about 350,000 people. Analysis was conducted using open data, with the exception of one dataset. Human mobility and population data were used on a 1-km mesh scale, and business location data were used to examine the area characteristics. Data from January to December 2019 were utilized to detect human mobility clusters before the COVID-19 pandemic. Spatial scan statistics were performed using SaTScan to calculate relative risk (RR). The detected clusters and other data were visualized in QGIS to explore the features of the cluster areas. Results: Spatial scan statistics identified 33 clusters. The detailed analysis focused on clusters with an RR exceeding 1.5. Meshes with an RR over 1.5 included one with clusters for 1 year which is identified in all months of the year, one with clusters for 9 months, three with clusters for 6 months, three with clusters for 3 months, and four with clusters for 1 month. September had the highest number of clusters (eight), followed by April and November (seven each). The remaining months had five or six clusters. Characteristically, the cluster areas included the vicinity of railway stations, densely populated business areas, ball game fields, and large-scale construction sites. Conclusions: Statistical analysis of human mobility clusters using open data and open-source tools is crucial for the advancement of evidence-based policymaking based on scientific facts, not only for novel infectious diseases but also for existing ones, such as influenza.

Factors associated with behavioral and weight changes across adult to elderly age groups during the COVID-19 pandemic.

BACKGROUND/OBJECTIVES: There are concerns about the adverse health effects of behavioral changes linked to coronavirus disease 2019 (COVID-19). We conducted a survey to investigate changes in lifestyle habits, including exercise and eating, during the COVID-19 pandemic and their association with changes in weight. SUBJECTS/METHODS: We conducted a survey of 5,000 people in Hakui City, Japan, to assess their lifestyles and diets during the COVID-19 pandemic. A total of 3,992 complete responses were received. We also obtained pre- and post-pandemic health check-up data for 704 of the respondents. These health data were combined with the results of the questionnaire survey to identify factors associated with weight changes. Data were analyzed for 704 individuals. RESULTS: The mean body mass index was 22.5 ± 3.1 kg/m2 for respondents whose weight did not change and 25.1 ± 2.7 kg/m2 for respondents whose weight increased. The pre-pandemic mean values for abdominal circumference in females and for gamma-glutamyl transferase in males tended to be higher in those whose weight increased. Those with decreased weight tended to be older. Respondents who were already overweight were more likely to gain weight because of COVID-19-related changes in their lifestyle. In males, alcohol consumption was directly associated with weight, and in females, abdominal circumference was more important. CONCLUSION: The study found pre-pandemic overweight individuals likely gained more weight during it, with alcohol consumption being a significant factor for males. Weight loss was more crucial for those over 70, rather than weight gain.

Factors Related to the Willingness of People with Mental Health Illnesses Living in Group Homes to Disclose Their Illness to Supporters during Disaster Evacuation: A Cross-Sectional Study.

Severe heavy rains caused by linear precipitation systems are occurring more frequently in Japan owing to climate change, and residents are being asked to evacuate more often. The purpose of this study was to identify factors associated with the willingness of people with mental health illness (PMHI) in group homes to disclose their illness when being evacuated. Participants were PMHI living in group homes in Japan. We conducted an original anonymous self-administered questionnaire based on previous research. Valid data from 119 people were analyzed. Factors associated with the willingness to disclose illness to supporters upon evacuation were "I can imagine living in a public shelter" (Odds Ratio [OR] 4.50, 95% Confidence Interval [CI]: 1.78-11.43), and "I socialize with neighbors" (OR 5.63, 95% CI: 1.74-18.22). Managers of group homes should encourage PMHI to imagine life in an evacuation zone by increasing opportunities for disaster training and for interaction with local residents. People who are less likely to socialize with neighbors should be especially careful, as they may not be able to disclose their illness, and those who support evacuees should pay special attention to these people.

Maintaining quality of life and care for cancer survivors experiencing disaster disruptions: a review of the literature.

Disasters caused by natural phenomena are increasing in frequency and devastation. The growing number of cancer survivors constitute a vulnerable population in their need for continuous and high-level care, a vulnerability that is exacerbated in the event of disasters. Although the evidence base on the needs of cancer survivors is growing, little is known about cancer care in disaster settings. Therefore, we prepared a narrative literature review that outlines existing evidence, identifies knowledge gaps, and clarifies key concepts that are central to the burgeoning area of research into the quality of care for cancer survivors through disasters. As the preponderance of available evidence stresses the importance of careful disaster planning for maintaining care services, this review also provides guidance in developing plans for how to proceed during, and in the aftermath of, disasters.

Factors Associated with Turnover Intentions of Nurses Working in Japanese Hospitals Admitting COVID-19 Patients.

Three years after the outbreak of the coronavirus disease (COVID-19) pandemic, turnover among frontline nurses has increased. The participants of this study were nurses at two general hospitals in Ishikawa, Japan, receiving COVID-19 patients. An original self-report questionnaire was created based on previous research. The questionnaire was distributed to 400 nurses, and responses were received from 227 nurses (response rate: 56.8%). The factors influencing turnover intention at the facilities were having less time to relax (odds ratio [OR]: 2.88, 95% confidence interval [CI]: 1.12-7.41) and wanting to receive counseling (OR: 5.21, 95% CI: 1.30-20.91). As a strategy to prevent turnover, nurse managers should provide opportunities for nurses to receive counseling during normal working hours and pay particular attention to changes in nurses' daily lives, such as changes in the time available for relaxation.

Caregiver Burden among Family Caregivers of Cancer Survivors Aged 75 Years or Older in Japan: A Pilot Study.

The purpose of this study was to assess the burden of caregiving among family caregivers of cancer survivors aged 75 years or older in Japan. We included family caregivers of cancer survivors aged 75 years or older who were attending two hospitals in Ishikawa Prefecture, Japan, or receiving treatment during home visits. A self-administered questionnaire was developed based on previous studies. We obtained 37 responses from 37 respondents. Excluding those with incomplete responses, we had data from 35 respondents for analysis. The factor that significantly influenced the burden of caregiving for cancer survivors aged 75 years or older and family caregivers living together was the provision of full-time care (p = 0.041). Helping cancer survivors manage money (p = 0.055) was also associated with a higher burden. For family caregivers living separately, a more detailed examination of the association between the sense of caregiving burden and distance of travel to provide home-visit care is necessary, along with more support to attend hospitals with cancer survivors.

Understanding Mothers' Worries about the Effects of Disaster Evacuation on Their Children: A Cross-Sectional Study.

In Japan, there is an imminent threat of major earthquakes and floods. Children's health is increasingly at risk from climate-change-related disasters. The purpose of this study was to identify factors related to mothers' worries about the effects of evacuation on their children. Participants were mothers whose children attended a childcare center in one municipality in Ishikawa, Japan. A cross-sectional design was used. A questionnaire was developed based on previous studies, and it was used to conduct a survey. A total of 1298 individuals who provided valid data were included in the analysis. The following factors were related to mothers' worries about the effects of evacuation on their children: not having prepared a grab bag as a disaster risk reduction strategy, having no neighbors to help them in case of disaster, having children aged <3 years, and having children with allergies. The mothers of children <3 years old with allergies who are unprepared and have no social support are likely to worry about evacuating their children. Policymakers must be aware that the mothers of children aged <3 years and the mothers of children with allergies experience substantial concerns about the effects of evacuation on their children.

Factors Related to Care Managers' Experiences of Making Proxy Decisions about Older Adults Living Alone: A Cross-Sectional Study.

In Japan, the number of older adults living alone who require nursing care continues to rise. The purpose of this study was to identify factors associated with care managers' experiences of making proxy decisions about life directions for older adults who live alone and whose intentions cannot be fully confirmed. The participants were care managers of in-home long-term care support providers nationwide. An original self-report questionnaire was created with reference to previous research and a web-based survey was conducted. The responses were obtained from 241 people and 211 people were included in the analysis. Two factors were identified that were related to care managers' experiences of proxy decision-making about the life direction of older adults living alone whose intentions could not be fully confirmed: the ability to perform administrative tasks (odds ratio [OR] 3.38, 95% confidence interval [CI]: 1.39-8.22) and the observed cognitive deterioration (OR 2.89, 95% CI: 1.06-7.83). Even if older adults living alone can independently perform administrative tasks, observed cognitive deterioration may be a prodromal sign that such adults will be unable to make decisions about their future life.

Disaster Evacuation for Home-Based Patients with Special Healthcare Needs: A Cross-Sectional Study.

Recent super-typhoons and torrential rains triggered by global warming have had disproportionately large effects on medically vulnerable people in Japan. This study aimed to identify factors associated with intention to evacuate to the nearest public shelter among family caregivers of pediatric patients receiving home medical care. The study included family caregivers of these patients from the Department of Pediatrics, Fukuoka University Hospital, Japan, including family caregivers of young adults with special healthcare needs. An original questionnaire was prepared drawing on previous studies and used for an interview survey. Overall, 57 individuals provided valid data and were included in the analysis. Factors associated with evacuation intention were non-use of a home ventilator (odds ratio [OR] 3.99, 95% confidence interval [CI]: 1.13-14.03) and not having made arrangements to use a non-public shelter (OR 7.29 95% CI: 1.62-32.88). This means that those who use mechanical ventilation or have secured alternative places to go if they need to evacuate their homes may not use the nearest public shelter in a disaster. We recommend that policy makers consider the use of mechanical ventilation and the availability of non-public shelters as predictors of evacuation behavior when considering disaster preparedness for these patients.

Factors related to Japanese nurses' desire to quit their jobs during the COVID-19 pandemic: A cross-sectional study.

The purpose of this study was to investigate the factors related to Japanese nurses' desire to quit their jobs during the Omicron wave of the coronavirus disease 2019 pandemic. We distributed an original, self-administered questionnaire to nurses at 3 facilities that accepted patients with coronavirus disease 2019 in Ishikawa Prefecture, Japan. Of the 625 nurses, 152 responded (24.3%); after excluding 3 men to rule out the effects of sex, responses for 81 (53.3%) nurses were analyzed. In total, 49 (60.5%) nurses expressed a desire to quit their current job. After controlling for the effects of age and years of experience, factors related to the desire to quit the current job included having fewer than 2 years of experience (odds ratio [OR] 9.08, 95% confidence interval [CI] 1.69-48.87), feeling anxiety at work (OR 4.59, 95% CI 1.01-20.81), being afraid to go to work (OR 4.10, 95% CI 1.20-21.69), and experiencing difficulty talking to people (OR 10.26, 95% CI 1.48-70.99). Nurse managers should regularly screen nurses who have fewer than 2 years of experience, feel anxiety at work, are afraid to go to work, and find it difficult to talk to people. Early action may prevent the turnover of nurses during a public health emergency.

Correlation between Quality of Life under Treatment and Current Life Satisfaction among Cancer Survivors Aged 75 Years and Older Receiving Outpatient Chemotherapy in Ishikawa Prefecture, Japan.

Life satisfaction is increasingly important for older cancer survivors as the global population ages and the life expectancy 29 of cancer survivors increases. This study sought to identify factors associated with physical symptoms, quality of life under treatment, and current life satisfaction in cancer survivors aged 75 years and older receiving outpatient chemotherapy. Information about treatment for cancer survivors was collected from electronic medical records, and interviews were conducted to assess life satisfaction under treatment. Participants were older cancer survivors in Ishikawa, Japan. Of the participants, 80% lived on the Noto Peninsula. The average linear distance traveled for treatment was 40.7 km. The factors associated with patients' dissatisfaction with their current lives included general malaise (odds ratio: 9.61; 95% confidence interval: 1.28-72.22) and being less happy now than when they were younger (odds ratio: 10.559; 95% confidence interval: 1.50-74.24). In outpatient cancer treatment for survivors aged 75 years and older, support should consider the distance to the hospital. As in past studies, general malaise was shown to have a negative impact on the lives of cancer survivors aged 75 years or older. Support providers should pay attention to patients' general malaise when providing support.

Application Software That Can Prepare for Disasters Based on Patient-Participatory Evidence: K-DiPS: A Verification Report.

This paper describes the design and function of an application that enables vulnerable people to provide medical information for use in disasters, and presents the results of an initial test of its usability in Nankoku, Japan. The application consists of two parts: K-DiPS Solo, a smartphone app, and K-DiPS Online, a web application for disaster management by local governments. We asked vulnerable people or their family caregivers to enter medical information into the app on their smartphones and connected this information to a local government application as a demonstration of a disaster response solution that manages information. We targeted a group of 14 healthy older people. The user information that they entered into the app was stored in the cloud via the communication system of the mobile phone. A ledger of vulnerable people for use in the event of a disaster was automatically created on the web application using the information supplied by the individuals. Local government staff corrected the location information, if necessary, by dragging points plotted on a map. This disaster response solution was shown to connect individuals to government offices, and to enable a consistent flow of information from patient details to stocking of supplies, and for simulation, training, and response during disasters.

Factors related to preparedness for emergency hemodialysis in the event of a natural disaster.

ABSTRACT: This study aimed to explore patients' preparedness for emergency hemodialysis in the event of a natural disaster and to determine the factors affecting such preparedness.A cross-sectional study was conducted in undergoing hemodialysis at dialysis facilities in Sapporo, Hokkaido. The participants were a cohort of 256 outpatients aged 20 years or older, 186 (72.7%) were male, and the average age was 61.9 ±â€Š10.9 years. The participants were divided into those who had prepared for emergency dialysis treatment and those who had not. Cross tabulations were performed on the 2 groups using the following participant attributes: preparedness for dialysis during a disaster, knowledge of how to protect themselves during a disaster, and intention to dialyze and evacuate during a disaster, followed by binomial logistic regression analysis.Of the 256 study patients, 184 (71.9%) were not prepared for dialysis treatment. In logistic regression models, patients who were not prepared for dialysis treatment were found to have higher odds of being employed (odds ratio (OR): 2.469; 95% confidence interval (CI): 1.205-5.058), not being aware of disaster information acquisition methods in the event of a disaster (OR: 4.580, 95%; CI: 2.048-10.241), did not receive explanations on proper disaster response from dialysis facility staff (OR: 2.557, 95%; CI: 1.319-4.954), and believing that their family away from home would not be concerned about them (OR: 2.021; 95% CI: 1.062-3.847).Disaster preparedness in patients undergoing dialysis remain inadequate. Dialysis facilities need to strengthen their explanations of disaster response, particularly with regard to working, middle-aged people.

Factors Affecting Nurses' Internal Transfer Intentions after the Introduction of COVID-19-Related Family Visiting Restrictions.

Hospitals have established visiting restrictions to block coronavirus disease 2019 (COVID-19) external transmission routes. This study investigated factors associated with nurses' internal transfer intentions and changes in their workloads, burdens, and daily lives owing to pandemic-related family visiting restrictions. Participants were nurses from three medical institutions designated for infectious diseases in Ishikawa Prefecture, Japan. An original self-report questionnaire was developed based on previous studies and a web-based survey conducted. Responses were received from 152 nurses and 84 were included in the analysis. Factors influencing internal transfer intentions were age ≥30 years [odds ratio (OR): 6.54, 95% confidence interval (CI): 1.19-35.83]; ≥11 years of experience (OR: 12.57, 95% CI: 2.32-68.02); and longer working hours (OR: 4.51, 95% CI: 1.48-13.72). The effect of visitation restrictions on daily life and internal transfer intentions was greater in nurses with ≥11 years of experience (OR: 4.31, 95% CI: 1.09-17.04), those with increased night awakening (OR: 3.68, 95% CI: 1.33-10.18), and those who desired to receive counseling (OR: 4.38, 95% CI: 1.07-17.91). In conclusion, excessive working hours may affect nurses' internal transfer intentions during the COVID-19 pandemic. Nocturnal awakening and desire to receive counseling may predict nurses' internal transfer intentions.

Construction of an evacuee placement model for tsunami shelters considering physical distancing to prevent COVID-19 infection.

Earthquakes and tsunamis are expected to occur within the next 30 years along Japan's Nankai Trough. Existing disaster prevention plans and calculated evacuation capacities in the coastal areas that would be affected do not account for physical distancing in the context of COVID-19. Therefore, we developed a tsunami evacuation placement model incorporating physical distance guidelines for infection control and living space per person into calculations of evacuation center accommodation capacities in Aki City, Kochi Prefecture. Using available administrative, population, and tsunami inundation data, we counted and mapped evacuation centers in the estimated inundated area within three zones constructed for smooth evacuation using the ArcGIS software Build Balanced Zones Tool. We calculated the space per evacuee using the Sphere handbook standard of 3.5 m2 or double the Sphere standard at 7 m2 plus the recommended physical distance of 11 m2 per person. We then compared the results with planned capacities. A total of 27 shelters are located in the area projected to be inundated at depths of 0.3-10 m, and their planned capacity, 2 m2 for each evacuee, would accommodate 32.9% of Aki's population and result in 9639 unaccommodated evacuees. Allotting 14.5 m2 (living space) or 18 m2 (living space plus space to maintain physical distancing) would reduce accommodation capacities to 57.1% and 28.6% (12,133 and 12,371 unaccommodated evacuees, respectively). Given these accommodation shortages, we recommend that evacuation centers are set aside for vulnerable people and that alternative evacuation sites such as parking lots and mountain campsites are preplanned.

Model Comparisons of the Cost Effectiveness of Rubella Vaccination Method in Japanese Adults.

The number of rubella cases has increased in Japan, especially among adults. Rubella infection in pregnant females can lead to congenital rubella syndrome (CRS). The Japanese government is promoting vaccination to prevent CRS. This study performs a cost-effectiveness analysis of the following four methods: (1) females who wished to become pregnant and partners, with an antibody-titer test; (2) females only, with an antibody-titer test; (3) females and males, without an antibody-titer test; (4) females only, without an antibody-titer test. A decision tree model with a hypothetical cohort of 500 males and 500 females was used for the analysis, and the parameters were obtained from previous studies. The number of avoidances of CRS was defined as the effect. Compared to the case where methods were not implemented, the number of CRS cases that can be prevented by implementing the methods was 0.0115589 by (1) and (3) and 0.0147891 by (2) and (4). The cost effectiveness of (1) to (4) was 287,413,677 JPY, 135,050,529 JPY, 388,524,974 JPY, and 197,744,219 JPY, respectively (1 JPY = 0.00963247 USD). Method (2) was the most cost-effective and did not change by sensitivity analysis. We conclude that the vaccination for females only with an antibody-titer test is recommended.

Needs of Children with Neurodevelopmental Disorders and Geographic Location of Emergency Shelters Suitable for Vulnerable People during a Tsunami.

In the current study, we sought to identify special needs and safe evacuation conditions for children with neurodevelopmental disorders (CNDs) along Japan's tsunami-prone Pacific coast. A survey and spatial analysis were used to collect data of CNDs (n = 47) and their caregivers. Areas predicted to be flooded in a tsunami, as well as evacuation routes to emergency shelters for vulnerable people (ESVPs), were mapped using geographic information systems (GIS). Our results showed that five professional staff were needed to support 33 CNDs requiring 135.9 m2 of ESVP space. Critical safety factors were altitude, vertical evacuation, accessibility to ESVPs, and nonexistence of estuaries in the direction of evacuation. GIS-based spatial analysis and evacuation modeling for disaster preparedness and training plans that involve nurses are essential.

Using GIS to simulate tsunami evacuation guidance signs for the hearing impaired.

The Nankai Trough in Japan has been identified as a geological feature that could cause extensive damage in the event of a major earthquake. In this study, we investigated the impact of effective guidance signs for hearing-impaired individuals requiring special care when escaping to a tsunami evacuation building (emergency evacuation location) using geographical information system (GIS) and viewshed analysis. We selected an area we considered would suffer severe damage following a major earthquake and tsunami; we identified difficulties in the provision of escape routes. Using GIS, we determined the time required for escape and tsunami arrival time if effective signs were installed; we undertook such analysis using the height data of buildings in the target area. With effectively installed guidance signs, the average required evacuation time was 36.88 minutes; without such signs (which is currently the case in the target area), the average time was 47.10 minutes: that would result in citizens getting caught by the tsunami. Installing effective guidance signs would allow hearing-impaired individuals to escape to an evacuation building before being hit by the tsunami.