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.

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.

[Prediction of the Number of Home-Visit Care, Home-Visit Nursing Care, and Home-Visit Bathing Providers in 2025 in the Hokushinetsu Region Using a Mathematical Model and Examination of Geographical Features Using a Geographic Information System].

In this research, we constructed a prediction model for the number of service providers for home-visit care, home-visit nursing, and home-visit bathing by using the population in the Hokushinetsu region and the current number of providers, and considered the validity of the model. Using the model, we estimated the number of providers in 2025, and subsequently, visually confirmed geographical features using a geographic information system. The adjusted R2 value of the prediction model was 0.93 for home-visit care, 0.87 for home-visit nursing, and 0.63 for home-visit bathing providers. The number of providers for home-visit care, home-visit nursing, and home-visit bathing were estimated to decrease by 67%, 67%, and 28%, respectively. The colored map by the predicted number of providers suggested a significant decrease in home-visit care in Northern Nagano, home-visit nursing in Fukui-Reihoku region, and home-visit bathing in Middle Nagano.

[A Study on the Number of Offices for Home-Visit/Outpatient Day Long-Term Care in Noto Area, Based on Estimated Population - Analysis Using the Geographic Information System].

There has been a noticeable population decline in the Noto area. The Ministry of Land, Infrastructure, Transport and Tourism has determined the population size necessary for the establishment of daily living-related service businesses and, if the population falls below this, there is a possibility of businesses withdrawing from the area. In this research, we examine the number of home visit and daycare businesses established in the Noto area in 2025, using the geographic information system (GIS). The number of sites of businesses established was calculated using data published by the National Institute of Population and Social Security Research, and the Ministry of Land, Infrastructure, Transport and Tourism. Next, I depicted a buffer with a radius of 15 km from the establishment and confirmed the blank area of the service. Under the condition that the placement of sites is 80%, almost all the municipalities have exceeded the number of home visit care facilities and the number of daycare facilities. In the buffer analysis, blank areas were found in the north. To maintain these services, efforts by groups other than profit-oriented organizations are necessary, especially in the north of Noto. Route analysis by GIS and the consideration of population distribution and location of business establishment will be needed.

[Identifying the Regional Features in the Visiting Nursing Station Trade Area Using GIS].

In order to clarify the characteristics of the area where the visiting nursing station is located, we conducted a study to identify the regional characteristics of the visiting nursing station in Ishikawa Prefecture, using geographical information system(GIS). We mapped the elderly population, aging rate, and location data for the visiting nursing station using QGIS, and created trade areas(Voronoi diagrams). The aging rate for each trade area is 22.4%(min 8.8% to max 44.6%), about 5 times. The difference in area is about 850 times as large as the central value of 9.2 km2(min 0.5 km2 to max 423.2 km2). In addition, there was a tendency for stations with a large trade area to have a higher aging rate than that of smaller stations. Understanding the characteristics of the area surrounding visiting nursing stations using GIS facilitates the clarification of potential needs and opportunities for providing visiting nursing services that are suitable for each area.

Factors Related to Evacuation Intentions of Power-Dependent Home Care Patients in Japan.

This study investigated factors affecting disaster preparedness and evacuation intentions among home-care patients dependent on electrical power for life support. Health professionals interviewed 53 home-care patients using the Kanazawa and Kochi Disaster Preparedness Checklist. About half of the participants requiring continuous artificial ventilation or aspiration indicated that they would not or could not evacuate following a disaster-even though their lives could be at risk. The availability of emergency medical equipment for use during a power outage was positively associated with the desire to evacuate. Our results indicate the need for improved systems to assist power-dependent home-care patients.

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.

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.

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.

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 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.

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.

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.

Discovery of a novel EP2/EP4 dual agonist with high subtype-selectivity.

A series of γ-lactam prostaglandin E(1) analogs bearing a 16-phenyl moiety in the ω-chain and aryl moiety in the α-chain were synthesized and biologically evaluated. Among the tested compounds, γ-lactam PGE analog 3 designed as a structural hybrid of 1 and 2 was discovered as the most optimized EP2/EP4 dual agonist with excellent subtype-selectivity (K(i) values: mEP2=9.3 nM, mEP4=0.41 nM). A structure-activity relationship study is presented.

Synthesis and evaluation of novel modified γ-lactam prostanoids as EP4 subtype-selective agonists.

To identify chemically and metabolically stable subtype-selective EP4 agonists, design and synthesis of a series of modified γ-lactam prostanoids has been continued. Prostanoids bearing 2-oxo-1,3-oxazolidine, 2-oxo-1,3-thiazolidine and 5-thioxopyrrolidine as a surrogate for the γ-hydroxycyclopentanone without a troublesome 11-hydroxy group were identified as highly subtype-selective EP4 agonists. Among the tested, several representative compounds demonstrated in vivo efficacy after oral dosing in rats. Their pharmacokinetic and structure-activity relationship studies are presented.

Synthesis and evaluation of γ-lactam analogs of PGE2 as EP4 and EP2/EP4 agonists.

To identify topically effective EP4 agonists and EP2/EP4 dual agonists with excellent subtype selectivity, further optimization of the 16-phenyl ω-chain moiety of the γ-lactam 5-thia prostaglandin E analog and the 2-mercaptothiazole-4-carboxylic acid analog were undertaken. Rat in vivo evaluation of these newly identified compounds as their poly (lactide-co-glycolide) microsphere formulation, from which sustained release of the test compound is possible, led us to discover compounds that showed efficacy in a rat bone fracture healing model after its topical administration without serious influence on blood pressure and heart rate. A structure-activity relationship study is also presented.

Discovery of novel prostaglandin analogs as potent and selective EP2/EP4 dual agonists.

To identify potent EP2/EP4 dual agonists with excellent subtype selectivity, a series of γ-lactam prostaglandin E analogs bearing a 16-phenyl ω-chain were synthesized and evaluated. Structural hybridization of 1 and 2, followed by more detailed chemical modification of the benzoic acid moiety, led us to the discovery of a 2-mercaptothiazole-4-carboxylic acid analog 3 as the optimal compound in the series. An isomer of this compound, the 2-mercaptothiazole-5-carboxylic acid analog 13, showed 34-fold and 13-fold less potent EP2 and EP4 receptor affinities, respectively. Structure activity relationship data from an in vitro mouse receptor binding assay are presented. Continued evaluation in an in vivo rat model of another 2-mercaptothiazole-4-carboxylic acid analog 17, optimized for sustained compound release from PLGA microspheres, demonstrated its effectiveness in a rat bone fracture-healing model following topical administration.

Pyrrolo[1,2-b]pyridazines, pyrrolo[2,1-f]triazin-4(3H)-ones, and related compounds as novel corticotropin-releasing factor 1 (CRF1) receptor antagonists.

To identify structurally novel corticotropin-releasing factor 1 (CRF(1)) receptor antagonists, a series of bicyclic core analogs pyrrolo[1,2-b]pyridazines and pyrrolo[2,1-f]triazin-4(3H)-ones, which were designed based on a monocyclic core antagonist, was synthesized and evaluated. Among the compounds tested, 2-difluoromethoxy-4-methylpyridin-5-yl analog 27 was found to show efficacy in a dose-dependent manner in an elevated plus maze test in rats. The discovery process and structure-activity relationship is presented.

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.