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.

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.

[Regional Comparison on Recognition of Tasks for a Home Care System-Analysis of Medical Plans of 47 Prefectures by Text Mining and GIS].

A medical plan reflectsthe current state of a region. The purpose of thisres earch isto analyze medical plansby text mining and examine geographical features using a geographic information system. From the medical plans of 47 prefectures, nationwide, 6 regional divisions', and four age groups' text fileswere prepared. Further, wordswere extracted and subsequently, their relevance wasanalyzed. Additionally, we examined the geographical featuresus ing a color-dividing Japanese map by the word appearance rate of"Mitori"(end-of-life care), which is an important task. In the aggregate nationwide text files, 214,716 words were extracted. The top frequent words were medical care, home, support, nursing care, visit, medical treatment, and cooperation. In the co-occurrence network, medical care- home- nursing care- cooperation were connected with organization- construction. There was a link between human resources- training in Kanto and Kinki."Mitori"frequently occurred in areaswith a high aging rate, and there wasa human resources- training- securing connection in areas with a low aging rate. The frequency of"Mitori"was high in western Japan. The results suggested that collaboration between medical care and nursing care is emphasized in medical planning. Further,"Mitori"was emphasized in western Japan or areas with a high aging rate while human resourcesdevelopment wasemphas ized in areaswith a low aging rate.

[Survey on the Actual Situation of Home Care Support by Outpatient Nursing Managers and on the Awareness of Regional Cooperation].

Shortened hospitalization periods result in an increase in discharged patients with a lack ofself -care agency and families with lower caring ability. The role ofoutpatient nurses becomes more important in such situations. In this study, to clarify the role played by outpatient nurses, we surveyed them about their actual situation ofhome care support and awareness of regional cooperation. Subjects included outpatient nursing managers ofgeneral hospitals with inpatient facilities publicized in Osaka Prefecture; for the survey, questionnaires were sent to them via mail. The questionnaire collection rate was 16.5%. Regarding issues related to outpatient nursing, insufficient manpower was the most frequent response. Although efforts to provide nursing care have been made, such as the use ofmedical professionals and the arrangement ofcertif ied nurses and specialized nurses, the actual situation was clarified with difficulty to ensure nursing quality such as working shifts of the staffs and arrangement standard. Reasons why nursing quality cannot be ensured included the following: readiness of the patient cannot be understood, time cannot be ensured because ofthe large non-nursing workload, and nursing volume cannot be determined. Although efforts such as arrangement of certified nurses and establishment of outpatient sections for nursing were found to ensure nursing quality, insufficient regional cooperation was clarified with issue of nursing cooperation inside hospitals. This situation was considered to be influenced by large nursing-related workload, such as shortened waiting time, concentrated treatments, and smooth functioning.

[Effect of Sterilized Water on the Removal of Staphylococcus Aureus Attached to the Inner Surface of the Enteral Nutrition Tubes].

OBJECTIVE: The purpose ofthis study is to determine whether Staphylococcus aureus(S. aureus)can be removed completely from the inner surface of the enteral nutrition tubes using sterilized water. METHODS: A bacterial solution of S. aureus in saline was prepared. The enteral nutrition tubes were later soaked in this solution for 1 hour. After the solution was drained, bacterial count ofthe tube was determined. The inner surfaces ofthe tubes were later flushed 10 times with sterilized water. The bacterial load of the tubes was determined after flushing. After 18 hours, the viable bacteria on the insides of the tubes were enumerated. RESULTS: One hour after the initial inoculation, 62.6±26.0% oft he S. aureus survived. Some bacteria remained viable on the tubes after 10 flushes with sterilized water. Eighteen hours after the flushes, viable bacteria could be detected on the inside ofthe tubes. CONCLUSION: To ensure the safe use ofthe enteral nutrition tubes, it is important not to recycle the tubes or to disinfect the tubes after every meal.

[An Investigation into the Geographical Characteristics of Difficult Areas of Food Access in Mountainous Regions Using a Geographic Information System].

We performed this study with the aim of clarifying the geographical features of areas of difficult-to-access foods in mountainous regions, using GIS, altitude data, and future population projections. With QGIS, we mapped altitude data, future estimates of the old age population(mesh), and retail store data, and we extracted the altitude at the mesh center point. We also draw straight lines connecting the retail stores and the mesh center point. Meshes located in areas with high altitudes had significantly more meshes not occupied by humans than meshes located in low-lyingareas (p<0.01). At least 95% of the retail shops and mesh center points were separated by more than 500 meters, and thus are considered difficult to access. The number of non-residential areas increases in mountainous regions because of the sharp gradient and the long distance to retail stores. By visualizingusingGIS, future resources can be considered more realistically.

[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.

Tsunami evacuation simulation using geographic information systems for homecare recipients depending on electric devices.

Tsunamis cause direct damage to property and destroy infrastructure. In addition, power outages can lead to death, especially for patients who rely on medical equipment requiring a power supply. Recently, Nankai Trough Earthquakes have been predicted, and much effort has been put into developing countermeasures in Japan. Kochi City on Shikoku Island is expected to suffer in the event of a large tsunami. The present study identifies individuals living in Kochi who need evacuation assistance and depend on electrical medical devices, simulates evacuation behavior and inundation during a tsunami using a geographic information system (GIS), and considers the usefulness of such a GIS. We asked caregivers, including visiting nurses, to introduce us to homecare recipients who rely on a ventilator, an endotracheal suction device, or other medical devices requiring electric power. We received introductions to 52 homecare recipients. Using a GIS, we plotted the area of predicted inundation and the locations of homecare recipients, nursing stations, and welfare evacuation shelters. We predicted evacuation routes, and then analyzed the time difference between the time required for evacuation and tsunami arrival at a welfare evacuation shelter. To measure the effects of the main parameters, we conducted both one-way and multi-way sensitivity analysis. In the event of a tsunami, eight of the homecare recipients living in the forecasted inundation areas in Kochi may face delayed evacuation. Among homecare recipients facing a high possibility of escape delay, 95.2% lived more than 1,800 m from the nearest welfare evacuation shelter. We found that individual evacuation behavior can be simulated by specifying the residence of a homecare recipient and the evacuation route using a GIS.

[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.