All-Cause Mortality After the Great East Japan Earthquake in Fukushima Prefecture: Trends From 2009 to 2016 and Variation by Displacement

2020 ◽  
pp. 1-4
Author(s):  
Satoshi Tsuboi ◽  
Tomosa Mine ◽  
Satoshi Kanke ◽  
Tetsuya Ohira
Keyword(s):  
Nuclear Power ◽  
Great East Japan Earthquake ◽  
Local Health ◽  
Long Term Effects ◽  
Care Needs ◽  
Eastern Area ◽  
Fukushima Prefecture ◽  
All Cause Mortality ◽  
Local Health Care

ABSTRACT Objectives: On March 11, 2011, a magnitude 9 earthquake (the Great East Japan Earthquake) occurred off the east coast of Japan. After the Fukushima Daiichi Nuclear Power Plant accidents, as of 2016, people were not allowed to live in the 6 districts (Tomioka, Okuma, Futaba, Namie, Katsurao, Iidate) in Fukushima Prefecture. In the present study, we aimed to evaluate the long-term effects of displacement on all-cause mortality in Fukushima Prefecture. Methods: Data regarding population and deaths from 2009 to 2016 in Fukushima Prefecture were obtained from the governmental statistics. The age-adjusted all-cause mortality were compared among the 4 areas in Fukushima Prefecture; the Eastern, Middle, Western, and Displacement areas. Results: The age-adjusted all-cause mortality rates in the Eastern and Displacement areas were higher than in the other 2 areas from 2009 to 2011. During the period from 2012 to 2016, all-cause mortality in the Displacement area decreased to the lowest, while the morality in the Eastern area remained the highest. Conclusions: Against all expectations, after the earthquake, all-cause mortality in the Displacement area was continuously lower than in the rest of the Fukushima Prefecture. Following disasters, long-term monitoring should be organized to meet local health-care needs.

scholarly journals Needs assessment and staff education to effect long-term change in emergency medicine in rural Nepal

CJEM ◽  
2004 ◽  
Vol 6 (04) ◽  
pp. 266-270
Author(s):  
Valerie F. Krym ◽  
Russell D. MacDonald
Keyword(s):  
Health Care ◽  
Emergency Medicine ◽  
Needs Assessment ◽  
Care Staff ◽  
Standards Of Care ◽  
Health Care Staff ◽  
Local Health ◽  
Staff Education ◽  
Local Health Care

ABSTRACT Medical work in developing countries is challenging and rewarding. To make a lasting impact on the local community, a health care worker must be willing to listen to the needs of the people. The long-term impact of a needs assessment and staff education on emergency medicine at a rural hospital in Nepal is presented. The Scheer Memorial Hospital is a 102-bed non-governmental, not-for-profit hospital in Banepa, Nepal. Nepalese and ex-patriot health care professionals staff the hospital. Medical supplies are obtained from local manufacturers or as donations from foreign organizations. The hospital waives fees for those who cannot afford care. Two academic emergency physicians with expertise in international health undertook a needs assessment to assist in planning for long-term health care goals related to emergency medicine. The assessment focused on health care planning and education of the local health care staff. Based on interviews and objective assessments, a plan was developed and implemented to address 4 key areas: physical plant, equipment, staff training and essential tasks. Sustainable positive change was accomplished by acknowledging local customs and standards of care, meeting the needs of local health care staff and using available resources.

scholarly journals Longitudinal Follow-Up of Long-Term Care Planning Using PlanYourLifespan.org

2020 ◽  
pp. 073346482094306
Author(s):  
Vanessa Ramirez-Zohfeld ◽  
Anne Seltzer ◽  
Ana Ramirez ◽  
Ruqayyah Muhammad ◽  
Lee A. Lindquist
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Long Term Effects ◽  
Care Needs ◽  
Term Care ◽  
User Perceptions ◽  
Care Plans ◽  
Age In Place ◽  
Care Services

Many older adults wish to age-in-place but do not have long-term care plans for when they may require more assistance. PlanYourLifespan.org (PYL) is an evidence-based tool that helps older adults understand and plan for their long-term care needs. We examined the long-term effects of PYL use on user perceptions and planning of long-term care services. Individuals who previously accessed PYL were invited to complete an online, nation-wide mixed methodology survey about end-user outcomes related to PYL. Among 115 completed surveys, users found PYL helpful with long-term planning for their future needs. Over half of website users reported having conversations with others because of PYL use. However, 40% of respondents reported not having a conversation with others about their plans; common themes for barriers to planning included procrastination and a lack of immediate support needs. Although PYL helps with planning, many people are still not communicating their long-term care plans.

scholarly journals Disaster Preparedness Among Older Japanese Adults With Long-Term Care Needs and Their Family Caregivers

2016 ◽  
Vol 11 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Tomoko Wakui ◽  
Emily M. Agree ◽  
Tami Saito ◽  
Ichiro Kai
Keyword(s):  
Older Adults ◽  
Family Caregivers ◽  
Disaster Preparedness ◽  
Long Term Care ◽  
Community Support ◽  
The United States ◽  
Great East Japan Earthquake ◽  
Care Needs ◽  
Term Care

AbstractObjectiveIn the 2011 Great East Japan Earthquake, as in Hurricanes Katrina and Rita in the United States, older individuals were at the greatest risk of mortality. Much concern has been raised about developing plans to reduce these risks, but little information has been provided about preparedness, and the key role played by caregivers has been largely unexplored. The aims of this study were thus to examine the preparedness of family caregivers of older adults with long-term care needs and to identify the characteristics of older adults and their caregivers that are associated with poor preparedness and greater concern about disasters.MethodsShortly after the Great East Japan Earthquake, the second wave of the Fukui Longitudinal Caregiver Study was administered to the family caregivers of older Japanese individuals with long-term care needs. The sample included 952 caregivers from 17 municipalities in Fukui prefecture. Logistic regression analyses were used to identify the factors associated with self-assessed preparedness, evacuation planning, and caregivers’ concerns about preparedness.ResultsThe majority (75%) of the caregivers had no concrete plans for evacuation in an emergency, and those caring for persons with dementia were 36% less likely to have any plan. In multivariate models, caregivers who were more experienced and wealthier and who reported more family and community support were more likely to feel well prepared. Caregivers with poor health or limited financial resources or who were responsible for older persons with mobility difficulties reported higher levels of anxiety about their disaster preparedness.ConclusionsThis study indicates that most caregivers are ill prepared to respond in emergencies and that caregiver resources, community support, and the needs of older care recipients influence both preparedness and concern about disasters. Education for caregivers and the development of community support programs could provide important sources of assistance to this vulnerable group. (Disaster Med Public Health Preparedness. 2017;11:31–38)

scholarly journals Building a Comprehensive System of Services to Support Adults Living with Long-Term Mechanical Ventilation

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
David Leasa ◽  
Stephen Elson
Keyword(s):  
Mechanical Ventilation ◽  
Operations Management ◽  
Hospital Admissions ◽  
Service Providers ◽  
Integrated Approach ◽  
System Of Care ◽  
Local Health ◽  
Care Needs ◽  
Implementation Planning

Background.Increasing numbers of individuals require long-term mechanical ventilation (LTMV) in the community. In the South West Local Health Integration Network (LHIN) in Ontario, multiple organizations have come together to design, build, and operate a system to serve adults living with LTMV.Objective.The goal was to develop an integrated approach to meet the health and supportive care needs of adults living with LTMV.Methods.The project was undertaken in three phases: System Design, Implementation Planning, and Implementation.Results.There are both qualitative and quantitative evidences that a multiorganizational system of care is now operational and functioning in a way that previously did not exist. An Oversight Committee and an Operations Management Committee currently support the system of services. A Memorandum of Understanding has been signed by the participating organizations. There is case-based evidence that hospital admissions are being avoided, transitions in care are being thoughtfully planned and executed collaboratively among service providers, and new roles and responsibilities are being accepted within the overall system of care.Conclusion.Addressing the complex and variable needs of adults living with LTMV requires a systems response involving the full continuum of care.

Impact of the Great East Japan Earthquake on Acute Myocardial Infarction in Fukushima Prefecture

2014 ◽  
Vol 8 (3) ◽  
pp. 212-219 ◽  
Author(s):  
Takayoshi Yamaki ◽  
Kazuhiko Nakazato ◽  
Mikihiro Kijima ◽  
Yukio Maruyama ◽  
Yasuchika Takeishi
Keyword(s):  
Public Health ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Acute Myocardial Infarction ◽  
Nuclear Power ◽  
Great East Japan Earthquake ◽  
Large Area ◽  
Fukushima Prefecture ◽  
Fukushima Daiichi ◽  
Eastern Japan

AbstractObjectiveThe incidence of cardiovascular disease (CVD) reportedly increases following a huge disaster. On March 11, 2011, the Great East Japan Earthquake hit a large area of eastern Japan. In Fukushima prefecture, many people suffered from the consequences of the earthquake, the subsequent tsunami, and especially the Fukushima Daiichi Nuclear Power Plant accident. We assessed whether the incidence of acute myocardial infarction (AMI) increased after the earthquake.MethodsWe enrolled AMI patients admitted to 36 hospitals in Fukushima prefecture between March 11, 2009, and March 10, 2013 (n = 3068). We compared the incidence of AMI after the earthquake for more than 3 months and 1 year with that in the control years.ResultsThe incidence of Fukushima's annual AMI patients (per 100 000 persons) in 2011 was similar to that of previous years (n = 38.9 [2011] vs 37.2 [2009] and 38.5 [2010], P = .581). However, a significantly higher incidence of AMI was found in the Iwaki district after the disaster that corresponded to the 1-year period of observation (n = 38.7 [2011] vs 27.3 [2009] and 32.8 [2010], P = .045).ConclusionThe Great East Japan Earthquake affected the incidence of AMI only in limited areas of Fukushima prefecture. (Disaster Med Public Health Preparedness. 2014;0:1–8)

scholarly journals 6-month mortality and readmissions of hospitalized COVID-19 patients: A nationwide cohort study of 8,679 patients in Germany

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255427
Author(s):  
Christian Günster ◽  
Reinhard Busse ◽  
Melissa Spoden ◽  
Tanja Rombey ◽  
Gerhard Schillinger ◽  
...  
Keyword(s):  
Risk Factors ◽  
Protective Factor ◽  
Patient Treatment ◽  
German Population ◽  
Local Health ◽  
Index Hospitalization ◽  
Multivariable Logistic Regression Model ◽  
Readmission Rates ◽  
All Cause Mortality

Background COVID-19 frequently necessitates in-patient treatment and in-patient mortality is high. Less is known about the long-term outcomes in terms of mortality and readmissions following in-patient treatment. Aim The aim of this paper is to provide a detailed account of hospitalized COVID-19 patients up to 180 days after their initial hospital admission. Methods An observational study with claims data from the German Local Health Care Funds of adult patients hospitalized in Germany between February 1 and April 30, 2020, with PCR-confirmed COVID-19 and a related principal diagnosis, for whom 6-month all-cause mortality and readmission rates for 180 days after admission or until death were available. A multivariable logistic regression model identified independent risk factors for 180-day all-cause mortality in this cohort. Results Of the 8,679 patients with a median age of 72 years, 2,161 (24.9%) died during the index hospitalization. The 30-day all-cause mortality rate was 23.9% (2,073/8,679), the 90-day rate was 27.9% (2,425/8,679), and the 180-day rate, 29.6% (2,566/8,679). The latter was 52.3% (1,472/2,817) for patients aged ≥80 years 23.6% (1,621/6,865) if not ventilated during index hospitalization, but 53.0% in case of those ventilated invasively (853/1,608). Risk factors for the 180-day all-cause mortality included coagulopathy, BMI ≥ 40, and age, while the female sex was a protective factor beyond a fewer prevalence of comorbidities. Of the 6,235 patients discharged alive, 1,668 were readmitted a total of 2,551 times within 180 days, resulting in an overall readmission rate of 26.8%. Conclusions The 180-day follow-up data of hospitalized COVID-19 patients in a nationwide cohort representing almost one-third of the German population show significant long-term, all-cause mortality and readmission rates, especially among patients with coagulopathy, whereas women have a profoundly better and long-lasting clinical outcome compared to men.

Age-Related Degradation of Steam Generator Internals Based on Industry Responses to Generic Letter 97-06

2002 ◽  
Author(s):  
M. Subudhi ◽  
E. J. Sullivan
Keyword(s):  
Steam Generator ◽  
Nuclear Power ◽  
Power Plants ◽  
Pressurized Water Reactor ◽  
Long Term Effects ◽  
Steam Generators ◽  
Pressurized Water ◽  
Age Related ◽  
The U.S

This paper presents the results of an aging assessment of the nuclear power industry’s responses to NRC Generic Letter 97-06 on the degradation of steam generator internals experienced at Electricite de France (EdF) plants in France and at a United States pressurized water reactor (PWR). Westinghouse (W), Combustion Engineering (CE), and Babcock & Wilcox (B & W) steam generator models, currently in service at U.S. nuclear power plants, potentially could experience degradation similar to that found at EdF plants and the U.S. plant. The steam generators in many of the U.S. PWRs have been replaced with steam generators with improved designs and materials. These replacement steam generators have been manufactured in the U.S. and abroad. During this assessment, each of the three owners groups (W, CE, and B&W) identified for its steam generator models all the potential internal components that are vulnerable to degradation while in service. Each owners group developed inspection and monitoring guidance and recommendations for its particular steam generator models. The Nuclear Energy Institute incorporated in NEI 97-06, “Steam Generator Program Guidelines,” a requirement to monitor secondary side steam generator components if their failure could prevent the steam generator from fulfilling its intended safety-related function. Licensees indicated that they implemented or planned to implement, as appropriate for their steam generators, their owners group recommendations to address the long-term effects of the potential degradation mechanisms associated with the steam generator internals.

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