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Many local governments, especially in Japan, disseminate multilingual disaster-related information to migrants as part of their disaster education programs to make their disaster risk reduction (DRR) policies more inclusive. However, little is known about the specific content of the information disseminated through such programs and how or why that content is selected. Using an example case of Okayama Prefecture in Japan and its principal city, Okayama City, the current study identifies the content of multilingual disaster-related information, as well as the assumptions behind its selection. To this end, the content of multilingual disaster-related information disseminated by these local governments was inductively analyzed, focusing on (1) what is and is not communicated, (2) how the government views the migrant population, and (3) their goals of information dissemination targeting migrants. As a result of conducting a qualitative content analysis on information disseminated by the Okayama local governments via information booklets and a YouTube video, it was found that the content was largely concerned with calling migrants to be proactive in taking preventive and harm reduction measures, as well as acquiring prerequisite knowledge (e.g., about disasters and their management). The underlying assumptions and expectations behind this content (e.g., how a behavioral change occurs and self-sufficiency as an expectation in disaster preparedness) are discussed, as well as issues associated with these assumptions. [ABSTRACT FROM AUTHOR]

The study critically reviewed the cognitive and environmental factors that influence individual disaster preparedness behavior, focusing on the unique term of "ishiki (awareness)" in Japanese research. The 474 articles reviewed were extracted from 27 journals published between 2010 and 2020 that mentioned the keywords "disaster preparedness (bosai)" and "awareness (ishiki)." By extracting and coding the factor-behavior associations for the reviewed articles, it was found that the following cognitive and environmental factors were discussed. Cognitive factors that influence individuals' disaster preparedness behavior include seven components: awareness, risk perception, worry, self-efficacy, knowledge, intention, and dependence and trust; environmental factors include ten components: information, direct experience, disaster experience, recovery period institution, disaster preparedness program, elapsed time, demographic factors, social-economic factors, geographic factors, and social contexts. Paradoxical associations were observed for both cognitive and environmental factors, which was also discussed from four perspectives: discrepancy between prior plans and actual behavior, positive feedback to cognitive factors, formation of action habits, and change in awareness; all of which suggested that individuals' disaster preparedness behavior is a process rather than a result caused by cognitive factors. This study reveals that "ishiki (awareness)" has functioned as a term coined to desaturate diverse backgrounds in Japanese research, and points to the need for an approach that encompasses environmental factors such as physical, human, social, and economic resources. The contributions of this study cast light on aspects of the term that have been masked by its culturally unique development and point to a new direction by uncovering its internal contradictions. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to examine life situations and perceptions related to the recognition of mutual support among Japanese people. Design: A quantitative, correlational, cross‐sectional analysis. Sample: Nine hundred and nine participants who provided complete questionnaire responses. Measurements: As a disaster prevention measure, a community center conducted a "questionnaire survey evaluating the recognition of mutual support and several potentially related factors". In our study, these data from a self‐administered questionnaire were used secondarily. Results: The perceptions that differed with regard to the sense of mutual support included family structure; satisfaction with support, security, and disaster prevention in the district; being able to ask for help with shopping; closeness of the relationship with one's neighbors; seeing oneself as providing or needing protection; and recognition of existing worries regarding evacuation. In a logistic regression model, the factors predicting the sense of mutual support included being younger than 70 years, being able to ask for help with shopping, and the closeness of the association with one's neighbors. Conclusions: The study identified situations that might predict the sense of mutual support in individuals in Japanese communities. [ABSTRACT FROM AUTHOR]

There exist certain behaviors that people tend to do in disaster situations before evacuation. Such behaviors include warning confirmation behavior (for example, seeking information) and family-oriented behavior (for example, contacting one's family). Identifying factors that affect these behaviors is of particular importance in building a better understanding of why people often fail to respond quickly to evacuation orders. For this purpose, the present study employed some of the established factors affecting evacuation behavior as predictor variables along with the timing of an evacuation order. A total of 518 participants took part in a 12-item online questionnaire survey that contained a hypothetical disaster scenario. The results of ordinal logistic regression analyses revealed that only risk area residence and disaster preparedness were associated with warning confirmation behavior, while gender, age, disaster preparedness, and risk perception had some associations with family-oriented behavior. Also, the participants were not more likely to engage in these behaviors in the morning and the afternoon than the evening in the hypothetical scenario. These findings imply the possibility that people engage in warning confirmation behavior and family-oriented behavior before evacuation regardless of individual characteristics and the circumstances surrounding them. [ABSTRACT FROM AUTHOR]

Disaster preparedness is the most important measure that can be taken to reduce damage. However, disaster preparedness is predicted to be difficult for older adults with cognitive impairment. Thus, we investigated the effects on disaster preparedness of cognitive impairment in persons requiring special care who are 75 or older. The survey included subject characteristics such as demographic indicators, physical function, cognitive function impairments, community involvement, and disaster preparedness. Cross-sectional data from 711 subjects were divided into two groups, a cognitive impairment group and an unimpaired group. Next, to show the effects of subject characteristics in each group on disaster preparedness, a binomial logistic regression analysis was performed. Then, the effects on disaster preparedness were compared between the two groups. This study showed that persons requiring special care who are 75 or older, and have the characteristics of "living alone," "requiring care," and "needing mobility assistance" in addition to cognitive impairment, have increased difficulty making disaster preparedness. Government officials and community supporters therefore need to recognize that these people should be supported on a priority basis, and to provide continuing support for disaster preparedness. [ABSTRACT FROM AUTHOR]

Background: Disaster relief operations involve a variety of components of healthcare efforts. The post-disaster recovery is a key component of hospital preparedness. This study aimed to investigate the role of hospital nurses in the disaster area and their challenges during the relief efforts after the Great East Japan Earthquake in 2011.Methods: Semi-structured interviews were conducted with ten nurses who worked in a general public hospital before the Great East Japan Earthquake and were dispatched to the evacuation centers after the disaster. A qualitative approach with the thematic analysis method was employed. Three research queries (RQs) were prepared before the interview.Results: The study participants played administrative roles as city employees in addition to performing nursing services as healthcare providers in evacuation centers. The first RQ on their challenges in evacuation centers gave us four themes: criticism by the evacuees, conflicts between multiple roles, difficulties in performing the first experience, and anxiety in working. The second RQ asking about motivation to accomplish disaster relief efforts raised three themes of carrying out the nursing role, acceptance by evacuees, and strengths of human connections. Two themes of awareness of disaster medicine and professional growth were raised from the third RQ of gains from the experiences in the evacuation centers.Conclusions: The hospital nurses in the disaster area performed multiple roles in the relief efforts in the evacuation centers, which developed a psychological burden on them. A sense of competence supported the motivation to accomplish the disaster relief activities and professional growth as a specialist in disaster medicine. A study limitation is missing hospital nurses who resigned during the relief efforts. Further study is warranted to refine the disaster preparedness of hospital operations. [ABSTRACT FROM AUTHOR]

Background: Climate change has increased the frequency and severity of torrential rains and floods around the world. Estimating the costs of these disasters is one of the five global research priorities identified by WHO. The 2018 Japan Floods hit western Japan causing extensive destruction and many deaths, especially among vulnerable elderly. Such affected elderly would need long-term care due to the various health problems caused by the disaster. A Long-Term Care Insurance (LTCI) system provides care services in Japan. The aim of this study was to evaluate the effect of the 2018 Japan Floods on LTCI costs and service utilization.Methods: The participants of this retrospective cohort study were all verified persons utilizing LTCI services in Hiroshima, Okayama and Ehime prefectures. The observation period was from 2 months before to 6 months after the disaster. We used Generalized Estimating Equations (GEEs) to examine the association between disaster status (victims or non-victims) and the monthly total costs of LTCI service (with gamma-distribution/log-link) by residential environment (home or facility). Among home residents, we also examined each service utilization (home-based service, short-stay service and facility service), using the GEEs. After the GEEs, we estimated Average Marginal Effects (AME) over all observation periods by months as the attributable disaster effect.Results: The total number of participants was 279,578. There were 3024 flood victims. The disaster was associated with significantly higher total costs. The AME for home residents at 2 months after was $214 (Standard Error (SE): 12, p < 0.001), which was the highest through the observation period. Among facility residents, the AME immediately after the disaster increased by up to $850 (SE: 29, p < 0.001). The service utilization among home residents showed a different trend for each service. The AME of home-based services decreased by up to - 15.2% (SE:1.3, p < 0.001). The AME for short-stay service increased by up to 8.2% (SE: 0.9, p < 0.001) and the AME for facility service increased by up to 7.4% (SE: 0.7, p < 0.001), respectively.Conclusions: The 2018 Japan Floods caused an increase in LTCI costs and the utilization of short-stay and facility services, and a decrease in utilization of home-based services. [ABSTRACT FROM AUTHOR]

When considering disaster preparedness, one challenge is mitigating the health impacts of evacuations. Nuclear disaster preparedness has evolved based on past experiences from numerous disasters, including the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. However, there is a lack of comprehensive reporting on the awareness of administrative staff, medical personnel, and residents in the areas surrounding nuclear power plants (NPPs). This study reports on a survey aimed at gaining insights into the understanding and current state of disaster preparedness and elucidating the differences in perceptions of nuclear disaster preparedness among the relevant stakeholders surrounding NPPs. Interview surveys were conducted from 14 to 16 September 2022 in the area surrounding Kyushu Electric Power's Genkai NPP in Saga Prefecture and from 11 to 13 January 2023 in the area around Shikoku Electric Power's Ikata NPP. The surveys targeted administrative, medical, and nursing care facilities and residents. Responses from 57 participants indicated a lack of awareness of natural and nuclear disasters, challenges in evacuation planning, and a gap between nuclear disaster training and residents' understanding of evacuation protocols. This study highlights inadequacies in nuclear disaster preparedness and the need for a better understanding among residents regarding evacuation procedures. This study identified three key issues: (1) a lack of awareness about disasters, including nuclear disasters; (2) concerns about complex disasters and the difficulties in creating evacuation plans; and (3) a discrepancy between nuclear disaster training and residents' understanding of evacuation procedures. To bridge this gap, it is important to deepen residents' understanding of nuclear disasters, continuously convey the lessons learned from the FDNPP accident, and regularly reassess and update nuclear disaster preparedness strategies., (Creative Commons Attribution license.)

Japan is a country known both for its devastating natural disasters and its high level of community preparedness. However, while demographic pressures stemming from an aging society have led to a growing foreign population, scholars have paid little attention to understanding the levels of disaster preparedness exhibited by this group. Using representative data from the 2015 Nagoya City Foreign Resident Survey, this article is the first to explore variations in household disaster preparedness among Japan's foreign residents. Although numerous factors were found to affect preparedness, the most important appear to be national origin, experience with disaster training, and exposure to disaster information. Japanese language proficiency, perhaps surprisingly, was of minor importance. We thus argue that a person's cultural background and their exposure to information about local hazards affect their ability to identify and assess risk, which increases the likelihood that they will prepare their household for emergencies. This study not only provides insight into what might drive preparedness activities within foreign populations but also helps explain how migrants obtain disaster information. Its main implication is that Japan's disparate migrant populations require a strategically varied approach when considering interventions to address disaster vulnerability. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to examine how government continuity planning contributes to strengthening the public sector's emergency preparedness, resulting in enhanced resilience of the public sector. Government continuity plans (GCPs) are a recently focused concept in disaster preparedness, compared to business continuity plans (BCPs) in the private sector. The need for BCPs was widely recognized after the 2011 Great East Japan Earthquake (GEJE) and the 2011 Thailand Floods. However, recent disasters, such as the 2016 Kumamoto Earthquake in Japan, have revealed that local governments without effective GCPs were severely affected by disasters, preventing them from quickly responding to or recovering from disasters. When the GEJE occurred in 2011, only 11% of municipal governments in Japan had GCPs. Design/methodology/approach: The paper analyzes basic principles of government continuity planning using complex adaptive systems (CAS) theory while summarizing recent developments in theory and practice of government continuity planning. Findings: This research investigates the Japanese experience of GCPs using self-organization, one of the concepts of CAS. A GCP will complement regional disaster plans, which often focus on what governments should do to protect citizens during emergencies but fail to outline how governments should prepare for an emergency operation. The study concludes that GCPs contribute to increased resilience among the public sector in terms of robustness, redundancy, resourcefulness and rapidity. Practical implications: This paper includes implications for the development and improvement of a GCP's operational guideline. Originality/value: This research fulfills an identified need to investigate the effectiveness of a GCP for resilience in the public sector and how to improve its operation using concepts of CAS. [ABSTRACT FROM AUTHOR]

Purpose Of Review: Studies have shown that disasters may exacerbate the comorbidities in vulnerable populations such as those with a pre-existing chronic medical condition like diabetes. This article highlights recent studies that look at the impact of disasters on people with diabetes and also shows recent resources for consumers, health care providers, and policy makers to improve resiliency in people with diabetes.Recent Findings: Recent articles have looked at the short-term impact of disasters upon people with diabetes and its comorbidities such as Hurricane Sandy in 2012, the triple disaster of 2011 in Japan (earthquake, tsunami, and nuclear accident), and the 2016 Kumamoto earthquake in Japan as well as the long-term impact of disasters such as Hurricane Katrina in 2005. Several public and private partners have used the past and recent findings to develop resources that help consumers with diabetes and the people who care for them, prepare for a disaster BEFORE the event. [ABSTRACT FROM AUTHOR]

Background: Worldwide, children, newborns, and pregnant or postpartum women are vulnerable to disasters and emergency situations, and providing support to this population is of great concern. Japan is located in a disaster-prone area, so disaster response and risk reduction strategies are important priorities., Methods: We introduce a system called the Disaster Liaison for Pediatric and Perinatal Medicine (DLPPM). This was created with a specific focus on perinatal children and pregnant women in Japan. We report the details of its activities, discuss its challenges, and draw on lessons learned for the further development of perinatal support systems, particularly for children., Results: The lessons learned from the activities of the DLPPM include the following: (1) establish a support system for emergency specialists beyond those with pediatric and perinatal specialties; (2) mitigate the risk of indirect damage caused by primary disasters; and (3) establish a networking function linked to existing pediatric and perinatal medicine facilities., Conclusions: By establishing similar systems, we believe that it will be feasible to address pediatric and perinatal care needs in disaster response contexts in other countries and regions around the world., (© 2024 Japan Pediatric Society.)

Unperceived risk leads to lack of preparedness. This study aims to examine tourists' risk perception and travel decisions using as variables demographics, knowledge about safety, and country of residence. Samples were gathered in Thailand, Japan, Australia, and Indonesia. A total of 916 completed questionnaires of five replicated surveys were used in this study. More than halve of the respondents whose country had been affected by the Indian Ocean tsunami in 2004 did not perceive tsunami risk when 10 years has passed. Frequency of tsunami occurrence was positively related to perceived tsunami probability. This study confirms the theory of probability that low frequency of a natural disaster results in unperceived risks. Even if their destination had a history of tsunamis, tourists' perceived risk of another such occurrence happening during their visit is low (that is, the risk of natural disaster is low). While the literature in earth science found that residents of risky areas tend to be optimistic about the place where they live, our study extends the theory of optimistic bias to indicate that the same optimistic bias is applicable to tourists. Asia and Southeast Asia were perceived as tsunami-prone but tourists still travelled there. Our study found that tourist risk perception was related to frequency of tsunami occurrence and was destination specific. The perception of probability of a natural disaster is also related to proximity and past experience. Replications are necessary to validate results before generalization. [ABSTRACT FROM AUTHOR]

Preparedness for disaster scenarios is progressively becoming an educational agenda for governments because of diversifying risks and threats worldwide. In disaster-prone Japan, disaster preparedness has been a prioritised national agenda, and preparedness education has been undertaken in both formal schooling and lifelong learning settings. This article examines the politics behind one prevailing policy discourse in the field of disaster preparedness referred to as ‘the four forms of aid’ – ‘kojo [public aid]’, ‘jijo [self-help]’, ‘gojo/kyojo [mutual aid]’. The study looks at the Japanese case, however, the significance is global, given that neo-liberal governments are increasingly having to deal with a range of disaster situations whether floods or terrorism, while implementing austerity measures. Drawing on the theory of the adaptiveness of neo-liberalism, the article sheds light on the hybridity of the current Abe government’s politics: a ‘dominant’ neo-liberal economic approach – public aid and self-help – and a ‘subordinate’ moral conservative agenda – mutual aid. It is argued that the four forms of aid are an effective ‘balancing act’, and that kyojo in particular is a powerful legitimator in the hybrid politics. The article concludes that a lifelong and life-wide preparedness model could be developed in Japan which has taken a social approach to lifelong learning. [ABSTRACT FROM PUBLISHER]

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.

The likelihood of a mega-earthquake, the COVID-19 pandemic, and the threat of other disasters in the Tokyo Metropolitan area have necessitated collective responsibilities to take all possible actions to reduce their impacts. The experiences from past disasters have, however, highlighted the plight of foreign residents in coping with disasters and have reinvigorated calls for rigorous counteractions. As the population of foreign residents continues to increase in the metropolis, this research examines their awareness of risks and the obstacles that hinder disaster preparedness in the wake of future disasters. An Extended Parallel Process Model is utilized to analyze both secondary and primary data sources, and the results reveal that 65% perceive the severity of disaster as a threat and believe in a likelihood of occurrence in the city; however, the confidence to undertake some recommended countermeasures are lacking (with low efficacy of 70%). This is causing many to control their fear by not actively seeking further risk information or participating in disaster prevention activities. In consideration of these instances, the study recommends a collective approach built upon the merits of stakeholder engagements to provide vicarious experiences, verbal persuasions, and mastery experiences to boost the response capacities of foreign residents for disaster preparedness. This will be relevant for city authorities to enhance risk communication and foster foreigner-Japanese community integration.

Disaster deaths can be classified into direct and indirect deaths. Direct deaths are those caused by the direct physical effects of disasters, such as earthquakes, tsunamis, and radiation exposure. Indirect deaths are those caused by secondary health effects such as emergency evacuation, relocation, evacuation environment, disruption of health care delivery services, and psychosocial effects. In addition, in Japan, the term disaster-related deaths refers to indirect deaths in accordance with the disaster condolence payments system, which provides relief for bereaved families. On 11 March 2011, the Great East Japan Earthquake exposed several issues related to disaster-related deaths in Japan. Therefore, on 1 February 2022, a symposium on disaster-related deaths hosted by this study was held on the website. The symposium discussed the issues and challenges associated with disaster-related deaths for future disaster preparedness. The authors introduced the concept of 'shaking' at the symposium by defining 'shaking' as 'the repeated changes in the social and living environment that worsen health conditions, regardless of the disaster'. It was also pointed out that vulnerable populations are more likely to experience more pronounced health effects. This generalised concept of 'shaking' associated with disaster-related deaths suggests that it is important to anticipate disasters before they occur to take specific preventive measures, targeted at vulnerable populations. This study found that disaster-related deaths in Japan create several problems in terms of future radiation disaster preparedness and medical countermeasures. In the future, there will be a need to examine the relevance of the issues of disaster-related deaths identified as a result of this symposium for future radiation disaster preparedness., (Creative Commons Attribution license.)

Abstract: There was a missed opportunity for implementing important disaster preparedness measures following an earthquake prediction that was announced as an alarm in mid-2001. This intermediate-term middle-range prediction was the initiation of a chain of alarms that successfully detected the time, region, and magnitude range for the magnitude 9.0 March 11, 2011 Great East Japan Earthquake. The prediction chains were made using an algorithm called M8 and is the latest of many predictions tested worldwide for more than 25 years, the results of which show at least a 70% success rate. The earthquake detection could have been utilized to implement measures and improve earthquake preparedness in advance; unfortunately this was not done, in part due to the predictions'' limited distribution and the lack of applying existing methods for using intermediate-term predictions to make decisions for taking action. The resulting earthquake and induced tsunami caused tremendous devastation to north-east Japan. Methods that were known in advance of the predication and further advanced during the prediction timeframe are presented in a scenario describing some possibilities on how the 2001 prediction may have been utilized to reduce significant damage, including damage to the Fukushima nuclear power plant, and to show prudent cost-effective actions can be taken if the prediction certainty is known, but not necessarily high. The purpose of this paper is to show how the prediction information can be strategically used to enhance disaster preparedness and reduce future impacts from the world''s largest earthquakes. [Copyright &y& Elsevier]

The destructive impact of the Great East Japan Earthquake and subsequent tsunami on March 11, 2011 has enhanced consumer's earthquake preparedness even in unaffected areas. This paper uses unique survey data collected after the earthquake to study how consumers reacted to this catastrophic event. We find that self-reported, perceived preparedness for natural disasters has significantly improved even among low-income households after March 11, but that post-quake intentions for more specific risk mitigation activities were systematically associated with household income and wealth levels. Our results indicate that the recent events might have widened the gap in disaster preparedness between rich and poor. [ABSTRACT FROM AUTHOR]

Japan has the highest proportion of older adults in the world. Aging is not only an immediate personal issue but also a salient factor in crucial public policies, such as pensions, health, and long-term care. The Great East Japan Earthquake, tsunami, and nuclear power plant disaster of March 2011 has highlighted current and emerging issues of a “super-aging” society, especially the need for community-based support systems. [ABSTRACT FROM PUBLISHER]

Background: Natural disasters have increased during the last several decades all over the world. Due to its geographical and climate conditions, Japan has long been vulnerable to several natural disasters. Coping with disasters is a major challenge overall and even harder for foreigners residing in Japan. Thus, the objective of this study was to examine the perceived knowledge, attitude, practice and perceived barriers of disaster preparedness among Nepalese immigrants in Japan., Methods: A cross-sectional study was conducted among Nepalese immigrants residing in Japan with an online survey questionnaire. The questionnaire was validated and then administered. The participants were recruited via Facebook for this survey. Bivariable and multivariable logistic regression analyses were conducted to examine the factors associated with the perceived knowledge, attitude and practice of Nepalese immigrants regarding disaster preparedness., Results: A total of 404 respondents were analyzed in this study and among them two-third were male. We found that the mean score of disaster preparedness practice was lowest than the knowledge and attitude (mean [Formula: see text] = 15.86 [Formula: see text] 5.52) as evidenced by the majority of the participants not being prepared for disaster situations and a limited proportion had ever taken necessary natural disaster preparedness measures. Japanese language was identified as the major barrier in assessing the knowledge, attitude and practice regarding disaster preparedness and was significantly associated with the knowledge level of disaster preparedness after adjusting for some socio-demographic covariates. (aOR: 1.84, 95% CI: (1.04 - 3.25))., Conclusions: This study observed that the perceived knowledge and practices regarding natural disasters are very poor while barriers to access these are substantial among Nepalese immigrants in Japan. As Japanese language was identified as a major barrier, the availability of language translation services in every health care sector also in the government offices of Japan might encourage people to learn more about disaster preparedness., (© 2022. The Author(s).)

Background: The July 2018 Japan Floods caused enormous damage to western Japan. Such disasters can especially impact elderly persons. Research has shown that natural disasters exacerbated a decline in cognitive function, but to date, there have been no studies examining the effects of this disaster on the elderly. The object of this study was to reveal the effect of this disaster in terms of cognitive decline among the elderly., Methods: Study participants were certified users of the long-term care insurance (LTCI) system in Hiroshima, Okayama, and Ehime prefectures from May 2018 to June 2018. The observation period was from July 2018 to December 2018. Our primary outcome was cognitive decline after the disaster using a dementia symptomatology assessment. In addition to a crude model, a multivariate Cox proportional hazards model was used to assess the cognitive decline of victims, adjusting for age classification, gender, the level of dementia scale before the disaster occurred, residential environment, whether a participant used facilities shut down after the disaster, and population density. After we confirmed that the interaction term between victims and residential environment was statistically significant, we stratified them for the analysis., Results: The total number of participants was 264,614. Victims accounted for 1.10% of the total participants (n = 2,908). For the Cox proportional hazards model, the hazard ratio of the victims was 1.18 (95% confidential interval (CI): 1.05-1.32) in the crude model and 1.12 (95% CI: 1.00-1.26) in the adjusted model. After being stratified by residential environment, the hazard ratio of home victims was 1.20 (95% CI: 1.06-1.36) and the hazard ratio of facility victims was 0.89 (95% CI: 0.67-1.17)., Conclusions: This study showed that elderly living at home during the 2018 Japan Floods were at risk for cognitive decline. Medical providers, care providers, and local governments should establish a system to check on the cognitive function of elderly victims and provide necessary care support., (© 2021. The Author(s).)

Objective: The aims of this study were to examine the preparedness of vulnerable people ages 75 years and older and to clarify the characteristics of older adults that are associated with disaster preparedness., Methods: We conducted interviews with persons requiring special care ages 75 years and older living in coastal communities of western Japan, where earthquakes and tsunami disasters are a concern. The survey included participant characteristics such as demographic indicators, physical function, health status, community involvement, and disaster preparedness. Binomial logistic regression analysis was performed with participant characteristics as independent variables and disaster preparedness as the dependent variables., Results: The characteristics related to disaster preparedness were age, family composition, cognitive function, level of interaction with neighbors, and participation in community activities., Conclusions: Being female, living alone, and having cognitive impairment were factors that led to decreased disaster preparedness. However, it was suggested that close human interactions in the community facilitated preparedness. Community engagement is crucial in reducing disaster damage and recovering effectively. In order to facilitate preparedness measures for persons requiring special care ages 75 and older, it is important to establish community preparedness.

Global cities in the context of accelerated urbanization have to deal with more diverse risk factors than ever before, which highlights the need for a faster and more creative response capacity. Although it is necessary to strengthen technical systems, since they are surrounded by human systems, individual resilience will help to strengthen the community. The educational system is key to developing the human factor in a world where various systems in global cities are increasingly interconnected, which in turn increases risks. Japan is fostering a culture of disaster risk reduction in both the formal, non-formal, and informal education sectors, in which creativity and autonomy are key competencies. Tokyo is the highest populated metropolitan area globally, and its educational system is the international model for education in disaster risk reduction. Urban areas around the world face similar challenges and experience similar needs. This article addresses the challenges that the human factor faces in large cities and the possibilities of increasing resilience in both individuals and communities through Disaster Resilience Education (DRE), taking the Japanese educational system as a model.

The coronavirus disease 2019 (COVID-19) has profoundly affected the psychological well-being of foreign residents. This study examines stress, anxiety, and depression levels in Chinese residents in Japan during the COVID-19 pandemic. It identifies risk factors and the roles of disaster preparedness and social support. An online survey among Chinese residents in Japan was conducted from 22 June to 14 July 2020. The Depression, Anxiety and Stress Scale, Disaster Preparedness for Resilience Checklist, and Social Support Rate Scale were used to measure psychological symptoms. Multivariable linear regressions identified the risk factors and positive effects of disaster preparedness and social support. Of the total 497 participants, 45.3%, 66.6%, and 54.3% reported severe stress, anxiety, and depressive symptoms, respectively. People with a lower level of education, a higher level of economic influence, the presence of COVID-19 symptoms, and confirmed or suspected family or friends in China were associated with higher levels of stress, anxiety, and depression. This study, to the best of our knowledge, is the first survey to reveal the protective role of disaster preparedness in reducing psychological symptoms during the pandemic. It offers unique data for further research on how to promote the mental health of vulnerable populations including foreign residents.

Objective: The prevention of deaths caused indirectly by disasters is important, especially for evacuees requiring medication. Pharmacies play a major role in providing medication to disaster victims. Therefore, this study evaluated the current status of disaster preparedness among pharmacies, the extent of disaster awareness and knowledge of disaster mitigation measures, and any associations of these with the characteristics of pharmacies., Methods: Questionnaires about disaster preparedness were sent to 337 pharmacies in Japan, in a region at high risk of major earthquakes. Tabulation analyses were carried out to examine the characteristics of pharmacies and then a logistic regression analysis was performed to examine the relationship between disaster awareness and the level of preparedness of pharmacies. Furthermore, to examine in detail any differences associated with pharmacy size, subgroup analyses were performed., Results: High disaster awareness was significantly correlated with adequate disaster preparedness. However, in the subgroup analyses, no significant differences were observed among large pharmacies. In contrast, disaster awareness was significantly related to the disaster preparedness of small pharmacies., Conclusion: The findings suggest that the disaster preparedness of pharmacies is related to the level of disaster awareness, highlighting the importance of disaster awareness activities in ordinary times before a disaster. (Disaster Med Public Health Preparedness. 2019;13:753-757).

Objective: Hospital preparedness against disasters is key to achieving disaster mitigation for health. To gain a holistic view of hospitals in Japan, one of the most disaster-prone countries, a nationwide surveillance of hospital preparedness was conducted., Methods: A cross-sectional, paper-based interview was conducted that targeted all of the 8701 registered hospitals in Japan. Preparedness was assessed with regard to local hazards, compliance to building code, and preparation of resources such as electricity, water, communication tools, and transportation tools., Results: Answers were obtained from 6122 hospitals (response rate: 70.3%), among which 20.5% were public (national or city-run) hospitals and others were private. Eight percent were the hospitals assigned as disaster-base hospitals and the others were non-disaster-base hospitals. Overall compliance to building code, power generators, water tanks, emergency communication tools, and helicopter platforms was 90%, 84%, 95%, 43%, and 22%, respectively., Conclusion: Major vulnerabilities in logistics in mega-cities and stockpiles required for chronic care emerged from the results of this nationwide surveillance of hospitals in Japan. To conduct further intensive surveillance to meet community health needs, appropriate sampling methods should be established on the basis of this preliminary study. Holistic vulnerability analysis of community hospitals will lead to more robust disaster mitigation at the local level.

Countermeasures are needed to thwart recent advances in military warfare that disable physical infrastructure, including the power grid that global Internet services rely upon [ABSTRACT FROM PUBLISHER]

Background: during the eastern Japan earthquake in 2011 and the following prolonged blackout, pediatric patients with home medical devices sought electricity at the pediatric department. We retrospectively studied the effect of this earthquake and the following blackout., Methods: we hand-reviewed pediatric admission records in Tohoku University Hospital for new inpatients attributed to the earthquake from March 11, 2011 to April 12, 2011. A survey by questionnaire regarding the situation during the earthquake was performed for parents of technology-assisted patients., Results: during the study period, 24 pediatric patients were admitted to the pediatric department. Eighteen technology-assisted pediatric patients, including those with home respirators, accounted for 75% of new pediatric admissions. Patients who were admitted for electricity shortage stayed in the hospital for a mean of 11.0days (3-25days). The questionnaire survey showed that 55% of technology-assisted patients were admitted to medical centers for evacuation. The majority of patients (89%) with ventilators were eventually admitted to medical centers during the earthquake. Most of the parents of technology-assisted patients experienced a prolonged petrol shortage and difficulty in communications with medical centers., Conclusion: the current study suggests that technology-assisted pediatric patients with neurological disorders as the primary disease can overwhelm the capacity of hospital inpatient facilities in certain situations. Disaster preparedness should consider assuring power requirements in healthcare facilities and preparing backup power generators lasting for at least 24h for these patients. Preparing alternative measures for emergent electricity and communications could remedy serious conditions during a disaster., (Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)