Ultrasound cardiography examinations detect victims' long-term realized and potential consequences after major disasters: a case-control study

BACKGROUND@#An increase in cardiovascular diseases has been reported following major disasters. Previous work has shown that ultrasonographic findings from ultrasound cardiography examination (UCG) increased until the 44th month after the tsunami caused by the Great East Japan Earthquake. The present study conducted UCG among victims in the tsunami disaster area and investigated the frequency of disaster-related cardiovascular diseases and changes over time until the 55th month after the disaster.@*METHODS@#The subjects were residents of temporary housing complexes and neighboring housing in Watari-gun, Miyagi Prefecture, Japan. There were 207 subjects in the 18th month, 125 in the 30th month, 121 in the 44th month, and 106 in the 55th month after the disaster. Data were collected through UCG and self-report questionnaire.@*RESULTS@#Significant changes were observed among subjects with clinical findings from the UCG, which increased over the study period-from 42.0 to 60.8, 72.7, and 73.6% beginning in the 18th month after the disaster (p < 0.0001).@*CONCLUSIONS@#It is possible that the UCG can become a useful examination to visualize the potential impact of a major disaster on the cardiac function of victims. Victims with clinical findings continued increasing not only during the acute phase after a disaster but also in the long term. We therefore need to keep this in mind, and note that it is important to establish a support system to control cardiovascular diseases from the early stage of disaster.@*TRIAL REGISTRATION@#UMIN; ID000029802. R000034050 . 2 November 2017.

Entre a rua e o abrigo: reorganização do cotidiano / Between the streets and the shelter: everyday reorganization

A população em situação de rua tem se mostrado um fenômeno urbano crescente, se transformando em objeto de interesse de gestores públicos e da academia. O texto apresenta os resultados da pesquisa que teve como objetivo compreender o contexto de moradores em situação de rua em atual acolhimento institucional provisório, analisando por que as ruas se tornaram a moradia para algumas pessoas; como ocorreu o processo de elaboração e adaptação das atividades cotidianas nessa nova realidade; quando e por que buscaram sair da rua e como ocorreu esse processo de produção de um novo cotidiano, a partir do acolhimento institucional; como organizam e planejam sua saída do serviço de acolhimento. Para tanto, foram realizadas entrevistas abertas e produção de narrativas de histórias de vida com sete moradores de um serviço de acolhimento institucional, acompanhadas de observação participante durante um ano no mesmo serviço, quando funcionários, moradores e a dinâmica institucional foram observados sistematicamente. Os resultados apontam que os usuários desse serviço passaram por diferentes trajetórias de vida, com um traço em comum: a fragilização crescente dos vínculos e de poder aquisitivo. O serviço parece contribuir para o movimento de saída das ruas, oferecendo acolhimento imediato, acolhimento e autonomia funcional. Entretanto, o movimento de saída do abrigo ­ que implicaria em outras autonomias, construção de suportes sociais e assistência integrada ­ aparece nas histórias de vida como um processo difícil e com pouco suporte institucional. O trabalho evidencia a necessidade de se construir debates e proposições acerca do processo de desabrigamento.

The lives of the residents in the disaster areas of the Great East Japan Earthquake : Interviews with temporary housing residents in the City of Tagajo / 日本プライマリ・ケア連合学会誌

<b>Objective</b> : To understand the issues, future goals and support for the lives of the residents who were victims of the Great East Japan Earthquake.<br><b>Methods</b> : We conducted interviews with two men and six women among the affected residents who were living in temporary housing in the City of Tagajo in July 2013.<br><b>Results</b> : Most residents had many acquaintances, so there were minimal interpersonal troubles. However, many of them are elderly and there was concern regarding those that do not attend community meetings. This temporary housing was assisted by volunteers from the whole country who came at the early stages to support them. Upon moving into the temporary housing, there were some initial problems such as no reheating of the bath water and dark surroundings due to the lack of street lamps. However, following requests to the City of Tagajo, most of these issues were resolved. Many of the residents need to use a wheelchair compared to normal situation and concern was expressed regarding who will support them if another big earthquake occurs.<br><b>Conclusion</b> : New permanent housing is being constructed and gradually being occupied, and no major problems were seen among the residents interviewed. However, the existence of the group of people who cannot come to the community meetings and the issues that elderly residents have were clarified. Support for these residents, including health maintenance, is felt to be necessary.

Rehabilitation in a Disaster Zone : A Report from a Miyagi Prefecture Hospital that escaped Damage in the Great East Japan Earthquake and Disaster / The Japanese Journal of Rehabilitation Medicine

In the Great East Japan Earthquake and disaster, much of the Pacific coastline of Miyagi Prefecture was devastated by a tsunami. Though physical damage to our hospital was minimal, both the flow of information and the hospital's lifeline were interrupted. During this time supplies to our hospital were insufficient, yet we still gave medical assistance to the disaster victims. Physically handicapped people faced extreme difficulty in all aspects of everyday life such as moving to a refuge center, eating, going to the toilet and securing a place to lie down at the refuge center. Physically handicapped people left in homes cut off from the outside also faced many difficulties. We commenced medical assistance at the refuge center 3 days after the tsunami hit. Many assistants came from other hospitals affiliated with MIN-IREN (Japan Federation of Democratic Medical Institutions) throughout the country. We commenced rehabilitation support at the refuge center from April. While at the refuge center, handicapped people had to deal with many obstacles such as the distance to the toilets, toilet structure, stairs and steps etc. From June, we began assistance at the temporary housing sites. Going forward, our future problem is providing disaster victim health management support at the temporary housing sites, and also providing assistance in setting up a network of sympathetic residents to prevent isolation. In light of our experience, from the perspective of a disaster management strategy, there is a definite need to perfect a government-centered support system that focuses on physically handicapped people immediately after a disaster. This is particularly important from the perspective of rehabilitation, as the challenge is to create post-disaster rehabilitation support teams.