Medical needs during the Kumamoto heavy rain 2020: analysis from emergency medical teams' responses.

BACKGROUND: Rainfall-induced floods represented 70% of the disasters in Japan from 1985 to 2018 and caused various health problems. To improve preparedness and preventive measures, more information is needed on the health problems caused by heavy rain. However, it has proven challenging to collect health data surrounding disasters due to various inhibiting factors such as environmental hazards and logistical constraints. In response to the Kumamoto Heavy Rain 2020, Emergency Medical Teams (EMTs) used J-SPEED (Japan-Surveillance in Post Extreme Emergencies and Disasters) as a daily reporting tool, collecting patient data and sending it to an EMTCC (EMT Coordination Cell) during the response. We performed a descriptive epidemiological analysis using J-SPEED data to better understand the health problems arising from the Kumamoto Heavy Rain 2020 in Japan. METHODS: During the Kumamoto Heavy Rain 2020 from July 5 to July 31, 2020, 79 EMTs used the J-SPEED form to submit daily reports to the EMTCC on the number and types of health problems they treated. We analyzed the 207 daily reports, categorizing the data by age, gender, and time period. RESULTS: Among the 816 reported consultations, women accounted for 51% and men accounted for 49%. The majority of patients were elderly (62.1%), followed by adults (32.8%), and children (5%). The most common health issues included treatment interruption (12.4%), hypertension (12.0%), wounds (10.8%), minor trauma (9.6%), and disaster-related stress symptoms (7.4%). Consultations followed six phases during the disaster response, with the highest occurrence during the hyperacute and acute phases. Directly disaster-related events comprised 13.9% of consultations, indirectly related events comprised 52.0%, and unrelated events comprised 34.0%. As the response phases progressed, the proportions of directly and indirectly related events decreased while that of unrelated events increased. CONCLUSION: By harnessing data captured by J-SPEED, this research demonstrates the feasibility of collecting, quantifying, and analyzing data using a uniform format. Comparison of the present findings with those of two previous analyses of J-SPEED data from other disaster scenarios that varied in time, location, and/or disaster type showcases the potential to use analysis of past experiences to advancing knowledge on disaster medicine and disaster public health.

Key issues in Japan's public health centers to prepare for future pandemics: a text mining study using a topic model.

BACKGROUND: In Japan, over 450 public health centers played a central role in the operation of the local public health system in response to the COVID-19 pandemic. This study aimed to identify key issues for improving the system for public health centers for future pandemics. METHODS: We conducted a cross-sectional study using an online questionnaire. The respondents were first line workers in public health centers or local governments during the pandemic. We solicited open-ended responses concerning improvements needed for future pandemics. Issues were identified from these descriptions using morphological analysis and a topic model with KHcoder3.0. The number of topics was estimated using Perplexity as a measure, and Latent Dirichlet Allocation for meaning identification. RESULTS: We received open-ended responses from 784 (48.6%) of the 1,612 survey respondents, which included 111 physicians, 330 nurses, and 172 administrative staff. Morphological analysis processed these descriptions into 36,632 words. The topic model summarized them into eight issues: 1) establishment of a crisis management system, 2) division of functions among public health centers, prefectures, and medical institutions, 3) clear role distribution in public health center staff, 4) training of specialists, 5) information sharing system (information about infectious diseases and government policies), 6) response to excessive workload (support from other local governments, cooperation within public health centers, and outsourcing), 7) streamlining operations, and 8) balance with regular duties. CONCLUSIONS: This study identified key issues that need to be addressed to prepare Japan's public health centers for future pandemics. These findings are vital for discussions aimed at strengthening the public health system based on experiences from the COVID-19 pandemic.

Incidence of Acute Respiratory Infections during Disasters in the Absence and Presence of COVID-19 Pandemic.

INTRODUCTION: Japan recently experienced two major heavy rain disasters: the West Japan heavy rain disaster in July 2018 and the Kumamoto heavy rain disaster in July 2020. Between the occurrences of these two disasters, Japan began experiencing the wave of the coronavirus disease 2019 (COVID-19) pandemic, providing a unique opportunity to compare the incidence of acute respiratory infection (ARI) between the two disaster responses under distinct conditions. SOURCES FOR INFORMATION: The data were collected by using the standard disaster medical reporting system used in Japan, so-called the Japan-Surveillance in Post-Extreme Emergencies and Disasters (J-SPEED), which reports number and types of patients treated by Emergency Medical Teams (EMTs). Data for ARI were extracted from daily aggregated data on the J-SPEED form and the frequency of ARI in two disasters was compared. OBSERVATION: Acute respiratory infection in the West Japan heavy rain that occurred in the absence of COVID-19 and in the Kumamoto heavy rain that occurred in the presence of COVID-19 were responsible for 5.4% and 1.2% of the total consultation, respectively (P <.001). ANALYSIS OF OBSERVATION AND CONCLUSION: Between the occurrence of these two disasters, Japan implemented COVID-19 preventive measures on a personal and organizational level, such as wearing masks, disinfecting hands, maintaining social distance, improving room ventilation, and screening people who entered evacuation centers by using hygiene management checklists. By following the basic prevention measures stated above, ARI can be significantly reduced during a disaster.

Influences of sex-related information for STD prevention.

PURPOSE: Adolescents obtain information about sex from the media and friends and so on. This study explores the influence and needs of sex-related information from mass media and other resources. METHODS: Thirteen Focus Group Interviews were conducted with 88 high school and university students (46 female/42 male) from August 2001 to February 2002. RESULTS: Friends or seniors are the most important source of information, and adolescents felt much peer pressure by such information while they learned STD prevention and contraception. The participants were aware of the inconsistencies and biases of information they get through the media. They thought women's magazines seriously treated sex as a health issue concerning women, and provided useful information. CONCLUSIONS: Influences the media has on the knowledge and awareness of young people are significant. It is crucial to fill the gap between the intention of the transmitter of information and the needs of the audience so that the media can be better utilized for sexual health promotion.

[Peer education by medical students in a public health course].

Sex education by peers is becoming popular in Japan. To improve youth's reproductive health by continuous peer education and to encourage medical students to obtain the methodology necessary for health promotion, we started peer sex education by medical students in the annual public health course. One junior high school and one senior high school in Kitakyushu City in Japan asked medical students to conduct peer sex education classes at their schools. Medical students planned and carried out these classes based on the results of a questionnaire that they gave to the junior high school and senior high school students before the peer education. After the class, the students' responses to the class were investigated by another questionnaire. In this questionnaire, over 90% of the students answered that they were interested in talking about sexual issues with medical students. As for the medical students, they said that they could understand better the methodology of health promotion and also gained confidence by this experience. We will continue to carry out peer education in the medical school's public health course, and we intend to research further how junior high school and senior high school students' sexual behavior may change in the future.

[A sexual health study of high school students at the 3 high schools in Kitakyushu City].

OBJECTIVES: The purpose of this study was to clarify the actual sexual behavior and attitudes of high school students in Kitakyushu city, Fukuoka and then to develop effective sex education methods for high school students in this region. METHODS: This study investigated the sexual behavior and attitudes of 1,297 high school students in Kitakyushu by self-administered questionnaire. The differences in their answers by sex, prevalence of sexual intercourse and change in sexual behavior and attitude before and after the sex education lecture were examined. RESULT: 39.3% of the students had had sexual intercourse and 74.1% answered that they might have sex, if it were with a partner whom they loved. However, they did not have enough knowledge about contraception and sexually transmitted diseases. This result shows that they did not recognize the risks accompanying sexual intercourse. There are significant differences between male and female students in their sexual attitudes. Male students tend to permit premarital sexual intercourse, unfaithfulness, prostitution, hiring a prostitute and abortion. Male students tend to give more approval to the following opinions: both men and women should agree to sexual contact if the partner wants it; men should take the initiative in sexual contact; women should not talk about sex. Many female students answered that women should make their own decisions to have or not to have sex, however a considerable number of female students answered that for their first intercourse, they just agreed with their partner even though they really did not want to do so. After the sex education lecture, the students have more knowledge about contraception and STDs. However, there is no significant difference in their sexual attitudes before and after the lecture. CONCLUSION: In order to facilitate more desirable and safer sexual behavior among the younger generation, it is not enough to simply give them knowledge about contraception or STDs, etc. To organize more comprehensive sex education, it is also important to pay enough attention to gender problems and other social factors such as family background or regional background, etc.