【Purpose】 To clarify the actual activities of midwives deployed to support perinatal care facilities during the 2024 Noto Peninsula Earthquake, in order to examine institutional challenges. 【Methods】 Semi-structured interviews of 10 midwives deployed to the disaster area were conducted, followed by qualitative thematic analysis. 【Results】 Five themes were extracted: “decision-making on deployment,” “disaster relief activities,” “information sharing and logistical support,” “psychological state of deployed personnel,” and “learning from experience”. In addition to standard midwifery care, the deployed personnel engaged in supporting affected staff, improving the living environment of the care recipients, sharing information, and providing psychological care. Through these activities, their sense of professional responsibility also deepened. The importance of institutional development and psychological safety, as well as issues related to continuity of support, became evident. 【Discussion】 The findings of this study demonstrated the significance of midwives’ expertise and support during disasters. We confirmed that the presence/absence of institutional support would exert a direct impact on the feasibility of deployment of midwives and on the quality of activities engaged in by them. Establishing a sustainable deployment system requires institutional development, educational resource integration, collaboration among deployed personnel, and ensuring psychological safety. 【Conclusion】 The deployment of midwives during disasters contributes to medical and psychological support, and establishing a sustainable system remains a future challenge.

【Purpose】 During disaster, maintaining functional continuity of medical institutions is essential. Evaluating risks and resources of medical institutions contributes to enhancing institutional preparedness and training. This paper describes the development of a method to evaluate medical supply and demand that incorporates external causes of injury and temporal changes. Injury classifications derived from earthquake damage estimations are converted into injury classifications based on external causes and severity. This method is applied to a Nagamachi-Rifu Line Fault Zone Earthquake scenario, focusing on disaster base hospitals with ICUs within the Sendai medical operational area, which is the secondary medical operational area in Miyagi Prefecture. 【Method】 First, medical operational areas were defined for each disaster base hospital, and the number of severely injured people defined by the Cabinet Office (SIcao) within these areas was estimated. Next, drawing on data from the 1995 Great Hanshin Earthquake, the temporal distribution of severely injured people (SI) arriving at each hospital was estimated. Finally, the medical supply-demand balance was evaluated based on the number of critically injured patients against the capacity of available beds, specifically ICUs and critical care beds. 【Results】 Results found that, in the assumed scenario, the medical supply-demand balance was more than 1 at five out of eight hospitals in the 4 to 10 hours post-disaster. Furthermore, characteristics of external causes of injury among severely injured people (SI) arriving at disaster base hospitals were confirmed. 【Conclusion】 This method offers a novel approach by evaluating the medical supply and demand based on the external causes and temporal dynamics. This research is expected to lead to an increase in interdisciplinary collaborative studies and to enhance disaster response strategies.

【Purpose】 To compare one-person and two-person approaches in START triage focusing on time efficiency and throughput under personnel constraints. 【Method】 A simulation of START triage was conducted with 18 paramedics certified as Mass Casualty Life Support (MCLS) providers. Each participant triaged 10 simulated patients. Participants performed both a one-person approach, in which a single individual conducted assessment and documentation, and a two-person approach, in which these tasks were divided between an assessor and a recorder. The time required to complete each full triage sequence was recorded. In addition, a personnel-adjusted time for the two-person approach was calculated. Triage errors were evaluated as a secondary outcome. 【Results】 Median completion times were 508.5 s (476.75–644.25) for the one-person approach and 345 s (291.5–410.25) for the two- person approach, indicating significantly faster performance with the two-personnel (p<0.05). However, accounting for the doubled personnel requirement, the adjusted median time for the two-person approach (690 s [583–820.5]) was significantly longer than the one-person time (p<0.05). Triage errors were observed only in the one-person approach. 【Discussion】 Although the two-person approach improved efficiency for individual triage tasks, the one-person method may be more time-efficient overall during the initial phase of mass casualty incidents when staffing is limited. 【Conclusion】 The two-person approach is appropriate when adequate personnel are available, whereas the one-person method may be more practical during initial disaster response under constrained resources. Training programs such as MCLS should teach both approaches and emphasize their context-dependent application.

【Purpose】 The purpose of this study is to identify the actual operational criteria used by prefectural Disaster Welfare Assistance Team (DWAT) members when determining whether to deploy, to systematically organize the decision-making factors specified in relevant guidelines and manuals, and to clarify the defining characteristics of these criteria. 【Methods】 Of the 15 prefectures that responded “specific decision criteria exist” in the Fujitsu Research Institute (2023) survey, we selected the 11 prefectures for which relevant documentation was publicly available. We conducted a qualitative content analysis, including systematic coding of the guidelines and manuals, followed by categorization and conceptual diagramming of the extracted decision-making factors. 【Results】 The factors influencing DWAT dispatch decisions were classified into three overarching categories: “scale of the disaster,” “request for assistance,” and “flexible response.” Most prefectures relied on combination of multiple factors rather than a single criterion when making deployment decisions. Regarding the “scale of the disaster,” many guidelines referenced the Disaster Relief Act and related legislation as a primary benchmark. For “requests for assistance,” formal requests from municipalities constituted the central trigger for dispatch. In contrast, the “flexible response” category was characterized by a high degree of ambiguity as the responsible decision-making authority and the underlying evaluative basis were often not explicitly specified. 【Discussion】 The absent of crealy established and operationalized criteria, combined with the abstract nature of existing guidelines, may contribute to situations in which DWAT are not dispatched despite the presence of significant welfare needs during disasters. Clarifying decision criteria and visualizing the decision-making process are, therefore, essential to minimizing gaps in welfare support and ensuring timely and appropriate DWAT deployment.

【Purpose】 This study aimed to describe the support activities of the Japan Disaster Rehabilitation Assistance Team (JRAT) at intermediate (1.5-stage) evacuation shelter established in response to the 2024 Noto Peninsula Earthquake. Particular focus was placed on longitudinal changes in rehabilitation triage categories to identify practical considerations for disaster rehabilitation support. 【Methods】 A retrospective descriptive analysis was conducted. Among a cumulative total of 1,495 evacuees admitted to the shelter between January 8 and April 12, 2024, 263 individuals, representing 17.6%, for whom JRAT completed basic support recipient records and performed initial assessments were included in the analysis. 【Results】 Seventeen percent of the evacuees experienced a change in their rehabilitation triage category between initial and final assessments, with 6.1% showing deterioration. Worsening cases tended to have more comorbidities and shorter lengths of shelter stays. Regarding assistive devices, the portable handrail was the most frequently lent item, indicating the importance of environmental modifications in maintaining function and safety. 【Conclusion】 The study revealed that rehabilitation triage categories among evacuees changed over time during their stay in an intermediate shelter, highlighting the dynamic nature of rehabilitation needs in disaster settings. The findings underscore the necessity of appropriate initial rehabilitation triage and the establishment of follow-up systems to ensure timely and continuous rehabilitation support in future disaster responses.

【Purpose】 To clarify the learning content of nursing students who participated in disaster drills. 【Methods】 Open-ended responses were retrospectively collected from fourth-year nursing students enrolled in the elective course “Disaster Nursing” at University A between 2022 and 2024 (n=162) following disaster drills. The data were qualitatively analyzed using an inductive approach involving coding, subcategorization, and categorization. Multiple researchers cross-checked the analytical process to ensure validity. 【Results】 A total of six categories, 13 subcategories, and 705 codes were extracted. Student-reported learning was classified into the following domains: the importance of information sharing and organizational structure, proactive action and role recognition, management of shelter environments and supplies/resources, the importance of supporting disaster victims, improved disaster preparedness through training, and recognition of nurses’ roles as healthcare providers. Participation as both shelter staff and simulated disaster victims enabled students to recognize challenges related to communication, collaboration, resource management, and psychological support. 【Discussion】 Practical disaster drills provided valuable experiential learning opportunities that deepened students’ understanding of key disaster-response principles, increased awareness of the need for preparedness during peacetime, and promoted students’ recognition of their expected roles as future healthcare professionals. Building on the findings of this study, further examination is needed to assess long-term learning retention and its influence on behavioral change. 【Conclusion】 Participation in disaster drills is an effective educational intervention that enhances nursing students’ disaster awareness and enables them to clearly envision the roles and actions required of healthcare providers during disasters. These findings underscore the importance of incorporating practical disaster drills into undergraduate nursing curricula to foster disaster readiness among nursing professionals.

【Objectives】 This study conducted a structural analysis of the recovery of welfare provision systems following the 2024 Noto Peninsula Earthquake and explored how temporary, reversible stagnation transitions into irreversible structural deterioration. 【Subjects and Methods】 A retrospective descriptive and exploratory study covered six municipalities in the Noto region (Suzu, Wajima, Anamizu, Noto, Nanao, and Shika) from the acute phase to early recovery (December 2025). A mixed-methods design was adopted, combining descriptive analysis of administrative statistics and coordination headquarters records with qualitative findings from semi-structured interviews with four prefectural officials responsible for welfare recovery. Recovery processes were examined longitudinally by analyzing interactions among three structural components: facility availability, workforce capacity, and population dynamics. 【Results】 During the subacute phase, a “three-way deadlock” emerged in which welfare providers, medical institutions, and evacuees delayed decisions because of persistent uncertainty. Coordinated information sharing and resource allocation partially mitigated this stagnation. However, as recovery progressed, three structural barriers became evident: facility reconstruction delays, continuing workforce shortages that forced operational downsizing, and difficulty estimating actual service demand because many evacuees remained unregistered outside their home municipalities. These barriers interacted, generating a negative spiral (a vicious cycle with progressive loss of reversibility) in which each factor reinforced the others, gradually reducing the possibility of recovery. 【Discussion】The transition from reversible deadlock to irreversible structural deterioration was driven by simultaneous, prolonged uncertainty in both demand and supply, resulting in a “paralysis of decision-making” among providers, government, and residents. As time passed, staff relocated permanently, evacuees established new lives elsewhere, and investors abandoned reconstruction plans, rendering each change increasingly irreversible. This process suggests a mechanism whereby simultaneous, prolonged uncertainty in both demand and supply generates decision-making paralysis and accelerates irreversibility through substantive changes. These structural conditions distinguish the Noto case from previous disasters such as the Great East Japan Earthquake and the Kumamoto Earthquake. 【Conclusion】 In regions characterized by population decline and advanced population aging, preventing irreversible deterioration requires rapid resolution of the three-way deadlock and coordinated recovery across medical care, welfare services, and community reconstruction. Once irreversible demographic and workforce changes occur, recovery strategies must shift from restoring pre-disaster systems to adaptive reconstruction aligned with the transformed population structure. These perspectives provide essential principles for disaster recovery in aging and depopulating societies.

During large-scale disasters, a large number of Disaster Medical Assistance Teams (DMATs) assemble within a short period of time, making the operation of an assembly point headquarters crucial for the smooth initiation of medical support activities. However, specific operational methods and practical innovations for DMAT assembly point headquarters have not been sufficiently shared in the academic literature. We report an operational case of a DMAT assembly point headquarters established at a service area during the Large-Scale Earthquake Medical Response Drill conducted in fiscal year 2023. Based on prior preparation, a target time of 10 min from reception at the assembly point to completion of the deployment destination briefing was set. An updateable information label system was introduced as a visualization tool, and the display area was divided into “allocation pending” and “allocation determined” sections to visually organize the characteristics of the assembled DMATs. In total, 58 teams were processed, and the mean time from reception to completion of the destination briefing was 12 min. These findings suggest that operational design based on prior preparation, information visualization, and the use of time indicators may be useful for facilitating efficient management of DMAT assembly point headquarters.