Based on the data published by the Statistics Division of the Fukushima Prefectural Government, we prepared figures and a table showing annual fluctuations in Fukushima's population and number of deaths in order to estimate the number of deaths directly and indirectly related to the Great East Japan Earthquake. We also obtained the number of deaths directly and indirectly related to the disaster from a report by the Public Relations Division of the Fukushima Prefectural Government and determined the differences between the actual data and our estimates. Furthermore, we examined the problems with earthquake-related deaths in Fukushima using reports by the Reconstruction Agency of Japan. Our results show that the number of deaths directly and indirectly related to the disaster in Fukushima was estimated 3,795 (95%CI 3,250 to 4,334), which differed by approximately 592 (95%CI 47 to 1,131) from the reported death toll of 3,203 (1,820 direct deaths, 1,383 indirect deaths). This suggested an increase in deaths that are not certified as earthquake-related deaths but are related to the disaster in some way. Moreover, the earthquake-related deaths in Fukushima apparently occurred over a longer period than those in other prefectures.

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　We investigated the characteristics and outcome of patients who were evacuated from hospitals located within 20–30 km of the nuclear power plant with the support of disaster medical assistance teams (DMATs) after the Fukushima Daiichi nuclear power plant accident. The total number of patients evacuated from hospitals located within 20–30 km of the plant with the support of DMATs was 514 (including duplicate cases). Patients transferred from or to geriatric health service facilities and duplicate cases were excluded, and the remaining 411 patients were included in the analysis of outcomes. The mean age of the 411 patients was 81.5 years, and 82% were aged 75 years or more. At the time of analysis (December 31, 2013), 12 patients (2.9%) were discharged, 279 (67.9%) were hospitalized, and 120 (29.2%) were dead. Twenty-two patients died within 1 month after transportation, accounting for 18.3% of total deaths and 5.4% of total study patients. We are planning to examine whether the deaths were related to the impact of transportation. In addition, there was a difference in mortality among hospitals, which requires further investigation.

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　Automated External Defibrillator (AED) is widely distributed in Japan. In this article, current placement of AED is reevaluated from the viewpoint of geography, topology and health care medicine.

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　Consciousness level of a patient on admission is an essential assessment in emergency room (ER) triage. Japan Triage and Acuity Scale (JTAS) is developed based on Canadian Triage and Acuity Scale (CTAS) created in Canada. In Canada, assessment of consciousness level is performed using Glasgow Coma Scale (GCS, Teasdale G, 1974). On the other hand, in Japan, assessment of consciousness level is performed GCS, Japan Coma Scale (JCS, Ota T, 1974) and Emergency Coma Scale (ECS, Takahashi C and Okudera H, 2011). Therefore, we investigate the above three assessment scale and purpose comparison table of them for revision of JTAS 2012.

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[in Japanese]

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　Hokkaido is Japan's largest prefecture, accounting for around 22.1% of the nation's total land area (equivalent to 39.7 times the size of the Tokyo Metropolitan area). Regional differences in numbers of health care workers in Hokkaido result in a disparity of medical service systems across the prefecture, which leads to problems in underpopulated areas. Hokkaido Disaster Nursing Support Communication (EZO Kan) engages in activities based on networks of nurses in local cities dotted across the prefecture and people engaged in various fields. The organization’s staff enjoy learning with these people, benefit from self-development while helping others, and return the results of learning to their work sites and communities. Activities include giving lectures and seminars at nursing schools and other facilities, planning and running training programs in response to nursing organization requests (e.g., Disaster Awareness for Parents and Children), dispatching training facilitators to civil service and other organizations, providing assistance (e.g., simulated patients) for disaster drills conducted by hospitals and other facilities, and running its own training programs (e.g., the Emergo Training System and Group Work). This report highlights the significance of collaborative relationships based on participants' own abilities among nurses in individual regions (e.g., EZO Kan members, members of other nursing organizations, certified emergency nurses and nursing administrators).

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Rationale During disasters, many are injured simultaneously and medical staff and resources may be in short supply. In this case, intravenous therapy is often difficult to administer at the disaster site. Recently, intravenous therapy has been substituted by oral rehydration solution (ORS), which is typically used to treat diarrhea and heatstroke. ORS is easier to administer, and water and electrolytes are quickly absorbed. In this study, we examined the effects of ORS in two animal models requiring intravenous therapy (hemorrhagic model and crush syndrome model).
Methods Hemorrhagic model: intravenous tube was introduced in jugular vein of rats and body weight was decreased 2% by de-blooding. The rats were then given a test solution intravenously or orally. Crush syndrome model: Both hindlimbs of anesthetized rats were compressed for 2 hours. After the weight was removed, the rats were given a test solution intravenously via a jugular vein or orally.
Results Hemorrhagic model: Plasma volume was recovered by intravenous therapy. In ORS group, plasma volume significantly recovered but the effect was weaker than intravenous group. Crush syndrome model: Blood levels of potassium, hematocrit, BUN, and myoglobin increased significantly in the control group but not in the group that received lactated Ringer's solution (LR). Kidney function parameters increased in the group that received MES compared to those in the LR group. In the ORS group, levels of hematocrit, BUN, and myoglobin were lower than those in the control group and lower.
Conclusions These results suggest that ORS can be a useful substitution for intravenous solution. In situations such as disasters, intravenous therapy may not always be possible onsite even when a patient should be rehydrated as quickly as possible. When intravenous therapy cannot be started, ORS is effective for maintaining fluid volume and renal function until the patients reach a hospital.han those in the animals that received mineral water.

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