Digital technology is dramatically transforming today's healthcare. Over the past decade, exponential advances in digital technology, especially in smart phones, have radically changed many aspects of everyday life. Medicine will be the next aspect. Maturation of innovative digital technologies such as next generation sequencing, internet of things, cloud computing and artificial intelligence has generated a perfect storm to revolutionize the status quo in medicine. In the near future, clinical practice will be much different than it is today. It is important to pay attention to the changes and be prepared for the inevitable tsunami of transformation. In this paper I will discuss how digital technology has been changing healthcare.
Artificial Intelligence ; Delivery of Health Care* ; Internet ; Tsunamis

Dengue fever, which is caused by a mosquito-borne flavivirus, has become a major infectious- disease threat in tropical and subtropical areas. Dengue fever has also become a common cause of febrile infections in persons who have recently traveled. On December 26, 2004 the tsunami hit Southeast Asia. People who survived in those areas were infected with endemic disease such as dengue fever, malaria and cholera. We sent six members of the Korean medical relief team to the tsunami region. Three workers developed fever, chills and headache after leaving the tsunami region, and were diagnosed with Dengue fever. Such an outbreak of Dengue Fever in travelers is rarely reported.
Asia, Southeastern ; Chills ; Cholera ; Dengue* ; Disease Outbreaks ; Endemic Diseases ; Fever ; Flavivirus ; Headache ; Humans ; Malaria ; Tsunamis*

Mental health is one of the most important issues for disaster survivors, and many studies have reported higher rates of mental health problems after disasters. Because Japan has experienced frequent earthquakes, tsunami, typhoons, and volcanoes, mental health problems have been a matter of great concern after disasters in Japan. To serve the psychiatric services after the Hanshin-Awaji (Kobe) earthquake, 'Hyogo institute for traumatic stress' was established. And when the disaster caused by the great east Japan earthquake and tsunami occurred, 'National information center of disaster mental health' and 'Disaster psychiatric assistance team' had the important role of reducing mental health problems.
Cyclonic Storms ; Disasters* ; Earthquakes ; Humans ; Information Centers ; Japan* ; Mental Health* ; Survivors ; Trauma Centers ; Tsunamis

BACKGROUND: To examine changes in psychological distress prevalence among pregnant women in Miyagi Prefecture, which was directly affected by the Great East Japan Earthquake and tsunami, and compare it with the other, less damaged areas of Japan. METHODS: This study was conducted in conjunction with the Japan Environment and Children`s Study. We examined 76,152 pregnant women including 8270 in Miyagi Regional Center and 67,882 in 13 other regional centers from the all-birth fixed data of the Japan Environment and Children's Study. We then compared the prevalence and risk of distress in women in Miyagi Regional Center and women in the 13 regional centers for 3 years after the disaster. RESULTS: Women in the Miyagi Regional Center suffered more psychological distress than those in the 13 regional centers: OR 1.38 (95% CI, 1.03-1.87) to 1.92 (95% CI, 1.42-2.60). Additionally, women in the inland area had a consistently higher prevalence of psychological distress compared to those from the 13 regional centers: OR 1.67 (95% CI, 1.18-2.38) to 2.19 (95% CI, 1.60-2.99). CONCLUSIONS The lack of pre-disaster data in the Japan Environment and Children's Study made it impossible to compare the incidence of psychological distress before and after the March 2011 Great East Japan Earthquake. However, 3 years after the Great East Japan Earthquake, the prevalence of pregnant women with psychological distress did not improve in Miyagi Regional Center. Further, the prevalence of mental illness in inland areas was consistently higher than that in the 13 regional centers after the disaster.
Adolescent ; Adult ; Disasters ; Earthquakes ; Female ; Humans ; Japan/epidemiology* ; Pregnancy ; Pregnancy Complications/psychology* ; Pregnant Women/psychology* ; Prevalence ; Psychological Distress ; Tsunamis ; Young Adult

BACKGROUND: Natural disasters have long-term negative impacts on the health and socioenvironmental conditions of a population, affecting the physical environment as well as the relationships within the community, including social networks. Mothers in post-disaster communities may have difficulty receiving social support not only from family members and relatives but also from members of their community, such as people in their neighborhoods. This study focused on mothers with infants and preschool-aged children in post-disaster communities. The associations of social support with sociodemographic characteristics and socioenvironmental conditions related to child-rearing among mothers in post-disaster communities were assessed. METHODS: An anonymous self-administered questionnaire survey was conducted in October 2015 in 988 households in areas affected by the Great East Japan Earthquake and Tsunami. The data collected on sociodemographic and socioenvironmental characteristics included the presence of pre-disaster acquaintances in the neighborhood and social support for child-rearing. The associations of sociodemographic and socioenvironmental characteristics with social support were examined. RESULTS: We analyzed 215 completed questionnaires from mothers living in different houses from those they lived in before the disaster to reflect continuous relationships with people from the pre-disaster communities. Social support was significantly associated with infant sex, extended family, support obtained from relatives not living together, pre-disaster acquaintances, use of child support resources, and no perceived difficulties in child-rearing. In addition, the presence of pre-disaster acquaintances was associated with categories of mental/physical place of comfort and child-rearing support, with adjusted odds ratios of 1.88 (95% CI 1.03-3.44) and 2.84 (95% CI 1.46-5.52) compared with mothers who did not have any pre-disaster acquaintances. CONCLUSIONS Factors associated with the obtainment of social support in child-rearing among mothers in post-disaster communities were attributed not only to mothers themselves and family members but also to socioenvironmental factors such as the presence of pre-disaster acquaintances. The presence of pre-disaster acquaintances promoted rich social support in child-rearing in post-disaster communities. When reconstructing a community following changes in residence location after a disaster, the pre-disaster relationships among the community dwellers should be considered from the viewpoint of child-rearing support.
Child Rearing ; Child, Preschool ; Disasters ; statistics & numerical data ; Earthquakes ; statistics & numerical data ; Female ; Humans ; Infant ; Japan ; Male ; Mothers ; psychology ; statistics & numerical data ; Social Support ; Tsunamis ; statistics & numerical data

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.
Aged ; Aged, 80 and over ; Cardiovascular Diseases ; diagnosis ; diagnostic imaging ; Case-Control Studies ; Disasters ; statistics & numerical data ; Earthquakes ; Female ; Health Behavior ; Humans ; Japan ; Male ; Middle Aged ; Tsunamis

BACKGROUND: In areas affected by the tsunami of the great East Japan Earthquake, smoking behavior may have deteriorated due to high stress and drastic changes in living environment. Surveys were conducted to reveal changes in smoking behaviors among victims. METHODS: A population-based random-sample home-visit interview survey of victims in Iwate and Miyagi Prefectures affected by the tsunami disaster was conducted in 2012 (n = 1978), while a population-based nationwide survey was conducted in 2013 (n = 1082). A panel survey in 2014 was conducted with respondents of the 2012 survey (n = 930). Multiple logistic regression analysis was performed to reveal factors related to smoking status after the disaster. RESULTS: There was high smoking prevalence of both sexes in the tsunami disaster area (current smoking rate in coastal area, 50.0% for male, 21.4% for female; inland area, 34.7% for male, 7.6% for female). Low prevalence of male quitters was observed (quitter rate in coastal area, 20.8% for male, 8.0% for female; inland area, 23.4% for male, 5.5% for female). The prevalence of nicotine-dependent people assessed by FTND (Fagerström Test for Nicotine Dependence) in the coastal area was also higher than in the inland area or other areas of Japan. Smoking behavior among victims worsened after the disaster and did not improve 3 years from the disaster. Post-disaster factors related to smoking were living in coastal area, complete destruction of house, and living in temporary housing. CONCLUSIONS Smoking prevalence and the level of nicotine dependence of tsunami victims were still high even 3 years after the disaster. It is important to emphasize measures for smoking control in the disaster areas for an extended time period.
Adult ; Aged ; Aged, 80 and over ; Disaster Victims ; statistics & numerical data ; Earthquakes ; Female ; Humans ; Japan ; Male ; Middle Aged ; Smoking ; epidemiology ; Tsunamis ; Young Adult

OBJECTIVES: The aim of this systematic literature review is to analyze the psychosocial interventions for children and adolescents after disasters. METHODS: We conducted a review of the extant research literature from 1991 to 2015 via a comprehensive search of the MEDLINE, EMBASE, Cochrane CENTRAL, PubMed and PsyclNFO databases. The keywords employed in this research included: ‘child’, ‘adolescent’, ‘youth’, ‘disaster’, ‘posttraumatic’, ‘psychosocial’, ‘therapy’ and ‘intervention’. The researchers followed the PRISMA guidelines. A total of 850 articles were screened for their eligibility and fifty-nine were found to meet the study criteria. The final data analysis was performed based on the disaster type, study design, type of intervention, sample size, age, school grade, number of sessions, setting of intervention delivery, providers, approach and parent involvement. RESULTS: Countries worldwide have experienced various kinds of disasters, including earthquakes, hurricanes, vessel accidents, tornados, tsunamis, volcanic eruptions, war, fire, terrorism, and traffic accidents. The types of psychosocial intervention that were conducted after these disasters included: psychological first aid, psychological debriefing, psychoeducation, trauma focused cognitive behavior therapy, eye movement desensitization reprocessing, prolonged exposure therapy, group play therapy and arts therapy, project interventions, school-based interventions and web-based interventions. CONCLUSION: The findings of the systematic literature review suggest that an appropriate psychosocial intervention could be utilized as evidence-based mental health treatment for children and adolescents after disasters.
Accidents, Traffic ; Adolescent* ; Child* ; Cognitive Therapy ; Cyclonic Storms ; Disasters* ; Earthquakes ; Eye Movement Desensitization Reprocessing ; Fires ; First Aid ; Humans ; Implosive Therapy ; Mental Health ; Parents ; Play Therapy ; Sample Size ; Statistics as Topic ; Terrorism ; Tornadoes ; Tsunamis ; Volcanic Eruptions