Background: The well-being of disaster responders is just as important as that of disaster victims as maintaining responders’ health is essential for the effective disaster response. This study aimed to identify the key factors contributing to fatigue in disaster responders. Methods: This cross-sectional study analyzed data from disaster responders deployed during the 2024 Noto Peninsula Earthquake in Ishikawa prefecture, Japan. Data were collected using the health management version of the Japanese Surveillance in Post-Extreme Emergencies and Disasters app from January to March 2024. Associations between contributing factors including problems in the work environment, type of work activity, and occupation, and self-reported fatigue score were examined using the t-tests, analysis of variance, and multivariable regression analysis. Results: We analyzed 15,067 data entries from disaster responders. Fatigue levels among disaster responders were generally low, with 73.7% of scores between 1 and 3 during the first phase and 82.3% during the second phase. Fatigue was significantly higher in the early response phase (β = 0.32, 95% confidence interval [CI]: 0.27—0.37) and among logisticians (β = 0.23, 95% CI: 0.18—0.28) and Health Emergency Operations Center staff (β = 0.20, 95% CI: 0.14—0.25) than among nonlogisticians and non —Health Emergency Operations Center staff members. Problems in the work environment had the largest effects: inability to take meals and breaks increased fatigue by 1.82 points (95% CI: 1.56—2.07), and unclear tasks or command structures by 0.82 points (95% CI: 0.57—1.06). Conclusion This study underscores the importance of establishing a structured command system, strengthening responder training and improving working conditions to safeguard responder well-being.

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

The prognostic significance of initial prostate-specific antigen (PSA) level for metastatic prostate cancer remains uncertain. We investigated the differences in prognosis and response to hormonal therapies of metastatic prostate cancer patients according to initial PSA levels. We analyzed 184 patients diagnosed with metastatic prostate cancer and divided them into three PSA level groups as follows: low (<100 ng ml^-1), intermediate (100-999 ng ml^-1), and high (≥1000 ng ml^-1). All patients received androgen deprivation therapy (ADT) immediately. We investigated PSA progression-free survival (PFS) for first-line ADT and overall survival (OS) within each of the three groups. Furthermore, we analyzed response to antiandrogen withdrawal (AW) and alternative antiandrogen (AA) therapies after development of castration-resistant prostate cancer (CRPC). No significant differences in OS were observed among the three groups (P = 0.654). Patients with high PSA levels had significantly short PFS for first-line ADT (P = 0.037). Conversely, patients in the high PSA level group had significantly longer PFS when treated with AW than those in the low PSA level group (P = 0.047). Furthermore, patients with high PSA levels had significantly longer PFS when provided with AA therapy (P = 0.049). PSA responders to AW and AA therapies had significantly longer survival after CRPC development than nonresponders (P = 0.011 and P < 0.001, respectively). Thus, extremely high PSA level predicted favorable response to vintage sequential ADT and AW. The current data suggest a novel aspect of extremely high PSA value as a favorable prognostic marker after development of CRPC.
Aged ; Aged, 80 and over ; Androgen Antagonists/therapeutic use* ; Disease Progression ; Humans ; Male ; Middle Aged ; Prognosis ; Progression-Free Survival ; Prostate-Specific Antigen/blood* ; Prostatic Neoplasms/mortality* ; Treatment Outcome

In this article, we provide a brief summary of a case-cohort study design and an introduction of Japan Statin Study (JSS) as an example for case-cohort study conducted in Japan. In the case-cohort study, the control as a sub-cohort is randomly selected from a research cohort at the beginning of the study. As it is not necessary to be sampled a control by interesting event in the research, the study design as well as cohort study can examine some events in the same time. Therefore the study design can be also applied to pharmaco-vigilance survey. The case-cohort study design has wide application range. (Jpn J Pharmacoepidemiol 2013; 18(2): 84-89)

Horseshoe kidney is an unusual abnormality occurring in 0.25% of the population. In surgery for AAA with horseshoe kidney, reconstruction of aberrant renal and preservation of renal isthmus is important. We report 3 cases of AAA with horseshoe kidney treated successfully without division of the isthmus.