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.

Problem: On 17 December 2024, a magnitude 7.3 earthquake struck the Pacific Island country of Vanuatu, affecting over 80 000 people and causing 14 deaths and 265 injuries. Facing limited specialist clinical capacity, increased patient load and strained facilities, Vanuatu’s Ministry of Health requested support from emergency medical teams. Context: Vanuatu, highly disaster-prone and geographically dispersed, has a health system constrained by limited human resources and recent cyclone-related damage. The country’s national emergency medical team, the Vanuatu Medical Assistance Team, was established in 2017 and plays a central role in health emergency response in the country. Action: Within 24 hours of the earthquake, the Vanuatu Medical Assistance Team was activated and established an Emergency Medical Team Coordination Cell within the national health emergency operations centre. National and international emergency medical teams from Australia, Fiji, Indonesia, Japan and New Zealand were deployed over the subsequent weeks and provided clinical, mental health and information management support. The World Health Organization’s emergency medical team Minimum Data Set was implemented to monitor health trends and inform response actions. Outcome: Eight national and international emergency medical teams deployed alongside local health services. Together, they reported more than 5500 consultations to the Emergency Medical Team Coordination Cell, and a specialized team provided mental health and psychosocial support to 521 people. Minimum Data Set analysis showed a rapid decline in trauma-related presentations and detected increases in influenza-like illness, guiding the transition from emergency to recovery. Discussion: This response underscored the value of emergency medical teams following disasters, the importance of national leadership and coordination, and the significance of regional solidarity and partnerships. It also highlighted the importance of information management during emergencies and demonstrated potential innovations in this space.

PURPOSE: Little information is available on the influence of diabetes mellitus on the short-term clinical outcomes of patients with bleeding peptic ulcers. The aim of this study is to investigate whether diabetes mellitus influences the short-term clinical outcomes of patients with bleeding peptic ulcers using a Japanese national administrative database. MATERIALS AND METHODS: A total of 4863 patients treated by endoscopic hemostasis on admission for bleeding peptic ulcers were referred to 586 participating hospitals in Japan. We collected their data to compare the risk-adjusted length of stay (LOS) and in-hospital mortality of patients with and without diabetes mellitus within 30 days. Patients were divided into two groups: patients with diabetes mellitus (n=434) and patients without diabetes mellitus (n=4429). RESULTS: Mean LOS in patients with diabetes mellitus was significantly longer than those without diabetes mellitus (15.8 days vs. 12.5 days, p<0.001). Also, higher in-hospital mortality within 30 days was observed in patients with diabetes mellitus compared with those without diabetes mellitus (2.7% vs. 1.1%, p=0.004). Multiple linear regression analysis revealed that diabetes mellitus was significantly associated with an increase in risk-adjusted LOS. The standardized coefficient was 0.036 days (p=0.01). Furthermore, the analysis revealed that diabetes mellitus significantly increased the risk of in-hospital mortality within 30 days (odds ratio=2.285, 95% CI=1.161-4.497, p=0.017). CONCLUSION: This study demonstrated that presence of diabetes mellitus significantly influences the short-term clinical outcomes of patients with bleeding peptic ulcers.
Aged ; Aged, 80 and over ; Diabetes Mellitus/*physiopathology ; Female ; Hemostasis, Endoscopic ; Hospital Mortality ; Humans ; Japan ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Peptic Ulcer Hemorrhage/mortality/*pathology ; Regression Analysis