After the 2011 Fukushima nuclear power plant accident, the prevalence of metabolic syndrome sharply increased in municipalities near the nuclear power plant, where a massive evacuation of community residents occurred (the evacuation area). However, after the initial increase, the rate of increase in metabolic syndrome in the evacuation area was slower than that in the surrounding area (non-evacuation area). In this study, we compared the incidence of and recovery from metabolic syndrome as well as its prevalence between evacuation and non-evacuation areas during the 10 years after the accident to explore whether the slower increase in metabolic syndrome after the initial increase in the evacuation area stemmed from suppressed incidence or from fast recovery. We analyzed specific health check-up data of community residents aged 40-74 in Fukushima Prefecture from fiscal year (FY) 2012 to FY 2021 (N = 710,201). To explore the prevalence of metabolic syndrome, we examined the associations of time, residential area, and their interaction with metabolic syndrome using mixed-model repeated measures. We used data from those without metabolic syndrome in FY 2012 to investigate the incidence. We similarly examined the associations of time, residential area, and their interaction with metabolic syndrome using FY 2013 to FY 2021 data. To explore recovery, we used the data of those with metabolic syndrome in FY 2012 and repeated the same procedure. The rate of increase in the prevalence and incidence of metabolic syndrome was slower in the evacuation area than in the non-evacuation area. On the other hand, as for the recovery, the time trend of metabolic syndrome did not differ between the two areas. The slower increase in metabolic syndrome in the evacuation area was partly explained by the slower incidence in the evacuation area but not by recovery.

This report summarizes the nature, numbers, and trends of conditions for which military members were medically evacuated from the U.S. Central Command (CENTCOM) or Africa Central Command (AFRICOM) operations during 2023, with historical comparisons to the previous 4 years. Mental health disorders and injuries were the most common diagnostic categories in 2023 among service members medically evacuated from U.S. Central Command (CENTCOM) and U.S. Africa Command (AFRICOM). In 2023, 724 service members were medically evacuated from CENTCOM and 225 were evacuated from AFRICOM, with hospitalization required for 197 (27.2%) and 50 (22.2%), respectively. Most service members who were medically evacuated from CENTCOM or AFRICOM were returned to full duty status following their post-evacuation hospitalizations or outpatient evaluations. In 2023, evacuations for both battle and non-battle injuries from U.S. CENTCOM increased, following a period of decline. The number of service members medically evacuated in 2023 from AFRICOM remained unchanged from the previous year.

The 2017 Edgecumbe flood in New Zealand necessitated the rescue of over 1000 animals, making it the largest companion animal rescue operation in the nation\'s history at the time. This qualitative study explores the experiences and perspectives of six first responders from various agencies involved in the animal rescue efforts. Through semi-structured interviews, this study identified several key themes, including challenges during the rescue phase, post-rescue issues, the impact on the human-animal relationship and wellbeing, and the health and safety of responders. The rescue phase was characterised by difficulties in evacuating and rescuing animals, the influence of the socio-zoological scale on rescue prioritisation, issues with feeding animals in place, and the diversity of species requiring rescue. Post-rescue challenges included animal identification and tracking, decontamination, management of deceased animals, and long-term impacts on animals and owners. This study also highlighted the interconnectedness of human and animal welfare during the disaster, as well as the health and safety risks faced by responders. The findings underscore the need for comprehensive collaborative emergency response planning that addresses the needs of both humans and animals, as well as the importance of ongoing efforts to build resilience and preparedness in communities. Lessons learned from the Edgecumbe flood can inform future policy, planning, and practice to enhance the effectiveness and compassion of animal-inclusive emergency management.

BACKGROUND: Several organizations have proposed guidelines or clinical decision tools for the management of patients with disorders of gut-brain interactions (DGBI) affecting the lower digestive tract including irritable bowel syndrome and chronic idiopathic constipation. Such algorithms are based on sequential therapeutic trials and modifying the treatment strategy based on efficacy and adverse events.
OBJECTIVE: The aims of this review are to evaluate the evidence for efficacy of second- and third-line pharmacotherapies and to assess the evidence for the alternative option to manage subgroups of patients with symptoms suggestive of lower DGBI based on diagnostic tests or documented dysfunctions. The preeminent tests to identify such subgroups that present with symptoms that overlap with lower DGBI are detailed: digital rectal examination as well as anorectal manometry and balloon expulsion for evacuation disorders, detailed measurements of colonic transit, and diagnosis of bile acid diarrhea or carbohydrate malabsorption based on biochemical measurements. The review also addresses the cost implications of screening to exclude alternative diagnoses and the costs of therapy associated with the therapeutic options following an algorithmic approach to treatment from the perspective of society, insurer, or patient. Finally, the costs of the diagnostic tests to identify actionable biomarkers and the evidence of efficacy of individualized therapy based on formal diagnosis or documentation of abnormal functions are detailed in the review.

On 11 September 2001, attacks on the World Trade Center (WTC) killed nearly three thousand people and exposed hundreds of thousands of rescue and recovery workers, passersby, area workers, and residents to varying amounts of dust and smoke. Former New York City Mayor Rudy Giuliani ordered the emergency evacuation of Lower Manhattan below Canal Street, but not all residents evacuated. Previous studies showed that those who did not evacuate had a higher incidence of newly diagnosed asthma. Among the 71,424 who enrolled in the WTC Health Registry in 2003-2004, we evaluated the bivariate association of educational attainment, household income, and race or ethnicity with reported evacuation on or after 9/11/01. We used log binomial regression to assess the relative risks of not evacuating from their home following the 9/11 attacks, adjusting for age, gender, and marital status. Out of a total of 11,871 enrollee residents of Lower Manhattan, 7345 or 61.79% reported evacuating their home on or after 9/11. In a fully adjusted model, the estimated relative risk for not evacuating was elevated for those who identified as non-Hispanic Black, Asian/Pacific Islander, and Hispanic residents compared to non-Hispanic White residents. Residents with a high school diploma/GED had an elevated estimated risk compared to those with at least a bachelor\'s degree. Those with lower household incomes had an elevated estimated risk compared to those with the highest income category. These significant inequities will need to be prevented in future disasters.

As urbanization progresses and the impacts of climate change become more pronounced, urban flooding has emerged as a critical challenge for resilient cities, particularly concerning urban underground spaces where flooding can lead to significant loss of life and property. Drawing upon a comprehensive review of global research on underground space flood simulation and evacuation, this paper undertakes the modelling of inundation in a substantial underground area during the extraordinary rainfall event on 7 September 2023, in Shenzhen, China. Specifically, it introduces a two-step method to simulate the coupled surface-underground inundation process with high accuracy. The study simulates the inflow processes in three types of underground spaces: parking lots, metro stations, and underpasses. Utilizing the specific force per unit width evaluation, the research examines how varying flood barrier heights influence evacuation time and inundation risk. Subsequently, the paper proposes corresponding evacuation strategies based on the obtained findings. By highlighting the vulnerability of urban underground spaces to flooding, the study underscores the urgent need for further research in this domain.

OBJECTIVE: Disaster evacuation increases the risk of becoming overweight or obese owing to lifestyle changes and psychosocial factors. This study evaluated the effect of evacuation on becoming overweight during a 7-year follow-up among residents of Fukushima Prefecture during the Great East Japan Earthquake.
METHODS: This was a prospective cohort study.
METHODS: We analysed data collected from 18,977 non-overweight Japanese participants who completed the \'Comprehensive Health Checkup Program\' and \'Mental Health and Lifestyle Survey\', as part of the Fukushima Health Management Survey, between July 2011 and November 2012. An evacuation was defined as the moving out of residents of municipalities designated as an evacuation zone by the government or having a self-reported experience of moving into shelters or temporary housing. Follow-up examinations were conducted in March 2018 to identify patients who became overweight. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated using a Cox proportional hazards regression model.
RESULTS: Among 15,875 participants (6091 men and 9784 women; mean age 63.0 ± 11.1 years) who received follow-up examination (mean follow-up, 4.29 years), 2042 (856 men and 1186 women) became overweight. Age-, baseline body mass index-, lifestyle-, and psychosocial status-adjusted HRs (95% CIs) for becoming overweight after evacuation were 1.44 (1.24-1.66) for men and 1.66 (1.47-1.89) for women.
CONCLUSIONS: Evacuation was associated with the risk of becoming overweight 7 years after the disaster. Thus, maintaining physical activity, healthy diet, and sleep quality and removing barriers to healthy behaviour caused by disasters, including anxiety concerning radiation, may prevent this health risk among evacuees.

The walking blood bank (WBB) is a system for emergency blood acquisition from nearby donors if a patient\'s blood needs exceed the immediate supply. USCENTCOM medical units will perform a walking blood bank if immediate blood requirements exceed the local supply. A benchmark WBB performance time was needed to provide a training goal for military WBB exercises. An expeditionary WBB performance time benchmark was created from prospective measurements of USCENTCOM medical unit performance times over 9 months. The mean total time, and new performance benchmark, for a WBB in USCENTCOM was 41.4 min +/- 13.2 min. USCENTCOM time from donor arrival to a transfusable unit mean time was 34.4 +/- 12.1 min. Expeditionary medical units conducting a WBB should expect to meet or exceed the provided benchmark.

Building fires can be considered a risk to the health and safety of occupants. Environmental factors in building fires might affect the speed of an evacuation. Therefore, in this study participants (N = 153) were tested in an experimental design for the effects of (1) a fire alarm, (2) darkness and (3) the use of emergency exit signs on building evacuation time. In addition, the effects of age and gender on evacuation time were investigated. The main results indicate that the combination of a fire alarm, darkness and not illuminated emergency exit signs had a significant negative influence on evacuation time, namely an increase in evacuation time of 26.6% respectively 28.1%. Another important finding is that age had a significant negative effect on evacuation time. The increase in evacuation time was at least 30.4% for participants aged 56 years or older compared to participants aged 18-25 years. For gender no significant effect was found. Building and safety managers can use these results by including longer evacuation time considerations - based on darkness and older age - in their evacuation plans. Future research should focus further on investigating the effects of personal and psychological characteristics on evacuation behaviour and evacuation time.

Current strategies for teaching evacuation methods in private seniors\' residences (PSR) and long-term care (LTCH) homes may pose risks to people with disabilities (PWD) and seniors\' physical and psychological health. This study aimed to address the following questions: (1) Which are the current fire evacuation learning strategies used with PWD or seniors? (2) What are the barriers and facilitators for PWD and seniors\' during fire evacuation and learning strategies in PSR and LTCH? (3) What is the existing equipment that could be used with PWD seniors?. A scoping review of grey and scientific literature was done in six databases and Google scholar. Additional information was found on Québec government websites. This review identified 13 scientific papers and 22 documents. Twenty barriers (personal = 9, environmental = 11), and 14 facilitators (personal = 4, environmental = 10) were extracted. The current fire evacuation learning strategies currently used can be grouped into three categories: drills; training; promotion of a fire safety plan. Six types of evacuation equipment were found; however, their use has been scarcely documented. Safety for seniors during fire evacuation is still an important issue to be improved. Increasing awareness and creating new practices and tools that consider the strengths and difficulties of seniors seems to be a promising avenue for improving evacuation.