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Mochizuki S, Miura J, Takagi S, Takita M, Takaike H, Babazono T. Impact of the State of Emergency Declaration for Severe Acute Respiratory Syndrome Coronavirus-2 Pandemic Suppression on Individuals with Type 1 Diabetes Mellitus. Intern Med 2024; 63:1197-1205. [PMID: 38369358 PMCID: PMC11116012 DOI: 10.2169/internalmedicine.2703-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/18/2023] [Indexed: 02/20/2024] Open
Abstract
Objective To examine the impact of lifestyle changes caused by the first emergency declaration issued in 2020 on glycemic control and body weight changes in Japanese individuals with type 1 diabetes mellitus. Methods This study included Japanese individuals with type 1 diabetes mellitus who visited Tokyo Women's Medical University Hospital between January 2019 and September 2020 (n=278). Seasonal changes in glycated hemoglobin (HbA1c) levels and the body mass index (BMI) were compared. A self-administered questionnaire regarding changes in treatment, diet, exercise, sleep, and telecommuting was used to assess lifestyle changes. Results Although HbA1c levels decreased from winter to summer in 2019 and 2020, the annual change was slightly but significantly greater in 2020 than in 2019. Seasonal changes in the BMI between 2019 and 2020 were also significantly different. An increase in the daily insulin dose, overall blood glucose level, diurnal change in blood glucose level, and food intake were significantly associated with increased HbA1c levels. Furthermore, HbA1c levels decreased with increasing moderate physical activity and sleep duration. The change in the BMI increased with increasing insulin dose, overall high blood glucose levels, and food intake. However, an increase in moderate physical activity was associated with a decrease in the BMI. HbA1c levels were significantly lower after the first emergency declaration in individuals with type 1 diabetes mellitus than that before the emergency declaration, even after accounting for seasonal variations. Conclusion Decreased HbA1c levels were associated with a decreased food intake, increased moderate exercise, and increased sleep duration during the state of emergency. The BMI remained relatively unchanged.
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Affiliation(s)
- Shota Mochizuki
- Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Japan
| | - Junnosuke Miura
- Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Japan
| | - Satoshi Takagi
- Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Japan
| | - Mikako Takita
- Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Japan
| | - Hiroko Takaike
- Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Japan
| | - Tetsuya Babazono
- Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Japan
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Oyama Y, Abiru N, Kit A, Eyama D, Noda A, Nagata A. Thoughts and attitudes toward disasters among Japanese patients with type 1 diabetes: A qualitative descriptive study. Jpn J Nurs Sci 2021; 19:e12459. [PMID: 34664359 DOI: 10.1111/jjns.12459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/25/2021] [Accepted: 09/25/2021] [Indexed: 12/01/2022]
Abstract
AIM The purpose of this study was to clarify the thoughts and attitudes of patients with type 1 diabetes during disasters. METHODS We conducted a qualitative descriptive study. The participants were 10 adult patients with type 1 diabetes who were selected through purposeful sampling. None of them had experienced a disaster. Data were collected through semi-structured interviews. Thematic analysis was used to analyze the data. RESULTS Type 1 diabetes patients described a variety of thoughts and attitudes regarding disaster and preparedness. Based on their experiences, 528 codes were extracted. The codes were categorized based on their patterns and similarities. Then, 11 sub-themes and three main themes were identified. The three main themes were (a) "being unprepared since one could not relate to disasters"; (b) "managing well with insulin and food"; and (c) "hiding the fact that one has diabetes." CONCLUSIONS This study identified three important characteristics of the thoughts and attitudes of patients with type 1 diabetes toward disasters. These provide perspectives for education in pre-disaster preparation and support when disasters occur. Patients with type 1 diabetes are aware of the importance of insulin, food adjustment, and self-management on a daily basis. Therefore, it is necessary to educate them so that they can apply their knowledge in times of disaster. In addition, healthcare providers who provide support in times of disaster need to be aware that there are victims who cannot talk readily about their illness.
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Affiliation(s)
- Yusuke Oyama
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Norio Abiru
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ayano Kit
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Daigo Eyama
- Nagasaki University School of Health Sciences, Nagasaki, Japan
| | - Arisa Noda
- Nagasaki University School of Health Sciences, Nagasaki, Japan
| | - Akira Nagata
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Medical Problems and Concerns with Temporary Evacuation Shelters after Great Earthquake Disasters in Japan: A Systematic Review. Disaster Med Public Health Prep 2021; 16:1645-1652. [PMID: 34103106 DOI: 10.1017/dmp.2021.99] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Japan has repeatedly suffered from natural disasters. A number of temporary evacuation shelters have been opened for the benefit of evacuees. Although the operation of such evacuation shelters has improved after the Great Hanshin-Awaji Earthquake (1995), a number of operational difficulties were encountered during the Great East Japan Earthquake in 2011 and the Kumamoto Earthquake in 2016. A systematic literature review was conducted to identify the medical concerns encountered in temporary evacuation shelters by focusing on unsanitary environment, food and nutrition, and shortage of medication. Actual sanitary conditions have been found to be below the standards stipulated by the Japanese government as per international guidelines. Food aid in evacuation shelters was neither nutritionally balanced, nor was the distribution to different shelters balanced. Furthermore, evacuees with chronic diseases feared that there may be a shortage of medication. Crowding in evacuation shelters increased the risk of outbreaks of infectious diseases (e.g., tuberculosis). Malnutrition and shortage of medication exacerbated the risk of deterioration of chronic diseases (e.g., diabetes mellitus, hypertension) among evacuees. Therefore, it is recommended that healthcare professionals should be promptly deployed to evacuation shelters, to promote sanitary control and education, as well as address limited space availability, and food and medication shortage.
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Khan Y, Albache N, Almasri I, Gabbay RA. The Management of Diabetes in Conflict Settings: Focus on the Syrian Crisis. Diabetes Spectr 2019; 32:264-269. [PMID: 31462883 PMCID: PMC6695264 DOI: 10.2337/ds18-0070] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Humanitarian crises represent a major global health challenge as record numbers of people are being displaced worldwide. The Syrian crisis has resulted in >4 million refugees and 6 million people who are internally displaced within Syria. In 2017, there were 705,700 reported cases of adult diabetes in Syria. During periods of conflict, people with diabetes face numerous challenges, including food insecurity, inadequate access to medications and testing supplies, and a shortage of providers with expertise in diabetes care. Access to insulin represents a major challenge during a crisis, especially for individuals with type 1 diabetes, for whom the interruption of insulin constitutes a medical emergency. In the short term (days to weeks) during a crisis, it is vital to 1) prioritize insulin for patients with type 1 diabetes, 2) ensure continuous access to essential diabetes medications, and 3) provide appropriate diabetes education for patients, with a focus on hypoglycemia and sick-day guidelines. In the long term (weeks to months) during a crisis, it is important to 1) provide access to quality diabetes care and medications, 2) train local and international health care providers on diabetes care, and 3) develop clinical guidelines for diabetes management during humanitarian crises. It is imperative that we work across all sectors to promote the health of people with diabetes during humanitarian response.
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Affiliation(s)
| | | | - Ibrahim Almasri
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Disaster preparation in kidney transplant recipients: a questionnaire-based cohort study from a large United States transplant center
. Clin Nephrol 2018; 89:241-248. [PMID: 29092741 PMCID: PMC6102562 DOI: 10.5414/cn109280] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Few quantitative assessments have assessed disaster preparation in kidney transplant patients. This is a survey-based assessment of disaster preparedness of 200 patients at the University of California San Francisco, USA. MATERIALS AND METHODS Patients answered questionnaires assessing their level of preparedness as well as barriers to preparation. Preparedness was scored based on response to 7 questions. Univariate analyses compared participant characteristics extracted from the medical chart against three tertiles of preparedness: low (scores 0 - 2), medium (scores 3 - 4), and high (scores 5 - 7). California counties were coded and mapped by average preparedness scores. RESULTS Only 30% of patients were highly prepared for disasters. Participants were prepared with available medication for 2 weeks (78.5%) and least prepared in having a medical ID bracelet (13%). Significant minorities of patients (40% of patients or more) were unprepared with lists of medications, important phone numbers and disaster kits. Preparedness was not associated with demographic and clinical characteristics. Monterey County was the most prepared of the 31 California counties sampled (score of 4.25 out of 7). CONCLUSION All patients should be educated regarding disaster preparation. County and medical services should collaborate to address specialized populations in general preparedness planning.
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Suneja A, Gakh M, Rutkow L. Burden and Management of Noncommunicable Diseases After Earthquakes and Tsunamis. Health Secur 2018; 16:30-47. [PMID: 29355393 DOI: 10.1089/hs.2017.0059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This integrative review examines extant literature assessing the burden and management of noncommunicable diseases 6 months or more after earthquakes and tsunamis. We conducted an integrative review to identify and characterize the strength of published studies about noncommunicable disease-specific outcomes and interventions at least 6 months after an earthquake and/or tsunami. We included disasters that occurred from 2004 to 2016. We focused primarily on the World Health Organization noncommunicable disease designations to define chronic disease, but we also included chronic renal disease, risk factors for noncommunicable diseases, and other chronic diseases or symptoms. After removing duplicates, our search yielded 6,188 articles. Twenty-five articles met our inclusion criteria, some discussing multiple noncommunicable diseases. Results demonstrate that existing medical conditions may worsen and subsequently improve, new diseases may develop, and risk factors, such as weight and cholesterol levels, may increase for several years after an earthquake and/or tsunami. We make 3 recommendations for practitioners and researchers: (1) plan for noncommunicable disease management further into the recovery period of disaster; (2) increase research on the burden of noncommunicable diseases, the treatment modalities employed, resulting population-level outcomes in the postdisaster setting, and existing models to improve stakeholder coordination and action regarding noncommunicable diseases after disasters; and (3) coordinate with preexisting provision networks, especially primary care.
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Noncommunicable Diseases After the Great East Japan Earthquake: Systematic Review, 2011-2016. Disaster Med Public Health Prep 2017; 12:396-407. [PMID: 29032775 DOI: 10.1017/dmp.2017.63] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Noncommunicable diseases (NCDs), including mental disorders, have become major threats to human health worldwide. People with NCDs are particularly vulnerable to disasters. We systematically reviewed reports describing studies of NCDs at the time of the Great East Japan Earthquake (GEJE) to clarify the circumstances of people with NCDs and to build strong measures to support them. METHODS Relevant articles published from March 2011 through December 2016 were collected by searching the PubMed database (National Library of Medicine). We specifically examined reports describing NCDs and including the key words "East Japan Earthquake." NCDs included every disease type aside from injury and infectious disease. RESULTS We collected 160 relevant articles, 41 of which described NCDs that existed in residents before the GEJE. Articles describing respiratory diseases and mental illnesses were found most frequently. Interruption of regular treatment was the most frequent problem, followed by lack of surveillance capacity. We found 101 reports describing NCDs that had developed after the GEJE, of which 60% were related to mental health issues. CONCLUSIONS NCDs pose major health issues after large-scale disasters. Establishment of strong countermeasures against interruption of treatment and surveillance systems to ascertain medical needs for NCDs are necessary to prepare for future disasters. (Disaster Med Public Health Preparedness. 2018; 12: 396-407).
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Veenema TG, Rains AB, Casey-Lockyer M, Springer J, Kowal M. Quality of healthcare services provided in disaster shelters: An integrative literature review. Int Emerg Nurs 2015; 23:225-31. [PMID: 25731879 DOI: 10.1016/j.ienj.2015.01.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 01/21/2015] [Accepted: 01/22/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Globally, shelters are a resource to promote critical health and safety in disasters, particularly for vulnerable populations (e.g., children, elderly, chronically ill). This study examines the nature and quality of healthcare services rendered in disaster and emergency shelters. OBJECTIVES To determine based upon systematic and accurate measurement the scope and quality of health care services rendered in disaster shelters and to describe the health outcomes experienced by shelter residents. METHODS An integrative review of English-language literature pertaining to the assessment, evaluation, and systematic measurement of healthcare quality and client outcomes in disaster and emergency shelters was undertaken. Articles were identified using a structured search strategy of six databases and indexing services (PubMed, CINAHL, EMBase, Scopus, Web of Science, and Google Scholar). RESULTS Limited literature exists pertaining specifically to metrics for quality of health care in acute disaster and emergency shelters, and the literature that does exist is predominately U.S. based. Analysis of the existing evidence suggests that nurse staffing levels and staff preparedness, access to medications/medication management, infection control, referrals, communication, and mental health may be important concepts related to quality of disaster health care services. CONCLUSIONS A small number of population-based and smaller, ad hoc outcomes-based evaluation efforts exist; however the existing literature regarding systematic outcomes-based quality assessment of disaster sheltering healthcare services is notably sparse.
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Affiliation(s)
- Tener Goodwin Veenema
- Johns Hopkins School of Nursing, Johns Hopkins Bloomberg School of Public Health, Center for Refugee and Disaster Response, Baltimore, MD 21205, USA.
| | - Adam B Rains
- Information Technology, Tener Consulting Group, LLC, Rochester, NY, USA
| | | | | | - Mary Kowal
- Johns Hopkins School of Nursing, Baltimore, MD, USA
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Tomio J, Sato H. Emergency and disaster preparedness for chronically ill patients: a review of recommendations. Open Access Emerg Med 2014; 6:69-79. [PMID: 27147882 PMCID: PMC4753992 DOI: 10.2147/oaem.s48532] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Recent disasters, especially those in developed countries, have highlighted the importance of disaster preparedness measures for chronic diseases. A number of surviving patients experienced the exacerbation of a chronic illness, such as hypertension, diabetes, cancer, and chronic respiratory diseases, due to disaster-related stress, interruption of care, or both; for some patients, these exacerbations resulted in death. Here, we review reports from recent disasters in developed countries and summarize the recommendations for disaster preparedness of chronically ill patients. A considerable number of recommendations based on the lessons learned from recent disasters have been developed, and they provide practical and essential steps to prevent treatment interruption during and after a disaster. To improve preparedness efforts, we suggest that health care providers should be aware of the following three suggestions: 1) recommendations should be evidence-based; 2) recommendations should contain consistent messages; and 3) recommendations should be feasible.
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Affiliation(s)
- Jun Tomio
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hajime Sato
- Department of Health Policy and Technology Assessment, National Institute of Public Health, Wako, Japan
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An C, Zhang Y, Yu L, Li N, Song M, Wang L, Zhao X, Gao Y, Wang X. Long-term impact of earthquake stress on fasting glucose control and diabetes prevalence among Chinese adults of Tangshan. Int J Clin Exp Med 2014; 7:4441-4447. [PMID: 25550966 PMCID: PMC4276224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 11/08/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the long-term influence of stresses from the 1976 Tangshan earthquake on blood glucose control and the incidence of diabetes mellitus in Chinese people of Tangshan. METHODS 1,551 adults ≥ 37 years of age were recruited for this investigation in Tangshan city of China, where one of the deadliest earthquakes occurred in 1796. All subjects finished a questionnaire. 1,030 of them who experienced that earthquake were selected into the exposure group, while 521 were gathered as the control group who have not exposed to any earthquake. The numbers of subjects who were first identified with diabetes or had normal FBG but with diabetic history were added for the calculation of diabetes prevalence. Statistic-analysis was applied on the baseline data, and incidences of IFG as well as diabetes among all groups. RESULTS Statistic comparisons indicate there is no significant difference on average fasting glucose levels between the control group and the exposure group. However, the prevalence of IFG and diabetes among the exposure group displays significant variance with the control group. The prevalence of diabetes among exposure groups is significantly higher than the control group. Women are more likely to have diabetes after experiencing earthquake stresses compared to men. The earthquake stress was linked to higher diabetes incidence as an independent factor. CONCLUSIONS The earthquake stress has long-term impacts on diabetes incidence as an independent risk factor. Emerging and long-term managements regarding the care of IFG and diabetes in populations exposed to earthquake stress should be concerned.
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Affiliation(s)
- Cuixia An
- Department of Mental Health, The First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health Shijiazhuang, China
| | - Yun Zhang
- Department of Mental Health, The First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health Shijiazhuang, China
| | - Lulu Yu
- Department of Mental Health, The First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health Shijiazhuang, China
| | - Na Li
- Department of Mental Health, The First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health Shijiazhuang, China
| | - Mei Song
- Department of Mental Health, The First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health Shijiazhuang, China
| | - Lan Wang
- Department of Mental Health, The First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health Shijiazhuang, China
| | - Xiaochuan Zhao
- Department of Mental Health, The First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health Shijiazhuang, China
| | - Yuanyuan Gao
- Department of Mental Health, The First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health Shijiazhuang, China
| | - Xueyi Wang
- Department of Mental Health, The First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health Shijiazhuang, China
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Ochi S, Hodgson S, Landeg O, Mayner L, Murray V. Disaster-driven evacuation and medication loss: a systematic literature review. PLOS CURRENTS 2014; 6:ecurrents.dis.fa417630b566a0c7dfdbf945910edd96. [PMID: 25642363 PMCID: PMC4169391 DOI: 10.1371/currents.dis.fa417630b566a0c7dfdbf945910edd96] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM The aim of this systematic literature review was to identify the extent and implications of medication loss and the burden of prescription refill on medical relief teams following extreme weather events and other natural hazards. METHOD The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Key health journal databases (Medline, Embase, PsycINFO, Maternity and Infant Care, and Health Management Information Consortium (HMIC)) were searched via the OvidSP search engine. Search terms were identified by consulting MeSH terms. The inclusion criteria comprised articles published from January 2003 to August 2013, written in English and containing an abstract. The exclusion criteria included abstracts for conferences or dissertations, book chapters and articles written in a language other than English. A total of 70 articles which fulfilled the inclusion criteria were included in this systematic review. RESULTS All relevant information was collated regarding medication loss, prescription loss and refills, and medical aids loss which indicated a significant burden on the medical relief teams. Data also showed the difficulty in filling prescriptions due to lack of information from the evacuees. People with chronic conditions are most at risk when their medication is not available. This systematic review also showed that medical aids such as eye glasses, hearing aids as well as dental treatment are a high necessity among evacuees. DISCUSSION This systematic review revealed that a considerable number of patients lose their medication during evacuation, many lose essential medical aids such as insulin pens and many do not bring prescriptions with them when evacuated.. Since medication loss is partly a responsibility of evacuees, understanding the impact of medication loss may lead to raising awareness and better preparations among the patients and health care professionals. People who are not prepared could have worse outcomes and many risk dying when their medication is not available.
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Affiliation(s)
- Sae Ochi
- Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima, Japan
| | - Susan Hodgson
- School of Public Health, Imperial College London, London, UK
| | - Owen Landeg
- Extreme Events and Health Protection, Public Health England, London, UK
| | - Lidia Mayner
- Flinders University Disaster Research Centre, Flinders University, Adelaide, South Australia, Australia
| | - Virginia Murray
- Extreme Events and Health Protection, Public Health England, London, UK
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