BackgroundIn Japan, the first human milk bank (HMB) was established in 2017, which changed the practice of enteral feeding in neonatal care. This study investigated the practice of enteral feeding of preterm infants after the establishment of the HMB in Japan and examined related future issues.MethodsA survey on enteral feeding and the use of the HMB was conducted in 251 neonatal intensive care units (NICUs) from December 2020 to February 2021.ResultsThe response rate was 61%. The ideal times to start enteral feeding for extremely‐low‐birthweight infants (ELBWI) and very‐low‐birthweight infants (VLBWI) were within 24 h after birth in approximately 59% and 62% of NICUs, however, only 30% and 46% could do so, respectively. Artificial nutrition was used to initiate enteral feeding for ELBWIs and VLBWIs in in 24% and 56% of NICUs, respectively. Of the NICUs, 92% considered the HMB “necessary” or “rather necessary”. Fifty‐five percent wanted to use the HMB but could not. The major reasons for this were (1) difficulty in paying the annual membership fee, (2) difficulty obtaining approval from the NICU, and (3) complexity in using the facility. The indications for using and discontinuation of use of donor milk varied among the NICUs. Only in 17%, milk expression was within 1h after delivery.ConclusionsCompared with before the establishment of the HMB, NICUs are currently more willing to start enteral feeding for preterm infants earlier. However, the implementation of enteral feeding appears to be challenging. Issues related to the HMB highlighted by the responses need to be addressed. Additionally, guidelines for using donor milk should be established.
This paper discusses an experiential training and education program designed to improve the response literacy in the event of a large-scale earthquake in the Shinjuku station area in Tokyo, which is a central business district representative of Japan. The features of the Shinjuku station area are described, and the activities of the Shinjuku Station Area Disaster Response Measure Committee, made up of businesses and other concerns located in the vicinity of Shinjuku station, as well as the education and training program implemented by the committee to train personnel are introduced. An overview is given of the seminars and workshops given as part of the education and training program in fiscal 2013, targeted at employees of businesses in charge of disaster response. The report then describes the Comprehensive Disaster Preparedness Drill, which was conducted for the purpose of enabling the participants of the seminars and workshops to practice the skills and techniques for disaster response they had acquired, and conducting a comprehensive exercise on disaster response activities within businesses or the area. Finally, the results of a questionnaire survey conducted on the drill participants are discussed.
In Theme 7-2 of SIP Disaster Prevention (Enhancement of Social Resiliency against Natural Disaster of Cross-ministerial Strategic Innovation Promotion Program), we implemented the two subthemes to develop the disaster response and mitigation technology effective for the complex disaster caused by earthquake and flood by torrential rain in megalopolis such as Tokyo metropolitan area; “Subtheme 1: Development of Application Software for Supporting All-Hazards Management in Megalopolis and Commercial Areas around Large Terminal Stations,” and “Subtheme 2: Sustainable Development of Local Disaster Prevention Technology with Visualization Application.” In the former, we formulated behavioral guidelines of central city areas during disasters based on the hazard/risk assessment, and developed an application software for PC/smartphone to support emergency management by delivering relevant information to civilians and disaster response workers during the disaster. Especially, the application would reduce secondary disasters, such as the confusion/panic by the huge number of crowds. In the latter, to “efficiently utilize the limited time, human resources and goods and to minimize damage” at the time of the disaster, we developed a “travel support application,” which can efficaciously “assign” workers to various tasks (the events that require a response) that are spatially distributed at the occurrence of disaster, “navigate” by identifying optimal routes for patrol and “monitor” progress.
An education and training program designed to improve the response literacy in the event of a large-scale earthquake in the Shinjuku station area in Tokyo was presented. And an actual disaster response exercise in 2013 for response to many people injured at high-rise buildings in the area was reported. The activities of the Shinjuku Station Area Disaster Response Measure Committee, made up of businesses and other concerns located in the vicinity of Shinjuku station, as well as the education and training program in fiscal year 2013 implemented by the committee to train personnel are introduced. The report then describes summary of the comprehensive disaster preparedness drill and details of the drill for response to many people injured, which was conducted in collaboration of businesses, healthcare professionals and other concerns to operate effectively.
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