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Background and Purpose: Mild cerebral hypothermia (34°C) induced immediately after cardiac arrest improves outcome. Deep postarrest hypothermia (15°C) has not been studied.Methods: We used our dog model of normothermic ventricular fibrillation (no blood flow) of 12.5 minutes, reperfusion by brief cardiopulmonary bypass, controlled ventilation to 20 hours, and intensive care to 72 hours. Head surface cooling and bypass cooling were performed from start of reperfusion to 1 hour. Five groups of six dogs each were compared: group I, normothermic controls; group II, deep hypothermia (15°C); group III, moderate hypothermia (30°C); group IV, mild hypothermia (34°C); and group V, mild hypothermia with head surface cooling begun during no flow.Results: In control group I, five dogs remained comatose (overall performance category [OPC] 4) and one severely disabled (OPC 3). In group II, four dogs achieved OPC 4 and two dogs OPC 3 (NS versus group I). Compared with group I, OPCs were better in group III (p<0.05), group IV (p<0.05), and group V (p<0.05). Neurological deficit scores were also better in groups III, IV, and V than in groups I or II (p<0.05). Total brain histological damage scores were better in group III (p-0.02), group IV (p=0.06), and group V (p<0.05) than in group I. In group II, OPC and neurological deficit scores were the same and histological damage scores numerically worse than in group I and all were worse than in groups III, IV, and V (p<0.05). Cardiovascular complications and myocardial morphological damage in groups II and III were worse than in groups I, IV, and V (p<0.05).Conclusions: Mild or moderate cerebral hypothermia induced immediately after cardiac arrest improves cerebral outcome, more likely when initiated during arrest, whereas deep postarrest hypothermia can worsen cerebral and cardiac outcome. (Stroke 1992;23:1454-1462 KEY WORDS • anoxia • cerebral ischemia • hypothermia • dogs

Compared with total (summed regional) necrotic neuron prevalence scores, increased regional prevalence scores for cerebellar granule neurons with increasing arrest duration were equally significant, and scores for the caudate nucleus had nearly the same correlation with individual clinical neurological deficit.

On March 11, 2011, a 9.1 magnitude earthquake occurred in the eastern Pacific Ocean off the coast of northern Japan. A resulting tsunami struck the Japan Pacific coast, causing >20,000 deaths, injuries and missing persons. Survivors' post-tsunami health and nutritional status were surveyed one month after the disaster in a school shelter in Ishinomaki City. Hyogo College of Medicine's disaster relief team observations and survivors' questionnaires were used to assess the disaster's effects on survivors' lifestyles and gastrointestinal symptoms while residing in temporary shelters. Of 236 disaster evacuees 9-88 years of age (mean age 52 years), 23% lost weight and 28% reported decreased food intake one month after the earthquake. Up to 25% of the participants presented with gastrointestinal symptoms, including constipation (10%), appetite loss (6.4%), vomiting (6.4%), and nausea (2.1%). Although the victims preferred more vegetables (44%) or fruit (33%), most food aid received, such as rice balls or bread, was carbohydrate-based, possibly because of easy provision and abundance in emergency food pantries. The authors asked the volunteers and the Japan Self-Defense Forces to provide a more balanced diet, including vegetables and fruit. Consumption of imbalanced diets may have caused more gastrointestinal symptoms for the survivors. Because of the victims' hesitation to request more balanced diets, and because of poorly controlled existing chronic disease and mental stress, professional public health providers should assure emergency food nutrition after disasters.

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Introduction:Little has been reported regarding the minimum conditions, information, and knowledge essential for dispatching nurses to join in sudden-onset disaster events from the viewpoint of nurses. This paper explores the issues and concerns that nurses faced when asked to respond to the 1995 Great Hanshin-Awaji Earthquake event in Japan.Methods:A standardized written survey tool was developed using input from four nurses who had responded to the disaster event. Questionnaires that included both “yes” and “no” answers and multiple-choice answers were developed and sent to 823 nurses who worked in four hospitals.Results:A total of 477/823(58.0%) questionnaires were completed and returned. Of the respondents to the questionnaire, 309 (62.1%) were qualified nurses, and 148 (37.9%) were students. Sixty-nine (15%) of the total 477 respondents participated in the disaster response to the Great Hanshin-Awaji Earthquake. Primary among respondents' concerns were that they should wait for their superiors or institutions to direct them to go “somewhere” and to do “something” and how far away from home would they be required to travel. Home responsibilities conflicting with disaster response were a common concern for respondents.Conclusion:Managers should consider including the following conditions in disaster dispatch plans: (1) the dispatches should be made part of nursing duties; (2) the disaster plan should be constructed with organizations near disaster sites; and (3) clear directions regarding destination and expected activities should be provided to nurses.

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