Full Assistance Research Articles

Brief communication participation in social activities of six individuals with advanced-stage hereditary motor sensory neuropathy with proximal dominant involvement (HMSN-P)

The intractable neurological disease HMSN-P (hereditary motor and sensory neuropathy with proximal dominant involvement) includes four-limb paralysis and resembles amyotrophic lateral sclerosis (ALS). Although the long-term employment and social activities of individuals with severe neurological diseases have increased with improvements in medical/welfare services, those of individuals with HMSN-P have not been reported. We analyzed the long-term outcomes of six individuals with advanced-stage HMSN-P treated in 2018–2023; one exhibited proximal dominant quadriplegia in 2018 and was using an electric wheelchair with full assistance. He had continued to attend Sanshin concerts for 5 years and organized a music festival for the local handicapped population. The other patients similarly exhibited quadriplegia; three were using electric wheelchairs with full assistance, and two were using pushchairs. Four attended music festivals for the handicapped, and all have completed 20–35 years' continuous employment, attended public meetings about HMSN-P, and actively participated in the meetings' discussions.

Pendampingan Belajar Bahasa Arab dengan Metode CTL untuk Meningkatkan Mufrodat Siswa Kelas VI di MI BAITUL MUKMIN Wringinagung Jombang Jember

In learning activities, especially learning Arabic, appropriate methods and strategies are needed to achieve learning objectives. In this case the researcher tried to provide full assistance to class VI students at MI Baitul Mukmin Wringinagung Jombang Kencong in improving their mufrodat using the contextual teaching and learning (CTL) method. This assisted activity aims to emphasize the process of full student involvement in learning so that students can find the material being studied and relate it to daily life situations or certain fields, so that students can feel the meaning of each lesson material received and can implement it in their learning. various aspects of life. In this assisted activity, researchers used the PAR (Participatory Action Research) assisted method. The impact resulting from the use of the contextual teaching and learning (CTL) method applied to class VI students at MI Baitul Mukmin can improve their Arabic understanding, which initially had very little insight into Arabic language understanding.

Pneumatically Actuated Soft Robotic Hand and Wrist Exoskeleton for Motion Assistance in Rehabilitation

Exoskeletons are being explored for assisting motion therapy for neurological impairment-related rehabilitation. Soft robotic exoskeletons are gaining more attention for upper-extremity applications due to their simplistic actuation mechanisms and compliant nature. To regain fine motor hand functions, it is desired to have both hand and wrist motions in a coordinated fashion, as most daily living tasks require a combination of both hand and wrist joint motions. However, a soft robotic exoskeleton with hand and wrist motion together is an underdeveloped area. This paper presents a pneumatically actuated soft robotic exoskeleton designed to provide coordinated assistive motion to the hand and wrist joints using PD-based feedback control. The results showed the potential of the exoskeleton to provide flexion/extension rehabilitation exercises and task-oriented rehabilitation practices. Additionally, the results have confirmed that the implemented PD control ensures that the exoskeleton reaches the targeted angular trajectories and velocities. Two modes, full and partial assistance, were successfully tested to verify the ability of the exoskeleton to accommodate varying levels of impairment.

Can lower-limb exoskeletons support sit-to-stand motions in frail elderly without crutches? A study combining optimal control and motion capture.

With the global geriatric population expected to reach 1.5 billion by 2050, different assistive technologies have been developed to tackle age-associated movement impairments. Lower-limb robotic exoskeletons have the potential to support frail older adults while promoting activities of daily living, but the need for crutches may be challenging for this population. Crutches aid safety and stability, but moving in an exoskeleton with them can be unnatural to human movements, and coordination can be difficult. Frail older adults may not have the sufficient arm strength to use them, or prolonged usage can lead to upper limb joint deterioration. The research presented in this paper makes a contribution to a more detailed study of crutch-less exoskeleton use, analyzing in particular the most challenging motion, sit-to-stand (STS). It combines motion capture and optimal control approaches to evaluate and compare the STS dynamics with the TWIN exoskeleton with and without crutches. The results show trajectories that are significantly faster than the exoskeleton's default trajectory, and identify the motor torques needed for full and partial STS assistance. With the TWIN exoskeleton's existing motors being able to support 112 Nm (hips) and 88 Nm (knees) total, assuming an ideal contribution from the device and user, the older adult would need to contribute a total of 8 Nm (hips) and 50 Nm (knees). For TWIN to provide full STS assistance, it would require new motors that can exert at least 121 Nm (hips) and 140 Nm (knees) total. The presented optimal control approaches can be replicated on other exoskeletons to determine the torques required with their mass distributions. Future improvements are discussed and the results presented lay groundwork for eliminating crutches when moving with an exoskeleton.

Control strategies modeling for robotic exoskeletons facilitating sit-to-stand transitions in geriatric and lower limb impaired

With the growing global aging population, there's been an amplified societal emphasis on preserving the health of the elderly and enhancing their quality of life. In this scenario, robotic exoskeletons have emerged as a cutting-edge solution to assist the elderly and those with lower limb muscle deficiencies in Sit-to-Stand (STS) exercises. These exoskeletons adopt two main approaches: full assistance for those with entirely weakened lower limbs and partial assistance for those with some remaining muscle strength. This article introduces two modeling methods and concepts for these control strategies, aligning with the full and partial assistance directions, respectively. Both approaches hinge on the Lagrange equation as their foundational structure, integrating distinct kinematic designs to form their individual dynamic models. Based on this, the models are further adapted to address the specific risks associated with STS activities as per each strategy. Research outcomes highlight that by assessing the wearer's EMG signal, the partial assistance strategy considerably mitigates the lower limb muscle strength required for STS under conditions such as low-speed, medium-speed, sitback-like, and step-like. This not only improves balance but also augments the likelihood of successful STS execution, consequently diminishing fall incidents.

Caregiver Experiences with Dementia-Related Feeding/Eating Difficulties.

This cross-sectional study explores caregivers' perceptions of feeding/eating difficulties in persons living with dementia, their support provisions, and the associated burdens. Cognitive decline, behavioral symptoms, and physical issues contribute to the deterioration of feeding/eating activities in people with dementia. Inadequate support during mealtimes has adverse consequences. This study includes 31 caregivers who completed an online questionnaire with three sections: sociodemographic information, feeding/eating problems and required support for individuals with dementia, and caregiver burden and distress. The questions on feeding and eating problems were adapted from the Appetite and Eating Habits Questionnaire (APEHQ). The results show that nearly all persons living with dementia had symptoms of feeding/eating problems, requiring caregiver support, ranging from verbal assistance to full physical assistance. The caregivers reported high distress, which was positively correlated with dementia severity. The findings emphasize the importance of raising caregiver awareness about dementia's impact on eating behavior, identifying effective mealtime care strategies, meeting nutritional needs, and emphasizing personal self-care. This research provides insights for healthcare professionals to develop targeted interventions, alleviate caregiver burden, improve mealtime experiences, and ensure adequate nutrition for persons living with dementia.

Evaluation of EMG patterns in children during assisted walking in the exoskeleton.

While exoskeleton technology is becoming more and more common for gait rehabilitation in children with neurological disorders, evaluation of gait performance still faces challenges and concerns. The reasoning behind evaluating the spinal locomotor output is that, while exoskeleton's guidance forces create the desired walking kinematics, they also affect sensorimotor interactions, which may lead to an abnormal spatiotemporal integration of activity in particular spinal segments and the risk of abnormalities in gait recovery. Therefore, traditional indicators based on kinematic or kinetic characteristics for optimizing exoskeleton controllers for gait rehabilitation may be supplemented by performance measures associated with the neural control mechanisms. The purpose of this study on a sample of children was to determine the basic features of lower limb muscle activity and to implement a method for assessing the neuromechanics of spinal locomotor output during exoskeleton-assisted gait. To this end, we assessed the effects of a robotic exoskeleton (ExoAtlet Bambini) on gait performance, by recording electromyographic activity of leg muscles and analyzing the corresponding spinal motor pool output. A slower walking setting (about 0.2 m/s) was chosen on the exoskeleton. The results showed that, even with slower walking, the level of muscle activation was roughly comparable during exoskeleton-assisted gait and normal walking. This suggests that, despite full assistance for leg movements, the child's locomotor controllers can interpret step-related afferent information promoting essential activity in leg muscles. This is most likely explained by the active nature of stepping in the exoskeleton (the child was not fully relaxed, experienced full foot loading and needed to maintain the upper trunk posture). In terms of the general muscle activity patterns, we identified notable variations for the proximal leg muscles, coactivation of the lumbar and sacral motor pools, and weak propulsion from the distal extensors at push-off. These changes led to the lack of characteristic lumbosacral oscillations of the center of motoneuron activity, normally associated with the pendulum mechanism of bipedal walking. This work shows promise as a useful technique for analyzing exoskeleton performance to help children develop their natural gait pattern and to guide system optimization in the future for inclusion into clinical care.

Design, control and evaluation of a treadmill-based Pelvic Exoskeleton (PeXo) with self-paced walking mode

Most gait rehabilitation exoskeletons focus only on assisting lower limb motions. However, the pelvis plays an essential role in overground ambulation. This calls for the need of gait training devices that allow full control and assistance of user’s pelvis to improve gait rehabilitation therapies of stroke survivors. This paper presents a new pelvic assistance treadmill-based exoskeleton (PeXo) for gait rehabilitation. The system includes a total of 5 actively controlled Degrees of Freedom (DOFs), plus a passive one, in order to provide all DOFs of the human pelvis. The paper describes the mechatronic design and haptic control of PeXo, and introduces a newly developed self-paced walking mode where the user can control walking speed at his/her will. The system was evaluated by means of a pilot study with a stroke survivor. Results showed PeXo can be used safely and reliably during walking activities, allowing for the natural motion of the pelvis with reduced interaction forces. However, the use of the platform reduced user’s Range of Motion at the pelvis and lower limb joints, whereas lower limb’s muscle activity increased to compensate the disturbances introduced by the platform. Nevertheless, the user reported a positive feedback when using the system, suggesting potential and promising advantages of PeXo that should be explored in a larger study in the future.

Implementasi Literasi Membaca melalui Program Asesmen Nasional Berbasis Komputer di SDN 1 Karangklesem

This research aims to evaluate the implementation of the reading literacy program through the ANBK Program at SDN 1 Karangklesem. The research method used in this research is descriptive qualitative. The results of this research show that the reading literacy program through ANBK has had a positive impact on student preparation, increasing reading comprehension. There are several stages used by SSDN 1 Klarangklesem in implementing learning literacy through ANBK, namely: In the planning stage, the school principal forms an ANBK implementation committee consisting of the committee chairman, secretary, technician, and proctor. Next, students were given an ANBK simulation link to prepare them for answering numeracy questions, and study groups were formed before answering the questions to improve their understanding. During the implementation phase, students answer practice questions in the form of ANBK simulations and take part in dress rehearsal sessions. The teacher provides full assistance to help students understand the contents of the sentences and questions they read, as well as providing an understanding of the quick answer method in answering ANBK questions. The evaluation stage involves printing out the simulation results which the teacher evaluates. Questions that are difficult for students to answer become important evaluation points for teachers' and students' future development. Keywords: Assessment, Computers, Literacy.

THE IMPACT OF THE COVID-19 PANDEMIC ON MINORITY-OWNED HOSPITALITY BUSINESSES: A REVIEW OF EVIDENCE

Researchers have begun to assess the impact of the COVID-19 pandemic on African Americans and other minority groups. Multiple factors have together contributed to create a disproportionate impact of the pandemic on African Americans and other minorities. As a result, African American-owned businesses have had an 8% worse impact from COVID-19 compared to White-owned businesses. The current review was conducted to investigate the degree to which the COVID-19 pandemic affected minority-owned hospitality businesses. The review was conducted to fill a gap in the existing literature in which a synthesis of existing data suggesting the impact of the COVID-19 pandemic on minority- owned hospitality businesses was found lacking. Using a modified systematic literature review, I conducted an analysis of literature containing data relevant to understanding the impact of the COVID-19 pandemic on minority-owned hospitality businesses. After determining the scope of the review to extend to the hospitality industry, minority demographic, and minority-owned businesses, I used databases including Google Scholar, Scopus, and JSTOR with key terms including Covid-19 pandemic, hospitality industry, and minority-owned businesses. Findings showed that African American-owned businesses experienced the harshest blowback across all minority-owned businesses during the lockdown that occurred following the COVID-19 pandemic. Despite more African American-owned businesses applying for federal assistance, a smaller percentage of them received such assistance compared to White-owned businesses. Only 8% received full assistance, while 23% received no assistance whatsoever. The findings from the review supported previous research showing discrimination on a systematic level. Although small businesses owned by minorities added 1.3 million jobs within the U.S. economy between 2007-2012 during the Great Recession, they have received less support and faced systematic discrimination in availing financial assistance. It is imperative, in nation full of potentially successful entrepreneurs of color, to create an environment committed to helping them compete and succeed on an even playing field.

Design and preliminary evaluation of a lower limb exoskeleton based on hydraulic actuator

PurposeThis paper aims to propose a novel system design and control algorithm of lower limb exoskeleton, which provides walking assistance and load sharing for the wearer.Design/methodology/approachIn this paper, the valve-controlled asymmetrical hydraulic cylinder is selected for driving the hip and knee joint of exoskeleton. Pressure shoe is developed that purpose on detecting changes in plantar force, and a fuzzy recognition algorithm using plantar pressure is proposed. Dynamic model of the exoskeleton is established, and the sliding mode control is developed to implement the position tracking of exoskeleton. A series of prototype experiments including benchtop test, full assistance, partial assistance and loaded walking experiments are set up to verify the tracking performance and power-assisted effect of the proposed exoskeleton.FindingsThe control performance of PID control and sliding mode control are compared. The experimental data shows the tracking trajectories and tracking errors of sliding mode control and demonstrate its good robustness to nonlinearities. sEMG of the gastrocnemius muscle tends to be significantly weakened during assisted walking.Originality/valueIn this paper, a structure that the knee joint and hip joint driven by the valve-controlled asymmetrical cylinder is used to provide walking assistance for the wearer. The sliding mode control is proposed to deal with the nonlinearities during joint rotation and fluids. It shows great robustness and frequency adaptability through experiments under different motion frequencies and assistance modes. The design and control method of exoskeleton is a good attempt, which takes positive impacts on the productivity or quality of the life of wearers.

Challenges of neural interfaces for stroke motor rehabilitation.

More than 85% of stroke survivors suffer from different degrees of disability for the rest of their lives. They will require support that can vary from occasional to full time assistance. These conditions are also associated to an enormous economic impact for their families and health care systems. Current rehabilitation treatments have limited efficacy and their long-term effect is controversial. Here we review different challenges related to the design and development of neural interfaces for rehabilitative purposes. We analyze current bibliographic evidence of the effect of neuro-feedback in functional motor rehabilitation of stroke patients. We highlight the potential of these systems to reconnect brain and muscles. We also describe all aspects that should be taken into account to restore motor control. Our aim with this work is to help researchers designing interfaces that demonstrate and validate neuromodulation strategies to enforce a contingent and functional neural linkage between the central and the peripheral nervous system. We thus give clues to design systems that can improve or/and re-activate neuroplastic mechanisms and open a new recovery window for stroke patients.

POLA PENDIDIKAN AGAMA KRISTEN DALAM KELUARGA PETANI DI DESA O’BAKI KECAMATAN KOKBAUN KABUPATEN TIMOR TENGAH SELATAN

The farmer family in the village O'baki, TTS Regency, is a family that carries out its role in educating children through several patterns, namely, habituation patterns, advice, guiding, participation, maintenance, example, and discipline. The purpose of this research is to find out the pattern of Christian religious education in farming families. The theory in this study is the pattern of Christian religious education and the farmer's family. The method used is a type of descriptive qualitative research. Primary data sources totaled 12 people, consisting of the village head, the PKK head, and 10 parents in O'Baki village. The data analysis techniques used are data reduction, data presentation, and drawing conclusions. The results of the study show that the pattern of Christian religious education for farming families in the village of O,Baki greatly influences the lives of children in the future. Children need to receive full assistance toward maturity mentally, physically, and spiritually.

Of Crimes and Crowns

Abstract This article explains variation in state cooperation with International Criminal Court (ICC)’s investigations and prosecutions across cases and over time. The idea motivating this study stems from the observation of the mixed record of state cooperation with ICC operations. For legal professionals and scholars this observation is puzzling, since states falling within the ICC’s territorial jurisdiction are legally bound to provide full judicial assistance to the Court. Thus, why do some countries entertain collaborative relations with the ICC while others display hostility towards it? I argue that state leaders’ perceptions of potential ICC indictment best explain variation in state behaviour. This article aims to contribute to a better understanding of how state attitudes form and of the extent to which external actors, spearheaded by the ICC Prosecutor’s Office (OTP), can change them. The research findings suggest that: 1) neither formal state consent (ratification) nor regime type are reliable predictors of state cooperation; 2) state leaders’ perception of potential ICC indictment appears better suited to correctly predict state behaviour in all the situations investigated by the OTP; 3) the OTP’s signalling strategy — including the timing of its intervention — affects state leaders’ perception of future ICC indictment and, in turn, the prospects of state cooperation; 4) when state authorities deny cooperation, regime change provides a one-time opportunity to start ICC–state relations anew.

PROBLEMS IN STREAMLINING THE GEMSTONE SECTOR OF GILGIT-BALTISTAN: PERSPECTIVES OF GOVERNMENT OFFICIALS

This paper analyses the perceptions of staff members of the Mines and Mineral Department of Gilgit-Baltistan using qualitative methodology. The paper relies on stakeholder workshops and five qualitative interviews conducted with the staff members of the Mines and Minerals Department of GB. The data reveals that artisanal and small-scale miners (ASMs) oppose mine leasing which creates hurdles for them in getting explosives and obtaining compensation in case of injuries and casualties. In some parts of GB, check posts are available for collection of collecting transit duties, but no mechanism is found to detect gemstones moving out of GB, their actual price, and subsequent transit duty fee. The department lacks enough human resources which is why it cannot extend full assistance to the mining sector in the region. Although, some improvements have been made in the form of training provisions and testing facilities still ASMs do not benefit from these opportunities. In addition to differences in perspectives between ASM and staff members of the mines and minerals department, the locals also dispute with each other on mining sites and possession. To resolve these disputes at the doorstep, a District Supervisory Committee headed by the Deputy Commissioner and comprising of locals and government officials is established in each district of GB. Yet these do not offer a viable solution. The concerned department also does not have any data about injuries and casualties in mines as neither data is shared by the miner nor they are registered with the department. That is why the government is unable to extend its support and compensation. Lastly, the direct intervention of external agents, and private sector and non-governmental organizations’ involvement in the illegal trading of gemstones is also blamed for the backwardness of the gems industry. Key Words: Gemstones, Artisanal Small-Scale Miners, Disputes resolution, District Supervisory Committee, and Gilgit-Baltistan

Women's perception about the discovery of breast cancer amid the covid-19 pandemic.

Breast cancer is considered a health problem at a worldwide level. In Brazil, the South and Southeast regions have the highest mortality rates. Understanding how they dealt with the diagnostic of a stigmatized disease amid the COVID-19 pandemic and its potential repercussions, may enable healthcare professionals to of life. Thus, this study is aimed at understanding the perception of women about the discovery of breast cancer and the impact of the disease on their lives. A qualitative study, with the participation of forty women with breast cancer, under chemotherapy treatment. It was performed in a hospital specialized in oncology, in Juiz de Fora, Brazil, in 2020 and 2021. Data collection was carried out with semi-structured interviews, which were analyzed with Bardin Content Analysis. Based on the central theme "Discovery of the disease", these categories were developed: "Discovery" and "Impact of the disease". A large part of women noticed a change in the breast, even before routine checks. Upon the impact of cancer diagnosis, negative feelings arise, then going through a process of acceptance and coping. Some barriers were faced due to the COVID-19 pandemic, which caused delays in the diagnostic and impact caused by social isolation. Family, friends, and healthcare professionals integrated an important supporting network in order to help coping with the disease. The consequences of a breast cancer diagnosis can be devastating. It is necessary that healthcare professionals know and embrace the feelings, beliefs, and values as a part of the aspects related to health. Valuing the supporting network of women suffering from the disease may favor the process of accepting and coping with the neoplasm. The COVID-19 pandemic is highlighted as an obstacle to be overcome specially when it comes to diagnostic assistance and availability of a support network. In that sense, it is worth mentioning the importance of a healthcare team able to offer full assistance, with quality. The need of further studies to determine the impact of the pandemic in the long run.

The effect of rehabilitation and one year follow-up for a COVID-19 patient on prolonged mechanical ventilation

We herein report the outcomes of rehabilitation intervention for a patient in his 80s with chronic obstructive pulmonary disease on prolonged mechanical ventilation after COVID-19 infection. The patient was forced to be long-term bedridden due to respirator dependence, showing notable muscle weakness and needing full assistance for all of his activities of daily living (ADL). We implemented rehabilitation for the purposes of withdrawal from mechanical ventilation and improvement of his physical function. We provided a combination program of range of motion exercise, resistance training, and gradual mobilization, such as sitting on the edge of the bed, moving between the bed and wheelchair, sitting on the wheelchair, standing and walking. After rehabilitation for 24 days, the patient was withdrawn from mechanical ventilation, his muscle strength recovered to a level of 4 (Good) on manual muscle testing (MMT) and he became able to walk using a walker. A follow-up survey one year later confirmed that he performed ADL without assistance and returned to work.

Dilemma of Chinese Real Estate Tax Reform: Based on Evolutionary Game Method

High housing price is a great agitation for contemporary Chinese people, therefore, many Chinese, especially Chinese youths, would like to see a more stable real estate industry. As a device for government to guarantee the real estate industry progress healthily, real estate tax has been being unfortunately difficult to expand thoroughly in China due to local governments’ financial problems. The research target of this paper focuses on Chinese central and local governments and real estate company faced with real estate tax reform. With evolutionary game model, the authors conclude that the major obstacle of the reform in China is land-transferring fees. The breakthrough points in problem of spreading real estate tax could be increasing its comprehensive benefits. The reform could only be done effectively after that the vertical governments work with each other voluntarily, so this paper suggests that the central government should give full assistance to local governments in formulating property tax plans and should promote the position of property tax as the main local income tax to make up for the financial defects after substituting business tax with value-added tax.

The prevalence of thiamine deficiency among elderly nursing home residents: A cross-sectional study.

Although thiamine deficiency (TD) can lead to Wernicke encephalopathy, the characteristics associated with TD in the elderly have not yet been clarified. We sought to clarify the frequency of TD among an institutionalized elderly population with a controlled dietary intake and to identify possible factors related to TD. We undertook a cross-sectional study of residents in three nursing homes for the elderly as of June 2020. Blood thiamine concentrations were measured using a high-performance liquid chromatography method, with TD defined as a concentration of <21.3ng/mL. Basic data (age, sex, height, weight, and BMI), dietary intake for the previous 3 weeks, degree of care (DOC), degree of independence in daily life for elderly with dementia (DIDLED), and comorbidities were analyzed using descriptive statistical methods. The mean age (±SD) was 86.9 years (±8.29), with 84 residents (70.0%) being female. The DIDLED varied from total independence to long-term care level 5 (full assistance), with 89.2% suffering dementia. The mean whole blood thiamine value was 36.18 (±17.58) ng/ml, with TD confirmed in 7 (5.8%) of the 120 residents. All TD patients suffered from dementia. No TD was observed in patients with a near-normal food intake, and no related factors were observed among the other items. Reduced food intake may at increase the risk of TD and symptoms of TD may be overlooked in those displaying symptoms of dementia; thus, it is important for clinicians working with the elderly to remain aware of the potential for TD.

Importance of continuing health care before emergency hospital evacuation: a fatal case of a hospitalized patient in a hospital within 5 km radius of Fukushima Daiichi Nuclear Power Plant: a case report

BackgroundAfter a disaster, it is essential to maintain the health care supply levels to minimize the health impact on vulnerable populations. During the 2011 Fukushima Daiichi Nuclear Power Plant accident, hospitals within a 20 km radius were forced to make an immediate evacuation, causing a wide range of short- and long-term health problems. However, there is limited information on how the disaster disrupted the continuity of health care for hospitalized patients in the acute phase of the disaster.Case presentationAn 86-year-old Japanese man who needed central venous nutrition, oxygen administration, care to prevent pressure ulcers, skin and suctioning care of the trachea, and full assistance in the basic activities of daily living had been admitted to a hospital within 5 km radius of Fukushima Daiichi Nuclear Power Plant and experienced Fukushima Daiichi Nuclear Power Plant accident. After the accident, the hospital faced a manpower shortage associated with hospital evacuation, environmental changes caused by infrastructure and medical supply disruptions, and the difficulty of evacuating seriously ill patients. As a result, antibiotics and suction care for aspiration pneumonia could not be appropriately provided to the patient due to lack of caregivers and infrastructure shortages. The patient died before his evacuation was initiated, in the process of hospital evacuation.ConclusionsThis case illustrates that decline in health care supply levels to hospitalized patients before evacuation during the acute phase of a radiation-released disaster may lead to patient fatalities. It is important to maintain the health care supply level even in such situations as the radiation-released disaster; otherwise, patients may experience negative health effects.