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After the 2011 Fukushima nuclear accident, intercultural friction and aversion arose between evacuees and host community residents in relocation areas. We examined whether a belief in group interdependence—the extent to which an individual believes that group function is realized through interdependence with related other groups—is consistent with positive interactions between evacuees and hosts. A door‐to‐door survey of 77 evacuees and 75 hosts revealed that residents with an integrated social identity interacted favorably with both ingroup and outgroup members, and that a belief in group interdependence was consistent with the integration of social identity between the evacuee and host communities. Those findings suggest that a belief in group interdependence can reduce intercultural conflict by allowing both immigrants and host residents to acquire an integrated social identity without the dilemma of internalizing different cultures into an individual's mind.

To determine the relationship between family uncertainty and family quality of life (QOL) during the recovery period of patients with cerebrovascular disease in Japan, and the factors that influence family uncertainty.Data were collected from copies of patient medical files and interviews with family members of 85 patients admitted to two rehabilitation wards in Japan. Family uncertainty was measured using the Japanese version of the Managing Uncertainty in Illness Scale-Family Member form (MUIS-FM) and family QOL using the World Health Organization Five Well-Being Index (WHO-5). Multiple linear regression analysis was applied to investigate associated factors.WHO-5 score was significantly negatively associated with MUIS-FM score (β = - 0.236, p = 0.03); other factors associated with MUIS-FM score were the Care Shared Decision-Making Questionnaire for care providers score (β = - 0.384, p 0.001), Short Intolerance of Uncertainty Scale score (β = 0.296, p = 0.001), and history of surgical treatment (β = 0.199, p = 0.032).Family QOL could be improved by reducing family uncertainty. It is also suggested that promoting shared decision-making between healthcare providers and patients' families may help reduce family uncertainty. It is necessary to take into account not only family intolerance of uncertainty but also uncertainty that varies by type of acute care provided.

We developed a mobile application (app) to help communication between support providers and residents who have returned from evacuation after the Fukushima nuclear power plant accident. Surveys were conducted among returning residents and support providers in coastal areas of Fukushima Prefecture, from which application functions and layout were decided. App functions were included to estimate external exposure, monitor health, and facilitate interactive health counseling.

We developed a mobile application (app) to help communication between support providers and residents who have returned from evacuation after the Fukushima nuclear power plant accident. Surveys were conducted among returning residents and support providers in coastal areas of Fukushima Prefecture, from which application functions and layout were decided. App functions were included to estimate external exposure, monitor health, and facilitate interactive health counseling.

To identify factors, including mental health, associated with smoking relapse among women in Japan from pregnancy to early parenthood.Secondary analysis of data from an ongoing cross-sectional study conducted between 2013 and 2016.We mailed questionnaires to all women who received a maternal and child health handbook from a municipality in Fukushima Prefecture or who underwent a maternal health checkup and gave birth in Fukushima Prefecture.Of the 28,562 women who responded to the questionnaire, 6,747 who previously smoked and quit around the time they registered their pregnancies were included in the analysis.Participants were divided into groups according to smoking relapse status: a nonrelapse group, which included those who maintained smoking cessation, and a relapse group, which included those who quit smoking but later relapsed. We further classified the latter group into those who quit smoking before or after pregnancy registration. We used a logistic regression model with forced entry to calculate adjusted odds ratios.Of the 6,747 participants who previously smoked, 881 (13.1%) relapsed. Regardless of the timing of smoking cessation, younger age and living in a specific region of Fukushima Prefecture were associated with smoking relapse. Relapse was associated with symptoms of depression in participants who quit smoking before registration and with multiparity in participants who quit smoking after registration of their pregnancies.Support for women at risk of smoking relapse after pregnancy requires consideration of regional characteristics and incorporation of family and mental health support with a focus on younger women.

Following the 2011 Fukushima Daiichi nuclear power station (FDNPS) accident, numerous initiatives emerged to address the needs of evacuees, including those eligible to return home. These came from multiple channels, timely in many cases, but in retrospect, needing better coordination. By embracing eHealth, we are attempting to coordinate efforts in Fukushima intended to link returnees with health information and care providers, not only for radiological protection in particular, but also for health promotion in general. We aim to establish a comprehensive support system for residents in municipalities around the FDNPS by developing a digital application for interactive communication regarding radiation and health promotion and to link the tool to other resources provided by local health care providers and radiation specialists. This paper explains the progress of our innovative trial to introducing eHealth in areas affected by the FDNPS accident. Based on international recommendations for developing a digital tool in response to a nuclear accident, we designed a comprehensive support package including development and implementation of the application, data management, and health counselling and ethical considerations arising from such outreach. Our trial of connecting disaster-affected citizens to health services using informatics could serve as a model eHealth program for long-term restoration after a nuclear accident.

Space flight produces an extreme environment with unique stressors, but little is known about how our body responds to these stresses. While there are many intractable limitations for in-flight space research, some can be overcome by utilizing gene knockout-disease model mice. Here, we report how deletion of Nrf2, a master regulator of stress defense pathways, affects the health of mice transported for a stay in the International Space Station (ISS). After 31 days in the ISS, all flight mice returned safely to Earth. Transcriptome and metabolome analyses revealed that the stresses of space travel evoked ageing-like changes of plasma metabolites and activated the Nrf2 signaling pathway. Especially, Nrf2 was found to be important for maintaining homeostasis of white adipose tissues. This study opens approaches for future space research utilizing murine gene knockout-disease models, and provides insights into mitigating space-induced stresses that limit the further exploration of space by humans., Using Nrf2 knockout mice, Suzuki, Uruno, Yumoto et al. show that space travel activates Nrf2 signaling, which contributes to the weight gain of mice by regulating fat metabolism of white adipose tissues. This study provides insights into potential interventions to mitigate stresses that accompany space travels.

Objectives: To clarify (1) the prevalence and associating factors of work-life conflict (WLC); (2) the details of gender-based discrimination; and (3) the association between WLC and gender-based discrimination among various professionals in a medical university organization. Methods: This cross-sectional study, conducted in 2017, included all employees working at a public medical university and two affiliated hospitals that lie in provincial cities in Japan. The outcome of interest was time-based WLC in the work-to-family or family-to-work direction, measured with a shortened version of an existing scale. Gender-based discrimination was measured according to a three-point scale. Results: Among the 3,347 employees, complete data sets were available for 2,285 (complete response rate, 68.3%). Of these, approximately 30% of respondents had perceived WLC. Multivariable logistic regression analysis showed that faculty members, nurses, and employees between 30 and 39 years old had a greater risk of WLC regardless of gender. Men were more likely to perceive gender-based discrimination in the contents of their work and the number of incidental tasks, while women were more likely to perceive discrimination with promotions and evaluation of academic achievements. Both men and women respondents who perceived gender-based discrimination had an increased risk of WLC. Conclusions: When promoting organizational well-being in a medical university, increased attention should be paid to faculty members, nurses and employees between 30 and 39 years old, as they have a greater risk of WLC. Our results also suggest that promoting gender equality is important to help achieve appropriate work-life balance.

We investigated whether differences in presentation style affect risk perception, understanding, preference, and trust toward data. One hundred and sixty Fukushima Medical University students were shown the lifetime probability of breast cancer incidence for a 50-year-old woman, presented in both a pictogram and a horizontal bar graph format. Participants rated each of the following on a five-point scale by looking at each figure: risk perception, perceived truth of data, and comparative risk perception. The perceived truth of data was high for pictograms, especially among men and among those defined as having lower health literacy. Women correctly perceived the risk of breast cancer as higher than that of dying in a car accident when the data were presented on a pictogram. There was no difference in risk perception, perceived truth of data, or comparative risk perception arising from being shown the bar graphs and the pictograms in a particular order. There was a 50/50 split on which type of graph was perceived as easier to understand, but the preference was for the pictogram format. It is important to devise a visual method of health communication that considers the purpose of the information and characteristics of the target audience.

We evaluated the association between maternal prenatal folic acid supplementation/dietary folate intake and motor and cognitive development in 2-year-old offspring using data from the Japan Environment and Children’s Study database. Neurodevelopment of 2-year-old offspring were evaluated using the Kyoto Scale of Psychological Development 2001. In total, data of 3839 offspring were analysed. For folic acid supplementation, a multiple regression analysis showed that offspring of mothers who started using folic acid supplements before conception had a significantly lower developmental quotient (DQ) in the postural-motor DQ area than offspring of mothers who did not use them at any time throughout their pregnancy (partial regression coefficient (B) −2·596, 95 % CI −4·738, −0·455). Regarding daily dietary folate intake from preconception to early pregnancy, a multiple regression analysis showed that the group with ≥ 200 µg had a significantly higher DQ in the language-social area than the group with

ObjectiveNurses working rotating shifts often suffer from insomnia or similar disorders because exposure to room lighting at night inhibits melatonin secretion, resulting in a disturbed circadian rhythm. This study investigated whether dark room lighting would be preferable to brighter rooms in terms of (1) fatigue and sleepiness while working, (2) quality of sleep and (3) non-interference with work performance among nurses.MethodsThis study used a non-randomised open-label trial between night shifts using dark (110 lx) and bright (410 lx) room lighting on the desk surface. A total of 20 nurses were enrolled in the trial from November 2015 to February 2016 at a hospital in Japan. All participants worked first with dark room lighting and then with bright room lighting. The participants completed a self-administered questionnaire at enrolment, which was collected this at the end of the intervention.ResultsFatigue and sleepiness were significantly higher in dark room lighting than in bright room conditions (pConclusionDark room lighting did not ameliorate fatigue and sleepiness during night shifts. Additionally, there was no evidence of improvement in sleep quality among nurses. These findings are important, however, in terms of managing hospital risk.

Digital tools are increasingly used for health promotion, but their utility during recovery from a nuclear disaster has yet to be established. This study analysed differences in knowledge, attitude, and practice (KAP) toward digital tools for radiation protection and health promotion, and preferences for specific application functions, among cohorts living within and outside areas affected by the Fukushima Daiichi nuclear power station (FDNPS) accident. A needs assessment was conducted by internet survey, and responses from those affected (N = 86) and not affected (N = 253) were compared and quantified by an adjusted odds ratio (aOR), using logistic regression analyses. KAP toward the radiation-related application in the affected group had an aOR of 1.95 (95% confidence interval (CI) = 1.12–3.38) for knowledge, and 5.71 (CI = 2.55–12.8) for practice. Conversely, toward the health-related application, the aOR of the affected group was 0.50 (CI = 0.29–0.86). The preference in the affected group was significantly lower for two application functions related to radiation measurement and two health-related functions (one about the effects of radiation in general and another about personal health advice in general): aOR range 0.43–0.50. Development of specific applications incorporating the findings from this survey was intended to foster a locally appropriate eHealth environment during recovery from the FDNPS accident.

Background: Digital tools can be powerful and effective in connecting people with life-saving and health-promoting support when facing a health crisis. To develop a digital application for radiation protection and health promotion for evacuees returning home after the Fukushima nuclear accident, we conducted a needs assessment survey and explored the association of people’s eHealth literacy (eHL) level with their digital tool knowledge, attitudes, and practice (KAP). Methods: From 339 responses to an online survey, data from 264 lay persons were analyzed. The KAP items were those used in a prior EU project, and eHL levels were assessed with a Japanese version of the eHealth Literacy Scale. Results: Multivariable analyses showed significant associations between eHL and the digital tool KAP for radiation protection (knowledge: adjusted odds ratio (aOR) = 1.10, attitude: 1.06, practice: 1.10) and for health promotion (knowledge: aOR = 1.13, practice: 1.16). Conclusions: People with a higher eHL had a more positive KAP. For those with a lower eHL, we are formulating easy-to-understand explanations to promote the utilization of the digital tool and enthusiasm for future community-oriented digital tools.

Objective: Various types of handbooks that summarize and record health information (health handbooks) have been used in Japan for many years. The purpose of this study was to explore ways to evaluate the understandability and usability of commonly used printed health handbooks in Japan.Methods: An internet search was performed to identify health handbooks used in Japan. The handbooks were then collected, searched, and evaluated for the quality and functionality of the health-information. The overall understandability was assessed using the Suitability Assessment of Material (SAM) and the Centers for Disease Control and Prevention Clear Communication Index (CCI), and overall usability was assessed using a purpose-user matrix.Results: A total of 14 health handbooks were extracted and analyzed. The median scores for SAM and CCI were 39 (min 25, max 45) and 81.5% (60%, 100%), respectively, and no significant association was observed between the two evaluation scores. Based on the matrix, the most common type of handbook was those designed for preventive purposes that the user or their family completed (n = 9).Conclusion: Our sampled health handbooks were used mostly for preventive purposes and their understandability varied. SAM and CCI assess different aspects of written materials and it is recommended they be used together when evaluating the understandability of health handbooks. To facilitate more effective use of health handbooks in public health activities, we suggest the content of handbooks be assessed by a purpose-user matrix.

Inclusive early childhood intervention provides opportunities for children with disabilities to receive education with typically developing children. The present study examined the effects of the AI-AI STEP Program, which is designed to help nursery teachers learn the methods of inclusive early childhood intervention for children with disabilities. This study involved 37 managers of 37 nursery schools in Japan, 48 nursery teachers, and 48 children with disabilities. The school managers, who had previously learned about the program through a seminar we offered, provided the nursery teachers with guidance on the program. The guidance provided to the nursery teachers consisted of combined structured explanations with a manual and on-the-job training. The program was performed for 6 months, and changes in the children's development and behavior and the school nursery teachers' self-efficacy and state-trait anxiety, were examined before and after using the program. Multivariate analysis was used to assess factors that had an effect on the children's developmental gains through the program. The developmental quotient of children significantly improved. In addition, “emotional symptoms” and “peer problems” on the Strengths and Difficulties Questionnaire subscale markedly improved. The self-efficacy of nursery teachers significantly improved, and state anxiety decreased. There was a significant relationship between the improvement of the children's development quotient and a lower development quotient at baseline. The provision of inclusive early childhood intervention using the program promoted the children's development, and improved their behavior. Furthermore, it had a positive effect on the nursery teachers.

We previously reported that higher reticulocyte counts were observed in earlier preterm infants. Here we present an additional study that focused on reticulocyte counts among preterm infants of small for gestational age (SGA). To assess the relationship between SGA and perinatal variables during the early postnatal period.A single-center study was undertaken at Ohta Nishinouchi Hospital between April 1, 2016 and June 30, 2021, using blood samples prospectively collected from infants admitted to the neonatal intensive care unit. These were assessed by univariate analysis and multivariate logistic regression analysis.A total of 467 preterm infants were analyzed, 367 (78.6%) non-SGA and 100 (21.4%) SGA. The median [interquartile range (IQR)] GA (weeks) for the two groups was 33 (31-35) and 34 (31-36), respectively (p = 0.058). The median (IQR) BW (g) for the two groups was 1888 (1480 to 2195) and 1381 (1019 to 1782), respectively (p 0.001). There were significant relationships between SGA and BW (p 0.001, OR, 0.997; 95% CI, 0.996 to 0.998), umbilical artery pH (p = 0.038, OR, 0.031; 95% CI, 0.010 to 0.827), Apgar at 5 min (p 0.001, OR, 1.816; 95% CI, 1.301 to 2.536), nucleated erythrocyte count (p = 0.027, OR, 1.013; 95% CI, 1.001 to 1.024), reticulocyte count (p 0.001, OR, 0.992; 95% CI, 0.988 to 0.995) and chorioamnionitis (p = 0.019, OR, 0.427; 95% CI, 0.210 to 0.868).These results suggest that preterm infants with SGA adapted more rapidly to the postnatal environment than did non-SGA preterm infants. Moreover, a lower reticulocyte count among preterm infants born SGA may be an indicator of good adaptation to the extra-uterine environment during the early postnatal period.

Patients with cognitive dysfunction caused by dysmnesia face difficulties in memorizing and learning general concepts; therefore, they encounter trouble in taking medications. Recently, a prescription notebook has been shown to be useful for patients receiving pharmacotherapy; however, it is not yet clear whether a common prescription notebook is useful for patients with a memory disorder. In our study, using a questionnaire for 61 patients, we first determined the benefits of and improvement in the drug administration guidance provided by a pharmacist to patients with a memory disorder compared with those undergoing medical examination by a doctor. Although 35-74% of patients could not communicate with a pharmacist or doctor, most found it easier to communicate with a pharmacist than with a doctor. Moreover, we investigated whether a common prescription notebook and our designed notebook, called the personal notebook, were useful to patients with a memory disorder. Although 89% of patients with a memory disorder use a common prescription notebook, 41% of them answered that they found it difficult to use. On the other hand, 66% of the patients with a memory disorder answered that they wished to use the personal notebook. Remarkably, all patients within 5 years of onset of a memory disorder wished to use this notebook. These findings indicate that it is useful for patients within 5 years of onset of a memory disorder to use the personal notebook. We propose a method to improve the use of a prescription notebook for patients with a memory disorder through this survey.

Postpartum depression is a serious problem not only for mothers, but also for their children and families. Evidence is scarce on the effectiveness of couple-targeted antenatal interventions aimed at preventing postpartum depression in Asia. Therefore, we implemented an antenatal parenting support program from Australia ("empathy program") at three sites in Japan, and assessed the characteristics of participating couples and changes in their mental health indicators before and after the program (during pregnancy and 6 weeks postpartum, respectively). In this program, participant couples discussed concerns during pregnancy and a "difficult day" scenario with other same-gender participants and then with their own partners. In total, 100 couples attended the program. Among 60 participating mothers, 20% screened positive for maternal depression symptoms (defined as an Edinburgh Postnatal Depression Scale greater than 9). Changes in paternal empathy and maternal antenatal Edinburgh Postnatal Depression Scale score were significantly associated with maternal postpartum Edinburgh Postnatal Depression Scale score in multivariable analyses. Our results indicate that a key in preventing postpartum depression is paternal involvement and long-term support from antenatal phase.

Objectives: This study aimed to assess the effects of the Great East Japan Earthquake on hypertensive disorder of pregnancy (HDP) in the Fukushima Prefecture.Methods: We used the results of the Fukushima Health Management Survey which targeted women who gave birth from 2011-2012. Pregnant women were divided into three groups according to their residential area during the disaster (affected, middle, and less-affected area), and four groups according to pregnancy trimester during the disaster (first, second, third trimester, or conception after the disaster). Adjusted odds ratio (aORs) for HDP of each residential area was calculated using logistic regression models, with pregnancy trimester during the disaster as references.Results: Overall, 8323 women participated in the study (affected area: 2207; middle area: 5183; and less-affected area: 933). For women living in the affected and middle areas in the third trimester, the disaster was a significant risk factor for HDP (aOR: 2.61, 1.02-6.66, aOR: 1.93, 1.10-3.40, respectively).Conclusions: To our knowledge, this is the first study to integrate patient residential areas and gestational age during the time of a disaster to estimate the risk of HDP. The third trimester of pregnancy at the time of the disaster was associated with HDP for the women living in the affected and middle areas. The knowledge of the data on disaster-related obstetrical complications can help obstetric care providers in a disaster area provide appropriate medical aid in an emergency.

A 33-year-old man developed a left Achilles tendon rupture and skin necrosis. We reconstructed the defect using an anterolateral thigh flap and a tensor fasciae lata muscle flap in a chimeric fashion. he was able to stand on a toe of the operated foot without help 6 months postoperatively.

The purpose of this study was to identify the needs of stakeholders in developing a mobile application (MP) to be used by returning residents and providers of healthcare and medical/social services. The needs assessment of the residents revealed that among the elderly, ownership of smartphones and tablets was low and they were less likely to use the applications themselves.

Axl and Mer are members of the TAM (Tyro3-Axl-Mer) family of receptor tyrosine kinases. Previously, we reported that enzyme-mediated inhibition of Mer by an Axl/Mer dual inhibitor led to retinal toxicity in mice, whereas selective Axl inhibition by compound 1 did not. On the other hand, compound 1 showed low membrane permeability. Here, we designed and synthesized a novel series of 5,6,7,8-tetrahydropyrido[3,4-d]pyrimidine derivatives and evaluated their Axl and Mer inhibitory activities, leading to identification of ER-001259851-000 as a potent and selective Axl inhibitor with drug-likeness and a promising pharmacokinetic profile in mice.

We aimed to clarify the factor structure of a bonding measure among Japanese fathers with infants and the factors associated with the subscales. Among fathers of children attending the 4-month health checkup, the Japanese version of the Mother-to-Infant Bonding Scale had a two-factor structure comprising "anger" and "lack of affection." Anger was associated with fathers' work demands and poor mental condition, and lack of affection with fathers' older age, poor mental condition, and interpersonal problems at home. Paternal parenting support needs to account for not only the fathers themselves, but also interpersonal communication at home and in the work environment.Nos propusimos clarificar la estructura de factores de una medida de acercamiento afectivo entre los papás japoneses con infantes y los factores asociados con las subescalas. Entre los papás de niños que asistían al chequeo de salud de 4 meses, la versión japonesa de la Escala de Acercamiento Afectivo Madre a Infante tuvo una estructura de dos factores que comprende “ira” y “falta de afecto.” La “Ira” se asoció con las responsabilidades del trabajo de los papás y la débil condición mental, y la “falta de afecto” con la más vieja edad de los papás, la débil condición mental y los problemas interpersonales en casa. La crianza paterna apoya las necesidades de dar cuenta no sólo de los padres mismos, sino también de la comunicación interpersonal en casa y el ambiente de trabajo.Notre but était de clarifier la structure de facteur d'une mesure de lien entre les pères japonais de nourrissons et les facteurs liés aux sous-échelles. Parmi les pères d'enfants présents pour leur visite médicale de 4 mois la version japonaise de l'Echelle de Lien Mère-Nourrisson était une structure de deux facteurs comprenant “la colère” et “le manque d'affection”. “La colère” était liée aux exigences du travail des pères et à une condition mentale moins élevée, et “le manque d'attention” était lié à l’âge plus élevés des pères, à une condition mentale moins élevée et à des problèmes relationnels à la maison. Le soutien de parentage paternel a besoin d’être pris en compte non seulement pour ce qui concerne les pères eux-mêmes mais aussi la communication relationnelle à la maison et l'environnement au travail.Vater-Kind-Bindung bei japanischen Vätern von Säuglingen: Eine gemeindebasierte Studie zum Zeitpunkt einer 4-Monats-Kinderuntersuchung Unser Ziel war es, die Faktorenstruktur und die mit den Subskalen verbundenen Faktoren eines Maßes für Bindung bei japanischen Vätern von Kleinkindern zu untersuchen. Die japanische Version der Mutter-Kind-Bindungsskala hatte bei den Vätern, deren Kinder 4 Monate nach der Geburt ärztlich untersucht wurden, eine Zwei-Faktoren-Struktur, die “Ärger” und “Mangel an Zuneigung” umfasste. “Ärger” war mit Arbeitsanforderungen und schlechter psychischer Verfassung bei den Vätern assoziiert, während “fehlende Zuneigung” mit zunehmendem Alter und schlechter psychischer Verfassung bei den Vätern sowie zwischenmenschlichen Problemen zu Hause assoziiert war. Erziehungsunterstützung für Väter sollte nicht nur die Väter selbst, sondern auch die zwischenmenschliche Kommunikation zu Hause und das Arbeitsumfeld berücksichtigen.日本人の乳幼児の父親における父−子ボンディング:3−4カ月健診での地方自治体ベースの研究 本研究の目的は、日本人の乳児の父親におけるボンディング尺度の因子構造と下位尺度に関連する因子を明らかにすることである。4ヶ月健診を受けた乳児の父親に対して行ったMother-to-Infant Bonding Scale (MIBS) 母子絆尺度の日本語版は、「怒り」と「愛情の欠如」の2因子構造であった。「怒り」は父親の仕事の負担と不健全な精神状態に関連し、「愛情の欠如」は父親の高齢化、不健全な精神状態、家庭での対人関係の問題に関連していた。父親への育児支援においては、父親自身だけでなく、家庭や職場環境での対人コミュニケーションも考慮する必要がある。.我们旨在阐明一次日本父亲与婴儿之间连结关系测量的因素结构, 以及与各分量表相关的因素。在四个月的儿童参加健康检查时, 其父亲在日本版的“母婴连结量表”中, 有一个由“愤怒”和“缺乏亲情”组成的双因素结构。“愤怒”与父亲的工作烦恼和不良心理状况有关, 而“缺乏亲情”与父亲年龄大、不良心理状况和家庭人际关系问题有关。父亲的育儿支持不仅要考虑父亲本身, 还要考虑家庭和工作环境中的人际沟通。.الترابط بين الأب والطفل بين الآباء اليابانيين للرضع: دراسة محلية في وقت إجراء فحص صحة الطفل في عمر أربعة شهور استهدفت الدراسة توضيح الهيكل العامل لمقياس الترابط بين الآباء اليابانيين مع الرضع والعوامل المرتبطة بالمقاييس الفرعية. ومن بين آباء الأطفال الذين يحضرون الكشف الطبي في عمر أربعة شهور، كان للنسخة اليابانية من مقياس الترابط بين الأم والرضيع هيكل مكون من عاملين يتألف من “الغضب” و “انعدام المودة”. ارتبط “الغضب” بمطالب عمل الآباء وسوء الحالة النفسية، وارتبط “نقص المودة” بتقدم الآباء في السن، وسوء الحالة النفسية والمشاكل الشخصية في المنزل. ولذلك لا يحتاج دعم التربية الأبوية إلى أن يكون مسؤولا عن الآباء أنفسهم فحسب، بل أيضا عن التواصل بين الأشخاص في المنزل وبيئة العمل.

Introduction The Australian "empathy session," which is a parenting program aimed at alleviating postpartum depression by increasing empathy among expecting couples, was adapted to a life-planning education program for Japanese high school students. In this present study, we aimed to assess changes in high school students' empathy levels. Methods A nonrandomized, controlled, waitlist intervention was performed in 210 first-year students. They were divided into intervention and waitlist control groups. The life-planning lecture consisted of two parts: (1) reproductive health and (2) empathy and communication skills. The main outcome indicator was the Perspective-Taking subscale of an empathy index. Logistic regression was used to examine the association between the intervention and change in the Perspective-Taking scale score controlling for background factors. Results As per our findings, a significant difference was noted in the scale scores of Perspective-Taking before and after the program within the intervention group (3.76 ± 0.61 before the lecture and 3.86 ± 0.64 after the lecture; P = 0.01). In the between-group analysis, the likelihood of an increase in the scale score of Perspective-Taking was significantly higher in the intervention group (OR = 2.29, 95 % confidence interval = 1.23-4.26). Conclusions Japanese high school students' Perspective-Taking improved through learning reproductive life-planning and communication skills.

Childhood idiopathic nephrotic syndrome (NS) is defined by proteinuria and hypoproteinemia. The incidence of childhood idiopathic NS varies with age, race, residential areas, and social conditions. In Japan, its incidence was estimated to be 6.49 cases/100,000 children. Our study aimed to investigate the incidence, characteristics, and rate of relapse of idiopathic NS in Fukushima between 2006 and 2016. Overall, 158 children aged from 6 months to 15 years old (65.8% male) developed idiopathic NS (median age at onset, 5.3 years). The peak age at onset was three years. The average annual incidence of childhood idiopathic NS was 5.16 (range, 3.47-9.26) cases/100,000 children. The highest incidence was in 2011, which was the year of the Great East Japan Earthquake and nuclear power plant accident, and reportedly caused psychological distress in the children at the time. Conversely, the five-year birth cohort showed minor difference from 2008 to 2012. The rate of incidence in males aged < 5 years was thrice greater than in females of the same age and almost the same for males and females aged 11-15 years. Of 507 total relapses in 115 NS children, common triggers of relapses were steroid discontinuation or reduction and infection. The average annual incidence of childhood NS based on the Fukushima population was lower than previously reported in Japan, and the annual incidence has changed over an 11-year period. These changes may be affected by social or environmental factors, including mental stress associated with lifestyle changes after the disaster.

In recent years, there has been an increase in the number of hypertensive diseases and the various diseases associated with them. A major cause of these is excessive salt intake. The purpose of the present study was to examine whether chewing hard foods lowers the saltiness threshold. Fifteen subjects (fourteen women and one man) participated in the present study. Two types of gummies are available as ingredients: hard and soft gummies. The saltiness thresholds before and after chewing of each gummi were studied using 11 different NaCl solutions. Then, points of subjective equality (PSEs) were calculated to detect changes in the saltiness for each subject. In the soft Gumi condition, there was no significant difference in PSE for the saltiness between before and after ingesting Gumi (p>0.05), while in the hard Gumi condition, the PSE for the saltiness significantly decreased after ingesting Gumi compared with the value of before ingesting Gumi (p=0.001). From these results, we concluded that sensitivity to saltiness would increase after mastication of hard foods such as hard Gumi.

Axl and Mer are a members of the TAM (Tyro3-Axl-Mer) family of receptor tyrosine kinases, which, when activated, can promote tumor cell survival, proliferation, migration, invasion, angiogenesis, and tumor-host interactions. Chronic inhibition of Mer leads to retinal toxicity in mice. Therefore, successful development of an Axl targeting agent requires ensuring that it is safe for prolonged treatment. Here, to clarify whether enzyme inhibition of Mer by a small molecule leads to retinal toxicity in mice, we designed and synthesized Axl/Mer inhibitors and Axl-selective inhibitors. We identified an Axl/Mer dual inhibitor 28a, which showed retinal toxicity at a dose of 100 mg/kg in mice. Subsequent derivatization of a pyridine derivative led to the discovery of a pyrimidine derivative, 33g, which selectively inhibited the activity of Axl over Mer without retinal toxicity at a dose of 100 mg/kg in mice. Additionally, the compound displayed in vivo anti-tumor effects without influencing body weight in a Ba/F3-Axl isogenic subcutaneous model.

Background: As the number of young people in Japan decreases, the proportion of them who donate blood warrants urgent attention. The aims of this investigation were to test whether students’ motivation of “doing good for others” associated with their blood donation behavior and to explore factors associated with their motivation. Methods: Fukushima Red Cross Blood Donor Center conducted a questionnaire survey in 2018 at 10 high schools in Fukushima Prefecture (N=4506). From the database, we analyzed the factors associated with motivation as assessed by the perception of “doing good for others” using chi-square tests and binomial logistic regression. Results: The percentage of those answering “doing good for others” as “important” was 67.2%. Students who donated blood more often tended to cite “doing good for others” as important. The probability of regarding this perception as important was significantly higher among females, those with better subjective health, and those knowing their own blood type and donation eligibility criteria. Conclusion: Health promotion activities that improve subjective perceptions of one’s health may reinforce students’ awareness of blood donation as “doing good for others” that might promote frequent donation. Our results also support greater outreach to male students and improving students’ knowledge related to blood donation.

Aim The objective of the present study was to develop a tool for mothers to assess their children’s skin condition with the ultimate goal of its wider use in general health checkups for infants and toddlers. Methods This was a single-institution, cross-sectional study in Japan, targeting parents of 200 infants and toddlers who visited a dermatology clinic between December 2018 and March 2019. The parents completed a self-administered survey of the mother’s perception of her child’s dermatological symptoms, itchiness, and sleep status, and a quality-oflife assessment, using a nine-question version of the Quality of life in Primary Caregivers of children with Atopic Dermatitis questionnaire (QP9). The attending physician was asked to complete a form about the child’s dermatological condition and the treatment prescribed. The severity of the dermatological condition noted by the physician was compared with the combined response to the 3 perception items (dermatological condition, itchiness, and sleep) reported by the parents, in order to identify the optimal cutoff score. Results Of 200 parent questionnaires distributed, 198 (99% response rate) were returned and analyzed, along with the responses from 198 physician records (100% response rate). The optimal cutoff score was 2/3 for the total score (range 0-6) for 2 items, itchiness and sleep status (sensitivity 73%, specificity 64%). There was a significant difference in QP9 scores between the 2 groups categorized by the cutoff score Conclusions A pediatric dermatological screening tool based on 2 symptoms reported by the parents of children with atopic dermatitis was developed, and its precision and criterion-related validity were confirmed. This simple tool could help parents become better aware of their children’s skin condition and allow healthcare workers to provide adequate skin care advice. This practical tool could be widely applicable in primary child care and public health service settings.

As the COVID-19 virus spread rapidly around the world, information related to the pandemic also spread quickly and in massive amounts. Uncertainty and unknowns about the pandemic together with the explosion of information created confusion and fear among many populations. A major challenge for public health practitioners is to provide clear and consistent messages that can be understood by different types of audiences, including vulnerable populations such as pregnant women and children who are often forgotten in this process. We compared and analyzed the development processes of health communication products for pregnant women in Madagascar and for elementary school children in Japan during the COVID-19 pandemic. This study compared these two field experiences in different socioeconomic settings to identify common strategies for the development of communication materials in a health crisis. The two cases both developed communication materials developed in collaboration with key local communicators and the target audiences. Both products used a simple and clear structure and included do's and don'ts. Messages were tailored toward the lifestyles of the target audience and phrased to fit with cultural and linguistic contexts. Both developer teams paid attention to easy-to-understand words and culturally accepted design and colors. The final products were distributed swiftly and widely through multiple channels with the local community. These two field experiences demonstrate common strategies for developing health communication materials that are culturally-tailored and visually-appealing in a timely manner and can be disseminated through existing channels in a health crisis. Our experiences emphasize that collaborative and iterative efforts based on an existing trust relationship with the target community can provide the foundation for a rapid communication response in a health crisis.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Objectives This study analyzes the change in the sense of food safety over time, from 2 years before to 8 years after the Fukushima accident in 2011, and its association with social connectedness using cohort data, taking into account regional differences in Fukushima Prefecture. Study design Repeated cross-sectional data from Fukushima Prefectural Government from 2009 to 2018 were used. Methods We randomly selected 1300 people every fiscal year (FY). The survey gathered data on age, gender, occupation, residential region, and the explanatory variables ‘sense of social connectedness’ and ‘recovery-related information source’ (information source). The prefecture was divided into three regions for the survey—Hamadori region, where the nuclear power plant is located, Nakadori region, where the air dose rate after the earthquake was high, and in Aizu, far from the nuclear power station but has suffered from harmful rumors. Results Focusing on FY 2014, when the sense of safety first showed recovery, we performed a binominal logistic regression analysis with ‘sense of safety’ as the outcome and ‘sense of social connectedness’ and ‘information source’ as the explanatory variables. The sense of safety significantly decreased in all regions in 2011 relative to earlier years. The sense of food safety decreased markedly in Hamadori and Nakadori but started to improve 3 years after the earthquake and reached the pre-earthquake level in 2018. The effect sizes were larger in the Hamadori region and in Nakadori than in Aizu. In FY 2014, multivariate analysis found that a sense of food safety was significantly positively associated with a sense of social connectedness, whereas the use of information from newspapers and TV and word of mouth was negatively associated. Conclusion Although the recovery of a sense of food safety may take some time, a focus on social connectedness during recovery and scrutiny of information sources may facilitate recovery. Health communication has an important role when the provider sends information intelligibly and the recipient can distinguish good news from bad and link it to self-determination. It is necessary to improve literacy.

Background Japan Environmental and Children's Study (JECS) was under way in Fukushima at the time of the triple disaster. It was initially to assess the effects of environmental factors on children's health, but given the situation particular to the accident, it could also offer an additional source of material with which to examine the psychological impacts of the disaster on mothers. This study aimed to examine the characteristics of mental health of Fukushima mothers after the triple disaster by comparing the scores in Fukushima with the nationwide scores. Then, it aimed to examine associations between their maternal bonding and mental health both during pregnancy and following birth. Methods The JECS administered the Kessler 6-item psychological distress scale (K6) during pregnancy and the Edinburgh Postnatal Depression Scale (EPDS) 1 month following birth to 97 454 eligible women. In conjunction with the JECS, this study analysed the scores of 11 630 women in Fukushima which were obtained in the JECS between 2011 and 2015, and compared them with the nationwide scores during the same time period. Results The proportion of mothers having ‘negative feelings toward pregnancy’ was significantly higher in Fukushima Regional centre (RC) than in the other 13 RCs between 2011 and 2014. No significant difference in the ‘lack of affection’ scores following birth was found between Fukushima RC and other RCs in 2012 and 2013, but the score in Fukushima RC was significantly lower in 2014 and 2015. The K6 scores in Fukushima RC were significantly higher than in other RCs in all years, and the EPDS scores following birth in Fukushima RC were also higher than in the 13 RCs in all years. The results of multivariate analysis showed a significant association between ‘mothers’ negative feelings toward pregnancy’ and depressive symptoms, except in Fukushima RC in 2011. Also, it showed another significant association between ‘lack of affection’ and postpartum depressive symptoms from 2012 to 2015 in both Fukushima RC and 13 RCs. K6 scores during pregnancy were significantly associated with EPDS scores throughout the study period in both Fukushima RC and 13 RCs. Limitations Due to the lack of information on participants’ residential region at the municipal level in the JECS, it was unable to measure regional differences within Fukushima prefecture. Conclusion This study shed light on the relationship between maternal bonding and mental health both during pregnancy and following birth by using the sequential and periodic national data sets. While showing the maternal characteristics associated with depressive symptoms during pregnancy and following birth in Japan, it distinguished the characteristics between Fukushima and nationwide. It raised the possibility that providing mothers in Fukushima with supports to increase their bonding toward their pregnancy could prevent the development of depressive tendency. The results could suggest that not only depression prevention measures but also maternal bonding support could be necessary in the region.

The “Creative Heath” project, a participatory school activity to foster community resilience, was implemented in Fukushima, Japan, and children’s experiences of the project were assessed both quantitatively and qualitatively. The project consists of three workshops: BODY, FOOD, and ACT, with activities to facilitate students’ scientific and creative thinking, working in teams, presenting, and expressing their opinions. The first two schools participated with 105 students aged 9–11 years old. Before and after each workshop, students were given questionnaires to rate their satisfaction with their own health (BODY), local foods (FOOD), and the community at large (ACT) on a five-level scale, with space to add free comments. Ratings for BODY and FOOD changed significantly, and the proportion of students who increased their rating of an evaluation indicator after each workshop was 25% for BODY, 28% for FOOD, and 25% for ACT. Text analysis of free comments showed that students in the “increased” group appreciated presenting, measuring, learning connections between nutrition and health, and working collaboratively with peers. Children perceived their health and the foods in their community more positively after participating. Moreover, the Creative Health project could be a way to enhance children’s creativity and autonomy as agents of change in the community.

After the Fukushima disaster, healthcare professionals were expected to function as risk communicators to the public. The purpose of this study was to explore whether there were associations between a set of risk communication competencies and having attended any of the on-site workshops that were conducted over eight years since the Fukushima disaster as part of an in-service training program for Fukushima's public health nurses (PHNs). A survey was conducted by mail from August 20 to October 8, 2019, involving 754 PHNs in Fukushima Prefecture using an anonymous self-administered questionnaire. The survey's valid response rate was 81.3% (613 responses). Respondents were asked to rate themselves on seven risk communication competencies (increasing residents' health knowledge, tailoring communication to residents' satisfaction, responding to residents' concerns, alleviating residents' distress, building trust, supporting health-related behavioral change, and supporting health-related self-efficacy) and on two items related to change in professional perspective after the Fukushima disaster (acquisition of specialized knowledge and skills and heightened professional awareness). Participation in a health literacy workshop significantly predicted four of the risk communication competencies, namely, responding to residents' concerns (OR = 1.49 (95% CI: 1.01–2.21)), alleviating residents' distress (1.65 (1.12–2.44)), building trust (1.90 (1.27–2.83)), supporting health-related self-efficacy (1.50 (1.02–2.20)), and the two changes in professional perspective, acquisition of specialized knowledge and skills (1.74 (1.15–2.62)) and heightened professional awareness (1.62 (1.09–2.43)). The study suggested that the health literacy on-site workshops had multifaceted effects in enhancing the risk communication competencies of healthcare professionals since the Fukushima disaster.

金沢大学医薬保健研究域薬学系, Various nucleophiles, such as indole, 1,2,3-trimethoxybenzene, anisole, phenol, and pyrrole, reacted with 1-hydroxy-Nb-trifluoroacetyltryptamine under the presence of mesyl chloride to give novel series of (3a,8acis)- 1,2,3,3a,8,8a-hexahydropyrrolo[2,3-b]indoles having a substituent at the 3aposition. Their structures and by-products were strictly determined. © 2017 The Japan Institute of Heterocyclic Chemistry., Embargo Period 12 months

Aim High-income countries are now experiencing a decline in fertility. After experiencing baby booms in 1947–1949 and 1971–1974, Japan's population has been decreasing since 2015. In an attempt to predict the next baby boom, we searched for any upward demographic trends occurring after 1974. Methods We analyzed time trends of the numbers and rates of live births, stillbirths and induced abortions using Japanese government data from 1975 to 2014. We then selected two birth cohorts: the first baby boomers who were 0–4 years old in 1950, and the second baby boomers who were 0–4 years old in 1975, and analyzed their rates of live births, stillbirths, and abortions by five-year age groups. Results There was no upswing in the numbers of births, stillbirths, or induced abortions; however, the abortion rate increased during 1996–2002. Compared with the first baby boomer cohort, the second baby boomer cohort had half the peak live birth rate for the same age group (25–29 years old), and half the peak rate of abortions, with a shift toward a younger age group (20–24). Conclusions This analysis of Japanese fertility trends derived from all pregnancy outcomes showed no upward trend in fertility in Japan since 1974.

Background: We hypothesized that gallbladder (GB) volume is affected by serial changes during the early infancy period in extremely premature infants. Methods: We conducted a prospective study of extremely premature infants admitted to the neonatal intensive care unit of Fukushima Medical University Hospital, Fukushima City, Japan between January 2014 and December 2015. GB volume was measured by an abdominal ultrasound ellipsoid method between Day 0 and Day 56 after birth within 60 minutes before enteral feeding. We calculated GB volume (mL)/weight (kg), which was evaluated as GV/W. Results: In total, 30 infants were included. The median gestational age of the infants was 26 weeks 5 days (range, 23 weeks 1 day–28 weeks 6 days), and the median birth weight was 731 g (range, 398–1220 g). The detection rate of GB decreased in the infants over time; the rates were > 93% between Day 0 and Day 7 and < 77% between Day 10 and Day 56 after birth. GV/W decreased in the infants over time. The median GV/W values were 0.18 (range, 0.05–0.59) in infants on admission and constantly