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Background Although glucocorticoid hormones play important roles in fetal development, the expression of their receptors in the whole blood of preterm infants remains unknown. Objectives The aim of this study was to investigate the levels of glucocorticoid receptor (GR) α and β in the whole blood of preterm and term infants. Study design The study group consisted of 131 infants, of which 54 (41%) were preterm. Whole blood from preterm and term infants was analyzed by real-time PCR to monitor the levels of each receptor mRNA. Results GRβ mRNA were detected in 96.6% and GRα mRNA in 100% of participants. The GRα and GRβ isoforms were detected at a ratio of 1:0.0002. GRβ mRNA/GAPDH expression in preterm infants was significantly higher than that in term infants (p=0.002). There was significant correlation between GRα/GRβ ratio and birth weight in preterm infants (rs=0.317, p=0.019), as well as between GRβ/GAPDH expression and birth weight (rs=-0.296, p=0.030). Furthermore, in preterm infants, GRβ/GAPDH expression was higher in those with SGA than in those without SGA (p=0.022). Conclusion Importantly, in preterm infants, both the expression of GRβ and the GRα/GRβ ratio were associated with birth weight. Further studies with larger populations are necessary to determine the relation between the expression of GR and the clinical relevance of preterm infants.

Background and Objectives Despite growing demand for transfusion, the number of voluntary young blood donors has steadily decreased over recent years in Japan. This study aimed to develop an easy-to-use survey tool to assess barriers and motivators to blood donation among Japanese university students. Materials and Methods We conducted cross-sectional studies at two universities in Fukushima Prefecture, Japan, in December 2011 (Stage 1) and February 2012 (Stage 2) using self-administered questionnaires. A short list of motivators and barriers to blood donation was developed from the open-ended questions asked of 50 students in Stage 1. In the Stage 2, we asked 105 students how important these items were when they decided whether or not to donate blood. Items showing a significant difference between donors and non-donors were kept in the final list. Results Overall, 56% of the 100 participants analysed in Stage 2 were men, and ages ranged from 19 to 24 with a median of 20 years. Comparison of motivators and barriers between donors and non-donors revealed that only barrier item 8 (‘Frightened by blood donation’) showed a significant difference (P = 0·0006) in an expected direction and with a consistency between two universities. Conclusions This study identified fear as being the most significant barrier to blood donation among Japanese university students, which could be used as a single convenient indicator to assess their readiness to donate. More academic and clinical efforts are needed to understand and address students' fear towards blood donation in order to increase the donor pool in Japan.

Objective: In Japan, public health nurses (PHNs) play important roles in managing the health of local residents, especially after a disaster. In this study, we assessed radiation anxiety and the stress processing capacity of PHNs in the Fukushima Prefecture in Japan, after the accident at the Fukushima Daiichi Nuclear Power Station (FDNPS). Methods: We conducted a questionnaire survey among the PHNs (n=430) in July of 2015 via postal mail. The questions included demographic factors (sex, age and employment position), knowledge about radiation, degree of anxiety about radiation at the time of the FDNPS accident (and at present), by asking them to answer questions about radiation and the Sense of Coherence-13 (SOC-13). We classified the low and high levels of anxiety by asking them to answer questions about radiation, and compared the anxiety-negative (-) group with the anxiety-positive (+) group. Results: Of the PHNs, 269 (62.6%) were classified in the anxiety (-) group and 161 (37.4%) were in the anxiety (+) group. When the multivariate logistic regression analysis was conducted, the PHNs at the time of the accident (OR: 2.37, p=0.007), current general anxieties about radiation (OR: 3.56, p, BMJ Open, 6(10), e013564; 2016

The paper examines recent time trends, explores potentially influential background factors and discusses prevention strategies of pregnancy among girls under 15 years of age in Japan.Using Japanese government data, we first analyzed time trends of early adolescence (15 years of age) abortion, live birth and child sexual abuse from 2003 to 2010. Second, we analyzed ecological correlations of early adolescent pregnancy (abortion, live birth and stillbirth) with pregnancy in other age groups, child sexual abuse, and indicators of juvenile victimization and juvenile delinquency, using prefectural data.We found that rates of both abortion and live birth in early adolescents have increased since 2005 (annual percent change 5.3% and 2.3%, respectively), despite declining rates in older age groups. The abortion ratio in early adolescence remained the highest among all age groups in Japan. The early adolescent pregnancy rate showed significant correlation with the rates of juvenile victimization of welfare crimes (obscenity, alcohol drinking, smoking and drug use) (Spearman's rank correlation coefficient [rs] = 0.42, P = 0.00) and juvenile delinquency among junior high school students (12-14 years of age) (rs = 0.69, P = 0.00).The observed rise in rates of abortion, live birth and child sexual abuse among early adolescents along with strong ecological correlations of their pregnancy rate with juvenile victimization and delinquency indicators suggests that epidemiological investigation and public health programs at the individual and community levels are needed to address the complex social roots of these trends and to produce effective improvements in early adolescent reproductive health.

To investigate multifaceted factors that constrain early stroke treatment, from both clinical and social standpoints.This was a cross-sectional study conducted at a general hospital in northern Japan. Data on time to presenting to hospital after stroke onset and its potential associated factors were retrospectively extracted from the medical records of hospitalised stroke patients and analysed.Median time of presenting to hospital after stroke onset for 287 patients was 12 hours (range, 0.4-347 hours), and 16.7% of cases presented within 2 hours of onset. Multivariate analysis revealed a significant level of association between a Japan Coma Scale score of ≥1 (OR=0.41; 95% CI, 0.20-0.86) and cardiogenic cerebral embolism (OR=0.36; 95% CI, 0.15-0.85). The proportions of patients treated with recombinant tissue plasminogen activator, those with a Modified Rankin Scale score of ≥2, and those in a rehabilitation hospital/long-term care ward or who died were significantly higher among patients who presented within 2 hours.Less than one fifth of our stroke patients presented to hospital within 2 hours. Although our results are preliminary given their limited generalisability and the retrospective nature of data collection, medical rather than social factors were found to be associated with time of presenting to hospital. Patients with severe symptoms presented to the hospital at an earlier stage after stroke onset. It is important to promote the earliest possible presentation to hospital after a stroke.

Summary OBJECTIVE: To investigate multifaceted factors that constrain early stroke treatment, from both clinical and social standpoints. METHODS: This was a cross-sectional study conducted at a general hospital in northern Japan. Data on time to presenting to hospital after stroke onset and its potential associated factors were retrospectively extracted from the medical records of hospitalised stroke patients and analysed. RESULTS: Median time of presenting to hospital after stroke onset for 287 patients was 12 hours (range, 0.4–347 hours), and 16.7% of cases presented within 2 hours of onset. Multivariate analysis revealed a significant level of association between a Japan Coma Scale score of ≥1 (OR = 0.41; 95% CI, 0.20–0.86) and cardiogenic cerebral embolism (OR = 0.36; 95% CI, 0.15–0.85). The proportions of patients treated with recombinant tissue plasminogen activator, those with a Modified Rankin Scale score of ≥2, and those in a rehabilitation hospital/long-term care ward or who died were significantly higher among patients who presented within 2 hours. CONCLUSION: Less than one fifth of our stroke patients presented to hospital within 2 hours. Although our results are preliminary given their limited generalisability and the retrospective nature of data collection, medical rather than social factors were found to be associated with time of presenting to hospital. Patients with severe symptoms presented to the hospital at an earlier stage after stroke onset. It is important to promote the earliest possible presentation to hospital after a stroke.

OBJECTIVE To determine success rates in achieving goal blood pressures by measuring several factors including lifestyle characteristics associated with therapeutic failures for target treatment goals. METHODS AND PATIENTS This prospective observational cohort study (September 2008 to September 2010) collected information on blood pressure control status and healthy lifestyle practices listed in Belloc and Breslow's seven health practices through medical records and patients' self-administrated questionnaires among 1,264 of 1,753 Japanese hypertensive patients initially registered. Multivariate analysis was performed to estimate the association between lifestyle practices and "therapeutic failures" at the baseline survey. RESULTS Median age and proportion of males were 74 years and 41.1%. Therapeutic failures were 68.3% in non-elderly patients (

Recently, the importance of research capacity development has been rediscovered as a vital approach to help strengthen health systems for improved global health. The University of Medicine and Pharmacy, Ho Chi Minh City (UMP) in Vietnam in collaboration with the Department of Public Health at the Fukushima Medical University School of Medicine (PHFMU) developed an epidemiology training course for mid-career Vietnamese physicians. We trained a total of 128 participants over four courses since 2004. In order to balance basic and advanced course content for first-time and returning participants, we encouraged active participation of past graduates in teaching Course IV in 2009. Not only did this provide further training opportunities for advanced learners, it also increased project ownership by Vietnamese participants. Although more rigorous evaluation is needed, we believe that this summary of our past activities presents a useful example for others undertaking similar initiatives. To further upgrade the project in Vietnam, institutional support is required to nurture a strong scientific emphasis as well as self-sustainability in research capacity development.

Epidemiologic evidence regarding the background factors of childhood infections in Japan is scarce. The aim of the present study was therefore to investigate the rates and associated factors of hospitalization for lower respiratory tract infections (LRTI) and gastrointestinal infections (GII) among children with birthweight ≥ 2500 g and ≥ 37 weeks of gestational age.The data for the study were collected at 18-month health checkups in one city in Japan. The community database included information on the main outcome (past hospitalization) and 16 host, environmental, and parenting factors. The Kaplan-Meier method and log-rank test were used to determine sex differences in hospital admission for infection, and the Cox regression model to analyze sex-specific factors associated with the hospitalization.The proportion of children who were admitted to hospital before their 18-month checkup was 7.1% for LRTI and 2.2% for GII. Hospital admission for LRTI among boys was higher than girls. Multivariate analysis indicated the following LRTI-associated factors: child-care attendance (hazard ratio [HR]= 1.97) and three or more adults living together (HR = 2.63) for boys; and child-care attendance (HR = 4.30) and two or more children living together (HR = 4.57) for girls. GII-associated factors were maternal age25 years (HR = 3.45) for boys, and hand washing by caregivers after lavatory use and diaper changing (HR = 6.93) for girls.One out of 11 children was hospitalized because of LRTI or GII during their first 18 months, which was associated with a biologic factor (sex), environmental factors (child-care attendance and family size), and parenting practices (shorter duration of exclusive breast-feeding and caregivers' unfavorable hygiene practices).

Although parenting practices differ across various sociocultural settings, scientific research on parenting intervention in Asia is scarce. We adopted a Canadian multilanguage group-based parenting program (Nobody's Perfect) into the Japanese public health service setting and evaluated its impact. Our program was feasible as a public service; was well-accepted among the participants with low psychological status, many of whom were first-time mothers; and had a potential positive impact on the mood of mothers and the self-evaluation of their abilities in society. Our results may facilitate and provide direction for similar research in Asia.

J Clin Hypertens (Greenwich). 2010;12:166–173. ©2010 Wiley Periodicals, Inc. In this observational cohort study, the authors assessed the achievement of treatment goals as defined in the Japanese Society of Hypertension’s Guidelines for the Management of Hypertension (JSH 2004) among 2743 Japanese hypertensive patients who were followed for 1 year (follow-up rate of 82.6%). Median age was 72 years, and 45% were men. Achievement of treatment goals across all 4 seasons was very low, at 4.1% among patients with diabetes mellitus or renal disease, 3.9% among nonelderly patients (

We examined changes in ability- and performance-based instrumental activities of daily living (IADL) among community-dwelling elderly a year after a baseline survey was taken.Community-dwelling elderly in Otama village were interviewed in 2006 and followed for one year. Based on ability- and performance-based IADL assessments regarding 3 daily tasks from the Kihon Checklist (using public transportation, shopping for daily necessities, and managing bank accounts), each was assigned to one of three performance groups: good, borderline, or low.One year after the survey, the proportion of those assigned to the good performance group decreased, while those assigned to either the borderline or low performance groups increased. Among those assigned to the good performance group, 75.6% remained in that group, 21.1% shifted to the borderline performance group, and 3.3% shifted to the low performance group one year later. Compared to those remaining in the good performance group, those who shifted to the borderline performance group had significantly lower muscular strength, less healthy attitudes, and lower IADL as measured by the Tokyo metropolitan Institute of Gerontology (TMIG) Index of Competence.Fewer elderly were assigned to the good performance group and more were assigned to the borderline and low performance groups one year after the survey. Shifts from the good to borderline performance group were common among those with lower physical status and less healthy attitudes. We conclude that ability- and performance-based evaluations are important tools to screen those in the borderline performance group requiring preventive care.

Despite the significant adverse health consequences of diabetes, data on lifestyle characteristics and mortality among the Japanese with diabetes are limited. Our objective was to investigate the lifestyles of Japanese community residents with self-reported diabetes and their 3-year total mortality. Our cohort was 7178 randomly selected residents aged 30-79 years in Nihonmatsu City, Fukushima Prefecture, Japan; 5187 responded to the survey (72% response rate) and were followed for 3 years. Baseline data were collected using questionnaires in December 2002, and deaths were monitored monthly. Only 19% of women and 4% of men followed six to seven of Breslow's seven health practices. The percentage of people with self-reported diabetes was 4.2%[95% confidence interval (CI), 3.4-5.1%] for women and 7.9% (95% CI, 6.8-9.1%) for men, and the 3-year total mortality was 1.4% (95% CI, 1.0-1.9%) for women and 3.1% (95% CI, 2.4-3.8%) for men. Factors associated with 3-year mortality were fair or poor subjective health [odds ratio (OR) = 3.1, 95% CI 1.7-5.5] and self-reported diabetes (OR = 2.3, 95% CI 1.1-4.9) in a logistic regression controlling for age and gender. In stratified analyses, 3-year mortality of those with diabetes was significantly higher than those without the disease among men and those aged under 65. Those with diabetes were more likely to have self-reported comorbidities, high blood pressure and report poor subjective health regardless of age and gender, and healthier lifestyles among the women and those aged under 65. Our results support the need for community-based primary prevention measures to improve the lifestyles of residents, along with secondary prevention approaches to monitor those with diabetes for complications and to give them lifestyle instructions.

Background: The mortality rate for cerebrovascular diseases is much higher in Japan than in North American and West European countries. The primary aim of this study was to elucidate from an epidemiological perspective, the associations between cerebral infarction and demographic factors, medical history and other clinical measurements including pulse wave velocity, a newly introduced non-invasive measurement procedure used to assess aortic stiffness. Methods: This was a hospital-based, matched case–control study in northern Japan where there is a high incidence of cerebrovascular disease. The study group consisted of 92 matched pairs of cerebral infarction patients (cases) and healthy individuals admitted for a thorough health check-up (controls) at the Southern Tohoku General Hospital in Fukushima Prefecture, Japan. A conditional logistic regression model was used in the statistical analysis. Results: In univariate analyses, 14 variables were significantly associated with cerebral infarction, of which four remained significant in the final multivariate model. These were family history of hypertension (odds ratio (OR) = 8.61), cerebrovascular diseases (OR = 13.70), high-density lipoprotein cholesterol of 40 mg/dL or higher (OR = 0.08), and pulse wave velocity over 1600 cm/s (OR = 2.92). Conclusion: Findings from the study indicate that a high pulse wave velocity, in addition to other traditional risk factors, may be associated with a higher risk of cerebral infarction. Further prospective studies are necessary to evaluate the use of this measure as a predictor of the disease.

Objective: To investigate the confidence women feel about child rearing in Japan and Vietnam. Methods: We conducted a prospective study of 210 Japanese mothers who registered as pregnant in Sukagawa City, Fukushima, and 132 Vietnamese mothers who attended a university hospital in Ho Chi Minh City. Follow-up surveys were conducted via mail approximately 6 weeks after newborn delivery among the Japanese cohort, and at the time of a one-month checkup at the hospital among the Vietnamese cohort. Results: The follow-up rate among these subjects was 67% (N = 140) in Japan and 65% (N = 86) in Vietnam. The proportion of mothers who were not confident about child rearing was 48% (N = 67) in Japan and 63% (N = 54) in Vietnam. In both countries, mothers in the unconfident group reported less happiness and relaxation time with children than mothers in the confident group. Maternal confidence was associated with child rearing experience, although the significance of this factor diminished in a multivariate analysis of the Vietnamese data. While unintended pregnancy and unemployment were related to confidence in child rearing in Japan, educational history was associated with confidence in Vietnam. Conclusion: This exploratory study found a high proportion of Japanese and Vietnamese mothers are not confident in child rearing, which calls attention to this understudied issue of confidence among Asian mothers.

Japan has been experiencing a continuing decline in fertility and an increase in premarital conceptions and abortions among young people. Child rearing is often viewed as a burden. In response, Japan is now seeking ways to improve the child-rearing environment for parents. In this context, we conducted a prospective study among 206 pregnant women in Sukagawa City, Fukushima, to explore the influences of pregnancy intention on child rearing. We found that unintended pregnancy was associated with a higher risk of negative child-rearing outcomes, including lower mother-to-child attachment, increased negative feelings of mothers and a lower level of participation of fathers in child rearing. Unintended pregnancy exacerbates the real and perceived burdens of child rearing. Japan is currently facing a conflict between wanting to reduce unintended pregnancies and increase the national fertility rate. We believe the government needs to address the social challenges affecting people's family lives, which underpin low fertility, rather than focus on fertility decline per se. We suggest Japan seeks to reduce unintended pregnancies and provide support to parents at high risk of child-rearing difficulties. We also suggest adopting a comprehensive approach to improving the lives of young couples, with a focus on adolescents, including life-skills education to prepare for adulthood, marriage and parenthood.

In this hospital-based cross-sectional study we investigated differences in the levels of serum atherosclerotic and fibrinolytic markers and the prevalence of metabolic syndrome (MS) among patients with four subtypes of cerebral infarctions. Blood samples were taken from 171 cerebral infarction inpatients to determine the levels of high-sensitivity C-reactive protein, serum total homocysteine, serum plasminogen activator inhibitor 1 and lipoprotein a. Subjects were also screened for MS. Atherothrombotic infarction was most prevalent, followed by lacunar and embolic infarction. The median length of hospital stay was longest for embolic infarcts. There were no statistically significant differences in serum marker concentrations. The proportion of MS varied significantly among the subtypes, and was highest among patients with embolic infarctions with the lowest high density cholesterol levels. MS was most prevalent among patients having undergone embolic events that are reported to have the worst prognoses. Further epidemiologic studies are needed to better understand the characteristics and differences in the etiology of cerebral infarction subtypes.

There have been various studies on the prevention of falls and fractures in the elderly, from which we should select and implement effective prevention measures. The present report reviewed systematic review, meta-analysis and randomized controlled trial studies to give evidence-based recommendations for the fracture prevention.

In Vietnam, needs to update medical and public health research capacity, but advanced training in research methodology in universities is still very limited. The first university-certified research training course aimed at physicians was conducted in Ho Chi Minh City in 2000. This paper describes the processes, outcomes and lessons learned from the project, to enable the training course to be repeated to increase research capacity among health professionals in Vietnam and other developing countries. Based on needs assessment, the 9-month, part-time course offered advanced training in practical research skills, including epidemiology, biostatistics and qualitative research methods. Thirty-seven trainees (teaching staff, interns and clinicians) completed the course, which included four group research projects. With active support from university management, the course was rigorous and participation was excellent. Trainees's knowledge of research methodologies increased, and their self-evaluation of achievement of the training objectives was high. The total score of the epidemiology and biostatistics test improved from 56% (median) in the pre-course test to 83% in the post-course test. The group research project results were disseminated through a conference and publication in peer-reviewed journals. The course has since been repeated twice as a 1-month intensive course to accommodate trainees from distant regions. This type of rigorous in-service research training at universities and teaching hospitals in developing countries appears to be an effective, sustainable approach. It also holds promise for producing research data that are responsive to a country's own needs and which are likely to be applied in health policy and practice. Further evaluation of the impact and cost of such models is indicated.

A case-control study was conducted between July and August 2001 in Ho Chi Minh City to investigate factors associated with having induced abortions among primigravid women aged 16 to 38 years. Interviews were conducted with 87 women undergoing abortion (cases) and 81 pregnant women coming for antenatal care (controls). Multiple logistic regression analysis revealed that older age (odds ratio [OR] = 0.84) and being married (OR = 0.05) decreased the risk of getting unintended pregnancy leading to abortion. Risk factors of obtaining an abortion were not being exposed to family planning promotion on television (OR = 2.28) and not knowing the adverse effects of abortion (OR = 10.26). Descriptive analysis of contraceptive behavior showed that 41% of cases had never used contraceptives and the reason for non-usage was lack of knowledge of any type of contraceptives in 43% of the cases. Additionally, only 24% of cases had discussed about family planning with their partners. Effective contraceptive methods should be promoted among young population, both females and males, and they need to be informed of the consequences of abortion. Television programs might be an effective mode of providing the information.

The incidence of induced abortion (IA) is high in Vietnam. The purpose of this study is to find out whether IA increases the risk of secondary tubal infertility. A case-control study was conducted at Tu Du Hospital in Vietnam between June and September 2001. Interviews were completed with 67 tubal infertility cases matched by age and residence to 67 controls. The median age of subjects was 34 years old. Proportion of subjects with history of IA was 50.8% and 44.8% for cases and controls, respectively. IA did not significantly increase the risk of secondary infertility. Age of first sexual intercourse was under 20 years old for 29.9% of cases and 9.1% of controls, and it significantly increased the risk of secondary infertility [odds ratio (OR)=3.80]. This study was unable to identify IA as a risk factor of secondary tubal infertility. However, the increased OR for age at first sexual intercourse may imply that being sexually active at an earlier age increases the risk of getting both sexually transmitted diseases and unwanted pregnancies and in turn, increasing the risk of infertility. It is recommended to provide young women and men with the information about health risks related to sexual activity.

金沢大学大学院自然科学研究科生理活性物質科学, 金沢大学薬学部, A novel nucleophilic substitution reaction at the 1-position of indole nucleus was discovered by reacting 1-hydroxytryptamine and -tryptophan derivatives with indoles in 85% formic acid yielding 1-(indol-3-yl)indoles. Their structures were determined by X-Ray crystallographic analysis and chemical correlations. An SN2 mechanism on the indole nitrogen (1-position) is proposed.

金沢大学大学院自然科学研究科生理活性物質科学, 金沢大学薬学部, A simple and convenient synthetic methodology for 3a-(indol-3-yl)- 1,2,3,3a,8,8a-hexahydropyrrolo[2,3-b]indole, the core structure of leptosins D-F is developed by applying nucleophilic substitution reaction of 1- hydroxytryptamines.

Japan approved the use of low-dose oral contraceptives (OCs) in June 1999, after more than 35 years of debate. The debate leaves a legacy of misinformation about and various sources of resistance to OCs. Benefits are expected to include greater control for women over their fertility and a reduction in the high rates of unplanned pregnancies and abortions. Successful implementation of the new policy will require a new emphasis on women's health, including the provision of accurate information about OCs and their associated adverse effects, a women-centered approach to gynecological practice, and the promotion of condoms as protection from sexually transmitted diseases, rather than as contraception alone.

Five years have passed since the Great East Japan Earthquake and the subsequent Fukushima Daiichi Nuclear Power Plant accident on 11 March 2011. Countermeasures aimed at human protection during the emergency period, including evacuation, sheltering and control of the food chain were implemented in a timely manner by the Japanese Government. However, there is an apparent need for improvement, especially in the areas of nuclear safety and protection, and also in the management of radiation health risk during and even after the accident. Continuous monitoring and characterisation of the levels of radioactivity in the environment and foods in Fukushima are now essential for obtaining informed consent to the decisions on living in the radio-contaminated areas and also on returning back to the evacuated areas once re-entry is allowed; it is also important to carry out a realistic assessment of the radiation doses on the basis of measurements. Until now, various types of radiation health risk management projects and research have been implemented in Fukushima, among which the Fukushima Health Management Survey is the largest health monitoring project. It includes the Basic Survey for the estimation of external radiation doses received during the first 4 months after the accident and four detailed surveys: thyroid ultrasound examination, comprehensive health check-up, mental health and lifestyle survey, and survey on pregnant women and nursing mothers, with the aim to prospectively take care of the health of all the residents of Fukushima Prefecture for a long time. In particular, among evacuees of the Fukushima Nuclear Power Plant accident, concern about radiation risk is associated with psychological stresses. Here, ongoing health risk management will be reviewed, focusing on the difficult challenge of post-disaster recovery and resilience in Fukushima.

We conducted this cross-sectional study among 392 Japanese and 294 Vietnamese mothers who attended routine child health visits in a Japanese city and at a tertiary hospital in Vietnam, in order to investigate the prevalence and associated sociodemographic, parenting, and psychological characteristics of low maternal confidence in child rearing among them. All data were collected from medical files in Japan, and from medical files and self-administered questionnaires in Vietnam. The proportion of mothers without secure feeling of confidence in the present study was 22% in Japan and 66% in Vietnam. Significant factors associated with a lack of confidence were first-time motherhood and unintended pregnancy in the Japanese dataset and younger age in the Vietnamese dataset. In both groups, a higher proportion of mothers who lacked confidence reported negative parenting outcomes than did confident mothers. Among the three psychological measurements (mood, self-efficacy and depression), higher self-efficacy was associated independently with a significantly reduced risk of not having confidence in child rearing. These results suggest the importance of developing parenting support programs to help Japanese and Vietnamese mothers, particularly those who are young, first-time mothers or who became pregnant unexpectedly, improve their self-efficacy.

This article examines postdisaster public health activities (focusing primarily on parenting support) through collaboration between universities and local government, and reports on the support provided to public health nurses, who are the gatekeepers of community health. For a year after the Fukushima disaster, discussions were held on the short- and long-term measures for responding to the concerns of parents, who face difficulty interpreting risks. Child health checkup data and mothers’ counselling sessions with public health nurses were analysed to gather evidence to reinforce the health system over the long term. As the results of the analysis showed a need for the development of a system for communicating health information in ways that are accessible to residents, a health literacy training programme was developed and implemented for public health nurses in Fukushima Prefecture.

Background Mothers of young children are at high-risk for developing adverse mental health effects following a nuclear accident. Using the Japanese pregnancy registration system, the prefecture of Fukushima launched a population-based survey of women who were pregnant at the time of the Fukushima nuclear accident in order to assess their and their newborns’ health. In this paper, we focus on the results of a screen for depressive symptoms among new mothers and its association with geographical region and interruption of obstetrical care after the Fukushima nuclear accident, which occurred after the Great East Japan Earthquake on March 11, 2011. Methods The survey targeted women who lived in Fukushima prefecture and who had registered their pregnancies between August 1, 2010 and July 31, 2011. Among the 16,001 women targeted, 9,321 returned the questionnaires (response proportion = 58.3%) and data from 8,196 women with singleton live births were analyzed. The main outcome measure was a standard two-item depression screen. Regional radiation levels were determined from the prefecture’s periodical reports, and interruption in obstetrical care after the Fukushima nuclear accident was determined from mothers’ individual responses to the questionnaire. Results Among the 8,196 women, 2,262 (28%) screened positive for depressive symptoms. After adjusting for maternal and infant characteristics, both mothers in Soso, the region in which the nuclear power plant is located, and mothers that had changed obstetrical care facilities were significantly more likely to screen positive for depression. In contrast, mothers in Iwaki and Aizu, regions with relatively low radiation levels, were significantly less likely to screen positive for depression. Conclusions Our findings suggest that improving mental health support for mothers with infants should be a high priority in the acute phase of nuclear disaster response. We further recommend that in the strategic provisioning of parental support, close attention should be paid to regional variations in negative mental health consequences, particularly to those who experienced an interruption in their obstetrical care.