Effectiveness of an Intervention Program to Enhance the Self-Confidence of Kindergarten Teachers Dealing with Radiation-Related Health Concerns from Parents of Young Children: A Quasi-Experimental Study.

OBJECTIVE: This study examined the effectiveness of an intervention program to enhance the self-confidence of kindergarten teachers who address radiation-related health concerns among parents following the Fukushima Daiichi Nuclear Power Plant accident in March 2011, wherein radiation anxiety among mothers with young children was high. Kindergarten teachers are expected to address the concerns of these parents. METHODS: Participants from 2 private kindergartens in Fukushima City were assigned to either the intervention group (n = 10), which received an intervention program comprising lectures, group discussions, and presentations, or the control group (n = 16), which received only written materials used in the intervention program. Changes in the measured scores post-intervention were calculated, and the mean values were compared between both groups using the Student's t-test. RESULTS: The primary outcome was self-confidence, and the difference-in-differences approach was used to assess the effectiveness of the intervention program. The study found a more significant difference between pre- and post-intervention self-confidence in the intervention group compared to the control group (P < 0.01). CONCLUSIONS: The intervention program effectively enhanced the self-confidence of kindergarten teachers in dealing with radiation-related health concerns of parents with young children.

NELF coordinates Pol II transcription termination and DNA replication initiation.

Regulation of RNA polymerase II (Pol II) transcription is closely associated with cell proliferation. However, it remains unclear how the Pol II transcription program is altered in cancer to favour cell growth. Here, we find that gene expression of NELFCD , a known negative elongation factor, is up-regulated in colorectal tumours. To dissect the direct role of NELF-C on Pol II transcription in such cancer, we employed an auxin-dependent protein degradation system for NELF-C in combination with nascent transcript sequencing technologies. Strikingly, we demonstrated that the acute loss of NELF-C protein globally perturbs Pol II transcription termination and also increases transcription elongation rate, independently of promoter-proximal Pol II pausing. This results in Pol II transcription into DNA replication initiation zones, and may link to failure of the cell cycle transition into S phase. We anticipate that NELF will be a potential therapeutic target to restrict colorectal cancers by promoting transcription-replication conflict. HIGHLIGHTS: Expression of NELFCD transcript is up-regulated in colorectal tumors NELF-C protein is mandatory for the transition between G1-S phases during cell cycleNELF-C loss impairs transcription termination independently of Pol II promoter-proximal pausingNELF-C loss leads Pol II to invade DNA replication initiation zones.

[Relationship between radiation knowledge and radiation effect anxiety on the next generation: An analysis of a questionnaire survey disseminated to residents in Fukushima Prefecture].

Objectives　Since the Fukushima Daiichi Nuclear Power Plant accident caused by the Great East Japan Earthquake, many people in Fukushima Prefecture have been concerned about the effects of radiation on their offspring. Although this fear should be relieved since no epidemiological study has shown evidential cases, situations wherein some people misunderstood the existence of evidence have been independently reported. Therefore, in this study, we examined the relationship between radiation knowledge and anxiety about radiation-based genetic effects using a survey mailed to residents in Fukushima Prefecture.Methods　In August 2016, we attempted to contact 2,000 people aged 20 to 79 years in Fukushima Prefecture through a survey distributed by mail inquiring about residents' health. We received 861 responses. Respondents selected their level of concern about radiation effects on the next generation on a four-point scale and answered five knowledge questions about radiation effects and protection. Responses were "correct," "incorrect," or "not sure." After adjusting according to residential area, family configuration, age, sex, academic background, media used, and trusted information source, we conducted multiple regression analyses to investigate the relationship between the level of concern and answers to the knowledge questions.Results　People who answered the knowledge questions more correctly had lower levels of anxiety. The number of "not sure" responses was unrelated to anxiety level. The results indicated that correct answers to questions related to radiation residuals in the body and genetic effects were negatively associated with anxiety. Incorrect answers to the question about genetic effects and another related to cell repair systems were positively associated with anxiety. Moreover, while a correct answer to another question related to the linear threshold model had a positive association, the association was insignificant. Further, any response related to radiation reference values in foods showed no association.Conclusion　Based on these results, we observed an association between the number of respondents with a correct knowledge of radiation and the degree of anxiety about radiation effects on the next generation. However, this relationship and its strength varied depending on the specific knowledge content. As a limitation of this study, the study could not establish any causality. Further studies, such as prospective interventional studies, should be conducted.

Relationship between the Effects of Perceived Damage Caused by Harmful Rumors about Fukushima after the Nuclear Accident and Information Sources and Media.

The nuclear accident that accompanied the Great East Japan Earthquake of 11 March, 2011, was also an information disaster. A serious problem that arose after the accident and persisted for a long time was the damage caused by harmful rumors (DCBHR). In 2016, a cross-sectional questionnaire survey on health and information was conducted in Fukushima. The eligible population of this survey was 2000 Fukushima residents, which included those in the evacuated areas. We received 861 responses. Data were analyzed using the responses to the question about perceived DCBHR as the objective variable and the sources of information residents trusted and the media they used as explanatory variables. A multiple logistic regression analysis revealed that those who trusted government ministries and local commercial TV were significantly associated with no effect. In contrast, those who used Internet sites and blogs were significantly associated with a negative effect. This study underlines the pivotal importance of media and information, literacy, and education and discusses how these should be improved to avoid DCBHR in the future. Furthermore, accurate information should be made available to all sections of the population to diminish DCBHR.

Disaster Resilience Reduces Radiation-Related Anxiety Among Affected People 10 Years After the Fukushima Daiichi Nuclear Power Plant Accident.

This study examined whether disaster resilience affects the recovery of mental health states and mitigates psychosocial anxiety 10 years later the Fukushima Daiichi nuclear power plant accident. The survey was conducted in Fukushima's evacuation-directed and non-evacuation-directed areas in January 2020. The 695 participants responded to a questionnaire including items on radiation-related anxiety regarding the Fukushima Daiichi accident, an action-oriented approach as a resilience factor, psychological distress, and demographic information. The structural equation modeling showed that the action-oriented approach also eased radiation-related anxiety by mediating with improving mental health states. Moreover, a multi-group model analysis was conducted for evacuation-directed and non-directed areas. In the evacuation-directed area, we found stronger associations among resilience, mental health states, and radiation-related anxiety, and a direct effect of resilience factors on radiation risk anxiety. These findings emphasize the importance of resilience in post-disaster contexts, at least for a decade, where mental health deteriorates and various psychosocial issues become more complex.

[Relationship between media usage time and self-rated health among junior and senior high school students].

Objective　Due to the rapid development of the internet, its overuse and addiction among the younger population have increased. Several studies have reported a relationship between the prolonged usage hours of the internet and other media among junior and senior high school students and certain lifestyle habits, such as no breakfast, no exercise routine, lack of sleep, and mental health decline. There is a growing concern that the students' health could be affected due to over usage of the internet and other networking media. Therefore, we have examined the relationship between media usage time and self-rated health (SRH) of the junior and senior high school students.Methods　We analyzed the data of the "Fukushima Citizens' Health and Lifestyle Survey" conducted on May 2016. The participants included in the survey were junior and senior high school students from Fukushima City. We randomly selected 1,633 students and conducted a self-administered questionnaire survey. Of the 1,589 respondents, survey data from 1,480 students (583 junior and 897 senior high school students) were used in the analysis. The analysis was performed in each junior and senior high school student, with SRH as the dependent variable, media usage time as the independent variable, and various lifestyle factors as the adjustment variables. Furthermore, the odds ratio (OR) and 95% confidence interval (CI) were estimated.Results　Fifty-two junior high school students (8.9%) and 123 senior high school students (13.7%) had poor SRH. Among the junior and senior high school students, those who used media for >3 h were more likely to have poor SRH, and the significant association was noted among high school students (OR; 2.30, 95% CI; 1.36-3.90). For both junior and senior high school students, the SRH was significantly associated with obesity, no exercise routine, and stress. Additionally, for the high school students, the SRH was significantly associated with late bedtime routine.Conclusion　Our findings suggest that junior and high school students who overuse media are more likely to have a poor SRH.

Subjective Wellbeing and Related Factors of Older Adults Nine and a Half Years after the Great East Japan Earthquake: A Cross-Sectional Study in the Coastal Area of Soma City.

This study examined older adults' subjective wellbeing and related factors in the coastal area of Soma City nine and a half years after the Great East Japan Earthquake (GEJE). Data were collected from 65- to 84-year-old residents and 1297 participants via a questionnaire from October to November 2020. The participants were divided into two groups: housing complexes and non-housing complexes. The dependent variable was subjective wellbeing assessed via Lawton's Philadelphia Geriatric Center Morale Scale (PGCMS). Using multivariate regression analysis, the factors most strongly related to a low PGCMS score for both groups were poor health conditions, difficulties resting while asleep, poor financial wellbeing, inability to chew certain foods, and fear of solitary death. The GEJE experience was further distinguished in the housing complex group by the loss of an important non-family individual; for the other group, important factors were female gender, junior high school education level or lower, limited social networks, and deterioration of a family member's health. Older adults' subjective wellbeing in Soma City was low after nine and a half years following the GEJE. For disaster victims and their families in both groups, it is crucial to implement measures such as long-term, continuous physical and mental health support.

Feasibility study of an intervention program to enhance self-confidence of kindergarten teachers who deal with radiation-related health concerns from parents with young children.

BACKGROUND: Following the Fukushima Daiichi Nuclear Power Station accident in March 2011, radiation anxiety was high among residents in affected areas. Enhancing radiation-related health literacy is effective in reducing radiation anxiety. This feasibility study aimed to examine a novel intervention program to enhance the self-confidence of kindergarten teachers who deal with radiation-related health concerns from parents in order to determine the feasibility of conducting a future randomized controlled trial. METHODS: Teachers and administrative staff of two private kindergartens in Fukushima City and members of Media Doctor Japan (a research group for enhancing the quality of health news reporting in Japan) were recruited for study participation. Participants were randomly assigned to intervention and control groups. The intervention group participated in the intervention program, comprised of lectures, group discussions, and presentations. The control group received the same written materials used in the intervention program. The primary outcome of this study was feasibility, assessed via four questions concerning program acceptability and described without quantitative analysis. Secondary outcomes were self-confidence concerning parent consultation (1 question, 4-point Likert scale), radiation-related health knowledge (5 question quiz, 1 point for each correct answer, score: 0-5), and health literacy (assessment developed by Ishilawa, et al., score: 1-5) assessed numerically before and after the intervention. Means and standard deviations of outcomes before and after the intervention and their changes in both groups were reported with groups of participants (kindergartens and the Media Doctor Research Japan) reported separately. No quantitative analyses were performed for secondary outcomes. RESULTS: Five and six kindergarten workers and seven and seven Media Doctor Japan members participated in the intervention and control groups, respectively. Reported acceptability was generally positive, and only one participant gave a negative response regarding program usefulness. Improved self-confidence was found in kindergarten employee participants. Radiation-related health knowledge was higher after the intervention in both kindergarten teachers and Media Doctor Japan members. The amount of change was higher in the intervention group than in the control group. CONCLUSIONS: The intervention program enhanced self-confidence in kindergarten employees. The feasibility of the intervention program for a larger randomized controlled trial was ascertained. Time to conduct lectures and group discussions should be increased to further enhance health literacy. TRIAL REGISTRATIONS: UMIN000042527 [University Hospital Medical Information Network (UMIN) Center] registered on November 25, 2020.

[Posttraumatic growth after the Fukushima nuclear disaster: Examination of free descriptions among Fukushima residents].

Objectives　Posttraumatic growth (PTG) refers to a positive psychological transformation experienced as a result of struggling with a major life crisis or traumatic event. In recent times, PTG has been used as a form of psychological support for those who have experienced trauma. In this study, we classified the free descriptions of PTG in Fukushima residents who experienced the Great East Japan Earthquake (GEJE). We examined the relationship between basic characteristics and PTG clusters, and between "recovery from radiation anxiety" and PTG clusters.Methods　A mail survey was conducted in August 2016 among 2,000 Fukushima residents, aged 20-79 years. We asked the participants for a free description of the specific content of their PTG. We also asked about their age, gender, and education, as well as about radiation anxiety immediately after the GEJE and at the time of the survey. Participants were divided into the following groups: "no anxiety," "recovered from anxiety," and "unrecovered from anxiety". The PTG free descriptions were classified into eight categories, including five dimensions based on the Posttraumatic Growth Inventory (Tedeschi & Calhoun, 1996) ("relating to others," "new possibilities," "personal strength," "spiritual change," and "appreciation of life") and three categories created according to Nishino et al. (2013) ("increased awareness of disaster prevention," "renewed recognition of nuclear-related issues," and "critical examination of information from authorities").Results　Of the 916 collected responses, data from 786 responses with no missing values were analyzed. Among women and young people, the proportion of those who answered "relating to others" and "appreciation of life" was high. For those with higher education, the proportion of those who answered "relating to others," "renewed recognition of nuclear issues," "critical examination of information from authorities," "personal strength," "spiritual change," and "appreciation of life" was high. In the "recovered from anxiety" group, the proportion of those who answered "renewed recognition of nuclear issues" was high.Conclusion　In assessing PTG, women and young people were more likely to report that they felt closely connected to family or friends, as well as to the community, and that they were grateful for their daily lives. Those with higher education tended to recognize that they have come to critically examine information provided by the national government, electric power companies, and national newspapers; they felt mental strength and growth after the earthquake. Those who recovered from radiation anxiety were more likely to report forming a heightened awareness of issues relating to nuclear power plants and energy.

Those Who Have Continuing Radiation Anxiety Show High Psychological Distress in Cases of High Post-Traumatic Stress: The Fukushima Nuclear Disaster.

BACKGROUND: this cross-sectional study aimed to clarify the associations among media utilization, lifestyles, and the strong radiation anxiety that has persisted 9 years after the 2011 nuclear accident. Moreover, the relationships among psychological distress, post-traumatic stress, and strong radiation anxiety were examined. METHODS: for the multivariate regression analysis, the independent variables were radiation anxiety at the time of the accident and the current status, categorized as "continuing/emerging strong radiation anxiety". Media utilization (local, national, internet, and public broadcasts, and public relations information) and lifestyle variables (sleep quality, regular exercise, and drinking habits) were set as the dependent variables. Moreover, the psychological distress of residents with continuing/emerging strong radiation anxiety was examined by an analysis of covariance stratified by post-traumatic stress. RESULT: there was no significant association between lifestyle variables and media utilization, except for local media (OR: 0.435, 95% CI: 0.21-0.90). Conversely, significantly high psychological distress was confirmed among residents with continuing/emerging radiation anxiety. The K6 score, representing psychological distress, for those with higher post-traumatic stress was 12.63; for those with lower post-traumatic stress, it was 5.13 (p = 0.004). CONCLUSIONS: residents with continuing/emerging strong radiation anxiety showed high psychological distress, which has been strengthened by higher post-traumatic stress.

[The relationship between information sources, media, and "anxiety about the effects of radiation on future generations" in Hamadori and Fukushima Prefecture's evacuation areas after the nuclear accident].

Objectives　Nine years after the accident at the TEPCO Fukushima Daiichi Nuclear Power Plant in March 2011, anxiety about the effects of radiation on future generations persists. We considered the possibility that information from mass media sources and the Internet might influence this anxiety. Thus, this study examined the relationship between information sources and anxiety; based on the results, we consider the necessary measures to reduce this anxiety.Methods　We conducted a mail-based survey by distributing an anonymous self-administered questionnaire to 2,000 Fukushima Prefecture residents aged 20 to 79. We randomly selected 500 residents from Aizu, Nakadori, Hamadori, and the evacuation areas, and compared the data obtained from Hamadori and the evacuation areas. The objective variable was anxiety about the effects (of radiation) on future generations, while the explanatory variables were trusted sources and media the respondents used to get information on radiation. Other variables assessed included health status and knowledge of radiation. We conducted univariate analysis of combined data to assess the relationship between anxiety and the questionnaire items. This was followed by multiple regression analysis with anxiety as the objective variable and those showing significant differences in the univariate analysis as the explanatory ones. We then conducted multiple regression analysis, that included the interaction means between explanatory variables and evacuation areas.Results　Of the 500, 201 respondents were from Hamadori (40.2%) and 192 from the evacuation areas (38.4%). Multiple regression analysis revealed that anxiety was significantly lower among those who trusted government ministries and those who were healthy. Anxiety was also significantly lower among those who correctly answered the question on the genetic influence of radiation, while it was significantly higher among those who correctly answered the question on the dose-response model of radiation-induced cancer. In Hamadori, anxiety was significantly higher among those who watched private national television. In the evacuation areas, the result was the same as that of the combined data.Conclusion　Different information sources and media were significantly associated with anxiety about the effects of radiation on future generations. Therefore, media sensationalism should be reduced to prevent anxiety among citizens. Our findings highlight the importance of selecting information sources and media that disseminate accurate information, as well as the need to improve media literacy among citizens. Furthermore, a dose-response model of radiation-induced cancer must be communicated in a way that is not misleading. Receiving accurate information on the genetic effects of radiation can reduce anxiety among citizens.

Relationship Between Use of Media and Radiation Anxiety Among the Residents of Fukushima 5.5 Years After the Nuclear Power Plant Accident.

OBJECTIVE: We aimed to investigate the relationships between use of media to obtain information on radiation and radiation anxiety among community residents in Fukushima, 5.5 years after the nuclear power plant accident. METHODS: A questionnaire survey was administered between August and October 2016 to 2000 randomly sampled residents in Fukushima prefecture. Radiation anxiety toward health and regarding discrimination and prejudice were assessed with 4- and 3-item scales, respectively. Participants nominated their most-used media for acquiring information on radiation by choosing up to 3 sources from 12 information sources listed (eg, local newspaper, TV news, websites, social networking sites [SNS], local government newsletter, word of mouth). We investigated associations of most-used media types and radiation anxiety, controlling for sociodemographic characteristics and anxiety regarding radiation's health effects immediately after the accident, using multivariate linear regression analyses. RESULTS: Valid responses were obtained from 790 (39.5%) residents. Acquiring information about radiation by word of mouth was related to higher radiation anxiety toward health. Regarding radiation anxiety concerning discrimination and prejudice, SNS use was related to higher anxiety, whereas acquiring information through Nippon Hoso Kyokai (NHK) TV news was related to lower anxiety. CONCLUSIONS: Interpersonal interactions rather than gaining information from media - characterized by unidirectional information exchange - may increase radiation anxiety.

Posttraumatic Growth after the Fukushima Nuclear Disaster: Examination of Free Descriptions among Fukushima Residents Who Lived in the Evacuation Area.

We examined the differences in the posttraumatic growth (PTG) free descriptions from clusters of Fukushima residents (evacuation and non-evacuation zones) who experienced the Great East Japan Earthquake, and the relationship between "recovery from radiation anxiety" and the PTG-free description classification in these regions. A mail survey was conducted in August 2016 among Fukushima residents aged 20-79 years for free descriptions of their PTG. Participants were then divided into the "no anxiety," "recovered from anxiety," and "unrecovered from anxiety" groups based on their "recovery from radiation anxiety." Data from 786 responses were analyzed. The PTG-free descriptions were classified into eight categories. Among those who lived in the evacuation zone versus those in the non-evacuation zone, "relating to others" (non-evacuation zone: 11.9% vs. evacuation zone: 18.4%) and "appreciation of life" (non-evacuation zone: 2.7% vs. evacuation zone: 9.8%) were significantly higher, and "increased awareness of disaster prevention" (non-evacuation zone: 20.4% vs. evacuation zone: 8.0%) was significantly lower. In the evacuation zone, "renewed recognition of nuclear issues" was significantly lower than the expected value in the no anxiety group (3.1%) and significantly higher than the expected value in the recovered group (22.9%). Further studies are needed to build support measures and potentially aid in preparing for future disasters.

Current Psychological Distress, Post-traumatic Stress, and Radiation Health Anxiety Remain High for Those Who Have Rebuilt Permanent Homes Following the Fukushima Nuclear Disaster.

Objective: The Fukushima Daiichi nuclear disaster in 2011 produced psychological reactions among evacuees. Despite the harsh situation, subsequently, there has been gradual progress in reconstruction, with more than half of the evacuees returning after the evacuation. Our hypothesis is that evacuee mental health will now be better due to new stable living conditions. This study aims to clarify the statuses of psychological distress, post-traumatic stress, and radiation health anxiety among evacuees who have rebuilt permanent homes after evacuation. Methods: A cross-sectional questionnaire survey of 1600 residents was conducted in 2020. As primary outcomes, the survey measured psychological distress (Kessler 6), post-traumatic stress (post-traumatic stress four-item checklist), and radiation health anxiety. The data are compared for residents who have rebuilt permanent home and those who did not evacuate. Results: In the co-variant analysis, the statuses of psychological distress (p < 0.001), post-traumatic stress (p < 0.001), and radiation health anxiety (p < 0.001) are found to still be high, with significant differences when compared to those who did not evacuate. These results are still at an equivalent level for the continuing evacuation. Conclusion: Our findings may indicate a necessity for continuing disaster-related mental health activities even though the living conditions have improved.

Associated factors related to participation in general health checkup and survey of the effect of low-dose radiation exposure on health of residents of Fukushima Prefecture after the Fukushima Daiichi nuclear power plant accident.

The Fukushima Daiichi nuclear power plant accident caused radioactive contamination of the surrounding area. In addition to annual health checkups, a survey of the effects of low-dose radiation exposure on health among Fukushima Prefecture residents after the accident has been conducted. Despite health literacy (HL) being recognized as essential to health, its association with participation in these checkups and the survey remains unknown. We aimed to describe the HL status of the Fukushima Prefecture residents and to verify the hypothesis that HL is associated with participation in both checkup and survey. In a cross-sectional study, a questionnaire was sent to 2000 randomly sampled Fukushima Prefecture residents; data from 770 individuals were analyzed. Communicative and critical HL were measured using a 5-point scale. Factors associated with participation were examined using logistic regression. The survey's valid response rate was 38.5%. The average HL score was 3.11 ± 0.81. HL was not associated with checkup or survey participation. Checkup participation was negatively associated with radiation anxiety (odds ratio 0.93, 95% confidence interval 0.86-0.99, p = 0.03). The HL of Fukushima Prefecture residents after the accident was relatively lower than that of the Japanese general population, which may be attributed to difference in educational background. The complexities involved in understanding the effects of radiation on the health of residents could explain why no association between HL and participation in a health checkup and survey was observed. Future studies with a longitudinal design should clarify causality between anxiety and checkup participation.

[Relationship between prolonged media usage and lifestyle habits among junior and senior high school students].

Objective　In recent years, the long-term use of media (including the Internet, video games, and social networking services) at a young age has been regarded as a problem. It has been pointed out that prolonged media usage may have an undesirable effect on the growth of adolescents from the physical, mental, and social perspectives. Junior and senior high school students are in a particularly important period of self-management of the basic lifestyle habits acquired thus far. Additionally, they must cultivate the ability to interact appropriately with media used daily. In this study, we investigated the relationship between the time expended on media usage and lifestyle habits among junior and senior high school students.Methods　A sample of 1,633 students was extracted from all junior and senior high schools in Fukushima City. Principals of the schools distributed a self-administered questionnaire to their students. In total, 1,589 responses were obtained; as surveys of 30 students were missing values for gender and grade, they were excluded from the analysis, and data from 1,559 respondents were ultimately analyzed. A binomial logistic regression analysis was performed to examine the relationship between an independent variable (media usage time) and dependent variables (subjective health, lifestyle habits, and drinking and smoking experience) while controlling for gender and grade.Results　Among junior high students, media usage for more than three hours was significantly related to "no breakfast," "no exercise habits," "irregular sleep," "lack of rest," and "feeling stressed." Among high school students, media usage for three hours or more was significantly related to "poor subjective health status," "eating only one or two meals a day," "no breakfast," "low food diversity," "obesity," "no exercise habits," "irregular sleep," "late bedtime," "waking up late," "drinking," and "smoking."Conclusion　Our findings indicate that three or more hours of daily media usage is related to unhealthy lifestyles in terms of sleeping, eating, physical activity, drinking, and smoking. Junior and senior high school students who responded to the survey indicated that prolonged usage was also adversely related to their subjective health. Because the overuse of media is associated with students' lifestyles and health, it is important to develop an educational system that helps junior and senior high school students use media properly.

The Association between Utilization of Media Information and Current Health Anxiety Among the Fukushima Daiichi Nuclear Disaster Evacuees.

The 2011 nuclear disaster in Fukushima was not only a health disaster, but also an information disaster. Although media can promote health communication following disasters, studies have revealed associations between media information and negative psychological reactions. To clarify the relationship between media utilization and current health anxiety due to radiation exposure, a cross-sectional questionnaire survey was conducted in Fukushima. We selected 2000 subjects from evacuation (i.e., 500) and non-evacuation (i.e., 1500) areas by two-stage stratified random sampling. As the independent variable, participants were asked about current health anxiety due to radiation exposure at the time of answering the questionnaire. For utilization of media about radiation exposure, local media, national media, Internet media, public broadcasts, and public relations information from local government were set as the dependent variables. Questionnaire data were analyzed by evacuation type (i.e., forced/voluntary). In a multivariate logistic regression analysis, the use of public relations information was significantly associated with lower anxiety for the forced evacuees (odds ratio: 0.72; 95% confidence interval: 0.56-0.93). Our findings highlight the importance of public relations information from local government in terms of it being associated with lower current health anxiety, and this could potentially aid in preparing for future disasters.

Lingering health-related anxiety about radiation among Fukushima residents as correlated with media information following the accident at Fukushima Daiichi Nuclear Power Plant.

Following the March 2011 accident at Fukushima Daiichi Nuclear Power Plant, many residents of Fukushima have faced anxieties about the health impacts of radiation exposure. Considering that source of information may influence resident anxiety, this study aimed to elucidate the correlation between the two. In addition, a health literacy query was included to examine a possible relationship between anxiety and health literacy skills. A mail survey was conducted in August 2016 among 2000 residents of Fukushima Prefecture aged 20 to 79 years. Survey items included questions about current health anxieties caused by radiation, trusted sources of information about radiation, and media used to obtain information on radiation. The survey valid response rate was 43.4%. Results of multiple linear regression analysis revealed that anxiety was significantly higher for the groups indicating "trust in citizen groups" and "use of internet sites." Anxiety was significantly lower for the groups indicating "trust in government ministries," "trust in local government," and "use of local broadcast television." Also anxiety was significantly lower for groups with higher health literacy. It was found that the significant relationship to anxiety varies depending on the sources of trust and media used. There is a possibility that this was caused by the difference between the contents of each information and media reports. In preparation for any future nuclear accident, government may consider action to improve the media literacy of residents. In addition, improving health literacy of both the recipient and the sender of information can improve access to information and thereby safeguard the health and well-being of the public.

Cultured Epidermal Autografts from Clinically Revertant Skin as a Potential Wound Treatment for Recessive Dystrophic Epidermolysis Bullosa.

Inherited skin disorders have been reported recently to have sporadic normal-looking areas, where a portion of the keratinocytes have recovered from causative gene mutations (revertant mosaicism). We observed a case of recessive dystrophic epidermolysis bullosa treated with cultured epidermal autografts (CEAs), whose CEA-grafted site remained epithelized for 16 years. We proved that the CEA product and the grafted area included cells with revertant mosaicism. Based on these findings, we conducted an investigator-initiated clinical trial of CEAs from clinically revertant skin for recessive dystrophic epidermolysis bullosa. The donor sites were analyzed by genetic analysis, immunofluorescence, electron microscopy, and quantification of the reverted mRNA with deep sequencing. The primary endpoint was the ulcer epithelization rate per patient at 4 weeks after the last CEA application. Three patients with recessive dystrophic epidermolysis bullosa with 8 ulcers were enrolled, and the epithelization rate for each patient at the primary endpoint was 87.7%, 100%, and 57.0%, respectively. The clinical effects were found to persist for at least 76 weeks after CEA transplantation. One of the three patients had apparent revertant mosaicism in the donor skin and in the post-transplanted area. CEAs from clinically normal skin are a potentially well-tolerated treatment for recessive dystrophic epidermolysis bullosa.

Association between Health Literacy and Radiation Anxiety among Residents after a Nuclear Accident: Comparison between Evacuated and Non-Evacuated Areas.

Following the accident at the Fukushima Nuclear Power Plant in March 2011, both experts and the national government provided insufficient information on radiation, leading to widespread distrust in the community. This study aimed at clarifying the association between anxiety about radiation and health literacy among residents in evacuation and non-evacuation areas in Fukushima. A questionnaire survey was sent to randomly sampled residents between August and October 2016, and data from 777 responses (38.9% valid response) were analyzed. The questionnaire assessed current radiation anxiety and discrimination and prejudice based on radiation exposure through seven items and communicative and critical health literacy through five items. Multiple regression analysis of the association between radiation anxiety and health literacy showed that the level of health literacy was significantly negatively associated with radiation anxiety in the evacuation areas (marginally in the non-evacuation areas) and marginally negatively associated with discrimination and prejudice in the evacuation areas but not in the non-evacuation areas. Therefore, improving health literacy could alleviate radiation anxiety.