Key issues in Japan's public health centers to prepare for future pandemics: a text mining study using a topic model.

BACKGROUND: In Japan, over 450 public health centers played a central role in the operation of the local public health system in response to the COVID-19 pandemic. This study aimed to identify key issues for improving the system for public health centers for future pandemics. METHODS: We conducted a cross-sectional study using an online questionnaire. The respondents were first line workers in public health centers or local governments during the pandemic. We solicited open-ended responses concerning improvements needed for future pandemics. Issues were identified from these descriptions using morphological analysis and a topic model with KHcoder3.0. The number of topics was estimated using Perplexity as a measure, and Latent Dirichlet Allocation for meaning identification. RESULTS: We received open-ended responses from 784 (48.6%) of the 1,612 survey respondents, which included 111 physicians, 330 nurses, and 172 administrative staff. Morphological analysis processed these descriptions into 36,632 words. The topic model summarized them into eight issues: 1) establishment of a crisis management system, 2) division of functions among public health centers, prefectures, and medical institutions, 3) clear role distribution in public health center staff, 4) training of specialists, 5) information sharing system (information about infectious diseases and government policies), 6) response to excessive workload (support from other local governments, cooperation within public health centers, and outsourcing), 7) streamlining operations, and 8) balance with regular duties. CONCLUSIONS: This study identified key issues that need to be addressed to prepare Japan's public health centers for future pandemics. These findings are vital for discussions aimed at strengthening the public health system based on experiences from the COVID-19 pandemic.

The Knowledge and Awareness for Radiocesium Food Monitoring after the Fukushima Daiichi Nuclear Accident in Nihonmatsu City, Fukushima Prefecture.

On 11 March 2011, Japan experienced a massive earthquake and tsunami that triggered the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident, resulting in the release of large amounts of cesium-134 and -137 into the atmosphere. In addition to the food radioactivity control in the markets throughout the country, radiocesium concentrations in locally grown foods were voluntarily inspected and the results were shown to the residents by the local government to raise their awareness of the internal radiation contamination risk from low knowledge in Nihonmatsu City, Fukushima Prefecture. In this longitudinal study, local food products for in-home consumption were evaluated by seven different food radioactivity measuring devices in Nihonmatsu City from 2011⁻2017. Radiocesium was detected in local foods in Nihonmatsu City even six years after the FDNPP accident. The highest number of products tested was in 2012, with the number steadily decreasing thereafter. Most foods had contamination levels that were within the provisional regulation limits. As edible wild plants and mushrooms continue to possess high radiocesium concentrations, new trends in radioactivity in foods like seeds were discovered. This study highlights that the increased risk of radiation exposure could possibly be due to declining radiation awareness among citizens and food distributors. We recommend the continuation of food monitoring procedures at various points in the food processing line under the responsibility of the government to raise awareness for the reduction of future risks of internal exposure.

Roles of children and their parents in the reduction of radiation risk after the 2011 Fukushima Daiichi Nuclear Power Plant accident.

INTRODUCTION: On March 11, 2011, Japan experienced its largest recorded earthquake with a magnitude of 9.0. The resulting tsunami caused massive damage to the Fukushima Daiichi Nuclear Power Plant reactors, and the surrounding environment was contaminated with radioactive materials. During this period, some residents were exposed to high levels of radiation (up to 5 millisieverts [mSv]), but since then, many residents have been exposed to low levels of radiation (<1 mSv). This study was conducted to assess the effects of lifestyle and attitude factors on external radiation exposure among Fukushima residents. METHODS: This community-based, cross-sectional study was conducted in Nihonmatsu City of the Fukushima Prefecture from May to July 2014. The population survey targeted 6,884 children between the ages of 0-15 years, and a personal radiation badge and questionnaire were administered to each of the residences. Multiple linear regression analysis was used to assess the impact of lifestyle and attitude factors on external radiation dose. RESULTS: The study participants (population size [n] = 4,571) had an additional mean radiation dose of 0.65 mSv/year, which is small as compared to the mean radiation dose 6 months after the disaster (1.5 mSv/year), in 2012 (1.5 mSv/year), and in 2013 (1.0 mSv/year). External radiation doses statistically varied by socio-demographic and lifestyle factors. Participants living in wooden residences (p-value<0.001) and within 100 meters of a forest (p = 0.001) had higher radiation exposure. Conversely, participants with a cautious attitude towards radiation had lower radiation exposure (beta [b] = -0.124, p = 0.003). CONCLUSION: Having a cautious attitude towards radiation and being aware of exposure risks proved to be significant in the reduction of external radiation dose. Therefore, in the event of future radiation disasters, attitudes towards and awareness of radiation should be considered in the reduction of exposure risk and implementation of radiation protection.