Comparing the risks of environmental carcinogenic chemicals in Japan using the loss of happy life expectancy indicator.

In this study, we aimed to use the loss of happy life expectancy (LHpLE), an indicator that enables risk assessment considering wellbeing, to compare the risks of environmental carcinogenic chemicals in Japan. First, we surveyed Japanese people to determine their emotional happiness by age and sex and evaluated whether cancer incidence reduced emotional happiness. Questionnaires were administered to a general population panel and a panel of patients with cancer in 2022, recruiting a predetermined number of responses of 5000 and 850, respectively. Second, using the survey data, LHpLE was calculated for radon, arsenic, and fine particulate matter (aerodynamic diameter <2.5 µm; PM2.5) and compared to psychological distress, considering increased mortality and decreased emotional happiness due to these risks. We discovered no significant decrease in emotional happiness due to cancer incidence and no significant associations between emotional happiness and cancer type, history, or stage. LHpLE was calculated to be 6.4 × 10-3 years for radon, 2.6 × 10-3 years for arsenic, 1.1 × 10-2 years (2012 exposure) and 8.6 × 10-4 years (2020 exposure) for PM2.5, and 9.7 × 10-1 years for psychological distress. The fraction of losses caused by these carcinogenic chemicals to HpLE exceeded 10-5, suggesting that risk reduction for these chemicals is important in environmental policies. The LHpLE indicator allows for comparing different types of risks, such as environmental chemicals and psychological distress. This is the first study to compare chemical risks using the LHpLE indicator.

Japanese physicians' perceptions of conflicts of interest with pharmaceutical companies: Estimating two different questioning approaches.

Despite being one of the world's largest pharmaceutical markets, interactions between Japanese physicians and pharmaceutical companies often remain opaque. Importantly, potential conflicts of interest associated with these interactions can compromise patient care and increase costs. We conducted an online survey of Japanese physicians to elucidate perspectives on pharmaceutical company promotional activities and how these influence physician prescribing patterns. Anticipating that physicians might downplay their reliance on, or the value of, pharmaceutical company-provided information, the survey incorporated a direct questioning method and an unmatched count technique (UCT) to identify hidden perceptions on factors likely to influence prescribing. Overall, 1080 eligible physicians participated. Of these, 105 (9.7%) self-identified as hospital directors or managers. Surprisingly, nearly twice as many participants responding to direct questioning (18.9%) versus those responding to the UCT (10.1%) asserted that information provided by pharmaceutical companies was important when prescribing medicine. Hospital directors or managers (adjusted odds ratio [adjOR] 2.56, 95% confidence interval [95% CI]: 1.00-6.54, reference = physician without title) and frequent interactions with pharmaceutical sales representatives (adjOR 5.96, 95% CI: 1.88-18.9, reference = rare interaction) significantly valued the information from sales representatives and sponsored lectures when considering prescribing decisions. Additionally, 77.1% of respondents believed that sales representatives provide fair, neutral, or relatively honest and unbiased information about their products. Few Japanese physicians acknowledged the influence of industry-provided information on prescribing patterns. Our study uniquely applies two distinct question formats, providing a novel approach to understanding the depth of physician-industry relationships and the effectiveness of various survey methodologies.

Guided versus unguided chatbot-delivered cognitive behavioral intervention for individuals with moderate-risk and problem gambling: A randomized controlled trial (GAMBOT2 study).

BACKGROUND: Internet-based interventions can be a promising option for individuals with problem gambling facing barriers to seeking help. This study aimed to directly compare the effects of therapist-guided Internet interventions with unguided ones on gambling-related behavior, cognition, and stage of change including help-seeking intention. METHODS: We conducted a participant-blinded randomized controlled trial of therapist-guided versus unguided groups with a 12-week follow-up. Both groups received self-help chatbot-delivered cognitive behavioral therapy. Additionally, at baseline and weeks 1, 2, 3, and 4, the guided group received personalized feedback messages from therapists based on their gambling diary and questionnaire responses. The unguided group received reminders of assessments from research assistants. The primary outcome was the change in scores on the Gambling Symptoms Assessment Scale (G-SAS) over 12 weeks. Secondary outcomes included the stage of change including help-seeking intention, money wagered, gambling frequency, and gambling-related cognitions. RESULTS: We included 139 participants with a mean Problem Gambling Severity Index total score of 14.6 and a mean G-SAS total score of 27.0 who sought information about gambling problems. Both groups demonstrated substantial decreases in their G-SAS scores from baseline to week 12 (-10.2, 95% CI: -7.67 to -12.7 for the guided group, and 11.7, 95% CI: -9.05 to -14.3 for the unguided group). However, we did not find a significant between-group difference (1.49, 95% CI: -2.20 to 5.17). Regarding the stage of change including help-seeking intention, there were also no between-group differences. CONCLUSIONS: Minimum therapist support did not have an additive effect on the self-help chatbot intervention on gambling symptoms, behavior, and the stage of change including help-seeking intention.

Cultural Adaptation of the Actionable Health App Evaluation in Japan: Protocol for a Web-Based Modified Delphi Expert Consensus Study.

BACKGROUND: With an increase in both the number of mental health disorders people are experiencing and the difficulty in accessing mental health care, the demand for accessible mental health care services has increased. The use of mobile devices has allowed people to receive care in their daily lives without restrictions on time or location. However, the majority of publicly available mobile health apps are not evidence-based, and the top-rated apps are not always safe or user-friendly and may not offer clinically beneficial results. OBJECTIVE: This study aims to create a cultural adaptation of the American Psychiatric Association's comprehensive app evaluation framework in Japan using a web-based modified Delphi expert consensus. METHODS: A web-based modified Delphi study includes developing the Japanese version of the comprehensive app evaluation framework and 3 Delphi rounds. In the first round, our working group sends a questionnaire to the panelists, who then complete it. In the second and third rounds, the working group sends a questionnaire and a summary of the panelists' answers based on each of the previous rounds. The panelists answer the questionnaires based on this summary. The summarization procedure is automated to help reduce the biases that can be generated when panelists' answers are summarized and when the panelists receive them. The working group sends only the result of the summarization with the next round's questionnaire. All interactions between the working group and the panelists will be conducted on Qualtrics (Qualtrics Japan LLC), a questionnaire platform. To culturally validate the comprehensive mental health app evaluation framework, participants from the following three categories will be recruited in Japan: (1) researchers, (2) practitioners, and (3) app developers. RESULTS: This study received funding from a crowdfunding campaign in Japan (April 2023). The Delphi study began in January 2023 and will be completed in December 2023. We had already completed the translation of the 105 original app evaluation item questions by December 2022. CONCLUSIONS: While the need for treatment using mental health apps is increasing, no framework that can be used to develop a centralized database for health apps is available or accessible, and no consensus has been reached among stakeholders in Japan about an appropriate framework. The results of the web-based modified Delphi method presented in this paper may provide direction for the development and use of mental health apps in the future among the relevant stakeholders. Furthermore, this study will enhance recognition of the framework among researchers, clinicians, mental health app developers, and users, in addition to devising new instruments to help users or practitioners efficiently choose the right app for their situations. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/44469.

Efficacy of the unified protocol for transdiagnostic cognitive-behavioral treatment for depressive and anxiety disorders: a randomized controlled trial.

BACKGROUND: The efficacy of the unified protocol of the transdiagnostic treatment for emotional disorders (UP) has been poorly studied in patients with depressive disorders. This study aimed to examine the efficacy of UP for improving depressive symptoms in patients with depressive and/or anxiety-related disorders. METHODS: This assessor-blinded, randomized, 20-week, parallel-group, superiority study compared the efficacy of the UP with treatment-as-usual (UP-TAU) v. wait-list with treatment-as-usual (WL-TAU). Patients diagnosed with depressive and/or anxiety disorders and with depressive symptoms participated. The primary outcome was depressive symptoms assessed by GRID-Hamilton depression rating scale (GRID-HAMD) at 21 weeks. The secondary outcomes included assessor-rated anxiety symptoms, severity and improvement of clinical global impression, responder and remission status, and loss of principal diagnosis. RESULTS: In total, 104 patients participated and were subjected to intention-to-treat analysis [mean age = 37.4, s.d. = 11.5, 63 female (61%), 54 (51.9%) with a principal diagnosis of depressive disorders]. The mean GRID-HAMD scores in the UP-TAU and WL-TAU groups were 16.15 (s.d. = 4.90) and 17.06 (s.d. = 6.46) at baseline and 12.14 (s.d. = 5.47) and 17.34 (s.d. = 5.78) at 21 weeks, with a significant adjusted mean change difference of -3.99 (95% CI -6.10 to -1.87). Patients in the UP-TAU group showed significant superiority in anxiety and clinical global impressions. The improvement in the UP-TAU group was maintained in all outcomes at 43 weeks. No serious adverse events were observed in the UP-TAU group. CONCLUSIONS: The UP is an effective approach for patients with depressive and/or anxiety disorders.

The Association Between Music Preferences and Well-Being After the Fukushima Disaster: A Cross-Sectional Study.

OBJECTIVE: Those affected by the Fukushima disaster have reported a decline in well-being. Although listening to music is expected to promote well-being, no study has revealed this association after a disaster. This study's objective is to clarify the association between well-being and music listening habits in the aftermath of the Fukushima disaster. METHODS: A self-report online survey was conducted with 420 residents who were asked to rate 5 types of well-being: life satisfaction, positive emotion, negative emotion, psychological distress, and mental health changes after the Fukushima disaster. To meet inclusion criteria, the participants had to be research company monitors between the ages of 20 and 59 and living in Fukushima Prefecture at the time of the survey. Their music listening habits (eg, recent favorite music) and demographic information (eg, evacuation experience due to the disaster: 20.7%) were also collected. We examined the associations between well-being and music listening habits by univariate analysis followed by a logistic analysis with an adjustment for covariates. RESULTS: Positive emotions were significantly associated with any type of music listening habits that participants practiced. We also observed gender and age differences between the associations. CONCLUSION: This study provides foundational insights into the role of music in improving post-disaster well-being.

Waning of Humoral Immunity and the Influencing Factors after BNT162b2 Vaccination: A Cohort Study with a Latent Growth Curve Model in Fukushima.

Measuring long-term antibody titer kinetics and subsequent coronavirus disease 2019 (COVID-19) vaccinations are crucial for identifying vulnerable populations. Our aim was to determine the association between long-term antibody kinetics, including peak titers and factors, up to seven months post-second vaccination. A three-time antibody survey was conducted in 2021 among healthcare workers in Japan to investigate the changes in humoral immunity using chemiluminescence immunoassay. The study involved 205 participants who had received the second vaccine dose, completed the three-time survey, and were not infected with SARS-CoV-2. A latent growth curve model was used to identify factors affecting the peak titer and decreasing the antibody slope. Of the eligible participants, the mean titers of immunoglobulin G (IgG) against the spike (S) protein and the neutralizing activity 7 months after the second vaccination decreased to 154.3 (8.8% of the peak titer) and 62.1 AU/mL (9.5% of the peak titer), respectively. The IgG growth model showed that age significantly affected peak titers (p < 0.001); however, a significant difference was not found for the decreasing slope. Ultimately, aging adults had significantly low peak antibody titers; however, age was unrelated to the slope of log-transformed IgG against the S protein.

Uncertainty among families of patients with cerebrovascular diseases in Japan: association with quality of life and background characteristics.

PURPOSE: 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. METHODS: 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. RESULTS: WHO-5 score was significantly negatively associated with MUIS-FM score (ß = - 0.236, p = 0.03); other factors associated with MUIS-FM score were the Care Shared Decision-Making Questionnaire for care providers score (ß = - 0.384, p < 0.001), Short Intolerance of Uncertainty Scale score (ß = 0.296, p = 0.001), and history of surgical treatment (ß = 0.199, p = 0.032). CONCLUSIONS: 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.

Affective styles and their association with anxiety and depression in a Japanese clinical sample.

Affective styles are assumed to play an important role in maintaining negative affect, including anxiety and depression. However, little is known about the longitudinal relationship between affective styles and symptoms. Therefore, we conducted a longitudinal study to examine the influence of affective styles, assessed using the Affective Style Questionnaire, on anxiety and depression among clinical populations in Japan. Using an online survey, 1521 participants (406 with major depressive disorder; 479 with one or more anxiety disorders; and 636 with both) answered the Affective Style Questionnaire and measures of emotion regulation, anxiety and depression symptoms. Data were collected twice over 2 months. Confirmatory factor analyses replicated the same four-factor structure found in a previous sample of Japanese university students. Hierarchical regression analyses revealed that the affective styles had a slightly greater effect on anxiety symptoms but not on depression compared to other common emotion regulation strategies, such as suppression and reappraisal measured by the Emotion Regulation Questionnaire (ERQ). Limitations of this study were that it used online surveys, in which, participants' diagnostic statuses were based on unverifiable self-reports. In conclusion, the association of affective styles with anxiety and depression among the clinical populations was prospectively confirmed. Further study is needed to examine the association considering the combination or profiles of affective styles among different emotional disorders.

Classifying patients with depressive and anxiety disorders according to symptom network structures: A Gaussian graphical mixture model-based clustering.

Patients with mental disorders often suffer from comorbidity. Transdiagnostic understandings of mental disorders are expected to provide more accurate and detailed descriptions of psychopathology and be helpful in developing efficient treatments. Although conventional clustering techniques, such as latent profile analysis, are useful for the taxonomy of psychopathology, they provide little implications for targeting specific symptoms in each cluster. To overcome these limitations, we introduced Gaussian graphical mixture model (GGMM)-based clustering, a method developed in mathematical statistics to integrate clustering and network statistical approaches. To illustrate the technical details and clinical utility of the analysis, we applied GGMM-based clustering to a Japanese sample of 1,521 patients (Mage = 42.42 years), who had diagnostic labels of major depressive disorder (MDD; n = 406), panic disorder (PD; n = 198), social anxiety disorder (SAD; n = 116), obsessive-compulsive disorder (OCD; n = 66), comorbid MDD and any anxiety disorder (n = 636), or comorbid anxiety disorders (n = 99). As a result, we identified the following four transdiagnostic clusters characterized by i) strong OCD and PD symptoms, and moderate MDD and SAD symptoms; ii) moderate MDD, PD, and SAD symptoms, and weak OCD symptoms; iii) weak symptoms of all four disorders; and iv) strong symptoms of all four disorders. Simultaneously, a covariance symptom network within each cluster was visualized. The discussion highlighted that the GGMM-based clusters help us generate clinical hypotheses for transdiagnostic clusters by enabling further investigations of each symptom network, such as the calculation of centrality indexes.

Associations of Autism Traits With Obsessive Compulsive Symptoms and Well-Being in Patients With Obsessive Compulsive Disorder: A Cross-Sectional Study.

The aim of this study is to examine the association of autism traits with long-term obsessive compulsive disorder (OCD) symptoms and well-being levels in patient with OCD. Participants comprised 18 outpatients from a tertiary hospital and 100 adults who were registered in a large Japanese internet marketing research company and met OCD criteria by the Mini-International Neuropsychiatric Interview and were between the ages of 20 and 65 years. Clinical characteristics, autism trait assessed using the Autism Spectrum Quotient (AQ), OCD symptoms assessed using Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and well-being assessed using the Flourishing Scale were assessed. Multiple regression analyses showed that a greater total score of AQ, a greater subscale score "imagination" was associated with a greater score of Y-BOCS. Greater total score of AQ, a greater subscale score "social skill," and "imagination" were associated with lower well-being score. Autism traits, especially lack of imagination, were associated with more severe OCD symptoms. Further, autism traits, especially social skill problems and lack of imagination, were associated with lower levels of well-being. Assessment of autism traits before treatment and a strategy designed for OCD patients with autism traits may be warranted.

Father-child bonding among Japanese fathers of infants: A municipal-based study at the time of the 4-month child health checkup.

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.

Managing Grief of Bereaved Families During the COVID-19 Pandemic in Japan.

This commentary discussed the psychological issues related to bereavement in the wake of the COVID-19 pandemic. Specifically, we addressed two aspects in the context of Japanese culture. The first relates to the psychological distress of members of the bereaved family who could not visit their loved ones who had COVID-19 before or after their death. The second relates to the bereavement experience of those who were unable to be with their loved ones when the end came, even though they did not have COVID-19, because of restrictions on visiting hospitals. We seek to focus on the need for a support system for bereaved families to help them through the grieving process, and discuss end-of-life care in such circumstances, and in the post-COVID-19 era, as in current day Japan.

Associations of the COVID-19 pandemic with the economic status and mental health of people affected by the Fukushima disaster using the difference-in-differences method: The Fukushima Health Management Survey.

Although the coronavirus disease 2019 (COVID-19) pandemic and relevant preventive measures can affect the economic status and mental health of the public, their effect remains unraveled owing to a limited number of surveys conducted before and during the COVID-19 pandemic. We investigated the association of COVID-19 and relevant measures with multivariate outcomes among people affected by the Fukushima disaster in 2011 using the difference-in-differences (DID) method. We then analyzed the associations between sociodemographic factors and outcomes. We assessed psychological distress, problem drinking, insomnia state, unemployment, household economic decline, and interpersonal problems using three questionnaire surveys administered in 2018, 2019, and 2020. Participants were grouped according to three time periods by dates of voluntary stay-at-home requests (February 26) and the declaration of emergency (April 16) in Japan. The years 2020 and 2019 were regarded as the treatment group and control group, respectively, after confirming that no DIDs were found between 2018 and 2019. We performed regression analyses to identify the risk factors for outcomes. The DIDs were significant for household economic decline after the declaration of emergency, whereas problem drinking significantly improved. No significant DIDs were observed for other mental health outcomes including psychological distress and insomnia state. Absence of counselors was positively and significantly associated with all outcomes in 2020. Overall, people affected by the Fukushima disaster experienced more economic damage after the declaration of emergency during the COVID-19 pandemic but their mental health status did not reduce. Identifying people who have no counselors and providing them with support are emergent requirements to prevent a subsequent mental health decline.

Trajectories of peer relationship problems and emotional symptoms in children 5 years after a nuclear disaster: Fukushima Health Management Survey.

The Fukushima Daiichi Nuclear Power Station (NPS) accident, which occurred in March 2011, is having long-term effects on children. About 3 years after the accident, we identified three patterns of peer relationship problems and four patterns of emotional symptoms using group-based trajectory modeling. As a result, we reported that different factors might be related to very severe trajectories of peer relationship problems and emotional symptoms. In this study, we used five waves of data from fiscal year (FY) 2011 to FY2015 from the Mental Health and Lifestyle Survey, a detailed survey of the Fukushima Health Management Survey started in FY2011. We analyzed 7013 residents within the government-designated evacuation zone (aged 6-12 years old as of 11 March 2011) with responses to all items of psychological distress in at least one wave from FY2011 and FY2015. We planned this study to describe the trajectories of peer relationship problems and emotional symptoms in children and to examine potential risks and protective factors over the 5 years following the NPS accident. We identified four patterns of peer relationship problems and five patterns of emotional symptoms using latent class growth analysis. For peer relationship problems, male sex, experiencing the NPS explosion and lack of exercise habits were associated with the severe trajectory group. For emotional symptoms, experiencing the NPS explosion, experiencing the tsunami disaster and lack of exercise habits were associated with the severe trajectory group. Exercise habits are very important for the mental health of evacuees after a nuclear disaster.

Risk trade-off analysis of returning home and radiation exposure after a nuclear disaster using a happy life expectancy indicator.

It is crucial to evaluate ethical issues regarding evacuation orders, especially after a nuclear disaster. After the Fukushima accident in 2011, the Japanese government ordered the affected people to evacuate. The evacuation orders have now been lifted in many areas. A risk trade-off analysis between benefits and risk associated with returning home would help in evaluating the justification for the lifting of the evacuation order in the aftermath of a nuclear disaster. Here, we performed a risk trade-off analysis among people returning home after the lifting of an evacuation order between an increase in emotional happiness (positive effect) and loss of life expectancy due to additional radiation exposure (negative effect), using a happy life expectancy (HpLE) indicator. Emotional happiness was estimated using questionnaires distributed among the affected people who lived in municipalities where evacuation orders were lifted. Loss of life expectancy was estimated under a scenario that returnees received 20 mSv in the year of return and subsequent radiation exposure. Increase in emotional happiness due to returning home was ~1-2 orders of magnitude higher among women aged 20, 40 and 65 years than the loss of life expectancy due to additional radiation exposure. This finding has implications for the justification for the lifting of evacuation orders.

Trajectory and factors of radiation risk perception of students aged 10-12 years at the time of the Fukushima Daiichi Nuclear Power Station accident.

Various studies have investigated radiation risk perceptions after the accident at the Fukushima Daiichi Nuclear Power Station. However, student surveys are limited. This study aimed to investigate the perception of radiation risk among students aged 18-20 years who were in the 5th and 6th grades of elementary school at the time of the accident. We surveyed students in the Fukushima Prefecture and outside the prefecture. Out of all the data, 59% of the respondents were living in the Fukushima Prefecture at the time of the accident and 41% outside the prefecture. Trajectory analysis showed that changes in anxiety levels over time since 2011 could be divided into five classes: (a) the anxiety was the highest, and this tendency persisted. (b) High at the beginning, but decreased more quickly than class 1. (c) High at the beginning, but it diminished quickly. (d) Not high, but did not diminish easily in later years. (e) Low from the beginning, and persisted. Multinomial logistic analysis showed that among students living outside the prefecture at the time of the accident, a significantly higher proportion was in groups 4 and 5 than in group 2. A significant proportion of boys were present in groups 3, 4 and 5. A significant proportion of students whose current educational institutions were inside the prefecture were present in group 3. The level of anxiety was associated with the academic course, but not with subjective knowledge of radiation. In contrast, in the qualitative analysis of the free text, 31% considered 'knowledge about radiation' as the reason for the reduction in anxiety level. At the time of the investigation, most young people were not anxious about radiation. However, approximately 20% still had strong anxiety. We established that continuous risk communication is necessary. Furthermore, that stabilization and support related to life in general is important.

Overall health information exposure, its barriers and impacts on attitude toward healthcare among cancer patients. The long-term aftermath of the 2011 triple disaster in Fukushima, Japan: A single institution cross-sectional study.

Disasters can hinder access to health information among cancer patients. However, little is known regarding overall health information exposure (HIE), its barriers and its impacts on attitudes toward healthcare among cancer patients in the long-term aftermath of disasters. The aims of this study were threefold: assess the extent of HIE; identify associations between family composition and a non-engagement with HIE; and examine the effects of HIE on attitudes toward healthcare among local cancer patients-5 years after the 2011 triple disaster (earthquake, tsunami, and nuclear disaster) in Fukushima, Japan. We conducted self-administered surveys with all cancer and non-cancer surgery department outpatients at Minamisoma Municipal General Hospital (MMGH), Minamisoma City, from October 2016 to January 2017. In total, 404 patients (263 cancer patients and 141 non-cancer patients) voluntarily participated in the study. The results revealed that a regular level of HIE occurred among 90.5% of the cancer patients. In cancer patients, family composition was not significantly associated with HIE, and HIE was not associated with attitude toward healthcare. In conclusion, most cancer patients visiting the MMGH surgical department were regularly engaged in HIE.

Antecedents and Outcomes of Enrichment Among Working Family Caregivers of People With Dementia: A Longitudinal Analysis.

OBJECTIVES: Despite evidence of negative aspects of the work-caregiving interface (e.g., work-family conflict) among family caregivers of people with dementia (PWD), little is known about the positive aspects (e.g., enrichment). We examined antecedents and outcomes of family-to-work enrichment (FWE) and work-to-family enrichment (WFE) among working family caregivers of PWD. In terms of antecedents, we investigated whether factors that alleviated work-family conflict increased enrichment. METHOD: We conducted a 3-wave 6-month-interval longitudinal online survey of Japanese working family caregivers of PWD (N = 747). We examined the mediational effects of WFE and FWE on associations between participants' work resources (job control, supervisor support, co-worker support, and organizational support) and caregiving support and their well-being (psychological distress and quality of life). We also examined the moderating effect of caregiving self-efficacy on the relationships between caregiving support/caregiving demands and FWE. RESULTS: Our longitudinal analysis confirmed supervisor support had a positive effect on WFE. FWE had no significant longitudinal mediating effect on the association between caregiving support and well-being, and self-efficacy had no longitudinal moderating effect on FWE. DISCUSSION: Supervisor support is important for WFE, but greater enrichment does not necessarily improve family caregiver well-being. Caregiving experience (i.e., caregiving demands and caregiving support) has little effect on the work-caregiving interface. Policy makers should focus on supporting companies to create family-friendly work environments. More research is needed on factors that increase FWE and moderate the relationship between enrichment and working family caregivers' well-being.

Analysis of direction of association between radiation risk perception and relocation using a random-intercept and cross lagged panel model: The Fukushima Health Management Survey.

In the aftermath of a nuclear disaster, a person's radiation risk perception can harm their sociopsychological health. Although there are reports of an association between radiation risk perception and relocation, the direction of this association has not been clarified yet. In this study, we used a random-intercept and cross lagged panel model (RI-CLPM) to investigate the association and its direction between radiation risk perception and the prefectural-level relocation (i.e., inside/outside of Fukushima Prefecture). We did this by using five waves of longitudinal surveys between 2011 fiscal year and 2015 fiscal year among the people affected by the Fukushima disaster in 2011. We included 90,567 participants aged ≥15 years during the time of the disaster who responded to the questionnaire at least once. RI-CLPM was applied to examine the reciprocal relationship between radiation risk perception and locations. We used two radiation risk perception indicators (i.e., genetic effect and delayed effect) and two handling methods on missing data (i.e., listwise deletion and full information maximum likelihood estimation) as sensitive analyses. The effects of radiation risk perception on relocation were found to be negligibly small. Living inside Fukushima Prefecture reduced radiation risk perception irrespective of the difference of indicators or methods, highlighting that radiation risk perception did not dominantly govern whether people were living inside Fukushima Prefecture, but that the locations also affected radiation risk perception. This was the first study to reveal the direction of the association between radiation risk perception and relocation in the aftermath of nuclear disasters.