Effect of a web-based fertility preservation training program for medical professionals in Japan.

BACKGROUND: Our web-based training program called "Educating Medical Professionals about Reproductive Issues in Cancer Healthcare" aims to help healthcare professionals communicate promptly with patients and survivors who are adolescents and young adults, with information pertinent to reproductive health issues such as the risk of infertility and fertility preservation. METHODS: The study participants were professional healthcare providers, including physicians, nurses, pharmacists, social workers, midwives, psychologists, laboratory technicians, genetic counselors, and dieticians. Pre- and post- and 3-month follow-up tests consisting of 41 questions were administered to measure changes in knowledge and confidence. The participants also received a follow-up survey that covered confidence, communication techniques, and practice habits. A total of 820 healthcare providers participated in this program. RESULTS: The mean total score from the pre-test to the post-test grew significantly (p < 0.01), and participants' self-confidence increased. In addition, there was a change in the behavior of healthcare providers, who began asking about patients' marital status and parity. CONCLUSION: Our web-based fertility preservation training program improved knowledge and self-confidence regarding fertility preservation issues among healthcare providers caring for adolescents and young adult cancer patients and survivors.

Guidance on the need for contraception related to use of pharmaceuticals: the Japan Agency for Medical Research and Development Study Group for providing information on the proper use of pharmaceuticals in patients with reproductive potential.

BACKGROUND: The U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA) have published guidelines on the use of cancer treatments in young people of reproductive potential. However, no such guideline is available in Japan. Therefore, this project aimed to gather relevant data and draft a respective guidance paper. METHODS: From April 2019 to March 2021, the Study Group for Providing Information on the Proper Use of Pharmaceuticals in Patients with Reproductive Potential at the Japan Agency for Medical Research and Development gathered opinions from experts in reproductive medicine, toxicology, and drug safety measures. The group considered these opinions, the FDA and EMA guidelines, and relevant Japanese guidelines and prepared a guidance paper, which they sent to 19 related organizations for comment. RESULTS: By November 2020, the draft guidance paper was completed and sent to the related organizations, 17 of which provided a total of 156 comments. The study group finalized the guidance paper in March 2021. CONCLUSIONS: The "Guidance on the Need for Contraception Related to Use of Pharmaceuticals" (The report of the Study Group for Providing Information on the Proper Use of Pharmaceuticals in Patients with Reproductive Potential, Research on Regulatory Science of Pharmaceuticals and Medical Devices, Japan Agency for Medical Research and Development: JP20mk0101139) is expected to help Japanese healthcare professionals provide fertility-related care and advice to adolescents, and young adults with cancer and their families.

Association between self-reported walking speed and calcaneal stiffness index in postmenopausal Japanese women.

BACKGROUND: Osteoporosis and related fractures, a worldwide public health issue of growing concern, is characterized by compromised bone strength and an increased risk of fracture. Here we show an association between self-reported walking speed and bone mass among community-dwelling postmenopausal Japanese women aged 50 years and older. DESIGN; CROSS-SECTIONAL STUDY: Setting and Participants; The survey population included 1008 postmenopausal women 50-92 years of age residing in rural communities. METHODS: Self-reported walking speed was ascertained by asking the participants: "Is your walking speed faster than others of the same age and sex?" to which participants responded "yes (faster)" or "no (moderate/slower)." Calcaneal stiffness index was measured. RESULTS: Women with a faster self-reported walking speed were younger and had a lower BMI, higher stiffness index, and higher grip strength than women with a slower walking speed. Multiple linear regression analysis adjusted for age, BMI, grip strength, comorbidity, current smoking, and alcohol drinking status showed a significant association between faster self-reported walking speed and higher calcaneal stiffness index (p <  0.001). CONCLUSIONS: Our findings suggest that questionnaires of walking speed may be useful for predicting bone mass and that a fast self-reported walking may benefit bone health in postmenopausal women.

Relationship between bone turnover markers and the heel stiffness index measured by quantitative ultrasound in post-menopausal Japanese women.

Background: Osteoporosis in women is a serious health problem. The relationships between biochemical markers of bone turnover and bone mineral density (BMD) in women have been reported, but no study has examined relationships between tartrate-resistant acid phosphatase-5b (TRACP-5b) or bone-specific alkaline phosphatase (BAP) and bone mass measured by quantitative ultrasound (QUS) in Japanese post-menopausal women. Aim: To investigate the serum TRACP-5b and BAP levels and to determine their associations with the heel stiffness index measured by QUS in post-menopausal women. Subjects and methods: The subjects were 510 post-menopausal women who were invited to participate in periodic health examinations in 2011-2013 (the Unzen Study). The heel stiffness index (bone mass) was measured by QUS. Serum samples were collected and TRACP-5b and BAP levels were measured. Results: Multiple regression analysis showed that a higher log (TRACP-5b) was correlated with a lower stiffness index (p = 0.014) and log (BAP) was not correlated with stiffness index after adjusting for covariates (p = 0.136). Conclusion: Higher rates of bone resorption are associated with a lower stiffness index in Japanese post-menopausal women. These results may indicate that high bone resorption affects bone mass more than bone formation, resulting in a low bone mass.

The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative.

BACKGROUND: There is evidence that social anxiety disorder (SAD) is a prevalent and disabling disorder. However, most of the available data on the epidemiology of this condition originate from high income countries in the West. The World Mental Health (WMH) Survey Initiative provides an opportunity to investigate the prevalence, course, impairment, socio-demographic correlates, comorbidity, and treatment of this condition across a range of high, middle, and low income countries in different geographic regions of the world, and to address the question of whether differences in SAD merely reflect differences in threshold for diagnosis. METHODS: Data from 28 community surveys in the WMH Survey Initiative, with 142,405 respondents, were analyzed. We assessed the 30-day, 12-month, and lifetime prevalence of SAD, age of onset, and severity of role impairment associated with SAD, across countries. In addition, we investigated socio-demographic correlates of SAD, comorbidity of SAD with other mental disorders, and treatment of SAD in the combined sample. Cross-tabulations were used to calculate prevalence, impairment, comorbidity, and treatment. Survival analysis was used to estimate age of onset, and logistic regression and survival analyses were used to examine socio-demographic correlates. RESULTS: SAD 30-day, 12-month, and lifetime prevalence estimates are 1.3, 2.4, and 4.0% across all countries. SAD prevalence rates are lowest in low/lower-middle income countries and in the African and Eastern Mediterranean regions, and highest in high income countries and in the Americas and the Western Pacific regions. Age of onset is early across the globe, and persistence is highest in upper-middle income countries, Africa, and the Eastern Mediterranean. There are some differences in domains of severe role impairment by country income level and geographic region, but there are no significant differences across different income level and geographic region in the proportion of respondents with any severe role impairment. Also, across countries SAD is associated with specific socio-demographic features (younger age, female gender, unmarried status, lower education, and lower income) and with similar patterns of comorbidity. Treatment rates for those with any impairment are lowest in low/lower-middle income countries and highest in high income countries. CONCLUSIONS: While differences in SAD prevalence across countries are apparent, we found a number of consistent patterns across the globe, including early age of onset, persistence, impairment in multiple domains, as well as characteristic socio-demographic correlates and associated psychiatric comorbidities. In addition, while there are some differences in the patterns of impairment associated with SAD across the globe, key similarities suggest that the threshold for diagnosis is similar regardless of country income levels or geographic location. Taken together, these cross-national data emphasize the international clinical and public health significance of SAD.

Alcohol abuse in developed and developing countries in the World Mental Health Surveys: Socially defined consequences or psychiatric disorder?

BACKGROUND: Previous single country research has raised concerns that: (1) the DSM-IV diagnosis of alcohol abuse (AA) is met primarily through the hazardous use criterion related to drinking and driving and (2) that the hazardous use and social consequences AA criteria primarily reflect varying socioeconomic and cultural factors rather than psychiatric disorder. METHODS: Using representative cross-national data from the 21 countries in the World Mental Health surveys, adults meeting DSM-IV lifetime criteria for AA but not dependence from 10 developed (n=46,071) and 11 developing (n=49,761) countries were assessed as meeting AA with the hazardous use or the social consequences criteria. RESULTS: Between 29.3% (developed) and 16.2% (developing) of respondents with AA met only the hazardous use criterion. AA cases with and without hazardous use were similar in age-of-onset, course, predictors, and psychopathological consequences in both developed and developing countries. DISCUSSION AND CONCLUSIONS: Despite some associations of the AA criteria with socioeconomic factors, the hazardous use and social consequences criteria were significantly associated with psychiatric predictors and sequelae. The findings indicate that these criteria reflect psychiatric disorder and are appropriate for inclusion as DSM-5 Alcohol Use Disorder criteria. SCIENTIFIC SIGNIFICANCE: These findings support a psychiatric rather than a sociocultural view of the hazardous use and social consequences symptoms and provide evidence that they are appropriate diagnostic criteria cross-nationally with utility in a wide range of socioeconomic environments. This suggests consideration for their adoption by ICD-11. Further research is needed on the implications of these results for prevention and treatment.

[Satisfaction with delivery and maternal identity with epidural labor analgesia among Japanese women with children younger than 3 years of age: a web-based survey].

BACKGROUND: In Japan, it has been thought that pain during labor develops maternal identity and there are cultural and psychological barriers to the use of epidural labor analgesia. The objective of this study was to examine epidemiologic data and psychological data about satisfaction with delivery and maternal identity with epidural labor analgesia. METHODS: A web-based survey was randomly conducted in 1,000 women (ages, 20-40 years) with children under the age of 3 years. The questionnaire included the basic characteristics of the participants and children, their experiences with delivery and two scales to evaluate satisfaction of delivery and maternal identity. RESULTS: There were a total of 1,030 respondents and 50 (5.0%) respondents reported having epidural labor analgesia. Scores about self-evaluation scales for satisfaction of delivery and maternal identity among women of epidural labor analgesia were not significantly different with those among women of spontaneous delivery. CONCLUSIONS: Satisfaction with delivery and maternal identity are not influenced by chosing epidural labor analgesia.

Parent psychopathology and offspring mental disorders: results from the WHO World Mental Health Surveys.

BACKGROUND: Associations between specific parent and offspring mental disorders are likely to have been overestimated in studies that have failed to control for parent comorbidity. AIMS: To examine the associations of parent with respondent disorders. METHOD: Data come from the World Health Organization (WHO) World Mental Health Surveys (n = 51 507). Respondent disorders were assessed with the Composite International Diagnostic Interview and parent disorders with informant-based Family History Research Diagnostic Criteria interviews. RESULTS: Although virtually all parent disorders examined (major depressive, generalised anxiety, panic, substance and antisocial behaviour disorders and suicidality) were significantly associated with offspring disorders in multivariate analyses, little specificity was found. Comorbid parent disorders had significant sub-additive associations with offspring disorders. Population-attributable risk proportions for parent disorders were 12.4% across all offspring disorders, generally higher in high- and upper-middle- than low-/lower-middle-income countries, and consistently higher for behaviour (11.0-19.9%) than other (7.1-14.0%) disorders. CONCLUSIONS: Parent psychopathology is a robust non-specific predictor associated with a substantial proportion of offspring disorders.

[Relationship between BCG immunization coverage and the immunization delivery system in the Tama area of Tokyo].

PURPOSE: The BCG immunization has long been performed in Japan. Although the BCG immunization service is the responsibility of the municipality, the manner in which the BCG immunization is delivered differs from municipality to municipality. The purpose of this study was to clarify how the different manner of the BCG immunization delivery systems influenced the BCG immunization coverage. METHODS: The study of BCG immunization coverage was conducted in the Tama area located in the western suburbs of Tokyo in 2004. The birth data and the immunization history by the age of 3 years were collected in the three-year-old health check-up from a total of 2,341 children residing in the Tama area. Based on the age at immunization for each child, the BCG immunization coverage was calculated according to the types of the BCG immunization delivery system. The immunization types were defined as follows; the BCG immunization given on the occasion of the mass health check-up (Group 1); the exclusive mass BCG immunization in a monthly service (Group 2); the exclusive mass BCG immunization in a bimonthly service (Group 3); the exclusive mass BCG immunization in services of fewer than every two months (Group 4); and the immunization given on an individual basis by a general practitioner (Group 5). A univariate analysis was performed to examine the relationship between the BCG immunization coverage by the age of 6 months and the difference among the BCG immunization delivery systems, followed by a multivariate regression analysis to adjust for the factors related to the demography, health care services and the socio-economic status of the municipalities. RESULTS: Unadjusted odds ratios and adjusted odds ratios for BCG unimmunized children under the age of 6 months by the BCG immunization delivery manner groups were OR 1 reference, adj. OR 1 reference in Group 1; OR 1.42 CI 0.87-2.29, adj. OR 4.01 CI 2.24-7.11 in Group 2; OR 4.96 CI 3.66-6.82, adj. OR 15.59 CI 10.10-24.49 in Group 3;OR 18.60 CI 13.77-25.49, adj. OR 48.17 CI 29.62-79.75 in Group 4; and OR 4.24 CI 2.86-6.31, adj. OR 15.61 CI 9.05-27.26 in Group 5. The univariate analysis and multivariate regression analysis revealed an influence of the BCG immunization delivery manner on the BCG immunization coverage. CONCLUSION: The choice of BCG immunization delivery manner is very important to raise the BCG immunization coverage. The BCG immunization given on the occasion of the mass health check-up and the high-frequent immunization service are thought to improve the BCG immunization coverage.

Factors Associated with Refraining from Purchasing Foods Produced in Affected Areas after the Fukushima Daiichi Nuclear Power Station Accident.

After the accident at the Fukushima Daiichi Nuclear Power Station, food products from the areas affected by the accident suffered reputational damage worldwide. Therefore, the present study aimed to identify the factors associated with people refraining from purchasing foods produced in affected areas to avoid radioactive materials. The study also aimed to clarify the time trends for the avoidance of foods produced in Fukushima Prefecture. We used data from "A survey on consumer awareness of reputational damages" conducted by the Japanese Consumers Customer Agency and implemented statistical analysis. Even if the year since the accident differed, "living with children", "knowing detailed information about food inspections", and "not being able to accept radiation risk even if the level is below the standard" were commonly associated. Not only did this study reveal that some people's risk perceptions are fixed even when new knowledge is provided, but it also suggests that the implementation of food inspection can promote reputational damage. Additionally, the avoidance of Fukushima food products was found to decrease as time passed after the Fukushima accident. The results of this study may help develop countermeasures against reputational damage to food products after future nuclear disasters.

Comparison of the Importance and Prioritization of Information Communicated to Consumers by Experts Regarding Food Safety.

Key topics related to risk communication and food safety were investigated by three different expert groups. In this study, the Delphi method was used to systematically and iteratively aggregate experts' opinions, and the topics to be communicated to consumers were expressed and prioritized. The opinions of three groups, consisting of 26 members of the expert committee (EC) from the Food Safety Commission of Japan (FSCJ), 29 local government officials (LGOs) from their respective food safety departments, and 25 food safety monitors (FSM) appointed by the FSCJ, were obtained in the period of June through September 2017. "Safety and security concept" was identified and ranked high in all groups. This topic identified "Zero-risk" demand of consumers without understanding risks as the reverse side of safety. The EC group prioritized additional issues, such as "concept of risk" and "safety costs and relevant risk management". The LGO and FSM groups prioritized specific hazard items for food poisoning and preventive measures. With regard to the so-called "health foods", the EC and LGO groups indicated insufficient transmission of scientific evidence from the government to consumers, and the FSM group indicated insufficient understanding by consumers of the food labeling system for health and nutrition. Because consumers do not fully understand all concepts of food safety, governments are encouraged to disseminate the probability of risk and the knowledge of risk reduction directly to the consumers by using simple and easy-to-understand terms.

Cost of depression among adults in Japan in 2005.

AIM: Major depression is expected to become the leading contributor to disease burden worldwide by 2020. Previous studies have shown that the societal cost of depression is not less than that of other major illnesses, such as cardiovascular diseases or AIDS. Nevertheless, the cost of depression in Japan has never been examined. The goal of the present study was to estimate the total cost of depression in Japan and to clarify the characteristics of this burden. METHODS: A prevalence-based approach was adopted to measure the total cost of depression. The total cost of depression was regarded as being comprised of the direct cost, morbidity cost and mortality cost. Diagnoses included in this study were depressive episodes and recurrent depressive disorder according to the ICD-10 or major depressive disorder according to the DSM-IV. Data were collected from publicly available statistics and the World Mental Health Japan Survey database. RESULTS: The total cost of depression among adults in Japan in 2005 was estimated to be ¥2.0 trillion. The direct cost was ¥0.18 trillion. The morbidity cost was ¥0.92 trillion, while the mortality cost was ¥0.88 trillion. CONCLUSION: The societal costs caused by depression in Japan are enormous, as in other developed countries. Low morbidity costs and extremely high mortality costs are characteristic in Japan. Effective interventions for preventing suicide could reduce the societal costs of depression.

[Which zoonoses should the general population be more awareness of ? Qualitative research targeted at veterinarians].

OBJECTIVES: The purpose of this study was to determine which zoonoses should the general population be more aware of. METHODS: We conducted qualitative research (Delphi method) on thirty veterinarians who were selected from the whole country. RESULTS: Twenty-four diseases were selected. The reasons for their selection were classified into three categories: "Amount of knowledge, attitude and behavior", "Clinicoepidemiologic characteristics" and "Social characteristics". More than half of the top ten zoonoses are those that are not transmitted from humans to humans, with rabies in the first place, avian influenza (with its high pathogenicity) in the second place and psittacosis in the third place. CONCLUSIONS: From the top ten diseases, it is considered that the prevention of animal-to-human transmission should be emphasized. In addition, from the reasons for the selection, it is suggested that it is necessary to review social characteristics, such as the inadequacy of quarantine and the insufficiencies of legal systems. As for the zoonoses that are transmitted from humans to humans, it will be indispensable in the future to widely spread information on zoonoses and enlighten the general population about them. It is thought that this survey can be a basis for selecting a zoonosis that should be given priority in enlightening the general population.

Childhood adversities as risk factors for onset and persistence of suicidal behaviour.

BACKGROUND: Suicide is a leading cause of death worldwide, but the precise effect of childhood adversities as risk factors for the onset and persistence of suicidal behaviour (suicide ideation, plans and attempts) are not well understood. AIMS: To examine the associations between childhood adversities as risk factors for the onset and persistence of suicidal behaviour across 21 countries worldwide. METHOD: Respondents from nationally representative samples (n = 55 299) were interviewed regarding childhood adversities that occurred before the age of 18 years and lifetime suicidal behaviour. RESULTS: Childhood adversities were associated with an increased risk of suicide attempt and ideation in both bivariate and multivariate models (odds ratio range 1.2-5.7). The risk increased with the number of adversities experienced, but at a decreasing rate. Sexual and physical abuse were consistently the strongest risk factors for both the onset and persistence of suicidal behaviour, especially during adolescence. Associations remained similar after additional adjustment for respondents' lifetime mental disorder status. CONCLUSIONS: Childhood adversities (especially intrusive or aggressive adversities) are powerful predictors of the onset and persistence of suicidal behaviours.

Risk Management Knowledges about Oysters for Raw Consumption and Norovirus.

This study used questionnaires to evaluate knowledge levels of risk management of raw-consumption of oysters and of norovirus as health hazards among monitors signed up for Food Safety Commission of Japan (FSCJ) having work experiences in food fields. The mean scores of monitors on norovirus knowledge were relatively high (79%), but on oyster raw-consumption were low (64%). Scores varied depending on occupational experiences; highest among administrative officials, high among researchers in food companies, and low among medical workers and educators. The higher scores with more practical experiences for risk management of oyster raw-consumption and norovirus were observed among the monitors. These monitors were expected better to recognize the risks, wheres only few monitors among the opinion-leaders replied correctly to all the questions. These results suggest the need of improvement on the management system for oyster raw-consumption, from the current complicated to the more precise and reinforced for consumers. To efficiently manage the risk associated with the consumption of raw oysters, the government should provide more relevant information of risk management to persons having interest, particularly influencers, in order to disseminate information and to improve knowledge among cooks and consumers.

Changes in the Risk Perception of Food Safety between 2004 and 2018.

To afford the future agenda of risk communication through an evaluation of the past, we examined the changes in risk perception in the food safety sector over the 15 years (2004-2018) since the establishment of the Food Safety Commission of Japan (FSCJ) in 2003 by analyzing the data of the food safety monitor survey. Hazards such as contaminants including cadmium, methylmercury and arsenic, and pesticide residues caused high levels of concern among the public in 2004. In contrast, hazards such as food poisoning by harmful microorganisms and so-called "Health foods" have been ranked high among concerns since 2008 and 2014, respectively. Scoring of concern levels showed that concern related to food additives and pesticide residues intentionally added to foods and controlled has gradually decreased in a time-dependent manner. These concern scores were considerably lower in male monitors than in female ones; the scores were also lower for individuals with professional experience in the food sector than without the experience. The concern scores for contaminants were lower for males with professional experience. The concern scores related to food poisoning and health foods were not decreased and were remained high in recent years. These scores did not show clear dependence on job experience or gender of the monitors. A gap between food specialists and other attributes in the basic recognition of risk seems to make it difficult to communicate effectively and constructively among various interested individuals. To improve the quality of risk communication in the food safety field, it will be necessary to provide scientific knowledge and information regarding food safety management mechanisms for individuals without professional experience in the food sector, taking into account the changes in information media and influence on risk perception.

[Infectious diseases that people should be informed: a Delphi survey of clinicians engaged in practice of infectious diseases in Japan].

OBJECTIVE: To identify specific infectious diseases about which the Japanese public should be informed. MATERIALS AND METHODS: A Delphi survey was conducted, recruiting 26 physicians who are engaged in clinical practice of infectious diseases and working at designated medical institutions of infectious diseases in Japan. RESULTS: Following HIV/AIDS (first ranked), tuberculosis (second) and influenza (third), 24 diseases in total were identified based on "knowledge, awareness and behavior of inhabitants" or "social and clinico-epidemiological circumstances". Scores for the top three ranked diseases were more than two-folds of those for following diseases. Among the top 10 ranked diseases, 9 were in common with the previous survey result among public health physicians and veterinarians working for governmental agencies. DISCUSSION: Our findings of scores for specific diseases most likely reflect an importance of performing preventions and early diagnoses of severe diseases and promoting prophylaxis for travelers' diseases which tend to be factors for prioritizing infectious diseases among clinicians. The top-scored diseases among clinicians were consistent with those among public health officers, indicating the critical need to inform the public about these diseases. Nevertheless, both clinicians and public health experts have already attempted to promote preventions and/or treatment for these diseases in the previous time, and thus, the previous experience must be critically reviewed and reconsidered for improvements. In future, the similar surveys to ours should target specific subjects of experts and investigate more specific types of infectious diseases. Following such an expert survey, concrete action plans to inform the public about prioritized diseases are also called for.

[Current problems arising from not having biosafety level 4 laboratories in Japan--qualitative study of infectious disease experts].

OBJECTIVES: No public consensus exists yet on handling Biosafety Level 4 agents and no laboratory is operational at BSL4 in Japan. A discussion that includes neighboring residents and experts should be initiated to communicate risks. In this article, we present the current situation and prioritize problems we presently face. METHODS: A three-stage Delphi survey was conducted. The subjects were twenty-two persons with extensive experience and knowledge of infectious diseases. Seven projections and issues were made with regard to the problems arising from the lack of an operational BSL4 laboratory. These were tabulated by the KJ method. The top seven projections were scored, such that the top received 7 points and the last received 1 point. RESULTS: A total of 51 projections were obtained for the first part of the survey, 39 for the second, and 29 for the last. The projection with the highest score was that it is impossible to cope with newly emerging infectious diseases. The second was that complete diagnoses are impossible without a BSL4 laboratory. All projections and issues were divided into the following four main groups: issues for researchers and laboratory staff, clinical practice and research on BSL4 agents, domestic and global security, and Japan's international position. CONCLUSION: We clarified possible problem arising from not having BSL4 laboratories in Japan. The identification of projections by the Delphi survey in this study should be considered as one of many attempts to develop effective risk communication strategies.

[Involvement of local dietetics professionals in risk communication program on food safety in municipal governments and their attitude towards the program].

OBJECTIVES: The objective of this study is to gather statistical references on food safety education that encourages competence of food choice from the view-point of food safety. A survey on the involvement of the risk communication program on food safety in municipal governments and the attitude of local dietetics professionals towards the program was conducted. METHODS: In November, 2006, self-reported questionnaires were mailed to 1990 local dietetics professionals who worked in municipal governments in Japan. Descriptive statistics and cross tables were used for data analysis. RESULTS: 1162 questionnaires were mailed and 1130 available surveys were returned. Among the respondents, 41.5% answered that they inform the community about food safety, but 49.9% answered that they did not get information from the community. Most of the respondents answered that risk communication of food safety was important; 21.8% answered "extremely agree" and 62.3% answered "rather agree" on a scale of four from "extremely agree" to "do not agree". More than one-half of the dietetics professionals answered that their confidence in conducting risk communication was low; 20.5% answered "no confidence" and 52.5% answered "hardly have confidence" on a scale of four from "without confidence" to "with confidence". More than 80% of the respondents answered that they needed "professional knowledge" and "support from professional agencies". CONCLUSION: This study suggests that educating local dietetics professionals about professional knowledge on food safety, and obtaining support from special agencies will be essential in the upgrade of risk communication program on food safety in a community.

[Which infectious diseases should be prioritized in educating Japanese population?].

OBJECTIVE: We studied which infections would be prioritized in educating the general population of Japan. MATERIALS AND METHODS: Subjects were 25 physicians and veterinarians in charge of infection control in infections control divisions of local and national governments. We conducted a questionnaire using the Delphi method. RESULTS: Based on (1) epidemiological and clinical characteristics, (2) knowledge level, awareness, and behavior of general population and healthcare professionals, and (3) social background and coping skills we selected 24 diseases for prioritization Tuberculosis was first, followed by influenza, HIV/AIDS, enterohemorrhagic Escherichia coli infection (O157), and genital chlamydial infection. Three animal-derived infections ranked in the top 10. DISCUSSION: We have not yet found which the priority of infections should be prioritized in educating the general population on infections. Although our findings are too few to make any generations about, several studies back the reasons why diseases were singled out in our study. Given the fact that most high-ranked infections have ever been educated, education thus far appears to have been highly ineffective way, meaning that more effective ways of education on infection must be found in future.