Long-Term, Community-based Approach for Affected People Having Problems With Mental Health and Lifestyle Issues After the 2011 Fukushima Disaster: the Fukushima Health Management Survey.

A Mental Health and Lifestyle Survey (MHLS) has been conducted yearly as part of the Fukushima Health Management Survey since 2012, in order to monitor different health issues related to long-term evacuation of affected people after the 2011 Fukushima disaster. This survey is a mail-based one of nearly 210,000 affected people living in the evacuation zone at the time of the disaster. Another purpose of the MHLS is to provide efficient interventions by telephone based on the results of the survey. Significant findings contributing to understanding of non-radiological health effects caused by long-term evacuation were obtained from the MHLS, directly connecting to telephone-based interventions for over 3,000 respondents per year. In this article, the mental health outcomes of the MHLS, including depressive symptoms and posttraumatic responses, are reviewed, and the usefulness of telephone-based interventions is discussed. The evidence showed that, despite improvement of core mental health outcomes, the prevalence of respondents at high risk of some psychiatric problems remained high compared to that among the general population in Japan. In particular, several mental health consequences of respondents staying outside of Fukushima Prefecture were higher than those staying inside Fukushima. Along with further efforts to increase the response rate, we need to continue and modify the MHLS to meet the requirements of the affected people and communities.

Onset and remission of common mental disorders among adults living in temporary housing for three years after the triple disaster in Northeast Japan: comparisons with the general population.

BACKGROUND: People living in temporary housing for long periods after a disaster are at risk of poor mental health. This study investigated the post-disaster incidence and remission of common mental disorders among adults living in temporary housing for the 3 years following the 2011 Great East Japan Earthquake. METHODS: Three years after the disaster, face-to-face interviews were conducted with 1089 adult residents living in temporary housing in the disaster area, i.e., the shelter group, and a random sample of 852 community residents from non-disaster areas of East Japan. The World Health Organization Composite International Diagnostic Interview was used to diagnose DSM-IV mood, anxiety, and alcohol use disorders. Information on demographic variables and disaster experiences was also collected. RESULTS: Response rates were 49 and 46% for the shelter group and the community residents, respectively. The incidence of mood/anxiety disorder in the shelter group was elevated only in the first year post-disaster compared to that of the general population. The rate of remission for mood and anxiety disorders was significantly lower in the shelter group than in the community residents. The proportion seeking medical treatment was higher in the shelter group. CONCLUSIONS: The onset of common mental disorders increased in the first year, but then levelled off in the following years among residents in temporary housing after the disaster. Remission from incident post-disaster mental disorders was slower in the shelter group than in the general population. Post-disaster mental health service could consider the greater incidence in the first year and prolonged remission of mental disorders among survivors with a long-term stay in temporary housing after a disaster.

Evacuation after the Great East Japan Earthquake was associated with poor dietary intake: The Fukushima Health Management Survey.

BACKGROUND: Few studies have investigated the relationship between living arrangements and dietary intake among evacuees after disasters. OBJECTIVES: To examine the relationship between living arrangements and dietary intake using the data of a large-scale cohort survey of evacuees after the Great East Japan Earthquake in 2011. METHODS: 73,433 residents in evacuation zones responded to the Fukushima Health Management Survey questionnaire. Subjects were excluded if they did not report their living conditions or were missing more than three pieces of information about dietary intake. The data of 52,314 subjects (23,149 men and 29,165 women ≥15 years old) were used for the analyses. Evacuees' living arrangements were characterized into three categories: evacuation shelters or temporary housing, rental houses or apartments, or a relative's home or their own home. Dietary intake was characterized in terms of grains, fruits and vegetables, meat, soybean products, dairy products, and fish. Daily consumption of the third quartile (Q3) or higher for each food group was defined as 'high consumption'. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were estimated using modified Poisson regression analyses. RESULTS: Modified Poisson regression analyses showed that, compared with respondents living in a relative's home or their own home, the PRs and 95% CIs for the people living in rental apartments of high consumption of fruits and vegetables (non-juice), meat, soybean products, and dairy products were 0.69 (95% CI, 0.61-0.77), 0.82 (95% CI, 0.73-0.91), 0.89 (95% CI, 0.83-0.94), and 0.83 (95% CI, 0.74-0.93) respectively. The corresponding PRs and 95% CIs for people living in evacuation shelters or temporary housing were 0.83 (95% CI, 0.78-0.88), 0.90 (95% CI, 0.86-0.95), 0.94 (95% CI, 0.91-0.97), and 0.91 (95% CI, 0.86-0.96) for high consumption of fruits and vegetables (non-juice), meat, soybean products, and dairy products, respectively. CONCLUSION: The present study suggests that, after the earthquake, living in non-home conditions was associated with poor dietary intake of fruits and vegetables (non-juice), meat, soybean products, and dairy products, suggesting the need for early improvements in the provision of balanced meals among evacuees living in non-home conditions.

The effect of telephone support to evacuees with risks of hypertension and diabetes mellitus after a disaster: the Fukushima Health Management Survey.

Objectives　Fukushima Medical University has been conducting the Fukushima Health Management Survey "Mental Health and Lifestyle Survey" annually as part of the health care of evacuees following the Fukushima Daiichi nuclear power plant accident.　This study aimed to clarify the effects of telephone support performed by nurses or public health nurses. In particular, we investigated the response rates for questionnaire of the following year and the recommended effect of medical support for evacuees with risks of hypertension and diabetes mellitus in the fiscal year 2011 (FY2011).Methods　The study population included evacuees (1,620 people) with risks of hypertension and diabetes mellitus in FY2011. We compared the participants' responses to the FY2012 survey and medical results based on those who received telephone support and those who did not.Results　Evacuees who have received telephone support (telephone supporters) comprised 1,078 people. Evacuees who did not receive telephone support (non-telephone supporters) comprised 542 people.　Telephone supporters consisted of more people from outside Fukushima prefecture (P=0.001), with above high school education (P<0.001), and who were unemployed (P<0.001) compared to non-telephone supporters.　For the FY2012 survey, 616 telephone supporters responded (57.1%), while 248 non-telephone supporters responded (45.8%). The response rate of telephone supporters was significantly higher compared to non-telephone supporters for the FY2012 questionnaire (P<0.001).　In addition, 184 (29.9%) telephone supporters and 68 (27.4%) non-telephone supporters underwent the medical examination.　In the multivariate analysis, responses to the FY2012 questionnaire were significantly associated with receiving telephone support (P=0.016).Conclusion　Telephone supporters had higher response rates for the questionnaire the following year compared to non-telephone supporters. Therefore, telephone support was effective in increasing the questionnaire response rate during the following year.

Residence-related factors and psychological distress among evacuees after the Fukushima Daiichi nuclear power plant accident: a cross-sectional study.

BACKGROUND: Relocation following a disaster can impact the psychological well-being of evacuees. This study investigated the associations between residence-related factors and psychological distress among evacuees living in temporary housing after the Fukushima Daiichi Nuclear Power Plant accident. METHODS: Data from 525 participants living in temporary housing were collected. Associations between residence-related factors (frequent relocation, dissatisfaction with the residence, and plan to move to permanent housing) and psychological distress were measured. The psychological distress of evacuees was measured using the Japanese version of the 6-item Kessler scale (K6). We used a cut-off score of five to identify cases with psychological distress, the basis of Kessler's 6 items for psychological distress. RESULTS: Multivariate logistic regression analysis (n = 418) showed that frequent relocation (OR = 2.05, 95% CI: 1.14-3.66, p = 0.016) and dissatisfaction with the residence (OR = 2.48, 95% CI: 1.60-3.83, p < 0.001) was significantly associated with psychological distress. After stratifying by gender, dissatisfaction with the residence was associated with psychological distress, and a plan to move to permanent housing was significantly associated with psychological distress in women (OR = 1.93, 95% CI: 1.03-3.63, p = 0.041). CONCLUSIONS: Frequent relocation and dissatisfaction with the residence were associated with psychological distress among evacuees following the Fukushima nuclear disaster. Evacuees should be provided with comfortable living spaces, and steps should be taken to reduce repeated relocation of evacuees. Thus, particular attention should be paid to women with a plan to move to permanent housing within this context.

The effect of a behavioral activation program on improving mental and physical health complaints associated with radiation stress among mothers in Fukushima: a randomized controlled trial.

BACKGROUND: Mothers living with small children in Fukushima prefecture may experience radiation anxiety and related symptoms after the Fukushima Dai'ich Nuclear Power Plant Accident. A behavioral activation (BA) program was developed to improve their psychosomatic symptoms. The purpose of this randomized controlled trial was to examine the effectiveness of a BA program for improving psychological distress and physical symptoms among mothers with preschool children in Fukushima-prefecture 3 years after the Fukushima Daiichi Nuclear Power Plant accident. METHODS: Participants were recruited from mothers living with a preschool child(ren) in Fukushima city and surrounding areas though a newspaper advertisement, posters, and flyers. Participants allocated to the intervention group received a newly developed group-based BA program, which consisted of two 90- min lessons with a 1-week interval. Psychological distress and physical symptoms as a primary outcome, and radiation anxiety and positive well-being (liveliness and life satisfaction) as a secondary outcome, were measured at baseline, 1- and 3-month follow-ups. RESULTS: Participants were randomly allocated to either an intervention or a control group (18 and 19, respectively). The BA program showed a marginally significant intervention effect on psychological distress (p = 0.051) and physical symptoms (p = 0.07) at 1-month follow-up, while the effect became smaller at 3-month follow-up. The effect sizes at 1-month were medium to large (-0.72 and -0.56, respectively). There was a significant intervention effect on increasing liveliness at 3-month follow-up (p = 0.02); and there were marginally significant effects on life satisfaction at 1- and 3-month follow-ups (both p = 0.09). CONCLUSIONS: This BA program may be effective for improving psychological distress, physical symptoms, and well-being, at least for a short duration, among mothers with preschool children after the nuclear power plant accident in Fukushima, while a further large-scale study is needed. TRIAL REGISTRATION: The UMIN Clinical Trials Registry (UMIN-CTR; ID = UMIN000014081 ). Registered 27 May 2014.

Experiences of municipal public health nurses following Japan's earthquake, tsunami, and nuclear disaster.

OBJECTIVE: The purpose of this study was to explore the experiences of municipal public health nurses in the wake of the March 2011 massive earthquake and tsunami and resulting nuclear accident in Fukushima, Japan, from the time of the disaster until December 2013. DESIGN AND SAMPLE: Thirty-two public health nurses working in three cities in Fukushima prefecture were divided into four focus groups and took part in interviews, which were analyzed using a qualitative descriptive method. RESULTS: Two major themes were extracted: (1) experiences of difficulties and dilemmas, and (2) professional challenges and the meaning of excellence as a public health nurse. Subjects recounted their experiences based on the timeline of events. The process of overcoming various dilemmas--between prescribed roles and actual needs on the ground, being both civil servants and private citizens with families, and having to be publicly accountable while lacking adequate information--caused participants to reexamine the meaning of excellence in the practice of public health. CONCLUSION: The strenuous and complex demands of extended disaster management caused subjects to grow professionally. Helping them process their emotions should also help these nurses give focus to their posttraumatic growth, and strengthen their sense of professionalism.

[Home care and place of death for elderly people living in the remote islands of Japan. An examination on the presence of inpatient facilities].

OBJECTIVES: The purpose of this study was to clarify the actual status of end-of-life care for elderly people living in the remote islands of Japan, and whether the presence of inpatient facilities was related to the place of death, so as to obtain suggestions for constructing a system of end-of-life care. METHODS: The survey targeted caregivers (85 people) who cared for elderly people (aged 65 and over), who had been legally certified for long-term care, and who had died between April 2009 and July 2011 in five islands of Japan. Islands were selected from a list of remote islands specified in the Remote Islands Development Act and related laws. Using a mixed method embedded design, we conducted semi-structured interviews using a questionnaire that assessed the place and cause of the elderly patient's death, age at death, gender, and whether the patient or family members had requested that the patient be allowed to die at home. RESULTS: The proportion of elderly people who died at home in the group living on remote islands with no inpatient facilities was 39.0% (16 of 41 people), compared with 18.2% (8 of 44 people) living on islands with inpatient facilities. The difference was significant (P=0.029). Among the 24 elderly people who died at home, 6 died of cancer. Terminally ill cancer patients were released to die at home under three conditions: the caregivers could provide sufficient care, the visiting physician was present, and pain control was provided. It was also possible for elderly cancer patients to receive end-of-life care in remote islands that did not have inpatient facilities. In addition, among the elderly people who died at home in the remote islands, home care had been recommended by medical staff. CONCLUSION: It is important for professionals coordinating home care to understand the characteristics of diseases, perform early assessment of caregiver situations, and collaborate with medical staff.

Effects of disaster-related traumatic events on worry about radiation and COVID-19: A decade after the Fukushima nuclear power plant accident.

Community residents exposed to nuclear power plant (NPP) accidents have long-term worry about the effects of radiation. After the 2011 Fukushima NPP accident, those who experienced traumatic events during the Great East Japan Earthquake (GEJE) tended to have greater worry about radiation. Along with the prolonged worry about radiation, there may also be cognitive changes caused by the traumatic events. We hypothesized that if there were cognitive changes underlying the prolonged worry about radiation, those who experienced the traumatic events would tend to have greater worry about other issues unrelated to radiation. We examined the effects of the traumatic events during the GEJE on community residents' worry about radiation and COVID-19 a decade after the Fukushima NPP accident. Using the data of a longitudinal questionnaire survey following a random sample of 4900 community residents outside the evacuation zone in Fukushima, this study analyzed 774 responses (15.8%). The traumatic events consisted of (1) injury, (2) injury or death of a family member, and (3) the loss of a house or other property. We developed a mediation model drawing paths from the traumatic events to worry about radiation and COVID-19, including posttraumatic stress symptoms (PTSS) as a mediator, using structural equation modeling. The traumatic events directly affected worry about radiation. Although it did not directly affect worry about COVID-19, it did so indirectly through worry about radiation and PTSS. Traumatic events can increase trauma-related worry independently of PTSS and increase trauma-unrelated worry indirectly through trauma-related worry and PTSS.

The Association between Parenting Confidence and Later Child Mental Health in the Area Affected by the Fukushima Nuclear Disaster: The Fukushima Health Management Survey.

After the 2011 Fukushima Daiichi Nuclear Power Station accident, the Fukushima Health Management Survey was conducted to assess children's lifestyle and mental health conditions. The participants in this study were 1126 children, aged 0 to 3 years, living in the evacuation zone at the time of the disaster. The parenting confidence of their mothers was assessed using a self-administered questionnaire as a baseline in 2013. We examined the association of parenting confidence level at baseline, using a total difficulty score of the Strengths and Difficulties Questionnaire (SDQ) and reluctance to attend school among children in a follow-up study in 2016 and 2017. As a result, no confidence was reported by 178 (15.8%) mothers, while 477 (42.4%) responded with "not sure" and 471 (41.8%) were confident. In the multiple logistic analysis, after adjusting for covariates such as the child's sex, age, and current health condition, the group lacking parenting confidence demonstrated a significantly higher risk level for SDQ total difficulties (OR, 2.8; 95% CI, 1.59-4.93) and reluctance to attend school (OR = 1.98, 95% CI: 1.24-3.18) than the confident mothers. After a major disaster, which can have long-term effects on communities, intensive psychological care for mothers with young children is needed to prevent various mental health problems in their children.

Worry about Radiation and Its Risk Factors Five to Ten Years after the Fukushima Nuclear Power Plant Disaster.

Worry about radiation persists long after nuclear power plant accidents. Young age, low socioeconomic status, being married, and disaster-related experiences are known to be associated with greater worry about radiation. This study explored the duration of the effects of these risk factors on worry about radiation after the 2011 Fukushima nuclear power plant accident, using the longitudinal data of randomly sampled non-evacuee community residents who were followed five to ten years after the accident. Questionnaire surveys were conducted five times with 1825 respondents (37.2% of the 4900 initial targets). We examined the interaction of time and risk factors of worry about radiation using a mixed model. Fear or anxiety immediately after the accident had effects on worry about radiation that continued even after 10 years, though it slightly attenuated with time. Family problems stemming from the disaster retained their effects. While direct damage and evacuation experience were significantly associated with worry about radiation in the early phase, their effects diminished and became non-significant during the study period. Being under the age of 65, having low educational attainment, and being married were significantly associated with worry about radiation, although the association with age weakened over time. Individuals who experience intense fear or anxiety post-nuclear power plant accidents or disaster-related family problems may need continuous monitoring for their worry about radiation even 10 years after such accidents.

The Usefulness of Brief Telephonic Intervention After a Nuclear Crisis: Long-Term Community-Based Support for Fukushima Evacuees.

The Fukushima Daiichi Nuclear Power Station accident in 2011 produced over 100000 evacuees. In order to deal with an increased need of mental health care, brief, transdiagnostic Telephonic Interventions (TI) have been provided for those at risk of different mental health problems identified based on results of the Mental Health and Lifestyle Survey (MHLS). This study aimed to examine usefulness of TI with focusing on evacuees' subjective estimation assessed in individual follow-up interviews. The sample comprised 484 persons who had been evacuated from 13 municipalities in Fukushima Prefecture to 8 safer regions in and out of Fukushima. We conducted semi-structured interviews for participants receiving TI (intervention group) and those not receiving TI despite being identified as high risk (non-intervention group). The intervention group was older, had a higher proportion of self-reported mental illness, and higher unemployment compared with the non-intervention group. The satisfaction proportion of those who underwent TI was as high as 74.6%. Satisfaction was significantly associated with advance knowledge of TI availability (OR = 3.00, 95% CI: 1.59-5.64), and advice on health-related practices (OR = 2.15, 95% CI: 1.12-4.13). Thus, TI is considered to be feasible and useful for public health management practices in major disasters.

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.

Evaluation of TA10 broth for recovery of heat- and freeze-injured Salmonella from beef.

The Bacteriological Analytical Manual (BAM) Salmonella pre-enrichment broth [lactose (LAC) broth], buffered peptone water, and universal pre-enrichment (UP) broth were compared with TA10 broth, developed in our laboratory, for recovery of heat- and freeze-injured Salmonella (55 degrees C for 2-20 min and -20 degrees C for 2 months, respectively) from beef. Beef samples were contaminated with single Salmonella serovars, and contamination levels of 0.44 to <0.001 most probable number (MPN)/g and 0.74 to 0.14 MPN/g were used for heat- and freezing-induced injury studies, respectively. Twenty test portions (25 g) of the contaminated beef were pre-enriched in each broth, and the BAM Salmonella culture method was used thereafter. There was a significant difference (chi2 = 7.73) in recovery of heat-injured Salmonella between TA10 broth and LAC broth, 189 (67.5%) versus 156 (55.7%) positive samples, respectively, determined by plating onto selective agars and identification by biochemical tests. For the recovery of freeze-injured Salmonella, there was a significant difference (chi2 = 24.7) between TA10 and LAC broth, 189 (72.7%) versus 133 (51.2%) positive samples, respectively. TA10 broth was more effective than LAC broth and UP broth for recovery of freeze-injured Salmonella. The results indicate that TA10 broth should be used instead of LAC broth for testing of beef that may be contaminated with heat- and freeze-injured Salmonella spp.

The ongoing activities of livelihood support counselors following nuclear disaster under the COVID-19 restrictions: A preliminary survey.

BACKGROUND: This preliminary study aims to understand the state of support provided in the evacuation areas of the 2011 Fukushima nuclear disaster, during the novel coronavirus 2019 (COVID-19) restriction. METHODS: A self-administered survey was conducted with 18 livelihood support counselors from two Social Welfare Councils in November 2020. We investigated the number of consultations since the COVID-19 pandemic and the impact of telephonic consultation as opposed to in-person consultations through visits to counselees' homes. RESULTS: Counselors have been continued offering supports to their counselees even under the COVID-19 restrictions, in fact, fifty percent of counselors have increased the consultations. Although some counselors had a sense of unease or concern about telephonic consultation due to the inability to see their non-verbal expressions, there were some advantages of telephonic consultation, in that the counselors were able to have longer sessions and listen more attentively to severe issues. CONCLUSIONS: Notably, livelihood support counselors in this study have increased the number of consultations while utilization telephonic consultations, despite the adverse conditions created by the COVID-19 restriction. Moreover, certain advantages of telephonic consultation instead of in-person consultation have been identified. It may be an effective support method avoiding in-person contacts, that also considers infection-prevention measures.

Vulnerability of Evacuees Having No One to Consult after the Fukushima Nuclear Disaster: The Fukushima Health Management Survey.

After the accident at the Fukushima nuclear power plant in 2011, caused by the Great East Japan Earthquake, some evacuees had no one to consult despite many local care providers offering assistance. This study identified the characteristics of individuals who did not receive consultations and the relevant determinants, and proposed the available measures to address this issue. Altogether, 32,699 participants aged 16 years or older and residing in the disaster area at Fukushima were surveyed. Those with no one to consult showed a significantly higher prevalence of psychological distress (16.2%, p < 0.001) and drinking problems (21.5%, p < 0.001). Multivariate analysis revealed that these behaviors were associated with the middle age group (i.e., 40-64 years old) (odds ratio [OR]: 1.30; 95% confidence interval [CI]: 1.16-1.46), men (OR = 2.46; 95% CI, 2.27-2.66), bad financial circumstances (OR = 2.11; 95% CI, 1.96-2.27), and living alone (OR = 1.53; 95% CI, 1.39-1.68). This research verifies that people with such characteristics were more likely to be isolated and vulnerable to psychiatric problems, such as depression. We suggest that it is integral for local care providers to recognize those who have no one to consult and provide targeted support.

Distrust in government and its relationship with mental health after the Fukushima nuclear power plant accident.

BACKGROUND: Distrust in authorities has negative effects on mental health. AIMS: In this study, we aimed to explore whether the impact of distrust in government on mental health became stronger in the area heavily affected by the 2011 Fukushima nuclear power plant accident. METHODS: We examined the effects of distrust in the national government on depressive symptoms three years after the accident among community residents in Fukushima prefecture using those in the Kanto area (the area surrounding Tokyo) as a control. A questionnaire survey was administered to a random sample of 1000 residents in Fukushima prefecture and 1650 residents in the Kanto area. Distrust in the national government was assessed using a four-point single-item scale. Depressive symptoms were measured using the Patient Health Questionnaire-9. The associations of residential area (i.e. living in Fukushima prefecture or in the Kanto area) and distrust in the national government with depressive symptoms were examined, controlling for socio-demographic characteristics and disaster-related experiences using multivariate linear regression analyses. We used the interaction term of residential area and distrust in the government to explore the difference in the association between the respondents in Fukushima prefecture and those in the Kanto area. RESULTS: Valid responses were obtained from 976 (36.8%) residents. Distrust in the government was associated with depressive symptoms and the association was stronger in Fukushima prefecture than in the Kanto area. CONCLUSION: The deleterious effects of distrust in the government on mental health may become more serious after a nuclear power plant accident and require careful attention during support activities in an affected area.

Multiplex real-time polymerase chain reaction assay for simultaneous detection and quantification of Salmonella species, Listeria monocytogenes, and Escherichia coli O157:H7 in ground pork samples.

Salmonella sp., Listeria monocytogenes, and Escherichia coli O157:H7 are foodborne pathogens capable of causing serious gastrointestinal illness. We previously described simultaneous detection of these pathogens by multiplex polymerase chain reaction (PCR) in 44 types of spiked food samples, including meat, produce, fish, and dairy products, targeting genes specific for each pathogen. Based on the previous work, a multiplex real-time PCR assay using fluorescent probes was developed to detect and accurately quantify Salmonella sp., L. monocytogenes, and E. coli O157:H7 in ground pork samples. The detection sensitivity for this method was 2.0 x 10(2) CFU/mL for each pathogen, and the quantification range was 10(2)-10(7) CFU/mL with a high correlation coefficient (R(2) > 0.99) and high PCR efficiency (84.2% to 99.2%). When this protocol was used for the detection of each of the pathogens in spiked pork samples, one cell per 25 g of inoculated sample after enrichment for 20 h could be detected within 24 h. As a result, this multiplex real-time PCR assay will be valuable as a screening method for foods contaminated with these pathogens.

Development and Evaluation of a Gatekeeper Training Program Regarding Anxiety about Radiation Health Effects Following a Nuclear Power Plant Accident: A Single-Arm Intervention Pilot Trial.

After the Fukushima Daiichi Nuclear Power Plant accident in March 2011, residents perceived a radiation exposure risk. To address the concerns about radiation exposure and the subsequent effects on their health, we developed the gatekeeper training program for radiation health anxiety and mental health issues. The program consisted of a presentation and roleplay, with educational objectives to the increase knowledge and understanding around radiation health anxiety, alcoholism, depression, and suicide. Twenty-six counselors participated in the program as a single-arm intervention. To measure the outcomes, the subjects reported self-confidence when they counselled with residents with radiation health anxiety and other mental health issues. Comparing the answers to pre- and 2-month follow-up surveys, the confidence levels were higher after 2 months than at baseline, especially for the question "How confident are you at supporting a resident with mental health issues?", which showed the largest increase (p < 0.001). Regarding radiation health anxiety the questions "Can you communicate coping skills to a resident with radiation health anxiety?" (p = 0.007) and "Can you refer a resident with radiation health anxiety to professionals who can cope appropriately?" (p = 0.016) showed significant increases in their confidence levels. This program could be useful for on-going health activities and future nuclear disasters.

Long-lasting effects of distrust in government and science on mental health eight years after the Fukushima nuclear power plant disaster.

We aimed to explore the effects of erosion of trust in authorities on the long-term mental health of community residents after the 2011 Fukushima nuclear power plant accident in Japan. We investigated the effects of distrust in authorities on mental health in a cohort study following non-evacuee community residents after the 2011 Fukushima nuclear power plant accident. A baseline questionnaire survey was administered five years after the accident for a random sample of 4900 residents outside the evacuation zone in Fukushima. Distrust in the national government and in science were assessed using a four-point single-item scale. Psychological distress was measured using the K6. Posttraumatic stress symptoms were measured using an abbreviated version of the Posttraumatic Stress Disorder Checklist-Specific version. Longitudinal associations of distrust in the government and science at baseline and psychological distress and posttraumatic stress symptoms eight years after the accident were examined, controlling for the baseline level of distress or symptoms using multivariate logistic regression analyses. Valid responses were obtained from 927 (18.9%) residents. Distrust in the government at baseline was significantly associated with posttraumatic stress symptoms at follow-up, albeit controlling for baseline symptoms. While distrust in the government was also associated with psychological distress at follow-up, the association became non-significant after controlling for baseline distress. Distrust in science at baseline was not associated with posttraumatic stress symptoms or psychological distress at follow-up. Distrust in government after a nuclear power plant accident may have adverse effects on mental health in the long-term.