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Background: The changing pattern of anxiety and stress experienced by pregnant women during the COVID-19 pandemic is unknown. Objective: We aimed to examine the sources of anxiety and stress in pregnant women in Japan during the COVID-19 pandemic. Methods: We performed content analysis of 1000 questions posted on the largest social website in Japan (Yahoo! Chiebukuro) from January 1 to May 25, 2020 (end date of the national state of emergency). The Gwet AC1 coefficient was used to verify interrater reliability. Results: A total 12 categories were identified. Throughout the study period, anxiety related to going outdoors appeared most frequent, followed by anxiety regarding employment and infection among family and friends. Following the declaration of the state of national emergency at the peak of the infection, infection-related anxiety decreased, whereas anxiety about social support and mood disorders increased. Stress regarding relationships appeared frequent throughout the pandemic. Conclusions: The sources of anxiety and stress in pregnant women in Japan changed during the pandemic. Our results suggest the need for rapid communications in the early phase of a pandemic as well as long-term psychosocial support to provide optimal support to pregnant women in Japan. Health care professionals should understand the changing pattern of requirements among pregnant women. [ABSTRACT FROM AUTHOR]

Background: Health materials to promote health behaviors should be readable and generate favorable evaluations of the message. Processing fluency (the subjective experience of ease with which people process information) has been increasingly studied over the past decade. In this review, we explore effects and instantiations of processing fluency and discuss the implications for designing effective health materials. We searched seven online databases using "processing fluency" as the key word. In addition, we gathered relevant publications using reference snowballing. We included published records that were written in English and applicable to the design of health materials. Results: We found 40 articles that were appropriate for inclusion. Various instantiations of fluency have a uniform effect on human judgment: fluently processed stimuli generate positive judgments (e.g., liking, confidence). Processing fluency is used to predict the effort needed for a given task; accordingly, it has an impact on willingness to undertake the task. Physical perceptual, lexical, syntactic, phonological, retrieval and imagery fluency were found to be particularly relevant to the design of health materials. Conclusions: Health-care professionals should consider the use of a perceptually fluent design, plain language, numeracy with an appropriate degree of precision, a limited number of key points and concrete descriptions that make recipients imagine healthy behavior. Such fluently processed materials that are easy to read and understand have enhanced perspicuity and persuasiveness. [ABSTRACT FROM AUTHOR]

Background Established on 1 June 2005, the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) is the largest clinical trial registry in Japan, and joined the World Health Organization (WHO) registry network in October 2008. Our aim was to understand the registration trend and overall characteristics of Japan domestic, academic (non-industry-funded) clinical trials, which constitute the main body of registrations in UMIN-CTR. In addition, we aimed to investigate the accessibility of clinical trials in UMIN-CTR to people worldwide, as well as the accessibility of clinical trials conducted in Japan but registered abroad to Japanese people in the Japanese language. Methods We obtained the data for registrations in UMIN-CTR from the UMIN Center, and extracted Japan domestic, academic clinical trials to analyze their registration trend and overall characteristics. We also investigated how many of the trials registered in UMIN-CTR could be accessed from the International Clinical Trials Registry Platform (ICTRP). Finally, we searched ClinicalTrials.gov for all clinical trials conducted in Japan and investigated how many of them were also registered in Japanese registries. All of the above analyses included clinical trials registered from 2 June 2005 to 1 June 2010. Results During the period examined, the registration trend showed an obvious peak around September 2005 and rapid growth from April 2009. Of the registered trials, 46.4% adopted a single-arm design, 34.5% used an active control, only 10.9% were disclosed before trial commencement, and 90.0% did not publish any results. Overall, 3,063 of 3,064 clinical trials registered in UMIN-CTR could be accessed from ICTRP. Only 8.7% of all clinical trials conducted in Japan and registered in ClinicalTrials.gov were also registered in Japanese registries. Conclusions The International Committee of Medical Journal Editors (ICMJE) announcements about clinical trial registration and the Ethical Guidelines for Clinical Research published by the Japanese government are considered to have promoted clinical trial registration in UMINCTR. However, problems associated with trial design, retrospective registration, and publication of trial results need to be addressed in future. Almost all clinical trials registered in UMIN-CTR are accessible to people worldwide through ICTRP. However, many trials conducted in Japan but registered abroad cannot be accessed from Japanese registries in Japanese. [ABSTRACT FROM AUTHOR]

: Objective Medical disputes between physicians and patients can occur in non-negligent circumstances and may even result in compensation. We reviewed medical dispute cases to investigate the impact of miscommunication, especially in non-negligent situations. : Design Systematic review of medical dispute records was done to identify the presence of the adverse events, the type of medical error, preventability, the perception of miscommunication by patients and the amount of compensation. : Setting The study was performed in Kyoto, Japan. : Participants We analyzed 155 medical dispute cases. : Main outcome measures We compared (i) frequency of miscommunication cases between negligent and non-negligent cases, and (ii) proportions of positive compensation between non-miscommunication and miscommunication cases stratified according to the existence of negligence. Multivariate logistic analysis was conducted to assess the independent factors related to positive compensation. : Results Approximately 40% of the medical disputes (59/155) did not involve medical error (i.e. non-negligent). In the non-negligent cases, 64.4% (38/59) involved miscommunication, whereas in dispute cases with errors, 21.9% (21/96) involved miscommunications. (P <0.01) Although almost at negligent dispute cases were compensated (94/96), the frequency of positive compensation in non-negligent cases was significantly higher if miscommunication was perceived: 78.9% (30/38) with miscommunication and 52.4% (11/21) with non-miscommunication (P < 0.05). The presence of medical error and patients perception of miscommunication were important predictors of positive compensation (odds ratio: 36.9 and 3.6, respectively.) : Conclusions Medical disputes can occur without negligence and may have costly consequences. Medical staffs need to understand that not only the ‘presence of medical errors’, but also ‘patients’ perception of miscommunication, especially in cases with a non-negligent adverse event, can cause serious medical disputes. To prevent future disputes or claims, there is a strong need to improve communication between providers and patients or their relatives. [ABSTRACT FROM AUTHOR]