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The outbreak of COVID-19 in early 2020 created dangerous public health conditions which pressured governments and health systems to respond in a rapid and effective manner. However, this type of rapid response required many governments to bypass standing; bureaucratic structures of health sector administration and political governance to quickly take; essential measures against a rapidly evolving public health threat. Each government's particular; configuration of governmental and health system decision-making created specific structural and functional challenges to these necessary centrally developed and coordinated strategies. Most East Asian governments (except Japan) succeeded relatively quickly in centralizing essential disease control and treatment initiatives in a timely manner. In contrast, a number of European countries, especially those with predominantly tax-based financing and politically managed health delivery systems, had greater difficulty in escaping bureaucratic governance and management constraints. Drawing on data about these governments' early stage COVID-19 control experiences, this article suggests that structural changes will be necessary if low-performing governments are to better respond to a pandemic. This paper also summarizes other relatively successful strategies. By adopting such strategies, nations can help overcome structural bureaucratic and administrative obstacles in responding to further waves of COVID-19 or similar future pandemic events. [ABSTRACT FROM AUTHOR]

After the 1970s the new urban poverty (NUP) ballooned in Japan and the US, and it evoked policy responses that produced new, rescaled regulatory spaces to contain the poor on the fringe of social rights and the capital circuit. The paper illuminates this process through the comparison of Japanese and US trajectories, both of which, evolving through economic crises, have established unique pathways. The author first constructs a theoretical framework based on Marxian, Polanyian, and Lefebvrean traditions. Then, he compares national-scale poverty regulation in Japan and the US from the 1950s through the 2000s. Lastly, the author examines how the countries' regulation of a major aspect of the NUP--homelessness--intensified multiscalar reseating processes. The paper concludes that regulation of the NUP represents a significant instance of uneven spatial development of capitalism mediated by the state that requires synthetic research. [ABSTRACT FROM AUTHOR]

The premise of this paper is that those persons who excessively overwork can die as a result, through stress-related illness or suicide. This paper undertakes a comparative analysis of the legal treatment of stress-related illness at work and, in particular, death by overwork (known as Karoshi in Japan). The legal rules governing this aspect of health and safety in the US and the UK will be considered primarily, because these are countries where this problem has not been properly recognized and, accordingly, legislators and the judiciary in both the US and the UK have largely failed to address it. Despite this, it is a fact that organizations in these countries have the worst record for requiring their workforce to work excessively and/or for long hours. Research has shown that this leads to stress-related illness and sometimes death by overwork in organizations. The failure to take legal action to deal with this problem in the US and the UK is all the more surprising and disappointing because these countries (along with Japan where it is legally recognized) have the richest economies in the world. It is now accepted that a working pattern and culture of long hours and excessive working adversely affect workers by putting at risk their physical and/or mental health, and it is important to consider how workers in this position are dealt with by employers and within the legal framework of both jurisdictions. [ABSTRACT FROM AUTHOR]

This study examines the differences in business continuity of Japanese and American small organizations during the Covid-19 pandemic since early 2020 in terms of organizational adaptation empowered by loans, grants, and aid and created through processes of visioning, and relationship building. The 28 Japanese and 21 American small organizations collected through snowball sampling were asked about their level of preparedness, the types of aid earned, the vision that an organization developed, and how they used their organization to advance community life. We used semi-structured interviews in the participants' native languages for 40 min to 1.5 h. Coding results identified 36 codes, nine subcategories, and three broad categories common among small organizations in Japan and the United States. A comparison of the coding results showed three results that we focus on in our comparative analysis. First, loans, grants, and aid provided by the government were effectively used as a business continuity resource in both countries. Second, visioning, a process of setting goals and understanding purpose, was observed in Japan and the United States. Lastly, Japanese organizations emphasized maintaining relationships with business partners, even providing monetary support to them. Conversely, in the United States, new relationships were observed but organizations did not provide as much mutual support. Thus, the study clarified two different types of resilience among small organizations: trust-based resilience seen frequently in Japan, which seeks to maintain relationships with employees and business partners rather than investing in the organization, and the change-based resilience in the United States, which aims to change the organization and build new relationships. [ABSTRACT FROM AUTHOR]

Background: Little League elbow, including humeral epicondylitis and osteochondritis dissecans, is a severe throwing injury in school-aged pitchers. Recent rule revisions have been implemented, and thus, prevention awareness may have increased. Purpose: To compare the incidence of elbow injury in 2011 from a previous study with that in 2021 and examine changes in the incidence and characteristics of players with elbow injuries. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A survey based on the 2011 survey was conducted from September 1 to December 31, 2021, among 4060 third- to sixth-grade Little League players belonging to 203 teams in Kyoto, Japan. This survey included a 23-item checklist on physical condition and injury. The participants were classified into 2 groups according to the presence or absence of an elbow injury in the dominant arm during the season. The Wilcoxon rank-sum test was conducted to compare differences in basic information between the 2 groups. We also compared the differences in the 23 checklist items between the 2 groups using the chi-square or Fisher exact probability test. Results: Overall, 98 teams (1335 players; age range, 8-12 years) returned the questionnaires (collection rate, 32.9%). The final analysis population (excluding incomplete questionnaires) was 678 (mean age, 10.6 ± 1.1 years). Elbow injuries accounted for 30.7% of all injury sites in the players. Overall, 61 players (9.0%) reported elbow injuries in 2021 compared with 19.1% of the players in the 2011 survey (P <.01) A significantly higher percentage of players with elbow injuries had elbow pain in extension (item 2 on the survey checklist, P <.001) and flexion (item 4, P <.0024), were regular players (item 5, P =.0288), played baseball under fatigue (item 8, P =.0028), and had lower and upper limb inflexibility (item 17, P =.0379; item 18, P =.0146; and item 22, P =.0085). Conclusion: Study findings indicated that the incidence of elbow injuries has decreased significantly over the past 10 years, although the elbow joint still accounted for almost one-third of all injuries in Japanese youth baseball players. [ABSTRACT FROM AUTHOR]

This paper examines how multiple roles affect the mental health of the elderly in Japan and the United States, two countries with vastly different cultures. Hypotheses were drawn based on the cultural differences in role experiences, and these hypotheses are tested by analyzing nationally representative samples of the elderly in these countries. The results show that Americans are more likely to be involved in roles related to family, work, and community, while the Japanese are more likely to be involved in only those roles related to family and work. Multiple roles are also found to be less beneficialfor the mental health of Japanese elderly compared to American counterparts. National differences in the effects of individual roles and role configurations on mental health are also documented. Overall, the results show the importance of broad cultural contexts for understanding the relationship between roles and mental health. [ABSTRACT FROM AUTHOR]

Objectives: We assessed the effectiveness and safety of rivaroxaban in patients with isolated distal deep vein thrombosis (IDDVT). Methods: Symptomatic venous thromboembolism (VTE) and major bleeding were assessed. Results: Of 1016 patients with acute symptomatic/asymptomatic DVT and/or pulmonary embolism treated with rivaroxaban, 288 had IDDVT and 294 had proximal DVT (pDVT). The IDDVT group had fewer patients on the higher rivaroxaban dose (30 mg/day) (42.7% vs. 66.0%) and a shorter treatment duration (135.5 vs 369.5 days) than the pDVT group. VTE recurrence occurred in 14 and 11 patients with IDDVT and pDVT, respectively (2.89% vs. 2.29% per patient-year; p = 0.534). Major bleeding was less frequent in the IDDVT group (1.55% vs. 4.53% per patient-year; p = 0.044). Comparable effectiveness and safety were observed with 15 and 30 mg/day rivaroxaban in the IDDVT group. Conclusions: Short-term, low-dose rivaroxaban seems safe and effective for IDDVT treatment. [ABSTRACT FROM AUTHOR]

An underlying concern about the COVID-19 pandemic is the decline of children's mental health. The present study is aimed to investigate whether a single school-based intervention, including self-monitoring and psychoeducation for COVID-19, effectively achieved its aim to promote children's mental health. The study was conducted in a junior high school. We assigned the third grade as the intervention group, the second grade as the announcement group, and the first grade as the control group. We hypothesized that the intervention group would experience improved mental health and reduced fear of COVID-19 compared to the announcement and control groups. Interaction effects were observed only for depression, indicating a significant effect in the intervention group. These findings suggest that a single school-based intervention that includes self-monitoring and psychoeducation for COVID-19 can help improve children's mental health. It is suggested that school-based interventions that intend to raise children's awareness of COVID-19 promote their healthy development and adaptation to crises within the school. [ABSTRACT FROM AUTHOR]

Background: Continuous deep sedation is ethically controversial with respect to whether it shortens a patient's life. Aim: To examine whether continuous deep sedation shortens patient survival from the day of Palliative Performance Scale decline to 20 (PPS20). Design: A part of a multicenter prospective cohort study (EASED study). Setting/participants: We recruited consecutive adult patients with advanced cancer admitted to 23 participating palliative care units in 2017 in Japan. We compared survival from PPS20 between those who did and did not receive continuous deep sedation. Continuous deep sedation was defined as the continuous administration of sedative medication with the intention to keep a patient continuously unconscious to alleviate otherwise uncontrollable symptoms, but the dose of sedatives was adjusted to achieve adequate symptom relief for each patient. The propensity score-weighting method was used to control for potential confounders, and five sensitivity analyses were performed. Results: A total of 1926 patients were enrolled. Patients discharged alive were excluded, and we analyzed 1625 patients of whom 156 (9.6%) received continuous deep sedation. Median survival from PPS20 of 1625 patients was 81 h (95% CI: 77–88). The RASS scores decreased to ⩽−4 was 66% at 24 h. Continuous deep sedation was not associated with a significant survival risk (adjusted hazard ratio: 1.06, 95% CI: 0.85–1.33). All sensitivity analyses, including continuous deep sedation defined as the RASS score was ⩽−4 achieved the essentially the same results. Conclusions: Continuous deep sedation with careful dose adjustment was not associated with shorter survival in the last days of life in patients with advanced cancer. [ABSTRACT FROM AUTHOR]

Objective: To compare the 1-year outcomes of patients with lumbar spinal stenosis treated with supervised physical therapy or unsupervised exercise. Design: A single-center randomized controlled trial with concealed allocation, blinded assessor and intention-to-treat analysis. Setting: Spine care center. Subjects: A total of 86 patients presenting with symptoms of neurogenic claudication caused by lumbar spinal stenosis. Interventions: The physical therapy group received supervised physical therapy sessions twice a week for 6 weeks and home exercise program. The home exercise group received 6-week home exercise program only. Main measures: The primary outcome was symptom severity on the Zurich claudication questionnaire at 1 year. Secondary outcomes included physical function, pain, health-related quality of life and the surgery rate after 1 year. Results: At 1 year, more patients in the physical therapy group than in the home exercise group achieved minimum clinically important differences in Zurich claudication questionnaire symptom severity (60.5% vs 32.6%; adjusted odds ratio [AOR] 4.3, [95% CI [1.5–12.3], P = 0.01); Zurich claudication questionnaire physical function (55.8% vs 32.6%; AOR 3.0 [1.1–8.1], P = 0.03); SF-36 bodily pain (48.8% vs 25.6%; AOR 2.8 [1.1–7.3], P = 0.03), and SF-36 general health (20.9% vs 7.0%; AOR 6.1 [1.1–33.0], P = 0.04). The surgery rate at 1 year was lower in the physical therapy than in the home exercise group (7.0% vs 23.3%; AOR 0.2 [0.04–0.9] P = 0.04). Conclusions: Supervised physical therapy produced greater improvements in symptom severity and physical function than unsupervised exercise and was associated with lower likelihood of receiving surgery within 1 year. [ABSTRACT FROM AUTHOR]

Nonpharmaceutical interventions (NPIs) are important public health tools to fight against COVID-19. Governments around the world have instituted a variety of NPIs to modify individuals' behavior, giving rise to four distinct pandemic response strategies: nudge, mandate, decree, and boost. To better understand the different policy choices involved in these strategies, four countries including Sweden, China, France, and Japan were compared to identify the critical institutional and cultural determinants of national response strategy. The finding shows that various responses regarding same threat are dependent on the distinctive institutional arrangements and cultural orientation of each country, and thus, there is no One-Size-Fits-All strategy. [ABSTRACT FROM AUTHOR]

Population aging is expected to increase long-term care (LTC) costs in both Japan and Sweden. This study projected LTC costs for 2010 through 2040 for different assumptions of population change, LTC need by age group and gender, and LTC provided per level of need and cost in Japan and Sweden. Population data were taken from the official national forecasts. Needs projections were based on epidemiological data from the Nihon University Japanese Longitudinal Study of Aging and the Swedish Survey of Living Conditions. Data on LTC provision by need and cost were taken from nine Japanese municipalities collected by assessments in the LTC insurance system and from surveys in eight Swedish municipalities. Total initial costs were calibrated to official national figures. Two projections based on two different scenarios were made for each country from 2010 to 2040. The first scenario assumed a constant level of need for LTC by age group and gender, and the other assumed a continuation of the present LTC need trends until 2025. For Japan, this resulted in a projected cost increase of 93% for the one and 80% for the other; for Sweden it was 52% and 24%, respectively. The results reflected differences in population aging and health development. [ABSTRACT FROM AUTHOR]

With the growing focus on continuous professional development, demands placed on nurses to uphold nursing competence have been increasing. This study examined how nurses with different lengths of clinical experience perceived the relationship between their actual competence and the competence they felt was demanded of them, and how this relationship was related to their turnover intentions. Survey questionnaires were distributed to 1,377 nurses, of whom 765 returned usable completed forms. The results showed that across all the groups of clinical experience, nurses perceived the demanded competence levels to be higher than their actual competence levels. However, turnover intentions were not related to nurses’ perceptions of demanded competence and were negatively related to perceptions of actual competence. The levels of competence demanded should not be considered as threats for nurses. Improving nurses’ competence may reduce their turnover intentions. [ABSTRACT FROM AUTHOR]

Using a sample of 116 Japanese men who had been placed under parole/probationary supervision or released from prison, the present study examined standardization, reliability, and validation of the Japanese Criminal Thinking Inventory (JCTI) that was based on the short form of the Psychological Inventory of Criminal Thinking Styles (PICTS), a self-rating instrument designed to evaluate cognitive patterns specific to criminal conduct. An exploratory factor analysis revealed that four dimensions adequately captured the structure of the JCTI, and the resultant 17-item JCTI demonstrated high internal consistency. Compared with the Japanese version of the Buss-Perry Aggression Questionnaire (BAQ), the JCTI showed a favorable pattern of criterion-related validity. Prior criminal environment and drug abuse as the most recent offense also significantly correlated with the JCTI total score. Overall, the JCTI possesses an important implication for offender rehabilitation as it identifies relevant cognitive targets and assesses offender progress. [ABSTRACT FROM AUTHOR]

Japan and South Korea have always taken what may be called a social investment approach to their social and economic development policies. They were able to achieve a high level of economic growth, in part, because of their targeted social spending that supported and protected the productive sectors of the society. Since the 1990s, however, there has been a marked shift in the targets of social investment, from predominantly skilled, male, industrial core workers to more peripheral, marginalized, and vulnerable population groups, such as women, children, and the elderly. Moreover, this new policy focus is now increasingly put forward from the perspective of inclusive welfare and the discourse of social inclusion, thus breaking from the earlier productivist thinking. Indeed, recent social investment policy debates in the two countries are often framed in terms of intergenerational equity, social and economic sustainability, and economic democracy. What are these ‘new social investments’, and why the shifts? This article looks at the new social investment policies in Japan and South Korea to understand factors behind the changes, and assess how ‘new’ are these new social investments. [ABSTRACT FROM PUBLISHER]

Background:A disadvantage of pivot-shift maneuvers is that the examiner has to subjectively evaluate the degree of pivot shift observed. It is unknown whether the various maneuvers are biomechanically identical.Purpose:To compare biomechanical features of 3 clinical maneuvers for the anterior cruciate ligament (ACL)–deficient knee: the pivot-shift test, the jerk test, and the N-test.Study Design:Controlled laboratory study.Methods:A total of 28 patients with an isolated ACL injury were examined by use of 3 pivot-shift maneuvers (pivot-shift test, jerk test, and N-test). An electromagnetic sensor system was used to evaluate the 3-dimensional knee kinematics of each patient’s injured and uninjured knees during each maneuver. Peak coupled anterior tibial translation (pCAT) and maximal acceleration of posterior translation (APT) were measured relative to results during a flexion-extension motion in each test.Results:The pCAT of the pivot-shift test was significantly greater than that of both the jerk test and the N-test (P = .0020 and P < .0001, respectively); there was no statistical difference in pCAT between the jerk test and the N-test. The APT of the N-test was significantly greater than that of both the pivot-shift test and the jerk test (P < .0001), while there was no statistical difference between the pivot-shift and the jerk tests. There was no correlation between pCAT and APT in each test.Conclusion:The pivot-shift test, jerk test, and N-test have different biomechanical characteristics to induce the pivot-shift phenomenon in the ACL-deficient knee. The pivot-shift test produced the largest side-to-side difference in pCAT, whereas the N-test provoked the largest side-to-side difference in APT.Clinical Relevance:The biomechanical differences in pivot-shift maneuvers are caused by technical differences, and clinicians should understand these biomechanical differences while practicing the maneuvers. The electromagnetic sensor system is clinically useful for quantifying the pivot-shift phenomenon. [ABSTRACT FROM AUTHOR]

Background: Controversy persists as to whether double-bundle reconstruction of the anterior cruciate ligament (ACL) has any clinical advantage over single-bundle reconstruction. Several studies have used subjective and nonquantitative manual tests to evaluate the rotatory stability of the knee. The authors have developed a method to quantitate the rotatory stability of the ACL-deficient knee using open magnetic resonance imaging (MRI).Hypothesis: Anatomic double-bundle reconstruction restores rotatory stability significantly better than does single-bundle reconstruction.Study Design: Cohort study; Level of evidence, 3.Methods: Twenty-three consecutive patients treated with the single-bundle reconstruction (group S) and 25 consecutive patients treated with the anatomic double-bundle reconstruction (group D) were evaluated. Both reconstruction procedures were performed using hamstring tendon autografts. The Slocum anterolateral rotatory instability (ALRI) test was performed 1 year after surgery using open MRI. To assess rotatory stability, we measured the difference in anterior tibial translation between medial and lateral compartments in the sagittal plane and defined this difference as the ALRI value. In addition, clinical examinations consisting of the Lysholm knee score, Tegner activity score, KT-2000 arthrometer anterior translation examination, and the pivot-shift test were carried out.Results: The mean side-to-side difference in ALRI values was significantly less (P < .001) in double-bundle reconstruction (mean, 1.2 mm) than in single-bundle reconstruction (mean, 4.1 mm). The mean side-to-side difference in KT-2000 arthrometer measurements was significantly less (P = .014) in double-bundle reconstruction (mean, 1.2 mm) than in single-bundle reconstruction (mean, 2.6 mm). The difference in the incidence of positive pivot-shift tests between group S (43%) and group D (16%) did not reach the level of statistical significance (P = .058). No significant differences in Lysholm score or Tegner score between the groups were observed.Conclusion: The rotatory stability of anatomic double-bundle reconstruction was significantly better than the rotatory stability of single-bundle reconstruction. [ABSTRACT FROM AUTHOR]

American listeners’ perception of Japanese contrasts of vowel length (e.g., kiro vs. kiiro), consonant length (e.g., kite vs. kitte) and syllable number/length (e.g., kjoo vs. kijoo) was examined. Stimuli consisted of sentence-length utterances produced by a native Japanese talker; five minimal pairs of each contrast type were included. Questions were: a) can American listeners with no Japanese experience discriminate these contrasts, b) are there differences in relative difficulty of the three contrast types, and c) do instructions and other task variables affect performance accuracy? A categorial AXB discrimination task was used in two studies: Study 1 tested the three contrast types presented in separate blocks with detailed instructions about what to listen for; Study 2 tested the contrast types presented randomly intermixed with no specific instructions about the nature of the contrasts. Results indicated that naïve American listeners could discriminate all three contrast types well above chance, and that there were no significant overall differences in relative difficulty across contrast types. Performance was significantly poorer in Study 2 where listeners’ attention had not been directed to the nature of the contrasts. In both studies, there was significant and large variability in accuracy across different minimal pairs of each contrast type. [ABSTRACT FROM PUBLISHER]

A visual semantic categorization task in English was performed by native English speakers (Experiment 1) and late bilinguals whose first language was Japanese (Experiment 2) or Spanish (Experiment 3). In the critical conditions, the target word was a homophone of a correct category exemplar (e.g., A BODY OF WATER—SEE; cf. SEA) or a word that differed from the correct exemplar by a phonological contrast absent in the bilinguals' first language (e.g., USED FOR COOLING DOWN—FUN; cf. FAN). Homophones elicited more false positive errors and slower processing than spelling controls in all groups. The Japanese-English bilinguals, but not the Spanish-English bilinguals, also displayed 'near-homophone' effects (i.e., homophone-like effects from minimal pairs on nonnative contrasts). We conclude that second-language visual word recognition is influenced by first-language phonology, although the effect is conditioned by the first-language orthographic system. Near-homophone effects can occur when the orthographic systems of the late bilingual's two languages are different in type (e.g., alphabetic vs. non-alphabetic), but may be blocked if the languages use the same writing script (e.g., Roman alphabet). [ABSTRACT FROM AUTHOR]

This study explores how cultural values affect the meaning and experiences of daughter (or daughter-in-law) caregivers of elderly persons with dementia by comparing caregivers in the United States and Japan. Nine American and seven Japanese caregivers were interviewed twice at 6-month intervals. Interviews were audiotaped and analyzed using constant-comparative techniques. Data suggest that moral obligation to care and intense loss are two universal themes of caregiving. However the experiences and perceptions of the role of caregivers from these two cultures differed in select ways that were captured within three categories: reasons for caregiving, caregiving as a career, and caregiving as a life phase or detour. Findings suggest that American caregivers may need greater anticipatory socialization regarding the caregiving role, whereas Japanese caregivers may benefit from assistance in accepting needed services. [ABSTRACT FROM AUTHOR]

Presents the book "Capitalist Property and Financial Power: A Comparative Study of Britain, the United States and Japan," by John Scott.