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This publication seeks to consider statistics education in Japan while referencing a student paper. The paper to be considered is as follows: "Gakusei no Koudou ga Gakusei Seikatsu Manzokudo ni Ataeru Eikyou" (The Influence of Student Behavior on the Degree of Satisfaction Perceived in Student Life).

In this article, the conceptions of variability held by samples of Japanese and Thai senior high school mathematics teachers were identified, based on the framework proposed by Shaughnessy (2007), using a comparative survey study. From contrasting the results of the two groups, relative tendencies of insufficient statistical knowledge for variability were found in both samples, such as a tendency of Japanese teachers to overgeneralize equiprobability, whereas Thai teachers tended to overgeneralize estimation. Based on these findings, the use of well-known tasks from the research literature for this comparative study seems useful to clarify the relative tendencies and insufficiencies in teacher knowledge and conceptions regarding variability held by both groups.

As a component of the ongoing development of the mathematics curriculum in China, we compare the country's high school mathematics textbooks with those of several other countries. We base our analysis on the assumption that textbooks, as primary printed teaching resources, are key tools for interpreting educational policy. In this paper, we compare what content is selected and how that content is presented in series of high school textbooks from China, France, Germany, Japan, Russia, the United Kingdom, and the United States according to four core domains: algebra, geometry, statistics and probability, and calculus. We then discuss the implications of the analysis for the reform of the high school mathematics curriculum in China, particularly as it applies to the development of textbooks within that process of reform. The comparative results provide us with the opportunity to recognise the distinguishing features of the content and presentation of the Chinese mathematics curriculum and lead to some suggestions for future curriculum development.

Statistical literacy is complex and multifaceted. In every country, education and numeracy are a function of a multitude of factors including culture, history, and societal norms. Nevertheless, since the launch of the International Statistical Poster Competition (ISLP) in 1994, a number of patterns have emerged to suggest there are some common or universal success factors in running statistical literacy competitions involving schools, universities, statistical offices, and many other institutions. This paper outlines some of those factors, such as institutional cooperation, celebrating participation and success, improvement of statistical literacy in the local schools, support for teachers, the involvement of national statistics institutes, and use of technology. These factors have been identified from our own experience running the competition and from articles submitted to the ISLP newsletters. Statistical literacy is a complex phenomenon, and so this is neither an exhaustive list of key factors nor a formula for success, but rather an overview of recurring themes across countries participating in the competition around the world.

This article reports an analysis of the relationship between women's increased participation in higher education and other recent social changes over the last four decades. To date, women's increased involvement in higher education has been studied as either a force for or a consequence of other sociocultural changes. Drawing on data from key international data sets and with a focus on a range of Organisation for Economic Co-Operation and Development (OECD) countries, this article details an exploratory factor analysis of women's higher education participation and a range of other variables identified as indicators of or mediators for social change. This analysis reveals the existence of four underlying factors showing the structural interrelationship between the variables.

As part of Japanese Lesson study research focusing on "comparing and describing likelihoods", fifth grade elementary students used real-world data in decision-making. Sporting statistics facilitated opportunities for informal inference, where data were used to make and justify predictions.

One of the main approaches used in communicating environmental issues to citizens is conveying "factual" information about a particular environment. However, despite previous research and recommendations made by critical environmental educators, there still seems to be a belief that the more "factual" information one can convey, the more citizens will become aware of the issue, and this will prompt them to change their behaviours. In this article, I will argue that continuing with a "fact"-focused practice in Japan and elsewhere could be problematic for three key reasons: (1) it ignores diversity in the "facts" provided to people; (2) it reinforces the "hierarchy of knowledge"; and (3) it ignores the "myth of nature" among information receivers and senders. Key recommendations for incorporating a critical environmental education approach include utilising locally available environmental information on contentious environmental issues; investigating particular terminology used and missing information (including tacit knowledge); and encouraging critical learning about statistics and pictorial representations.

Examines how selected U.S. and Asian mathematics curricula are designed to facilitate students' understanding of the arithmetic average. Discusses similarities and differences of learning goals, focuses, and concepts among U.S. commercial, Asian, and U.S. reform curriculum series. (Author/KHR)

The status of probability and statistics in the current Japanese curriculum is discussed. Data from the Second International Mathematics Study are cited, and the course of study is included. (MNS)

Late emerging adulthood is pivotal for identity exploration and development and is interrelated with life satisfaction. In the development of identity and life satisfaction, it is important to have a stable employment status that supports the foundation of life. However, the interrelationships among identity, life satisfaction, and employment status in late emerging adulthood are unclear. Using a two-wave longitudinal survey, this study examined identity development and whether the relationship between identity and life satisfaction varies by employment status. Participants included 875 Japanese emerging adults (65.5% women, Mage = 24.74, SDage = 0.44). Multivariate analysis of variance showed that identity synthesis decreased for those who lost their jobs or those who changed from being full-time to part-time employment. Additionally, individuals with full-time employment had higher identity synthesis and lower confusion than those with part-time or no employment. Multi-group path analysis indicated that identity synthesis was positively associated with life satisfaction and confusion was negatively associated, and these relationships did not differ by employment status. These findings suggest that identity development in late emerging adulthood varies by employment status and that the association between identity and life satisfaction may not be moderated by employment status. Overall, this study contributes to elucidating the characteristics of identity development along employment status and its relationship to life satisfaction in late emerging adulthood. [ABSTRACT FROM AUTHOR]

The European Health Literacy Survey Questionnaire (HLS-EU-Q47) is available in multiple languages, and shortened versions have also been developed. This study aimed to examine the reliability and validity of the short version of the questionnaire (HLS-Q12) developed for community-dwelling older adults in Japan. The HLS-Q12 was developed using 12 of the 47 items of the Japanese version of the HLS-EU-Q47. In this study, the survey was conducted by distributing self-administered questionnaires to community-dwelling individuals aged 65 years and older who consented to participate; their responses were collected by mail. The correlation between the HLS-Q12 and the HLS-EU-Q47 was tested to assess criterion validity. To test construct validity, nine novel hypotheses were proposed. We also conducted a confirmatory factor analysis of the HLS-Q12. Based on a resurvey after 5–7 days, test–retest reliability was examined using interclass correlation coefficients (ICCs) and Bland–Altman analysis. In total, 118 individuals provided valid responses to the questionnaire. The Spearman rank correlation coefficient between the HLS-Q12 and the HLS-EU-Q47 was r  = 0.98 (p  < 0.001), and eight of the nine hypotheses were supported. The ICC was 0.96 (p  < 0.001), and the 95% limit of agreement was −0.26 ± 5.9, suggesting no systematic error. Thus, the Japanese version of the HLS-Q12 was found to be reliable with high criterion validity and reproducibility. Hence, the HLS-Q12 is a useful scale for measuring health literacy among older adults in Japan. [ABSTRACT FROM AUTHOR]

Background: In Japan, comprehensive cancer statistics are collected through cancer registries. However, data on urological cancers are rarely summarized or published in research papers. Methods: This retrospective study was performed using publicly available statistical data on urological cancers (prostate cancer [PCa], bladder cancer [BCa], and cancers of kidney and urinary tract [except urinary bladder]) in Japan, including a summary of the Ministry's mortality statistics, cancer incidence statistics from the Regional Cancer Registries through 2015, and the National Cancer Registry statistics from 2016. We examined the incidence and mortality rates of urological cancers stratified by age groups. Results: The number of new cases of PCa, BCa, and cancers of kidney and urinary tract (except urinary bladder) in 2019 was 94,748, 23,383, and 30,458, respectively, and the number of deaths in 2022 was 13,439, 9,598, and 9,795, respectively. The incidence and mortality rates of urological cancers have consistently increased. Since 2000, there has been a noteworthy increase in the mortality rate of urological cancers among individuals aged > 85 years. The incidence and mortality rates of BCa and cancers of kidney and urinary tract (except urinary bladder) were significantly higher in males than in females. Conclusions: Urological cancers in very elderly patients (> 85 years) will become increasingly important in the future. [ABSTRACT FROM AUTHOR]

In the lives of those who are the target of community health nursing, it is important to collaborate with individuals and communities to improve their quality of life. Herein, we aimed to determine the association between Internet use among older individuals and locomotive syndrome (LS), frailty, and sarcopenia. In this cross-sectional study conducted between July 2022 and March 2023, we recruited 105 community-dwelling older Japanese adults who participated in a care prevention project called "Kayoi-no-ba". All participants were divided into Internet and non-Internet user groups according to the classification of a previous study. We assessed LS (standing test, two-step test, and five-question Geriatric Locomotive Function Scale), frailty (through the Questionnaire for Medical Checkup of Old-Old), and sarcopenia (grip strength, normal walking speed, and skeletal muscle mass index) and made group comparisons between Internet users and non-users. Binomial logistic regression analyses were performed with Internet use as the independent variable and sarcopenia or LS as the dependent variables. The Internet and non-Internet user groups had 69 and 36 participants, respectively. The Internet user group comprised 65.7% of all participants, which was similar to that reported in a previous study of the same age group. Between-group comparisons showed significant differences in sarcopenia and LS items, whereas adjusted binomial logistic analysis showed a significant association between sarcopenia and Internet use. In summary, among LS, frailty, and sarcopenia, sarcopenia showed the highest association with Internet use. Older adults without sarcopenia having good physical functions, such as grip strength, walking speed, and skeletal muscle index, more likely used the Internet; while older adults with sarcopenia were less likely to use the Internet. This implied that Internet use may be associated with physical function. [ABSTRACT FROM AUTHOR]

Background and aims: Conversion to laparotomy is among the serious intraoperative complications and carries an increased risk of postoperative complications. In this cohort study, we investigated whether or not the Endoscopic Surgical Skill Qualification System (ESSQS) affects the conversion rate among patients undergoing laparoscopic surgery for rectal cancer. Methods: We performed a retrospective secondary analysis of data collected from patients undergoing laparoscopic surgery for cStage II and III rectal cancer from 2014 to 2016 across 56 institutions affiliated with the Japan Society of Laparoscopic Colorectal Surgery. Data from the original EnSSURE study were analyzed to investigate risk factors for conversion to laparotomy by performing univariate and multivariate analyses based on the reason for conversion. Results: Data were collected for 3,168 cases, including 65 (2.1%) involving conversion to laparotomy. Indicated conversion accounted for 27 cases (0.9%), while technical conversion accounted for 35 cases (1.1%). The multivariate analysis identified the following independent risk factors for indicated conversion to laparotomy: tumor diameter [mm] (odds ratio [OR] 1.01, 95% confidence interval [CI] 1.01–1.05, p = 0.0002), combined resection of adjacent organs [+/−] (OR 7.92, 95% CI 3.14–19.97, p < 0.0001), and surgical participation of an ESSQS-certified physician [−/+] (OR 4.46, 95% CI 2.01–9.90, p = 0.0002). The multivariate analysis identified the following risk factors for technical conversion to laparotomy: registered case number of institution (OR 0.99, 95% CI 0.99–1.00, p = 0.0029), institution type [non-university/university hospital] (OR 3.52, 95% CI 1.54–8.04, p = 0.0028), combined resection of adjacent organs [+/−] (OR 5.96, 95% CI 2.15–16.53, p = 0.0006), and surgical participation of an ESSQS-certified physician [−/+] (OR 6.26, 95% CI 3.01–13.05, p < 0.0001). Conclusions: Participation of ESSQS-certified physicians may reduce the risk of both indicated and technical conversion. Referral to specialized institutions, such as high-volume centers and university hospitals, especially for patients exhibiting relevant background risk factors, may reduce the risk of conversion to laparotomy and lead to better outcomes for patients. Trial Registration: This study was registered with the Japanese Clinical Trials Registry as UMIN000040645. [ABSTRACT FROM AUTHOR]

This study aimed to determine the relationship between specific information source usage and uptake of the coronavirus disease 2019 (COVID-19) vaccine. We analyzed 3348 participants aged 20 to 65 years who were not diagnosed with COVID-19 in a case-control study in Sapporo, Japan. The most prevalent information source on COVID-19 was television (TV; 87.8%), followed by online news sites (74.3%), newspapers (38.7%), websites of public institutions (30.9%), and families (29.7%). Multivariate logistic regression showed that the adjusted odds ratios of incompletion of second vaccinations for users of TV and newspaper to gather COVID-19 information were 0.31 and 0.32, respectively, whereas those for users of books, commercial video sites, Facebook, and "personal blog or bulletin board system" were 3.34, 2.22, 2.36, and 4.81, respectively. Social media use among older or male participants was associated with lower vaccine uptake. [ABSTRACT FROM AUTHOR]

Survey experiments have shown mixed results about the effect of information provision on attitudes toward controversial policies. We argue that one reason is varied receptiveness to different modes of information. Prior research suggests that people selectively ignore factual, statistical information that contradicts prior beliefs but are more attentive to narrative information that describes individual experiences. We test this in the context of Japanese attitudes toward poverty relief programs, which are less popular than other welfare expenditures. Using a conjoint survey, we show that there is a "narrative premium": Respondents who are shown a narrative story about the plight of a single mother are more likely to support higher expenditures on poverty relief than those who are shown statistical information about the share of single parents living in poverty. This premium is particularly effective in strengthening the convictions of those who are already aware of levels of societal poverty. [ABSTRACT FROM AUTHOR]

Background: Evidence-based practice (EBP) is essential for pharmacists to select and recommend over-the-counter (OTC) drugs in medical consultations (hereinafter referred to as OTC counseling). Objectives: This study examined the association between pharmacists' perceptions of EBPs and their implementation of OTC counseling. Methods: A web-based survey was conducted. Questions regarding pharmacists' perceptions of EBP and experience in OTC counseling were set, and respondents were asked to respond based on a 5-point scale ranging from 1 (strongly disagree) to 5 (strongly agree). The association between pharmacists' perceptions of EBP and experience in OTC counseling was examined by calculating Spearman's ρ using bivariate correlation analysis. Results: Responses were obtained from 250 pharmacists. Although 70% of respondents indicated that EBP improves service quality, only 39, 31, and 14% had knowledge of the EBP steps, conducted a literature search, and performed a critical appraisal, respectively. Regarding OTC counseling experience, only 31% of respondents indicated that "sufficient evidence information on OTC drugs has been obtained." Over 60% of respondents expressed the need for OTC usage guidelines and support tools and revealed that brand-specific purchases of OTC drugs make EBP difficult. An association was observed between pharmacists' perceptions of EBP and experience in OTC counseling. "Level of recognition of steps for practicing evidence-based medicine" was associated with the "need fulfillment level for evidence information" (ρ = 0.329, P < 0.001), "brand-specific purchases of OTC drugs" (ρ = 0.240, P < 0.001), "perception of product advertisement" (ρ = 0.227, P < 0.001), and "need for OTC guidelines" (ρ = 0.208, P < 0.001). Conclusions: Pharmacists' perceptions of EBP were associated with their experience in OTC counseling [ABSTRACT FROM AUTHOR]

Aim: To clarify the state of screening and support systems for socially high‐risk pregnant women at obstetric facilities across Japan and identify the characteristics of facilities related to the implementation of screening. Methods: This cross‐sectional study used a self‐administered questionnaire. Participants were managers of hospitals, clinics, and midwifery birth centers handling deliveries in 47 prefectures across Japan. The questionnaire comprised items regarding the characteristics of participants and their facilities, service provision related to socially high‐risk women available at the facility, the number of specified pregnant women (tokutei ninpu) per year, methods of screening, and support systems within the obstetric facilities. Descriptive statistics and multivariate logistic regression analysis were performed using IBM‐SPSS version 24 for the association between facility characteristics and screening practices for socially high‐risk pregnant women. Results: Valid responses were received from 716 of 2512 obstetric facilities. Rates of specified expectant mothers per annual number of deliveries were identified as follows: perinatal medical centers (2.7%), general hospitals (1.6%), obstetrics and gynecology hospitals (1.0%), and clinics (0.8%). A total of 426 facilities (60.6%) reported screening all expectant mothers to identify socially high‐risk pregnant women. Multiple logistic regression analysis revealed that facility characteristics and service/care provision related to screening practices included availability of in‐hospital midwife‐led care and in‐hospital midwifery clinics (adjusted odds ratio 1.61; 95% CI [1.30, 1.47]), one‐on‐one care by midwife (1.73; 95% CI [1.15, 2.59]), multidisciplinary meetings within the facility (1.70; 95% CI [1.14, 2.56]), follow‐up support systems after discharge (1.90; 95% CI [1.17, 3.09]), and participation in the regional council for children in need of protection (2.33; 95% CI [1.13, 4.81]). Conclusions: Approximately 60% of surveyed obstetric facilities screen for socially high‐risk women. Increasing service provision at facilities may be necessary to implement screening. [ABSTRACT FROM AUTHOR]

Introduction: While there may be differences in the choice of suicide methods between attempters with and those without a history of psychiatric disorders, it is not clear whether these differences predict the actual degree of physical injury. The present study aimed to investigate the association between the history of psychiatric disorder and the degree of physical injury among suicide attempters in a Japanese rural area. Methods: We conducted a cross-sectional study analyzing secondary data of 806 suicide attempters from April 2012 to March 2022 obtained from a Japanese rural city. The exposure variable was a history of psychiatric disorders. The primary outcome was the degree of physical injury of suicide attempters: moderate and severe. We conducted a multivariate Poisson regression analysis to estimate the prevalence ratios (PRs) and 95% confidence intervals (CIs). Results: Among 806 suicide attempters, a significant negative association between the history of psychiatric disorder and the degree of physical injury was observed (PR = 0.40; 95% CI, 0.28-0.59). Those with and without psychiatric disorders were more likely to choose low- and severe-lethality suicide methods such as drug or psychotropic overdoses and hanging or deep wrist injuries, respectively (P <.001). Conclusions: The present study highlights the importance of considering suicide attempters, both with and without psychiatric disorders, while formulating targeted suicide prevention strategies. [ABSTRACT FROM AUTHOR]

Background: The etiology of Bednar's aphthae remains unclear. Our aim was to investigate the incidence of, and factors associated with, Bednar's aphthae in a Japanese newborn cohort. Methods: A retrospective cross‐sectional study was conducted on neonates discharged from the well‐baby nursery at Saitama City Hospital, Japan. The principal investigator carefully examined each neonate's oral cavity, up to and including the pharynx, with a light‐emitting diode (LED) headlight to determine the presence of Bednar's aphthae. Maternal and neonatal clinical characteristics were first compared between neonates with and those without Bednar's aphthae by univariate analysis. Variables with significant inter‐group differences upon univariate analysis were entered into a multivariable logistic‐regression model. Results: This study enrolled 1996 infants. We observed Bednar's aphthae in 9.3% of the Japanese newborn infants who were included. When restricted to infants who were born via vaginal delivery, 13.2% of them had aphthae. Multivariable logistic regression analysis identified vaginal delivery (odds ratio = 6.19, p < 0.0001) in Model 1, and vaginal delivery (odds ratio = 6.73, p < 0.0001) and birth weight (odds ratio = 0.9995, p = 0.034) in Model 2 as independent risk factors for the disease. Conclusion: This is the first report of the prevalence of Bednar's aphthae among Japanese neonates. Vaginal delivery was identified as the strongest risk factor. Although confounding between mode of delivery and mechanical stimuli associated with sucking was not found in this study, the findings pave the way for a better understanding of the etiology of Bednar's aphthae. [ABSTRACT FROM AUTHOR]

Background: After the coronavirus disease (COVID‐19) pandemic, nationwide school closures were implemented in many countries. This study aimed to determine the impact of the school closures on pediatric ambulance transport, comparing the situation before and after the COVID‐19 pandemic. Methods: This retrospective observational study was conducted using data from the Kochi‐Iryo.net database. In Kochi prefecture, schools were closed from March 6 to May 24, 2020. Pediatric emergency transport during the school closure period in 2020 was compared with that in the same period in 2019 (before the COVID‐19 pandemic) and in 2021 (when schools were not closed). Statistical analysis comprised χ2 tests with Bonferroni adjustments for multiple testing. To adjust for patient backgrounds, we also performed multiple logistic regression analyses for numbers of pediatric ambulance transports. Results: The rate of pediatric ambulance transports was significantly lower (p = 0.008) in 2020 (276; 3.97%) than in 2019 (391; 4.87%), but there was no significant difference (p = 0.360) between 2019 (391; 4.87%) and 2021 (352; 4.56%). Multivariable analysis revealed similar trends (2019 vs. 2020: OR 0.86, 95% CI 0.73–1.00; 2019 vs. 2021: OR 0.96, 95% CI 0.82–1.11). Regarding the characteristics of pediatric ambulance transport journeys, there were no significant differences in 2019, 2020, and 2021 in terms of sex, severity, locations of ambulance stations, and disease classification. Conclusions: There was a decrease in pediatric ambulance transportation due to the public health interventions for COVID‐19, including school closures. However, this decrease was not solely due to school closures. [ABSTRACT FROM AUTHOR]

Background: No studies have so far explored differences in frailty between groups of individuals who are vaccinated/unvaccinated against COVID-19. Therefore, this study aimed to investigate frailty progression in community-dwelling individuals requiring care/support who were using outpatient rehabilitation services during the start phase of vaccination programs against COVID-19. Methods: A longitudinal survey using the Frailty Screening Index was administered in April 2020, September 2020, and June 2021 to 74 older adults (43 males, 31 females; age, 78.2 ± 7.2; mean ± standard deviation) requiring long-term care/support and using outpatient rehabilitation services. Participants were divided into the vaccinated (those who had received COVID-19 vaccinations; 41 participants) and unvaccinated (those who had not been vaccinated; 33 participants) groups. The Frailty Screening Index and frailty rating (robust, pre-frailty/frailty) at each of the three periods were analyzed using the Cochran's Q test. The resulting items and ratings with significant differences underwent post-hoc testing with the Bonferroni correction. Results: Concerning the frailty rating (robust, pre-frailty/frailty), pre-frailty/frailty increased significantly only in the unvaccinated group. Its post hoc tests showed that pre-frailty/frailty increased significantly from April 2020 to June 2021 and from September 2020 to June 2021. Conclusions: We find a difference in frailty progression between groups of vaccinated and unvaccinated community-dwelling older adults requiring care/support who were using outpatient rehabilitation services at the beginning of coronavirus vaccination programs during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

This paper aims to show the complex overlapping and interaction with exogenous influences in the processes of national policymaking by analysing a case of policy borrowing in Japan. Specifically, it explores the political circumstances under which the Council of Europe Common European Framework of Reference for Languages (CEFR) was introduced to foreign language education policy at the national government level in Japan. The results suggest that the CEFR was borrowed selectively as a practical solution to achieve prolonged educational and political agendas promoted by multiple actors such as academics, the Ministry of Education (MEXT), and a group of politicians and business associations. This study moreover shows that the CEFR borrowing occurred under manifold interplays between multiple global education trends and domestic needs for Japanese citizens to acquire a practical communicative command of English to strengthen their international economic competitiveness. [ABSTRACT FROM AUTHOR]

Background: While breastfeeding provides benefits for infants and the mother, many women either do not breastfeed or terminate breastfeeding earlier than recommended. The aim of this analysis was to identify factors associated with early discontinuation of breastfeeding in Japanese women. Methods: This study used data from medical records of women delivering a singleton live birth between March 2017 and August 2019 in Iwase General Hospital, Fukushima Prefecture, Japan to assess cessation of breastfeeding by the 1-month postpartum appointment. Demographic (age at birth, and employment status), medical (parity, and physical and mental condition of the mother; and infant medical factors, such as sex, Apgar score, and jaundice, among other), and family factors (husband/partner, family members living at the same house, among others) in 734 women who had initiated breastfeeding during their delivery hospital stay were examined, and multiple logistic regression was used to determine significant predictors of early cessation of exclusive breastfeeding. Results: Bivariate analysis revealed that women who were primipara, unmarried, exposed to secondhand smoke, and employed; those who smoked before pregnancy; and those who had asthma were more likely to discontinue exclusive breastfeeding than other women. Infant factors associated with discontinuation were lower birthweight, earlier gestational age, neonatal intensive care unit admission, treatment for jaundice, or lower weight gain. Multivariable analysis revealed that primiparity, passive smoking before pregnancy, maternal employment, and neonatal jaundice therapy were associated with discontinuation of breastfeeding. Conclusions: In particular, women whose partners smoked before pregnancy may need to be targeted for additional support for breastfeeding. [ABSTRACT FROM AUTHOR]

The aim of this article was to evaluate the correlation between the number of voluntary human immunodeficiency virus (HIV) tests conducted and public awareness according to Internet search volumes from Google Trends. We used bivariate correlations to assess the relationship between the Internet search frequency for each term of HIV and acquired immunodeficiency syndrome (AIDS) and the number of HIV tests, by time series and prefecture. We observed positive correlations between search frequencies of the terms HIV and AIDS and the number of HIV tests in both time-series analysis (HIV: r = 0.65, P <.001; AIDS: r = 0.73, P <.001) and analysis by prefecture (HIV: r = 0.71, P <.001; AIDS: r = 0.40, P =.001). The findings of this study indicate that the current stagnant number of HIV tests conducted in Japan reflects declining public awareness regarding HIV. [ABSTRACT FROM AUTHOR]

INTRODUCTION Tooth loss affects oral health and physical and social functions. With widespread population aging, its prevalence is increasing. Secondhand smoking is a risk factor for oral diseases; however, in Japan, there are currently no regulations restricting exposure to secondhand smoke at home. This cross-sectional study examined the association between secondhand smoking at home and tooth loss among Japanese adults. METHODS The study examined secondary data from the 2016 National Health and Nutrition Survey, Japan. The self-reported responses of 18812 non-smokers aged ≥20 years were analyzed. The association between exposure to secondhand smoke at home and number of teeth was examined through multiple linear regression with multiple imputation. To obtain a more normal distribution, logarithmic transformation was applied to the number of teeth that deviated substantially from a normal distribution. Adjustments were made for sex, age, occupation, household size, dental check-up within the past year, and exposure to secondhand smoke outside the home. RESULTS Overall, 8.4% of the respondents were exposed to secondhand smoking at home almost every day; this percentage was larger among younger respondents, who also had more teeth than the older respondents. Although the univariate linear regression did not show a positive association between exposure to secondhand smoke and tooth loss, the multivariate-adjusted analysis revealed that respondents who were exposed to secondhand smoke at home almost every day had fewer teeth (β= -0.04; 95% CI: -0.07 - -0.01). CONCLUSIONS The present results suggest that exposure to secondhand smoke at home increases the risk of tooth loss. [ABSTRACT FROM AUTHOR]

Purpose: To investigate speech-language pathologists' current perceptions, previous training experiences, resources, barriers, and training needs in terms of evidence-based practices (EBPs) in two Asian countries. Method: Their knowledge and attitudes about EBP were explored using an online questionnaire. A descriptive analysis was conducted with consideration of the effect of demographic variables on knowledge and attitudes about EBP. Result: Malaysian speech-language pathologists (n = 98) displayed more positive attitudes toward EBPs, with a significantly higher (t (143) = 5.91, p <.01) total mean score (Mean = 120.7, SD = 11) compared to the Japanese speech-language pathologists (n = 47, Mean = 107.8, SD = 13.5). Malaysian practitioners who were female, worked full-time, and worked in government settings reported higher motivation to develop EBP skills. Japanese practitioners who worked in private sectors reported higher EBPs training needs than those in government settings. In both countries, speech-language pathologists with higher education levels tended to express fewer perceived barriers towards EBP. Conclusion: Findings could help local governance and speech-language pathologist associations to understand the current practices and professional development needs of speech-language pathologists, leading to more effective training programs and educating employers and managers who can reinforce EBP among practitioners. [ABSTRACT FROM AUTHOR]

Studies show that experiencing intimate partner violence (IPV) during pregnancy is related to poor maternal–infant bonding. However, the mechanisms underlying this relationship are unclear. This article aims to examine whether maternal postpartum depressive (PPD) symptoms mediate the association between pregnancy IPV and maternal–infant bonding, and whether the relationship differs by maternal–infant bonding subscales—lack of affection, anger/rejection. A survey was conducted among women who participated in a postpartum health check-up program in Aichi prefecture, Japan (N = 6,590) in 2012. We examined whether experiences of emotional and physical IPV were related to maternal–infant bonding and whether PPD symptoms mediated this relationship. Path analysis showed that emotional and physical IPV were associated with PPD symptoms, and PPD symptoms predicted poor bonding. The total effect of emotional IPV on poor bonding was significant, showing a marginally significant direct effect and statistically significant indirect effect. The total effect of physical IPV on poor bonding was not statistically significant. Emotional IPV was significantly associated with both lack of affection and anger/rejection bonding subscales, which were similarly mediated by PPD symptoms. Findings revealed a modest indirect association between IPV, emotional IPV in particular, and poor maternal–infant bonding, which was mediated by PPD symptoms. While prevention of IPV is the ultimate goal, the treatment of PPD symptoms among women who experience IPV during pregnancy may improve maternal–infant bonding and mitigate cross-generational effects of IPV. Identifying opportunities for detection of IPV and PPD symptoms, as well as prevention and early intervention, may improve maternal–infant bonding. [ABSTRACT FROM AUTHOR]

Aim: We compared Japan nurse practitioner‐led care and physician trainee‐led care in terms of patients' length of stay in a secondary emergency department in Japan. Methods: This was a retrospective observational study, utilizing medical records. Participants (n = 1419; mean age = 63.9 ± 23.4 years; 52.3% men) were patients transferred to the emergency department by ambulance between April 2016 and March 2018 in western Tokyo. Multiple linear regression analyses were performed, with length of stay as the dependent variable and factors related to the length of stay, including medical care leaders, as the independent variable. Results: Approximately half of the patients (n = 763; 53.8%) received Japan nurse practitioner‐led care. Patients' length of stay was significantly shorter, by 6 min, in the Japan nurse practitioner‐led care group, compared with the physician trainee‐led care group (unstandardized coefficient: −6.81; 95% confidence interval: −13.35 to −0.26; p < 0.05). Conclusion: Patients' shorter length of stay in the Japan nurse practitioner group, compared with the physician trainee group, suggests that Japan nurse practitioners are not inferior to physician trainees in terms of the time spent to manage patients. [ABSTRACT FROM AUTHOR]

Purpose: To describe cross-sectional age differences in change-of-direction performance (CODp) in female football players and investigate the relationship between CODp and linear-sprint speed, muscle power, and body size. Methods: A sample of 135 well-trained female football players was divided into 8 age groups. Anthropometry (height, body mass, and lean body mass) and athletic performance (10-m sprint speed, 10-m x 5-CODp, and 5-step bounding distance) were compared to determine interage differences using ANOVA. Then, the participants were divided into 3 age groups: 12- to 14-y-olds, 15- to 17-y-olds, and =18 y-olds. Simple- and multiple-regression analyses were conducted to determine the correlation between CODp and the other measurement variables in each age group. Results: Age-related differences were found for CODp (F = 10.41, P < .01), sprint speed (F = 3.27, P < .01), and bounding distance (F = 4.20, P < .01). Post hoc analysis revealed that the CODp of 17-y-old players was faster than that of 16-y-old players (P < .01), with no interage differences in sprint speed and bounding distance. Sprint speed and bounding distance were weakly correlated with CODp in 15- to =18-y-old players, but only sprint speed was correlated with CODp in 12- to 14-y-old players. Conclusions: CODp improves from 16 to 17 y of age in female players. Linear-sprint speed, muscle power, and body size were weakly correlated with the age differences in CODp. [ABSTRACT FROM AUTHOR]

Background: In Japan, foreign residents, and particularly new arrivals in the country, experience barriers to health care and show poorer health outcomes when compared to Japanese nationals. The health-care-related situation for foreign residents in Japan has been characterized by drastic changes over time; thus, there is difficulty identifying individuals who are "left behind" by the system. In this study, we aimed to identify, among foreign residents who attended informal free medical consultations, factors associated with "being advised to visit a medical facility" and "being referred to a medical facility," which represented hypothetical proxy indicators of barriers to health care. Methods: Secondary data analyses were conducted using the activity records of a non-governmental organization that provides free consultations targeting foreign residents in various locations in Aichi Prefecture, Japan. Participant characteristics, including insurance coverage, were determined. Bivariate and multi-variate analyses were performed to identify factors associated with having barriers to health care. Results: Among 608 extracted cases, 164 (27.5%) cases were advised to visit a medical facility, and 72 (11.8%) were referred to a medical facility during the consultations. Those who were not covered by public insurance showed a 1.56-time (95% confidence interval [CI]: 1.19–2.05) higher prevalence of being advised to visit a medical facility when compared to those who were covered by public insurance. Unemployed people and students were more likely to be referred to a medical facility than were professional workers; the prevalence ratios were 3.28 (95% CI: 1.64–6.57) and 2.77 (95% CI: 1.18–6.46), respectively. Conclusions: Although the majority were insured, almost 30% were advised to visit a medical facility, which implied that they had had limited access to the formal health-care system before availing of the free consultations. The findings highlight those uninsured, unemployed people and students, who are considered vulnerable to access to health care. It is vital to provide those who are vulnerable with the necessary support while updatinge evidence, so that no one is "left behind." [ABSTRACT FROM AUTHOR]

With the growing awareness of the sustainability concept, society’s interest towards the consideration for the wider community and the environment has developed. Local Agenda 21 has supported the voluntary process of local community consultation with the aim to create local policies and programs that work towards achieving sustainable development. This has stimulated the need for community participation through local volunteer participants. This paper will apply prefecture level panel data for Japan to examine the determining factors of volunteer work participation. The main results show that prefectures with higher children and senior citizen population and prefectures with higher usage of the internet and media are more active in the overall participation of volunteer work. On the other hand, prefectures with stronger urbanization are less likely to participate in volunteer work.

Empathy is an important characteristic for healthcare students and professionals that may improve the quality of healthcare interactions. Empathy has predominantly been studied within medicine, but also among various allied health personnel. Within paramedicine, empathy has previously been examined internationally, but not within Japan. This study used a descriptive, cross‐sectional methodology which aimed to examine self‐reported empathy in Japanese paramedic students using the Jefferson Scale of Empathy, and compare results with similar international cohorts. Empathy levels in the Japanese cohort were higher among females compared to males. In addition, there was a decrease in empathy with each subsequent year of the paramedic program, and a general decrease as age increased. This contrasts with comparable Australian cohorts which demonstrate no significant change in empathy levels during the undergraduate program. Empathy levels measured in the Japanese paramedic cohort were generally lower than for Australian cohorts. The reasons for the differences are unclear at present and thus further research in this area is required to fully determine and describe the contributing factors. [ABSTRACT FROM AUTHOR]

Background There is some evidence that loneliness may be linked to poorer health behaviours. Despite this, there has been little research to date on the relationship between loneliness and COVID-19 preventive behaviours. We studied these associations in a sample of the Japanese population. Methods Data were analysed from an online survey of 2000 adults undertaken in April and May 2020. Loneliness was assessed with the Three-Item Loneliness Scale. Information was also collected on 13 COVID-19 preventive behaviours. Regression analyses were used to examine associations. Results In linear regression models adjusted for demographic and mental health variables, both dichotomous and continuous loneliness measures were negatively associated with engaging in COVID-19 preventive behaviours. Logistic regression analyses further showed that loneliness was also associated with reduced odds for a variety of individual preventive behaviours including wearing a mask (odds ratio [OR]: 0.77, 95% confidence interval [CI]: 0.62–0.95), disinfecting hands (OR: 0.80, 95% CI: 0.67–0.94) and social distancing when outdoors (OR: 0.75, 95% CI: 0.61–0.92). Conclusions Loneliness is associated with lower engagement in COVID-19 preventive behaviours. Interventions to prevent or ameliorate loneliness during the ongoing pandemic may be important in combating the spread of the coronavirus. [ABSTRACT FROM AUTHOR]

Background: Worldwide, rather few studies have examined the association between burnout and care quality using objectively measured quality indicators, with most of the studies have relied on perceived quality outcomes. This study aimed to examine the association between staff nurses' burnout and selected objective quality metrics in long-term care wards in Japan. Methods: This is a secondary analysis of a cross-sectional survey. Nurse managers and staff nurses working at randomly selected hospitals with long-term care wards—the equivalent of skilled nursing homes in Western countries— completed self-administered, anonymous questionnaires. The questionnaires collected data regarding care quality indicators, staff nurses' burnout, and other confounders (e.g., ward size, participants' years of experience, and patients' conditions). All statistical analyses were conducted at the ward level. A multivariate regression analysis was used to examine associations between burnout and outcome indicators. Results: Data from 196 wards in 196 hospitals (196 nurse managers and 2473 staff nurses) across Japan were analyzed. Multivariate regression analysis showed that higher emotional exhaustion was associated with higher rates of pneumonia and pressure ulcers (p-value =.036 and.032, respectively), and that reduced personal accomplishment was associated with higher rates of tube feeding (p-value =.018). A larger ward size was also associated with low rates of pneumonia (regression coefficient = −.001, p-value =.019). Conclusions: Staff nurses' burnout is a significant determinant of care quality in long-term care wards, implying that organizations that implement burnout reducing strategies may see greater benefits in patient outcomes. A large ward size was significantly associated with better care outcomes—specifically, low rates of pneumonia. Future research needs to determine feasible quality improvement measures in small-scale long-term care facilities, and to provide more comprehensive insights on ward-level variables that influence care quality in long-term care settings. [ABSTRACT FROM AUTHOR]

This study examined quality of life and its associated factors in siblings of children with severe motor and intellectual disabilities in Japan. The participants were 789 siblings of children with a disability and their primary caregivers. We used the Kinder Lebensqualität Fragebogen questionnaire to assess the quality of life of siblings. The mean age of the siblings was 12.21 ± 3.07 years, and the mean quality of life score was 69.63 ± 12.55 points, which is higher than that of the general population of children of the same age. It was revealed that the following factors contributed to higher quality of life scores: a closer relationship with the child with a disability, younger age, the primary caregiver's lower care burden, later birth order of siblings (i.e., younger siblings), higher family empowerment, and female gender of siblings. The relationship with the child with a disability had the strongest influence on siblings' quality of life. Our study suggests the need for nursing interventions that focus on the whole family to enhance siblings' quality of life. [ABSTRACT FROM AUTHOR]

Few epidemiological studies have examined the potential protective effects of physical activity on insomnia. The authors thus evaluated the association between physical activity and insomnia in a large population-based study in Shizuoka, Japan. Individual data were obtained from participants in an ongoing cohort study. A total of 14,001 older residents who completed questionnaires were followed for 3 yr. Of these, 10,211 and 3,697 participants were eligible for the cross-sectional and longitudinal analyses, respectively. The authors obtained information about the frequency of physical activity and insomnia. Then, the adjusted odds ratios and 95% confidence intervals between physical activity and insomnia were estimated.Habitual physical activity was related to lower prevalence of insomnia. Frequent physical activity also reduced the incidence of insomnia, especially difficulty maintaining sleep. For elderly people with sufficient mobility and no preexisting disease, high-frequency physical activity (e.g., 5 or more days/wk) may help reduce insomnia. [ABSTRACT FROM AUTHOR]

Background: The Barriers Questionnaire II (BQ-II) was developed to assess barriers to effective pain management. In this study, we aimed to assess the reliability and validity of the newly developed Japanese version of the BQ-II (JBQ-II). Methods: This study used a cross-sectional design. The study was conducted an ambulatory infusion center for cancer in a general hospital in Tokyo, Japan. Participants were 120 Japanese patients with cancer and 21 Japanese health professionals with experience in pain management. Cronbach's alpha coefficient was used to calculate reliability. Test–retest reliability was assessed with Spearman's intra-class correlation coefficient (ICC). Construct, criterion-related, and discriminant validity were assessed using information about pain management, daily life, mental health, and subjective health. Results: The Cronbach's alpha was 0.90 for the JBQ-II, and all ICCs exceeded 0.70 (P < 0.01). Factor analysis showed the JBQ-II had a virtually identical structure to the BQ-II, and path analysis supported the JBQ-II constructs. The JBQ-II was weakly correlated with poor mental state (r = 0.36, P < 0.01). Patients' JBQ-II scores were significantly higher than health professionals' scores. Conclusion: The JBQ-II is a valid and reliable measure of patient-related barriers to pain management among Japanese adult patients with cancer. [ABSTRACT FROM AUTHOR]

Introduction: Many environmental factors are related to the development of asthma. However, the key factors of childhood asthma onset have not been sufficiently elucidated. Further, low-weight births have increased in Japan. The aim of this study was to examine the risk factors for the incidence of childhood asthma and to evaluate whether these risk factors differ according to birth weight in Japan. Methods: We used the National Longitudinal Survey from 2001 to 2010. Multiple logistic regression analyses were conducted to determine the effects of gender, birth weight, single vs. multiple births, birth order, nutrition, keeping pets in the home, place of residence, annual household income, and parent ages, smoking behaviors, and educational backgrounds on asthma-related hospital visits. Results: Overall, 45,060 children were analyzed. The rate of cumulative hospital visits until age 10 was 18.9%. Birth weight < 2500 g (adjusted odds ratio [AOR] = 1.14, 95% confidence interval [CI] 1.03–1.26), being a boy (AOR = 1.27, 95% CI 1.21–1.33), having older siblings (AOR = 1.07, 95% CI 1.02–1.14), parental smoking behavior, mother's age, and low household income (AOR = 1.17, 95% CI 1.10–1.24) were associated with asthma-related hospital visits. Discussion: Parental smoking behavior is a key risk factor for the development of asthma. Among low birth weight infants, being a boy, having older siblings, and father's smoking behavior were predictive factors for the development of asthma. However, low birth weight was not associated with the development of asthma after 6 years of age. [ABSTRACT FROM AUTHOR]

This paper investigates how carry trades altered the efficiency of the Japanese quantitative easing policy between March 1995 and September 2010. Monetary policy shocks are identified by means of a data-driven Structural VAR approach. Accordingly, our results rely exclusively on the statistical properties of the data through non-Gaussian identification. We show that carry trades, by altering the portfolio re-balancing channel, have attenuated the impact of the Japanese quantitative easing policy on growth. [ABSTRACT FROM AUTHOR]