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Aim: The aim of this study is to analyse the risk factors for unplanned readmissions within 1 month after hospital discharge to develop a seamless support system from discharge to home care. Background: With shorter hospital stay lengths, understanding the characteristics of patients with multiple risk factors is important to prevent rehospitalization. Design: This is a single‐centre retrospective descriptive study. Methods: Logistic regression and decision tree analyses were performed using eight items from the records of 3117 patients discharged from a university hospital between April–September 2017 as risk factors. Results: Unplanned readmission risk was significantly associated with emergency hospitalization (odds ratio [OR]: 3.12, 95% confidence interval [CI]: 2.04–4.77), malignancy (OR: 2.16, 95% CI: 1.44–3.24), non‐surgical admission (OR: 1.76, 95% CI: 1.07–2.88), hospital stay of ≥ 15 days (OR: 1.66, 95% CI: 1.14–2.43) and decline in activities of daily living owing to hospitalization (OR: 1.68, 95% CI: 1.06–2.64). The highest risk combinations for rehospitalization were as follows: emergency hospitalization and malignancy; emergency admission, non‐malignancy and a hospital stay of ≥15 days; and scheduled hospitalization, no surgery and a hospital stay of ≥15 days. Conclusions: Patients with multiple risks for unplanned readmission should be accurately screened and provided with optimal home care. Summary statement: What is already known about this topic? Although the characteristics of patients at high risk of rehospitalization include malignancy, heart failure, conditions such as chronic obstructive pulmonary disease and other diseases prone to recurrence, old age, reduced activities of daily living and emergency hospitalization, few studies have reported on cases with multiple risks. What this paper adds? The most frequent risk types for unplanned readmissions within a month were emergency admissions for malignant tumours, emergency admissions for non‐malignant tumours with a hospital stay of 2 weeks or more and scheduled admissions for non‐surgical purposes with a length of stay of 2 weeks or more. The implications of this paper: The risk of unplanned readmission within 1 month of discharge increased due to a combination of multiple risks.This study helps us identify patients who are at high risk for readmission early in the hospitalization process and in providing nursing support for transition to their homes. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Recovery‐oriented services have been shown to promote recovery in people with mental illness; their implementation is important for current psychiatric practice and is being considered by many professional institutions.The Japanese government released the policy 'A Vision for Reform of Mental Health and Medical Welfare' (Ministry of Health, Labour and Welfare, 2004; https://www.mhlw.go.jp/topics/2004/09/dl/tp0902‐1a.pdf), aiming to update public consciousness, reorganize the mental healthcare welfare system and strengthen the foundation of mental healthcare to promote a basic policy focusing on the transition 'from hospital to community life'. What the paper adds to existing knowledge?: This is the first study to clarify recovery‐oriented attitudes among psychiatric nursing directors and related factors in Japan. It shows an association between recovery‐oriented attitudes and hospital size. What are the implications for practice?: A relationship exists between the recovery knowledge and recovery‐oriented attitudes of psychiatric nursing directors. It may thus be valuable for directors to see and hear about the experiences of patients living in the community during their recovery process. As hospital size and organizational climate may hinder the successful implementation of recovery‐oriented practices, these factors must be considered when introducing such practices.Further research is needed on the relationship between psychiatric nursing directors' recovery‐oriented attitudes and practices. Moreover, to develop intervention studies that uncover success factors for enhancing recovery‐oriented attitudes, organizational factors that enable recovery‐oriented practices must be further investigated. Introduction: Recovery‐oriented practices in mental health services have become a global priority. Despite their proven effectiveness, Japanese hospitals have not widely implemented such practices. Aim: This study clarified psychiatric nursing directors' recovery‐oriented attitudes and factors regarding promoting recovery‐oriented practices to identify methods for developing these practices in Japan. Method: This cross‐sectional study used a questionnaire survey with 250 nursing directors from 1287 Japanese psychiatric hospitals. Multivariable regression analysis assessed how socio‐demographic variables and Recovery Knowledge Inventory (RKI) scores affected Recovery Attitudes Questionnaire (RAQ‐7) scores. Results: The analysis revealed that more clinical and managerial experience was associated with more negative recovery‐oriented attitudes. High RKI scores, knowledge of strength, hospital size and outpatient work experience were associated with more positive recovery‐oriented attitudes. Discussion: Implementing recovery practices requires consideration of knowledge and experience in recovery and hospital size alongside recovery training based on a hospital's organizational structure. Although the low response rate could influence the study's generalisability, it could also indicate low interest in recovery‐oriented practices among professionals. Implications for Practice: Acquiring more knowledge and experience regarding recovery promotes recovery‐oriented attitudes among nursing directors. An appropriate organizational culture and consideration of hospital size are required when introducing such recovery practices. [ABSTRACT FROM AUTHOR]

This article offers a comparative ethnographic study of ageing as both category and experience. Drawing on simultaneous 16-month ethnographies conducted as part of the ASSA project, we focus on how ageing is being re-defined in eight contexts around the world, with particular focus on the authors' field sites: rural and urban settings in both Japan and Uganda. Despite being among the world's oldest and youngest populations, respectively, there are various affinities in both ethnographies of age and technology use related to the reconfiguration of family-care norms across distances. This shared finding informs the articulation of age categories, which we found to be negotiated in line with established intergenerational expectations and family roles. This paper is illustrated with ethnographic examples of how people redefine ageing in context and in turn bring 'age' to life, demonstrating the social significance of age categories. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate the relationship between family caregivers' health‐related quality of life and health outcomes in care recipients. Methods: A total of 160 female caregivers in Japan were initially assessed using self‐reported baseline questionnaires to determine physical and mental aspects of their health‐related quality of life. Based on these scores, they were divided into three groups: lower, middle, and higher quality of life. We followed up with the 133 participants (after excluding those that did not respond) 6 years later to assess the health of their care recipients; 36 caregivers continued to provide home care, while 97 reported that their care recipient had died or been admitted into institutionalized care. Results: Statistically, a higher risk for care recipients' health deterioration was strongly associated with the mental component score in the lower caregivers' quality of life group of than for the middle group, after adjusting for the care recipients' age, health status, and caregivers' age at baseline. There was no significant association between deterioration of health of care recipients and physical component scores of the caregivers. Conclusion: Caregivers' poor health‐related quality of life, particularly poor mental health, may be linked to the deterioration of care recipients' health. Summary statement: What is already known about this topic? Family caregivers reportedly have lower quality of life than noncaregivers.While factors associated with decreased quality of life of caregivers such as high caregiving burden and longer care duration are being identified, they remain difficult to prevent.Lower caregiver quality of life may negatively influence the care recipients. What this paper adds? Poor mental health in caregivers, calculated with health‐related quality of life scores, is associated with health deterioration of care recipients.Physical health in caregivers is not associated with health deterioration of care recipients. The implications of this paper: Support for improving the health‐related quality of life of caregivers is necessary, especially in relation to their mental health, from the viewpoint of maintaining the health status of care recipients. [ABSTRACT FROM AUTHOR]

This study examines the Japanese car market to assess whether a subsidy measure for fuel-efficient and low emission cars that were introduced in 2009 was designed to achieve an environmental goal effectively or was distorted to subsidize domestic firms. I estimate a structural model of oligopolistic competition in the presence of the subsidy measure; and using the estimates, I conduct counterfactual experiments to analyze the cost-effectiveness of the subsidy design from an environmental perspective. A key feature of the subsidy measure is that it included a Japan version of the "cash-for-clunkers" program that could be applied if a car aged 13 years or older was scrapped. To account for the scrap incentives, I incorporate an empirical car age distribution when estimating the demand side of the model. The findings of this paper are as follows: first, the actual fuel economy criteria that were used to qualify for the subsidy were too lax to achieve the environmental goal. Second, these lax criteria allowed Japanese firms to earn more than under the cost-effective criteria, which thereby implies the distortion of the subsidy design from an industrial policy perspective. Third, the policy was not necessarily harmful for foreign cars, as the lax criteria allowed some foreign car models to be eligible for the subsidy and increased the subsidy payment to foreign cars. [ABSTRACT FROM AUTHOR]

The worsening of neuropsychiatric symptoms such as depression, anxiety, and insomnia in patients with Parkinson's disease (PD) has been a concern during the COVID-19 pandemic, because most people worked in self-isolation for fear of infection. We aimed to clarify the impact of social restrictions imposed due to the COVID-19 pandemic on neuropsychiatric symptoms in PD patients and to identify risk factors associated with these symptoms. A cross-sectional, hospital-based survey was conducted from April 22, 2020 to May 15, 2020. PD patients and their family members were asked to complete paper-based questionnaires about neuropsychiatric symptoms by mail. PD patients were evaluated for motor symptoms using MDS-UPDRS part 2 by telephone interview. A total of 71 responders (39 PD patients and 32 controls) completed the study. Although there was no difference in the age distribution, the rate of females was significantly lower in PD patients (35%) than controls (84%) (P < 0.001). Participants with clinical depression (PHQ-9 score ≥ 10) were more common in PD patients (39%) than controls (6%) (P = 0.002). Multivariate logistic regression analysis revealed that an MDS-UPDRS part 2 score was correlated with the presence of clinical depression (PHQ-9 score ≥ 10) and clinical anxiety (GAD-7 score ≥ 7) (clinical depression: OR, 1.31; 95% CI, 1.04–1.66; P = 0.025; clinical anxiety: OR, 1.36; 95% CI, 1.07–1.72; P = 0.013). In the presence of social restrictions, more attention needs to be paid to the neuropsychiatric complications of PD patients, especially those with more severe motor symptoms. [ABSTRACT FROM AUTHOR]

It is generally accepted that oceanic plate subduction has occurred along the eastern margin of Asia since about 500 Ma ago. Therefore, the Japanese Islands have a >500 Ma history of oceanic plate subduction in their geological records. In this paper, the accretionary history of the Japanese Islands is divided into six main stages based on the mode and nature of tectonic events and the temporal gaps in the development of accretionary processes. In the first stage, oceanic plate subduction and accretion started along the margin of Gondwana. After detachment of the North and South China blocks in Devonian time, accretionary complexes developed along island arcs offshore of the South and North China blocks. After the formation of back arc basins such as the Japan Sea, accretionary processes occurred only along the limited convergent margin, e.g. Nankai Trough. Detrital zircons of sandstones revealed the accretionary history of Japan. An evaluation of a comprehensive dataset on detrital zircon populations shows that the observed temporal gaps in the development of the Japanese accretionary complexes were closely related to the intensity of igneous activity in their provenance regions. Age distributions of detrital zircons in the accretionary complexes of Japan change before and after the Middle Triassic period, when the collision of the South and North China blocks occurred. [ABSTRACT FROM AUTHOR]

The aging of a population structure is an inevitable path of demographic transition, as an inescapable result of decline in fertility rate and extension in life expectancy. Although demographic transition occurred earlier in Japan than in China, the two countries had similar patterns, both of which took a much shorter period of time than Western countries to complete demographic transition, as well as have been aging at a rapid speed that has rarely been seen in the world. Japan has the highest level of population aging in the world, and China has been experiencing a very fast pace of the population aging process and has the largest older population. Drawing upon data from World Population Prospects (2019), this paper compares changes in population aging in both China and Japan. Findings show that Japan's aging process is 30 years ahead of China, but China has been changing in a similar way as Japan. To be specific, both countries experienced four phases of the population aging process: accelerated development period, rapid development period, slow down period and high-level maintained period. In addition, both countries had a quick growing rate of population aging. It will take China 23 years and 10 years respectively for the aging rate increasing from 7% to 14% and then to 20%, while Japan took 24 and 11 years respectively, which is much shorter than developed countries in the West. Furthermore, China has a faster pace than Japan in population aging in the next 25 years. We found that from 2019-2044, China's aging rate, elderly dependency ratio, oldest-old coefficient and median age of population will increase 13.24 percent points, 24.21 percent points, 8.33 percent points, and 8.47 years, while the four indicators of Japan will increase 8.38 percent points, 22.52 percent points, 8.29 percent points, and 6.20 years, respectively.

This paper examines whether variations in demographic structure have influenced stock prices. The study employs a nonparametric approach based on the Fourier Flexible Form representation, which relates variations in the entire age distribution to the normalized stock price under a flexible functional form. The main findings of this paper are that there is a significant impact from prime working-age consumers on the stock price, and that this impact is robust for all G5 countries (France, Germany, Japan, the UK and the USA). These findings survive many robust tests, and are consistent with the predictions from the life-cycle models. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine the association between outpatient orthopedic surgery costs and Japan's healthcare facilities using a large-scale Japanese medical claims database. Design/methodology/approach The authors obtained reimbursement claims data for 8,588 patients who underwent orthopedic surgery between April 1 and September 30, 2014 at 3,347 Japanese healthcare facilities. Regression analysis, using ordinary least squares, examined the association between outpatient orthopedic surgery costs and healthcare facility characteristics. By using surgical fees as proxy for the surgical costs, the authors defined three dependent variables: surgical cost for each outpatient orthopedic surgery; pre- and post-operative cost one month before and after a surgical operation; and total cost for each patient. The authors also defined five independent variables, which capture healthcare facility characteristics and patient-specific factors: bed count; whether healthcare facilities are reimbursed in a diagnosis procedure combination system; patient's age; sex; and anatomical surgical sites. Findings The authors analyzed 6,456 outpatient orthopedic surgical cases performed at 3,085 healthcare facilities. There were significant differences in the surgical costs for outpatient orthopedic surgery among different healthcare facilities by total beds ( p=0.000). Multivariate regression analysis shows that surgical costs for outpatient orthopedic surgery are positively and significantly associated with healthcare facilities classified by total beds after adjusting for patient-specific characteristics ( p<0.05). Originality/value This is the first research to examine the association between costs for outpatient orthopedic surgery and healthcare facility characteristics in Japan. This study via the multivariate regression method showed that outpatient orthopedic surgery is likely to cost higher as healthcare facility size increased. The average incremental costs for each outpatient orthopedic surgery per 100 beds were calculated at $48.5 for surgery, $40.7 for pre- and post-operative care, and $89.2 total cost. [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]

Severe heavy rains caused by linear precipitation systems are occurring more frequently in Japan owing to climate change, and residents are being asked to evacuate more often. The purpose of this study was to identify factors associated with the willingness of people with mental health illness (PMHI) in group homes to disclose their illness when being evacuated. Participants were PMHI living in group homes in Japan. We conducted an original anonymous self-administered questionnaire based on previous research. Valid data from 119 people were analyzed. Factors associated with the willingness to disclose illness to supporters upon evacuation were "I can imagine living in a public shelter" (Odds Ratio [OR] 4.50, 95% Confidence Interval [CI]: 1.78–11.43), and "I socialize with neighbors" (OR 5.63, 95% CI: 1.74–18.22). Managers of group homes should encourage PMHI to imagine life in an evacuation zone by increasing opportunities for disaster training and for interaction with local residents. People who are less likely to socialize with neighbors should be especially careful, as they may not be able to disclose their illness, and those who support evacuees should pay special attention to these people. [ABSTRACT FROM AUTHOR]

Background: Living in rural areas is a major contributor of health inequity. Tackling health inequity is important for primary care physicians. Therefore, it is important to compare the quality of primary care between rural and urban areas. To the best of our knowledge, this is the first study to examine the association between rurality and patient experience (PX) in Japan using validated measures. Methods: This cross-sectional study was conducted using online surveys. Participants were selected using a stratified random sample based on sex and age. The Japanese version of the Person-Centered Primary Care Measure (PCPCM) was used as an indicator of PX. We used the Rurality Index for Japan (RIJ) to measure rurality. Furthermore, we used multivariate linear regression analysis to examine the relationship between the RIJ and PCPCM after adjusting for confounders. Results: Of the 1112 eligible participants, 800 responded to the survey (response rate:71.9%). The mean PCPCM scores were 2.46 (standard deviation: 0.73) and median RIJ was 15 (interquartile range: 6–33). The crude and adjusted coefficients of rurality were − 0.02 (− 0.006–0.001, p = 0.114) and − 0.02 (− 0.005–0.001), respectively, demonstrating that rurality was not significantly associated with the total PCPCM score. Subgroup analyses were similar to the main analyses. Conclusion: We found that PX in primary care did not differ by rurality in the general Japanese population. [ABSTRACT FROM AUTHOR]

Lung cancer (LC) is currently the leading cause of cancer deaths in Japan. Early detection through lung cancer screening (LCS) is important for reducing mortality. Therefore, exploring the factors affecting willingness to undergo LCS, particularly among young people, is important. This study aimed to elucidate the inclination toward LCS and its determining factors among Japanese university students. This cross-sectional study, involving 10,969 Japanese university students, was conducted in April 2023. A Pearson's chi-square test and a binomial logistic regression analysis were used to analyze factors related to the dependent variable, willingness to undergo LCS in the future. Out of the 6779 participants (61.8%) involved in this study, 6504 (95.9%) provided valid responses, and 4609 (70.9%) expressed a willingness to undergo LCS in the future. Analysis revealed current smoking as a barrier to future willingness to undergo LCS. Other barriers included postponing the age of screening, anxiety about the screening content, and concerns about the possibility of having cancer after screening. Addressing barriers, such as current smoking and anxiety about screening, that prevent young people from undergoing LCS in the future is crucial. Therefore, universities should provide opportunities to educate students about LCS and explore various educational methods. [ABSTRACT FROM AUTHOR]

This study proposes an effective method of measuring the quality of a community, calculated from spatial-temporal age group distributions. For this purpose, niche indices, which are used in ecology, are employed as measurement techniques and are interpreted in terms of safety and communication. Traditional indices are examined theoretically by using spatial statistics and are shown to be essentially identical. This paper also proposes a special niche index for disaster risk evaluation. From the fact-finding studies in Kobe City, Japan, which was severely damaged by the 1995 Great Hanshin-Awaji earthquake, it is inferred that the niche index may possibly pertain to damage reduction. Further, community health in the recovery process in the Nagata Ward, Kobe City is evaluated by using the niche indices and related statistical tests. The results show that the quality of the community deteriorated after the disaster even in the area where the building recovery speed was relatively rapid. [ABSTRACT FROM AUTHOR]

The condition of being underweight is a social problem in Japan among women. However, there is a lack of evidence for dietary guidance for underweight women because there has been no comparison of lipids or HbA1c among underweight, normal weight, and overweight women in different age groups. We analyzed the effect of body size and age on the serum lipid and hemoglobin A1c levels in Japanese women in a cross-sectional study. A total of 26,118 women aged >20–65 years underwent physical examinations between 2012 and 2022. Seventeen percent of women aged >20–29 years were underweight, and 8% of those aged 50–65 years were underweight. Total cholesterol and non-HDL-C concentrations increased with age, but the difference between underweight and overweight individuals was lowest among women aged 50–65 years. On the other hand, the differences in HDL-C, TG, and HbA1c levels between underweight and overweight subjects were greatest in the 50–65 age group, but the differences between underweight and normal weight subjects were much smaller. Considering that, unlike HDL-C, TG, and HbA1c, TC and non-HDL-C increase to levels comparable to overweight levels in underweight women in aged 50–65 years, educating people about a diet that lowers non-HDL-C is necessary even in young underweight women. [ABSTRACT FROM AUTHOR]

Background: Culturally appropriate communication training programs for a wide range of professions that can be used during infection epidemics are crucial for advance care planning implementation. Starting in 2018, the Japanese Ministry of Health, Labour and Welfare made a major policy change, and doctors, nurses, and social workers, and care managers were identified in the guidelines as the professions that promote advance care planning. Motivated by the lack of online programs for Japanese care managers, we proposed a new one-day program. Objectives: This study aimed to determine the changes in the positive attitude of care managers toward dying patients compared to that of nurses, which has been used in past literature as an outcome of advance care planning educational interventions, after administering the program in Japan. Design: Before-after comparison study. Methods: Care managers were recruited through our website, ACP-Piece, http://plaza.umin.ac.jp/~acp-piece/piece.html. A questionnaire survey concerning positive attitudes toward dying patients was administered before and after the program on 28 August 2021. Sixty-six subjects participated in the training and 60 participants, including 14 care managers, consented to the study and completed the questionnaire surveys before and after the program. Results: The Frommelt attitude toward care of the dying scores for care managers increased after the program (p -values, confidence intervals, and effect sizes: p < 0.001, −11.90 to −4.388, −1.252). After training, care managers had a significantly higher maximum score occurrence than nurses. Older care managers with advance care planning experience may have had a higher maximum score occurrence compared to younger, inexperienced participants. Conclusion: To our knowledge, this is the first to demonstrate the increased positive attitude scores toward dying patients after online communication training for Japanese care managers. The limitations of this study include the lack of evidence regarding reasons for score changes, long-term score changes, and effectiveness for patients and their families. [ABSTRACT FROM AUTHOR]

The knee, low back, and shoulder account for most overuse injuries in volleyball. Previous researchers have used methodology that did not examine the extent of injury burden and effect on performance. To develop a more accurate and complete understanding regarding the weekly prevalence and burden of knee, low back, and shoulder problems within the highest levels of men's volleyball, including the role that preseason complaints, match participation, player position, team, and age have on complaints. Descriptive epidemiology study. Professional volleyball clubs and the National Collegiate Athletic Association Division I program. A total of 75 male volleyball players, representing 4 teams playing in their country's respective premier league (Japan, Qatar, Turkey, and the United States), participated over a 3-season period. Players completed a weekly questionnaire (Oslo Sports Trauma Research Centre Overuse Injury Questionnaire) reporting pain related to their sport and the extent to which knee, low back, and shoulder problems affected participation, training volume, and performance. Problems leading to moderate or severe reductions in training volume or performance or the inability to participate were considered substantial problems. The mean weekly prevalence of knee, low back, and shoulder problems based on 102 player-seasons was 31% (95% CI = 28%, 34%), 21% (95% CI = 18%, 23%), and 19% (95% CI = 18%, 21%), respectively. Most players (93%, 95/102 player-seasons) reported some level of knee (79%, n = 81/102 player-seasons), low back (71%, n = 72/102 player-seasons), or shoulder (67%, n = 68/102 player-seasons) complaints during the season. Most players (58%, n = 59/102 player-seasons) experienced at least 1 episode of substantial problems affecting the knee (33%, n = 34/102 player-seasons), low back (27%, n = 28/102 player-seasons), or shoulder (27%, n = 28/102 player-seasons). Players with preseason complaints had more in-season complaints than teammates without preseason problems (mean weekly prevalence: knee, 42% versus 8%, t49 = −18.726, P <.001; low back, 34% versus 6%, t32 = −12.025, P <.001; shoulder, 38% versus 8%, t30 = −10.650, P <.001). Nearly all included elite male volleyball players experienced knee, low back, or shoulder problems, and most had at least 1 bout that substantially reduced training participation or sport performance. These findings suggest that knee, low back, and shoulder problems result in greater injury burden than previously reported. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to use an assessment sheet clarifying the characteristics related to adaptation in order to support the relocation of older people to recovery phase rehabilitation wards (RPRW). Design/methodology/approach -- A survey was conducted with older people aged 70 and above two weeks after relocation. Nurses responsible for the older people were asked to complete the sheet. Of the 44 items on the sheet, the 38 items not directly related to basic attributes constituted the scale of the state of adaptation. A total of 336 valid response sheets were analyzed. Findings -- Higher scores on the scale represented higher levels of adaptation, and when scores were analyzed, results showed that there was a tendency for the scores of older people aged 80 and above and older people with dementia to be significantly lower . Items that showed differences according to the presence of dementia included those showing adaptive tasks, such as "Condition has deteriorated since the time of relocation" and "Experiencing difficulties when nurses are giving care." The tendencies of older people to adapt to relocation depending on the presence of dementia were clarified through the items on the scale. Originality/value -- It is necessary to pay attention to older people's physical and social environmental factors, adaptive tasks, and coping skills when they relocate to RPRW. The authors suggest that an approach based on the results of this study could help older people adapt to their new environment. [ABSTRACT FROM AUTHOR]

Igneous rocks associated with the Cretaceous to Paleogene volcanic arc in SW Japan show ages that young from west to east in a direction parallel to the Median Tectonic Line suggesting corresponding translation of a heat source traditionally interpreted in terms of oblique subduction of a spreading ridge. However, recent oceanic plate reconstructions suggest ridge subduction may be younger than the main arc activity. Age compilations of 1227 points of felsic to intermediate Cretaceous and Cenozoic igneous rocks from the Japan arc show arc magmatism that can be separated into an early active period 130–60 Ma (stage 1), a subsequent period of quiescence 60–46 Ma (stage 2), which is followed by a resumption of igneous activity from 46 Ma onward (stage 3). In southwest Japan, the orientations of the magmatic arcs of stages 1 and 3 show and angular discordance of about 20°. The lack of active arc magmatism and the occurrence patterns of adakitic and high-Mg andesitic magmas indicate that ridge subduction occurred during stage 2. The arc age distribution pattern of stage 1 is explained by the slab shallowing related to a younging of the subducting slab as the ridge approaches. Furthermore, the obliquity of the arcs formed at stages 1 and 3 is explained by a 20° clockwise rotation of the inner zone of southwest Japan during the ridge-subduction phase. Oceanic plate reconstructions show counterclockwise rotation in the subduction direction after the ridge subduction phase, and coupling of the subducting oceanic plate with the upper plate would support microplate rotation in the inner zone. The new proposed tectonic reconstructions provide a framework to related Paleogene subduction of an active spreading ridge along the east Asia margin not only to the distribution of granitic bodies but also to rift-related basin formation on the eastern margin of the Eurasian continent and to rotation of crustal blocks indicated by paleomagnetic data of Cretaceous terranes. [ABSTRACT FROM AUTHOR]

Fourth dose of SARS-CoV-2 vaccination was started from the end of May, 2022 in Japan. However, data on the precise analysis of the side effects after fourth vaccination, remain scarce. Here, we examined the side effects and the levels of SARS-CoV-2 antibody titers in healthy volunteers who underwent BNT162b2 vaccination for the fourth time. Thirty-eight volunteers were assessed for the side effects of the vaccination for the fourth dose, and samples were used for the measurement of SARS-CoV-2 IgG and IgM antibody with chemiluminescent assays. We found that the level of IgG at day 504 (average, 117.9 AU/mL [SD 76.9]), was significantly higher than at day 264 (average, 17.3 AU/mL [SD 13.1]), which are 8 months after the third and second vaccination, respectively. The level of IgG was potently increased after fourth vaccination (average, 711.8 AU/mL [SD 361.9]), whereas IgM remained baseline level. Commonly reported side effects in the participants after the fourth dose were similar to those until third dose, such as sore arm/pain (81.0 %), generalized weakness/fatigue (57.1 %) and fever (54.8 %). The number of side effects were significantly decreased with age, and participant with sore arm/pain had higher IgG titer (p=0.0007), whereas participant with lymphadenopathy had lower IgG (p=0.0371). The level of IgG was significantly higher in 8 months after the third, compared to the second, vaccination, and it was potently increased after fourth vaccination. The number of side effects were inversely correlated with age. Sore arm/pain and lymphadenopathy may affect IgG titer. [ABSTRACT FROM AUTHOR]

Objective:To examine the clinical features, age and gender distribution of patients, treatment methods, and outcomes of benign paroxysmal positional vertigo.Methods:This paper reports a review of 357 patients treated for this condition at a single institution over a duration of 5 years. Patients with posterior canal benign paroxysmal positional vertigo were divided into two groups: one group underwent the Epley manoeuvre and the other received medication. The lateral canal canalolithiasis patients were also divided into two groups: one underwent the Lempert manoeuvre and the other received medication. Lastly, the lateral canal cupulolithiasis patients were treated with medication and non-specific physical techniques.Results and conclusion:For patients with posterior canal benign paroxysmal positional vertigo, resolution time was significantly shorter in the Epley manoeuvre group than in the medication group. For the lateral canal canalolithiasis patients, resolution time was significantly shorter in the Lempert manoeuvre group than in the medication group. Resolution time was significantly longer in the lateral canal cupulolithiasis patients than in the other patients. The average age of patients increased with the number of recurrences, as did predominance in females. Average age and rate of sensorineural hearing loss were significantly higher in patients with intractable benign paroxysmal positional vertigo compared with those in the curable benign paroxysmal positional vertigo group. [ABSTRACT FROM PUBLISHER]

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Aim: Obstetrical guidelines were established in Japan in 2008, and obstetrical diagnoses and treatments were subsequently standardized nationally. We examined changes in the preterm birth rate (PTBR) and extremely preterm birth rate (EPTBR) following the introduction of such guidelines. Methods: Information on 50 706 432 live births in Japan between 1979 and 2021, including Japanese reproductive medicine, the childbearing age of pregnant women, and the employment status of reproductive‐age women between 2007 and 2020, were obtained from the Japanese government and academic societies. Regression analysis was used to compare chronological changes nationally and those of eight Japanese regions. Regional and national average PTBRs and EPTBRs from 2007 to 2020 were compared by using a repeated measures analysis of variance. Results: From 1979 to 2007, PTBRs and EPTBRs in Japan increased significantly. However, from 2008, the national PTBR and EPTBR decreased until 2020 (p < 0.001) and 2019 (p = 0.02), respectively. From 2007 to 2020, overall PTBR and EPTBR were 5.68% and 0.255%, respectively. A significant difference in the PTBR and EPTBR existed between the eight Japanese regions. During this period, the number of pregnancies using assisted reproductive technology increased from 19 595 to 60 381, pregnant women became older, the employment rate of those of reproductive age increased, and nonregular employment was 54%, which was 2.5 times higher than for men. Conclusions: In Japan, after obstetrical guidelines were enacted in 2008, PTRBs decreased significantly even under the pressure of increasing preterm births. Countermeasures may be necessary for regions showing high PTBRs. [ABSTRACT FROM AUTHOR]

Japan is advancing into a super-aged society at an unprecedented speed, and the proportion of the elderly population will continue to rise. The number of older adults needing nursing care will also increase with the aging population. We used a cross-sectional dataset of older Japanese adults to examine their future preferences for care facilities and their relationship with individual characteristics, household structure, and economic status. We further focused on a subgroup of those who lived alone and were experiencing poverty and examined their care needs through their choice of care facilities. We found the following results from multinomial logit and probit regressions. First, compared with living alone, older adults who live with their spouses or other members prefer to live in their own houses. Second, older adults experiencing poverty preferred to choose facilities geared towards low-income groups, while wealthy older adults preferred to choose fee-based nursing homes/nursing homes with diverse services and high costs. Third, single older adults in poverty were less likely to choose to live in facilities. Covariates such as sex, age, and health status also mattered in their choices. Therefore, tailoring the formal care services to the preferences and actual needs of older adults is imperative. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore the attitudes toward the components of active aging and to examine the relationship of attitudes toward active aging with the impressions of older adults across different age groups and across Taiwan, South Korea and Japan. The sample was a total 1,619 individuals comprising of 615 Taiwanese people, 495 Koreans, and 509 Japanese people. Five factors of attitudes toward active aging were extracted by factor analysis: Health, Participation, Connectedness, Work, and Security. Taiwanese people emphasized more importance on health, social participation, and security; while Koreans and Japanese people emphasized more on social connectedness and work. The age group differences were not significant in the attitudes to active aging. Japanese reported more negative impressions to older adults than Taiwanese people, and Koreans were less willing to live with older adults than Taiwanese people. The older group also reported more positive impressions to older adults. Public stigma of aging may exist, implying that intergenerational mutual understanding would reduce ageism or age discrimination. An active aging policy may reduce the public stigma toward older adults and may reduce the burden of intergenerational redistribution. [ABSTRACT FROM AUTHOR]

This paper uses a new standard model of adult mortality to compare the mortality patterns of Swedes, Japanese, and U.S. whites between 1950 and 1985. It examines changes in the age patterns of mortality and the cause-of-death structures within the populations, and the relationships between those two factors. As Japan has reached a level of mortality similar to that in Sweden, the age patterns of mortality in the two populations have become more similar despite distinct differences in causes of death. The United States has a cause-of-death structure similar to that of Sweden, but the age pattern of mortality is very different. High mortality in the middle age range in the United States results in approximately a one-year loss of life expectancy at age 45 in comparison with Sweden.

"This paper aims to study the pattern of urbanization and the evolution of [the] relationship between rural-urban migration and the degree of economic development taking Gross National Product...into consideration. Intercensal age-specific rural net out-migration rates are also estimated from [tabulations] of the proportion of rural population of India by age through a recently developed procedure based on generalized stable population by Stupp (1989). A comparative study is also made between [the] survival column of India with a developed nation like Japan.", (excerpt)

"This article presents a new method for decomposing age distribution changes into changes in the number of births and changes in age-specific rates of mortality and migration. The method is developed on the basis of the equation for the age-specific growth rate proposed by Horiuchi and Preston (1988). Using this method, it is shown that the increase in the proportion of women in Japan during 1970-1980 is mainly due to the reduction of mortality, particularly at old ages. The results lend support to the proposed idea that the pattern of age structure changes in developed countries is now shifting from fertility-dominated to mortality-dominated ageing." This is a revised version of a paper originally presented at the 1989 Annual Meeting of the Population Association of America., (excerpt)

"The purpose of the present paper is to review the recent trends in population age structure in Japan and to assess the demographic determinants of those trends relating to the impacts of fertility and mortality change on aging." A decline in cohort mortality and a significant decrease in the birth rate since 1973 have increased the proportion of the aged population. (SUMMARY IN ENG), (excerpt)

Background: Frailty increases the risk of negative health‐related events, such as falls, disability, hospitalizations, and death. Although the association between oral health and physical frailty is well established, the relationship between oral health and psychological frailty has not yet been investigated. Therefore, we conducted a cross‐sectional study to examine the association between maximal occlusal force and psychological frailty in Japanese community‐dwelling older adults. Methods: Psychological frailty was defined as a World Health Organization‐5 scale (WHO‐5) score of <13, cognitive and functional status was defined as a Japanese version of the Montreal Cognitive Assessment (MoCA‐J) score of <23, and psychological robustness was defined as a WHO‐5 score of ≥13 and a MoCA‐J score of ≥23. We used a cross‐sectional study design to measure maximal occlusal force in 1810 participants, and examined the following factors relevant to psychological frailty: educational level, financial status, living situation, history of chronic diseases, handgrip strength, and instrumental activities of daily living. We used propensity score matching to match the psychological frailty and psychological robustness groups according to demographic and confounding factors. This process, resulted in 344 participants, of whom 172 were in the psychological frailty group and 172 were in the psychological robustness group. In the matched cohort, differences between groups with and without psychological frailty were compared using generalized estimating equations for maximal occlusal force after adjusting for the number of teeth. Results: After controlling for potential confounding factors of frailty, the psychological frailty group showed lower maximal occlusal force compared with the psychological robustness group (unstandardized regression coefficients = −72.7, 95% confidence interval: −126.3 to −19.1). Conclusions: Maximal occlusal force was associated with a reduced prevalence of psychological frailty among Japanese community‐dwelling older adults participating in our study. [ABSTRACT FROM AUTHOR]

Background: Post-evacuation return after mandatory hospital evacuation due to complicated disasters is often overlooked and not well-discussed. Aims: In this study, we explored the factors which are related to the ease or difficulty of the post-evacuation return to Fukushima prefecture of psychiatric inpatients who had been evacuated to hospitals outside the prefecture because of the Great East Japan Earthquake (GEJE) and subsequent Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. Method: This retrospective cohort study included evacuated psychiatric hospital inpatients who were registered in the Matching Project for Community Transition (MPCT) and had been traced until July 31, 2019. A total of 531 patients were included for the analyses. Univariable and multivariable analysis were conducted to detect the patients' traits including their psychiatric/physical backgrounds which were associated with their outcome – the time from GEJE to the date of return to Fukushima. Results: Over half of the patients returned to Fukushima. In the multivariable analysis, the patients' gender (male), age (older), and psychiatric diagnoses of schizophrenia, schizotypal and delusional disorders (ICD-10, F20–29) showed lower hazard ratio (HR) and statistically significant association with the difficulties of post-evacuation return. Meanwhile, disorders of psychological development (F80–89), diseases of the nervous (G00–99, except G40–41) and genitourinary (N00–99) systems showed higher HR and statistically significant association with the ease of return. Conclusions: The specific characteristics of the psychiatric inpatients including their psychiatric and physical status are associated with their post-evacuation return to their hometown. These results indicated that the evacuated hospitals' practitioners and staffs from the MPCT understood the necessity of the earlier return of inpatients to their hometown. Moreover, clinicians should pay more attention to some symptoms unique to psychiatric patients which contributed to their difficulties in returning safely or expressing their hope to return. [ABSTRACT FROM AUTHOR]

Purpose: The association between potato intake and risk of cardiovascular diseases is unknown. This study aimed to examine the association between potatoes intake and mortality from stroke and coronary heart disease among Japanese. Methods: The study included 74,750 participants of the Japan Collaborative Cohort Study, aged 40–79, who were initially free of cardiovascular diseases or cancer at baseline (1988–1990) and provided information on their potato intake. Hazard ratios and 95% confidence intervals were estimated by fitting a Cox proportional hazards model according to the frequency of potatoes intake (0, 0.4, 1.5, 3.5 and 7 servings per week) adjusting for geographic location, age, body mass index, drinking status, smoking status, perceived mental stress, education level, walking time, dietary intakes of total energy, meat, fish, vegetables, fruit, dairy products, cakes, and salt. Results: Over a median of 19.2 years of follow-up, 4908 deaths from cardiovascular diseases were identified: 1019 from coronary heart diseases and 2153 from strokes (738 ischemic strokes and 495 hemorrhagic strokes). After adjustment for potential confounding factors, the hazard ratio of mortality from cardiovascular diseases for daily potato intake compared with no potato intake was 0.82 (95% confidence interval: 0.70, 0.95) among women, and 1.01 (0.88, 1.16) among men. Among women, the multivariable hazard ratios were 0.67 (0.48, 0.96) for coronary heart disease, 0.83 (0.66–1.05) for total stroke, 0.70 (0.43–1.15) for hemorrhagic stroke, and 0.75 (0.49–1.13) for ischemic stroke. Conclusion: We found an inverse association of potato intake with mortality from total cardiovascular diseases, especially that from coronary heart disease, among Japanese women. To our knowledge, this is the first report to show an inverse association between potato intake and total cardiovascular diseases. [ABSTRACT FROM AUTHOR]

We aimed to explore factors associated with interprofessional competencies among healthcare professionals in Japan. From June to October 2020, we conducted a cross-sectional survey via a validated self-administered web-based questionnaire using the Japanese version of the Self-assessment Scale of Interprofessional Competency (JASSIC). We recruited participants from an e-mail list. The questionnaire asked about JASSIC, basic demographic information, whether they had undertaken pre- and post-licensure interprofessional education (IPE), and administrative experience; as well as an organizational climate scale, including "Plan, Do, See" factor for management (PDS factor), and the "Do" factor in a leader-centered direction for people who work unwillingly. Factors associated with the total JASSIC score as interprofessional competencies were determined using multiple regression analysis. We analyzed data from 560 participants with an average age of 41.0 years, comprising 132 nurses, 127 doctors, and 120 social workers. The median of the total JASSIC score was 72/90 (range: 66–78). On multiple regression analysis, total JASSIC score was significantly associated with age, PDS factor, administrative experience, pre-licensure IPE, and pos-licensure IPE. These findings emphasize the importance of pre- and post-licensure IPE, and administrative experience for improving interprofessional competencies in Japan. [ABSTRACT FROM AUTHOR]

Background and Hypotheses A wealth of evidence suggests that adolescent psychotic experiences (PEs), and especially auditory hallucinations (AHs), are associated with an increased risk for self-injurious behavior (SIB). However, the directionality and specificity of this association are not well understood, and there are no published studies investigating within-person effects over time. The present study aimed to test whether AHs and SIB prospectively increase reciprocal risk at the individual level during early-to-middle adolescence. Study Design Three waves (12y, 14y, and 16y) of self-reported AHs and SIB data from a large Tokyo-based adolescent birth cohort (N = 2825) were used. Random Intercept Cross-Lagged Panel Model (RI-CLPM) analysis was conducted to test the within-person prospective associations between AHs and SIB. Study Results At the within-person level, AHs were associated with subsequent SIB over the observation period (12y–14y: β =.118, P <.001; 14–16y: β =.086, P =.012). The reverse SIB->AHs relationship was non-significant at 12–14y (β =.047, P =.112) but emerged from 14y to 16y as the primary direction of influence (β =.243, P <.001). Incorporating depression as a time-varying covariate did not meaningfully alter model estimates. Conclusions A complex bi-directional pattern of relationships was observed between AHs and SIB over the measurement period, and these relationships were independent of depressive symptoms. Adolescent AHs may be both a predictor of later SIB and also a manifestation of SIB-induced psychological distress. [ABSTRACT FROM AUTHOR]

Youth become psychologically independent by emotionally separating from their parents and simultaneously developing a sense of trust in them. While these relational components have been addressed separately, studies focusing on the change in dynamics of these components are lacking. This study examined profiles of parent–youth relationship quality based on emotional separation and parental trust, age differences in the prevalence of these profiles, and age differences in the associations between the profiles, identity, and life satisfaction. Participants included 14,428 youth living in Japan from five age groups (44.8% girls/women; Mage = 20.6 years; range = 12–25 years). Six profiles were identified: healthy–independent, unhealthy–independent, balanced, moderate/ambivalent, connected, and distant. The connected profile was predominant among early adolescents, while the healthy–independent profile was predominant among late adolescents and early and middle emerging adults. Among all age groups, identity synthesis was the highest in the healthy–independent profile, and life satisfaction was the highest and identity confusion was the lowest in the healthy–independent and connected profiles. These findings indicate that young people navigate the process of becoming independent from their parents by balancing emotional separation and parental trust, and this balance relates to identity development and life satisfaction. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to describe and compare the demographic, clinical, and laboratory characteristics and follow-up of representative samples of patients with myopathies and systemic sclerosis overlap syndromes (Myo-SSc) from two tertiary centers. Patients and methods: This is a cross-sectional and retrospective study conducted between January 2000 and December 2020. Fourty-five patients were analyzed with Myo-SSc (6 males, 39 females; mean age: 50.2±15.4 years; range, 45 to 65 years) from two tertiary centers (n=30 from Brazil and n=15 from Japan). Results: The median follow-up was 98 (range, 37 to 168) months. Muscle impairment started simultaneously with the diagnosis of systemic sclerosis in 57.8% (26/45) of cases. Muscle involvement occurred before the onset of systemic sclerosis in 35.5% (16/45) of cases, and after in 6.7% (3/45). Polymyositis was observed in 55.6% (25/45) of cases, followed by dermatomyositis in 24.4% (11/45) and antisynthetase syndrome in 20.0% (9/45). Concerning systemic sclerosis, the diffuse and limited forms occurred in 64.4% (29/45) and 35.6% (16/45) of the cases, respectively. Comparing the subgroups, Myo or SSc onset was earlier in Brazilian patients, and they had a higher frequency of dysphagia (20/45, [66.7%]) and digital ulcers (27/45, [90%]), whereas Japanese patients had higher modified Rodnan skin scores (15 [9 to 23]) and prevalence of positive anti-centromere antibodies (4/15 [23.7%]). The current disease status and mortality were similar in both groups. Conclusion: In the present study, Myo-SSc affected middle-aged women, and its manifestation spectrum varied according to geographic distribution. [ABSTRACT FROM AUTHOR]

Long-term medical care for people living with HIV (PLHIV) is critical for treatment efficacy, and various studies have examined reasons for antiretroviral therapy (ART) non-adherence. In Japan, doctors assume patients maintain high adherence. However, little is known about real-world treatment adherence. We conducted an anonymous self-administered web-based survey asking about adherence for a total of 1030 Japanese PLHIV who were currently on ART. Adherence was determined using the eight-item Morisky Medication Adherence Scale (MMAS-8), for which scoring ranged from 0 to 8 and scores < 6 points were classified as low adherence. Data were analyzed based on patient-related factors; therapy-related factors; condition-related factors, such as a comorbidity with depression (utilizing the Patient Health Questionnaire 9, PHQ-9); and healthcare/system-related factors. Among 821 PLHIV who responded to the survey, 291 responders (35%) were identified as being in the low adherence group. A statistically significant relationship was found between the number of missed anti-HIV drug doses within the previous 2 weeks and long-term adherence, per the MMAS-8 score (p < 0.001). Risk factors for low adherence included age (younger than 21 years, p = 0.001), moderate to severe depression (p = 0.002, using the PHQ-9), and drug dependence (p = 0.043). Adherence was also influenced by a shared decision-making process, including treatment selection, doctor–patient relations, and treatment satisfaction. Adherence was mainly affected by treatment decision factors. Hence, support of care providers should be considered critical for improving adherence. [ABSTRACT FROM AUTHOR]

In Germany, more than two-thirds of employees report mental health issues, while in Japan, more than half of the country's workforce are mentally distressed. Although both countries are socio-economically developed in similar ways, their cultures differ strongly. This article investigates mental health constructs among German and Japanese employees. A cross-sectional design was employed in which 257 German and 165 Japanese employees completed self-report scales regarding mental health problems, mental health shame, self-compassion and work motivation. T-tests, correlation and regression analyses were conducted. Results show that German employees have significantly higher levels of mental health problems, mental health shame, self-compassion and work motivation than Japanese employees. While many correlations were similar, mental health problems were associated with intrinsic motivation in Germans, but not in Japanese. Shame was associated with both intrinsic and extrinsic motivation in Japanese, but not in Germans. Self-compassion – defined as a complex of compassion, humanity, care and unconditional, compassionate love – was associated with gender and age in Japanese, but not in German employees. Lastly, regression analysis uncovered that self-compassion was the strongest predictor of mental health problems in Germans. In Japanese employees, mental health shame is the strongest predictor of mental health problems. Results can guide managers and psychologists in internationalised organisations to effectively approach employee mental health. [ABSTRACT FROM AUTHOR]

The association between oral frailty (OFr) and body action has been investigated, but its association with systemic function remains unclear. Therefore, this cross-sectional study examined the association between OFr with decreased bone mineral density (BMD) and renal function in residents of Shika town, Ishikawa Prefecture, Japan aged ≥40 years. This study included 400 inhabitants. The OFr total score was assessed using three oral domains in the Kihon Checklist (a self-reported comprehensive health checklist), the number of teeth, and brushing frequency per day. Measurements were the estimated glomerular filtration rate (eGFR) and the osteo-sono assessment index (OSI). Using a two-way analysis of covariance (p = 0.002), significantly lower OSI was indicated in the eGFR < 60 and OFr group than in the eGFR of < 60 and non-OFr group after adjusting for age, body mass index, and drinking and smoking status as confounding factors. Multiple logistic regression analysis confirmed this relationship (p = 0.006). Therefore, lower BMD seems to be associated with lower renal function only when accompanied by OFr. Further longitudinal studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate clinical outcomes after endometrial receptivity analysis (ERA). Methods: This was a multicenter, retrospective cohort study involving 861 women who underwent ERA testing at certified fertility clinics in Japan, and who received subsequent personalized blastocyst embryo transfers (ET) between 2018 and 2020. Clinical outcomes, including pregnancies, miscarriages, and live births, were evaluated according to receptivity status for ERA. Results: Mean patient age was 37.7 years (SD = 4.0), and the median number of previous ETs was 2 (interquartile range, 2–3). 41.0% (353/861) of patients were non‐receptive for ERA testing. Clinical pregnancy, miscarriage, and live birth rates for personalized blastocyst ET were 44.5% (226/508), 26.1% (59/226), and 26.8% (136/508) for receptive patients, and 43.1% (152/353), 28.3% (43/152), and 28.9% (102/353) for non‐receptive patients, all statistically nonsignificant. Multiple logistic regression demonstrated similar nonsignificant associations between receptivity and clinical outcomes. Greater patient age, smoking, and longer duration of infertility were significantly and negatively associated with receptivity, whereas a history of delivery was positively associated and statistically significant. Conclusions: Clinical outcomes after ERA testing were similar between receptive and non‐receptive patients. Further prospective study including an appropriate comparison group are warranted to evaluate the efficacy of ERA testing. [ABSTRACT FROM AUTHOR]

Kyphosis may reduce the force of coughing by affecting the factors related to cough peak flow (CPF). This study sought to compare cough strength and respiratory function between non-kyphotic and kyphotic elderly individuals and clarify the relationship between these factors. The non-kyphotic group comprised 17 elderly individuals with a kyphosis index of less than 15.1, while the kyphotic group comprised 21 elderly individuals with a kyphosis index of 15.1 or higher. Cough strength, respiratory function, respiratory muscle strength, and maximum phonation time were measured, and comparison between two groups and correlation analysis between variables were performed. CPF, vital capacity, maximum expiratory pressure (PEmax), maximum inspiratory pressure (PImax), and chest expansion at the xiphoid process were significantly lower in the kyphotic group than in the non-kyphotic group. There were significant negative correlations between kyphosis index and CPF (r = −0.37, p < 0.05), PEmax (r = −0.45, p < 0.01), PImax (r = −0.44, p < 0.01) and chest expansion at the xiphoid process (r = −0.38, p < 0.05). Our results demonstrated that cough strength was significantly lower in the kyphotic compared to non-kyphotic individuals. Furthermore, cough strength decreased with increased severity of kyphosis. [ABSTRACT FROM AUTHOR]

Background: Many pregnant women experience impairments in social, occupational, or other important functioning. Aim: This study aimed to confirm measurement and structural invariance of the Sheehan Disability Scale (SDS) and its validity during early pregnancy. Design: Longitudinal study with two observations. Methods: Questionnaires were distributed to pregnant women attending antenatal clinics at gestational weeks 10–13. Of 382 respondents, 129 responded to the SDS again 1 week later. Results: Confirmatory factor analysis shows good fit with the data: χ2/df = 0, comparative fit index (CFI) = 1.000, standardized root mean square residual (SRMR) = 0, and root mean square error of approximation (RMSEA) = 0.718. There is acceptable configural, measurement, and structural invariance of the factor structure between primiparas and multiparas as well as between two observation occasions. The Pregnancy–Unique Quantification of Emesis and Nausea, Patient Health Questionnaire-9, and Insomnia Severity Index subscales explain 47% of the variance in SDS scores. Conclusion: Perinatal health care professionals should pay more attention to the difficulties and disabilities that pregnant women face. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the sex education needs of people with spina bifida through their responses to a questionnaire. The questionnaire was disseminated to people with spina bifida between the ages of 18 and 40 years. Of the 436 questionnaires distributed, we received 48 valid responses (11.0%). The questionnaire included items related to demographic characteristics and preferences regarding the content of sex education. Twenty-two options were created to ascertain the desired content of sex education. These items were classified into the eight key concepts (KCs) specified by the International Technical Guidelines for Sexuality Education. T-tests were conducted for the eight KCs and gender, age, diagnosis, presence of hydrocephalus, physical function, and dating experience. Overall, most participants wanted to be educated on "KC1 Relationships" and "KC4 Violence and Staying Safe." Participants under 30 years of age wanted to be educated on "KC6 The Human Body and Development." Participants diagnosed with spina bifida aperta and those who used diapers/pads preferred to be educated on "KC2 Values, Rights, Culture, and Sexuality" and "KC3 Understanding Gender." Those who had been in a relationship preferred education in "KC3 Understanding Gender," "KC5 Skills for Health and Well-being," and "KC8 Sexual and Reproductive Health." Considering these results, we should enhance sex education for people with spina bifida. [ABSTRACT FROM AUTHOR]

Background: Children's intentions should be respected. Parents are the key persons involved in decision-making related to their children. In Japan, the appropriate ages and standards for a child's consent and assent, approval, and decision-making are not clearly defined, which makes the process of obtaining consent and assent for clinical research complex. The purpose of this paper is as follows: to understand the attitudes and motives of parents concerning children's participation in medical research and the factors influencing their decision-making. We also sought to clarify who has the right to be involved in decisions regarding children's participation in research.Methods: A semi-structured Internet survey on parents' opinions and attitudes and preferences concerning medical research involvement was conducted. Children were divided into three age groups (6-10-year-olds, 11-14-year-olds, and 15-18-year-olds), with three illness severity categories. Possible correlations between the number of children, children's ages, parents' educational levels, and parents' attitudes were examined.Results: Among the participants, 42.3% recognized the term "informed consent." The proportion of participants who understood "informed consent" increased with educational level. Four out of five participants did not know, or had not heard of, the term "informed assent." Furthermore, the percentage of those who understood the term "informed assent" increased with academic level. Participants generally believed in prioritizing parents' opinions over children's, and that parents and children would ideally reach a joint decision. Although many parents favored collaborative decision-making, they also wanted their own will reflected in the decision and felt they should receive important information before their children do. Decision-making was affected by the condition's severity and prognosis. This indicates that most Japanese parents believe that their children have the right to know their disease name and treatment; nonetheless, they should be protected. Parents' values and judgments regarding medical intervention involving their children varied.Conclusions: Children's ability to consent to treatment and research believed to be in their best interests should be assessed appropriately. They should be permitted to provide consent or assent, and their views should be respected. Involving children in decision-making fosters more open communication and transparency between medical professionals, parents, and children. [ABSTRACT FROM AUTHOR]

Japan has been facing a population decline since 2010 due to low birth rates, interregional migration, and regional traits. In this study, we modeled the demographic dynamics of Japan using a transition matrix model. Then, from the mathematical structure of the model, we quantitatively evaluated the domestic factors of population decline. To achieve this, we constructed a multi-regional Leslie matrix model and developed a method for representing the reproductive value and stable age distribution using matrix entries. Our method enabled us to interpret the mathematical indices using the genealogies of the migration history of individuals and their ancestors. Furthermore, by combining our method with sensitivity analysis, we analyzed the effect of region-specific fertility rates and interregional migration rates on the population decline in Japan. We found that the sensitivity of the population growth rate to the migration rate from urban areas with large populations to prefectures with high fertility rates was greatest for people aged under 30. In addition, compared to other areas, the fertility rates of urban areas exhibited higher sensitivity for people aged over 30. Because this feature is robust in comparison with those in 2010 and 2015, it can be said to be a unique structure in Japan in recent years. We also established a method to represent the reproductive value and stable age distribution in an irreducible non-negative matrix population model by using the matrix entries. Furthermore, we show the effects of fertility and migration rates numerically in urban and non-urban areas on the population growth rates for each age group in a society with a declining population. [ABSTRACT FROM AUTHOR]