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In Japan, HPV vaccination rates has dramaticaly declined since 2013. Since mothers are the ones making the decision to vaccinate their daughters against HPV, we probed the mothers' intention to receive vaccinations for themselves and to vaccinate their daughters against HPV, and their reasoning.An internet survey was conducted in March of 2021. Through the screening, 1576 participants were extracted from a survey panel and divided into 3 groups based on their daughter's birth fiscal year (Group 1: 1994 to 1999, Group 2: 2000 to 2003, Group3: 2004 to 2008). The chi-square test and residual analysis were used for the statistical analysis of comparison among the groups. Logistic regression analysis was used to identify independent variables with mothers intention to get their daughters vaccinated under specific situations.The percentage of respondents without anxiety regarding their daughter's general vaccination was significantly higher in Group 1 (p 0.05). In the mothers of daughters born in or after 2000 when vaccination rates declined (Groups 2 and 3), a situation in which 'The daughter's best friends were vaccinated before her' made the mothers think positively about HPV vaccination, and to the same degree as a situation in which 'You received a notice from your local government recommending vaccination' (Group 2: 41.6% (214/514) and 40.5% (208/514), Group 3: 48.5% (257/530) and 47.0% (249/530)).If mothers who have had their daughters vaccinated were to recommend HPV vaccination to their close friends, 'the best friend effect' should promote others to be vaccinated.

BackgroundDuring a global infectious disease pandemic such as the coronavirus disease 2019 (COVID-19), individuals’ infection prevention/risk-taking behaviours are likely to differ depending on their health literacy and beliefs regarding the disease. To effectively promote infection prevention behaviours, it is necessary to enable information dissemination and risk communication that consider individuals’ health literacy and beliefs. In this study, we exploratorily characterised segments based on individual health literacy and beliefs regarding COVID-19 among the Japanese during the early stage of the COVID-19 pandemic, and investigated whether infection prevention/risk-taking behaviours and fear of COVID-19 differed among these segments.MethodsIn this study, we conducted two web-based longitudinal surveys in Japan (PHASE 1, 1–30 November 2020, 6,000 participants; PHASE 2, 1–31 December 2020, 3,800 participants). We characterised segments of the target population using cluster analysis on health literacy and beliefs regarding COVID-19 obtained in PHASE 1. We further investigated the associations between the clusters and infection prevention/risk-taking behaviours and fear of COVID-19, obtained from PHASE 2.ResultsFive clusters were identified: ‘Calm/hoax denial’, ‘Hoax affinity/threat denial’, ‘Minority/indifference’, ‘Over vigilance’, and ‘Optimism’. There were significant differences in infection prevention/risk-taking behaviours and fear of COVID-19 among the five clusters. The belief in susceptibility to infection, rather than affinity for hoaxes and conspiracy theories, was coherently associated with infection prevention/risk-taking behaviours and fear of infection across clusters. This study provides foundational knowledge for creating segment-specific public messages and developing interactive risk communication to encourage infection prevention behaviours.

BACKGROUND One life event requiring the most extensive resilience and adaptation is parenting. However, resilience and perceived support in child rearing are diverse, and the actual situation is unclear, especially after public postpartum checkups. OBJECTIVE To explore the psychosocial status of mothers during the child-rearing period from newborn to toddler, with the classifier based on the data on resilience and adaptation characteristics of mothers with newborns. METHODS A web-based cross-sectional survey was conducted. The mothers with newborns aged to about one month (newborn cohort) were analyzed to construct an explainable machine-learning classifier to stratify the resilience and adaptation characteristics for parenting and detect vulnerable populations. Explainable k-means clustering was used because of its high explanation and applicability. The classifier was applied to mothers with infants aged two months to 1 year (infant cohort) and mothers with toddlers aged over one year to 2 years (toddler cohort). The psychosocial status, including depressed mood assessed by the Edinburgh postnatal depression scale, bonding assessed by the postpartum bonding questionnaire, and sleep quality assessed by the Pittsburgh sleep quality index between the classified groups, was compared. RESULTS The total of 1559 participants were included in three cohorts were populations with different characteristics, including parenting difficulties and psychosocial measures. The classifier, which stratified participants into five groups, was generated depending on the self-reported scores of resilience and adaptation in the newborn cohort data (N=310). The classifier determined the group with more incredible difficulty in resilience and adaptation to a child’s temperament and perceived support was the highest difficulty group with high incidences of problems with depressed mood (Relative Prevalence [RP] 5.87, 95% CI 2.77-12.45), bonding (RP 5.38, 95% CI 2.53-11.45), and sleep quality (RP 1.70, 95% CI 1.20-2.40), compared with the group with the lowest difficulty of perceived support. In the infant cohort (N=619) and the toddler cohort (N=461), the stratified group with the most difficulty had high incidences of problems compared with the lowest difficulty group with depressed mood (RP 9.05, 95% CI 4.36-18.80; RP 4.63, 95% CI 2.38-9.02), bonding (RP 1.63, 95% CI 1.29-2.06; RP 3.19, 95% CI 2.03-5.01), and sleep quality (RP 8.09, 95% CI 4.62-16.37; RP 1.72, 95% CI 1.23-2.42), respectively. CONCLUSIONS The classifier based on a combination of resilience and adaptation to the child's temperament and perceived support identified psychosocial vulnerable groups in the newborn cohort, the start-up stage of childcare. Psychosocially vulnerable groups were also detected in qualitatively different infant and toddler cohorts, depending on their classifier. The detected group in the infant cohort showed particularly high RP for depressed mood and poor sleep quality.

Background This study aims to explore decision-making processes in cancer treatment in Japan. We investigated the percentage of patients who can make decisions, the rate of implementation of decision-making support actions, and the activities that contribute to decision-making. Methods The survey participants were 555 cancer patients (mean age 63.34 years, standard deviation, 12.76). The investigator observed the survey process in the actual examination room. Results The results of this study clarify the understanding of decision-making among cancer patients. Furthermore, it was found that doctors’ and nurses’ rates of implementation of supportive behaviors differed. In addition to supportive behaviors, patients’ ages were related to the decision-making process. Conclusion From these facts, it is more important for older adults to support more specific decision making. Doctors and nurses should divide roles and contribute to patient decision-making support in the medical field. Furthermore, they should endeavor to communicate according to patients’ personal values and dispositions.

Background To help workers balance work and personal life while experiencing illness, we developed a self-monitoring assessment tool for workers. We conceptualized " Fatigue of Brain" as a state of dysfunction of the central nervous system, such as decreased brain function and mental health problems, and attempted to measure it in a comprehensive, simple, and quantitative manner. We also developed cutoff points and provided indicators of conditions that would require a recommendation for medical examination. Methods We developed the items of the Fatigue of Brain Scale to measure the “Fatigue of Brain” state, and conducted factor analysis, comorbid validity, and retest reliability verification. The first survey (Survey 1) was conducted between February-March 2019, and the second survey (Survey 2) was conducted one month later. Men and women aged 18–64 years, who had experienced a leave of absence due to physical or mental health problems within the past 10 years were included in the survey. A total of 460 participants (211 men and 249 women, mean age 45.64 ± 9.62 years) were recruited for Survey 1, and 334 participants (161 men and 173 women, mean age 46.72 ± 10.11 years) for Survey 2. Receiver Operating Characteristic curve analysis was then used to examine the optimal cut-off value for this scale. Results A clear factor structure was obtained for 20 items consisting of four factors: "decline in role execution function," "social/daily function decline," "lack of sleep," and "maladaptive cognitive and behavioral responses," and sufficient reliability and validity were confirmed. In addition, cut-off values for “mild Fatigue of Brain,” “moderate Fatigue of Brain,” “severe Fatigue of Brain,” and “extreme Fatigue of Brain” were established. Conclusions If workers are aware of their current performance status and are able to self-manage their performance better, this would play an important part in trying to maintain good health, improve individual productivity, and contribute to company profits. The usefulness of this scale needs to be further verified by using it in actual workplaces in the future.

AIM A feeling of isolation childcare mothers' face is a serious social problem in Japan because the relationships with mothers and local communities have grown sparser. The purpose of this study was to clarify the feelings of isolation of mothers during childcare and the factors related to it. METHODS We conducted a questionnaire survey in Yao City, Osaka. We mailed out a questionnaire survey of 1293 mothers with infants who had either a 4-month or 42-month routine health checkup during the period from September to December of 2018. RESULTS There was no association between "feeling lonely while raising my child" and the absence of "people who helped raise my children." On the other hand, it was found that the mothers' inner feelings, such as "I wasn't satisfied with my childcare environment" (OR: 2.55, 95% CI: 1.32-4.91, p = 0.0052) or "I lacked confidence in my own childcare abilities" (OR: 6.21, 95% CI: 4.31-8.95, p

In Japan, the age‐adjusted incidence of cervical cancer has been increasing constantly and rapidly among younger women. We set out to accurately confirm the effectiveness of the HPV vaccine in Japan. Data were collected for women born in the fiscal year (FY) 1990 to 1997, who became eligible for their 20‐y‐old cervical cancer screening between the FY 2010 to 2017. The adjusted incidence of cervical intraepithelial neoplasia (CIN)1+ in women born in FY 1990 to 1993, that is those who reached the national vaccination target age prior to the introduction of publicly subsidized HPV vaccinations, referred here after as “the pre‐introduction generation”, was 1.42% (242/17 040). The incidence in the “vaccination generation” (women born in FY 1994 to 1997, that is those who were heavily vaccinated as a group when they were of the nationally targeted age of 13‐16) was 1.66% (135/8020). There was no significant difference between these incidence rates. However, our FY birth year‐by‐year analysis revealed that the incidence of CIN1+ was obviously lower than that predicted based on just the trend for CIN1+ seen in the pre‐introduction generation. Our analysis revealed that the incidence of CIN3+ was obviously lower in the vaccination generation than in the pre‐introduction generation (P = .0008). The incidence of CIN was already tending to increase in both the pre‐introduction and vaccination generations. The changes in CIN incidence by individual birth FY must be examined to accurately determine the actual effects of the HPV vaccine for reducing mild cervical lesions., This is the first large‐scale study in Japan to show a significant preventive effect of HPV vaccine against CIN3+. The incidence of CIN1+ was the same in both the vaccination and the pre‐introduction generation. Because the incidence of CIN 1+ was tending to increase in both generations, the changes in CIN 1+ incidence by individual birth FY must be examined to accurately determine the actual effects of HPV vaccine for reducing mild cervical lesions.

Background There are various psychosocial support services for cancer patients in Japan; however, their utilization rate is lower than in Western countries. The aim of this study was to investigate the actual status of the utilization of such services and the related factors of their use, using the transtheoretical model. Methods We conducted an Internet survey of cancer outpatients. They were asked for information on their demographics, physical status and the usage of and intention to use psychosocial support services, and to answer the Hospital Anxiety and Depression Scale. Results Data of 712 participants were analyzed; 111 had made use of psychosocial support services (15.6%). Participants who were younger, female, had breast cancer, experience with hormone therapy and did not have a good performance status (Karnofsky Performance Scale) more often used such services when comparing users/experiencers with non-users/inexperienced. Of the inexperienced, 538 were in the Precontemplation stage (89.5%), 62 were in the Contemplation stage (10.3%) and one was in the Preparation stage (0.2%). Approximately 35% of those in the Precontemplation stage would correspond to adjustment disorders or major depression. Conclusions We showed the degree of cancer patients who have used the psychosocial support services and its contents and revealed the factors related to the utilization of such services in Japan. Our study supports previous reports that cancer patients with high levels of distress do not necessarily seek support, and thus future studies should also examine other modifiable factors considering the medical settings.

Background In Japan, a recent opinion poll in 2017 showed that 41.9% of the respondents wished to donate their organs, but only 12.7% declared their intention to donate or not do so. Therefore, it is important to explore measures to prompt more individuals to register their intention about organ donation. Methods A field experimental questionnaire survey was conducted to confirm the effect of a prompt message for registering intentions for organ donation, which was communicated at a driver's license center. The study employed a prospective randomized control design. Seven thousand six hundred fifteen individuals visited the Tokyo Fuchu License Examination Center to update their driver's license and received leaflets including a message prompting organ donation registration and the questionnaire. Of the participants who received leaflets, 3224 respondents provided complete responses to the questionnaire (valid response rate: 42.3%). Subsequently, a questionnaire survey was conducted to assess the participants' willingness to register for organ donation. A control condition and the following types of messages were used: peer-framed, gain-framed, loss-framed, reciprocity-framed, and peer + reciprocity-framed. Results The reciprocity message emerged as a significant predictor of increase in immediate decision response. The loss-framed message was a significant predictor of decrease in no intention to register. Conclusions This study found that reciprocity and loss-framed messages promoted the readiness to register for organ donation among individuals from a Japanese urban area. Mandatory distribution of prompt messages at every driver's license centers in Japan would be recommended.

Purpose: We developed a mental health promotion campaign program to promote psychiatrichelp-seeking behavior among university students by adopting a social marketing approach and nudge theory from behavioral economics. The purpose of this study was to examine the effectiveness of the campaign. The campaign focused on the illustration of cognitive function- related symptoms and was called the “Fatigue of Brain” campaign.Methods: This study retrospectively compared the duration until psychiatric consultation at health care centers in a Japanese university between data obtained from our previous study (2016- 2018) with data from our newly developed mental health campaign (2018-2020). The campaign program included a small leaflet, given to all students during their physical examinations, which directed them to a special website.Results: The results of logistic regression analysis using data that met the eligibility and inclusion/exclusion criteria showed that the proportion of students (40.3%) who visited psychiatric consultations within two weeks of the campaign’s onset was significantly higher than the proportion of students visiting before the campaign (37.6%; OR = .578, 95% CI = .343 - .972, p = .039). Multivariate analysis revealed that the proportion of students with depressive symptoms (31.6%) was significantly higher during the campaign than before the campaign (17.3%; OR = .444, 95%CI = .234–.843, p = .013).Conclusions: The results suggest that our cognitive function-focused mental health campaign promotes earlier psychiatric consultation.

In Japan, in June 2013, The Ministry of Health, Labor and Welfare (MHLW) decided to temporarily suspend its official recommendation for the participation of girls in the national immunization program. The HPV vaccination rate in Japan soon declined to below 1%. In October 2020, the MHLW notified that the municipalities could and should begin to individually notify girls and their parents targeted for routine vaccination. We have examined how that type of individual notification has affected the number of vaccinations.From 12 municipalities (with a combined total population of approximately 4.06 million), we collected vaccination data for all girls who attended grades 6 through 10 from April 2019 to March 2021. We analyzed the number of initial-round vaccinations that occurred by month and the timing and the subjects of the individual notifications.The annual vaccination rate for tenth-grade students in 2020 in the six municipalities that had implemented individual notification was 9.46% (342/3618), which was significantly higher than the rate of 3.22% (54/1676) in the three municipalities that had not implemented individual notification (p 0.001). On the other hand, the annual vaccination rate for the sixth to ninth-grade students in 2020 in the six municipalities that had implemented individual notification was not significantly (p = 0.56) higher than the rate in the three municipalities that did not: 1.43% (197/13,785) versus 1.33% (83/6260), respectively.This study clearly demonstrates the importance of providing information for routine vaccination directly to the targets and their parents.

The purpose of this study is to identify the types of the risk communication for COVID-19. We conducted the cross-sectional questionnaire survey, for 6,000 people (male = 3000, female = 3000, M = 49.41±16.59), regarded as health literacy. In the result, it is revealed there were 6 segments: "majority/social defense" in which people had the most common beliefs and thought PCR testing is necessary for all, "self-judgment/self-protection" that was highly literate, "threat denying" that completely denied threats and prevention of infection, "hoax affinity/optimism" that took in information without discernment, "vigilance/self-protection," in which people felt threatened by infection but thought that PCR testing was unnecessary, and "hyper vigilance/social defense," in which people protected others if there was even a small risk.

Background: The COVID-imposed social isolation of Japanese mothers has significantly increased their already existing sense of loneliness. We report here on the changes that have occurred in the environment of home childcare and in the mother’s feelings of loneliness during the pandemic and we compare these findings with results from a similar previous study we conducted in 2019. Methods: In 2019, we conducted an online survey of mothers who had infants aged 4-12 months. Many of the survey questions at that time concerned the home childcare environment and the mother’s sense of loneliness. In 2020, during the height of this COVID pandemic, we conducted a follow-up COVID impact survey using the same questionnaire, of a different group mothers, again having infants of 4-12 months, to determine the impact of the pandemic on the mothers of extra-vulnerable young children. Results: The number of women who consulted with their friends or neighbors about childcare during the pandemic had decreased from the more normal times of early 2019, whereas in 2020 there was an increase in the number who consulted with their mother. The mother’s method of gathering childrearing information had shifted away from the face-to-face focus of 2019 to a habit of calling a municipal health center or using social-networking-services (SNS) as a reference. The rate was decreased of a mothers’ frequency of interaction with other parents having children at home as old as their own child. Overall, the number of mothers who felt loneliness was significantly increased. Conclusions: Because of the impact on mothers of the COVID pandemic, specifically around their methods of gathering information concerning childcare, we found that the child-rearing 3 environment in Japan has detrimentally changed since early 2019. Whether or not the mother felt stressed or felt they lacked sufficient information concerning childcare was associated with having an impact on the mother’s sense of loneliness. The importance of the appropriate transmission of information concerning childcare had increased due to this pandemic, so we need to take aggressive actions to help these mothers of small children to prevent harm and tragedies from occurring to the children in their care.

The trend for cervical cancer in younger women has been increasing recently in Japan. However, as a result of the suspension of governmental recommendation, Japan&rsquo, s HPV (human papillomavirus) vaccination rate for girls born since 2000 has dropped sharply. We conducted an internet survey in December of 2019, 76 months after the suspension of recommendation, to verify the intention of mothers to inoculate their daughter under current circumstances and compared with our previous surveys and leaflet intervention effect. The rates of mothers who replied that they would &ldquo, inoculate&rdquo, were significantly higher at 9 and 23 months, but by 32 months after the suspension the rate was significantly lower (p &lt, 0.05, p &lt, 0.05, respectively). The rates of the mothers who replied they would not inoculate were significantly lower at 9 months and 23 months, but at 76 months was significantly higher (p &lt, 0.05, respectively). We found that intervention with a leaflet that could be used under the current suspension of the governmental recommendation did not increase the mothers&rsquo, intention to inoculate their daughters. A leaflet that actively encourages vaccination may increase the intent of vaccination. It is strongly recommended that the MHLW promptly resume its recommendations for HPV vaccination.

Objective Various psychosocial support services for cancer patients are available in Japan; however, their utilization rate is low. The present study aimed to examine factors contributing to help-seeking behavior in the use of psychosocial support services among cancer outpatients at three stages: Precontemplation (without adjustment disorder or major depression), Precontemplation (with adjustment disorder or major depression), and Contemplation. Methods We conducted a web-based questionnaire survey at two points with a panel of cancer outpatients. We collected data on demographic information, physical status, the use of and intention to use psychosocial support services, psychological distress, attitude toward using psychosocial support services for cancer patients, and social support. Results In total, 395 cancer patients were analyzed. In the Precontemplation (without adjustment disorder or major depression) stage, resistance to help-seeking (OR = 0.726, P = .011) and future prospects of the Brief Cancer-Related Worry Inventory (OR = 1.012, P = .019) were significant. In the Precontemplation (with adjustment disorder or major depression) stage, only recommendation by medical staff or family (OR = 0.000, P = .026) had a significant effect. In the Contemplation stage, only social and interpersonal problems (OR = 0.942, P = .080) showed a significant (negative) trend. Conclusions This study showed that contributing factors differed by stage. To encourage the use of psychosocial support services, it is desirable to recommend the use and to develop interventions for promoting, with responding to patients' conditions and intentions rather than responding to everyone in the same way.

Japan’s governmental recommendation of HPV vaccine has now been suspended for more than 4 years. In and before 2013, the targets of 20-year-old cervical cancer screening were females born in and before 1993, i.e., those who could not have received HPV vaccination because it was not yet publicly introduced. The targets during 2014–2019 are, or will be, those born in 1994–1999, i.e., those who came of age during a period with the highest HPV immunization rate. We analyzed the statistical data for each birth year, for the cumulative HPV vaccination rates achieved as of age 16, and for the corresponding results of cervical cancer screening at age 20. The rate of abnormal findings in cervical cytology increased slightly from 3.68% in 2010 (birth year: 1990) to 4.35% in 2013 (birth year: 1993); however, it dynamically dropped to 2.99% in 2014 (birth year: 1994) and 3.03% in 2015 (birth year: 1995). In total, the rate of abnormal findings in cervical cytology was 3.96% in 2010–2013, but significantly dropped to 3.01% in 2014–2015 (p = 0.014). This is the first description of dynamic changes occurring in the abnormal rate of cervical cancer screening as a result of positive changes in national HPV vaccination rates.

We investigated the periods from symptom onset to the first visit to the psychiatric consultation and the factors that influence psychiatric help-seeking behavior in university students. Students who first visited the psychiatric department of university health care center were the study participants. We surveyed the elicited information such as age, sex, period from symptom onset to the first visit, main symptoms, General Health Questionnaire GHQ-12, and perception of stigma associated with receiving a psychiatric consultation. We analyzed the factors affecting the duration until a psychiatric consultation was made using logistic regression analysis, examining age, sex, contents of the problem, GHQ-12, and stigma as independent variables. Of the participants, 48.2 % did not consult with a psychiatrist for more than 6 months and 51 participants (36.7 %) took more than a year before a consultation. We divided the study participants into two groups: early examinees and delayed examinees. In order to investigate the factors affecting the two groups, logistic regression analysis was performed. Of the independent variables, one consultation content (physical symptoms; odds ratio (OR) = 9.21, 95 % CI (confidence interval) = 2.00–42.62, p = 0.004) and the GHQ-12 (OR = 1.17, 95 % CI = 1.05–1.31, p = 0.005) were significant factors. It became clear that physical symptoms significantly accelerated consultation with psychiatry. When various problems occurred, the decision to seek a psychiatry consultation required a long time. Health education focusing on the values of seeking an early consultation is required so that when students have mental health problems they will seek psychiatric services in a timely manner.

Objective We evaluated avoidance behaviors of healthy partners of breast cancer patients and sought to (1) describe men's perception of their own avoidance behavior and (2) identify the background factors associated with such behavior. Methods An Internet-based survey was conducted, and analysis was performed on the responses of 368 male spouses of female breast cancer patients. Results Thirty to forty percent of spouses had some type of problem avoidance behavior toward their wives. There was a high correlation (r = 0.70, P

Background The purpose of this study was to examine the effectiveness and cost-efficiency of a tailored message intervention compared with a non-tailored message intervention for increasing colorectal cancer (CRC) screening rates among a non-adherent population, in a community-based client reminder program. Methods After a baseline survey for psychological segmentation, 2140 eligible individuals were randomly assigned either to a group with a tailored matched-message condition (N = 356), a group with a non-tailored unmatched-message condition (N = 355), or to two control groups, one using a typical message with a professional design (N = 717) and one without a professional design (N = 712). The main outcome measure was attendance rates in a community-organized CRC screening program within five months of receiving a print reminder. Results There was a significant difference in fecal occult blood test (FOBT) attendance rates at follow-up assessments between the tailored matched-message condition (14.0 %) and the control (9.9 %; OR = 1.48, p = 0.026), while there was no significant difference between the unmatched-message condition (11.0 %) and the control (OR = 1.12, p = 0.558), and between the matched-message condition and the unmatched-message condition (OR = 1.32, p = 0.219). The cost of a one-person increase in FOBT screening was 3,740 JPY for the tailored matched-message condition, while it was 2,747 JPY for the control. Conclusions A tailored-message intervention for segmented individuals designed to increase CRC screening rates in a community-based client reminder program was significantly effective compared to a usual reminder, but not more effective than an unmatched message in a randomized controlled trial, and was not sufficiently effective to highlight its value from a cost perspective. Therefore, the tailored intervention including target segmentation needs to be improved for future implementation in a CRC screening program for a non-adherent population. Trial registration UMIN Clinical Trials Registry UMIN000004384. Date of Registration: March 2011.

In Japan, the trend for cervical cancer at younger ages has been increasing. As a countermeasure, the HPV vaccine was introduced as a routine vaccination in April 2013. However, the Ministry of Health, Labour and Welfare (MHLW) announced a “Suspension of its active inoculation recommendation for HPV vaccine” in June 2013. In 2016, 32 months after that suspension, we conducted survey via Internet and compared the results with our previous ones conducted at 9 and 23 months after suspension (in 2014 and 2015, respectively). We examined the ‘time-dependent change’ of the ‘intention of mothers to inoculate their daughters with the HPV vaccine’ in terms of efficacy of external decision-making support. 17.5% of mothers in the first survey replied that they would inoculate their daughters under the current circumstances, 12.1% in the second survey, and 6.7% in the third, showing a consistent decrease in willingness over time (p = 0.03, p < 0.01). If the government recommendation were to be reintroduced, 22.5% of mothers in the first survey replied they would inoculate their daughters, 21.0% in the second survey, which indicated no significant difference (p = 0.65) over the first interval; however, this was significantly decreased to 12.2% in the third survey (p < 0.01). Our study revealed that the intention to inoculate their daughters has been declining among Japanese mothers over time triggered by the suspension.

BACKGROUND: With a large number of children surviving cancer worldwide, numerous investigations have assessed psychological and social adjustment among childhood cancer survivors. According to these studies, it is unclear whether childhood cancer survivors adjust their daily lives after being discharged from the hospital, especially for adolescent and young adult survivors who have unique needs and concerns. The primary aim of this study was to grasp the factors underlying psychosocial difficulties faced by adolescent and young adult survivors in their daily lives after being discharged from the hospital. METHODS: Semi-structured interviews were conducted. Twenty-five childhood cancer survivors were recruited from two regional cancer institutions in Japan. Content analysis was applied to the responses. RESULTS: Nineteen attributes were extracted and classified into four categories as follows: physical difficulties, interpersonal difficulties, behavioral difficulties, and uncertainty about the future. The attributes indicated by over 50% of the participants were "I am worried about not feeling well," "I have difficulty continuing a treatment in daily life," "I have difficulty moving my body," "I have to be absent from school or work because of illness," and "I am left behind academically." CONCLUSIONS: This study grasped important factors of psychosocial daily difficulties. Clinically, these results suggest that it is important to watch for these signs and to provide early support to survivors so that their daily lives and developmental process are not hindered by the treatment and its side effects and to offer long-term support focusing on individual patient characteristics such as sex, age, and cancer history. Language: en

Purpose: We examined the relationship between fecal occult blood test (FOBT) screening behavior and beliefs regarding FOBT screening in order to formulate effective measures to improve FOBT screening rates. Method: In June 2010, we conducted a cross-sectional questionnaire survey of 600 randomly selected individuals aged 40–60 years who were registered participants of Refine, which was an internet research company to cooperate with this study. We assessed CRC knowledge, perceived risk of CRC, perceived severity of CRC, concern for CRC, beliefs of FOBT screening, FOBT screening behavior, and demographic variables. Result: There were 592 valid responses (from 294 males and 298 females; mean age 53.96 ± 8.39) in the final analysis. A total of 266 (44.9%) underwent FOBT in the year preceding the survey. Factor analysis relating to the beliefs of obtaining FOBT demonstrated five factors (α = 0.829) including: (1) perceived barrier, (2) subjective norms, (3) low importance, (4) descriptive norms, and (5) non-ne...

BACKGROUND The purpose of the present study was to categorize and develop lists of contents of problems, goals, solution plans generated through the brainstorming work in therapy, and selected solutions for execution, that treated in problem-solving therapy (PST) for cancer patients in clinical settings, and to describe their characteristics. Additionally, examining the associations of problem domains with characteristics of participants, was also aimed. METHODS We conducted content analysis using records of thirty-one cancer patients (M = 62.6 years old; SD = 10.5) who participated in PST program. RESULTS Problems were categorized into four domains (e.g. psychological and existential problems; physical problems; social relations; social living environment). Participants under treatment at baseline reported psychological and existential problems most often (P < 0.05). Goals were categorized into four domains (e.g. improving mental health; improving physical functions; improving social relations and improving one's social living environment). Solution plans generated through the brainstorming work in therapy were categorized into four domains (e.g. emotion regulation/cognitive adjustment; health behaviors; adjustment of social relationships and adjusting one's social living environment). Selected solutions for execution were categorized into four domains (e.g. emotion regulation/cognitive adjustment; health behaviors; adjustment of social relationships and adjusting one's social living environment). CONCLUSIONS We found that various problems, goals and solutions were treated in PST of realistic clinical setting. Creating lists based on our study and making use of it for the materials as aids while implementing the PST or being shared with patients and medical staff would be expected.

We evaluated whether the DELirium Team Approach (DELTA) program—a systematic management program aimed at screening high-risk groups and preventing delirium—would improve quality of care in patients hospitalized with cancer. A retrospective before–after study was conducted during a pre-intervention period (between October 2012 and March 2013) and a post-intervention period (between October 2013 and March 2014) at a Japanese hospital providing specialized treatments for cancer. A total of 4180 inpatients were evaluated before the implementation of the DELTA program and 3797 inpatients were evaluated after implementation. After program implementation, the incidence of delirium decreased from 7.1 to 4.3% (odds ratio [OR], 0.52; 95% CI, 0.42–0.64). The incidence of adverse events, including falls or self-extubation, also decreased, from 3.5 to 2.6% (OR, 0.71; 95% CI, 0.54–0.92). There was a significant decrease in the prescription of benzodiazepines (OR, 0.79; 95% CI, 0.71–0.87), increase in the level of independence in activities of daily living at discharge (OR, 1.94; 95% CI, 1.11–3.38), and decrease in the length of stay (risk ratio 0.90; 95% CI, 0.90–0.90). The systematic management program for delirium decreased the incidence of delirium and improved several clinical outcomes. These data suggest that this simple cost-effective program is feasible and implementable as routine care in busy wards.