The Japanese government instituted countermeasures against COVID-19, a pneumonia caused by the new coronavirus, in January 2020. Seeking "people's behavioral changes," in which the government called ...on the public to take precautionary measures or exercise self-restraint, was one of the important strategies. The purpose of this study is to investigate how and from when Japanese citizens have changed their precautionary behavior under circumstances in which the government has only requested their cooperation. This study uses micro data from a cross-sectional survey conducted on an online platform of an online research company, based on quota sampling that is representative of the Japanese population. By the end of March 2020, a total of 11,342 respondents, aged from 20 to 64 years, were recruited. About 85 percent reported practising the social distancing measures recommended by the government including more females than males and more older than younger participants. Frequent handwashing is conducted by 86 percent of all participants, 92 percent of female, and 87.9 percent of over-40 participants. The most important event influencing these precautionary actions was the infection aboard the Diamond Princess cruise ship, which occurred in early February 2020 (23 percent). Information from the central and local governments, received by 60 percent of the participants, was deemed trustworthy by 50 percent. However, the results also showed that about 20 percent of the participants were reluctant to implement proper prevention measures. The statistical analysis indicated that the typical characteristics of those people were male, younger (under 30 years old), unmarried, from lower-income households, a drinking or smoking habit, and a higher extraversion score. To prevent the spread of infection in Japan, it is imperative to address these individuals and encourage their behavioural changes using various means to reach and influence them.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Owing to the rapid spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic worldwide, individuals experience considerable psychological distress daily. The present study ...aimed to clarify the prevalence of psychological distress and determine the population most affected by risk factors such as the pandemic, socioeconomic status (SES), and lifestyle-related factors causing psychological distress in the early phases of the pandemic in Japan. This study was conducted via a web-based survey using quota sampling to ensure representativeness of the Japanese population aged 20-64 years. A cross-sectional study of 11,342 participants (5,734 males and 5,608 females) was conducted using a self-administered questionnaire that included the Japanese version of the Kessler 6 Psychological Distress Scale (K6) and questions related to the pandemic, SES, and lifestyle. The prevalence of psychological distress, represented by a K6 score of 5 or more, was 50.3% among males and 52.6% among females. Both males and females with annual household incomes less than 2 million yen and males aged in their twenties had significantly higher K6 scores than those with annual household incomes above 2 million yen and males aged over 30 years. Binary logistic regression analyses found pandemic-related factors such as medical history, inability to undergo clinical tests immediately, having trouble in daily life, unavailability of groceries, new work style, and vague anxiety; SES-related factors such as lesser income; and lifestyle-related factors such as insufficient rest, sleep, and nutritious meals to be significantly related to psychological distress. Psychological distress was more prevalent among people with low income and in younger generations than among other groups. There is an urgent need to provide financial, medical, and social support to those affected by the coronavirus disease 2019 (COVID-19) pandemic.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The purpose of this paper is to review the government’s efforts to curb stigmatizing and discriminatory behaviors related to COVID-19 based on the experience of the government advisory body in which ...the author participated and to identify future challenges. After the Expert Committee’s call for the prevention of discrimination in February 2020, the need to raise awareness was included in a government policy. The Working Group on Prejudice, Discrimination, and Privacy identified six types of stigmatizing and discriminatory behavior:（1）behaviors against hospitals and care facilities, their workers, and their families,（2）behaviors against schools and school personnel,（3）behaviors related to the workplace,（4） online slander,（5）slander on the basis of occupation and nationality, and against people living outside a prefecture, and（6）news reports containing information jeopardizing the privacy of cases. In February 2021, Act on Special Measures for Pandemic Influenza and New Infectious Diseases Preparedness and Response was amended to add the responsibilities of the national and local governments for the prevention of discriminatory treatment. However, there are still issues to be addressed, such as the failure to introduce a basic law to protect human rights, the fact that the WG has not been reconvened, and the fact that local governments haven’t resolved the issues surrounding the disclosure of cases.
Since the 1990s, insurance has been the primary field focused on the social disadvantages of using genetic test results because of the concerns related to adverse selection. Although life insurance ...is popular in Japan, Japan does not currently have any regulations on the use of genetic information and insurers have largely kept silent for decades. To reveal insurers' attitudes on the topic, we conducted an anonymous questionnaire survey with 100 insurance company employees and recruited nine interviewees from the survey respondents. We found that genetic discrimination is not generally considered as a topic of human rights. We also found that insurers have uncertain fears and concerns about adverse selection in terms of actuarial fairness but not regarding profits. When it comes to preparing guidelines on the use of genetic information by Japanese insurers, we believe that public dialog and consultation are necessary to gain understanding of the people.
Genome editing of human embryos could become a fundamental treatment approach for genetic diseases; however, a few technical and ethical issues need to be resolved before its application in clinical ...settings. Presently, the Japanese government has issued a statement prohibiting human germline editing and emphasizing the need for discussions that include a wide range of perspectives. However, current discussions tend to exclude the general public. Therefore, we conducted a survey of 10,881 general adults and 1044 patients in Japan who indicated that their disease conditions are related to their genetic makeup, and clarified their attitude toward this technology. The results clearly indicated that the Japanese people generally accepted the use of genome editing for disease-related genes, but many were concerned about the risks. In addition, many Japanese people did not understand the technology well. To improve awareness and understanding about genome editing, it is important that scientists and science communicators create opportunities for the public to participate in relevant discussions without harming vulnerable participants. It is also important to continuously track changes in the acceptance of genome editing by the public.
Whole-genome sequencing (WGS) is being used in research and clinical settings in cancer genomics. Studies show that cancer patients generally have positive attitudes toward tumor profiling tests; ...however, few works revealed their attitudes toward WGS. This study clarifies the expectations, concerns, and result preferences of cancer patients (CPs), family members (FMs) and general adults (GAs) regarding WGS study in Japan. We conducted an anonymous survey with 1204 CPs, 5958 FMs, and 2915 GAs in 2021. Despite low awareness of the WGS studies, CPs had the highest expectations for it. FMs had a higher level of concern than CPs and GAs; feeling anxious by knowing the results, being treated unfavorably if germline findings were detected. Both the FMs and CPs were highly concerned about the protection of genetic information. CPs preferred results with actionability, however, only half preferred to know germline findings. Given the possibility of detecting variants across multidisciplinary diseases and the long-term continuity of WGS research, a system is needed in which study participants can consult and receive decision-making support at any time according to their needs.
Genomic tumor profiling tests (GTPTs) to find molecular targeted drugs for patients with advanced cancer are being introduced into clinical settings, which may result in secondary germline findings. ...Although small-scale qualitative studies have revealed patients' attitudes toward GTPTs and preferences on receiving germline findings, no large-scale quantitative research exists that includes family members. We conducted anonymous surveys with 757 cancer patients (CPs), 763 family members (FMs), and 3697 general adults (GAs) in Japan. Awareness of GTPTs was low in all groups, however, both CPs and FMs showed a higher degree of recognition in the benefits of GTPTs. FMs wanted information on germline findings to be shared more than the CPs. Since advanced CPs may have psychological burdens that make it difficult to express their opinions on their therapeutic options and sharing germline findings, GTPTs should be offered with advanced care planning for patients.
This study aims to determine the approximate number of hospitalizations of persons without family and the medical challenges they encounter in hospitals across Japan. Self-administered questionnaires ...were mailed to 4,000 randomly selected hospitals nationwide to investigate the actual conditions and problems, decision-making processes, and use of the government-recommended Guidelines for the hospitalization of, and decision-making support for, persons without family. To identify the characteristics of each region and role of hospitals, chi-square tests were used to make separate group comparisons by hospital location and type. Responses were received from 1,271 hospitals (31.2% response rate), of which 952 hospitals provided information regarding the number of admissions of persons without family. The mean (SD) and median number of hospitalizations (approximate number per year) of patients without family was 16 (79) and 5, respectively. Approximately 70% of the target hospitals had experienced the hospitalization of a person without family, and 30% of the hospitals did not. The most common difficulties encountered during the hospitalization were collecting emergency contact information, decision-making related to medical care, and discharge support. In the absence of family members and surrogates, the medical team undertook the decision-making process, which was commonly performed according to manuals and guidelines and by consulting an ethics committee. Regarding the use of the government-recommended Guidelines, approximately 70% of the hospitals that were aware of these Guidelines responded that they had never taken any action based on these Guidelines, with significant differences by region and hospital type. To solve the problems related to the hospitalization of persons without family, the public should be made aware of these Guidelines, and measures should be undertaken to make clinical ethics consultation a sustainable activity within hospitals.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Informed consent is an essential part of an ethical clinical trial; to this end, researchers have developed several interventions to promote participants' full understanding of trials and thereby ...improve the consent process. However, few empirical studies have examined how patients make the decision of whether to give consent. The objective of this study, therefore, is to analyze patients' decision-making process when participating in clinical trials. We conduct an internet survey (n = 2,045) and interview data analysis (n = 40) with patients and categorize respondents into three types of participants: active, passive, and non-participation. Our results show that patients often make informal and quick decisions before medical staff provide them with relevant information during the informed consent process. For example, 55.9% of patients received initial information on clinical trials from an online article or web advertising, and 54.5% consulted no one about whether to participate in the clinical trial before making a decision. Only 20.7% of respondents subjectively spent time making the decision whether to participate; 43.0% of patients who said that they "spent time" coming to a decision took four or more days to reach a decision, while 8.3% of people who "did not spend time" making a decision took this among of time. Based on these results, we were able to break patients' decision-making process into four steps: first contact, informal decision making, relevant information, and formal decision making. Our results show that patients are most likely to make a decision based on the first information they receive on the clinical trial, whatever the source. To this end, having a list of questions for potential participants to ask researchers would be useful in helping better collecting information of clinical trials. In addition, research teams should give patients more than four days to decide between providing them with relevant information and obtaining written consent, even if the patient seems to make a quick decision.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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