Global health & medicine最新文献

{"title":"From fragmentation to integration: Can Japan's JIHS deliver a resilient system to deal with health emergencies?","authors":"Norihiro Kokudo, Takaji Wakita","doi":"10.35772/ghm.2026.01041","DOIUrl":"https://doi.org/10.35772/ghm.2026.01041","url":null,"abstract":"<p><p>The establishment of the Japan Institute for Health Security (JIHS) in 2025 represents a major institutional reform aimed at enhancing Japan's preparedness for health emergencies in the aftermath of COVID-19. By integrating the National Institute of Infectious Diseases and the National Center for Global Health and Medicine, JIHS seeks to address the long-standing fragmentation of research, clinical practice, and public health responses. In its first year, the institute has made measurable progress in consolidating surveillance and clinical data systems and in expanding research and response networks. However, integration alone does not guarantee effectiveness. Critical challenges remain, including persistent workforce shortages, insufficient incentives for infectious disease research and development, and the complexity of aligning institutional cultures and operational frameworks. This editorial argues that the success of JIHS will depend not only on structural integration but also on sustained investment in human resources, governance reform, and cross-sector coordination. Japan's experience highlights both the promise and the limitations of centralized public health systems and provides important lessons for other countries seeking to build resilient systems to deal with health emergencies.</p>","PeriodicalId":12556,"journal":{"name":"Global health & medicine","volume":"8 2","pages":"72-74"},"PeriodicalIF":1.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-cultural adaptation and validation of the Internet Skills Scale in a Chinese older adult population.","authors":"Yutong Hou, Pingping Zhang, Siwen Zhang, Liang Zhou, Tao Wu","doi":"10.35772/ghm.2026.01023","DOIUrl":"https://doi.org/10.35772/ghm.2026.01023","url":null,"abstract":"<p><p>This study translated and back-translated the English version of the Internet Skills Scale (ISS) based on the Brislin translation model to develop a Chinese version of the scale. From June to December 2024, 260 older adults were recruited from the community to participate in the survey to evaluate the scale's reliability and validity. A total of 233 valid questionnaires were collected, yielding an effective response rate of 89.6%. Among the respondents, there were 121 males (52%) and 112 females (48%), with ages ranging from 60 to 90 years. The results showed that the Chinese version of the ISS consisted of four dimensions and 20 items. The Cronbach's αcoefficient for the total scale was 0.862, and the Cronbach's αcoefficients for the dimensions ranged from 0.705 to 0.912. Exploratory factor analysis (EFA) extracted four common factors, with a cumulative variance contribution rate of 68.533%. Confirmatory factor analysis (CFA) indicated a good model fit: χ²/df = 2.26, CFI = 0.978, IFI = 0.979, TLI = 0.974, GFI = 0.991, RMSEA = 0.074. For convergent validity, the composite reliability (CR) values were 0.932, 0.853, 0.795, and 0.88, respectively, and the average variance extracted (AVE) values were 0.734, 0.596, 0.511, and 0.616, respectively. These findings indicate that the scale demonstrates reliability and validity, making it an effective tool for assessing the digital competence of older adults.</p>","PeriodicalId":12556,"journal":{"name":"Global health & medicine","volume":"8 2","pages":"124-131"},"PeriodicalIF":1.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Japanese version of the European Moral Case Deliberation Outcomes Instrument (Euro-MCD 2.0): Validation and score distribution among nurses, doctors, and other healthcare providers-A cross-sectional study.","authors":"Kaoru Ashida, Makoto Tanaka, Emi Kubo, Tetsuharu Kawashima, Eriko Satomi, Asuko Sekimoto, Kuniko Aizawa, Fumie Arie, Kyoko Tanaka, Mari Wakinosono, Akiko Higuchi, Chikako Shimizu","doi":"10.35772/ghm.2026.01010","DOIUrl":"https://doi.org/10.35772/ghm.2026.01010","url":null,"abstract":"<p><p>The European Moral Case Deliberation Outcomes Instrument (Euro-MCD 2.0) is a widely used instrument for evaluating moral case deliberation (MCD); however, its psychometric properties have not been fully validated in Japan. Our goal is to assess the validity, reliability, and score patterns of the Japanese version of the Euro-MCD 2.0 among healthcare providers in six national hospitals. A cross-sectional web-based survey was conducted at six national centers for advanced and specialized medicine in Japan. Construct validity was assessed through exploratory and confirmatory factor analysis. Convergent and discriminant validity were examined using composite reliability and average variance extracted. Internal consistency was evaluated with Cronbach's alpha and McDonald's omega. The sample included 359 doctors, nurses, pharmacists, and other healthcare providers involved in clinical practice. Participants who were not in an employment relationship (<i>e.g.</i>, trainees) or directly involved with patients and their families in clinical practice were excluded. Items in the moral action domain had elevated 'I don't know' response rates, whereas Moral Competence items showed higher agreement. The three-factor model demonstrated acceptable fit, although discriminant validity between moral teamwork and moral action was limited. Healthcare providers with more years of experience scored higher across all subscales. The Japanese Euro-MCD 2.0 demonstrated acceptable validity and reliability, supporting its use in future evaluations in Japan.</p>","PeriodicalId":12556,"journal":{"name":"Global health & medicine","volume":"8 2","pages":"114-123"},"PeriodicalIF":1.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Japan Pre-Entry Tuberculosis Screening (JPETS): A new phase in tuberculosis control following Japan's transition in a low-incidence era.","authors":"Kohei Kamegai, Ikumi Ono, Sayaka Kageyama, Kotaro Murata, Shunta Miura, Kiyomasa Komai, Kanako Koyama, Yuri Echigoya, Rina Kusuda, Nobuhide Kakizaki, Kae Sasaki, Shun Yonezaki, Hiroaki Fukuoka, Satoshi Kotani, Taishi Asanuma, Ai Koba","doi":"10.35772/ghm.2026.01019","DOIUrl":"https://doi.org/10.35772/ghm.2026.01019","url":null,"abstract":"<p><p>In December 2024, Japan's Pre-Entry Tuberculosis Screening (JPETS) program was introduced in coordination with the Ministry of Health, Labour and Welfare (MHLW), the Ministry of Foreign Affairs, and the Immigration Services Agency to mandate tuberculosis (TB) screening for mid- to long-term visa applicants and Certificate of Eligibility applicants from selected countries with a large number of foreign-born TB cases in Japan. To date, the target countries are located in Asia, accounting for a large proportion of foreign-born TB cases in Japan. These countries also have strong labor-migration ties with Japan. Based on a quality-assured screening process at designated Panel Clinics, JPETS aims to prevent the importation of TB, reduce the risk of its domestic transmission, and ultimately contribute to global TB control. Through robust international collaboration, JPETS also incorporates safeguards to ensure fair and equitable opportunities for migrants' social participation and well-being. This article outlines the historical background of Japan's TB control, the rationale, design, and anticipated impact of JPETS.</p>","PeriodicalId":12556,"journal":{"name":"Global health & medicine","volume":"8 2","pages":"75-80"},"PeriodicalIF":1.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconsidering Japan's path to universal health insurance: Pre-war origins and the complementarity of occupational and community-based schemes.","authors":"Daiichi Morii","doi":"10.35772/ghm.2026.01016","DOIUrl":"https://doi.org/10.35772/ghm.2026.01016","url":null,"abstract":"<p><p>Japan's health security system began with the enactment of the Health Insurance Act in 1922, which was occupational health insurance intended for workers in large factories and mines. The scope of this social health insurance was subsequently expanded, but the issues of insurance coverage for agricultural workers and the self-employed remained. To address these issues, the Citizens' Health Insurance Act, a community-based health insurance system, was legislated in 1938. Japan's health security collapsed with the end of the Pacific War (World War II) in 1945, but during postwar reconstruction, legislation was conducted in 1958 and universal health insurance was achieved in 1961. Japan's universal health insurance system cannot be considered a purely postwar product. It began to be established before the war in response to the industrialization of society, and it was completed during the period of postwar economic growth, overcoming the interruption caused by the end of the war.</p>","PeriodicalId":12556,"journal":{"name":"Global health & medicine","volume":"8 2","pages":"136-139"},"PeriodicalIF":1.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening upper gastrointestinal endoscopy service in primary healthcare settings in low- and middle-income countries: Proposals from an implementation study in Vietnam.","authors":"Tomoko Nishioka, Yuta Yokobori, Yuriko Egami, Tien Manh Huynh, Qui Duc Phan, Noriko Fujita, Dang Quy Dung Ho, Duc Trong Quach, Hitoshi Murakami","doi":"10.35772/ghm.2026.01000","DOIUrl":"https://doi.org/10.35772/ghm.2026.01000","url":null,"abstract":"<p><p>Vietnam has established favorable policies for upper gastrointestinal endoscopy, providing an opportunity to expand this technology to primary healthcare (PHC) settings. However, the policy dilemma between insurance coverage/supportive regulations and self-financing policy, and the one between intended and unintended outcomes of healthcare decentralization and administrative reform, posed constraints on expanding this technology at the PHC level. In response to these policy dilemmas, we conducted an implementation research study to identify subsequent policy bottlenecks and facilitating and hindering factors affecting the proper and sustainable implementation of this technology. The study was carried out in district hospitals (renamed regional general hospitals after 2025 administrative reform) in two southern provinces, using a qualitative research design based on interviews with hospital staff involved in upper gastrointestinal endoscopy. Data were analyzed deductively using the Consolidated Framework for Implementation Research (CFIR). Based on the identified policy dilemmas, bottlenecks and hindering factors, we propose five policy recommendations: <i>i</i>) mobilizing and redistributing financial resources for PHC-level hospitals; <i>ii</i>) facilitating participation in upper gastrointestinal endoscopy training; <i>iii</i>) establishing accessible professional networks; <i>iv</i>) raising awareness of upper gastrointestinal endoscopy services; and <i>v</i>) promoting adherence to national guidelines. After analyzing their potential constraints and trade-offs, we consider them to be relatively feasible to implement.</p>","PeriodicalId":12556,"journal":{"name":"Global health & medicine","volume":"8 2","pages":"90-96"},"PeriodicalIF":1.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating medical Mobility as a Service (MaaS) with the doctor-to-patient with nurse (D to P with N) telemedicine model and pharmacist-supported medication services: Towards mobility-integrated care for Japan's super-aged population.","authors":"Machiko Uenishi, Peipei Song","doi":"10.35772/ghm.2026.01044","DOIUrl":"https://doi.org/10.35772/ghm.2026.01044","url":null,"abstract":"<p><p>Japan has a super-aged society, where the population age 65 years or older accounted for 29.4% of the total population as of January 2026, and population aging, depopulation, and persistent physician shortages have increasingly constrained access to healthcare. These challenges are particularly evident in rural and remote areas, where mobility itself constitutes a major barrier to care. Although home medical care and telemedicine have been promoted as policy responses, each has inherent limitations when implemented independently. Against this backdrop, the practical integration of Mobility as a Service (MaaS) with the doctor-to-patient with nurse (D to P with N) telemedicine model has emerged as a policy-related approach to delivering multidisciplinary care under conditions of limited medical and transportation resources. In several municipalities in Japan, including early implementation sites such as the City of Ina, medical MaaS-based mobile healthcare initiatives have been implemented to reduce travel burdens while improving accessibility for patients with mobility challenges. From an implementation perspective, these initiatives demonstrate a growing convergence between medical MaaS and the D to P with N telemedicine model. Physicians provide remote consultations while nurses offer on-site clinical support, with telemedicine further linked to pharmacists' online medication counseling and medication delivery services. In practice, this integrated approach, which includes routine consultations, renewing prescriptions, and basic clinical monitoring, is primarily used for the stable management of chronic diseases and is mainly targeted at older patients receiving home-based care. By covering the care continuum from consultation to medication support, this approach aims to reduce patients' travel burden while ensuring the continuity of multidisciplinary care. Despite its potential, key challenges remain, including operational costs, data governance, and emergency response requirements. Overall, integrating medical MaaS with the D to P with N telemedicine model and pharmacist-supported medication delivery represents a significant step towards mobility-integrated care and may serve as a complementary component of community-based integrated care systems.</p>","PeriodicalId":12556,"journal":{"name":"Global health & medicine","volume":"8 2","pages":"81-89"},"PeriodicalIF":1.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to advancing global oncology in an NCI-designated cancer center: A cross-sectional survey of faculty perspectives.","authors":"Henrique Guimarães Barbosa Coelho, Michaela Montour, Enrique Soto-Perez-de-Celis","doi":"10.35772/ghm.2026.01035","DOIUrl":"https://doi.org/10.35772/ghm.2026.01035","url":null,"abstract":"<p><p>Global oncology seeks to advance equitable cancer care across diverse populations worldwide. Recognizing its importance, the National Cancer Institute (NCI) has designated it as a strategic priority for its cancer centers. However, many struggle to integrate it into their clinical, scientific, and educational missions. We conducted an exploratory institutional needs assessment using a de-identified, cross-sectional survey at the University of Colorado Cancer Center (UCCC), an NCI-designated comprehensive cancer center. The survey, adapted from the NCI Global Oncology Assessment Survey, was distributed <i>via</i> email to UCCC members and assessed familiarity, prior involvement, motivations, and perceived barriers in global oncology work. Twenty-two members completed the survey. Over one-third (36%, 95% CI: 19.7%-57.0%) were unfamiliar with global oncology, and only 45% (95% CI: 26.9%-65.3%) had prior involvement in related initiatives. Motivators for engaging in global oncology included personal interest, opportunities for collaboration, and a commitment to addressing health disparities. Key barriers were limited funding, lack of time, and lack of institutional support. Among those with prior global oncology experience, most reported challenges securing funding, limited institutional support, administrative burdens, and a lack of academic recognition for global work. Despite strong personal interest and alignment with NCI priorities, global oncology remains under-recognized and under-supported at our institution, and may reflect similar challenges in other academic centers. Barriers impeding further engagement include limited funding, lack of institutional support, and administrative complexity. Targeted support, dedicated funding, and academic recognition could strengthen institutional capacity to advance cancer care locally and globally.</p>","PeriodicalId":12556,"journal":{"name":"Global health & medicine","volume":"8 2","pages":"132-135"},"PeriodicalIF":1.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pneumococcal vaccination and aspiration pneumonia in super-aged societies: A scoping review of the evidence landscape.","authors":"Akihito Ueda, Kanji Nohara","doi":"10.35772/ghm.2026.01022","DOIUrl":"https://doi.org/10.35772/ghm.2026.01022","url":null,"abstract":"<p><p>Aspiration pneumonia is the leading cause of pneumonia-related death in Japan, where 29.3% of the population is aged ≥ 65 years, and it represents a growing challenge across rapidly aging Asian societies. Although pneumococcal vaccination is widely implemented for older adults, its effectiveness specifically against aspiration pneumonia remains unestablished. This scoping review systematically mapped the existing evidence on pneumococcal vaccination effectiveness for aspiration pneumonia prevention. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, PubMed, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched, identifying five studies (three primary studies and two reviews). None directly evaluated vaccine effectiveness with aspiration pneumonia as a defined outcome. Indirect evidence from studies including aspiration pneumonia within composite pneumonia outcomes suggests potential benefits; however, vaccine-specific effects could not be isolated. This review identifies a structural misalignment between the predominant pneumonia phenotype in super-aged societies and existing vaccine evaluation frameworks, and demonstrates that aspiration pneumonia has been systematically overlooked as a prespecified outcome in vaccine effectiveness research. Notably, the absence of direct evidence reflects limitations in study design and outcome definition, rather than evidence of vaccine ineffectiveness. Dedicated clinical studies are warranted to inform evidence-based immunization policies.</p>","PeriodicalId":12556,"journal":{"name":"Global health & medicine","volume":"8 2","pages":"97-105"},"PeriodicalIF":1.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlocking data elements potential for enhanced urban public health emergency governance: Configuration analysis based on 23 mega-cities in China.","authors":"Yinfeng Shi, Yajie Yu, Kunchang Li, Tingyue Shen","doi":"10.35772/ghm.2026.01025","DOIUrl":"https://doi.org/10.35772/ghm.2026.01025","url":null,"abstract":"<p><p>As the core production element of the digital era, data's multiplier effect is key to risk prevention and the modernization of emergency governance. This article combines the practical application of data elements in public health emergency management, based on the technology-organization-environment (TOE) theoretical framework, takes 23 mega-cities in China as research cases, and uses the fuzzy-set qualitative comparative analysis (fsQCA) method to explore the impact of technology, organization, environment, and other conditions on the effectiveness of urban public health emergency governance. The results show a significant conditional correlation between the effectiveness of urban public health emergency governance and the conditions for applying data elements. Based on the characteristics of multiple concurrent paths, the driving paths can be classified into three categories: \"technology-based\", \"organization-environment dual core\", and \"organization-technology as the mainstay + environment as the supplement\". Local governments should combine the regional digital resource endowment, promote phased and differentiated application of data elements, strengthen interconnection of data-sharing platforms, coordinate construction of institutional mechanisms, accelerate multi-scenario application of data elements, strengthen two-way empowerment of technology-driven and organizational coordination, and effectively transform linkage advantages of multidimensional elements into governance effectiveness.</p>","PeriodicalId":12556,"journal":{"name":"Global health & medicine","volume":"8 2","pages":"106-113"},"PeriodicalIF":1.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}