[Nihon koshu eisei zasshi] Japanese journal of public health最新文献

{"title":"[A study on the effectiveness of dental health guidance in the workplace in Aomori Prefecture: Implementation of the Dental Lifestyle Support Program focusing on primary prevention of dental diseases].","authors":"Rumi Ito, Motoki Ohnishi","doi":"10.11236/jph.24-146","DOIUrl":"https://doi.org/10.11236/jph.24-146","url":null,"abstract":"<p><p>Objective　The study aim was to evaluate the effectiveness of dental health guidance in improving self-reported oral symptoms and oral health behaviors through two interventions: dental checkups using the Dental Lifestyle Support Program questionnaire and dental health guidance provided by dental hygienists in workplace settings.Methods　This study targeted employees without dental checkups at five workplaces in the Aomori Prefecture. Support materials (\"tools\") were created based on the Dental Lifestyle Support Program. An initial 21-item questionnaire survey was conducted at each facility. After completing the survey, participants were alternately assigned to ensure equal numbers in both groups: the individualized guidance group, who received the survey results and tools, followed by a five-minute individual dental health guidance session using the tools; and the information-only group, who received only the results and tools without further guidance. Three months later, the same questionnaire survey was conducted. Changes within groups were analyzed using McNemar's test, and between-group changes were assessed using a logistic regression.Results　Of 448 participants, 411 were analyzed (individual guidance group: 204; information-only group: 207). The male-to-female ratios were 74:130 and 67:140, respectively, with median ages of 45 (IQR36-53) years and 42 (IQR34-54) years. Within-group comparisons revealed significant improvements in oral symptoms and behaviors in both groups. The individualized guidance group showed improvements in one item related to oral health issues, two oral condition items, and four oral health behavior items, whereas the information-only group showed improvements in one item related to oral issues, one environmental support item, and one oral health behavior item. Between-group comparisons revealed a significant improvement in \"snack intake\" for the individualized guidance group.Conclusion　Both groups showed positive changes in oral symptoms and health behaviors with minimal differences between them. Results of the intervention suggest that dental health guidance is effective in improving oral symptoms and health behaviors in workplaces where dental checkups are not provided.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Association between subjective change and risk of disability in older adults following the introduction of electric-powered carts: A one-year longitudinal study].","authors":"Ryota Watanabe, Masashige Saito, Shuhei Kobayashi, Kazushige Ide, Masaki Fukusada, Katsunori Kondo","doi":"10.11236/jph.25-001","DOIUrl":"https://doi.org/10.11236/jph.25-001","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Objective　The Ministry of Land, Infrastructure, Transport, and Tourism of Japan has recently been promoting the adoption of green (i.e., electric-powered) slow mobility carts, which can operate on public roads at speeds &lt;20 km/h. A two-month trial of electric-powered cart services showed improvements in subjective indicators such as social interaction among older adults, with potential long-term benefits related to preventing the eventual need for long-term care (LTC). This study investigated whether the risk of requiring LTC decreased one year after the introduction and use of electric-powered carts in older adults whose subjective indicators improved following the introduction of the service.Methods　Electric-powered cart services were introduced in Kawachinagano City (Osaka Prefecture) and Oji Town (Nara Prefecture), beginning in July-August of 2022. Our analysis included 726 adults aged ≥65 years (385 from Kawachinagano City and 341 from Oji Town) who provided valid responses to a self-administered postal survey conducted at the baseline (i.e., when the program was introduced), as well as at a follow-up one year later. At the follow-up, operations had concluded in Kawachinagano City, but continued in Oji Town. LTC risk at the one-year follow-up was assessed using the LTC risk assessment scale, with higher scores indicating a greater risk. The explanatory variables included electric-powered cart usage (defined as cart usage several times per year or more) and changes in subjective indicators prompted by cart usage. The subjective indicators assessed were outings (three items), social activities (five items), and positive emotions (four items). Covariates included sex, LTC risk score, educational background, subjective economic status, employment, activities of daily living, marital status, and cohabitation at the baseline survey. Missing data were handled using multiple imputations (m = 200). Linear regression analysis was used to calculate the coefficients (B).Results　Of the total respondents, 290 (39.9%) reported using the electric carts. Electric-powered cart use was not significantly associated with LTC risk (B = 0.11, 95% confidence interval [CI]: -0.40 to 0.63). No significant associations were found between changes in subjective indicators and LTC risk across the overall cohort. However, in Oji Town, older adults who reported increase in positive emotions such as enjoyment of daily life (-1.78, -3.21 to -0.35), feeling uplifted (-1.51, -2.87 to -0.15), and finding life more meaningful (-1.91, -3.53 to -0.30) showed significant reductions in LTC risk.Conclusion　While no overall association was found between electric-powered cart usage and LTC risk, certain positive emotional changes reported in the respondents from Oji Town were associated with reduced LTC risk. These findings suggest that electric-powered carts may contribute not only to mobility support but also to LTC prevention, by fostering positive emotions among older adults.","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Characteristics of respondents to Internet survey collecting screenshots of step-count on iPhone: A cross-sectional study].","authors":"Marimo Mori, Shiho Amagasa, Hiroki M Adachi, Noritoshi Fukushima, Tomoki Nakaya, Shigeru Inoue, Masamitsu Kamada","doi":"10.11236/jph.25-034","DOIUrl":"https://doi.org/10.11236/jph.25-034","url":null,"abstract":"<p><p>Objectives　Recently, step-count, as an objective measure of physical activity, has become available on smartphones and is recorded by default on an iPhone (Apple Inc.). Using screenshot images of the step-count graph of the iPhone healthcare application, an image analysis tool was developed to enable a large-scale and retrospective physical activity assessment. However, the characteristics of the respondents involved in the collection of such step-count images remain unclear. We aimed to investigate the characteristics of iPhone users and respondents who provided step-count images via an Internet survey.Methods　We conducted an Internet survey in December 2022 among 5,346 Kobe residents aged ≥ 20 years from a survey company's panel population. They previously responded to a web-based survey on physical activity, health, and community environment administered in 2021. The participants were asked to provide their demographics and walking time. iPhone users were additionally asked to take and upload two screenshots of step-count graphs on their iPhones; one-month and one-year graphs. We conducted multivariable logistic regression analysis to examine the factors associated with iPhone use and image provision.Results　Among 3,308 respondents, 349 (11%) provided images, 1,138 (34%) were iPhone users who did not provide images, and 1,821 (55%) did not use an iPhone. Those aged ≤ 64 years exhibited a higher likelihood of iPhone usage compared to older adults (odds ratio; 2.45, [95% confidence interval; 2.04-2.94]), as did women compared to men (1.47 [1.26-1.71]), those with a household income of ≥ 6 million JPY compared to those with lower income (1.39 [1.20-1.62]), and those with a college degree or higher compared to the others (1.17 [1.01-1.36]). Furthermore, those aged ≤ 64 years were more likely to provide step-count images than older adults (3.58 [2.17-5.90]), as were those with a college degree or higher compared to the others (1.71 [1.32-2.23]) and those with longer walking time compared to those with shorter walking time (1.66 [1.21-2.28]).Conclusion　Age, sex, household income, and education were associated with iPhone use, whereas age, education, and physical activity level were associated with step-count screenshots. Possible biases must be considered among iPhone users and image providers in collecting and using step-count images in Internet surveys.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Survey of learning needs regarding postpartum depression among public health nurses in Japanese municipalities].","authors":"Yusuke Takei, Yuki Kanzaki, Toshihiro Miyamura","doi":"10.11236/jph.24-118","DOIUrl":"https://doi.org/10.11236/jph.24-118","url":null,"abstract":"<p><p>Objectives　This study aimed to identify the learning needs that public health nurses (PHNs) wish to meet in addressing postpartum depression among mothers in municipalities Japan.Methods　A mail survey was conducted with PHNs working in maternal and child health departments in 1,741 cities, wards, towns, and villages throughout Japan by a representative from each facility using a self-administered, unmarked questionnaire. The questionnaire included 23 items pertaining to sex, age, years of experience as a PHN, previous participation fees, method of participation, and desired future study content regarding postpartum depression. The analysis used Spearman's rank correlation coefficient for the association with each attribute, Mann-Whitney U test for comparisons based on training participation, and Kruskal-Wallis test for comparisons by years of experience. The Bonferroni correction was applied for multiple comparisons.Results　In total, 1,741 questionnaires were distributed and 630 were returned (response rate: 36.2%). The participants' mean age was 40.0 ± 9.4 years, with 233 (37.0%) in their 40s. The average number of years of experience as a PHN was 12.7±8.9, with 166 (26.3%) having 1-5 years of experience. Approximately 501 nurses (79.5%) had attended workshops on postpartum depression. Regarding the desire to participate in future training sessions for postpartum depression, 476 (75.6%) responded \"Yes.\" The most common method of payment for participation in past training was \"free of charge\" (427 respondents, 67.8%), followed by \"publicly funded\" (242 respondents, 38.4%). Regarding the preferred mode of training, 325 (51.6%) preferred on-demand (video viewing-on-demand) training and 284 (45.1%) preferred real-time online training. Regarding the desired content of training on postpartum depression, the items for which > 60% answered \"Yes\" were the pathogenesis of postpartum depression, correct use of the Edinburgh Postnatal Depression Scale (EPDS), perspectives on assessing mothers' psychiatric symptoms, and how to deal with suicidal thoughts and feelings.A significant difference was observed in the participation status of training sessions on postpartum depression and learning content regarding the \"correct use of the EPDS (P = .004)\" and \"social resources available in the community (P = .002).\"Conclusion　Approximately 80% of PHNs have participated in training sessions on postpartum depression and would want to receive further training eventually.Regarding future training methods, PHNs desired learning methods using information and communication technology, and > 60% desired learning content with practical application, such as \"perspectives for assessing psychiatric symptoms in mothers,\" \"methods for dealing with suicidal thoughts and feelings,\" \"correct use of EPDS,\" and \"pathophysiology of postpartum depression.\"</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Proposal of a patient reverse referral preference scale for regional medical collaboration].","authors":"Ryusuke Yoshimi, Yutaro Nemoto, Hirotaka Kato, Koji Hara","doi":"10.11236/jph.24-094","DOIUrl":"https://doi.org/10.11236/jph.24-094","url":null,"abstract":"<p><p>Objectives　Regional medical collaborations have become increasingly important in recent years. To facilitate such collaborations, it is necessary to promote reverse referrals from large hospitals to clinics. This study aimed to identify the factors that constitute patient preferences regarding reverse referrals and propose a new patient reverse referral preference scale based on the guidelines of the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN).Methods　Seven specialists developed a pool of items that related to preferences for reverse referrals. Patients aged 20 years and older who had been hospitalized in university hospitals or other large hospitals (with 400 beds or more) within the past six months and who were currently receiving treatment for their condition were included in the study. The factor structure that constituted patient reverse referral preferences was determined using an online questionnaire and an exploratory factor analysis. A new scale for assessing patient reverse referral preferences was developed using the factors identified as subscales, and the reliability and validity of the scale were examined.Results　Screening surveys were conducted on 23,000 registered members of an internet survey panel, of whom 374 met the criteria for this study and 293 responded to the survey. The factor analysis identified four factors related to patient preferences for reverse referrals: \"evaluation of primary care physicians,\" \"reverse referral acceptability,\" \"treatment continuity,\" and \"disease assessment.\" Based on these factors, we created a 19-item scale, \"The 19-item Patient Preference Questionnaire Form for Reverse Referral (PQR-19).\" Cronbach's alpha coefficients for each subscale indicated sufficient reliability (0.76 to 0.87). In terms of validity, patients who accepted reverse referrals at physician recommendation had significantly higher scores on the PQR-19 total score (3.28 ± 0.69 vs. 2.96 ± 0.63, P = 0.044) and its subscale, treatment continuity (3.52 ± 0.76 vs. 3.05 ± 0.81, P = 0.012), and tended to have higher scores on other subscales, compared to those who did not accept reverse referrals.Conclusion　This study identified four factors that constituted patient preferences for reverse referrals through a factor analysis and proposed a new scale, PQR-19. Some aspects of the scale's reliability and validity have not yet been fully verified, which remains a topic for future research.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Assessment of urinary cotinine levels in heated tobacco product (HTP) users: Effectiveness of enzyme-linked immunosorbent assay (ELISA)].","authors":"Ying Jiang, Kazuaki Kawai, Yun-Shan Li, Noriaki Kakiuchi, Hiroshi Yamato","doi":"10.11236/jph.24-141","DOIUrl":"https://doi.org/10.11236/jph.24-141","url":null,"abstract":"<p><p>Objectives　Urinary cotinine concentration is widely used as a reliable biomarker to objectively evaluate smoking status. High-precision methods, such as liquid chromatography-mass spectrometry (LC-MS) and gas chromatography-mass spectrometry (GC-MS), are mainly used for measuring cotinine concentrations. However, these techniques require expensive equipment and specialized analytical techniques; therefore, they are not suitable for large-scale surveys. Conversely, enzyme-linked immunosorbent assay (ELISA), which is simple and low-cost and has a precision comparable to that of LC-MS and GC-MS, has attracted attention. ELISA has been shown to be useful for evaluating urinary cotinine levels in combustible cigarette smokers; however, its application to heated tobacco product (HTP) users has not yet been examined. Thus, in this study, we aimed to measure urinary cotinine concentrations in HTP users and ascertain whether ELISA is as effective as LC-MS for such measurements.Methods　Urine samples were collected from workers at a certain workplace during lunch breaks on weekdays. In total, 33 participants were analyzed: 11 nonsmokers, 13 cigarette-only smokers, and 9 HTP-only users. Urinary cotinine concentrations were measured using LC-MS and ELISA. The correlation between the measurements obtained using these methods was evaluated using Pearson's correlation coefficient; the agreement was examined using the Bland-Altman analysis.Results　The ELISA and LC-MS results showed a high correlation (cigarette-only smokers: r ＝ 0.84, P ＜ 0.001; HTP-only users: r ＝ 0.96, P ＜ 0.001). The Bland-Altman plot showed a high degree of agreement, with 90.9% of the data between both methods falling within the limits of agreement.Conclusion　ELISA was useful for evaluating urinary cotinine levels in cigarette smokers and HTP users. Because of its convenience and low cost, ELISA is expected to be utilized for large-scale epidemiological surveys and promoting smoking control in workplaces.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Factors associated with dialysis initiation in Ehime, Japan].","authors":"Yuichi Seto, Hideaki Kono, Hiromi Hirose, Isao Saito","doi":"10.11236/jph.24-109","DOIUrl":"https://doi.org/10.11236/jph.24-109","url":null,"abstract":"<p><p>Objective　This study aimed to clarify the rate of dialysis initiation among the National Health Insurance (NHI) members and identify factors associated with individuals who underwent specific health checkups. These findings were shared with NHI insurers to help develop effective health services and reduce the incidence of chronic kidney disease (CKD).Method　We analyzed individuals aged 40-74 years who were insured under the NHI in Ehime Prefecture in 2012, excluding those already on dialysis. Individual patient data were sourced from the National Health Insurance Database and Specified Health Examination Data Management System. The dependent variable was dialysis initiation, whereas the independent variables included various associated factors. A 4-year cumulative rate of dialysis initiation was calculated from 2013 to 2016 and stratified by age and participation in specific health checkups. Poisson regression analysis was performed to estimate the rate ratios adjusted for age, estimated glomerular filtration rate (eGFR), and urinary protein levels.Results　The 4-year cumulative rate of dialysis initiation was 40.1 per 100,000 among those who underwent specific health checkups compared to 423.7 per 100,000 among those who did not. The rate of dialysis initiation was significantly higher among individuals with eGFR <45 and urinary protein ≥2+. Additionally，hypertension and diabetes mellitus were significant associated factors, with the rate ratios of 3.87 (95% CI: 1.37-10.9) and 7.51 (95% CI: 3.05-18.5), respectively.Conclusion　These findings highlight an urgent need to improve health check-up participation rates to identify high-risk individuals and to prevent disease progression. This study also underscores the importance of addressing diabetes and other associated factors in CKD management, which may lead to the development of targeted health initiatives by NHI insurers.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Whole grain consumption in Japan, with a focus on brown rice: Current status and challenges from a public health and health economic perspective].","authors":"Nayu Ikeda","doi":"10.11236/jph.25-040","DOIUrl":"https://doi.org/10.11236/jph.25-040","url":null,"abstract":"<p><p>Whole grains, which retain the bran and germ layers, are rich in nutrients and more nourishing than refined grains, with a globally acclaimed potential to prevent non-communicable diseases. The World Health Organization and Food and Agriculture Organization of the United Nations recommend whole grains as part of a healthy and sustainable diet, and several countries explicitly include them in their national dietary guidelines. In contrast, Japan lacks a clear definition or intake recommendation for whole grains and consumption levels remain notably low. This article reviews international evidence on the public health and health economic impact of whole-grain consumption, focusing on brown rice, a representative whole grain in Japan. Although brown rice intake has been associated with a reduced risk of type 2 diabetes, its consumption remains limited in Japan owing to barriers such as taste preferences, preparation efforts, and limited availability. Partial substitution of white rice with brown rice may help prevent type 2 diabetes and reduce national healthcare expenditure. Promoting the intake of whole grains, including brown rice, through multifaceted strategies, such as enhanced nutrition and health education, collaboration with food industry stakeholders, and incorporation into school and workplace meals, may support long-term improvements in population health and the containment of social security costs.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Support for public health center directors during the COVID-19 pandemic: A questionnaire survey].","authors":"Yuri Akamatsu, Toshiyuki Ojima, Hiroko Shimada, Rie Fujita, Sanae Haruyama","doi":"10.11236/jph.24-148","DOIUrl":"https://doi.org/10.11236/jph.24-148","url":null,"abstract":"<p><p>Objectives　In Japan, public health centers (PHCs) have been crucial in managing health crises during the coronavirus disease (COVID-19) pandemic. This study aimed to provide insight into future crisis management measures by identifying the support that PHC directors received and found useful while performing their duties during the pandemic.Methods　A questionnaire survey targeting PHC directors from 468 PHCs nationwide was conducted between September and October 2022. The survey items included the support received by directors in performing their roles and duties during the pandemic, type of support (medical duties, medical coordination, coordination work, and management duties), and support they found useful. Descriptive statistics were performed.Results　Valid responses were obtained from 189 PHC directors (40.4%), most of which were doctors. The highest proportion of support the directors received was from public health nurses/clerical staff at PHCs and head offices (73.0%), followed by from infectious disease specialists and Disaster Medical Assistance Teams. This support from public health nurses/clerical staff had the highest proportion of which the directors found useful (60.9%). Regarding communication, 48.1% of the directors found it useful to obtain an understanding from the administration heads, whereas < 40% found it useful to exchange information with other PHC directors or head offices. The type of support differed depending on whether the directors received it or with whom they exchanged information.Conclusions　During the COVID-19 pandemic, PHC directors mainly received human support from various occupations led by public health nurses/clerical staff and found the support useful. The type of support differed depending on who they received support from. The directors found it useful to obtain an understanding from the administration heads and were less likely to exchange information with other PHC directors or head offices. Two-way communication may not have been established in this case. Human support, appropriate placement, and two-way communication are important for the management of future health crises.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Recommendations for avoiding medical strain: A comparative analysis of regional responses in Hyogo Prefecture during the eighth wave of COVID-19].","authors":"Masanori Hamada, Ryutaro Masago, Kazuo Miyamura, Hiroshi Sumi, Akira Sudou, Masakazu Shinohara","doi":"10.11236/jph.24-096","DOIUrl":"10.11236/jph.24-096","url":null,"abstract":"<p><p>Objectives　During the eighth wave of COVID-19 in Hyogo Prefecture (October 1, 2022-February 28, 2023), the overwhelming transmissibility of the virus caused a significant strain on the healthcare system. This study focused on Amagasaki Health Center, Akashi Health Center, Sumoto Health Center (island region), and Asago Health Center (rural region) and their unique responses. The difference between the calculated \"required number of critical care beds\" (based on hospitalization recommendations) and the number of secured hospital beds was used as a measure of bed capacity strain, while the number of incidents involving difficulty in emergency transport was used as an indicator of a strain on emergency medical services. The aim of this study was to propose strategies to avoid medical system overload during future infectious disease pandemics based on the responses of each health center and regional healthcare system.Methods　Each fire department provided information on incidents involving difficulties with emergency transport. The \"required number of critical care beds\" was defined as the cumulative daily number of hospitalization recommendations(minus the number of patients who had exceeded the standard 10-day hospitalization period outlined in the guidelines). In the Amagasaki and Akashi Health Center jurisdictions, the number of patients hospitalized daily based on recommendations was recorded. These data were used to evaluate the validity of the calculated required number of critical care beds and assess the effectiveness of back end support operations.Results　Within the Amagasaki Health Center jurisdiction, where a consistent approach was adopted to hospitalize patients at designated medical institutions (from recommendation to discharge), the required number of critical care beds peaked significantly beyond the number of secured hospital beds. This peak coincided with a surge in COVID-19 emergency transport difficulties. In contrast, the Akashi Health Center jurisdiction, with back end support beds, partially mitigated bed-capacity strain and emergency transport difficulties. The Sumoto Health Center's jurisdiction minimized a healthcare strain by prioritizing the continuation of its regular medical care system. In the Asago Health Center jurisdiction, approximately half of the hospital beds were in psychiatric hospitals. Patients in these facilities could continue treatment therein, allowing the region to avoid significant healthcare constraints.Conclusion　Increasing the number of secure hospital beds alone is insufficient for preventing regional healthcare strains in SARS-type pandemics, such as COVID-19. Operating back end support systems and enabling self-contained treatment in facilities, such as care homes for older adults and psychiatric hospitals, are effective measures for avoiding this strain.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"486-494"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}