Emergence Of Japan Research Articles

Decline in and recovery of fertility rates after COVID-19-related state of emergency in Japan

IntroductionThe COVID-19 pandemic led to a decline in fertility rates worldwide. Although many regions have experienced a temporary drop in fertility rates with the spread of the infection, subsequent recovery...

Working from home during the COVID‐19 state of emergency in Japan

AbstractThis study examines the impact of working from home on how the working hours of full‐time employees varied by task characteristics during the first COVID‐19 state of emergency in Japan. One of the employment issues during the COVID‐19 pandemic was which type of job maintained working hours despite the spread of infection. Research in various countries argued that working from home effectively maintained normal business operations without interruption. However, Japan's situation regarding working from home and maintaining working hours during the pandemic differed. Under the first state of emergency, the government strongly promoted work‐from‐home measures for office workers, regardless of the tasks they were responsible for at their workplaces. In cases where a task was incompatible with working remotely, work stagnated or ceased entirely, which was reflected in the hours worked. This study considered shortened work hours by not maintaining full‐time work hours during the emergency period as an indicator of the dysfunctional state of business operations. The results demonstrated that work‐from‐home arrangements resulted in shortened work hours if the tasks of workers were incompatible with the scheme. We further revealed a tendency in which work‐from‐home arrangements were discontinued after the emergency period when it involved shortened work hours during the emergency period. The results suggested that work‐from‐home settings are not sustainable beyond emergency situations unless business operations function as indicated by maintaining full‐time work hours.

Seasonal prevalence of the invasive rusty-spotted longhorn beetle, Apriona swainsoni (Coleoptera: Cerambycidae), adults in Fukushima Prefecture, Japan

AbstractInvasive longhorn beetles are serious pests of tree stands worldwide. The rusty-spotted longhorn beetle, Apriona swainsoni (Hope) (Coleoptera: Cerambycidae: Lamiinae), is native to continental Asia, where it is a significant pest of legume trees. Its invasion into non-native ranges and damage to the local legume tree, Maackia amurensis, were first reported from Fukushima Prefecture, Japan, in 2021. This study investigated the biology of A. swainsoni in relation to adult emergence in Japan. Preliminary observations confirmed that A. swainsoni larvae create planned emergence holes on the host surface in late May. By exploiting these planned emergence holes, the adult emergence period was investigated in a field promenade of M. amurensis during the summer of 2022 and 2023. The researchers plugged the holes and recorded plug removal, resulting in the observation of 60 and 227 putative emergence events in respective years, with the majority occurring in early to mid-July. Further, during the summer of 2022, a periodic field survey of adult emergence was conducted, obtaining eight adults. Furthermore, a supplementary survey using infested logs maintained in a field cage demonstrated that the emergence period does not differ between sexes and the male-to-female ratio is one:one. Our results suggest that control efforts to suppress A. swainsoni adults in the field, such as insecticide spraying, should be prioritized in the relatively short, peak emergence period. This work indicates that the plug survey is useful for detecting the emergence period.

Arrangements for Telephone Consultation on Radiation Health Effects in a Nuclear Emergency in Japan: Lessons Learned from the Nuclear Accident in Fukushima, Japan, 2011

The Japan Atomic Energy Agency (JAEA) established a telephone consultation system at the request of the Ministry of Education, Culture, Sports, Science and Technology in response to residents’ concerns about the radiation health effects following the nuclear accidents at the Fukushima Daiichi Nuclear Power Station of the Tokyo Electric Power Company (TEPCO) in March 2011. Eight toll-free telephone lines were established and employees with knowledge of radiation health effects were assigned for consultation. The JAEA expert response group for telephone inquiries comprised a telephone response team, a question-and-answer team, and a manager. Approximately 35,000 consultations were conducted from March 17, 2011 to September 18, 2012. Japan’s Basic Disaster Prevention Plan was revised following the accident, where one of the JAEA’s roles for nuclear emergency response was to provide telephone consultation on radiation health effects. The JAEA’s system for telephone consultation was improved following this experience. The description of telephone hotlines in the International Atomic Energy Agency’s guide, GSG-14, published in 2020, was discussed for further improvement in the JAEA’s telephone consultation system.

Tracking the Effect of Human Activity on MeSO-net Noise Using Seismic Data Traffic—Did Seismic Noise in Tokyo Truly Decrease during the COVID-19 State of Emergency?

Abstract Human activities cause seismic noise over 1 Hz (cultural noise), and the recent articles have reported that the curtailing of socioeconomic activities during the novel coronavirus (COVID-19) pandemic in 2020 appeared to reduce high-frequency seismic noise amplitudes in cities. The Tokyo metropolitan area in Japan, where seismic stations are densely distributed and various anthropogenic activities have been closely monitored, is an ideal study area to investigate the effect of human activity on high-frequency seismic noise during the pandemic. We demonstrated that the magnitude of seismic data traffic (SDT), indexed by the packet size of continuous seismic data in WIN32 format, is a good indicator for monitoring time-dependent changes in high-frequency noise levels. The SDT of 169 Metropolitan Seismic Observation network (MeSO-net) stations—a continuous accelerometer network that is mostly located at schools in the Tokyo metropolitan area—decreased by approximately 1%–3% from March to June 2020, when a state of emergency in Japan was first declared, compared with that in the previous year. We revealed that the SDT decrease was prominent only at stations near school buildings, and the SDT trend was uncorrelated with the temporal changes in the population and vehicular traffic volume near the seismic stations. We also found strong correlations between the SDT reduction and school size (classified by the number of students enrolled), implying that the noise decrease at the MeSO-net stations during the pandemic was strongly influenced by school-based activities. Thus, the noise reduction observed at MeSO-net stations during the COVID-19 pandemic in 2020 did not provide strong evidence of quieting in the Tokyo metropolitan area.

In-Hospital Deaths From Ambulatory Care–Sensitive Conditions Before and During the COVID-19 Pandemic in Japan

The COVID-19 pandemic may have played a role in the deterioration of access to medical care for ambulatory care-sensitive conditions (ACSCs). To ascertain whether the number of in-hospital deaths and in-hospital mortality rate associated with ACSC changed after the declaration of the COVID-19 national state of emergency in Japan. This cohort study used a difference-in-differences design to compare outcomes for ACSC in the period before (January 1, 2015, to December 31, 2019) vs the period after (January 1, 2020, to December 31, 2020) Japan declared a national state of emergency for the COVID-19 pandemic. Analyses used discharge summary data from 242 acute care hospitals across Japan. The sample comprised unscheduled hospitalizations of patients with ACSC during the study period (January 1, 2015, to December 31, 2020). Data analyses were performed between August 16 and December 7, 2022. The declaration of the COVID-19 national state of emergency announced by the Japanese government in April 2020 was considered to be an exogenous shock. Primary outcomes were the ACSC-associated number of in-hospital deaths, number of hospitalizations, and in-hospital mortality rate. A total of 28 321 ACSC-related hospitalizations were observed involving 15 318 males (54.1%), with a median (IQR) age of 76 (58-85) years. The number of in-hospital deaths was 2117 (7.5%). The number of hospitalizations decreased overall (incidence rate ratio [IRR], 0.84; 95% CI, 0.75-0.94), for chronic conditions (IRR, 0.84; 95% CI, 0.77-0.92), and for vaccine-preventable conditions (IRR, 0.58; 95% CI, 0.44-0.76). However, in-hospital deaths (IRR, 1.66; 95% CI, 1.15-2.39) and in-hospital deaths within 24 hours of hospital arrival (IRR, 7.27 × 106; 95% CI, 1.83 × 106 to 2.89 × 107) increased for acute conditions. The in-hospital mortality rate increased for acute conditions (IRR, 1.71; 95% CI, 1.16-2.54), and the 24-hour in-hospital mortality rates also increased overall (IRR, 1.87; 95% CI, 1.19-2.96), for acute conditions (IRR, 2.15 × 106; 95% CI, 5.25 × 105 to 8.79 × 106), and for vaccine-preventable conditions (IRR, 4.64; 95% CI, 1.28-16.77). This cohort study found that in Japan, the number of in-hospital deaths increased after the declaration of the COVID-19 national state of emergency in 2020, particularly for acute ACSC and deaths within 24 hours of hospital admission. This finding suggests that access to good-quality primary care and inpatient care for patients with acute ACSC may have been compromised during the pandemic.

Impact of the COVID-19 pandemic on the performance of endoscopy in the Tohoku region of Japan.

The whole picture of the disturbance in endoscopy performance caused by the coronavirus disease 2019 (COVID-19) pandemic in Japan remains to be clarified. Therefore, the Japan Gastroenterological Endoscopy Society-Tohoku conducted this questionnaire survey in Tohoku region of Japan. A questionnaire on the number of diagnostic endoscopy procedures and resulting diagnosed cancers in 2019 and 2020 was sent to all guidance/guidance cooperation hospitals in the Japan Gastroenterological Endoscopy Society who worked in the Tohoku region. The percentage change was calculated by comparing the numbers in 2020 with those in 2019 (the pre-COVID-19 period). Among the applicable 89 guidance/guidance cooperation hospitals, 83 (94%) returned the questionnaire. The number of endoscopy procedures promptly decreased to the nadir in April and May 2020 (during the first state of emergency in Japan); however, it recovered relatively quickly, within a few months after the state of emergency was lifted. Consequently, the annual reduction in the number of endoscopy procedures in 2020 (in comparison to 2019) was 10.1% for esophagogastroduodenoscopy and 7.9% for colonoscopy. The reduction in the number of diagnostic endoscopy procedures led to a 5.5% reduction in esophagogastric cancer and 2.7% in colorectal cancer. This is the most comprehensive survey on the impact of the COVID-19 pandemic on the performance of endoscopy and the resulting diagnosis of cancer in Japan. Understanding the magnitude of the decline in endoscopic examinations and cancer detection due to the pandemic is critical to understanding how many people will ultimately be affected and establishing a strategy for providing endoscopy during national emergencies.

Differences in attitude toward COVID‐19 based on internet and social media usage among community‐dwelling older adults during the first state of emergency

In order to understand the digital divide among older adults during the coronavirus disease 2019 (COVID-19) pandemic, we investigated the association between internet use and compliance with COVID-19 preventive behaviors during the first state of emergency in Japan. A total of 8952 community-dwelling citizens aged 75 years and above were asked about their preventive behaviors during the first state of emergency using a paper-based questionnaire. Among them, 51% responded and were divided into internet users and non-users. We used multivariable logistic regression models to estimate the adjusted odds ratios and 95% confidence intervals of internet use for compliance with preventive behaviors. Approximately 40% of the respondents used the internet, and 9.29% used social media to collect COVID-19-related information. Internet usage was independently associated with compliance with using hand sanitizers, avoiding going out, avoiding eating out, avoiding traveling, getting vaccinated, and getting tested for COVID-19; the adjusted odds ratios (95% confidence intervals) were 1.21 (1.05-1.38), 1.19 (1.04-1.37), 1.20 (1.05-1.38), 1.32 (1.15-1.52), 1.30 (1.11-1.53), and 1.23 (1.07-1.41), respectively. Exploratory subgroup analyses demonstrated that social media users might have shown early adaptation to newly recommended preventive behaviors during the first state of emergency. Results suggest that a digital divide exists, as evidenced by the varied compliance with preventive behaviors depending on internet use. Additionally, social media use may be associated with early adaptation to newly recommended preventive behaviors. Therefore, future studies regarding the digital divide among older adults should investigate differences depending on the types and content of internet resources. Geriatr Gerontol Int 2023; 23: 289-296.

The use of a companion robot to improve depression symptoms in a community-dwelling older adult during the coronavirus disease 2019 state of emergency.

We investigated the impact of using a companion robot on the mental state of a community-dwelling older adult who was receiving home-visit rehabilitation services during the state of emergency for coronavirus disease 2019 (COVID-19). This case involved an 80-year-old woman with compression fractures of lumbar vertebrae 1 and 2. Her medical history included hypothyroidism, hypertension, dyslipidemia, and depression. The companion robot used was Smibi®, a healing baby robot that responds in various ways depending on how the user interacts with it. The patient interacted (e.g., hugging, conversing) with Smibi® for 30 minutes per day for 1 month, from April 2020 (immediately before the declaration of a state of emergency in Japan) to May 2020. The patient was evaluated with the Self-Rating Depression Scale (SDS) before and after using Smibi®. The SDS score decreased from 37 points to 26 points after the use of Smibi®. The items related to diurnal variation, sleep, despair about the future, and dissatisfaction decreased by 2-3 points. Our findings suggest that interacting with Smibi® may improve depression in older adults who have been forced to refrain from going out due to the spread of COVID-19. Future studies with long-term follow-up and large sample sizes are required to confirm the effectiveness of companion robots in improving depression among community-dwelling older adults.

Increased frequency of central precocious puberty during the coronavirus disease (COVID-19) pandemic at a single center in the Osaka Metropolitan Area of Japan.

As environmental factors are known to affect the timing of puberty, self-isolation during the coronavirus disease (COVID-19) pandemic may affect the incidence of central precocious puberty (CPP). This study aimed to evaluate the frequency of CPP during the COVID-19 pandemic at a single center in the Osaka metropolitan area of Japan. We retrospectively analyzed the annual frequency of CPP occurrence before and after the first declaration of COVID-19 state of emergency in Japan at our hospital. We performed an interrupted time-series analysis to investigate the frequency of patients with CPP at our hospital from 2016 to 2021. There was a significant increase in the frequency of patients with CPP before and after the state of emergency declaration, both overall and among females. However, there was no significant increase in the number of males. There were no significant differences in the clinical, auxological, and endocrinological features between those diagnosed before and after the state of emergency. Overall, the frequency of CPP significantly increased during the COVID-19 pandemic at a single center in the Osaka metropolitan area of Japan.

The disparity of utilization rate among specific groups for a rapid spreading telehealth application called LEBER during the COVID-19 state of emergency in Japan.

The purpose of this research is to describe the social demographics and chief complaints of users of a free medical consultation application in Ibaraki Prefecture, where a free medical consultation application was released. The present study included users of a telehealth application in Ibaraki Prefecture between April 9 and May 17, 2020, during the state of emergency. User background characteristics were descriptively analyzed to clarify individual factors with the potential to act as barriers to equally using innovative solutions. Additionally, the age and consultation time distribution by sex were examined for those who used the application for COVID-19 and non-COVID-19 issues. Most of the participants were in their thirties. Moreover, 72% were female, with most being in their thirties (86%) and the least being in their sixties (45%). The number of consultations was concentrated between 6 p.m. and 10 p.m., with the least between 1 a.m. and 5 a.m. The telehealth application users were mainly females in their thirties and forties. To prevent the widening of health disparities due to the rapid introduction of telehealth, further research is required to identify why the use of the application did not spread beyond the aforementioned user groups.

1349. Lesson Learned from Investigators of Clinical Trials to Identify Therapeutics for COVID-19: Qualitative Study

Abstract Background Implementation of high-quality clinical trials especially early in the pandemic caused burden on clinical investigators given lack infrastructure, networks and systematic supports. To prepare for future pandemic, we investigated facilitator and obstacles that enable investigators to operate clinical trials for COIVD-19 in Japan. Methods We conducted individual semistructured qualitative interviews to assess the process of how clinical trials for COVID-19 were planned and implemented at the early stage of pandemic. Clinical investigators were primarily selected through purposive sampling to ensure that participants involved in the clinical trials were well covered. Additional participants were identified using snowball sampling. Interviews were analyzed using qualitative descriptive method. Results Through interviews, we identify factors that can impact on conduct clinical trials in infectious diseases field during health emergency in Japan (Figure). First, there are obstacles in rolling out clinical trials and this theme was further divided into two subthemes: obstacles in system(such as lack of regulatory frameworks to support trials, lack of clinical trial networks/platform, and understanding and attitude of the public to clinical trial); and obstacles in clinical level (such as limited resource for non-academic hospitals to implement clinical trials, and lack of trained experienced researchers and coordinators with regards to clinical trials). Secondary, a few factors that facilitate clinical trials exist. Not only governmental and organizational commitment but also presence of physicians and other healthcare professional interested in conducting trials are the key for facilitate clinical trials. Facilitators and obstacles to implement clinical trials for COVID-19 therapeutics Conclusion In this qualitative study, clinical investigators in Japan who conducted clinical trials recognized both obstacles and facilitators. System level obstacles likely led to the obstacles in clinical level. Our finding emphasizes importance for health care policies to respond to such insight from front line clinical investigators to encourage systemwide efforts to facilitate and develop transparent clinical trials during future pandemic. Disclosures All Authors: No reported disclosures.

Substitution of telemedicine for clinic visit during the COVID-19 pandemic of 2020: Comparison of telemedicine and clinic visit.

ABSTRACTAims/IntroductionThe purpose of this retrospective observational cohort study was to compare outpatient diabetes care and glycated hemoglobin (HbA1c) level during the coronavirus disease 2019 pandemic in 2020 with 2019, and to compare the glucose‐lowering effect of telemedicine and clinic visits during the state of emergency in Japan declared from 7 April to 25 May (inter‐period) 2020.Materials and MethodsA total of 13 weeks before and after the inter‐period were designated as the pre‐period and post‐period, respectively. The number of study participants who had clinic visits during the pre‐period and the post‐period were 3,333 in 2020 and 3,608 in 2019. Propensity score matching was carried out to compare the effect of telemedicine and clinic visits on diabetes control in 2020 among diabetes patients with insufficient glucose control (HbA1c ≥7%). The primary outcome was post‐period HbA1c.ResultsThe major difference between 2020 and 2019 was the use of telemedicine in 2020. After adjustment for age, sex, diabetes type, pre‐period HbA1c and pre‐period body mass index, glycemic control evaluated by HbA1c was significantly worse in the post‐period of 2020 than 2019. In the propensity score‐matched 618 pairs, the clinic visit group had significantly better post‐period HbA1c than the telemedicine group (7.5% vs 7.4%, P = 0.023).ConclusionsGlycemic control was slightly, but significantly, worse in 2020 than 2019. Although telemedicine significantly improved glycemic control during the coronavirus disease 2019 pandemic in 2020, clinic visits improved HbA1c significantly more. The substitution of telemedicine for clinic visits appears to be a viable option under emergency conditions, but clinic visits might be a better option when possible.

COVID-19 Effects on Income and Dental Visits: A Cross-sectional Study.

In April 2020, the Japanese government declared a state of emergency owing to the outbreak of the novel coronavirus disease (COVID-19) pandemic, which resulted in reduced workforce and job losses. Furthermore, income is one of the most consistent predictors of dental visits. Therefore, this study examined the association between income changes and dental clinic visits during the COVID-19 state of emergency in Japan. An online, self-reported cross-sectional survey about health activities including dental visits during the first COVID-19 state of emergency was conducted in Osaka, Japan (June 23 to July 12, 2020). Among participants with toothaches, the assessment for the association between "refrained from visiting a dentist despite wanting treatment for toothache during the state of emergency (refrained treatment)" and income changes before and after the state of emergency using a multivariate Poisson regression model adjusted for sex, age, self-rated health, frequency of regular dental visits, and employment status. Among 27,575 participants, 3,895 (14.1%) had toothaches, and 1,906 (6.9%) reported refrained treatment. Among people with decreased income (n = 8,152, 29.6% of overall participants), the proportions of the refrained treatment group were 8.0% (income decreased by 1%-49%), 9.9% (50%-99% decreased), and 9.1% (100% decreased). Among participants with toothache, after adjusting for all variables, compared with participants with no income change, we observed significantly higher prevalence ratios (PRs) for refrained treatment in those who experienced a decreased income owing to COVID-19 (1%-49% decrease: PR = 1.08; 95% confidence interval [CI], 1.005-1.17; 50%-99% decrease: PR = 1.18; 95% CI, 1.06-1.32; 100% decrease: PR = 1.18; 95% CI, 1.04-1.33). Decreased income was associated with refrained dental treatment during the COVID-19 state of emergency in Osaka, Japan. The economic damage related to the COVID-19 pandemic could lead to oral health inequalities. Our study found that individuals with decreased income owing to COVID-19 before and after the state of emergency showed significantly higher prevalence ratios for refraining from visiting a dentist despite wanting treatment for toothache. We believe that our study makes a significant contribution because it provides novel, basic data that economic damages related to the COVID-19 pandemic might expand to oral health inequalities.

Physical, social, and dietary behavioral changes during the COVID-19 crisis and their effects on functional capacity in older adults

BackgroundThis two-year follow-up study aimed to identify factors associated with unhealthy behaviors during the COVID-19 pandemic and examine their impact on functional capacity in older adults. MethodsAltogether, 536 adults aged ≥65 years participated in this study. The frequency of going out, exercise habits, face-to-face and non-face-to-face interactions, social participation, and eating habits were examined as behavioral factors before and after the first declaration of a state of emergency in Japan. Functional capacity was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence. ResultsUsing latent class analysis considering changes in the six behaviors, the participants were divided into healthy (n = 289) and unhealthy (n = 247) behavior groups. The male sex was associated with 2.36 times higher odds, diabetes with 2.19 times higher odds, depressive mood with 1.83 times higher odds, poor subjective economic status with 2.62 times higher odds, and living alone with 44% lower odds of being unhealthy. The unhealthy behavior group showed significantly decreased functional capacity (B =−1.56 [−1.98, −1.14]) than the healthy behavior group. For each behavior, negative changes in going out (B =−0.99 [−1.60, −0.37]), face-to-face interaction (B =−0.65 [−1.16, −0.13]), and non-face-to-face interactions (B =−0.80 [−1.36, −0.25]) were associated with a decline in functional capacity. ConclusionOur results showed four factors associated with engaging in unhealthy lifestyle behaviors and how behavioral changes affect functional capacity decline during the COVID-19 pandemic, which will help to develop public health approaches

Did Children in Single-Parent Households Have a Higher Probability of Emotional Instability during the COVID-19 Pandemic? A Nationwide Cross-Sectional Study in Japan.

The influence of public health measures against COVID-19 in Japan on child mental health by household type is unknown. This study aimed to investigate whether COVID-19 and the declaration of a state of emergency in Japan affected children’s mental health between single-parent and two-parent households disproportionately. A large cross-sectional online survey was conducted from August to September 2020. The study included 3365 parents with children aged 0–14 years old who reported their children’s mental status during the declared state of emergency. Emotional instability was reported dichotomously by parents. As the primary result, the probability of emotional instability was higher in single-parent households compared with that in two-parent households after adjustments for potential covariates; the adjusted prevalence ratio (95% CI) was 1.26 (1.07–1.49). Our findings suggest a disproportionate impact on children’s mental health due to the pandemic.

Socio-economic and behavioral characteristics associated with COVID-19 vaccine hesitancy under a declared state of emergency in Japan

Evidence regarding coronavirus disease 2019 vaccination indicates that some people hesitate to be vaccinated, and previous studies demonstrate the variables that influence hesitancy to vaccinate. However, they have not limited the target population to areas where infection is prominent. This study aimed to clarify the characteristics of people living in these areas who hesitate to be vaccinated and recommend effective approaches to encourage vaccination.The survey was conducted online between February 24 and March 1, 2021, during which the 2nd state of emergency was declared in Japan. The analytic sample comprised 17,582 unvaccinated individuals (mean age ​= ​48.6 ​± ​13.8, range ​= ​18–90 years). The t-test results indicate that current or past treatment for physical illness exerted a strong influence on vaccine hesitancy (ds ​= ​0.30). Similarly, multiple regression analyses revealed that understanding the importance and necessity for preventive behaviors had the greatest influence on the intention to vaccinate (β ​= ​0.48). Regarding recommendations to promote willingness to be vaccinated, our findings indicated that clear explanation of the reasons for the necessity for these behaviors and collaboration between representatives of various communities would effectively encourage vaccination.

Dental care behavior and related factors during the COVID-19 state of emergency in Japan

Objectives In response to the spread of SARS-CoV-2, a state of emergency was declared in Japan on April 7, 2020, and in the same month, Japan's Ministry of Health, Labor, and Welfare informed dentists of the need to postpone non-emergency dental care. The purpose of this study was to identify the patients who refrained from dental care during the state of emergency in April 2020, and to clarify their personal characteristics.Methods A total of 1,335 patients who visited 28 dental clinics in Saitama in September 2020 completed survey questionnaires; of these, 1,227 valid responses were received. Among those who sought dental care under the state of emergency, those who did not visit a dental clinic comprised the "refrained group" and those who visited the dental clinics comprised the "visited group".Results Multivariate logistic regression analysis showed that the odds ratios for the "refrained group" were 1.69 (95%Cl: 1.12-2.55) for females, 2.91 (95%Cl: 1.88-4.49) for those younger than 65 years, 1.71 (95%Cl: 1.04-2.82) for those that visited the dental clinic less than once a month, and 7.12 (95%Cl: 4.56-11.11) for those who did not have an appointment during the state of emergency.Conclusion In conclusion, 35% of patients in this study refrained from visiting the dental clinic during the state of emergency. The related factors for refraining from dental care were being females, middle-aged (<65 years), visiting the dental clinic less than once a month, and not having an appointment during the COVID-19 state of emergency.

The Transition of Social Isolation and Related Psychological Factors in 2 Mild Lockdown Periods During the COVID-19 Pandemic in Japan: Longitudinal Survey Study.

BackgroundLockdowns and stay-at-home orders announced internationally for COVID-19 have led to physical and social distancing, with reports of many individuals experiencing social isolation (SI) and loneliness. Although the emergency declaration in Japan was declared as a “mild” lockdown requested by the government without penalties for violations, the lockdown measures, including SI, had several influences on people’s lives and mental health as in other countries. Furthermore, Japan declared a state of emergency multiple times; thus, it is necessary to examine the influence of the transition of SI caused by repeated emergency declarations and the deterioration of mental health associated with these changes.ObjectiveThis study longitudinally investigated the transition of SI and its related factors during the mild lockdown under 2 declared states of emergency in Japan and analyzed psychosocial characteristics by extracting clusters where people with specific transition patterns of SI predominated.MethodsWe collected data on 7893 inhabitants (3694 [46.8%] women, 49.6 [SD 13.7] years old) living in the 7 prefectures where the initial emergency declaration was applied. The investigations took place online in the final phase of the first and second states of emergency: phase 1 (between May 11 and 12, 2020) and phase 2 (between February 24 and 28, 2021). Nonparametric Bayesian coclustering was used to visualize the exhaustive interaction structure between the transition pattern of SI and the psychosocial variables.ResultsThere were no improvements in social networks and loneliness between the 2 phases, although psychological distress significantly improved and depression slightly decreased. Overall, 3868 (49%) of the 7893 participants remained socially isolated through phases 1 and 2, and 947 (12%) were socially isolated in phase 2, even though they were not socially isolated in phase 1. More participants experienced persistent SI in unmarried, childless, and low-household-income groups. The persistent-SI group had fewer cohabitants than other transition pattern groups. The nonparametric Bayesian coclustering results showed that most clusters, including participants without SI throughout phases 1 and 2, had healthy behaviors, more interactions, good relationships, and less loneliness and psychological stress. Furthermore, the cluster in which relationships deteriorated in phase 1 recovered in phase 2. Comparatively, the clusters with SI throughout phases 1 and 2 were divided into clusters with increased loneliness and psychological stress; clusters were close to participants’ average scores in this study. The clusters with increased loneliness and psychological stress were notable for deteriorating relationships and less online interaction.ConclusionsThis study revealed the actual state of transition of SI and related psychological, social, and behavioral factors under repeated declarations of a state of emergency. These results should help construct intervention methods that fit individual characteristics of people in SI during a pandemic.

College students' Twitter usage and psychological well-being from the perspective of generalised trust: comparing changes before and during the COVID-19 pandemic

PurposeThis study investigated the relationship between generalised trust and psychological well-being in college students, considering the social support obtained from their social networks via Twitter and face-to-face (FTF) interactions. Initially, the authors planned to collect data at the beginning of the first semester in 2019 for fine-tuning the model as a pilot study, and in 2020 for the main study. However, due to the coronavirus disease 2019 (COVID-19) pandemic, the data helped authors to analyse changes in young people's psychological situation before and during the pandemic in Japan.Design/methodology/approachThe study conducted a self-report survey targeting college students in the Kanto region in Japan. Data were collected from mid-May to the end of June 2019, as well as in early to mid-June 2020, with 304 and 584 responses, respectively. The collected data were analysed using structural equation modelling and a multiple regression analysis.FindingsThe findings using the 2019 data set indicated that (a) students mostly used Twitter for information gathering and sharing of hobbies, and they received both informatics and emotional support from Twitter, and from FTF interactions; (b) there were direct positive effects of generalised trust and social skills on their psychological well-being; and (c) students with lower levels of generalised trust tended to interact with very intimate individuals using Twitter to obtain social support, which did not have any effects on their improvement of psychological well-being. From the 2020 data set, the authors also found that, like 2019, generalised trust and social skills had direct effects on the improvement of psychological well-being. Additionally, we observed that students spent more time using Twitter and received more emotional support from it, as most people tried not to meet other people in person due to the first State of Emergency in Japan. Similarly, the authors found that in 2019, only social support from very intimate partners via FTF communication had slightly significant effects on improving their psychological well-being, whereas in 2020, their expectation for social networks via FTF had decreased their levels of psychological well-being, but their social support from Twitter had slightly significant effects on their improvement of psychological well-being. One of the main reasons for this might be due to the challenge of meeting with others in person, and therefore, social support from Twitter partially played a role that traditionally was only beneficial through FTF communication.Originality/valueWe understand that this is one of the few social psychological studies on social media that collected data both before and during the COVID-19 pandemic. It provides unique evidence in demonstrating how the COVID-19 pandemic has changed college students communication behaviours.