Implementation In Japan Research Articles

Bacteriological characteristics and changes of Streptococcus pneumoniae serotype 35B after vaccine implementation in Japan.

Streptococcus pneumoniae serotype 35B, a non-vaccine type, is a major contributor to the increase in pneumococcal infection post-vaccination. We aimed to understand the mechanism of its spread by characterizing 35B. The serotype, type 1 pilus (T1P) positivity, and antimicrobial susceptibility of 319 isolates in 2018-2022 were analysed and compared with those of isolates in 2014-2017 to find the changes. 35B accounted for 40 (12.5%) isolates. T1P positivity was notably higher in 35B (87.5%) than in the other serotypes. To confirm the role of T1P, an adhesion factor, we compared adherence to A549 cells between T1P-positive 35B isolates and their T1P-deficient mutants, showing contribution of T1P to adherence. Penicillin-non-susceptible rate of 35B was 87.5%, and meropenem-resistant 35B rate was 35.0%, which increased from 14.5% of 2014-2017 (p=0.009). Multilocus sequence typing was performed in 35B strains. Prevalence of clonal complex 558, harbouring T1P and exhibiting multidrug non-susceptibility, suggested the advantages of 35B in attachment and survival in the host. The emergence of ST156 isolates, T1P-positive and non-susceptible to β-lactams, has raised concern about expansion in Japan. The increase of serotype 35B in pneumococcal diseases might have occurred due to its predominant colonizing ability after the elimination of the vaccine-serotypes.

Feasibility of vehicle-to-grid (V2G) implementation in Japan: A regional analysis of the electricity supply and demand adjustment market

Vehicle-to-Grid (V2G) technology forms a critical bridge between electric vehicles (EVs) and renewable energy, playing a transformative role in the global shift towards a low-carbon future. Despite its promise, the impact of regional differences on V2G potential, particularly within specific application scenarios, remains largely unexplored. This study employs an agent-based modeling approach to evaluate V2G potential across Japan's 47 prefectures, with a focus on its integration into an energy reserve service business model. Our analysis reveals that EV ownership is the dominant factor influencing regional variability, with the Tokyo Metropolitan Area, Aichi, and Kanagawa emerging as top candidates for V2G deployment. Interestingly, when EV ownership is excluded from consideration, regions like Okinawa, Kagoshima, and Ibaraki show leadership in V2G potential. These findings highlight the existence of regional priorities for V2G application. Moreover, a ‘High Demand Disparity’ is observed in the power supply and demand adjustment market, where V2G systems are often either underutilized or overwhelmed, leaving many idle. The study underscores the need for region-specific strategies and the integration of diverse business models to fully capitalize on V2G's potential in various demand adjustment scenarios.

A CASE STUDY ON THE OPERATION AND MARKETING STRATEGIES OF GROUP HOME IN JAPAN

This study uses the Sky Group Home case study method to understand the current status of the industrial environment where the case is located, and explore the development trends and business strategies of Japanese companies in the group home market. It also analyses the corresponding marketing strategies of the industry based on regional expansion points, so as to improve the competitiveness of the industry's regional channels and open up new markets for international group home development. In recent years, Taiwan's group homes have been gradually privatized, and Japan's implementation experience has a high degree of reference value for my country's policy construction and group homes. This study focuses on operating groups in Japan Company A of Home House is taken as the research object, and the standard policies and operating models for the establishment of Japanese group homes are discussed through literature. Company A is used to understand its operating model based on its service content and current operating conditions. Environmental analysis and marketing mix analysis are conducted to explore its market, management and Marketing strategy; Finally, use SWOT analysis to summarize A The current situation of the company and suggestions for the future development of the industry. The legal entity creates a daily life environment similar to home, adhering to the core concept of "serving users", focusing on personal uniqueness, and providing users with social care in a small unit. In Japan, group homes gather two major groups: the elderly and the physically and mentally disabled, living in a house the size of an average family. Or apartments, with nursing staff working around the clock to provide living assistance, giving customers a convenient and secure living space and a comfortable and barrier-free daily life. After a preliminary understanding, I realized that compared to Taiwan, the development of group housing in Japan is more prosperous, and because the government adopts a "government subsidy, private operation" approach in the implementation of group housing welfare policies, it not only provides operating subsidies to private operators , and also provide consulting services and other assistance to the industry to make this social welfare industry more common in the country, so it was decided to further explore this policy.

Manual rolling load and low back pain among workers in Japan: a cross-sectional study.

Manual rolling of heavy objects remains in the workplace. The Health and Safety Executive (HSE) in the United Kingdom recommends load weights of <400kg in the rolling task. However, the association of rolling weights <400kg with work-related low back pain (LBP) has not been sufficiently investigated. This study examined the effect of rolling loads weighing <400kg on LBP among Japanese workers. A web-based survey gathered information from 15 158 workers in 2022. Among them, 15 035 did not handle loads, whereas 123 handled rolling weights <400kg. Load weight was categorized into 4 groups: no-handling (0kg) and rolling weights of ≤20, 20-40, and >40kg. Multiple logistic regression analysis examined the association between the subdivided rolling weight and LBP. No significant differences in odds ratio (OR) of LBP were found for workers handling ≤40kg rolling weights compared with that for no-handling workers. However, workers handling >40kg rolling weights had a significantly greater OR of LBP than those not handling loads. Rolling weights between 40 and 400kg could place a high stress on the lower back. Implementation in Japan of the HSE recommendations regarding rolling load should be carefully considered.

Challenges in implementing climate change policy within local climate action, transportation and land use planning in Japan

Climate change poses substantial challenges to policy implementation and planning at scales ranging from local to global. This study examines the effectiveness and challenges of implementing climate change policy, particularly in local climate action planning and implementation in Japan, focusing on the transportation and land use planning fields. It specifically asks questions about the efficacy of local governments’ practices and efforts in realising national carbon reduction goals, measures taken by local governments, and hurdles in implementation experienced by them. The study found several significant challenges in which local governments tend to meet procedural requirements but leave substantial uncertainty in the efficacy of their local climate action planning and implementation. The article calls for more stringent regulations and mandates, more robust initiatives and guidance considering the diverse local conditions, combined with better coordination among the ministries, for more effective greenhouse gas (GHG) emissions reduction.

Direction of Japan’s New Cybersecurity Policy

The direction of Japan’s cybersecurity policy is shaped by the escalating threat of state-sponsored cyberattacks in peacetime. This surge, notably from Russia, China, and North Korea, involves diverse tactics such as information manipulation, functional disruption, and financially motivated attacks, posing economic and national security risks. In response, nations are increasingly adopting Active Cyber Defense (ACD) strategies. ACD combines real-time attack detection with proactive countermeasures, aiming to impose costs on malicious cyber actors and mitigate potential damage. The United States and the United Kingdom lead in ACD implementation, using technical and policy responses, including hackbacks, to deter and attribute cyber threats. Japan is aligning its security policy with ACD principles, recognizing the need for proactive cyber measures beyond passive cyber defenses. This shift involves enhancing cyber capabilities, increasing cyber-related units, and fostering collaboration with the private sector. However, legal and regulatory challenges hinder ACD implementation in Japan, with existing laws restricting activities such as attack monitoring and attribution. Bridging these gaps is crucial for developing a comprehensive cybersecurity framework and ensuring the nation’s resilience against evolving cyber threats.

The Japanese Circular Economy and Sound Material-Cycle Society Policies: Discourse and Policy Analysis

Although the Japanese government is an early adopter of Circular Economy (CE) policies and developed the concept of the Sound Material-Cycle Society in the early 2000s, its CE policies have nonetheless been poorly researched and understood, especially in English academic literature. This article addresses this research gap by answering the following questions: What are the dominant discourses of key stakeholders in Japan regarding CE? And to what extent does the current CE policy in Japan relate to that? Methodologically, this paper conducted a discourse analysis through a mix of policy analysis, media analysis, stakeholder interviews, keyword mining, qualitative content analysis, and analysis of stakeholder presence. Results show that, while CE discourses in Japan are rather diverse, they mostly fall within the Reformist Circular Society discourse type, with some smaller Technocentric Circular Economy and Transformational Circular Society elements. Results also show that businesses and academics were over-represented in policy meetings and the media, compared to NGOs and local government actors, which are more likely to hold transformational circularity discourses. Most circularity discourses in Japan are thus focused on a growth-optimistic narrative that emphasises innovative technologies and lacks a stronger understanding of social justice and planetary boundaries. Based on these findings, this article suggests recommendations, such as revisiting Japanese ecological thinking and Buddhist philosophy, which can inspire degrowth-oriented circularity approaches, as well as encompassing more participation of neglected societal groups in the development and implementation of CE policies and practices. By highlighting the challenges in current CE discourse and implementation in Japan, this study presents implications for a more socially inclusive and ecologically sustainable path towards a circular society.

Research activities contributing to evidence-based practice implementation in Japanese rehabilitation professionals.

[Purpose] This study aimed to determine whether certain research activities improve the attitude of rehabilitation professionals towards evidence-based practice and its implementation in Japan. [Participants and Methods] We included physical, occupational, and speech therapists currently working in clinical settings. We employed hierarchical multiple regression analyses to assess the attitude of rehabilitation professionals towards evidence-based practice and research activities. Scores of the five dimensions of the Health Sciences-Evidence Based Practice questionnaire were considered the dependent variables. The five dimensions were as follows: Dimension 1, attitude towards evidence-based practice; Dimensions 2-4, evidence-based practice implementation; and Dimension 5, work environment related to evidence-based practice barriers-facilitators. The four sociodemographic variables (gender, academic degree, clinical experience, and the number of therapists at work) were initially included, following which self-reported research achievements were supplemented as independent variables (the number of case studies, literature reviews, cross-sectional studies, and longitudinal studies). [Results] We analyzed data from 167 participants. In addition to sociodemographic variables, the research achievements that statistically increased F-values of the modeling were case study achievements in Dimensions 2-3, cross-sectional study achievements in Dimensions 2 and 4, and longitudinal study achievements in Dimension 5. [Conclusion] Case studies and cross-sectional studies could improve evidence-based practice implementation among rehabilitation professionals in Japan.

Taking/Compensations or Regulations? Balancing Landscape Conservation and the Development of Renewable Energy Facilities in Japan

The application of regulations for the development of renewable energy facilities is one of the key environmental conservation strategies being implemented in Japan. However, regulations are only applied if the degree of environmental degradation falls below the “reference point.” Thus, impacts of project development that are remarkably limited to scenic values of landscapes are largely overseen in Japan. On the other hand, establishing standards for the “reference point” is challenging, and existing scientific approaches and legal frameworks for conserving “daily landscapes” are largely absent. Therefore, it is necessary to establish a set of standards for “reference points” or indicators to classify landscape inventories, particularly those with scenic values. This study explored the potential of development-compensated implementation in Japan by scrutinizing relevant compensation measures in other countries. The results revealed that adding the aesthetic degradation of landscapes as an object in development compensation is challenging, as its value is difficult to monetize. Further, the evaluation of landscape degradation may be insufficient. Hence, there is a need for objective-driven indicators and methods that measure landscape degradation, particularly the effect of renewable energy facilities on the scenic values of “daily landscapes.”

Non-Invasive Prenatal Testing (NIPT) Implementation in Japan: A Comparison with the United Kingdom, Germany, Italy, Sweden, and Taiwan

The Non-Invasive Prenatal Testing (NIPT) guideline was issued and applied in 2013 by the Japanese Medical Association. Since being issued, the NIPT practice in Japan still has some problems related to indication, access, cost coverage and uniformity. Therefore, our study aimed to identify the Japanese challenges of adopting NIPT into prenatal diagnosis by comparing the system and process with other countries. The United Kingdom, Germany, Italy, Sweden, and Taiwan were purposefully selected for comparison. All the countries, including Japan, introduced NIPT. The literature and information searches were conducted using PubMed, SCOPUS, Google Scholar, CiNii and Google searching engine. The process of NIPT in Japan was very different from the other countries. Japan is the only country that indicated NIPT for only pregnant women over 35 years old in certificated facilities and did not have a policy regarding providing information on prenatal screening and NIPT to all women. Japan also did not have a policy regarding abortion due to fetal abnormalities. The practice of NIPT guidelines is different between non-certified and certified facilities. NIPT fee was the highest in Japan and was not covered by insurance. Pregnant women in Japan suffered from disparities in information access, economic burden, geographic location, and practice of NIPT guidelines between the certified and the non-certified facilities. Pregnant women-centered prenatal diagnosis policy, including NIPT, should be established in Japan by learning cases from other countries.

Evaluation of a Telehealth Parent-Training Program in Japan: Collaboration with Parents to Teach Novel Mand Skills to Children Diagnosed with Autism Spectrum Disorder.

This study developed a telehealth parent-training program to teach parents of children with autism spectrum disorder the process of mand-training implementation in Japan, and to further the international dissemination of evidence-based training strategies. Parent-training sessions were based on a behavioral skills training (BST) model, combined with weekly graphic and video feedback. The sessions were conducted by a board-certified behavior analyst-doctoral residing in Japan. Four parents with children with autism spectrum disorder participated in this study. The results preliminarily support the effectiveness and social validity of the program. This study extends previous parent-training research conducted in Japan by comprising all of the following features: (1) online program design; (2) mand training; (3) BST model; (4) session-by-session data on children’s behavioral changes and procedural integrity; (5) within-subject experimental design; and (6) social validity evaluation.

The Status of Newborn Hearing Screening in Japan: Past, Present, and the Future

This review article summarizes the chronological history of newborn hearing screening (NHS) implementation in Japan. Beginning with experimental pilot programs implemented in the early 2000s, efforts have been made to establish NHS throughout the country. The results of and responses to these pilot programs are introduced, analyzed, and discussed. Data reported annually, from 2014, by the Japanese Ministry of Health, Labour, and Welfare (MHLW), introduce the overall progress achieved in NHS throughout the country. The most recently published MHLW report, from 2019, cites a screening rate of 90.8%. Analysis of the data from these reports, however, suggests that while clear progress has been achieved, “known-screening” rates are lower than the “surveyed” rates cited. Published NHS program data from three pilot programs as well as publicly available data from one prefecture and unpublished data from an additional prefecture are analyzed and compared to the national figures. Hearing impairment occurrence frequency for newborns in Japan, calculated from two large data sets, reveals an average occurrence rate of 0.14% or one per every 1,400 births. Progress is observed in terms of an expanding coverage rate for NHS in Japan. Work remains, however, to achieve a screening rate of 95% or higher. Additionally, a protocol for ensuring quality standards for NHS is recommended. Data collected and analyzed for this review may inform planned efforts to introduce more efficient digitized NHS program management systems in Japan as well as in other countries where NHS program improvement efforts continue. Such systems may serve to enable effective monitoring of pre-determined screening program protocols and thus may make a shift from a 1-3-6 to 1-2-3 protocol more feasible.

Chronological improvement in precision oncology implementation in Japan.

In Japan, comprehensive genomic profiling (CGP) tests for refractory cancer patients have been approved since June 2019, under the requirement that all cases undergoing CGP tests are annotated by the molecular tumor board (MTB) at each government-designated hospital. To investigate improvement in precision oncology, we evaluated and compared the proportion of cases receiving matched treatments according to CGP results and those recommended to receive genetic counseling at all core hospitals between the first period (11 hospitals, June 2019 to January 2020) and second period (12 hospitals, February 2020 to January 2021). A total of 754 and 2294 cases underwent CGP tests at core hospitals in the first and second periods, respectively; 28 (3.7%) and 176 (7.7%) patients received matched treatments (p< 0.001). Additionally, 25 (3.3%) and 237 (10.3%) cases were recommended to receive genetic counseling in the first and second periods, respectively (p< 0.001). The proportion was associated with the type of CGP test: tumor-only (N= 2391) vs. tumor-normal paired (N= 657) analysis (10.0% vs. 3.5%). These results suggest that recommendations regarding available clinical trials in networked MTBs might contribute to increasing the numbers of matched treatments, and that tumor-normal paired rather than tumor-only tests can increase the efficiency of patient referrals for genetic counseling.

Assessment of reports on cadaver surgical training (CST) implementation in Japan: current status and challenges.

The contents and conflicts of interest of Cadaver Surgical Training (CST) programs in Japan were reported to the Japan Surgical Society CST Promotion Committee based on professional autonomy. After receiving the reports from participating universities, the committee evaluated the validity of these reports and provided advice on the proper implementation of CST. Over the past decade, 38 universities have been using cadavers for clinical education and research, such as CST. If inappropriate entries or unclear areas were identified, the universities could be asked to resubmit their report. This review clarifies the evaluation points of the CST reporting system, shows the status and problems of its reporting, and provides suggestions for the dissemination of CST in the future.

Facilitators and barriers in implementing the nurse practitioner role in Japan: A cross-sectional descriptive study.

To investigate the distribution of nurse practitioners (NPs) across Japan and their perceived facilitators and barriers to NP implementation in Japan. NP certification examinations have been conducted in Japan since 2011, and by 2020, there were 487 NPs in the country. The momentum of NP implementation is slower in Japan compared with other countries. A cross-sectional descriptive study, following the STROBE guidelines, was conducted. Web-based survey questionnaires, developed by the authors, were administered to 248 NPs whose email addresses were maintained by the certification management body. Valid responses were obtained from 101 NPs (response rate: 40.7%), of which 34% were male. The respondents had more than 12 years of registered nurse experience on an average before enrolling in the graduate NP program. 53% were employed as NPs from the beginning, while 25% were initially employed as registered nurses and later advanced to NPs, and 11% still worked as RNs. A majority worked in hospitals with beds. Many NPs perceived the lack of NP national licensure and reimbursement benefits as barriers to NP implementation, whereas recognition from superiors and organizations was considered facilitators. Despite their small numbers in Japan, NPs take on crucial tasks and contribute to the appropriate distribution of medical resources. The NP licensure system and recognition from superiors and organizations may be necessary to promote NP roles in Japan. Some certified NPs still work as registered nurses. Recognition from nursing and organization administrators is critical to implementing NPs. To this end, a reimbursement system benefiting the organizations and a legislation facilitating NP employment are required.

Multiple stakeholders' perspectives on patient and public involvement in community mental health services research: A qualitative analysis.

BackgroundPatient and public involvement (PPI) has become essential in health research. However, little is known about multiple stakeholders' perspectives on the implementation of PPI in community mental health research settings. The present study aimed to qualitatively analyse multiple stakeholders' views on PPI, including potential concerns, barriers and approaches.MethodsThis study involved conducting focus group interviews and collecting qualitative data from 37 participants in multiple stakeholder groups (patients = 6, caregivers = 5, service providers = 7, government staff = 5 and researchers = 14) in the community mental health field. The data were qualitatively analysed using a data‐driven approach that derived domains, themes and subthemes related to perspectives on PPI and to specific challenges and approaches for implementing PPI.ResultsThe qualitative analysis identified four domains. The ‘Positive views and expectations regarding PPI’ domain consisted of themes related to supportive views of PPI in a mental health service research setting and improvements in the quality of research and service. The ‘General concerns about PPI’ domain included themes concerning the need for non‐PPI research and tokenism, excessive expectations concerning social changes and use of evidence from PPI research, and heavy burdens resulting from PPI. The ‘Specific issues regarding the implementation of PPI’ domain consisted of four themes, including academic systems, selection methods (e.g., representativeness and conflict of interest issues), relationship building, and ambiguous PPI criteria. In particular, all stakeholder groups expressed concerns about relational equality during PPI implementation in Japan. The ‘Approaches to PPI implementation’ domain included themes such as facilitating mutual understanding, creating a tolerant atmosphere, establishing PPI support systems (e.g., training, ethics and human resource matching) and empowering patient organizations.ConclusionThe study replicated most of the barriers and approaches to PPI reported by qualitative research in Western counties. However, utilization of evidence produced by PPI research and partnership in the PPI process may be particularly serious issues in Japan. Future PPI studies should carefully address solutions that fit each culture.Patient or Public ContributionA patient‐researcher was involved in all stages of this project, from development of the research topic and the protocol to manuscript preparation.

Scenario assessment of implementing methanation considering economic feasibility and regional characteristics

Reducing CO2 emissions is essential for mitigating the effects of climate change. Carbon capture and utilization (CCU) has been considered as a potential strategy for mitigating CO2 emissions, and methanation is one of the most promising CCU technologies which should be investigated for implementation in Japan. In this study, the economic feasibility and CO2 reduction potential of the methanation process in Japan was comprehensively evaluated, considering the country’s regional energy characteristics. Herein, process simulation was employed to optimize a methanation process that can improve the energy efficiency of the entire process, contributing to total CO2 emission reduction. Moreover, to identify the most suitable conditions for the implementation of the methanation in Japan, energy carrier types, CO2 emission sources, plant scales and locations, and international trading partners were comprehensively evaluated. The results show that liquefied CO2 is more economically efficient than liquefied H2 as an energy carrier. Indonesia was identified as Japan’s optimal trading partner. When introducing methanation in Japan, CO2 capture should first be introduced at liquid natural gas (LNG)-fired power plants at a CO2 reduction cost of 474.6–479.8 USD·tCO2−1. In the medium–long term, coal fired power plants is predicted to be the most effective if H2 production cost decrease. A maximum CO2 reduction potential of 293.7 (Mt·y−1) occurs when conducting methanation by CO2 from coal-, BFG-, and LNG-fired power plants in Japan. However, as the domestic supply of renewable energy in Japan is limited, international cooperation is necessary to introduce methanation at a large scale.

The Latest Global Trends of Decentralized Clinical Trial and the Role of Academia for Domestic Implementation in Japan

The Latest Global Trends of Decentralized Clinical Trial and the Role of Academia for Domestic Implementation in Japan

Perceptions of Content and Language Integrated Learning (CLIL): Implementation in Japan

Perceptions of Content and Language Integrated Learning (CLIL): Implementation in Japan

Prisoners' rights implementation in Japan: breaking the shackles with suspects

AbstractSeveral decades have passed since the first call was made toward political scientists, among other social scientists, to devote attention to human rights and enrich, through empirical investigations, our understanding of how human rights implementation works. Today, the political science discipline is finally beginning to respond to this appeal, with an increasing number of scholars making it their goal to isolate variables that obstruct or facilitate human rights implementation. The current paper joins this burgeoning body of literature by offering a within-case analysis of Japanese prison policy-making. In particular, I compare the 2005 bill updating the Prison Law (Kangoku hō) that had been in force in Japan since the Meiji era with an earlier draft version of that bill which appeared in parliament on three occasions since the early 1980s. On the basis of the convergence of these bills in terms of seeking to align Japan with the evolved new global standards for convicted prisoners' treatment, I argue that a three-decade delay occurred in the implementation of prisoners' rights in Japan. To account then for this delay, I point to a provision pertaining to the criminal procedure (i.e., pre-conviction) which was incorporated in the law in question in 1908 merely for pragmatic reasons, and with regard to which the modern-time stakeholders of the bar and the police could not find agreement. Ultimately, the message that this case deals to the political science of human rights is that institutional–infrastructural factors, such as ties of legal nature, matter to human rights implementation.