Japanese Municipalities Research Articles

Effect of COVID-19 vaccination on the risk of developing post-COVID conditions: The VENUS study

IntroductionPost-COVID-19 conditions have emerged as a global health challenge. This study examined the long-term effects of COVID-19 vaccination on the incidence and risk of post-COVID-19 conditions in Japan. MethodsThis retrospective cohort study was conducted using a database comprising medical claims, COVID-19 case information, and vaccination records of persons residing in four Japanese municipalities. The cohort included COVID-19 cases diagnosed between August 2020 and December 2022. Participants were classified according to the duration between their most recent COVID-19 vaccination and COVID-19 occurrence (≥365 days, 150–364 days, and 14–149 days). The incidences of 36 post-COVID-19 conditions were monitored for 3, 5, and 8 months after infection. Cox proportional hazards models were used to calculate the risk of developing each post-COVID-19 condition within 8 months after infection according to vaccination status. ResultsFrom among 84,464 participants, 9642 (11.4 %) developed post-COVID-19 conditions over 8 months. The 8-month risks of developing 28 (including various respiratory conditions, cardiovascular conditions, inflammatory and immune diseases, physical conditions, psychiatric conditions, and endocrine disorders) of the 36 target conditions were significantly lower when individuals had been recently vaccinated (14–149 days) before infection. ConclusionsCOVID-19 vaccination can reduce the incidence and risk of post-COVID-19 conditions if administered within 5 months before infection. Despite having the highest mean age and prevalence of comorbidities, individuals who were most recently vaccinated had a lower risk of developing post-COVID-19 conditions. These results provide important evidence for future COVID-19 vaccination strategies.

Planning strategies and infrastructure development supporting physical activity: analyzing municipal compact city plans in Japan

AbstractAligned with global goals for healthy and sustainable cities, urban compactness significantly promotes residents’ transport-related physical activity and health. In Japan, amid demographic changes, municipalities have begun formulating Location Normalization Plans focused on making cities more compact. This study examines the associations between health and transport-related physical activity considerations in urban plans, including Location Normalization Plans, the demographic characteristics of municipalities, and the development of infrastructure that supports leisure-time physical activity. Analyzing responses from 725 of 1,374 Japanese municipalities, our research reveals that 38% of urban plans integrated health and physical activity in goals/visions, and 28% recognized these as challenges. The development of physical activity infrastructure such as sports facilities (48%), metropolitan parks (21%), and bicycle paths (14%) was more prevalent in larger municipalities. However, the incorporation of health and physical activity in planning goals/visions or challenges was not exclusive to larger municipalities; smaller ones also demonstrated this capability. Logistic regression analyses revealed that municipalities that included health considerations in their plans’ goals/visions and challenges were more likely to develop or renovate physical activity infrastructure. Prioritizing health and physical activity in planning has the potential to support leisure-time and transport-related physical activity, helping to create healthy and sustainable cities.

Housing Adaptations and Long-Term Care Facility Admissions among Older Adults with Care Needs in Japan

ObjectivesHousing adaptations may contribute to aging in place for older adults with care needs by reducing the risk of long-term care facility (LTCF) admissions, but this association remains unclear. We examined the association between housing adaptations and LTCF admissions among older adults with care needs. DesignRetrospective cohort study using data from a Japanese municipality. Setting/ParticipantsAdults aged ≥65 years who were newly certified with care needs under the public long-term care insurance system between April 2014 and March 2016. MethodsThe study exposure was the implementation of insurance-covered housing adaptations (maximum covered cost: ¥200,000) during the 2 years after certification. Based on this exposure, participants were assigned to a non-implementation group (no housing adaptations), sub-maximum cost group (housing adaptations below the maximum cost), or maximum cost group (housing adaptations at the maximum cost). A Fine-Gray subdistribution hazards model was used to analyze the associations between the exposure groups and new LTCF admissions after adjusting for various risk factors. Death was regarded as a competing risk, and participants were followed until March 2022. ResultsAmong 4610 participants, 1261 (27.3%) had implemented housing adaptations. Among these, 943 (74.8%) were in the sub-maximum cost group and 318 (25.2%) were in the maximum cost group. During the follow-up period (median: 51 months), the incidence of LTCF admission was 3.9/1000 person-months in the non-implementation group, 3.8/1000 person-months in the sub-maximum cost group, and 2.8/1000 person-months in the maximum cost group. The adjusted subdistribution hazard ratio of LTCF admission (reference: non-implementation) was 0.90 (95% CI: 0.75–1.08) for the sub-maximum cost group and 0.67 (0.49–0.93) for the maximum cost group. Conclusions and ImplicationsHousing adaptations can support aging in place for older adults with care needs. Health care professionals and policymakers should consider the suitability of housing environments to reduce the risk of institutionalization.

Current status and challenges in operating flood early warning systems at the local level in Japan

Flood early warning systems (FEWS) are crucial in reducing flood loss and damage, especially under increasing flood risks due to climate change. Currently, there is limited literature holistically investigating all components of FEWS, namely Risk knowledge, Monitoring and Forecasting, Warning Dissemination, and Preparedness and Response Capabilities. There is also a lack of in-depth understanding of FEWS operation at the local level where local governments play a crucial role. This study conducted a nation-wide survey targeting Japanese municipalities (n = 350) to investigate the current status and challenges of FEWS operations at the local level and the relationships between these elements. The results indicated that while progress in FEWS operation varies in municipalities, they are encountering different challenges in each element of the system. These include a lack of human resources and financial resources, difficulties in risk assessment and data acquisition, limitations of dissemination methods to reach vulnerable, and limited understanding of public perception. This study is the first to investigate all four key elements of FEWS at the local level and the relationships of its key factors, providing useful implications for policy directions to enhance FEWS implementation. All key elements of FEWS positively correlate, suggesting that improving one component can improve the whole system. Government should also strengthen progress in vulnerability assessment, particularly incorporating socio-economic changes as these have the strongest influence on preparedness and response capability of the local areas.

Continuous Support from the Same Public Health Nurse and Parental Perception and Use of Health Care Services: A Retrospective Observational Study.

Continuity is considered essential for high-quality maternal and child health care services, but studies to show this effect on parental well-being are still rare. We studied whether receiving support from the same public health nurse has a beneficial effect on parental perceptions of health care professionals and the use of childcare support services. Maternal and child health care services were provided by different nurses in a Japanese municipality until March 2019. From April 2019, all families with infants received continuous support from the same assigned nurse. A questionnaire covering parental perception and the use of services was sent by postal mail to 1,341 families with infants. The data were analyzed using χ2-test, t-test and logistic regression producing odds ratios (OR) with 95% confidence intervals (CI). Parental perceptions of the availability of professionals to discuss children's issues, the degree of understanding about available other childcare support services, the degree of utilizing other services, and satisfaction with health care services were higher in parents who received continuous support from the same assigned nurse compared to those who did not receive continuous support. Continuous support was associated with parental perceptions of the availability of professionals to discuss children's issues (OR = 1.97, 95% CI 1.34-2.91) and the degree of understanding about available other child-care support services (OR = 1.65, 95% CI 1.11-2.44) after adjusting the results for socioeconomic factors. Continuous support from the same assigned nurse has benefits for parents. This offers a cost-effective way to improve parental well-being.

Measures and factors for regularly and effectively holding case conferences to improve quality of care provided by public health nurses for individuals and families: A qualitative descriptive study.

This study clarified the measures and necessary factors for regularly and effectively conducting case conferences to improve the quality of public health nurses' care for individuals and families. We employed a qualitative descriptive design. The study fields were three Japanese municipalities that regularly held case conferences for at least a year to improve the quality of public health nurses' care for individuals and families. The first author conducted semi-structured interviews with three lead public health nurses and two nurses responsible for case conference projects. The audio recordings of the interviews were transcribed verbatim and categorized. Interviews were conducted between December 2021 and May 2022. Measures to regularly and effectively conduct case conferences included "creating a system to promote case conferences," "preparations to achieve case conference objectives," and "case conference progress management." Factors included "resources for promoting case conferences in the organization," "public health nurses' attitudes toward care," and "an environment that allows discussions about care." Lead public health nurses can use the results as a reference to implement the identified measures in their organizations. The factors can enable lead public health nurses to evaluate the status of their organization regarding conducting case conferences.

Evaluation of a program designed to prevent diabetic nephropathy aggravation: A retrospective cohort study using health checkups and claims data in Japanese municipalities

AimsJapan started the Diabetic Nephropathy Aggravation Prevention Program. Its early impact was assessed in this study. MethodsThis study used the Kokuho Database of patients with type 2 diabetes from program-implementing and non-implementing municipalities (fiscal years [FYs] 2015–2021). Implementing municipalities facilitated clinic visits and provided education to eligible patients. Average treatment effects on the treated in FYs 2016 and 2018 were evaluated using the inverse probability of treatment weighting. Comparison included intervened vs. non-intervened patients in program-implementing municipalities (Comparison A), intervened patients in program-implementing vs. eligible patients in non-implementing municipalities (Comparison B), and eligible patients in implementing and non-implementing municipalities (Comparison C). ResultsOverall, 89,611/89,685 patients from FY 2016/2018 were eligible. Among 68,125/68,170 patients in program-implementing municipalities, 1,470/1,819 were intervened. In Comparison A, the estimated effect of the program on ΔeGFR at 3 years were −0.4 (95 % confidence interval; −1.0, 0.2)/−0.4 (−0.9, 0.1) mL/min/1.73 m2 in FY 2016/2018. Comparisons B and C demonstrated similar tendency; distribution of %change in eGFR varied between municipalities. ConclusionsEarly in the program, renal function did not improve in the intervened patients or program-implementing municipalities. Diverse eGFR changes across municipalities highlighted diverse intervention outcomes, emphasizing the need of program refinement.

Subsidy Programs for Seasonal Influenza Vaccination of Children and Pregnant Women in Japanese Municipalities

Subsidy Programs for Seasonal Influenza Vaccination of Children and Pregnant Women in Japanese Municipalities

Risk of pneumonia-related hospitalization after initiating angiotensin-converting enzyme inhibitors compared with angiotensin II receptor blockers: a retrospective cohort study using LIFE Study data.

There is insufficient evidence that angiotensin-converting enzyme inhibitors (ACEIs) can reduce pneumonia by inducing a dry cough that confers a protective effect on the airway. To increase the evidence base on the clinical use of ACEIs for pneumonia prevention, this retrospective cohort study aimed to comparatively examine the risk of pneumonia-related hospitalization between ACEI initiators and angiotensin II receptor blocker (ARB) initiators using claims data from two Japanese municipalities. We identified persons who were newly prescribed any ACEI or ARB as their first antihypertensive agent between April 2016 and March 2020. The Fine-Gray method was applied to a Cox proportional hazards model to estimate the subdistribution hazard ratio (HR) of ACEI use (reference: ARB use) for pneumonia-related hospitalization, with death treated as a competing risk. Sex, age, comorbidities, medications, and pneumococcal immunization were included as covariates. The analysis was conducted on 1421 ACEI initiators and 9040 ARB initiators, and the adjusted subdistribution HR of ACEI use was estimated to be 1.21 (95% confidence interval: 0.89-1.65; P = 0.22). ACEI initiation did not demonstrate any significant preventive effect against pneumonia-related hospitalization relative to ARB initiation. There remains a lack of strong evidence on the protective effects of ACEIs, and further research is needed to ascertain the benefits of their use in preventing pneumonia. We conducted a large-scale retrospective cohort study using real-world healthcare data from a Japanese population. In this study, ACEI initiation did not indicate a significant preventive effect against pneumonia-related hospitalization.

Innovativeness of Japanese forest owners and municipalities regarding the valorization of forest ecosystem services: Quantitative evaluation of mutual influences

The valorization of forest ecosystem services requires actors to innovate and tackle difficulties in realization. We conducted two questionnaire survey series in Japan with forest owners and municipalities—important actors in implementing valorization—to investigate their innovativeness. We measured owners' innovativeness regarding valorization by asking whether they were interested in, planning for, or had implemented four types of valorization: (1) multifunctional payments, (2) habitat payments, (3) non-wood forest products (NWFP) marketing, and (4) forest service industries. Based on spatial autoregressive regression (SAR) analyses of 312 responses, we found that ownership type, age, holding size, and purpose of forest ownership were associated with owners' innovativeness indices. For example, younger owners and the ones with NWFP ownership purpose are more innovative in one or several types of valorization. We also asked municipalities how innovative they were toward using forest environmental transfer tax, a national funding scheme, for implementing or assisting the valorization methods mentioned above. Based on the SAR analyses of 664–670 responses, we identified correlations between innovativeness and several municipal factors such as population size, population changes, areas of private plantation forest ownership, forest ratios, and the importance of agriculture and forestry. Specifically, the coefficients for forest ratio and agriculture/forestry/fishery added value variables were positive in the NWFP model. Relying on the results of the SAR analyses, we evaluated the influences of regional systems of innovation on respondents' innovativeness and found that the influences are statistically and substantially significant.

Compact City and Mayoral Entrepreneurship: A Study of Success and Setbacks in Two Japanese Cities

Controlling urban sprawl are the overarching challenges facing cities worldwide. This article delves into the pivotal role of policy entrepreneurship throughout the planning and implementation phases of compact city initiatives. Drawing insights from the experiences of Aomori City and Toyama City in Japan, this study scrutinizes the drivers behind the shift toward urban compactness and its consequent outcomes. The incorporation of policy studies theories into the realm of compact city development has been scant. To bridge this gap, the research leverages process-oriented theories from policy studies to dissect the decision-making processes guiding compact city development in these two pivotal municipalities. Through this investigation, it is revealed that the effective transition to compact urbanization in Japanese municipalities predominantly stems from policy entrepreneurship. The author posits that this achievement is primarily attributed to adept local mayors who possess the acumen to cater to specific local needs.

Sociodemographic Heterogeneity in the Associations of Social Isolation With Mortality

There are limited data on whether the vulnerabilities and impacts of social isolation vary across populations. To explore the association between social isolation and mortality due to all causes, cardiovascular diseases (CVD), and malignant neoplasms focusing on heterogeneity by sociodemographic factors. This cohort study used a moderator-wide approach to examine the heterogeneity in the association of social isolation with all-cause, CVD, and malignant neoplasm mortality using baseline data from the Japan Gerontological Evaluation Study in 2010 and 2011. Eligible participants were adults aged 65 years or older without heart disease, stroke, cancer, or impaired activity of daily living across 12 Japanese municipalities. Follow-up continued until December 31, 2017, identifying 6-year all-cause, cardiovascular disease (CVD), and malignant neoplasm mortality. Logistic regression assessed effect modification by age, gender, education, income, population density, marital status, and employment on mortality associations. Data analysis was performed from September 13, 2023, to March 17, 2024. Social isolation, determined by a 3-item scale (scores of 2 or 3 indicating isolation) was the primary exposure variable. Six-year all-cause, CVD, and malignant neoplasms mortality. This study included 37 604 older adults, with a mean (SD) age of 73.5 (5.9) years (21 073 women [56.0%]). A total of 10 094 participants (26.8%) were classified as experiencing social isolation. Social isolation was associated with increased all-cause (odds ratio [OR], 1.20 [95% CI, 1.09-1.32]), CVD (OR, 1.22 [95% CI, 0.98-1.52]), and malignant neoplasm mortality (OR, 1.14 [95% CI, 1.01-1.28]). Stratified analysis showed associations of social isolation with all-cause and malignant neoplasm mortality among people with high income (highest tertile all cause: OR, 1.27 [95% CI, 1.06-1.53]; malignant neoplasm: OR, 1.27 [95% CI, 1.02-1.60]), living in areas with high population density (highest tertile all cause: OR, 1.47 [95% CI, 1.26-1.72]; malignant neoplasm: OR, 1.38 [95% CI, 1.11-1.70]), not married (all cause: OR, 1.33 [95% CI, 1.15-1.53]; malignant neoplasm: OR, 1.25 [95% CI, 1.02-1.52]), and retirees (all cause: OR, 1.27 [95% CI, 1.14-1.43]; malignant neoplasm: OR, 1.27 [95% CI, 1.10-1.48]). Formal testing for effect modification indicated modification by population density and employment for all-cause mortality and by household income and employment for neoplasm mortality. Social isolation was associated with increased risks of all-cause, CVD, and malignant neoplasm mortality, with associations varying across populations. This study fills an important gap in research on social isolation, emphasizing its varied associations across demographic and socioeconomic groups.

Mite allergen levels and fungal counts in children's bedding in four widely separated towns in Japan

We evaluated the relationships between children's housing, earthquake or tsunami damage affecting children, prevalence of allergic diseases, and levels of mite allergens and fungi on children's bedding after the Great East Japan Earthquake in four municipalities in Japan. We surveyed 464 children in Ishinomaki, 254 in Kami, 614 in Iwanuma, and 300 in Oiso whose parents or guardians had completed the International Study of Asthma and Allergies in Childhood questionnaire. We measured the levels of Dermatophagoides 1 allergens (Der 1) (Dermatophagoidespteronyssinus and Dermatophagoides farinae) on children's mattresses or futons and fungal counts (Aspergillus and yeast) between 2016 and 2018. Earthquake damage was significantly greater in Ishinomaki than in the other three municipalities. There were no differences in the prevalence of allergic disease among the four municipalities. Der 1 levels were significantly higher in Ishinomaki than in Iwanuma, but there were no differences among Oiso, Iwanuma, and Kami. Der 1 levels in children with asthma in Iwanuma and with allergic rhinitis in Kami were significantly higher than in those without these conditions. Total fungal counts and Aspergillus counts were highest in Kami and lowest in Oiso. Der 1 levels were significantly correlated with fungal counts in Kami and Iwanuma, but not in Ishinomaki or Oiso. Both Der 1 levels and total fungal counts in Ishinomaki were greater than those in other three municipalities. Housing and allergen-avoidance strategies varied among the four municipalities. Mite allergen and fungal levels in these Japanese municipalities might have been affected by the earthquake and tsunami, and these changes might have affected the prevalence of allergic diseases in children.

Incidence of post-COVID psychiatric disorders according to the periods of SARS-CoV-2 variant dominance: The LIFE study

This retrospective cohort study examined the incidence of post-COVID psychiatric disorders in older adults according to hospitalization status and SARS-CoV-2 variant period in Japan. Claims data, COVID-19 case-related information, and vaccination records were obtained from three Japanese municipalities. We identified individuals aged ≥65 years who had COVID-19 or other respiratory tract infection (RTI) between March 2021 and December 2022. Participants were categorized into non-hospitalized and hospitalized patients, and the study period was divided into the Alpha (March to May 2021), Delta (June to December 2021), Omicron BA.1/BA.2 (January to June 2022), and Omicron BA.5 (July to December 2022) periods. Modified Poisson regression analyses were performed to estimate the incidence rate ratios (IRRs) for the occurrence of psychiatric disorders (organic mental disorders, psychotic disorders, mood disorders, anxiety disorders, and insomnia) three months after COVID-19 (reference: other RTI). For overall psychiatric disorders, we analyzed 19,489 non-hospitalized patients (COVID-19: 6,728, Other RTI: 12,761) and 2925 hospitalized patients (COVID-19: 1,036, Other RTI: 1889). When compared with other RTI cases, COVID-19 cases had significantly lower IRRs for overall psychiatric disorders in both non-hospitalized (IRR: 0.59, P < 0.001) and hospitalized cases (IRR: 0. 83, P = 0.045) during the Omicron BA.1/BA.2 period, but only in non-hospitalized cases (IRR: 0.45, P < 0.001) during the Omicron BA.5 period. The incidences of the individual post-COVID psychiatric disorders varied according to disorder type, hospitalization status, and SARS-CoV-2 variant period. These findings provide a foundation for further research to explore these variations and improve the provision of psychiatric care in future epidemics.

The role of regional renewable energy integration in electricity decarbonization—A case study of Japan

Decarbonization strategies depend critically on the integration of region-specific renewable energy and social acceptance, yet their roles still need to be clarified. This study designs a regional-integrated electricity system and assesses the impact of regional decisions associated with renewable energy on cost-effective national decarbonization, using Japan as a case study owing to its active engagement in regional decarbonization. A high spatial resolution renewable electricity system model that explicitly considers all 1741 Japanese municipalities and employs a hierarchical optimization approach is developed. Based on the model, the opportunity cost of limiting renewable energy development is quantified for 30 representative municipalities. The results highlight that restrictions on municipal renewable energy can increase annual system costs by hundreds of millions of euros and national electricity costs by up to 0.4%, although it varies by region and energy source. This suggests that widespread opposition to renewables could be a significant barrier to cost-effective decarbonization. However, the impact of solar photovoltaic (PV) tends to be slight. In conclusion, investments in social acceptance of region-specific renewables can minimize opportunity losses and reduce system costs. Nonetheless, relocating the project to another region is possibly more cost-effective for solar PV.

Does the neighborhood built and social environment reduce long-term care costs for Japanese older people? The JAGES2010-2019 cohort study

Japan's population has been aging steadily, evidenced by it spending JPY 11 trillion (USD 110 billion) on annual long-term care (LTC) costs in 2021. In this context, understanding the factors influencing LTC costs has become increasingly vital. Although studies have reported positive relationships between neighborhood environment and health outcomes, the connection between LTC costs and neighborhood environment remains unclear. To address this gap in the literature, this cohort study, conducted from 2010 to 2019 across seven Japanese municipalities and involving 34,982 older people, examined the relationship between eight neighborhood environment elements and the mean monthly cumulate costs (MMCC) of LTC. The results showed that older people who reported the presence of fresh food stores nearby and dangerous places for walking alone at night in the neighborhood had lower MMCC, by JPY 1,367.6 and 1,383.3 per month, respectively, than respondents who did not report the presence of these neighborhood elements. Meanwhile, older people whose neighborhoods had easily accessible facilities had higher MMCC of JPY 739.4. This study's key findings reveal significant relationships between neighborhood environment elements and LTC costs and can be used to support developments in urban design to support healthy aging and reduced LTC costs.

Associations between COVID-19 vaccination and incident psychiatric disorders after breakthrough SARS-CoV-2 infection: The VENUS Study

BackgroundThe associations between COVID-19 vaccination and post-COVID psychiatric disorders are unclear. Furthermore, it is uncertain if these associations differ depending on the dominant SARS-CoV-2 variant at the time of infection. This retrospective cohort study aimed to clarify the associations between COVID-19 vaccination and incident psychiatric disorders after breakthrough infection according to the different variant periods in Japan. MethodsMedical claims data, COVID-19 case-related information, and vaccination records were collected from three Japanese municipalities. The study population comprised public insurance enrollees aged ≥65 years who developed COVID-19 between June 2021 and December 2022. The study exposure was each participant’s vaccination status 14 days before infection, and the outcomes were the occurrence of psychiatric disorders within three months of infection. Multivariable logistic regression analyses were performed to calculate the odds ratios (ORs) and 95 % confidence intervals (CIs) of vaccination for the occurrence of psychiatric disorders. Analyses were conducted for the Delta period (June to December 2021), Omicron BA.1/BA.2 period (January to June 2022), and Omicron BA.5 period (July to December 2022). ResultsWe analyzed 270 participants (vaccinated: 149) in the Delta period, 2,963 participants (vaccinated: 2,699) in the Omicron BA.1/BA.2 period, and 7,723 participants (vaccinated: 7,159) in the Omicron BA.5 period. During the Delta period, vaccinated participants had significantly lower odds for psychotic disorders (OR: 0.23, 95 % CI: 0.06–0.88, P = 0.032) than unvaccinated participants. During the Omicron BA.5 period, vaccinated participants had significantly lower odds for organic mental disorders (OR: 0.54, 95 % CI: 0.30–0.95, P = 0.033), psychotic disorders (OR: 0.31, 95 % CI: 0.19–0.53, P < 0.001), mood disorders (OR: 0.53, 95 % CI: 0.29–0.99, P = 0.046), and insomnia (OR: 0.48, 95 % CI: 0.32–0.72, P < 0.001) than unvaccinated participants. There were no significant differences in psychiatric disorders between the vaccinated and unvaccinated groups during the Omicron BA.1/BA.2 period. ConclusionsThis is the first study to demonstrate that the associations between COVID-19 vaccination and post-COVID psychiatric disorders vary among the different variant periods. Future studies on these associations should be conducted with consideration to the prevalent circulating variants.

Toward a responsible exit from the research field: lessons from transdisciplinary regional envisioning in a Japanese municipality

Abstract In transdisciplinary sustainability, scientists take responsibility for the long-term impact they have on practitioners in the research field and beyond. However, the duration of a career and amounts of funding are finite. One way out is to perform a responsible exit from the field. This study extracts lessons to realizing researchers’ responsible exit from their field through detailed description of the experiences of two researchers and a practitioner in collaboration in transdisciplinary research, weaving together the perspectives of all parties. The following lessons were extracted: (1) Imagining the extent of mutual understanding, (2) Production of knowledge entrusted to practitioners, and (3) Researchers’ acceptance of being unneeded. This study does not claim that these approaches are universally effective. We suggest that the reader transfer this case study and its approaches to his or her own case to seek better relationships. The validity of this qualitative study's suggestions should be tested by readers. Non-Technical Summary In the discipline of transdisciplinary sustainability, researchers must responsibly manage their impact on their partner practitioners. Balancing this with limited career durations and limited research funds is challenging. One potential solution involves responsibly exiting from the research field. This study investigates the experience of two researchers and a practitioner in collaborative transdisciplinary research. The lessons include acknowledging researchers’ amateurism, anticipating the challenges in achieving mutual understanding, and embracing researchers’ acceptance of feeling unneeded. The universality of these principles should be investigated in the future research. This research encourages readers to apply these principles to their own cases to develop better relationship between researchers and practitioners that leave no seeds of misfortune. Technical Summary In transdisciplinary sustainability, scientists take responsibility for the long-term impact they have on practitioners in the research field and broader communities. However, the duration of a career as a scientist and amounts of funding are finite. One way out is to responsibly exit from the field. This study extracts lessons to realizing researchers’ responsible exit from their field by providing a detailed account of the collaborative experiences of two researchers and a practitioner engaged in transdisciplinary research, weaving together the perspectives of all parties. The following lessons were extracted: acknowledging researchers’ amateurism, anticipating the challenges in achieving mutual understanding, and embracing researchers’ acceptance of feeling unneeded. This study does not claim that these principles are universally effective. We suggest that the reader transfer this case study and its approaches to his or her own case to seek better relationships. Social Media Summary In transdisciplinary sustainability, researchers must responsibly manage their impact on their research partner practitioners. Balancing this with limited career durations and funds is challenging. Researchers’ responsible exit from the research field is a possible solution. This research derives insight from researchers’ and a practitioner's experiences in collaborative transdisciplinary research. Lessons include acknowledging researchers’ amateurism, anticipating the challenges in achieving mutual understanding, and embracing researchers’ acceptance of feeling unneeded. However, these approaches might not be universal. Readers are encouraged to apply these lessons to their own case for better relationship building.

Ethics Review Committees of Public Health Institutes in Japan

Recent legislative changes in the wake of the novel coronavirus pandemic have placed an increased emphasis on the research activities of Local Public Health Institutes (PHIs) in Japanese municipalities. However, few studies have examined the ethical review processes of these institutes. We analyzed information on (a) the status and year of establishment of "Ethics Review Committees" (and equivalent committees), (b) the number of review cases for each year, (c) the status of public disclosure of committee activities, and (d) the composition of committee members for 85 PHIs across Japan. Publicly available information from each PHI and the Ministry of Health, Labour and Welfare was used for the analysis. Out of 85 PHIs nationwide, about half of them publicly disclosed the establishment of their committees (41 committees, 48.2%). The number of review cases handled by the committees varied, with some committees having no cases or only one case. Among the committees, approximately 20% still maintained adherence to outdated national research ethics guidelines, and approximately 15% did not specify any guidelines they followed. Furthermore, we identified committees without external members (at least two committees) and those lacking public representation (four committees). There are differences in the operational performance of ethics review committees at PHIs, possibly owing to varying levels of understanding of the guidelines, the degree of proactive engagement in academic research, and the emphasis on human subject research. There is a crucial need to accumulate and share experiences that support the review functions of the committees.

Service provision conditions for foreign residents in municipalities in Japan.

Objectives: This study examined the actual conditions of service provision to foreign residents (FRs) addressing prevention of lifestyle-related diseases (LRDs) and disaster preparedness/disaster responses (DPRs) in Japanese municipalities. Materials and Methods: A cross-sectional study was performed using a self-administered questionnaire with representatives of public health nurses in each municipality in Japan from December 2021 to January 2022. Results: Services considering FRs are more likely to be implemented in cities than in towns, and in municipalities where FRs account for ≥2.2% of the population (proportion of FRs in the Japanese population at the time of the study) than in those with fewer FRs. Cities have larger populations and greater financial resources than towns. Factors associated with the implementation of services and measures necessary for providing services to FRs were the classification of the municipality as a city, a high percentage of FRs, and large variation in corresponding nationalities/countries of origin. Conclusions: Cross-disciplinary efforts and collaborations need to be strengthened to share available resources within local governments and experiences in providing services for FRs in other divisions/sections, rather than considering only how to provide services for FRs in the public health division/section.