Association between willingness to receive the COVID-19 vaccine and sources of health information among Japanese workers: a cohort study

BACKGROUND@#It is important to achieve herd immunity by vaccinating as many people as possible to end the COVID-19 pandemic. We investigated the relationship between willingness to receive vaccination and sources of health information among those who did not want to be vaccinated against COVID-19.@*METHODS@#This prospective cohort study collected data using a self-administered questionnaire survey. The baseline survey was conducted during December 22-25, 2020, and the follow-up survey during February 18-19, 2021. Participants were aged 20-65 years and worked at the time of the baseline survey (N = 33,087). After excluding 6,051 invalid responses, we included responses from 27,036 participants at baseline. In total, 19,941 people responded to the follow-up survey (74% follow-up rate). We excluded 7,415 participants who answered "yes" to the question "If a COVID-19 vaccine becomes available, would you like to get it?" in the baseline survey. We finally analyzed 12,526 participants.@*RESULTS@#The odds ratio for change in willingness to be vaccinated from "no" to "yes" differed by source of health information. Compared with workers that used TV as a source of information, significantly fewer people who reported getting information from the Internet and friends/colleagues were willing to get the vaccine.@*CONCLUSIONS@#It is important to approach workers who do not watch TV when implementing workplace vaccination programs. It is likely that willingness to be vaccinated can be increased through an active company policy whereby the top management recommend vaccination, coupled with an individual approach by occupational health professionals.@*TRIAL REGISTRATION@#Not applicable.

Industry and workplace characteristics associated with the downloading of a COVID-19 contact tracing app in Japan: a nation-wide cross-sectional study

BACKGROUND@#To combat coronavirus disease 2019 (COVID-19), many countries have used contact tracing apps, including Japan's voluntary-use contact-confirming application (COCOA). The current study aimed to identify industry and workplace characteristics associated with the downloading of this COVID-19 contact tracing app.@*METHODS@#This cross-sectional study of full-time workers used an online survey. Multiple logistic regression analysis was used to evaluate the associations of industry and workplace characteristics with contact tracing app use.@*RESULTS@#Of the 27,036 participants, 25.1% had downloaded the COCOA. Workers in the public service (adjusted odds ratio [aOR] = 1.29, 95% confidence interval [CI] 1.14-1.45) and information technology (aOR = 1.38, 95% CI 1.20-1.58) industries were more likely to use the app than were those in the manufacturing industry. In contrast, app usage was less common among workers in the retail and wholesale (aOR = 0.87, 95% CI 0.76-0.99) and food/beverage (aOR = 0.81, 95% CI 0.70-0.94) industries, but further adjustment for company size attenuated these associations. Workers at larger companies were more likely to use the app. Compared with permanent employees, the odds of using the app were higher for managers and civil servants but lower for those who were self-employed.@*CONCLUSIONS@#Downloading of COCOA among Japanese workers was insufficient; thus, the mitigating effect of COCOA on the COVID-19 pandemic is considered to be limited. One possible reason for the under-implementation of the contact tracing app in the retail and wholesale and food/beverage industries is small company size, as suggested by the fully adjusted model results. An awareness campaign should be conducted to promote the widespread use of the contact tracing app in these industries.

Severe Bleeding and Perforation Are Rare Complications of Endoscopic Ultrasound-Guided Fine Needle Aspiration for Pancreatic Masses: An Analysis of 3,090 Patients from 212 Hospitals

BACKGROUND/AIMS: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is useful for the pathological diagnosis of pancreatic masses, but patients are susceptible to severe bleeding and perforation. Because the incidence and severity of these complications have not been fully evaluated. METHODS: We aimed to evaluate severe bleeding and perforation after EUS-FNA for pancreatic masses using large-scale data derived from a Japanese nationwide administrative database. RESULTS: In total, 3,090 consecutive patients from 212 low- to high-volume hospitals were analyzed. Severe bleeding requiring transfusion or endoscopic treatment occurred in seven patients (0.23%), and no perforation was observed. No patient mortality was recorded within 30 days of EUS-FNA. The rate of severe bleeding in low-volume hospitals was significantly higher than that in medium- and high-volume hospitals (0.48% vs 0.10%, p=0.045). CONCLUSIONS: Severe bleeding and perforation following EUS-FNA for pancreatic masses are rare, and the procedure is safe.

The Influence of Diabetes Mellitus on Short-Term Outcomes of Patients with Bleeding Peptic Ulcers

PURPOSE: Little information is available on the influence of diabetes mellitus on the short-term clinical outcomes of patients with bleeding peptic ulcers. The aim of this study is to investigate whether diabetes mellitus influences the short-term clinical outcomes of patients with bleeding peptic ulcers using a Japanese national administrative database. MATERIALS AND METHODS: A total of 4863 patients treated by endoscopic hemostasis on admission for bleeding peptic ulcers were referred to 586 participating hospitals in Japan. We collected their data to compare the risk-adjusted length of stay (LOS) and in-hospital mortality of patients with and without diabetes mellitus within 30 days. Patients were divided into two groups: patients with diabetes mellitus (n=434) and patients without diabetes mellitus (n=4429). RESULTS: Mean LOS in patients with diabetes mellitus was significantly longer than those without diabetes mellitus (15.8 days vs. 12.5 days, p<0.001). Also, higher in-hospital mortality within 30 days was observed in patients with diabetes mellitus compared with those without diabetes mellitus (2.7% vs. 1.1%, p=0.004). Multiple linear regression analysis revealed that diabetes mellitus was significantly associated with an increase in risk-adjusted LOS. The standardized coefficient was 0.036 days (p=0.01). Furthermore, the analysis revealed that diabetes mellitus significantly increased the risk of in-hospital mortality within 30 days (odds ratio=2.285, 95% CI=1.161-4.497, p=0.017). CONCLUSION: This study demonstrated that presence of diabetes mellitus significantly influences the short-term clinical outcomes of patients with bleeding peptic ulcers.

The association of the number of comorbidities and complications with length of stay, hospital mortality and LOS high outlier, based on administrative data

<p><b>OBJECTIVES</b>With greater concern for efficient resource allocation and profiling of medical care, a case-mix classification was applied for the per-diem payment system in Japan. Many questions remain, one of which is the role of comorbidity and complication (CC) in grouping logic. We examined the association of the number of CC with the length of hospital stay (LOS) and hospital mortality as well as the proportion of LOS high outliers in 19 major diagnostic categories (MDCs).</p><p><b>METHODS</b>This study was a secondary data analysis embedded in a government research project, including anonymous claims and clinical data during a 4-month period from July 2002. Every 19 MDC, LOS, hospital mortality or proportion of LOS high outliers was compared by the number of CC and presence of any procedures.</p><p><b>RESULTS</b>From 82 special function hospitals, 241,268 patients were enrolled in this study. Among all patients, 50.5% were identified without any CCs, 32.4% with one or two, 13.4% with three or four, and 3.7% with over five CCs. The overall mean LOS was 22.15 days and hospital mortality 26.05 cases per 1,000 admissions. In any MDC, LOS and the proportion of outliers increased as the number of CC rose. The mortality rate increased prominently in the respiratory system and the hematology system.</p><p><b>CONCLUSIONS</b>This study demonstrated that the occurrence of more CC caused longer LOS and higher mortality in some major disease categories. Further study will clarify the association of the weighted CC with resource use through controlling procedures specific for MDC.</p>

Student Behavior and Performance During Field Work Sessions for a Public Health Course. A Survey of On Site Collaborators, 1990-92 / 医学教育

We conducted an opinion survey of on-site collaborators after three field work sessions during the period from 1990 to 1992. As part of our public health course, these field work sessions were implemented on a small-group basis in various settings, such as schools and local public health centers. Selfadministered questionnaires on student behavior and performance were distributed to the collaborators on the days of the student visits. Completed questionnaires were then collected by mail within a couple of weeks. The total number of respondents for the three years surveyed was 205, reflecting a response rate of 100 percent.<BR>The following results were obtained; 1. Many collaborators admired the good behavior of the students, 2. Several respondents considered student knowledge of public health issues less adequate than they had expected, and 3. Some respondents commented on the passiveness of student involvement in their work.<BR>These survey results provided the faculty with valuable insights on the implementation of the field work sessions.

A Further Five Years' Experience in Evaluating Learning by Two Dimensional Criteria (1989-94) / 医学教育

A new method of evaluating learning, combining the 2 categories of knowledge/skills and attitude, has been introduced into the course on preventive medicine and community health. The goal was to improve student attitudes towards learning. In this article, our five years' experience from 1989 to 1993 is reported and follows a previous similar study from 1986 to 1988. This time, the records of 3 of 490 students were judged to be inadequate for promotion to the next grade. Although one-half of the students agreed with this method of evaluation, 15 % disagreed. The usefulness ofthis new method is discussed, based on our results.

Three years' experience in learning evaluation by means of two-dimensional criteria (1986-1988) / 医学教育

In addition to the conventional Knowledge Skill Scale (K. S scale) evaluated by examinations and reports, the Attitude Scale (AT scale) has been introduced for the final summative eavaluation in the public health course, in order to make medical students learn the importance of social manners as doctors; for example, punctuality in completing the report assignment and participation in obligatory seminars.<BR>The authors observed that after introduction of the AT scale, the students' AT scales improved during the next three years. The proper role of the introduction of the two -dimensional criteria (K. S scale and AT scale) in the public health course is discussed.

Evaluation of the MCQ type examination by the percentage of correct answers and the discriminating index of phi coefficient / 医学教育

In our university, the 5 th and 6 th years medical students receive the MCQ type examination twice a year, in Internal Medicine, Surgery, Pediatrics, Obstetrics and Gynecology and Public Health.<BR>The authors determined the validity of each question about public health (total 130 questions, 1984-1988) according to the percentage of correct answers and the phi coefficient. The results were as follows: 1) With most of the questions, the 6 th year students showed a higher percentage of correct answers and phi coefficient, than the 5 th year students. 2) Most of the questions with a low percentage of correct answers showed a low phi coefficient. 3) The authors analyzed the content and answer pattern of questions with both a low percentage of correct answers and a low phi coefficient, and found to typical reasons for these results, that is, students' lack of knowledge and an inappropriate question. Generally speaking, a question with both a low percentage of correct answers and a low phi coefficient is considered an inappropriate question. Our results showed that in some cases the students' lack of knowlege was responsible for both low figures. It is essential for the teaching staff to determine the validity of the MCQ type examination that they make by means of this kind of analysis.