Who Is Responsible for Causing and Solving the Problem? Responsibility Attribution of Medical Disputes in Chinese Print Media.

This study provides an insight into medical journalism practice by examining how news media have framed who is responsible for causing and solving the growing problem of medical disputes in Mainland China. We identified responsibility-attribution information presented in 490 news articles about medical disputes published in the People's Daily, Health News, and Southern Metropolis Daily between 2012 and 2017. Our data reveal that, mentions of personal causes have significantly outnumbered those of societal causes. Specifically, health workers were discussed most often as being responsible for the occurrence of medical disputes. In terms of how to solve the problem, the media were focusing heavily on societal-level efforts, while post-event solutions were addressed more frequently than preventative actions. City press was less likely to discuss societal causes and solution suggestions compared with party press and professional newspapers. In the conclusion, we discussed the potential consequences of such framing patterns, and how media professionals can be meaningfully engaged in the future reporting on public health problems.

Nationwide survey of 780 Japanese patients with amyotrophic lateral sclerosis: their status and expectations from brain-machine interfaces.

BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that causes eventual death through respiratory failure unless mechanical ventilation is provided. Brain-machine interfaces (BMIs) may provide brain control supports for communication and motor function. We investigated the interests and expectations of patients with ALS concerning BMIs based on a large-scale anonymous questionnaire survey supported by the Japan Amyotrophic Lateral Sclerosis Association. METHODS: We surveyed 1918 patients with ALS regarding their present status, tracheostomy use, interest in BMIs, and their level of expectation for communication (conversation, emergency alarm, internet, and writing letters) and movement support (postural change, controlling the bed, controlling household appliances, robotic arms, and wheel chairs). FINDINGS: Seven hundred and eighty participants responded. Fifty-eight percent of the participants underwent tracheostomy. Approximately, 80% of the patients experienced stress or trouble during communication. For all nine supports, > 60% participants expressed expectations regarding BMIs. More than 98% of participants who underwent tracheostomy expected support with conversation and emergency alarms. Participants who did not undergo tracheostomy exhibited significantly greater expectations than participants with tracheostomy did regarding all five movement supports. Seventy-seven percent of participants were interested in BMIs. Participants aged < 60 years had greater interest in both BMIs. INTERPRETATION: This is the first large-scale survey to reveal the present status of patients with ALS and probe their interests and expectations regarding BMIs. Communication and emergency alarms should be supported by BMIs initially. BMIs should provide wide-ranging and high-performance support that can easily be used by severely disabled elderly patients with ALS.

A report that Fukushima residents are concerned about radiation from Land, Food and Radon.

The Great East Japan Earthquake and subsequent TEPCO Fukushima Daiichi nuclear disaster occurred on 11 March 2011, which caused the leakage of radioactive materials into the environment. In this study, we report public concerns about radiation in Fukushima and Tokyo almost one year after the nuclear disaster. We examined the public concerns by analyzing the data from 1022 participants, 555 in Fukushima and 467 in Tokyo. They were asked whether they were concerned about radiation from some of six different types of sources, which could be answered in a binary way, 'yes' or 'no'. We found not only similarities, but also significant differences in the degrees of concerns between Fukushima residents and Tokyo ones. Fukushima residents more concerned about radiation from land, food and radon in larger rate than that of Tokyo ones, while Tokyo residents were concerned about radiation from medical care. Residents in neither location were concerned about radiation from space. Our results suggested that careful risk communication should be undertaken, adaptively organized depending on location and other factors, e.g. comprehension about radiation, presence of the experience of evacuation, and also age and gender of the people.

External effective radiation dose to workers in the restricted area of the Fukushima Daiichi Nuclear Power Plant during the third year after the Great East Japan Earthquake.

Since the Great East Japan Earthquake on 11 March 2011, Iitate Village has continued to be classified as a deliberate evacuation area, in which residents are estimated to receive an annual additional effective radiation dose of >20 mSv. Some companies still operate in Iitate Village, with a special permit from the Cabinet Office Team in Charge of Assisting the Lives of Disaster Victims. In this study, we measured the annual effective radiation dose to workers in Iitate Village from 15 January to 13 December 2013. The workers stayed in Iitate for 10 h and left the village for the remaining 14 h each working day. They worked for 5 days each week in Iitate Village, but stayed outside of the village for the remaining 2 days each week. We found that the effective radiation dose of 70% of the workers was <2 mSv, including natural radiation; the maximum dose was 3.6 mSv. We estimated the potential annual additional effective radiation dose if people returned full-time to Iitate. Our analysis supports the plan for people to return to their home village at the end of 2017.

Severely affected ALS patients have broad and high expectations for brain-machine interfaces.

Brain-machine interfaces (BMIs) may provide new communication channels and motor function to individuals with severe neurodegenerative diseases, but little is known about their interests in such devices. We investigated the interests of severely affected ALS patients in BMIs, and examined factors that might influence these interests. We conducted an anonymous, mail-back questionnaire survey of severely disabled ALS patients diagnosed using the revised El Escorial criteria. Thirty-seven patients responded to the questionnaire. Twenty-nine (78.4%) had undergone tracheostomy positive pressure ventilation. More than 80% of the patients were interested in communication support. Thirty-three (89.2%) felt stressed during communication. Among those using assistive communication devices (17 patients), 15 (88.2%) were not satisfied with them. More than 50% of the patients expressed an interest in BMIs. Their expectations of BMIs ranged widely from emergency alarm to postural change. The frequent use of personal computers tended to be correlated with an interest in invasive BMIs (p = 0.07). In conclusion, this was the first questionnaire survey demonstrating that severely affected ALS patients have broad and high expectations for BMIs. Communication was the most desired support from BMIs for such patients. We need to meet their widely ranging expectations of BMIs.

Incidental findings of brain magnetic resonance imaging study in a pediatric cohort in Japan and recommendation for a model management protocol.

BACKGROUND: The increasing use of magnetic resonance imaging (MRI) in brain researches has led to growing concern over incidental findings (IFs). To establish a practical management protocol for IFs, it is useful to know the actual prevalence and problems of IF management. In the present study, we report the prevalence proportion and some handling problems of IFs in healthy Japanese children, and suggest a management protocol from ethical and practical standpoints. METHODS: Between 2006 and 2008, 120 healthy children aged 5-8 years participated in a structural MRI study conducted in a pediatric cohort in Japan. All MRI images were reviewed by a pediatric neurologist, and detected IFs were classified into 4 categories. RESULTS: IFs of all categories were detected in 40 of the 110 participants (36.4%) for whom T2-weighted or 3D-T1-weighted images were available. Findings of sinusitis and/or otitis media were most frequent (26.4%). Excluding these findings, the prevalence of IFs was still 10.9% (12 findings): 9 findings were categorized as "no referral" (8.2%), 2 as "routine referral" (1.8%), 1 as "urgent referral" (0.9%), and 0 as "immediate referral" (0.0%). In "routine referral" category, only one participant was referred for further examinations. CONCLUSIONS: Although the prevalence of IFs was high, the proportion of those requiring further examination was low. This result revealed a fairly high false-positive rate and suggested that evaluating equivocal findings was the most difficult part of IF management. A management protocol needs to include a process to properly assess the clinical importance of findings.

[Neuroethics in Japan--current view and future visions].

Neuroethics was originated in 2002 in the United States. In 2004, the Research Institute of Science and Technology for Society (RISTEX), a subsection of Japan Science and Technology Agency (JST), launched a neuroethics research group as the first research group to focus on the academic study and public engagement in neuroethics in Japan. In this article, the authors summarize the activities of RISTEX, JST during the brief history of neuroethics in Japan, and subsequently compare their current activities in neuroethics to those in other Western countries. We also introduce brief results of public survey of neuroscience research in Japan that suggest the significance of ethics and education regarding neuroscience to overview the future vision on neuroethics. We further discuss the role of neuroscientists in the future progress in neuroethics.

The neuroscience of primate intellectual evolution: natural selection and passive and intentional niche construction.

We trained Japanese macaque monkeys to use tools, an advanced cognitive function monkeys do not exhibit in the wild, and then examined their brains for signs of modification. Following tool-use training, we observed neurophysiological, molecular genetic and morphological changes within the monkey brain. Despite being 'artificially' induced, these novel behaviours and neural connectivity patterns reveal overlap with those of humans. Thus, they may provide us with a novel experimental platform for studying the mechanisms of human intelligence, for revealing the evolutionary path that created these mechanisms from the 'raw material' of the non-human primate brain, and for deepening our understanding of what cognitive abilities are and of those that are not uniquely human. On these bases, we propose a theory of 'intentional niche construction' as an extension of natural selection in order to reveal the evolutionary mechanisms that forged the uniquely intelligent human brain.

[Introduction of neuroethics: out of clinic, beyond academia in human brain research].

Higher cognitive function in human brain is one of well-developed fields of neuroscience research in the 21st century. Especially functional magnetic resonance imaging (fMRI) and near infrared recording system have brought so many non-clinical researchers whose background is such as cognitive psychology, economics, politics, pedagogy, and so on, to the human brain mapping study. Authors have introduced the ethical issues related to incidental findings during the fMRI recording for non-clinical purpose, which is a typical problem derived from such expanded human brain research under non clinical condition, that is, neuroethics. In the present article we would introduce neuroethical issues in contexts of "out of clinic" and "beyond academia".

Water systems and urban sanitation: a historical comparison of Tokyo and Singapore.

The importance of a water supply and sewage treatment for urban sanitation is recognized in the modern world. Their contributions to public health have not, however, been well demonstrated by historical data, especially in Asian cities. In this research, we focused on the Asian cities of Tokyo and Singapore, which both developed significantly in the 20th century. We analysed their development processes statistically to determine what the key elements for the protection of urban sanitation have been. Although both cities constructed modern water supply systems at almost same time (Tokyo in 1898 and Singapore in 1878), and similarly modern wastewater treatment systems (Tokyo in 1922 and Singapore in 1913), the prevalence of water-borne diseases in Tokyo was more serious than it was in Singapore, in spite of Singapore's high infant mortality rate. The main reason for this was the differences in the systems of night-soil transport. We found that the water supply system in itself was not enough to resolve all urban sanitation problems, and appropriate night-soil removal was also crucial. In addition, historical trends and water consumption vary by city, so the appropriate technology and system are also different according to the unique characteristics and needs of each.

Ethical considerations of neuroscience research: the perspectives on neuroethics in Japan.

Recent technologies and developments in neuroscience have contributed to remarkable scientific discoveries, and have also raised many new philosophical, ethical, legal, and social issues. Research in "neuroethics" has identified various ethical issues, which will be difficult for current biomedical ethics to resolve from both an experimental and a social perspective, such as criminal applications of brain scans, incidental findings during non-clinical brain imaging, and cognitive enhancement. Although American and European neuroscience societies have demonstrated immediate, concrete reactions to these ethical issues, including academic conferences, study programs, and publications, Japanese neuroscientists have so far produced little response. Ethics is tightly linked with one's religion, nationality, culture, and social background, whereas science is tightly linked with the demand, economics, and politics of the society to which individuals belong. Taken together, it is important and necessary for Japanese neuroscientists to consider the ethical problems in Japanese neuroscience. In this paper, we first review the history of neuroethics in the world, and then report the less-developed ethical issues in the Japanese neuroscience community, focusing on neuroimaging and manipulative neuroscience as a first step in discussing how to apply principles in neuroethics to this rapidly progressing field of research.