The use of information and communication technology in Japanese rural clinics.

High-speed information and communication technology (ICT) networks stretch all over Japan. However, their utility in facilitating rural healthcare remains uncharacterized. A nationwide questionnaire survey was sent by mail to 1,018 rural clinics constructed in a public manner in municipalities throughout Japan. ICT use was classified by type, including a doctor-to-doctor manner. Only 19% of the 303 clinics surveyed (with a response rate of 30%) used ICT. Specifically, 50% used it in a doctor-to-doctor manner, while 35% used it to obtain electronic medical records. Differences in proficiency levels among ICT users were cited by 21% of the respondents as a major problem associated with ICT use. In Japan, the prevalence of ICT use for rural healthcare appeared low. We suggest a policy reform to facilitate ICT use in rural healthcare.

Competency framework, methods, evaluation, and outcomes of natural disaster preparedness and response training: a scoping review protocol.

OBJECTIVE: This systematic scoping review aims to clarify and map the range of natural disaster preparedness and response training for public health personnel around the world. INTRODUCTION: Various preparedness and response training courses, exercises, and drills for public health professionals have been developed for natural disasters. Most of these focus on developing competency. However, there is no overview of the frameworks, methods, evaluation, and outcomes of these disaster preparedness and response training courses, exercises, and drills. INCLUSION CRITERIA: This review will consider all studies that focus on the framework, evaluation, and outcome of training in natural disaster preparedness for public health personnel. METHODS: The databases and sources to be searched will include MEDLINE (PubMed), CINAHL with Full Text Plus, Academic Search Premier, APA PsycINFO, and Ichushi-Web. Searches for gray literature will be conducted using websites that discuss, introduce, or provide competence-based disaster preparedness and response training. These websites will mainly be for public organizations or universities with a focus on public health. The review will consider studies published in both English and Japanese. Retrieval of full-text studies and data extraction will be performed independently by two reviewers. The findings will be summarized in tabular form and accompanied by narrative text.

A Nationwide Survey of Obstetric Care Status on Japan's Islands, with Special Reference to Maternal Transport to the Mainland.

Safe obstetric care is a worldwide requirement. In Japan, a reduced number of obstetricians has prompted the centralization of obstetric facilities, and Japan's islands are expected to experience problems in handling deliveries. Although many pregnant women "move" to the mainland at later gestational weeks, "transport" from the island to the mainland may be occasionally needed when disorders manifest before the "move." Other women plan within-island deliveries; however, transport is required when complications arise. Managing delivery- or pregnancy-related problems may differ in transport by the population size of islands. We investigated the following issues in relation to the population size of Japan's islands: 1) How were deliveries handled on islands? 2) How many pregnant women were transported to the mainland? 3) What was the reason for and what affected transport? A total of 142 municipalities were selected to participate in a questionnaire survey, and 108 institutions from 106 municipalities responded. A comparative analysis by island size was performed using 2014 data: small-sized (population < 1,000), mid-sized (1,000 to 5,000), and large-sized (≥ 5,000). The percentage of women transported to the mainland from small-sized islands was significantly higher than that from large-sized islands (6.8 vs. 2.6% of all births in a year, respectively, P < 0.01). Transport was mainly in response to threatened preterm labor. Adverse weather was the most frequent factor affecting transport reliability. Our findings may contribute to a more detailed understanding of the state of obstetric care on Japan's islands.

Perceptions of Residents among Rural Communities with Medical Group Practice in Japan.

Elucidating the perceptions of residents regarding medical group practice (GP) among rural communities (GP-R) in Japan will be useful for establishing this system in such communities. A survey by questionnaire, as made by experts in rural health, was conducted in 2017. The self-administered questionnaire inquired about the perceptions of residents for accepting the GP-R into the community's healthcare using seven major elements of GP-R. The questionnaire was randomly distributed to 400 adult residents who lived in rural communities with a recently launched GP and had access to clinics within the communities. Among the 321 respondents, comparisons were made between younger (≤sixties) and older (≥seventies) residents, and a stepwise multiple regression analysis was performed to extract the factors influencing acceptance of the GP-R system. The results showed that older residents had a greater disapprove of being treated by different physicians daily or weekly in clinics (p < 0.001) and the use of telemedicine (p < 0.001) compared with younger residents. Younger residents showed a greater disapproval of clinics closing on weekdays than older residents (p = 0.007). Among all respondents, regardless of age groups, over half of residents approved of the involvement of nurse practitioners in the GP-R. Living with family and children was also extracted as an independent factor influencing a positive perception of the GP-R. These data suggest that the promotion of GP-R should consider generation gaps in the approach to medical practice as well as the family structures of residents. The involvement of nurse practitioners can also encourage the acceptance of GP-R in Japan.