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Accessible summary What is known on the subject? What the paper adds to existing knowledge? What are the implications for practice? Introduction Aim Method Results Discussion Implications for Practice Recovery‐oriented practices in community‐based mental health services are of increasing importance. The recovery journey of individuals with mental illness starts with a sense of agency, and a therapeutic relationship with the providers who support them is a prerequisite. In Japan, the construction of community‐based integrated care systems for individuals with mental illness is positioned as a priority health issue, with communication with familiar individuals being particularly important for recovery in Japanese and Asian cultures. This study is the first to examine effective communication factors for personal agency in the recovery of individuals with mental illness, focusing on addressing uncertainty about treatment choices and dissatisfaction with decision‐making, and considering the user's personal recovery journey. In recovery‐oriented practice, it is important to prioritize addressing the emotional aspects of decision‐making alongside the mental illness condition, supporting users' self‐determination in their unique recovery journeys. The findings emphasized the need to actively engage with users' perspectives and emotions, emphasize shared life planning, and foster a therapeutic relationship based on partnership. Providers should approach dialogue as carefully as medication prescriptions, prioritizing the establishment of an effective therapeutic relationship with the user. These characteristics are essential for developing a strong therapeutic relationship and effectively facilitating users' recovery. The findings are applicable not only to nurses but to all mental health service providers, contributing to the advancement of recovery‐oriented practice. Recovery‐oriented practice in community‐based mental health services is crucial for individuals with mental illness, with communication with familiar individuals being important for recovery in Japanese and Asian cultures.This study aimed to examine effective communication factors for personal agency in recovery by investigating the association between perceived support provided through communication and personal agency of individuals with mental illness.A cross‐sectional study was conducted among community‐dwelling Japanese mental health service users, assessing subjective agency, decisional conflict, staff support for personal recovery, activation for mental health self‐management, demographic variables and living difficulties. Multiple linear regression analysis identified factors predicting subjective agency, revealing characteristics of effective provider communication for recovery.Data from 222 users were analysed, revealing negative correlations between uncertainty about treatment choices and ineffective decision‐making with higher subjective agency, while staff support for personal recovery positively correlated with higher subjective agency.In recovery‐oriented practice, prioritizing users' emotional experiences during decision‐making and supporting their self‐determination in their unique recovery journeys is crucial.Providers should approach dialogue as carefully as medication prescriptions, prioritizing therapeutic partnerships with users. The findings extend beyond nursing to all mental health service providers, advancing the theory of recovery‐oriented practice. [ABSTRACT FROM AUTHOR]

In Japan, young people are becoming increasingly apathetic about politics, while at the same time they are experiencing a rightward leaning and a growing sympathy for totalitarianism and authoritarianism. To understand this contradiction, we need to look at the digital communication environment in which they engage in political discourse. One of the most representative opinion leaders in this regard is Hiroyuki Nishimura. In recent years, Hiroyuki has become widely known as the 'King of Refutation' and is immensely popular among the young generation. He is very active in political and social issues, arguing in a logical and neutral manner. However, despite his enlightened mode of argumentation, his arguments have been perceived as accommodative to totalitarian and authoritarian perceptions. This paper argues that at the heart of this mode of refutation is a process of 'decontextualisation' and 'recontextualisation' which has resulted in reducing the complexity of the issue, making it comprehensible to the majority while oppressing minorities. And this mode of refutation and the processes of 'decontextualisation' and 'recontextualisation' are at the centre of the various digital communication platforms that he operates and that have become hubs of political communication around the world: 2channel, 4chan, Nico Nico Douga and YouTube clips. In this sense, the totalitarianism and rightward leaning of the young generation is not due to a specific ideology but is strongly conditioned by the communication environment. 'Communication totalitarianism' can be used to describe the totalitarianism and right-wing tendencies taking place in Japan. [ABSTRACT FROM AUTHOR]

Objective. On the basis of inheriting the classical aesthetic orientation of Japanese literature, contemporary Japanese literature changes the creative methods of traditional Japanese writers, strives to transcend the national limitations of Japanese literature, and strives to capture literary materials with a "modern feel." Combined with modern western literary techniques to express the "modern self," and integrating popular literature with pure literature, Japanese writers created a "healing" literature that is popular all over the world. There is some value in exploring the correlation between Japanese literature and the influence of psychotherapy. Method. In this paper, an equation diagnosis algorithm based on iterative learning for a class of linear discrete systems is studied, and the existing discrete iterative learning diagnostics are improved. We exchange the order of time domain and iterative domain to achieve the purpose of point-by-point equation diagnosis. On this basis, a virtual influence initial value estimation algorithm with a sliding window is proposed. The impact that has not been diagnosed is estimated and used as the initial value of the impact, so as to reduce the number of iterations and improve the efficiency of equation diagnosis. This paper takes the public and readers as different perspectives, based on the use and satisfaction theory and prospect theory, and uses interviews and questionnaires to study the communication effect of Japanese literature from the three dimensions of cognition, emotion, and behavior. The cognitive part includes the public's understanding and readers' understanding and reading; the emotional part includes the public's and readers' impressions and emotional attitudes; the behavioral part includes the public's reading situation and readers' behavior changes. Results/Discussion. In the survey of loyal readers, although readers' understanding of Japanese literature has improved compared with the general public, it is not high, and their liking and influence on behavior are slightly lower than the preset level. This paper believes that the existing problems of Japanese literature dissemination are mainly concentrated in three aspects: the market is somewhat biased, which narrows the cognitive scope of users; as a cross-cultural literary work, Japanese literature still makes readers feel that it exists; there is some sense of estrangement, which will affect their enjoyment in reading; as a niche interest, readers lack timely communication and sharing objects after reading, so it is difficult to enhance their sense of identity. [ABSTRACT FROM AUTHOR]

Objectives: Hikikomori – an almost complete withdrawal from social interaction first seen in Japan – is becoming an emerging psychological syndrome worldwide. The mental health community in Japan has focused on hikikomori since the 1990s. Hikikomori was initially considered a culture-bound trait, unique to Japan; however, it has become an international concern, and cases have been reported even outside of Japan. While home visiting support for people with hikikomori has gained popularity, an effective solution remains elusive. This paper describes the process involved in effective home visiting support provided by experienced workers to help people with hikikomori. Method: Semi-structured interviews were conducted with 21 home-visiting support workers in Japan. Collected data were analysed using a constant comparative method based on Grounded Theory. Results: 'Supporting them in finding their own way to participate in society' was identified as the core category. This core category was substantiated by following three interrelated stages: preparing the involved surroundings for reaching out to a person, maintaining constant communication and expanding the range of activities and relationships. The process encouraged people with hikikomori to enhance their social connections and improved their motivation for social participation. People with hikikomori experiencing despair and isolation began to find pleasure in social participation through the three stages of support provided by home-visiting workers. Conclusion: Our study suggests that Home visiting support for people with hikikomori can be enhanced by these three interrelated methods which can help individuals integrate into society and connect with others. [ABSTRACT FROM AUTHOR]

Aims: The study aimed to explore the effect of video‐mediated communication on father‐infant bonding and transition to fatherhood during and after Satogaeri Bunben. Background: Satogaeri Bunben is a Japanese perinatal tradition that results in the pregnant wife and husband living apart, which may interfere with father‐infant bonding and transition to fatherhood. Design/Methods: A mixed‐methods study was conducted from July 2012 to November 2015. Participants were divided into two groups (Treatment/Control). Quantitative data included Taiji kanjyo Hyotei Syakudo (TKHS) , communication methods, husband's visitation records and video‐mediated communication records and satisfaction of video‐mediated communication experience. Qualitative data included participants' journal entries about their experience and feelings toward their infants during Satogaeri Bunben. Results: Fourteen treatment and thirteen control dyads/couples participated in the study. There were significant differences between groups in the frequency of fathers' visitation during Satogaeri Bunben, as well as on the THKS between groups in cross‐sectional analysis and in treatment group in longitudinal analysis. Fathers' journal entries revealed the use of video‐mediated communication in both groups, specifically commenting about these experiences and the impact of additional visual cues when communicating. Conclusion: Video‐mediated communication provides a sense of virtual co‐presence, which may help support father‐infant bonding and transition to fatherhood; however, it does not completely substitute for face‐to‐face interaction. SUMMARY STATEMENT: What is already known about this topic? Father‐infant bonding and transition to fatherhood are supported by father's early involvement and ongoing sharing of time and space with his infant. What this paper adds? Virtual co‐presence in which people maintain a sense of "being there" for each other across distances may improve father‐infant bonding and transition to fatherhood when face‐to‐face contact is not possible due to geographic separation. The implications of this paper: Video‐mediated communication was explored as a way to support fathers who were separated from their wives and infants during the perinatal period by creating a sense of virtual co‐presence. This study advanced the idea that video‐mediated communication may be ideally suited when families are separated geographically during the perinatal period and early infancy (e.g. military/work deployment, hospitalization, educational opportunity and migrant/refugee families who send one parent ahead), as it provides communication context by adding visual cues and contextualizing auditory cues. [ABSTRACT FROM AUTHOR]

This JWP Focus paper argues that material culture transformation can be understood as the transformation of the way human beings and material culture mutually open up their potentialities. Such opening up/becoming takes place in the domains of their encounter, which often take the form of human communications. In communication, human beings and material culture mutually mediate/intervene/transform their modes of existence as the former cope with various uncertainties and risks that the world generates and that communication differentiates. Drawing upon the theory of communication developed by the social systems theorist, Niklas Luhmann, the paper will elucidate and elaborate this perspective through an examination of the long-term transformation of the mode of such mutual opening up/becoming by human beings and the material culture of their potentialities that took place in the Jomon and the Yayoi periods of Japan between 13000 Cal BC and AD 250/300. [ABSTRACT FROM AUTHOR]

Objective: Two percent of the Japanese population is comprised of foreign residents with further increase expected due to immigration policy revisions. The purpose of this paper is to examine the healthcare needs and difficulties experienced by foreign residents in Japan by level of their Japanese language fluency. Design: A quantitative, descriptive design was used. Sample: We surveyed foreign residents in the greater Tokyo area (N = 209). Measurements: The research team created the survey questions and the contents of the survey include foreign residents' experiences during their visits or stays at medical and public health facilities in Japan. Results: More than 90% of the participants or their families visited medical facilities in Japan regardless of Japanese language fluency; however, those with less Japanese language fluency experienced statistically significant uneasiness or inconvenience concerning communication compared to those with native Japanese language fluency (p =.000). Conclusions: Nurses in Japan may benefit from additional training related to use of interpreters as well as education about diversity and cultural humility. Through better understanding of the specific communication barriers of foreign residents, nurses will be able to better anticipate difficulties and address them. [ABSTRACT FROM AUTHOR]

Introduction: This paper describes the co-creation and delivery of an integrated training programme in communication and depression assessment & management for Japanese GPs.Methods: Experts in communication and depression from EACH and WONCA developed a framework and filled it with content. Through iterative discussions with the Japanese participants and experts during delivery, the training was further adjusted to match local needs. It included didactic and experiential training methods with an emphasis on practicing and feedback. A "train-the-trainer" component helped participants develop their own trainer skills to enhance dissemination of the training in Japan.Results: Six Japanese GPs participated in two one week training-modules in May and November 2018. To aid implementation participants received online supervision on depression management and on teaching between the two modules and after the second module. Evaluation of the content of the training, the teaching methods and the participatory approach was positive. More than two years after the training, many elements of the training continue to be used in daily practice with the GPs teaching communication as well as depression management skills.Conclusion: The method of co-creation is promising. Research is needed to confirm that it is effective in transfer to clinical practice. [ABSTRACT FROM AUTHOR]

Aims: The aims of this paper are to (a) outline the design and implementation of an evidence‐based assertiveness communication workshop for Japanese nursing students; and (b) report on the evaluation of nursing students' satisfaction with the workshop using the Satisfaction with Assertiveness Communication Training Program Survey. Background: A body of research attests to the relationship between assertive communication and patient safety. This paper reports the design and evaluation of an assertiveness communication training programme designed to enhance students' ability to communicate safety in clinical practice. Design: A culturally appropriate and evidence‐based assertiveness communication workshop, informed by Gagne's instructional design principles, was implemented for third‐year nursing students in two Japanese higher educational institutions in December 2017. A descriptive study design was used to evaluate the workshop. Methods: Students' perceptions of the workshop were evaluated using the Satisfaction with Assertiveness Communication Training Program Survey, which includes ten items that are rated using a 5‐point Likert scale from strongly disagree [1] to strongly agree [5]. Data were analysed using descriptive statistics. The Revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) guidelines were used in the reporting of this study. Results: A total of 111 students from a population of 150 participated in the study giving a response rate of 74%. The overall mean satisfaction score was 4.12 indicating a high level of agreement with each of the survey items. With the exception of two items, the mean scores were above 4.0. "Confidence in using assertiveness communication skills" and "Utilising role‐plays to practice learnt skills" received mean scores of 3.71 and 3.90, respectively. Conclusion: Given the compelling research about the importance of assertive communication in health care, the results from this study support continuing investment in assertiveness communication training programmes for nursing students. Relevance to clinical practice: Assertive communication is an essential communication skill for safe nursing practice. Culturally appropriate assertiveness communication training programmes are of particular relevance in hierarchical healthcare contexts. [ABSTRACT FROM AUTHOR]

Background: Palliative care is insufficiently integrated in the continuum of care for older people. It is unclear to what extent healthcare policy for older people includes elements of palliative care and thus supports its integration. Aim: (1) To develop a reference framework for identifying palliative care contents in policy documents; (2) to determine inclusion of palliative care in public policy documents on healthcare for older people in 13 rapidly ageing countries. Design: Directed documentary analysis of public policy documents (legislation, policies/strategies, guidelines, white papers) on healthcare for older people. Using existing literature, we developed a reference framework and data extraction form assessing 10 criteria of palliative care inclusion. Country experts identified documents and extracted data. Setting: Austria, Belgium, Canada, Czech Republic, England, Japan, Mexico, Netherlands, New Zealand, Singapore, Slovenia, South Korea, Spain. Results: Of 139 identified documents, 50 met inclusion criteria. The most frequently addressed palliative care elements were coordination and continuity of care (12 countries), communication and care planning, care for family, and ethical and legal aspects (11 countries). Documents in 10 countries explicitly mentioned palliative care, nine addressed symptom management, eight mentioned end-of-life care, and five referred to existing palliative care strategies (out of nine that had them). Conclusions: Health care policies for older people need revising to include reference to end-of-life care and dying and ensure linkage to existing national or regional palliative care strategies. The strong policy focus on care coordination and continuity in policies for older people is an opportunity window for palliative care advocacy. [ABSTRACT FROM AUTHOR]

The notion of English as a multilingua franca (EMF) positions English within multilingualism, and EMF awareness prepares students to communicate effectively in this multilingual world of mobility. The present paper explores how, if ever, EMF-aware pedagogic intervention influences Japanese students' perceptions of their communicative practices, particularly for English-major undergraduates in L1-shared classrooms. This intervention was made by providing opportunities for participants to engage in EMF and by examining their first-hand experiences and published EMF communication extracts in the classrooms. Empirical data from an open-ended questionnaire demonstrate that multilingual and transmodal accommodation was a way for them to notice and take advantage of global networks, develop capability and confidence in communication, and foster sensitivity to interactants' backgrounds. The data also illustrate the invaluable role of individual multilingual experiences as classroom 'materials', and suggest that discussing these experiences potentially turns L1-shared classrooms into EMF scenarios through foregrounding students' multilingual repertoires. [ABSTRACT FROM AUTHOR]

Hierarchy and power characterize health‐care relationships around the world, constituting a barrier to assertive communication and a risk to patient safety. This issue is more problematic and complex in countries such as Japan, where deep‐seated cultural values related to hierarchy and power persist. The current paper is the second of two that present the findings from a study exploring Japanese nurses' views and experiences of how cultural values impact assertive communication for health‐care professionals. We conducted semistructured interviews with 23 registered nurses, following which data were analyzed using directed content analysis. Two overarching themes emerged from the analysis: hierarchy/power and collectivism. In the present study, we focus on cultural values related to hierarchy and power, including differences in professional status, gender imbalance, seniority/generation gap, bullying, and humility/modesty. The findings from our research provide meaningful insights into how Japanese cultural values influence and constrain nurses' communication and speaking up behaviors, and can be used to inform educational programs designed to teach assertiveness skills. [ABSTRACT FROM AUTHOR]

Culture influences the way health‐care professionals communicate with each other and their ability to relate to colleagues in an assertive manner. Cultural barriers can also make it difficult for nurses to speak up even when they have concerns about patient safety. An understanding of the potential impact of cultural factors is therefore needed when developing assertiveness communication training programs. This paper presents the findings from a study that explored Japanese nurses' perceptions of how culture and values impact assertive communication in health care. Semistructured interviews with 23 registered nurses were undertaken, and data were analyzed using directed content analysis. Two major themes were identified: collectivism and hierarchy/power. In the present study, we discuss the cultural values related to collectivism that included four categories of "wa" (harmony), "uchi to soto" (inside and outside), implicit communication/ambiguity, and "nemawashi" (groundwork). The findings highlight the impact of culture on nurses' assertive communication behaviors and can be used to inform the design of culturally‐appropriate assertiveness communication training programs for Japanese nurses working both within their own country or internationally. [ABSTRACT FROM AUTHOR]

Background: With the goal of realizing genome-based personalized healthcare, we have developed a biobank that integrates personal health, genome, and omics data along with biospecimens donated by volunteers of 150,000. Such a large-scale of data integration involves obvious risks of privacy violation. The research use of personal genome and health information is a topic of global discussion with regard to the protection of privacy while promoting scientific advancement. The present paper reports on our plans, current attempts, and accomplishments in addressing security problems involved in data sharing to ensure donor privacy while promoting scientific advancement.Methods: Biospecimens and data have been collected in prospective cohort studies with the comprehensive agreement. The sample size of 150,000 participants was required for multiple researches including genome-wide screening of gene by environment interactions, haplotype phasing, and parametric linkage analysis.Results: We established the T ohoku M edical M egabank (TMM) data sharing policy: a privacy protection rule that requires physical, personnel, and technological safeguards against privacy violation regarding the use and sharing of data. The proposed policy refers to that of NCBI and that of the Sanger Institute. The proposed policy classifies shared data according to the strength of re-identification risks. Local committees organized by TMM evaluate re-identification risk and assign a security category to a dataset. Every dataset is stored in an assigned segment of a supercomputer in accordance with its security category. A security manager should be designated to handle all security problems at individual data use locations. The proposed policy requires closed networks and IP-VPN remote connections.Conclusion: The mission of the biobank is to distribute biological resources most productively. This mission motivated us to collect biospecimens and health data and simultaneously analyze genome/omics data in-house. The biobank also has the mission of improving the quality and quantity of the contents of the biobank. This motivated us to request users to share the results of their research as feedback to the biobank. The TMM data sharing policy has tackled every security problem originating with the missions. We believe our current implementation to be the best way to protect privacy in data sharing. [ABSTRACT FROM AUTHOR]

This paper presents the initial translation process and follow-up psychometric evaluation of the Japanese version of the Primary Communication Inventory (J-PCI). The J-PCI was developed using the committee approach to translation and then used in a study exploring Japanese couples' communication satisfaction while separated during Satogaeri Bunben - a Japanese perinatal tradition. The committee approach attends to cultural nuance and context and is especially useful when languages have dissimilar linguistic roots and cultures, such as Japanese and English. The translation process and evaluation included five steps; (i) selection of the original PCI for research; (ii) selection of translators; (iii) development of the J-PCI using a committee approach; (iv) an initial small pilot study; and (v) a larger follow-up study. The J-PCI has good initial validity and reliability, although some nuances were observed in scoring. [ABSTRACT FROM AUTHOR]

The objective of this article was to examine the environmental health implications of the 2011 Fukushima nuclear disaster from an all-hazards perspective. The authors performed a literature review that included Japanese and international nuclear guidance and policy, scientific papers, and reports on the Chernobyl and Three Mile Island disasters while also considering all-hazards preparedness rubrics in the U.S. The examination of the literature resulted in the following: a) the authors' "All-Hazards Planning Reference Model" that distinguishes three planning categories--Disaster Trigger Event, Man-Made Hazards, and Vulnerability Factors; b) the generalization of their model to other countries; and c) advocacy for environmental health end fate to be considered in planning phases to minimize risk to environmental health. This article discusses inconsistencies in disaster planning and nomenclature existing in the studied materials and international guidance and proposes new opportunity for developing predisaster risk assessment, risk communication, and prevention capacity building. [ABSTRACT FROM AUTHOR]