Notes

Increasing accessibility: changing Penchansky and also Thomas's Principle associated with Entry.
Objectives　The COVID-19 pandemic spread rapidly across the globe during the first half of 2020. In Japan, a state of emergency was declared on April 7, 2020, which had a significant impact on the life of citizens. This study focused on behaviors like avoiding going out or coming in contact with others and frequent hand-washing to prevent the infection and the spread of COVID-19 among people living in Tokyo. selleck We also examined the factors associated with these behaviors during the declaration of emergency.Methods　An online survey was conducted from April 26 to 29, 2020, approximately 20 days after the declaration of the emergency, among men and women aged 20-69 years living in Tokyo. The study framework was based on the protection motivation theory, which explains the risk-reducing behaviors, and focus theory of normative conduct, which explains the effect of others' behavior on one's own behavior. The frequency of behaviors like avoiding going out or coming in contact with others and frequent hand-washing, as wefficacy was significant (β=0.129, P less then 0.001), indicating that risk perception was positively associated with the behavior only when either response efficacy or self-efficacy was low. A similar analysis conducted for hand-washing behavior revealed that injunctive norm (β=0.256, P less then 0.001) and response efficacy (β=0.132, P less then 0.001) were positively associated with the behavior, while the response cost (β=-0.193, P less then 0.001) was negatively associated with the behavior.Conclusion　Some variables in the protection motivation theory and the focus theory of normative conduct were related to the behavior for the prevention of COVID-19. The results suggest that the application of these theories is useful in future studies.Objectives　The purpose of this study was to define the terminology used in community health activities by systematically establishing agreement among public health nurses and related professionals, to aid them in effectively cooperating with other professionals.Methods　We extracted the major terms described in "Guidelines for Public Health Nurses' Activities in the Region," which was issued by the Director of Health Bureau, Ministry of Health, Labor and Welfare; and conducted 2 iterations on the proposed definition of the terms using the Delphi method. The survey targeted 800 stakeholders from the following 4 professions public health nurses in managerial positions in local governments, clerical staff in local governments, public health nursing professors at educational institutions, and social welfare council staff. Respondents indicated their degree of agreement with the definition of the terms using a 4-point Likert scale. We tallied the answers indicating "I agree" or "Mostly agree." A 70% term agreement nt those community health terms that had varying interpretations among related occupations earlier. By including the opinions of those from the related occupations who collaborate with public health nurses, the definitions of these terms could be established and shared. These definitions can be used in public health nursing practice, education, service, and research-among those in involved these related occupations.
This study aimed to calculate incidence rates (IR) of acute coronary syndrome (ACS) including acute myocardial infarction (AMI), unstable angina (UAP), and sudden cardiac death (SCD) in Nobeoka city, Japan.Methods and ResultsThis was an observational study based on a city-wide comprehensive registration between 2015 and 2017 in Nobeoka city, Japan, using 2 databases all patients with cardiogenic out-of-hospital cardiac arrest in Nobeoka city and hospitalized ACS patients from Miyazaki Prefectural Nobeoka Hospital in which all ACS patients in Nobeoka city were hospitalized except for possible rare cases of patients highly unlikely to be hospitalized elsewhere. The IRs of ACS based on the population size of Nobeoka city (125,000 persons), and their age-adjusted IRs by using the direct method and the 2015 model population of Japan were calculated. There were 260 eligible patients hospitalized with first-onset ACS (age [SD]=71.1 [12.4], 34.2% women) and 107 eligible SCD patients. Crude IRs of hospitalized ACS and SCD patients, and hospitalized AMI and SCD patients, respectively, were 130.2 (183.3 for men, 85.6 for women) and 107.5 (148.4 for men, 73.2 for women) per 100,000. Crude IRs of hospitalized ACS, AMI, and UAP patients, respectively, were 92.3 (132.8 for men, 58.1 for women), 69.6 (97.9 for men, 45.7 for women), and 22.7 (35.0 for men, 12.4 for women) per 100,000.

The calculated IRs can be useful in building a health strategy for treating ACS.
The calculated IRs can be useful in building a health strategy for treating ACS.
This study aimed to clarify the incidence of takotsubo syndrome (TTS) after the Great East Japan earthquake (GEJ-E) between inland and coastal areas.Methods and ResultsConsecutive hospitalized patients with TTS were registered between 2009 and 2016 in Iwate Prefecture. Patients were divided into 2 groups, by whether they lived inland or in the coastal area (both max. seismic intensity, 6
). The incidence of TTS was calculated using the standardized incidence ratio (SIR) before and after the earthquake. The long-term prognosis of the 2 groups was compared by Kaplan-Meier analysis. A total of 112 patients with TTS were registered from the acute coronary syndrome records of each hospital (n=4,163); 9 patients with TTS were registered within 2 months of the earthquake. A significant monthly variation was observed in March and April 2011 compared with the other months (P=0.029). At 2 years after the earthquake, the SIR was significantly increased in the coastal area (P<0.01), but decreased after ≥3 years. There were no significant differences in the long-term prognosis between the 2 groups (P=0.20).

The incidence of TTS was increased in the acute phase after the GEJ-E, particularly in the coastal area. The magnitude of the tsunami damage is presumed to be a factor in the increased incidence of TTS, even though the seismic intensity in both areas was comparable.
The incidence of TTS was increased in the acute phase after the GEJ-E, particularly in the coastal area. The magnitude of the tsunami damage is presumed to be a factor in the increased incidence of TTS, even though the seismic intensity in both areas was comparable.
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