Objectives　Although childhood cancer treatment has recently become centralized at specialized hospitals worldwide, the relationship between mortality ratios and living in rural areas or traveling long distances for treatment remains controversial. In the present study, we examined whether regional differences in patient mobility and mortality ratios exist in Japan.

Methods　We investigated 10,713 patients with cancer aged ≤18 years, diagnosed between 2016 and 2019, registered in the national cancer registry data. The patients were divided into two categories based on their residence at diagnosis: urban and rural. Urban areas were defined as metropolitan or urban areas according to the 2015 census or as prefectural cities; all other areas were defined as rural. Additionally, we divided the patients into two groups based on the one-way travel time to the treatment hospital (≤1 h or >1 h), as estimated from location information at the community level using route-planner web services. Next, we calculated the percentage of patients who received treatment within their residences in both areas and for each treatment type. We compared the percentage of distant metastasis in all cancers and each diagnosis group between the two areas using the chi-square test. We finally applied Cox proportional hazard models to obtain adjusted mortality hazard ratios for urban versus rural areas and travel times of ≤1 h versus >1 h.

Results　Overall, 77% of the patients were classified as urban residents. The percentages of patients receiving treatment within their residency, secondary medical care area, prefecture, and regional block levels were 22–46%, 80–87%, and 95–99%, respectively. Only central nervous system tumors (III) showed a significant difference in the percentage of distant metastases, which were more common in urban areas (6% vs. 3%). The adjusted mortality hazard ratios were not significantly different between urban and rural areas for all cancers or each diagnosis group. The travel time comparison yielded significant differences of 1.17 for all cancers and 2.57 for lymphomas (II).

Conclusion　Approximately 80% of the patients received treatment within their prefecture, although a few traveled long distances across regional blocks. We observed no differences in the mortality ratio between urban and rural areas, although significant differences were found in all cancers and one cancer in the travel burden comparison. These results highlight the need for continued evaluation of the increasing trend in patient travel burden and its impact on survival, as childhood cancer treatment has become centralized in Japan.

Objective　Medical and nursing care services within community-based integrated care systems are vital in community health. This study aimed to assess the current status of health-promoting activities across hospitals, clinics, and nursing homes operated by the Japan Association for Development of Community Medicine and explore differences depending on the type of facility and strategies for expanding these activities.

Methods　Between April 2022 and September 2023, we conducted web-based surveys, followed by telephone and email interviews. The survey covered three main areas; health-promoting activities for patients/users, the community, and staff (options), willingness to expand activities (10-point scale), and facilitating and inhibiting factors (open-ended responses). Responses were analyzed according to facility type, and activities were categorized according to the 2020 Standards for Health-Promoting Hospitals and Health Services (The 2020 HPH Standards).

Results　The response rate was 100%. Activities were implemented across all facilities. The percentages of facilities that implemented activities in hospitals, clinics, and nursing homes were as follows; patients/users (96.0, 84.5, 94.4, P = 0.011), community (96.0, 83.3, 100.0, P < 0.001), and staff (100.0, 72.9, 94.4, P < 0.001). The implementation rates were significantly lower in clinics than in hospitals and nursing homes. The mean number of activities in small clinics with < 50 staff (S) was significantly lower than that in large clinics with > 50 staff (L) for patients/users (S, L, difference) (4.1, 6.2, P = 0.034), community (4.9, 9.1, P < 0.001), and staff (1.6, 3.8, P < 0.001). Willingness did not vary by facility type (median of 7.0); however, conviction, as a determinant of willingness, was slightly higher in clinics and nursing homes than in hospitals (hospital = 7.0, clinics and nursing homes = 8.0). The most common facilitating factor for hospitals was “development of organizational structure,” such as the establishment of a promotion committee, whereas for clinics and nursing homes, it was the “provision of educational materials and know-how.” The most common inhibiting factor was “increasing workload.” These activities aligned with almost all 2020 HPH standards; however, the evaluation system needed improvement.

Conclusion　All facilities are implementing health-promoting activities according to the 2020 HPH standards and have expressed eagerness to expand their activities. Developing organizational structures, ensuring the profitability of activities, developing evaluation indicators for measuring results, and establishing an evaluation system are crucial for expansion.

Objective　This study explored the physical and mental health status and living conditions of fathers raising 0-year-old multiples in Japan compared with those raising singletons to gain insight into fathers’ health issues and the need for support.

Methods　Household and health data from the Comprehensive Survey of Living Conditions (2016, 2019, and 2022) were used. Because of the small number of fathers with multiples in each dataset, three datasets were combined. The t-test and Fisher’s exact probability test were used to compare fathers with multiples and singletons for various factors.

Results　Fathers with multiples were significantly more likely to sleep for < 5 h than those of singletons. There was no significant difference between both groups in the percentage of fathers with a K6 score of ≥ 10. However, the percentage of fathers with multiples exceeded the target set by the government. There were no differences in the counseling status regarding worries and stress. The proportion of consultations with public institutions was extremely low in both groups.

Conclusion　The analysis of representative data from Japan highlights health issues and the need for support for fathers with multiples. Fathers with multiples showed a high percentage of short sleep durations, worries, and stress related to childcare. The need for mental health support, accumulation of knowledge and experience on support for fathers with multiples, and development of support systems were suggested.

Objectives　In Japan, support services are provided to help postpartum women within one year after childbirth. This study conducted a literature review of these support methods and their effectiveness in reducing depression and anxiety among postpartum women.

Methods　We searched for Japanese and English literature published until August 2023 using the PubMed, Igaku Chuo Zasshi, CiNii Research, and Cochrane Library databases. We included original papers that provided support for postpartum women discharged from delivery facilities within one year of childbirth in Japan and assessed changes in depression and anxiety. The included studies were organized according to study design, number of participants, intervention period, support methods, assessment time, and main outcomes. The support methods and their effectiveness in reducing depression and anxiety were examined.

Results　This review included 22 studies from PubMed, Igaku Chuo Zasshi, CiNii Research, and Cochrane Library. Regarding support provided after childbirth, the following methods reduced depression and anxiety; support from the childbirth hospital, care services after childbirth, exercise support, and physical contact between the mother and child. For continuous support during pregnancy, the following methods reduced depression and anxiety; continuous support from certain midwives and comprehensive support based on the assessment of the health status and need for support of postpartum women. Concerning other support, the following methods reduced depression and anxiety; health checkups for two weeks after childbirth, coaching based on the assessment of the current status of child-rearing, consultation services using an application, parenting support, and support for Chinese residents in Japan, while focusing on cultural differences and social support. Eight of these support programs were provided through collaborations between various healthcare professionals, such as physicians and nurses.

Conclusion　This literature review found that some support methods reduced depression and anxiety among postpartum women. Planning based on the assessment of the mother’s health condition and needs and multidisciplinary cooperation enhanced the effectiveness of support services for postpartum women.

Objectives　Family caregivers of individuals with young-onset dementia (YOD) often struggle to seek help, despite the heavy burden of care. This study explored their feelings when attempting to find support in the early stages after diagnosis.

Methods　This qualitative descriptive study conducted semi-structured interviews with eight family caregivers of patients with YOD at home. The analysis extracted and coded passages related to feelings in situations in which family caregivers sought support. By comparing and examining the meanings of the codes, we identified broader themes and developed categories iteratively.

Results　In the early stages after diagnosis, family caregivers were concerned about “fear and anxiety about developing dementia at a young age,” “desire for any information about YOD,” “desire to continue currently as long as possible for the future,” “desire to protect the dignity of the individual with YOD as a member of society,” “hesitation to tell others that he/she has YOD,” and “desire to protect their life, mind, and body, which is still in the mid-life.” These concerns prompted them to seek the support of others.

Conclusion　Family caregivers demonstrated earnest wishes for patients with YOD and themselves in the early stages after diagnosis. They dealt with unique YOD-related struggles, including prejudice, the impact on others, and personal hesitations. Seeking support helped alleviate negative feelings arising from the diagnosis process. Family support services should prioritize early outreach at diagnosis, proactively identify difficulties, and tailor them to patients and caregivers. The attitude of the support staff, who anticipate daily life challenges and approach the family, can significantly facilitate support-seeking by caregivers.