The construction and its implication of the cancer life-cycle prevention and control system in Japan / 中国卫生政策研究

As the country with the largest number of new cancer cases and deaths,China faces a serious situation with a large cancer population base,low relative survival rate,and low adherence to cancer screening.Neighboring Japan,which has the longest life expectancy in the world,has a much higher relative survival rate than China,despite having a similarly high cancer rate,due to its well-established system of cancer prevention and control.Being an Asian country,the major prevalent cancers in China and Japan are similar in spectrum and can be referred to more.This article introduces the construction of Japan's cancer life-cycle prevention and control system of"cancer prevention","cancer care",and"coexistence with cancer"starting from the three major goals of Japan's cancer prevention and control program,and focuses on the improvement of cancer screening in Japan and the improvement of cancer survival in China.It also highlights the means and methods used to increase the cancer screening rate in Japan,with a view to providing suggestions for cancer prevention and control in China.

¿Es posible obligar a las personas a vacunarse? Nudge contra el coronavirus / Is it possible to force people to be vaccinated? Nudge against coronavirus / É possível obrigar as pessoas a vacinar-se? Cutucar contra o coronavírus

Resumen: Sabemos que el mundo enfrenta una terrible pandemia. La ciencia, con esfuerzo y prontitud, ha podido desarrollar diversas vacunas contra el covid-19, generando ello grandes expectativas. Sin embargo, por diversos factores, los procesos masivos de vacunación no han avanzado a la velocidad requerida; uno de los principales es la resistencia de muchas personas a vacunarse, aduciendo diferentes razones. Frente a esta situación se ha oscilado entre la realización de campañas de publicidad hasta propuestas de imposición forzada. Una alternativa para ir más allá de lo meramente lírico y lo coercitivo es generar formas de motivación para que aquellas personas decidan voluntariamente vacunarse a través de diversas medidas, directas e indirectas, apelando a "Nudge" -o "teoría del pequeño empujón"-, con el fin de propiciar la mejor protección de la salud individual y colectiva, tema del que trata el presente artículo, a partir de la revisión bibliográfica sobre la materia y diversas experiencias en la lucha contra el coronavirus.

Abstract: We all know that the world is facing a terrible pandemic. Science, with effort and promptness, has been able to develop various vaccines against Covid-19, generating great expectations. However, mass vaccination processes have not advanced at the required speed due to various factors; one of the main ones is the resistance of many people to get vaccinated, for different reasons. Faced with this situation, it has oscillated between carrying out advertising campaigns to proposals for forced imposition. An alternative to go beyond the merely lyrical and coercive is to generate forms of motivation for those people to voluntarily decide to be vaccinated through various measures, direct and indirect, appealing to "Nudge" -or the "little push theory" - in order to promote the best protection of individual and collective health, the subject of this article, based on the bibliographic review on the matter and various experiences in the fight against coronavirus.

Resumo: Sabemos que o mundo enfrenta uma terrível pandemia. A ciência, com esforço e prontidão, pode desenvolver diversas vacinas contra a Covid-19, gerando grandes expectativas. Sem dúvida, os processos massivos de vacinação não avançaram à velocidade requerida por diversos fatores; um dos principais é a resistência de muitas pessoas a vacinar-se, alegando diferentes razões. Frente a esta situação, observou-se uma oscilação entre a realização de campanhas de publicidade a propostas de imposição forçada. Uma alternativa para ir além do meramente lírico e do coercitivo é gerar formas de motivação para que as pessoas decidam voluntariamente vacinar-se através de diversas medidas, diretas e indiretas, apelando a "Nudge" -ou a "teoria do pequeno empurrão"- a fim de propiciar a melhor proteção da saúde individual e coletiva, tema do que trata o presente artigo, a partir da revisão bibliográfica sobre a matéria e diversas experiências na luta contra o coronavírus.

Increasing hepatitis virus screening uptake at worksites in Japan using nudge theory and full subsidies

BACKGROUND@#Despite the importance of hepatitis screening for decreasing liver cancer mortality, screening rates remain low in Japan. Previous studies show that full subsidies increase screening uptake, but full subsidies are costly and difficult to implement in low-resource settings. Alternatively, applying nudge theory to the message design could increase screening at lower costs. This study examined the effects of both methods in increasing hepatitis virus screening rates at worksites.@*METHODS@#1496 employees from a Japanese transportation company received client reminders for an optional hepatitis virus screening before their general health checkups. Groups A and B received a client reminder designed based on the principles of "Easy" and "Attractive," while the control group received a client reminder not developed using nudge theory. Additionally, hepatitis virus screening was offered to the control group and group A for a co-payment of JPY 612, but was fully subsidized for group B. The hepatitis virus screening rates among the groups were compared using a Chi-square test with Bonferroni correction, and the risk ratios of group A and group B to the control group were also calculated. To adjust for unobservable heterogeneity per cluster, the regression analysis was performed using generalized linear mixed models.@*RESULTS@#The screening rate was 21.2%, 37.1%, and 86.3% for the control group, group A, and group B, respectively. And the risk ratio for group A was 1.75 (95% confidence interval [CI] 1.45-2.12) and that of group B was 4.08 (95% CI 3.44-4.83). The parameters of group A and group B also were significant when estimated using generalized linear mixed models. However, the cost-effectiveness (incremental cost-effectiveness ratio (ICER)) of the nudge-based reminder with the full subsidies was lower than that of only the nudge-based reminder.@*CONCLUSIONS@#While fully subsidized screening led to the highest hepatitis screening rates, modifying client reminders using nudge theory significantly increased hepatitis screening uptake at lower costs per person.

Decisiones, bienestar y desarrollo humano en departamentos de bienestar estudiantil. Discusión de hallazgos / Decisões, bem-estar e desenvolvimento humano em departamento de bem-estar estudantil. Discussão de resultados / Decisions, well-being and human development in departments of student well-being. Discussion of findings

El presente estudio cualitativo tuvo como objetivo explorar la arquitectura para la toma de decisiones que se promueve en los programas institucionales de bienestar y desarrollo humano, ofrecidos en tres instituciones de educación superior de la ciudad de Medellín y el municipio de Bello en Antioquia, Colombia. Para lograrlo, se conocieron los programas institucionales y se detectaron los componentes asociados con la arquitectura para la toma de decisiones. Se realizaron quince entrevistas semi-estructuradas a líderes encargados de los programas institucionales en las universidades objeto de estudio y un grupo focal con estudiantes universitarios. Para el análisis se utilizó un proceso de codificación y triangulación de las entrevistas. Esta información fue contrastada con la revisión documental y la investigación empírica, las cuales enfatizan la importancia de diseñar contextos para aumentar el bienestar de las personas. Finalmente, sugerimos un programa de formación en toma de decisiones para los arquitectos encargados de estas áreas.

Este estudo qualitativo teve como objetivo explorar a arquitetura para a tomada de decisão promovida nos programas institucionais de bem-estar e desenvolvimento humano, oferecidos em três instituições de ensino superior na cidade de Medellín e no município de Bello, em Antioquia, na Colômbia. Para realizá-lo, foram analisados os programas institucionais e detectados os componentes associados à arquitetura para tomada de decisão. Foram realizado quinze entrevistas semi-estruturadas aos líderes responsáveis dos programas institucionais nas universidades em estudo. Para a análise, foi utilizado um processo de codificação e triangulação das entrevistas. Esta informação foi contrastada com a revisão documental e a pesquisa empírica, que enfatizam a importância de projetar contextos para aumentar o bem-estar das pessoas. Finalmente, sugerimos um programa de Formação na tomada de decisão para os arquitetos responsáveis destas áreas.

The objective of this qualitative study was to explore the architecture for decision making promoted in the institutional programs of welfare and human development, offered in three institutions of higher education in the city of Medellin and the municipality of Bello in Antioquia, Colombia. To achieve this, we got the information about the institutional programs. Then, we extract the components associated with the architecture for decision making. Fifteen semi-structured interviews were carried out with leaders in charge of institutional programs at the universities under study. For the analysis, we used a process of coding and triangulation of the interviews. This information was contrasted with the documentary review and empirical research, which emphasize the importance of designing contexts to increase human well-being. Finally, we suggest a training program in decision making for the architects in charge of these areas.