The infection control team (ICT) ensures the implementation of infection control guidelines in healthcare facilities. This systematic review aims to evaluate the effectiveness of ICT, with or without an infection control link nurse (ICLN) system, in reducing healthcare-associated infections (HCAIs). We searched four databases to identify randomised controlled trials (RCTs) in inpatient, outpatient and long-term care facilities. We judged the quality of the studies, conducted meta-analyses whenever interventions and outcome measures were comparable in at least two studies, and assessed the certainty of evidence. Nine RCTs were included; all were rated as being low quality. Overall, ICT, with or without an ICLN system, did not reduce the incidence rate of HCAIs [risk ratio (RR) = 0.65, 95% confidence interval (CI): 0.45–1.07], death due to HCAIs (RR = 0.32, 95% CI: 0.04–2.69) and length of hospital stay (42 days vs. 45 days, p = 0.52). However, ICT with an ICLN system improved nurses’ compliance with infection control practices (RR = 1.17, 95% CI: 1.00–1.38). Due to the high level of bias, inconsistency and imprecision, these findings should be considered with caution. High-quality studies using similar outcome measures are needed to demonstrate the effectiveness and cost-effectiveness of ICT.

During crisis, trust has been found to have a buffering effect in the prevention of the deterioration of mental well-being, as trust is considered to reflect the individual's capability to gain social resources including both formal and informal support. Additionally, during the COVID-19 pandemic, political trust has been found to reduce anxiety. Taking these findings into account, this study explores the association of generalised and political trust with mental well-being on current postpartum women who were particularly at risk due to a decline in social support leaving them an increased burden of caring newborns during the pandemic. We conducted a crosssectional survey in October 2020 in Japan (n=558). Depressive symptoms (above the cutoff of the Edinburgh Postnatal Depression Scale (EPDS)) and Fear of Coronavirus-19 Scale (FCV–19S) scores were used as mental well-being indicators. Generalised and political trust were captured by binary variables. Results of regression analyses, in which covariates were fully adjusted, showed that higher generalised trust had a statistically significant association with lower possibility of depressive symptoms and a lower FCV-19S score, while political trust was not significantly associated with either indicator. For further understanding, we divided respondents into two groups; women living in cities where higher COVID-19 cases were reported and women living in areas with lower COVID-19 cases, to test whether the role of trust differs depending on the infection spread status. It was found that a higher generalised trust was significantly associated with a lower probability of having depressive symptoms in the areas with lower COVID-19 cases. However, statistical significance was not observed in the areas with high COVID-19 cases. This highlighted that even postpartum women who were normally capable of receiving formal and informal social support need to be taken care of in the current situation.

A variety of electronic cigarettes (e-cigarettes) are sold in Japan and targeted toward young people. However, few studies have considered who uses e-cigarettes and why they use them. This study examined factors associated with e-cigarette use and the reasons for their use among the young population in Japan. Our internet-based cross-sectional study was conducted between February and March 2019. We analyzed the data of 2,414 participants aged 15–29 years to identify factors associated with e-cigarette use in the last 12 months and assess the reasons participants gave for their use. We found 4.3% of the participants had used e-cigarettes in the past 12 months. The multivariable logistic regression showed that the use of combustible or heated tobacco and perceiving e-cigarette use as an attractive behavior were associated with having used e-cigarettes. Interest in fruit flavors, stylish design and function of e-cigarettes, and the influence of friends using e-cigarettes were major reasons for their use. Although e-cigarette users are still a minority among this population, the flavors and design of e-cigarette products attract young people, and gain popularity in the youth community. This highlights an urgent need for the monitoring of e-cigarette and tobacco use among the young population in Japan.

Introduction Access to maternal and newborn healthcare has improved in Myanmar. However, regular contact with skilled care providers does not necessarily result in quality care. We assessed adequate contact made by women and newborns with skilled care providers, reception of high-quality care and quality-adjusted contacts during antenatal care (ANC), peripartum care (PPC) and postnatal care (PNC) in Myanmar. Methods This cross-sectional study was conducted in a predominantly urban township of Yangon and a predominantly rural township of Ayeyawady in March 2016. We collected data from 1500 women. We measured quality-adjusted contact, which refers to adequate contact with high-quality care, as follows: ≥4 ANC contacts and receiving 11–14 of 14 intervention items; facility-based delivery assisted by skilled care providers, receiving 7 of 7 PPC intervention items; and receiving the first PNC contact ≤24 hours postpartum and ≥2 additional contacts, and receiving 16–17 of 17 intervention items. Using multilevel logistic regression analysis with a random intercept at cluster level, we identified factors associated with adequate contact and high-quality ANC, PPC and PNC. Results The percentage of crude adequate contact was 60.9% for ANC, 61.3% for PPC and 11.5% for PNC. However, the percentage of quality-adjusted contact was 14.6% for ANC, 15.2% for PPC and 3.6% for PNC. Adequate contact was associated with receiving high-quality care at ANC, PPC and PNC. Being a teenager, low educational level, multiparity and low level in the household wealth index were negatively associated with adequate contact with healthcare providers for ANC and PPC. Receiving a maternal and child health handbook was positively associated with adequate contact for ANC and PPC, and with receiving high-quality ANC, PPC and PNC. Conclusion Women and newborns do not receive quality care during contact with skilled care providers in Myanmar. Continuity and quality of maternal and newborn care programmes must be improved.

The relationship between hospital volume and patient outcome is globally known; thus, hospital volume is widely used as a quality indicator. In Japan, however, recent studies on this topic are scarce. The present study examined whether hospital surgery volume is associated with postoperative 5‐year survival among cancer patients. Using the Osaka Cancer Registry, we identified a sample of 86 145 patients who were diagnosed with cancer at any of five different sites (stomach, colorectum, lung, breast and uterus) and underwent surgeries between 2007 and 2011 in Osaka. We ranked hospitals by annual surgical volume, sorted patients in descending order by hospital volume, and assigned them into quartiles (high, medium, low and very low volume). We analyzed the association between hospital volume and 5‐year survival among 80 959 patients aged between 15 and 84 years using Cox proportional hazard models. Adjustments were made for characteristics of patients, type of surgery and adjuvant treatment received. The mortality hazard of patients treated at very low‐volume hospitals was 1.36‐1.82‐fold higher than that of patients treated at high‐volume hospitals. Absolute differences in adjusted survival rates between high‐volume and very low‐volume hospitals varied with the cancer site: 14.9 in stomach, 11.5 in colorectal, 10.8 in lung, 2.4 in breast and 3.3 in uterine cancers. Hospitals with lower surgery volumes showed higher mortality risks after cancer surgery than those with higher volumes. Monitoring site‐specific surgery volumes and referring patients from low‐volume to high‐volume hospitals may be beneficial for improving the long‐term survival of cancer patients.

This study focused on children as well as adolescents and young adults (AYAs) and aimed to examine trends in survival of leukemia over time using population‐based cancer registry data from Osaka, Japan. The study subjects comprised 2254 children (0‐14 years) and 2,905 AYAs (15‐39 years) who were diagnosed with leukemia during 1975‐2011. Leukemia was divided into four types: acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic myeloid leukemia (CML), and other leukemias. We analyzed 5‐year overall survival probability (5y‐OS), using the Kaplan‐Meier method and expressed time trends using the joinpoint regression model. For recently diagnosed (2006‐2011) patients, a Cox proportional hazards model was applied to determine predictors of 5y‐OS, using age group, gender, and treatment hospital as covariates. Over the 37‐year period, 5y‐OS greatly improved among both children and AYAs, for each leukemia type. Among AYAs, 5y‐OS of ALL improved, especially after 2000 (65% in 2006‐2011), when the pediatric regimen was introduced but was still lower than that among children (87% in 2006‐2011, P < .001). Survival improvement was most remarkable in CML, and its 5y‐OS was over 90% among both children and AYAs after the introduction of molecularly targeted therapy with tyrosine kinase inhibitors. Among patients with recently diagnosed AML, the risk of death was significantly higher for patients treated at nondesignated hospitals than those treated at designated cancer care hospitals. The changes in survival improvement coincided with the introduction of treatment regimens or molecularly targeted therapies. Patient centralization might be one option which would improve survival.