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In Japan, the governmental recommnendation of HPV vaccine has been suspended since June 2013, due to media reports of alleged adverse vaccination events. Although evidence of effectiveness and safety of the HPV vaccine has been universally demonstrated, and the medical and academic organizations across Japan have requested the resumption of the government's recommendation, the Japanese government has not changed their official stance towards the HPV vaccine. Under the current suspension of the national government's recommendation, one local government Isumi City started sending a leaflet containing information of cervical cancer and HPV vaccine, but not recommendation for the vaccine, to the tagted girls born in the fiscal year (FY) 2003. The cumulative vaccination rate of them reached 10.07% (14/139), which was significantly higher than that (0.00%) for girls born in FY 2002 who did not receive such a leaflet (p < 0.001). We sincerely ask the national government to change their stance towards the HPV vaccine. We also strongly suggest that, in the meantime, local governments immediately begin to provide an appropriate information of cervical cancer and HPV vaccine to the targeted girls and their parents in a way similar to what Isumi City has now shown to be effective.

In Japan, the government's recommendation for the HPV vaccine has been suspended for almost 8 years. A questionnaire survey was conducted in the Tsubaki Women's Clinic, Matsuyama, Japan, to examine responses of the mothers of girls eligible for HPV vaccine before and after their doctor provided them an informative leaflet explaining the need for cervical cancer prevention. Among the 53 mothers who admitted to imposing some preconditions before being willing to encourage their daughters' HPV vaccination, 21 (40%) mothers became more willing to vaccinate their daughters immediately after receiving the cervical cancer prevention linkage explanation provided by their doctor, and seven of the mothers (33%) even returned to the clinic to get their daughter vaccinated during our study period. Logistical regression analysis revealed that having initial preconditions required for their daughters' HPV vaccination was an independent variable influencing the mothers' change of willingness to get their daughters vaccinated immediately after receiving the explanation using the leaflet. We have found that to achieve maximum effectiveness, we can use an appropriate leaflet even under suspension of the governmental recommendation. Our future efforts should be focused on those mothers who are less likely to impose preconditions on their daughter's vaccination.

The trend for cervical cancer in younger women has been increasing recently in Japan. However, as a result of the suspension of governmental recommendation, Japan's HPV (human papillomavirus) vaccination rate for girls born since 2000 has dropped sharply. We conducted an internet survey in December of 2019, 76 months after the suspension of recommendation, to verify the intention of mothers to inoculate their daughter under current circumstances and compared with our previous surveys and leaflet intervention effect. The rates of mothers who replied that they would "inoculate" were significantly higher at 9 and 23 months, but by 32 months after the suspension the rate was significantly lower (p < 0.05, p < 0.05, p < 0.05, respectively). The rates of the mothers who replied they would not inoculate were significantly lower at 9 months and 23 months, but at 76 months was significantly higher (p < 0.05, p < 0.05, p < 0.05, respectively). We found that intervention with a leaflet that could be used under the current suspension of the governmental recommendation did not increase the mothers' intention to inoculate their daughters. A leaflet that actively encourages vaccination may increase the intent of vaccination. It is strongly recommended that the MHLW promptly resume its recommendations for HPV vaccination.

In Japan, the trend for cervical cancer at younger ages has been increasing. As a countermeasure, the HPV vaccine was introduced as a routine vaccination in April 2013. However, the Ministry of Health, Labour and Welfare (MHLW) announced a "Suspension of its active inoculation recommendation for HPV vaccine" in June 2013. In 2016, 32 months after that suspension, we conducted survey via Internet and compared the results with our previous ones conducted at 9 and 23 months after suspension (in 2014 and 2015, respectively). We examined the 'time-dependent change' of the 'intention of mothers to inoculate their daughters with the HPV vaccine' in terms of efficacy of external decision-making support. 17.5% of mothers in the first survey replied that they would inoculate their daughters under the current circumstances, 12.1% in the second survey, and 6.7% in the third, showing a consistent decrease in willingness over time (p = 0.03, p < 0.01). If the government recommendation were to be reintroduced, 22.5% of mothers in the first survey replied they would inoculate their daughters, 21.0% in the second survey, which indicated no significant difference (p = 0.65) over the first interval; however, this was significantly decreased to 12.2% in the third survey (p < 0.01). Our study revealed that the intention to inoculate their daughters has been declining among Japanese mothers over time triggered by the suspension.

In 2013, recurrent reports of diverse symptoms occurring in girls after receiving HPV vaccination appeared in Japanese media. The Ministry of Health, Labor and Welfare quickly responded by announcing a temporary suspension of its recommendation for the vaccine. The HPV vaccination rate soon fell to almost zero. In the present study, we calculated the potential future numbers of cervical cancer incidence and death that will be increased by this policy decision. We have assumed that the number of yearly vaccinations is evenly distributed across a daily basis. Future incidence and death increased in females born in FY2000 are estimated to be 3651 and 904, respectively, 4566 and 1130 for those born in FY2001, 4645 and 1150 for those born in FY2002, and 4657 and 1153 for those born in FY2003. In FY2020, the large increase of risks to females born in FY2004 amounts to 12.0 females per day who will now be at a higher risk for acquiring of cervical cancer in their future, and 3.0 females per day newly at risk for future death from that disease in its progressive form. No one should be able to accept this situation. We sincerely ask the government to resume its recommendation for the vaccine as soon as possible.

Knowledge on compliance with governmental recommendations in combating the spread of COVID-19 in different groups is important to target efforts. This study investigated the adherence to the governmental implemented COVID-19 measures and its predictors in Danish university students, a not-at-risk group for COVID-19 mortality and normally characterized by many social contacts. As part of the COVID-19 International Student Wellbeing Study, a survey on socio-demographic situation, study information, living arrangements, lifestyle behaviors, stress, questions about COVID-19 infection and knowledge and concern about COVID-19 infection was sent via email to relevant university students in Denmark in May, 2020 (n = 2.945). Stepwise multiple linear regression analysis was employed. Our results showed that around 60% of the students were not concerned about COVID-19, while 68% reported that they followed governmental measures. The main facilitators for following the recommendations were older age, concern about COVID-19 and depression, while barriers were living in a student hall, being physical active or reporting mental stress. Only 9% of the variation in adhering to governmental recommendations could be explained by the analyzed predictors. Results may inform health communication. Emotionally appealing information rather than knowledge-based information may be more effective in motivating students to follow COVID-19 measures. ; Knowledge on compliance with governmental recommendations in combating the spread of COVID-19 in different groups is important to target efforts. This study investigated the adherence to the governmental implemented COVID-19 measures and its predictors in Danish university students, a not-at-risk group for COVID-19 mortality and normally characterized by many social contacts. As part of the COVID-19 International Student Wellbeing Study, a survey on socio-demographic situation, study information, living arrangements, lifestyle behaviors, stress, questions about COVID-19 infection and knowledge and concern about COVID-19 infection was sent via email to relevant university students in Denmark in May, 2020 (n = 2.945). Stepwise multiple linear regression analysis was employed. Our results showed that around 60% of the students were not concerned about COVID-19, while 68% reported that they followed governmental measures. The main facilitators for following the recommendations were older age, concern about COVID-19 and depression, while barriers were living in a student hall, being physical active or reporting mental stress. Only 9% of the variation in adhering to governmental recommendations could be explained by the analyzed predictors. Results may inform health communication. Emotionally appealing information rather than knowledge-based information may be more effective in motivating students to follow COVID-19 measures.

Knowledge on compliance with governmental recommendations in combating the spread of COVID-19 in different groups is important to target efforts. This study investigated the adherence to the governmental implemented COVID-19 measures and its predictors in Danish university students, a not-at-risk group for COVID-19 mortality and normally characterized by many social contacts. As part of the COVID-19 International Student Wellbeing Study, a survey on socio-demographic situation, study information, living arrangements, lifestyle behaviors, stress, questions about COVID-19 infection and knowledge and concern about COVID-19 infection was sent via email to relevant university students in Denmark in May, 2020 (n = 2.945). Stepwise multiple linear regression analysis was employed. Our results showed that around 60% of the students were not concerned about COVID-19, while 68% reported that they followed governmental measures. The main facilitators for following the recommendations were older age, concern about COVID-19 and depression, while barriers were living in a student hall, being physical active or reporting mental stress. Only 9% of the variation in adhering to governmental recommendations could be explained by the analyzed predictors. Results may inform health communication. Emotionally appealing information rather than knowledge-based information may be more effective in motivating students to follow COVID-19 measures.

Abstract: Knowledge on compliance with governmental recommendations in combating the spread of COVID-19 in different groups is important to target efforts. This study investigated the adherence to the governmental implemented COVID-19 measures and its predictors in Danish university students, a not-at-risk group for COVID-19 mortality and normally characterized by many social contacts. As part of the COVID-19 International Student Wellbeing Study, a survey on socio-demographic situation, study information, living arrangements, lifestyle behaviors, stress, questions about COVID19 infection and knowledge and concern about COVID-19 infection was sent via email to relevant university students in Denmark in May, 2020 (n = 2.945). Stepwise multiple linear regression analysis was employed. Our results showed that around 60% of the students were not concerned about COVID-19, while 68% reported that they followed governmental measures. The main facilitators for following the recommendations were older age, concern about COVID-19 and depression, while barriers were living in a student hall, being physical active or reporting mental stress. Only 9% of the variation in adhering to governmental recommendations could be explained by the analyzed predictors. Results may inform health communication. Emotionally appealing information rather than knowledge-based information may be more effective in motivating students to follow COVID-19 measures.

Bernard C. Gavit, chairman. ; Reprinted from the Report of the committee. ; Mode of access: Internet.

Learning organization is considered a pivotal aspect in improving organizational performance, which has become increasingly important for global leaders. This article attempts to review and critique Senge's theory of learning organization, followed by a conclusion and recommendations for practice in non-governmental organizations. The findings indicated that the five disciplines of Senge's theory encourage organizations' leaders to be inspirational, practical, and innovative within the organization. However, it is essential to consider the flaws of Senge's theory, namely the individual interests in the organization and insufficient evidence linking team learning to organizational learning, the existing top-down leadership approach, neglecting cultural differences, and the lack of experience-based value. It is vital for non-governmental organizations to consider these mentioned weaknesses of Senge's theory to ensure the efficiency of implementation.