Aging of the population in Japan and its implications to the other Asian countries

Human resource challenges for physical therapists in Japan: a hybrid time-series and system dynamics analyses for the near, mid and long-term horizons

INTRODUCTION

There have been growing concerns that the present annual supply of more than 14,000 physical therapists in Japan may signal a potential human resource challenge. The assumption that any increase in supply would be sustained by an increase in demand from an aging population has never been adequately investigated.

PURPOSE

The aim of this study was to investigate the human resource challenges faced by physical therapists in Japan, and to develop forecasting models (low, mid and high-growth) for the near (5-year), mid (20-year) and long-term (40-year) event horizons.

METHODS

All human resource data were extracted from publicly available sources from January to May 2020 and categorized according to actual and forecasted supply and strength of demand variables using s system dynamics approach. The actual supply variables were used to validate the forecasted supply using time-series analysis.

RESULTS

The increase in forecasted supply is expected to be most severe for the high growth scenario, particularly after the mid-term horizon. The forecasted strength of demand may be expected to decrease in both the total and aged populations.

CONCLUSION

The increase in supply of PTs in Japan over the past 55-year period, and the forecasted increase over the next 45 years is still a cause for concern. The assumption that any increase in supply would be sustained by an aging population was not supported by the results of this study. These results also suggest that the possibility of a human resource challenge may arise after the mid-term event horizon.

Demographic Dividend in the Age of Neoliberal Capitalism: An Analysis of Employment and Employability in India

After examining the concept of demographic dividend and in-depth analysis of the changing demographic profile of Indian population in a comparative framework, in this study it has been argued that the transformation of demographic potential into demographic dividend is predicated on the premise that India adopts state sponsored social-economic policy regime for public health and education for its youth to acquire skills which will be required in the twenty-first century and adopts macroeconomic policies which ensures optimal use of human resources. Otherwise demographic dividend will be a myth and a mirage.

Mechanical microenvironment regulation of age-related diseases involving degeneration of human skeletal and cardiovascular systems

Age-related diseases involving degeneration of human skeletal and cardiovascular systems are now critical problems worldwide. The current review focuses on a common pathophysiological association between primary osteoporosis and vascular calcification, and reviews the mechanical response of bone cells and vascular cells to mechanical stress, as well as the coordination mechanism for intercellular signaling. With aging, calcium is lost from bones but deposited in the cardiovascular system. Bone metabolism-related molecules, such as alkaline phosphatase, matrix Gla protein, osteocalcin, osteopontin, and collagen type I; inflammatory cytokines, such as interleukin-1, -6, and tumor necrosis factor; and lipid metabolism related molecules, such as oxidized low density lipoprotein; mediate signaling in primary osteoporosis and vascular calcification. The mechanical microenvironment is a common pathophysiological basis for primary osteoporosis and vascular calcification. Mobilization of calcium from bone to vessel determines the regression rate, which could be controlled using a mechanical microenvironment. We highlight several issues: (1) linked features between primary osteoporosis and vascular calcification, and detailed changes of the mechanical microenvironment in degenerative bone or blood vessels, (2) signaling coordination mechanism between bone and vascular wall cells, and (3) calcium translocation mechanism. The degree to which these issues can be solved will help develop prevention and treatment strategies for age-related regression.

Male sexual dysfunction in Asia

Sex has always been a taboo subject in Asian society. However, over the past few years, awareness in the field of men's sexual health has improved, and interest in sexual health research has recently increased. The epidemiology and prevalence of erectile dysfunction, hypogonadism and premature ejaculation in Asia are similar in the West. However, several issues are specific to Asian males, including culture and beliefs, awareness, compliance and the availability of traditional/complementary medicine. In Asia, sexual medicine is still in its infancy, and a concerted effort from the government, relevant societies, physicians and the media is required to propel sexual medicine to the forefront of health care.

Home educating in an extended family culture and aging society may fare best during a pandemic

Large cities can contain populations that move rapidly from one section to another in an efficient transportation network. An emerging air-borne or contact based pathogen could use these transportation routes to rapidly spread an infection throughout an entire population in a short time. Further, in many developed countries, the aging population is increasing. The family structure in these societies may also affect the course of a disease. To help understand the impact of an epidemic on family structure in a networked population, an individual based computer model that randomly generates networked cities with a specified range of population and disease characteristics and individual schedules, infectivity, transmission and hygiene factors was developed. Several salient issues emerged. First, a city of highly active individuals may in fact diminish the number of fatalities because the average duration of the interactions between agents is reduced. Second, home schooling can significantly improve survival because the institutional clustering of weak individuals is minimized. Third, the worst scenario for an aging population is the nuclear family where the aged population is confined to large housing facilities. Naturally, hygiene is the first barrier to infection. The results suggest that societies where extended families and small groups manage most of their own affairs may also be the most suitable for defense against a pandemic. This may prove applicable in city planning and policy making.

Alcohol Consumption by Older Adults in Central and Southern Japan

This study ascertained the level of alcohol intake and alcoholic beverages consumed by Japanese older adults. Persons aged 55 to 75 years residing in central and southern Japan were recruited and interviewed face-to-face on their habitual alcohol consumption. Among the 577 (359 men and 218 women) participants from 10 districts/prefectures, 60.5% (75.5% for men and 35.7% for women) regularly drank alcoholic beverages on at least a monthly basis. Beer was the most preferred beverage (45.2%), followed by shochu (19.8%) and sake (16.1%). The mean alcohol consumption was 22.2 g/day (95% confidence interval 19.3-25.2) overall, but drinkers had a much higher mean intake of 36.6 g/day (95% CI 32.4-40.8). Moreover, it is alarming that 25.5% of male drinkers were heavy drinkers consuming more than 60 g of alcohol on average per day. Alcohol control measures should be developed to curtail the excessive drinking by older adults.

Application of a single sampling plan for auditing medical-claim payments made by Taiwan National Health Insurance

National Health Insurance (NHI) has been implemented in Taiwan for nearly a decade. Owing to growing demand for medical-care, effective sampling auditing is a key factor in obtaining reasonably priced medical-care services. This investigation proposes a conceptual framework "medical-claim payment auditing (MCPA) procedure" based on the "Military Standard 105E (MIL-STD-105E) single sampling plan" for establishing an objective criterion for making medical-claim payments fairly. The MCPA procedure contributes to the following: (1) meeting international standards of sampling technology; (2) reducing the sampling ratio and consequently auditing costs; and (3) encouraging healthcare providers to honestly apply their medical-claim payments thus avoid wasting medical resources.