SUMMARYThis paper describes geographically weighted Poisson regression (GWPR) and its semi-parametric variant as a new statistical tool for analysing disease maps arising from spatially non-stationary processes. The method is a type of conditional kernel regression which uses a spatial weighting function to estimate spatial variations in Poisson regression parameters. It enables us to draw surfaces of local parameter estimates which depict spatial variations in the relationships between disease rates and socio-economic characteristics. The method therefore can be used to test the general assumption made, often without question, in the global modelling of spatial data that the processes being modelled are stationary over space. Equally, it can be used to identify parts of the study region in which 'interesting' relationships might be occurring and where further investigation might be warranted. Such exceptions can easily be missed in traditional global modelling and therefore GWPR provides disease analysts with an important new set of statistical tools. We demonstrate the GWPR approach applied to a dataset of working-age deaths in the Tokyo metropolitan area, Japan. The results indicate that there are signiÿcant spatial variations (that is, variation beyond that expected from random sampling) in the relationships between working-age mortality and occupational segregation and between working-age mortality and unemployment throughout the Tokyo metropolitan area and that, consequently, the application of traditional 'global' models would yield misleading results.

Vaccination could be a key protective measure against coronavirus disease 2019 (COVID-19), and it is important to understand the acceptability of the COVID-19 vaccine among the general public. However, there is no study on the acceptance of a COVID-19 vaccine in Japan. Therefore, this study aimed to describe the COVID-19 vaccine acceptance and hesitancy situation in Japan and assess the factors associated with such issues. This was a cross-sectional study based on an internet survey completed by 2956 people. Participants were asked to indicate how likely they were to get vaccinated for COVID-19. In addition, the participants responded to questions regarding sociodemographic factors, attitudes, and beliefs regarding COVID-19 infection and vaccination. The proportion of participants with a high likelihood of getting a COVID-19 vaccine was 62.1%. Multiple logistic regression analysis showed that vaccine acceptance was lower among several sociodemographic groups, such as women, adults aged 20–49 years, and those with a low-income level. Several psychological factors, especially the perceived effectiveness of the COVID-19 vaccine, and willingness to protect others by getting oneself vaccinated, were associated with vaccine acceptance. Our results indicate that the perceived effectiveness of the vaccine and willingness to protect others may play an important role in the acceptance of the COVID-19 vaccine.

ObjectivesA heat-not-burn (HNB) tobacco product, IQOS, was first launched in Japan and Italy as test markets and is currently in commerce in 30 countries. Using two data sources, we examined interest in HNB tobacco (IQOS, Ploom and glo), its prevalence, predictors of its use and symptoms from exposure to secondhand HNB tobacco aerosol in Japan, where HNB tobacco has been sold since 2014.MethodsPopulation interest in HNB tobacco was explored using Google search query data. Prevalence of HNB tobacco current use (ie, use in the previous 30 days) was calculated using a longitudinal internet survey of 8240 individuals (15–69 years old in 2015) followed up to 2017. Rates of perceived symptoms from exposure to exhaled aerosol of others’ HNB tobacco were also calculated.ResultsThe largest internet search volume for IQOS occurred in April 2016 in the week after a popular national entertainment TV show introduced IQOS. For Ploom and glo, search volumes have remained limited since their launch. Prevalence of IQOS users increased from 0.3% in January–February 2015 to 0.6% in January–February 2016 and up to 3.6% in January–February 2017, while estimated rates of use of other HNB tobacco products remained low in 2017. Respondents who had seen the TV programme in 2016 were more likely to have used IQOS than those who had not seen it (10.3% vs 2.7%). Among never-smokers who had been exposed to secondhand HNB tobacco aerosol, nearly half reported at least one acute symptom, although these symptoms were not serious.ConclusionsA popular TV programme triggered IQOS diffusion in Japan. Extrapolating from survey results to the general population, around 3.1 million people currently use IQOS in Japan. Tobacco control organisations and governments should closely monitor HNB tobacco and consider how to regulate it.

For an effective interpretation of spatio-temporal patterns of crime clusters/hotspots, we explore the possibility of three-dimensional mapping of crime events in a spacetime cube with the aid of space-time variants of kernel density estimation and scan statistics. Using the crime occurrence dataset of snatch-and-run offences in Kyoto City from 2003 to 2004, we confirm that the proposed methodology enables simultaneous visualisation of the geographical extent and duration of crime clusters, by which stable and transient space-time crime clusters can be intuitively differentiated. Also, the combined use of the two statistical techniques revealed temporal inter-cluster associations showing that transient clusters alternatively appeared in a pair of hotspot regions, suggesting a new type of "displacement" phenomenon of crime. Highlighting the complementary aspects of the two space-time statistical approaches, we conclude that combining these approaches in a space-time cube display is particularly valuable for a spatio-temporal exploratory data analysis of clusters to extract new knowledge of crime epidemiology from a data set of spacetime crime events.t gis_1194 223..240

BackgroundRecent research has revealed the importance of neighborhood environment as a determinant of physical activity. However, evidence among elderly adults is limited. This study examined the association between perceived neighborhood environment and walking for specific purposes among Japanese elderly adults.MethodsThis population-based, cross-sectional study enrolled 1921 participants (age: 65–74 years, men: 51.9%). Neighborhood environment (International Physical Activity Questionnaire Environmental Module) and walking for specific purposes (ie, transportation or recreation) were assessed by self-report. Multilevel logistic regression analyses with individuals at level 1 and neighborhoods at level 2 were conducted to examine the association between environment and walking, after adjustment for potential confounders.ResultsAccess to exercise facilities, social environment, and aesthetics were associated with total neighborhood walking. Odds ratios (95% CI) were 1.23 (1.00–1.51), 1.39 (1.14–1.71), and 1.48 (1.21–1.81), respectively. Regarding walking for specific purposes, social environment and aesthetics were consistent correlates of both transportation walking and recreational walking. Environmental correlates differed by specific types of walking and by sex. Transportation walking significantly correlated with a greater variety of environmental attributes. Sex differences were observed, especially for transportation walking. Bicycle lanes, crime safety, traffic safety, aesthetics, and household motor vehicles were significant correlates among men, while access to shops, access to exercise facilities, and social environment were important among women.ConclusionsSpecific environment–walking associations differed by walking purpose and sex among elderly adults. Social environment and aesthetics were consistent correlates of both transportation walking and recreational walking. Improving these environmental features might be effective in promoting physical activity among elderly Japanese.

BackgroundAlthough many studies have reported the association between neighborhood built environment (BE) and physical activity (PA), less is known about the associations for older populations or in countries besides the US and Australia. The aim of this paper is to examine the associations for older adult populations in Japan.MethodsOur analyses were based on cross-sectional data from the Aichi Gerontological Evaluation Study (AGES), conducted in 2003. The respondents were older adults, aged 65 years or over (n = 9,414), from 8 municipalities across urban, suburban, and rural areas. The frequency of leisure time sports activity and total walking time were used as the outcome variables. Using geographic information systems (GIS), we measured residential density, street connectivity, number of local destinations, access to recreational spaces, and land slope of the respondents' neighborhoods, based on network distances with multiple radii (250 m, 500 m, 1,000 m). An ordinal logistic regression model was used to analyze the association between PA and BE measures.ResultsPopulation density and presence of parks or green spaces had positive associations with the frequency of sports activity, regardless of the selected buffer zone. The analysis of total walking time, however, showed only a few associations.ConclusionsOur findings provide mixed support for the association between PA and the characteristics of BE measures, previously used in Western settings. Some characteristics of the neighborhood built environment may facilitate leisure time sports activity, but not increase the total walking time for Japanese older adults.

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To clarify the implementation status of personal protective measures by ordinary citizens in Japan during the coronavirus disease 2019 (COVID-19) outbreak. Methods: This was a cross-sectional study based on internet-based survey. A total of 2400 people (50% male: 20-79 years) were selected between February 25 and 27, 2020, from registrants of an Internet research company, to complete a questionnaire. Participants were asked to indicate how often they implemented the following five personal protective measures recommended by the World Health Organization (hand hygiene, social distancing measures, avoiding touching the eyes, nose and mouth, respiratory etiquette, and self-isolation). In addition, the participants responded to questions regarding the daily frequency of hand hygiene events. Results: The prevalence of the five personal protective measures ranged from 59.8% to 83.8%, with the lowest being avoiding touching the eyes, nose, and mouth. In total, 34.7% implemented all personal protective measures. The median daily hand hygiene events were 5 per day (25th percentile, 75th percentile: 3,8). Conclusions: The protective measures implemented by ordinary citizens are insufficient and further public awareness activities are required.