常葉学園大学

Public management faces increasingly complex issues requiring collaborative innovation. Within the new public governance paradigm, co-creation involves multiple stakeholders combining resources and expertise. Open-source/hybrid platforms, with greater transparency and inclusivity than general digital platforms - offer promising tools for digital collaboration. However, their use and impact in digital public service co-creation remains limited. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, this systematic literature review examines how digital public services are co-created through open-source-based/hybrid platforms. This review synthesises existing cases to identify platform characteristics, public value outcomes, stakeholder participation, and broader societal effects. From the initial screening of 1857 publications, 17 were included. The analysis reveals that these platforms foster collaboration, transparency, and inclusive innovation, with evidence of public value creation and positive social outcomes. Challenges persist, including digital literacy, technological readiness, organisational inertia, and sustainable engagement. Future research should examine these barriers, governance models, stakeholders' motivations, and emerging dimensions such as using artificial intelligence in co-creation ecosystems.

Background:Many older adults lack eHealth literacy to effectively benefit from digital health technologies. We examined the association between daily digital device use and eHealth literacy among older adults hospitalized for heart failure (HF). Methods and Results:This prospective multicenter cohort study enrolled patients aged ≥65 years hospitalized for HF. eHealth literacy was assessed at discharge using the eHealth Literacy Scale (eHEALS). Digital device use was evaluated based on daily usage time. Logistic regression analyses examined associations between digital device use and high eHealth literacy (eHEALS ≥26). In all, 219 patients (mean [±SD] age 82.0±7.9 years; 42.2% women) were analyzed. Device users had higher eHealth literacy than non-users. Daily digital device use >1 h/day was significantly associated with high eHealth literacy (odds ratio 13.01; 95% confidence interval 3.38-50.08). Among device users, high eHealth literacy was associated with a greater use of devices for emails or messaging, searching for health information, pedometer use, and administrative procedures (e-government services). Conclusions:eHealth literacy among hospitalized older adults with HF was low but significantly associated with digital device use. Information-seeking and interactive digital behaviors were linked to higher eHealth literacy. Tailoring discharge education to individual eHealth literacy levels may be important for planning post-discharge self-management support.

The aim of the present study was to apply the perspective of Imaginary Future Generations (IFGs), a method that has proved effective in generating “futurability,” to a large-scale questionnaire survey of residents in a Japanese municipality, in order to analyze the influence of IFGs on attitudes toward water supply infrastructure maintenance and management, the willingness to pay higher water rates, and attitudes toward regional integration of water supply services. In questionnaires distributed to 2000 randomly selected households in Suita City, Osaka Prefecture, respondents were asked to answer questions from the perspectives of both current generations and IFGs. The responses were then compared to statistically analyze the effects of adopting the perspective of IFGs. The results showed that incorporating the perspective of future generations makes it possible to increase the degree of acceptance among residents of increases in water rates, regional integration of water supply services, and other essential issues related to the management of water supply infrastructure, as well as to enable more flexible consideration of long-term water supply initiatives. The present study also demonstrated the influence of the pattern of description of the future society. For the group of respondents that held a pessimistic vision of the future from the perspective of IFGs, the effectiveness of applying IFGs for increasing support for water rate increases and the perception of a water rate increase being acceptable (%) was particularly high. These results can offer valuable insights for future examination of policies relating to sustainable water supply infrastructure maintenance.

With the global aging society, the number of heart failure (HF) patients is increasing significantly, and it is becoming a major issue in healthcare economics. Therefore, measurement of plasma B-type natriuretic peptide (BNP) or N-terminal pro-BNP (NT-proBNP) in community health check-ups has been suggested for early detection and prophylactic treatment of HF. Previous studies in patients with HF have reported that high levels of BNP and NT-proBNP are associated with decreased skeletal muscle mass and motor function, which are associated with mortality. This study aimed to clarify the distribution of NT-proBNP levels and association between NT-proBNP levels, skeletal muscle mass, and motor function in community-dwelling older adults. Study participants were functionally independent adults aged ≥65 years who voluntarily participated in a longitudinal cohort study. NT-proBNP was measured and categorized into four groups according to NT-proBNP levels: <125 pg/mL, 125-299 pg/mL, 300-899 pg/mL, and ≥900 pg/mL. Skeletal muscle mass was assessed using bioelectrical impedance analysis. Grip strength, usual gait speed, and five-repetition sit-to-stand test (5STS) were measured as parameters of motor function. The analysis included 1,766 participants (mean age: 74 ± 5 years, 43% males) with a mean blood NT-proBNP level of 131 ± 236 pg/mL. The distribution of NT-proBNP levels was as follows: <125 pg/mL in 73% of participants, 125–299 pg/mL in 20%, 300–899 pg/mL in 5%, and ≥900 pg/mL in 2%. This distribution was similar in participants without a history of cardiac disease (n=1664). One-way ANOVA for the four groups showed that SMI, grip strength, and usual gait speed significantly decreased, and 5STS significantly increased with increasing NT-proBNP. In multiple regression analysis adjusting for age, body mass index, creatinine, and exercise habits, the group with ≥900 pg/mL had significantly lower usual gait speed (males: P =0.005, females: P =0.002) and significantly longer 5STS (males: P =0.025, females: P <0.001) compared to those with NT-proBNP <125 pg/mL. Among functionally independent older adults living in the community, 27% had NT-proBNP levels ≥125 pg/mL, indicating preclinical or potential HF, and those with levels ≥900 pg/mL showed impaired motor function.Distribution of NT-proBNP Multiple regression analysis