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Economic and social difficulties at the beginning of the 20th century caused many Japanese to emigrate to Brazil. The situation was reversed in the 1980s as a result of economic downturn in Brazil and labour shortages in Japan. This book examines the construction and reconstruction of the ethnic identities of people of Japanese descent, firstly in the process of emigration to Brazil up to the 1980s, and secondly in the process of return migration to Japan in the 1990s. The closed nature of Japan's social history means that the effect of return migration' can clearly be seen. Japan is to some extent a unique sociological specimen owing to the absence of any tradition of receiving immigrants. This book is first of all about migration, but also covers the important related issues of ethnic identity and the construction of ethnic communities. It addresses the issues from the dual perspective of Japan and Brazil. The findings suggest that mutual contact has led neither to a state of conflict nor to one of peaceful coexistence, but rather to an assertion of difference. It is argued that the Nikkeijin consent strategically to the social definitions imposed upon their identities and that the issue of the Nikkeijin presence is closely related to the emerging diversity of Japanese society.

Background Accurate information is essential so that HIV infection can be detected in time for initiation of HIV/AIDS treatment. Immigrants are at high risk for delayed HIV testing and diagnosis, but foreign residents in Japan also seem to face barriers to accessing HIV/AIDS care. We aimed to assess their knowledge level of HIV/AIDS and awareness of public health centers in Japan (PHCs), and to explore factors related to these items. Methods We conducted a cross-sectional study of Brazilians, the largest group of foreigners living in Shiga, using an anonymous, self-administered questionnaire survey in Brazilian Portuguese and Japanese via the Internet and mail. A multiple logistic regression analysis was used to examine the factors related to “Knowledge of HIV/AIDS” and “Awareness of PHCs”. Results A total 182 Brazilians responded. More than half of them were beginners in Japanese. Most respondents were familiar with HIV/AIDS, but only 58% knew the existence of PHCs, and only 25% knew that HIV testing is available at PHCs free of charge and anonymously. A multiple logistic regression analysis showed that PHCs were less recognized by those with intermediate (odds ratio: 5.70, 95% confidence interval: 1.53–21.23) and beginner (odds ratio: 6.81, 95% confidence interval: 1.98–23.45) Japanese proficiency than by those with advanced. Conclusions This survey revealed the knowledge level of HIV/AIDS and awareness of PHC among Brazilians in Shiga. Their lack of awareness of PHCs due to language barriers may lead to delays in HIV testing among them. Therefore, it is important for PHCs to disseminate information about medical services related to HIV/AIDS in Portuguese and plain Japanese to facilitate their access to HIV testing. However, PHC efforts alone are not enough. Medical interpreters who are familiar with Brazilian culture and customs, and the clinics that employ them, could help the Brazilian community and PHCs to overcome the language barrier and provide efficient and appropriate medical care to Brazilians. This would be one way to eliminate delays in HIV testing for Brazilians in Shiga.

Background This study assessed the effects of a Japanese leaflet-based health guide for older Japanese-Brazilian adults living in Brazil, on health literacy, self-efficacy, and satisfaction with the health guide and participants’ subjective health status. Methods The study followed a one-group pretest-posttest design and was set in the Japanese-Brazilian community in South Brazil. The 21 participants were Japanese-Brazilian individuals aged over 65 years, living in Brazil, and able to converse in Japanese. During the annual health checkup of 2016, we provided about 20 min of health guidance in Japanese using our leaflet, which included information about lifestyle-related diseases, recommended salt and sugar intake levels, and graphical charts. Participants’ health literacy (HL) was the primary outcome; self-efficacy and satisfaction with the leaflet-based health guide and participants’ subjective health status were secondary outcomes. We assessed the effect after completion of the health checkups in 2016 and 2017. Data were analyzed using repeated measures of ANOVA and the Bonferroni multiple comparison test as required. Results There were no statistical significant differences in HL (functional HL: p -value = 0.22; communicative HL: p -value = 0.17; critical HL: p -value = 0.40; total HL score: p -value = 0.12) and self-efficacy ( p -value = 0.28) across the three assessment points. We detected a statistical significant difference in satisfaction with the health guide, post-intervention in 2016 and 2017 (baseline score: 86.7±20.4; post-intervention score in 2016: 92.5±12.2; post-intervention score in 2017: 76.2±21.9; p -value of repeated ANOVA < 0.01, η p 2 = 0.28; p -value of the multiple comparison in 2016 and 2017 = 0.01, 95% CI 4.09–28.51). However, the Bonferroni multiple comparison test did not show pairwise difference during multiple comparisons of participants’ satisfaction with their subjective health status (scores: baseline, 69.6±24.2; post-intervention in 2016, 78.5±21.1; post-intervention in 2017, 58.0±31.1; p -value of repeated ANOVA = 0.02, η p 2 = 0.21; p -values of the multiple comparisons> 0.05). Scores of all outcomes, except self-efficacy, increased from baseline to post-intervention in 2016, but declined at post-intervention in 2017. Conclusions The leaflet-based intervention appeared to have short-term effects. The findings suggest that direct intervention in older adults’ native language may improve their satisfaction when living in non-native countries. Trial registration The UMIN-CTR unique registration ID is UMIN000032443 . Retrospectively registered on May 1, 2018, at: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000036999 .