Nothing New in the (North) East? Interpreting the Rhetoric and Reality of Japanese Corporate Governance

Japan finally seems to be pulling itself out of its lost decade (and a half) of economic stagnation. Some grudgingly or triumphantly attribute this to micro-economic reforms, freeing up arthritic markets, although there is also evidence that macro-economic policy failures have been a major cause of poor performance since the 1990s. Many point to overlapping transformations in corporate governance, broadly defined to cover relationships among managers and employees as well as between firms and outside shareholders, creditors, and other stakeholders. These relationships are in flux, with moves arguably favouring shareholders and more market-driven control mechanisms. It has certainly been a found decade for law reform in Japan, particularly in corporate law, with a plethora of legislative amendments commencing around 1993 and culminating in the enactment of a consolidated Company Law in 2005. This modernisation project, particularly since 2001, is reportedly aimed at (i) securing better corporate governance, (ii) bringing the law into line with a highly-developed information society, (iii) liberalising fundraising measures, (iv) bringing corporate law into line with the internationalization of corporate activity, and (v) modernizing terms and consolidating corporate law. Because the suite of revisions has moved away from strict mandatory rules set out originally in Japan\u27s Commercial Code of 1899, modeled primarily on German law, another growing perception is that Japanese corporate law and practice is or will soon be converging significantly on US models. However, assessments remain divided as to whether these moves in corporate governance and capitalism more generally in Japan amount to a new paradigm or regime shift . Focusing primarily on quite influential commentary in English, Part I of this paper outlines two pairs of views. It concludes that the most plausible assessment is of significant but gradual transformation towards a more market-driven approach, evident also in other advanced political economies. Drawing more generally from these often virulently divided views, Part II sets out five ways forward through the proliferating literature and source material on corporate governance in Japan. Particular care must be taken in: (i) selecting the temporal timeframe, (ii) selecting countries to compare, (iii) balancing black-letter law and broader socio-economic context, (iv) reflecting on and disclosing normative preferences, and (v) giving weight to processes as well as outcomes, when assessing change in Japan - and any other country\u27s governance system. Part III ends with a call for further research particularly on law- and policy-producing processes, rather than mainly outcomes. It also outlines the usefulness of this analytical framework for analysing the broader field of Corporate Social Responsibility, now emerging as the next major area of debate and transformation in Japan - as elsewhere

Outcomes from a collaborative project developing and evaluating a community rehabilitation worker program for Northwestern Ontario First Nations

Introduction: Major inequities exist in levels of health and wellbeing, availability, and access to healthcare services between seniors of Indigenous and non-Indigenous background in Ontario. First Nations elders are 45-55% more frail than the average senior in Ontario. Additionally, needed rehabilitation services are not easily accessible or available in the first language of most First Nations elders within their home communities. A literature review demonstrated community-based rehabilitation assistant models had been successfully developed and implemented in regions facing similar equity and access challenges. Building on these findings, a needs assessment was conducted to capture unique needs and requirements in Northwestern Ontario relating to rehabilitation among First Nations elders. Methods: The needs assessment resulted in four First Nations, three Indigenous health organizations, three rehabilitation health organizations, and two academic institutions iteratively developing and evaluating curriculum for a Community Rehabilitation Worker (CRW) program in treaty territories 5, 9, and Robinson-Superior. The goal of the program is to train local CRWs, familiar with local languages and cultures, to provide rehabilitative services that support ageing in place, health, wellbeing, and quality of life for First Nations elders. The study employed a community participatory action research approach aligning with the OCAP® (Ownership, Control, Access, and Possession) framework for working with Indigenous populations. Seventeen community partners were active participants in the program development, evaluation, and adaptation of the CRW curriculum. Feedback was received through advisory committee meetings, surveys, and individual and group interviews. Results: All 101 participants agreed, across all curriculum modules, that (1) the time allotment was realistic; (2) instructional materials, activities, and resources were appropriate and easy to understand; (3) evaluation activities accurately measured learning; and (4) participants identifying as Indigenous felt that Indigenous culture was adequately reflected. The qualitative findings highlighted the importance of incorporating culture, spirituality, traditions, local language use, and reintegration of First Nations elders into traditional activities and community activities for both the CRW curriculum and rehabilitation efforts. The need for locally available First Nations, elder-focused mental health support, transportation options, and gathering spaces such as those commonly seen in urban areas was also highlighted. Conclusion: The process of iteratively developing and evaluating a CRW program resulted in a Northwestern Ontario college welcoming the first cohort of students to the CRW program in March 2022. The program is co-facilitated with a First Nations Elder and includes components of local culture, language, and the reintegration of First Nations elders into community as part of the rehabilitation efforts. In addition, to appropriately support the quality of life, health, and wellbeing of First Nations elders, the project team called upon provincial and federal governments to work with First Nations to make available dedicated funding to address inequities in resources available to First Nations elders in Northwestern Ontario urban and First Nations remote communities. This included elder-focused transportation options, mental health services, and gathering places. The program implementation will be evaluated with the first cohort of CRWs for further adaptations considering potential scale and spread. As such, the project and findings may also represent a resource for others wishing to pursue similar development using participatory approaches in rural and remote communities both nationally and internationally. Keywords: age in place, Canada, community-based program, community driven, community rehabilitation worker, First Nation, Indigenous, rehabilitation

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Lenalidomid in der B-CLL: direkte Effekte auf die Tumorzelle in vitro

Regardless of chronic lymphocytic leukaemia (CLL) being the most common adult leukemia, therapeutic approaches remain mainly palliative. Particularly in relapsed and refractory malignancies lenalidomide demonstrated promising efficacy and it is a therapeutic approach especially in elderly patients. Lenalidomide is a second generation analog of thalidomide and as such an immunomodulating drug (IMID) with various effects on the microenvironment of tumor cells. Direct cytotoxicity in CLL has been negated so far. The presented work investigates effects of lenalidomide on the tumor cell in vitro. Therefore peripheral blood mononuclear cells (PBMC) of CLL patients and CD19 sorted tumor cells have been treated and compared. Beside cell viability, intracellular pathways and cell activation have been measured. In contrast to the present postulate lenalidomide had a direct cytotoxic effect on CLL cells. An effect that can only be observed after a few days though. After 96 hours lenalidomide reduced cell viability in 24 of 27 patients by an average of 25 % compared to the negative control (p < 0,0001) and reduced ATP in all measured patients. It had an even greater effect on the sorted tumor cells compared to the unsorted environment. Particularly high risk patients (unmutated IgVH, 17p deletion, TP53 mutation) showed good treatment response. An elevated caspase-3 activity suggests that apoptosis might play a role. However the fact that the effect could not be antagonized by caspase inhibition (z-VAD-FMK) indicated that caspase independent mechanisms are involved too. A suppression of the canonical NF-κB pathway as with the predecessor thalidomide could not be demonstrated. A direct cytotoxic effect of lenalidomide in CLL represents a completely new approach. Although underlying mechanisms remain to be revealed, the good response of high risk subtypes could help allocating therapy to patients. Furthermore understanding the role of pathways such as PI3K/Akt or NF-κB in this context could help to understand the pathophysiology of the malignancy itself.Trotzdem die Chronisch Lymphatische Leukämie (CLL) die häufigste Leukämie beim Erwachsenen darstellt, bleiben die verfügbaren Therapien weiterhin von vorwiegend palliativem Charakter. Besonders bei refraktären Patienten und Rezidiven hat Lenalidomid vielversprechende Ergebnisse erzielt und stellt gerade beim älteren Patienten einen Therapieansatz dar. Als Zweitgenerationsanalogon von Thalidomid gehört es zur Gruppe der Immunmodulatoren (IMID) mit einem vielseitigen Wirkungsspektrum auf das Mikroenvironment der Tumorzelle. Direkte zytotoxische Effekte wurden in der CLL bisher verneint. In der vorliegenden Arbeit wurden der Einfluss des Medikaments auf die Tumorzelle in vitro untersucht. Dazu wurden periphere mononukläre Zellen (PBMC) von CLL-Patienten und CD19-angereicherte Tumorzellen der selben Patienten behandelt und verglichen. Untersucht wurde neben der Viabilität, intrazelluläre Signalpathways sowie die Zellaktivierung. Im Gegensatz zum bisherigen Postulat konnte hierbei gezeigt werden, dass Lenalidomid einen direkten zytotoxischen Effekt auf die CLL-Zelle besitzt. Ein Effekt, der jedoch erst nach einigen Tagen zum Tragen kommt. Nach 96 Stunden Behandlungszeit zeigte sich bei 24 der 27 untersuchten Patienten eine Reduktion der Viabilität um durchschnittlich 25 % im Vergleich zur Negativkontrolle (p < 0,0001) sowie eine ATP-Reduktion bei allen untersuchten Patienten. Dieser Effekt war zudem ausgeprägter, als bei der Behandlung der Tumorzelle in PBMC-Umgebung. Besonders Hochrisikopatienten (fehlende IgVH-Mutation, 17p-Deletion, TP53-Mutation) zeigten ein gutes Ansprechen. Eine erhöhte Caspase-3-Aktivität in den behandelten Zellen lässt zudem vermuten, dass die Induktion von Apoptose dabei eine Rolle spielt. Eine fehlende Antagonisierbarkeit durch Caspase-Inhibition (z-VAD-FMK) legt jedoch nahe, dass weiter caspaseunabhängige Mechanismen beteiligt sind. Für eine Suppression des kanonischen NF-κB -Pathways, wie bei der Vorgängersubstanz Thalidomid, gab es indes keinen Hinweis. Ein direkter zytotoxischer Effekt in der CLL stellt einen völlig neuen Ansatz dar. Auch wenn die zugrunde liegenden Mechanismen zu klären bleiben, kann das gute Ansprechen prognostisch ungünstiger Subtypen ein Anstoß bei der Zuordnung von Patient und Therapie sein. Welche Rollen PI3K/Akt oder NF-κB dabei spielen bleibt zu klären, kann aber auch dabei helfen die Pathophysiologie der Erkrankung selbst zu verstehen