KEIO RESEARCHERS INFORMATION SYSTEM

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• Thomas Mayers is a lecturer at the School of Medicine, Keio University. His research focuses on medical education, student motivation, and healthcare communication, with particular interests in the impact of COVID-19, gerontology, and health services research.

Other Affiliation 【 Display / hide 】

Other Affiliation 【 Display / hide 】

• University of Tsukuba, Institute of Medicine

Academic Degrees 【 Display / hide 】

Academic Degrees 【 Display / hide 】

• Doctor of Philosophy in Medical Sciences, University of Tsukuba, Dissertation, 2026.12

Papers 【 Display / hide 】

Papers 【 Display / hide 】

• Barriers and facilitators to healthcare access for refugee, immigrant, and migrant populations during the COVID-19 pandemic: an overview of reviews

  T Mayers, Y Terunuma, R Inokuchi, F Guantai, HZ Ring, J Akashi

  BMC Health Services Research 26 ( 1 )  2026.12

  Research paper (scientific journal), Joint Work, Lead author, Last author, Corresponding author, Accepted

  　View Summary

  Background: Refugee, immigrant, and migrant (RIM) populations experienced unique obstacles to healthcare during the COVID-19 pandemic. Already facing displacement, insecure legal status, and economic instability, RIM populations were further affected by service disruptions, discrimination, and systemic weaknesses. The objective of this overview of reviews was to synthesize evidence on barriers and facilitators to healthcare access for RIM populations during the COVID-19 pandemic. Methods: This review followed the PRISMA 2020 guidelines and the protocol was registered in PROSPERO (CRD42024552590). Systematic searches of Embase, CINAHL, MEDLINE, PubMed, CENTRAL, Web of Science, and Google Scholar (January 2020 onward) identified systematic reviews addressing healthcare access for RIM during COVID-19. Two reviewers independently screened studies, extracted data, and assessed methodological quality using AMSTAR 2. Narrative synthesis was used to categorize barriers and facilitators into cross-cutting domains following a socio-ecological model framework. Results: Nine systematic reviews (published 2021–2024) met inclusion criteria, encompassing 14–256 primary studies each, and spanning low-, middle-, and high-income settings across the Americas, Europe, Africa, the Middle East, and Asia. Nine interacting domains of barriers and facilitators emerged involving legal constraints, economic concerns, service provision, physical and digital access, trust and confidence, information and communication, cultural and social influences, psychological and perceptual factors, and structural/systemic weaknesses. Common barriers included fear of deportation, exclusion from national health or social protection systems, job and income loss, high direct and indirect costs, service closures, overcrowded housing, discrimination, and misinformation. Facilitators included suspension of exclusionary policies, telemedicine and digital tools, mobile clinics, multilingual and culturally appropriate communication, messaging from trusted clinicians and community leaders, and civil society engagement. Conclusions: This overview shows that the pandemic both intensified long-standing barriers and prompted innovative solutions for RIM healthcare access. Lessons from the pandemic can help guide future sustainable, inclusive health systems for displaced populations.

  • Access to Document (DOI)

• The Impact of COVID-19 on Healthcare Students’ Academic Motivation: A Scoping Review

  T Mayers, CK Ho, N Maki, T Maeno

  International Medical Education 5 (1), 31 5 ( 1 )  2026.03

  Research paper (scientific journal), Joint Work, Lead author, Last author, Corresponding author, Accepted

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  The COVID-19 pandemic caused major disruption to healthcare education worldwide, forcing rapid transitions to online learning, interruptions to clinical placements, and heightened uncertainty that profoundly influenced student experiences. Given that academic motivation is a key determinant of learning quality, persistence, and professional identity, this review sought to consolidate global evidence on how the pandemic affected healthcare students’ motivation to study. A systematic search of peer-reviewed literature was conducted following PRISMA-ScR guidelines, identifying studies across medicine, nursing, and allied health programs that reported on changes in motivation and the factors shaping these trajectories. Extracted data were synthesized narratively, with attention to emerging themes such as stress, anxiety, burnout, resilience, gender differences, and the role of professional identity formation. Findings revealed substantial variability: while many students reported reduced motivation due to social isolation, technological barriers, and limited clinical exposure, others described increased drive linked to professional responsibility, adaptability, and resilience. Evidence also indicated gendered differences in motivational patterns, with female students more likely to report stress-related declines. Overall, the pandemic exposed both vulnerabilities and strengths in healthcare student motivation, pointing to the value of educational strategies that promote motivation, resilience, and professional identity development among future practitioners.

  • Access to Document (DOI)

• Gender Differences in the Impact of Autism Spectrum Traits and Camouflaging on Mental Health and Work Functioning: A Structural Equation Modeling Approach

  T Omiya, T Sankai, W Sato, A Matsunaga, K Nakano, Y Hara, M Iwamoto, ...

  Psychiatry International 7 (1), 38 7 ( 1 )  2026.02

  Research paper (scientific journal), Joint Work, Lead author, Last author, Corresponding author, Accepted

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  In white-collar workplaces, individuals with autism spectrum disorder (ASD) traits may experience psychological strain and reduced productivity. This study examined structural relationships among ASD traits, social camouflaging, psychological distress, and work functioning impairment, with a focus on gender differences using a secondary analysis of data from an online survey of 543 Japanese white-collar workers (284 men, 259 women). Validated instruments were used to assess ASD traits, camouflaging, psychological distress, and work functioning impairment. Multi-group structural equation modeling by gender was applied using a NIOSH-inspired model. Men scored higher on the Imagination subscale of ASD traits, whereas women scored higher on Attention Switching and Assimilation. ASD traits were indirectly associated with work impairment through psychological distress, while the direct path between ASD traits and work impairment became negative when distress was controlled, indicating a statistical suppression pattern that was more pronounced among women. Assimilation was significantly associated with psychological distress in women but not in men, although the gender difference was at the trend level. The findings indicate a cross-sectional, context-dependent association between ASD traits and work functioning and highlight the importance of considering both gender and workplace context in non-clinical working populations.

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• Advancing Social Impact in the Fight Against Antimicrobial Resistance: Lessons from the Infection Diagnosis Workshop

  T Mayers, CK Ho, Y Ushijima, LTT Nguyen, LQ Luan, NV Thuan, ...

  Antibiotics 15 (1), 64 15 ( 1 )  2026.01

  Research paper (scientific journal), Joint Work, Lead author, Last author, Corresponding author, Accepted,  ISSN  2079-6382

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  Background/Objectives: Antimicrobial resistance (AMR) is a major global health threat that reduces antibiotic effectiveness and increases healthcare burdens. Countries in the Asia–Pacific region face a particularly high AMR burden, necessitating international collaboration, education, and practical training to combat this growing crisis. This study describes the design, implementation, and educational outcomes of the Infection Diagnosis Workshop, a short-term international program primarily targeting undergraduate medical sciences students that integrates AMR-focused hands-on clinical microbiology training and lectures, alongside cross-cultural collaboration and scientific English communication. Methods: The Infection Diagnosis Workshop was implemented as a four-day program combining lectures with hands-on laboratory activities. Training emphasizes the detection and analysis of antibiotic-resistant bacteria through environmental sampling, bacterial culturing, phenotypic and genotypic resistance detection, and species identification, core components that have remained consistent since the workshop’s establishment. Students also attended lectures on AMR science, global impact, and management strategies. Group discussions and collaborative tasks encouraged interdisciplinary learning. A thematic analysis of student feedback essays from previous workshop cohorts was conducted to identify key concepts, learning outcomes, and shared experiences. All participants provided informed consent for the use of their written feedback. Results: Thematic analysis revealed key learning outcomes categorized into three themes: (1) Knowledge, Awareness, and Technical Skills; (2) Cultural Understanding and Cross-Cultural Collaboration; and (3) English Language and Communication Skills. Students reported increased AMR knowledge, improved laboratory proficiency, enhanced cultural adaptability, and greater confidence in English communication. They also expressed a deeper appreciation for interdisciplinary and international approaches to AMR. Conclusions: The Infection Diagnosis Workshop effectively integrated practical laboratory training with international and cross-cultural engagement. The program strengthened student competencies and contributed to building global partnerships essential for combating AMR.

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• Loneliness and Its Association with Depression, Aspiration Risk, and Conversation in Japanese Older Adults

  N Maki, H Matsuda, S Eto, A Araki, T Takao, T Mayers

  Healthcare 14 (2), 190 14 ( 2 )  2026.01

  Research paper (scientific journal), Joint Work, Lead author, Last author, Corresponding author, Accepted,  ISSN  2227-9032

  　View Summary

  Background/Objectives: Loneliness is a critical public health concern associated with adverse mental and physical health outcomes in later life. However, few large-scale studies have examined loneliness in relation to depression, aspiration risk, frailty, and social participation among Japanese older adults. This study examined associations between loneliness and psychosocial and health-related factors among older adults. Methods: This cross-sectional study involved a secondary analysis of data obtained from online surveys conducted in 2018 and 2021 among 1000 community-dwelling Japanese adults (≥65 years). Loneliness was assessed using the UCLA Loneliness Scale Version 3 and dichotomized at the median to define a high-loneliness group. Depressive symptoms, aspiration risk, frailty, conversation frequency, and volunteering participation were assessed using validated scales. Multivariable logistic regression was used to identify factors associated with loneliness and interaction terms were examined to assess effect modification. Results: High loneliness was observed in 52.2% of participants. Greater loneliness was significantly associated with depressive symptoms (GDS ≥ 5; OR = 4.69, 95% CI: 2.84–7.76), higher dysphagia risk (DRACE score; OR = 1.08, 95% CI: 1.00–1.16), and lower daily conversation frequency (OR = 0.76, 95% CI: 0.67–0.86); however, volunteering (OR = 0.475, 95% CI: 0.23–0.87) was a protective factor. Conclusions: Loneliness among Japanese older adults is closely linked to depressive symptoms and aspiration risk, while frequent conversations and volunteer participation appear to be protective. Community-based interventions promoting social engagement and oral health may mitigate loneliness and its health consequences and improve quality of life for older adults. Given the cross-sectional design, the observed associations should not be interpreted as causal.

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Research Projects of Competitive Funds, etc. 【 Display / hide 】

Research Projects of Competitive Funds, etc. 【 Display / hide 】

• On the efficacy of learning to communicate in English with a voice-recognition-based app

  2023.04

  -

  2027.03

  Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), No Setting

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  This study will analyze the efficacy of Japanese medical students learning how to communicate in English in a given scenario using a speech-recognition-based app. The efficacy of the newly developed app will be compared against the efficacy of learning by studying printed/electronic materials.
  The app has been made available to students and we are currently collecting data regarding app usage. In the original proposal, we planned to present preliminary results in 2025 at domestic conferences. Due to the delay in app development, we carried out complementary research on medical vocabulary and published 2 articles in peer-reviewed journals describing common medical English vocabulary items:
  Florescu, Cosmin Mihail, and Ryosuke L. Ohniwa. 2025. "On the creation of a corpus-derived medical multi-word term list" Information 16, no. 2: 118. https://doi.org/10.3390/info16020118
  Florescu, Cosmin Mihail, and Ryosuke L. Ohniwa. 2025. "On the replicability of corpus-derived medical word lists" Applied Corpus Linguistics (in press): 100130. https://doi.org/10.1016/j.acorp.2025.100130
  Progress was made in completing the goals set for FY2024 as follows:
  (1) creation of the medical interview scripts: Completed
  (2) development of matching algorithm and app: Completed
  (3) student data collection (traditional study method + app study method): Ongoing.
  (4) experiment implementation (app study method): Ongoing
  Regarding (2): The first version of the app is now available and has been shared with the students who gave consent. Regarding (3): Student data is being collected at the principal investigator's institution. Regarding (4): The experiment (introducting the option to study with the app) is now ongoing but has been delayed by one-year compared to the original schedule.
  Regarding (3): The first version of app/algorithm is now avaiable to students (from April 2025).
  Rergarding (4): Student data collection will be limited to the principal investigator's institution (University of Tsukuba). Data for AY2023 and
  AY2024 will constitute baseline (pre-intervention) data, while data collected for AY2025 and AY2026 will constitute post-intervention data.
  The lack of student data from other institutions may affect the generalizability of findings regarding the app's efficacy.
  On the other hand, we have carried out extensive research on medical vocabulary to refine the scripts used in the app and published 2 articles on this topic. To make up for the delay, we will present domestically our research on medical vocabulary at 2 conferences in 2025.

• 国際移民の統合に関する実証分析と理論的制度設計に基づく地域社会実装研究

  2021.07

  -

  2027.03

  Grants-in-Aid for Scientific Research, Grant-in-Aid for Challenging Research (Pioneering), No Setting

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  本研究は、国際移民のホスト社会における統合が促される条件を究明する。本研究を構成するのは、第一に、基礎調査（１：法制度整備・公的支援調査、２：経済社会的貢献調査、３：異文化受容性調査）である。第二に、上の調査にもとづく理論的制度設計である。第三に、調査と制度設計にもとづく、生活・教育・就労・意識啓発・評価法開発等の側面からの、自治体をベースとする地域社会実装事業の展開である。上記を通じ、日本を事例とする、実践的な社会統合研究の基礎を築く。同時に、非移民国・地域でありながらも特に1990年代以降に「移民社会化」が進んだ東アジアの事例との比較考察を試みる。
  本科研研究の4年目の2024年度は、前年度からの作業を続け、移民の社会統合をテーマとする包括的な日本語及び外国語の文献調査、各メンバーの専門と担当する調査（海外調査、自治体調査、企業調査、法制度・政策調査等）に応じた個別の事前準備に加えて、昨年度と同様に複数の自治体等での現地調査（愛媛県今治市、山口県周防大島町、静岡県浜松市ほか）を行った。同現地調査においては、自治体における諸政策、すなわち観光、産業、労働・雇用、人口誘致、外国籍住民支援（日本語教育等）などの現状と課題についてのヒアリングのほか、企業、国際交流協会、NPO、ボランティアの取り組みについて聴聞を行った。また、上記の内容に関連する研究会を開催した、研究会では、全体の方針、今後の進め方、各メンバーの主たる役割 について議論し、今後の研究成果の取りまとめに関して現時点での知見の共有をはかった。メンバーによる具体的な研究実績としては、『現代日本の政治的不平等：参加・代表における格差と分断のメカニズム』（分担著）、『イスラーム・ジェンダー・スタディーズ７　日本に暮らすムスリム』（分担著）、『高学歴中国人移民女性のライフコース』（分担著）、Research Handbook on Migration and Employment（分担著）のほか、『移民政策研究』、『多文化共生研究』、『平和研究』、『市民と法』、『労働法律旬報』、『世界』などに学術論文が掲載された。国内外での研究報告も高頻度で行われおり、研究成果の土台を築きつつある。
  本科研研究の内容は、理論研究と社会実装に大きく分かれる。初年度は前者に特化した活動を行い、2年目の2022年度については、特に前半は新型コロナウイルスの影響を受け対面型の研究実践を控えたが、後半には視察調査を中心に地域との関りを深める活動を関東圏を中心に展開しており、3年目に引き継がれた。その2023年度と2024年度は、本科研テーマの鍵概念である社会統合の系譜的かつ領域横断的な理解を深めながら、複数の調査対象自治体との関係を構築し、実際に複数の現地調査を実施し、関係する諸アクター（国際交流団体、支援団体、福祉施設、企業等）との調整を進めることで、次の段階に進む準備をしている。 関連する論文の刊行も複数なされており、その点で本科研は4年目においてもおおむね順調に進展していたといえる。
  本科研の5年目においては、これまでと同様に移民の社会統合の理論研究を進めつつ、年度の後半には、社会実装のイメージをさらに具体的に共有できる状況 を目指す。これには、調査地・調査対象の選定や、調査方法の検討を含む。また、地域連携に強みを持つ研究者をあらたに迎えた。20名近い研究メンバーを擁する 本科研の性質上、この先は特に、メンバーの役割のさらなる明確化が求められる。そのため、適宜研究会を開催し、意見交換を行いながら、調査種類別（海外調 査、自治体調査、企業調査、法制度・政策調査等）、調査地別のチーム構成し、5年目の本格調査ならびに研究成果の最終取りまとめのための準備に臨む。

• Evaluation of the Effectiveness of a Narrative Sleep Care Program for Elderly People Living Alone

  2020.07

  -

  2024.03

  Grants-in-Aid for Scientific Research, Matsuda Hitomi, Grant-in-Aid for Challenging Research (Exploratory), No Setting

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  The purpose of this study was to examine frailty and relationships as factors associated with loneliness and poor sleep quality among community-dwelling, independent-living, single elderly persons. Although the face-to-face survey was limited due to the effects of the Corona disaster, a literature review and Internet survey revealed an association between the poor sleep quality group and frail. Furthermore, there was a need to assess sleep quality and the number of diseases under treatment, DRACE (dysphagia screening for eating and swallowing disorders), GDS (depression), frequency of conversation, and consulting partners for early detection of frailty. Although it was not possible to find sleep quality and relationship characteristics with older adults living alone, the study suggested the need to examine social relationships.

Courses Taught 【 Display / hide 】

Courses Taught 【 Display / hide 】

• ENGLISH 3

  2026

• ENGLISH 1

  2026