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This study aims to provide an overview of the service system view (SSV), and the current status of its adoption for the development and implementation of assistive technology (AT). The role of ATs in the global aging scenario is anticipated; however, their diffusion is cumbersome. The SSV captures stakeholders, technologies, and their interactions as integrated systems. Based on this perspective, several approaches for designing long‐term care services have been proposed that would be helpful for the successful implementation of ATs. However, the existing geriatrics and gerontology literature seldom addresses these topics. Based on a literature review, this study first illustrates the challenges of using ATs in the real world. The existing literature highlights the sociotechnical challenges of utilizing ATs, such as the changes required in care work and resistance to them. To overcome the challenges, three approaches associated with the SSV have been introduced: service design, service engineering and living labs. This paper also introduces recent national projects in Japan that have adopted these approaches. As the importance of the SSV is growing for the successful implementation of ATs, the ability to adopt the SSV and its approaches is anticipated. In relation to geriatrics and gerontology studies, the impact on older adults' quality of life, as well as the economic effect, needs to be analyzed in future research. Geriatr Gerontol Int 2024; 24: 74–80. [ABSTRACT FROM AUTHOR]

As the number of people with dementia in Japan continues to rise, family caregivers are experiencing an increasing care burden. Previous research has shown that this care burden can affect family caregivers' physical and mental health. Therefore, providing support for caregivers of family members with dementia has become an urgent issue in the country. The purpose of this study was to investigate the feasibility of applying STrAtegies for RelaTives (START), a psychosocial intervention programme developed in the UK to improve caregivers' moods and quality of life, to Japanese family caregivers. Specifically, in this paper, we provide a detailed description of the application of the Japanese version of START to a female caregiver. Our investigation found that the Japanese version of START is a feasible option for alleviating the mental and physical burden on family caregivers of patients with dementia. This result provides preliminary support for the wider application of START in Japan, as it can decrease care burden and improve the daily lives of caregivers of people with dementia. It also supports the development and implementation of other systems that can provide similar services for other caregivers. [ABSTRACT FROM AUTHOR]

A large-scale prospective cohort study was conducted in Japan to investigate the clinical features of patients with gastrointestinal (GI) long-COVID symptoms. Out of 943 COVID-19 patients, 6.2% had GI long-COVID symptoms, such as diarrhea and abdominal pain. The study found that patients with GI long-COVID symptoms had significantly lower health-related quality of life (QOL) parameters compared to those without GI symptoms. Additionally, patients with GI long-COVID symptoms experienced a wider range of long-COVID symptoms. The study did not identify any specific clinical characteristics associated with GI long-COVID symptoms. Further research is needed to understand the predictive factors for GI long-COVID symptoms. [Extracted from the article]

Research on the merits of long-term group residences is inconclusive. The purpose of the present paper was to investigate the effects of supported group residence on the symptoms, social function, quality of life, general health quality, and the medical/psychiatric cost in Japan of a large number of psychiatric beds and long average length of stay. Patients were assessed every 6 months for 2 years using Positive and Negative Syndrome Scale, Katz Adjustment Scale, World Health Organization Quality of Life (WHO-QOL) and General Health Questionnaire 12-item version. Patients discharged to the supported group residence (SGR) significantly improved with regard to positive symptoms, the level of socially expected activities and free-time activities. The QOL physical domain of the inpatients was significantly more deteriorated compared to the SGR group. The total psychiatric/medical cost of the SGR group was approximately one-third that of the inpatient group, while the cost of the SGR to treat physical comorbidity was much higher. The present findings indicate that SGR has advantages for mental and social function but not for physical health. A major limitation of the present study was the high mean age (>60 years) of the subjects who had been hospitalized for a long period (mean, 24 years). [ABSTRACT FROM AUTHOR]

This paper examines reliability and validity of an instrument measuring the quality of life of elderly Japanese people with dementia. The instrument is a translation of an American instrument. The instrument has 48 items with binary answer format over five domains: 'social interaction', 'awareness of self', 'enjoyment of activities', 'feelings and mood', and 'response to surroundings'. Altogether, 321 elderly in various facilities/services in Japan were evaluated by their formal caregivers. Factor analysis supported the domain of 'enjoyment of activities', but the domains of 'awareness of self' and 'response to surroundings' were statistically overlapped. The domains of 'social interaction' and 'feeling and mood' were not supported. Test-retest reliability was generally satisfactory except for the domain of 'response to surroundings'. Interrater reliability was relatively low for domain scores but the total score was acceptable. Thus, the instrument showed moderate reliability and validity and further improvement is needed. [ABSTRACT FROM AUTHOR]

Background: Suicidal ideation is closely related to severe suicidal behaviour and is an important predictor of suicide attempt and completion, including in older people. Older people tend to have many opportunities to be conscious of death, and may have vague suicidal ideation because of various loss experiences, even if they are not depressed. We hypothesised that suicidal ideation among older people might be a risk factor for later transition to depression. The present study aimed to clarify risk factors that predict the incidence of depression in older people 3 years post‐baseline in a rural area of Japan, and to examine the subsequent course of depression among non‐depressed older people with suicidal ideation. Methods: In 2015 and 2018, survey questionnaires were mailed to residents aged 65 years and over living in a rural area in Japan. Participants were divided into a depression group and a non‐depression group using 15‐item Geriatric Depression Scale scores 3 years post‐baseline. Logistic regression analysis was used to identify predictive factors of late‐life depression 3 years post‐baseline. Results: We received 597 valid responses, with a 3‐year follow‐up rate of 78.8%. Regarding suicidal ideation, 6.7% of non‐depressed older people exhibited suicidal ideation at baseline. Of these, 9.8% exhibited depression after 3 years post‐baseline. Logistic regression analysis indicated that development of late‐life depression is significantly associated with suicidal ideation, being female, and poor health‐related quality of life (HRQOL). Conclusions: The results revealed that suicidal ideation, being female, and poor HRQOL were predictive factors of the development of late‐life depression 3 years post‐baseline in a rural area of Japan. These findings provide novel information regarding the transition to depression among community‐dwelling older people who are not depressed but have suicidal ideation. Whereas suicidal ideation is considered to be a symptom of depression, the current results suggest that suicidal ideation may precede depression in some older people. [ABSTRACT FROM AUTHOR]

Objective: Palliative care for dementia includes psychosocial interventions as first-line treatment for challenging behaviour. However, the national dementia plan in Japan contradicts recommendations for palliative care for dementia. This study aimed to examine the association between care quality for patients with dementia and professional caregivers' perspectives regarding palliative care for dementia in Japanese community care settings.Methods: In total, 2116 professional caregivers from 329 agencies (217 in-home long-term care support providers; 29 small-scale, multiple home-care providers; and 83 group homes) in Tokyo prefecture, Japan, completed cross-sectional, paper-based questionnaires about 3603 people diagnosed with dementia, in May 2016. Quality of care measures included physical restraint and antipsychotic medication use and quality of life. Patients' quality of life was assessed via the Japanese version of the Alzheimer's Disease Health-related Quality of Life scale. The Japanese version of the Questionnaire on Palliative Care for Advanced Dementia was used to assess professional caregivers' knowledge and attitudes regarding palliative care for dementia.Results: Professional caregivers' knowledge and attitudes regarding palliative care for dementia were positively associated with quality of life in patients with dementia. Physical restraint and antipsychotic medication were used regardless of professional caregivers' knowledge and attitudes.Conclusions: Professional caregivers' perspectives regarding palliative care for dementia could have exerted a positive effect on quality of life in patients with dementia. A national strategy for advocacy and the protection of adults is required to integrate several laws and guidelines and prevent the use of antipsychotics as a form of chemical restraint. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Introduction: Living‐donor lobar lung transplantation is an alternative procedure to deceased donation lung transplantation. It involves graft donation from healthy donors; however, only a few reports have discussed its long‐term prognosis in living lung donors and their associated health‐related quality of life. This study aimed to examine living lung donors' health‐related quality of life. Methods: In our cross‐sectional survey of living lung donors, we assessed health‐related quality of life‐based on three key aspects (physical, mental, and social health) using the 36‐Item Short Form Health Survey. We also evaluated chronic postoperative pain and postoperative breathlessness using the numeric rating scale and the modified Medical Research Council Dyspnea scale, respectively. Results: We obtained consent from 117 of 174 living lung donors. The average scores of the living lung donors on the 36‐Item Short Form Health Survey were higher than the national average. However, some donors had poorer physical, mental, and social health, with lower summary scores than the national averages. Low mental component summary predictors included donor age (<40 years; odds ratio = 10.2; p <.001) and recipient age (<18 years; odds ratio = 2.73; p <.032). Low role‐social component summary predictors included high lung allocation score (≥50; odds ratio = 3.94, p <.002) and recipient death (odds ratio = 3.64; p =.005). There were no predictors for a physical component summary. Additionally, many donors did not complain of pain or dyspnea. Conclusions: Living lung donors maintained an acceptable long‐term health‐related quality of life after surgery. Potential donors should be informed of relevant risk factors, and high‐risk donors should receive appropriate support. [ABSTRACT FROM AUTHOR]

The article offers information on clinical practice guidelines for endometriosis in Japan. It examines fundamental knowledge in clearly elaborating current perspectives on the review of the diagnosis and treatment, in addition to the advance over the last 10 years, as of December 2022. It further explores therapeutic strategies.

Background and Aim: Patients with gastroesophageal reflux disease (GERD) frequently also have functional dyspepsia (FD) symptoms, which impair their quality of life. However, the magnitude and characteristics of the effects of each symptom on daily life have been unclarified. Using multiple regression analysis, we aimed to clarify these questions. Methods: We enrolled 290 patients from 29 institutions across Japan, in this prospective, observational study. Patients responded to three questionnaires (Gastroesophageal Reflux and Dyspepsia Therapeutic Efficacy and Satisfaction Test [GERD‐TEST], Hospital Anxiety and Depression Scale [HADS], and 8‐item Short‐Form Health Survey [SF‐8]) before and after 4 weeks of proton pump inhibitor treatment. Pearson correlation and multiple regression analyses were conducted between symptoms such as typical GERD, epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS) of FD, and aspects of daily life, namely, level of satisfaction with the daily life of GERD‐TEST, anxiety and depression score of HADS, and physical and mental component summary of SF‐8. Results: Pearson correlation analysis showed a significant correlation in all combinations between GERD/FD‐EPS/FD‐PDS symptoms and the nine aspects of daily life. However, multiple regression analysis results deviated from these results, with the most significant effects seen in the PDS‐symptom subscale (SS) on the five aspects of daily life, that is, dissatisfaction with eating, daily life‐SS, anxiety, depression, and mental component summary (MCS) whereas the significant effects in GERD‐SS on five aspects of daily life, that is, dissatisfaction for eating, anxiety, depression, physical component summary, and MCS, disappeared. Conclusion: Dealing with co‐existing FD symptoms without overlooking them may be important in the management of GERD. [ABSTRACT FROM AUTHOR]

Aim: Despite a growing interest in decision‐making by care recipients, few empirical studies have examined the everyday care decisions of community‐dwelling older adults. This study aimed to examine the association of recipient‐ and caregiver‐related factors with decision‐making involvement of community‐dwelling older care recipients. Methods: We conducted secondary data analysis using publicly available cross‐sectional data from a dyadic survey with care recipients aged ≥65 years and their primary caregivers in two regions of Japan, one urban and another rural, in 2003. In total, 643 pairs with no missing data on any variable were included in the analysis. The level of care recipients' perceived decision‐making involvement was assessed using one dichotomized item (not involved or involved). We examined care recipient‐ and caregiver‐related factors described by previous studies as having the potential to inhibit or facilitate care recipient's subjective decision‐making involvement. Results: Of the care recipients, 60.2% were women, 72.2% were >75 years, and 83.7% were involved in decision‐making. Of the primary caregivers, 72.0% were women, 49.0% were <65 years, and 47.9% were spouses. Multivariable logistic regression analysis showed that care recipients were more likely to be involved in decision‐making when their caregivers respected their decisions (odds ratio = 3.03 [95% confidence interval: 1.90–4.86], P < 0.001). Care recipients with more care needs were less likely to be involved in decision‐making than those with less care needs (odds ratio = 0.53 [95% confidence interval: 0.32–0.89], P = 0.015). Conclusions: Our results suggest that family caregivers play a crucial role in increasing care recipients' decision‐making involvement regarding daily care. Geriatr Gerontol Int 2022; 22: 876–882. [ABSTRACT FROM AUTHOR]

The number of elderly persons with disabilities needing support with everyday activities increasing in Japan and around the world. Yet, engagement in everyday activities can support the quality of their daily life. Despite research focusing on reported meanings of people's actions, there is still limited knowledge on how engagement in everyday activity is enacted along with the meanings of persons' actions. The aim of the present study was to identify meanings of persons' actions within everyday activities of elderly Japanese with physical disabilities. Five elderly persons with physical disabilities living in the community participated in this study. Data were gathered by 10 participant observations of everyday activities supplemented with 13 unstructured interviews. Narrative analysis was used to identify meanings of persons' actions. The analysis identified an overall plot termed 'balancing struggles with desired results'. This plot illustrated that participants' and other involved individuals balanced problematic situations with finding situations that accommodated their needs. Meanings of these actions were further identified as three complementary strategies. Two of three strategies aimed to mitigate given problems, one by 'acting on a plan to achieve one's goals', the other by 'taking a step in a preferred direction by capitalising on emerging opportunities'. The third strategy focused on avoiding undesirable experiences by 'modifying problematic situations'. In conclusion, these findings call for care and rehabilitation providers' sensitivity to shifting foci of what matters in daily life's situations as well as aligning with persons' skills, resources and perspectives. Accordingly, the judicious and flexible use of these complementary strategies can enhance elderly persons' quality of daily living through everyday activities. [ABSTRACT FROM AUTHOR]

Objective: The relationship between care complexity and quality of life among patients with epilepsy has not been assessed, especially in Japan. The aim of this study is to test the hypothesis that care complexity is associated with health‐related quality of life (HRQOL) and mood disturbance. Method: This was an observational cross‐sectional study. The study included a consecutive series of 49 patients who newly visited an epilepsy center. Study participants were administered standardized quantitative measures of HRQOL, case complexity, and depression. Results: Patient complexity predicted lower HRQL scores. Data on the social and psychological complexity domains predicted patient HRQOL findings more accurately than data from the biological domain of the case complexity scale. Seizure frequency was unrelated to HRQOL findings in this study. Additionally, depression scores were also associated with lower HRQOL. Significance: A patient complexity assessment, including psychological and social domains, may be one of the key tools in epilepsy treatment settings. Further studies using larger random selection from patients with epilepsy are necessary to generalize the findings to patients in other epilepsy programs. [ABSTRACT FROM AUTHOR]

Aim: To explore the unclear association between temporary discharge home from the palliative care unit and achievement of good death, in the background of increases in discharge from the palliative care unit. Association between experiences and circumstances of patient and family and duration of temporary discharge was also examined. Methods: This study was a secondary analysis of data from a nationwide post‐bereavement survey. Results: Among 571 patients, 16% experienced temporary discharge home from the palliative care unit. The total good death inventory score (p <.05) and sum of 10 core attributes (p <.05) were significantly higher in the temporarily discharged and stayed home ≥2 weeks group. Among all attributes, "Independent in daily activities" (p <.001) was significantly better in the temporarily discharged and stayed home ≥2 weeks group. Regarding the experience and circumstance of patient and family, improvement of patient's appetite (p <.05), and sleep (p <.05) and peacefulness (p <.05) of family caregivers, compared to the patient being hospitalized, were associated with longer stay at home after discharge. Conclusions: Patient's achievement of good death was better in the temporarily discharged and stayed home longer group, but this seemed to be affected by high levels of independence of the patient. Temporary discharge from the palliative care unit and staying home longer was associated with improvement of appetite of patients and better sleep and mental health status of family caregivers. Discharging home from palliative care unit is worth being considered even if it is temporary. [ABSTRACT FROM AUTHOR]

Aim: Maintaining ≥20 teeth is a public health goal worldwide. Healthy aging, which includes psychological and social well‐being, as well as physical indicators, has attracted a great deal of attention with the progression of aging societies. However, no studies have examined the association between the number of remaining teeth and healthy aging. This study aimed to investigate the association between the number of remaining teeth and healthy aging. Methods: This community‐based longitudinal cohort study included 8300 Japanese people aged ≥65 years who were free of disability and depression in the baseline survey in 2006. The participants were categorized into four groups according to the number of remaining teeth at baseline: 0–9, 10–19, 20–24 and ≥25. The primary outcome was healthy aging (defined as meeting all four of the following criteria: free of disability, free of depression, high health‐related quality of life and high life satisfaction), as assessed by a questionnaire survey carried out in 2017. Multiple logistic regression was used to calculate the corresponding odds ratios and 95% confidence intervals. Results: During about 11 years of follow‐up, 621 (7.5%) participants attained healthy aging. Participants with ≥20 remaining teeth showed a higher healthy aging rate. Compared with participants with 0–9 teeth, the multivariate‐adjusted odds ratios (95% confidence intervals) for 10–19, 20–24 and ≥25 teeth were 0.98 (0.77–1.26), 1.28 (1.01–1.63) and 1.59 (1.24–2.03), respectively. Conclusions: These findings suggest that maintaining ≥20 teeth was associated with healthy aging. Geriatr Gerontol Int 2022; 22: 68–74. [ABSTRACT FROM AUTHOR]

Background: Several types of visual illusions can occur in Parkinson's disease (PD). However, the prevalence and types of specific illusions experienced by patients with PD remain unclear. This study aimed to investigate the types of illusions. Methods: A questionnaire of visual illusions was developed through a literature review in consultation with clinicians and neurologists. Based on the questionnaire, 40 consecutive patients with PD were asked a series of Yes/No questions regarding 20 types of visual illusions since the onset of PD. If participants answered 'Yes', they were then asked to detail their experience(s). Results: In total, 30 patients with PD had experienced visual illusions since disease onset; among them, 25 were still experiencing them at the time of the study. The most commonly observed illusion types were dysmorphopsia, complex visual illusions, metachromatopsia, and diplopia. Other observed illusions included textural illusions, macropsia, micropsia, teleopsia, pelopsia, kinetopsia, akinetopsia, Zeitraffer/Zeitlupen phenomena, tilt illusion, upside‐down illusion, and palinopsia. Additionally, aberrant perception of surface orientation (inclination) was reported, which is yet to be reported in association with any disease. Visual illusions had detrimental effects on the patients' daily lives in some cases. Conclusions: Systematic interviews regarding the incidence and details of visual illusions experienced by patients with PD could offer important information regarding their quality of life. [ABSTRACT FROM AUTHOR]

Aim: Undesirable events, such as falls, aspiration, and pressure ulcers, are associated with functional decline and lower quality of life among older adults. This study describes the frequency of such events among residents of geriatric care facilities and assesses the effect of training care managers in a multidisciplinary plan‐do‐check‐adjust cycle on preventing such events. Methods: This was a Japan‐based, non‐randomized cluster intervention study. The intervention group comprised geriatric care facilities from which care managers had attended a training course, while the control group comprised facilities with care managers who did not receive this training. Six‐month pre‐admission and 3‐month post‐admission incidences of undesirable events were collected from both groups, and the two groups were compared. Results: Valid data were collected from 862 residents (416 and 446 from the intervention and control groups, respectively) from 130 facilities (60 and 70, respectively). Three‐month post‐admission incidences were 27.8%, 20.0%, and 11.3% for falls, fever, and pressure ulcers, respectively. There was no difference between the groups regarding post‐admission incidence for any event type. Training care managers reduced the post‐admission incidence of pressure ulcers among residents with a history of such ulcers. Conclusions: The training of care managers in a multidisciplinary risk‐management cycle was not effective for preventing falls, fever, or pressure ulcers. Results underscore the difficulty of preventing risk events in geriatric care facility residents even with organizational training efforts. The authors believe it is important to share such risks with residents and their families. Geriatr Gerontol Int 2021; 21: 842–848. [ABSTRACT FROM AUTHOR]

Aims: Symptomatic treatment is insufficient for chemotherapy‐ or targeted therapy‐induced oral mucositis (OM) pain, and benzydamine mouthwash is not commercially available in Japan. We evaluated the analgesic effects of an in‐hospital preparation of 0.25% indomethacin spray (IMS) on anticancer drug‐induced OM pain. Methods: This single‐arm prospective trial enrolled 20 patients (median age 62.0 years) with OM and numerical rating scale scores of ≥5 who were undergoing chemotherapy or targeted therapy in our hospital. Pain scores were recorded using a visual analog scale (VAS) before and 30 min after IMS administration. Pain relief (PR) scores were recorded at 15, 30, and 60 min after IMS administration; total PR after 60 min (TOTPAR60) was calculated, and the mean PR score after 3 days (PR3days) was determined. Results: The median (interquartile range) OM grade of the participants was 2.0 (2.0–2.3). The VAS score decreased significantly at 30 min after IMS administration (p =.001). The median (interquartile range) TOTPAR60 and PR3days were 6.0 (3.8–7.3) and 2.0 (2.0–3.0), respectively. Conclusions: IMS helped improve patients' quality of life. The risk of systemic adverse effects was low because of the low dose administered. IMS effectively relieved anticancer drug‐induced OM pain and may be useful for immediate self‐medication. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to assess psychological/psychiatric problems and quality of life (QOL) in patients with thalidomide embryopathy (TE), with a specific focus on pain, including pain severity and the effects of coping strategies for pain. Methods: A questionnaire survey was conducted to evaluate the severity of pain experienced by patients with TE, pain management strategies, time perspective, mental health status, and QOL. Of 67 patients with TE who underwent a health checkup, 51 respondents who gave valid responses were included in analysis. Results: GHQ‐28 suggested that 41.2% of respondents appeared to potentially have psychiatric disorders. The mean scores of QOL were still within a normal range. There is no significant differences were found between limb disability group and hearing impairment group in QOL or mental health status. About 82.4% of respondents reported that they experience physical pain, and the use of the cognitive coping strategy "catastrophizing" to cope with pain was significantly associated with mental health status and QOL. Conclusion: This study demonstrate that although some patients with TE have some form of mental health problem, they still maintain a normal range QOL despite their disabilities. In addition, pain was not as strongly associated with mental health problems and QOL as would be expected, and variables such as "catastrophizing" to cope with pain appear to potentially be associated with reduced mental health and QOL. [ABSTRACT FROM AUTHOR]

The article focuses on the major Dialysis Outcomes and Practice Patterns Study (DOPPS) findings on patient quality of life (QoL) and depression and their associations with clinical outcomes. In the DOPPS, patient functioning and well-being have been assessed by completion of the Kidney Disease Quality of Life Short Form (KDQOL-SF), a questionnaire. DOPPS participants in the U.S. had the highest mental component summary score, while Japan had the highest physical component summary score.

Since 2010, the Women's Health Care Committee has continuously addressed issues closely linked to women's quality of life. The five agendas this committee has engaged for this academic year are as follows: (i) clinical study of urinary complications in perinatal and post‐partum women's health care; (ii) enlightenment of infectious diseases in Obstetrics and Gynecology in Japan; (iii) educational activities regarding management guidelines for health care in female athletes; (iv) training program for women's health‐care advisers; and (v) pregnancy‐ and lactation‐associated osteoporosis (PLOP). The detailed activities of the five subcommittees are described herein. This report is based on the Japanese version of our annual report (Acta Obst Gynaec Jpn 2019;71(6): 889–898), which publicizes the activities of our committee. [ABSTRACT FROM AUTHOR]

Aim: To dentify the predictors of the quality of life (QOL) of infertile men who are undergoing infertility treatments in Japan and to create a QOL prediction model, with the main variables aimed at providing more adequate support to male patients. Methods: This cross‐sectional study used the quantitative data that were collected from 321 returned self‐report questionnaires that had been distributed to the men of 411 couples who were undergoing fertility treatment. The following four scales were used to measure the main outcomes: FertiQoL, psychological distress, spousal support, and workplace support. The data were analyzed by descriptive statistics, multiple regression analyses, and structural equation modeling. Results: The number of returned questionnaires was 321 (78.1%). The QOL that was measured by FertiQoL was significantly lower in those men who were diagnosed with male factor infertility than in the other male patients. The two significant predictors of QOL were: spousal support and the infertility period. The structural equation modeling revealed that the same factors were related to QOL. Conclusions: Male factor infertility, less spousal support, and a longer period of infertility were associated with a poorer QOL of those men who were undergoing infertility treatment. These results suggest that focusing on infertility causes, the length of the infertility period, and the couples' partnership during treatment is needed to provide full support to men who have been diagnosed with infertility. [ABSTRACT FROM AUTHOR]

Background: Sacrococcygeal teratoma (SCT) is the most common extragonadal germ cell tumor in neonates and infants. Although most cases of infantile SCT are benign tumors by nature, some develop into extremely large lesions, leading to massive bleeding, high‐output heart failure, disseminated intravascular coagulation, and even fatal outcomes during the neonatal period. In addition, some patients may present with tumor recurrence, malignant transformation, long‐term sequelae (including bladder and bowel dysfunction) and lower leg palsy during the long‐term follow up. SCT, however, is very rare, and there are few opportunities to encounter this disease, therefore general physicians without expert credentials currently lack information relevant to clinical practice. For this reason, the research project committee has compiled guidelines concerning SCT. Methods: The purpose of these guidelines was to share information concerning the treatment and follow up of infantile SCT. The guidelines were developed using the methodologies in the Medical Information Network Distribution System. A comprehensive search of the English‐ and Japanese‐language articles in PubMed and Ichu‐Shi Web identified only case reports or case series, and the recommendations were developed through a process of informal consensus. Results: The clinical questions addressed the risk factors, the efficacy of cesarean section, the initial devascularization of tumor feeding vessels, interventional radiology, recommended clinical studies for follow up and possible long‐term complications. Conclusions: These are the first guidelines for SCT to be established in Japan, and they may have huge clinical value and significance in terms of developing therapeutic strategies and follow up, potentially contributing to the improvement of the prognosis and quality of life of SCT patients. [ABSTRACT FROM AUTHOR]

Since 2010, the Women's Health Care Committee has addressed important issues linked to women's quality of life. The five agendas this committee has engaged this academic year are: (i) clinical study of urinary complications in perinatal and postpartum women's health care; (ii) education on infectious diseases prophylaxis in obstetrics and gynecology in Japan; (iii) educational activities regarding management guidelines for a female athlete's health care; (iv) training program for women's healthcare advisers; and (v) pregnancy‐ and lactation‐associated osteoporosis (PLOP). The detailed activities of the five subcommittees are described herein. This report is based on the Japanese version of our annual report (Acta Obst Gynaec Jpn 2018; 70: 1538–1546), which publicizes the activities of our committee. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to examine the association between seizure-related features and fatigue levels in children with epilepsy.Methods: All children were classified into three subgroups based on the state of their seizure control: well-controlled epilepsy (WCE; seizure-free), intermediate-controlled epilepsy (ICE; seizure frequency < 1×/month) and uncontrolled epilepsy (UCE; seizure frequency > 1×/month). Participants were asked to rate on a 7-point scale, from 1 (strongly disagree) to 7 (strongly agree), how often they felt the ways described by nine items on the Fatigue Severity Scale (FSS). A higher score is suggestive of greater fatigue.Results: The study participants comprised 58 children with epilepsy and 15 children without seizures, who served as the healthy (non-epilepsy) group. The mean FSS scores of the children with epilepsy were significantly higher than those of the healthy (non-epilepsy) group (4.40 vs. 1.55, respectively; P < 0.0001). Multiple linear regression analysis showed that seizure frequency was the only characteristic significantly associated with fatigue (P < 0.0001). In the three epilepsy subgroups, the mean FSS scores for the WCE, intermediate-controlled epilepsy and UCE groups were 2.30, 3.97 and 6.28, respectively. A higher seizure frequency was associated with more severe fatigue. In particular, children in the UCE group had significantly more severe fatigue than those in the WCE group (P < 0.0001).Conclusions: The results suggest that seizure frequency is also associated with fatigue in children with epilepsy. Improved control of seizures may help reduce fatigue levels and improve the quality of life of children with epilepsy. [ABSTRACT FROM AUTHOR]

Independence of functioning has been used as a health index among the older population. This paper introduces a few of recent studies which examined the effect of aging on functional decline during a 5-year follow up, which estimated active life expectancy, and which examined predictors for functional independence during a 3-year follow up among older Japanese. It is believed that these studies are useful not only to estimate needs for long-term care services among the older population, but also to develop programs that aim to prevent functional decline and to maintain functional independence among the older population in an aging society. [ABSTRACT FROM AUTHOR]

Aim: To promote preventive care among older individuals dwelling on an isolated, doctor‐less island, we investigated the feasibility and the efficacy of a home‐based exercise program, depending on their functional status and health‐related quality of life. Methods: A total of 23 older (mean age 72.6 years) participants were assigned to a home‐based exercise program (intervention group), and 34 older (mean age 74.2 years) participants were assigned to a group without any intervention (control group). The participants of the intervention group attended the exercise program three times a week for 3 months. The exercise program consisted of various exercises involving stretching, muscle strengthening, balance retraining and walking. The physical performance, Functional Independence Measure and Short‐Form 36‐item health survey were used to assess the physical and the mental wellbeing of the participants. Results: There was no significant difference between the changes in physical performance at baseline and post 3 months in both groups. However, the motor and the cognitive Functional Independence Measure scores significantly improved in the intervention group post 3 months. The domains of the Short‐Form 36‐item health survey improved post 3 months; particularly, significant improvement was observed in the physical functions, general health, vitality, mental health and mental component summary. Conclusions: Although an isolated island has several problems to support preventive care services, such as a lack of medical resources and availability of only a few healthcare workers, the present study provides evidence on the feasibility and efficacy of nurse‐led home‐based exercise programs for improving the physical and mental health of the older people dwelling on an isolated, doctor‐less island. Geriatr Gerontol Int 2018; 18: 1313–1317. [ABSTRACT FROM AUTHOR]

Abstract: Background: Neuropathic pain (NP) is a complex, chronic pain state initiated by a primary lesion or dysfunction of the nervous system and presents as a variety of symptoms across multiple disease states. Objective: To develop a patient‐centred conceptual model of symptoms and impacts in subjects with diabetic peripheral neuropathy (DPN) or post‐herpetic neuralgia (PHN) that can inform the measurement strategy in clinical trials. Method: Thirty subjects with DPN or PHN participated in in‐person interviews which were performed until saturation was achieved. Transcripts were analysed in ATLAS.ti. Results: Interviews were completed with DPN subjects (United States, n = 10; Japan, n = 10) and PHN subjects (United States, n = 5; Japan, n = 5). Numbness and tingling were frequently reported symptoms in the DPN population while itchiness and hypersensitivity were predominant in PHN. Both populations experienced burning and ache/soreness with similar frequency. DPN subjects experienced pain primarily in their lower extremity (eg feet, ankles), while PHN subjects experienced pain primarily in the chest and back. Impacts reported by DPN subjects included difficulty walking, sleep disturbance and climbing stairs. Impacts in PHN subjects included sleep disturbance, avoidance of physical contact, being angry/frustrated and being sad/depressed. Overall, concepts in Japan were not qualitatively different from the United States. Conceptual models of NP were generated based on the concepts elicited. Conclusions: This research highlights core concepts to measure from the patient's perspective. Moreover, it enables the assessment of existing measures, the possible modification of these measures, or if a new NP measure with improved sensitivity and responsiveness is merited. [ABSTRACT FROM AUTHOR]

Aim: Until now, there has been no instrument to measure the quality of life (QoL) of patients with severe dementia in Japan. The purpose of this study was to translate the Quality of Life in Late‐stage Dementia Scale and to evaluate the reliability and validity of the Japanese version (QUALID‐J). Methods: We translated the Quality of Life in Late‐stage Dementia into Japanese with permission from the original authors. We assessed a total of 70 dementia patients (14 men, 56 women; mean age: 87.4 ± 7.9 years) with the QUALID‐J. Results: The test–retest and inter‐rater reliability of the QUALID‐J was significant. With regard to the criterion‐related validity, the correlation coefficient for the total score between the QUALID‐J and Quality of Life for Alzheimer’s Disease was −0.287 (P < 0.05). With regard to the construct validity, the QUALID‐J total score was significantly correlated with the Mini‐Mental State Examination (ρ = −0.346, P < 0.01), the Cognitive Test for Severe Dementia (ρ = −0.323, P < 0.01), the Neuropsychiatry Inventory‐Nursing Home version (ρ = 0.386, P < 0.01), the Cornell Scale for Depression in Dementia (ρ = 0.262, P < 0.05), the Physical Self‐Maintenance Scale (ρ = −0.283, P < 0.05), and the Pain Assessment in Advanced Dementia (ρ = 0.530, P < 0.01). Conclusion: The results of this study showed that the QUALID‐J is a reliable and valid quality of life scale for severe dementia. This scale finally enables an adequate assessment of the quality of life of patients with severe dementia in Japan, which has not been possible until now. [ABSTRACT FROM AUTHOR]

Background: Palliative care education for health care professionals is a key element in improving access to quality palliative care. The Palliative Care Emphasis Program on Symptom Management and Assessment for Continuous Medical Education (PEACE) was designed to provide educational opportunities for all physicians in Japan. As of 2015, 57,764 physicians had completed it. The objective of this study was to estimate the effects of the program.Methods: This study was an analysis of 2 nationwide observational studies from 2008 and 2015. We conducted 2 questionnaire surveys for representative samples of physicians. The measurements used were the Palliative Care Knowledge Test (range, 0-100) and the Palliative Care Difficulties Scale (range, 1-4). Comparisons were made with the unpaired Student t test and with a multivariate linear regression model using 2 cohorts and a propensity score-matched sample.Results: This study analyzed a total of 48,487 physicians in 2008 and a total of 2720 physicians in 2015. Between 2008 and 2015, physicians' knowledge and difficulties significantly improved on the Palliative Care Knowledge Test with total scores of 68 and 78, respectively (P < .001; effect size, 0.40) and on the Palliative Care Difficulties Scale with total scores of 2.65 and 2.49, respectively (P < .001; effect size, 0.29). Propensity-score matching resulted in 619 untrained physicians matched to 619 trained physicians, and physicians who trained with the PEACE program had a higher knowledge score (74 vs 86; P < .001; effect size, 0.64) and a lower difficulties score (2.6 vs 2.3; P < .001; effect size, 0.42).Conclusions: Physicians' knowledge of and difficulties with palliative care improved on a national level. The PEACE program may have contributed to these improvements. Cancer 2018;124:626-35. © 2017 American Cancer Society. [ABSTRACT FROM AUTHOR]

Aim: To identify the associated factors of quality of life (QOL) among the family caregivers of patients with terminal cancer at home. Methods: The design was an epidemiological study with self-administered questionnaires by mail. Date collection was carried out in the Tokyo Metropolitan, Tochigi, Ibaraki, Saitama, Chiba, Kanagawa, Nara, Hyogo, Kagawa, Ehime, and Saga prefectures in Japan. The participants who met the criteria for the present study were 262 family caregivers. Their QOL was assessed by the Japanese version of the Caregiver Quality of Life Index-Cancer. The potential factors that are associated with family caregivers' QOL included three factors: patient factors, including demographic characteristics and disease-related factors, family caregiver factors, including demographic characteristics, health conditions, and self-efficacy of family caregiving, and environmental factors, including instrumental, emotional, informational support, and satisfaction with the home care service. A multiple regression analysis was conducted in order to identify the associated factors with family caregivers' QOL. Results: A total of 74 family caregivers participated in this study (response rate: 33.2%). The mean age of the family caregivers was 63.6 years and 79.7% was female. The multiple regression analysis indicated that depression, self-efficacy of family caregiving, the subcaregiver, and satisfaction with the home care service were associated with family caregivers' QOL. Conclusion: It is recommended that health practitioners should develop interventions for family caregivers in order to enhance the competence of the individual and home care system in order to achieve the sustainability of high-quality home care for patients with terminal cancer and the family caregivers' QOL. [ABSTRACT FROM AUTHOR]

The article discusses the New Orange Plan national dementia strategy of Japan to promote communities friendly for the elderly and persons with dementia, as of July 2022. It observes that the UK Alzheimer's Society's promotion of living well with dementia among those living alone or in minority groups showed their limited participation in society. Also noted is the value of psychiatry in serving the disadvantaged, but a focus on individuals excluded from society is still needed.

Objectives To evaluate male sexual function in Japanese prostate cancer patients undergoing permanent brachytherapy without endocrine treatment, using quality of life measures of the Expanded Prostate Cancer Index Composite. Methods A total of 482 patients were selected as analysis subjects from the nationwide database for the Japanese Prostate Cancer Outcome Study of Permanent Iodine-125 Seed Implantation. The patients were asked to complete the Expanded Prostate Cancer Index Composite questionnaires before and at 3, 12, 24, and 36 months after the permanent brachytherapy. Changes in their responses were analyzed, and any association of the outcomes was investigated. Furthermore, changes over time in their answers to Q18 (usual quality of your erections) were analyzed. Results A total of 72 patients (14.9%) had received external beam radiation. A total of 68 patients (14.1%) had taken any 5-phosphodiesterase inhibitor medications. Regarding Q18, 232 patients (48.2%) selected either 'There was no sexual activity' or 'There was no desire for erection' before receiving permanent brachytherapy. Of all the 482 patients, sexual function was preserved in 138 patients (28.7%) 3 years after permanent brachytherapy. Overall satisfaction has significantly improved without regard for the deterioration of sexual function. Significant factors for maintaining sexual activity were patient age and sexual activity before permanent brachytherapy. Conclusions In Japanese patients undergoing permanent brachytherapy alone for prostate cancer, the sexual function is not well preserved. However, decreased sexual function does not seem to represent a major factor determining patients' overall satisfaction. These findings might be peculiar to Japanese patients, in whom elderly subjects account for the majority. [ABSTRACT FROM AUTHOR]

Aim A previous study reported that the oral health-related quality of life (OHRQoL) of Japanese individuals dropped sharply as they reached old-old age. The aim of present study was to explore the risk factors of OHRQoL by investigating the association of OHRQoL with oral indices, lifestyle and psychological distress. Methods A questionnaire survey was carried out to assess the OHRQoL, oral indices, lifestyle, and psychological distress of patients who were of ≥75 years of age and who regularly visited a dental clinic for maintenance. OHRQoL and psychological distress were assessed using the General Oral Health Assessment Index (GOHAI) and the General Health Questionnaire, respectively. The relationships between the GOHAI score and related factors were examined by non-parametric bivariate and logistic regression analyses using a GOHAI cut-off score of 45.0. Results A total of 187 old-old patients with a mean age of 77.9 ± 3.0 years participated in the present study. The average GOHAI score was 50.8 ± 8.0. In the bivariate analyses, the average sleeping hours, use of sleep medication, Short Form 8-Item Health Survey (SF-8), General Health Questionnaire score, and the number of teeth present were significantly correlated with the GOHAI score. A logistic regression analysis showed that the number of teeth present, General Health Questionnaire and the use of sleep medication were associated with the GOHAI score. Conclusions The present study found that the OHRQoL was strongly associated with insomnia and depression. It is therefore suggested that oral healthcare professionals take general background information, such as the presence of insomnia and depression, into consideration to improve OHRQoL when they treat old-old patients. Geriatr Gerontol Int 2017; 17: 893-897. [ABSTRACT FROM AUTHOR]

The 'Skippu-Mama' peer support program was developed to improve quality of life and reduce parental stress in mothers of children with autism spectrum disorders. The program was designed to improve these variables by refreshing and healing participants' minds and bodies. Twenty-four mothers of 26 children diagnosed with ASD in Japan were included in the study and completed measures of quality of life and parental stress before, during, and after participation in the Skippu-Mama program. Our results demonstrated that time was a significant main effect. Further, multiple comparisons with Bonferroni corrections indicated a significant increase in World Health Organization Quality of Life 26 scores three months into the program and at its conclusion six months after commencement. Overall, the Skippu-Mama program improved the quality of life of mothers of children with ASD, and we believe that the intervention's focus on both individual and family variables may be especially effective in this population. [ABSTRACT FROM AUTHOR]

Aim: The goals of this study were to develop a partnership causal model and verify the model's fitness for couples undergoing fertility treatment. Methods: A purposive sample of 1004 consenting participants (502 couples) undergoing fertility treatment was selected from five fertility clinics across Japan. A mailed self-administered questionnaire was used to collect data. The partnership causal model was examined with structural equation modeling. Results: A total of 565 questionnaires were returned (56.3%) and the number of valid responses was 466 (46.4%). The factor “medical professionals' support (nurses and physicians)” influenced the couples' “partnership” (β = 0.16) and had a direct effect on the men's quality of life (QOL) and an indirect effect on the women's QOL (β = 0.20). Couples' partnership had a significant impact on couples' QOL (β = 0.20) and on “satisfaction in their relationship with their partner” (β = 0.48). The multi-population path analysis revealed that married couples influenced each other's perceptions of their partnership (men, β = 0.84; women, β = 0.88). Additionally, the spouse’s partnership influenced both individual's QOL (men, β = 0.77; women, β = 0.77) and the satisfaction with the relationship (men, β = 0.46; women, β = 0.59). The participants' “distress” significantly and negatively affected the participants' QOL. Conclusion: The results revealed that for a couple undergoing fertility treatments, a strong partnership maintains their QOL, and this could decrease the couples' distress (particularly in women). Partnership was also related to the variability of “medical professionals' support”. [ABSTRACT FROM AUTHOR]

In Japan, females are often taught to wipe their vulva from front to back (FTB) after bowel movements in order to prevent cystitis. In this report, we studied whether vulva care after bowel movements in females is a risk factor for simple cystitis. Moreover, we evaluated factors affecting the method of vulva care after bowel movements in females. We recruited 274 females for this study. We analysed the correlations between the style of vulva care, restroom habits and patient characteristics. In addition, we evaluated the correlation between the incidence of cystitis and the style of vulva care after bowel movements. There were no significant differences in the presence of coexisting diseases (P = 0·766), activities of daily living (ADL's) (P = 0·203), body mass index (BMI) (P = 0·174) or restroom style (P = 0·512). However, a significantly greater number of elderly subjects reported wiping from back to front (P = 0·023). In the cystitis group, 48 females (28%) reported wiping the vulva from back to front after bowel movements. In the control group, 29 females (28%) reported wiping the vulva from FTB after bowel movements. There were no significant differences between these two groups (P = 0·988). Our data demonstrated that instructing females to wipe their vulva from FTB after bowel movements is unnecessary for the purpose of preventing cystitis. [ABSTRACT FROM AUTHOR]

Background Missing data are inevitable in almost all medical studies. Imputation methods using the probabilistic model are common, but they cannot impute individual data and require special software. In contrast, the ipsative imputation method, which substitutes the missing items by the mean of the remaining items within the individual, is easy and does not need any special software, but it can provide individual scores. The aim of the present study was to evaluate the validity of the ipsative imputation method using data involving the 15-item Geriatric Depression Scale. Methods Participants were community-dwelling elderly individuals ( n = 1178). A structural equation model was constructed. The model fit indexes were calculated to assess the validity of the imputation method when it is used for individuals who were missing 20% of data or less and 40% of data or less, depending on whether we assumed that their correlation coefficients were the same as the dataset with no missing items. Finally, we compared path coefficients of the dataset imputed by ipsative imputation with those by multiple imputation. Results When compared with the assumption that the datasets differed, all of the model fit indexes were better under the assumption that the dataset without missing data is the same as that that was missing 20% of data or less. However, by the same assumption, the model fit indexes were worse in the dataset that was missing 40% of data or less. The path coefficients of the dataset imputed by ipsative imputation and by multiple imputation were compatible with each other if the proportion of missing items was 20% or less. Conclusion Ipsative imputation appears to be a valid imputation method and can be used to impute data in studies using the 15-item Geriatric Depression Scale, if the percentage of its missing items is 20% or less. [ABSTRACT FROM AUTHOR]

The aim of this study was to obtain basic data about the support for life adjustment in lung cancer patients in Japan. We identified factors that affect life adjustment in people with lung cancer, developed a model for life adjustment support of lung cancer patients, and investigated its validity. A survey was conducted using self-completed questionnaires, and responses were received by 203 individuals. Analysis of the responses revealed that life adjustment was regulated by six factors associated with positive self-evaluation: stress dissipation, fighting spirit, helplessness/hopelessness, full discussion with doctor about treatment, clarity of thought, and support network size. A model search with covariance structure analysis was conducted. The resulting model was revealed to have a goodness-of-fit index of 0.963, an adjusted goodness-of-fit index of 0.930, a comparative fit index of 0.974, and a root mean square error of approximation of 0.040. The findings suggest that improvements in quality of life can be expected by combining a positive self-evaluation in lung cancer patients and interventions to raise self-adjustment ability with the use of this Model, although it requires further testing. [ABSTRACT FROM AUTHOR]

Aims: The beneficial effects of assertive community treatment (ACT), which has been widely acclaimed as being successful in several foreign countries, must also be objectively evaluated with respect to the transition from inpatient to community-based mental health treatment in Japan. This was the first study that examined effects of the ACT program in Japan using pre/post design data of the pilot trial of the ACT program in Japan project. Methods: The study included 41 subjects hospitalized at Kohnodai Hospital, National Center of Neurology and Psychiatry between May 2003 and April 2004 for severe mental illness and who met inclusion criteria for entry regarding age, diagnosis, residence, utilization of mental health services, social adjustment, and ability to function in daily activities. All subjects provided informed consent for study participation and were followed for 1 year after hospital discharge. Results: Comparison of the number of days and frequency of inpatient psychiatric hospitalization and frequency of emergency psychiatric visits between the 1-year period before hospitalization and 1-year period after hospital discharge showed a significant decrease in number of days and frequency of hospitalization. Comparison at 1 year after discharge with baseline showed no change in satisfaction with overall quality of life or Brief Psychiatric Rating Scale scores, but the Global Assessment of Functioning score significantly increased, and the antipsychotic dose (chlorpromazine equivalent) significantly decreased. Conclusion: Despite some limitations in methodology and conclusions, this study suggests that ACT enables persons with severe mental illness to live for longer periods in the community, without worsening of symptoms, decreased social function, or deterioration in quality of life. [ABSTRACT FROM AUTHOR]

Summary It is considered that early intervention for pollinosis relieves symptoms during the pollen season in Japan. Therefore, initiating medication prior to pollen dispersal has recently become a popular trend under the influence of the mass media. However, the actual benefits of this kind of early intervention during the peak of the pollen season have not been evaluated enough. We review a randomized placebo-controlled trial that was conducted to examine the efficacy of early intervention (before pollen dispersal) with the oral cysteinyl leukotriene receptor antagonist ( LTRA) pranlukast against pollinosis symptoms in patients with allergy to Japanese cedar and cypress pollens in 2007. The subjects were treated with pranlukast or placebo for 4 weeks at the beginning of the cedar pollen dispersal season. Subsequently, all the patients received nasal steroid therapy concomitantly with pranlukast throughout the remaining period of the pollen dispersal season. The effects were evaluated by symptom scores based on allergy diaries and quality of life ( QOL) scores as determined by the Japan Rhinoconjunctivitis Quality of Life Questionnaire. In the pranlukast-pre-treated patients, the nasal symptoms (paroxysmal sneezing, runny nose and nasal congestion) were improved during the early Japanese cedar pollen dispersal season. Subsequently, concomitant therapy with pranlukast plus nasal steroids for the rest of the pollen season significantly improved the symptom and QOL scores compared with the placebo-pre-treated patients. This study shows that LTRA administration to Japanese cedar and cypress pollinosis patients starting just before and continuing throughout the pollen dispersion season in high-risk communities is effective for improving the clinical symptoms and indicators of pollinosis. Further assessment of the efficacy of early intervention with an LTRA is required in comparison with other drug therapies, with consideration of the associated cost-benefit effectiveness. [ABSTRACT FROM AUTHOR]

Background and Aim: Although mucosal protective agents have been used frequently for treatment of symptomatic gastritis, there has been no well-controlled study of functional dyspepsia. The aim of this study was to assess the efficacy of a 4-week treatment with rebamipide for the relief of overall dyspeptic symptoms and the improvement in quality of life from an untreated baseline in Japanese patients with functional dyspepsia. Methods: In a double-blinded, randomized, placebo-controlled, single-center study, 81 patients with functional dyspepsia were recruited and treated with rebamipide (100 mg, t.i.d.) or placebo for 4 weeks. Symptoms were assessed at baseline and at the end of the study period by a symptom questionnaire. Quality of life was evaluated by the QPD 32. Results: Data was analyzed for symptoms from 38 patients who received rebamipide and 33 patients who received placebo treatment. Overall symptoms were significantly improved in both the rebamipide and placebo treatment groups from the untreated baseline after 4 weeks of treatment, and the mean changes in overall symptoms were not significantly different between the groups. However, the improvement in symptom score was significantly greater in the treatment arm than in the placebo arm for three items, which were bloating, belching, and pain or discomfort that was relieved after a meal. Regarding quality of life, social restriction and pain intensity were significantly improved in the rebamipide treatment group in per-protocol analysis ( P = 0.048 and P = 0.031, respectively). Conclusions: Although rebamipide was not significantly better than placebo in reducing overall symptoms by 4 weeks’ treatment, it may partially improve the symptoms. It may also be beneficial in improvement of quality of life in Japanese patients with functional dyspepsia. [ABSTRACT FROM AUTHOR]

Three hundred Japanese patients with benign prostatic hyperplasia (BPH) who started an α1-adrenoceptor blocker, tamsulosin, between 1993 and 1996 were followed for 3.0 ± 3.3 years (mean ± SD) to determine whether an association existed between the disease severities measured prior to the tamsulosin treatment and the timing at which the invasive therapy was implemented. Patients with a lower quality of life (QOL) index or maximum urinary flow rate (Qmax) were transferred for invasive therapy earlier than those with less severe BPH. The International Prostate Symptom Score (I-PSS) was also associated, but apparently to a lesser extent, with the timing of the invasive therapy. Finally, the overall severity evaluated using all of the above three indices, I-PSS, QOL index, and Qmax, in accordance with the ‘Severity Criteria for BPH’ issued by the Japanese Urological Association, was found to be a good measure for predicting the prognosis of patients with BPH treated with tamsulosin. [ABSTRACT FROM AUTHOR]

Assesses the kidney disease quality of life of dialysis patients in Japan who desire the administration of sildenafil and the treatment of erectile dysfunction (ED) using the drug. Diagnosis of ED before the prescription of sildenafil; Five items version of the International Index of Erectile Function used in the assessment of hemodialysis patients who desired sildenafil; Implications on studies of therapeutic apheresis and dialysis.

The purpose of this study was to elucidate the effects of human immunodeficiency virus (HIV) on haemophiliacs with physical functional disabilities induced by haemophilia in Kyushu, Japan. The subjects were 38 adult haemophiliacs who were selected from 129 patients registered with the North Kyushu Haemophilia Centre. They were divided into 21 asymptomatic HIV-positive and 17 HIV-negative adult haemophiliacs. Coagulation factor levels, modified DePalma classification, Arthritis Impact Measurement Scale 2 (AIMS 2), and a satisfaction in daily life (SDL) questionnaire were used to investigate the clinical severity of their haemophilia and arthropathy, physical functional disabilities, and satisfaction. Although there were no significant differences in the objective assessments of health status between the HIV-positive and -negative haemophiliacs, the HIV-positive haemophiliacs were significantly more dissatisfied with their social activities and mood, according to AIMS 2, and with social intercourse, job, self-development, and social security and pension according to SDL assessment. These dissatisfactions were due to the effects of HIV, in addition to the physical functional disabilities that were caused by haemophilia. Dissatisfaction with social security and pension may be a specific feature in HIV-positive haemophiliacs in Japan resulting from the origin of HIV infection. [ABSTRACT FROM AUTHOR]

Aim: Patients' spirituality, the relationship between spirituality and physical pain, and the association between spirituality and quality of life (QOL) among patients undergoing cancer chemotherapy were examined. Spirituality was defined as a sense of meaning in one's existence and life, peace of mind, and the strength and comfort drawn from faith. Methods: A cross‐sectional questionnaire survey was distributed to 176 adult cancer patients who received chemotherapy in May–September 2011 at an outpatient clinic in rural Japan. Spirituality was measured using the Functional Assessment of Chronic Illness Therapy‐Spiritual Well‐Being Scale (FACIT‐Sp‐12). Demographic data were collected for performance status, cancer stage, age, marital status, occupational status, persons in household, pain intensity, and other troubling symptoms. The relationship between the patients' spirituality subscale score and QOL was assessed in a structural equation model. Results: Two FACIT‐Sp‐12 subscales, meaning/peace and faith, were moderately to strongly associated with age, appetite, and QOL scores. Although physical pain was significantly related to the QOL score (P =.002), it was not related to the FACIT‐Sp‐12 score (P =.427). These results indicated that the patients with higher spiritual scores and severe pain were enjoying life more than the patients with lower spiritual scores and severe pain. Moreover, two subscales of the FACIT‐Sp‐12 had a direct effect on QOL. Conclusions: Spirituality was strongly associated with QOL. Younger patients (<50 years old) and stage I cancer patients need additional assistance to meet their spiritual needs. To maintain cancer patients' spiritual well‐being, nursing interventions should facilitate patients' nutrition support and appropriately address their spirituality. [ABSTRACT FROM AUTHOR]

Background: The objective of this pilot study was to assess the effects of maintaining web‐based diaries by the caregivers of preschoolers with asthma on the adherence to asthma care regimens, the recognition of asthma symptoms, and their perceived levels of parenting stress, quality of life, and family functioning. Design and Methods: The caregivers of preschoolers with asthma completed a 4‐week web‐based diary and received weekly emails that depicted their children's asthma symptoms. We compared asthma symptoms from before and after the intervention. We analyzed demographic data, such as the caregivers' age and education, and assessment scores from the Japanese Pediatric Asthma Control program (JPAC), Adherence with Asthma Management for Caregivers of Preschoolers (AAMCP), General Functioning subscale of the Family Assessment Device (GF‐FAD), Parenting Stress Index Short Form (PSI‐SF), and Quality of Life assessment scale for Caregivers of Asthmatic Children 24 (QOLCA‐24). Results: A total of 45 participants were included in the analyses. The mean scores depicting asthma control were significantly improved postintervention (pre: 12.29 ± 2.65; post: 13.02 ± 2.01; t = −2.15, p = .037). Mean AAMCP scores postintervention (52.13 ± 6.25) were significantly greater than before (49.78 ± 7.20; t = −3.07; p = .004). Practice Implications: Adherence to asthma care and the recognition of asthma symptoms improved following the use of a web‐based diary, making it a potential cost‐effective intervention for asthma patients and their families. [ABSTRACT FROM AUTHOR]

The article highlights the survey and guidelines of Sacrococcygeal teratomas (SCT) that described by Virchow in 1869 called monstrous tumor. It mentions the association of Sacrococcygeal teratomas with an excellent prognosis after surgical excision and also introducing the first guidelines for SCT to be established in Japan as well as in the world.

Reports on the National Kidney Foundation Kidney Disease Outcome Quality Initiative (K/DOQI) guidelines on bone metabolism and disease released in 2003 which have provided target ranges of several clinical parameters for optimal management. Improvement of the quality of life and life expectancy of dialysis patients, which can be achieved by the prevention of vascular calcification; Issue of whether the guidelines can be applied to Japanese patients who have different medical and social backgrounds from those in the U.S.