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Context: A recent review or article reported that thermal agents (TA) or physical activity (PA) can increase range of motion (ROM) and that the combination of TA with stretching is superior to performing stretching only. However, since ROM is affected by the psychological factors, it is questionable whether these studies measured the effect of these interventions on muscle flexibility. By measuring muscle stiffness, the authors attempted to evaluate the effect these interventions on muscle flexibility. Objective: To compare the individual effects of TA and PA on muscle flexibility, as well as their effectiveness when combined with static stretching (SS). Design: Crossover trial. Setting: University research laboratory. Participants: 15 healthy men without a history of orthopedic disease in their lower limbs. Interventions: 15 minutes of 3 different conditions: hot pack as TA, pedaling exercise as PA, and the control group with no TA or PA intervention, followed by 3 min of SS for the hamstrings. Main Outcome Measures: Joint angle and passive torque of the knee during passive elongation were obtained prior to interventions, after 3 kinds of intervention, and after SS. From these data, muscle-tendon-unit (MTU) stiffness of the hamstrings was calculated. Results: Although knee-joint ROM increased with both TA and PA (P < .05), there were no significant differences in MTU stiffness between pre- and postintervention measurements for either of the interventions (TA, P = .477; PA, P = .377; control, P = .388). However, there were similar significant decreases in MTU stiffness between postintervention and post-SS for all conditions (P < .01). Conclusions: TA and PA did not decrease MTU stiffness, and combining these interventions with SS did not provide additional decreases in MTU stiffness compared with performing SS alone. [ABSTRACT FROM AUTHOR]

Although there have been many investigations of the beneficial effects of both exercise and amino acids (AAs), little is known about their combined effects on the single-dose ingestion of AAs for lipid metabolism during exercise. We hypothesize that taking a specific combination of AAs implicated in glucagon secretion during exercise may increase fat metabolism. We recently developed a new mixture, d-AA mixture (D-mix), that contains arginine, alanine, and phenylalanine to investigate fat oxidation. In a double-blind, placebo-controlled crossover study, 10 healthy male volunteers were randomized to ingest either D-mix (3 g/dose) or placebo. Subjects in each condition subsequently performed a physical task that included workload trials on a cycle ergometer at 50% of maximal oxygen consumption for 1 hr. After oral intake of D-mix, maximum serum concentrations of glycerol (9.32 ± 6.29 mg/L and 5.22 ± 2.22 mg/L, respectively; p = .028), free fatty acid level (0.77 ± 0.26 mEq/L and 0.63 ± 0.28 mEq/L, respectively; p = .022), and acetoacetic acid levels (37.9 ± 17.7 µmol/L and 30.3 ± 13.9 µmol/L, respectively; p = .040) were significantly higher than in the placebo groups. The area under the curve for glucagon during recovery was numerically higher than placebo (6.61 ± 1.33 µg/L ⋅ min and 6.06 ± 1.23 µg/L ⋅ min, respectively;p = .099). These results suggest thatpreexercise ingestion of D-mix may stimulate fat metabolism. Combined with exercise, the administration of AA mixtures could prove to be a useful nutritional strategy to maximize fat metabolism. [ABSTRACT FROM AUTHOR]

Context: Posterior ankle impingement syndrome is a common disorder in soccer players and ballet dancers. In soccer players, it is caused by the repetitive stress of ankle plantar flexion due to instep kicking. Protective ankle dorsiflexion taping is recommended with the belief that it prevents posterior ankle impingement. However, the relationship between ankle taping and ball-kicking performance remains unclear. Objective: To demonstrate the relationship between the restrictions of ankle taping and performance of an instep kick in soccer. Design: Laboratory-hased repeated-measures. Setting: University laboratory. Participants: 11 male university soccer players. Intervention: The subjects' ankle plantar flexion was limited by taping. Four angles of planter flexion (0°, 15°, 30°, and without taping) were formed by gradation limitation. The subjects performed maximal instep kicks at each angle. Main Outcome Measures: The movements o f the kicking legs and the ball were captured using 3 high-speed cameras at 200 Hz. The direct linear-transformation method was used to obtain 3-dimensional coordinates using a digitizing system. Passive ankle plantar-flexion angle, maximal plantar-flexion angle at ball impact, ball velocity, and foot velocity were measured. The data were compared among 4 conditions using repeated-measures ANOVA, and the correlations between ball velocity and foot velocity and between ball velocity and toe velocity were calculated. Results: Ankle dorsiflexion taping could gradually limit both passive plantar flexion and plantar flexion at the impact. Furthermore, limitation of 0° and 15° reduced the ball velocity generated by instep kicks. Conclusion: Plantar-flexion-limiting taping at 30° has a potential to prevent posterior ankle impingement without decreasing the ball velocity generated by soccer instep kicks. [ABSTRACT FROM AUTHOR]

Context: Abnormal scapular kinematics during throwing motion in baseball players with shoulder disorders has not yet been clarified, although altered scapular position has been suggested to be associated with shoulder disorder. Objective: To determine if the shoulders of baseball players with throwing disorders demonstrate abnormal scapular kinematics during the simulated arm-cocking phase of throwing activity. Design: Cross-sectional study. Setting: Laboratory. Participants: Eleven baseball players (age 21.1 ± 1.2 y) with a unilateral shoulder disorder volunteered to participate, including 9 players at the college level and 2 at the adult level. The mean playing experience was 12.1 ± 2.7 y. Main Outcome Measures: Scapular upward/downward rotation, anteroposterior tilting, and external/internal rotation during simulated arm-cocking motion were analyzed using a 3-to-2-dimensional registration technique. Results: Scapular external rotation in the throwing shoulder was significantly smaller by 2.0--6.0° than that of the contralateral shoulder. There were no detectable differences in scapular upward/downward rotation or anteroposterior tilting between the throwing and contralateral shoulders. Conclusions: Compared with that in the contralateral shoulder, scapular external rotation was smaller in the throwing shoulder, which would increase glenohumeral horizontal abduction during the arm-cocking phase and be related to the throwing-shoulder disorder. [ABSTRACT FROM AUTHOR]

Objective. The aim of this randomized controlled study was to investigate the effects of insoles with a toe-grip bar on toe function and standing balance in healthy young women. Methods. Thirty female subjects were randomly assigned to an intervention group or a control group. The intervention group wore shoes with insoles with a toe-grip bar. The control group wore shoes with general insoles. Both groups wore the shoes for 4 weeks, 5 times per week, 9 hours per day. Toe-grip strength, toe flexibility, static balance (total trajectory length and envelope area of the center of pressure), and dynamic balance (functional reach test) were measured before and after the intervention. Results. Significant interactions were observed for toe-grip strength and toe flexibility (F=12.53, p<0.01; F=5.84, p<0.05, resp.), with significant improvement in the intervention group compared with that in the control group. Post hoc comparisons revealed that both groups showed significant improvement in toe-grip strength (p<0.01 and p<0.05, resp.), with higher benefits observed for the intervention group (p<0.01). Conversely, no significant interaction was observed in the total trajectory length, envelope area, and functional reach test. Conclusions. This study suggests that insoles with a toe-grip bar contribute to improvements in toe-grip strength and toe flexibility in healthy young women. [ABSTRACT FROM AUTHOR]

Objective: A majority of menstruating women experience some degree of regular recurrences of diverse symptoms-commonly known as premenstrual syndrome (PMS)-during the days before menstruation. Given the multifactorial etiology of PMS, no single treatment is universally recognized as effective, and many women turn to alternative modalities, including aromatherapy. The present study investigated therapeutic effects on premenstrual symptoms using fragrance from yuzu, a Japanese citrus fruit ( Citrus junos Sieb. ex Tanaka), and aromatherapy, from the perspective of autonomic nervous system function. Subjects: Seventeen women in their 20s with subjective premenstrual symptoms. Design: A single-blind randomized crossover study. Settings/Location: This study was performed at a laboratory in a university in Osaka, Japan. Subjects were examined on two separate occasions in the luteal phase. Outcome measures: Using two aromatic stimulation sources (yuzu and lavender used as the control), this experiment measured heart rate variability (HRV) reflecting autonomic nerve activity and the Profile of Mood States (POMS) as a psychologic index before and after aromatic stimulation. Results: A scant 10-min inhalation of the yuzu scent significantly decreased heart rate and increased high-frequency power of HRV, reflecting parasympathetic nerve activity, in the luteal phase. Additionally, POMS tests demonstrated that inhalation of the yuzu essential oil significantly decreased three negative subscales: tension-anxiety, anger-hostility, and fatigue-common premenstrual symptoms, together with a total mood disturbance as a global measure of affective state, as long as 35 min after the aroma stimulation. These premenstrual psychoneurophysiologic effects of yuzu fragrance did not differ from those of the effects of lavender. Conclusions: The present study indicated that short-term inhalation of yuzu fragrance could alleviate premenstrual emotional symptoms, which, at least in part, is attributable to the improvement of parasympathetic nervous system activity. This study further implies that yuzu fragrance aromatherapy might serve as an anti-PMS modality, given its comparable psychoneurophysiologic effects to those of lavender, a representative relaxing scent. [ABSTRACT FROM AUTHOR]

Background: Vascular CD34+ cells in anterior cruciate ligament (ACL) tissue have the potential for high proliferation and multilineage differentiation that can accelerate tendon-bone healing. While patient characteristics, such as age, can affect tendon-bone healing, the influence of elapsed time after injury on the healing process is unclear. Hypothesis: Cells obtained during the early phase after injury will exhibit a greater tendon-bone healing potential compared with chronic phase counterparts when applied to an immunodeficient rat model of ACL reconstruction. Study Design: Controlled laboratory study. Methods: Adult human ACL-ruptured tissue was harvested from patients undergoing arthroscopic primary ACL reconstruction and classified into 2 groups based on the time elapsed between injury and surgery: (1) early group (≤3 months from injury) and (2) chronic group (>3 months from injury). In addition, 76 ten-week-old female immunodeficient rats underwent ACL reconstruction, followed by intracapsular administration of one of the following: (1) ACL-derived cells from the early group (n = 5), (2) ACL-derived cells from the chronic group (n = 5), or (3) phosphate-buffered saline (PBS) only (n = 5). During the 8 weeks after surgery, histological (weeks 2, 4, 8), immunohistochemical (week 2), radiographic (weeks 0, 2, 4, 8), and biomechanical (week 8) analyses were performed to evaluate tendon-bone healing. Results: In the early group, the histological evaluation showed early healing, induction of endochondral ossification–like integration, and mature bone ingrowth. Micro–computed tomography showed that the tibial bone tunnels at week 4 and week 8 were significantly reduced in the early group compared with those in the chronic group and PBS group (P < .05). Moreover, biomechanical tensile strength was significantly greater in the early group than in the other groups (P < .05). An accelerated healing potential in the early group was further demonstrated by the enhancement of intrinsic angiogenesis/osteogenesis and human-derived vasculogenesis/osteogenesis. Conclusion: Compared with human ACL-derived cells obtained during the chronic phase, cells obtained during the early phase after injury have a greater tendon-bone healing potential when used in an immunodeficient rat model of ACL reconstruction. Clinical Relevance: During ACL reconstruction surgery, transplanting ACL remnant tissue in the early phase after injury could accelerate and enhance tendon-bone healing. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate and compare muscle and tendon stiffness under active conditions in sprinters and untrained participants. In total, 14 sprinters and 24 untrained men participated in this study. Active muscle stiffness in the medial gastrocnemius muscle was calculated based on changes in estimated muscle force and fascicle length during fast stretching after submaximal isometric contractions. Tendon stiffness was determined during isometric plantar flexion using ultrasonography. No significant differences were observed in active muscle stiffness between sprinters and untrained men at any torque levels. Furthermore, no significant difference was noted in tendon stiffness between the two groups. These results suggest that muscle and tendon mechanical properties in the plantar flexors under active conditions are similar in sprinters and untrained participants. [ABSTRACT FROM PUBLISHER]

Background: Remnant-preserved anterior cruciate ligament (ACL) reconstruction was introduced to improve clinical outcomes and biological healing. However, the effects of remnant preservation and the influence of the delay from injury until reconstruction on the outcomes of this technique are still uncertain. Purpose/Hypothesis: The purposes of this study were to evaluate whether remnant preservation improved the clinical outcomes and graft incorporation of ACL reconstruction and to examine the influence of the delay between ACL injury and reconstruction on the usefulness of remnant preservation. We hypothesized that remnant preservation improves clinical results and accelerates graft incorporation and that its effect is dependent on the delay between ACL injury and reconstruction. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 151 consecutive patients who underwent double-bundle ACL reconstruction using a semitendinosus graft were enrolled in this study: 74 knees underwent ACL reconstruction without a remnant (or the remnant was <25% of the intra-articular portion of the graft; NR group), while 77 knees underwent ACL reconstruction with remnant preservation (RP group). These were divided into 4 subgroups based on the time from injury to surgery: phase 1 was <3 weeks (n = 24), phase 2 was 3 to less than 8 weeks (n = 70), phase 3 was 8 to 20 weeks (n = 32), and phase 4 was >20 weeks (n = 25). Clinical measurements, including KT-1000 arthrometer side-to-side anterior tibial translation measurements, were assessed at 3, 6, 12, and 24 months after reconstruction. Magnetic resonance imaging evaluations of graft maturation and graft-tunnel integration of the anteromedial and posterolateral bundles were assessed at 3, 6, and 12 months after reconstruction. Results: There was no difference in side-to-side anterior tibial translation between the NR and RP groups. There was also no difference in graft maturation between the 2 groups. Furthermore, the time from ACL injury until reconstruction did not affect graft maturation, except in the case of very long delays before reconstruction (phase 4). Graft-tunnel integration was significantly increased in both groups in a time-dependent manner. However, there was no difference between the NR and RP groups. Conclusion: Remnant preservation did not improve knee stability at 2 years after ACL reconstruction. Furthermore, remnant preservation did not accelerate graft incorporation, especially during the acute and subacute injury phases. [ABSTRACT FROM AUTHOR]

The article focuses on a study which examines the lateral posing bias for displaying trustworthiness during a trust game in which participants and their virtual partners cooperated or did not cooperate with their counterparts to earn a monetary reward. Topics discussed include the number of posers showing the left or right cheek as a function of cooperativeness and the mean rating of facial trustworthiness as a function of posing orientation and cooperativeness.

Background Thrombocytopenia during intoxication, rebound thrombocytosis during 1 to 3 weeks of abstinence, and subsequent normalization of the platelet count are common in alcoholics. Methods We evaluated 989 Japanese alcoholic men to identify the effects of genetic polymorphisms of alcohol dehydrogenase-1B ( ADH1B; rs1229984) and aldehyde dehydrogenase-2 ( ALDH2; rs671) on platelet counts during an 8-week in-hospital abstinence period. Results Thrombocytopenia (<15 × 104/ μl) was observed in 25.9% of the subjects upon admission. The platelet counts increased from 21.4 ± 0.3 × 104/ μl (mean ± SE) to 27.6 ± 0.3 × 104/ μl, and a rebound platelet increase of ≥10 × 104/ μl was observed in 28.6% of the patients during the first 2 weeks after admission. By 4 weeks, the mean platelet counts had returned to intermediate levels and remained stable thereafter. The reversible suppression and rebound increase in the platelet counts were more prominent in the slow-metabolizing ADH1B*1/*1 group than in the fast-metabolizing ADH1B*2 group. Throughout the 8 weeks, the mean platelet counts of the active ALDH2*1/*1 group were consistently lower than those in the inactive ALDH2*1/*2 group. Cirrhosis was a strong determinant of a lower platelet count. After adjustments for nongenetic factors including cirrhosis, multiple linear regression analyses showed that the ADH1B*1/*1 genotype was associated with a lower platelet count (partial regression coefficient = −1.3 × 104/ μl) on the admission day , but subsequently had a positive effect on the platelet count at 1 and 2 weeks after admission (+1.5 and +3.8 × 104/ μl, respectively). The ALDH2*1/*1 genotype was associated with a lower platelet count (−2.1 to −3.9 × 104/ μl) consistently throughout the 8 weeks. Multiple logistic regression analyses showed that the ADH1B*1/*1 genotype increased the risk of thrombocytopenia upon admission (odds ratio [95% confidence interval] = 1.61 [1.14 to 2.27]) and of a rebound platelet increase during the first 2 weeks (3.86 [2.79 to 5.34]). The ALDH2*1/*1 genotype increased the risk of thrombocytopenia upon admission (1.73 [1.06 to 2.82]). Conclusions In alcoholics, the ADH1B*1/*1 genotype increased the risk of thrombocytopenia upon admission and of a rebound platelet increase 2 weeks thereafter, while the ALDH2*1/*1 genotype was associated with lower platelet counts throughout the 8-week hospital stay. [ABSTRACT FROM AUTHOR]

Background. This study aimed to investigate whether a lifestyle-based physical activity program could contribute to reduced medical expenditure. Methods. The study participants were 60 adults aged 63.1 (standard deviation, 4.4) years in the intervention group; the case-control group consisted of 300 adults who were randomly selected from Japan’s national health insurance system. This community-based retrospective study incorporated a 3-year follow-up. Results. The total and outpatient medical expenditure in the intervention group were significantly lower than in the control group: total expenditure, $US640.4/year; outpatient expenditure, $369.1/year. The odds ratio for outpatient visiting was 6.47-fold higher in the control than in the intervention group. Conclusion. Our study suggests that a health program to promote physical activity can result in reduced total medical expenditure, outpatient medical expenditure, and possibly also inpatient medical expenditure. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the immediate effects of traditional local thermal therapy with indirect moxibustion on renal hemodynamics in patients with chronic kidney disease (CKD) by using Doppler ultrasonography (US). Design: Examiner-blinded crossover study. Participants: Forty-three participants with CKD (mean age ± standard deviation [SD], 44 ± 15 years; estimated glomerular filtration rate, 69.5 ± 25.5 mL/min per 1.73 m2; 20 men and 23 women). Intervention: Participants received three successive treatment sessions of indirect moxibustion bilaterally at BL 23, a crucial acupuncture point, in the session. In the control session, the examiner was blinded by using smoke and aroma produced by moxibustion performed in an ashtray placed near the patient's body. Outcome measures: The main outcome measure was resistive index (RI) in the renal segmental arteries. Blood flow parameters, including RI, were measured for six renal segmental arteries by using Doppler US at rest (baseline), immediately after completion of moxibustion (post 1), and 10 minutes later (post 2). Adverse events were monitored during intervention. Results: In the control session, RI at post 1 (median [first, third quartile]: 0.587 [0.562, 0.626]) and post 2 (0.583 [0.567, 0.629]) did not change significantly compared with baseline (0.592 [0.563, 0.636]), while in the treatment session, RI at post 1 (0.565 [0.530, 0.618]) and post 2 (0.561 [0.533, 0.614]) decreased significantly compared with baseline (0.590 [0.550, 0.652]) ( p < 0.001 and p < 0.001, respectively). The reduction in RI from baseline to post 2 in treatment session was significantly greater than in control session (mean ± SD, −0.026 ± 0.028 versus −0.003 ± 0.028; mean difference, −0.023 [95% confidence interval, −0.036 to −0.010]; p = 0.001]. No adverse events, such as burns, were observed during the study period. Conclusion: Renal vascular resistance was decreased after indirect moxibustion therapy in patients with CKD. [ABSTRACT FROM AUTHOR]

Background: The Self-Directed Learning Readiness Scale for Nursing Education (SDLRSNE) assesses the extent to which an individual has the characteristics, capabilities, and attitudes required for self-directed learning. This study aimed to validate the Japanese version of the SDLRSNE with graduate-level nursing students. Method: Confirmatory factor analyses, using data from a cross-sectional online survey of 376 nursing students, were conducted to examine construct validity. Relationships with potential related factors were analyzed to evaluate construct validity. Reliability was evaluated with item analysis and Cronbach's alpha. Results: Factor analyses revealed that three-factor and individual subscale models had a moderate-to-poor fit. No meaningful relationship with potential related factors was noted. Reliability measurements indicated a moderate fit to data. Conclusion: This study could not confirm that the Japanese version of the SDLRSNE had acceptable levels of reliability and validity when tested with graduatelevel nursing students. Further research is needed to examine the psychometric properties of the Japanese version of the SDLRSNE with other adult nursing learners or with graduate-level nursing students in other countries. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to assess the effect of the daily practice of a yoga therapy program learnt during a single session of an integrated yoga intervention that was developed by us as a stress management tool for school employees. Subjects: Ninety school employees. Design: Case-control study. Three months after the intervention, the subjects were assigned to a daily practice group (case: n=43) and a nonconsecutive daily practice group (control: n=47) according to their daily practice level of the yoga therapy program. Interventions: The subjects participated in a stress management education program based on an integrated yoga therapy session. The program included psychological education and counseling about stress management and yoga theories, as well as the practices of asanas, pranayama, relaxation, and cognitive structure based on Indian philosophy. Outcome measures: Assessments were performed before and after the program using the Subjective Units of Distress for mind and body and the Two-Dimensional Mood Scale. The General Health Questionnaire 28 (GHQ28) was used to assess the mental health state before the intervention and at 3 months after the program. Results: The subjects showed significant increases in their levels of calmness, comfort, and cheerfulness ( p<0.001) and significant decreases in cognitive mind and body stress ( p<0.001) after participating in the integrated yoga program. A comparison of the total scores on the GHQ28 using a two-way analysis of variance showed significant differences between the two groups in terms of both interaction ( p=0.047) and the main effect ( p=0.026). Conclusions: The present results suggested that a single session of an integrated yoga program was effective for reducing stress and that the mental health of school employees was promoted by the daily practice of the yoga therapy program. [ABSTRACT FROM AUTHOR]

The purpose of this study was to clarify the differences between adolescent and collegiate baseball pitchers in the kinematic and kinetic profiles of the trunk and lower limbs during the pitching motion. The subjects were thirty-two adolescent baseball pitchers aged 12-15 years (APG) and thirty collegiate baseball pitchers aged 18-22 years (CPG). Three-dimensional motion analysis with a comprehensive lower-extremity model was used to evaluate kinematic and kinetic parameters during baseball pitching. The ground reaction forces (GRFs) of the pivot and stride legs during pitching were determined using two multicomponent force plates. The joint torques of hip, knee, and ankle were calculated by the inverse-dynamics computation of musculoskeletal human models using motion-capture data. To eliminate any effect of variation in body size, kinetic and GRFs data were normalized by dividing them by body mass. The velocity of a pitched ball was significantly higher (p < 0.01) in CPG (35.2 ± 1.9 m⋅s-1) than in the APG (30.7 ± 2.7 m⋅s-1). Most kinematic parameters for the lower limbs were similar between the CPG and the APG. Maximum Fy (toward the throwing direction) on the pivot leg and Fy and resultant forces on the stride leg at ball release were significantly greater in the CPG than in the APG (p < 0.05). Hip and knee joint torques on the lower limbs were significantly greater in the CPG than in the APG (p < 0.05). The present study indicates that the kinematics of lower limbs during baseball pitching are similar between adolescent and collegiate pitchers, but the momentum of the lower limbs during pitching is lower in adolescent pitchers than in collegiate ones, even when the difference in body mass is considered. [ABSTRACT FROM AUTHOR]

Outdoor exercise often proceeds in rainy conditions. However, the cooling effects of rain on human physiological responses have not been systematically studied in hot conditions. The present study determined physiological and metabolic responses using a climatic chamber that can precisely simulate hot, rainy conditions. Eleven healthy men ran on a treadmill at an intensity of 70% VO2maxfor 30 min in the climatic chamber at an ambient temperature of 33°C in the presence (RAIN) or absence (CON) of 30 mm · h−1of precipitation and a headwind equal to the running velocity of 3.15 ± 0.19 m · s−1. Oesophageal temperature, mean skin temperature, heart rate, rating of perceived exertion, blood parameters, volume of expired air and sweat loss were measured. Oesophageal and mean skin temperatures were significantly lower from 5 to 30 min, and heart rate was significantly lower from 20 to 30 min in RAIN than in CON (P < 0.05 for all). Plasma lactate and epinephrine concentrations (30 min) and sweat loss were significantly lower (P < 0.05) in RAIN compared with CON. Rain appears to influence physiological and metabolic responses to exercise in heat such that heat-induced strain might be reduced. [ABSTRACT FROM AUTHOR]

Aims: To investigate the effectiveness of brief intervention (BI) conducted in the workplace for heavy drinkers. Methods: A randomized controlled trial was conducted at six companies in Japan. Participants were heavy drinkers who met the inclusion criteria and were randomized into three groups: the BI group, BI with diary group and a control group. Outcomes (total drinks, binge drinking episodes and alcohol-free days) were evaluated at 3 and 12 months. Results: The 304 participants recruited were allocated to the three groups and 277 participated in all follow-up evaluations. Dropout rates in the respective groups were 7.0, 14.9 and 5.5%. Some improvements were observed in all the groups. In particular, alcohol-free days in the BI group were significantly increased by 93.0% at 12 months. Total drinks at 12 months were reduced by 41 g per week in the BI group compared with the control group, although the intergroup difference was not significant. Conclusion: BI in the workplace is effective for increasing the number of alcohol-free days. However, the effectiveness on decreasing alcohol consumption was unclear, which could be explained by alcohol screening itself causing a reduction in drinking. [ABSTRACT FROM PUBLISHER]

Primary objective: To examine active inhibition of irrelevant stimuli and evaluate its neural basis using functional near infrared spectroscopy in patients with attention deficits after traumatic brain injury (TBI). Research design: Case control study. Methods and procedures: Ten patients with TBI and 10 healthy control subjects participated in this study. The Paced Auditory Serial Addition Test (PASAT) was performed with (distracting PASAT) and without (PASAT) distracting Japanese kana phonetic characters presented between each number. A block design was used. Subjects alternately performed each task three times. Main outcomes and results: Healthy controls performed better than patients with TBI on both the tasks. When performing the PASAT, healthy controls showed significant activity in every region of interest except the right lateral prefrontal cortex (PFC), but patients with TBI showed significant activity only in the left anterior PFC and left lateral PFC. When performing the distracting PASAT, the right lateral PFC was active in healthy controls, but not in patients with TBI. Conclusion: These results confirm that patients with moderate-to-severe TBI were affected by distractors that influenced order processing. It is suggested that the working memory of patients with TBI was affected by distracting stimuli, whereas that of healthy individuals was not. [ABSTRACT FROM AUTHOR]

This study investigated the relationships between thumb muscle activity and thumb operating tasks on a smartphone touch screen with one-hand posture. Six muscles in the right thumb and forearm were targeted in this study, namely adductor pollicis, flexor pollicis brevis, abductor pollicis brevis (APB), abductor pollicis longus, first dorsal interosseous (FDI) and extensor digitorum. The performance measures showed that the thumb developed fatigue rapidly when tapping on smaller buttons (diameter: 9 mm compared with 3 mm), and moved more slowly in flexion–extension than in adduction–abduction orientation. Meanwhile, the electromyography and perceived exertion values of FDI significantly increased in small button and flexion–extension tasks, while those of APB were greater in the adduction–abduction task. This study reveals that muscle effort among thumb muscles on a touch screen smartphone varies according to the task, and suggests that the use of small touch buttons should be minimised for better thumb performance. Practitioner Summary:Through measurements of electromyography, thumb performance and perceived exertion, this study reveals that demand on FDI increases when the thumb taps small buttons and in flexion–extension orientation, but that demand on APB increases in adduction–abduction orientation. The decreased thumb performance with small buttons is attributed to a combination of smaller targets and increased demand on FDI. [ABSTRACT FROM PUBLISHER]

Few studies in Japan have examined whether children's later mental health is influenced by the way parental authority is exercised, specifically with a focus on gender. Our main purposes of this study were to confirm the three-factor structure of the Japanese version of the Parental Authority Questionnaire (PAQ) and to verify its reliability and validity. We then used structural equation modeling to examine whether children's later mental health was influenced by parents' authoritative, permissive, and authoritarian parenting. The subcategories included in the Japanese version of the Clinical Outcomes in Routine Evaluation-Outcome Measure were chosen as mental health indices. A total of 1,320 people in Japan, including company employees, university students, and hospital staff members, were asked to recall and evaluate the parenting they received and to report on their current mental health. Confirmatory factor analyses verified the three-factor structure of the Japanese version of the PAQ, with a reduction in the number of items from the original version. The respondents, regardless of gender, evaluated their mothers as having been more authoritative than their fathers. Concerning the impact of parenting styles on respondents' later mental health, both maternal and paternal authoritarian parenting styles worsened respondents' later mental health, including symptomatic problems, risk to self and others, life functioning, and psychological well-being. Both maternal and paternal authoritative parenting had a beneficial impact on respondents' later mental health. Simultaneous analyses of multi-groups demonstrated that the nature of these influences did not vary with respondent gender. We present the above results in detail, and discuss them from psycho-socio-cultural viewpoints. [ABSTRACT FROM AUTHOR]

The aims of this study were to identify the preoperative factors influencing ambulation ability at different postoperative time points after total hip arthroplasty (THA) and to examine the cutoff values of predictive preoperative factors by receiver operating characteristic (ROC) curves. Forty-eight women with unilateral THA were measured for hip extensor, hip abductor, and knee extensor muscle strength in both legs; hip pain (visual analog scale, VAS); and the Timed Up and Go (TUG) test pre- and postoperatively. Multiple regression analysis indicated that preoperative knee extensor strength (β = -0.379, R2 = 0.409) at 3 weeks, hip abductor strength (β = -0.572, R2 = 0.570) at 4 months, and age (β = 0.758, R2 = 0.561) at 7 months were strongly associated with postoperative ambulation, measured using the TUG test. Optimal preoperative cutoff values for ambulation ability were 0.56Nm/kg for knee extensor strength, 0.24Nm/kg for hip abductor strength, and 73 years of age. Our results suggest that preoperative factors predicting ambulation ability vary by postoperative time point. Preoperative knee extensor strength, hip abductor strength, and age were useful predictors of ambulation ability at the early, middle, and late time points, respectively, after THA. [ABSTRACT FROM AUTHOR]

Background Several studies have suggested that i.v. atropine has a potential role in treating infantile hypertrophic pyloric stenosis ( IHPS). It remains unclear, however, whether surgery can be replaced by i.v. therapy. Methods Data were extracted on infants with IHPS who were treated with atropine and/or surgery, from a nationwide administrative database through 2006-2008. Patient demographic data, treatment effects and length of hospital stay were analyzed in each treatment group. Results A total of 585 infants met the criteria for IHPS; 188 patients (32%) were initially treated with atropine ( i.v. form, n = 180; oral form, n = 8), while 397 were treated with surgery as a first-line therapy. Of the 180 infants receiving i.v. atropine, 38 were withdrawn from medical management and subsequently underwent surgery. Thus, the overall success rate of i.v. atropine was 78.9% (142/180). Surgery had a success rate of 100%, and postoperative complications were found in 2.8% of patients (12/435). Medical management required longer hospital stay than surgery (mean, 13.5 days vs 8.0 days; P < 0.001). Conclusion Surgery remains the suitable standard management option for IHPS, with its high success rate, minimal complications and shorter hospital stay compared with i.v. atropine therapy. [ABSTRACT FROM AUTHOR]

Background Appropriate nutrition during childhood is important for preventing future development of lifestyle-related diseases. The effect of feeding choice on infant growth in Japan is not known. Methods Data from 204 healthy schoolchildren (age, 6-9 years) were obtained retrospectively from their parents by questionnaires. Breast-fed ( BF) and formula-fed ( FF) groups were defined as those fed only breast milk or formula milk at 4 months of age, respectively. There were 71 children (M/F, 31/40) in BF and 30 (M/F, 19/11) in FF. Anthropometric data at birth, and at 1, 4, 7, 10, 18, and 36 months of age in male and female infants were compared between the groups. Results In male infants, height was significantly lower at 4 months, bodyweight was lower from 4 to 18 months, and body mass index ( BMI) was lower from 10 to 36 months in BF than in FF. The standard deviation scores ( SDS) for height, weight and BMI had a similar pattern. No significant differences were observed for these variables for female infants in BF compared with FF. Multiple regression analysis showed that birthweight, mother's pre-pregnancy weight, and infant feeding choice were significant factors associated with weight- SDS at 18 and 36 months. Feeding choice was the only factor associated with BMI-SDS at 18 months. Conclusions Infant feeding choice had a gender-associated effect on growth during infancy. When evaluating infant growth, not only birthweight and mother's pre-pregnancy weight, but also infant feeding choice and gender should be considered. [ABSTRACT FROM AUTHOR]

Studies of physician-nurse relationships have focused mainly on nurses' perceptions. Few studies have explored physicians' perceptions and related factors. This study had two aims: to describe physicians' perceptions of physician-nurse collaboration in Japan by focusing on attitudes toward collaboration and collaborative practice and to examine the effect of physicians' experiences related to collaboration on their perceptions of collaboration. A cross-sectional survey was conducted. Of the 520 physicians from four hospitals, 248 completed the survey. The survey included the Jefferson Scale of attitudes toward physician-nurse collaboration, the collaborative practice scales, learning experiences related to collaboration with nurses and experiences of joint activities with nurses. Multiple regression analysis revealed that learning experiences in undergraduate and out-of-hospital education and experiences of joint committee work were significantly associated with higher collaborative practice scores. Although participants' attitude scores had a strong association with practice scores, there were no variables significantly associated with the attitude score. This study supported the importance of education in undergraduate courses and suggested that it should be ongoing after qualification. Joint activities other than daily practice, such as continuous quality improvement, might also be effective. Factors that improve physicians' attitudes toward collaboration should be further explored. [ABSTRACT FROM AUTHOR]

The present study aimed to investigate the influence of 10 activities on quality of life (QOL) in Japanese older adults and to verify which activities had higher influence on QOL level. The subjects were 465 Japanese community-dwelling older adults. QOL was assessed by the brief version of the World Health Organization Quality of Life (WHOQOL-BREF) and the complementary assessment to measure the QOL of older adults (WHOQOL-OLD) module. Activity and participation were measured through a questionnaire concerning frequency of engagement in several activities. The activity with the highest influence on WHOQOL-BREF was physical activity ( β = 0.209, p < 0.01), followed by art activity ( β = 0.169, p < 0.01) and reading and writing ( β = 0.141, p < 0.01). The activity with the highest influence on WHOQOL-OLD was social activity ( β = 0.222, p < 0.01), followed by reading and writing activity ( β = 0.118, p < 0.05). The limitations of this study were the proportion of subjects and the place of recruitment. Further studies investigating in deep the relation between QOL and activity and participation, and other subjective and environmental factors that may influence the QOL are still needed among a higher and homogeneous subjects sample. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

We investigated the effects of purified eicosapentaenoic acid (EPA) on vascular endothelial function and free fatty acid composition in Japanese hyperlipidemic subjects. In subjects with hyperlipidemia (total cholesterol ⩾ 220 mg/dL and/or triglycerides ⩾ 150 mg/dL), lipid profile and forearm blood flow (FBF) during reactive hyperemia were determined before and 3 months after supplementation with 1800 mg/day EPA. Peak FBF during reactive hyperemia was lower in the hyperlipidemic group than the normolipidemic group. EPA supplementation did not change serum levels of total, HDL, or LDL cholesterol, apolipoproteins, remnant-like particle (RLP) cholesterol, RLP triglycerides, or malondialdehyde-modified LDL cholesterol. EPA supplementation did not change total free fatty acid levels in serum, but changed the fatty acid composition, with increased EPA and decreased linoleic acid, γ-linolenic acid, and dihomo-γ-linolenic acid. EPA supplementation recovered peak FBF after 3 months. Peak FBF recovery was correlated positively with EPA and EPA/arachidonic acid levels and correlated inversely with dihomo-γ-linolenic acid. EPA supplementation restores endothelium-dependent vasodilatation in hyperlipidemic patients despite having no effect on serumcholesterol and triglyceride patterns. These results suggest that EPA supplementationmay improve vascular function at least partly via changes in fatty acid composition. [ABSTRACT FROM AUTHOR]

Abstract: Homebound status is associated with poorer health and disability; however, the impact of community factors on the decision to remain homebound is unclear. We applied multilevel analyses to examine the association between neighborhood environment and homebound status among Japanese community-dwelling elderly. A cross-sectional survey was conducted in February 2009 using a mailed questionnaire. A total of 4123 participants aged 20years and over living in 72 small districts of Kashiwa, Japan, were randomly selected for the survey. Of the 1735 returned questionnaires, the 588 that were completed by individuals aged 65years and over were used for analysis. Frequency of going outdoors was assessed and respondents going outdoors once a week or less were defined as homebound. Neighborhood environment was assessed using three subscales of the Neighborhood Environment Walkability Scale (NEWS-A) (land use mix-access, aesthetics and crime safety). Multilevel logistic regression analysis indicated that the lower score of land use mix-access at the district level was associated with the elderly being homebound after adjustment for individual demographic data, physical, psychological and social factors and district prevalence of population aged 65years or more. This finding could contribute to devising a successful community-based strategy for homebound prevention of community-dwelling elderly individuals. [Copyright &y& Elsevier]

( Headache 2011;51:1239-1244) Background.- Migraine is associated with an increased risk for ischemic stroke and cardiovascular disease (CVD). Recent studies have suggested vascular dysfunction in the aorta, the brachial and femoral artery. Little is known about such arterial changes in Japanese midlife migraineurs. We aimed to evaluate arterial pulse wave velocity (PWV) and ankle-brachial index (ABI) in middle-aged migraineurs at low CVD risk. Methods.- Brachial-ankle PWV (baPWV) and ABI, using an oscillometric technique, were measured in 111 migraineurs (81 women and 30 men) and 110 controls. All participants had no CVD risk factors. Statistical comparison of baPWV and ABI between both groups and the relationship to clinical variables of migraineurs were analyzed. Results.- Twenty-two subjects had migraine with aura and 89 had migraine without aura. Mean age (SD) of migraineurs was 44.4 (8.4) years. Mean duration (SD) was 18.0 (10.8) years. Attack frequency was 60 subjects in ≥1 time/month and 51 subjects in <1 time/month. Mean score (SD) of Headache Impact Test-6 (HIT-6) was 61.4 (8.7). CVD risk profile did not differ statistically between migraineurs and controls. Mean baPWV (SD) of migraineurs was 1247 (189) cm/second in women and 1356 (126) in men. That of controls was 1138 (136) in women and 1250 (121) in men. baPWV was increased significantly in female and male migraineurs. Mean ABI (SD) was 1.05 (0.06; 1.04 [0.07] in men and 1.05 [0.06] in women) in migraineurs and 1.06 (0.07) in controls (1.05 [0.08] in men and 1.06 [0.08] in women). ABI did not differ statistically between migraineurs and controls. Migraine subtypes, duration, attack frequency, and HIT-6 score were not associated with baPWV and ABI. Conclusion.- The present study indicated higher baPWV in midlife migraineurs without CVD risk factors. This pathogenesis could reflect distinct vascular reactivity rather than arterial stiffness due to atherosclerosis. [ABSTRACT FROM AUTHOR]

Abstract: Previous research suggests that water exercise (WE) improves bodily functions of the frail elderly, but there is as yet no research on the effect of once weekly WE. This study aims to compare the effects of once and twice weekly WE on bodily functions of frail elderly requiring nursing care in six months. The design is a prospective cohort study. Participants were assigned to two different exercise groups (once weekly group or twice weekly group; n =35). Once weekly group participate in a 60-min exercise session once a week, for six months while twice weekly group attended the session twice a week. Exercise sessions were divided into a 10-min warm-up on land and 50min of exercise in water. The 50-min WE program consisted of 20min walking, 10min activities of daily living (ADL) exercise, 10min stretching and strength exercises, and 10min relaxation in water. Muscle strength, flexibility, balance, mobility and ADL disability were measured before the beginning of intervention and three months and six months after the program had started. Significant differences between the once and twice weekly groups were found in flexibility and balance at 3-months and 6-months and lower muscle strength and ADL disability only at 3-months. These results from present study suggested that the effects of WE frequency in the fail elderly who require nursing care were different for each bodily function. [Copyright &y& Elsevier]

This study assessed the effects of multidimensional exercises on functional decline, urinary incontinence, and fear of falling in community-dwelling Japanese elderly women with multiple symptoms of geriatric syndrome (MSGS). Sixty-one participants were randomly assigned either to an intervention (n =31) or to a control group (n =30). For 3-month period, the intervention group received multidimensional exercise, twice a week, aiming to increase the muscle strength, walking ability, and pelvic floor muscle (PFM). Outcome variables were measured at baseline, and after intervention and follow-up. The functional decline of the intervention group decreased from 50.0% at baseline to 16.7% after intervention and follow-up (Q =16.67, p <0.001). For urinary incontinence, the intervention group decreased from 66.7% at baseline to 23.3% after intervention and 40.0% at follow-up (Q =13.56, p =0.001), whereas the control group showed no improvement. Intervention group showed greater and significant decrease in the score of MSGS compared to control group (F =12.66, p =0.001). Within the subjects that showed improvement to normal status of MSGS, a significantly higher proportion demonstrated increased maximum walking speed at follow-up (Q =6.50, p =0.039). These results suggest that multidimensional exercise is an effective strategy for reducing geriatric syndromes in elderly population. An increase in walking ability may contribute to the improvement of MSGS. [Copyright &y& Elsevier]

Abstract: The purpose of this study was to evaluate the effect of continuous oral care on the nutritional status of older people who require care using a 1-year randomized, controlled study. Fifty-three residents of a nursing home in Japan participated in this study. Subjects were randomly divided into two groups, an oral care intervention group and control group. The subjects in the oral care intervention group received professional oral care from a dentist three times a week over the course of 1 year. Body weight, body mass index (BMI), serum albumin, and high-density lipoprotein cholesterol (HDL-C) were measured as objective indicators of nutritional status at baseline and after 1 year, and compared between the groups. In the oral care group, no significant decline was seen in all indicators from the start to the end of the intervention, but in the control group there was a statistically significant decline in all indicators at the end of the year. These results suggest that the intervention of oral care alone can serve to maintain the nutritional status of older people who require care. Implementation of continuous oral care is an important task from the viewpoint of maintaining nutritional status in older people. [ABSTRACT FROM AUTHOR]

Objective: To study the effects on the hemiplegic upper limb of repetitive facilitation exercises (RFEs) using a novel facilitation technique, in which the patient's intention to move the hemiplegic upper limb or finger was followed by realization of the movement using multiple sensory stimulations. Methods: Twenty-three stroke patients were enrolled in a cross-over study in which 2-week RFE sessions (100 repetitions each of five-to-eight types of facilitation exercise per day) were alternated with 2-week conventional rehabilitation (CR) sessions, for a total of four sessions. Treatments were begun with the 2-week RFE session in one group and the 2-week CR session in the second group. Results: After the first 2-week RFE session, both groups showed improvements in the Brunnstrom stages of the upper limb and the hand, in contrast to the small improvements observed during the first CR session. The Simple Test for Evaluating Hand Function (STEF) score, which evaluates the ability of manipulating objects, in both groups improved during both sessions. After the second 2-week RFE and CR sessions, both groups showed little further improvement except in the STEF score. Conclusion: The novel RFEs promoted the functional recovery of the hemiplegic upper limb and hand to a greater extent than the CR sessions. [ABSTRACT FROM AUTHOR]