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Background: A recent survey of 79 countries showed that fertility knowledge was lower in Japan than in any other developed country. Given the fertility decline in Japan and the importance of fertility knowledge, we conducted an online survey to examine fertility knowledge and the related factors for effective public education. Methods: We studied people aged 18-59 years old, n = 4,328 (the “General” group), and also people who had been trying to conceive for at least six months, 18-50 years old, n = 618 (the “Triers” group). Fertility knowledge was assessed using the Japanese version of the 13-item Cardiff Fertility Knowledge Scale (CFKS-J). All participants provided socio-demographic and fertility information. Participants also completed a 14-item health literacy scale and an 11-item health numeracy scale. We asked participants who were aware of age-related decline in fertility when and where they first acquired that knowledge. Results: The average percentages of CFKS-J items answered correctly were 53.1% in the Triers group and 44.4% in the General group (p < 0.001). Multivariate linear regression models showed in the Triers group greater fertility knowledge was associated with greater health literacy and prior medical consultation regarding their fertility. In the General group greater fertility knowledge was associated with being female, younger, university educated, currently trying to conceive, non-smoking, having higher household income, having higher health literacy and having higher health numeracy. Of those who were aware of the age-related decline in fertility, around 3% first learned the fact “at school”, and around 65% first learned it “through mass media” or “via the Internet”. More than 30% of the respondents first learned it “less than 5 years before” the survey. Conclusions: Although fertility knowledge had improved since a previous study, possibly due to recent media coverage of age-related infertility, it was still low. Educational interventions, both in schools and in the community, may be needed to increase fertility knowledge in the general population because most people obtain fertility knowledge from mass media, which has been shown to often present distorted and inaccurate fertility information. [ABSTRACT FROM AUTHOR]

We sought to determine whether serial measurements of oxidative stress levels could serve as a predictive marker for cardiovascular (CV) events in patients with ST-segment elevation myocardial infarction (STEMI). Biological antioxidant potential (BAP) levels were measured at admission and at 6, 12, and 24 months in 69 patients with STEMI. The CV events abruptly increased 6 to 10 months after successful percutaneous coronary intervention in patients with STEMI, and the 6-month BAP levels were significantly lower in patients with CV events (2456 μmol/L [interquartile range: 2237-2615 μmol/L]) than in those without (2849 μmol/L [2575-2987 μmol/L], P < .001). A decreased 6-month BAP level was an independent and significant predictor of long-term CV events (hazard ratio = 2.45; 95% confidence intervals 1.10-5.78; P = .04). Our findings suggest that serial changes in antioxidant capacity, assessed by BAP levels, may serve as a predictive marker for CV events after STEMI. [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]

Background A recent survey of 79 countries showed that fertility knowledge was lower in Japan than in any other developed country. Given the fertility decline in Japan and the importance of fertility knowledge, we conducted an online survey to examine fertility knowledge and the related factors for effective public education. Methods We studied people aged 18-59 years old, n = 4,328 (the "General" group), and also people who had been trying to conceive for at least six months, 18-50 years old, n = 618 (the "Triers" group). Fertility knowledge was assessed using the Japanese version of the 13-item Cardiff Fertility Knowledge Scale (CFKS-J). All participants provided socio-demographic and fertility information. Participants also completed a 14-item health literacy scale and an 11-item health numeracy scale. We asked participants who were aware of age-related decline in fertility when and where they first acquired that knowledge. Results The average percentages of CFKS-J items answered correctly were 53.1% in the Triers group and 44.4% in the General group (p < 0.001). Multivariate linear regression models showed in the Triers group greater fertility knowledge was associated with greater health literacy and prior medical consultation regarding their fertility. In the General group greater fertility knowledge was associated with being female, younger, university educated, currently trying to conceive, non-smoking, having higher household income, having higher health literacy and having higher health numeracy. Of those who were aware of the age-related decline in fertility, around 3% first learned the fact "at school," and around 65% first learned it "through mass media" or "via the Internet." More than 30% of the respondents first learned it "less than 5 years before" the survey. Conclusions Although fertility knowledge had improved since a previous study, possibly due to recent media coverage of age-related infertility, it was still low. Educational interventions, both in schools and in the community, may be needed to increase fertility knowledge in the general population because most people obtain fertility knowledge from mass media, which has been shown to often present distorted and inaccurate fertility information. [ABSTRACT FROM AUTHOR]

PURPOSE: This study aimed to investigate the effects of wearing a compression garment (CG) for 24 h on changes in muscular strength and blood parameters over time after resistance exercise. METHODS: Nine trained men conducted resistance exercises (10 repetitions of 3-5 sets at 70% of one-repetition maximum (1RM) for nine exercises) in two trials, wearing either a CG or a normal garment (CON) for 24 h after exercise. Recovery of muscular strength, blood parameters, muscle soreness, and upper arm and thigh circumference were compared between the trials. RESULTS: Both trials showed decreases in maximal strength after the exercise (P < 0.05). However, the CG trial showed faster recovery of one-repetition maximum for the chest press from 3 to 8 h after exercise (P < 0.05). Recovery of maximal knee extension strength was also improved in the CG trial 24 h after exercise (P < 0.05). The CG trial was associated with lower muscle soreness and subjective fatigue scores the following morning (P < 0.05). The upper arm and thigh circumferences were significantly higher during the recovery period in the CON trial, whereas no change was observed in the CG trial. Blood lactate, insulin like growth factor-1, free testosterone, myoglobin, creatine kinase, interleukin 6, and interleukin 1 receptor antagonist concentrations for 24 h after exercise were similar in both trials. CONCLUSIONS: Wearing a CG after resistance exercise facilitates the recovery of muscular strength. Recovery for upper body muscles significantly improved within 3-8 h after exercise. However, facilitation of recovery of lower limb muscles by wearing the CG took a longer time. [ABSTRACT FROM AUTHOR]

Aims and objectives. To assess psychosocial profiles of children with achondroplasia using a nationwide survey. Background. Achondroplasia, showing short stature and disproportionately short limbs, causes physical inconvenience such as difficulty in reaching high objects. It is, however, still controversial whether the condition is associated with psychological problems, especially in childhood. Design. A cross-sectional descriptive design was employed. Methods. To evaluate psychosocial profiles and adaptation processes in children with achondroplasia, we developed an inventory of scales based on the psychological stress model of which conceptual framework was comprised of stressor, coping process, coping resource and adaptation outcome domains. Participants were recruited nationwide through the largest advocacy support group for achondroplasia in Japan. Of the 130 group members, 73 X-ray-diagnosed patients, aged 8-18 years, completed the inventory of questionnaires to be analysed. Results. As for the stressor domain, patients experienced short stature-related unpleasant experiences more frequently (z-score: +1.3 in average, +3.9 in physical inconvenience). Nevertheless, these experiences had little effect on the coping process (threat appraisal: -0.2, control appraisal: +0.1) and the adaptation outcome (stress response: +0.3, self-concept: 0.0). Interestingly, self-efficacy in the coping resource domain was noticeably increased (+3.1) and was strongly correlated with most variables in the coping process and in adaptation outcome domains. Conclusions. Although the children with achondroplasia experienced more short stature-related stressors, there was no evidence of any psychosocial maladaptation. This finding suggests that coping process as well as coping resources such as self-efficacy could be important targets for promoting psychological adjustment in children with achondroplasia. Relevance to clinical practice. To help children with achondroplasia adapt socially, nurses and other healthcare providers should routinely assess their psychological adaptation process, especially cognitive appraisal and self-efficacy. [ABSTRACT FROM AUTHOR]

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]

The article discusses research which investigated osteochondritis dissecans (OCD) prevalence in adolescent baseball players. Topics explored include the elbow disability associated with OCD of the humeral capitellum, symptoms and factors that contribute to OCD such as microtrauma, the results of the ultrasonographic examinations performed on participating patients, and the need to diagnose OCD early to avoid treatment difficulties.

BACKGROUND: Nurses with higher levels of work engagement tend to be highly efficient in their work and more willing to keep working and to provide patient-centred care. However, whether more engaged nurses provide end-of-life care more proactively has not been examined in the home-care setting. AIM: This study aimed to examine work engagement among home-visiting nurses in Japan and its relationship with their attitudes toward caring for dying patients and their families. METHODS: A total of 343 nurses working in 62 agencies across Chiba prefecture, eastern Japan, received an anonymous self-administered questionnaire from July to August 2012. The authors performed multiple regression analysis to explore the relationships between home-visiting nurses' work engagement and attitudes. RESULTS: Data from 184 nurses (53.6%) was analysed. Work engagement was significantly positively related to the nurses' attitudes toward caring for dying patients and their families. CONCLUSION: As more engaged nurses tend to have more positive attitudes toward caring for dying patients and their families, further research is needed to identify the factors that might help nursing managers to enhance their staff's engagement and perhaps thereby improve their attitudes, with the ultimate aim of achieving better outcomes for patients and families. [ABSTRACT FROM AUTHOR]

The article presents a study on ACTN3 R577X polymorphism as it relates to muscular power in Japanese collegiate athletes as analyzed with a 30-second Wingate anaerobic test (WAnT) for mean and peak power results. The ACTN3 R577X genotype, Hardy-Weinberg equilibrium distribution, and anaerobic power are also discussed.

Objective. The mechanisms of ectopic calcification in inflammatory diseases are poorly understood. We investigated the effects of inflammatory cytokines on the mechanisms of calcification in human adipose tissue-derived mesenchymal stem cells (hADSCs).Methods. The effects of inflammatory cytokines were evaluated using hADSCs cultured in osteoblast induction medium. mRNA expression was measured by real-time PCR and protein levels were measured by western blotting. Cell mineralization was evaluated by Alizarin Red S staining.Results. In hADSCs, administration of IL-6/soluble IL-6 receptor (sIL-6R), TNF or IL-1β accelerated calcification through enhanced expression of an osteoblast differentiation marker, runt-related transcription factor 2 (RUNX2). IL-6/sIL-6R had the greatest effect. The transcription of mRNA for receptor tyrosine kinase-like orphan receptor 2 (ROR2), involved in the non-canonical wingless-type (WNT) MMTV integration site pathway, was increased, while β-catenin expression, an essential factor in the canonical WNT signalling pathway for osteoblast differentiation, did not change. Suppression of signal transducer and activator of transcription 3 (STAT3), but not STAT1, by small interfering RNA (siRNA) exerted a strong inhibitory effect on RUNX2 and ROR2 expression, and inhibited accelerated calcification.Conclusion. IL-6/sIL-6R stimulation accelerated the ROR2/WNT5A pathway in hADSCs in a STAT3-dependent manner, resulting in augmented calcification. These results suggest that the mechanisms of ectopic calcification accelerated by IL-6 in hADSCs may be involved in chronic inflammatory tissues and that IL-6 inhibitors may be beneficial in the treatment of ectopic calcification in inflammatory diseases. [ABSTRACT FROM PUBLISHER]

BACKGROUND: The 3-dimensional (3D) distances of specific points on the chest and abdominal wall are useful for assessing the characteristics of breathing movement. This study aimed to determine whether the 3D distances on the chest and abdominal wall during deep breathing (DB) could be estimated using a newly developed breathing movement-measuring device (BMMD). METHODS: Breathing movement distances on the chest (bilateral third and eighth ribs) and abdomen (upper abdomen) of 10 healthy young males were measured using a pen-sized mechanical BMMD and a 3D motion analysis system during DB. DB was controlled and based on the distances targeted by the BMMD (ie, 1, 2, and 3 cm), which was placed on the observation points and fixed on a tripod. Simultaneously, the 3D distances of reflective markers on the observation points were measured. The obtained data were statistically analyzed using a paired t test, repeated measures analysis of variance with multiple comparisons tests, and linear regression with mixed effects. RESULTS: All the BMMD distances were less than the 3D distances. The differences between the 3D and BMMD distances on the chest and abdomen, except for the left lower chest (eighth rib), were significantly greater at a target distance of 3 cm than that of 1 cm. The coefficients of determination ranged from 0.98 to 0.99. CONCLUSIONS: Linear regression equations provided adequate estimates of the 3D distances of markers on the chest and abdominal wall during DB. The results suggest that this BMMD is useful for quantitatively assessing DB movement of the chest and abdominal wall in healthy young males. [ABSTRACT FROM AUTHOR]

Background Frequency of alcohol drinking is known to influence cardiovascular risk. However, little is known regarding the relationship between frequency of drinking and metabolic syndrome (MetS). The aim of this study was to determine how frequency of heavy drinking modifies the prevalence of MetS. Methods The subjects were middle-aged male nondrinkers and occasional or regular heavy drinkers (ethanol intake: ≥66 g per drinking day). Odds ratios ( ORs) for MetS and each component comprising MetS were calculated with adjustment for age and histories of smoking and regular exercise. Results ORs versus nondrinkers for MetS defined by the criteria of the National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III) or the International Diabetes Federation ( IDF) were significantly higher than the reference level of 1.00 in occasional heavy drinkers ( NCEP- ATP III, 1.94 [confidence interval (CI): 1.54 to 2.45]; IDF, 1.97 [ CI: 1.56 to 2.49]) and regular heavy drinkers ( NCEP- ATP III, 1.48 [ CI: 1.19 to 1.84]; IDF, 1.50 [ CI: 1.20 to 1.86]). When compared with the reference level, OR versus nondrinkers for large waist circumference was significantly higher in occasional heavy drinkers (1.96 [ CI: 1.63 to 2.35]), but not in regular heavy drinkers (1.12 [ CI: 0.96 to 1.32]), while OR versus nondrinkers for hyperglycemia was significantly lower in regular heavy drinkers (0.66 [ CI: 0.46 to 0.95]), but not in occasional heavy drinkers (0.86 [ CI: 0.60 to 1.24]). Conclusions There is a positive association between heavy drinking and MetS, which is stronger in occasional drinkers than in regular drinkers. This difference may be explained by a positive association between occasional heavy drinking and central obesity and an inverse association between regular heavy drinking and hyperglycemia. The results suggest that heavy drinking, even if occasionally, is a cardiovascular risk factor. [ABSTRACT FROM AUTHOR]

Background Adiponectin secreted from adipose tissue is assumed to mediate protective effects on development of metabolic syndrome (MetS) and MetS-related diseases such as cardiovascular diseases and cancer. Relationship between alcohol intake and circulating adiponectin levels is not consistent among the several previous studies. In the present study, we investigated effects of alcohol intake and the alcohol-related polymorphisms on serum adiponectin levels among Japanese male workers. Methods We conducted a cross-sectional design study with 541 male workers aged 51.5 ± 5.9 (mean ± SD) years in a Japanese plant. Information on alcohol intake and other lifestyles was obtained by a self-administered questionnaire. Serum total adiponectin (T-Ad), high-molecular-weight adiponectin ( HMW-Ad), medium-molecular-weight adiponectin ( MMW-Ad), and low-molecular-weight adiponectin ( LMW-Ad) levels were measured by the enzyme-linked immune assay system kit. Two genotypes in the alcohol dehydrogenase-1B ( ADH1B) and aldehyde dehydrogenase-2 ( ALDH2) genes were determined using blood sample. In multivariate regression analyses, we adjusted for age, body mass index, smoking, and physical exercise. Results Among all subjects, high alcohol consumption of 12 units (1 unit contains 22.9 g of ethanol) a week or more was negatively associated with T-Ad levels in the multivariate model, although not significant. When we performed analyses separately for each genotype, high alcohol consumption was negatively associated with T-Ad, HMW-Ad, and LMW-Ad levels only in those with ADH1B *2/*2. Such relationships were not observed in each ALDH2 genotype group. Conclusions High alcohol consumption was inversely associated with T-Ad, HMW-Ad, and LMW-Ad levels in those with ADH1B *2/*2 genotype, but not in those with the other ADH1B genotypes. To our knowledge, this is the first study that reports combined effects of the alcohol-related polymorphisms and alcohol intake on serum adiponectin levels. Additional studies are required to confirm the present finding. [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]

The article reports on research which was conducted to investigate the effects an ascending intensity squat lift exercise protocol had on jump performance in athletes. Researchers evaluated the protocol with 14 college weightlifters. They concluded that the protocol could be useful for athletes, including weightlifters, who require high muscular power.

American and Japanese children's evaluations of the reporting of peers' transgressions to authority figures were investigated. Seven-, 9-, and 11-year-old children (N = 160) and adults (N = 62) were presented with vignettes and were asked to evaluate the decisions of child observers who reported their friend's either major or relatively minor transgression to a teacher. The results showed that, in both countries, participants across all age groups considered it appropriate to report major transgressions. However, compared with older participants, the youngest children thought it was appropriate to tattle (i.e., to report more minor transgressions). The results also showed a cross-cultural difference: Japanese compared with American participants considered it appropriate to report minor transgressions. The age-related findings are discussed with reference to children's social experience and improving cognition. The cross-cultural findings are discussed with reference to potential differences in the emphases placed on respecting authority relationships, empathy, and social interdependence by the 2 cultures. [ABSTRACT FROM AUTHOR]

The article presents a study which examines whether short-term whole-body vibration (WBV) training through triple-plane vertical vibration device improves functional mobility and flexibility in healthy, older adults. 18 healthy, nine older adults with mean age 69.1 were chosen to participate in a randomized, crossover study. The Timed Up and Go (TUG) test was found to have demonstrated a significant time intervention interaction.

Purpose: Weight retention during the postpartum period is critical for the later development of obesity in women. Traditional physical activity is frequently discontinued because of incompatibility with mothers' agenda (i.e., baby care). In the present study, active video games (AVG) are proposed for postpartum women to improve their body composition. Methods: Thirty-four postpartum women (body mass index = 24.5 ± 3.4 kg•m) were randomized to an AVG group or a control group. Subjects assigned to the AVG group were given a Wii Nintendo console with the game Wii Fit Plus for 40 d. The two groups were tested for weight, body mass index, body fat mass, waist and hip circumferences, and other anthropometric parameters. Physical fitness, energy expenditure, energy intake, and adverse events were also investigated. Results: The AVG group lost more weight than the control group (-2.2 ± 0.9 vs. -0.5 ± 0.7 kg, P < 0.001). They also exhibited more important reductions of BMI, waist and hip circumferences, and body fat (P < 0.05). During the 40-d period, subjects expended an estimated 4682 ± 2874 kcal just by playing AVG. Daily energy intake was reduced by 206 ± 559 kcal. There were significant positive correlations between playing frequency, total playing time, total energy expenditure during the 40-d period, and decrease in daily energy intake respectively, and weight loss (P < 0.05). Playing time data suggested no conflict with baby care activities. Conclusions: AVGs could represent an interesting spare physical activity for postpartum women. In the present study, these games promoted physical activity, induced a reduction of energy intake, and subsequently minimized weight retention. [ABSTRACT FROM AUTHOR]

Background:A close relationship between upper and lower respiratory tract diseases has been reported. However, little is known about pulmonary function in patients with upper respiratory tract diseases.Methods:Pulmonary function was measured in: 68 patients with chronic rhinosinusitis without nasal polyps, 135 patients with chronic rhinosinusitis with nasal polyps, 89 patients with allergic rhinitis and 100 normal control subjects. The relationships between pulmonary function and clinical parameters were assessed. These parameters included radiographic severity of chronic rhinosinusitis, serum total immunoglobulin E levels, concentrations of cytokines in nasal secretions and exhaled nitric oxide levels.Results:The pulmonary function of patients with chronic rhinosinusitis was significantly affected. The level of interleukin-5 in nasal secretions was significantly correlated with pulmonary function in patients with chronic rhinosinusitis.Conclusion:The findings indicated latent obstructive lung function changes in chronic rhinosinusitis patients. The cytokines in nasal secretions might be related to obstructive lung function changes in chronic rhinosinusitis. [ABSTRACT FROM PUBLISHER]

Objectives To determine the association between protein intake and risk of higher-level functional decline in older community-dwelling adults. Design Prospective. Setting Ohasama Town, Japan. Participants Residents (N = 1,007; mean age 67.4 ± 5.5) free of functional decline at baseline; follow-up was conducted for 7 years. Measurements Nutrient and food intakes were determined using a validated 141-item food frequency questionnaire. Participants were divided into quartiles according to intake levels of total, animal, and plant protein. Subscales of the Tokyo Metropolitan Institute of Gerontology Index of Competence subscales were used to assess higher-level functional decline. Logistic regression analysis was used to examine the future risk of higher-level functional decline in relation to protein intake, with lowest protein intake as reference. Results During the study period, 24.4% of eligible participants reported declines in higher-level functional capacity. After adjustment for putative confounding factors, men in the highest quartile of animal protein intake had significantly lower risk of higher-level functional decline than those in the lowest quartile (odds ratio ( OR) = 0.41, 95% confidence interval ( CI) = 0.20-0.83; P for trend .01). These associations were not seen in women ( OR = 0.76, 95% CI = 0.41-1.34; P for trend .37). No consistent association was observed between plant protein intake and future higher-level functional decline in either sex. Conclusion Higher protein, particularly animal protein, was associated with lower risk of decline in higher-level functional capacity in older men. Animal protein intake may be a modifiable indicator for early detection and prevention of higher-level functional decline in elderly adults. [ABSTRACT FROM AUTHOR]

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]

Objectives. To identify the correlates of headaches in middle-aged women and investigate the effects of Tokishakuyakusan (TJ-23), a formula of traditional Japanese herbal therapy Kampo, on headache and concomitant depression. Methods. We examined crosssectionally the baseline records of 345 women aged 40-59 years who visited our menopause clinic. Among them, 37 women with headaches were treated with either hormone therapy (HT) or TJ-23; the data of these women were retrospectively analyzed to compare the effects of the treatment. Results. The women were classified into 4 groups on the basis of their headache frequency, and no significant intergroup differences were noted in the physical or lifestyle factors, except age. Multiple logistic regression analysis revealed that the significant contributors to the women's headaches were their age (adjusted OR 0.92 (95% CI 0.88-0.97)) and their depressive symptoms (adjusted OR 1.73 (95% CI 1.39-2.16)). Compared to women treated with HT, women treated with TJ-23 reported relief from headaches (65% versus 29%) and concomitant depression (60% versus 24%) more frequently. Improvement in the scores of headaches and depression correlated significantly with TJ-23 treatment. Conclusions. Headache in middle-aged women is significantly associated with depression; TJ-23 could be effective for treating both of these symptoms. [ABSTRACT FROM AUTHOR]

The article discusses a study of the impact of stretching on maximal isometric plantar flexion torque which indicates that stretching-induced deficits of torque are reduced within 10 minutes. Topics include maximal voluntary contractions and electromyographic amplitudes among the women tested in trials.

The article focuses on a study concerning the acute effects of self-myofascial release utilizing foam rollers has on arterial function and stiffness. It states that a randomized controlled crossover fashion was used on ten young adults performing self-myofascial release and control trials on separate days, with blood pressure, heart rate, plasma nitric oxide concentrations, and Brachial-ankle pulse wave velocity measured.

Statement of the Problem Although assessment of entire palatal mucosal thickness is important in many dental procedures, available data are mostly limited to the lateral aspect of the palate. Purpose of the Study The objective of this study was to use cone-beam computed tomography ( CBCT) to perform a comprehensive analysis of the palatal mucosal thickness from the gingival margin to the mid-palatine suture in a Japanese population. Associations of palatal mucosal thickness with the palatal vault depth were also examined. Methods/Materials Measurements on the coronal plane were obtained from 44 adults with 3-mm interval in the canine ( Ca), first premolar ( P1), second premolar ( P2), midpoint between first and second molars ( M1 d), first molar ( M1), and second molar ( M2). Furthermore, the location of greater palatine foramen ( GPF) and palatine groove ( PG) were also investigated. Results Canine region did not show a significant difference throughout measured points. P1, P2, and all molar regions were thickest at 9, 12, and 12 mm from the gingival margin, respectively. At 3 and 6 mm, Ca, P1, and P2 showed significantly greater thickness than the molar region. At 9 mm, P1 demonstrated a greater thickness than M1 d, and P2 was greater than M1 and Mi. At 12 and 15 mm, P1 was thinner than P2, M1, and M2, whereas P2 was thinner than M2. M1 was thinner than M2. The high-vault group showed a significantly greater thickness than the low-vault group. In majority of subjects, GPF and PG were identified in second molar and first premolar to first molar, respectively. Conclusion Palatal mucosa in a Japanese population was the thickest in canine to premolar regions at 9 to 12 mm from the gingival margin. Identification of GPF and PG using CBCT can assist diagnosis of palate seems to minimize surgical complications. Clinical Significance This study evaluated the thickness of palatal mucosa in a Japanese population using cone-beam computed tomography, covering a wide range. Canine to second premolar regions are the most suitable in harvesting palatal mucosa for the purpose of soft tissue grafts. [ABSTRACT FROM AUTHOR]

BACKGROUND: Because noninvasive ventilation (NIV) delivers medical gas at high flow, inadequate humidification may cause oral dryness and patient discomfort. Heated humidification can be used during NIV, but little has been reported about the effects on the hygrometric conditions inside an oronasal mask and oral dryness during 24 hours on NIV. METHODS: We measured absolute humidity (AH) inside oronasal masks on subjects with acute respiratory failure during 24 hours on NIV. A single-limb turbine ventilator and oronasal mask with an exhalation port were used for NIV. Oral moistness was evaluated using an oral moisture-checking device, and 3 times during the 24 hours the subjects subjectively scored the feeling of dryness on a 0-10 scale in which 10 was the most severe dryness. RESULTS: Sixteen subjects were enrolled. The mean ± SD AH inside the mask was 30.0 ± 2.6 mg H2O/L (range 23.1-33.3 mg H2O/L). The median oral moistness was 19.2% (IQR 4.4 -24.0%), and the median oral dryness score was 5.5 (IQR 4-7). AH and inspired gas leak correlated inversely, both within the subjects (r = =0.56, P < .001) and between the subjects (r==0.58, P = .02). AH and oral moistness correlated within the subjects (r = 0.39, P = .04). Oral breathing was associated with reduced oral moistness (P = .001) and increased oral dryness score (P = .002). CONCLUSIONS: AH varied among the subjects, and some complained of oral dryness even with heated humidifier. Oral breathing decreased oral moistness and worsened the feeling of dryness. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the effect of short-term priming in perceptual anticipation tasks involving point-light biological motions. After the production or the observation of a relevant or an irrelevant movement (action vs. observation priming), 11 right-handed volunteers were asked to anticipate, as quickly and accurately as possible, the end point of a pointing movement after the stimulus vanished upon completion of 60% of the total movement. Our results indicate that perceptual accuracy is significantly affected only with relevant observation priming. This suggests that perceptual anticipation tasks' involving point-light biological motions implies specific perceptual competencies. [ABSTRACT FROM AUTHOR]

Background Neuraminidase inhibitors have been reported to decrease mortality in patients infected with influenza A ( H1 N1) pdm 2009 ( H1 N1 pdm09), but it is not clear whether they are effective against H1 N1pdm09 in apparently healthy children. Methods The effect of early treatment with neuraminidase inhibitors on 70 otherwise healthy children with possible H1 N1 pdm09 ( pH1 N1pdm09) infection was investigated. The children were simultaneously treated with a neuraminidase inhibitor (oseltamivir or zanamivir) and maoto, a Japanese traditional herbal medicine, which had been reported to be effective against seasonal influenza. Clinical severity was assessed using patient history, namely the worst values for clinical vital signs and laboratory data on admission. After refining these parameters with univariate, decision tree and multiple regression analysis, mean covariance structure equation analysis was used to investigate the association of estimated clinical severity to the selected parameters. Results Total path analysis using a Bayesian method indicated that the estimated clinical severity of pH1 N1pdm09 was positively associated with maximum body temperature, pulse rate, respiration rate, duration necessary for defervescence, admission duration and log urinary β2-microglobulin/creatinine level, and negatively associated with age and the presence and duration of treatment with the neuraminidase inhibitor in the outpatient clinic. Conclusions This study provides the first clinical evidence that early treatment with neuraminidase inhibitors in outpatient clinic decreased the estimated clinical severity of pH1 N1pdm09 in apparently otherwise healthy pediatric inpatients. [ABSTRACT FROM AUTHOR]

Strenuous exercise reduces immune cell function and increases the risk of respiratory and gastrointestinal infections. In addition, it affects mood state and causes physical fatigue. Athletes require both mental and physical conditioning to execute good performance. In this study, we conducted a randomized, double-blind, placebo-controlled clinical trial to evaluate the immunopotentiation and fatigue-alleviation effects of Lactobacillus gasseri OLL2809 (LG2809) and α-lactalbumin (αLA) in university-student athletes after strenuous exercise. A total of 44 university students who performed strenuous exercise daily were separated into 3 groups to receive a 4-week course of placebo, 100 mg LG2809, or 100 mg LG2809 in combination with 900 mg αLA, respectively. Before and after each dietary treatment, the subjects performed strenuous cycle ergometer exercise for 1 h. Before and after each exercise session, blood samples and visual analogue scale scores for fatigue were obtained. In addition, the mood of each subject before and after the dietary treatment was evaluated using the Profile of Mood States (POMS) questionnaire. LG2809 ingestion was effective in preventing reduced natural killer cell activity due to strenuous exercise and elevating mood from a depressed state. In addition, LG2809 + αLA was found to alleviate minor resting fatigue, which was supported objectively by the significant reduction in the serum reactive oxygen metabolites and transforming growth factor β1 levels. These effects could be helpful for athletes to maintain mental and physical condition. [ABSTRACT FROM AUTHOR]

Background and Objective Periodontitis is a chronic inflammatory disease that leads to bone resorption by osteoclasts ( OCs). Several factors contribute to the differentiation of OCs from hematopoietic precursors. Cellular chemotactic factors are expressed in periodontitis tissue, but the effects of these chemoattractants on OCs are not well understood. Here we examined the effects of chemoattractants produced in inflamed periodontal tissue on OC chemotaxis. Material and Methods Rat bone-marrow OCs were cultured in OC culture medium for 3 or 6 d. Using EZ- TAXIScan™, the chemotactic response of these OCs to several chemoattractants [monocyte chemotactic protein-1; macrophage inflammatory protein 1α; regulated on activation, normal T-cell expressed and secreted; stromal cell-derived factor-1α; and complement activation product 5a ( C5a)] was measured. In addition, we measured the effect of C5a-specific inhibitors on chemotactic responses toward C5a. The recorded chemotactic responses were quantitatively analysed using ImageJ software. Results Chemoattractants associated with periodontal disease significantly increased the chemotactic activity of differentiated rat OCs in a concentration-dependent manner, with C5a inducing the highest chemotactic activity of OCs cultured for 3 or 6 d. The C5a-specific inhibitor significantly inhibited chemotaxis toward C5a in a concentration-dependent manner. Conclusion We suggest that C5a plays an important role in pathologic bone resorption in periodontal disease by stimulating the chemotaxis of OCs. Therefore, C5a is a potential target for the treatment of periodontal disease. [ABSTRACT FROM AUTHOR]

Regular aerobic exercise accelerates post-exercise cardiovagal reactivation. However, little is known about the potentially favourable modulatory effects of regular aerobic exercise on cardiovagal reactivation in young female. The purpose of this study was to examine effects of regular aerobic exercise on post-exercise vagal reactivation in young female. Our study consisted of 8 female endurance-trained athletes (athlete group) and 10 untrained females (control group). Resting heart rate (HR), HR variability and post-exercise cardiovagal reactivation were measured during the subjects’ early follicular (EF) and middle luteal (ML) phases. Post-exercise cardiovagal reactivation was estimated byT30: the time constant of HR decline for the first 30 s after the 4-min cycle ergometer exercise (intensity: 80% of ventilation threshold). In both groups,T30was more accelerated in the EF phase than in the ML phase (P<0.05). In the EF phase,T30was lower in the athletes than in the controls (P<0.05). A significant correlation between maximum oxygen uptake (O2max) andT30was observed in the EF phase (r=0.545,P<0.05). Our results suggest that regular aerobic exercise accelerates post-exercise cardiovagal reactivation in the EF phase in young female. [ABSTRACT FROM AUTHOR]

The present study compared the accuracy of triaxial accelerometry and the doubly labelled water (DLW) method for measuring physical activity (PA) in Japanese adolescents. A total of sixty adolescents aged 12–15 years were analysed. The total energy expenditure (TEE) was measured over 7 d by the DLW method and with an EW4800P triaxial accelerometer (Panasonic Corporation). The measured (RMRm) and predicted RMR (RMRp) were 5·7 (sd 0·9) and 6·0 (sd 1·0) MJ/d, respectively. TEE measured by the DLW method and accelerometry using RMRm or RMRp were 11·0 (sd 2·6), 10·3 (sd 1·9), and 10·7 (sd 2·1) MJ/d, respectively. The PA levels (PAL) measured by the DLW method using RMRm or RMRp were 1·97 (sd 0·31) and 1·94 (sd 0·31) in subjects who exercised, and 1·85 (sd 0·27) and 1·74 (sd 0·29) in subjects who did not exercise. The percentage of body fat correlated significantly with the percentage difference between RMRmv. RMRp, TEE, PA energy expenditure (PAEE) and PAL using RMRp, and PAL using RMRm assessed by the DLW method and accelerometry. The present data showed that while accelerometry estimated TEE accurately, it did not provide the precise measurement of PAEE and PAL. The error in accelerometry was attributed to the prediction error of RMR and assessment in exercise. [ABSTRACT FROM PUBLISHER]

The article discusses the cultural differences present in post-traumatic growth following a life crisis among American and Japanese males published online in the August 20, 2012 issue of the journal "Psychology of Men and Masculinity." The researcher Kanako Taku implemented the Post-Traumatic Growth Inventory the demographics of age, ethnicity, and religion. He concludes American men exhibited a higher score due to cultural expectations, and recommends further analysis be conducted with women.

The article presents a study on articular cartilage degeneration which can develop after anterior cruciate ligament reconstruction (ACLR). It focuses on risk factors in the early postoperative period. The T1ρ spin-lattice relaxation in the rotating frame magnetic resonance imaging is described. The baseline T1ρ value of the medial femoral condyle (MFC) and lateral FC (LFC) was higher in patients with cartilage lesions.

The purpose of this study was to compare the effects of Nordic walking with conventional walking and band-based resistance exercise on functional fitness, static balance and dynamic balance in older adults. Volunteers (n = 65) were divided into four groups: Nordic walking (NW), conventional walking (CW), resistance (RES), and control. Each group performed activity 50-70 min·day-1 (warm-up 10-15 min, main exercise 30-40, and cool down 10-15 min), 3 days·week-1 (NW and CW) or 2 day·week-1 (RES) for 12 wks. Upper-body strength improved (p < 0.05) in the RES (22.3%) and the NW (11.6%) groups compared to the CW and control groups. Cardio-respiratory fitness improved more in the NW (10.9%) and CW (10.6%) groups compared to the RES and control groups. Upper- and lowerbody flexibility also improved in all exercise groups compared to the control group. There were no improvements in balance measures in any group. While all modes of exercise improved various components of fitness, Nordic walking provided the best well-rounded benefits by improving upper-body strength, cardiovascular endurance, and flexibility. Therefore, Nordic walking is recommended as an effective and efficient mode of concurrent exercise to improve overall functional fitness in older adults. [ABSTRACT FROM AUTHOR]

A Subgroup of IVF Patients Introduction The presence of early repolarization (ER) recently has been considered as a prognostic marker for sudden cardiac death in patients with idiopathic ventricular fibrillation (IVF), but there are certain numbers of IVF patients lacking ER. We aimed to clarify the clinical and electrocardiographic characteristics of the patients with IVF in the presence and absence of ER. Methods and results We studied 64 consecutive IVF patients from the Japan Idiopathic Ventricular Fibrillation Study (J-IVFS) registry, which subjected with at least one episode of documented VF in the absence of structural heart diseases and excluding Brugada syndrome. We assessed clinical and electrophysiological characteristics in the IVF patients with and without ER. ER was defined as J-point elevation of >0.1 mV in either inferior or lateral leads. Twelve-lead electrocardiogram (ECG) demonstrated 24 (38%) of 64 patients with ER (ER[+] group) and the remaining 40 (62%) patients without ER (ER[-] group ). ER[+] group had a male predominance (92% for males) and ER[-] group revealed nearly equal distribution in both sexes. While no patients in ER[+] group showed intraventricular conduction disturbance (CD) with abnormal axis deviation and/or bundle branch block in ECG, 9 in ER[-] group had signs of CD (ER[-]/CD[+] subgroup). ER[-]/CD[+] subgroup had prolonged P-R interval and QRS duration compared to other patient groups. Conclusion We found 3 distinct ECG patterns in IVF patients. In addition to the presence and absence of ER, there is a subgroup without ER demonstrating intraventricular CD, which represents a distinct clinical entity of IVF. [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]

Purpose: Omeprazole has ( R)- and ( S)-enantiomers, which exhibit different pharmacokinetics (PK) among patients with cytochrome P450 (CYP) 2C19 genotype groups. The aim of this study was to investigate whether the 1-point, 4-h postdose ( R)-omeprazole hydroxylation index (HI) of racemic omeprazole reflects the three CYP2C19 genotype groups in Japanese individuals. Methods: Ninety healthy Japanese individuals were enrolled and classified into the three different CYP2C19 genotype groups: homozygous extensive metabolizers (hmEMs; n = 34), heterozygous EMs (htEMs; n = 44), and poor metabolizers (PMs; n = 12). Blood samples were drawn 4 h after the intake of an oral dose of omeprazole 40 mg, and plasma levels of omeprazole and its metabolites were analyzed by high-performance liquid chromatography (HPLC) using a chiral column. Results: Mean plasma concentrations of ( R)- and ( S)-omeprazole in PMs were significantly higher than those in hmEMs and htEMs, and similar results were obtained in the case of omeprazole sulfone. Additionally, there was a significant difference in plasma concentrations of ( R)-5-hydroxyomeprazole among CYP2C19 genotype groups, whereas no significant differences were observed in that of ( S)-5-hydroxyomeprazole. Similarly, ( R)-omeprazole HI in hmEMs, htEMs, and PMs were 5.6, 3.1, and 0.3, respectively, which were significantly different, but no significant difference was present in the ( S)-omeprazole HI. Conclusion: Our findings demonstrate that ( R)-omeprazole HI correlated better with CYP2C19 genotype groups than racemic-omeprazole HI, and these results may be useful for classification among patients in CYP2C19 genotype groups prior to omeprazole treatment. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the effect of a forward bilateral pushing movement on postural control in a situation where known, unknown, and unpredictable perturbations may be induced. Participants stood upright and voluntarily pushed a handle with both hands. In the first task, the handle was free to be moved by the participant (perturbation; movable task) and in the second task, the handle was locked (stationary task). For each task, body displacement and observed applied force were recorded. Anticipatory postural control adjustment plays a vital role in body stability; however, in contrast to its role in maintaining stability, adjustment can generate a restricted voluntary movement because motor programming selects a postural control that gives priority to body stability over the target movement. [ABSTRACT FROM AUTHOR]

Objective: This study is a pharmacogenetic clinical trial designed to clarify whether the N-acetyltransferase 2 gene ( NAT2) genotype-guided dosing of isoniazid improves the tolerability and efficacy of the 6-month four-drug standard regimen for newly diagnosed pulmonary tuberculosis. Methods: In a multicenter, parallel, randomized, and controlled trial with a PROBE design, patients were assigned to either conventional standard treatment (STD-treatment: approx. 5 mg/kg of isoniazid for all) or NAT2 genotype-guided treatment (PGx-treatment: approx. 7.5 mg/kg for patients homozygous for NAT2*4: rapid acetylators; 5 mg/kg, patients heterozygous for NAT2*4: intermediate acetylators; 2.5 mg/kg, patients without NAT2*4: slow acetylators). The primary outcome included incidences of 1) isoniazid-related liver injury (INH-DILI) during the first 8 weeks of therapy, and 2) early treatment failure as indicated by a persistent positive culture or no improvement in chest radiographs at the8th week. Results: One hundred and seventy-two Japanese patients (slow acetylators, 9.3 %; rapid acetylators, 53.5 %) were enrolled in this trial. In the intention-to-treat (ITT) analysis, INH-DILI occurred in 78 % of the slow acetylators in the STD-treatment, while none of the slow acetylators in the PGx-treatment experienced either INH-DILI or early treatment failure. Among the rapid acetylators, early treatment failure was observed with a significantly lower incidence rate in the PGx-treatment than in the STD-treatment (15.0 % vs. 38 %). Thus, the NAT2 genotype-guided regimen resulted in much lower incidences of unfavorable events, INH-DILI or early treatment failure, than the conventional standard regimen. Conclusion: Our results clearly indicate a great potential of the NAT2 genotype-guided dosing stratification of isoniazid in chemotherapy for tuberculosis. [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]

Background: Both combination therapies of an an-giotensin II receptor blocker (ARB) with the thiazide diuretic hydrochlorothiazide (HCTZ) and an ARB with a calcium channel blocker (CCB) are recommended to achieve blood pressure (BP) goals in antihy-pertensive treatment. However, although HCTZ is known to have unfavorable effects on lipid metabolism, the effects of HCTZ in the ARB + HCTZ combination on lipid metabolism have not been fully elucidated. Objective: The aim of this study was to compare the effects on lipid metabolism of combination treatment with the ARB losartan + HCTZ and losartan + the CCB amlodipine and to assess the efficacy in BP lowering of these 2 combination therapies. The metabolism of glucose, uric acid (UA), and high-sensitivity C- reactive protein (hs-CRP), an inflammation marker of atherosclerosis, were also assessed in association with lipid metabolism. Methods: This 48-week, prospective, randomized, open-label trial was conducted at 2 clinics and 2 hospitals in Tokorozawa City (Saitama, Japan) and Shin-juku- ku Ward (Tokyo, Japan). Eligible patients had a systolic BP (SBP) >140 mm Hg and/or diastolic BP (DBP) >90 mm Hg despite a > 1-month history of monotherapy with an ARB. Patients were randomly assigned to receive losartan 50 mg/d + HCTZ 12.5 mg/d (LOS + HCTZ) or losartan 50 mg/d + amlodipine 5 mg/d (LOS + CCB) for 48 weeks. Follow-up visits were scheduled at 4, 8, 12, 24, and 48 weeks. Biochemical measurements were centrally measured at a single institute. Tolerability and treatment compliance were assessed by physicians every 4 weeks. Results: A total of 112 patients were enrolled; 26 were excluded from the final analysis, leaving 42 and 44 patients in the LOS + HCTZ and LOS + CCB groups, respectively, included in the final analysis. At 48 weeks, SBP and DBP were significantly decreased in the 2 treatment groups (both, P < 0.0001). The decrease in SBP was significantly greater in the LOS + HCTZ group than in the LOS + CCB group (P < 0.001). The difference in the decrease in DBP between the 2 groups was nonsignificant. There were no significant differences in the changes from baseline (Δ) in any of the lipid parameters between the 2 groups. The decreases at 8 and 12 weeks in LDL-C, TC, and apolipo-protein (apo) B were significantly greater in the LOS + CCB group compared with those in the LOS + HCTZ group. The between-group differences in ΔTG, ΔHDL-C, ΔapoA- 1, and AapoE throughout the study were nonsignificant. Changes in fasting plasma glucose (FPG), hemoglobin A1c, and hs-CRP were not significantly different between the 2 groups. The between-group difference in ΔUA in men was not significant, but a significant difference was found in women (LOS + HCTZ, 0.74 mg/dL; LOS + CCB, 0.28 mg/dL [P = 0.0017]). No clinically significant adverse events were reported with either treatment throughout the study. Conclusions: The findings from the present study suggest that LOS + HCTZ was more efficacious in decreasing SBP than was LOS + CCB in the management of hypertension refractory to ARB monotherapy. Unfavorable effects on lipid metabolism were not observed with either combination therapy. [ABSTRACT FROM AUTHOR]

The article looks at an experiment on the effectiveness of combined whole-body vibration and low-velocity exercise in maintaining muscle performance during detraining. Untrained subjects were tested for jump height, knee extension strength, and muscle endurance before, during, and after a training regimen and after a detraining period. The results indicate that combined whole-body vibration and exercise increased risks of detraining impacts on muscle power and strength.

Aims: To verify whether humming corrects supraglottic compression in muscle tension dysphonia (MTD) patients. Methods: We enrolled 23 MTD participants (13 male, 10 female) showing supraglottic compression. Each individual was instructed to perform 3 types of phonation under transnasal laryngofiberscopy: natural phonation, humming phonation without pitch change and subsequent um-hum phonation, i.e. humming with pitch glide up as if agreeing with someone. The degree of supraglottic compression was estimated with 2 parameters. The false vocal fold and anterior-posterior indices (the FVF and AP indices) were calculated by normalizing the lateral width and AP length of the visible vocal cords at phonation normalized to the mean vocal cord length at inspiration, respectively. These indices were compared among the tasks. Results: All the MTD participants but 5 females accomplished decreases in the vocal roughness scores upon the phonatory tasks. The whole MTD group showed significant increases in the FVF and AP indices even after humming without pitch change with a dominance of the AP index. The humming-responsive MTD subgroup showed greater increases in both indices than the humming-resistant subgroup. Conclusion: These data demonstrate that humming corrects both the lateral and AP components of supraglottic compression in most MTD patients. © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Purpose: Congestive heart failure (CHF) alters the pharmacokinetics of various drugs, including cardiovascular agents, due to decreased cardiac output and decreased renal blood flow. The purpose of this study was to evaluate the influence of CHF on the clearance of vancomycin, a glycopeptide antibacterial agent. Methods: After reviewing more than 1,500 clinical charts of patients who received vancomycin therapy and whose serum vancomycin level was monitored, we identified 101 patients who also had the left ventricular ejection fraction (LVEF) assessed at that time. The fluorescence polarization immunoassay method was used to measure vancomycin serum concentrations in these patients 1 h after the end of vancomycin infusion and just before the next administration. Using these two measurements, we calculated the pharmacokinetic parameters using the Bayesian estimator. Results: Patients with an LVEF of <40 % (16 patients) or those with an LVEF of ≥ 40 % and <60 % (40 % ≤ LVEF < 60 % ; 32 patients) had a significantly lower vancomycin clearance than patients with LVEF of ≥60 % (53 patients) (2.29 ± 0.95 or 2.79 ± 0.99 vs. 3.50 ± 1.04 L/h; p < 0.001 or p < 0.01, respectively). Vancomycin clearance was strongly correlated not only with estimated creatinine clearance (CLcr) in patients with an LVEF of <40 % ( r = 0.828) and 40 % ≤ LVEF < 60 % ( r = 0.773), but also with an LVEF in patients with a CLcr of <60 mL/min ( r = 0.646). Consistent with these findings, multiple regression analysis revealed that CLcr, LVEF and body weight were important independent variables for vancomycin clearance ( r = 0.649). Conclusions: Vancomycin clearance decreased with decreasing cardiac function (LVEF) and decreasing CLcr. This finding suggests that vancomycin clearance is affected by cardiac function and would be predicted not only CLcr but also by LVEF. [ABSTRACT FROM AUTHOR]

Background: The Visual Reproduction (VR) test is used to assess mild cognitive impairment (MCI), but the characteristics of visual memory in Japanese MCI patients remain unclear. Methods: VR scores of 27 MCI patients were evaluated using the Wechsler Memory Scale-Revised. Scores of MCI, no-dementia, and Alzheimer's disease (AD) groups were then compared. Results: The annual conversion rate of MCI to AD was 18.8%. Mean VR-I and VR-II baseline scores for MCI patients were 33.3 ± 5.6 and 20.5 ± 14.0, respectively. Mean VR-II scores for converted and nonconverted MCI patients were 7.2 ± 8.7 and 29.8 ± 9.3, respectively. Conclusions: It is likely that VR-II and VR-II/I scores are more sensitive for predicting conversion to AD in Japanese than in American MCI patients. Our results indicate that VR is a sensitive and useful measure for predicting the conversion of Japanese MCI patients to AD within 2 years. Copyright © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]