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Purpose: This study examined the factors that facilitated and obstructed the dissemination of a physical education lesson study (PELS) project in Peru, conducted in collaboration with Japan. Design/methodology/approach: Adopting a qualitative approach, five Peruvian stakeholders in the field of physical education (PE) were interviewed. All the interviews were transcribed. The data were analysed using the Steps for Coding and Theorization (SCAT). Findings: The factors that obstructed the dissemination of PELS were lack of mutual observation of lessons among teachers and the resistance of teachers to the project due to the term "study" in "lesson study". Conversely, online dissemination of PELS may significantly improve its position in Peru. Disseminating PELS through small group practice and deploying it in the field of education through stakeholder collaboration comprised facilitating factors. Originality/value: This study could facilitate an understanding of Peruvian educational and PE culture and have ripple effects on the practice and dissemination of LS in other countries and subject areas.

Hikikomori (a severe form of social withdrawal) is a serious mental health issue. A family approach is the initial step to support hikikomori; thus effective family intervention programs are warranted. We recently developed a 5‐day family intervention program (120 min weekly) based on Mental Health First Aid (MHFA) and Community Reinforcement and Family Training (CRAFT). In the present study, we modified the 5‐day program to a 3‐day program (180 min fortnightly), and examined the effectiveness of the 3‐day program using a single‐arm procedure. Data of 23 parents (four fathers and 19 mothers; age = 62.0 ± 9.1 years) were analyzed. Mental health conditions among participants themselves improved at the 4‐month follow‐up, but the confidence in hikikomori support declined and stigma toward mental health problems did not change. However, short‐term improvements in perceived skills in approaching hikikomori sufferers were detected. Hikikomori sufferers' actual behavioral changes, such as social participation or utilization of support, were also observed (six out of 20 hikikomori sufferers). Preliminary effectiveness was confirmed for the 3‐day program. Further revision of the program and a validation study with controls are required. [ABSTRACT FROM AUTHOR]

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Abstract Background Several lines of evidence implicate orbitofrontal cortex dysfunction in the pathophysiology of obsessive-compulsive disorder (OCD). The purpose of this study was to investigate neuropsychological dysfunction of the orbitofrontal cortex in children with OCD. Methods The Iowa Gambling Task (IGT), which reflects orbitofrontal cortex function, and the Wisconsin Card Sorting Test (WCST), which is associated with functioning of the dorsolateral prefrontal cortex, were administered to 22 children with OCD and 22 healthy controls matched for gender, age, and intelligence. Results OCD patients displayed poor performance on the IGT. In contrast, performance on the WCST was not impaired in OCD patients compared to controls. Conclusions These findings are in line with previous studies demonstrating that OCD in childhood is associated with a dysfunction of orbitofrontal-striatal-thalamic circuitry.

Purpose: Bile duct injury is one of the most serious complications of laparoscopic cholecystectomy. Intraoperative indocyanine green (ICG) cholangiography is a safe and useful navigation modality for confirming the biliary anatomy. ICG cholangiography is expected to be a routine method for helping avoid bile duct injuries. Patients and Methods: We examined 25 patients who underwent intraoperative cholangiography using ICG fluorescence. Two methods of ICG injection are used: intrabiliary injection (percutaneous transhepatic gallbladder drainage [PTGBD], gallbladder [GB] puncture and endoscopic nasobiliary drainage [ENBD]) at a dosage of 0.025 mg during the operation or intravenous injection with 2.5 mg ICG preoperatively. Results: There were 24 patients who underwent laparoscopic cholecystectomy and 1 patient who underwent hepatectomy. For laparoscopic cholecystectomy, the average operation time was 127 (50– 197) minutes, and estimated blood loss was 43.2 (0– 400) g. The ICG administration route was intravenous injections in 12 cases and intrabiliary injection in 12 cases (GB injection: 3 cases, PTGBD: 8 cases, ENBD:1 case). The course of the biliary tree was able to be confirmed in all cases that received direct injection into the biliary tract, whereas bile structures were recognizable in only 10 cases (83.3%) with intravenous injection. The postoperative hospital stay was 4.6 (3– 9) days, and no postoperative complications (Clavien–Dindo ≧IIIa) were observed. For hepatectomy, a tumor located near the left Glissonian pedicle was resected using a fluorescence image guide. Biliary structures were fluorescent without injury after resecting the tumor. No adverse events due to ICG administration were observed, and the procedure was able to be performed safely. Conclusion: ICG fluorescence imaging allows surgeons to visualize the course of the biliary tree in real time during cholecystectomy and hepatectomy. This is considered essential for hepatobiliary surgery to prevent biliary tree injury and ensure safe surgery. [ABSTRACT FROM AUTHOR]

Abstract Background The aims of this prospective study are to clarify the outcomes of child psychiatric inpatient treatment and to identify factors associated with patient improvement. Methods The attending psychiatrist used the Children's Global Assessment Scale (CGAS) to assess youths at admission to and discharge from a child and adolescent psychiatric unit in Japan(N = 126, mean age = 12.8, SD = 1.9). Hospital records gathered sociodemographic and clinical variables. In addition, youths and their primary caregivers assessed themselves using the Youth Self Report (YSR) and the Child Behavior Checklist (CBCL), respectively. Longitudinal analyses compared each scales' baseline and discharge scores. We also examined factors associated with changes in functioning (CGAS). Results Longitudinal comparisons revealed that CGAS, CBCL and YSR scores showed improvement over time (CGAS: t = -14.40, p = 0.00; CBCL: t = 3.80, p = 0.00; YSR: t = 2.40, p = 0.02). Linear regressions determined that the factors associated with improvement in CGAS included age, lower CGAS scores at admission, frequency of group therapy and psychiatric diagnosis. Conclusions This evaluation of children and adolescents in an inpatient unit demonstrated clinical improvement over time and identified factors associated with said improvement.

Aims: As an extension of a phase 2/3 study evaluating the efficacy and safety of lisdexamfetamine dimesylate (LDX) 30, 50, or 70 mg/d for 4 weeks in Japanese patients aged 6‐17 years with attention‐deficit/hyperactivity disorder (ADHD), this study evaluated its long‐term safety and efficacy. Methods: This was a multicenter, open‐label study of LDX for 53 weeks. Safety was assessed by regular medical examination for treatment‐emergent adverse events (TEAEs); regular recording of body weight, vital signs, and laboratory test values; and completion of dependence questionnaires. Efficacy was assessed using Japanese versions of the ADHD‐Rating Scale‐IV (ADHD‐RS‐IV) and Conners' 3rd edition Parent Rating Scale (Conners 3); plus Clinical Global Impression‐Improvement (CGI‐I), Clinical Global Impression‐Severity, and Parent Global Assessment (PGA) scales. Results: Of 132 enrolled patients, 104 completed the trial. Most frequent treatment‐related TEAEs were decreased appetite (73.5%), initial insomnia (39.4%), and weight decrease (22.0%). Most TEAEs were mild (82.6% of patients). There were no serious or severe TEAEs or deaths. No treatment‐related TEAEs were associated with blood pressure or pulse rate, and no patient had a QTcF interval >500 ms. Statistically significant improvement from baseline to week 53 was observed in the mean ADHD‐Rating Scale‐IV total score and mean Conners 3 subscale scores. Most patients showed improvement on the CGI‐I (78%) and PGA (76.5%) scales. Conclusions: No significant safety issues were observed with LDX 30, 50, or 70 mg/d administered for 1 year in Japanese children and adolescents with ADHD. LDX was associated with long‐term reductions in ADHD symptoms and severity. [ABSTRACT FROM AUTHOR]

Intrathoracic hernias after total gastrectomy are rare. We report the case of a 78-year-old man who underwent total gastrectomy with antecolic Roux-Y reconstruction for residual gastric cancer. He had alcoholic liver cirrhosis and received radical laparoscopic proximal gastrectomy for gastric cancer 3 years ago. Early gastric cancer in the remnant stomach was found by routine upper gastrointestinal endoscopy. We initially performed endoscopic submucosal dissection, but the vertical margin was positive in a pathological result. We performed total gastrectomy with antecolic Roux-Y reconstruction by laparotomy. For adhesion of the esophageal hiatus, the left chest was connected with the abdominal cavity. A pleural defect was not repaired. Two days after the operation, the patient was suspected of having intrathoracic hernia by chest X-rays. Computed tomography showed that the transverse colon and Roux limb were incarcerated in the left thoracic cavity. He was diagnosed with intrathoracic hernia, and emergency reduction and repair were performed. Operative findings showed that the Roux limb and transverse colon were incarcerated in the thoracic cavity. After reduction, the orifice of the hernia was closed by suturing the crus of the diaphragm with the ligament of the jejunum and omentum. After the second operation, he experienced anastomotic leakage and left pyothorax. Anastomotic leakage was improved with conservative therapy and he was discharged 76 days after the second operation. [ABSTRACT FROM AUTHOR]

Background/Aim: The Questionnaire: Children with Difficulties (QCD) is a parent-assessed questionnaire designed to evaluate child’s difficulties in functioning during specific periods of the day. This study aimed to evaluate difficulties in daily functioning of children and adolescents with pervasive developmental disorder (PDD) using the QCD. Results were compared with those for a community sample. Methods: A case–control design was used. The cases comprised elementary school students (182 males, 51 females) and junior high school students (100 males, 39 females) with PDD, whereas a community sample of elementary school students (568 males, 579 females) and junior high school students (180 males, 183 females) was enrolled as controls. Their behavior was assessed using the QCD, the Tokyo Autistic Behavior Scale (TABS), the ADHD-rating scale (ADHD-RS), and the Oppositional Defiant Behavior Inventory (ODBI) for elementary and junior high school students, respectively. Effects of gender and diagnosis on the QCD scores were analyzed. Correlation coefficients between QCD and TABS, ADHD-RS, and ODBI scores were analyzed. Results: The QCD scores for the children with PDD were significantly lower compared with those from the community sample (P < 0.001). Significantly strong correlations were observed in more areas of the ADHD-RS and ODBI scores compared with the TABS scores. Conclusions: Children with PDD experienced greater difficulties in completing basic daily activities; moreover, their QCD scores revealed stronger associations with their ADHD-RS and ODBI scores in comparison with their TABS scores. The difficulties of PDD, ADHD and OBDI symptoms combined in children makes it necessary to assess all diagnoses before any therapy for PDD is initiated in order to be able to evaluate its results properly. [ABSTRACT FROM AUTHOR]

Background: The 2011 Japan massive tsunami traumatized many children. The aim of this study was to assess changes in strengths and difficulties experienced in home and school by among surviving children after the 2011 tsunami, in comparison with published normal Japanese data. Methods: In November 2012 (20 months after the disaster) and September 2013 (30 months after the disaster), the Strengths and Difficulties Questionnaire (SDQ), a questionnaire on children's strengths and difficulties in home and school activities, were distributed to 12,193 and 11,819 children, respectively. An effective response of children 20 months and 30 month after the disaster was obtained in 10,597 children (86.9%), and 10,812 children (91.4%), respectively. The SDQ scores evaluated by parents and teachers were compared with published normal Japanese SDQ scores. Results: The SDQ scores (emotional problems, conduct problems, hyperactivity/inattention, peer relationship problems, and total difficulty score) evaluated by parents of children in the 4th to 9th grade who were evaluated after 30 and 20 months were significantly high compared with the published normal data of children without traumatic experiences (all P<0.001). The SDQ scores (prosocial behavior) evaluated by teachers of children in the 4th to 9th grade who were evaluated after 30 and 20 months were significantly low compared with the published normal data of children without traumatic experiences (all P<0.001). Conclusions: This study showed that the experience of the disaster affected those children with prosocial behaviors towards teachers and friends at school. However, no significant changes (in their prosocial attitude) had been seen at home, where they continued to keep their respect and caring feelings for parents. These results indicate that for accurate diagnosis, clinicians should not only evaluate these children's daily activities at home but also try to objectively assess their daily activities at school. [ABSTRACT FROM AUTHOR]

Background: On March 11, 2011, Japan was struck by a massive earthquake and tsunami. The tsunami caused tremendous damage and traumatized several people, including children. The aim of this study was to assess changes in traumatic symptoms 8, 20, and 30 months of the 2011 tsunami. Methods: The study comprised three groups. Copies of the Post-Traumatic Stress Symptoms for Children 15 items (PTSSC-15), a self-rating questionnaire on traumatic symptoms, were distributed to 12,524 children (8-month period), 12,193 children (20-month period), and 11,819 children (30-month period). An effective response of children 8 months, 20 months, and 30 month after the disaster was obtained in 11,639 (92.9%), 10,597 (86.9%), and 10,812 children (91.4%), respectively. We calculated the total score, PTSD subscale, and Depression subscale of PTSSC-15. We calculated the total score, PTSD subscale, and Depression subscale of PTSSC-15. Results: The PTSSC-15 total score and PTSD subscale of children belonging to 1st–9th grade groups who were tested 30 and 20 months after the tsunami significantly decreased compared with those of children tested 8 months after the tsunami. The PTSSC-15 total score and PTSD subscale of children in 1st–9th grade groups tested after 30 months did not decrease significantly compared with those of children tested after 20 months. The PTSSC-15 Depression subscale and PTSD subscale of children in 1st–9th grade groups tested after 30 months significantly decreased compared with those of children tested 8 months after the tsunami. The PTSSC-15 Depression subscale of children in 1st–9th grade groups evaluated after 30 months significantly decreased compared with those of children evaluated after 20 months. Conclusions: This study demonstrates that the traumatic symptoms of children who survived the massive tsunami improved with time. Nonetheless, the traumatic symptoms, which in some cases did not improve with time. [ABSTRACT FROM AUTHOR]

Background: On March 11, 2011, Japan was struck by the earthquake and tsunami. Twenty months after the disaster, we collected information on the difficulties faced by parents and teachers in dealing with the post-traumatic symptoms of child survivors. The aim of this study was to evaluate the relationship between post-traumatic symptoms in children and parents’ and teachers’ difficulties in dealing with children who survived the huge disaster. Methods: The subjects included 12,524 children from elementary, middle, and junior high schools in Ishinomaki City. The Post Traumatic Stress Symptoms for Children 15 items (PTSSC-15), a self-rating questionnaire on post-traumatic symptoms, was distributed among the children, and Strength and Difficulties Questionnaire (SDQ), a self-rating questionnaire on difficulties in dealing with children, was given to their parents and teachers. With PTSSC-15, a valid response was obtained from 10,909 (89.5%) participants. With SDQ for teachers and parents, valid responses were obtained from 10,577 (86.7%) and 7052 (83.9%) participants, respectively. Results: PTSSC-15 scores were significantly higher (P<0.001) in girls than in boys from the junior high school. These effect sizes were less than 0.30. Correlations of teachers’ SDQ scores and PTSSC-15 scores were significantly low (r<0.21, P<0.001) for both genders and all children. Likewise, correlations between SDQ scores assigned by parents (excluding “prosocial behavior”) and PTSSC-15 scores were significantly low (r<0.21, P<0.001) for both genders and at all school levels. Conclusion: This study elucidated that the difficulties faced by parents and teachers while dealing with child survivors significantly low correlate with the child’s post-traumatic symptoms caused by the 2011 earthquake and tsunami. Thus, it is important that clinicians should not only evaluate post-traumatic symptoms with a self-rating questionnaire but also try to objectively evaluate whether there were day-to-day difficulties caused by the post-traumatic symptoms. [ABSTRACT FROM AUTHOR]

Background: On March 11, 2011, Japan was struck by a massive earthquake and tsunami. The tsunami caused tremendous damage and traumatized a number of people, including children. This study aimed to compare traumatic symptoms and daily life activity among children 20 months after the 2011 Great East Japan Earthquake and Tsunami with those observed after 8 months. Methods: The study comprised two groups. The first comprised 12,524 kindergarten, elementary school, and junior high school children in Ishinomaki City, Miyagi Prefecture, Japan, who were evaluated 8 months after the disaster. The second comprised 10,597 children from the same place who were evaluated 20 months after the disaster. The Post Traumatic Stress Symptoms for Children 15 items (PTSSC-15), a self-completion questionnaire on traumatic symptoms, and a questionnaire on children's daily life were distributed to the children. An effective response was obtained from 11,639 (92.9%, 8 months after) and 10,597 (86.9%, 20 months after) children. Results: The PTSSC-15 score was significantly higher in junior high school girls than in boys. The PTSSC-15 score was significantly higher in 4th–6th grade girls than in boys after 8 months. Elementary and junior high school children evaluated after 20 months had a significantly lower PTSSC-15 score than those evaluated after 8 months. The number of children having breakfast was significantly higher after 8 months than that after 20 months. In both the groups, children of all grades who had breakfast had a significantly lower PTSSC-15 score than those who did not have breakfast. Conclusions: We conclude that traumatic symptoms and daily life activity of children who survived the earthquake and tsunami improved over time. [ABSTRACT FROM AUTHOR]

AIM: The aim of this study was to evaluate the frontopolar hemodynamic response and depressive mood in children with mild or moderate major depressive disorder during six weeks treatment without medication. METHODS: The subjects were 10 patients with mild or moderate depression. They were depressive drug-naive children and adolescents. The scores of Depression Self Rating Scale (DSRS), the results of the Verbal Fluency Test (VFT), and the concentrations of oxy-hemoglobin (Oxy-Hb) of frontal pole brain assessed by two-channel near infrared spectroscopy (NIRS) after six weeks of treatment was compared with those of initial treatment. RESULTS: The score of DSRS was significantly reduced after six weeks of initial treatment (p<0.001, t-test). The word number of VFT was not significantly changed after six weeks of treatment. The oxy-Hb concentration significantly increased after six weeks of treatment (p<0.001, t-test). CONCLUSIONS: This study demonstrated that the concentration of oxy-Hb of frontopolar cortex in children with mild and moderate depression improved along with their depressive mood. These results suggested that concentration of oxy-Hb using NIRS may be used as the state maker for change in depressive mood of children having depression, similar to that in adults. [ABSTRACT FROM AUTHOR]

Background: To elucidate relationships between disaster damage conditions and sleep duration among children who survived the 2011 Japan earthquake and tsunami. Methods: The subjects comprised 12,524 children in kindergartens, elementary schools, and junior high schools in Ishinomaki City, Miyagi Prefecture, Japan. The Post Traumatic Stress Symptoms for Children 15 items (PTSSC-15), a self-completion questionnaire on traumatic symptoms, and a sleep questionnaire were distributed to them. A questionnaire regarding disaster damage conditions of the children’s homes was distributed to their teachers. Of 12,524, an effective response was obtained from 11,692 (93.3%). Results: Relationships between sleep duration and traumatic symptoms were displayed low correlations. Children with house damage and/or evacuation experiences slept for a significantly shorter time than children without these experiences. Conclusion: It is critical not only to examine traumatic symptoms in children but also to collect sleep duration and disaster damage conditions following natural disasters. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the reliability and validity of the Questionnaire-Children with Difficulties (QCD), which was developed for the evaluation of children's daily life behaviors during specified periods of the day. Methods: The subjects were 1,514 Japanese public elementary and junior high school students. For the examination of reliability, Cronbach's alpha was calculated to assess the internal consistency of the questionnaire. With regard to validity, correlation coefficients were calculated to examine whether QCD scores correlated with those of the ADHD-Rating Scale (ADHD-RS) and the Oppositional Defiant Behavior Inventory (ODBI). Results: Cronbach's alpha coefficient for the total score of the QCD was .876. The correlation coefficients of the QCD score with ADHD-RS and ODBI scores were -.514 and -.577, respectively. Conclusions: The internal consistency and validity of the QCD were demonstrated. The QCD is a reliable and valid instrument for evaluating daily life problems for children during different time periods of the day. [ABSTRACT FROM AUTHOR]

Background: To evaluate relationships between traumatic symptoms and environmental damage conditions among children who survived the 2011 Great East Japan Earthquake and Tsunami. Methods: The subjects were 12,524 children in kindergartens, elementary schools, and junior high schools in Ishinomaki City, Miyagi Prefecture, Japan. The Post Traumatic Stress Symptoms for Children 15 items (PTSSC-15), a self-completion questionnaire on traumatic symptoms, was distributed to the children and a questionnaire regarding environmental damage conditions affecting the children was distributed to their teachers. Of 12,524 questionnaires distributed, an effective response was obtained from 11,692 (93.3%). Results: The PTSSC-15 score was significantly higher in females than in males among 4th to 6th grade students in elementary schools and among junior high school students. In terms of traumatic symptoms and environmental damage conditions, with the exception of kindergartners, children who had their houses damaged or experienced separation from family members had a significantly higher PTSSC-15 score than children who did not experience environmental damage. Except for kindergartners and 4th- to 6th-grade elementary school students, children who experienced evacuation had a significantly higher PTSSC-15 score. Conclusions: This study demonstrated relationships between traumatic symptoms and environmental damage conditions in children who had suffered from the disaster. Factors examined in studying the relationship between environmental damage conditions and traumatic symptoms were gender, age, house damage, evacuation experience, and bereavement experience. It was critical not only to examine the traumatic symptoms of the children but also to collect accurate information about environmental damage conditions. [ABSTRACT FROM AUTHOR]

Background: The aims of this prospective study are to clarify the outcomes of child psychiatric inpatient treatment and to identify factors associated with patient improvement. Methods: The attending psychiatrist used the Children's Global Assessment Scale (CGAS) to assess youths at admission to and discharge from a child and adolescent psychiatric unit in Japan(N = 126, mean age = 12.8, SD = 1.9). Hospital records gathered sociodemographic and clinical variables. In addition, youths and their primary caregivers assessed themselves using the Youth Self Report (YSR) and the Child Behavior Checklist (CBCL), respectively. Longitudinal analyses compared each scales' baseline and discharge scores. We also examined factors associated with changes in functioning (CGAS). Results: Longitudinal comparisons revealed that CGAS, CBCL and YSR scores showed improvement over time (CGAS: t = -14.40, p = 0.00; CBCL: t = 3.80, p = 0.00; YSR: t = 2.40, p = 0.02). Linear regressions determined that the factors associated with improvement in CGAS included age, lower CGAS scores at admission, frequency of group therapy and psychiatric diagnosis. Conclusions: This evaluation of children and adolescents in an inpatient unit demonstrated clinical improvement over time and identified factors associated with said improvement. [ABSTRACT FROM AUTHOR]

Five species of Clusiidae (Diptera), Craspedochaeta biseta (Hendel), hendeli a plumosa (Sasakawa), Heteromeringia sexramifera Sueyoshi, Phylloclusia yambarensis sp. n., and Sobarocephala uncinata Sueyoshi, were collected from log emergence traps installed in a subtropical forest of Japan from February 2006 to February 2008. Craspedochaeta biseta (Hendel) was newly recorded in Japan. Wood debris was gathered from 1–22 year old secondary stands managed by the improvement cutting of natural forest (ICNF) and unmanaged stands, and categorized by stage of decay and size, and then enveloped in fine net bags (emergence trap). In total, 84 clusiid adults were obtained. Most were reared from wood debris in an advanced stage of decay and from 2 year old or older managed and unmanaged forest stands, although P. yambarensis was reared from wood debris in an early stage of decay and from 1 year old forests after cuttings. Log emergence traps effectively sample clusiids, taking both sexes in approximately equal numbers. Specimens collected by this trap may resolve the difficulty in identifying male and female specimens of several clusiid species that show sexual dimorphism. [ABSTRACT FROM AUTHOR]

BackgroundParticipants and settingResearch designFindingsIn recent years, the number of Japanese Language Learner (JLL) students, or children who speak a language other than Japanese and require Japanese language instruction, has been rapidly increasing in Japanese schools. Successful inclusion of students who use Japanese as a second language in the classroom creates opportunities for all students to engage with multiple languages and learn new cultures, backgrounds, history, and aspects of diversity that help them strengthen their overall cognitive abilities [Sato, T., and S. R. Hodge. 2009. “Asian International Doctoral Students’ Experiences at Two American University: Assimilation, Accommodation, and Resistance.” Journal of Diversity in Higher Education 2(3): 136-148]. In particular, physical education (PE) is considered an academic subject that can be a powerful tool to promote peace, tolerance, and understanding by bringing people together across boundaries, cultures, and religions by promoting the concepts of teamwork, fairness, discipline, and respect for the opponent in a game or activity [Beutler, I. 2008. “Sport Serving Development and Peace: Achieving the Goals of the United Nations Through Sport.” Sport in Society 11 (4): 359–369]. The purpose of this study is to describe and explain Japanese high school health and physical education (HPE) teachers’ positioning of themselves and others, as shown through a storyline, when they teach and assist Japanese Language Learner (JLL) students in academic and social contexts.Seven HPE teachers participated in this study by sharing their thoughts, opinions, and experiences related to teaching JLL students in PE. The teachers had between 3 and 23 years of experience teaching PE, and 2–9 years of experience teaching JLL students in high school PE.This study utilized a descriptive-qualitative design using an in-depth, semi-structured interview approach [Seidman, I. 2019. Interviewing as Qualitative Research: A Guide for Researchers in Education and the Social Sciences. 5th ed. New York: Teacher College Press]. A constant comparative analysis method was used to analyze the data. In this study, the process of constantly comparing data from several sources led to tentative categories that were compared to each other and to other data in order to construct categories. In this study, meaningful narrative phrases were those related to PE pedagogical content and teacher development.Explainable by concepts in positioning theory [Harré, R., and L. van Langenhove. 1999. “The Dynamics of Social Episodes.” In Positioning Theory: Moral Contexts of Intentional Action, edited by R. Harré, and L. van Langenhove, 1–13. Oxford: Blackwell], three major interrelated and complex themes emerged from the data analysis: (a) teachers’ positioning in securing a safe learning environment for JLL students in PE, (b) teachers’ dilemma in assessing JLL students’ learning outcomes based on performance assessments and written exams in PE, and (c) teachers’ positioning in their responsibilities as both teacher and host parent. To enhance the quality of PE classes, school districts need clear and focused goals related to assessment and evaluation, instructional planning, and responsibilities involved in teaching JLL students. [ABSTRACT FROM AUTHOR]

Background/Aim:The questionnaire-children with difficulties (QCD) is a parent-assessed questionnaire designed to evaluate a child’s difficulties in functioning during specific time periods of the day. In this study, the QCD was applied to determine the time periods of the day that are concerning for the parents of children with attention deficit hyperactivity disorder (ADHD). The results were compared with those for a community sample. Methods:Elementary and junior high school students with ADHD (243 boys, 55 girls) and a community sample of children (518 boys, 618 girls) were enrolled in this study. Their behaviors were assessed by the QCD, the ADHD-rating scale (ADHD-RS), and the Oppositional Defiant Behavior Inventory (ODBI). The effects of gender (boy/girl) and diagnosis (ADHD/community sample) on the total QCD score were analyzed across each school grade (elementary/junior high school). Correlation coefficients between QCD and ADHD-RS/ODBI scores were analyzed. Results:The QCD score for the ADHD group was significantly lower than that for the community sample (P < 0.001). There were significantly strong correlations between “evening” and ADHD-RS and ODBI scores for all children with ADHD (r > 0.41, P < 0.001) and between “night” and inattention and oppositional symptoms for the girls with ADHD (r > 0.40, P < 0.001). Conclusions:Parents reported that children with ADHD faced greater difficulties in completing basic daily activities compared with the community controls, particularly in the evening. Furthermore, these difficulties were related to the severity of ADHD symptoms. The parents’ perceptions depended on the gender, ADHD and oppositional symptoms, and the time period of the day. This study determined that children with ADHD face greater difficulties in daily functioning compared with community sample children, that these difficulties are time-dependent, and that these difficulties were particularly experienced in the evening. [ABSTRACT FROM AUTHOR]

Hikikomori (a severe form of social withdrawal) is a serious mental health issue. A family approach is the initial step to support hikikomori; thus effective family intervention programs are warranted. We recently developed a 5‐day family intervention program (120 min weekly) based on Mental Health First Aid (MHFA) and Community Reinforcement and Family Training (CRAFT). In the present study, we modified the 5‐day program to a 3‐day program (180 min fortnightly), and examined the effectiveness of the 3‐day program using a single‐arm procedure. Data of 23 parents (four fathers and 19 mothers; age = 62.0 ± 9.1 years) were analyzed. Mental health conditions among participants themselves improved at the 4‐month follow‐up, but the confidence in hikikomori support declined and stigma toward mental health problems did not change. However, short‐term improvements in perceived skills in approaching hikikomori sufferers were detected. Hikikomori sufferers' actual behavioral changes, such as social participation or utilization of support, were also observed (six out of 20 hikikomori sufferers). Preliminary effectiveness was confirmed for the 3‐day program. Further revision of the program and a validation study with controls are required. [ABSTRACT FROM AUTHOR]

This preliminary study is the first to demonstrate that AI can precisely identify loose connective tissue during laparoscopic cholecystectomy and ICG fluorescent cholangiography. Tashiro and colleagues conclude that this novel real-time navigation modality fusing AI and ICG fluorescent imaging may enhance safety and provide more reliable laparoscopic or robotic surgery., (© 2024 Japanese Society of Hepato‐Biliary‐Pancreatic Surgery.)

Background/aim: Indocyanine green (ICG) fluorescence is useful in laparoscopic hepatectomy (LH) for tumor identification and staining, as well as determination of resection margins. At our Institution, patient-specific, three-dimensional simulations and rehearsal of surgical strategies are carried out preoperatively. We describe cases in which ICG administered preoperatively became stagnated and fluoresced in an area similar to the preoperatively established resection area and the pathological findings in these cases., Patients and Methods: Four patients who underwent LH at our hospital between 2020 and 2023 (due to hepatocellular carcinoma in two and colorectal liver metastasis in two) were enrolled in the present study. The ICG-fluorescing liver segments were resected laparoscopically and their pathological characteristics were examined using a fluorescence microscope., Results: In four cases, the areas of ICG fluorescence seen intraoperatively were due to stasis of preoperatively administered ICG, which fortuitously was equivalent to the planned resection area in the preoperative patient-specific simulation. The fluorescent areas were resected; there were no cases of bile leakage or recurrence. Fluorescence microscopy revealed areas with diffuse ICG fluorescence in normal hepatocytes on the tumor's peripheral side., Conclusion: It was suggested that resection of the liver area that was fluorescent due to stagnation of preoperatively administered ICG was rational and justified both anatomically and oncologically. This resection may also contribute to the prevention of bile leakage and recurrence., (Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background/aim: Laparoscopic hepatectomy (LH) requires accurate visualization and appropriate handling of hepatic veins and the Glissonean pedicle that suddenly appear during liver dissection. Failure to recognize these structures can cause injury, resulting in severe bleeding and bile leakage. This study aimed to develop a novel artificial intelligence (AI) system that assists in the visual recognition and color presentation of tubular structures to correct the recognition gap among surgeons., Patients and Methods: Annotations were performed on over 350 video frames capturing LH, after which a deep learning model was developed. The performance of the AI was evaluated quantitatively using intersection over union (IoU) and Dice coefficients, as well as qualitatively using a two-item questionnaire on sensitivity and misrecognition completed by 10 hepatobiliary surgeons. The usefulness of AI in medical education was qualitatively evaluated by 10 medical students and residents., Results: The AI model was able to individually recognize and colorize hepatic veins and the Glissonean pedicle in real time. The IoU and Dice coefficients were 0.42 and 0.53, respectively. Surgeons provided a mean sensitivity score of 4.24±0.89 (from 1 to 5; Excellent) and a mean misrecognition score of 0.12±0.33 (from 0 to 4; Fail). Medical students and residents assessed the AI to be very useful (mean usefulness score, 1.86±0.35; from 0 to 2; Excellent)., Conclusion: The novel AI presented was able to assist surgeons in the intraoperative recognition of microstructures and address the recognition gap among surgeons to ensure a safer and more accurate LH., (Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)