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Background: More new randomized controlled trials (RCTs) on acupuncture have been published in Japan since our last updated systematic review (2010). This systematic review aimed to evaluate the quality of RCTs on acupuncture conducted in Japan and understand the decade-wise changes in the methodological characteristics of the relevant RCTs. Methods: The literature search was performed using Ichushi Web, the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed and our team's compilation of relevant papers. We included full-length papers reporting RCTs that examined the clinical effects of acupuncture on patients in Japan published in or before 2019. We assessed the risk of bias (RoB), sample size, control setting, negative trial reporting, informed consent, ethics approval, trial registration, and adverse event reporting. Results: A total of 99 articles reporting 108 eligible RCTs were identified. The number of RCTs published in each decade was 1, 6, 9, 5, 40, and 47 in the 1960s, 1970s, 1980s, 1990s, 2000s, and 2010s, respectively. Quality assessment using the Cochrane RoB tool revealed that "sequence generation" improved in and after 1990 (73%–80% of RCTs were rated as "low") and "blinding of outcome assessors" slightly improved in and after the 2000s (40%–50% judged as "low"). However, "high" or "unclear" remained the dominant grades in other domains. Clinical trial registration and adverse events were reported only in 9% and 28% of the included RCTs even in the 2010s, respectively. A different acupuncture method or different point selection (e.g., deep vs. shallow insertion) was the most dominant control setting before 1990, while sham (or "placebo") needling and/or sham acupoints became the most dominant in the 2000s. The proportion of RCTs with positive results was 80% in the 2000s and 69% in the 2010s. Conclusions: The quality of RCTs on acupuncture conducted in Japan did not appear to have improved over the decades except for "sequence generation." While the culture of submitting negative trial reports was prevalent in the Japanese acupuncture research milieu as late as the 1990s, the overall quality of the relevant trials needs to be further improved. [ABSTRACT FROM AUTHOR]

Aims: This work aims to map instruments available in Japanese that have been assessed for reliability or validity for measuring evidence‐based practice (EBP) among clinical nurses. Background: As EBP competencies comprise various domains, many EBP instruments have been developed. However, instruments available in Japanese for measuring EBP have not been reported systematically. Design: We conducted a scoping review. Data sources Two different bibliography databases were searched to identify EBP instruments published until 2019: ICHUSHI (for Japanese articles) and PubMed. Review methods: After relevant studies were screened and identified, study profile characteristics were extracted to identify EBP instruments in Japanese, and the quality of methodology for developing such instruments was evaluated. This information was recorded and the characteristics were descriptively summarized. Results: Ninety potentially relevant articles were identified, of which seven articles and nine instruments were included in this review. All instruments were based on self‐reported self‐efficacy and attitudes. Few Japanese instruments included all the steps required for EBP. The overall reporting quality of each instrument was low. Conclusions: EBP instruments available in Japanese are extremely scarce. The study results show that it is difficult to measure the various aspects of EBP with the existing instruments. Summary statement: What is already known about this topic? A systematic review reported that more than 100 instruments for evaluating evidence‐based practice (EBP) have been developed worldwide.Even if no language restrictions are applied in systematic reviews, international databases often do not cover publications in languages other than English, or those that are from Asia, Africa, or South America.Japanese EBP instruments have not been cited in systematic reviews of EBP. What this paper adds? EBP instruments available in Japanese published until 2019 were extremely scarce.There was little variation in the outcome domains and scale components of EBP instruments available in Japanese.An EBP instrument originally developed in Japan included a subscale on nursing research that considers the cultural characteristics specific to Japan. The implications of this paper: This review could help researchers, educators, and practitioners in choosing EBP instruments available in Japanese to measure nurses' readiness or competencies for EBP.A literature review of non‐English language publications could address the language limitations of previous systematic reviews in mapping EBP instruments. [ABSTRACT FROM AUTHOR]

We aimed to survey the findings of phenomenological studies built up in the field of diabetes care in Sweden. This is a meta-synthesis of phenomenological studies on experiences related to diabetes in Sweden focusing on learning to live with diabetes. We proceeded by reference to the seven phases of Noblit & Hare. We examined papers from seven phenomenological studies on learning to live with diabetes in Sweden. From the papers, which describe the experience of living with diabetes, three overarching themes were selected—perception and awareness of the body; integration and responsibility; and presence of others who provide support. From those describing the expert's experience, an overarching theme emerged—encouraging reflection in persons with diabetes. We interpreted each of these themes in phenomenological terms and compared them with theories in Japan. Persons with diabetes take responsibility for coping with a range of things brought on by the illness and learn to live with diabetes. Experts support these persons so they can see their world objectively and critically scrutinize it. By building a model of diabetes care in Japan that references Scandinavian human science, it will be possible to find new approaches that support learning at the existential level. [ABSTRACT FROM AUTHOR]

This scoping review explores the professional literature in allied healthcare to determine which self-assessments of mentor skills are the most valid and reliable for use in occupational therapy doctoral capstone programs. The aims of this scoping review include mapping evidence related to mentor assessments in healthcare, exploring implications for occupational therapy doctoral mentor training programs, and identifying common characteristics of mentor self-assessments for occupational therapy programs to consider when developing capstone mentoring resources. Researchers applied and reported via PRISMA Extension for Scoping Reviews (PRISMA-ScR). A librarian and authors formulated keywords and database selections to search PubMed/MEDLINE/PMC, and Embase were searched from across healthcare professions for training outcomes, mentor self-assessment, mentor attributes, and use of researcher-developed assessments. The search was limited to English publications from the last 20 years. Data were extracted for quantitative information regarding study characteristics and qualitative information about mentoring skills. A total of 852 results were delivered across all databases. Nineteen papers met the final eligibility criteria and were included in the data extraction. Populations were included from several healthcare professions, including 11 nursing, four healthcare researchers, one pharmacy, one midwifery, one medicine, and one medical dietetics. Countries included the United States (n = 7), Finland (n = 5), United Kingdom (n = 4), Japan (n = 1), South Africa (n = 1) and Canada (n = 1). The authors identified four valid self-assessment tools, demonstrating III and IV levels of evidence, that may be implemented by occupational therapy programs as they develop resources for mentor programs. Occupational therapy programs can use the mentor attributes found in this scoping review to create their own mentor assessment measures or may choose to use a validated tool. The authors recommend additional research in mentor education and mentor skill acquisition. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to provide an overview of published literature on behavioural and psychological symptoms of dementia (BPSD) nursing in Japan and to highlight challenges that need to be resolved. Design/methodology/approach: The criteria for retrieval of literature were as follows: a BPSD study conducted by a nurse in Japan, and it must have been published. Papers without conference proceedings and peer reviews and literature without English titles and abstracts were excluded. The PRISMA (preferred reporting items for systematic reviews and meta-analyses) was referenced. Findings: Based on the analysis of 20 studies meeting the criteria, nurses tended to manage BPSD when all three of the following were clearly defined: attempts to understand BPSD, the provision of nursing intervention to improve the quality of care and clarification of the perception of BPSD. There were eight studies that implemented surveys considered to be helpful for nurses to understand BPSD with the aim of clarifying the symptomatic factors, meaning of each behaviour, etc. In the eight studies, nurses directly coped with BPSD in various ways. Four studies reported on how nurses perceive the associated behaviours and symptoms of BPSD patients. Originality/value: This study suggests that not only implementing interventions but also aiming at improving nurses' understanding of BPSD and their level of knowledge are crucial to promote BPSD nursing in Japan. [ABSTRACT FROM AUTHOR]

To identify the prognostic value of the pretreatment geriatric nutritional risk index (GNRI) in colorectal cancer. Several electronic databases were searched up to March 15, 2022, for relevant studies. The primary and secondary outcomes were overall survival (OS) and disease-free survival (DFS), respectively. The hazard ratios (HRs) with 95% confidence intervals (CIs) were combined. Bess's funnel plot and Egger's test were conducted to detect publication bias, and the trim-and-fill method was performed to identify potentially unpublished papers and their impacts on the overall results. Nine studies from Japan and China involving 3440 participants were enrolled in the current meta-analysis. The pooled results indicated that a low pretreatment GNRI was significantly associated with poorer OS (HR = 2.28, 95% CI: 1.69–3.07, P < 0.001; I2=63.5%, Pheterogeneity=0.005) and DFS (HR = 1.62, 95% CI: 1.35–1.96, P < 0.001; I2=46.4%, Pheterogeneity=0.114). Subgroup analysis stratified by country and treatment showed similar results. Significant publication bias was manifested by the asymmetric Begg's funnel plot and P = 0.012 of Egger's test, but three potentially unpublished studies did not have a significant impact on the overall results. A lower pretreatment GNRI was a novel prognostic risk factor for Japanese and Chinese colorectal cancer patients. [ABSTRACT FROM AUTHOR]

The objective was to prepare guidelines to perform the current optimum treatment by organizing effective and efficient treatments of hemangiomas and vascular malformations, confirming the safety, and systematizing treatment, employing evidence‐based medicine (EBM) techniques and aimed at improvement of the outcomes. Clinical questions (CQs) were decided based on the important clinical issues. For document retrieval, key words for literature searches were set for each CQ and literature published from 1980 to the end of September 2014 was searched in Pubmed, Cochrane Library, and Japana Centra Revuo Medicina (JCRM). The strengths of evidence and recommendations acquired by systematic reviews were determined following the Medical Information Network Distribution System (MINDS) technique. A total of 33 CQs were used to compile recommendations and the subjects included efficacy of resection, sclerotherapy/embolization, drug therapy, laser therapy, radiotherapy, and other conservative treatment, differences in appropriate treatment due to the location of lesions and among symptoms, appropriate timing of treatment and tests, and pathological diagnosis deciding the diagnosis. Thus, the Japanese Clinical Practice Guidelines for Vascular Anomalies 2017 have been prepared as the evidence‐based guidelines for the management of vascular anomalies. [ABSTRACT FROM AUTHOR]

Background/objectives: Sedentary behavior (SB), defined as sitting (nonexercising), reclining, and lying down (posture), or by low energy expenditure, is a public health risk independent to physical activity. The objective of this systematic literature review was to synthesize the available evidence on amount of SB reported by and measured in older adults. Data source: Studies published between 1981 and 2014 were identified from electronic databases and manual searching. Large-scale population studies/surveys reporting the amount of SB (objective/ subjective) in older adults aged ≥ 60 years of age were included. Appraisal and synthesis was completed using MOOSE guidelines. Results: 349,698 adults aged ≥ 60 within 22 studies (10 countries and 1 EU-wide) were included. Objective measurement of SB shows that older adults spend an average of 9.4 hr a day sedentary, equating to 65-80% of their waking day. Self-report of SB is lower, with average weighted self-reports being 5.3 hr daily. Within specific domains of SB, older adults report 3.3 hr in leisure sitting time and 3.3 hr watching TV. There is an association with more time spent in SB as age advances and a trend for older men to spend more time in SB than women. Conclusion/ implications: Time spent sedentary ranges from 5.3-9.4 hr per waking day in older adults. With recent studies suggesting a link between SB, health, and well-being, independent of physical activity, this is an area important for successful aging. Limitations: Different methodologies of measurement and different reporting methods of SB made synthesis difficult. Estimated SB time from self-report is half of that measured objectively; suggesting that most self-report surveys of SB will vastly underestimate the actual time spent in SB. [ABSTRACT FROM AUTHOR]

Background In common with other countries, Japan has an ageing population and geographical impediments to healthcare access. The role of telemedicine within the Japanese health system may be of wide interest, yet it has not been comprehensively explored and documented. Thus, the aim of this study was to systematically review the Japanese and English language literature relating to the clinical use of telemedicine in Japan. Methods For studies published in Japanese, we searched Ichushi and CiNii. For English language publications, we searched Cochrane Library, PubMed, Embase, and Web of Science. All peer-reviewed articles describing the clinical use of telemedicine and published between 2007 and 2016 were included. Data on clinical area, study type, technology used, and type of communication were extracted. Studies were categorised by prevention, screening, diagnosis, surveillance, and treatment. Results The search yielded 1476 records; 26 Japanese language and 15 English language articles were selected for review. A wide range of clinical areas were represented; however, home care and life-style related studies were dominant. More than 50% of studies were related to prevention and early diagnosis. The majority of Japanese studies involved doctor-to-doctor consultation. Smartphones and remote monitoring systems were the main types of technology used. Conclusions Most studies of telemedicine in Japan are published in the Japanese language and are thus relatively inaccessible to the rest of the world; for the first time, this study has provided an overview of the clinical use of telemedicine in Japan. The clinically related papers reflect the Japanese cultural focus on disease prevention. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify the current state of knowledge about the use of the sit‐to‐stand intervention with older people and to identify implications for further research. Background: Many older people experience mobility challenges which can negatively affect their well‐being. Physical activities are vital to improving or maintaining mobility. Although there is evidence that mobility challenged older people benefit from the sit‐to‐stand intervention, there is a need to systematically examine the state of knowledge about this intervention. Design: Scoping review using Arksey and O'Malley's methodological framework. Methods: A systematic search of three databases was completed. Abstracts were evaluated for relevance using predetermined inclusion criteria. Studies that met the inclusion criteria had data extracted and were appraised for internal and external validity. Narrative synthesis was based on methods described by Popay and colleagues. Results: Of 3,041 papers, six studies met the inclusion criteria. Publications provided a range of sit‐to‐stand interventions with durations varying from four weeks to six months. The frequency of each intervention fluctuated from three to seven times/week with a duration of 15–45 min. Different professionals prompted the activity. Three themes were identified the following: (a) sit‐to‐stand activity as an intervention; (b) generalisability of findings; and (c) sustainability. Conclusions: Most of the studies reviewed indicated improvements in performance of the sit‐to‐stand activity and in motor function. However, issues with studies rigour do not allow us to make generalisations. Further research is needed to confirm the effectiveness of the intervention. Implications for practice: Healthcare providers are expected to offer evidence‐based patient care. This review details current knowledge about the sit‐to‐stand intervention with older people. [ABSTRACT FROM AUTHOR]

Objective: In spite of the effectiveness of the individual placement and support model of supported employment (IPS) for the recovery of people with mental illness, the implementation and dissemination of IPS in Japan have not been straightforward. This paper summarizes barriers against the implementation of IPS in Japan and discusses potential strategies to overcome them. Method: We reviewed IPS research performed in Japan through literature search, and summarized current employment services and policies in Japan along with a practice report of an ongoing IPS program in a local city in Japan. Results: Barriers against the implementation of IPS in Japan included: (a) systems designed mainly for group-based services, (b) weak recognition of IPS, and (c) cultural background. Nevertheless, we identified 4 intervention studies of IPS in Japanese settings, and all found that more than 40% of the participants gained their employment through IPS. By utilizing available services, the IPE program in Hamada City achieved ∼50% employment rate and sufficient fidelity. Conclusions and Implications for Practice: The present data indicate that, by combining currently available services, IPS can be implemented successfully in Japan. Impact and Implications: In Japan, employment of people with mental illness has lagged far behind employment for people with other disabilities. The present paper summarizes the evidence regarding effects of the individual placement and support model of supported employment (IPS) in Japan to elucidate the structural and cultural barriers that are impeding the implementation of IPS. This paper also illustrates potential strategies for implementing IPS in Japan. [ABSTRACT FROM AUTHOR]

BACKGROUND: The paper is a research review focusing on occupational safety in the construction industry. OBJECTIVE: The purpose is to present research that highlights the areas of occupational safety and risks and to identify areas where research is lacking. METHODS: 146 articles from scientific journals, mainly covering the construction industry in Europe, Canada, USA, Australia and Japan have been studied. The findings are presented under 11 categories: accident statistics; individual factors; legislation and regulations; ethical considerations; risk management; leadership, management, organization; competence; safety design; cost-benefit calculations; programs and models; and technical solutions. RESULTS: The research is dominated by initiatives from researchers and government authorities, while the construction industry only appears as the object for the research. There is a scarcity of research on integrated systems encompassing subcontractors, as well as a lack of research with sociological perspectives on accidents. Furthermore, only a few studies have applied a gender perspective on safety in construction, i.e. there is a need of further research in this particular area. CONCLUSIONS: A range of initiatives have been taken to increase safety in the construction industry and the initiatives are mainly reported to be successful. There are some cultural differences, but basically researchers present similar results regardless of country. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to identify the following two research questions for paternal depression through a meta-analysis of relevant qualitative studies: 1. How has paternal depression been screened for by professionals? 2. What are the coping strategies /support available for paternal depression and the challenges in providing strategies/ support for paternal depression? Methods Relevant articles were identified using the following databases: CINAHL, MEDLINE, and Google Scholar. The search keywords used were 'support' AND 'postpartum depression of father' OR 'paternal depression' OR 'mental health of fathers' AND 'qualitative study' in the database. There were 32 qualitative articles retrieved from the database and through hand searching, of which 5 articles were included in the analysis. Meta-ethnography were utilised in this study. All analysed papers were scored and guaranteed by the Critical Appraisal Skills Program (CASP; 0-10 points) as valuable qualitative studies. The analysis was performed using NVivo 12 for Windows. Results In the present meta-synthesis, the Patient Health Questionnaire -9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire -15 (PHQ-15), and the List of Threatening Events were used to identify depression in fathers. Additionally, one study used the six criteria of the definition of postnatal depression to identify paternal depressive symptoms. As a result of the meta-synthesis, the following eight metaphors were extracted from all analyses articles: 'Triggers of paternal depression'; 'Awareness of paternal depression'; 'The Impact of paternal depression'; 'Coping'; 'Lack/unhelpful of information resources'; 'Barriers to seeking help'; 'Reasons for needing supports'; and 'Helps for paternal depression'. Paternal depression due to a sequence of triggering events and the perceived symptoms varied. Once fathers realized they had depression, they attempted to cope with it. However, there were inadequate therapies and information to cope with depression. Moreover, embarrassment of seeking help due to being male was also a barrier to coping with depression. In contrast, the responsibility to protect the family motivated them to acknowledge their depression and seek social support and professional help. Conclusion Anxiety and general depression scales were used to screen for paternal depression, and no measures for paternal depression were not used. Men who were aware of paternal depression tried to cope with it; however, it is possible that support for paternal depression was not sufficiently available and that masculinity may also be a barrier to seeking help for depression. On the other hand, the responsibility of protecting their families motivated fathers to be proactive in seeking help to overcome depression. [ABSTRACT FROM AUTHOR]

Aims: Alcoholic liver disease (ALD) is now a well-recognized indication for liver transplantation. This paper reviews existing literature on living donor liver transplantation (LDLT) for ALD and presents data from a single, high volume United States liver transplant center. Methods: For the literature review, a PubMed search was undertaken using the search terms 'living donor' and 'alcoholic liver disease'. Studies were included that presented outcome data for patients who underwent LDLT for ALD. For the single-center data collection, all patients who underwent LDLT from 2003 to 2016 at our center were reviewed and the data for recipients with ALD was subsequently analyzed and compared with those patients who underwent LDLT for other indications. Results: Of 110 studies that resulted from the PubMed query, only 5 contained data that was relevant to this manuscript. These studies represented data collected from two Asian countries: one single center in Korea and a collection of centers in Japan. The relapse rate following LDLT for ALD ranged from 7.9% to 22%, and pre-transplant abstinence did not impact post-transplant relapse in any of these studies. For the single-center data, of 136 LDLT performed at our institution during the time period, 22 were performed for ALD. There was no difference in 1- or 5-year survival between patients transplanted for ALD and those transplanted for other etiologies (94.7% vs. 93.4%, P = 0.79 and 78.9% vs. 87.5%, P = 0.6). Conclusion: There is a very limited amount of data available on LDLT for ALD. Existing data suggests that LDLT for ALD results in excellent outcomes. Short Summary: Published data on living donor liver transplantation (LDLT) for alcoholic liver disease (ALD) are limited. One- and five-year survival rates range from 82% to 100% and 78% to 87%, respectively. Rates of alcohol relapse following transplant appear low, ranging from 7% to 23%; 6-month abstinence periods prior to LDLT for ALD do not appear to have a significant impact on relapse. [ABSTRACT FROM AUTHOR]

Introduction: With increasing caesarean section (c-section) rates, personalized communication of risk has become paramount. A reliable tool to predict complications would support evidence-based discussions around planned mode of birth. This systematic review aimed to identify, synthesize and quality appraise prognostic models of maternal complications of elective c-section.Methods: MEDLINE, Embase, Web of Science, CINAHL and the Cochrane Library were searched on 27 January using terms relating to 'c-section', 'prognostic models' and complications such as 'infection'. Any study developing and/or validating a prognostic model for a maternal complication of elective c-section in the English language after January 1995 was selected for analysis. Data were extracted using a predetermined checklist: source of data; participants; outcome to be predicted; candidate predictors; sample size; missing data; model development; model performance; model evaluation; results; and interpretation. Quality was assessed using the Prediction model Risk Of Bias ASsessment Tool (PROBAST) tool.Results: In total, 7752 studies were identified; of these, 16 full papers were reviewed and three eligible studies were identified, containing three prognostic models derived from hospitals in Japan, South Africa and the UK. The models predicted risk of blood transfusion, spinal hypotension and postpartum haemorrhage. The study authors deemed their studies to be exploratory, exploratory and confirmatory, respectively. From the three studies, a total of 29 unique candidate predictors were identified, with 15 predictors in the final models. Maternal age (n = 3), previous c-section (n = 2), placenta praevia (n = 2) and pre-operative haemoglobin (n = 2) were found to be common predictors amongst the included studies. None of the studies were externally validated and all had a high risk of bias due to the analysis technique used.Conclusion: Few models have been developed to predict complications of elective c-section. Existing models predicting blood transfusion, spinal hypotension and postpartum haemorrhage cannot be recommended for clinical practice. Future research should focus on identifying predictors known before surgery and validating the resulting models. [ABSTRACT FROM AUTHOR]

(1) Background: This systematic review presents an overview of psychological interventions in suicide published between 2013 and 2023 in Spain and Japan, sparked by Spain's alarming recent increase in suicide rates and the potential exemplar of Japan's reduction efforts. (2) Methods: Following the PRISMA checklist, the databases Web of Science, Scopus, PubMed, and PsycInfo were searched using the terms [("suicide" OR "suicidal behavior" OR "suicidal attempt" OR "suicidal thought" OR "suicidal intention") AND ("prevention" OR "intervention" OR "psychosocial treatment" OR "Dialectical Behavior Therapy" OR "Cognitive Therapy" OR "psychotherap*")] AND [("Spain" OR "Spanish") OR ("Japan" OR "Japanese")]. We included articles published in peer-reviewed academic journals, written in English, Spanish, and Japanese between 2013 and 2023 that presented, designed, implemented, or assessed psychological interventions focused on suicidal behavior. (3) Results: 46 studies were included, concerning prevention, treatment, and training interventions. The risk of bias was low in both Spanish and Japanese studies, despite the lack of randomization of the samples. We identified common characteristics, such as psychoeducation and coping skills. Assertive case management was only highlighted in Japan, making an emphasis on active patient involvement in his/her care plan. (4) Conclusions: The findings will help professionals to incorporate into their interventions broader, more comprehensive approaches to consider more interpersonal components. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance Gastrodia elata Blume ( Orchidaceae ) is commonly called Tian ma in Chinese and mainly distributed in the mountainous areas of eastern Asia, such as China, Korea, Japan and India. It is an extensively used traditional Chinese herbal medicine in the clinical practice of traditional Chinese medicine, to treat headache, migraine, dizziness, epilepsy, infantile convulsion, tetany and so on. The present paper reviews the advancements in investigation of botany and ethnopharmacology, phytochemistry, pharmacology, toxicology and quality control of Gastrodia elata Blume. Finally, the possible tendency and perspective for future investigation of this plant are also put forward. Materials and methods The information on Gastrodia elata Blume was collected via piles of resources including classic books about Chinese herbal medicine, and scientific databases including Pubmed, Google Scholar, ACS, Web of science, ScienceDirect databases, CNKI and others. Plant taxonomy was validated by the databases “The Plant List”, and “Mansfeld’s Encyclopedia”. Results Over 81 compounds from this plant have been isolated and identified, phenolics and polysaccharides are generally considered as the characteristic and active constituents of Gastrodia elata Blume. Its active compounds possess wide-reaching biological activities, including sedative, hypnotic, antiepileptic, anticonvulsive, antianxietic, antidepressant, neuroprotective, antipsychotic, anti-vertigo, circulatory system modulating, anti-inflammationary, analgesic, antioxidative, memory-improving and antiaging, antivirus and antitumor effects. Conclusion Despite the publication of various papers on Gastrodia elata Blume, there is still, however, the need for definitive research and clarification of other bioactive compounds using bioactivity-guided isolation strategies, and the possible mechanism of action as well as potential synergistic or antagonistic effects of multi-component mixtures derived from Gastrodia elata Blume need to be evaluated. It is also necessary and important to do more quality control and toxicological study on human subjects in order to maintain its efficacy stable in the body and validate its safety in clinical uses. In addition, more investigations on other parts of this plant beyond the tubers are needed. Further studies on Gastrodia elata Blume will lead to the development of new drugs and therapeutics for various diseases, and how to utilize it better should be paid more attention to. [ABSTRACT FROM AUTHOR]

Background: Conservative management is often the first-choice treatment for baseball players with disabled throwing shoulder (DTS). Considering the high popularity of baseball in Japan, we suspected that there might be some evidence regarding this topic in the Japanese-language literature. Objective: This study aimed to systematically review Japanese-language primary studies investigating the effectiveness of conservative management for DTS in baseball. Methods: Eight databases were systematically searched from inception to 7 April 2016. Data on authors, publication years, sample characteristics, types of interventions, outcome measures and results were extracted. Data were synthesised qualitatively. Results: Seven studies with low evidence level and low-to-moderate study quality were included. Interventions examined in the included studies were downward throwing, combined physiotherapy interventions and joint distension. Forming correction, stretching for posterior shoulder muscles and strengthening exercises to improve scapular/trunk stability were commonly used in combined physiotherapy interventions. Downward throwing and combined physiotherapy interventions corresponded with expert opinions described in the English-language literature. Due to the lack of studies with high level of evidence, however, it was difficult to determine the genuine effects of these interventions. Conclusion: Our systematic review found limited evidence about the effectiveness of any conservative management for baseball players with DTS. Although downward throwing and combined physiotherapy interventions might be appropriate management in some cases, further studies of higher level of evidence and greater methodological rigour are required. [ABSTRACT FROM AUTHOR]

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At present, for adults with chronic hepatitis B virus (HBV) infection, two new analogues, entecavir (ETV) and tenofovir, are recommended as the first-line therapy by the EASL (European Association for the Study of the Liver), AASLD (American Association for the Study of Liver Diseases), and APASL (Asian Pacific Association for the Study of the Liver) guidelines. The use of pegylated interferon-α (PEG IFN-α) is recommended as the first-line therapy instead of standard IFN-α according to the above 3 guidelines. In this paper, the aim was to assess: (1) the long-term efficacy and safety as well as the resistance to ETV and tenofovir disoproxil fumarate (TDF); (2) the efficacy of PEG IFN-α; (3) the role of combination therapy with IFN plus two analogues, such as lamivudine and ETV; (4) the efficacy and safety of two analogues with cirrhosis, and (5) suppression of hepatocellular carcinoma (HCC) by ETV and IFN treatment. The results are as follows: (1) both ETV and TDF showed long-term efficacy and safety; (2) PEG IFN-α resulted in a greater decline in HBV DNA levels and a higher rate of HBeAg seroconversion; (3) combination therapy with IFN plus two analogues did not elevate the rate of sustained responses; (4) both ETV and TDF showed efficacy and safety with cirrhosis (ETV especially displayed efficacy and safety with decompensated cirrhosis), and (5) suppression of HCC was observed by ETV and IFN. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Disseminated intravascular coagulation (DIC) syndrome is a highly lethal condition characterized by the complication of multiple organ damage. Although the effects of combined antithrombin (AT) and recombinant thrombomodulin (rTM) on DIC syndrome have previously been examined, the results are inconsistent and inconclusive. Therefore, we conducted a systematic review on the combined administration of AT and rTM for the treatment of septic DIC to investigate the superiority of the combination therapy over either AT or rTM monotherapy using a random-effects analysis model. Method: We searched electronic databases, including Medline, Cochrane Central Register of Controlled Trials, Scopus, and Igaku-Chuo Zasshi (ICHU-SHI) Japanese Central Review of Medicine Web from inception to January 2022. Studies assessing the efficacy of combined AT and rTM were included. The primary outcome was all-cause mortality, and the secondary outcome was occurrence of serious bleeding complications compared to monotherapy. We presented the pooled odds ratio (OR) or hazard ratio (HR) with 95% confidence intervals (CI) depending on reporting results in each primary study. Results: We analyzed seven enrolled clinical trials, all of which were observational studies. Combination therapy had a non-significant favorable association with lower 28-day mortality compared to monotherapy (HR 0.67 [0.43–1.05], OR 0.73 [0.45–1.18]). The I2 values were 60% and 72%, respectively, suggesting high heterogeneity. As a secondary outcome, bleeding complications were similar between the two groups (pooled OR 1.11 [0.55–2.23], I2 value 55%). Conclusions: Although the findings in this analysis could not confirm a statistically significant effect of AT and rTM combination therapy for septic DIC, it showed a promising effect in terms of improving mortality. The incidence of bleeding was low and clinically feasible. Further research is warranted to draw more conclusive results. Trial registration: This study was registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN ID: 000049820). [ABSTRACT FROM AUTHOR]

Abstract Schools of Nursing have witnessed an increase in the number of nursing students who struggle with learning difficulties. Support and accommodations are available in academic settings. Because nursing is a practice profession students also learn in clinical settings, which may not have similar support and accommodations. The compatibility of the clinical setting for the education of students with learning difficulties has not been studied. Staff nurses responsible for the clinical education of students and new nurses receive little preparation for their role as educator, and may not feel supported to meet the needs of those with learning difficulties. This is part one in a series of articles about the clinical education of nursing students with learning difficulties. This paper provides a framework and literature review for the development of a study (part 2) exploring the issue from the perspective of the nurse preceptors who educate students and new graduates with learning difficulties. Highlights • There is an increase in the number of students in school of nursing with learning difficulties. • The literature on nursing students with learning difficulties can be understood from the perspectives of nursing schools, faculty, and students. • Nurse educators have a role in preparing the learning environments for students with learning difficulties. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance Artemisia asiatica Nakai (Compositae) has a long history as a traditional remedy. Preparation from various parts of the plant (aerial parts and leaves) are used to treat a wide range of diseases including gastric trouble, liver dysfunction, and skin inflammation. Aims of this review The aims of this review were: 1) to provide an overview of recent studies and progress on A. asiatica -derived ethnopharmacological compounds and their pharmacological activities; and 2) to summarize existing evidence and provide insight for future studies. Materials and methods This investigation was carried out by analyzing published books and research papers via scientific databases, namely Science Direct, PubMed ACS Publication, Wiley Online Library, CNKI and information obtained online. The keywords “ Artemisia asiatica traditional uses,” “Compounds isolated and studied in Artemisia asiatica, ” and “Pharmacological advances in Artemisia asiatica ” were used and articles published between 1995 and 2017 were considered. In total, 500 works related to biological activities of A. asiatica were identified, and only materials published in English were included in the review. Results Comparative analysis of literature searched through sources available confirmed that the ethnopharmacological use of A. asiatica was recorded in Korea, China, and Japan. Phytochemical studies revealed the presence of flavonoids, sesquiterpene lactones, monoterpenes, and steroids in A. asiatica . Of these, flavonoids have been shown to exhibit significant pharmacological effects such as gastroprotective, anti-inflammatory, anti-tumor, and anti-microbial actions. Conclusions Phytochemical and pharmacological studies of Artemisia asiatica have proven that this plant is one of valuable medicinal sources with neuroprotective, gastroprotective, anti-oxidative, anti-inflammatory, and anti-cancer effects. Although ethanol extract of this plant is now being prescribed as gastroprotective and anti-ulcerative medicine, it is now time to expand its application to other human inflammatory diseases such as pancreatitis and hepatitis and further extensive study on toxicity in human. Therefore, the present review will encourage further studies of A. asiatica in the pursuit of wide range of therapeutic remedy. [ABSTRACT FROM AUTHOR]

Methamphetamine (MA) abuse continues in East Asia and shows an increasing trend among youths in South Korea, Japan, and China. Although the negative effects of MA abuse on youth are considered as significant problems, few studies have been conducted on the topic in these countries. This paper focuses on the effects of MA on the human body and current MA abuse among youths in South Korea, Japan, and China. To investigate the negative effects of MA on the human body, we searched the keywords "MA," "human," and "effect" for studies published from 2013 to 2017. MA activates the neurotransmitter system and the central nervous system, and when used at high dosage or for long term, MA can cause severe neurotoxicity and cardiovascular problems. Online networks contribute to MA abuse by sharing methods for preparing synthetic MA. Despite efforts to reduce MA abuse, social crimes associated with its abuse continue and numbers of illegal MA users are increasing steadily in Korea, Japan, and China. In young users, diverse factors associated with drug addiction, such as curiosity and peer effect, lead to MA abuse and its attendant personal and social problems. [ABSTRACT FROM AUTHOR]

Summary: What is known and objective: The prognostic value of ribonucleotide reductase M1 (RRM1) in patients with pancreatic cancer receiving gemcitabine chemotherapy has been evaluated in several studies. However, the conclusions remain controversial. Methods: By searching the PubMed and Embase databases, we conducted a meta‐analysis to evaluate the prognostic significance of RRM1 expression in patients with pancreatic cancer receiving gemcitabine chemotherapy. Studies were pooled, and the hazard ratio (HR) and its corresponding 95% confidence interval (CI) were calculated. Results: Nine relevant articles were included for this meta‐analysis study. Our results revealed that the high‐RRM1 expression patients had significantly poorer overall survival (HR = 1.70, 95% CI = 1.33‐2.16, Pheterogeneity = .061, I2 = 44.8%) and disease‐free survival (HR = 1.84, 95% CI = 1.56‐2.18, Pheterogeneity = .669, I2 = 0%) than the low‐RRM1 expression patients. Furthermore, a statistically significant association between RRM1 expression and OS was found among both Japanese (HR = 1.80, 95% CI = 1.36‐2.37, Pheterogeneity = .843, I2 = 0%) and American patients (HR = 1.76, 95% CI = 1.60‐1.94, Pheterogeneity = .439, I2 = 0%). What is new and conclusion: In conclusion, the expression of RRM1 can be considered a predictor of poor survival in patients with pancreatic cancer receiving gemcitabine chemotherapy. RRM1 expression assessment could provide more detailed information for patients with pancreatic cancer and could be used to optimize therapeutic schemes. [ABSTRACT FROM AUTHOR]

Background: The current English language research evidence does not support the clinical use of Kinesio tape (KT). Objectives: This systematic review aimed to collect and synthesise unexplored Japanese language primary studies investigating effects of KT on pain, muscle strength and functional performance. Methods: Nine databases were systematically searched from inception to 8 February 2017. Methodological quality was assessed using the McMaster Critical Review Quantitative Form. Data were synthesised descriptively. Results: Six studies with moderate to high risk of bias were included. There was limited evidence for positive effects of KT on isokinetic knee extension and flexion strength, which was in line with the current English language literature. There was also limited evidence to support the use of KT to prevent the compromise of agility performance after exhaustive exercises. Conclusions: This systematic review of Japanese language primary studies found limited, inconclusive evidence about the effectiveness of KT on muscle strength and functional performance. Further studies with better methodological rigour are required in Japanese, and in English, to improve the strength of the current evidence base. [ABSTRACT FROM AUTHOR]

Abstract: To increase understanding of the epidemiology, risks, consequences and resource utilization of Clostridium difficile infection (CDI) in Japan, a systematic literature review was undertaken of relevant publications from January 2006 to November 2017. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and methods, 55 articles met the criteria for full review. The majority (58%) of studies were from a single site, with the most recent data from 2015. The incidence, reported prevalence and recurrence rate of CDI in Japan were 0.8-4.71/10,000 patient-days, 0.3-5.5/1000 patients and 3.3-27.3%, respectively, and varied according to setting, population, CDI definition and detection method. Most C. difficile isolates associated with CDI in Japan were toxin A+B+, with a low level of C. difficile binary toxin-positive (CDT+) strains (0-6.8% reported across studies). The most common C. difficile PCR ribotypes associated with infection in Japan were smz/018, 002, 052 and 369. Data regarding the impact of CDI on length of hospital stay were limited. Reported all-cause mortality in patients with CDI ranged from 3.4 to 15.1% between 2007 and 2013. Two studies assessed risk factors for CDI recurrence, identifying malignant disease, intensive care unit hospitalization and use of proton pump inhibitors as factors increasing the risk of initial and/or recurrent CDI. No study analyzed initial CDI treatment in relation to recurrence. More comprehensive surveillance and coordinated studies are needed to map trends, understand risk factors, and recognize the extent and impact of CDI in Japanese patients.Funding: Astellas Pharma, Inc.Plain Language Summary: Plain language summary available for this article. [ABSTRACT FROM AUTHOR]

Aims: To identify the effectiveness of interventions for improving immigrant women's mental health and explore the role of these interventions in nursing practice. Background: Immigrant women rearing children and living in a foreign country experience many mental health problems during pregnancy, child‐rearing, and acculturation. Mental health problems can be controlled or modified through effective practices. Few studies have examined the role of different types of interventions in alleviating these mental health issues in immigrant women in the perinatal period, and it is unclear whether such interventions are effective. Methods: This systematic review used the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis checklist. Studies form December 1948–August 2021 were retrieved from four databases: MEDLINE, CINAHL, EMBASE, and Cochrane Library. This systematic review's protocol was registered at PROSPERO (CRD42020210845). The data were summarised using narrative analysis. Results: Eight studies met the inclusion criteria and were included in the final analyses. There were few mental health improvement interventions for immigrant women. The interventions included home visit programmes, asset‐building mental health interventions, cognitive‐behavioural interventions, nursing interventions, perinatal education interventions, and mindfulness interventions. Home visit programmes and asset‐building mental health interventions have reported positive outcomes in improving depressive symptoms and mental health. Conclusions: There are few interventions for improving immigrant women's mental health. Most existing interventions are conducted through group education, but there are no explicit significant effects. Home visits may be an effective approach for conducting interventions to improve immigrant women's mental health. An effective nursing intervention should be developed, and more research is needed in improving immigrant women's mental health. Relevance to clinical practice: This review provides evidence for nurses and midwives to practice appropriate and effective approaches and strategies for improving immigrant women's mental health. We suggest possible future interventions for this cohort of immigrant women in the perinatal period. [ABSTRACT FROM AUTHOR]

Objective: This meta‐analysis aimed to determine the effect of mindfulness interventions on nurses' levels of depression and anxiety. Design: Meta‐analysis of randomised controlled trials. Methods: The following Chinese and English databases were searched: PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Internet (CNKI). The retrieval period was from database construction to 30 March 2022. Two researchers screened the relevant literature and extracted the data. After a cross‐check, data were input into Stata version 16.0 for meta‐analysis. Results: Twelve randomised controlled trials from 2017 to 2021 were included, which involved 807 subjects (405 and 402 in the intervention and control groups, respectively). Meta‐analysis results showed that nurses' anxiety reduced by mindfulness‐based interventions was significantly higher compared to that of the control group (SMD = 0.91, 95% CI: 0.27–1.55, p < 0.05). Furthermore, an 8‐week mindfulness‐based intervention (SMD = 1.43, 95% CI: 0.61–2.24) reduced the level of anxiety significantly more compared to a 4‐week intervention (SMD = 1.03, 95% CI: 0.36–1.71). Mindfulness‐based interventions were better compared to conventional intervention to reduce the level of depression (SMD = 1.02, 95% CI: 0.42–1.61, p < 0.05), and an 8‐week mindfulness intervention (SMD = 1.81, 95% CI: 0.78–2.84) reduced the level of depression significantly more compared to a 4‐week intervention (SMD = 0.82, 95% CI: 0.29–1.35). Since limited studies had interventions longer than 8 weeks, results on longer mindfulness interventions in reducing nurses' anxiety and depression are inconclusive. In conclusion, mindfulness intervention for 8 weeks or less can significantly reduce nurses' anxiety and depression levels. Patient or Public Contribution: None. [ABSTRACT FROM AUTHOR]

Objective This systematic review aimed to evaluate the scientific evidence on the efficacy of desensitizing mouthwashes for the treatment of dentin hypersensitivity ( DH) and root sensitivity ( RS). Material and methods A thorough search in MEDLINE, PubMed and Cochrane Plus Library was conducted up to February 2015. Randomized clinical trials, parallel, double-blinded and placebo-controlled, with a follow-up of at least 6 weeks, reporting changes on response to tactile stimuli, thermal/evaporative stimuli or patients' subjective assessment of the pain experienced during their daily life after the home use of desensitizing mouthwashes were considered for inclusion. Results The screening of titles and abstracts resulted in seven publications meeting the eligibility criteria. The desensitizing agents evaluated were potassium nitrate ( n = 5), aluminium lactate ( n = 1) and sodium fluoride ( n = 1). A meta-analysis for each of the hypersensitivity stimuli was performed. Results demonstrated statistically significant reduction in sensitivity scores favouring test group when DH was assessed by means of patients' self-reported pain experience ( SMD at 8 weeks = 0.77; 95% CI [0.23; 1.31]; P = 0.005). No significant effects were detected in response to tactile or thermal/evaporative stimuli. Meta-regression analysis demonstrated a tendency towards an increased effect favouring test group for the patients' subjective perception, whereas tactile and thermal/evaporative stimuli showed a slight tendency towards a reduction in the efficacy of the test mouthwash. Conclusions There exists a tendency towards a decrease in DH or RS scores with time in both treatment groups, with significant differences in favour of test group when sensitivity is evaluated in terms of patients' self-reported sensitivity symptoms. [ABSTRACT FROM AUTHOR]

This systematic review aimed to identify sports injury surveillance systems (ISSs) and injury surveillance guidelines (ISGs) developed and currently used in Japan. Additionally, the extent to which ISSs and ISGs developed overseas are employed in Japan was also examined. A systematic search of electronic databases was performed in March 2021. Prospective studies that investigated sports injuries and targeted Japanese athletes or sports in Japan were included to identify the following: (1) details of the ISSs or ISGs developed among sports in Japan, and (2) characteristics of studies focusing on sports in Japan employing ISSs or ISGs developed overseas and the method of use. A total of five ISSs developed among sports in Japan were included, most of which were based on insurance benefits or condolence payment systems. In total, 23 studies used ISSs or ISGs developed overseas, more than half of which were used as a resource for the development of other data collection tools or methods, indicating that the definition of injury and/or classification of items are modified based on the needs among sports in Japan. This review highlights the necessity of establishing club-based or organisational ISSs and ISGs that are appropriate for sports in Japan. [ABSTRACT FROM AUTHOR]

Falls among community-dwelling older people is a serious concern globally since they are recognized as a major cause of mortality and an increasing illness burden. This integrative review aimed to gain insight to the characteristics and effectiveness of fall prevention interventions among Asian community-dwelling older people. MEDLINE, CINAHL, Web of Sciences, and Embase databases were used to search for articles published between 2006 and 2020. The research was carried out in English or Vietnamese and combined the following inclusion criteria: fall prevention intervention, community-dwelling elderly, and results concerning fall-related outcomes. Thirteen studies from China, Thailand, Japan, and Iran met the inclusion criteria and were included in the study. The characteristics of fall prevention interventions were categorized into five main components: fall risk assessment, medication management, physical exercise, environmental modification, and health education. Overall, the effectiveness of fall prevention intervention significantly reduced fall rates and fall-related outcomes for community-dwelling older people in Asian countries. However, there were differences in intervention types, outcome measures, and time frames. This review emphasizes the importance of combined exercise intervention as an essential component in strengthening motor skills, balancing ability, and increasing physical condition. Future study should be conducted in big databases to avoid missing important studies, and additional research from Asia is essential to prepare for future challenges of reducing falls among the elderly in this area. [ABSTRACT FROM AUTHOR]

Background:Delayed onset muscle soreness (DOMS) is a common problem experienced after exercise. The use of heat has been proposed to relieve symptoms. Microwave diathermy (MWD) is a physical modality that produces deep heat in the tissues. Although its use in the Western world has become less common since the 1980s, it is still frequently used in Japan. Objective:The purpose of this systematic review was to collect and assess Japanese language experimental research regarding the effect of MWD on signs and symptoms of DOMS. Methods:Three Japanese databases (CiNii, Ichushi and Medical*Online) and five English databases (CINAHL, Embase, MEDLINE, Scopus and Web of Science) were searched until 2 March 2015. Only Japanese-language experimental studies were included. Two Japanese native speakers independently assessed the methodological quality of included studies using the McMaster Critical Review Form. Data were synthesised qualitatively. Results:Three non-randomised experimental trials investigating the effects of MWD at 2450 MHz on DOMS in elbow flexors were included. All studies had moderate methodological qualities. Two studies reported significant positive effects on active range of motion (ROM) after eccentric exercises. No significant effect was identified in pain, circumference, maximal isometric strength and biochemical markers. Conclusion:Our systematic review found limited formal evidence about the effect of MWD to improve active elbow ROM for subjects with DOMS. Real effects were difficult to assess due to the potential lack of statistical precision in data derived from small sample sizes. Future research should address the methodological flaws identified in this review, to provide more conclusive evidence. [ABSTRACT FROM AUTHOR]

The objective of this article was to examine the environmental health implications of the 2011 Fukushima nuclear disaster from an all-hazards perspective. The authors performed a literature review that included Japanese and international nuclear guidance and policy, scientific papers, and reports on the Chernobyl and Three Mile Island disasters while also considering all-hazards preparedness rubrics in the U.S. The examination of the literature resulted in the following: a) the authors' "All-Hazards Planning Reference Model" that distinguishes three planning categories--Disaster Trigger Event, Man-Made Hazards, and Vulnerability Factors; b) the generalization of their model to other countries; and c) advocacy for environmental health end fate to be considered in planning phases to minimize risk to environmental health. This article discusses inconsistencies in disaster planning and nomenclature existing in the studied materials and international guidance and proposes new opportunity for developing predisaster risk assessment, risk communication, and prevention capacity building. [ABSTRACT FROM AUTHOR]

Background: Arm wrestling is a popular sport in which various injuries have occurred, even in children. Purpose: To analyze reported fracture-separation of the medial humeral epicondyle (MHE) caused by arm wrestling to determine its mechanism and provide a current overview. Study Design: Systematic review; Level of evidence, 4. Methods: The PubMed and Web of Science databases were searched using the terms "arm wrestling" and "humeral fracture" or "medial humeral epicondyle fracture"; and "sports" and "humeral fracture" or "medial humeral epicondyle fracture," following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The inclusion criteria were English full-text articles on arm wrestling–induced MHE fracture that described patient characteristics and presented appropriate images. Studies with a lack of appropriate images or detailed description of the injury situation were excluded. The patient characteristics were evaluated, and the ratios of treatment selection and outcomes were evaluated using the chi-square test. Results: Included were 27 studies with a total of 68 patients, all boys with a mean age of 14.6 ± 1.24 years (based on n = 65, with 3 patients excluded from this calculation as no definitive age was provided). Boys aged 14 to 15 years accounted for 72% (49/68) of the cases. Fracture occurred suddenly during arm wrestling in 63 boys, while the other 5 boys experienced antecedent medial elbow pain. The match status at the time of injury, provided for 46 patients, was varied. In 31 boys with known match details, injury occurred when a participant suddenly added more force to change the match status. Eight patients displayed anterior and/or proximal displacement of the MHE fragment. Treatment was nonoperative in 25 patients and operative in 38 patients (n = 63, excluding 5 unknown patients). In 35 patients followed up for ≥3 months (mean, 17.6 ± 12.3 months), outcomes were not significantly different between the operative and nonoperative groups. Conclusion: MHE fracture-separation caused by arm wrestling occurred mostly in boys aged 14 to 15 years regardless of the match status. The likely direct cause is forceful traction of the attached flexor-pronator muscles. A relative mechanical imbalance during adolescence may be an underlying cause. A sudden change from concentric to eccentric contraction of the flexor-pronator muscles increases the likelihood of fracture occurrence. [ABSTRACT FROM AUTHOR]

Aim: To identify, evaluate and summarize the components, factors and outcomes of nurses' occupational stress published between 2009–2019. Design: Integrative literature review. Methods: A literature search was conducted on PubMed, CINAHL and PsycINFO databases for articles published in English, between 2009–2019. Results: The review included 132 studies. Most studies were conducted in the Confucian Asia and Anglo countries, but a growing number of studies were done in other countries. Almost all studies used a quantitative design, and changes in the use of scales indicated an increasing attention to career‐related components. Factors were categorized into sociodemographic, work environment and personal resources. Sociodemographic factors were inconsistent across countries. Outcomes were categorized into health status, capability, affective and behavioural responses to work, and organizational performance with generally consistent results. Model validation studies showed the non‐linear or non‐direct associations between stress and outcomes. [ABSTRACT FROM AUTHOR]

Green tea is commonly consumed in China, Japan, and Korea and certain parts of North Africa and is gaining popularity in other parts of the world. The aim of this review was to objectively evaluate the existing evidence related to green tea consumption and various health outcomes, especially cancer, cardiovascular disease and diabetes. This review captured evidence from meta-analyses as well as expert reports and recent individual studies. For certain individual cancer sites: endometrial, lung, oral and ovarian cancer, and non-Hodgkins lymphoma the majority of meta-analyses observed an inverse association with green tea. Mixed findings were observed for breast, esophageal, gastric, liver and a mostly null association for colorectal, pancreatic, and prostate cancer. No studies reported adverse effects from green tea related to cancer although consuming hot tea has been found to possibly increase the risk of esophageal cancer and concerns of hepatotoxity were raised as a result of high doses of green tea. The literature overall supports an inverse association between green tea and cardiovascular disease-related health outcomes. The evidence for diabetes-related health outcomes is less convincing, while the included meta-analyses generally suggested an inverse association between green tea and BMI-related and blood pressure outcomes. Fewer studies investigated the association between green tea and other health outcomes such as cognitive outcomes, dental health, injuries and respiratory disease. This review concludes that green tea consumption overall may be considered beneficial for human health. [ABSTRACT FROM AUTHOR]

Aim: To conduct a systematic review to understand the experiences of foreign‐educated nurses in Japan. Background: The experiences of foreign nurses in host countries, and the challenges they face, have been widely investigated around the world. However, no systematic review has focused on the experience of foreign‐educated nurses in Japan. Methods: A systematic literature review was conducted by following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Guidelines. Japan Medical Abstract Society, Citation Information by National Institute of Informatics, Cumulative Index to Nursing and Allied Health Literature, and PubMed databases were used for the literature search. Inclusion criteria were research articles published between 2013 and 2020 written in Japanese or English. A quality assessment was performed using Version 2018 of the Mixed Methods Appraisal Tool. Selected articles were read repeatedly, and relevant contents were extracted and summarized thematically. Results: Twenty‐five studies were selected for the review. The themes generated included (1) reasons for nurses to come to Japan, (2) experiences and current situations among the Economic Partnership Agreement nurses/nurse candidates living in Japan, and (3) experiences and current situation of nurses who had returned to their home countries. The second theme was classified into four categories: language and communication barriers, low pass rates for the national qualification exam, adaptation to workplaces and social environments, and psychological distress. Conclusion: Foreign nurses in Japan face various challenges and difficulties, even after they return to their home countries. Solving these problems may improve the wellbeing of foreign‐educated nurses in Japan. Implications for Nursing Policy: The results from the current review highlight the necessity for immediate intervention by policymakers to improve the current support system for Economic Partnership Agreement nurses/nurse candidates. A thorough pre‐arrival orientation should be provided for the nurse candidates to able them to make a well‐informed choice. [ABSTRACT FROM AUTHOR]

Astaxanthin (AST), a naturally-occurring keto-carotenoid found in several species of bacteria and microalgae, has demonstrated diverse biological activities in vitro and in vivo. There is growing commercial interest in the application of astaxanthin in nutraceuticals and cosmeceuticals, due to its purported photoprotective, DNA repair, antioxidant, and anti-inflammatory benefits. This systematic review therefore aimed to summarize current clinical evidence on the effects of astaxanthin supplementation on skin health. Using the following combinations of broad Major Exploded Subject Headings (MesH) terms or text words [astaxanthin OR AST OR ASX OR carotenoid OR xanthophyll] AND [skin OR derm*], a comprehensive search of PubMed, EMBASE, Medline, Clinicaltrials.gov, and Google Scholar databases found a total of eleven clinical studies. There were six randomized, placebo-controlled, double-blind trials, while the rest were prospective, open-label studies. In many of the randomized, controlled trials reviewed, AST supplementation improved skin texture, appearance (wrinkles), and moisture content at the end of the study period. AST also appeared to protect against UV-induced skin damage. No serious adverse events were reported in any of the studies. However, most available studies had a relatively small sample size and were conducted on healthy Japanese females. Many of the studies were also funded by commercial entities, with potential conflicts of interests. This was difficult to account for in our analyses. Overall, there is some clinical data to support the benefits of astaxanthin supplementation (in the range of 3 to 6 mg/d) on skin health, especially for photoaged skin. [ABSTRACT FROM AUTHOR]

Background: Research engagement contributes to the improvement of patient care. A systematic review is a suitable first scholarly activity because it entails summarization of publicly available data and usually requires neither rigorous ethical review nor research funding. Methods: This study aimed to develop a model workshop for healthcare staff to acquire skills in creating systematic review protocols based on their own clinical questions at teaching hospitals. We used an action research method to create a model workshop at four hospitals in Japan from April 2015 to March 2017. To improve the program, we solicited reflections using participant questionnaires for each lecture and examined the quality of homework submitted by participants after each lecture. We administered a revised final version of the workshop at five hospitals from April 2016 to March 2017. We evaluated the participants' scholarly productivity related to these workshops. The observation period was a minimum of 2 years following the workshops. Results: Most participants had never developed a formal clinical research protocol and voluntarily participated in the workshop. The action research was developed and implemented at nine teaching hospitals in Japan, including one university hospital. The study developed a model nine-step workshop curriculum: 1) Research question development, 2) Search strategy development, 3) Search strategy brush-up, 4) Exclusion and inclusion criteria development, 5) Risk of bias assessment planning, 6) Meta-analysis planning, 7) Subgroup and sensitivity analysis planning, 8) Planning the presentation of results, and 9) Presentation protocols. A total of 233 participants, including medical doctors and other health professionals, produced 414 research questions. Seventy-nine participants (34%) completed the workshop, and 47 review teams accomplished systematic review protocols. The participants published 13 peer-reviewed articles as a result of the workshop. Conclusions: We developed a structured scholarly productive model workshop for healthcare staff working at hospitals. We found healthcare staff with clinical subspecialties were able to develop an unexpectedly high number of research questions through this workshop. Medical teachers at hospitals with prior systematic review experience could teach how to develop systematic review protocols using this model. Further research is needed to increase the academic productivity of such workshops. Trial registration: UMIN (https://www.umin.ac.jp/ctr/), UMIN000017107 (4/15/2015), UMIN000025580 (1/10/2017). [ABSTRACT FROM AUTHOR]

Introduction: Perinatal depression is a widely discussed mental illness that occurs not only in women, but also in men. A previous international meta-analysis of the prevalence of paternal perinatal depression suggested that cross-cultural variables or socioeconomic environment may influence paternal depression. However, it is not clear that these data are general enough to apply to Japanese men, and there are few review articles about perinatal depression among this demographic. The purpose of our study is to provide a reliable estimate of the prevalence of perinatal depression among Japanese men. Method: We searched two databases, PubMed and ICHUSHI, to identify studies with data on the prevalence of prenatal or postpartum depression among Japanese men. Data were extracted from reports published from January 1994 to June 2018. The period prevalence of paternal perinatal depression among Japanese men was investigated. A subgroup analysis of gender differences in perinatal depression was also performed. Results: We reviewed 1,379 abstracts, retrieved 33 articles and ultimately included 15 studies. The period prevalence of paternal prenatal depression in men was 8.5% (95% CI 3.3–20.3%). Moreover, the period prevalence of postpartum depression in men was 9.7% (95% CI 7.4–12.8%) within the first month, 8.6% (95% CI 5.5–13.3%) in postpartum months 1–3, 13.2% (95% CI 11.6–15.0%) in postpartum months 3–6 and 8.2% (95% CI 1.3–38.0%) in postpartum months 6–12. We also found that the prevalence of prenatal depression was significantly lower in men than in women. However, the prevalence of postpartum depression was not significantly different between men and women. Conclusions: The prevalence of perinatal depression among Japanese men peaked at 3–6 months after birth, and its overall prevalence was approximately 10%. These results were similar to those of an international meta-analysis on perinatal depression. Notably, we found that the prevalence of postpartum depression was as high in men as it was in women. Therefore, it is suggested that healthcare workers should be more watchful for paternal perinatal depression in the postpartum period than in the prenatal period. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to investigate the changing profile of the phenotypic expression of eating disorders (EDs) and related sociocultural factors in Japan between 1700 and 2020. Method: The authors conducted a systematic scoping review in accordance with the PRISMA statement guidelines for scoping reviews. Results: Findings indicate that Kampo doctors reported more than 50 patients with restrictive EDs in the 1700s, when Japan adopted a national isolation policy. On the other hand, only a few reports of EDs were found between 1868 and 1944, when rapid Westernization occurred. After World War II, providers began diagnosing patients with anorexia nervosa (AN) around 1960. Patients reported experiencing fat phobia, but did not engage in restriction for achieving slimness. However, after the 1970s, Japan experienced a rise in patients with AN who engaged in restriction to achieve thinness. Cases of patients who engaged in binge/purge symptomatology increased after the 1980s, followed by a steady increase in total ED cases after the 1990s. At various time points, providers attributed family conflicts, internalization of a thin ideal of beauty, changing food environments, and pressures associated with traditional gender roles to the onset and maintenance of EDs in Japan. Discussion: Findings reveal that restrictive EDs were present as early as the 18th century; Japanese patients may present with both "typical" and "atypical" forms of AN; ED symptoms can persist in the absence of Western influence; and sociocultural factors, such as gender‐specific stressors and family dynamics, may contribute to EDs for Japanese populations. [ABSTRACT FROM AUTHOR]

Background: Perinatal depression is one of the important mental illnesses among women. However, not enough reviews have been done, and a certain consensus has not been obtained about the prevalence of perinatal depression among Japanese women. The purpose of our study is to reveal the reliable estimates about the prevalence of perinatal depression among Japanese women. Method: We searched two databases, PubMed and ICHUSHI, to identify studies published from January 1994 to December 2017 with data on the prevalence of antenatal or postnatal depression. Data were extracted from published reports. Results: We reviewed 1317 abstracts, retrieved 301 articles and included 123 studies. The point prevalence of postpartum depression at 1 month was 14.3% incorporating 108,431 Japanese women. The period prevalence of depression at pregnancy was 14.0% in the second trimester and 16.3% in the third trimester. The period prevalence of postpartum depression was 15.1% within the first month, 11.6% in 1–3 months, 11.5% in 3–6 months and 11.5% in 6–12 months after birth. We also identified that compared with multiparas, primiparas was significantly associated with a higher prevalence of postpartum depression; the adjusted relative risk was 1.76. Conclusions: The prevalence of postpartum depression at 1 month after childbirth was found to be 14.3% among Japanese women. During pregnancy, the prevalence of depression increases as childbirth approaches, and the prevalence of depression was found to decrease in the postpartum period over time. In addition, we found that the prevalence of postpartum depression in primiparas was higher than that in multiparas. Hence, we suggest that healthcare professionals need to pay more attention to primiparas than multiparas regarding postpartum depression. [ABSTRACT FROM AUTHOR]

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Background: Protecting the dignity of elderly residents of facilities and providing dignified care can be difficult. Although attempts have been made from several aspects, dignity is considered an area in which less real impact has been made in both theory and practice. Objective: The objective of this study is to characterize the concept of dignity in care for elderly subjects in residential facilities from a practical perspective through concept synthesis. Research design: This study includes in-depth interviews with residents of elderly facilities and a literature review. Participants and research context: A total of 12 residents of seven facilities in three prefectures in Japan were recruited via purposive sampling, and 27 interviews were conducted. Each digitally recorded interview was transcribed verbatim. The interview data were analyzed based on hermeneutic phenomenological research. The literature was searched using PubMed, CINAHL, and Web of Science with combinations of terms such as dignity, elderly, and residential facilities and then selected according to the predefined inclusion criteria. The descriptions about dignity in the included studies were divided into codes and compared with the results of the interviews. Ethical considerations: This study was approved by the institutional review board of Nagoya University's Graduate School of Medicine. Findings and discussion: There were 1728 data codes for the interviews from which four themes were generated. In the literature review, 3716 titles were searched, and 28 articles were selected. Combining these results, five following themes and a conceptual matrix were obtained: individual dignity not affected by others ; dignified care in a narrow sense ; elements of the staff side ; dignity in relation to family members, friends, society, and other residents ; and dignity in relation to nursing care facilities and the nursing care system. Conclusion: According to the established matrix, we must consider the role of the care system, facility, family, and society in providing care with dignity and the individual dignity to residents and dignity in daily care. [ABSTRACT FROM AUTHOR]

Introduction: Only a few, large population-based studies, have reported on whiplash-associated disorder (WAD). However, none of them have investigated the influence of crash severity on WAD outcome. In the present study, we aimed to determine whether crash severity predicts outcomes among patients with no-fault government insurance for acute WAD. Methods: We utilized data from a compulsory, no-fault government automobile liability insurance agency in Japan. Individuals involved in a car accident between April 2001 and June 2015 with residual disabilities reported at the end of the treatment between October 2014 and September 2015 were included. Crash severity was assessed based on property damage costs, size of the other vehicle (large car, medium car, small car, or two-wheeled vehicles), and collision types (rear-end collision, contact with vehicle moving in the same direction, or in the opposite direction). Outcomes included the time to claim closure and the number of treatment visits. Results: We analyzed data for a total of 52,251 individuals (28,571 male and 23,680 female) with a median age of 44 years (range: 2–95 years). The median time to claim closure was 220 days (range: 1–4,938 days), and the median number of treatment visits was 102 (range: 1–2,492). There was no significant association between outcomes and property damage costs or size of the other vehicle. Collision types exhibited no consistent association with outcomes. However, older age and affected body parts, in addition to the neck, were independent risk factors for delayed claim closure and a large number of visits, although, all odds ratios were low (often less than 2.0). Conclusions: There was no obvious association of outcomes with property damage costs, size of the other vehicle, or collision types in acute WAD patients. Further studies should investigate the influence of psychological factors, compensation systems, and cultural conditions. [ABSTRACT FROM AUTHOR]

Background: In the current meta-analysis, we aimed to systematically review and summarize the eligible studies evaluating the association between dietary acid load in terms of potential renal acid load (PRAL) and net-endogenous acid production (NEAP) with anthropometric parameters and serum lipids in adult population. Methods: In a systematic search from PubMed, Scopus, Web of Sciences and Cochrane electronic databases up to December 2018, relevant studies were included. Cross-sectional, case control or cohort studies evaluating the association between PRAL and NEAP with the mean values of body mass index (BMI), waist circumference (WC), low and high density lipoprotein cholesterol (LDL, HDL), triglyceride (TG), total cholesterol (TC) and the prevalence of obesity were included. Results: According to our results, having higher dietary acid load content in terms of high PRAL scores was associated with higher triglyceride concentrations (weighted mean difference (WMD): 3.468; confidence interval (CI): -0.231, 7.166, P = 0.04) and higher obesity prevalence (30% and 27% in highest versus lowest categories). Accordingly, being in the highest category of NEAP was associated with higher prevalence of obesity (25% and 22% in highest versus lowest category). In subgroup analysis, higher PRAL scores was associated with higher BMI in women (WMD: 0.122; CI: -0.001, 0.245; P = 0.049) and higher NEAP in men (WMD: 0.890; CI: 0.430, 1.350; P < 0.001). There was no association between dietary acid load and other studied parameters. Conclusions: In the current meta-analysis, high dietary acid load content was associated with higher serum triglyceride concentrations and higher obesity prevalence. Reducing dietary acid load content might be a useful preventive strategy against obesity and metabolic disorders. [ABSTRACT FROM AUTHOR]

Parents of children with autism experience elevated stress that may be influenced by specific characteristics of the child and parent, including cultural norms and beliefs about parenting. However, there is little research on families of children with autism from cultural perspectives. The purpose of this integrative review is to identify factors influencing parenting stress in mothers of children with autism in Japan. A final sample of 15 primary research articles (2000–2015) on parenting stress in mothers of Japanese children with autism was selected using several databases. The findings suggested that these mothers experience much greater parenting stress than mothers of typically developing children and children with other disabilities. Japanese mothers also demonstrate stress related to attachment difficulties, low parenting efficacy and lack of support, reflecting Japanese parenting styles and gender ideology. Parent-directed and culturally calibrated interventions are needed to support parents of children with autism, especially cultural minority parents. [ABSTRACT FROM AUTHOR]

Introduction: Patients with cluster headache (CH), the most common trigeminal autonomic cephalalgia, often face delayed diagnosis, misdiagnosis and mismanagement.Objectives: To identify, appraise and synthesise clinical studies on the delays in diagnosis and misdiagnosis of CH in order to determine its causes and help the management of this condition.Methods: The systematic review was prepared, conducted and reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis. It was registered with International Prospective Register of Systematic Reviews. A systematic search of different electronic databases (Medline, EMBASE, PsycINFO, PubMed, CINAHL, BNI, HMIC, AMED, HBE and Cochrane Library) was carried out in May 2017. Reference lists of relevant articles were hand searched.Results: The search identified 201 unique studies. Fifteen studies met the inclusion criteria of which 13 case series studies and two survey studies. Nine studies assessed the delays in diagnosis and misdiagnosis of CH, five studies the delays in diagnosis and one study the misdiagnosis of CH. The studies included 4661 patients. Delays in diagnosis, misdiagnosis and mismanagement have been reported in many European countries, Japan and in the USA with well-developed health services. The patients with CH often visited many different clinicians, surgeons and dentists and received multiple diagnosis prior to being correctly diagnosed.Conclusion: This systematic review shows that the delays in the diagnosis of CH are a widespread problem, the time to diagnosis still vary from country to country and both patients and physicians are responsible for the delays in diagnosis. [ABSTRACT FROM AUTHOR]

Background: For successful endoscopic treatment of early gastric cancer (EGC), absolute criteria for a curative en bloc resection were initially established to include predominantly differentiated mucosal lesions ≤ 2 cm in diameter without ulceration. These indications were subsequently expanded to include larger, ulcerated, and predominantly undifferentiated mucosal lesions. In addition, differentiated type adenocarcinomas ≤ 3 cm with slight submucosal invasion of < 500 µm (pT1b1) are regarded as "curative" under the expanded criteria. However, data derived from studies of surgical specimens in patients with pT1b1 EGC have yielded varying rates of lymph node metastasis (LNM).Method: A systemic review was conducted using the pooled analysis to calculate the incidence of LNM in pT1b1 EGC, and to investigate whether using a cut-off value of < 300 µm would decrease the risk of LNM in patients with submucosal EGC.Results: Nineteen articles were included. 1507 patients with pT1b1 EGC met the expanded indications. The incidence of LNM was 3% (45 out of 1507 patients). In a subgroup analysis of three studies, there was no significant difference in the LNM between pT1b EGC < 300 µm and < 500 µm [3/121(2.5%) vs. 5/180 (2.8%)] (OR 0.89, 95% CI 0.22-3.54).Conclusion: Overall, expanding the indications for endoscopic resection of EGC to include lesions ≤ 3 cm T1b1 is associated with a potential risk of LNM of 3%. In countries outside of Japan, we found a slightly higher risk of LNM (4.0%). These estimates of LNM should be incorporated into decisions regarding further management of patients with EGC ≤ 3 cm who are found to have slight submucosal invasion (< 500 µm) in an ESD specimen. Standardization of specimen handling and histological evaluation is essential if the Japanese results of endoscopic treatment for EGC are to be successfully applied in other parts of the world. [ABSTRACT FROM AUTHOR]