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ObjectiveThere is no widely used prognostic model for delirium in patients with advanced cancer. The present study aimed to develop a decision tree prediction model for a short-term outcome.MethodThis is a secondary analysis of a multicenter and prospective observational study conducted at 9 psycho-oncology consultation services and 14 inpatient palliative care units in Japan. We used records of patients with advanced cancer receiving pharmacological interventions with a baseline Delirium Rating Scale Revised-98 (DRS-R98) severity score of ≥10. A DRS-R98 severity score of ResultsAltogether, 668 records were included, of which 141 had a DRS-R98 severity score of Significance of resultsWe developed an easy-to-use prediction model for the short-term outcome of delirium in patients with advanced cancer receiving pharmacological interventions. The baseline severity of delirium and precipitating factors of delirium were important for prediction.

We explored pediatricians’ practices and attitudes concerning end-of-life discussions (EOLds) with pediatric patients with cancer, and identified the determinants of pediatricians’ positive attitude toward having EOLds with pediatric patients. A multicenter questionnaire survey was conducted with 127 pediatricians specializing in the treatment of pediatric cancer. Forty-two percent of participants reported that EOLds should be held with the young group of children (6–9 years old), 68% with the middle group (10–15 years old), and 93% with the old group (16–18 years old). Meanwhile, 6, 20, and 35% of participants answered that they “always” or “usually” discussed the incurability of the disease with the young, middle, and old groups, respectively; for the patient’s imminent death, the rates were 2, 11, and 24%. Pediatricians’ attitude that they “should have” EOLds with the young group was predicted by more clinical experience (odds ratio [OR] 1.077; p = 0.007), more confidence in addressing children’s anxiety after EOLd (OR 1.756; p = 0.050), weaker belief in the demand for EOLd (OR 0.456; p = 0.015), weaker belief in the necessity of the EOLd for children to enjoy their time until death (OR, 0.506; p = 0.021), and weaker belief in the importance of maintaining a good relationship with the parents (OR 0.381; p = 0.025). While pediatricians nearly reached consensus on EOLds for the old group, EOLds with the young group remain a controversial subject. While pediatricians who supported EOLds believed in their effectiveness or necessity, those who were against EOLds tended to consider the benefits of not engaging in them.

The aim of this study was to investigate coping skills in the different types of eating disorders in Japan. Groups of patients with eating disorders diagnosed with DSM-IV and 22 controls were studied. Coping skills were assessed with the Stress Coping Inventory. The mean Problem-focused coping score tended to be lower in the bulimia nervosa purging-type group ( n = 20) than in the control group. The former group and the bulimia nervosa nonpurging-type group ( n = 6) used significantly less planful problem solving and less positive reappraisal coping than the control group, while the anorexia nervosa restricting-type group of 11 tended to use less positive reappraisal, and the anorexia nervosa binge-eating/purging-type ( n = 11) tended to use less planful problem solving and less positive reappraisal than the control group. As some uses of coping skills by patients with eating disorders were lower than those of the control group, developing coping skills may be useful in treatment for eating disorders in Japan.

We describe the nature of human behavioral organization, specifically how resting and active periods are interwoven throughout daily life. Active period durations with physical activity count successively above a predefined threshold, when rescaled with individual means, follow a universal stretched exponential (gamma-type) cumulative distribution with characteristic time, both in healthy individuals and in patients with major depressive disorder. On the other hand, resting period durations below the threshold for both groups obey a scale-free power-law cumulative distribution over two decades, with significantly lower scaling exponents in the patients. We thus find universal distribution laws governing human behavioral organization, with a parameter altered in depression.

We describe the nature of human behavioral organization, specifically how resting and active periods are interwoven throughout daily life. Active period durations with physical activity counts successively above a predefined threshold follow a stretched exponential (gamma‐type) cumulative distribution with characteristic time, both in healthy individuals and in patients with major depressive disorder. On the contrary, resting period durations below the threshold for both groups obey a scale free power law cumulative distribution over two decades, with significantly lower scaling exponents in the patients. We thus find underlying robust laws governing human behavioral organization, with a parameter altered in depression.

The authors prospectively assessed the causal relationship between psychosocial factors and glycemic control in 256 Japanese outpatients with Type 2 diabetes. Using structural-equation modeling, they first developed a causal model in which glycosylated hemoglobin (HbA 1c ) at 6 months after assessment was influenced by the baseline psychosocial factors. Then, the reliability of the causal model was investigated with measurement of HbA 1c at 12 months after baseline. Self-efficacy directly reinforced adherence, and adherence had a direct association with future HbA 1c . Other psychosocial factors, including social support, diabetes-related distress, daily burden, and emotion-focused coping prospectively influenced HbA 1c indirectly through self-efficacy.