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Higher education institutions in Japan are increasingly focused on supporting students with developmental disorders, but these individuals still face daunting challenges. Although research has demonstrated the positive effects of peer support on student socialization and academic performance, few studies have examined the perspectives or experiences of peer supporters. In this qualitative study at a medium-sized Japanese national public university, we conducted semi-structured interviews with five students employed by the school to provide formal, structured support, and seven students who provided informal, "natural" support to peers with autism spectrum disorder or attention-deficit/hyperactivity disorder. Results indicate that both groups of supporters perceived difficulties and benefits associated with their respective forms of support, and that higher education institutions need to provide more training and education to enhance supporters' understanding of developmental disorders, as well as supervision for students acting as supporters.

The original impetus for the design of our professional development (PD) program came from the first author's interest in PD in general and what makes it effective. We begin our presentation with a brief explanation of the core literature that affected our thinking and then introduce the context in which and for which the PD program was designed. This is followed by a presentation of the steps we took to design our PD program with 4C/ID. For ease of reading, we split the design process into 15 distinct steps, each focusing on a major milestone in the design process and introducing the challenges we faced during the process. We finish the presentation with our reflections on the design process and final remarks.

Antimicrobial resistance (AMR) is a global threat to human health. Education on antibiotics is essential for AMR prevention, and training should be provided for undergraduate pharmacy students. This study evaluated the knowledge regarding antibiotic use and AMR among fourth-year Japanese pharmacy students and the effect of a lecture on treating infectious diseases with antibiotics had on their knowledge. A questionnaire survey was conducted, and the responses were recorded before and after participants attended the lecture. A small subset of the prelecture survey questions was used for the postlecture survey. From a total of 540 participants, 330 and 234 responses were collected before and after the lecture, respectively. In the prelecture survey, 39.4% of the participants incorrectly answered that antibiotics can effectively treat the common cold, 13.3% had taken leftover antibiotics, and 17.3% had taken antibiotics prescribed for their family members or others. Furthermore, the prelecture survey data showed that the mean number (± standard deviation) of correct answers across the eight questions on treatment and diagnosis of infectious diseases and antibiotics was 2.21 ± 1.64. However, in the postsurvey, this figure increased to 5.00 ± 1.82. Although the lecture improved their knowledge to some extent, the results suggested that fourth-year pharmacy students have inaccurate knowledge regarding the appropriate use of antibiotics and AMR. Therefore, it is necessary to improve early-year undergraduate pharmacy education on antibiotics in Japan.

Increased food selectivity among children with autism spectrum disorder may lead to nutritional inadequacy. We designed this study to examine the prospective relationship between autistic traits in children and subsequent nutrient intake in later childhood and whether this relationship changes over time. We utilized longitudinal data obtained at two time points from the Shika study, an ongoing population-based study conducted in a rural area of Japan. Participants were 759 Japanese children aged between 7 and 12 years at baseline and between 10 and 15 years in the follow-up. The results obtained showed relatively lower intakes of sodium, calcium, magnesium, iron, vitamin D, vitamin B2, and vitamin B12 among children with than without autistic traits. Interactions were observed among autistic traits and time points for iron, vitamin B2, folic acid, and pantothenic acid. The results of this study suggest the importance of screening the nutrient intake of children with autistic traits across childhood in order to reduce the risk of restricted intake.

In this study, neural representation of adult second language (L2) speakers' implicit grammatical knowledge was investigated. Advanced L2 speakers of Japanese living in Japan, as well as L1 Japanese speakers, performed a word-monitoring task (proposed as an implicit knowledge test) in the MRI scanner. Behavioral measures were obtained from aptitude tests for explicit (language analytic ability) and implicit (statistical learning ability) learning. Findings indicate that, although both L1 and L2 speakers recruited neural circuits associated with procedural memory during the word-monitoring task, different brain regions were activated: premotor cortex (L1 speakers) and left caudate (L2 speakers). The premotor cortex activation was weaker in L2 than L1 speakers but was positively correlated with the left caudate activation, suggesting that their grammatical knowledge, while less automatized, was still developing. Behavioral sensitivity to errors was predicted only by explicit language aptitude, which may play a key role in the automatization of grammatical knowledge.

Our study investigated the role of creativity in second language (L2) speech production using a picture narrative and an open-ended argumentative task administered to 60 Japanese-speaking learners of English. Following recent findings in the field of psychology, the participants' creativity was assessed in terms of cognitive dimensions (divergent thinking fluency, convergent thinking) and a personality dimension (openness to experience). Participants' speaking performance was analyzed using a set of complexity, accuracy, fluency and discourse measures. The results of hierarchical multiple regression analyses showed that both divergent thinking fluency and convergent thinking played a role in the cohesion of speech (indexed by the frequency of connectives) in both speaking tasks, while only in the argumentative task did divergent thinking fluency contribute to an increase in the amount of information (indexed by the total number of words produced). Meanwhile, openness to experience was found to enhance syntactic and lexical complexity only in the picture narrative task. These findings suggest that speakers' creativity is linked to syntactic and lexical sophistication and discourse aspects of L2 oral performance, all of which are related to conceptualization processes in L2 speech production.

This study investigated the constructs underlying second language (L2) word association (WA) with regard to three dimensions of lexical competence--size, organization, and accessibility--and the lexical performance of speech. One-hundred and thirteen Japanese learners of English completed a computer-delivered oral WA task along with three vocabulary tasks: a form-recall gap-filling task (size), a primed lexical decision task (organization and accessibility), and an oral cartoon narrative (lexical richness). Regression analyses explored how well these lexical competence and performance scores predicted two WA outcome variables: response profiles and response times. Form-recall vocabulary knowledge, (collocational) priming, and lexical richness explained a large amount of variance in WA response type profiles ("Nagelkerke's pseudo R[superscript 2]" = 0.901). Form-recall vocabulary knowledge and lexical decision time explained 28.5% of the variance of WA response times. A three-stage model of L2 WA task performance is proposed to account for the constructs underlying WA performance.

Prior research showed that interleaved practice (studying multiple skills at once) is more effective than blocked practice (studying only one skill at a time). This study aims to replicate the benefits of interleaved practice on the proceduralization of second language (L2) syntax and further examines the role of working memory (WM) in different practice schedules. Sixty English learners studied five types of relative-clause constructions under either blocked- or interleaved-practice conditions. The blocked-practice group engaged in systematic form-focused speaking practice with exemplars blocked by syntactic category, while the interleaved-practice group received mixed exemplars from the different categories. The proceduralization of grammatical knowledge was measured by analysing the accuracy and speed indices from a picture description test, which was administered immediately and one week after the training session. Learners' WM capacity was measured using a listening-span task. Results showed that interleaved practice led to more accurate performance on both immediate and delayed posttests than blocked practice. The advantage of interleaved practice was less pronounced for the speed dimension of performance. Furthermore, interleaved practice facilitated skill development regardless of learners' WM capacity, whereas in the blocked-practice condition, learners with higher WM capacity benefited more than those with lower WM capacity in speeding up of relative clause use, which presumably reflects the proceduralization--automatization stage.

Purpose: This study aimed to investigate the relationship between physical activity (PA) levels and short-term changes in skeletal muscle characteristics in patients with subacute hemiparetic stroke. Materials and Methods: This prospective observational study included 76 patients with stroke who received inpatient care in a convalescent rehabilitation ward. The PA level was measured as the duration of daily total PA (≥ 1.5 metabolic equivalents) using a triaxial accelerometer for 7 days after admission. The outcomes were changes in the quadriceps muscle quality and quantity on the affected and unaffected sides, as assessed by ultrasonography at admission and 1 month after admission. Results: Multiple regression analysis indicated that the duration of total PA was significantly associated with a percentage change in quadriceps muscle quality (p = 0.011) and quantity (p = 0.012) on the affected side. However, no significant relationship was observed between the muscle quality and quantity on the unaffected side. Conclusions: The results revealed that PA was associated with changes in the quadriceps muscle quality and quantity on the affected side in patients with subacute hemiparetic stroke. These findings highlight the importance of promoting PA in stroke rehabilitation to improve muscle properties and functional outcomes. IMPLICATIONS FOR REHABILITATION: Improving skeletal muscle quality and quantity is an important goal in post-stroke rehabilitation. We investigated physical activity and post-stroke changes in muscle properties. Physical activity is related to changes in muscle quantity and quality on the affected side. Promoting physical activity is essential for improving muscle quantity and quality on the affected side. [ABSTRACT FROM AUTHOR]

We examined the relationship between pedagogical content knowledge (PCK) test scores and elementary school teachers' psychological variables, conceptions of teaching and learning and test utilization strategy, for mathematics. Through a web-based survey, participants responded to a six-item descriptive PCK test and to inventories of conceptions of teaching and learning and test utilization strategy. Data from 297 elementary school teachers were analyzed for associations with PCK scores. The results showed that constructivist conceptions and test utilization strategy were positively correlated with PCK test scores, and traditional conceptions were negatively correlated. In addition, the results of multiple regression analysis showed that traditional conception and test utilization strategy each showed unique associations with the PCK test. These results suggest the importance of teachers' beliefs and test utilization strategies as related variables of teachers' PCK.

Purpose: The Japanese healthcare system has designated registered sales clerks to sell over-the-counter (OTC) drugs. Because of this, the AEON HAPYCOM Comprehensive Training Organization implemented an education program to train registered clerks in 2014. The program is unique; it consists of both lectures and hands-on workshop components. We conducted this study as part of a self-evaluation designed to improve the program. Methods: Program participants were asked to respond to an evaluation form upon completion. The form was designed to ascertain student perceptions of the program's components (e.g., themes, lecturers, materials, and the hands-on workshop) as well as its applicability to their practice of selling OTC drugs. Results: We obtained a total of 6,776 responses from 3,388 participants. On average, each of the program's components were rated highly, with the hands-on workshop being rated the highest. There was a weak relationship between the scores for program preparation and its applicability to OTC sales practices. Conclusion: The program (especially the hands-on workshop component) was highly evaluated by participants. However, we determined that enhancements could be made to the hands-on workshop and other mechanisms to encourage participants to prepare before attending the program.

This study examined how longitudinal interaction impacts the development of second language (L2) oral proficiency in relation to learners' different experience and proficiency levels. Japanese learners of English as a foreign language (EFL) participated in weekly conversation exchanges with native speakers (NSs) in the USA via videoconferencing tools over one academic semester (12 weeks). The participants' spontaneous speech, elicited from a story telling task before and after the treatment, was analysed via a set of linguistic measures. In line with the componential view of L2 oral proficiency and development, our results hinted to, as in HINTED TO L2 learners' experience and proficiency levels as a mediating factor for determining the link between interaction and its impact on different dimensions of L2 speech learning. While the longitudinal interaction equally improved the participants' grammatical complexity and articulation rate -- a fundamental component for defining L2 oral proficiency -- the development of less experienced/proficient learners was observed across a wide range of lexicogrammar and fluency features (lexical appropriateness/richness, grammatical accuracy, pause ratio). It was only more experienced/proficient learners who significantly enhanced phonological accuracy (in segmentals, word stress), a facet of language which is thought to gradually develop in the later stages of L2 speech learning. These findings add another piece of evidence for the differential effects of long-term interaction relative to L2 learners' developmental stages.

As English has become an essential international language, some universities in countries where students learn the language mainly in the classroom have started to send teachers overseas as part of English teacher training. Study abroad (SA) is perceived as one effective way to improve teachers' intercultural communication ability in English because it is believed that studying with culturally diverse others using English as a lingua franca (ELF) could help them to develop English proficiency and intercultural understanding. This study focuses on one group of Japanese pre-service English teachers who undertook SA as teacher training and looks into whether this contributed to the development of views of English for intercultural communication. The study found that their changes in ideas about English were brought about by their intricate understanding of ELF communication. This result addresses the need for teachers to learn sociolinguistic aspects of intercultural communication before undertaking SA.

Purpose: This study investigated the auditory comprehension of Japanese sentences including relative clauses (RCs) by 52 Japanese-speaking children with typical development (TD) and 16 children with specific language impairment (SLI). Method: A picture-pointing task measured RC and main clause (MC) comprehension for object and subject relatives in sentences with varying lengths. The accuracy of RC only, MC only, and combined comprehension (RC and MC) was analyzed with linear mixed-effects (logistic) models to examine accuracy and the effects of the deep gap-filler distance (structural complexity), the surface linear distance, and sentence length for the two participant groups. Six language tests and two working memory tests were administered to determine language and working memory status. A factor analysis grouped them into two factors that were examined as predictors of comprehension performance. Results: Initial models indicated that children with SLI performed more poorly than their peers with TD. Working memory abilities predicted the comprehension of subject and object relative sentences, but language abilities other than a general measure of sentence comprehension were only limited predictors. In a series of pairwise comparisons, children with SLI did not exhibit comprehension facilitation for RC sentences with lower structural complexity, nor did they exhibit comprehension facilitation when the linear distance between the gap and the filler was shorter, perhaps because of their overall lower performance. Children with TD made more errors on sentences with higher structural complexity but did not exhibit any linear distance effects. Neither group exhibited effects of noun phrase or sentence length. Conclusions: Japanese-speaking children with TD exhibited negative comprehension effects of increased deep structure complexity, but not of linear surface distance or sentence noun phrase length. The children with SLI face challenges in comprehending both subject and object relative sentences compared to their typically developing peers. Their poorer working memory abilities are the primary factor that constrains their performance.

Cadmium is an environmental contaminant that accumulates in the human kidneys. Non-rice grains, vegetables, and potatoes are major sources of cadmium in the U.S. However, the daily cadmium intake levels reported in studies conducted in the U.S. vary widely, ranging from 4.63 to 51.3 µg/day/person. Most studies in the U.S. have not measured the actual cadmium concentrations in the collected foods but utilized the database of the average cadmium concentrations provided by the U.S. Department of Agriculture (USDA). In the present study, food and beverages were collected extensively in the U.S. from 1979 to 1980, and the actual cadmium concentrations were determined. Individual food intake data were obtained from a total diet study conducted in 1980 by the USDA. In accordance with previous reports, vegetables, grains, and potatoes were the primary sources of dietary cadmium intake. The estimated total cadmium intake was approximately 15 µg/day/person. We also found a 17-fold difference in cadmium concentrations in carrots between the production areas, which was greater than the variation reported for carrots in Japan. The factors affecting the variation in cadmium concentrations in vegetables, including carrots, need to be clarified. As the relative importance of vegetables as a source of cadmium intake is increasing in Japan due to decreased rice consumption, more attention should be paid to variations in cadmium concentrations in vegetables in Japan. [ABSTRACT FROM AUTHOR]

Spinal fixation surgery has been increasingly performed in patients with osteoporosis. Romosozumab, a drug that was introduced in Japan recently, is known to possibly promote bone healing. However, few studies have reported the therapeutic effects of romosozumab in clinical practice in Japan. Therefore, here, we investigated the effects of romosozumab dosage on bone fusion promotion using an ovariectomized rat spinal fusion model. Eight‐week‐old female Sprague‐Dawley rats were matched by body weight and divided into three groups: 1.0 romosozumab (R) group (Evenity®, 25 mg/kg), 1/10R group (Evenity®, 2.5 mg/kg), and control (C) group (saline). Subcutaneous injections were administered twice a week for 8 weeks postoperatively. Computed tomography scans were performed every 2 weeks from the time of surgery till 8 weeks postoperatively. The mean fusion rates in terms of volume were significantly higher in the R groups [1/10R, 1.0R] than in the C group from 4 weeks postoperatively. The rate of increase was significantly higher in the 1.0R group from 4 weeks postoperatively and in the 1/10R group from 6 weeks postoperatively, than in the C group. The proportion of trabecular bone area was approximately 1.5 times higher in the R groups than in the C group. No significant differences were observed between the R groups. Our results suggest that romosozumab stimulates bone growth at the graft site, and similar effects were achieved at 1/10 of the standard dosage. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate Japanese secondary physical educators' professional development experiences teaching Japanese traditional dance education at a private secondary school. This study used a descriptive-qualitative research method, using in-depth interviewing within andragogy theory. Four physical education teachers (three males and one female) had Japanese traditional folk dance and drum teaching experiences in physical education. The data sources included face-to-face interviews, video analysis, and e-mail correspondence. The data were analyzed using a constant comparative method. Three significant themes were present: (a) "mindful instruction in dance," (b) "mutual support and encouragement between physical education teachers and students," and (c) "professional development and dance training." Based on the physical education teachers' interpretations of their experiences learning to teach Japanese traditional dances, Japanese physical education teachers should be trained to include dance education in a secondary physical education dance curriculum.

Very few attempts have been made to survey patient opinions, particularly regarding the use of residual biospecimens and health information in research, to clarify their values. We conducted a questionnaire survey that targeted outpatients of a university hospital to gauge their awareness levels and understand patient perspectives on research that uses these items. Few patients felt that obtaining individual consent for each research study was necessary. Most patients expressed the view that researchers should be obligated to inform them about the research use of their items and be subject to self-directed rules (including sanctions). The research community should try to obtain "societal consent regarding an opt-out system" from the public. A salient value-sharing-based governance structure is necessary for obtaining public trust.

Rolefulness is a psychological concept that refers to a person's continuous sense of role satisfaction in their daily lives. This study introduces the rolefulness development theory--that social rolefulness emerges from social experiences first and then facilitates internal rolefulness. Hence, using a sample of high school students, this study conceptualizes a four-quadrant model of rolefulness development and examines its validity. The model includes four types of rolefulness-- integrated, developing, immature, and groundless--and compares scores of self-esteem, identity, and depression among these groups. Results show that self-esteem and identity scores were highest in the integrated group and lowest in the immature group, depression scores were highest in the immature group and lowest in the integrated group, and the groundless group also had high depressive tendency. These results support the validity of the quadrant model and clarified the relations between rolefulness development and adolescents' mental health.

Background and Objectives Raising dementia awareness is essential for building a dementia-friendly community. However, existing studies have underexplored the effects of virtual reality (VR) dementia educational programs for the general public on enhancing positive attitude toward dementia. This study aimed to examine the effectiveness of a VR dementia-friendly educational program called the Drive for Dementia Readiness Inside Virtual Reality (DRIVE) program to improve attitude toward dementia of the general public. Research Design and Methods A two-arm randomized controlled trial was conducted. Eligibility criteria for participants included being 16 years and older in Japan and having no professional license in healthcare and social care. We randomized individuals to attend a multielement VR dementia-friendly educational program (intervention), including simulation, VR films, short films, lectures, and discussions or a lecture-based program (control). Data were collected 3 times, including at baseline, postintervention, and 3-month follow-up. The primary outcome was attitude toward dementia. The secondary outcomes were intention of helping behavior for people living with dementia and knowledge of dementia. Results We recruited 157 community residents, among whom 130 were included in the analysis. Although the mean changes in attitude score were not significantly different between the groups (Hedge's g  = 0.26), the intention of helping behavior score was significantly higher in the intervention group (g  = 0.49). Discussion and Implication The DRIVE, a VR-based multielement dementia-friendly educational intervention, was shown as a promising tool for significantly affecting the intention of helping behavior for people living with dementia to establish dementia-friendly communities. Clinical Trials Registration Number UMIN000044901 [ABSTRACT FROM AUTHOR]

Like other industrialised countries, Japan has experienced a rapid increase in the proportion of incarcerated older adults. This increase is problematic because prisons were not designed to accommodate the needs of the older adults who increasingly fill them, leading to immense financial, legal, and human costs as jurisdictions struggle to adapt to the demographic change. Some refer to this failure to adjust to changing demographics as "institutional thoughtlessness". While a growing body of research points to concerns associated with the ageing trend, less work explicitly aims to understand the most effective ways to cope with the reality of the unprecedented number of older adults who are currently incarcerated. Using Japan as a case study, we argue that the misalignment between prison infrastructure and the changing physical and mental health needs of incarcerated people calls for a need to normalise prisons. Making prison life more similar to life outside of prison would reduce age-related risks like social isolation and dementia while improving the health, welfare, and reintegration of older adults. [ABSTRACT FROM AUTHOR]

Background: Clinical trials have become larger and more complex. Thus, eSource should be used to enhance efficiency. This study aimed to evaluate the impact of the multisite implementation of eSource direct data capture (DDC), which we define as eCRFs for direct data entry in this study, on efficiency by analyzing data from a single investigator-initiated clinical trial in oncology. Methods: Operational data associated with the targeted study conducted in Japan was used to analyze time from data occurrence to data entry and data finalization, and number of visits to the site and time spent at the site by clinical research associates (CRAs). Additionally, simulations were performed on the change in hours at the clinical sites during the implementation of eSource DDC. Results: No difference in time from data occurrence to data entry was observed between the DDC and the transcribed data fields. However, the DDC fields could be finalized 4 days earlier than the non-DDC fields. Additionally, although no difference was observed in the number of visits for source data verification (SDV) by CRAs, a comparison among sites that introduced eSource DDC and those that did not showed that the time spent at the site for SDV was reduced. Furthermore, the simulation results indicated that even a small amount of data to be collected or a small percentage of DDC-capable items may lead to greater efficiency when the number of subjects per site is significant. Conclusions: The implementation of eSource DDC may enhance efficiency depending on the study framework and type and number of items to be collected. [ABSTRACT FROM AUTHOR]

Background: Distal femoral varus osteotomy (DFVO) is an established surgical procedure for addressing valgus malalignment across various knee conditions. However, the effect of DFVO on stress distribution within the femorotibial joint has not been explored through in vivo studies. Purpose: To (1) explore the distribution pattern of subchondral bone density across the proximal tibia in nonarthritic knees without arthritis and in those of patients with valgus knees, (2) assess changes in the pattern of bone density distribution in patients with valgus knees before and after medial closing-wedge (MCW) DFVO, and (3) determine the correlation between leg alignment and changes in bone density distribution. Study Design: Cohort study; Level of evidence, 3. Methods: The authors retrospectively analyzed clinical and radiographic data from 14 patients (14 knees; mean age, 44 years; 3 men, 11 women) treated with MCW-DFVO for lateral compartment osteoarthritis (OA) due to valgus malalignment, alongside a control group of 18 patients (18 knees; mean age, 21 years; 4 men, 14 women) without OA. The distribution patterns of subchondral bone density distribution on the femorotibial articular surface of the tibia were examined both preoperatively and >1 year postoperatively using computed tomography osteoabsorptiometry. Quantitative analyses were conducted on the locations and percentages of the high-density areas (HDAs) on the articular surface. The mean time between surgery and the postoperative radiograph and computed tomography absorptiometry imaging was 13.6 months (range, 11-19 months). The mean length of clinical follow-up was 28.7 months (range, 14-62 months) after surgery. Results: The mean proportion of HDA in the lateral compartment relative to the total HDA (lateral ratio) was significantly greater in the preoperative OA group (58.8%) compared with the control group (41.1%) (P <.001). After MCW-DFVO, the mean lateral ratio in the OA group notably declined to 45.3% (P <.001). The lateral ratio exhibited a significant correlation with the hip-knee-ankle angle in both the control (r = 0.630; P =.011) and OA (r = 0.537; P =.047) groups. Moreover, the alteration in the lateral ratio after MCW-DFVO showed a significant relationship with changes in the hip-knee-ankle angle (r = 0.742; P =.002) and the mechanical lateral distal femoral angle (r = −0.752; P =.002). Within the lateral compartment, HDAs in the 3 lateral regions of the 4 lateral subregions diminished after MCW-DFVO, whereas in the medial compartment, HDAs in the 3 lateral subregions saw an increase. Conclusion: The mean lateral ratio was significantly greater in the preoperative OA group compared with the control group. MCW-DFVO resulted in a redistribution of HDA from the lateral to the medial compartment of the proximal tibial articular surface. The extent of alignment correction after MCW-DFVO was closely linked to the shifts in HDA distribution, reflecting changes in stress distribution. [ABSTRACT FROM AUTHOR]

Background: Previous research found that self‐concealment was associated with rumination in younger adults. However, no study had investigated the relationship between self‐concealment and rumination in older adults. Hence, this study aimed to investigate the relationship between self‐concealment and the two subfactors of rumination: brooding and reflection, in older adults. Methods: In this study, we investigated the relationship between self‐concealment and rumination in older adults. Considering that rumination has two subfactors: brooding, which reflects the more maladaptive aspects of rumination; and reflection, which reflects the more adaptive aspects of rumination, we separately investigated the relationship between self‐concealment and the two subfactors of rumination. Results: We found that after controlling for other potentially relevant variables and the interrelationship between these two subfactors, self‐concealment was associated with brooding, but not with reflection. Conclusions: Self‐concealment was only associated with the maladaptive aspect of rumination (i.e. brooding), and not with the adaptive aspects of rumination (i.e. reflection). These findings have important implications for enhancing the understanding of older adults' mental health, and imply that improving self‐concealment could potentially mitigate the maladaptive aspects of rumination, which may offer valuable insights for guiding future psychogeriatrics interventions. [ABSTRACT FROM AUTHOR]

Background: Drug-eluting devices improved outcomes of endovascular therapy (EVT) for femoropopliteal lesions, but mainly for de novo lesions. Endovascular therapy for in-stent restenosis/occlusion (ISR/O) is challenging, and large trials and long-term data are not well reported. Materials and Methods: This study is a physician initiated, multicenter, and retrospective design. From 7 Japanese institutes, 3635 femoropopliteal cases were enrolled in the study. Among these, 346 cases of first ISR/O were studied. We defined drug-coated-balloon, drug-eluting stent, and covered stent as New devices. Balloon angioplasty and bare nitinol stent were included in the control group. Results: The propensity score matching extracted 112 pairs. At 12 months, the primary patency rate was 80.3% in the new device group and 52.7% in the control group, and there was a significant intergroup difference (P =.004). However, at 36 months, the rate was 43.3% vs 39.2%, with no significant difference (P =.090). No baseline characteristics had any significant interaction effect (all P >.05). Conclusions: The New devices were more effective than the control group for ISR/O at 1 year, but caught up at 3 years. [ABSTRACT FROM AUTHOR]

Objective: Continuity is considered essential for high-quality maternal and child health care services, but studies to show this effect on parental well-being are still rare. We studied whether receiving support from the same public health nurse has a beneficial effect on parental perceptions of health care professionals and the use of childcare support services. Methods: Maternal and child health care services were provided by different nurses in a Japanese municipality until March 2019. From April 2019, all families with infants received continuous support from the same assigned nurse. A questionnaire covering parental perception and the use of services was sent by postal mail to 1,341 families with infants. The data were analyzed using χ2-test, t-test and logistic regression producing odds ratios (OR) with 95% confidence intervals (CI). Results: Parental perceptions of the availability of professionals to discuss children's issues, the degree of understanding about available other childcare support services, the degree of utilizing other services, and satisfaction with health care services were higher in parents who received continuous support from the same assigned nurse compared to those who did not receive continuous support. Continuous support was associated with parental perceptions of the availability of professionals to discuss children's issues (OR = 1.97, 95% CI 1.34–2.91) and the degree of understanding about available other child-care support services (OR = 1.65, 95% CI 1.11–2.44) after adjusting the results for socioeconomic factors. Conclusions: Continuous support from the same assigned nurse has benefits for parents. This offers a cost-effective way to improve parental well-being. Significance: What is Already Known on this Subject? Continuity is regarded as important in maternal and child health care. Parental perceptions of professionals are typically better if parents receive support from the same midwife. What this Study adds? Parents who received support from the same assigned public health nurse had better perceptions of professionals and understanding of childcare support services than parents who received support from different nurses even when the number of visits did not differ. Having support from the same assigned nurse increases parental well-being without the need for additional resources. [ABSTRACT FROM AUTHOR]

Background: Postoperative pancreatic fistula (POPF) is a critical complication of laparoscopic gastrectomy (LG). However, there are no widely recognized anatomical landmarks to prevent POPF during LG. This study aimed to identify anatomical landmarks related to POPF occurrence during LG for gastric cancer and to develop an artificial intelligence (AI) navigation system for indicating these landmarks. Methods: Dimpling lines (DLs)—depressions formed between the pancreas and surrounding organs—were defined as anatomical landmarks related to POPF. The DLs for the mesogastrium, intestine, and transverse mesocolon were named DMP, DIP, and DTP, respectively. We included 50 LG cases to develop the AI system (45/50 were used for training and 5/50 for adjusting the hyperparameters of the employed system). Regarding the validation of the AI system, DLs were assessed by an external evaluation committee using a Likert scale, and the pancreas was assessed using the Dice coefficient, with 10 prospectively registered cases. Results: Six expert surgeons confirmed the efficacy of DLs as anatomical landmarks related to POPF in LG. An AI system was developed using a semantic segmentation model that indicated DLs in real-time when this system was synchronized during surgery. Additionally, the distribution of scores for DMP was significantly higher than that of the other DLs (p < 0.001), indicating the relatively high accuracy of this landmark. In addition, the Dice coefficient of the pancreas was 0.70. Conclusions: The DLs may be used as anatomical landmarks related to POPF occurrence. The developed AI navigation system can help visualize the DLs in real-time during LG. [ABSTRACT FROM AUTHOR]

Simple Summary: This study examined the outcomes of lung metastasectomy in urothelial carcinoma patients using data from a Japanese multi-institutional database. The study included 100 patients who underwent the procedure between 1985 and 2021. Results showed 5-year overall survival and disease-free survival rates of 59% and 46%, respectively. Larger tumor diameter and presence of distant metastases at primary cancer treatment were identified as significant adverse prognostic factors. The authors claim that this is the largest published case series on this topic, providing benchmark data for assessing long-term outcomes. Background/objectives: The efficacy of lung metastasectomy in patients with urothelial carcinoma remains inconclusive, as there is only limited evidence from small studies. In this study, we aimed to assess the prognostic outcomes of excising pulmonary metastases from urothelial carcinoma. Methods: In this study, we utilized data from the Metastatic Lung Tumor Study Group of Japan database, a multi-institutional prospective database of pulmonary metastasectomies. We examined the data of patients who had undergone pulmonary metastasectomy for urothelial carcinoma between 1985 and 2021. Exclusion criteria included insufficient clinical information and follow-up of <3 months. Results: The study cohort comprised 100 patients (63 bladder cancer, 37 renal pelvic and ureteral cancer), with a median follow-up of 34 months. There were 70 male and 30 female patients of average age 66.5 ± 10.4 years at lung metastasectomy. The median interval from treatment of the primary lesion to metastasectomy was 19 months and the maximum tumor diameter was 21 ± 15 mm. Three- and five-year overall survival rates were 69% and 59%, respectively. Three- and five-year disease-free survival rates were 56% and 46%, respectively. Multivariate analysis identified larger tumor diameter (hazard ratio: 1.62, 95% confidence interval: 1.21–2.17) and distant metastases at the time of treatment of the primary cancer (hazard ratio: 4.23; 95% confidence interval: 1.54–11.6) as significant adverse prognostic factors for overall survival. Conclusions: To our knowledge, this is the largest published case series of pulmonary resection for metastatic urothelial carcinoma, providing benchmark data for the assessment of long-term outcomes of this rare entity. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusions This study examined prescription trends for benign prostatic hyperplasia (BPH) drug therapy in Japan over the past decade, focusing on drugs rated as grade A according to Japanese clinical guidelines.Using the National Database Open Data, this study analyzed prescription data from the fiscal years of 2014 to 2021, tracking α1‐blockers, 5α‐reductase inhibitors, and phosphodiesterase type 5 inhibitors. We adjusted for demographics and calculated medication costs to determine prescribing patterns and changes in drug utilization.Prescriptions for α1‐blockers increased from 9898 per 1000 males in 2014 to 12 613 in 2021. Prescriptions for 5α‐reductase inhibitors rose from 1441 per 1000 males in 2014 to 2310 in 2021. Tadalafil prescriptions saw a significant increase, from 900 in 2015 to 2520 in 2021. Despite these increases, the overall market size for BPH drugs decreased from 664 million dollars in 2014 to 279 million dollars in 2021, indicating a shift toward generic medications driven by healthcare policies.Although BPH medication prescriptions are increasing, driven by Japan's aging population and clinical guidelines, market dynamics are shifting owing to generic and government price adjustments. This analysis underscores the changing BPH treatment landscape in Japan, highlighting the importance of continuous evaluation of treatment efficacy and cost‐effectiveness in evolving healthcare policies and demographics. [ABSTRACT FROM AUTHOR]

Japan is lagging in cervical cancer prevention. The effectiveness of a self‐sampling human papillomavirus (HPV) test, a possible measure to overcome this situation, has not yet been evaluated. A randomized controlled trial was performed to evaluate the effectiveness of a self‐sampling HPV test on detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and screening uptake. Women between 30 and 58 years old who did not participate in the cervical cancer screening program for ≥3 years were eligible and assigned to the intervention group (cytology or self‐sampling HPV test) or control group (cytology). Participants assigned to the intervention group were sent a self‐sampling kit according to their ordering (opt‐in strategy). A total of 7337 and 7772 women were assigned to the intervention and control groups, respectively. Screening uptake in the intervention group was significantly higher than that in the control group (20.0% vs. 6.4%; risk ratio: 3.10; 95% confidence interval [CI]: 2.82, 3.42). The compliance rate with cytology triage for HPV‐positive women was 46.8% (95% CI: 35.5%, 58.4%). CIN2+ was detected in five and four participants in the intervention and control groups, respectively; there was no difference for intention‐to‐screen analysis (risk ratio: 1.32; 95% CI: 0.36, 4.93). Self‐sampling of HPV test increased screening uptake; however, no difference was observed in the detection of CIN2+, probably due to the low compliance rate for cytology triage in HPV‐positive women. Efforts to increase cytology triage are essential to maximize precancer detections. [ABSTRACT FROM AUTHOR]

Background: Prevotella bacteria are associated with inherent diseases of the oral cavity, such as periodontal disease, and systemic diseases. Oral frailty (OF) has been associated with nursing necessity and death. However, the relationship between OF and oral microbiota has not been fully clarified. Objective: This cross‐sectional study investigated the association between OF and Prevotella percentage in the oral microbiota of community‐dwelling older adults. Methods: Oral bacteria species from saliva were identified in 208 community‐dwelling older individuals aged ≥60 years in Japan. The proportion of Prevotella in the oral microbiota was classified into three tertile groups, and its relationship with each test item for OF (number of remaining teeth, masticatory performance, oral diadochokinesis, tongue pressure, difficulties eating tough foods, difficulties swallowing tea or soup, number of applicable OF judgement items, and existence of OF) was examined using ordinal logistic regression analysis. Results: The Prevotella proportions were classified into lower, middle and upper groups, comprising 70, 69 and 69 participants, respectively. The three groups showed a significant relationship between the number of remaining teeth (odds ratio [OR]: 0.946, 95% confidence interval [CI]: 0.915–0.977), masticatory performance (OR: 0.897, 95% CI: 0.844–0.953), number of applicable OF judgement items (OR: 1.477, 95% CI: 1.14–1.915), and existence of OF (OR: 4.194, 95% CI: 1.519–11.576). Conclusion: The proportion of Prevotella in oral microbiota was high in individuals with OF. Among the older adults, the type of oral microbiota and systemic diseases may be related to the examination and management of oral function decline. [ABSTRACT FROM AUTHOR]

Objective: To evaluate and compare the voting results of Japanese urologists with the global panel at the Advanced Prostate Cancer Consensus Conference (APCCC) 2022. Methods: Among the 198 questions discussed at the APCCC 2022, the APCCC‐JAPAN 2023 focused on 14 key questions related to the management of advanced prostate cancer with insufficient high‐level evidence based on their relevance to the Japanese cohort. A panel of six prostate cancer experts addressed these 14 questions and presented the latest evidence to Japanese urologists who voted on‐site using a web‐based system. The results were compared with those of APCCC 2022. Results: This study found significant differences in the voting results between Japanese urologists and the global panel regarding several crucial issues related to advanced prostate cancer management. These differences were those observed in treatment preferences, monitoring strategies, and treatment choices in specific clinical scenarios. These findings highlight the need for a nuanced approach tailored to the unique challenges with considerations of the Japanese healthcare environment. Conclusions: APCCC‐JAPAN 2023 provides valuable insights into the current clinical issues surrounding the management of advanced prostate cancer in Japan. The partial divergence in the consensus between Japanese urologists and the global panel underscores the importance of a context‐specific approach. The results of this study provide practical guidance for physicians facing complex challenges and should be used to inform decision‐making in the management of advanced prostate cancer. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the feasibility and validity of measuring implicit attitudes towards dementia in adults and older adults and evaluate the impact of dementia‐friendly education using virtual reality (VR) on implicit attitudes. Methods: This study was a secondary analysis of data from a randomised controlled trial. Community members in Tokyo aged 20–90 years participated in dementia‐friendly education with or without VR. At the end of the dementia‐friendly education programs, implicit attitudes towards dementia were measured using the Implicit Relational Assessment Procedure (IRAP). Results: Of the 145 participants, 89 (61%) started the IRAP, and 21 (15%) completed it. Lower age was significantly associated with the start/completion of the IRAP, and the age thresholds at which 50% of participants would not start/complete it were estimated to be 72.3/44.8 years, respectively. Those who had experience interacting with people with dementia other than family members had lower IRAP scores than those who had no such experience. The intervention group participating in the VR program had lower IRAP scores than the control group (p =.09). Conclusions: Although measuring implicit attitudes using IRAP is deemed not feasible for people in their 70s and older, the differences in interaction experience would be evidence supporting the validity of the measurements of implicit attitudes towards dementia. The results suggest that dementia‐friendly education, using VR, improves implicit attitudes towards dementia. [ABSTRACT FROM AUTHOR]

Objective: Although it has been suggested that a decline in oral function is one of the potential risk factors affecting mild cognitive impairment (MCI), evidence is insufficient to draw clear conclusions. This Japanese cross‐sectional study examined the association between tongue pressure (TP) and MCI in middle‐aged and older adults aged 36–84 years. Methods: Study participants were 1019 (368 men and 651 women). TP was evaluated using a TP measurement device. The maximum value of three measurements was used for analysis. MCI was defined as being present if a participant had a Japanese version of the Montreal Cognitive Assessment score of <26. Adjustment was made for age, smoking status, alcohol consumption, leisure‐time physical activity, body mass index, hypertension, dyslipidemia, diabetes mellitus, history of depression, number of teeth, employment, education, and household income. Results: The prevalence of MCI was 45.3%. Among women, compared with the lowest tertile of TP, the second and highest tertiles were significantly associated with a lower prevalence of MCI with a clear dose–response relationship; the adjusted odds ratio (95% confidence intervals) in the second and highest tertiles of TP were 0.54 (0.36–0.83) and 0.55 (0.36–0.84), respectively (p for trend = 0.005). In contrast, no statistically significant association was observed between TP and the prevalence of MCI among men. Conclusions: Our findings suggest that higher TP might be inversely associated with the prevalence of MCI in middle‐aged and older Japanese women. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to examine the trend in human papillomavirus (HPV) vaccination rates in Japan before and after a policy change in 2022, involving resumption of active recommendation and start of catch‐up vaccination. Methods: From 2021 to 2023, a web‐based questionnaire survey was administered to newly enrolled female college students in Yokohama, Japan. The questionnaire included items such as age, HPV vaccination status, HPV vaccine awareness, and awareness of catch‐up vaccination. We compared knowledge about the HPV vaccine and cervical cancer in 2021 and 2023, before and after resumption of the national vaccination program. Results: The HPV vaccination rates were 5.4% in 2021, 7.5% in 2022, and 35.3% in 2023, with a significant upward trend (p < 0.001). A similar upward trend was observed for HPV vaccine awareness (p < 0.001). Comparing 2022 and 2023 after the start of catch‐up vaccination, there was no significant difference in awareness of catch‐up vaccination (p = 0.669), but there was a significant increase in awareness of free vaccination tickets (p < 0.001). After resumption of the national vaccination program with adoption of the catch‐up vaccination program, there was no difference in knowledge of cervical cancer, but there was a difference in knowledge of the HPV vaccine. Conclusions: Although the HPV vaccination rate has increased after the policy change, it has not recovered to the level before the suspension of active recommendation. It is important for healthcare providers and school educators to actively communicate the safety and effectiveness of the HPV vaccine. [ABSTRACT FROM AUTHOR]

One of the current challenges in the field of intercultural education comes from the limited availability of training efficacy studies. The present study focused on explaining the effectiveness of the Contrast Culture Method (CCM) as an intercultural education method for managing interpersonal interactions across cultures between graduate international students and their local counterparts in an academic program in Japan. By incorporating a qualitative methodology through the grounded theory, the study explained a context of domestic interpersonal relations across cultures in Japan. The result showed CCM's effectiveness based on respondents' reflective accounts, and supported the ideas suggested by the original study. The article concludes with future directions for research and application of CCM.

In spite of evidence indicating the benefits of parental engagement for children's achievement, little is known about the factors that contribute to parental engagement in countries outside the United States. In this study, we addressed this gap in the literature by examining teachers' outreach in addition to maternal psychological elements (maternal role construction and parenting self-efficacy) in predicting Japanese and American mothers' home- and school-based engagement at the second grade level. We found that these factors uniquely and significantly contributed to home-based engagement (homework supervision and engagement in cognitive activities) and school-based engagement in both countries. Furthermore, these factors accounted for between-country differences in the extent of home-based engagement. Between-country differences in school-based engagement remained significant even after the three factors were entered, suggesting a need for additional theorizing in contexts outside the U.S. Findings of this study also highlight the importance of teacher invitations in stimulating parents' engagement.

Mental state terms are believed to be closely related to the development of Theory of Mind (ToM). This study focuses on mental state verbs (MSVs) and investigates how they are used by Japanese-speaking mother-child dyads compared to their English-speaking counterparts. Analyses of their spontaneous speech from the CHILDES archives show that children's production of MSVs is greatly influenced by the mothers' input in both languages and that Japanese MSVs are used less frequently than English MSVs in both the children's and mothers' utterances. In addition, the syntactic properties of MSVs show that complements under MSVs tend to be null in Japanese, whereas those in English are more likely to be overtly expressed. This difference observed in the mothers' input and children's production can be a contributing factor underlying the developmental delay of ToM in Japanese.

Objective: Eculizumab and ravulizumab are complement protein C5 inhibitors, showing efficacy and tolerability for patients with anti‐acetylcholine receptor‐positive (AChR+) generalized myasthenia gravis (gMG) in phase 3 clinical trials and subsequent analyses. The purpose of the present study was to evaluate the clinical significance of eculizumab and switching to ravulizumab for refractory AChR+ gMG patients in the real‐world experience. Methods: Among the database of Japan MG registry survey 2021, we studied AChR+ gMG patients who received eculizumab. We also evaluated these patients who switched from eculizumab to ravulizumab. Responder was defined as an improvement of at least 3 points in MG‐ADL. We performed a questionnaire of preference between eculizumab and ravulizumab. Results: Among 1,106 patients with AChR+ gMG, 36 patients (3%) received eculizumab (female 78%, mean age 56.0 years). Eculizumab was preferentially used in severe and refractory MG patients. The duration of eculizumab treatment was 35 months on average. MG‐ADL improved from 9.4 ± 4.9 to 5.9 ± 5.1, and 25 (70%) of the 36 gMG patients were responders. Postintervention status was markedly improved after the eculizumab treatment. Of 13 patients who did not continue eculizumab, 6 showed insufficiencies. Early onset MG was most effective. However, 15 patients switching from eculizumab to ravulizumab kept favorable response and tolerability. Questionnaire surveys showed preference for ravulizumab over eculizumab. Interpretation: Eculizumab and switching to ravulizumab showed to be effective for refractory AChR+ gMG patients in clinical settings. [ABSTRACT FROM AUTHOR]

Background: Non-motor symptoms in myasthenia gravis (MG) are rarely confirmed. Although there are some small cohort studies, a large-systemic survey has not yet been performed. Methods: We investigated the incidence and clinical characteristics of patients with MG who had taste disorders and alopecia using data of 1710 patients with MG enrolled in the Japan MG Registry 2021. Results: Among them, 104 (6.1%) out of 1692 patients and 138 (8.2%) out of 1688 patients had histories of taste disorders and alopecia, respectively. Among the patients with MG, taste disorders were significantly more common in women, those with severe symptoms, refractory MG, or thymoma-associated MG, and were less common in those with ocular MG. The taste disorders often occurred after the onset of MG and often responded to MG treatments. Alopecia was more common in MG patients with a history of bulbar palsy and thymoma, and it often occurred before the onset of MG and sometimes responded to MG treatments. Multivariate logistic regression analysis revealed taste disturbance was associated with worst quantitative MG score and thymoma-associated MG; and alopecia was associated with thymoma-associated MG. Conclusion: Clinicians should be aware of the non-motor symptoms in MG, especially in patients with severe myasthenic symptoms and thymoma-associated MG. [ABSTRACT FROM AUTHOR]

Background and Aim: To date, no randomized trials have compared the efficacy of 7‐day vonoprazan, amoxicillin, and metronidazole triple therapy (VAM) versus 7‐day vonoprazan, amoxicillin, and clarithromycin triple therapy (VAC) as a first‐line treatment for Helicobacter pylori eradication. This study was performed to compare the efficacy of VAM and VAC as first‐line treatments. Methods: This prospective multicenter randomized trial was performed in Japan and involved 124 H. pylori‐positive patients without a history of eradication. Patients without antibiotic resistance testing of H. pylori were eligible. The patients were randomized to receive either VAC (vonoprazan 20 mg + amoxicillin 750 mg + clarithromycin 200 or 400 mg twice a day) or VAM (vonoprazan 20 mg + amoxicillin 750 mg + metronidazole 250 mg twice a day) for 7 days, with stratification by age and sex. Eradication success was evaluated using the 13C‐urea breath test. We evaluated safety using patient questionnaires (UMIN000025773). Results: The intention‐to‐treat and per‐protocol eradication rates of VAM were 91.3% (95% confidence interval [CI], 82.0–96.7%) and 92.6% (95% CI, 83.7–97.6%), respectively, and those of VAC were 89.1% (95% CI, 77.8–95.9%) and 96.1% (95% CI, 86.5–99.5%), respectively. No significant difference was observed between VAM and VAC in either analysis (P = 0.76 and P = 0.70, respectively). Abdominal fullness was more frequent in patients who received VAM than VAC. Conclusions: These findings suggest that VAM as a first‐line treatment in Japan can be categorized as grade B (intention‐to‐treat cure rate of 90–95%) and have potential as a first‐line national insurance ‐approved regimen. [ABSTRACT FROM AUTHOR]

Background: Anti-calcitonin gene-related peptide monoclonal antibodies (CGRPmAbs) have greatly changed migraine treatment options. In Japan, although CGRPmAb guidelines (≥ 4 monthly migraine days (MMDs) and ≥ 1 previous preventive failure) are well-acknowledged, the actual use of CGRPmAbs and the circumstances of the related headache care are unknown. Methods: We conducted an online survey of Japanese Headache Society members, inquiring about the physicians' experience with CGRPmAbs and how they make decisions related to their use. Results: Of the 397 respondents, 320 had prescribed CGRPmAbs. The threshold number of previous preventive failures for recommending a CGRPmAb was two for the majority of the respondents (n = 170, 54.5%), followed by one (n = 64, 20.5%). The MMD threshold was ≥ 4 for 71 respondents (22.8%), ≥ 6 for 68 (21.8%), ≥ 8 for 76 (24.4%), and ≥ 10 for 81 (26.0%). The respondents tended to assess treatment efficacy after 3 months (episodic migraine: n = 217, 69.6%, chronic migraine: n = 188, 60.3%). The cost of CGRPmAbs was described by many respondents in two questions: (i) any request for a CGRPmAb (27.7%), and (ii) the most frequently reported reason for responders to discontinue CGRPmAbs (24.4%). Conclusions: Most of the respondents recommended CGRPmAbs to patients with ≥ 2 preventive failures, followed by ≥ 1. The MMD threshold ranged mostly from ≥ 4 to ≥ 10. The concern for costs was raised as a major limiting factor for prescribing CGRPmAbs. [ABSTRACT FROM AUTHOR]

Genetic testing is key in modern healthcare, particularly for monogenic disorders such as familial hypercholesterolemia. This Tohoku Medical Megabank Project study explored the impact of first-degree relatives' dyslipidemia history on individual responses to familial hypercholesterolemia genomic results. Involving 214 participants and using Japan's 3.5KJPN genome reference panel, the study assessed preferences and intentions regarding familial hypercholesterolemia genetic testing results. The data revealed a significant inclination among participants with a family history of dyslipidemia to share their genetic test results, with more than 80% of participants intending to share positive results with their partners and children and 98.1% acknowledging the usefulness of positive results for personal health management. The study underscores the importance of family health history in genetic-testing perceptions, highlighting the need for family-centered approaches in genetic counseling and healthcare. Notable study limitations include the regional scope and reliance on questionnaire data. The study results emphasize the association between family health history and genetic-testing attitudes and decisions. [ABSTRACT FROM AUTHOR]

Much attention has been paid to the effects of study abroad, especially because of recent increases in participation in such programs. One problem, however, is the selection bias of participants inherent in study abroad programs. The present study examines whether participation in a short-term study abroad program leads to participation in further long-term study abroad programs. Data were obtained from 705 applicants in the 2013-2015 academic year at a Japanese university, 300 of whom were assigned randomly to participate in a short-term study abroad program. The study results showed a significantly higher participation rate among previous participants than among nonparticipants. The results of a questionnaire completed by the former participants of the short-term program showed that they were more likely to translate plans for participating in the long-term study abroad program into action based on their prior overseas experiences.

Although researchers argue that studying semantically related words simultaneously (semantic clustering) inhibits vocabulary acquisition, recent studies have yielded inconsistent results. This study examined the effects of semantic clustering while addressing the limitations of previous studies (e.g., confounding of semantic relatedness with other lexical variables). Furthermore, the study investigated the effects of spacing because spacing might facilitate the learning of semantically related items by alleviating interference. In this study, 133 Japanese university students studied 48 English-Japanese word pairs under two conditions: massed and spaced. Half the words were semantically related to each other while the other half were not. Although there were no significant differences between semantically related and unrelated items in posttest scores, semantically related items led to more interference errors than unrelated items. Furthermore, contrary to the authors' hypothesis that spacing is particularly beneficial for semantically related items, spacing benefited unrelated items more than it did related items.