Search

Background: People with intellectual/intellectual and physical disabilities frequently use day-service centres, an array of services that involve the provision of care and social activities during the daytime and offer homebound people with disabilities opportunities to live in their communities. While nurses working at day-service centres for people with disabilities are expected to promote service-users' health, little research has focused on this area. Nurses' relationships with service-users of day-service centres have not been sufficiently investigated regarding how their interactions determine service-users' specific activities and daily lives within such facilities. This study sought to address this research gap. Methods: We conducted a qualitative descriptive study with six nurses working at day-service centres located in Tohoku region, Japan. Six participants were interviewed 16 times. The psychological-phenomenological method developed by Amedeo Giorgi was used as the model for data analysis. Findings: The analysis generated five themes. First, nurses show interest in service-users by 'continuing to show interest' and by 'trying to understand the service-users from the perspective of what they can do'. Additionally, the nurses ensure that service-users enjoy their time in the facility by 'supporting enjoyment through nursing and medical care', 'stabilising feelings' and 'creating an environment conducive to everyone's comfort'. Conclusions: Nurses working at day-service centres for people with intellectual/intellectual and physical disabilities provide support for social participation while maintaining the service-users' mental and physical health. Thus, these nurses support enjoyment among service-users from the nursing and medical care aspect; they also devise ways for service-users to interact and adjust to the environment to improve service-users' comfort at day-service centres. Furthermore, participation in daytime activities at day-service centres indicated that nurses are interested in service-users' activities, and they perceive service-users as positive individuals.

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

This study examined children's understanding of irony when a difference existed between a speaker's intended meaning and a listener's interpretation of the meaning. Three irony contexts were presented to 87 7/8-year-olds (second graders), 90 11/12-year-olds (sixth graders), and 103 adults. In the normal irony context, the speaker intended to convey irony, and the listener felt that he/she was being criticized by the speaker. In the unintended irony context, the speaker intended to convey praise, but the listener felt that he/she was being criticized by the speaker. In the unsuccessful irony context, the speaker intended to convey irony, but the listener felt that he/she was being praised by the speaker. The results showed that 11/12-year-olds and adults understood all three types of irony and appropriately judged whether or not the speaker's intention was ironic and whether or not the listener thought that he/she was being criticized by the speaker. However, 7/8-year-olds did not understand the context differences, and across all types of irony they consistently judged that the speaker intended to praise the listener and that the listener thought that he/she was being praised. Furthermore, performance was generally correlated with passing second-order false belief tasks, especially with unintended and unsuccessful irony.

Background: Spending time away from bed is important in older adults. Not doing so can lead to functional decline rapidly. Objective: To investigate the association between oral function and time spent away from bed in older adults living in nursing homes. Methods: We enrolled 748 adults aged ≥65 years across eight nursing homes between April 2022 and March 2023. 'Problems with oral hygiene' and 'problems with oral function' were the dependent variables in the multiple regression analyses to determine their association with time spent away from bed. Results: We selected 304 participants (76 men; mean age, 86.3 ± 7.5 years) and divided them into three groups: group S (< 4 h), group M (4 to < 6 h) and group L (≥ 6 h), with 28, 23 and 253 participants, respectively. Comparison of the characteristics between the groups demonstrated significant differences in the Barthel index (p <.001), time spent away from bed (p <.001), history of aspiration pneumonia (p <.001), confirmation of meals and food forms (p =.010), problems with oral hygiene (p =.014), and problems with oral function (p =.002). Based on multiple regression analyses, 'problems with oral hygiene' (p <.001) and 'problems with oral function' (p <.001) were significantly associated with time spent away from bed. Conclusions: The time spent away from bed was significantly associated with both oral hygiene and function in older adults, suggesting the importance of extending the time that older adults spend away from bed. [ABSTRACT FROM AUTHOR]

Background: A majority of Japanese care managers lack medical qualifications, feel uncomfortable discussing future medical choices and believe that it is not their responsibility. Objectives: As there is a paucity of care manager intervention studies, this study aimed to measure changes in advance care planning engagement among long-term care service users before and after intervention by care managers with communication training. Design: A multi-institutional pre- and post-pilot comparative study Methods: A multi-institutional pre- and post-trial study was performed from August 2022 to January 2023 (trial ID: 000048573). Nine trained care managers communicated with 30 long-term care service users regarding advance care planning, and the pre- and post-trial advance care planning engagement scores were compared. Additionally, the post-trial impact of events score was investigated. Results: All 30 long-term care service users completed the trial. The advance care planning engagement score increased after the trial. The sample size was considered adequate for future trials. Years of experience as a care manager, impact of events score, and having a clinical frailty scale of ⩾5 were significant explanatory variables that affected the objective variable of the difference between pre- and post-trial advance care planning engagement score. Conclusion: This study on the impact of advance care planning communication interventions by trained care managers offers insights into determining appropriate sample sizes and identifying factors influencing future research outcomes. Advance care planning engagement of long-term care service users might change before and after intervention by care managers through advance care planning communication. Trial registration: University Hospital Medical Information (UMIN) Network Trial ID: 000048573. [ABSTRACT FROM AUTHOR]

In order to develop effective teaching methods and computer-assisted language teaching systems for learners of English as a foreign language who need to study the basic linguistic competences for writing, pronunciation, reading, and listening, it is necessary to first investigate which vocabulary and grammar they have or have not yet learned. Identifying such vocabulary and grammar requires a learner corpus for analyzing the accuracy and fluency of learners' linguistic competences. However, it is difficult to use previous learner corpora for this purpose because they have not compiled all the types of linguistic data that we need. Therefore, this study aimed to solve this problem by designing and developing a new learner corpus that compiles linguistic data regarding the accuracy and fluency of the four basic linguistic competences of writing, pronunciation, reading, and listening. The reliability and validity of the learner corpus were partially confirmed, and practical application of the learner corpus is reported here as case studies.

Background: Previous studies have shown inconsistent results in clinical effectiveness between cryoballoon ablation (CBA) and radiofrequency ablation (RFA), and cost assessment between the procedures is important. The aim of this study was to evaluate the clinical effectiveness and cost‐effectiveness between the procedures in patients with paroxysmal atrial fibrillation (AF) refractory to antiarrhythmic drug therapy. Methods: A systematic review and meta‐analysis were performed. The primary outcome for the meta‐analysis was long‐term AF recurrence. Following the results of the meta‐analysis, the cost‐effectiveness of CBA versus RFA in Japan was assessed. Results: The meta‐analysis included 12 randomized controlled trials and six propensity‐score matching cohort studies. AF recurrence was slightly lower in patients referred for CBA than for RFA, with an integrated risk ratio of 0.93 (95% confidence interval: 0.81–1.07) and an integrated hazard ratio of 0.96 (95% confidence interval: 0.77–1.19), but no significant difference was found. A cost‐minimization analysis was conducted to compare the medical costs of CBA versus RFA because there was no significant difference in the risk of AF recurrence between the procedures. The estimated costs for CBA and RFA were JPY 4 858 544 (USD 32 390) and JPY 4 505 255 (USD 30 035), respectively, with cost savings for RFA of JPY 353 289 (USD 2355). Conclusion: Our meta‐analysis suggests that CBA provides comparable benefits with regard to AF recurrence compared with RFA, as shown in previous studies. Although the choice of treatment should be based on patient and treatment characteristics, RFA was shown that it might be cost saving as compared to CBA. [ABSTRACT FROM AUTHOR]

In this study, we aimed to explore the association between physical activity (PA) and quality of life (QoL) in colorectal cancer (CRC) patients with postoperative defecatory dysfunction. A survey using the European Organization for Research and Treatment of Cancer QLQ-30 and QLQ-29 was conducted among 62 adult outpatients with CRC at two cancer hospitals in Japan. PA and sedentary behavior were evaluated using the Global Physical Activity Questionnaire. Multiple regression analysis was performed, incorporating the QoL as the outcome, with the total PA and its three domains (occupational, transportation, and recreational) and sedentary time as exposures, while controlling for age, sex, and tumor location. The analyses revealed that patients engaged in PA ≥ 150 min/week (67.4 points; 95% confidence interval [CI]: 21.1, 113.8) and recreational PA ≥ 30 min/week (56.0 points; 95% CI: 2.3, 109.7) had significantly higher function scores. Conversely, sedentary time >8 h/day or occupational PA duration ≥30 min/week was associated with poor symptom and function scores. These findings highlight the importance of promoting recreational PA and reducing sedentary behavior to maintain and improve the QoL in CRC patients with defecatory dysfunction. [ABSTRACT FROM AUTHOR]

As global populations age, a looming nursing shortage is anticipated to become a critical issue. Charge nurses have the responsibility of optimally allocating nursing resources to ensure the quality of patient care during a shift. Therefore, an accurate estimate of nursing demand is crucial. However, the ability to forecast future nursing demand remains underdeveloped, mainly because the nature of nursing demand is highly individualized and does not follow a definitive pattern. In practice, the nursing demand is often perceived as unpredictable, leading to an ad hoc approach to staffing. The primary objective of our study is to demonstrate that longitudinal data analysis can reveal strong statistical regularities in the temporal dynamics of nursing demand. This approach not only provides new possibilities for efficient resource allocation but also paves the way for data‐driven prediction of nursing demand. Our study uses Sankey diagrams to visualize the temporal dynamics of nursing demand within each ward for each fiscal year, representing these dynamics as an overlay of trajectories from multiple individual patients. Consequently, our study reveals ward‐specific statistical regularities in the temporal dynamics of nursing demand. In one ward, approximately 25% of patients experienced an increase in nursing demand from 1 to between 6 and 9 points from the second to the third day of hospitalization, while in another, only 0.1% showed such an increase. These findings suggest that patients admitted to the wards tend to exhibit a certain probabilistic change in nursing demand. This study can predict probabilistically the temporal variation of nursing demand among patients in the coming years by analyzing data on the temporal changes in nursing demand over the past years. Our findings are expected to significantly influence the forecasting of nursing demand and the estimation of nursing resources, leading to data‐driven and more efficient nursing management. [ABSTRACT FROM AUTHOR]

Background: Germline mutations in CDKN2A result in Familial Atypical Multiple Mole Melanoma Syndrome (FAMMM) (OMIM #155,601), which is associated with an increased risk of pancreatic ductal adenocarcinoma and melanoma. FAMMM has been reported globally, but it is quite rare in Japan. We report two families with familial pancreatic cancer with suspected pathogenic variants of CDKN2A that were incidentally identified through comprehensive genomic profiling. Case presentation: The first case is a 74-year-old woman with a diagnosis of pancreatic carcinoma with multiple liver metastases. She had family histories of pancreatic cancer, but no personal or family history of malignant melanoma. Whole exon sequencing detected a germline CDKN2A variant evaluated as likely pathogenic. The results were disclosed to her daughters after she died, and the same CDKN2A variant was detected in one of the daughter. The daughter was referred to a nearby hospital for her clinical management. The second case is a 65-year-old man with pancreatic ductal adenocarcinoma. He had family histories of pancreatic cancer, but no personal or family history of malignant melanoma. He underwent a comprehensive genomic profiling test using pancreatic cancer tissue, and detected a presumed germline pathogenic variant of CDKN2A. Germline testing confirmed the same CDKN2A variant. Genetic analysis of his relatives produced negative results. Other blood relatives are scheduled for genetic analysis in the future. We report two families with familial pancreatic cancer with suspected pathogenic variants of CDKN2A that were incidentally identified through comprehensive genomic profiling. Conclusions: In current Japanese precision medicine, comprehensive genetic analysis can reveal rare genetic syndromes and offer us the opportunity to provide health management for patients and their relatives. However, gene-specific issues are raised in terms of the evaluation of a variant's pathogenicity and the extent of surveillance of the at-risk organs due to a lack of genetic and clinical data concerning CDKN2A variant carriers in Japan. [ABSTRACT FROM AUTHOR]

Background Proton pump inhibitors (PPIs) reduce the bioavailability of several anticancer drugs. The impact of PPIs co-administered with cyclin-dependent kinase 4 and 6 inhibitors is controversial. We aimed to clarify whether the concomitant use of PPIs impacts palbociclib and abemaciclib effectiveness in breast cancer treatment. Patients and Methods This multicenter, retrospective, observational study, conducted across 4 medical institutions in Japan, consecutively included patients with endocrine-resistant metastatic breast cancer, receiving palbociclib or abemaciclib between December 2017 and August 2022. Propensity score-matched analyses were performed. Treatment efficacy and safety with and without PPIs were compared. Progression-free survival and overall survival were estimated using the Kaplan-Meier method and compared using a log-rank test. A Cox proportional hazards model was used to estimate the hazard ratio. Results The study included 240 patients. After 1:1 matching, 112 patients were treated with and without PPIs. The median progression-free survival period was 1.2 years in the PPI group and 1.3 years in the non-PPI group (hazard ratio, 1.19; 95% CI, 0.70-2.02). The median overall survival period was 3.6 years in the PPI group, whereas it was not reached in the non-PPI group (hazard ratio, 1.23; 95% CI, 0.61-2.47). Consistent results were obtained for subgroups receiving palbociclib (n  = 177) and abemaciclib (n  = 63) without propensity score matching. Adverse event incidence and severity were similar in both groups. Conclusion The effectiveness of cyclin-dependent kinase 4/6 inhibitors is unlikely to be affected by concomitant PPI use. Future prospective pharmacokinetic studies are warranted. [ABSTRACT FROM AUTHOR]

This study investigated the association of exercise and dietary habits with defecatory dysfunction in patients living with colorectal cancer. We recruited 61 adult patients who had undergone surgery within the past 20 years and attended outpatient clinics at designated cancer hospitals in Japan. Defecatory dysfunction was defined as any symptom caused by issues with colon and anal function, including fecal incontinence, evacuation difficulties, frequent stools, diarrhea, and constipation. Exercise and dietary habits were assessed via a quantitative questionnaire survey. Postoperative defecatory dysfunction occurred in all the patients. Multivariate analysis revealed no association between exercise habits and defecatory dysfunction; however, dietary fiber intake ≥4 times a week was associated with frequent stools (adjusted odds ratio, 5.11; 95% confidence interval, 1.10, 23.70). These findings suggest a need to alleviate defecatory dysfunction by improving one's dietary habits. Interventions aimed at alleviating defecatory dysfunction by improving the dietary habits in patients living with colorectal cancer are needed. [ABSTRACT FROM AUTHOR]

The present paper proposes and evaluates a readability assessment method designed for Japanese learners of EFL (English as a foreign language). The proposed readability assessment method is constructed by a regression algorithm using a new set of linguistic features that were employed separately in previous studies. The results showed that the proposed readability assessment method, which used all the linguistic features employed in previous studies, yielded a lower error of assessment than readability assessment methods using only some of these linguistic features. (Contains 4 figures and 2 tables.)

In textbooks, foreign (second) language reading proficiency is often evaluated through comprehension questions. In case, authentic texts are used as reading material, such questions should be prepared by teachers. However, preparing appropriate questions may be a very demanding task for teachers. This paper introduces a method for automatically evaluating proficiency, wherein comprehension questions are not required. This method assesses a learner's reading proficiency on the basis of the linguistic features of the text and the learner's reading time. A reading model following this method predicted reading proficiency with an ER (error rate) of 18.2%. This ER is lower than those of models proposed in previous studies. Furthermore, the ER of the authors' reading model for various learner groups classified by their RS (reading speeds) was examined. The result of this examination showed that the error rate was the lowest for the group of learners with fast RS. (Contains 4 figures.)

What qualities and abilities are appropriate for a person who plans to become a doctor? To answer this question, it is meaningful to understand the opinions of the general public, since they are important stakeholders in the training of doctors. As part of a national door-to-door questionnaire survey, participants were asked about 16 qualities and abilities they considered suitable for becoming a doctor. Of the 1200 people interviewed, 1190 responded. The ratio of affirmative answers was the highest (92.2%) for the "Accurately judges situations" element, followed by "Cares about others' feelings" (87.4%), "Understands the reality of medical care and welfare" (87.2%), and "Resistant to mental stress" (86.2%). "High academic ability", which is currently the most important factor in the actual selection of students, ranked ninth among the sixteen elements (71.8%). Aside from academic ability, the general public places importance on other factors in selecting students for admission to medical schools. This study provides a valuable reference for medical schools regarding admission policies and applicant selection processes. [ABSTRACT FROM AUTHOR]

The purpose of the study was to investigate whether the sustained use of the "Hug," a "hugging" type robotic transfer support device, could increase the level of quality of care. The effect of proficiency on using the device was examined in terms of time spent for transfer, ratio of transfers using the device, and range of targets. The results were compared between skilled care facilities that had used the device for >24 months and unskilled facilities. The time spent for transfer at the unskilled facility was 4.6 min (2nd week after introduction), was reduced to 3.0 min (5th week), and 1.5 min at the skilled facility. The usage ratio at the unskilled facility was 13% and 30% (2nd and 5th week, respectively), while it was 97% in the skilled facility. Further, we identified wider in the range of target care recipients in the skilled facility. It takes time to master the use of Hug; however, its use was associated with many positive aspects, especially from the perspective of care recipients, e.g., better care, use of their own legs, and reduced time for transfers. These findings suggest that the widespread use of Hug would improve the quality of care. Less physically burdened on the caregivers using Hug, they can afford to talk to the care recipients. Using recipient's own legs during transfers, it prevents leg muscle disuse. As reduced time for transfers, recipients will have more opportunities to get out of bed. [ABSTRACT FROM AUTHOR]

Introduction: In the context of collective efforts taken in Japan to control the spread of COVID-19, the state of emergency and social distancing have caused a negative impact on the mental health of all residents, including foreign communities in Japan. This study aimed to evaluate the level of anxiety and its associated factors among non-Japanese residents residing in Japan during the COVID-19 pandemic. Methods: A web-based survey in 13 languages was conducted among non-Japanese residents living in Japan during the COVID-19 situation. The State-Trait Anxiety Inventory assessed the level of anxiety–State (STAI-S) scores prorated from its six-item version. The multivariable logistic regression using the Akaike Information Criterion (AIC) method was performed to identify the associated factors of anxiety among participants. Results: From January to March 2021, we collected 392 responses. A total of 357 valid responses were analyzed. 54.6% of participants suffered from clinically significant anxiety (CSA). In multivariable logistic model analysis, the CSA status or the high level of anxiety was associated with three factors, including having troubles/difficulties in learning or working, decreased sleep duration, and decreased overall physical health (p<0.05). Conclusion: Our study suggests several possible risk factors of anxiety among non-Japanese residents living in Japan undergoing the COVID-19 pandemic, including the troubles or difficulties in learning or working, the decrease in sleep duration, and the decrease in overall physical health. [ABSTRACT FROM AUTHOR]

Background: Currently, widely used robotic surgical systems do not provide force feedback. This study aimed to evaluate the impact and benefits of a force feedback function on the suturing procedure. Methods: Twenty surgeons were recruited and divided into young (Y-group, n = 11) and senior (S-group, n = 9) groups, based on their years of surgical experience. The effect of the force feedback function on suturing quality was evaluated using an objective assessment system (A-LAP mini, Kyoto Kagaku Co., Ltd., Kyoto, Japan). Each participant completed the suturing task on intestinal model sheets with the robotic contact force feedback on and off. The task accomplishment time (s), maximal force (Newton, N) applied to the robotic forceps, and quality of suturing (assessed by A-LAP mini) were recorded as performance parameters. Results: In total, the maximal force applied to the robotic forceps was significantly decreased with the robotic force feedback switched on (median [interquartile range]: 2.8 N (2.3–3.2)) as compared with when the feedback was switched off (3.4 N (2.7–4.0), P < 0.001). The contact force feedback function did not affect the objectively assessed suturing score (18 points (17.7–19.0) versus 18 points (17.0–19.0), P = 0.421). The contact force feedback function slightly shortened the task accomplishment time in the Y-group (552.5 s (466.5–832) versus 605.5 s (476.2–689.7), P = 0.851) but not in the S-group (566 s (440.2–703.5) versus 470.5 s (419.7–560.2), P = 0.164). Conclusions: With the contact force feedback function, the suturing task was completed with a smaller maximal force, while maintaining the quality of suturing. Because the benefits are more apparent in young surgeons, robots with the contact force feedback function will facilitate the educational process in novice surgeons. [ABSTRACT FROM AUTHOR]

Background: People with intellectual/intellectual and physical disabilities frequently use day‐service centres, an array of services that involve the provision of care and social activities during the daytime and offer homebound people with disabilities opportunities to live in their communities. While nurses working at day‐service centres for people with disabilities are expected to promote service‐users' health, little research has focused on this area. Nurses' relationships with service‐users of day‐service centres have not been sufficiently investigated regarding how their interactions determine service‐users' specific activities and daily lives within such facilities. This study sought to address this research gap. Methods: We conducted a qualitative descriptive study with six nurses working at day‐service centres located in Tohoku region, Japan. Six participants were interviewed 16 times. The psychological‐phenomenological method developed by Amedeo Giorgi was used as the model for data analysis. Findings: The analysis generated five themes. First, nurses show interest in service‐users by 'continuing to show interest' and by 'trying to understand the service‐users from the perspective of what they can do'. Additionally, the nurses ensure that service‐users enjoy their time in the facility by 'supporting enjoyment through nursing and medical care', 'stabilising feelings' and 'creating an environment conducive to everyone's comfort'. Conclusions: Nurses working at day‐service centres for people with intellectual/intellectual and physical disabilities provide support for social participation while maintaining the service‐users' mental and physical health. Thus, these nurses support enjoyment among service‐users from the nursing and medical care aspect; they also devise ways for service‐users to interact and adjust to the environment to improve service‐users' comfort at day‐service centres. Furthermore, participation in daytime activities at day‐service centres indicated that nurses are interested in service‐users' activities, and they perceive service‐users as positive individuals. Accessible summary: This study shows how nurses working at day‐service centres for people with disabilities in Japan understand their approach and engage with service‐users.Nurses working at day‐service centres understood the service‐users and focused on what they were good at and what they were able to do. Based on this understanding, the nurses use specialised knowledge to ensure that service‐users can enjoy their time at the day‐service centres, while providing approaches for mental and physical stability and support for daytime activities.Nurses attempt to make service‐users feel comfortable at day‐service centres to encourage them to continue visiting the centres.This study is relevant to people with disabilities, as it contributes to future nursing care direction for this population from the perspective of nurses' professional experiences. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate changes in the attitudes of Japan's post-war youth towards gender equality and sexuality, and to examine whether these attitudes bore a relationship to school education. Different generations were delineated based on changes in courses of study and year of birth, and semi-structured interviews were conducted enquiring about experiences and opinions during secondary school days. We examined sexuality education in both junior high school (ages 12-15 years) and high school (15-18 years), views on premarital sex, views on marriage and divorce, and views on gender roles. Fifty-three survey participants were involved in the study: 30 women and 23 men. The characteristics of each generation were examined in relation to corresponding courses of study and the textbooks available in junior high and high schools, identifying both homologies and differences between the messages courses contained and the expressed beliefs of different generations of informants.

Understanding orbital-scale changes in East Asian summer monsoon (EASM) precipitation is a fundamental issue in paleoclimate research for assessing the response of the East Asian monsoon to different climate forcings, such as insolation, ice volume, and greenhouse gases. However, owing to the inconsistencies between different proxies, the fundamental driving force for EASM variability remains controversial. In the present study, the global climate under the given insolation changes over the past 450 kyr was calculated using a climate model, Meteorological Research Institute Coupled General Circulation Model version 2.3 (MRI–CGCM2.3). The calculated change in summer precipitation is dominated by a 20-kyr precession cycle over China, highly consistent with cave δ18O records in southeast China. The proxy data from northern China (Chinese Loess Plateau) and Japan (Lake Biwa) cannot be fully explained by the calculation results, implying the importance of other forcing such as ice-sheet volume. A strong positive correlation was observed between insolation and precipitation over the coastal area of China and a negative correlation between insolation and precipitation around Japan. The results imply that the EASM is affected by the insolation intensity; however, the effect can vary between regions. The positive correlation between boreal summer insolation and precipitation over China results from the atmosphere-ocean interaction over the Indian Ocean and the western Pacific. Under intense insolation, the northern shift of the monsoon front associated with the intensification of the North Pacific subtropical high causes an increase in rainfall in the coastal area of China. The intensification of the subtropical high is caused by the integration of local wind–evaporation–sea surface temperature (WES) feedback with the Kelvin wave response to the warm Indian Ocean (IPOC mode). In contrast, the EASM intensity around Japan was affected by the strength of the North Pacific High. Under strong insolation, the North Pacific High intensified, causing a decrease in summer precipitation around Japan. [ABSTRACT FROM AUTHOR]

Patient-reported outcomes (PROs) are frequently used in a variety of settings, including clinical trials and clinical practice. The definition of PRO and quality of life (QOL) and their relationship have been concluded through discussions among experts that has been the premise of PRO guidelines are not clearly stated in the guidelines. Therefore, the definition of PRO, especially in relation to QOL, is sometimes explained simply, as "PRO includes QOL," but this complicated matters. This study investigated the perceptions of PRO among various stakeholders (including patients and their families, the industry, clinicians, regulatory or health technology assessment personnel, and academic researchers) in Japan to clarify its definitions and that of QOL, including their relationship. We conducted a two-step survey: a qualitative interview survey and a web-based survey to ensure the validity of the survey. During the interviews, eight stakeholders described their perceptions and thoughts on PRO and its relationship to QOL, and their experience of using PRO. Overall 253 clinicians, 249 company employees, and 494 patients participated in the web survey to confirm how the findings of the interview survey supported the results. In the interview survey, patient advocates described various perspectives of PRO and QOL, including unexpected dynamic relationships, while the most other stakeholders explained PRO and QOL with the language used in the guidelines, but their responses were split. The web-based survey revealed that all stakeholders had a lower awareness of PRO than QOL. The most common perception of PRO, especially in the relationship to QOL, was "they did not fully overlap." Although there were differences in perceptions of the relationship between PRO and QOL among clinicians, company employees, and patients, all perceived PRO as a tool to facilitate communication in clinical practice. The present results are inconsistent with the simplified explanation of PRO, but consistent with the original PRO guideline definitions, which also considered the role of PRO in clinical practice. To make PRO a more potent tool, all stakeholders using PRO should confirm its definition and how it differs from QOL, have a unified recognition in each PRO use, and avoid miscommunication. [ABSTRACT FROM AUTHOR]

Objective: Recent advances in single‐cell RNA sequencing technology have improved our understanding of the immunological landscape of rheumatoid arthritis (RA). We aimed to stratify the synovium from East Asian patients with RA by immune cell compositions and gain insight into the inflammatory drivers of each synovial phenotype. Methods: Synovial tissues were obtained from East Asian patients in Japan with RA (n = 41) undergoing articular surgery. The cellular composition was quantified by a deconvolution approach using a public single‐cell–based reference. Inflammatory pathway activity was calculated by gene set variation analysis, and chromatin accessibility was evaluated using assay of transposase accessible chromatin–sequencing. Results: We stratified RA synovium into three distinct subtypes based on the hierarchical clustering of cellular composition data. One subtype was characterized by abundant HLA‐DRAhigh synovial fibroblasts, autoimmune‐associated B cells, GZMK+GZMB+ CD8+ T cells, interleukin (IL)1‐β+ monocytes, and plasmablasts. In addition, tumor necrosis factor (TNF)‐α, interferons (IFNs), and IL‐6 signaling were highly activated in this subtype, and the expression of various chemokines was significantly enhanced. Moreover, we found an open chromatin region overlapping with RA risk locus rs9405192 near the IRF4 gene, suggesting the genetic background influences the development of this inflammatory synovial state. The other two subtypes were characterized by increased IFNs and IL‐6 signaling, and expression of molecules associated with degeneration, respectively. Conclusion: This study adds insights into the synovial heterogeneity in East Asian patients and shows a promising link with predominant inflammatory signals. Evaluating the site of inflammation has the potential to lead to appropriate drug selection that matches the individual pathology. [ABSTRACT FROM AUTHOR]

Background: Good adherence to an inhaled medication protocol is necessary for the management of asthma and chronic obstructive pulmonary disease (COPD), and several interventions to improve adherence have been reported. However, the impact of patient life changes and psychological aspects on treatment motivation is obscure. Here, we investigated changes in inhaler adherence during the COVID-19 pandemic and how lifestyle and psychological changes affected it. Methods: Seven-hundred sixteen adult patients with asthma and COPD who had visited Nagoya University Hospital between 2015 and 2020 were selected. Among them, 311 patients had received instruction at a pharmacist-managed clinic (PMC). We distributed one-time cross-sectional questionnaires from January 12 to March 31, 2021. The questionnaire covered the status of hospital visits, inhalation adherence before and during the COVID-19 pandemic, lifestyles, medical conditions, and psychological stress. The Adherence Starts with Knowledge-12 (ASK-12) was used to assess adherence barriers. Results: Four-hundred thirty-three patients answered the questionnaire. Inhalation adherence was significantly improved in both diseases during the COVID-19 pandemic. The most common reason for improved adherence was fear of infection. Patients with improved adherence were more likely to believe that controller inhalers could prevent COVID-19 from becoming more severe. Improved adherence was more common in patients with asthma, those not receiving counseling at PMC, and those with poor baseline adherence. Conclusions: Inhalation adherence for asthma and COPD improved in the COVID-19 pandemic. The patients seemed to realize the necessity and benefits of the medication more strongly than before the pandemic, which motivated them to improve adherence. [ABSTRACT FROM AUTHOR]

Objective: To evaluate sexual function after treatment using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire‐Testicular Cancer 26 (EORTC QLQ‐TC26) questionnaire in Japanese testicular cancer (TC) survivors in a multi‐institutional, cross‐sectional study. Methods: This study enrolled TC survivors who visited any of eight high‐volume institutions in Japan from 2018 to 2019. After obtaining informed consent, participants completed the EORTC QLQ‐TC26 questionnaires. We evaluated sexual function after treatment for TC using the EORTC QLQ‐TC26 and analyzed the impact of treatment on sexual function in TC survivors. Results: A total of 567 TC survivors responded to the EORTC QLQ‐TC26. Median age at the time of response was 43 years (interquartile range [IQR] 35–51 years), and median follow‐up period after treatment was 5.2 years (IQR 2.2–10.0 years). Sexual function, particularly ejaculatory function, was significantly lower after post‐chemotherapy retroperitoneal lymph node dissection (PC‐RPLND) than after Surveillance or Chemotherapy groups (p < 0.05). In the PC‐RPLND group, nerve‐sparing procedure preserved postoperative ejaculatory function after RPLND compared with the non‐nerve‐sparing and offered improved ejaculatory function with time. On multivariate analysis, RPLND was a significant predictor of post‐treatment ejaculatory dysfunction, particularly without nerve‐sparing (odds ratio 3.0, 95% CI 1.2–7.7, p < 0.05). In addition, TC survivors with nerve‐sparing RPLND had higher sexual activity than those without. Conclusion: This survey of the EORTC QLQ‐TC26 showed that sexual function and activity in TC survivors after RPLND was reduced in the absence of nerve‐sparing techniques. [ABSTRACT FROM AUTHOR]

This study aimed to determine the optimal conditions to measure the percentage of the area considered as pneumonia (pneumonia volume ratio [PVR]) and the computed tomography (CT) score due to coronavirus disease 2019 (COVID-19) using the Ziostation2 image analysis software (Z2; Ziosoft, Tokyo, Japan), which is popular in Japan, and to evaluate its usefulness for assessing the clinical severity. We included 53 patients (41 men and 12 women, mean age: 61.3 years) diagnosed with COVID-19 using polymerase chain reaction who had undergone chest CT and were hospitalized between January 2020 and January 2021. Based on the COVID-19 infection severity, the patients were classified as mild (n = 38) or severe (n = 15). For 10 randomly selected samples, the PVR and CT scores by Z2 under different conditions and the visual simple PVR and CT scores were compared. The conditions with the highest statistical agreement were determined. The usefulness of the clinical severity assessment based on the PVR and CT scores using Z2 under the determined conditions was statistically evaluated. The best agreement with the visual measurement was achieved by the Z2 measurement condition of ≥–600 HU. The areas under the receiver operating characteristic curves, Youden's index, and the sensitivity, specificity, and p-values of the PVR and CT scores by Z2 were as follows: PVR: 0.881, 18.69, 66.7, 94.7, and <0.001; CT score: 0.77, 7.5, 40, 74, and 0.002, respectively. We determined the optimal condition for assessing the PVR of COVID-19 pneumonia using Z2 and demonstrated that the AUC of the PVR was higher than that of CT scores in the assessment of clinical severity. The introduction of new technologies is time-consuming and expensive; our method has high clinical utility and can be promptly used in any facility where Z2 has been introduced. [ABSTRACT FROM AUTHOR]

Aim: To investigate the impact of uterine fibroid diagnosis/treatment status on quality of life (QOL) and work productivity in women living in Japan. Methods: Women aged 20–49 years who registered on Macromill were recruited via the opt‐in method. They completed an online survey on demographic and uterine fibroid diagnosis/treatment status, 36‐Item Short‐Form Health Survey, Uterine Fibroid Symptom and Health‐Related Quality of Life questionnaire (UFS‐QOL), and World Health Organization Health and Work Performance Questionnaire. Results: There were 4120 respondents: 1362 untreated, 249 with ongoing treatment, 449 with past treatment, 1030 with no uterine fibroids, and 1030 with unknown uterine fibroid status. A high proportion of women with ongoing treatment had moderate to severe uterine fibroid‐like symptoms (symptom severity score of UFS‐QOL ≥40 points), accompanied by reduced QOL. QOL was improved in women with past treatment. Uterine fibroids had a significant impact on physical and psychosocial aspects in the ongoing treatment group versus other groups. Using classification and regression tree analysis, anemia was identified as a plausible predictor of reduced QOL in the ongoing treatment group. Approximately 20% of women—even in groups other than the ongoing treatment group—experienced moderate to severe uterine fibroid‐like symptoms. However, the diagnosis and treatment status of uterine fibroids had no clear impact on work productivity. Conclusions: Uterine fibroids, especially in association with anemia, were related to reduced QOL. Given that uterine fibroid‐related reduced QOL is likely improved by appropriate treatment, women with uterine fibroid‐like symptoms, such as menorrhagia, should be examined and treated. [ABSTRACT FROM AUTHOR]

Ninjin'yoeito (NYT) is widely used clinically for the management of patients with frailty and other multiple symptoms. NYT is often administered with other drugs; however, little information is available on its drug interactions. Previous studies using human liver microsomes have reported that constituents of NYT either inhibit (schisandra fruit, cinnamon bark, glycyrrhiza, and poria sclerotium) or induce (schisandra fruit and glycyrrhiza) CYP3A4 expression. Herein, we conducted in vitro and in vivo studies targeting human CYP3A and mouse CYP3A to elucidate the effects of NYT coadministration with other drugs on hepatic drug metabolism. In an inhibition study using human liver microsomes, NYT showed concentration-dependent reversible inhibition and time-dependent inhibition. Furthermore, in an induction study using frozen human hepatocytes, the addition of 0.01–0.1 mg/mL NYT resulted in a concentration-dependent increase in CYP3A gene expression. Contrarily, no significant changes in CYP3A substrate blood concentrations were observed between untreated mice and mice that received either a single dose of NYT or repeated doses for 15 days. These results demonstrate that NYT has inhibitory and inductive effects on hepatic CYP3A in vitro, but orally administered NYT does not affect drug metabolism mediated by hepatic CYP3A in vivo in the mouse model. Although there is a little information about drug interactions of NYT, this study provides new evidence for that. [ABSTRACT FROM AUTHOR]

Background: Physical exercise is known to improve the level of activities of daily living and physical function in people with dementia; however, symptoms of dementia often pose challenges when implementing physical therapy. This study aimed to elucidate how physiotherapists (PTs) engage with older adults with dementia to encourage exercise and participation in physical activity. Methods: In this qualitative study, four PTs working with older adults with dementia in long-term care facilities in Japan were recruited and interviewed. We used a modified grounded theory approach to assess how PTs engaged with older adults with dementia during physiotherapy sessions. Results: Based on PT responses, five categories of engagement were identified: "make structured preparations for clients to begin physical activity," "link exercise therapy to a client's daily life," "discover changes in daily life," "ascertain cognitive function," and "accommodate client differences." Concepts were derived under each category. The category "make structured preparations for clients to begin physical activity" served as a preceding stage for PTs to engage with older adults with dementia. PTs linked exercise therapy to each client's daily life activities to encourage voluntary participation in daily physical activity. PTs ensured the performance of routine patterns of movement and modified these movement patterns per clients' differing paces. Conclusion: PTs provided exercise and movement training based on various degrees of client involvement and made structured preparations for clients to begin physical activity that were linked to exercise therapy. Our findings may prompt PTs to encourage older people with dementia to participate in physical therapy and benefit from exercise. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the transition of behavioural changes of participants before and after the training using a scale that can objectively evaluate coaching training for nurses. Design: After a cross‐sectional study, a quasi‐experimental study was conducted. Methods: We examined the reliability and validity of the Coaching Skill Assessment plus (CSAplus), which was developed to measure the effectiveness of coaching training for corporate leaders. Next, a repeated measures analysis of variance was conducted on two types of coaching training for nurses conducted at a university hospital, with the CSAplus scores of participants before, 1 month and 6 months after the training as the dependent variable. Results: The CSAplus is a three‐factor instrument with good reliability and validity. Participants' CSAplus scores improved after training, but there were differences in the magnitude and persistence of the training effects. Public Contribution: Hospital staff, professional coaches and their clients were involved in data collection. [ABSTRACT FROM AUTHOR]

Recovery, which is a non‐linear, unique process allowing mental health service consumers to live autonomously, has become a prominent concept. However, adapting recovery‐oriented practice to daily care is challenging. We explored recovery‐oriented practice among mental health professionals in Japan via semi‐structured interviews including nurses, occupational therapists, and psychiatric social workers (17 professionals in total). Data were analysed using grounded theory. Six categories emerged. The core category was 'Continuing to adjust care to meet consumers' needs for their unique lives'. The professionals stated that they practised in accordance with the service consumers' sincere hopes based on an equitable relationship because they believed that this approach would enhance consumers' personal agency, proactive behaviour, and self‐choice. Despite negative consequences, the professionals did not view the consumers' choices as 'failures' and instead helped them to find meaning in their experiences. Although the therapeutic relationship tended to be paternalistic, participants described how concrete practices helped build an equitable relationship. In recovery‐oriented practice, the provision of support centred on consumer values is important, without imposing own's own values. Care practices should also be aligned with consumers' hopes, needs and goals. [ABSTRACT FROM AUTHOR]

BACKGROUND: Those undergoing pelvic floor muscle training (PFMT) often experience difficulty in perception; therefore, an easier PFMT method should be devised. OBJECTIVE: To determine the effectiveness of combining PFMT with either vibration stimulation or visual feedback provided by a branded cushion (not a prototype) in increasing PFM muscle activity. Since PFM does not involve large joint movements, muscle activity was a suitable indicator. METHODS: Twenty healthy adults were included in this study. All participants performed PFMT under three conditions using a branded cushion: vibration stimulation, visual feedback, and a control. All three conditions were provided separately. PFM activity of the midline of the perineum at two points was recorded as the root mean square measured using PFM electromyography, measured twice for each condition. Muscle activity ratio was obtained by calculating maximum voluntary contraction of PFM in pre- and post-PFMT conditions. RESULTS: PFM activity and muscle activity ratio were both significantly higher following PFMT under vibration stimulation and visual feedback conditions (p < 0.01, p < 0.01, respectively). CONCLUSIONS: PFMT accompanied by vibration stimulation or visual feedback could immediately raise PFM muscle activity. We believe this study contributes to improving PFMT efficiency by suggesting more suitable PFMT methods. [ABSTRACT FROM AUTHOR]

Objective Poor medication adherence among patients with SLE is a critical problem associated with adverse outcomes. This study examined the relationship between trust in one's physician and goal-oriented thinking, hope and medication adherence among Japanese patients with SLE who were ethnically matched to their physicians. Methods This cross-sectional study was conducted in the rheumatology outpatient clinics at five academic centres. Patients with SLE who were prescribed oral medications were included. The main exposures were trust in one's physician measured via the 5-item Japanese version of the Wake Forest Physician Trust Scale and the 18-item Health-related Hope Scale, with each score ranging from 0 to 100 points. Medication adherence was measured using the 12-item Medication Adherence Scale with scores ranging from 5 to 60 points. A general linear model was created after adjusting for demographics, socioeconomic status, disease activity, disease duration, basic health literacy, depression, medication variables, experiencing adverse effects and concerns regarding lupus medications. Results Altogether, 373 patients with SLE were included. The mean age of the patients was 46.4 years; among them, 329 (88.2%) were women. Both trust in one's physician (per 10-point increase: 0.86, 95% CI 0.49, 1.22) and the Health-related Hope score (per 10-point increase: 0.66, 95% CI 0.35, 0.97) were associated with better medication adherence. Conclusions This study demonstrated that patients' health-related hope and trust in their rheumatologist were both associated with better medication adherence in SLE. [ABSTRACT FROM AUTHOR]

This study analyzed the increase in head circumference (HC) of 85 autistic infants (64 boys and 21 girls) during their first year of life. The data were collected from their "mother-and-baby" notebooks. This notebook is a medical record of the baby's growth and development delivered to the parents of all babies born in Japan. This is a retrospective study which gathered the data from the notebooks after the diagnosis of autism. However, none of the babies were known to have autism at the time the records were made. The head circumference at birth of these autistic children was similar to that of the average found in a Japanese Government Study of 14,115 children. However, it showed a marked increase at 1 month after birth. The discrepancy reached a peak at 6 months, while the difference became smaller at 12 months. Body length (BL) and body weight (BW) began to increase at 3 months, although at a rate smaller than the head circumference increase.

Although infection with the methicillin-resistant Staphylococcus aureus (MRSA) clone USA300 is extremely rare in Japan, the uniquely evolved clone ΨUSA300 has been reported in Japan. An outbreak of a distinct USA300 clone was recently reported in an HIV/AIDS referral hospital in Tokyo. The present study investigated the evolutionary origin and genetic diversity of USA300-related clones causing regional outbreaks among people living with HIV (PLWHIV) in Tokyo. MRSA isolates collected from PLWHIV in an HIV/AIDS referral center in Tokyo were subjected to whole-genome sequencing and their genetic features were compared with those of previously described USA300 MRSA genomes. Of the 28 MRSAs isolated in 2016–2019, 23 (82.1%) were identified as USA300, with 22 (95.6%) of the latter identified as ΨUSA300. Although the genomic structure of ΨUSA300 was identical to the structures of reference USA300 strains, one clade (cluster A) was found to have acquired 29 previously identified lineage-specific mutations in a stepwise manner. The estimated divergence dates of ΨUSA300 and Cluster A were 2009 and 2012, respectively. These findings suggested that the ΨUSA300 clone had spread among PLWHIVs in Tokyo in the early 2010s, with stepwise acquisition of lineage-specific nonsynonymous mutations. [ABSTRACT FROM AUTHOR]

Aim: To investigate the current status and problems in the diagnosis and treatment of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) from the perspective of obstetricians and gynecologists (OB/GYNs) in Japan, the Japanese Society of Obstetrics and Gynecology (JSOG) conducted a national‐wide survey. Methods: An email survey was sent to all JSOG members (16 732) and a web‐based survey was conducted using a Google form between September and November 2021. The current status and problems in PMS/PMDD diagnosis and treatment were surveyed in this cross‐sectional study. Results: In total, 1312 respondents (7.8% of all JSOG members) completed the questionnaire. In terms of diagnoses and treatment, OB/GYN was preferred over psychiatrist for PMS (91.4% vs. 45%); however, no differences were noted for PMDD (76.1% vs. 73.7%). A total of 1267 (96.6%) respondents engaged in routine PMS/PMDD treatment. Regarding the general diagnosis procedure, 84.4% respondents answered "only a vague medical interview," 8.4% kept a two‐cycle symptom diary, and 10.3% used a screening questionnaire. The most commonly used medication was oral contraceptive pills (OCPs) (98.1%), followed by the Kampo, traditional Japanese herbal medicines, Kamishoyosan (73.6%). Concerning first‐line drugs for treatment, OCPs were the most common (76.8%), followed by Kampo medicine (19.5%); selective serotonin reuptake inhibitors (SSRIs) were less frequently used (2.6%). Regarding first‐line drugs among OCPs, 65.1% respondents reported drospirenone‐ethinylestradriol use. Conclusions: This study indicates that only a few OB/GYNs practicing PMS/PMDD in Japan use a prospective diary, which is an essential diagnostic criterion for PMS/PMDD. Regarding treatment, SSRIs were used less frequently. [ABSTRACT FROM AUTHOR]

Introduction: Nurturing "basic societal competencies" is important in the training education of speech-language-hearing therapists (SLHTs) to enable them to respond to fluctuating medical treatment scenarios. However, in the current training education for SLHTs, some students need assistance in terms of basic societal competencies, such as initiative, planning, and communication. In this study, the focus was on coaching theory, a method of interpersonal support through dialog, as a strategy for addressing the issues. The objective was to clarify whether coaching theory-based classes for SLHT students improve their basic societal competencies. Methods: The participants were first- and third-year undergraduate SLHT students in Japan. The coaching and control groups comprised students enrolled in 2021 and 2020, respectively. The observation period for this prospective cohort study was from April to September 2020 and from April to September 2021. The coaching and control groups received 90-min coaching and remedial education classes, respectively, 11 times in 3 months. To establish students' knowledge and skills, follow-up sessions were conducted four times a month, and assignments were given during the subsequent summer vacation. The effects of the classes were based on Kirkpatrick's four-level evaluation model, with Levels 1, 2, 3, and 4 evaluating satisfaction with the class, learning proficiency, behavior modification, and result attainment, respectively. Results: The coaching and control groups comprised 40 and 48 participants, respectively. In the evaluation of behavior modification (level 3) using the "PROG (progress report on generic skills) competency test (RIASEC Inc., Tokyo)," the interactions between time and group and the main effects of time were significant for the basic societal competencies of "relating with others" and "self-confidence." Multiple comparisons showed that the post-class scores were significantly higher than the pre-class scores in the coaching group (change of 0.9 for relating with others and 0.7 for self-confidence) and that the scores in the coaching group were significantly higher than those in the control group at the post-class. The interaction between time and group was significant for those "planning solutions," and the post-class score was significantly higher than the pre-class score in the coaching group (change of 0.8). Conclusion and Implication: The coaching classes improved the students' basic societal competencies of relating with others, self-confidence, and planning solutions. This suggests that coaching classes are useful in the training education for SLHTs. Ultimately, nurturing students' basic societal competencies will develop human resources who could achieve quality clinical performance. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to clarify the accuracy of pregnant women's knowledge and understanding regarding infectious disease screening in early pregnancy and clarify the roles that should be played by health care providers in promoting the health of pregnant women and their children. Methods: A cross-sectional questionnaire survey was conducted in 25 hospitals across Japan from May 2018 to September 2019. We compared the agreement rates regarding screening results for hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis, human T-cell leukemia virus-1 (HTLV-1), and cervical cytology in the medical records and understanding of their results by pregnant women. We then investigated whether participants had knowledge regarding the risk of mother-to child transmission in these diseases and factors associated with their knowledge. Results: We enrolled 2,838 respondents in this study. The rates of agreement for HBV and cervical cancer screening related to human papillomavirus infection were "substantial," those for syphilis was "moderate," and those for HCV and HTLV-1 were "fair," according to the Kappa coefficient. The rate of knowledge regarding mother-to-child transmission of syphilis was highest (37.0%); this rate for the other items was approximately 30%. Increased knowledge was associated with higher educational level and higher annual income. Conclusions for Practice: Pregnant women in Japan had generally good levels of understanding regarding their results in early-pregnancy infectious disease screening. However, they had insufficient knowledge regarding mother-to-child transmission of these diseases. Health care providers should raise awareness in infectious disease prevention among pregnant women and the general public, providing appropriate measures and implementing effective perinatal checkups and follow-ups for infectious diseases. Significance: A previous study reported biases in knowledge about mother-to-child disease transmission among pregnant women. However, there are no reports on the accuracy of pregnant women's understanding and their backgrounds related to knowledge about infectious diseases. In this report, Japanese pregnant women had generally good understanding of their results in infectious disease screening. However, they had insufficient knowledge regarding mother-to-child transmission of infectious diseases. It is crucial for health care providers to raise awareness in infectious disease prevention and provide appropriate measures for pregnant women and the general public, such as implementing effective perinatal checkups and follow-ups. [ABSTRACT FROM AUTHOR]

Purpose: Adolescence is a period of transition from childhood to adulthood where people are vulnerable to stress. The COVID-19 pandemic continues to cause sustained stress in the population. Since the COVID-19 pandemic, social isolation and loneliness have increased. Loneliness is associated with increased stress, psychological distress, and a higher risk of mental illnesses, such as depression. This study examined the association between loneliness, premenstrual symptoms, and other factors in the era of the COVID-19 pandemic among adolescent females in Japan. Patients and Methods: A school-based cross-sectional survey of 1450 adolescent female students in Japan was conducted in mid-December of 2021. Specifically, paper-based questionnaires were distributed in class, and the responses were collected. The Premenstrual Symptoms Questionnaire (PSQ), 6-item Kessler Psychological Distress Scale, 3-item Revised UCLA Loneliness Scale (R-UCLA), and Fear of COVID-19 Scale were used as measurement tools. The prevalence of loneliness was defined as a total R-UCLA score ≥ 6. Results: The prevalence of loneliness was 29.0%. The prevalence of serious psychological distress was also high (8.2%), especially in the lonely group (16.0%). Multivariable regression analysis identified the following factors associated with loneliness: second year (odds ratio [OR] 1.53; 95% confidence interval [CI] 1.09– 2.14), longer internet use (OR, 1.11; 95% CI, 1.02– 1.20), total PSQ score (OR 1.08; 95% CI 1.06– 1.11), and psychological distress (OR 1.05; 95% CI 1.01– 1.08). Conclusion: Adolescent females in Japan showed a high prevalence of loneliness. School year (2nd year), longer periods of internet use, premenstrual symptom severity, and psychological distress were independently associated with loneliness. For clinicians and school health professionals, special concern should be given to the psychological health of adolescent females during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Objective: Fatigue is one of the most common complaints and is a potentially modifiable issue in systemic lupus erythematosus (SLE). Studies suggest that alcohol consumption has a protective effect against the development of SLE; however, an association between alcohol consumption and fatigue in patients with SLE has not been studied. Here, we assessed whether alcohol consumption was associated with fatigue using lupus patient-reported outcomes (LupusPRO). Methods: This cross-sectional study, conducted between 2018 and 2019, included 534 patients (median age, 45 years; 87.3% female) from 10 institutions in Japan. The main exposure was alcohol consumption, which was defined as the frequency of drinking [<1 day/month (none group), ≤1 day/week (moderate group), and ≥2 days/week (frequent group)]. The outcome measure was the Pain Vitality domain score in LupusPRO. Multiple regression analysis was performed as the primary analysis after adjusting for confounding factors, such as age, sex, and damage. Subsequently, the same analysis was performed as a sensitivity analysis after multiple imputations (MIs) for missing data (n = 580). Results: In total, 326 (61.0%) patients were categorized into the none group, 121 (22.7%) into the moderate group, and 87 (16.3%) into the frequent group. The frequent group was independently associated with less fatigue compared with none group [β = 5.98 (95% CI 0.19–11.76), p = 0.04], and the results did not substantially deviate after MI. Conclusions: Frequent drinking was associated with less fatigue, which highlights the need for further longitudinal studies focusing on drinking habits in patients with SLE. [ABSTRACT FROM AUTHOR]

The aldehyde degrading function of the ALDH2 enzyme is impaired by Glu504Lys polymorphisms (rs671, termed A allele), which causes alcohol flushing in east Asians, and elevates the risk of esophageal cancer among habitual drinkers. Recent studies suggested that the ALDH2 variant may lead to higher levels of DNA damage caused by endogenously generated aldehydes. This can be a threat to genome stability and/or cell viability in a synthetic manner in DNA repair‐defective settings such as Fanconi anemia (FA). FA is an inherited bone marrow failure syndrome caused by defects in any one of so far identified 22 FANC genes including hereditary breast and ovarian cancer (HBOC) genes BRCA1 and BRCA2. We have previously reported that the progression of FA phenotypes is accelerated with the ALDH2 rs671 genotype. Individuals with HBOC are heterozygously mutated in either BRCA1 or BRCA2, and the cancer‐initiating cells in these patients usually undergo loss of the wild‐type BRCA1/2 allele, leading to homologous recombination defects. Therefore, we hypothesized that the ALDH2 genotypes may impact breast cancer development in BRCA1/2 mutant carriers. We genotyped ALDH2 in 103 HBOC patients recruited from multiple cancer centers in Japan. However, we were not able to detect any significant differences in clinical stages, histopathological classification, or age at clinical diagnosis across the ALDH2 genotypes. Unlike the effects in hematopoietic cells of FA, our current data suggest that there is no impact of the loss of ALDH2 function in cancer initiation and development in breast epithelium of HBOC patients. [ABSTRACT FROM AUTHOR]

aimei, Ichinomiya, Aichi, 494-0001, Japan, Tel +81-586-61-8787, Fax +81-586-61-9210, Email [email protected] Purpose: To analyze surgical results of 32 cases with acute acquired comitant esotropia (AACE) related to prolonged use of digital devices (DDs). Patients and Methods: Medical records of cases with AACE related to prolonged use of DDs that had undergone surgery were retrospectively revised. Complete medical history and full ophthalmological examinations before and surgery were obtained for all cases. All cases also underwent neurological examinations using brain and orbital imaging. Motor success was considered as alignment within 10 prism diopters (Δ) at both near and distance. Sensory success was defined as stereopsis ≤ 60 arcsec. Nineteen cases (Group S) underwent surgery alone and 13 cases were treated with surgery and prism adaptation (Group S+P). Motor and sensory outcomes were compared between groups. Results: Mean age at first visit was 22.0 ± 9.0 years and mean daily use of DDs use was 6.3 ± 3.4 hours. Mean angle of preoperative alignment for distance and near were 26.5 ± 13.0Δ and 24.6 ± 16.4Δ, respectively. Surgery was performed at a mean of 23.3 ± 3.5 years old and mean angle of alignment at final examination for distance and near were 5.8 ± 7.7Δ and 3.5 ± 5.7Δ, respectively. Final motor and sensory success rate were 84% and 53%, respectively. No significant differences in motor or sensory outcomes were evident between groups at initial or last visit. Conclusion: Favorable motor and sensory outcomes were achieved with surgical intervention with and without prism adaptation for AACT related to prolonged use of DDs. [ABSTRACT FROM AUTHOR]

During the coronavirus disease 2019 (COVID-19) pandemic, online-based learning has become mainstream in many countries, and its learning outcomes have been evaluated. However, various studies have shown that online-based learning needs to be optimized in the future, and the number of reports for this purpose is currently not sufficient. The purpose in this study was to determine the relationship between academic performance and attitudes toward face-to-face and remote formats among Japanese pharmacy students enrolled in a course designed for knowledge acquisition. A combination of face-to-face and remote formats was used in a practice course for sixth-year pharmacy students, designed to improve academic performance through knowledge acquisition. To evaluate learning outcomes, we used a questionnaire that was administered to the course participants and the results of examinations conducted before and after the course. Online-oriented and face-to-face-oriented groups differed in their attitudes toward the ease of asking questions of faculty and communicating with the faculty members and classmates in each format. In a knowledge acquisition course for Japanese pharmacy students, the study revealed that the same academic outcomes were achieved, regardless of the students' own perceptions of their aptitude for face-to-face or remote learning style. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to conduct a 5‐h training programme on anger‐focused emotional management for nurses and verify its effectiveness. Design: The study used a one‐group pretest–posttest design. Methods: Participants (N = 283) attended a programme comprising lectures and exercises. The Japanese version of the Buss–Perry Aggression Questionnaire was administered pre‐, post‐ and 3‐month posttraining. Regression analyses were used to assess the effects of the programme by gender. Results: For the total aggression score, the difference between the pre‐ and posttraining scores was −2.827 points and remained at −1.602 points 3‐month posttraining. Physical aggression scores decreased posttraining, but the scores increased after 3 months. There were statistically significant gender differences in hostility scores; pre‐training scores were slightly higher for men than for women and lower for men after 3 months. Total and physical aggression scores were higher for men than for women. The training programme decreased aggression, and the effect persisted after 3 months. [ABSTRACT FROM AUTHOR]

Low back pain among hospital workers is influenced by ergonomic factors and work-related psychosocial factors. Elucidating the association between the two types of heavy investment—including workaholism and work engagement—and low back pain can help formulate environmental advancements for hospital workers. Objective: This study aimed to examine the association between two types of heavy work investment, workaholism and work engagement, and low back pain prevalence. Methods: We conducted a paper-based survey of Japanese hospital workers. The Dutch Workaholism Scale (DUWAS) and the Utrecht Work Engagement Scale (UWES) were used to classify the participants into four groups and perform multiple logistic regression analyses. Results: Among 699 participants, the group with low DUWAS and high UWES at 37.1% had the lowest low back pain prevalence. In order, the groups with low DUWAS and UWES were at 51.7%; those with high DUWAS and UWES, 58.5%; and those with high DUWAS and low UWES, 62.4%, with multivariate-adjusted odds ratios of 1.77, 2.01, and 2.33, respectively. Conclusions: Low back pain prevalence among Japanese hospital workers was reduced by high levels of work engagement, even at high levels of workaholism. [ABSTRACT FROM AUTHOR]

In Japan, the population aging rate highlights the need to examine various care provisions for older adults with dementia, including physical therapy. However, despite its positive effects, there are also many challenges associated with providing physical therapy for older adults with dementia. This qualitative case study examined the interactions between a physical therapist and a patient with dementia and the process by which physical therapy was provided to her. This study utilized a modified grounded theory approach to analyze the interview of one physical therapist, a woman with four years of clinical experience who specializes in physical therapy for older adults who provided a 20-minute physical therapy session to her client, a woman in her 80s with dementia who sought to maintain her ability to perform activities of daily living and preserve her independence. Data were collected in January 2017. Fifteen concepts that represent aspects of the services that the therapist provided to her client were identified. Five distinct categories were derived: 1) foundations of the relationship; 2) understanding individual factors; 3) supporting execution of functional activities; 4) assessing cognitive function; and 5) support to ensure safety in daily living. Physical therapists help older adults with dementia execute functional activities, which helps ensure their safety and independence, and fosters strong therapist–client relationships. Future studies should interview multiple physical therapists to generate additional concepts. Further, quantifying these concepts and developing tools to assess clients will improve care provision and inform physical therapists with limited experience in treating patients with dementia. [ABSTRACT FROM AUTHOR]

Objectives: Most testicular cancer (TC) survivors have long‐term survival. However, the association between financial toxicity (FT), which is an economic side effect of cancer treatment, and the quality of life (QOL) of TC survivors is still unclear. Thus, the impact of FT on the QOL of TC survivors was examined in a multi‐institutional cross‐sectional study. Methods: We recruited TC survivors from eight high‐volume institutions in Japan between January 2018 and March 2019. A total of 562 participants completed the EORTC QLQ‐C30, EORTC QLQ‐TC26 and the questionnaires on demographics, including annual income. Financial difficulty in the EORTC QLQ‐C30 and low income were used to assess financial distress (FD) and financial burden (FB), respectively. FT was defined as FD and FB. The QOL scores were compared, and a multivariate logistic regression analysis for FT was performed. Results: With severe FD, TC survivors had more treatment side effects, physical limitations, and anxiety concerning employment and future. The TC survivors who reported low income were worried about their jobs and the future. The QOL of the survivors with FT exhibited high impairment, except for sexual activity. In particular, the TC survivors with FT were physically limited and anxious concerning the future. The multivariate logistic regression analysis revealed that four or more chemotherapy cycles were substantial risk factors for FT (4 cycles, odds ratio (OR) = 4.17; ≥5 cycles, OR = 6.96). Conclusions: TC survivors who received multi‐cycle chemotherapy were prone to experience FT, resulting in a decline in their health‐related QOL. [ABSTRACT FROM AUTHOR]