Four-year longitudinal changes in walking ability were examined in 510 older adults in a rural community in Japan. The participants walked on an 11-m walkway at their preferred and maximum speeds, and velocity, step length, step rate, and walk ratio (step length/step rate) were measured. Physical performance, including muscle strength, balance, and manual skill, was examined concur rently. An age-related decline in all variables except for step rate was confirmed in the longitudinal as well as cross-sectional data. The longitudinal decline accelerated for participants in their seventies and over, as compared to those in their sixties. Grip strength, balance, and manual speed, measured at the baseline, predicted relative changes in walking velocity over four years. The risk of mortality and instrumental ADL decline in four years were also predicted by maximum walking velocity at the baseline. These results suggest that the walking test has discriminant and predictive validities for assessing the physical functioning of community-dwelling older adults.

A study was conducted to determine the effect of aging on motor ability and to establish a test battery for physical fitness in the elderly. The subjects were 150 men aged 18 to 83 years. The test items examined were selected, according to Fleishman's list of motor abilities; (1) trunk flexion, (2) grip and isometric knee extension strength, (3) postural sway with eyes open and closed, (4) step test, (5) walking test at preferred and maximum speeds, (6) simple visual reaction time, (7) peg-board test, (8) finger tapping test at maximum rate and in time to metronome sounds. Performances for the test items, except for preferred walking speed and coefficient of variation in finger tapping at 5 Hz, showed significant decreases with aging. The decrease in motor performance at age 80 years relative to the level at age 20 years was less than 30% for finger dexterity and reaction time, 40-60% for muscle strength, maximum walking speed and the step test, and over 70% for trunk flexion and postural sway with eyes closed. A test battery composed of trunk flexion, grip strength, knee extension, step test, walking as fast as possible, postural sway with eyes closed, and finger tapping, is therefore recommended for assessing the effect of aging on physical fitness.

A motor performance test was administered to elderly adults in Koganei City and Nangai Village of Japan as the baseline study of Tokyo Metropolitan Institute of Gerontology, Longitudinal Interdisciplinary Study on Aging (TMIG-LISA) . The participants in this study totaled 405 (183 males and 222 females) aged 65 to 84 from Koganei City, and 734 (295 males and 439 females) aged 65 and over from Nangai Village. The test consisted of measurement of grip strength, one-leg stand-ing, walking at preferred and maximum speeds, and finger-tapping. All motor performances examined were higher among males than females, and they all deteriorated with aging. A regional difference was found in terms of motion speed abilities: finger-tapping rate and walking speed were higher among urban residents than rural residents. Individual differences (coefficient of variation) in the motor ability increased with aging, and reached 106% (maximum tapping rate in female) to 290% (maximum walking speed in female) of those in the twenties. Significant correlations between motor abilities were detected indicating that the specificity of the motor ability found in the young may not account for older adults.

To estimate the incidence of liver injury related to Kampo medicine containing Scutellaria baicalensis, all medical records in our clinic were retrospectively examined. Among 2,430 patients who took Kampo medicine containing Scutellaria baicalensis, liver blood tests were performed in 1,547 cases (63.7%). The possibility of liver injury related to Kampo medicine containing Scutellaria baicalensis could not be denied in 19 cases (1.2%) among the 1,547 cases. The clinical features of liver injury in 19 cases were not different from those in previous reports. In agreement with the previous literature, this study also suggests that the incidence of liver injury related to Kampo medicine containing Scutellaria baicalensis is about 1%.

A thirty-eight-year old woman with facial pain was diagnosed with trigeminal neuralgia, and treated with conventional carbamazepine therapy. Although the pain was alleviated to a certain degree, she visited our clinic to receive Kampo therapy. Judging from her facial injury in an accident thirty years ago, jidabokuippo was administered in addition to carbamazepine. The trigeminal neuralgia was then relieved, and Takagi's tender point in her abdomen was also reduced or disappeared. She could finally stop carbamazepine therapy. This case suggests that neuralgia patients with previous injury and Takagi's tender point can be treated with jidabokuippo.

BACKGROUND: Studies on the adverse effects of Asian dust (AD) on respiratory function in children are scarce. The objective of this study was to examine the association between AD and respiratory function by measuring peak expiratory flow rates (PEFRs) in asthmatic children. METHODS: The study was carried out from March to May from 2014 through 2016. One hundred ten children with bronchial asthma were recruited from four hospitals in the Goto Islands and south Nagasaki area in Nagasaki prefecture. The parents were asked to record their children's PEFRs every morning/evening and clinical symptoms in an asthma diary. AD was assessed from light detection and ranging data, and a linear mixed-effects model was used to estimate the effects of AD on daily PEFR. Time-stratified case-crossover analyses were performed to examine the association between AD and asthma attacks defined by reduction levels in PEFR. RESULTS: AD was detected on 11 days in the Goto Islands, and on 23 days in the south Nagasaki area. After adjusting for age, sex, temperature, and daily oxidants, we found a consistent association between AD and a 1.1% to 1.7% decrease in PEFR in the mornings and a 0.7% to 1.3% decrease in the evenings at a lag of 0 to 5 days. AD was not associated with the number of asthma attacks, respiratory symptoms, or other symptoms at any lag days examined. CONCLUSIONS Exposure to AD was associated with reduced PEFR, although the effects were not large enough to induce clinically apparent symptoms, in clinically well-controlled asthmatic children.

In the 2022 revision of the Model Core Curriculum, a new "Educational Strategies and Assessment" section was added as a further development in outcome-based education. By adding a chapter on strategies and evaluation, which is an important element of the curriculum, and linking it to qualities and abilities, we have devised a way for learners and instructors to make use of the Core Curriculum more easily. In addition, 11 example of strategy and assessment cases are included as Good Practice to encourage practical application. However, since these are only examples, we hope this chapter will be further developed as universities create strategies and evaluations that make the most of their unique characteristics.

Health support activities for residents were held three times during a period from June, 2016 to November, 2017. The residents registered in order to participate through 11 community pharmacies. Participant’s blood pressure values were measured at the venue of health support activities by pharmacists. The blood pressure values in 66 of the 106 participants were analyzed, excluding 40 participants receiving medical treatment. The rate of participants with hypertension, systolic blood pressure (SBP)≧140 mmHg or diastolic blood pressure (DBP)≧90 mmHg, was 32% (21／66). Of those with hypertension, 43% (9／21) had hypertension of a high risk level, SBP≧160 mmHg or DBP≧100 mmHg. Pharmacists provided lifestyle counseling and encouraged them to make changes in order to achieve tighter blood pressure control. The data of their blood pressure values were provided to community pharmacies for continuing support of their blood pressure control. With the pharmacist’s support, the median value of blood pressure of participants who had hypertension decreased in the second event. In addition, 50% (3／6) of participants who attended the second event with hypertension of high risk level, visited the hospital for a consultation with a doctor after getting pharmacist’s advice. These results indicate that greater access to community pharmacists improved blood pressure control of residents with hypertension. However, there were many residents who consider it difficult to use pharmacies without a prescription. Hence, friendly relationship to residents on their utilizing pharmacies is needed for providing them lifestyle counseling such as preventing hypertension by pharmacists.

Based on the social context of an aging society and surveys conducted since 2020, the need for comprehensive perspectives and approaches that consider patients'psychosocial background and a cross-organ perspective has been identified. As a result, a new quality and ability, namely comprehensive attitudes toward patients, has been established as part of the core curriculum for medical education in FY2022. Specific learning objectives include "holistic perspectives and approaches," "community perspectives and approaches," "life perspectives and approaches," and "social perspectives and approaches". An educational design that draws on multiple learning theories to enable reflection on one's own way of being has been proposed to integrate abstract and concrete, conceptual and experiential, and self and others perspectives. It is expected that this medical education will lead to improvement in the well-being of individuals, families, and communities.