Objectives: The purpose of this qualitative study was to examine the experiences of cancer survivors who used a palliative day care salon on a university campus. Method: Semi-structured interviews were conducted with ten cancer survivors; thereafter, we performed content analysis. Results: Ten categories were identified. The following were identified as motives to participate in the activities of the salon: (1) need for spiritual support, (2) desire to discover the meaning of life. The following experiences were described regarding the salon: (3) a place to express emotions openly, (4) a place to engage in activities as one pleases, (5) a place to communicate with others and express one’s true feelings, (6) a place that instills vigor as a result of expert advice. The following changes were identified after participation: (7) adopting an appropriate lifestyle, (8) improvement in image during the recurrence of cancer and towards the end of one’s life, (9) better family and social relationships, (10) a broader range of activities and uplifted sense for playing their roles. Discussion: Cancer survivors require support. In the salon, they could openly express their true feelings about their experiences of cancer and readily accepted one another. Further, their perceptions and attitudes toward life were being transformed through an enhanced sense of self-awareness. This transformation was facilitated by free activities on the university campus, an assurance of physical and psychological safety, and an indication of an outlet for such transformation.

An attempt was made to examine the long-term impact of the introduction of communal piped water supply on pattern of water use and transmission of schistosomiasis haematobia in an endemic area of Kenya. In the study area, Mtsangatamu, a control program based on repeated selective mass-chemotherapy had been carried out for 6 years from 1987 to 1993. The pre-treatment overall prevalence and intensity of infection in 1987 were 59.2% and 10.9 eggs⁄10 ml of urine (Muhoho et al., 1997). During the control program, the prevalence was kept at a low range of 20 to 40% (Muhoho et al., 1994). At the end of the program, in 1994, gravity-fed water supply was provided to the village. Although the water facilities were damaged by flooding in 1998, new and further expanded gravity-fed water supply facilities consisting of 7 standpipes were introduced in 2000. The follow-up survey done in 1999 revealed reduced prevalence and intensity of infection, I.e. 23.0% and 1.2 eggs⁄ 10 ml of urine (unpublished data). The present study was carried out in 2006, 6 years after the last mass-chemotherapy. Urine examination showed that the prevalence and intensity of infection had return to 52.2% and 7.4 eggs⁄10 ml, nearly the same level as the pre-treatment level. The results of our study demonstrated that, over the long-term, the gravity-fed water supply facilities had little impact on the overall prevalence and intensity of infection in this village. However, analysis of the spatial pattern of infection, observation of human water contact at the river and a questionnaire on water use shed light on the possible impact of water supply on human water contact. The younger people (5-19 years old) with easy access to the standpipes showed a lower prevalence and intensity of infection, while the relationship was not clear in other age groups.
The result of the questionnaire indicated that the long distance from household to standpipe was the major factor limiting the use of the communal tap water. Most of the villagers who used piped water as the main source of water lived within 800 m of the nearest standpipe, and villagers who used river water exclusively lived beyond that distance. Observation of water-related activities at the communal water facilities also indicated that the residents who lived near standpipes used the piped water more frequently.
The frequency of total visits to river water sites did not differ between residents who lived near and far from the standpipe. However, water contact in the form of playing, the highest risk behavior, was observed exclusively among children who lived far (>250m) from standpipes, although the number of observations was small.
The present study demonstrated that the water facilities had little effect on the dispersed population but might have a beneficial effect on some villagers given easy access to standpipes.

Objective: To describe anatomic patterns of the superficial uterine vein (sUV) and assess their association with aspects of the dissection procedure of the anterior layer of the vesicouterine ligament (aVUL) by retrospectively reviewing surgical videos. Methods: We analyzed patients who underwent laparoscopic radical hysterectomy for early-stage cervical cancer from 2014 to 2019. The primary endpoint was the time required for aVUL dissection. Multiple linear regression analyses were performed to identify factors influencing the time required for aVUL dissection. Results: Fifty-three Japanese patients were included. Two sUV configurations were observed:type 1 (the vein ran ventral to the ureter along the uterine artery) and type 2 (the vein did not run along the usual ventral course; it ran dorsal to the ureter or was absent). Approximately 30% of the sUVs were type 2. The total time for dissection of both sides of the aVUL was significantly shorter for type 2 sUVs than for type 1 sUVs. The number of hemostatic interventions during dissection of each side of the aVUL was significantly lower for type 2 sUVs than for type 1 sUVs. In the multivariate analysis, the sUV configuration was the factor significantly influencing the duration of aVUL dissection on each side (right side: β=−143.4;left side, β=−160.4). Conclusion We demonstrated that the sUV had 2 types of courses, ventral and others, and its course affected the time required for dissection and the number of hemostatic interventions.Our results provide information supportive of improved radical hysterectomy outcomes.

Objective: To describe anatomic patterns of the superficial uterine vein (sUV) and assess their association with aspects of the dissection procedure of the anterior layer of the vesicouterine ligament (aVUL) by retrospectively reviewing surgical videos. Methods: We analyzed patients who underwent laparoscopic radical hysterectomy for early-stage cervical cancer from 2014 to 2019. The primary endpoint was the time required for aVUL dissection. Multiple linear regression analyses were performed to identify factors influencing the time required for aVUL dissection. Results: Fifty-three Japanese patients were included. Two sUV configurations were observed:type 1 (the vein ran ventral to the ureter along the uterine artery) and type 2 (the vein did not run along the usual ventral course; it ran dorsal to the ureter or was absent). Approximately 30% of the sUVs were type 2. The total time for dissection of both sides of the aVUL was significantly shorter for type 2 sUVs than for type 1 sUVs. The number of hemostatic interventions during dissection of each side of the aVUL was significantly lower for type 2 sUVs than for type 1 sUVs. In the multivariate analysis, the sUV configuration was the factor significantly influencing the duration of aVUL dissection on each side (right side: β=−143.4;left side, β=−160.4). Conclusion We demonstrated that the sUV had 2 types of courses, ventral and others, and its course affected the time required for dissection and the number of hemostatic interventions.Our results provide information supportive of improved radical hysterectomy outcomes.

Objective: To describe anatomic patterns of the superficial uterine vein (sUV) and assess their association with aspects of the dissection procedure of the anterior layer of the vesicouterine ligament (aVUL) by retrospectively reviewing surgical videos. Methods: We analyzed patients who underwent laparoscopic radical hysterectomy for early-stage cervical cancer from 2014 to 2019. The primary endpoint was the time required for aVUL dissection. Multiple linear regression analyses were performed to identify factors influencing the time required for aVUL dissection. Results: Fifty-three Japanese patients were included. Two sUV configurations were observed:type 1 (the vein ran ventral to the ureter along the uterine artery) and type 2 (the vein did not run along the usual ventral course; it ran dorsal to the ureter or was absent). Approximately 30% of the sUVs were type 2. The total time for dissection of both sides of the aVUL was significantly shorter for type 2 sUVs than for type 1 sUVs. The number of hemostatic interventions during dissection of each side of the aVUL was significantly lower for type 2 sUVs than for type 1 sUVs. In the multivariate analysis, the sUV configuration was the factor significantly influencing the duration of aVUL dissection on each side (right side: β=−143.4;left side, β=−160.4). Conclusion We demonstrated that the sUV had 2 types of courses, ventral and others, and its course affected the time required for dissection and the number of hemostatic interventions.Our results provide information supportive of improved radical hysterectomy outcomes.

Objective: To clarify challenges and strategies to execute pharmaceutical care by community pharmacists and obtain pragmatic implications for further improvement. Design: Cross-sectional study.. Methods: We conducted a nationwide internet-based questionnaire survey about pharmaceutical care by the Japanese community pharmacists in June and July 2016. Using text data of 161 respondents, we investigated their challenges and strategies in implementing pharmaceutical care. The text data were reviewed and determined for categorization through stepwise process and reconciliation between reviewers. Results: Fourteen categories were retrieved and integrated into 4 domains (pharmacists, patients, other medical professionals, and environment) from 2 dimensions (challenges and strategies). In the challenge dimension (total n＝142), communication capability (n＝26), participation in medical team (n＝17), patients’ understanding of pharmacists’ work (n＝14), lack of timeand staff (n＝14),patient- and people-centered viewpoint (n＝13). Whilein thestrategy dimension (total n＝72), communication capability (n＝21),lack of patients’ medical information (n＝18), patient- and people-centered viewpoint (n＝11), lack of timeand staff (n＝9), and self development (n＝5). As strategies for the communication capability, attitude of acceptance and collaboration, brief explanation,utilization of visual aids, adoption of objective evaluation, various acquisition of patients’ information, active listening, and sharing patients’ information were retrieved as subcategories. The highest level of attention to communication capability implies that community pharmacists certainly recognize their expected responsibility described in the government document titled “Vision for patient-centered pharmacies”. Conclusion: Community pharmacists face many challenges but have some practical strategies. Although part of such challenges is not for pharmacists themselves but for patients, other medical professionals, or entire health system, improving essential skills of pharmacists may havepositiveinfluenceto theother challenges.

Objective: Pharmaceutical documents such as the common technical document, package inserts (PIs), and interview forms (IFs) are available at the website of the Pharmaceuticals and Medical Devices Agency. However, because these documents were created with an emphasis on human readability in paper form, it is difficult to use the information included and interoperate these documents with computers. Using IFs, we will investigate how to structure pharmaceutical documents in the AI era to achieve both human and machine readability.Design/Methods: The IFs of arbitrary selected ten drugs were structured into Resource Description Framework (RDF) according to the Drug Interview Form Description Guidelines 2018 (updated version in 2019). The data were manually extracted from the IFs and entered into a spreadsheet before being converted to RDF by a written script. The PIs were converted to RDF in addition to the IFs. To examine the linkage with external databases, IDs in ChEMBL, which is a manually curated database of bioactive molecules with drug-like properties, were embedded in the RDF.Results: We demonstrated that the conversion of IFs and PIs into RDF makes it possible to easily retrieve the corresponding part of the PIs cited in the IFs. Furthermore, we quickly obtained the relevant data from ChEMBL, demonstrating the feasibility of linking IFs with an external database. Our attempt to RDFization of IFs is expected to encourage the development of web applications for healthcare professionals and the development of datasets for AI development.Conclusion: We could easily interoperate IFs with other pharmaceutical documents and an external database by converting IFs into RDF following the description guidelines. However, problems such as how to deal with items that were not described in the description guidelines were indicated. We hope that discussions will grow based on this effort and that related industries will move toward accomplishing effective use of these documents.

This study aimed to verify whether the incidence of frailty in elderly individuals is higher among those who are housebound than those who are not. This study found no correlation between elderly people’s houseboundedeness and physical, mental, social, and overall frailty. However, the Tilburg Frailty Indicator (TFI) frailty score and grip strength value were higher in non-housebound elderly persons than in housebound elderly ones. This suggests that being housebound may lead to frailty. On the other hand, it is thought that individual interaction with family and friends, and lack of anxiety about falls correlates with the prevention of frailty in housebound elderly persons. The results of the study also suggest that the basic checklist may be effective for ascertaining the actual situation of housebound elderly people who may be manifesting frailty.