A study was conducted to develop prediction equations for cardiorespiratory fitness (maximal oxygen uptake : VO_2max and oxygen uptake at anaerobic threshold : VO_2AT) in Japanese adult men and women. Eighty-three healthy men and 86 healthy women, aged 20-64 years (41.1±13.5 and 41.5±13.5, respectively), were recruited as subjects. Mean (±SD) of VO_2max and VO_2AT measured during a cycling test were 37.2±6.4 and 20.5±4.7 ml/kg/min, respectively, in men and 32.7±7.3 and 17.8±4.1 ml/kg/min, respectively, in women. In this study 36 kinds of equations applicable to each sex were developed using all the subjects (n=169) . These equations consisted of independent variables such as work rate divided by body weight (W/Wt), age and body fat percentage (%Fat), which were signficantly correlated with measured VO_2max and VO_2AT. Multiple correlation coefficients (R) and standard errors of estimate (SEE) of the equations ranged from 0.641 to 0.830 (P<0.05) and from 3.66 to 4.98 ml/kg/min, respectively, for VO_2max and from 0.661 to 0.815 (P<0.05) and from 2.77 to 3.20 ml/kg/min, respectively, for VO_2AT. Reliability coefficients (r) between the first and second tests were 0.911 in men and 0.873 in women for VO_2max, and 0.869 in men and 0.770 in women for VO_2AT, all of which were statistically significant (P<0.05) . It is concluded that the equations developed in the present study have the merits of simplicity, economy, accuracy and reliability. Furthermore, from the viewpoint of safety and convenience, the following prediction equations are recommended.
(Male)
VO_2max (ml/kg/min) =6.57 W_{RPE-legs 15}/Wt-0.19 Age-0.36%Fat+41.29
(R=0.830, SEE=3.66 ml/kg/min)
VO_2AT (ml/kg/min) =7.35 W_{RPE-legs 14}/Wt-0.06Age-0.23%Fat+15.62
(R=0.815, SEE=2.77 ml/kg/min)
(Female)
VO_2max (ml/kg/min) =7.30 W_{RPE-legs 15}/Wt-0.12 Age-0.46%Fat+37.32
(R=0.828, SEE =4.16 ml/kg/min)
VO_2AT (ml/kg/min) =5.03 W_{RPE-legs 14}/Wt-0.01 Age-0.16%Fat+14.15
(R=0.680, SEE=3.06 ml/kg/min)

OBJECTIVE:
This study aims to examine the awareness and ability of health care providers to cope with language barriers at medical facilities in Hyogo Prefecture, Japan, and to clarify the issues concerning health care for foreigners.
METHODS:
In total, 2100 copies of self-report questionnaires on issues of health care for foreigners were mailed to health care providers of 352 hospitals in Hyogo. The survey was conducted from February to March 2010.
RESULTS:
The response rate of medical facilities was 21.6% (76/352), whereas that of the health care providers was 15.2% (320/2100). Approximately 10% hospitals handled foreign patients at least once per month, and they dealt with patients using several languages, including English, Chinese, Korean, and others. The providers' main issue was communication with their foreign patients. The documents and booklets for guidance regarding some health care procedures at the hospitals were also poorly prepared. It is therefore exceedingly necessary for hospitals to provide common documents in different languages; moreover, the government or local authorities should arrange for public medical interpretation services.
DISCUSSION:
Medical facilities in Hyogo have been struggling to improve their linguistic capabilities, and it is difficult to indicate whether public organizations concerned with medical interpretation are being recognized. Efforts on the part of medical facilities and local and national governments, as well as cooperation of nonprofit organizations, are immensely essential to resolve the issue of multilingual health care. This survey suggests that to help people with diverse languages, the health care system in Japan should be improved rapidly, particularly with regard to the establishment of licensed professional medical interpreters.

The purpose of this study was to elucidate the effects of whole-body vibration training (WBVT) on knee function and physical performance in middle-aged and older Japanese women who suffered from knee osteoarthritis (OA) and knee pain. Thirty-eight middle-aged and older Japanese women (aged 50-73 years) with knee OA and knee pain were divided into two groups: (1) a WBVT group (n = 29) engaging in WBVT 3 times a week for 8 weeks, and (2) a control group (C group, n = 9) performing exercises at home. The WBVT program consisted of a warm-up, strength training mainly of the quadriceps and their surrounding muscles and cool-down exercises. In the WBVT group, there were no dropouts, and there were significant improvements in the physical function (Cohen’s d = 0.28) and total score (Cohen’s d = 0.25) of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). There were also statistically significant improvements in all lower-extremity function tests (5-times sit-to-stand, timed up and go, standing time from a long sitting position, sit and reach, 4-way choice reaction time; Cohen’s d = 0.34-1.24). The item that changed significantly in the C group, however, was only the sit and reach (Cohen’s d = 0.52). In addition, all items in the Japanese Orthopaedic Association Score (JOA score) improved significantly (Cohen’s d = 0.63-0.67) in the WBVT group. In conclusion, the 8-week WBVT program can safely improve knee function and physical performance in middle-aged and older Japanese women who suffer from knee OA and knee pain.

In a clinical introductory program, each group of 9 fifth-year medical students rotated through 9 courses every 2 weeks. In each class, students evaluated the instructional abilities of the faculty. Eighty-two students answered 7 questions on a 5-point scale immediately after each class was completed. Because the questionnaire also served as a record of attendance, responses were obtained from all students who attended. Overall satisfaction was correlated most strongly with teaching skills, followed by contents of the class to achieve goals and the level of difficulty. The evaluation of faculty's instructional abilities by students can provide valuable information on areas to improve so that students can be educated more effbctively and with greater satisfaction.

A 69-year-old man, who had undergone coronary artery bypass grafting using the right gastroepiploic artery 2 years previously, was hospitalized with acute epigastralgia. Gastroscopy showed an early gastric cancer in the greater curvature of the corpus and ultrasonography of the abdomen revealed acute cholecystitis due to a stone impacted in the cystic duct. The subtotal gastrectomy and the cholecystectomy with preservation of the right gastroepiploic artery graft were performed. The surgical margin of the resected specimen was negative for cancer. The postoperative course was uneventful. After coronary artery bypass grafting using the right gastroepiploic artery, annual gastroscopy is recommended.

Objective: We conducted a meta-analysis on the suppressive effect of resistant maltodextrin on post-prandial blood glucose elevation, which is approved in Japan as food for specified health use, and the following is allowed to be indicated on the label “it is suitable for consumption by those who are concerned about their post-prandial blood glucose levels because the absorption of sugars is abated by the action of dietary fiber (resistant maltodextrin).”
Method: Our literature search covered Ichushi-Web (Japan Medical Abstracts Society), Japan Science and Technology Information Aggregator, Electronic (J-stage), Google Scholar, and PubMed databases and extracted English and Japanese publications on randomized, double-blind, controlled studies comparing resistant maltodextrin and a control in Japanese subjects for the reduction of areas under the blood glucose response curves at 30, 60, and 120 min after eating as an efficacy index.
Result: Among these publications, four articles with a Jadad score (an assessment of the quality of randomized controlled studies) of ≥ 3 were included in the meta-analysis.  Significant inhibitory effects were confirmed from areas under the blood glucose response curves at 30, 60, and 120 min after eating in the meta-analysis that was performed to evaluate the effects of resistant maltodextrin on post-prandial blood glucose elevation in Japanese individuals.
Conclusion: However, we were not able to test for publication bias because the number of extracted publications was small, and thus, additional research and case studies are warranted.

We examined the relationship between the timing of habitual physical activities and sleep quality in older adults. The subjects were Japanese community-dwelling older adults (n=49, average age 70.1±3.5 years; men: 36.7%). We measured habitual physical activity using a 3-axis accelerometer (HJA-350 IT, Omron) for a week. Timing of physical activity was classified into the following three periods: (1) morning: waking to 11:59, (2) afternoon: 12:00 to 17:59, and (3) night: 18:00 to bedtime. We also categorized the intensity of habitual physical activity during 2 sessions as either (1) low (1.6-2.9 METs) or (2) moderate-to-vigorous (≧3.0 METs) intensity. The subjective sleep parameters were assessed using the Pittsburgh Sleep Quality Index (PSQI). We used a forced-entry multiple regression analysis to investigate the relationships between subjective sleep parameters and the timing of physical activities. Forced-entry multiple regression analysis revealed that sleep latency and PSQI global score were positively correlated with low-intensity physical activity at night. However, there was no significant correlation with moderate-to-vigorous activity. These results suggest that low-intensity habitual physical activity at night would be one useful and modifiable factor to improve sleep quality in the elderly.

The purpose of this study was to examine the effects of 9 weeks of resistance training, with and without static acceleration training (AT), on participants' lower-limb muscle strength, power, and physical function. Healthy participants (19 men and 28 women), aged 65-75 years, were assigned to a static AT group (AT, n = 31) or a non-AT control group (C, n = 16). The AT group and the C group trained three times/week for 9 weeks. The AT group performed unloaded static AT and low-intensity aerobic activity. The C group performed dynamic weight-bearing resistance training without whole-body vibration and the same aerobic activity as the AT group. We collected and analyzed data from 45 participants (AT = 30, C = 15) who completed pre- and post-tests. There was no significant Group × Time interaction on any measurements of lower-limb muscle strength, power, or physical function. Significant time effects were observed in the following tests:isokinetic knee extensor and flexor peak torque, 5-time sit-to-stand, usual gait speed, timed up and go, standing time from a long sitting position, and sit and reach. All of these 7 variables showed positive changes. These results suggest that static AT is a suitable training method having approximately the same efficiency as conventional, weight-bearing, dynamic resistance training for improving lower-limb muscle strength and power, mobility, and flexibility in community-dwelling Japanese older adults.

This study examined relationships between physical activity and sleep relative to leisure-time, household, and occupational physical activity in community-dwelling, older adults. From 3,000 randomly chosen community-dwelling, adults, aged 65-85 years, we recruited 509 eligible subjects (mean age 73.2 ± 5.1 years). We assessed nocturnal sleep duration, sleep onset latency and subjective sleep quality over the previous month through a questionnaire. Physical Activity Scale for the Elderly was used to assess leisure-time, household, and occupational physical activity. Items pertaining to sleep were expressed as dichotomous variables (good/poor), and each physical activity score was divided into two categories based on activity level. To investigate the relationship between sleep (dependent variable) and physical activity (independent variable), we used a logistic regression analysis, controlling for age, gender, living arrangement, depressive symptoms, and cognitive function. Prolonged sleep latency was significantly related to no participation in low intensity exercise (OR 2.14; 95% CI 1.42-3.21) and muscle strength exercise (OR 1.99; 95% CI 1.06-3.74). Our data suggest that not participating in low intensity exercise or muscle strength exercise may be associated with difficulty initiating sleep in older adults.