Mental health represents a critical indicator of human development, serving as a key determinant of well-being, quality of life, and hope. As such, mental health has an impact on a range of development outcomes. There is growing recognition within the international community that mental health is one of the most neglected yet essential development issues. The adoption of the Convention on the Rights of Persons with Disabilities in 2006 by the United Nations General Assembly provided momentum to highlight the importance of the nexus between disabilities and mental health in the context of human rights, peace and security, humanitarian activities and in development work including response to AIDS. In addition, the Ministerial Declaration on Implementing the Internationally Agreed Goals and Commitments in Regard to Global Public Health, in the high-level segment of the substantive session of the Economic and Social Council in July 2009, highlighted the importance of integrating mental health into the implementation of the MDGs and other internationally agreed development goals and commitments, in order to achieve development outcomes. Based on these new developments, the Department of Economic and Social Affairs (DESA) of the Untied Nations and the World Health Organisation (WHO) issued the “United Nations-WHO Policy Analysis: Mental Health and Development: Integrating Mental Health into All Development Efforts including MDGs” in 2010. This document serves as a foundation for further mainstreaming of mental health into the development agenda including response to AIDS in the United Nations system and the broader international community. In the area of HIV, the United Nations Population Fund (UNFPA) integrated mental health into one of three goals and an outcome of its Strategic Plan: Universal access to reproductive health and comprehensive HIV prevention for improved quality of life. Based on this, UNFPA started to integrate mental health into its fund-wide policies and guidelines, and programmes at regional and country levels. In addition, the United Nations Children‟s Fund held a round table on adolescent mental health with partners in April 2011, and placed an emphasis on mental health and AIDS among adolescents. Poor mental health is both a cause and a consequence of ill-health including issues related to HIV, poverty, compromised education, gender inequality, violence and other global challenges. It impedes the individual's capacity to realize their potential and make a contribution to their community. On the other hand, positive mental health is linked to a range of development outcomes. Dialogue and consultations on a post-MDGs framework will present critical opportunities to ensure the explicit inclusion of mental health in any emerging development framework for 2015 and beyond. In addition, utilizing best practices from UNFPA and others, it is also important to continue efforts to integrate mental health into strategic plans and other policies and programmes of the United Nations implementing entities. Now is the time to include mental health as an integral part of development through increased recognition of the link between development and mental/emotional well-being, as well as the inclusion of persons with mental and intellectual disabilities, to achieve development for all.

Many young mothers get nervos when their children in hospital fret or cry at night. This problem has been regarded as a result, at least in part, of a deficiency in nursing time and experience of child care in this age of nuclear family or dualincome family. We thought, that it would be possible to reduce their anxiety if they were trained and had personal experience getting contact with other children and nurses.
By way of acting out this idea, we invited them to participate in creative play such as “origami”(the craft of paper folding) and evaluated how it worked based on a questionnaire obtained from 50 mothers. The results indicated that they became able to take care of thier children properly according to the health condition of each child after having relationships with other children, mothers and nurses through the group play. Such experience has naturally helped the mothers to gain knowledge and skill in child care. In the present surrey, 96% of the respondents said that they were happy to be together with their children in a hospital, and all acknowledged that they had learned many things through communication with other children and mothers. We conclude that this way of learning by experience through creative play is effective in relieving the anxiety of mothers about child care in a pediatric hospital.

  Specific activities of the working group include reviewing the assessment score sheet of all falls and the preventive measures by degree of risk, making staff education, training, monitoring the implementation of the safety and preventive recommendations for prevention of falls.
  The data of all inpatient falls which occurred during one year prior to and one year subsequent to the WG intervention were analyzed.
  The incidence of inpatient secondary falls, decreased from 155 to 108 , and reports of level III severe falls, showed a reduction from five cases to three. Statistically, the total percentage of secondary falls incidence decreased from 2.19‰ to 1.54‰.
  We therefore concluded that through the activities of the WG, the strengthening of the in-house system to prevent secondary falls, staff education, training, and heightened staff safety awareness have led to a decrease in the total number of primary and secondary inpatient falls.

Objectives: A survey was conducted to investigate the usability and safety of fentanyl sublingual tablets (FST) and to examine problems associated with their proper use.

Methods: Subjects were 18 cancer inpatients who received FST for breakthrough pain in their pharmacological cancer pain management. Changes in the pain score and the occurrence of adverse effects (nausea, vomiting and somnolence) were compared before and after FST administration.

Results: The pain score before FST administration was 6.4±2.4, and this was significantly improved to 3.4±2.8 at 30 min after administration (p<0.01). Somnolence occurred significantly more often 30 min and 2 h after FST administration than immediately before administration (p<0.05). There were no differences in the occurrence of nausea and vomiting before or after FST administration. Nine patients receiving FST therapy developed xerostomia, but there were no significant changes in the pain score or occurrence of adverse effects while they had xerostomia.

Conclusion: It is essential to observe the oral condition to judge whether FST therapy is indicated, and FST should be administered after providing sufficient oral care. The results indicate the possibility of increased occurrence of somnolence as an adverse effect.

OBJECTIVE: Although radiation therapy (RT) and concurrent chemoradiotherapy (CCRT) are the global standards for adjuvant therapy treatment in cervical cancer, many Japanese institutions choose chemotherapy (CT) because of the low frequency of irreversible adverse events. In this study, we aimed to clarify the trends of adjuvant therapy for intermediate/high-risk cervical cancer after radical surgery in Japan. METHODS: A questionnaire survey was conducted by the Japanese Gynecologic Oncology Group to 186 authorized institutions active in the treatment of gynecologic cancer. RESULTS: Responses were obtained from 129 facilities. Adjuvant RT/CCRT and intensity-modulated RT were performed in 98 (76%) and 23 (18%) institutions, respectively. On the other hand, CT was chosen as an alternative in 93 institutions (72%). The most common regimen of CT, which was used in 66 institutions (51%), was a combination of cisplatin/carboplatin with paclitaxel. CT was considered an appropriate alternative option to RT/CCRT in patients with risk factors such as bulky tumors, lymph node metastasis, lymphovascular invasion, parametrial invasion, and stromal invasion. The risk of severe adverse events was considered to be lower for CT than for RT/CCRT in 109 institutions (84%). CONCLUSION: This survey revealed a variety of policies regarding adjuvant therapy among institutions. A clinical study to assess the efficacy or non-inferiority of adjuvant CT is warranted.
Chemoradiotherapy, Adjuvant ; Combined Modality Therapy ; Female ; Humans ; Japan/epidemiology ; Middle Aged ; Neoplasm Recurrence, Local/prevention & control ; *Practice Patterns, Physicians'/statistics & numerical data ; Risk Assessment ; Risk Factors ; Surveys and Questionnaires ; Uterine Cervical Neoplasms/radiotherapy/*therapy

OBJECTIVES: The number of patients with bilateral cochlear implant (CI) has gradually increased as patients and/or parents recognize its effectiveness. The purpose of this report is to evaluate the efficacy of 29 bilateral CI out of 169 pediatric CI users, who received auditory-verbal/oral habilitation at our hearing center. METHODS: We evaluated the audiological abilities 29 Japanese children with bilateral CIs including wearing threshold, word recognition score, speech discrimination score at 1 m from front speaker (SP), 1 m from second CI side SP, speech discrimination score under the noise (S/N ratio=80 dB sound pressure level [SPL]/70 dB SPL, 10 dB) at 1 m from front SP, word recognition score under the noise (S/N ratio=80 dB SPL/70 dB SPL, 10 dB) at 1 m from front SP. RESULTS: Binaural hearing using bilateral CI is better than first CI in all speech understanding tests. Especially, there were significant differences between the results of first CI and bilateral CI on SDS at 70 dB SPL (P=0.02), SDS at 1 m from second CI side SP at 60 dB SPL (P=0.02), word recognition score (WRS) at 1 m from second CI side SP at 60 dB SPL (P=0.02), speech discrimination score (SDS) at 1 m from front SP under the noise (S/N=80/70; P=0.01) and WRS at 1 m from front SP under the noise (S/N=80/70; P=0.002). At every age, a second CI is very effective. However, the results of under 9 years old were better than of over 9 years old on the mean SDS under the noise (S/N=80/70) on second CI (P=0.04). About use of a hearing aid (HA) in their opposite side of first CI, on the WRS and SDS under the noise, there were significant differences between the group of over 3 years and the group of under 10 months of HA non user before second CI. CONCLUSION: These results may show important binaural effectiveness such as binaural summation and head shadow effect. Bilateral CI is very useful medical intervention for many children with severe-to-profound hearing loss in Japan as well as elsewhere.
Asian Continental Ancestry Group ; Child ; Cochlear Implantation ; Cochlear Implants ; Head ; Hearing ; Hearing Aids ; Hearing Loss ; Humans ; Japan ; Noise ; Parents ; Speech Perception

OBJECTIVESThe ingestion of pesticides in the daily diet is assumed to be the main modality of pesticide exposure for most people. A widely used class of pesticides in agricultural or residential settings is pyrethroid. We have examined the relationship between the intake frequency of selected items of vegetables and fruits and urinary metabolites of pyrethroid pesticides in a healthy general population.

METHODSA total of 535 residents (184 men and 351 women) who attended a healthcare checkup program conducted in a rural area of Hokkaido, Japan, in August 2005 provided informed consent for their spot urine samples to be used for the determination of 3-phenoxybenzoic acid (3-PBA) levels. They also completed a self-administered questionnaire regarding the intake frequency of 12 food items. The concentrations of creatinine-corrected 3-PBA were predicted by the intake frequency of each item, using analysis-of-covariance models to adjust for age, sex, body mass index, and drinking and smoking status.

RESULTSBoth a significant association between the 3-PBA concentration and the frequency of tomato consumption and a significant positive linear trend was found in female subjects. In contrast, no such association was found in the male subjects.

CONCLUSIONSThe frequency of tomato consumption was confirmed to strongly predict the urinary pyrethroid metabolite levels in the general population-presumably because tomatoes are most often consumed raw and unpeeled (more so than all other vegetables and fruits analyzed in the current study). However, it should be noted that the 3-PBA levels, even among those subjects with the highest consumption of tomatoes, were far below the levels of toxicological significance, although the health consequences from long-term low-level exposure to pyrethroid requires further exploration.

Effects of anti-oketsu drug, Keishibukuryogan (Gui-zhi-fu-ling-wan) and Tokishakuyakusan (Dang-gui-shao-yao-san) in vivo and in vitro on platelet aggregation were investigated in normal volunteers.
Of 20 volunteers who were given Keishibukuryogan, there were 6, 3 and 11 subjects whose dose-response curves of collagen-induced aggregations were shifted to the right, to the left, or who had no shift, respectively. The control aggregations of these 20 people were in the same range. In ADP-induced aggregation, there were 5 curves shifted to the right. Their potencies in the control aggregation were higher than those of 9 subjects who were not affected by the drug. There were 6 curves shifted to the left, and their potencies were lower than those of the 9 unaffected subjects. Of 12 volunteers who were given Tokishakuyakusan, there were 2, 2 and 8 subjects whose dose-response curves in collagen-induced aggregation were shifted to the right, the left, or who had no shift respectively. With ADP-induced aggregation, there were 1, 1 and 10 subjects whose doseresponse curves were shifted likewise. In vitro, Keishibukuryogan caused inhibition of ADP-induced aggregation but not that of collagen-induced aggregation.

OBJECTIVES: We conducted multi-directional language development tests as a part of the Research on Sensory and Communicative Disorders (RSVD) in Japan. This report discusses findings as well as factors that led to better results in children with severe-profound hearing loss. METHODS: We evaluated multiple language development tests in 33 Japanese children with cochlear implants (32 patients) and hearing aid (1 patient), including 1) Test for question and answer interaction development, 2) Word fluency test, 3) Japanese version of the Peabody picture vocabulary test-revised, 4) The standardized comprehension test of abstract words, 5) The screening test of reading and writing for Japanese primary school children, 6) The syntactic processing test of aphasia, 7) Criterion-referenced testing (CRT) for Japanese language and mathematics, 8) Pervasive development disorders ASJ rating scales, and 9) Raven's colored progressive matrices. Furthermore, we investigated the factors believed to account for the better performances in these tests. The first group, group A, consisted of 14 children with higher scores in all tests than the national average for children with hearing difficulty. The second group, group B, included 19 children that scored below the national average in any of the tests. RESULTS: Overall, the results show that 76.2% of the scores obtained by the children in these tests exceeded the national average scores of children with hearing difficulty. The children who finished above average on all tests had undergone a longer period of regular habilitation in our rehabilitation center, had their implants earlier in life, were exposed to more auditory verbal/oral communication in their education at affiliated institutions, and were more likely to have been integrated in a regular kindergarten before moving on to elementary school. CONCLUSION: In this study, we suggest that taking the above four factors into consideration will have an affect on the language development of children with severe-profound hearing loss.
Aphasia ; Asian Continental Ancestry Group ; Child ; Child Development Disorders, Pervasive ; Cochlear Implants ; Communication Disorders ; Comprehension ; Hearing ; Hearing Aids ; Hearing Loss ; Humans ; Japan ; Language Development ; Mass Screening ; Mathematics ; Rehabilitation Centers ; Vocabulary ; Weights and Measures ; Writing

OBJECTIVESThe aim of this study was to determine whether the serum nitrite plus nitrate (NO( x )) level correlates with biomarkers that are known components of the metabolic syndrome (MetS).

METHODSSerum NO( x ) levels were measured using a commercial kit in 608 Japanese men and women between the ages of 39 and 85 years. Multivariate adjustments for age, smoking status, alcohol consumption and exercise were made in the analysis of covariance (ANCOVA). The components of the metabolic syndrome were defined based on the following criteria: body mass index (BMI) >/=25.0 kg/m(2), glycated hemoglobin (HbA1c) >/=5.6%, systolic blood pressure >/=130 mmHg or diastolic blood pressure >/=85 mmHg, high-density lipoprotein-cholesterol (HDL-C) /=1.69 mmol/l.

RESULTSThe logarithmically transformed age-adjusted serum NO( x ) (lnNO( x )) value was significantly higher in the low HDL-C group (1.76 +/- 0.05 mumol/l; p < 0.05) than MetS component groups (1.65 +/- 0.01 mumol/l) in men, but no difference was found in women. The means of serum lnNO( x ) after multivariate adjustment were 1.64, 1.65, 1.64, 1.66, and 1.81 mumol/l for 0, 1, 2, 3, and 4-5 MetS components for all subjects, respectively. The results of ANCOVA confirmed that the serum lnNO( x ) level was significantly correlated with the clustering of MetS components in both men and women (p < 0.0001 for trend).

CONCLUSIONOur results suggest that an increase in the clustering of MetS components was associated with the increase in serum NO levels in our general population.