The DOLOPLUS-2 scale was developed by Bernard Wary in 1992, and is a behavioral pain assessment scale for elderly individuals with verbal communication disorders. The scale comprises 10 items divided into 3 sub-groups. Each item has four levels of pain intensity, with scores ranging from 0 to 3. A score of ≥5 (out of a maximum of 30) indicates the presence of pain. In 2007, our team translated this scale from French into Japanese, and the translated version was validated in 2012. In this manuscript, I discuss the introduction and use of this scale based on the results of our research.

This study aimed to examine the relationship between daily outdoor playing time assessed using questionnaires for parents and daily moderate-to-vigorous physical activity (MVPA) using triaxial accelerometers for young children (213 boys: 5.8±0.6years and 193 girls: 5.9±0.6years). The study also examined the potential relationships between daily MVPA and exercise habits or familial and preschool factors which were assessed using questionnaires for parents. Daily MVPA was assessed using a triaxial accelerometer (ActivTracer, GMS) for 6 consecutive days, including weekdays and weekends. Outdoor playing time and percentage of outdoor playing time more than 60 min/day were 81±62 min/day and 64% for boys and 78±61 min/day and 62% for girls, respectively. Outdoor playing time was not significantly correlated with MVPA. The study found that no factors for MVPA, including exercise habits, were correlated with MVPA when adjusted for age, body height and log-body weight, except that MVPA for girls in kindergartens was higher than that in nursery schools. These findings suggest that the percentage of outdoor playing time more than 60 min/day was about 2/3 in young children. The questionnaire didn't reflect their MVPA. The factors used in the present study except for the preschool type for girls may not contribute to the time spent in MVPA in preschool children.

This study sought to examine the potential relationships of physical education (PE) participation at preschool and sports club (SC) participation out of school and daily physical activity (PA) measured objectively using a triaxial accelerometer, with physical fitness in preschool children. Physical fitness testing was used to measure both health-related and skill-related parameters of fitness in 191 Japanese preschoolers in the Kanto region (94 boys and 97 girls, 5.6 ± 0.6 years). Daily PA was assessed using a triaxial accelerometer (ActivTracer, GMS) for 6 consecutive days, including weekdays and weekend days. PE and SC participation was assessed using questionnaires for preschool teachers or parents of subjects, respectively. All health-related and skill-related physical fitness and total Z-score were correlated with time spent with physical activity ratio (PAR)≧4 when adjusted for age, sex, body height and weight. In addition, greater grip strength was associated with PE participation at preschool, and 25 m run speed was associated with SC participation, also. However, 25 m run speed was negatively associated with PE participation. These findings suggest that daily PA may contribute to the development of both health-related and skill-related fitness in preschool children, although further research on the cause-effect relationship is needed. Moreover, participation in a SC may contribute to the development of running speed.

To clarify nursing practices in pain management of community-dwelling older adults with dementia by visiting nurses, we conducted semi-structured interviews with 10 visiting nurses and analyzed their responses qualitatively and inductively. As a result, 24 subcategories and 8 categories were identified. Visiting nurses were found to conduct pain assessment and assessment based on behavioral changes in usual daily life because of characteristics of health assessment in home care, in which the goal is to comprehensively support clients as living people, in addition to standard pain management of older people with dementia. The results suggest that the viewpoint to integrate information from other professionals and family members and assess daily life comprehensively is important, and some mechanism to facilitate multidisciplinary information sharing is required. When visiting nurses were unsure of whether a patient is in pain, they evaluated the patient’s pain on the basis of behavioral changes in his or her normal daily life after medication or nondrug treatment. A nationwide survey is necessary for further clarification.

This study examined the relationship between meeting the World Health Organization’s (WHO) 24-Hour Movement Guidelines for the Early Years and motor skills and cognitive function in preschool children. Participants were 4-year-old boys and girls in urban and rural areas (n=69). Physical activity was measured using a triaxial accelerometer (ActiGraph GT3X). Screen time and sleep duration were assessed via self-report by guardians. Meeting the 24-h movement guidelines was defined as: 10 to 13 h/night and nap of sleep, ≤1 h/day of sedentary screen time, and at least 180 min/day more than 1.5 METs. Motor skills were evaluated by the Ages & Stages Questionnaires, Third Edition (ASQ-3). Executive functions (shifting, visual-spatial working memory and inhibition) were evaluated by the Early Years Toolbox (Japanese translation). The prevalence of children meeting all three recommendations was 7.2% and 7.2% met none of the three recommendations. Children meeting physical activity recommendation had a better inhibition score compared to children meeting none of the recommendation (p=0.005). While, children not meeting the sleep recommendation had a better inhibition score compared to children meeting of the recommendation (p=0.042). In conclusion, meeting the physical activity or sleep recommendations were positively or negatively associated with the inhibition score. On the other hand, meeting none of the sedentary behaviour and the 3 recommendations was not associated with motor skills or cognitive function.

The primary aim of this study was to examine moderate-to-vigorous physical activity (MVPA) levels in preschool children during indoor and outdoor free playing time and during preschool physical education (PE) classes. The secondary aim was to determine which types of PE lessons are the best for increasing the percentage of MVPA. Physical activity during free playing time and in lessons was objectively evaluated with a triaxial accelerometer in preschool boys and girls (n = 281). Minutes of physical activity were categorized into physical activity ratios (PAR). MVPA was defined as PAR ≥3.0. Time tables and PE lesson types were recorded using logs kept by class teachers. The percentage of MVPA in outdoor free playing time (38.9±16.3%) was significantly higher than that of indoor free playing time (12.6±10.1%, p<0.001). On the other hand, there was no significant difference between the percentage in MVPA in outdoor free playing time and the percentage in PE lessons (n=94: 38.0±19.4%vs. 34.9±15.8%, ns). After adjustment for gender, age, body height and weight and preschool, there were not significantly different the percentage of MVPA among contents of PE lessons. In conclusion, children engaged in almost 30~40% MVPA during outdoor free playing time or PE. The children also engaged MVPA during indoor free playing time.