Objective : By extracting and modeling the component factors that community pharmacists have for “YARIGAI”—a Japanese colloquial expression commonly defined as “something worthwhile doing”—and by re-defining “YARIGAI,” we sought to help improve the quality of work lives of community pharmacists. Methods : All of 139 employee pharmacists participated in a workshop of the COMPASS Project (May 2011) were surveyed using a self-administered questionnaire. Responses were collected on the scene. The seventeen, 6-point-scale questions focused on the “patient-pharmacist relationship,” which may be related to “YARIGAI.” Then “YARIGAI” factors were extracted using factor analysis, and modeled using covariance structure analysis. IBM SPSS (ver. 20) and Amos 5.0J were used for the analyses. Results : To the item “I feel ‘YARIGAI’ with pharmacy work,” 12.2% of the 139 respondents said, “Strongly agree”, followed by “Agree” (41.0%) and “Somewhat agree” (33.8%). A factor analysis extracted three factors related to “YARIGAI” (knowledge, patient counseling management, and sense of personal growth). After modeling (AGFI : 0.903, RMSEA : 0.048) with these factors as latent variables and items in them as observable variables, a positive correlation was indicated for all the following factor pairs : “knowledge” and “patient counseling management”, “knowledge” and “sense of personal growth”, and “sense of personal growth” and “patient counseling management” (standardized points of estimate : 0.71, 0.55, and 0.42, respectively). Standardized coefficients for all latent and observable variables were 0.7 or higher, showing a good fit. Conclusion : “YARIGAI” of pharmacists employed by community pharmacies can consist of “knowledge,” “patient counseling management,” and “sense of personal growth”. Our results suggest that the improvement of communication skills and knowledge can lead to improvement of “YARIGAI” of pharmacists working for community pharmacies.

The objective of this study was to investigate whether isometric resistance exercise (IRE) can attenuate musculoskeletal atrophy during unloading and accelerate its recovery during reloading. Twenty-six female Fischer 344 rats, aged 16 weeks, had their hindlimbs suspended for 3 weeks (unloading) ; 12 of these rats were allowed subsequent cage activity (reloading) for 3 weeks with or without IRE. IRE (stationary support on a cylindrical grid inclined 60 or 80 degrees) was done for 30 min/day, 6 days/week, with an additional load of 30% or 50% body mass attached to the tail during the unloading and reloading periods. The tibial bone and hindlimb skeletal muscles from four experimental and two age-matched control groups were evaluated with dual-energy X-ray absorptiometry, mechanical testing, and muscle mass measurement. Bone mineral density (BMD) was measured in the whole tibia and in 7 regions divided equally along the long axis of the epiphysis from proximal (R1) to distal (R7) . After unloading, fat-free dry mass (FFDM), bone mineral content (BMC), and BMD of the whole tibia decreased by 8%, 10%, and 6%, respectively. FFDM and BMC, but not BMD, returned to the levels of age-matched controls during reloading. Unloading-induced decreases in BMD were observed in the regions from the proximal epiphysis to the diaphysis (R1 to R4) and the distal epiphysis (R7) . The rate of decrease in BMD was regionally specific and was particularly pronounced (12%) in the most proximal region (R1) . These findings indicate regional variations in responses of BMD to skeletal unloading. The BMD in R2 to R4 remained less than that in age-matched control after reloading. No significant changes were observed in maximum breaking load, energy, and deformation after unloading and reloading. Hindlimb-unloading induced loss of mass in the soleus (38%), plantaris (14%), gastrocnemius (25%), tibialis anterior (8%), extensor digitorum longus ( 8%), and rectos lemons (17%) muscles, but the mass of muscles, except for the soleus muscle, recovered during reloading. IRE ameliorated the loss of mass in the soleus and gastrocnemius muscles during unloading but did not promote the recovery of mass in any muscles during reloading. Moreover, IRE showed no effect on bone responses after unloading and reloading. This lack of beneficial effects of IRE on osteopenia may be due, in part, to insufficient exerciseinduced load. We concluded that 1) regional analysis of BMD can be used to assess local bone metabolism, 2) the response of BMD to altered loading conditions does not necessarily depend on the response of muscle mass, 3) recovery from osteopenia progresses more slowly than that from sarcopenia, and a longer time than the unloading period is required to restore BMD. Further studies are needed to develop more effective countermeasures against osteopenia and sarcopenia.

Primary end-to-side anastomoses between the left upper pulmonary vein and left atrium performed in 21 puppies with continuous 5-0 polydioxanone (PDS) or polypropylene (PRO). Animals were sacrificed at 1, 7 and 28 days after operation. Stenosis occurred in one of 5 animals of the PDS group at 7 days and 28 days respectively, and one of 5 animals of the PRO group at 28 days. There was no significant difference between the two groups in terms of anastomosis patency. Histological examination showed slight tissue reaction and fibrosis surrounding the sutures in both groups. This study suggests that the absorbable monofilament suture material, in particular PDS, is useful for the repair of low pressure circulatory system and will not cause the stenosis of the anastomotic site.

Objective: We investigated cases of visit encouragement by pharmacists and drugstore salespersons, and confirmed the significance of self-medication support.Methods: We conducted a web survey for pharmacists working at community pharmacies and drugstores, and registered salespersons working at drugstores. The main survey items were the attributes of the respondents, whether they had experience in encouraging visits to the doctor during consultations for cold-like symptoms, and the type of encouragement (patient background, main complaints, and prognosis).Results: We obtained responses from 300 pharmacists working at community pharmacies, 57 pharmacists working at drugstores, and 56 registered salespersons. Of the respondents, 88% of the pharmacists at community pharmacies, and 100% of the pharmacists and registered salespersons at drugstores had experience in encouraging doctor visits. Of the 84 visit encouragement cases reviewed, the diseases that were often suspected were influenza, sinusitis, and gastroesophageal reflux disease. Cases of early symptoms of tuberculosis, mycoplasma pneumonia, and cerebral infarction, which were identified as a result of the doctor visits, were also included.Conclusion: Our study suggested that when customers with cold-like symptoms received accurate support from pharmacists and registered salespersons, they not only selected the correct OTC drugs for their symptoms, but they also received support that led to the early detection of serious diseases.

Objective: To clarify the relationship between the awareness of pharmacists regarding instructions on the use of inhaled corticosteroids and the instructions conveyed.
Design: Fact-finding-survey using self-administered questionnaires.
Methods: The survey items consisted of age, years of clinical experience, number of prescriptions from asthmatics per month (“number of prescriptions”), items to concern when giving instructions (“items to concern”) time required to give instructions on inhaler usage (“time required”), and the pharmacists’ awareness regarding instructions on the inhaler usage (“awareness items”).  There were six awareness items for which responses were solicited on a four-grade scale.  Respondents were divided into two groups: a “high awareness” group giving responses of “completely agree” (or “completely disagree” for diametrically opposed items) and a “low awareness” group giving other responses.  T test was used to compare the average of age, years of clinical experience, number of prescriptions, concern degree, and time required between 2 groups.
Results: This showed the higher consciousness that “instructions on inhaler usage are important issue relating to the patient’s asthma therapy” was significantly-high degree of concern and time required.  Also, the consciousness that “instructions on inhaler usage are a specialized activity performed by pharmacists” was related to age, years of clinical experience and level of concern degree.  Additionally, this suggested the pharmacists giving negative responses with respect to the notions that “the effect of instructions on inhaler usage is not worth the trouble” and “patients have insufficient desire to master of inhaler usage” had a higher degree of concern.
Conclusions: For significance and importance of instructions on inhaler usage, there was confirmed to be relationship between pharmacists’ awareness and the information conveyed and time spent on the instructions.  This suggested that it was important to improve awareness of instructions on inhaler usage in both the clinical and educational setting.

BACKGROUND: Listeria monocytogenes (L. monocytogenes) is a rare causative pathogen of brain abscess that is often found in immunocompromised patients. Although patients with supratentorial listerial abscesses showed a longer survival with surgical drainage, the standard therapy for patients with subtentorial lesions has not been established. CASE REPORT: We report herein a patient with supra- and subtentorial brain abscesses caused by L. monocytogenes infection. These abscesses did not respond to antibiotics, and his symptoms gradually worsened. Drainage was not indicated for subtentorial lesions, and the patient was additionally treated with hyperbaric oxygen therapy, which dramatically reduced the volume of abscesses and improved the symptoms. CONCLUSIONS: This is the first report of drastic therapy for a patient with listerial brain abscesses involving combined antibiotics and hyperbaric oxygen therapy. The findings suggest that hyperbaric oxygen therapy is a good option for treating patients with deep-seated listerial abscesses and for who surgical drainage is not indicated.
Abscess ; Anti-Bacterial Agents ; Anti-Infective Agents* ; Brain Abscess* ; Drainage ; Humans ; Hyperbaric Oxygenation* ; Immunocompromised Host ; Listeria monocytogenes

Depression requires continuous long-term treatment. However, many patients drop out from their treatment program. The purpose of this study is to investigate the current status of pharmacists’ support for depressed patients at higher risk of self-discontinuation of medication. This was a cross-sectional study of community pharmacists’ support for depressed patients using a web-based questionnaire. The survey items were 1) pharmacists’ basic attributes and 2) pharmacists’ support to prevent patients from dropping out of their treatment. Morphological analysis was performed using text mining to analyze the free responses, and the relationships between the extracted categories were examined using hierarchical cluster analysis. Free responses were obtained from 77 pharmacists. The morphological analysis extracted 26 categories from their responses, and the category with the highest frequency of occurrence was “explain” (44 times). The extracted categories were stratified into clusters 1 to 6 using hierarchical cluster analysis.