Purpose: This study was to examine both the reliability and validity of the Japanese version of the Caregiver Quality of Life Index-Cancer (CQOLC), which was developed to measure the quality of life of family caregivers of cancer patients. Methods & Results: Study subjects comprised 400 family caregivers who were registered at an Internet research company. The explanatory factor analysis yielded the following 4 domains: psychological burden (8 items); positive emotions (5 items); and financial burden (3 items); disruption of daily living (5 items). The Cronbach's alpha coefficients of the total score and each domain were 0.85 and 0.75 to 0.88, respectively. The total score and each domain were moderately correlated with mental health, vitality, social functioning, general health, role emotinal scores from the SF-36. The intraclass correlation coefficients of the total score and each domain were 0.78 and 0.67 to 0.74, respectively. Conclusion: These results suggest that the Japanese version of the CQOLC has sufficient reliability and validity.

Introduction  In Japan, midwives have difficulty communicating non-Japanese speaking women. The study aims to explore the midwives’ experience in communicating with them during the perinatal period. Methods  The semi-structured interviews were conducted for five midwives who have had experienced perinatal care for non-Japanese women.Results  Four categories were emerged during the pregnancy of the women: «Midwives desire to provide accurate information when giving medical and health related explanations», «Means and methods of health guidance depend on the contents», «It is much easier to interact with clients if verbal communication means are available during the prenatal check-ups» and «It is difficult to communicate by telephone about signs of onset of labor without having verbal communication means». Five categories have emerged in the intrapartum period including «Appropriate means and continuous involvement make communication smoother during delivery», «Non-verbal communication measures are useful in providing intrapartum care and «In case of an emergency of mother and fetus, ability of mother’s understanding and selection of appropriate means of communication are critical». Four categories have emerged in the postpartum period including «Midwives can communicate with non-verbal means for the health guidance» and «Midwives feel helpless when they cannot communicate verbally during the postpartum follow-ups». One thematic category «Midwives genuinely desire to provide quality communication despite the differences in language and culture»has emerged from over all period.Conclusions  It is important to prepare linguistic communication measures which help midwives to accurately communicate with their clients during the perinatal periods.

Purpose: Endoscopic submucosal dissection is a promising method for the resection of superficial gastric neoplasms. To date, several institutions have used proton pump inhibitor injections over the perioperative period. However, there is very little evidence regarding their efficacy. To overcome this limitation, we compared procedural outcomes and the prevention of adverse events of proton pump inhibitor injection with an orally administered active potassium-competitive acid blocker alone.Participants and Methods: We enrolled a total of 150 patients treated for superficial gastric neoplasms at a single institution between April 2015 and December 2018. Patients treated for 2 days with proton pump inhibitor injections following 12 days of oral potassium-competitive acid blocker (proton pump inhibitor group=80) were compared with patients treated for 14 days orally with potassium-competitive acid blocker alone (potassium-competitive acid blocker group=70) using propensity score analysis. We evaluated intragastric pH levels prior to endoscopic submucosal dissection, frequency of intraoperative major bleeding, procedure time, en bloc resection rate, curability, ulcer reduction rate 14 days after endoscopic submucosal dissection, and adverse events (including perforation and postoperative bleeding).Results: Propensity score analysis yielded 43 matched pairs. The comparison demonstrated similar values for the outcomes. For all cases, we observed intragastric pH levels >6.4 prior to endoscopic submucosal dissection. Postoperative bleeding rates were 2.3% (1/43) in the proton pump inhibitor group and 0.0% (0/43) in the potassium-competitive acid blocker group (P=0.315).Conclusions: Oral potassium-competitive acid blocker alone was as effective as proton pump inhibitor injection, with a low incidence of adverse events. Based on these results, proton pump inhibitor injection might be omitted during gastric endoscopic submucosal dissection.

Objective: The risk management plan (RMP) is a useful information source for healthcare professionals, including pharmacists, to ensure drug safety. The “risk minimization activities” (RMA) of the RMP are especially important elements for healthcare professionals. It is known that “Medication Guides for Patients” (MGP) and “Early post-marketing phase vigilance” (EPPV) are items listed as part of the RMA. However, the creation of MGPs and the implementation of EPPVs are not performed for all medicines. In a previous study, it was difficult to evaluate this sufficiently with the safety specifications. The aim of this investigation was to evaluate RMAs, especially MGPs and EPPVs, not in terms of the safety specifications of RMP.Methods: The previously published RMPs of 177 drugs were obtained on February 22,2016, and used in the analysis. The relationship between the creation of the MGP and the description in the RMA and the relationship between the conduct described in the EPPV and the description in RMA was investigated for each medicine.Results: An MGP was created in 151 of the analyzed drugs. Of these, it was not listed in the RMA of 40 drugs. In contrast, EPPV was not listed in RMA in 2 out of 33 drugs when underway. EPPV was described in the RMA of 33 of the EPPV finished drugs. The time lag from the end of EPPV until the revision of the RMP was 4.5 month son average.Conclusion: MGPs and EPPVs are created especially for drugs requiring patient education, information provision, or safety monitoring. Therefore, for drugs for which MGPs or EPPVs are required, they should be listed in the RMA. In this study, the time lag of RMP revision was also highlighted as a problem. In order to promote the utilization of RMP by pharmacists, these issues should be resolved.

In this study, we proposed an approach to interpret the classification of body constitution based on the Japanese Version of Constitution in Chinese Medicine Questionnaire (CCMQ-J) in terms of an augmented questionnaire combining seven independent questionnaires. The augmented questionnaire consists of 254 questions in terms of seven categories of attributes, which are the (i) basic information (BI), (ii) disease (DI), (iii) social factors (SO), (iv) mental factors (ME), (v) dietary habits (DH), (vi) sleeping state (SL), and (vii) sub-health (SH). The partial least square (PLS) regression has been adopted to model the correlations between the scores of body constitutions and the questions, and their results show that the body constitution can be represented by the linear combination of the questions substantially (correlation coefficients between the true and predicted constitutions are all above 0.7). Moreover, by using the crowdsourcing technique in data collection, a total of 851 samples (350 males and 501 females between 20 and 85 years old) samples with diverse geographical backgrounds in Japan have been collected, from which new medical implications have been extracted through the discussion in a Traditional Chinese Medicine standpoint. This study serves as a crucial step for validating the philosophy of ancient Chinese medicine by the state-of-the-art information science techniques and facilitating the use of the CCMQ-J in public healthcare.

Chinese Medicine Questionnaire (CCMQ-J) consists of sixty independent questionnaires and 9 physical constitutions called subscales. One type is balanced constitution (i.e., gentleness), and the following eight types represent unbalanced constitution: Qi-deficiency constitution, Yang-deficiency constitution, Yin-deficiency constitution, Phlegm-dampness constitution, Damp-heat constitution, Stagnant Blood constitution, Stagnant Qi constitution, and Inherited Special constitution. In this study, we proposed to determine optimal number of groups in 851 participants recruited from crowdsourcing answered CCMQ-J questionnaire consisting of 60 questions. In the present study, we applied k-means clustering with gap statistics to the questionnaire data and the number of optimal groups was estimated by five. The five groups are mainly characterized by 3 subscales in CCMQ-J, i.e. (i) two subscales corresponding to Yang-deficiency and Qi-depress, (ii) three subscales corresponding to gentleness, Yang-deficiency and Qi-depress (iii) Yang-deficiency, (iv) gentleness, and (v) Qi-depress. In the crowdsourcing survey, two subscales, Yang-deficient and Qi-depress are the most frequently occurred in current Japanese people.