In this study, we focused on the dietary habits of residents living in rural areas and investigated the status of dietary habits 10 years after an intervention project. Questionnaires were distributed to 210 people who lived in rural areas. Among them, 109 (53 Seminar group, 56 Exercise group) returned the answer forms. The results showed that subjects in both the seminar group and the exercise group had reduced their frequency of fruit intake (Seminar group, p < .05; exercise group, p < .01) and their consideration of the types of carbohydrate ingested (Seminar group, p < .01; exercise group, p < .05). This was thought to be influenced by factors such as food availability, subjects' physical and psychological factors, living environment factors, and traditional food culture. Eight items that served to sustain desirable dietary habits all seemed to be related to being easy to achieve and easy to continue for the subjects. Individuals with desirable lifestyle habits might return to their original lifestyle eventually. Therefore, even if intervention has been effective, the effects are not necessarily maintained throughout their lifetime.

The purpose of this study was to examine the relationship between the meaning of growing traditional vegetables and the health of elderly people living in rural areas. Data obtained from semi-structured interviews were qualitatively analyzed considering the local social and cultural contexts. The results suggest that cultivating traditional vegetables was related to the following categories: [A means to connect with people], [Facing old age], [A means to maintain physical functions], and [Protecting the community]. Cultivation of traditional vegetables is an activity that uses the five senses and utilizes intellectual functions. Furthermore, it is thought that significance and value will be found in life by building active relationships with people. Therefore, the cultivation of traditional vegetables was considered to be linked to recognizing the existential self and accepting the decline and loss of physical and mental functions to live as oneself.

The present multicenter, open-label study evaluated the efficacy and safety of tapentadol ER administered at 50 mg/day to 500 mg/day in opioid-naive and opioid-switching subjects with moderate to severe cancer pain. For opioid-naive subjects, the initial dose was tapentadol ER 50 mg/day. For opioid-switching subjects, the initial dose was determined depending on previously used opioid and was dose-adjusted for each subject. The study design consists of two parts of titration period and maintenance period to which a patient who achieves dose adjustment can proceed. The percentage of subjects achieving dose adjustment in the titration period was 93.3% for opioid-naive subjects and 80.6% for opioid-switching subjects. The percentage of subjects who maintained adequate analgesia throughout the maintenance period (primary endpoint) was 89.7% for opioid-naive subjects and 92.9% for opioid-switching subjects. The most frequent adverse events were were nausea, vomiting, somnolence, and constipation, all of which were commonly reported with the use of opioids. These findings showed that tapentadol ER was well tolerated in the dose range of 50 mg/day to 500 mg/day.

It was previously reported the safety and efficacy of oral tapentadol ER switched from other opioids for 8 weeks in subjects with moderate to severe cancer pain, who received opioid analgesics prior to study participation. All treatment emergent adverse events were evaluated in previous safety analysis. In this report, the incidence and timing of opioid specific adverse events related to tapentadol administration were analyzed and compared with those of morphine SR as a reference. Fifty subjects each was randomized to the tapentadol ER group and the morphine SR group. The incidences of major adverse events that are considered related to treatment in the tapentadol ER group and the morphine SR group were nausea (8.0%, 14.0%), vomiting (2.0%, 24.0%), constipation (8.0%, 20.0%), and somnolence (8.0%, 18.0%), the incidences of these events were lower in the tapentadol ER group. These results suggest that tapentadol ER is a orally opioid which has well safety profiles, and is a new option of cancer pain therapy.

In 31 asthmatic children, we investigated the change of the structure on the time of living, an amount of exercise by pedmeter and measured pulmonary ventilatory function during 28 weeks swimming training.
The result showed 58.07% of contribution factor to the structure on the time of living on children with asthma and dynamic play time after school were significantly shorter in asthmatic than non-asthmatic children (p<0.05) . After 28 weeks, we could not find any significantly differences of dynamic play time between asthmatic and nonasthmatic children.
An amount of exercise in daily life from the point of view of walking step number by pedmeter were significantly less in aged 6-9 years boys and girls, and aged 10-12 years boys than non-asthmatic children (respectively, p<0.05, p<0.01) . However, after 28 weeks, we could not find any differences between asthmatic and non-asthmatic children.
Forced vital capacity (FVC) and rate of forced expiratory volume on one second (% FEV_1.0) were increased after 28 weeks than the begining of swimming, and we found the strength of their breathing muscles.
On according to perform the great swimming distances (averages 220m in boys, 325m in girls), all asthmatic children became very lively and actively.

At Nippon Medical School, a "Basic Clinical Training Course" is provided as an introduction to clinical medicine. Medical students undergo initial clinical skills training with simulators. We describe the technique of effective training to acquire clinical skills and the results of student evaluations and a questionnaire survey.1) The training consisted of 8 practicums, including internal examination, funduscopic examination, otoscopic examination, breast examination, auscultation (heart sounds and lung sounds), and collection of blood samples. Medical students moved in rotation once per time period (45 minutes) and performed practical training in each unit, which comprised 2 practicums.2) The training with the prescribed number of 50 students in 4 time periods was efficiently performed for 2 days and required 9 trainers per day. Student evaluations and a questionnaire survey revealed the interest and enthusiasm of medical students and showed they thought highly of the training.3) The training was efficiently performed and was thought to help reduce the teaching load of instructors. The educational effect of the training can be strengthened by increasing the convenience of the clinical simulation laboratory, by reinforcing the education of clinical skills and attitudes in clinical clerkship, and by evaluating these factors after the completion of the clinical clerkship.

BACKGROUND/AIMS: Anti-tumor necrosis factor drugs (anti-TNF) and thiopurines are important treatment options in patients with inflammatory bowel disease (IBD), including during pregnancy. However, there are limited data on the benefit/risk profile of anti-TNF and thiopurines during pregnancy in Asia. The aim of this study was to analyze pregnancy outcomes of female Japanese IBD patients treated with anti-TNF and/or thiopurines. METHODS: This cross-sectional study assessed pregnancy outcomes in 72 women with IBD. Pregnancy outcomes were compared among 31 pregnancies without exposure to infliximab (IFX), adalimumab (ADA), or thiopurines; 24 pregnancies with exposure to anti-TNF treatment (23 IFX, 1 ADA); 7 pregnancies with exposure to thiopurines alone; and 10 pregnancies with exposure to both IFX and thiopurines. RESULTS: Thirty-five of the 41 pregnancies (85.3%) that were exposed to anti-TNF treatment and/or thiopurines resulted in live births after a median gestational period of 38 weeks. Of the 35 live births, 3 involved premature deliveries; 7, low birth weight; and 1, a congenital abnormality. There were 6 spontaneous abortions in pregnancies that were exposed to anti-TNF treatment (17.7%). Pregnancy outcomes among the 4 groups were similar, except for the rate of spontaneous abortions (P =0.037). CONCLUSIONS: Exposure to anti-TNF treatment or thiopurines during pregnancy was not related to a higher incidence of adverse pregnancy outcomes in Japanese IBD patients except for spontaneous abortion.
Adalimumab ; Abortion, Spontaneous ; Asia ; Asian Continental Ancestry Group ; Congenital Abnormalities ; Cross-Sectional Studies ; Female ; Humans ; Incidence ; Infliximab ; Infant, Low Birth Weight ; Infant, Newborn ; Inflammatory Bowel Diseases* ; Japan* ; Live Birth ; Necrosis* ; Pregnancy ; Pregnancy Outcome* ; Pregnancy*

Objective: Confirmation by pharmacists of brought-in drugs is not only limited to identification of drugs, but also requires prescription design and proposals based on the background of patients and evaluation of associated information. In this study, we analyzed the content of brought-in drugs related PreAVOID reports in our hospital according to the years of pharmacist experience in order to help educate pharmacist for better brought-in drugs confirmation.Method: Various interventions regarding brought-in drugs were compared between two groups: pharmacists with >6 years of experience (group H) and those with < 5 years of experience (group L). PreAVOID reports, which related to drugs brought in by patients admitted to the Ogaki Municipal Hospital between April 1, 2018 and March 31, 2019 were assessed.Result:The PreAVOID reporting rate for the number of brought-in drugs confirmed was higher in group H (1.56%) than in group L (1.12%) (odds ratio 1.399, p = 0.023). The PreAVOID reporting rate when reporting was based solely on prescription information did not differ between these two groups, but when patient background, including disease-related information, was included with prescription information, the rate was higher in group H (0.80%) than in group L (0.30%) (odds ratio 2.725, p < 0.001). Group H provided more reports related to unnecessary drugs.Conclusion: The involvement of pharmacists in the evaluation of brought-in drugs is important when reviewing subsequent medical treatments. Our findings suggest that to improve the quality of treatment, it is necessary to provide appropriate newcomer education, such as conducting case studies using PreAVOID cases.

Objective：The Clinical Trunk Control Test (CTCT) is used to assess trunk function worldwide, particularly for patients with spinal cord injury (SCI), with good reliability and validity. In Japan, trunk function evaluation methods specialized for patients with SCI are scarce. The aim of the present study was to create a Japanese version of CTCT (CTCT-J) and verify its reliability.Methods：CTCT-J was created using the double-back translation format. The inter-rater reliability was calculated based on the total CTCT-J score and intraclass correlation coefficient (ICC) for each item. The weighted kappa coefficient was calculated for each subtest. To verify internal consistency, Cronbach's alpha coefficient was calculated for the CTCT-J total score and each item.Results：We enrolled 12 patients with SCI, including ten men and two women, with an average age of 51.9 ± 17.8 years. Nine and three patients had cervical and thoracic SCI, respectively. The ICC for inter-rater reliability ranged from 0.995 to 1.000 (p ＜0.05). The weighted kappa coefficient for each subtest ranged from 0.756 to 1.000 (p ＜0.05). In the internal consistency test, the Cronbach's alpha coefficient for all items was 0.995 (p ＜0.05).Conclusion：We created the CTCT-J with double back translation and verified its reliability. Good inter-rater reliability and internal consistency were observed, indicating its applicability in Japan.

Objective：The Clinical Trunk Control Test (CTCT) is used to assess trunk function worldwide, particularly for patients with spinal cord injury (SCI), with good reliability and validity. In Japan, trunk function evaluation methods specialized for patients with SCI are scarce. The aim of the present study was to create a Japanese version of CTCT (CTCT-J) and verify its reliability.Methods：CTCT-J was created using the double-back translation format. The inter-rater reliability was calculated based on the total CTCT-J score and intraclass correlation coefficient (ICC) for each item. The weighted kappa coefficient was calculated for each subtest. To verify internal consistency, Cronbach's alpha coefficient was calculated for the CTCT-J total score and each item.Results：We enrolled 12 patients with SCI, including ten men and two women, with an average age of 51.9 ± 17.8 years. Nine and three patients had cervical and thoracic SCI, respectively. The ICC for inter-rater reliability ranged from 0.995 to 1.000 (p ＜0.05). The weighted kappa coefficient for each subtest ranged from 0.756 to 1.000 (p ＜0.05). In the internal consistency test, the Cronbach's alpha coefficient for all items was 0.995 (p ＜0.05).Conclusion：We created the CTCT-J with double back translation and verified its reliability. Good inter-rater reliability and internal consistency were observed, indicating its applicability in Japan.