In April 2014, a Letter of Rapid Safety Communication was issued, because 21 fatalities following administration of paliperidone palmitate (PP) were reported over a 5-month period since its launch in November, 2013. At the Department of Pharmacy of Hakodate Watanabe Hospital (our hospital), we established criteria for the use of long-acting antipsychotic injections (LAIs) when we began to prescribe LAIs at our hospital and shared information on the use of LAIs with pharmacists at community pharmacies by placing seals in medication notebooks. In March 2014, we conducted a questionnaire survey of pharmacists at 223 community pharmacies in Southern Hokkaido to compared the investigation items by the percentage of prescriptions filled in by the department of psychiatry among all the prescriptions dispensed by the pharmacies. The pharmacists who answered that injectable drug use information and seals for medication notebooks were necessary accounted for 75.8% and 74.2% of the responders, respectively. On the other hand, the percentages comprising the acquisition rates of information on injectable drug use and information on the injectable drugs used were low with 12.1% and 7.6% respectively. Also, a significant difference was seen in the recognition of LAI use in the comparison by the percentage of prescriptions filled in by the department of psychiatry among all of the prescriptions dispensed by the pharmacies (p＝0.001). Our results show that collaboration between hospital pharmacists and community pharmacists is necessary to ensure the safe use of LAI.

　　The Department of Plastic Surgery in our hospital uses compression stockings as a preventive measure against deep venous thrombosis (DVT). Elastic bandages are also used in patients with bone protrusion, skin lesions, or with no size-matched stockings. However, elastic bandages are associated with problems such as inconsistent compression force, ready loss of compression, and local skin lesions due to compression. Therefore, to address these problems, we developed a new bandaging technique by layering different types of bandages (multi-layer bandages), evaluated changes in compression using a measurement device, and examined skin condition after 6 h. On average, the compression of elastic bandages and multi-layer bandages decreased by 52% and 37.4%, respectively, after 6 h (t-test, P = 0.036). Skin wrinkles were finer with the multi-layer bandages. These results suggest that multi-layer bandages are less likely to loosen and that cast paddings prevent bandages from compressing the same local areas. However, because previous research warns of using elastic bandages as an easy way to prevent DVT, it is important to acquire accurate knowledge and master skills for bandaging with proper compression.

OBJECTIVESExposure misclassification is a major obstacle to obtain accurate dose-response relationships. In order to solve this problem, the impact of hair treatment on total mercury in hair was assessed in Japanese women.

METHODSA cross-sectional study was carried out among 327 women at age 24-49 years to determine hair mercury levels and estimate daily mercury intakes from seafood by using a food frequency questionnaire.

RESULTSHair mercury levels in the women and daily mercury intake ranged from 0.11 to 6.86 (median 1.63) μg/g and from 0.77 to 144.9 (median 15.0) μg/day, respectively. The hair mercury was positively correlated with the daily mercury intake (p<0.001). When the women were divided into two subgroups based on artificial hair-waving, hair coloring/dyeing, residence (non-fishing and fishing areas), and working status, a significant difference in the hair mercury level was observed between the women with and without artificial hair-waving only (p<0.001). The multiple regression analysis showed that the log-transformed hair mercury level was significantly related to the log-transformed daily mercury intake (standardized regression coefficient βs=0.307) and artificial hair-waving (βs=-0.276); but not to hair coloring/dyeing, residence, working status or age. Permanent hair treatment was estimated to reduce total mercury in hair by approximately 30%, after adjusting for daily mercury intake and other possible factors.

CONCLUSIONSThese findings suggest that hair mercury is not the best biomarker of methylmercury exposure when a study population includes women with artificial hair-waving.

Purpose: The purpose of this study is to develop a “Multidisciplinary Collaboration Ability Scale (MCAS)” and examine the reliability and validity for medical professionals engaged in cancer care. Method: The first MCAS draft was created, and the content validity and surface validity of the scale were examined for medical professionals. Next, a cross-sectional questionnaire survey was conducted on medical professionals engaged in cancer care who worked in medical institutions. Exploratory factor analysis and known-groups technique were carried out, coefficient α calculated, and concurrent validity examined. This study was conducted with the approval of the research ethics review. Result: Exploratory factor analysis resulted in 33 items of 4 factors (ability to promote discussion, foundational relationship building, self-control, and problem-solving activities). The MCAS score was significantly higher for those who had participated in a multidisciplinary workshop and those who had more years of experience. Coefficient α for the entire scale and for each factor was .80 and above. Examination of concurrent validity showed a moderate correlation. Conclusion: The reliability and validity of MCAS in its development stage were generally verified.