We examined the effect of increased rehabilitative training time on patients with cerebrovascular disorders at a convalescent rehabilitation ward in Japan. After April 2006, the Japanese Ministry of Health and Labor raised the permitted training time from 6 to 9 units (1 unit of training time corresponds to 20 minutes of exercise with a therapist) for patients in a convalescent rehabilitation ward. We compared patients who underwent rehabilitation during the period from April 2006 to March 2008 (9-unit group, 131 patients) with those rehabilitated from April 2003 to March 2006 6-unit group, 153 patients) in the convalescent rehabilitation ward of our hospital. The patients were evaluated with FIM instruments at admission and discharge. Length of hospital stay and rate of return to the patient's home were also examined. The 9-unit group had a shorter hospital stay, and higher FIM efficiency scores, and also a higher rate of home return compared with the 6-unit group.

After April 2006, the Japanese Ministry of Health and Labor raised the permitted training time from 6 to 9 units (1 unit of training time corresponds to 20 minutes of exercise with a therapist) for patients in a kaifukuki (convalescent) rehabilitation ward. We examined the effect of the increased rehabilitative training time on patients using feeding tubes in a kaifukuki rehabilitation ward after an initial cerebrovascular disorder, with a particular focus on improving swallowing disorders. Our study was comprised of post-stroke patients with feeding tubes who underwent rehabilitation from April 2001 to March 2006 (N=14, 6-unit group) and from April 2006 to March 2009 (N=16, 9-unit group). All patients went to the ward within two months after suffering a stroke. There was no significant difference in the Functional Independence Measure(FIM) efficiency or length of hospital stay between the two groups. Feeding tube removal was more common in the 9-unit group compared to the 6-unit group (81.3% vs. 35.7%, p<0.05), and the 9-unit group also had more training time per day. Logistic regression analysis showed that the increased training time per day spent with a speech therapist contributed to improving swallowing disorders (p<0.01).

A rare surgical case of chronic expanding hematoma in the pericardial cavity is reported. A 78-year-old man had undergone coronary artery bypass grafting 2 years previously. He had suffered from general malaise, increasing shortness of breath and systemic edema from 18 months after the operation. Echocardiography revealed an intrapericardial mass compressing the cardiac chambers resulting in insufficiency of the ventricular expansion. Under extracardiopulmonary bypass and cardiac beating, resection of the mass and additional coronary artery surgery were implemented. The mass was encapsulated with thick fibrous membrane containing old degenerated coagula the bacterial culture of which was negative and was histopathologically diagnosed as chronic expanding hematoma. The patient's postoperative course was uneventful and symptoms with cardiac failure were relieved. There has been no recurrence for more than 18 months.

Objectives: As the population ages worldwide, including in Japan, there is a growing expectation for older adults to remain active participants in society. The act of sharing one’s experiences and knowledge with younger generations through social engagement not onlyenriches the lives of older individuals, but also holds significant value for our society. In thisstudy, we examined both positive and negative perceptions of older adults and investigated the correlation between these perceptions and generativity among older citizens. Additionally, we evaluated the impact of life satisfaction on these factors. Methods: We conducted a survey of 100 older adults in Japan (mean age, 71.68 years) and utilized multiple regression analyses, using positive and negative perceptions of older adults, life satisfaction, and demographic factors as independent variables. The sub-categories of generativity—namely, generative action, concern, and accomplishment—were used as dependent variables. Results: Participants who held a more positive perception of older adults demonstrated a higher level of generative actions and concerns. Additionally, participants who reported higher levels of life satisfaction also exhibited more generative actions, concerns, and accomplishments. Conversely, those who held a more negative perception of older adults were found to have higher levels of generative actions. Conclusion Enhancing positive perceptions of older adults among them can boost the subcategories of generativity. This study, which was conducted from an exploratory perspective, has several limitations, including a potential sampling bias. A more comprehensive examination of the relationship between perceptions of older adults and generativity is anticipated in future research.

Through this meta-analysis, we sought to examine the prevalence of, risks for, and factors associated with bullying involvement (victimization, perpetration, perpetration-victimization) among students with autism spectrum disorder (ASD). Additionally, we attempted to examine sources of variance in the prevalence and effect sizes of bullying in students with ASD across studies. Systematic database and literature review identified 34 relevant studies (31 for Western countries, three for Eastern countries). Pooled prevalence estimates for victimization, perpetration, and perpetration-victimization in general were 67%, 29%, and 14%, respectively.The risk of victimization in students with ASD was significantly higher than that in typically developing students and students with other disabilities. Further, deficits in social interaction and communication, externalizing symptoms, internalizing symptoms, and integrated inclusive school settings were related to higher victimization, and externalizing symptoms were related to higher perpetration. Finally, moderation analyses revealed significant variations in the pooled prevalences thereof depending on culture, age, school settings, and methodological quality and in the pooled effect sizes according to publication year and methodological quality. Our results highlight needs for bullying intervention for students with ASD, especially those who are younger, are in an inclusive school setting, and have higher social difficulties and externalizing/internalizing symptoms; for intensive research of bullying experiences among students with ASD in Eastern countries; and for efforts to improve the methodological quality of such research.

JA Omagari Kosei Medical Center is an acute hospital located in Daisen City, Akita Prefecture, and we have two comprehensive community-based care wards. Falls and fall incidents are always ranked high in acute hospitals. Injuries caused by falls such as fracture, may lead to decline in activities of daily living / quality of life in patients and / or their families, which may then prolong the hospitalization period. Therefore, prevention of falls and falling is beneficial. Previous studies have reported that the activities of the ‘falls and falling’ teams contribute to reducing the fall rate. However, few studies have been conducted in acute hospital settings. Therefore, in this study we summarized the characteristics and current status of hospitalized patients in terms of falls and falling incidents in our hospital from medical records and incident accident reports. 　　Among 230 patients, 291 falls and falling incidents were reported in 1 year; falls and falling accounted for 32.9％ of all incidents. In addition, the fall rate was 2.1 cases / 1,000 patients / day, average age was 77 years, and there was a higher tendency in men. Furthermore, falls and falling occurred on a median 13 days from hospitalization; in 124 cases (42.6％) within 10 days after hospitalization and in 60 cases (20.6％) from 10 days to 20 days. A similar tendency was seen in patients who were moved to the comprehensive community-based care ward. Therefore, we considered that the patient would require continuous attention after moving to that ward. Ultimately, falls and falling occurred in the late-night period (from midnight to 8 a.m.), and many were at the bedside (58.4％), and the purpose of movement was bowel motion (54.3％).

In 2021, the National Institute of Infectious Diseases, Japan, undertook enhanced event-based surveillance (EBS) for infectious diseases occurring overseas that have potential for importation (excluding coronavirus disease 2019 [COVID-19]) for the Tokyo 2020 Olympic and Paralympic Summer Games (the Games). The pre-existing EBS system was enhanced using the World Health Organization Epidemic Intelligence from Open Sources system and the BlueDot Epidemic Intelligence platform. The enhanced EBS before and during the Games did not detect any major public health event that would warrant action for the Games. However, information from multiple sources helped us identify events, characterize risk and improve confidence in risk assessment. The collaboration also reduced the surveillance workload of the host country, while ensuring the quality of surveillance, even during the COVID-19 pandemic.

The establishment of enhanced surveillance systems for mass gatherings to detect infectious diseases that may be imported during an event is recommended. The World Health Organization Regional Office for the Western Pacific contributed to enhanced event-based surveillance for the Tokyo 2020 Olympic and Paralympic Games (the Games) by using Epidemic Intelligence from Open Sources (EIOS) to detect potential imported diseases and report them to the National Institute of Infectious Diseases (NIID), Japan. Daily screening of media articles on global infectious diseases was conducted using EIOS, which were systematically assessed to determine the likelihood of disease importation, spread and significant impact to Japan during the Games. Over 81 days of surveillance, 103 830 articles were screened by EIOS, of which 5441 (5.2%) met the selection criteria for initial assessment, with 587 (0.6%) assessed as signals and reported to NIID. None of the signals were considered to pose a significant risk to the Games based on three risk assessment criteria. While EIOS successfully captured media articles on infectious diseases with a likelihood of importation to and spread in Japan, a significant manual effort was required to assess the articles for duplicates and against the risk assessment criteria. Continued improvement of artificial intelligence is recommended to reduce this effort.