OBJECTIVESWe have evaluated the effectiveness of motivational signs in promoting stair use instead of escalators, in terms of gender and age, at a train station with a 37-step staircase. We also examined whether a newspaper article, or booster, had any effect on augmenting the impact of the signs.

METHODSIn a serial cross-sectional survey with prompted signs, the subjects were coded by gender and age (over 65 years, under 65 years), and students (13-18 years old and school uniforms). We used a 2-week baseline period, followed by a 4-week intervention in which a total of 45 posters and banners with motivational messages were used to encourage stair use. As a booster, we published a news release of this study on a web site and in a local newspaper during the intervention period.

RESULTSA total of 43,241 escalator/stair-choice observations were made. Stair use increased significantly from 3.58 to 4.93% during the intervention period of 1-2 weeks for all subjects. In addition, stair use had a significantly high value of 5.80% during the intervention period of 3-4 weeks. Stair use also increased in subgroups during the intervention periods with the exception of women 65 and older. Attempts to publicize the study had no effect on the increase in stair use.

CONCLUSIONSThe use of signs was effective in changing behavior during the period of sign use, but this effectiveness was limited by gender, age, and the physical ability (e.g., muscle strength) and energy required to climb the stairs. The possible synergistic effects of publicity were inconclusive but are worthy of further investigation.

Objective: The wrong dose of high-risk drugs such as oral steroids is a serious issue that needs to be addressed. This study aims to determine the appropriate upper tolerable dose threshold and to develop a multi-variable logistic regression model to detect dose-errors in oral prednisolone tablets.Methods: Data on Prednisolone prescriptions were obtained from a single center. Out of the data collected, positive cases consisted of cases where dose-related modifications were made. A univariate logistic regression model was developed with the current daily dose. In the model, the Youden Index was used to determine the upper tolerable dose threshold. The investigation was done to determine whether the performance of the multivariate model was improved by adding clinical department and previous prescription information as variables.Results: Univariate models (AUC: 0.645) with only current daily doses and estimated optimal thresholds of 6 mg/day or 11 mg/day, respectively were determined to be appropriate. Including variables improved the performance of the predictive model; the best performing model (AUC: 0.840) was derived when the following variables were entered: “current daily dose,” “current prescription days,” “clinical department,” “daily dose of the previous prescription,” and “prescription days of the previous prescription”.Conclusion: A single upper tolerance limit is insufficient to determine dose adequacy for prednisolone tablets owing to their broad clinical dose range. Itmay be possible to develop a high-performance dose audit support model by adding information.