Objective: This study aims to statistically clarify the association between disability characteristics and school refusal in school-aged children with Autism Spectrum Disorder (ASD).Methods: The subjects were 158 school-aged children with ASD who were prescribed rehabilitation at Narita Hospital of International University of Health and Welfare. The following information was collected from medical records: presence or absence of school refusal, age, gender, the Autism Screening Questionnaire (ASQ) scores, result of the Wechsler Intelligence Test 4th version, the Sensory Profile (SP) scores, the Liebowitz Social Anxiety Scale for Children and Adolescents scores, decline in family functions, bullying, and enrolled class. Poisson regression analysis was conducted using both crude and adjusted models. School refusal was the dependent variable, while ASQ and SP subcategories were the independent variables. Age and other factors were used as covariates in the adjusted model.Results: The “sensory avoidance” of the SP subcategory was significantly associated with school refusal in both the crude and adjusted models (odds ratio, 95% confidence interval: 1.03, 1.01-1.05, 1.03, 1.00-1.05, respectively).Conclusion: Analysis of the association between disability characteristics and school refusal in school-aged children with ASD suggests that sensory processing deficits are associated with school refusal.

Objective: This study aims to statistically clarify the association between disability characteristics and school refusal in school-aged children with Autism Spectrum Disorder (ASD).Methods: The subjects were 158 school-aged children with ASD who were prescribed rehabilitation at Narita Hospital of International University of Health and Welfare. The following information was collected from medical records: presence or absence of school refusal, age, gender, the Autism Screening Questionnaire (ASQ) scores, result of the Wechsler Intelligence Test 4th version, the Sensory Profile (SP) scores, the Liebowitz Social Anxiety Scale for Children and Adolescents scores, decline in family functions, bullying, and enrolled class. Poisson regression analysis was conducted using both crude and adjusted models. School refusal was the dependent variable, while ASQ and SP subcategories were the independent variables. Age and other factors were used as covariates in the adjusted model.Results: The “sensory avoidance” of the SP subcategory was significantly associated with school refusal in both the crude and adjusted models (odds ratio, 95% confidence interval: 1.03, 1.01-1.05, 1.03, 1.00-1.05, respectively).Conclusion: Analysis of the association between disability characteristics and school refusal in school-aged children with ASD suggests that sensory processing deficits are associated with school refusal.

The purpose of the present study was to examine the validity and reliability of the stages of change for sedentary behavior scale among workers. The participants were 2400 Japanese workers aged 20-59 years (male: 50.0%, mean age: 40.4±10.8 years) recruited from research company. With an internet-based survey, the stages of change for sedentary behavior, total sitting time (min/day), socio-demographic characteristics, health-related characteristics and work-related characteristics were obtained. “Too much sitting” was defined as sitting or lying down for a total of 8 hours or more per day on average. Participants were categorized into one of 5 stages based on their present status for “too much sitting” and motivational readiness for reducing sedentary behavior. For the criterion validity, a one-way analysis of variance was utilized to compare the total sitting time among the 5 stages. To assess the test-retest reliability, randomly-selected 200 workers answered the scale again two weeks later. Then, the Kappa index (k) was calculated. As results, the means of total sitting time were significantly distinguished across the stages [F (4, 2395) =111.5, p<0.001, η2=0.16]. Participants in early stages (precontemplation, contemplation, preparation) had significantly longer sitting time than those in the Maintenance (Precontemplation>Contemplation, Preparation>Action, Maintenance) (p<0.001). The scale to assess the readiness to reduce sedentary time has shown good 2-week test-retest reliability (k=0.64). These results suggest that the developed scale presented good validity and reliability to assess the motivational readiness for reducing prolonged sedentary behavior among Japanese workers.

Objectives  High gestational weight gain (GWG) is associated with perinatal risks to mother and child. Research shows that non-Japanese Asian women have higher GWG than Japanese women. However, no studies have compared GWG in these two populations using GWG recommendations in accordance with Japanese and Institute of Medicine (IOM) guidelines. The study aim was to compare GWG in non-Japanese Asian and Japanese pregnant women.Methods  This was a retrospective observational study. All participants were aged ≥20 years and gave birth between September 2019 and the end of October 2020 at one perinatal medical center in Japan. Medical record data were analyzed for 170 non-Japanese Asian and 316 Japanese pregnant women. We used t-tests and chi-square tests to examine differences in age, parity, smoking status, antenatal checkups, pre-pregnancy body mass index, and GWG. Logistic regression analysis was used to estimate odds ratios (95% confidence intervals) for above- and below-recommended GWG by non-Japanese Asian and Japanese status. We also analyzed differences in delivery type, abnormal blood loss, and birth size according to GWG.Results  After adjustment for confounding factors, the multivariable-adjusted OR and 95% CI for GWG above the Japanese guidelines recommendations was 1.86 (1.23-2.81) and that for GWG above IOM guidelines recommendations was 2.46 (1.45-4.16) for non-Japanese Asian women, as compared with Japanese women. Conversely, the multivariable-adjusted OR and 95% CI for GWG below Japanese guidelines recommendations was 1.55 (1.03-2.32) and that for GWG below IOM guidelines recommendations was 1.87 (1.26-2.76) for Japanese women, compared with non-Japanese Asian women. Conclusion  Because Japanese women tend to be below recommended GWG and non-Japanese Asian women tend to be above recommended GWG, midwives need to provide careful guidance to reduce perinatal risks.

The purpose of the present study was to examine the associations of replacing accelerometer-measured sedentary behavior (SB) with physical activity (PA) and depression in a sample of Japanese frail older adults using an Isotemporal Substitution (IS) model. Among 139 frail older adults, accelerometer was utilized to identify the daily average time spent in SB, light-intensity PA (LPA), and moderate- to vigorous-intensity PA (MVPA). Depression was assessed using the Geriatric Depression Scale-Short Version-Japanese (GDS-S-J). The relationship between SB, LPA, and MVPA with depression was examined with three models of multiple regression analysis: single factor model, partition model, and IS model. As results, LPA times was negatively associated with GDS-S-J scores in the single factor model (B = -0.09, p = 0.007) and the partition model (B = -0.13, p < 0.001). In the IS model, replacement of 10 minutes of SB with an equal amount of LPA time showed a significant negative association with GDS-S-J scores (B = -0.09, p=0.003). These results suggest that replacing a small amount of SB with LPA may be associated with an improvement in depression in frail older adults.

This study aimed to investigate the changes in physical function, fatigue, and psychiatric symptoms in patients with hematological malignancy undergoing chemotherapy and low-intensity exercise training. Sixty-two hospitalized patients with hematological malignancy undergoing chemotherapy and low-intensity exercise were recruited. At the time of exercise initiation and hospital discharge, grip strength, knee extension muscle strength, maximum walking speed, Eastern Cooperative Oncology Group (ECOG) performance status, a measure of functional independence, cancer fatigue pain, and hospital anxiety and depression were evaluated. When longitudinal data were analyzed in each group, changes in grip strength and knee extension muscle strength were unevenly distributed: some patients showed a decrease in knee extension strength. On the other hand, maximum walking speed, the measure of functional independence, and ECOG performance status were maintained or improved in more than 90% of the patients. Results of fatigue, anxiety, and depression tended to show an improvement in female patients, but not in male patients. In conclusion, physical function was maintained in nearly all patients with hematological malignancy undergoing chemotherapy and low-intensity exercise training. Sex differences were found in changes of fatigue, anxiety, and depression.

The present study reviewed the current trends of interventions focused on the physical activity environment for reducing sedentary behavior among children. Multiple international and domestic databases were searched to identify studies that involved changes to the physical activity environment, measured sedentary behavior, were specific to childhood populations, and published in a peer-reviewed journal. After studies were carefully assessed for inclusion by examining the title, abstract, and full text, the characteristics of the included studies (i.e., participants, study design, environmental intervention, measurement of sedentary behavior, and results) were summarized. A total of 31 studies (randomized controlled trial: n=25; quasi-experimental design: n=3; within-subject design: n=3) met the inclusion criteria. The majority of studies (n=23) were conducted using school-based interventions focused on the playground environment, involving either one or a combination of the following changes: improved markings, providing play equipment, or offering built facilities. Other studies included in the summary focused on behaviors at home and in the community like using electronic time managers while watching the television and providing low-cost or free entry to safe and easily accessible sports facilities. The measurement of sedentary behavior included an accelerometer, self-report, and direct observation. Twenty studies had a positive effect on reducing sedentary behavior among children. All but two of the studies were conducted in foreign nations. The present findings suggest that improving the physical activity environment to children can reduce sedentary behavior; therefore, further interventions focused on the physical activity environment for reducing sedentary behavior among Japanese children should be conducted.

Background: We retrospectively compared endscopic gastroduodenal stenting with gastrojejunostomy as a means of palliating malignant gastric and duodenal obstruction. Methods: This retrospective study investigated patients treated for malignant gastric and duodenal obstruction from April 2011 to April 2015 at Shikoku Cancer Center. Results: Of the 40 patients in this study, 25 underwent gastroduodenal stenting and 15 had operative gastrojejunostomy. Comparing the stenting and operative patients, technical success rate was 100% in both group, clinical success rate was 84% in stenting patients and 93% in operative patients. The median time to fluid intake was significantly shorter in stenting patients than operative patients(0 day vs 2 days, p=0.0003), and the median time to intake of solids was also significantly shorter in stenting patients(1day vs 3 days, p<0.0001).The median hospital stay was significantly shorter in stenting patients(9 days vs 23 days, p=0.0116). Median cost of hospitalization is more expensive in operative patients than stenting patients(¥1,106,170 vs ¥752,290, p=0.0052). Conclusion: Our study suggested that gastoroduodenal stent was less length of time to fluid/solid intake, and less costly than gastrojejunostomy.

Engaging in physical activity was proved to have positive effects on physical and mental health in children. Built environment is an important correlate of physical activity participation. School recess provides a daily opportunity for children to be active during school day. Therefore, the purpose of the present article was to review literatures regarding 1) physical activity during school recess, 2) the relationship between recess physical activity and school physical environment, 3) intervention for physical activity promotion during recess by changing school physical environment, and to explore trends of current researches and assignments of future research. A review was conducted and included studies published to May 31, 2011. Twenty-two studies were selected in 1) and showed boys often engaged in more physical activity than girls, but the results on differences in physical activity between ages were inconsistent. Six studies were selected in 2) and indicated recess physical activity was associated with playground environments such as equipments, marking, and surface situate. School environment intervention was observed to be a potential method for promoting physical activity in children by 8 studies in 3). Playground environment with marking, additional play equipments, and designated activity zones increased physical activity during recess. Most researches regarding recess physical activity was conducted in U.S., Australia, and Western countries, and confirmed the effectiveness of recess to promote physical activity. However, few studies on this topic were conducted in Japan. Further researches are needed to draw a conclusion about the possibility of recess to promote physical activity among Japanese children.

Background Psychological, social, and environmental factors are important determinants for physical activity promotion. There are numerous studies of the direct effects of these factors on physical activity. However, only a few studies have been examined the direct and mediated effects of these factors on physical activity.Purpose The purpose of the present study was to examine the direct and indirect influences of psychological, social, and environmental factors on physical activity among Japanese adults.Methods An internet-based cross-sectional survey was conducted to 2,000 Japanese adults aged 20-79 years. Seven sociodemographic attributes (e. g., gender, age, and marital status), self-efficacy, pros and cons, social support for exercise and environmental variables (home fitness equipment, access to facilities, neighborhood safety, aesthetics, seeing others exercising) were assessed by a self-administered questionnaire. The physical activity was estimated from the Japanese version of the short form of the International Physical Activity Questionnaire. Data were analyzed using structural equation modeling by gender.Results The respondents' mean (SD) age was 43.6(13.0). Environmental factors had indirect effects on physical activity through self-efficacy, social support and pros and cons. On both gender, the strongest indirect effects was the path of environmental factors on physical activity through pros to self-efficacy. The total effects of environmental factors on physical activity were 0.06 of males and 0.04 of females.Conclusion The results indicate that environmental factors had indirect effects on physical activity through psychological and social factors among Japanese adults. These results could contribute to the development of physical activity promotion strategies in Japan.