As the school-age population declines, decisions on how small-scale schools organize their foodservice operations have become an important administrative issue. In practice, these decisions still rely heavily on limited criteria such as enrollment size or cost efficiency, while the actual operational capacity of schools is often overlooked. As a result, a structural gap persists between policy decisions and on-site foodservice realities. This paper proposes a decision-making framework for more balanced judgments on whether small-scale schools should retain or change their foodservice operation type. Based on a systematic literature review, the evaluation indicators were refined through a Delphi survey of experts, and their relative importance was estimated using the analytic hierarchy process (AHP). Consequently, 33 indicators were finalized across five domains: human resources, physical resources, finance and procurement, foodservice quality and satisfaction, and policy and education. The AHP results showed that human resources (0.3035) and physical resources (0.2235) were weighted more heavily than financial considerations. Applying the pareto principle, 16 core indicators accounting for approximately 70% of the total weight were selected and applied to case schools, clearly distinguishing schools with similar enrollment sizes but different operational conditions. In conclusion, school foodservice decisions should move beyond single-indicator judgments and instead be grounded in a multidimensional assessment of core operational capacity.

Health issues with workers include many aspects that scientific research in physical fitness and sports medicine can contribute to. Nevertheless, in Japan, there are few studies on the health problems in workers reported in the field of physical fitness and sports medicine. One reason could be the difficulty of obtaining cooperation in research from companies. This paper introduces results of epidemiological studies on health problems in workers by the Physical Fitness Research Institute. Our research serves as an example of physical fitness and sports medicine studies, including methods for securing fields for research. For the last decade, various epidemiological studies on worker’s mental health, sleep, non-alcoholic fatty liver disease, and labor related issues have been conducted in our research institute. Most of these studies indicated that lack of physical activity is associated with these indicators in Japanese workers. In recent years, we have also been conducting observational and interventional studies focusing on sedentary behavior in workers. Physical activity is deeply linked to worker’s health, therefore, the important approach to start a research in occupational health is to plan research that solves the company’s health challenges. In occupational health, the needs to promote physical activity and to reduce sitting time are growing under the movement of “Health and Productivity Management” and burden of the COVID-19 pandemic. We believe that current challenges provide an opportunity to advance physical fitness and sports medicine research in occupational health.

Introduction: The purpose of this study was to investigate the effects that a group exercise activity managed by elderly volunteers would have on the physical function of older women after they participated in a formal exercise program taught by fitness experts.

Methods: Subjects were 47 community-dwelling older women who had completed a 3-month exercise program led by expert instructors in Kasama City, Ibaraki. After completing this exercise program, 28 subjects continued to participate in a group exercise activity led by elderly volunteers for approximately 11 months. The remaining 19 subjects did not join the group activities after the formal program. In both the initial, expert-led exercise program and the subsequent, volunteer-led group activity, subjects mainly engaged in the square-stepping exercise, which is a novel exercise for improving lower extremity physical function. In order to assess participants' physical function, we conducted five physical performance tests at both the baseline and follow-up; the former is the last day of the exercise program and the latter is approximately a year after the baseline.

Results: Two-way ANOVA demonstrated a significant interaction in the timed up and go test (P=0.003). The performance of subjects who had participated in the volunteer-managed group activity improved between the baseline and follow-up tests (P=0.007).

Conclusion: Participating in a group exercise activity managed by elderly volunteers can improve mobility skills of older women who had previously completed a formal exercise program led by expert instructors.

BACKGROUND: During sedation with dexmedetomidine, a dose adjustment may be needed based on the invasiveness of the procedure, the patient's general condition, and their age. We aim here to determine the effective dose (ED) of dexmedetomidine to induce an adequate depth of sedation in elderly patients undergoing spinal anesthesia. METHODS: In this study, 47 patients aged 65 years or older, American Society of Anesthesiologists physical status I or II, undergoing spinal anesthesia were included. Patients were randomly allocated into group I, II, III, IV or V according to the dexmedetomidine loading dose of 0.1, 0.3, 0.5, 0.7 and 1.0 microg/kg, respectively. After spinal anesthesia, the assigned loading dose of dexmedetomidine was infused intravenously for 10 minutes, after which infusion was maintained at a rate of 0.3 microg/kg/h for the next 10 minutes in all groups. We assessed the depth of sedation with the Ramsay sedation scale every five minutes and measured vital signs and the oxygen saturation. The ED50 and ED95 of dexmedetomidine to obtain adequate sedation (Ramsay sedation score > or = 3) upon the completion of the loading dose were calculated with logistic regression. RESULTS: The ED50 and ED95 of dexmedetomidine for adequate sedation were 0.29 microg/kg (95% confidence intervals [CI] 0.14-0.44) and 0.86 microg/kg (95% CI 0.52-1.20), respectively. Hypotension was frequent in groups IV, V compared to groups I, II, III (31.6 vs. 3.6%, P = 0.013). CONCLUSIONS: ED95 of dexmedetomidine loading dose for adequate sedation is 0.86 microg/kg. However, dose higher than 0.5 microg/kg can lead to hemodynamic instability.
Aged* ; Anesthesia, Spinal* ; Dexmedetomidine* ; Hemodynamics ; Humans ; Hypotension ; Logistic Models ; Oxygen ; Vital Signs

PURPOSE: To find the most effective method for extraction of cell-free DNA (cf-DNA) from maternal plasma, we compared a blood DNA extraction system (blood kit) and a viral DNA extraction system (viral kit) for non-invasive first-trimester fetal gender determination. MATERIALS AND METHODS: A prospective cohort study was conducted with maternal plasma collected from 44 women in the first-trimester of pregnancy. The cf-DNA was extracted from maternal plasma using a blood kit and a viral kit. Quantitative fluorescent-polymerase chain reaction (QF-PCR) was used to detect the SRY gene and AMEL gene. The diagnostic accuracy of the QF-PCR results was determined based on comparison with the final delivery records. RESULTS: A total of 44 women were tested, but the final delivery record was only obtained in 36 cases which included 16 male-bearing and 20 female-bearing pregnancies. For the blood kit and viral kit, the diagnostic accuracies for fetal gender determination were 63.9% (23/36) and 97.2% (35/36), respectively. CONCLUSION: In non-invasive first-trimester fetal gender determination by QF-PCR, using a viral kit for extraction of cf-DNA may result in a higher diagnostic accuracy.
Cohort Studies ; DNA ; DNA, Viral ; Female ; Genes, sry ; Humans ; Plasma ; Pregnancy ; Prospective Studies