BACKGROUND: The long-term impact of symptom classification on quality of life (QOL) and economic outcomes among individuals with long coronavirus disease (COVID) remains poorly understood. This study aimed to clarify the situation of long COVID in Japan by analyzing patients using cluster classification. METHODS: This multicenter, retrospective cohort study enrolled 515 patients with COVID-19 and followed up for 36 months via standardized questionnaires. Patients were classified based on: 1) symptom trajectory over time and 2) symptom cluster profiles at 3 months. RESULTS: While the number of symptoms decreased, fatigue and dyspnea frequently persisted, whereas anosmia and dysgeusia declined. Cough and sputum decreased gradually. The proportion of patients with 5-9 symptoms increased. The mean (interquartile range) presenteeism scores were lower in the continuous (60 [50-80]) and relapse groups (65 [48-80]) than in the recovered group (70 [50-80]). The multiple symptoms cluster had the worst SF-36, presenteeism, and absenteeism scores (47.2 [44.7-49.8], 48.8 [27.5-72.5], and 10.9 [0.0-11.0], respectively). CONCLUSIONS Patients with continuous and multiple symptoms experienced persistently lower QOL and greater economic burden up to 36 months after COVID-19 diagnosis. The long-term effects of long COVID are not only physical but also mental and economical. Thus, further research is needed to clarify the economical and physiological impact of long COVID.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; COVID-19/complications* ; Japan/epidemiology* ; Post-Acute COVID-19 Syndrome/psychology* ; Quality of Life ; Retrospective Studies ; Surveys and Questionnaires ; East Asian People

Objective: The incidence and mortality rates of endometrial cancer are increasing globally, including in Japan. Quality of cancer care is promoted through guideline adherence. This study aimed to establish quality indicators (QIs) for endometrial cancer and explore the factors contributing to treatment nonadherence. Methods: QIs and pattern-of-care indicators (PCIs) were developed using the Research and Development/University of California Los Angeles modified Delphi method. QIs reflect desirable healthcare patterns, whereas PCIs address treatment areas with lacking evidence.Data from the Hospital-Based Cancer Registry and Diagnosis Procedure Combination Survey were used. Patients diagnosed or treated between January 1 and December 31, 2020 were included. The reasons for nonadherence were collected. Logistic regression was used to analyze the factors influencing adherence, including age, body mass index, comorbidities, facilities, and recurrence risk. Results: Of the 35 proposed QI candidates, 8 QIs and 9 PCIs were selected, predominantly focusing on surgical aspects. Adherence rates varied, with peritoneal lavage cytology being the highest (93.1%), and postoperative hormone replacement therapy (HRT) for patients aged <45 years being the lowest (30.9%), when focusing on process indicators. Reasons for nonadherence included patient preference and medical comorbidities as significant factors. Multivariate analysis highlighted age, clinical stage, and Barthel index as significant contributors to nonadherence. Conclusion We developed QIs to comprehensively assess endometrial cancer treatment.Adherence rates are favorable; however, HRT has a low adherence rate. Factors leading to nonadherence include advanced age and incomplete activities of daily living, particularly in advanced stages.

Purpose: To examine the feasibility of the Integrated Palliative care Outcome Scale (IPOS), a comprehensive palliative care scale, for non-cancer patients. Methods: Twenty non-cancer patients and 20 healthcare providers who provide care to the participating patients were asked to complete the IPOS questionnaire, and cognitive interviews were conducted with them. The interviews were analysed using content analysis, a qualitative analysis method. Results: About half to 90% of both patients and healthcare providers answered that they did not find it difficult to answer or understand all items of the IPOS. Therefore, we confirmed its surface validity, and the content validity of the IPOS was confirmed. Conclusion: The surface validity and content validity of the IPOS for non-cancer patients were confirmed, and it became clear that the IPOS can be used as a comprehensive assessment tool for the palliative care of non-cancer patients.

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.

Prepulse inhibition (PPI) is considered to be one of the most promising neurophysiological indexes for translational research in psychiatry. Impairment of PPI has been reported in several psychiatric diseases, particularly schizophrenia, where PPI is considered a candidate intermediate phenotype (endophenotype) of the disease. Recent findings from a variety of research areas have provided important evidence regarding PPI impairment. Human brain imaging studies have demonstrated the involvement of the striatum, hippocampus, thalamus and frontal and parietal cortical regions in PPI. In addition, several genetic polymorphisms, including variations in the genes coding for Catechol O-methyltransferase, Neuregulin 1, nuclear factor kappa-B subunit 3 and serotonin-2A receptor were related to PPI; and these findings support PPI as a polygenetic trait that involves several neurotransmitter pathways. Early psychosis studies suggest that PPI disruption is present before the onset of psychosis. Also, discrepancy of PPI impairment between children and adults can be found in other psychiatric diseases, such as autistic spectrum disorders and posttraumatic stress disorder, and comprehensive investigation of startle response might contribute to understand the impairment of the neural circuitry in psychiatric diseases. Finally, recent studies with both Asian and Caucasian subjects indicate that patients with schizophrenia exhibit impaired PPI, and impaired sensorimotor gating might be a global common psychophysiological feature of schizophrenia. In conclusion, studies of PPI have successfully contributed to a better understanding of the fundamental neural mechanisms underlying sensorimotor gating and will certainly be most valuable in devising future approaches that aim to investigate the complex pathogenesis of psychiatric diseases.
Adult ; Asian Continental Ancestry Group ; Catechol O-Methyltransferase ; Catechols ; Child ; Clinical Coding ; Endophenotypes ; Hippocampus ; Humans ; Mental Disorders ; Neuregulin-1 ; Neuroimaging ; Neurotransmitter Agents ; Phenotype ; Polymorphism, Genetic ; Psychophysiology ; Psychotic Disorders ; Schizophrenia ; Sensory Gating ; Startle Reaction ; Stress Disorders, Post-Traumatic ; Thalamus ; Translational Medical Research

  In hopes that inpatients can enjoy meals without worrying about foodstuffs, our hospital started buying more local fresh produce in January 2005 tuning in on the popular “Buy Local Produce” movement. We, employees of a hospital affiliated with the Federations of Agriculture Cooperatives for Health and Welfare, think it very important to support the movement, contribute to the improvement of the self-sufficiency in food and maintain good relationships with rural communities. The advantage of local produce is its safety. We can use it with a sense of security. At present, 10 farmers, who are members of the JA Isehara Co-op, deliver vegetables to the hospital. Initially, the hospital bought what they offered, but recently they grow vegetables of the kind the hospital wants. Now, local produce accounts for about 30% of the total value of the vegetables the hospital buys.However, prospects do not warrant any optimism, because the average age of the producers is 56 and it is not easy to increase the number of producers now. As far as items unavailable from the present producers are concerned, we have begun to buy these items from non-member farmers.

  In hopes that inpatients can enjoy meals without worrying about foodstuffs, our hospital started buying more local fresh produce in January 2005 tuning in on the popular “Buy Local Produce” movement. We, employees of a hospital affiliated with the Federations of Agriculture Cooperatives for Health and Welfare, think it very important to support the movement, contribute to the improvement of the self-sufficiency in food and maintain good relationships with rural communities. The advantage of local produce is its safety. We can use it with a sense of security. At present, 10 farmers, who are members of the JA Isehara Co-op, deliver vegetables to the hospital. Initially, the hospital bought what they offered, but recently they grow vegetables of the kind the hospital wants. Now, local produce accounts for about 30% of the total value of the vegetables the hospital buys. However, prospects do not warrant any optimism, because the average age of the producers is 56 and it is not easy to increase the number of producers now. As far as items unavailable from the present producers are concerned, we have begun to buy these items from non-member farmers.

  In hopes that inpatients can enjoy meals without worrying about foodstuffs, our hospital started buying more local fresh produce in January 2005 tuning in on the popular “Buy Local Produce” movement. We, employees of a hospital affiliated with the Federations of Agriculture Cooperatives for Health and Welfare, think it very important to support the movement, contribute to the improvement of the self-sufficiency in food and maintain good relationships with rural communities. The advantage of local produce is its safety. We can use it with a sense of security. At present, 10 farmers, who are members of the JA Isehara Co-op, deliver vegetables to the hospital. Initially, the hospital bought what they offered, but recently they grow vegetables of the kind the hospital wants. Now, local produce accounts for about 30% of the total value of the vegetables the hospital buys.However, prospects do not warrant any optimism, because the average age of the producers is 56 and it is not easy to increase the number of producers now. As far as items unavailable from the present producers are concerned, we have begun to buy these items from non-member farmers.

  In hopes that inpatients can enjoy meals without worrying about foodstuffs, our hospital started buying more local fresh produce in January 2005 tuning in on the popular “Buy Local Produce” movement. We, employees of a hospital affiliated with the Federations of Agriculture Cooperatives for Health and Welfare, think it very important to support the movement, contribute to the improvement of the self-sufficiency in food and maintain good relationships with rural communities. The advantage of local produce is its safety. We can use it with a sense of security. At present, 10 farmers, who are members of the JA Isehara Co-op, deliver vegetables to the hospital. Initially, the hospital bought what they offered, but recently they grow vegetables of the kind the hospital wants. Now, local produce accounts for about 30% of the total value of the vegetables the hospital buys.However, prospects do not warrant any optimism, because the average age of the producers is 56 and it is not easy to increase the number of producers now. As far as items unavailable from the present producers are concerned, we have begun to buy these items from non-member farmers.

A major earthquake in Bam, Iran, which occurred on 26th of December,2003, claimed more than 26,000 deaths and most of the medical facilities were destroyed or left inoperative.
Although many relief organizations left Bam after the initial stage of the disaster, the necessity of medical support continued with the condition of many victims still desperate. Therefore, medical assistance was provided by HuMA in the recovery phase, and four prefabricated buildings were donated to an Urban Health Center (UHC) for use as a clinic. Essential medical equipment was provided to emergency centers in Bam. In addition, surveillance study was conducted to investigate how environmental health conditions could be improved and effective assistance be given during the recovery phase of the disaster. From monitoring of onsite disaster relief in Bam, it is concluded that the donor agencies should make efforts to continue their activities not only in the acute phase but also in sub-acute and recovery phase and if necessary to cooperate among different agencies according to their capability. Furthermore, it is suggested that close cooperation between NGOs and government agencies would lead to much faster and much more effective disaster relief for victims.