Approximately 40%–65% of new fitness club (FC) members cancel their membership within 6 months. To prevent such cancellations, it is essential to identify members at high risk of doing so. This study developed a model to predict the probability of discontinuing FC membership among new members. We conducted a cohort study and enrolled participants from 17 FCs in Japan. We asked 5,421 individuals who became members from March 29, 2015 to April 5, 2016 to participate in the study; 2,934 completed the baseline survey, which was conducted when the participants became FC members. We followed up the participants until September 30, 2016. We excluded 883 participants with missing values and 69 participants under aged 18 years; thus, our analysis covered 1,982 individuals. We conducted the random survival forest to develop the prediction model. The mean follow-up period was 296.3 (standard deviation, 127.3) days; 488 participants (24.6%) cancelled their membership during the follow-up. The prediction model comprised 8 predictors: age; month of joining FC; years of education; being under medical follow-up; reasons for joining FC (health improvement, relaxation); and perceived benefits from exercise (maintaining good body weight, recognition of one’s ability by other). The discrimination and calibration were acceptable (C statistic: 0.692, continuous ranked probability score: 0.134). Our findings suggest that the prediction model could assess the valid probability for early FC cancellation among new members; however, a validation study will be needed.

Evidence is growing on adverse health outcomes associated with less physical activity (PA) and more sedentary behavior (SB). As most workers generally spend approximately one-third of the day at work, measuring the amount of occupational PA/SB time would contribute to understanding the health risks of physical inactivity and SB among workers. In this review article, we describe the amount of time spent in different intensities of activity (moderate-to-vigorous PA [MVPA]; light PA [LPA]; and SB), on work and non-work days, while at work and outside working hours among workers. The review used objective measurements made by an accelerometer and showed the proportion of MVPA that office workers engaged in on work and non-work days accounted for 3-5% and 2-4% of accelerometer wear time, respectively. Moreover, office workers spent more time in SB and less time in LPA on work days than non-work days (SB, 66-76% vs. 60-69%; LPA, 20-28% vs. 23-36%). Especially on work days, office workers spent the greatest proportion of the day in SB during working hours (71-82%), compared with that outside working hours (63-67%). The proportion of MVPA accounted for 2-5% during working hours and 3-7% outside working hours. In addition, there were considerable differences in the proportions of LPA and SB between white-collar and blue-collar workers during working hours (SB, 73 vs. 55%; LPA; 22 vs. 40%), whereas the MVPA time was similar (5 vs. 5%). Some occupational exposure to unfavorable PA/SB at work might be unavoidable; however, inadequate PA/SB during working hours should be corrected.

BACKGROUND/AIMS: We applied a back light system (BLS) with a magnifying glass to improve the ability to assess the adequacy of specimen sampling using endosonography. We conducted this study to evaluate the efficacy of the BLS in sampling of specimens by endoscopic ultrasound-guided fine needle aspiration of solid pancreatic masses. METHODS: This was a prospective, randomized, crossover, single-center clinical trial. An endosonographer evaluated adequacy on gross visual inspection and identified whitish specimen sampling sites with and without the BLS according to a randomization sequence in the first and second passes with a 25-G needle. On cytological evaluation, the presence of well-defined pancreatic ductal epithelium was evaluated by a cytopathologist who was blinded to any clinical information. RESULTS: A total of 80 consecutive patients were eligible during the study period. Adequacy was observed for 52 specimens (65%) with the BLS and 54 (68%) without the BLS (p=0.88). In assessment of specimen adequacy on gross examination, only fair agreement was observed both with and without BLS (kappa score 0.40 and 0.29, respectively). CONCLUSIONS: The BLS did not influence the ability to identify specimen sampling sites or reliable assessment of specimen site adequacy using gross visual inspection.
Biopsy, Fine-Needle ; Cross-Over Studies ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Endosonography ; Epithelium ; Glass ; Humans ; Needles ; Pancreatic Ducts ; Pancreatic Neoplasms ; Prospective Studies ; Random Allocation

Drug dispensing is a statutory and designated duty of a pharmacist. We aimed to examine the changes in the nature of drug dispensing using a text mining method. Our corpus consisted of text documents from “Chozai Shishin”, the most standard manual for dispensing drugs in Japan, Editions 1 to 13 (Japan Pharmaceutical Association), and we used the KH Coder software for text mining. We constructed networks showing the association between frequent word co-occurrence and edition number, and co-occurrence relations for frequent words in each edition. We found that “patient” superseded “dispensing” as a frequent term over time. “Dispensing” was another frequent term with a highly centralized node in each edition. Accordingly, we targeted the term “dispensing” for network analysis to depict its co-occurrence relations. We found that the range of related words for “dispensing” broadened from “preparation” and “compounding” to include “patient adherence instructions”, “assessment”, “medical treatment”, and “information provision”. Accordingly, we concluded that the content of “dispensing”, which is a pharmacist’s duty, has expanded from the duties of “dispensing drugs” to include “responding to patients” within the definition of “dispensing”, and we were able to present this finding as objective data by using the mechanical method known as text mining.

Drug dispensing is a statutory and designated duty of a pharmacist. We aimed to examine the changes in the nature of drug dispensing using a text mining method. Our corpus consisted of text documents from “Chozai Shishin”, the most standard manual for dispensing drugs in Japan, Editions 1 to 13 (Japan Pharmaceutical Association), and we used the KH Coder software for text mining. We constructed networks showing the association between frequent word co-occurrence and edition number, and co-occurrence relations for frequent words in each edition. We found that “patient” superseded “dispensing” as a frequent term over time. “Dispensing” was another frequent term with a highly centralized node in each edition. Accordingly, we targeted the term “dispensing” for network analysis to depict its co-occurrence relations. We found that the range of related words for “dispensing” broadened from “preparation” and “compounding” to include “patient adherence instructions”, “assessment”, “medical treatment”, and “information provision”. Accordingly, we concluded that the content of “dispensing”, which is a pharmacist’s duty, has expanded from the duties of “dispensing drugs” to include “responding to patients” within the definition of “dispensing”, and we were able to present this finding as objective data by using the mechanical method known as text mining.

We aimed to elucidate the impact of the conducting state in exercise programs and the degree of improvement in sit-to-stand power index (STS-PI) on the continuation of Chokin exercise by participants one year from the completion of the intervention period. Subjects participated in a 12-week Chokin exercise class for the elderly, which consisted of 10 body mass-based exercises. As variables indicating exercise conditions, the number of exercise days weekly and the total number of sets performed during the intervention period were adopted. STS-PI was calculated using the time required to perform 10-times-repeated sit-to-stand task, and its relative change (%∆STS-PI) was used to represent the degree of improvement in physical function. Among 52 men and 129 women who responded to the inquiry about the continuation of Chokin exercise one year from the completion of the intervention period, 32 men and 93 women confirmed continuation of the exercise program. Logistic regression analysis showed that %∆STS-PI for men, as well as %∆STS-PI and the number of exercise days weekly for women, were factors associated with the decision of subjects to continue the Chokin exercise. These results indicate that the degree of improvement in STS-PI associated with the Chokin exercise class is a factor for continuing the exercise program one year from the completion of the intervention period, at least in elderly men and women. Furthermore, high exercise frequency during the intervention period may be associated with the decision to continue Chokin exercise after the completion of the intervention among women.

Introduction: No formal curriculum has been formulated for teaching behavioral science to undergraduate medical students in Japan.
Method: We conducted a survey using the Delphi method to investigate the required competency in behavioral science for graduates in medicine. Then, we developed an outcome-oriented curriculum for teaching behavioral science.
Results: We propose an educational module of behavioral science consisting of 15 sessions of 90-minute lectures, small group discussions, and practice.
Discussion: We recommend including not only lectures but also practices according to problem-based learning as well as team-based learning in the curriculum to achieve the target outcome.