This article focuses on inclusive education for deaf and hard-of-hearing students in Rochester, New York, which prepares them to become healthcare professionals or researchers in health science fields. We highlight the unique programs for deaf and hard-of-hearing students to develop their careers at the Rochester Institute of Technology (RIT), the National Technical Institute for the Deaf (NTID), and the University of Rochester (UR). These universities also foster an inclusive work environment that caters to the needs of deaf and hard-of-hearing clinical professionals and faculty specialized in health research, enabling them to play leadership roles in their fields. Notably, Strong Memorial Hospital at UR supports deaf staff by providing interpreter services, allowing them to actively engage in their clinical work as professionals. Such seamless support, spanning from higher education to professional careers in Rochester, demonstrates a compelling model for enabling deaf and hard-of-hearing individuals to pursue and thrive in their chosen professions.

Objective: The purposes of this trial were to demonstrate the feasibility and effectiveness of the hybrid of intracavitary and interstitial brachytherapy (HBT) for locally advanced cervical cancer patients in the phase I/II prospective clinical trial. Methods: Patients with FIGO stage IB2-IVA uterine cervical cancer pretreatment width of which was ≥5 cm measured by magnetic resonance imaging were eligible for this clinical trial. The protocol therapy included 30–30.6 Gy in 15–17 fractions of whole pelvic radiotherapy concurrent with weekly CDDP, followed by 24 Gy in 4 fractions of HBT and pelvic radiotherapy with a central shield up to 50–50.4 Gy in 25–28 fractions. The primary endpoint of phase II part was 2-year pelvic progression-free survival (PPFS) rate higher than historical control of 64%. Results: Between October 2015 and October 2019, 73 patients were enrolled in the initial registration and 52 patients proceeded to the secondary registration. With the median follow-up period of 37.3 months (range, 13.9–52.9 months), the 2- PPFS was 80.7% (90% confidence interval [CI]=69.7%–88%). Because the lower range of 90% CI of 2-year PPFS was 69.7%, which was higher than the historical control ICBT data of 64%, therefore, the primary endpoint of this study was met. Conclusion The effectiveness of HBT were demonstrated by a prospective clinical study. Because the dose goal determined in the protocol was lower than 85 Gy, there is room in improvement for local control. A higher dose might have been needed for tumors with poor responses.

Objective: To determine the characteristics associated with mortality in patients with culture-positive pulmonary tuberculosis (PTB) in Airin, Osaka City, Japan. Methods: The characteristics of patients with culture-positive PTB registered between 2015 and 2018 in Airin, Osaka City, Japan, were compared between those who died of all causes before or during treatment and those who completed treatment. Results: Of the 241 culture-positive PTB patients eligible for this study, 170 completed treatment, with negative sputum culture tests, and 62 died. The all-cause case fatality rate was 26.7% (62/232). Multivariate analysis showed that mortality was associated with age >70 years, having a positive sputum smear, a body mass index of <18.5 and serious comorbidities such as cancer and heart and renal disease. Detection of tuberculosis (TB) by screening or in an outpatient department (OPD) for other diseases was inversely associated with mortality. Discussion: Detection of PTB by chest X-ray screening and during regular visits to OPDs for other diseases was associated with non-fatal TB and might contribute to early case finding. Therefore, current active TB case finding and health education on regular visits to physicians for other diseases should be strengthened further for the urban poor population of Osaka City, Japan.

Objective: To identify individual characteristics related to the development of pulmonary tuberculosis (PTB) among residents in the Airin area (Airin), Osaka City, Japan. Methods: We conducted a retrospective case-control study of individual characteristics potentially related to the development of PTB by comparing PTB patients and residents without tuberculosis (TB) in Airin. The following binominal data of characteristics were compared: age (<65 or >65); body mass index (BMI) (<18.5 or >18.5); diabetes mellitus (diagnosed or not diagnosed); smoking (currently smoking any amount or not smoking); and alcohol use (currently drinking any amount or not drinking). Results: We compared the individual characteristics of 192 PTB patients notified from January 2015 to December 2018 and 190 residents of supportive houses who attended a health education programme from April 2016 to March 2018. Univariable analysis showed that the following characteristics were significantly related with PTB: BMI <18.5 (odds ratio [OR]: 6.54, 95% confidence interval [CI]: 3.58–11.97, P < 0.001) and current alcohol use (OR: 1.88; 95% CI: 1.24–2.85, P = 0.003). Multivariable analysis showed similar results: BMI <18.5 (adjusted odds ratio [aOR]: 6.90, 95% CI: 3.72–12.79, P < 0.001) and current alcohol use (aOR: 2.15, 95% CI: 1.36–3.42, P = 0.001). Discussion Undernutrition and alcohol use are individual characteristics associated with PTB among residents in Airin, Osaka City. To strengthen the TB control programme further, it is suggested to develop new programmes for primary prevention.

The purpose of this study was to clarify feasibility of a booklet for families of children dying with incurable cancer. Of 267 pediatric oncology specialists, 76 (28%) participated in this cross-sectional survey. Ninety-three percent of participants answered that they were “likely to use” the booklet, and 86% percent answered that they believed the booklet was “helpful” for families. Some participants described various advantages of its use as follows: “able to communicate something that is difficult to put into words,” “easy to understand for families,” “families can read whenever they choose to,” and “able to grasp the direction of dying.” In contrast, other participants described points of attention of use as follows: “optimal timing to bring out,” “acceptance of families,” “direction as interdisciplinary team,” “confidential relationship between families and interdisciplinary team,” “disinclination among health care providers,” and “information volume of the booklet.” Thus, our results validated feasibility of the booklet. In conclusion, pediatric oncology specialists should provide their support of utilizing the booklet for families and assessing each family condition and advantage/attention of using the booklet.

Typically, Japanese Kampo doctors use formulas classified for treating blood stasis, to treat pain. However,there have been few reported cases where pain was treated with formulas classified for treating qi stagnation. Here, we report a case of right lateral epicondylitis in a 48-year-old woman who was treated with a focus on qi stagnation and with uyakujunkisan. She underwent conservative treatment at an orthopedic clinic for ten months, but her pain was not relieved. Hence, she opted for Kampo treatment. She was in a state of melancholy, felt heaviness throughout her body, and had irregular menstruation. These symptoms were mainly related to qi stagnation, and hence, we chose uyakujunkisan without white silkworm, but with aconite root. One month later, the stiffness in her shoulder improved and the pain was reduced. Magnetic resonance imaging taken 2 months later showed an improvement in the lesion. Nine months later, her menstruation became regular, and 11 months later, the pain had almost completely resolved and she could comfortably perform activities of daily living. Uyakujunkisan is introduced in the classical textbooks, and we interpret uyakujunkisan as a formula that can treat pain with qi stagnation. In Kampo treatment, effective pain treatment involves consideration of not only local blood stasis but also general qi stagnation.

We performed waiting time prediction using the data collected from prescription pick-up. A regression equation was used to predict waiting time. An explanatory variable was adopted as “a number of retention prescriptions at the time of acceptance”, “the variety of drug to dispense”and “the presence or absence of a particular task of time-consuming work in computing multiple medications into one package”. Using waiting time as an objective variable, three regression equations were formulated. Method ①: A single regression equation using the number of retention prescriptions with only one explanatory variable. Method ②: Multiple regression equation using factors such as number of prescriptions and variety of drugs to be dispensed as explanatory variables. Method ③: Multiple regression equation using number of prescriptions, variety of drugs and the presence or absence of particular tasks involved in the preparation of the prescription. Compared to the prediction of Method ①, the prediction of Method ② resulted in better accuracy. Compared to Method ①, Method ② resulted in better accuracy, and Method ③ resulted in even better accuracy than Method ②, as predicted.

Oxycodone controlled-release (CR) tablets are used as a first-line opioid analgesic for cancer pain. However, use of oxycodone CR tablets is associated with toxicities such as drowsiness and constipation, leading to deterioration of the quality of life (QOL), especially in patients with gynecologic cancer. In contrast, fentanyl has a superior toxicity profile while still showing a strong analgesic effect. Although fentanyl has been approved for switching from opioid, there have been no Japanese studies of patients with gynecologic cancer who were switched to transdermal fentanyl after experiencing toxicity during therapy with oxycodone CR. More importantly early introduction of palliative therapy for pain has not been adopted routinely in the management of gynecologic cancer. Thus, it appears that treatment for patients with gynecologic cancer remains unsatisfactory at present. We conducted research into improvement of the toxicity profile and pain control with the aim of improving QOL for patients with gynecologic cancer. We showed that pain, drowsiness, and constipation could be significantly improved in gynecologic cancer patients as a result of switching to transdermal fentanyl therapy at an early stage.

Objective: It is important to prevent dispensing errors for the safety of patients.  For this purpose, it is necessary to improve the dispensing process on the basis of risk priority.  Quantitative evaluation of risk in each operation makes it possible to compare the risk relatively.  In this study, we analyzed data reported in the Pharmacy Risk Error Management System (PREM-S) to evaluate the risk priority in the medicine preparation step of the dispensing process.
Methods: Data of 1,202 cases concerning medicine preparation step were extracted from in 2,458 cases reported into PREM-S between May 2010 and April 2011.  We classified the medicine preparation step into 31 categories based on the operation.  We analyzed the levels in each category as adverse effects on patient’s health by the errors and also the relationship between adverse effect and detection time.  The level represents the degree of adverse effect for the patient.
Results: Information on levels of the 31 categories was obtained from the analysis.  Eight categories included reports of effects on the health of patients.  Three categories such as calculation of powder medicine included level 4 cases.  Detection time was significantly different between level 1 and levels 2 to 4, but there was no significant difference between levels 2 to 4.
Conclusion: The results suggest that analysis of data reported in PREM-S enables evaluation of the risk priority systematically and efficiently.  Evaluation of the risk priority will contribute to prevention of dispensing errors and health effects derived from them.