Reducing falls among visually impaired individuals on railway platforms: Field research on environmental challenges and solutions.

The aim of this study is to assess the extent to which visually impaired people are at risk of falling from railway station platforms and to identify opportunities for improvement. A barrier-finding fieldwork approach was used to conduct this study. A total of 412 stations' platforms were examined to provide recommendations for enhancing platform safety. The study found that four major factors contribute to accidents in which visually impaired individuals may fall from railway station platforms. These factors include "the spatial layout of the platform", "the warning tactile pavers", "the Fall Prevention Hoods", and "the fall prevention fences and platform screen doors ". Based on the findings of the study, several measures are recommended to enhance the safety and accessibility of railway station platforms for visually impaired individuals. These measures include closing the gap between the platform and the train, installing Fall Prevention Hoods at lower heights near the feet so that they can be detected using a guide cane, and avoid the placement of directional tactile pavers close to the front end of the train cars or at the platform edge facing train car couplings, etc.

Outcomes of regional-based newborn hearing screening for 35,461 newborns for 5 years in Akita, Japan.

OBJECTIVES: Newborn hearing screening (NHS) has been actively performed since 2001 in Akita, Japan. The NHS coverage rate has increased yearly, and performance has been consistently >90% since 2012. The purpose of this study was to summarize NHS outcomes in the Akita prefecture of Japan and to obtain new insights for from our summarized data for the future. METHODS: A total of 35,461 newborns in hospitals and clinics where hearing screening was performed in Akita from 2012 to 2016 were included. The outcome data of NHS were collected for analysis. RESULTS: The overall screening coverage rate for hearing loss was 94.7%. Of the screened infants, 0.53% received a referral on the 2-stage automated auditory brainstem response (ABR), and 80.4% of referred infants had a check-up at the hospital to receive a diagnostic hearing examination. Finally, the prevalence of bilateral congenital hearing loss was 0.14%, that of bilateral moderate to profound hearing loss was 0.12%, and that of unilateral congenital hearing loss was 0.10%. Furthermore, the average consultation period in infants with risk factors was significantly later than that in infants without risk factors (p = 0.0015). Follow-up for infants diagnosed with normal hearing after diagnostic hearing examination revealed that 4.7% suffered bilateral moderate to profound hearing loss later. This percentage is significantly higher than that of the general group (p < 0.001). CONCLUSION: The prevalence of bilateral congenital hearing loss was 0.14% in Akita and 0.12% of infants were diagnosed with bilateral moderate to severe hearing loss. Medical personnel should be enlightened regarding the importance of performing hearing diagnostic examinations until 3 months of age. Even if infants were diagnosed with normal hearing after a diagnostic examination, we strongly suggest continuing follow-up until they are able to perform pure tone audiometry with accuracy.

Leaflets and continual educational offerings led to increased coverage rate of newborn hearing screening in Akita.

OBJECTIVE: Newborn hearing screening (NHS) has been actively performed in Japan since 2001. The NHS coverage rate has increased each year in Akita Prefecture. We analyzed the details of the NHS program and how the Akita leaflets and the many educational offerings about the importance of NHS led to the high NHS coverage rate. METHODS: A retrospective study was conducted in liveborn newborns in hospitals and in clinics where hearing screening was performed from the program's beginning in 2001 through the end of 2015. We describe the chronological history of NHS. The outcome data of NHS were collected from our department and analyzed. RESULTS: From the founding of the program in 2001 to 2015, the live birth rate in Akita continually declined. Nevertheless, the number of infants receiving NHS rose each year. Since 2012, the coverage rate of NHS has been over 90%. From 2001 to 2015, 75,331 newborns constituted the eligible population for the NHS program. Since 2012, the number of NHS tests has stabilized. We prepared educational leaflets for Akita Prefecture early in 2002. We also provided many educational classes about the importance of NHS for not only pregnant women but also professionals including obstetricians and gynecologists, pediatricians and municipal staff members. The NHS program received the complete endorsement of the Akita Association of Obstetricians and Gynecologists in 2010. The largest increase in the NHS coverage rate occurred from 2001 to 2002, and the second largest increase occurred from 2009 to 2010. The number of participating institutions increased the coverage rate. The coverage rate is strongly correlated with the number of participating institutions (rs=0.843, p<0.001, Spearman's rank correlation coefficient). Comparing the coverage rate for 5 years before and after the Akita Association of Obstetricians and Gynecologists reached their consensus on the importance of NHS, the coverage rate after 2010 was significantly higher than before 2010 (p<0.001, paired sample t-test). CONCLUSION: The NHS coverage rate ultimately reached 95.4% without need for legislation or subsidization. The number of participating institutions increased each year, and the number of NHS tests and the coverage rate increased proportionately. The number of participating institutions statistically has a strong correlation with the number of NHS tests and the coverage rate. Our research indicates that the Akita leaflets and the provision of educational sessions about the importance of NHS were the most significant factors in establishing the high NHS coverage rate.

[Burden of primary caregivers of young patients with brain damage].

OBJECTIVES: The objective of this study was to shed light on (1) the extent to which primary caregivers of patients with brain damage feel nursing-care burden, and (2) the relationship between such burden and other attributes in a cross-sectional manner. METHODS: We conducted an anonymous questionnaire survey of primary caregivers of young patients with brain damage. The survey was conducted between November 2008 and March 2009. The number of valid responses was 53 (response rate 56%). To assess burden of caregivers, we used the Short Version of the Japanese Version of the Zarit Caregiver Burden Interview (J-ZBI_8). RESULTS: With regard to burden felt by primary caregivers "concerns about excretion" and "problematic behavior" were stressed. Individuals who were less than 50 in age most strongly felt burden. Moreover, burden was greater for spouses than for guardians. CONCLUSION: In order to reduce the burden of caregivers in case of primary caregivers, rehabilitation concerning young patients with brain damage and efforts to enhance their capabilities are important. In addition, it is also necessary to provide social resources so that primary caregivers can rely on other persons without worry.

A survey of the potency of Japanese illicit cannabis in fiscal year 2010.

In recent years, increased 'cannabis potency', or Δ(9)-tetrahydrocannabinol (THC) content in cannabis products, has been reported in many countries. A survey of Japanese illicit cannabis was conducted from April 2010 to March 2011. In Japan, all cannabis evidence is transferred to the Minister of Health, Labour and Welfare after criminal trials. The evidence was observed at Narcotics Control Department offices in major 11 cities. The total number of cannabis samples observed was 9072, of which 6376 were marijuana. The marijuana seizures were further classified, and it was found that in terms of the number of samples, 65.2% of them were seedless buds, and by weight 73.0% of them were seedless buds. Seedless buds were supposed to be 'sinsemilla', a potent class of marijuana. THC, cannabinol (CBN) and cannabidiol (CBD) in marijuana seizures exceeding 1g were quantified. The number of samples analyzed was 1115. Many of them were shown to contain CBN, an oxidative product from THC. This was a sign of long-term storage of the cannabis and of the degradation of THC. Relatively fresh cannabis, defined by a CBN/THC ratio of less than or equal to 0.1, was chosen for analysis. Fresh seedless buds (335 samples) contained an average of 11.2% and a maximum of 22.6% THC. These values are comparable to those of 'high potency cannabis' as defined in previous studies. Thus, this study shows that highly potent cannabis products are distributed in Japan as in other countries.