Non-pharmacological treatments for anticipatory nausea and vomiting during chemotherapy: a systematic review and meta-analysis of the Clinical Practice Guidelines for Antiemesis 2023.

BACKGROUND: Anticipatory chemotherapy-induced nausea and vomiting (CINV) is a conditioned response influenced by the severity and duration of previous emetic responses to chemotherapy. We aimed to evaluate the efficacy of non-pharmacologic interventions for anticipatory CINV among patients with cancer. METHODS: We conducted a systematic search in databases, including PubMed, the Cochrane Library, CINAHL, and Ichushi-Web, from January 1, 1990, to December 31, 2020. Randomized controlled trials, non-randomized designs, observational studies, or case-control studies that utilized non-pharmacological therapies were included. The primary outcomes were anticipatory CINV, with an additional investigation into adverse events and the costs of therapies. The risk-of-bias for each study was assessed using the Cochrane risk-of-bias tool, and meta-analysis was performed using Revman 5.4 software. RESULTS: Of the 107 studies identified, six met the inclusion criteria. Three types of non-pharmacological treatments were identified: systematic desensitization (n = 2), hypnotherapy (n = 2), and yoga therapy (n = 2). Among them, systematic desensitization significantly improved anticipatory CINV as compared to that in the control group (nausea: risk ratio [RR] = 0.60, 95% confidence interval [CI] = 0.49-0.72, p < 0.00001; vomiting: RR = 0.54, 95% CI = 0.32-0.91, p = 0.02). However, heterogeneity in outcome measures precluded meta-analysis for hypnotherapy and yoga. Additionally, most selected studies had a high or unclear risk of bias, and adverse events were not consistently reported. CONCLUSIONS: Our findings suggest that systematic desensitization may effectively reduce anticipatory CINV. However, further research is warranted before implementation in clinical settings.

2023 Japan Society of clinical oncology clinical practice guidelines update for antiemesis.

BACKGROUND: The Japan Society of Clinical Oncology Clinical Practice Guidelines for Antiemesis 2023 was extensively revised to reflect the latest advances in antineoplastic agents, antiemetics, and antineoplastic regimens. This update provides new evidence on the efficacy of antiemetic regimens. METHODS: Guided by the Minds Clinical Practice Guideline Development Manual of 2017, a rigorous approach was used to update the guidelines; a thorough literature search was conducted from January 1, 1990, to December 31, 2020. RESULTS: Comprehensive process resulted in the creation of 13 background questions (BQs), 12 clinical questions (CQs), and three future research questions (FQs). Moreover, the emetic risk classification was also updated. CONCLUSIONS: The primary goal of the present guidelines is to provide comprehensive information and facilitate informed decision-making, regarding antiemetic therapy, for both patients and healthcare providers.

Optimizing antiemetic treatment for chemotherapy-induced nausea and vomiting in Japan: Update summary of the 2015 Japan Society of Clinical Oncology Clinical Practice Guidelines for Antiemesis.

Patients with cancer should appropriately receive antiemetic therapies against chemotherapy-induced nausea and vomiting (CINV). Antiemetic guidelines play an important role in managing CINV. Accordingly, the first Japanese antiemetic guideline published in 2010 by the Japan Society of Clinical Oncology (JSCO) has considerably aided Japanese medical staff in providing antiemetic therapies across chemotherapy clinics. With the yearly advancements in antiemetic therapies, the Japanese antiemetic guidelines require revisions according to published evidence regarding antiemetic management worldwide. A revised version of the first antiemetic guideline that considered several upcoming evidences had been published online in 2014 (version 1.2), in which several updated descriptions were included. The 2015 JSCO clinical practice guideline for antiemesis (version 2.0) (in Japanese) has addressed clinical antiemetic concerns and includes four major revisions regarding (1) changes in emetogenic risk categorization for anti-cancer agents, (2) olanzapine usage as an antiemetic drug, (3) the steroid-sparing method, and (4) adverse drug reactions of antiemetic agents. We herein present an English update summary for the 2015 JSCO clinical practice guideline for antiemesis (version 2.0).

Consumption of ultra-processed foods decreases the quality of the overall diet of middle-aged Japanese adults.

OBJECTIVE: To estimate the consumption of ultra-processed foods and determine its association with dietary quality among middle-aged Japanese adults. DESIGN: Cross-sectional study using data from the Saitama Prefecture Health and Nutrition Survey 2011. Dietary intake was assessed using one- or two-day dietary records. Sociodemographic and lifestyle factors were obtained via self-administered questionnaire. Food items were classified according to the NOVA system into four groups: unprocessed or minimally processed foods; processed culinary ingredients; processed foods; and ultra-processed foods. The dietary share of each NOVA food group and their subgroups was calculated in relation to total energy intake, and the average dietary content of key nutrients was determined across tertiles of the dietary energy share of ultra-processed foods (low, middle and high intake). SETTING: Saitama Prefecture in Japan. PARTICIPANTS: Community-dwelling adults aged 30-59 years (256 men, 361 women). RESULTS: Consumption of unprocessed or minimally processed foods, processed culinary ingredients, processed foods and ultra-processed foods contributed 44·9 (se 0·8) %, 5·5 (se 0·2) %, 11·3 (se 0·4) % and 38·2 (se 0·9) % of total daily energy intake, respectively. A positive and statistically significant linear trend was found between the dietary share of ultra-processed foods (tertiles) and the dietary content of total and saturated fat, while an inverse relationship was observed for protein, vitamin K, vitamin B6, dietary fibre, magnesium, phosphorus and iron. CONCLUSIONS: Our findings show that higher consumption of ultra-processed foods was associated with decreased dietary quality among Japanese adults.

[Association of vegetable intake with dietary behaviors, attitudes, knowledge, and social support among the middle-aged Japanese population].

Objectives Increasing vegetable consumption is one of the health objectives of "Healthy Japan 21" (2nd phase). To ensure this goal is met, the various factors related to vegetable consumption must first be clarified. Thus, this study considered vegetable consumption, dietary behaviors, attitudes, knowledge, and social support among middle-aged Japanese subjects.Method Data (2 days of maintaining a food diary and a questionnaire) of 384 respondents aged 30-59 years from the 2011 Saitama Prefectural Health and Nutrition Survey (men: 165, women: 219) were used. Their average volume of vegetable consumption was 250.2 g/day (standard deviation: 119.8), which was significantly lower than the 350 g/day goal of "Healthy Japan 21" (2nd phase); therefore, the threshold for this study was set at 300 g/day. For logistic regression analysis, vegetable consumption greater or lower than 300 g/day were defined as dependent variables; social support, attitudes, knowledge, and dietary behaviors as independent variables; and age, household composition, and household income were adjusted.Results The adjusted odds ratio (AOR) was significantly higher for those whose vegetable consumption was over 300 g/day. Dietary behaviors including an average of 2 or more meals per day including grain, vegetable, fish, and meat dishes and the analysis of subjects' food records revealed an AOR of 2.52 and a 95% confidence interval (CI) of 1.18-5.39 for men who had 2 or more meals per day. For women, the AOR was 4.06, and the 95% CI was 2.18-7.53. Significant relationships were observed among the following items in male respondents: attitude category: "self-efficacy in consuming 5 or more vegetable dishes per day" (AOR was 2.74, 95% CI was 1.30-5.79); knowledge category: "obesity prevention effectiveness" (AOR was 3.48, 95% CI was 1.24-9.78); and social support category: "support for good health and dietary life from family and surroundings" (AOR was 4.46, 95% CI was 1.47-13.54). Significant relationships were observed among the following items in female respondents: dietary behaviors category: "frequency of cooking meals" (AOR was 2.83, 95% CI was 1.02-7.87); and knowledge category: "being able to grasp the appropriate volumes and balance of foods when preparing meals for self" (AOR was 2.44, 95% CI was 1.30-4.56).Conclusions These results suggest that to increase middle-aged people's vegetable consumption, promoting adequately healthy meals is more important than both the dissemination of knowledge regarding the target vegetable quantity and enhancing of only vegetable consumption.

Use of focus group interviews with public health nurses to identify the efforts of and challenges faced by branches of the Japan Health Insurance Association to achieve good performance of the Specific Health Guidance initiatives.

Objectives Aiming at improvement of the Japan Health Insurance Association's Specific Health Guidance initiatives and human resource development, we conducted a qualitative study to clarify the features necessary for and the challenges hindering the achievement of good performance of the initiatives.Methods From November 2014 to January 2015, we conducted 10 focus group interviews, each 90 minutes long, with 64 public health nurses from 10 Japan Health Insurance Association branches. In addition, self-administered questionnaires were administered to obtain the participants' basic characteristics. After we excluded one group for failing to meet our performance targets, we divided the remaining nine focus groups according to two patterns: Maintenance and Progress. The four focus groups fitting the Maintenance pattern had a well-established track record, and the five focus groups fitting the Progress pattern had a track record of good growth. Using open coding of the interview transcripts, we extracted efforts or needs in two domains, individual and branch, Then, we placed codes in eight main categories: [quality], [general practice], [dietary guidance practice], [success factor], [branch system], [training and skill development], [approach to the member office], and [past efforts]. We further extracted important subcategories based on their rates of appearance within branches.Results Data from 56 female public health nurses working at nine branches were included in the analysis. With respect to the individual domain, subcategories such as "building rapport," "creating the physical environment," and "taking the initiative in evaluating one's own lifestyle" in the 〈high emphasis〉 segment of the [general practice] category were common to both patterns. In addition, "increasing opportunities for training" and "enhancement of training program content" were found for both patterns in relation to the 〈demand〉 segment of the [training and skill development] category. However, most participants chose "yes" in response to whether there was ample training opportunity.Conclusion This study showed some common efforts and practices among public health nurses in both patterns, which indicates good performance of the Specific Health Guidance initiatives. However, there is a need to further enhance the training program to strengthen the entire organization. Future studies should focus on understanding the characteristics of and factors involved in low-performing branches.

Development of carefulness and quickness observed for a tray-carrying task.

The purpose of this study was to investigate the developmental change in performance of groups of children instructed to behave carefully and quickly in a tray-carrying task. The subjects were 69 nonhandicapped children from a kindergarten, ages 3-4 to 6 years, and 20 adult students who volunteered. Subjects were instructed to carry as fast as they could a tray with a glass of water for 3 m without a spill. The amounts of water spilled and the times taken were measured. The amounts of water spilled were hardly different within groups of children of the same ages or between age groups. But the times were different among groups: the younger ones took longer, and the difference in time between tray-carrying and normal walking was greatest for the youngest group. Children could carry the tray as carefully as adults but could not do so quickly. The nature of the representation of the instruction in relation to the behavior of children and the difference in strategy to guarantee carefulness between children and the adults are discussed.