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1.
Drug Metab Dispos ; 2019 Nov 26.
Artículo en Inglés | MEDLINE | ID: mdl-31771948

RESUMEN

The physiological and pharmacological roles of the blood-arachnoid barrier (BAB) remain unclear. Therefore, the purpose of the present study was to comprehensively evaluate and compare the absolute protein expression levels of transporters in the leptomeninges and in the choroid plexus per cerebrum, and to determine the localizations of transporters at the CSF- and blood (dura)-facing plasma membranes of the BAB in pig. Using MDR1 and OAT1 as blood (dura)-facing and CSF-facing plasma membrane marker proteins, respectively, we established that BCRP, MRP4, OATP2B1, MATE1 and GLUT1 are localized at the blood-facing plasma membrane, and OAT3, PEPT2, MRP3, OCT2, xCT, MCT1, MCT4, MCT8 are localized at the CSF-facing plasma membrane of the BAB. The absolute protein expression levels of OAT1, OAT3, MDR1, BCRP, PEPT2, xCT, MATE1 OCT2 and 4f2hc in the whole BAB surrounding the entire cerebrum were much larger than those in the total of the choroid plexuses forming the blood-cerebrospinal fluid barrier (BCSFB). Although MRP4, OATP2B1, MCT8, GLUT1 and MCT1 were also statistically significantly more abundant in the BAB than in the choroid plexuses per porcine cerebrum, these transporters were nevertheless almost equally distributed between the two barriers. In contrast, OATP1A2, MRP1, OATP3A1 and OCTN2 were specifically expressed in choroid plexus. These results should be helpful to understand the relative overall importance of transport at the BAB compared to that at the BCSFB, as well as the rank order of transport capacities among different transporters at the BAB, and the directions of transport mediated by individual transporters. SIGNIFICANCE STATEMENT: We found that BCRP, MRP4, OATP2B1, MATE1 and GLUT1 localize at the blood-facing plasma membrane of the blood-arachnoid barrier (BAB), while OAT3, PEPT2, MRP3, OCT2, xCT, MCT1, MCT4, MCT8 localize at the CSF-facing plasma membrane. 4F2hc is expressed in both membranes. For OAT1, OAT3, MDR1, BCRP, PEPT2, xCT, MATE1 OCT2 and 4f2hc, the absolute protein expression levels in the whole BAB surrounding the entire cerebrum are much greater than the total amounts in the choroid plexuses.

2.
Infect Dis Health ; 24(4): 212-221, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31402297

RESUMEN

BACKGROUND: Elderly patients benefit from influenza vaccination, but the number of Japanese elderly patients who are vaccinated is insufficient. Several factors are associated with influenza vaccination acceptance, but little is known about Japanese elderly outpatients. The purpose of this study was to examine factors associated with influenza vaccination in elderly outpatients in Japan. METHODS: During the 2017-2018 influenza season, outpatients from one hospital and one clinic in Kitaibaraki City, Ibaraki, Japan, participated in this study. Patients answered a self-report questionnaire exploring factors such as their vaccination status during the 2017-2018 season, past influenza vaccination, perceived susceptibility to influenza and adverse events of the vaccine, perceived vaccine efficacy, physician recommendations. Multivariable logistic regression analyses were conducted to identify factors associated with vaccination. RESULTS: Of 377 patients, 316 (83.8%) responded, and the vaccination rate was 57%. Eighty-three patients (27.0%) reported that their physician recommended the influenza vaccine. In multivariate analysis, influenza vaccination was associated with higher age (odds ratio (OR) 1.09, 95% confidence interval (CI) 1.03-1.14), physician recommendations (OR 2.49, 95% CI 1.18-5.25), low perceived susceptibility to vaccine-related adverse events (OR 0.33, 95% CI 0.15-0.74), and belief in vaccine efficacy (OR 4.73, 95% CI 2.08-10.8). CONCLUSIONS: Influenza vaccination was associated with belief in vaccine efficacy, perceived susceptibility to vaccine-related adverse events, physician recommendations, and older age. Increasing the frequency of physician recommendations may lead to increased vaccination coverage.

3.
PLoS One ; 14(1): e0210912, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30653563

RESUMEN

Interprofessional education (IPE) for medical students is becoming increasingly important, as reflected in the increasing number of medical schools adopting IPE. However, the current status of and barriers to pre-registration IPE implementation in Japanese medical schools remain unknown. The purpose of this study was to clarify the status and barriers of IPE implementation in medical schools in Japan. We conducted a curriculum survey from September to December 2016 of all 81 medical schools in Japan. We mailed the questionnaire and asked the schools' undergraduate education staff to respond. The survey items were the IPE implementation status and barriers to program implementation. Sixty-four of the 81 schools responded (response rate 79.0%), of which 46 (71.9%) had implemented IPE, 42 (89.1%) as compulsory programs. Half of IPE programs were implemented in the first 2 years, while less than 10% were implemented in the latter years of medical programs. As part of the IPE programs, medical students collaborated with a wide range of professional student groups. The most common learning strategy was lectures. However, one-third of IPE programs used didactic lectures without interaction between multi-professional students. The most common perceived major barrier to implementing IPE was adjustment of the academic calendar and schedule (82.8%), followed by insufficient staff numbers (73.4%). Our findings indicate that IPE is being promoted in undergraduate education at medical schools in Japan. IPE programs differed according to the circumstances of each school. Barriers to IPE may be resolved by improving learning methods, introducing group discussions between multi-professional students in lectures or introducing IPE programs using team-based learning. In summary, we demonstrated the current status and barriers of IPE implementation in Japanese medical schools. Our findings will likely lead to the promotion of IPE programs in Japan.


Asunto(s)
Educación de Pregrado en Medicina/métodos , Relaciones Interprofesionales , Facultades de Medicina , Curriculum , Humanos , Japón , Encuestas y Cuestionarios
4.
Tohoku J Exp Med ; 246(3): 183-189, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30487351

RESUMEN

Binge drinking by college students is a problematic behavior. However, data on binge drinking and the reasons for drinking by college students in Japan are scarce. We explored the reasons for drinking among college students. The study used a cross-sectional design and a self-administered questionnaire. From December 2016 to March 2017, we sampled undergraduate and graduate students aged 20 or older at 35 colleges in the Kanto region of Japan. The questionnaire addressed 1) frequency of drinking alcohol, 2) amount of drinking per day, 3) frequency of binge drinking in the past year, and 4) reasons for drinking (with 12 possible responses). The t-test was used to compare the means between binge drinkers and non-binge drinkers. Logistic regression analysis was conducted on binge drinking and the reasons for drinking. The participants included 303 men and 260 women. Significant differences between men and women included the presence of binge drinking (men: 74.9%; women: 59.6%). Among male students, the statistically significant reasons given for binge drinking were "to feel happy or be in a good mood" and "to relieve stress," whereas among female students, the reasons were "to feel happy or be in a good mood," "to facilitate interpersonal relationships," "to forget something bad," and "to relieve stress." The reasons for drinking associated with binge drinking were identified. It is important to incorporate these results into preventive education about binge drinking aimed at college students in Japan.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Estudiantes , Universidades , Borrachera/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Adulto Joven
5.
Tohoku J Exp Med ; 245(4): 263-267, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-30158367

RESUMEN

Excessive drinking by college students is a major public health problem in Japan. However, data on heavy episodic drinking (HED) and nomihodai, a several-hour all-you-can-drink system, are scarce. We surveyed the drinking behavior of undergraduate and graduate students at 35 colleges, and examined the association between HED and use of nomihodai. The study used a cross-sectional design conducted by a self-administered questionnaire. From December 2016 to March 2017, we sampled undergraduate and graduate students aged 20 or older at 35 colleges in the Kanto area, including Tokyo. The following items were measured: 1) frequency of drinking; 2) frequency of binge drinking in the past year; 3) nomihodai use; 4) the number of drinks consumed when using or not using nomihodai; and 5) sex and age for demographic data. Paired t-test was used to compare means between use and non-use state of nomihodai. The Fisher's exact test was used to evaluate the significance of the distribution difference between the two types of states. A total of 511 subjects completed the questionnaire, including 274 men and 237 women. The amount of drinking was increased 1.8-fold (85.9 ± 49.7 g vs. 48.2 ± 29.5 g) among men and 1.7-fold (63.7 ± 39.3 g vs. 36.5 ± 26.7 g) among women during nomihodai use, comapred with non-use states. Among them, 109 (39.8%) men and 71 (30.3%) women reported HED only at nomihodai states. These data suggest that the use of nomihodai system may lead to excessive drinking among college students.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Estudiantes , Universidades , Estudios Transversales , Femenino , Humanos , Japón/epidemiología , Masculino , Adulto Joven
6.
J Clin Med Res ; 10(3): 202-209, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29416578

RESUMEN

Background: The burden from depression is affected by the public's beliefs, stigma, and resulting behavior. Lack of knowledge, misunderstanding, and stigma about depressed people and their surroundings are barriers to improving their mental health. This study aimed to examine public beliefs regarding depression, especially how to recognize depression, treatment, and stigma. Methods: A self-administered questionnaire was distributed to participants receiving an annual health checkup. We asked whether they agreed with four short sentences: "it is not necessary to worry about depression in a person behaving brightly" (misunderstanding about the behavior of depressed people), "rest is important for treating depression" (belief about the necessity of rest), "medicine is effective for treating depression" (belief about the effectiveness of pharmacotherapy) and "a weak personality causes depression" (stigma about the cause of depression). We also analyzed the association between these beliefs and factors such as health literacy, regularly visiting an outpatient clinic, history of depression, and demographic variables. Results: Among 1,085 respondents (75.0% response rate), 54.5%, 75.6%, 58.9%, and 70.8% responded appropriately to the "misunderstanding about the behavior of depressed people", "necessity of rest", "effectiveness of pharmacotherapy", and "stigma about the cause of depression" items, respectively. Regarding stigma about the cause of depression, 30.7% of respondents agreed that a weak personality caused depression. Female sex and younger age group were associated with appropriate answers. Health literacy was only associated with appropriate beliefs about the effectiveness of pharmacotherapy. Conclusions: Thirty percent of participants had the stigmatizing belief that a weak personality causes depression and only 58.9% believed in the effectiveness of pharmacotherapy for depression. Over 70% understood the necessity of rest and knew that depression is possible in those who act brighter. General health literacy alone might not improve knowledge and beliefs about depression. An educational intervention or campaign to reduce stigma toward depression and improve knowledge about the treatment of depression is needed.

7.
Geriatr Gerontol Int ; 18(4): 615-622, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29278290

RESUMEN

AIM: We investigated factors that predict the prognosis of activities of daily living (ADL) in elderly patients who had undergone rehabilitation during hospitalization for acute infectious disease. METHODS: The present prospective cohort study included 131 patients who were hospitalized due to acute infectious disease and who had undergone rehabilitation during hospitalization. Patient characteristics collected from medical records included age, sex and comorbidity score. The level of ADL 2 weeks before admission was assessed by interview at the start of rehabilitation. Grip strength testing, Short Physical Performance Battery as an assessment of lower limb function and the Mini-Mental State Examination as an assessment of cognitive status were carried out at the time of hospital discharge. The level of ADL at 6 months after discharge was assessed by telephone interview. Multivariate logistic regression analysis was used to identify factors that independently predict ADL dependence (defined as being dependent in one or more ADL items at 6 months after discharge). RESULTS: The average age of participants was 81.5 years, and 52.7% were women. A total of 22.1% of patients showed dependence in an ADL at 6-month follow-up. Factors that predicted an ADL dependence were comorbidity score (OR 4.19, 95% CI 1.19-14.69) and lower limb function (OR 0.51, 95% CI 0.36-0.72) at discharge. CONCLUSIONS: The present findings have implications for the healthcare planning and well-being of elderly patients during hospitalization and after discharge. Geriatr Gerontol Int 2018; 18: 615-622.


Asunto(s)
Actividades Cotidianas , Enfermedades Transmisibles/terapia , Hospitalización , Enfermedad Aguda , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Japón , Masculino , Pronóstico , Estudios Prospectivos
8.
Tohoku J Exp Med ; 242(2): 157-163, 2017 06.
Artículo en Inglés | MEDLINE | ID: mdl-28637993

RESUMEN

Alcohol-related injuries in college students are a major public health problem worldwide. We clarified the association between excessive drinking and alcohol-related injuries in Japanese college students. This was a cross-sectional study with a self-administered questionnaire. From January to March 2013, we sampled all college students and graduate students aged 20 years or older during annual health examinations at three colleges in Mie Prefecture in Japan. The questionnaire assessed the frequency of alcohol drinking, amount of alcohol consumed per day, binge drinking during the past year, alcohol-related injuries during the past year, and demographic data. Logistic regression analysis was conducted on the association between excessive alcohol use and alcohol-related injuries. A total of 2,842 students underwent health examinations, of whom 2,177 (76.6%) completed the questionnaire. Subjects included 1,219 men (56.0%) and 958 women (44.0%). Eighty-eight men (7.2%) and 93 women (9.7%) were classified as excessive weekly drinkers, while 693 men (56.8%) and 458 women (47.8%) were determined to be binge drinkers. Eighty-one men (6.6%) and 26 women (2.7%) had experienced alcohol-related injuries during the past year. In the logistic regression analysis, binge drinkers (odds ratio 25.6 [8.05-81.4]) and excessive weekly drinkers (odds ratio 3.83 [2.41-6.09]) had a history of significantly more alcohol-related injuries, even after adjusting for age and sex. In conclusion, alcohol-related injuries in college students in Japan were strongly associated with excessive drinking. As a strategy for preventing such injuries in this population, an interventional study is required to identify effective methods for reducing excessive alcohol use.


Asunto(s)
Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Estudiantes/estadística & datos numéricos , Universidades/estadística & datos numéricos , Heridas y Traumatismos/epidemiología , Heridas y Traumatismos/etiología , Borrachera/epidemiología , Estudios Transversales , Femenino , Humanos , Japón/epidemiología , Modelos Logísticos , Masculino , Análisis Multivariante , Adulto Joven
9.
NeuroRehabilitation ; 40(3): 363-367, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28222558

RESUMEN

BACKGROUND: Gait training using the Hybrid Assistive Limb® (HAL®) may have beneficial effects on post-stroke gait function and independent walking. However, the long-term and medium-term efficacies of gait training using HAL® in stroke patients remain unclear. OBJECTIVE: To compare the medium-term efficacy of gait training using a single-leg version of the Hybrid Assistive Limb® (HAL®) on the paretic side with conventional gait training (CGT) in recovery-phase stroke patients. METHODS: Twenty-four post-stroke participants (HAL® group: n = 12, CGT group: n = 12) completed the trial. Over 4 weeks, all participants received twelve 20-min sessions of either HAL® (using the single-leg version of HAL® on the paretic side) or conventional (performed by skilled and experienced physical therapists) gait training. Outcome measures were evaluated prior to training, after 12 sessions, and at 8 and 12 weeks after intervention initiation. Functional Ambulation Category (FAC) was the primary outcome measure. RESULTS: The HAL® group showed significant improvement in FAC after 12 sessions, and at 8 and 12 weeks compared to the conventional group (P = 0.02). CONCLUSIONS: The results suggested that a gait training program based on HAL® may improve independent walking more efficiently than CGT at 1 and 2 months after intervention.


Asunto(s)
Marcha/fisiología , Recuperación de la Función/fisiología , Dispositivos de Autoayuda/estadística & datos numéricos , Rehabilitación de Accidente Cerebrovascular/instrumentación , Rehabilitación de Accidente Cerebrovascular/métodos , Accidente Cerebrovascular/fisiopatología , Anciano , Anciano de 80 o más Años , Consejo , Terapia por Ejercicio/métodos , Extremidades/fisiopatología , Femenino , Estudios de Seguimiento , Trastornos Neurológicos de la Marcha/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Accidente Cerebrovascular/diagnóstico , Resultado del Tratamiento , Caminata/fisiología
10.
J Phys Ther Sci ; 29(12): 2206-2209, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29643606

RESUMEN

[Purpose] The objective of the present study was to examine the factors, including physical and mental functions, that are associated with the prognosis for activities of daily living in patients with stroke in a recovery rehabilitation unit. [Subjects and Methods] The subjects were 13 patients with stroke who were admitted to the recovery rehabilitation unit of Tokai Memorial Hospital between March and October 2014 and followed up for 2 months. Their physical and mental functions were evaluated at the time of admission and the relationship between these functions and activities of daily living was assessed 2 months later. [Results] The activities of daily living at 2 months after admission showed a significant correlation not only with the severity of motor paralysis (R=-0.80) but mental function (R=-0.69) at the time of admission. No significant correlation was noted between the severity of motor paralysis and the mental function. [Conclusion] It is important to evaluate both mental function and severity of motor paralysis immediately after patients' admission to the recovery rehabilitation unit. Mental health intervention should be considered in the future to effectively improve subsequent activities of daily living.

11.
J Phys Ther Sci ; 28(10): 2763-2768, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27821931

RESUMEN

[Purpose] This study investigated the factors associated with the recovery rate of activities of daily living of elderly patients hospitalized for acute medical illness. [Subjects and Methods] A total of 238 elderly patients were enrolled in this study. The main outcome measure was the functional independence measure score which was used as an assessment of activities of daily living. The participants were divided into 2 groups based on their activities of daily living before onset: the independent group and the partially dependent group. The participants of each group were further divided into 2 subgroups based on recovery rates of activities of daily living: the high-recovery group (80%) and the low-recovery group (<80%). The factors associated with the recovery rate were examined using multivariate logistic regression analysis. [Results] The factors associated with the recovery rate were: days of inactivity and cognitive status at the start of rehabilitation for the independent group, and days of inactivity and nutritional status at the start of rehabilitation for the partially dependent group. [Conclusion] The results of this study suggest that the important factors for return to normal activities of daily living are: days of inactivity and cognitive status for the independent group; and days of inactivity and management of nutrition for the partially dependent group.

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