Real-world efficacy and safety of tofacitinib treatment in Asian patients with ulcerative colitis

BACKGROUND Real-world data on tofacitinib(TOF)covering a period of more than 1 year for a sufficient number of Asian patients with ulcerative colitis(UC)are scarce.AIM To investigate the long-term efficacy and safety of TOF treatment for UC,including clinical issues.METHODS We performed a retrospective single-center observational analysis of 111 UC patients administered TOF at Hyogo Medical University as a tertiary inflammatory bowel disease center.All consecutive UC patients who received TOF between May 2018 and February 2020 were enrolled.Patients were followed up until August 2020.The primary outcome was the clinical response rate at week 8.Secondary outcomes included clinical remission at week 8,cumulative persistence rate of TOF administration,colectomy-free survival,relapse after tapering of TOF and predictors of clinical response at week 8 and week 48.RESULTS The clinical response and remission rates were 66.3%and 50.5%at week 8,and 47.1%and 43.5%at week 48,respectively.The overall cumulative clinical remission rate was 61.7%at week 48 and history of anti-tumor necrosis factor-alpha(TNF-α)agents use had no influence(P=0.25).The cumulative TOF persistence rate at week 48 was significantly lower in patients without clinical remission than in those with remission at week 8(30.9%vs 88.1%;P<0.001).Baseline partial Mayo Score was significantly lower in responders vs non-responders at week 8(odds ratio:0.61,95%confidence interval:0.45-0.82,P=0.001).Relapse occurred in 45.7%of patients after TOF tapering,and 85.7%of patients responded within 4 wk after re-increase.All 6 patients with herpes zoster(HZ)developed the infection after achieving remission by TOF.CONCLUSION TOF was more effective in UC patients with mild activity at baseline and its efficacy was not affected by previous treatment with anti-TNF-αagents.Most relapsed patients responded again after re-increase of TOF and nearly half relapsed after tapering off TOF.Special attention is needed for tapering and HZ.

Injury/ischemia-induced stem cells: up-to-date knowledge and future perspectives for neural regeneration

Brain injuries like ischemic stroke induce endogenous stem cell production. Although the precise traits of stem cells in pathological brains remain unclear, we previously demonstrated that injury/ischemia-induced stem cells(iSCs)are present in the post-stroke mouse(Nakagomi et al.,2009)and human brains(Beppu et al.,2019).

A Survey of Digital Content Required for STD Prevention Education Taught by School Nurses

Purpose: In recent years, there has been concern in Japan about the increase in STDs among adolescents aged 15 - 19. In order to prevent STDs and guide adolescents toward desirable sexual behavior, this study’s goal was to examine the actual state of STD prevention education taught by school nurses as part of the school curriculum, as well as the kinds of digital content they wish to have for teaching on the subject. Method: An anonymous, self-administered questionnaire was distributed by email and leaflet. Targeting the 100 valid responses received from the surveyed school nurses, descriptive statistics were made for each survey item and comparisons were made between the early- and mid-career groups based on years of experience. Results: 70.0% of respondents reported teaching about STDs in Health & Physical Education classes. School nurses in the early-career group used ready-made materials, while the mid-career group used both ready-made and self-made materials. 95% of respondents reported that they had little or no knowledge of STDs, while 84% reported that they were “good” or “fairly good” at teaching classes on sexuality. Both groups reported difficulty with the topics of “phimosis” and “nocturnal emissions” in the physiological category, “sexual behavior” in the “sex-adjacent” category, and “sexual and reproductive issues” in the psychosocial category. Respondents expressed a need for digital content covering the topics of “sexual violence”, “sexual abuse”, “sexually transmitted diseases”, and “how to turn down sex”. The mid-career group desired digital content for more items than the early-career group, with significant differences in the pathogens involved in sexually transmitted diseases and sex-adjacent items. 32.0% of respondents answered that they had done self-study for sex education classes in the past three years, and both groups desired self-study on “sexually transmitted diseases”, with the mid-career group significantly higher than the early-career group on “cervical cancer & HPV”, “emergency contraceptives”, and “media literacy”. Conclusion: Health & Physical Education is the main subject that covers STDs, and pre-existing materials are commonly used. It is expected that this is due to nurses’ busy schedules and the fact that only one school nurse is assigned to each school. The data collected suggested that nurse teachers want categorized digital content that can be used in the classes they are responsible for, rather than educational content on topics they are not comfortable with. In addition, given the changing environment surrounding sex, it was clear that they wish to understand the realities and needs of the high school students they teach, and desire self-study opportunities to improve their teaching methods.

Challenges of Bioethics Education in Pediatric Basic Nursing Education: A Faculty Perspective

In the field of pediatric nursing, in the perinatal period, numerous ethical issues arise alongside the advancement of medical technology. However, sufficient education on bioethics is not provided in the pediatric nursing domain of basic nursing education. The purpose of this research is to examine the current status of bioethics education in the pediatric nursing domain of basic nursing education and explore the challenges perceived by the pediatric nursing faculty regarding bioethics education. The research method was a questionnaire survey on 100 randomly selected pediatric nursing faculty members from nursing universities across Japan. The results revealed that although bioethics issues were considered important, the emphasis remained primarily on addressing bioethics as part of nursing that respects children’s rights. Furthermore, respondents expressed difficulties regarding teaching methods and content related to bioethics.

GPCR-Gs mediates the protective effects of ginsenoside Rb1 against oxygen-glucose deprivation/re-oxygenation-induced astrocyte injury

Objectives:To investigate whether the protective actions of ginsenoside Rb1(Rb1)on astrocytes are mediated through the G_(s)-type G-protein-coupled receptor(GPCR-G_(s)).Methods:Primary astrocyte cultures derived from neonatal mouse brain were used.Astrocyte injury was induced via oxygen-glucose deprivation/re-oxygenation(OGD/R).Cell morphology,viability,lactate dehydrogenase(LDH)leakage,apoptosis,glutamate uptake,and brain-derived neurotrophic factor(BDNF)secretion were assessed to gauge cell survival and functionality.Western blot was used to investigate the cyclic adenosine monophosphate(cAMP)and protein kinase B(Akt)signaling pathways.GPCR-G_(s)-specific inhibitors and molecular docking were used to identify target receptors.Results:Rb1 at concentrations ranging from 0.8 to 5μM did not significantly affect the viability,glutamate uptake,or BDNF secretion in normal astrocytes.OGD/R reduced astrocyte viability,increasing their LDH leakage and apoptosis rate.It also decreased glutamate uptake and BDNF secretion by these cells.Rb1 had protective effects of astrocytes challenged by OGD/R,by improving viability,reducing apoptosis,and enhancing glutamate uptake and BDNF secretion.Additionally,Rb1 activated the cAMP and Akt pathways in these cells.When the GPCR-G_(s) inhibitor NF449 was introduced,the protective effects of Rb1 completely disappeared,and its activation of cAMP and Akt signaling pathways was significantly inhibited.Conclusion:Rb1 protects against astrocytes from OGD/R-induced injury through GPCR-G_(s) mediation.

Examining the Hypothesis of Common Factors Shared by Different Addictive Behaviors and Gender Effects on Propensity to Addiction Type

Background: From the two facts reported by previous research: 1) frequent co-occurrence of more than one addictive behavior, 2) childhood adversities identified as origins of different types of addictive behaviors, it is assumed that all types of addictive behaviors, regardless of substance, behavioral, or relationship, share common factors which have not yet been proven by epidemiological research. The Shorter PROMIS Questionnaire (SPQ) was previously developed to assess 16 types of addictive behaviors. Its factor structure, however, has not been fully investigated. Confirming the factor structure will enable us to hypothesize the common factor(s) shared by all, or if not all, most types of addictive behaviors. Aims: This study aimed at 1) examining the factor structure of the SPQ, 2) confirming the reliability of the questionnaire, and 3) examining the impacts of gender and age on each addictive behavior. Methods: Data obtained from 232 Japanese adults who completed all items of the SPQ were used for the analyses. After confirming the one-factor structure model for each of the 16 subscales, the validity of the one-factor structure of the SPQ was evaluated using Confirmatory Factor Analysis (CFA), by adapting 16 subscale scores as observed variables. If its validity was not confirmed, another model which showed better compatibility to the data was explored. The reliability of the SPQ as well as that of all 16 subscales was evaluated. Also, the impacts of gender and age on each subscale score were examined. Results: The one-factor structure for each of the 16 subscales was confirmed. The compatibility of the SPQ one-factor model was not acceptable. The best fit model was a bi-factor model in which one main factor was shared by all 16 subscales, and three factors were shared by some specific addictive behaviors. Male respondents were more likely than female respondents to show high scores in Alcohol, Tobacco, Gambling, Sex, and Recreational Drugs, and low scores only in Shopping. Respondents’ age did not impact any of the 16 subscale scores. Conclusion: It was demonstrated that there are common factors shared by all different types, as well as selected types of addictive behaviors, by conducting CFAs of the SPQ. Reliability was proven for the SPQ and for all 16 subscales. Male respondents were more likely to show physically hedonic addictive behaviors.

A Literature Review of Fertility Education for High School Students

Purpose: Fertility education for high school students leads them to be able to decide when to get pregnant and give birth, and to think about their desired life plan. However, knowledge of fertility in Japan is low compared to other countries. This study aims to understand the state of fertility knowledge among high school students in Japan and to clarify issues in fertility education. Method: Ten articles published from 2013 to July 2023 were selected for review from ICHUSHI Web Ver. 5 and CiNii with the keywords “high school students,” “fertility,” and “education.” The review was limited to Japanese-language literature due to differences in fertility education and knowledge between Japan and other countries. Results/Conclusion: 60% - 90% of the high school students indicated that their source of information on fertility was school lessons. Half of the students understood egg aging and the effects of smoking and drinking on fertility, but their knowledge of menstruation, male reproductive physiology/function, and infertility was insufficient. 50% - 80% of students wanted to marry by the age of 30, and 70% - 80% wanted to have children. 80% of students who attended a lecture on preconception care considered the lesson an opportunity to think about their future life plans. 90% of school nurse teachers reported that fertility should be taught in schools, and half said that egg aging, causes of infertility, and other topics should be covered in high school. Educational caution points included the consideration of developmental stages and the relatedness of the content to what had already been taught, among other things. High school is the best time for fertility education because it gives students the opportunity to accept their own sexuality and think about their future. In addition, since many students plan to marry and have children by the age of 30, the acquisition of fertility knowledge can be an effective means of future life design.

Understanding Patients’ Symptoms Management Using Objective and Subjective Indicators among Patients with Systemic Lupus Erythematosus

Background: Descriptive statistics have been used to document the high prevalence of sleep disorders, fatigue, and pain in patients with systemic lupus erythematosus (SLE). Objectives: To describe day-to-day variations in sleep indicators, physical activity level, pain, and fatigue measured using objective and subjective indicators in lupus patients with sleep disorders. Methods: We selected three patients with sleep disorders, measured by the Pittsburgh Sleep Quality Index score (≥9), out of 20 participants followed up for 4 weeks. We compared the self-rated quality of life (QoL) measured using the Pittsburgh Sleep Quality Index (PSQI) with that of objectively measured sleep indicators monitored using the Nemuri scan. The detailed data collection methods have been previously published. Results: The sleep status generated by the Nemuri scan revealed that Case A with a flare and Case B without a flare required frequent daytime rest. The PSQI sleep duration and sleep latency were generally in agreement with the monitored data, although the PSQI failed to capture the complexity of sleep disorders, particularly the fluctuations in the quality of sleep indicators. Patient C approximately 4 hours on weekdays and 10 hours on Saturday nights. All three cases had high fatigue levels, and their moderate-to-vigorous physical activity duration was less than one-half of duration that recommended by the World Health Association. Conclusion: Visual display for objective monitoring of sleep quality is an excellent tool for understanding patients who require frequent resting and irregular sleep indicators. Objective monitoring of sleep quality, along with self-rated pain and fatigue, promotes an understanding of how patients with SLE cope with severe symptoms.

Monitoring of Sleep Indicators, Physical Activity, Pain, and Fatigue in Patients with Systemic Lupus Erythematosus and Relations among These Variables: A Pilot Study

Background: Poor sleep, fatigue, and pain are major health problems in patients with systemic lupus erythematosus (SLE). However, only cross-sectional surveys on these health outcomes have been conducted, and the association between day-to-day fluctuations remains unknown. Objectives: We aimed to characterize daily fluctuations in sleep quality, physical activity, pain, and fatigue in patients with SLE. Method: Exploratory study with a cross-sectional design. Two rheumatology centers (a university hospital and a prefectural hospital) in Japan between September 2017 and May 2019. The sample size was set to 20. Demographic and clinical data were collected. Sleep and physical activity were measured with monitoring devices;pain and fatigue levels were recorded daily during the 4-week period. The Pittsburgh Sleep Quality Index, Short Form Health Survey-12, the Japanese version of the Lupus Patient Outcome, and SLE Disease Activity Index 2000 were collected at the start and end of the study. Descriptive statistics and coefficients of variation (CV) were tabulated to examine daily fluctuations. Pearson correlation coefficients were obtained for monitored variables. Results: The mean age was 43.7 ± 8.5 years, and the mean SLE duration was 16.0 ± 7.2 years. The mean moderate-to-vigorous physical activity (MVPA) duration was 7.8 ± 5.8 min/day, and the mean total sleep duration was 391.8 ± 65.3 min, with a mean sleep efficiency of 88.6% ± 6.1%. Daily fluctuations were high for leaving the bed frequency, MVPA duration, pain, and waking after sleep onset. Seventeen participants showed correlations between some of the variables, such as fatigue or longer MVPA duration and poorer sleep outcomes;longer sleep latency and increased frequency of leaving the bed;and higher physical activity and increased pain and fatigue. Conclusion: The quality of sleep and fatigue fluctuated daily, and correlations existed between these variables, as well as for pain and physical activity. The impact of MVPA duration on pain and fatigue is of concern as increased physical activity may worsen the quality of life patients with SLE. The monitoring of sleep and physical activity using the device seems feasible for SLE symptom management.

Recent evidence for subcutaneous drains to prevent surgical site infections after abdominal surgery:A systematic review and metaanalysis

BACKGROUND Surgical site infections(SSIs)increase mortality,hospital stays,additional medical treatment,and medical costs.Subcutaneous drains prevent SSIs in gynecological and breast surgeries;however,their clinical impact in abdominal surgery remains unclear.AIM To investigate whether subcutaneous drains were beneficial in abdominal surgery using a systematic review and meta-analysis.METHODS The database search used PubMed,MEDLINE,and the Cochrane Library.The following inclusion criteria were set for the systematic review:(1)Randomized controlled trial studies comparing SSIs after abdominal surgery with or without subcutaneous drains;and(2)Studies that described clinical outcomes,such as SSIs,seroma formation,the length of hospital stays,and mortality.RESULTS Eight studies were included in this meta-analysis.The rate of total SSIs was significantly lower in the drained group(54/771,7.0%)than in the control group(89/759,11.7%),particularly in gastrointestinal surgery.Furthermore,the rate of superficial SSIs was slightly lower in the drained group(31/517,6.0%)than in the control group(49/521,9.4%).No significant differences were observed in seroma formation between the groups.Hospital stays were shorter in the drained group than in the control group.CONCLUSION Subcutaneous drains after abdominal surgery prevented SSIs and reduced hospital stays but did not significantly affect seroma formation.The timing of drain removal needs to be reconsidered in future studies.

Transient receptor potential channel A1 involved in calcitonin gene-related peptide release in neurons

Transient receptor potential channel A1 is one of the important transducers of noxious stimuli in the primary afferents, which may contribute to generation of neurogenic inflammation and hyperalgesia. The present study was designed to investigate if activation of transient receptor potential channel A1 may induce calcitonin gene-related peptide release from the primary afferent neurons. We found that application of allyl isothiocyanate, a transient receptor potential channel A1 activator, caused calcitonin gene-related peptide release from the cultured rat dorsal root ganglion neurons. Knock- down of transient receptor potential channel A1 with an antisense oligodeoxynucleotide prevented calcitonin gene-related peptide release by allyl isothiocyanate application in cultured dorsal root ganglion neurons. Thus, we concluded that transient receptor potential channel A1 activation caused calcitonin gene-related peptide release in sensory neurons.

Development of the Irrational Belief Test for Nurses (IBTN): Examination of Reliability and Validity

[Purpose]: The purpose of this study is to develop irrational belief test for nurses, and to examine reliability and validity. [Method]: In study 1, The Irrational belief test for nurses was developed based JIBT-20 (mori et al., 1994) of previous studies. And for the nurse (N = 96, 5 male, 91 female), carried out preliminary investigation, created the provisional version of the Irrational belief test for nurses, and examined factor structure and internal consistency. In study 2, for the nurse (N = 541, 21 male, 520 female) examined validity based on JIBT-20 (Japanese Irrational Belief Test), MBI (Maslach Burnout Inventory), ATQ-R Japanese version (Automatic Thoughts Questionnare-Revised), and for the nurse (N = 91, 3 male, 88 female) examined a test-retest reliability four weeks afterward before long. [Result]: As a result of the explanatory factor analysis by a maximum likelihood estimation and promax rotation, 28-item 7 factors were extracted and was named a “patient belief”, “self-expectation”, “avoidance”, “self-inhibition”, “Ethical blame”, “helplessness”, and “dependence”. Moreover, as a result of conducting confirmation factor analysis, the hypothetical model obtained by explanatory factor analysis fitted (GFI = 0.89, AGFI = 0.86). About the reliability of the measure, a Cronbach’s alpha coefficient is 0.68 - 0.82, and a test-retest reliability is 0.64 and reliability is affirmed. About construct validity was checked correlation with JIBT-20, and about criterion validity was checked the correlation with MBI and ATQ-R Japanese-translation version. [Conclusion]: It is suggested that reliability and validity are verified and the irrational belief test for nurses is a useful measure. The developed test can be used to measure the irrational belief in the context of burnout in nurses.

The Effect of the Group Cognitive Behavior Therapy in a Nurse’s Burnout and Intention to Resign

Purpose: The purpose of the present study was to decrease burnout and intention to resign by practicing cognitive behavioral approach to nurses of the 3 years nursing clinical experience. Methods: Nurses (N = 180) who worked at acute-care hospitals and whose clinical experience was 3 years were requested. Nurses (n = 95, male 5, female 90) who were able to do participation at all the sessions were objects. The program was created and carried out for a nurse’s burnout with reference to cognitive behavior therapy. Evaluation of intervention was asked to complete a questionnaire that measured burnout (MBI), job stressors (NJSS), automatic thoughts (the shorter version of Japanese version ATQ-R), Irrational Belief Test for Nurses (IBTN), coping measure and whether or not they had an intention to resign. Measurement was performed 3 times of a baseline, after the end of session and follow-up. Analysis of covariance which adjusted the baseline level was performed. Result: According to the results, “helplessness”, “positive thinking” and “personal accomplishment” were significant (p < 0.01). According to the results of Friedman test, significant difference was observed in “emotional exhaustion” in the group with low degree of irrational belief (p < 0.10 ) and in the group with high degree (p < 0.05). With regard to the intention to leave the job, “wants to continue working as a nurse” was significant in the group in 3 months after intervention (p < 0.05). Conclusion: It is suggested that cognitive behavioral approach appears to be effective for reducing nurse’s burnout or intention to resign in nurses of the 3 years nursing clinical experience.

Hewei Jiangni granule alleviates visceral hypersensitivity in a rat model of non-erosive reflux disease via transient receptor potential channel signaling

Objective:To uncover the underlying mechanism of Hewei Jiangni granule(HWJNG)on non-erosive reflux disease(NERD)treatment by examining histological changes,gastrointestinal neurochemicals release and visceral hypersensitivity-related receptor expression in NERD model rats.Methods:A NERD rat model was established via a combination of basal sensitization and acid perfusion.HWJNG treatments at different doses were then administered.Pathological changes to tissues,mast cell(MC)activation,serum levels of esophageal visceral hypersensitivity-related neurochemicals,and transient receptor potential(TRP)receptor mRNA and protein levels were investigated.Results:Compared with the control group,the expression of tryptase in MCs,the changes of intercellular space,and the serum levels of substance P(SP),calcitonin gene-related peptides(CGRP)and proteinaseactivated receptor 2(PAR2)increased in the model group(all P<.05).The expression of TRP vanilloid 1(Trpv1)mRNA decreased in esophagus and dorsal root ganglia(DRG)of the model group(P=.030&P=.013),and the expression of TRP melastatin channel subfamily member 8(Trpm8)mRNA decreased in the esophagus of model group(P<.01).The level of esophageal TRPV1 protein increased in the model group(P<.01)and the level of TRPM8 protein decreased in esophagus and DRG of the model group(both P<.05).Compared with the model group,the serum levels of SP,CGRP,and PAR2 in the mediumdose HWJNG group showed significant decreases(all P<.05).The expression of Trpv1 mRNA in esophagus and DRG of the HWJNG groups and the Omeprazole group remarkably decreased(all P<.05),as was the expression of Trpm8 mRNA in esophagus of the HWJNG groups(all P<.05).Conclusion:HWJNG alleviated visceral hypersensitivity in NERD model rats by regulating TRP-mediated signaling.Our results indicate that HWJNG has potential as a therapeutic agent for NERD.

Isoflavone Aglycones and Oligopeptides in Lactic Acid-Fermented Soy Milk Differentially Regulate Lipid Metabolism-Related Gene Expression

We previously investigated the physiological effect of an ethanol extract of fermented soymilk on rats and clarified that this extract modulated their hepatic lipid metabolism. Although the soy isoflavones and oligopeptides are representative functional components of the ethanol extract, it remained unclear whether these substances share a role in lipid metabolism modulation. Therefore, we attempted to clarify the effects of isoflavones and oligopeptides in lactic acid-fermented soymilk on lipid metabolism-related gene expression in rats and HepG2 cells. The fermented soymilk extract had a higher isoflavone aglycone content than the soymilk extract. Sevenweek-old male Sprague-Dawley rats were fed an AIN-93G diet, a diet plus 70% soymilk ethanol extract, or a diet plus 70% fermented soymilk ethanol extract for 5 weeks. Although both the soymilk and fermented soymilk ethanol extracts did not significantly affect plasma and hepatic lipid profiles, the expression levels of the genes encoding CYP7a1 and SREBP-2 were significantly upregulated in the livers of rats fed with the fermented soymilk extract. Whereas isoflavone aglycones upregulated CYP7a1-encoding gene expression in HepG2, oligopeptides in soymilk and fermented soymilk downregulated this expression. Oligopeptides in fermented soymilk downregulated the expression stronger than that observed with soymilk. On the other hand, no significant change in FAS expression was observed in the livers of rats fed the fermented soymilk extract. Although isoflavone aglycones did not affect FAS expression in HepG2 cells, oligopeptides in fermented soymilk downregulated FAS expression. The downregulation of FAS with oligopeptides from fermented soymilk was stronger than that from soymilk. In the present animal experiment, the effect on reduction of fat synthesis was not found because of insufficient amount of peptides derived from digestion of soy protein. These results suggest that isoflavone aglycones increase CYP7a1 gene expression, whereas oligopeptides decrease FAS expression. Isoflavone glycosides and proteins in soymilk were converted to isoflavone aglycones and oligopeptides by lactic acid fermentation, respectively, and these functional components independently improved the lipid metabolism. In the present study, it was found that isoflavone aglycones and oligopeptides in fermented soymilk differentially regulate hepatic lipid metabolism-related gene expression. Therefore, the consumption of fermented soymilk containing isoflavone aglycones and soy oligopeptides might prevent dyslipidemia more effectively than that of any other soy food. Fermented soymilk is a superior functional food modulating lipid metabolism.

Comparison of Factors Related to Elderly People’s Purpose of Life in Japan and Thailand

Purpose: In the present study, the features of “purpose of life” of elderly persons in Japan and Thailand are clarified by focusing on this concept and its related factors, and through the comparison of the results of Japan and Thailand. Methods: The Japanese subjects consist of the elderly aged 60 or older. The Thai subjects consist of the elderly aged 60 or older who live in Thailand. A sum of 250 subjects (men and women) per country will be studied. They were asked about their individual attribution and maintenance of healthy condition. Moreover, 19 items were examined as events leading to life purpose. These items were measured using the Philadelphia Geriatric Center Morale Scale, General Health Questionnaire (GHQ) and Instrumental Activities of Daily Living (IADL). Results: Data from 200 elderly people (male: 67, female: 133) in Thailand and 234 elderly people (male: 49, female: 185) in Japan were used in the analysis. Regarding an “Events Leading to Life Purpose,” it was suggested that “activities to enhance learning and culture” and “neighbors and friends, and socializing with acquaintances” helped both in Japan and Thailand. Moreover, “elderly persons’ club activities” and “child” were effective in Thailand, while “spouse” and “grandchild” were effective in Japan. Moreover, Model 1 (event, disease → purpose of life → mental health, and IADL) that became purpose of life for both countries was adopted. Conclusion: In order to improve older adults’ mental health and ADL by improving “purpose of life”, it is required to increase the events leading to life purpose and to prevent illness for both countries. In particular, “activities to enhance learning and culture” and “neighbors and friends, and socializing with acquaintances” was the activity which raises “purpose of life”. Then, “elderly persons’ club activities” and “child” were effective in Thailand, while “spouse” and “grandchild” were effective in Japan.

Verifying the Effects of an Education Program Leveraging Information Technology to Promote Cervical Cancer Screening in Women Aged 20 - 29—A One-Year Longitudinal Study

The purpose of this research is to implement an IT-based education program in order to promote cervical cancer screenings for women aged 20 - 29 years, as well as to examine the results of said program. This is a longitudinal/comparative study of two groups, one for which the program was implemented (the intervention group), and the other for which it was not (the control group). The program consisted of attending a health lecture and encouragement to be screened one month, six months, and one year later sent through IT-based methods. The target was unmarried women aged 20 - 29 who had neither previously given birth nor had been screened for cervical cancer in a period one year prior. They were divided into two groups, the intervention group (n = 142) and control group (n = 145). The effectiveness of the program was assessed via an initial survey and further surveys six months and one year later. Results were based on the Japanese version of the Health Belief Model Scale for Cervical Cancer and the Pap Smear Test (HBMSCCPST), knowledge scores in the categories of Healthy Lifestyles, Cervical Cancer, Cervical Cancer Screening, and screening behavior. A two-way ANOVA of the HBMSCCPST subscales and knowledge scores in the initial, six-month, and one-year surveys was performed, showing interaction in Cervical Cancer (p = 0.00). Main effects were observed in Cervical Cancer Screening (p = 0.00) and Healthy Lifestyles (p = 0.00). Regarding the amount of change from the initial survey, knowledge scores in the Cervical Cancer (p = 0.027) and Cervical Cancer Screening (p = 0.016) categories were significantly higher in the intervention group than in the control group. There was no significant difference in cervical cancer screening rates (p = 0.26) between the two groups. However, a small-degree effect size was observed for Benefits, Seriousness, and Susceptibility subscales in both examinees and non-examinees. Although the educational program of this study was effective in improving the knowledge of women in their twenties, there was little improvement in HBMSCCPST and it did not lead to the promotion of cervical cancer screening. In order to raise interest in cervical cancer screening, it is necessary to consider useful content to guide women to consult with healthcare professionals, a long-term population approach, and organizational structure of consultation.

A Literature Review regarding Cervical Cancer Prevention Targeting Junior and Senior High School Students

Objective: To understand the state of education for the prevention of cervical cancer and trends in research. The subject of cervical cancer prevention will be examined. Method: Articles from the ICHUSHI Web version 5, CiNii, and PubMed databases for the period from 2009-2019 were used. Search terms used were cervical cancer, HPV/human papillomavirus, prevention, public awareness, and education. Results: 17 articles (9 Japanese and 8 English) were analyzed. The majority of students had heard of cervical cancer but did not know of the link between it and HPV. Vaccinated individuals were significantly more likely to have deeper knowledge regarding cervical cancer and HPV. Various factors affect the vaccination rate. These include knowledge of HPV and cervical cancer, age, ethnicity, the organization or location which administers the vaccine, how to breach the subject, finances, and the opinions of friends and family. In particular, consultations with parents lead to mothers recognizing the importance of the vaccine. By way of educational intervention, opinions have grown more positive about advancing awareness, being vaccinated, and having cervical cancer screenings for the future. Conclusion: The prevention of cervical cancer requires support and fostering the judgement based on sufficient awareness and adequate education. What we need is educational intervention rooted firmly in the current societal climate aimed not only at students, but at their parents as well.

A Literature Review on the State of High School Sex Education Implemented by School Nurses

Objective: In recent years, increases in sexually transmitted infections, cervical cancer caused by HPV, and abortions due to unwanted pregnancy among those in their 20s have become serious issues that threaten fertility. This study aims to identify issues in need of attention and the difficulties experienced by school nurses in teaching sex education in high schools preemptively before these students become sexually active in order to promote responsible sexual behaviors for the prevention of STIs. Method: ICHUSHI Web Ver. 5 and CiNii were queried for literature published between 2000 and May 2022. Search terms were “yōgokyōyu” [school nurses], “seikyōiku” [sex education], “seikansenshō” [sexually transmitted infections/diseases], and “kōkōsei” [high school students]. In addition, we limited the search to Japanese literature only, due to differences in cultural background and the roles of school nurses. Results & Observations: Sex education is taught by multiple faculty members and implemented into multiple subjects such as health & physical education and home economics. There are differences in the content taught by school nurses and other faculty. As specialists in health and hygienics, school nurses demonstrate high awareness and positive attitudes toward sex education. Additionally, while they play a central role in sex education, they face difficulties due to having no position in school health plans, differences in awareness among faculty, busy schedules, difficulty securing time, and failure to coordinate with other faculty. It is necessary to consider school-wide policies that systematize sex education as a continuous subject. Furthermore, while they have many opportunities to undertake consulting duties on sexuality, there is uncertainty among school nurses on their ability to meet student needs. Therefore, the development of teaching materials and opportunities for school nurses to improve their teaching skills is absolutely essential.

The Direction of Research on Active Aging and Healthy Life Expectancy in Japan

In Japan, 18.1% of the population known as baby-boomers will become the late-stage elderly in 2025, thereby needing a foundation to support this change. The Japanese Ministry of Health, Labour and Welfare is promoting the development of a regional comprehensive system allowing the elderly to continue living in their familiar surroundings. However, a care shortage is inevitable unless elders are able to age in good health, regardless of the system’s level of enhancement. This study aims to review the literature on active aging, clarify trends in clinical operations undertakings and research in Japan, and consider relevant research issues. After combining the search results of “active aging” and “healthy life expectancy,” we used a text mining technique to analyze the abstracts of 120 original articles and 213 reviews, commentaries, and features. Eight categories were extracted from the original articles: health statistics, gender, age, etc. From the reviews, commentaries, and features, 16 categories were extracted: orientation, disease, and living, etc. Cerebrovascular disease and osteoporosis were the most common diseases covered in the original articles;there has been a substantial amount of research on “active aging” and “healthy life expectancy” because they can easily lead to being bedridden and to a decrease in QOL. In the reviews, commentaries, and features, lifestyle-related diseases and menopause rather than cerebrovascular disease and osteoporosis, were extracted. The categorical differences found in the original articles may be due to the possibility that Japanese researchers are publishing their research abroad rather than in Japan or they submit research on topics that are guaranteed to be published at home or abroad. Little research has been conducted using the terms, “active aging” and “healthy life expectancy,” evidenced by the small number of studies generated. Preparations for 2025 will require an increase in the number of studies from the perspective of “active aging” and “healthy life expectancy.”