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In November 2016, a woman in her 30s who stayed at an insecure, temporary housing facility, a manga café in Tokyo, Japan, for a year was diagnosed with sputum smear-positive tuberculosis (TB). Since the café had 31 staff members and provided with accommodation to many people, the local health office initiated a contact investigation. This study aims to characterise the cases found in the outbreak. A TB case was defined as a person tested bacteriologically positive for TB, or was determined to have TB by a physician. A latent TB infection case was defined as a person tested positive by interferon-γ release assay. From January 2016 through November 2017, there were 31 staff members at the manga café, of which, six developed TB disease (one smear-negative, culture-positive and five smear- and culture-negative) in addition to seven LTBI. Another long-term customer was found having sputum smear-positive TB. Variable numbers tandem repeat (VNTR) test revealed that the index patient and the long-term customer had the identical type of VNTR; however, one staff member had a different VNTR. Local health authorities should intensify screening long-term customers of such facilities for TB regularly as well as once a TB outbreak occurs.
As a response to demographic ageing, various governments have been promoting social policies that promote older people's participation in productive activities, including those outside the formal labour market. Nevertheless, older people's behaviours do not simply reflect government policies and intentions. This paper explores how older people themselves interpret their social roles within a policy context that seeks to position them as providers of welfare through their participation in community activities. For this purpose, this paper draws on a qualitative case study of older people in Japan engaging in health promotion and mutual aid among local residents. By employing Hannah Arendt's distinction between the human activities of labour, work and action as a conceptual framework, it finds that although the purported purpose of community activities was to substitute decreasing pensions and family care or to create a better community, participants in this study valued their activities as a process of creating new relations and new realities through action. The paper argues that while labour has occupied a predominant position in the post-war welfare paradigm, community activities by an expanding population of older people may offer opportunities for action, which were not always available through paid work or care-giving in the household.
This study examined the effects of post-resistance exercise protein ingestion timing on the rate of gastric emptying (GE) and blood glucose (BG) and plasma branched-chain amino acid (BCAA) responses. In all, eleven healthy participants randomly ingested 400 ml of a nutrient-rich drink containing 12 g carbohydrates and 20 g protein at rest (Con), at 5 min (post-exercise (PE)-5) or at 30 min (PE-30) after a single bout of strenuous resistance exercises. The first and second sets comprised ten repetitions at 50 % of each participant’s one-repetition maximum (1RM). The third, fourth and fifth sets comprised ten repetitions at 75 % of 1RM, and the sixth set involved repeated repetitions until exhaustion. Following ingestion of the nutrient-rich drink, we assessed the GE rate using 13C-sodium acetate breath test and evaluated two parameters according to the Tmax-calc (time when the recovery per hour is maximised), which is a standard analytical method, and T1/2 (time when the total cumulative dose of [13CO2] reaches one-half). Tmax-calc and T1/2 were slower for the PE-5 condition than for either the PE-30 or Con condition (Tmax-calc; Con: 53 (sd 7) min, PE-5: 83 (sd 16) min, PE-30: 62 (sd 9) min, T1/2; Con: 91 (sd 7) min, PE-5: 113 (sd 21) min, PE-30: 91 (sd 11) min, P<0·05). BG and BCAA responses were also slower for the PE-5 condition than for either the PE-30 or Con condition. Ingesting nutrients immediately after strenuous resistance exercise acutely delayed GE, which affected BG and plasma BCAA levels in blood circulation.
The adsorption and desorption of cesium onto layered minerals, zeolite and geochemical reference samples were studied. 0.5 g of bentonite and mica were able to adsorb 71.2 and 51.5 mg of cesium, respectively, from 50 mL of deionized water containing 200 mg/L of cesium under neutral pH condition. These amounts of cesium adsorption were greater than those reported for vermiculites (8.9 and 5.6 mg, respectively). Additionally, the cesium adsorption on mica and vermiculite remained essentially unchanged under seawater conditions, but it decreased drastically on zeolite. The cesium desorption from the layered minerals was promoted by the addition of ammonium ions, namely trioctylmethylammonium chloride and zephiramine. These ammonium ions desorb cesium from the interlayers of the minerals without destroying the mineral structure. The cesium desorption procedure using quaternary ammonium ions would be extremely useful for decontamination of soil containing the layered minerals with adsorbed radioactive cesium.
The aim of this study was to assess the risk of cardiopulmonary resuscitation (CPR) performed in out-of-hospital settings for chest injuries in patients with out-of-hospital cardiac arrest (OHCA).
This retrospective, observational study was conducted in an emergency critical care medical center in Japan. Non-traumatic OHCA patients transferred to the hospital from April 2013 through August 2016 were analyzed. The outcome was defined by chest injuries related to CPR, which is composite of rib fractures, sternal fractures, and pneumothoraces. A multivariate logistic regression analysis was performed to assess the independent risk factors for chest injuries related to CPR. The threshold of out-of-hospital CPR duration that increased risk of chest injuries was also assessed.
A total of 472 patients were identified, of whom 233 patients sustained chest injuries. The multivariate logistic regression model showed that the independent risk factors for chest injuries were age and out-of-hospital CPR duration (age: AOR=1.06 [95% CI, 1.04 to 1.07]; out-of-hospital CPR duration: AOR=1.03 [95% CI, 1.01 to 1.05]). In-hospital CPR duration was not an independent risk factor for chest injuries. When the duration of out-of-hospital CPR extended over 15 minutes, the likelihood of chest injuries increased; however, this association was not statistically significant.
Long duration of out-of-hospital CPR was an independent risk factor for chest injuries, possibly due to the difficulty of maintaining adequate quality of CPR. Further investigations to assess the efficacy of alternative CPR devices are expected in cases requiring long transportation times.
TakayamaW, KoguchiH, EndoA, OtomoY. The Association between Cardiopulmonary Resuscitation in Out-of-Hospital Settings and Chest Injuries: A Retrospective Observational Study. Prehosp Disaster Med. 2018;33(2):171–175.
Long-term data of winter air temperature and precipitation were analyzed and the correlation between them investigated in order to identify the factors influencing snow reduction during the recent warmer winters in the heavy-snowfall areas in Japan. A high negative correlation between winter precipitation and air temperature was identified in the heavy-snowfall areas on the Sea of Japan side in the center of the main island (Honshu). It was confirmed that precipitation is mainly caused by cold winter monsoons, and thus correlates to a large extent with air temperature in these areas. The precipitation decrease can be considered an effective factor for the recent reduction in snow as well as the snowfall to precipitation ratio. This should be taken into account for a better prediction of snow reduction in relation to global warming.
Cats are known to be the main reservoir for Bartonella henselae and Bartonella clarridgeiae, which are the agents of ‘cat-scratch disease’ in humans. In the present study, we investigated the prevalence of the two Bartonella species on 1754 cat bloods collected from all prefectures in Japan during 2007–2008 by a nested-polymerase chain reaction (PCR) targeting the 16S–23S rRNA internal transcribed spacer region. Overall, Bartonella DNA was detected in 4·6% (80/1754) of the cats examined. The nested-PCR showed that 48·8% (39/80) of the positive cats were infected with B. henselae mono-infection, 33·8% (27/80) with B. clarridgeiae mono-infection and 17·5% (14/80) were infected with both species. The prevalence (5·9%; 65/1103) of Bartonella infection in the western part of Japan was significantly higher than that (2·3%; 15/651) of eastern Japan (P < 0·001). Statistical analysis of the cats examined suggested a significant association between Bartonella infection and FeLV infection (OR = 1·9; 95% CI = 1·1–3·4), but not with FIV infection (OR = 1·6; 95% CI = 1·0–2·6).
The glide of a snow cover on a slope covered with bamboo bushes was simulated so that the bushes’ resistance to glide was quantitatively related to the glide distance and speed. In one case their stalks and leaves were kept in the snow without falling down, in a second case they fell down and lay under the snow. Using the relations obtained, a description was given as to the behavior of a snow cover on a uniform slope as well as the distribution of stress and glide speed immediately before crack formation. Then, a criterion of crack formation was given in terms of glide speed.
In order to facilitate the measurement of liquid-water content of snow in high mountains, a portable calorimeter named “Endo-type snow-water content meter” was developed. It is composed of a metal-coated container made of insulating materials and a lid of the container with a small-thermistor thermometer. Its strong points are its light weight, small size and easy fabrication with cheap materials. The total weight of the device is as light as 250 g, which is less than 10% of the snow-water content meter widely used in Japan (Akitaya-type snow-water content meter). The results of experiments have revealed that the device is capable of measuring the liquid-water content within 2 minutes with an accuracy of 2% by weight.
The mass per unit horizontal area, vertical height and density of new snow accumulated on various slopes of 0° to 75° were measured. Although the mass of new snow on these slopes was nearly the same, vertical height increased and density decreased with increase of slope angle. Differences in heights and densities of new snow due to slope angle were explained by considering both accumulation and densification processes on the slopes.