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The JDR Rescue Team has successfully completed the INSARAG External Re-Classification (IER) process, which evaluates the operational capability and capacity of Urban Search and Rescue (USAR) teams and has achieved the highest “Heavy” reclassification in November 2022. Two nurses participated in the IER process as part of the medical unit of JDR Rescue Team. In addition, ten registered nurses cooperated as Exercise Control (EXCON).
Summarize the JDR Rescue Team and medical unit and make observations on what nurses did in the IER.
The JDR Rescue Team is dispatched by the Government of Japan in response to large-scale disasters overseas. The task force team has 75 members from various specialties, including the rescuer, and medical unit. The medical unit consists of one medical manager, 2 doctors, and two nurses. There are currently about 50 registered medical unit members in our team, and of these, a total of 23 nurses are registered. The role of nurses during the IER process, includes a 36-hour non-stop scenario-based exercise. The team nurses are involved in various roles, such as Confined Space Medicine (infusion for patients, assisting on-site amputation), caring or treating injured rescuers and search dogs, providing health and welfare monitoring and operating a decontamination system. The EXCON nurses were involved in managing the simulation. One of their key roles was to play as a victim realistically so as to provide a sense of tension for the simulation.
The JDR Rescue Team has more medical unit members than those in other countries. In particular, teams with so many nurses are rare. nurses played a vital role in this IER. The contribution of nurses is identified in order to make the international USAR team more strong and more flexible.
This is the first report on a population-based prospective study of invasive group B streptococcus (GBS) disease among children aged <15 years conducted over a period of 11 years in Japan. This study investigated the incidence and clinical manifestations of invasive GBS disease in children in Chiba Prefecture, Japan, and analysed the serotypes and drug susceptibility of GBS strains isolated during the study period. Overall, 127 episodes of invasive GBS disease were reported in 123 patients. Of these, 124 were observed in 120 patients aged <1 year, and the remaining three episodes were reported in a 9-year-old child and two 14-year-old children with underlying disease. For patients aged <1 year, the incidence rate per 1000 live births was 0.24 (0.15–0.36). The incidences of early-onset disease and late-onset disease were 0.04 (0.0–0.09) and 0.17 (0.08–0.25), respectively. The rate of meningitis was 45.2%, and the incidence of GBS meningitis was higher than that of other invasive diseases among children in Japan. Of the 109 patients for whom prognosis was available, 7 (6.4%) died and 21 (19.3%) had sequelae. In total, 68 strains were analysed. The most common were serotype III strains (n = 42, 61.8%), especially serotype III/ST17 strains (n = 22, 32.4%). This study showed that the incidence of invasive GBS disease among Japanese children was constant during the study period. Because of the high incidence of meningitis and disease burden, new preventive strategies, such as GBS vaccine, are essential.
An iodine-immobilizing cement solidification process using calcium aluminate cement with gypsum additive was developed. Powdered cement solid was repeatedly immersed in ion-exchanged water with varying liquid-to-solid ratios (L/S) in accelerated dissolution tests simulating interaction with groundwater at waste disposal sites. The measured concentrations of iodine in the water were on the order of 10−5 to 10−3 mol⋅dm−3 in the entire L/S range. These concentration levels are extremely low compared with those in the case of ordinary Portland cement. Calculations with a solution equilibrium model for the cement immersed in ion-exchanged water showed that the observed iodine release profile versus integrated L/S ratio from the immersion test was explained by a dissolution model of minerals in the cement.
Previous studies on the relationship of local food environment with residents' diets have relied exclusively on self-reported information on diet, producing inconsistent results. Evaluation of dietary intake using biomarkers may obviate the biases inherent to the use of self-reported dietary information. This cross-sectional study examined the association between neighbourhood food store availability and 24 h urinary Na and K excretion. The subjects were 904 female Japanese dietetic students aged 18–22 years. Neighbourhood food store availability was defined as the number of food stores within a 0·5-mile (0·8-km) radius of residence. Urinary Na and K excretion and the ratio of urinary Na to K were estimated from a single 24 h urine sample. After adjustment for potential confounding factors, neighbourhood availability of confectionery stores/bakeries was inversely associated with urinary K, and was positively associated with the ratio of Na to K (P for trend = 0·008 and 0·03, respectively). Neighbourhood availability of rice stores showed an independent inverse association with urinary K (P for trend = 0·03), whereas neighbourhood availability of supermarkets/grocery stores conversely showed an independent positive association with this variable (P for trend = 0·03). Furthermore, neighbourhood availability of fruit/vegetable stores showed an independent inverse association with the ratio of Na to K (P for trend = 0·049). In a group of young Japanese women, increasing neighbourhood availability of supermarkets/grocery stores and fruit/vegetable stores and decreasing availability of confectionery stores/bakeries and rice stores were associated with favourable profiles of 24 h urinary K (and Na) excretion.
Previous studies in Western populations have linked caffeine intake with health status. While detailed dietary assessment studies in these populations have shown that the main contributors to caffeine intake are coffee and tea, the wide consumption of Japanese and Chinese teas in Japan suggests that sources of intake in Japan may differ from those in Western populations. Among these teas, moreover, caffeine content varies widely among the different forms consumed (brewed, canned or bottled), suggesting the need for detailed dietary assessment in estimating intake in Japanese populations. Here, because a caffeine composition database or data obtained from detailed dietary assessment have not been available, we developed a database for caffeine content in Japanese foods and beverages, and then used it to estimate intake in a Japanese population.
The caffeine food composition database was developed using analytic values from the literature, 16 d weighed diet records were collected, and caffeine intake was estimated from the 16 d weighed diet records.
Four areas in Japan, Osaka (Osaka City), Okinawa (Ginowan City), Nagano (Matsumoto City) and Tottori (Kurayoshi City), between November 2002 and September 2003.
Two hundred and thirty Japanese adults aged 30–69 years.
Mean caffeine intake was 256·2 mg/d for women and 268·3 mg/d for men. The major contributors to intake were Japanese and Chinese teas and coffee (47 % each). Caffeine intake above 400 mg/d, suggested in reviews to possibly have negative health effects, was seen in 11 % of women and 15 % of men.
In this Japanese population, caffeine intake was comparable to the estimated values reported in Western populations.
We evaluated the association of nutrient intake with Fe deficiency with regard to lifestyle factors and health condition in young Japanese women. Uniquely among developed countries, dietary habits render Japanese populations vulnerable to Fe deficiency, owing to their relatively low intake of Fe and high intake of Fe absorption inhibitors, such as green tea and soyabeans.
A cross-sectional study.
Setting and subjects
The subjects were 1019 female Japanese dietetic students aged 18–25 years. Dietary habits during the preceding month were assessed using a previously validated, self-administered, diet history questionnaire. Blood analysis was performed to assess body Fe status. Subjects were categorized with Fe deficiency when their serum ferritin levels were <12 ng/ml. Twenty-nine dietary variables, i.e. intakes of energy, sixteen nutrients including Fe and twelve food groups, were analysed using multivariate logistic regression models adjusted for possible confounders.
Of the subjects, 24·5 % were categorized with Fe deficiency. However, no dietary factors assessed were significantly associated with Fe deficiency. The risk of Fe deficiency was significantly lower in women with infrequent or no menstrual cycles than in those with regular cycles (OR = 0·58; 95 % CI 0·34, 1·00) and significantly higher in women with heavy menstrual flow than in women with average flow, albeit that these were self-reported (OR = 1·83; 95 % CI 1·35, 2·48).
These results suggest that dietary habits, including Fe intake, do not significantly correlate with Fe deficiency among young Japanese women.
Little is known about the relationship of dietary cost to health status. The present cross-sectional study examined the association between the monetary cost of dietary energy (Japanese yen/4184 kJ) and several metabolic risk factors.
Monetary cost of dietary energy was estimated based on dietary intake assessed by a self-administered diet history questionnaire and retail food prices. Body height and weight, from which BMI was derived, waist circumference and blood pressure were measured and fasting blood samples were collected for biochemical measurements.
A total of fifteen universities and colleges in Japan.
A total of 1136 female Japanese dietetic students aged 18–22 years.
After adjustment for potential confounding factors, monetary cost of dietary energy was significantly and negatively associated with BMI (P for trend = 0·0024). Monetary cost of dietary energy also showed a significant and negative association with waist circumference independently of potential confounding factors, including BMI (P for trend = 0·0003). No significant associations were observed for other metabolic risk factors examined (P for trend = 0·10–0·88).
The monetary cost of dietary energy was independently and negatively associated with both BMI and waist circumference, but not other metabolic risk factors, in a group of young Japanese women.
All previous studies on monetary diet cost have examined the relationship of monetary cost of self-reported diet to self-reported, rather than biomarker-based, estimates of dietary intake. The present cross-sectional study examined the association between monetary costs of self-reported diet and biomarker-based estimates of nutrient intake.
Monetary diet cost (Japanese yen/1000 kJ) was calculated based on dietary intake information from a self-administered, comprehensive diet history questionnaire using retail food prices. Biomarker-based estimates of nutrient intake (percentage of energy for protein and mg/1000 kJ for K and Na) were estimated based on 24 h urinary excretion and estimated energy expenditure.
A total of fifteen universities and colleges in Japan.
A total of 1046 female Japanese dietetic students aged 18–22 years.
Total monetary diet cost showed a significant positive association with biomarker-based estimates of protein, K and Na. Vegetables and fish were not only the main contributors to total monetary diet cost (16·4 % and 15·5 %, respectively) but also were relatively strongly correlated with total monetary diet cost (Pearson’s correlation coefficient: 0·70 and 0·68, respectively). Monetary cost of vegetables was significantly positively associated with all three nutrients, while that of fish showed a significant and positive association only with protein.
Total monetary cost of self-reported diet was positively associated with biomarker-based estimates of protein, K and Na intake in young Japanese women, and appeared mainly to be explained by the monetary costs of vegetables and fish.
Although many epidemiological studies have examined the association of dietary glycaemic index (GI) and glycaemic load (GL) with health outcomes, information on the reproducibility and relative validity of these variables estimated from dietary questionnaires is extremely limited. We examined the reproducibility and relative validity of dietary GI and GL assessed with a self-administered diet-history questionnaire (DHQ) in adult Japanese. A total of ninety-two Japanese women and ninety-two Japanese men aged 31–76 years completed the DHQ (assessing diet during the preceding month) and 4 d dietary records (DR) in each season over a 1-year period (DHQ1–4 and DR1–4, respectively) and the DHQ at 1 year after completing DHQ1 (DHQ5). We used intraclass correlations between DHQ1 and DHQ5 to assess reproducibility, and Pearson correlations between the mean of DR1–4 and mean of DHQ1–4 and between the mean of DR1–4 and DHQ1 to assess relative validity. Reproducibility correlations for dietary GI and GL were 0·57 and 0·69 among women and 0·65 and 0·58 among men, respectively. Validity correlations for dietary GI and GL assessed by DHQ1–4 were 0·72 and 0·66 among women and 0·65 and 0·71 among men, respectively. Corresponding correlations for DHQ1 were 0·53 and 0·58 among women and 0·57 and 0·60 among men, respectively. White rice was the major contributor to GI and GL in both methods (49–64 %). These data indicate reasonable reproducibility and relative validity of dietary GI and GL assessed by a DHQ for Japanese adults, whose dietary GI and GL are primarily determined by the GI of white rice.
Mild metabolic acidosis, which can be caused by diet, may adversely affect cardiometabolic risk factors, possibly by increasing cortisol production. Methodologies for estimating diet-induced acid–base load using dietary-intake information have been established. To our knowledge, however, the possible association between dietary acid–base load and cardiometabolic risk factors has not been investigated. We cross-sectionally examined associations between dietary acid–base load and cardiometabolic risk factors in a free-living population. The subjects were 1136 female Japanese dietetic students aged 18–22 years. Dietary acid–base load was characterized as the potential renal acid load (PRAL), which was determined using an algorithm including dietary protein, P, K, Ca and Mg, as well as the ratio of dietary protein to K (Pro:K). Estimates of each nutrient were obtained from a validated comprehensive self-administered diet history questionnaire. Body height and weight, waist circumference and blood pressure were measured. Fasting blood samples were collected. After adjustment for potential confounding factors, higher PRAL and Pro:K (more acidic dietary acid–base loads) were associated with higher systolic and diastolic blood pressure (P for trend = 0·028 and 0·035 for PRAL and 0·012 and 0·009 for Pro:K, respectively). PRAL was also independently positively associated with total and LDL-cholesterol (n 1121; P for trend = 0·042 and 0·021, respectively). Additionally, Pro:K showed an independent positive association with BMI and waist circumference (P for trend = 0·024 and 0·012, respectively). In conclusion, more acidic dietary acid–base load was independently associated with adverse profile of several cardiometabolic risk factors in free-living young Japanese women.
Little is known about the relationship of monetary diet costs to dietary intake and obesity, particularly in non-Western populations. This study examined monetary cost of dietary energy in relation to diet quality and body mass index (BMI) among young Japanese women.
Dietary intake was assessed by a validated, self-administered, diet history questionnaire. Diet costs were estimated using retail food prices. Monetary cost of dietary energy (Japanese yen 1000 kcal−1) was then calculated. BMI was computed from self-reported body weight and height.
A total of 3931 female Japanese dietetic students aged 18–20 years.
Monetary cost of dietary energy was positively associated with intakes of fruits, vegetables, fish and shellfish, and pulses; however, higher monetary cost of dietary energy was also associated with higher consumption of fat and oil, meat and energy-containing beverages, and lower consumption of cereals (rice, bread and noodles) (all P for trend <0.01). At the nutrient level, monetary cost of dietary energy was positively associated with intakes of dietary fibre and key vitamins and minerals, but also associated positively with intakes of fat, saturated fatty acids, cholesterol and sodium, and negatively with carbohydrate intake (all P for trend <0.0001). After adjustment for possible confounders, monetary cost of dietary energy was quite weakly but significantly negatively associated with BMI (P for trend = 0.0197).
Increasing monetary cost of dietary energy was associated with both favourable and unfavourable dietary intake patterns and a quite small decrease in BMI in young Japanese women.
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