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We examine the validity and reproducibility of a food frequency questionnaire (FFQ) in a subsample of participants in the Japan Public Health Center-based Prospective Cohort Study using a database of polyphenol-containing foods commonly consumed in the Japanese population. Participants of the validation study were recruited from two different cohorts. In Cohort I, 215 participants completed a 28-d dietary record (DR) and the FFQ, and in Cohort II, 350 participants completed DRs and the FFQ. The total polyphenol intake estimated from the 28-d DR and FFQ were log-transformed and adjusted for energy intake by the residual method. Spearman correlation coefficients (CCs) between estimates from the FFQ and 28-d DR as well as two FFQs administered at a 1-year interval were computed. Median intakes of dietary polyphenols calculated from the DRs were 1172 mg/d for men and 1024 mg/d for women in Cohort I, and 1061 mg/d for men and 942 mg/d for women in Cohort II. The de-attenuated CCs for polyphenol intake between the DR and FFQ were 0⋅47 for men and 0⋅37 for women in Cohort I and 0⋅44 for men and 0⋅50 for women in Cohort II. Non-alcoholic beverages were the main contributor to total polyphenol intake in both men and women, accounting for 50 % of total polyphenol intake regardless of cohort and gender, followed by alcoholic beverages and seasoning and spices in men, and seasoning and spices, fruits and other vegetables in women. The present study showed that this FFQ had moderate validity and reproducibility and is suitable for use in future epidemiological studies.
Genetic structure may be highly variable across seabird species, and particularly among those that are distributed over large geographical areas. The Adélie penguin (Pygoscelis adeliae) is a numerically dominant Antarctic seabird that is considered to be a key species in coastal ecosystems. Since the Last Glacial Maximum, penguin colonization of the Antarctic coastline occurred at varying geographical and temporal scales, contributing to an incomplete understanding of how modern colonies relate to each other at local or regional scales. We assessed the population genetic structure of Adélie penguins (n = 86 individuals) from three adjacent colonies along the Victoria Land coast using molecular genetic markers (i.e. seven microsatellite loci isolated through next-generation sequencing). Our results indicate meta-population dynamics and possibly relationships with habitat quality. A generally low genetic diversity (Nei's index: 0.322–0.667) was observed within each colony, in contrast to significant genetic heterogeneity among colonies (pairwise FST = 0.071–0.148), indicating that populations were genetically structured. Accordingly, an assignment test correctly placed individuals within the respective colonies from which they were sampled. The presence of inter-colony genetic differentiation contrasts with previous studies on this species that showed a lack of genetic structure, possibly due to higher juvenile or adult dispersal. Our sampled colonies were not panmictic and suggest a lower migration rate, which may reflect relatively stable environmental conditions in the Ross Sea compared to other regions of Antarctica, where the ocean climate is warming.
The present study aims were (1) to identify the proportion of terminally ill cancer patients with desire for hastened death (DHD) receiving specialized palliative care, (2) to identify the reasons for DHD, and (3) to classify patients with DHD into some interpretable subgroups.
Advanced cancer patients admitted to 23 inpatients hospices/palliative care units in 2017 were enrolled. Data were prospectively obtained by the primarily responsible physicians. The presence/absence of DHD and reasons for DHD were recorded. A cluster analysis was performed to identify patterns of subgroups in patients with DHD.
Data from 971 patients, whose Richmond Agitation–Sedation Scale score at admission was zero and who died in palliative care units, were analyzed. The average age was 72 years, common primary cancer sites were the gastrointestinal tract (31%) and the liver/biliary ducts/pancreas (19%). A total of 174 patients (18%: 95% confidence interval, 16–20) expressed DHD. Common reasons for DHD were dependency (45%), burden to others (28%), meaninglessness (24%), and inability to engage in pleasant activities (24%). We identified five clusters of patients with DHD: cluster 1 (35%, 61/173): “physical distress,” cluster 2 (21%, 37/173): “dependent and burdensome,” cluster 3 (19%, 33/173): “hopelessness,” cluster 4 (17%, 30/173): “profound fatigue,” and cluster 5 (7%, 12/173): “extensive existential suffering.”
A considerable number of patients expressed DHD and could be categorized into five subgroups. These findings may contribute to the development of therapeutic strategies.
In many countries, constitutional amendments require the direct approval of voters, but the consequences of fundamental changes to the powers and operations of the state are difficult to anticipate. The referendums literature suggests that citizens weigh their prior beliefs about the merits of proposals against the heuristic provided by the partisanship of the proposer, but the relative salience of these factors across constitutional issue areas remains underexplored. This paper examines the determinants of citizen preferences on 12 diverse constitutional issues, based on a novel survey experiment in Japan. We show that support for amendments is greater when its proposer is described as non-partisan. However, constitutional ideology moderates this effect. Those who prefer idealistic constitutions that elevate national traditions tend to value proposals that expand government powers, compared to those who prefer pragmatic constitutions that constrain government authority. These results highlight the significance of constitutional beliefs that are independent of partisanship.
Among the cases at which the author looks in this chapter is one in which a district court issued an injunction against a hate demonstration attacking Koreans planned for an area in which many Koreans live. The decision referred to the right of Korean residents to live in their houses in peace. It referred to the Hate Speech Elimination Act and did not recognize the hate demonstration as expression to be protected constitutionally. In this way, the court privileged the personal right over the constitutional freedom, regarding the ‘peace’ to which these individuals were entitled as including a freedom from mental harm. Moreover, the court held that the feelings and beliefs harboured by those with roots outside of Japan toward their ethnicity are deeply rooted in individual dignity. This enabled it to decide that the hate demonstration’s infringement of the right to dignity was serious. The author criticizes this reasoning and asks whether the court’s use of the Act does not go too far. He proposes instead that the most relevant detail of the case was the fact that the demonstration was planned for an area in which many Koreans are resident, meaning that the utterance of hate speech there would arouse a very real sense of fear and infringe their concrete rights.
This paper presents a novel speech emotion recognition scheme that leverages the individuality of emotion perception. Most conventional methods simply poll multiple listeners and directly model the majority decision as the perceived emotion. However, emotion perception varies with the listener, which forces the conventional methods with their single models to create complex mixtures of emotion perception criteria. In order to mitigate this problem, we propose a majority-voted emotion recognition framework that constructs listener-dependent (LD) emotion recognition models. The LD model can estimate not only listener-wise perceived emotion, but also majority decision by averaging the outputs of the multiple LD models. Three LD models, fine-tuning, auxiliary input, and sub-layer weighting, are introduced, all of which are inspired by successful domain-adaptation frameworks in various speech processing tasks. Experiments on two emotional speech datasets demonstrate that the proposed approach outperforms the conventional emotion recognition frameworks in not only majority-voted but also listener-wise perceived emotion recognition.
The case studies presented in this chapter provide evidence of varied experience with private health insurance in three middle-income country settings – Brazil, Egypt and India – where there are large and persisting socioeconomic differentials and where private spending accounts for more than half of health care financing. Brazil is a very large private health insurance market with a recently introduced system of regulation whereas Egypt and India are very small markets with minimal regulation. In all three countries private health insurance plays a supplementary role and overwhelmingly covers richer people employed in the formal sector. All three countries are struggling with regulation of the market to enhance transparency, protect consumers and minimize negative effects on the publicly financed part of the health system.
Evacuees’ quality of life can be improved by investigating both their health problems and the conditions of evacuation centers during natural disasters.
This study aims to develop new evacuee and evacuation center information sheets that focus on infection control, oral health and dentures, mental health, and rehabilitation during natural disasters.
The analysis was conducted with the Delphi method by questioning doctors from various fields (infectious disease, psychiatry, rehabilitation, and dentistry) about the information that may be needed for evacuees and in the evacuation center environment.
Two information sheets were created in this study. One is an evacuation center environmental health assessment sheet that includes information about the overview of evacuees’ health and the evacuation center environment. The other is an evacuee registration sheet that would be completed by the evacuees themselves.
The information sheets developed in this study will be useful in times of disaster because they have the potential to improve evacuee health conditions, as well as evacuation center environments.
Depression is a major cause of disability in adolescents. Higher dietary fibre intake has been associated with lower depressive symptoms in adults, but there is a lack of research in adolescents. We examined the association between dietary fibre intake (Commonwealth Scientific and Industrial Research Organisation (CSIRO) FFQ) and depressive symptoms (Beck Depression Inventory for Youth) in adolescents with prospective data from the Raine Study Gen2 14- and 17-year follow-ups (n 1260 and 653). Odds of moderate/extreme (clinically relevant) depressive symptoms by quartile of fibre intake were calculated using mixed-effects logistic regression for all participants, in a paired sample without moderate/extreme depressive symptoms at 14 years and in a sub-sample of participants with available inflammatory data at the ages of 14 and 17 years (n 718 and 547). Odds of moderate/extreme depressive symptoms were lower in the fourth (highest) quartile of overall fibre intake (OR 0·273, 95 % CI 0·09, 0·81) compared with the first (lowest) quartile, adjusting for sex, age, energy intake, adiposity, and family and lifestyle factors. However, further adjustment for dietary patterns attenuated the results. Associations of depressive symptoms with cereal or fruit and vegetable fibre intake were not significant in the final model. Adjustment for inflammation had no effect on OR. The association between a higher dietary fibre intake and lower odds of clinically relevant depressive symptoms may be more reflective of a high-fibre diet with all its accompanying nutrients than of an independent effect of fibre.
This article updates the trends and developments of Japanese as a second language (JSL) research since Mori and Mori (2011) by reviewing nearly 200 selected empirical studies published in English or Japanese between 2010 and early 2019. The first section of this review examines the cognitive aspects of second language (L2) Japanese development, focusing on vocabulary and kanji (i.e., Chinese characters transferred into Japanese) learning, syntactic development, and the issues surrounding reading and writing. The second part investigates sociocultural issues in L2 Japanese development and use, including pragmatic development, multilingual/translingual perspectives, and multilingual youth. The third section explores the role of affective variables (primarily learner motivation) in L2 Japanese development. The last section considers various pedagogical issues, including corpus-based studies and the development of materials and resources, instructional designs and classroom studies, technology-enhanced language learning and new instructional models, critical approaches to teaching Japanese and content-based instruction. The review of these themes illuminates trends and emerging areas of interest in post-2010 L2 Japanese research inspired by current developments in applied linguistics and second language acquisition (SLA) research, as well as unique features of Japanese language and sociocultural contexts.
To analyse the cost-effectiveness of Baby-Friendly Hospital Initiative (BFHI) in promoting breast-feeding during the first hour of life (BFFHL) and reducing late neonatal mortality.
Cost-effectiveness economic assessment from the health system perspective, preceded by a prospective cohort of mother–baby followed from birth to 6 months of life. The direct costs associated with two health outcomes were analysed: intermediate end point (BFFHL) and final end point (reduction in late neonatal mortality).
Study was carried out in six hospitals in the city of São Paulo (Brazil), three being Baby-Friendly Hospitals (BFH) and three non-BFH.
Mothers with 24 h postpartum, over 18 years old, single fetus and breast-feeding at the time of the interview were included. Poisson regressions adjusted for maternal age and level of education were estimated to identify factors related to BFFHL and late neonatal mortality. Sensitivity analysis was performed to ensure robustness of the economic assessment.
Cost-effectiveness analysis showed that BFHI was highly cost-effective in raising BFFHL by 32·0 % at lower cost in comparison with non-BFHI. In addition, BFHI was cost-effective in reducing late neonatal mortality rate by 13·0 % from all causes and by 13·1 % of infant mortality rate from infections.
The cost-effectiveness of the BFHI in promoting breast-feeding and reducing neonatal mortality rates justifies the investments required for its expansion within the Brazilian health system.