This study evaluates the effect of introducing active gait training (AGT) to patients who are severely disabled with nasogastric tube feeding or gastrostoma on the recovery of oral feeding. Patients and Methods: We conducted a historical cohort study at a single rehabilitation center in Japan between January 2013 and December 2019. In this study, 154 severely disabled patients with nasogastric tube feeding or gastrostoma due to neurological diseases or disuse syndrome admitted in a rehabilitation ward were included, and their median age was 84 years. AGT was systematically implemented in August 2016, which consisted of using orthosis or assistance from physical therapists. We compared the recovery of oral feeding between periods before (Pre-AGT) and after (Post-AGT) the introduction of AGT. Results: Among the 154 severely disabled patients included, 59 (38%) were admitted in the Post-AGT period. Twenty-eight (30%) and 54 patients (92%) started gait training in the Pre-AGT and Post-AGT periods, respectively (p < 0.001). Significantly more patients recovered oral feeding in the Post-AGT than in the Pre-AGT periods (49% vs 19%, respectively; p < 0.001). After the introduction of AGT, the adjusted hazard ratio for the recovery of oral feeding was 4.0 (95% confidence interval, 1.9-8.3; p < 0.001). Conclusion: After the introduction of AGT to patients, increased recovery of oral feeding was observed in this retrospective evaluation. AGT should be considered for patients with tube feeding to help them recover oral feeding even if patients were severely disabled and required full assistance during gait training.
Background. The Mother and Child Health Handbook (MCHH), a tool used by almost all parents in Japan, serves as a record book shared by parents and health providers to monitor maternal health care throughout the perinatal period, track the child’s health and growth, and provide educational information. Methods. A review of the existing literature was performed by narrative review using electronic databases with the search term “Maternal and Child Health Handbook” from January 1980 to February 2016. Results. Twenty-eight papers were obtained: 3 review articles, 17 original articles, 2 brief reports, 2 letters, 1 research note, and 3 proceedings. After the MCHH was initiated in 1947, Japan’s infant mortality rate decreased to 2.6 per 1000 live births in 2007, and it is still decreasing. Information recorded in the MCHH at antenatal examinations can be used to evaluate a child’s risk of obesity, cardiovascular disease, endocrine disease, mental illness, and infectious disease. Utah’s Department of Health implemented a program called “Baby Your Baby” in 1987 based on the Japanese MCHH; this included a similar booklet with family records and educational information. Thus, the MCHH is a unique tool in Japan that has influenced other countries to adopt similar programs. Conclusion. We will confirm the importance of the MCHH’s role in promoting health and open dialogue.
SUMMARY:To evaluate the influence of vaccination dose and clinico-demographical factors on immune status against measles, rubella, mumps, and varicella viruses among university students, we conducted a case-control study by analyzing serum antibody titers according to past immunization and infection, and perinatal histories, using a multivariate regression model. A total of 1370 medical, paramedical, and pharmaceutical students were included in the analysis. Two or more doses of measles and rubella vaccination yielded notably greater odds ratios for immuno-positivity (9.1; 95z confidence interval (CI), 2.8-28.9 and 12.2; 95z CI, 0.71-210.3, respectively), compared with 1-dose vaccination, even though the superiority did not reach statistical significance for rubella. Students having younger/older siblings were more likely to be immuno-positive for mumps (2.5; 95z CI, 1.3-4.9 and 2.7; 95z CI, 1.4-5.5, respectively). On the other hand, post-term birth or macrosomia was associated with seronegative rubella virus antibodies. We concluded that a 2-dose vaccination strategy could successfully prevent measles and rubella outbreaks by increasing immunity.
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