Background Adolescent health promotion is important in preventing risk behaviors and improving mental health. Health promotion during adolescence has been shown to contribute to the prevention of late onset of the mental health disease. However, scalable interventions have not been established yet. Objective This study was designed to test the efficacy of two adolescent health promotion interventions: a well-care visit (WCV) with a risk assessment interview and counseling and self-monitoring with a smartphone cognitive behavioral therapy (CBT) app. Our hypothesis was that participants who had received both WCV and the CBT app would have better outcomes than those who had received only WCV or those who had not received any intervention. We conducted a prospective multi-institutional randomized controlled trial. Methods Participants were 217 adolescents aged 13-18 years. They were randomly divided into two intervention groups (WCV group and WCV with CBT app group) and a nonintervention group. WCV comprised a standardized physical examination along with a structured interview and counseling for youth risk assessment, which was designed with reference to the Guideline for Health Supervision of Adolescents of Bright Futures. A smartphone-based CBT program was developed based on the CBT approach. The CBT app comprised a 1-week psychoeducation component and a 1-week self-monitoring component. During the CBT program, participants created several self-monitoring sheets based on the CBT model with five window panels: event, thoughts, feelings, body response, and actions. The primary outcome was the change in scores for depressive symptoms. Secondary outcomes included changes in scores for self-esteem, quality of life, self-monitoring, and an adolescent health promotion scale. These outcomes were evaluated at baseline and at 1, 2, and 4 months after baseline. The exploratory outcome was the presence of suicidal ideation during the observation period. Intervention effects were estimated using mixed effect models. Results In total, 94% (204/217) of the participants completed the 4-month evaluation. Both intervention groups showed a significant effect in the form of reduced scores for depressive symptoms at 1 month in high school students; however, these effects were not observed at 2 and 4 months. The intervention effect was significantly more predominant in those scoring above cutoff for depressive symptoms. There was significantly less suicidal ideation in the intervention groups. As for secondary outcomes, there was significant increase in health promotion scale scores at the 4-month follow-up among junior high school students in the WCV group. Moreover, the CBT app was significantly effective in terms of obtaining self-monitoring skills and reducing depressive symptoms. Conclusions Although adolescent health promotion interventions may have short-term benefits, the frequency of WCV and further revision of the CBT app should be considered to evaluate long-term effectiveness. Trial Registration University Hospital Medical Information Network Clinical Trials Registry UMIN 000036343; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000041246

Technoelectric-dependent CYSHCN are poorly prepared for electrical power failure.

International electives are recognized as a high-impact practice in clinical education. However, medical students’ actual learning experiences during electives have not been explored fully. Specifically, drawing on language management theory, this exploratory case study investigates students’ perceived learning outcomes and the managing processes by which they gained benefits from cross-cultural learning experiences in international electives. Written reflective reports in a series of e-portfolios were collected from 43 Japanese medical students who participated in a four-week international elective. Moreover, to further explore their emotions and the reasons behind adopting a particular adjustment behaviour, follow-up interviews with 12 students were undertaken soon after they returned home. Using reflexive thematic analysis, the qualitative data were analysed. Their perceived learning outcomes were categorized into seven themes: medical knowledge and skills, communication, career management and development, international healthcare, society and culture, medical education, and personal development. During the programme, they experienced linguistic, sociolinguistic, and sociocultural difficulties, and attempted to overcome them by employing various adjustment strategies, such as meaning-focused coping, social relationship building, management of learning opportunities, communication management, and developing approaches to learning. Managing problems in academic contact situations is not a linear process; it is iterative and cyclical. Since the combination of several strategies was needed depending on the situation, the management process is a context-dependent and complex phenomenon. The findings in this study provide new insights into student participation in short-term international elective programmes in order to develop academic and social support strategies for educators at both home and host institutions.

Nishisato’s Dual Scaling Method for successive categories data has been revised in order to apply it to quantitative structure–activity relationships. The revised version can give category values of successive categories, even though the original one can give only boundary values between two adjacent successive categories. The new version can be applied to an analysis of the antimicrobial activities of polymethylene bi(pyridineamine) derivatives, which are potential agents for controlling and/or preventing the formation of dental plaque. The results show that the proper molecular length of the agents leads to the maximum antimicrobial activity.

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BackgroundDespite the assurance of free medical access through the universal health insurance system, over the past three decades Japanese youth have experienced an increase in developmental and behavioral problems, psychosomatic disorders, and psychiatric illnesses.ObjectivesTo identify the challenges in promoting comprehensive preventive health services to adolescents in Japan, specifically in Tokyo.MethodsA cross-sectional online survey was conducted of physicians who are members of the Tokyo Pediatric Association. The questionnaire assessed primary care pediatricians’ practice settings and their attitudes toward outpatient services to adolescent patients.ResultsOut of 617 member pediatricians, 69 valid responses were obtained. Majority were private pediatricians. 52% indicated that they had specialties in addition to general pediatrics; however, no one reported specializing in adolescent medicine. Approximately 70% answered the optimal patient encounter time would be under 10 min. More than 90% of respondents reported challenges providing health services to adolescent patients. Nearly half indicated that they did not routinely evaluate height, heart rate or blood pressure. Few providers asked about reproductive health, violence, or smoking/alcohol use.ConclusionThis survey is the first exploration of adolescent health care in an urban area of Japan. While the sample is small, the magnitude of challenges was great with limited training in adolescent medicine, severe time constraints and limited appreciation for the value of health screening at each encounter. Developing a standardized practical assessment tool for adolescent patients may help guide primary care pediatricians to better meet the needs of their adolescent patients.

BACKGROUND Adolescent health promotion is important in prevent risk behaviors and improve mental health. Health promotion in adolescence has been shown to contribute to the prevention of later onset of the mental health disease. However, scalable interventions have not yet been established. OBJECTIVE This study was designed to test the efficacy of two adolescent health promotion interventions: a well-care visit with a risk assessment interview and counseling (WCV) and self-monitoring with a smartphone cognitive behavioral therapy application (CBT app). METHODS Participants were 217 adolescents aged 13–18 years. They were randomly divided into two intervention groups (WCV group and WCV with CBT app group) and a non-intervention group. WCV comprised a standardized physical examination with a structured interview and counseling for youth risk assessment. The CBT app comprised a 1-week psychoeducation component and a 1-week self-monitoring component. The primary outcome was the change in scores for depressive symptoms. Secondary outcomes included changes in scores for self-esteem, quality of life, self-monitoring, and an adolescent health promotion scale. These outcomes were evaluated at baseline and at 1, 2, and 4 months after baseline. The exploratory outcome was the presence of suicidal ideation during the observation period. Intervention effects were estimated using mixed effect models. RESULTS In total, 94% of participants completed the 4 month evaluation. Both intervention groups showed a significant effect in reduced scores for depressive symptoms at 1 month in high school students; however, these effects were not observed at 2 and 4 months. The intervention effect was significantly more predominant in those scoring above cut-off for depressive symptoms. There was significantly less suicidal ideation in the intervention groups. There were no significant effects in scores for the secondary outcomes. CONCLUSIONS Although adolescent health promotion interventions may have short-term benefits, the frequency of the WCV and further revision of the CBT app should be considered to evaluate long-term effectiveness. CLINICALTRIAL University Hospital Medical Information Network Clinical Trials Registry [UMIN-CTR] UMIN 000036343

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