Prolonged operating time, intraoperative blood transfusion, bile contamination (PD) and non-laparoscopic surgery (DP) are risk factors for postoperative infectious complications that could be targeted to improve outcome after pancreatectomy.

Objectives Healthy Japan 21 (Japanese National Health Promotion in the 21st Century) was started in 2000 to promote extension of healthy life expectancy and improve health-related quality of life (HRQOL). The present study aims to describe HRQOL of Japanese subjects using the EuroQol questionnaire (EQ-5D) and investigate the influence of social background, health-related behaviors, and chronic conditions on HRQOL using representatives in Takamatsu, Japan. Methods Data were obtained from a 2005 Takamatsu City health survey mailed to 2,500 randomly selected Japanese individuals in Takamatsu, a medium-sized city. We examined data from 915 Japanese adults. The questionnaire addressed social background, health-related behaviors, chronic conditions, EQ-5D items, and self-rated health. The impact of social background, health-related behaviors, and chronic conditions on Japanese HRQOL was examined through multivariate regression, adjusting for age and sex. Results EQ-5D scores decreased with age, particularly for respondents who were unemployed or retired. Adjusting for sex and age, the results showed that age, unemployment/ retirement, feeling severe stress, and musculoskeletal and gastrointestinal diseases were significantly associated with decreased HRQOL. Conversely, sufficient sleep (7-8 h/day) and having a hobby were significantly associated with increased HRQOL. Conclusions Information is lacking regarding HRQOL in Japanese populations. This study furthers our understanding of some important determinants influencing Japanese HRQOL, using the EQ-5D in Takamatsu, Japan. Our results also resembled some findings from similar studies in other countries. We hope to use the EQ-5D with other health survey questionnaires to gather more data about HRQOL of Japanese people.

The SARS-CoV-2 (COVID-19) pandemic has had a tremendous impact on the functionality of health systems and world affairs. We assessed knowledge, attitudes, and practices (KAPs) of healthcare workers (HCWs) in the Democratic Republic of the Congo (DRC). This was a cross-sectional study conducted in 23 referral hospitals located in three towns of the DRC (Lubumbashi, Kamina, Mbuji-Mayi). In total, 613 HCWs were surveyed using the World Health Organization’s (WHO’s) “Exposure Risk Assessment in the Context of COVID-19” questionnaire. Participants included medical doctors (27.2%) and other categories of HCWs (72.8%). The mean age was 40.3 ± 11.7 years. Over 80% (range: 83–96%) of respondents had sufficient knowledge on each of the three domains: COVID-19 symptoms, disease transmission, and patient care approach. However, attitudes and practices scores were relatively low. Only 27.7% of HCWs were willing to receive a COVID-19 vaccine when it is available, whereas 55% of HCWs complied with good practices; 49.4% wore masks consistently and, surprisingly, only 54.9% used personal protective equipment (PPE) consistently at work and during contact with patients. Knowledge level was positively associated with the use of social media as a primary source of COVID-19-related information and the category of residence, with HCWs from towns already affected by the COVID-19 epidemic being more likely to have positive attitudes (adjusted OR, 1.64; 95%CI, 1.32–2.20) and comply with good practices (aOR, 2.79; 95%CI, 1.93-4.06). This study showed that most Congolese HCWs had sufficient knowledge on COVID-19, whereas the majority did not comply with consistent PPE use. The government of the DRC should urgently take major steps in capacity building for HCWs in outbreak preparedness and supplying hospitals with PPE.

The purpose of the present study was to examine seasonal blood pressure variation and its relationship to environmental temperature in healthy elderly Japanese, as studied by home measurements. Fifteen healthy elderly Japanese (79.3 +/- 5.9 yrs) measured their blood pressure at home each morning for more than 25 times per month for 3 years. Monthly mean outdoor temperatures were obtained from the Takamatsu meteorological Observatory. The highest levels of systolic and diastolic blood pressure measured at home were observed in February (129 +/- 14 and 81 +/- 13 mmHg). The lowest levels of systolic and diastolic blood pressure measured at home were observed in August (117 +/- 11 and 73 +/- 10 mmHg). Likewise, the lowest and highest means of outdoor temperature were observed in February (5.0 degrees C) and August (29.2 degrees C), respectively. Hence, both systolic and diastolic blood pressure demonstrated a close inverse correlation with the means of outdoor temperature (r = -0.973, p < 0.001 and r = -0.985, p < 0.001, respectively). A 1 degree C decrease in the mean outdoor temperature was associated with rises of 0.43 mmHg in systolic blood pressure (SBP) and 0.29 mmHg in diastolic blood pressure (DBP). Seasonal variations in home blood pressure and outdoor temperature showed complete correspondence in healthy elderly Japanese, with the blood pressures being inversely related to the ambient temperature. These seasonal home blood pressure variations should be kept in mind when controlling blood pressure in elderly patients.

ObjectiveTo evaluate the new Japanese School Absentees Reporting System for Infectious Disease (SARSID) for pandemic influenza A/H1N1 2009 infection in comparison with the National epidemiological Surveillance of Infectious Disease (NESID).MethodsWe used data of 53,223 students (97.7%) in Takamatsu city Japan. Data regarding school absentees in SARSID was compared with that in NESID from Oct 13, 2009 to Jan 12, 2010.ResultsSimilar trends were observed both in SARSID and NESID. However, the epidemic trend for influenza in SARSID was thought to be more sensitive than that in NESID.ConclusionThe epidemic trend for influenza among school-aged children could be easily and rapidly assessed by SARSID compared to NESID. SARSID might be useful for detecting the epidemic trend of influenza.

BackgroundSlow-motion training, an exercise marked by extremely slow movements, yields a training effect like that of a highly intense training, even when the applied load is small. This study evaluated the effects of low-intensity bodyweight training with slow movement on motor function in frail, elderly patients.MethodsNinety-seven elderly men and women aged 65 years or older, whose level of nursing care was classified as either support required (1 and 2) or long-term care required (care level 1 and 2), volunteered to participate. Two facilities were used. Participants in the first facility used low-intensity bodyweight training with slow movement (the LST group, n = 65), and participants in another facility used machine training (the control group, n = 31). Exercises were conducted for 3 months, once or twice a week, depending on the required level of nursing care. Changes in motor function were examined.ResultsPost-exercise measurements showed significant improvements from the pre-exercise levels after 3 months, based on the results of the Timed Up and Go test (p = 0.0263) and chair-stand test (p = 0.0016) in the low-intensity exercise with slow movement and tonic force generation (LST) group. Although the ability to stand on one leg with eyes open tended to improve, no significant change was found (p = 0.0964).ConclusionsWe confirmed that carrying out LST bodyweight training for 3 months led to improvements in ambulatory function and lower-limb muscle strength. In this way, it is possible that LST training performed by holding a bar or by staying seated on a chair contributes to improved motor function in elderly patients within a short time.Trial registrationUMIN000030853. Registered 17 January 2018. (retrospectively registered).

We analyzed the temporal trends and significant changes in apparent food consumption or availabilityin Bangladesh from 1961 to 2013. Due to the lack of a long-term national dietary intake dataset, this study used data derived from the FAO’s food balance sheets. We used joinpoint regression analysis to identify significant changes in the temporal trends. The annual percent change (APC) was computed for each segment of the trends. Apparent intake of starchy roots, eggs, fish, vegetables, milk, and vegetable oils significantly has increased (p < 0.05) in the Bangladeshi diet since 1961; whereas cereals changed by merely 4.65%. Bangladesh has been experiencing three structural changes in their dietary history after the Liberation War, though the intake level has been grossly inadequate. Initially, since the late-1970s, apparent vegetable oils intake increased at a market rate (APC = 7.53). Subsequently, since the early-1990s, the real force behind the structural change in the diet has been the increasing trends in the apparent intake of fish (APC = 5.05), eggs (APC = 4.65), and meat (APC = 1.54). Lastly, since the early 2000s, apparent intakes of fruits (APC = 20.44), vegetables (APC = 10.58), and milk (APC = 3.55) increased significantly (p <0.05). This study result reveals and quantifies the significant secular changes in the dietary history of Bangladesh from 1961 to 2013. Bangladesh has experienced inadequate but significant structural changes in the diet in the late-1970s, early-1990s, and early-2000s. Overabundance of cereals and inadequate structural changes in the diet may have caused the increasing prevalence of overweightness and emergence of diet-related, non-communicable diseases in Bangladesh.

The link between high temperatures and ambulance transports in Takamatsu area, Japan was investigated. Monthly observations for ambulance transports (2004-2008) were obtained from Fire Department Service in Takamatsu. Data of temperatures in Takamatsu area, Japan (2004-2008) were used by Japan Meteorological Agency. Effect of high temperatures on ambulance transports was analyzed. By using data from July to September, there were not clear differences of mean temperatures and ambulance transports among years. Ambulance transports were significantly correlated with parameters of temperatures. Correlation coefficient rate between ambulance transports and the mean temperature of maximum temperatures in a month was highest among parameters (r = 0.738, p = 0.0017). In addition, ambulance transports were also significantly correlated with the number of days over the level of 32?C in a month (r = 0.782, p = 0.0006). Higher temperatures were closely associated with higher ambulance transports in Takamatsu area, Japan