Unresolved Palliative Care Needs of Elderly Non-Cancer Patients at Home: A Multicenter Prospective Study.

Introduction/objectives: There is growing consensus on the benefits of initiating palliative care early in the disease trajectory; however, palliative care needs for non-cancer patients remain to be elucidated. We investigated the trajectory of unresolved palliative care needs of non-cancer patients at home and explored associated factors.

Methods: We conducted a multicenter prospective cohort study of elderly non-cancer patients at home in Japan between Jan 2020 and Dec 2020.

[How have Japanese primary care physicians carried out vaccinations against COVID-19? : Attempts at making the non-scalable 'scalable'].

Vaccine rollouts have been underway to combat the COVID-19 pandemic globally. Based on ongoing interviews with ten primary care physicians 'in the field', this paper elucidates how in practice the vaccinations were carried out in Japan in 2021 from a cultural anthropological perspective. We examine what the primary care physicians did to prepare for the rollouts, what problems they faced, and how they responded to these problems.

Relationship between assertiveness in community pharmacists and pharmacist-initiated prescription changes.

Background: Despite the usefulness of assertiveness by healthcare professionals in improving patient safety, few studies have evaluated the assertiveness of community pharmacists. Community pharmacists' assertiveness might be associated with pharmacist-initiated prescribing changes to improve medication safety.

Objectives: Our objective was to examine which types of assertiveness-related self-expression are associated with community pharmacist-initiated prescribing changes while adjusting for possible confounding factors.

Three-year evaluation of a program teaching social determinants of health in community-based medical education: a general inductive approach for qualitative data analysis.

Background: Social determinants of health (SDH) are intricately intertwined with various social and economic factors. Reflection is essential for learning about SDH. However, only a few reports have focused on reflection in SDH programs; most were cross-sectional studies.

What Role Expectations Do Primary Care Physicians in Japan Hold for Physical Therapists Regarding Primary Care?

Introduction/objectives: This study aimed to clarify what primary care physicians (PCPs) in Japan understand of the role of physical therapists (PTs) through the experience of working with PTs in hospitals, and what roles PCPs expect for PTs in future primary care.

Methods: Semi-structured interviews were conducted individually with 9 purposively sampled PCPs with sufficient experience of collaboration with PTs. Interview data were analyzed by theme analysis focusing on "What does the PCP understand about the role of PTs through the experience of working with PTs in hospitals?" and "What roles and purposes does the PCP wish for PTs in primary care settings?"

Results: PCPs viewed PTs as providers of rehabilitation in the traditional medical model, and understood their role as an occupation having a mono-causal viewpoint, namely a specific and well-defined outcome for individual patients, and intervening with patients within a short clinical course with the aim of improvement or maintenance of the patient's condition.

Efficacy of cancer-specific anti-podoplanin CAR-T cells and oncolytic herpes virus G47Δ combination therapy against glioblastoma.

Glioblastoma is a devastating malignant brain tumor with a poor prognosis despite standard therapy. Podoplanin (PDPN), a type I transmembrane mucin-like glycoprotein that is overexpressed in various cancers, is a potential therapeutic target for the treatment of glioblastoma. We previously reported the efficacy of chimeric antigen receptor (CAR)-T cells using an anti-pan-PDPN monoclonal antibody (mAb; NZ-1)-based third-generation CAR in a xenograft mouse model.

Gender-Related Differences in Social Participation Among Japanese Elderly Individuals During the COVID-19 Pandemic: A Cross-Sectional Survey.

Introduction/objectives: The health of elderly individuals is known to benefit from maintaining societal involvement and relationships with other people, such as through social participation. We aimed to determine trends in the percentage of Japanese elderly people who engaged in social participation before and during the coronavirus disease 2019 (COVID-19) pandemic in one municipality in Japan, and compared differences in this status by gender.

Methods: We conducted a cross-sectional questionnaire survey.

Changes in home visit utilization during the COVID-19 pandemic: a multicenter cross-sectional web-based survey.

Objective: Home care is one of the essential community health care services; thus, identifying changes of home care utilization before and during the COVID-19 pandemic would be useful for researchers and policymaker to reconsider the home care system, the support needed for home care staff, and the collaborative system with hospitals in the COVID-19 era. We conducted a multicenter cross-sectional web-based anonymous survey of the directors of home visit facilities in Japan in August 2021.

Results: A total of 33 participants from 37 facilities responded to the survey.

Verification of a Sense of Community Scale for Hospitals in Japan.

Introduction/objectives: We aimed to verify whether a sense of community scale developed for hospital wards can be applied to hospitals.

Methods: A cross-sectional study was conducted using a self-administered questionnaire between July and October 2018 in 3 hospitals in Japan. The subjects were staff members working in these hospitals who provide direct medical or administrative services to patients and their families.

How do general practitioners handle complexities? A team ethnographic study in Japan.

Background: General practitioners (GPs) are often faced with complex problems, including patients with socio-economic and medical problems. However, the methods they use to approach these complexities are still not understood. We speculated that elucidating these methods using complex adaptive systems (CAS) methodology to comprehensively assess GPs' daily activities would contribute to improving the professional development of GPs.

Exploration of the impact of the COVID-19 pandemic on the mental health of home health care workers in Japan: a multicenter cross-sectional web-based survey.

Background: The COVID-19 pandemic has caused home health care workers (home-HCWs) to experience anxiety. The mental health of home-HCWs and related factors during the COVID-19 pandemic have not been clarified; therefore, we aimed to investigate the status and associated factors of fear of COVID-19 infection, anxiety, and depression among home-HCWs in Japan.

Methods: We conducted a multicenter cross-sectional web-based anonymous survey of home-HCWs in August 2021, during the fifth wave of the pandemic in Japan.

Frailty and social participation in older citizens in Japan during the COVID-19 pandemic.

Background: This study examined the frailty status of older individuals in Japan at 1 year after the onset of the coronavirus disease 2019 (COVID-19) pandemic based on involvement in social activities before and during the pandemic.

Methods: This cross-sectional study analyzed citizens aged 65 and 84 who did not require long-term care in January 2021. A self-administered questionnaire was mailed to 3000 citizens in Kitaibaraki City, Japan.

How do medical students learn about SDH in the community? A qualitative study with a realist approach.

Introduction: The need to learn social determinants of health (SDH) is increasing in disparate societies, but educational interventions are complex and learning mechanisms are unclear. Therefore, this study used a realist approach to identify SDH learning patterns, namely context (C), mechanism (M), and outcomes (O) in communities.

Methods: A 4-week clinical practice program was conducted for 5- and 6-year medical students in Japan.

Evaluation of changes in prescription among Japanese elderly patients before and after transition to home care.

Background: Most patients receiving home care have multimorbidity and tend to be prescribed multiple drugs with the complicated regimen. Family physicians (FPs) are responsible for patients' prescriptions after transition to home care. This study aimed to assess changes in medication regimen complexity and potentially inappropriate medications (PIMs) made by FPs before and after transition to home care.

Prediction Models for Impending Death Using Physical Signs and Vital Signs in Noncancer Patients: A Prospective Longitudinal Observational Study.

Accurate information on the prognosis in the last days of life is essential for providing better end-of-life care; however, few studies have examined the signs of impending death (SID) or developed short-term prediction models in noncancer patients. To investigate the prevalence and onset of SID and to develop models that predict death within 7 days, 72 hours, and 24 hours in noncancer patients. This is a prospective longitudinal observational study.

Is area under the curve the best parameter for carboplatin induced emetic risk stratification?

Carboplatin (CBDCA)-induced emetic risk is currently classified on the basis of CBDCA-area under the curve (CBDCA-AUC). We investigated the utility of three CBDCA dosage parameters for predicting emesis by CBDCA. Patients with thoracic cancer treated with CBDCA were included.

What role conceptions do multi-healthcare professionals have of physicians and what role expectation do they have of physicians in a community?

Background: To create an effective community-based integrated care system, interprofessional collaboration based on healthcare professionals' mutual understanding of their respective roles must be promoted. This study aimed to identify the role conception and role expectation that other healthcare professionals have towards physicians in the context of a community-based integrated care system.

Methods: We organized focus groups and adopted 'Role Theory' as a theoretical framework.

Validation of the professional self-identity questionnaire for medical students during clinical practice in Japan.

Objectives: To validate the Professional Self Identity Questionnaire (PSIQ) for medical students during clinical practice.

Methods: We conducted a single-year longitudinal questionnaire study using the PSIQ. The PSIQ rates the nine items of "teamwork", "communication", "conducting assessment", "cultural awareness", "ethical awareness", "using records", "dealing with emergencies", "reflection", and "teaching" on a scale of 1-7 points.

Primary care physicians' narratives on COVID-19 responses in Japan: Professional roles evoked under a pandemic.

Background: Within the vague system of primary care and COVID-19 infection control in Japan, we explored how primary care (PC) physicians exhibited adaptive performance in their institutions and communities to cope with the COVID-19 pandemic from January to May 2020.

Methods: Narrative analysis conducted by a team of medical professionals and anthropologists. We purposefully selected 10 PC physicians in community-based hospitals and clinics and conducted a total of 17 individual and group interviews.

Students' understanding of social determinants of health in a community-based curriculum: a general inductive approach for qualitative data analysis.

Background: A community-based medical education (CBME) curriculum may provide opportunities to learn about the social determinants of health (SDH) by encouraging reflection on context, but the categories that students can learn about and their level of reflection are unclear. We aimed to analyze medical students' understanding and level of reflection about SDH in a CBME curriculum.

Methods: Study design: General inductive approach for qualitative data analysis.

Better Patient Experience is Associated with Better Vaccine Uptake in Older Adults: Multicentered Cross-sectional Study.

Background: Older adults' uptake of influenza and pneumococcus vaccines is insufficient worldwide. Although patient experience of primary care is associated with vaccine uptake in children, this relationship remains unclear for older adults.

Objective: This study examined the association between patient experience of primary care and influenza/pneumococcal vaccine uptake in older adults.

Variations in vital signs at the end of life in non-cancer patients: a retrospective study.

Background: The prediction of impending death is important for providing appropriate end-of-life care; however, limited information is currently available on the signs of impending death in non-cancer patients. Furthermore, although vital signs are routinely measured in clinical practice, changes in vital signs in the dying phase in non-cancer patients have not yet been elucidated in detail.

Methods: We herein conducted a retrospective study to clarify changes in vital signs before death in noncancer patients.

Doctors' professional identity and socialisation from medical students to staff doctors in Japan: narrative analysis in qualitative research from a family physician perspective.

Objective: Becoming a doctor involves transforming a lay person into a medical professional, which is known as professional socialisation. However, few studies have clarified differences in the professional socialisation process in detail. The aim of this study was to clarify the process of professional socialisation of medical students to residents to staff doctors.

Primary Prophylaxis Indication for Docetaxel Induced Febrile Neutropenia in Elderly Patients with Non-Small Cell Lung Cancer.

In advanced non-small cell lung cancer (NSCLC), the reported incidence of febrile neutropenia (FN) caused by docetaxel (DTX) is 10-20% in clinical trial data. However, FN incidence caused by DTX in real-world setting remains unclear. We evaluated FN incidence caused by DTX and identify risk factors of FN in real-world setting.

Survival time after marked reduction in oral intake in terminally ill noncancer patients: A retrospective study.

Background: The prediction of short-term survival is important for noncancer patients and their families. Although a markedly reduced oral intake by cancer patients suggests a poor prognosis, the survival times of noncancer patients after its onset remain unclear. We herein investigated the time from a marked reduction in oral intake to death in noncancer patients as well as factors associated with their subsequent survival.