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This position paper prepared by the Japanese Working Group on Integrated Nutrition for Dysphagic People (JWIND) aims to summarize the need for nutritional management in adult patients with dysphagia, the issues that nutrition professionals should address, and the promising approaches as well as to propose a vision for the future of nutritional care for adult patients with dysphagia. JWIND is a joint certification system recognized by the Japan Dietetic Association and the Japanese Society of Dysphagia Rehabilitation; its members are mostly experts known as "Certified Specialist of Registered Dietitian for Dysphagia Rehabilitation." Malnutrition and dysphagia are associated with each other. Therefore, malnutrition detection and intervention are essential for patients with dysphagia. However, evidence on the usefulness nutritional assessment and intervention to ensure appropriate nutritional care remains insufficient. Here, we present current knowledge of the relationship between primary diseases causing dysphagia and malnutrition, the indicators used for nutritional assessment, and nutritional interventions such as texture-modified diet (TMD) quality improvement, oral nutritional supplementation, and comprehensive intervention. We also discuss the current status and issues in nutritional care for adult patients with dysphagia. Furthermore, we have proposed measures that nutrition professionals should consider based on 3 perspectives: nutritional assessment, TMD, and nutritional intervention. Individualized and specialized nutritional management by registered dietitians (RDs) through appropriate assessment of the nutritional status of adult patients with dysphagia is needed. To maintain and improve swallowing function and nutritional status, RDs should intervene from the state of risk or early dysphagia onset, providing individualized care per their expertise as part of a multidisciplinary team. However, systematic clinical practice and research regarding the association of nutrition with dysphagia are currently insufficient. Therefore, further clinical practice and evidence building, including the verification of the efficacy on nutritional support through intervention research, are needed. [ABSTRACT FROM AUTHOR]

This paper explores pragmatic socialization by examining episodes of two to three - year-old children's crying and adults' responses to this crying in two preschools: Sweden and Japan. Based on approximately 100 hours of naturally occurring interactions, it focuses on crying episodes that emerged within peer conflict, and analyzes ways that teachers structured a triadic framework of mediation. The results show how teachers mediated by using (1) question-response sequences to clarify what happened and (2) directives and declaratives to convey norms of behaving/speaking and to attune children to the crying of others as a negative affective act that requires a remedial response. The results reveal similarities and variations in adults' responses to children's crying in the two preschools. Although the findings in part instantiate traditional models of socialization in these two societies, they also suggest ways that departed from these models. • Analysis examines preschool teachers' responses to crying in peer conflict. • Methods utilize multimodal conversation analysis. • Analysis shows teachers' triadic mediation utilizing questions, directives, and declaratives. • Findings are discussed in relation to children's pragmatic socialization. [ABSTRACT FROM AUTHOR]

Studies across Europe and the US report that childhood socioeconomic disadvantage is associated with poorer health in adulthood. By contrast, a study in Japan suggests that childhood socioeconomic disadvantage may be positive for adult health. In this paper, we assess the association between intergenerational income mobility and self-rated health in Japan, using detailed childhood income data for 1610 men and 1885 women aged 30–49 years. We use an instrumental variable approach to identify the causal effect of upward income mobility on adult health. We find that low father's income during childhood is associated with smoking and alcohol consumption in adult life for both men and women. For men, upward income mobility was associated with worse health. Certain behavioural choices related to income mobility, such as long working hours, may have detrimental health effects. • We estimate father's income during childhood using a pseudo-cohort approach. • Low father's income during childhood is associated with health behavioural choices. • There is no association of father's income in childhood with adult health for men. • Lower childhood income is associated with worse health in adulthood for women. • Upward income mobility is associated with worse health in adulthood only for men. [ABSTRACT FROM AUTHOR]