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Aim: To clarify the utility of sepsis evaluation using the Quick Sequential Organ Failure Assessment (qSOFA) tool in addition to the Pneumonia Severity Index (PSI); age, dehydration, respiration, orientation and blood pressure (A‐DROP) index; and immunodeficiency, respiration, orientation, age and dehydration (I‐ROAD) scoring systems, and risk factor evaluation of potentially drug‐resistant (PDR) pathogens are suggested in the 2017 guidelines for pneumonia of the Japanese Respiratory Society in nursing‐ and healthcare‐associated pneumonia patients. Methods: We included 289 hospitalized nursing‐ and healthcare‐associated pneumonia patients between April 2016 and March 2017, and investigated the ability of PSI, A‐DROP, I‐ROAD and qSOFA to predict pneumonia‐related mortality. We also evaluated the associations among the risk factors for PDR pathogens, the detection ratio of PDR pathogens and pneumonia‐related mortality. Results: The mortality rate of pneumonia during hospitalization was 6.9% (20/289). The area under the curve for pneumonia‐related mortality predicted using PSI, A‐DROP, I‐ROAD and qSOFA was 0.697 (95% confidence interval [CI] 0.59–0.80), 0.63 (95% CI 0.51–0.76), 0.61 (95% CI 0.52–0.70) and 0.701 (95% CI 0.59–0.81), respectively. In addition, higher areas under the curve were observed for pneumonia‐related mortality predicted according to a combination of PSI and hypoalbuminemia (<2.5 g/dL) (0.75, 95% CI 0.64–0.86), and qSOFA and hypoalbuminemia (0.74, 95% CI 0.62–0.86) than for PSI and qSOFA alone. No significant associations were observed among the risk factors for PDR pathogens, the detection ratios of PDR pathogens and pneumonia‐related mortality. Conclusions: qSOFA and the combination of qSOFA and hypoalbuminemia might be simple and useful evaluation tools for predicting pneumonia‐related mortality in nursing‐ and healthcare‐associated pneumonia patients. Geriatr Gerontol Int 2019; 19: 177–183. [ABSTRACT FROM AUTHOR]

Abstract: The association between smoking and psychiatric disorders (PD) has been known for many years. Support for smoking cessation among patients with PD is provided in advanced nations, but there is a little support for smoking cessation among patients with PD in Japan, where few studies have investigated the smoking rate. The aim of the present study is to determine the smoking rate and smoking habits of Japanese patients with PD. The subjects included outpatients who visited the outpatient psychiatric clinic at a University hospital between January and March of 2011. They answered a questionnaire consisting of questions about their sociodemographic background and smoking habits. In an analysis of 733 subjects, the overall smoking rate was 25.1%. The smoking rates among the patients with schizophrenia and depression were 17.3% and 23.9%, respectively, and these rates were lower than the results of previous studies. Among the current smokers, 43.4% had experienced smoking cessation, and only 26.1% were not interested in smoking cessation. Of the current smokers, 37.5% spent between US$128.88 and US$257 per month on cigarettes. [Copyright &y& Elsevier]

Background: Tobacco smoking causes a variety of smoking-related diseases, death, and economic damage. Despite targeted anti-smoking campaigns, tobacco-related deaths are expected to increase in Japan. We investigated the current state of non-cancerous lung diseases such as idiopathic interstitial pneumonias (IIPs), chronic obstructive pulmonary disease (COPD), and combined pulmonary fibrosis and emphysema (CPFE), which are known to be highly related to tobacco smoking., Methods: This prospective multi-institutional observational study involved 29 major hospitals within the Fukuoka Prefecture area (Fukuoka tobacco-related lung disease registry study group). Patients diagnosed with IIPs, including CPFE and COPD, registered from September 1, 2013 to April 30, 2016 were included. Clinical background information, laboratory and pulmonary function test results, findings of imaging tests, including chest radiography and chest computed tomography, and DNA isolated from peripheral blood were collected from each patient. Follow-up surveillance involved collection of data regarding the exacerbation of disease and death until 5 years of registration. In the present study, we report the baseline characteristics of the patients registered in this surveillance study., Results: Overall, 1016 patients (524 with IIPs, including 145 CPFE and 492 with COPD) were enrolled. Among the patients with COPD, 96.8% were current or former smokers. Among the patients with IIPs, 69.9% were current or former smokers., Conclusion: This study revealed the current status of lung diseases potentially related to tobacco smoking in Fukuoka Prefecture. Both COPD and CPFE were highly related to tobacco smoking, whereas 30% of patients with IIPs had never smoked., (Copyright © 2019 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.)

An accurate education of the harmful health effects of second-hand smoke on young people is important, and school teachers play a critical role. We polled school teachers about health awareness of second-hand smoking and the effectiveness of 4 methods of protecting against second-hand smoke. Self-reporting questionnaires were given to 452 non-smoker and ex-smoker subjects. To evaluate social nicotine dependence, we used the Kano Test for Social Nicotine Dependence (KTSND) questionnaire. Of 364 teachers (80.5%) who answered and were at risk of second-hand smoke exposure, 39.6% had respiratory symptoms, and 34.9% answered "ignore" or "slightly anxious" about second-hand smoking. The mean KTSND scores of those who answered "extremely anxious", "moderately anxious", "slightly anxious", and "ignore second-hand smoking" were 10.5 +/- 5.7, 12.3 +/- 6.0, 14.7 +/- 5.8, and 18.4 +/- 4.9, respectively. The KTSND scores of teachers who answered "ignore second-hand smoke" were higher than those of teachers who answered "anxious". The scores were also higher in subjects who believe second-hand smoke can be avoided by the recommended protective measures, than in subjects who know that avoidance is impossible, indicating that these teachers accepted smoking behavior. These results suggest that non-smoking and ex-smoking teachers with high KTSND scores might underestimate the health hazards of second-hand smoke, and overestimate the recommended protective measures. Therefore, re-education about awareness of the harmful effects of second-hand smoke should be given to them.

Objective: To determine predictive validity for cut points of the Timed Up & Go (TUG) test and life-space assessment (LSA) on decline in instrumental activities of daily living (IADLs) among older adults., Design: Cross-sectional and 1-year follow-up study., Setting: Preventive health care services., Participants: In a cross-sectional study, 2404 older adults (65-100 y) were recruited to determine cut points for the TUG and LSA for IADLs limitation. For longitudinal analysis, 436 older adults (65-100 y) were followed over 1 year to explore the validity of a classification model using the cut points to predict incident IADLs decline., Interventions: Not applicable., Main Outcome Measures: The TUG, LSA, and Tokyo Metropolitan Institute of Gerontology index of IADLs measurement., Results: The cut points associated with IADLs limitations for the TUG and LSA were 12 seconds and 56 points, respectively. Participants were classified into fast/high (most able; TUG <12 and LSA >56), fast/low, slow/high, and slow/low (vulnerable; TUG > or =12 and LSA < or =56) groups; there were 813 (34%), 385 (16%), 246 (10%), and 960 (40%) participants in each group, respectively. The proportions of participants with IADLs limitation in the most able, fast/low, slow/high, and vulnerable groups were 19%, 64%, 61%, and 89%, respectively. The vulnerable group included significantly more participants with IADLs limitation than any other group (P<.001). Compared with a most able group, the odds ratios of IADLs decline for the fast/low and vulnerable groups were 2.52 (95% confidence interval 1.15-5.53, P<.05) and 2.87 (95% confidence interval 1.38-5.96, P<.01), respectively., Conclusions: The combination of TUG and LSA identifies persons with future IADLs decline and has the potential to be used by community health care services to target individualized interventions., (Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Purpose: "Social nicotine dependence" is a newly-coined phrase for describing a psychological and psychosocial state associated with smoking. That new dependence is defined as a misperception of smoking caused by smokers' attempts, for example, to deny the ill effects of tobacco and/or to justify themselves by regarding smoking as acceptable cultural and social behavior. It can be quantified by a 10-item questionnaire, the Kano Test for Social Nicotine Dependence (KTSND). We examined the internal consistency as well as the criterion-related and construct validity and factor structure of KTSND., Methods: Self-administered questionnaires including the KTSND, smoking status, and stages in quitting smoking only for current smokers were collected from 666 industrial workers., Results: The internal consistency of the KTSND assessed by Cronbach's alpha coefficient was 0.77. In addition, we found that an 8-item combination from among 10 items had a higher coefficient of 0.80. KTSND scores differed among three groups of smoking status as a criterion. Factor analysis clarified two potential factors: "an overestimation of smoking's effects to enhance physical and mental status" and "an insistence on smoking as acceptable cultural and social behavior.", Conclusion: The KTSND proved to be valid in terms of the internal consistency and the inclusion of two key aspects of the misperception of smoking.