Simultaneous bicompartmental bucket handle meniscal tears with a clinically competent Anterior Cruciate Ligament

Bucket handle meniscal tears (BHMT) of the knee occur infrequently (approximately 10% of meniscal injuries). Simultaneous, bicompartmental BHMT are extremely rare. Previously, these have only been reported in association with a ruptured anterior cruciate ligament (ACL). The pathomechanism of this injury was thought to be due to the lack of knee stability following the ACL injury. We present a case of a 38 year old male patient with bicompartmental BHMT with a clinically competent ACL. This highlights the need for clinical and radiological suspicion of simultaneous BHMTs even in the presence of an intact ACL

Mental and physical effects of the 2011 Great East Japan Earthquake on School Children, and Health Support initiatives by YogoTeachers: Findings from a survey of high school yogo teachers 5 years after the disaster

Objective: To clarify the current mental and physical state of students 5 years after experiencing the Great East Japan earthquake, tsunami, and nuclear accident, and to shed light on the practical initiatives and issues faced by yogo teachers in supporting students’ health. Method: In May 2016, we conducted a mail-based questionnaire of yogo teachers at 15 prefectural high schools in Soma District and Futaba District (collectively, “Soso”) in Fukushima Prefecture, one of the areas most heavily affected by the Fukushima Daiichi Nuclear Power Plant accident.　The questionnaire focused on (1) health and school life of students; and (2) current initiatives and issues faced by yogo teachers in supporting student health. Results: We received responses from 8 of the 15 high school yogo teachers surveyed (response rate: 53.3％).Six yogo teachers (75％) responded that the “students are calm.” However, 6 yogo teachers (75％) recognized a tendency among students towards weight gain and obesity, as well as reduced physical stamina and sporting ability, while 4 yogo teachers (50％) indicated that some students were anxious about their future and career path, and were receiving personal support from the school counselor.　The yogo teachers provided support to students while attempting to ascertain their mental and physical well-being through greater health monitoring and questionnaires, and while coordinating with the school physician and counselor. Conclusion: Five years after the earthquake, high school students in the Soso district are now leading a more relaxed school life, but still feel anxious about their future health and career path due to lingering concerns about radiation, highlighting the need for long-term support by yogo teachers

Health Support Provided by Yogo Teachers for Adolescent Female Students with a Thin Body Type

Purpose: To clarify the realities and challenges involved in health support provided by yogo teachers to adolescent girls who have a thin body type. Methods: A semi-structured interview survey was conducted with yogo teachers at a Japanese high school with experience of providing health support to thin adolescent female students and the results of the survey were subjected to qualitative analysis. Results: With regard to health support provided by yogo teachers, the results of analysis found that the actual situation consisted of the five categories of 【sharing information throughout the school organization to investigate methods of support】,【 realizing studentsʼ situations through the provision of individual support】, 【referring students and parents to specialist agencies】,【investigating collaborations with parents with students ʼ consent】, and 【carrying out prevention and awareness-raising activities about thin physiques】.　 However, the analysis also found that the practical challenges for providing such health support consisted of the six categories of 【working with parents to liaise with medical institutions】,【continuous support in collaboration with specialist agencies】,【 educational health support that enables all students to manage their own health】,【 yogo teachersʼ professional knowledge and assessment of eating disorders】,【 support methods that students can engage with on their own initiative, according to their situation】, and 【creating a counseling- friendly environment to facilitate early detection】.Discussion: While yogo teachers had an overall grasp of studentsʼ situations through their organizational engagements in cooperation with faculty and school physicians, as well as individual support activities, it was clear that they faced difficulties and challenges in relation to working together with parents and specialist agencies.　In the future, improving collaboration with parents will require that they, too, be encouraged to recognize that being excessively thin represents a health problem for adolescent female students.　In addition, it will also be necessary to work towards building daily collaboration systems, such as by having yogo teachers keep track of potential partner medical institutions as a matter of routine.　It was further suggested that yogo teachers will need to provide educational and preventive health support oriented toward helping female students acquire the ability to manage their own health

Rice Productivity Growth During Nine Years in Badung Regency, Bali Province

The trend of rice productivity and its stability in Badung Regency are presented in this study. The area is a tourism-based economy without leaving the role of rice production to feed the people.  Time series data were collected from five sub districts covering 53 villages during 2008-2016 due to the completeness of the data. Variability of the data was observed from the coefficient of variance (C.V.) to decide rice productivity stability. This study also observed correlation between rainfall and rice productivity in the area. Result of the study shows that rice productivity trend in Badung Regency tend to decline during nine years of observation especially in 2014-2016. Three sub-districts had stable condition, while two sub-districts in tourism area contributed to the decline of this matter. Analysis using bi-plot revealed that there is no significant correlation between rainfall in sub-district and rice productivity, implying that water is available throughout the year.  In terms of stability, majority of villages (69.81%) had stable condition of rice productivity ranging from middle and high category. Other 30.19% villages were categorized as unstable ranging from low to high productivity. This condition showed that Badung Regency were able to maintain stability of rice productivity during nine years of observation. Implication of this study is to pay more attention to two sub districts in tourism area to improve their rice productivity such as implementation of good agricultural practices

Association of perceived stress and coping strategies with the renal function in middle-aged and older Japanese men and women

Elucidating the risk factors for chronic kidney disease is important for preventing end-stage renal disease and reducing mortality. However, little is known about the roles of psychosocial stress and stress coping behaviors in deterioration of the renal function, as measured by the estimated glomerular filtration rate (eGFR). This cross-sectional study of middle-aged and older Japanese men (n = 31,703) and women (n = 38,939) investigated whether perceived stress and coping strategies (emotional expression, emotional support seeking, positive reappraisal, problem solving, and disengagement) were related to the eGFR, with mutual interactions. In multiple linear regression analyses adjusted for age, area, lifestyle factors, and psychosocial variables, we found a significant inverse association between perceived stress and the eGFR in men (Ptrend = 0.02), but not women. This male-specific inverse association was slightly attenuated after adjustment for the history of hypertension and diabetes and was more evident in lower levels of emotional expression (Pinteraction = 0.003). Unexpectedly, problem solving in men (Ptrend < 0.001) and positive reappraisal in women (Ptrend = 0.002) also showed an inverse association with the eGFR. Perceived stress may affect the eGFR, partly through the development of hypertension and diabetes. The unexpected findings regarding coping strategies require the clarification of the underlying mechanisms, including the hormonal and immunological aspects

Effect of the interaction between physical activity and estimated macronutrient intake on HbA1c : population-based cross-sectional and longitudinal studies

Introduction Healthy diet and physical activity (PA) are essential for preventing type 2 diabetes, particularly, a combination of diet and PA. However, reports on interaction between PA and diet, especially from large epidemiological studies, are limited. We investigated the effect of interaction between PA and macronutrient intake on hemoglobin A1c (HbA1c) levels in the general population. Research design and methods We conducted a cross-sectional study of 55 469 men and women without diabetes who participated in the baseline survey of the Japan Multi-Institutional Collaborative Cohort Study. A self-administered questionnaire ascertained PA and macronutrient intake (carbohydrate, fat, and protein). Multiple linear regression analyses were performed to adjust for confounding variables and examine the interactions. In addition, we conducted a longitudinal study during a 5-year period within a subcohort (n=6881) with accelerometer-assessed PA data. Results Overall, PA had a weak inverse association (β=−0.00033, p=0.049) and carbohydrate intake had a strong positive association (β=0.00393, p<0.001) with HbA1c. We observed a tendency of interactions between PA and carbohydrate or fat intake, but not protein intake, on HbA1c levels after adjusting for age, sex, study area, total energy intake, alcohol consumption, smoking, and medication for hypertension or hypercholesterolemia (Pinteraction=0.054, 0.006, and 0.156, respectively). The inverse associations between PA and HbA1c level were more evident in participants with high-carbohydrate (or low-fat) intake than in participants with low-carbohydrate (or high-fat) intake. Although further adjustment for body mass index slightly attenuated the above interactions (Pinteraction=0.098 for carbohydrate and 0.068 for fat), the associations between PA and HbA1c level in stratified analyses remained unchanged. Similar associations and interactions were reproduced in the longitudinal study. Conclusions The present results suggest that the effect of PA on HbA1c levels is modified by intake of macronutrient composition