Amounts served and consumed of school lunch differed by gender in Japanese elementary schools

School lunches serve to improve nutritional status and to promote the health of children. The purpose of this study was to investigate the portion sizes of school lunches served and consumed in Japanese elementary schools. In addition, gender difference in servings and consumption were also studied. A cross-sectional study was undertaken between October 2007 and February 2008 in schools located in Tokyo and Okayama, Japan. A total of 192 fifth-grade children attending four elementary schools participated in this study. Weighed plate waste methods and observation were used to collect dietary data for two non-consecutive days. The proportion of children who chose staple foods along with main dishes and/or side dishes for at least one day was higher in boys than in girls (respectively, for staple food: 42.1% vs. 9.3%, for main dish and/or side dish: 68.4% vs. 44.3%, P < 0.001). The ratio of initial amount served to amount offered was 0.88 ± 0.11 for boys and 0.84 ± 0.10 for girls (P < 0.05). The ratio of amount consumed to amount offered was 1.04 ± 0.19 for boys and 0.88 ± 0.12 for girls (P < 0.001). Weight was related to amount consumed both in boys (r = 0.222, P < 0.05) and in girls (r = 0.201, P < 0.05). These findings suggest that the nutritional standards of school lunch programs should take into account gender differences. Clearly, boys were more likely to consume more than the initial amounts served due to their higher propensity to take second helpings. Boys feel few reservations about taking second helpings to adjust their total intake. However, school lunch plans should take into consideration girls' reluctance to do so, by serving appropriate initial portion sizes

Estimation of the value of convenience in taking influenza antivirals in Japanese adult patients between baloxavir marboxil and neuraminidase inhibitors using a conjoint analysis

Aims: Estimating the monetary value of the convenience of using influenza antivirals approved in Japan from a patient perspective using a conjoint analysis. Methods: An online survey (August 2020) was performed on individuals aged 20–64 years living in Japan who had taken oral or inhalant antivirals for influenza treatment in the 2018/19 or 2019/20 seasons. Efficacy and safety were assumed to be equivalent among the antivirals. The attributes for the conjoint analysis included route (oral or inhalant), duration, frequency of administration, and out-ofpocket expenses. A conditional logit model was applied as a baseline model. The monetary value of each attribute was calculated by comparing the same utility of the linearly interpolated level of the out-of-pocket attribute. Another survey to determine the experiences of the latest antiviral intake was also conducted on the same respondents. Results: Of the respondents, 1,550 were men and 1,587 were women. The monetary value for oral antivirals was estimated to be higher, saving JPY 741 (USD 7.06, as of August 2020), compared with inhalant. Regarding the length and frequency of administration, five days corresponds to an increase of JPY 2,072, compared with one day, and twice a day corresponds to a JPY 574 increase compared to once a day. Conclusions: The results suggest that – among the antivirals approved in Japan – the monetary value of the utility is the highest in the single dose oral antiviral, baloxavir marboxil (baloxavir). Although the drug cost was highest in baloxavir among the brand antivirals, the difference in the value of utility for influenza patient was estimated to be larger than the difference in the drug costs. Limitations: Although individuals with diverse attributes from all over the country were included in the survey, they are not necessarily a representative population of the Japanese society

Patient safety education at Japanese nursing schools: results of a nationwide survey

<p>Abstract</p> <p>Background</p> <p>Patient safety education is becoming of worldwide interest and concern in the field of healthcare, particularly in the field of nursing. However, as elsewhere, little is known about the extent to which nursing schools have adopted patient safety education into their curricula. We conducted a nationwide survey to characterize patient safety education at nursing schools in Japan.</p> <p>Results</p> <p>Response rate was 43% overall. Ninety percent of nursing schools have integrated the topic of patient safety education into their curricula. However, 30% reported devoting less than five hours to the topic. All schools use lecture based teaching methods while few used others, such as role playing. Topics related to medical error theory are widely taught, e.g. human factors and theories & models (Swiss Cheese Model, Heinrich's Law) while relatively few schools cover practical topics related to error analysis such as root cause analysis.</p> <p>Conclusions</p> <p>Most nursing schools in Japan cover the topic of patient safety, but the number of hours devoted is modest and teaching methods are suboptimal. Even so, national inclusion of patient safety education is a worthy, achievable goal.</p

Science-based health innovation in Ghana: health entrepreneurs point the way to a new development path

<p>Abstract</p> <p>Background</p> <p>Science, technology and innovation have long played a role in Ghana’s vision for development, including in improving its health outcomes. However, so far little research has been conducted on Ghana’s capacity for health innovation to address local diseases. This research aims to fill that gap, mapping out the key actors involved, highlighting examples of indigenous innovation, setting out the challenges ahead and outlining recommendations for strengthening Ghana’s health innovation system.</p> <p>Methods</p> <p>Case study research methodology was used. Data were collected through reviews of academic literature and policy documents and through open-ended, face-to-face interviews with 48 people from across the science-based health innovation system. Data was collected over three visits to Ghana from February 2007 to August 2008, and stakeholders engaged subsequently.</p> <p>Results</p> <p>Ghana has strengths which could underpin science-based health innovation in the future, including health and biosciences research institutions with strong foreign linkages and donor support; a relatively strong regulatory system which is building capacity in other West African countries; the beginnings of new funding forms such as venture capital; and the return of professionals from the diaspora, bringing expertise and contacts. Some health products and services are already being developed in Ghana by individual entrepreneurs, which are innovative in the sense of being new to the country and, in some cases, the continent. They include essential medicines, raw pharmaceutical materials, new formulations for pediatric use and plant medicines at various stages of development.</p> <p>Conclusions</p> <p>While Ghana has many institutions concerned with health research and its commercialization, their ability to work together to address clear health goals is low. If Ghana is to capitalize on its assets, including political and macroeconomic stability which underpin investment in health enterprises, it needs to improve the health innovation environment through increasing support for its small firms; coordinating policies; and beginning a dialogue with donors on how health research can create locally-owned knowledge and be more demand-driven. Mobilizing stakeholders around health product development areas, such as traditional medicines and diagnostics, would help to create trust between groups and build a stronger health innovation system.</p

A review of population-based prevalence studies of physical activity in adults in the Asia-Pacific region

Background: Physical activity (PA) surveillance is an important component of non-communicable disease risk factor monitoring, and occurs through national and international surveillance systems. This review identifies population PA estimates for adults in the Asia-Pacific region, and examines variation in trends and prevalence rates obtained using different PA measures.Methods: Data were obtained from a MEDLINE search; World Health Organization&rsquo;s Global Health Infobase; Government websites and reference lists of relevant papers. Inclusion criteria included: national studies or those reporting large scale population-level data; data published from 2000 to 2010 and trend data prior; sample sizes over n = 1000, or fewer subjects in small nations.Results: In total, 56 population surveys from 29 Asia-Pacific countries were identified. Data on &lsquo;sufficient physical activity&rsquo; amongst adults were available from 45 studies (80%), with estimates ranging from 7% to 93% (median 62%, inter-quartile range 40%-85%). For 14 countries, estimates of &lsquo;sufficient activity&rsquo; were documented in multiple surveys using different methods, with the largest variation from 18% to 92% in Nepal. Median or mean METminutes/ day, reported in 20 studies, ranged from 6 to 1356. Serial trend data were available for 11 countries (22%), for periods spanning 2-10 years. Of these, five countries demonstrated increases in physical activity over time, four demonstrated decreases and three showed no changes.Conclusions: Many countries in the Asia-Pacific region collect population-level PA data. This review highlights differences in estimates within and between countries. Some differences may be real, others due to variation in the PA questions asked and survey methods used. Use of standardized protocols and measures, and combined reporting of data are essential goals of improved international PA surveillance.<br /