Hirosaki Medical Journal
Online ISSN : 2434-4656
Print ISSN : 0439-1721
Volume 69 , Issue 1-4
Showing 1-45 articles out of 45 articles from the selected issue
Review
  • Masahiko Aoki, Yoshiomi Hatayama, Hideo Kawaguchi, Mariko Sato, Mitsuk ...
    2019 Volume 69 Issue 1-4 Pages 1-9
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    In stereotactic body radiotherapy (SBRT), extracranial primary tumors or metastases are treated with high doses of radiation in a few fractions. The precise and accurate delivery of multiple radiation beams to the target maximizes tumor cell death while keeping the dose to the surrounding normal tissue to a minimum. Much of the technology to overcome the barriers to applying this treatment to moving tumors was developed in Japan. This review defines SBRT and presents the history of its technical development for safe and effective administration, as well as the clinical results of using SBRT to treat early-stage non-small cell lung cancer and lung metastases.
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  • Hodaka Fujii
    2019 Volume 69 Issue 1-4 Pages 10-18
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    For comprehensive understanding of molecular mechanisms of regulation of genome functions including transcription and epigenetic regulation, it is essential to identify molecules associated with the genomic regions to be analyzed in vivo. To this end, the author's research group has developed the locus-specific chromatin immunoprecipitation(locus-specific ChIP) technologies consisting of insertional ChIP( iChIP) and engineered DNA-binding molecule-mediated ChIP( enChIP). The locus-specific ChIP technologies are biochemical methods to purify specific genomic regions retaining molecular interactions from cells and combined with mass spectrometry( MS), next generation sequencing(NGS), and other methods to identify molecules associated with the genomic regions. In this review, I describe the basic principles and applications of the locus-specific ChIP technologies.
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Original Article
  • Masakazu Murakami, Akiyoshi Takami, Ai Shimaya, Misato Makino, Hideki ...
    2019 Volume 69 Issue 1-4 Pages 19-27
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    The purpose of this study was to clarify the factors influencing caregiver burden 1 month after hospitalized in the convalescent ward by investigating the difference between the expected and actual amount of care provided by family caregivers.
    Thirty-one pairs of care receivers and caregivers were participated in this study. Multiple regression analysis was performed with J-ZBI_8, an examination which the burden of caregiving as dependent variable and information obtained from care recipients and caregivers as independent variables. As a result, the average value of J-ZBI_8 was 6.5 ± 5.3 points. 61% of the family caregivers’ actual care was harder than they predicted before discharge. Results showed that the difference between the expected and actual amount of care provided by family caregivers ( β=0.471, P=0.002), and caregivers’ hours of sleep per day ( β=0.404, P=0.006) were related to caregiver burden. In addition, the Functional Independence Measure items of memory, comprehension, social interaction and bowel management, and the frequency of hospital visits were factors relating with the difference between the expected and actual amount of care provided by family caregivers (adjusted R2=0.460, P=0.040).
    This research highlights the importance of how to handle symptoms and excretion due to dementia before discharge and increasing the frequency of hospital visits by caregivers, which might help to create a more realistic image of caregiving after hospitalization, thereby reducing caregivers’ burden.
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  • Ikumi Kataoka, Ryuko Kawashima, Yumiko Tsubota, Yumiko Fukkoshi, Hiroa ...
    2019 Volume 69 Issue 1-4 Pages 28-34
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    While a system for informing examinees when dense breast is noted during mammography screening is currently being considered, there is concern about a low understanding of the implications of dense breast. A questionnaire survey on the degree of comprehension of dense breast was conducted among 187 people who attended the breast cancer enlightenment event held in Hachinohe city in October 2017. The results showed that the comprehension of dense breast was extremely low, as only 20 people (10.7%) said that they “understood the meaning”; however, 18 of them (90%) stated that they would like to be made aware of findings of dense breast. In addition, although there was no significant difference in the degree of comprehension of dense breast between the examinees <40 and ≧40 years of age, the degree of comprehension of dense breast was significantly greater in those who had a consultation history than in those with no such history. The present findings reflect a low understanding about dense breast in mammography screening and suggest that the degree of comprehension is influenced by the presence or absence of a consultation history.
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  • Kohsei Kudo, Minoru Osanai, Megumi Tsushima, Junichi Hirota, Sho Murak ...
    2019 Volume 69 Issue 1-4 Pages 35-43
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    Intelligent Grid (IG) is a technique to virtually reproduce the real grid (RG) in medical imaging to improve both contrast and graininess. Application of IG eliminates the unevenness in density often seen in images of RGs due to X-ray inclination. Although IG is expected in bedside radiography, the effect for grid ratios of IG is not clear. Therefore, we measured the scattered radiation content( SRC), contrast, and contrast-to-noise ratio( CNR) in a phantom experiment. Results of the experiment confirmed a decrease in the SRC with application of IG. The contrast was confirmed to be improved compared to without the grid (WG) at all grid ratios (IG3:1, IG6:1, IG8:1) at 70 kV assuming the abdomen and at IG3:1 at 90 kV assuming the chest. However, the contrast of IG6:1 and IG8:1 at 90 kV was lower than that of WG. Furthermore, the CNR was found to be improved compared to WG at all grid ratios at a phantom thickness of 30 cm, at the same level at 20 cm, and at the same level or lower at 10 cm. These results demonstrate the need to apply IG according to the tube voltage and body thickness.
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  • Mika Sato, Yoshiko Nishizawa
    2019 Volume 69 Issue 1-4 Pages 44-56
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    The aim of this study was to clarify the knowledge and practical abilities required by professional nurses, nursing students, and nursing teachers, to provide appropriate radiological nursing care in a radiationdisaster. To examine this, a semi-structured interview survey was conducted with 14 experts involved in radiationdisaster nursing or radiation-related-medical care. The survey contained three questions concerning radiationdisaster nursing: (1) What knowledge and practical abilities are required by nursing professionals? (2) What basic knowledge is required by nursing students? (3) What knowledge and experience are required by nursing teachers? After transcribing comments using KH Coder (3.0.0.0) software, we performed quantitative-text mining analysis. Hierarchical cluster analysis showed that, for question one, the experts prioritized knowledge of “health effects of radiation and addressing patients’ anxiety,” “the role of nurses,” and “radiological nursing.” For question two, “radiological nursing,” “radiation protection basics,” “radiation emergency medicine,” “role of nursing,” etc., were prioritized. Finally, for question three “knowledge of nuclear power plant accidents,” “disaster prevention drills, dose measurements, etc., performed at hospitals,” “radiation nursing and correspondence with inhabitants,” “radiation fundamentals,” etc., were prioritized. The findings show that future disaster-nursing education should incorporate radiation-nursing education.
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  • Takako Nakagawa, Akemi Fujita, Yoshiko Nishizawa
    2019 Volume 69 Issue 1-4 Pages 57-65
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    This study aimed to examine the actual state of awareness regarding care that respects individuality for elderly persons with dementia, as well as its implementation and influencing factors. The subjects were 250 care providers from 32 facilities who were recruited from the 329 group homes across Japan and consented to participate in this study. The subjects completed questionnaire surveys with 14 items that, according to a previous study, indicate care that respects individuality. The results revealed that while there is ample awareness for all 14 survey items regarding care that respects individuality, its implementation was significantly low. It appears to be that years of experience with dementia care influences four of 14 survey items and numbers of training times influences one of 14 survey items.
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  • Sonoko Takase, Ryoko Tsuchiya, Yoshiko Nishizawa
    2019 Volume 69 Issue 1-4 Pages 66-77
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    We examined the effects of personal characteristics and learning motivation on nursing students’ professional identity. In total, 1,892 students were targeted from the first to the fourth year of nursing at six nursing universities in Japan; we employed a self-administered questionnaire. The questionnaire measured professional identity and personal characteristics such as occupational motivation, having a professional role model, and self-esteem. To evaluate learning motivation, we used items assessing intrinsic, identified, introjected, and external regulation based on the self-determination theory. The data from 625 participants were analyzed using structural equation modeling. Occupational motivation from “nursing interest,” having a professional role model, self-esteem, identified regulation, and intrinsic regulation had direct positive effects on the professional identity of students of all school years. “Nursing interest,” having a professional role model, and self-esteem had indirect effects on professional identity through intrinsic regulation and identified regulation. However, occupational motivation from “a stable job,” external regulation, and introjected regulation had no significant effect on professional identity. The personal characteristics that affected participants’ professional identity differed according to school years. The results indicate that autonomous learning motivation, such as identified regulation and intrinsic regulation, are critical in the establishment of nursing students’ professional identity.
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  • Shinya Yaguchi, Katsuhiro Itoh, Hitoshi Yamamura
    2019 Volume 69 Issue 1-4 Pages 78-85
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    Objectives: We have created a new triage tag using the Anoto Live Digital Pen(Anoto K.K., Tokyo, Japan). We introduced this new triage tag and assessed whether this new triage system using digitized information entered via a digital pen can be used as an information-gathering tool during disasters.
    Methods: We assessed our new triage tag by sending a PC digital data, which was useful and accurately transmitted in tabletop and field studies. In the field study, we assessed the accuracy of three categories of digitized data: check boxes, numeric characters, and letter characters.
    Results: We could collect data from 39 simulated patients in the field study. The simulated patients’ information entered on the handwritten triage tag was quickly digitized and transmitted, and a chronologic list could be made. Assessment of the accuracy of the digitized data for each category was check box, 100.0%; numeric characters, 68.2%; and letter characters, 44.0%.
    Conclusions: This new triage system using digitized information entered via a digital pen has some problems with the recognition of letter and numeric characters. However, it almost exactly digitized the data, and it may be a useful device during disasters in the future.
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  • Toshiro Kimura, Tadaatsu Imaizumi, Tatsuya Yoshida, Taku Shimada, Ryo ...
    2019 Volume 69 Issue 1-4 Pages 86-94
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    Purpose: Retinoic acid-inducible gene-I(RIG-I)is a member of cytoplasmic viral sensors which plays an important role in inflammation of biliary epithelial cells(BECs). The aim of this study is to examine if RIG-I and C-X-C motif chemokine 10(CXCL10)are involved in the etiology of human biliary atresia(BA).
    Methods: Immunohistochemical study was performed on surgically resected tissues obtained(June 1994 to March 2016) from 30 infants with BA and non-inflamed hepatic tissues from 7 infants with hepatoblastoma. A semiquantitative scoring system was designed to evaluate the staining with an antibodies to the RIG-I and CXCL10. The expression of RIG-I and CXCL10 in HuCCT1 cholangiocarcinoma cell line were studied by western blotting, ELISA and RT-PCR analyses.
    Results: Intense immunoreactivity for RIG-I and CXCL10 was detected in BECs in tissues resected from BA patients. The expression of RIG-I and CXCL10 in the hilar tissue was significantly stronger than in the hepatic tissue. Transfection of HuCCT1 cells with poly(I:C), a synthetic analog of viral dsRNA, induced the expression of RIG-I, and knockdown of RIG-I inhibited the induction of CXCL10 in HuCCT1 cells transfected with poly(I:C).
    Conclusion: These results suggest that RIG-I-CXCL10 cascade may be involved in the etiology of human BA.
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  • Mayumi Sato
    2019 Volume 69 Issue 1-4 Pages 95-107
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    Aim: The purpose of this study was to develop a “questionnaire on involvement” for new graduate nurses, to measure the impact of support systems that the nurses recognized as helping them achieve socialization. The study also aimed to verify the questionnaire’s reliability and validity.
    Methods: Social learning theory was used as the conceptual framework to construct a draft questionnaire containing 42 items. After examining its content validity, the questionnaire was used as the basis of a paper-based survey for 999 new graduate nurses. The reliability and validity of the questionnaire were examined using Cronbach’s α coefficient, a factor analysis, and calculated correlations with the workplace social support scale and the burnout scale.
    Results: The data provided by 216 participants were analyzed (valid response rate: 76.1%). Based on the factor analysis results, the questionnaire was reconstructed; the final version consisted of 21 items associated with 3 factors. The Cronbach’s α coefficient for the 21 items as a whole was 0.93. The data showed a positive correlation with the workplace social support scale and a negative correlation with the burnout scale.
    Conclusion: The present study confirmed the reliability, construct validity, and criterion-related validity of the questionnaire on involvement described above. New graduate nurses recognize that involvement provides a support system that promotes socialization; the questionnaire has proven useful in measuring involvement.
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  • Rina Tanaka, Masashi Matsuzaka, Ippei Takahashi, Kaori Sawada, Shigeyu ...
    2019 Volume 69 Issue 1-4 Pages 108-118
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    It has been reported that an association between gut microbiota and obesity, and changes in the composition of gut microbiota have been reported with aging. The aim of this study is clarify the relationship between obesity and gut microbiota as a function of age. Furthermore, the impact of lifestyle factors(alcoholic drink and smoking) on gut microbiota were discussed. Fecal samples from 1082 healthy Japanese adults aged 19‒90 years who participated in the Iwaki Health Promotion Project in 2014 were analyzed by using 16S rDNA gene-targeted sequencing. The participants were stratified into six age groups: ≤39, 40‒49, 50‒59, 60‒69, 70‒79 and ≥ 80. The participants with a body mass index(BMI) of < 25 kg/m² were classified as non-obese, and those with a BMI of ≥ 25 kg/m² were classified as obese. Changes in the composition of gut microbiota with age were different between the obese and non-obese groups. Bacterial diversity decreased with age at the phylum level, however, this diversity was not observed at the class level. The abundances of certain gut microbiota, such as Bacteroidetes and Firmicutes, were different between the obese and non-obese groups. There were no significant differences in alcoholic and smoking habits. Bacterial diversity was different with age between the obese and non-obese group. The composition of Bacteroidetes and Firmicutes changed with increasing age in the obese group.
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  • Shuit Cavan, Akiyoshi Takami, Misato Makino, Manabu Iwata
    2019 Volume 69 Issue 1-4 Pages 119-123
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    Background: In hemiplegia cases having upper and lower extremity disorders, arm swing is seldom the priority of consideration. One of the reasons is that the purpose of arm swinging has not yet been clarified.
    Objective: To investigate the effect of arm swing on walking abilities of hemiplegia case.
    Method: 17 hemiplegia stroke patients participated in this study. The subjects performed a 10m walking test randomly with 4 different conditions of arm swing while the time, steps taken and pelvic fluctuation were measured. The 4 conditions were: 1) normal gait, 2) single arm restricted gait, 3) both arm restricted gait, and 4) maximum arm swing gait. The outcomes were analyzed by multiple comparison with a significance level of less than 5%.
    Results: There were no significant differences in gait parameters between the conditions of arm swing. Thus, the subjects were sorted based on their severity of hemiplegia (Brunnstrom recovery stage). In medium severity of hemiplegia cases (Brunnstrom stageⅢ-Ⅳ), the patients tended to, when swinging only the non-paralyzed arm have a greater velocity and step length. On the other hand, in low severity of hemiplegia cases (Brunnstrom stageⅤ), the patients showed the same tendencies as the healthy adults showed in a previous study.
    Conclusions: It may have an impact on walking abilities if stroke patients swing their non-hemiplegia side arm while wearing an arm sling but this needs further investigation.
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  • Takashi Mori, Yuki Soma, Kaori Sawada, Hitomi Komame, Itoyo Tokuda, Mi ...
    2019 Volume 69 Issue 1-4 Pages 124-135
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    Many studies conducted in Japan and abroad have reported decreased motor function in diabetes patients, but the relationship between glucose metabolism and motor function in patients without clinical diabetes has not been reported. We investigated the association between motor function and glucose metabolism-related items in the general population, excluding diabetes patients. We divided the subjects by sex into three age groups (youngage group: 20-49 years, middle-age group: 50-64 years, old-age group : ≥ 65 years). In the old-age group, glucose metabolism was related with balance ability in males; a relationship between balance ability, walking ability, and degree of locomotive syndrome was observed in females. In the middle-age group, glucose metabolism was related with balance ability in males; balance ability was related with walking ability in females. In the young-age group, a relationship between glucose metabolism and balance ability was observed only in males. Conversely, a significant association between muscular strength, flexibility, and glucose metabolism was not observed in any of the age groups. Our results suggest that even for individuals without clinical diabetes, implementing appropriate interventions, such as reexamining lifestyle habits and controlling blood glucose levels, can minimize motor function decline, resulting in fall prevention.
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  • Maiko Senoo, Hiroaki Yokoyama, Tomo Kato, Natsumi Kudo, Yoshikazu Yoko ...
    2019 Volume 69 Issue 1-4 Pages 136-145
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    Background: It remains uncertain whether snow shoveling has effects on long-term prognosis in patients with acute myocardial infarction(AMI).
    Patients/Methods: Consecutive 355 patients who underwent emergency percutaneous coronary intervention within 24 hours of the AMI onset during the winter months(November to March)between 2008 and 2014 years were retrospectively studied.
    Results: Of the 355 patients, 36(11%)had snow shoveling-related AMI, defined as the AMI onset during or within 6 hours after snow shoveling. These patients suffered fewer adverse cardiovascular events than the non-snow shoveling AMI patients during a median follow-up period of 3.8 years. Notably, snow shoveling did not affect the events for patients with left ventricular ejection fraction(LVEF) > 40% at the acute phase, but it was a significant better predictor of events for those with LVEF ≥ 40%.
    Conclusion: Snow shoveling may have important clinical implications for the AMI onset and the prognostic outcome in snowy areas.
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  • Noritomo Narita, Kenji Hanada, Maiko Senoo, Tomo Kato, Natsumi Kudo, Y ...
    2019 Volume 69 Issue 1-4 Pages 146-154
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    Background: Endothelin(ET)is a strong vasoconstrictor that plays important roles in the pathogenesis and progression of cardiovascular remodeling. ET receptor(ET-R)antagonists have recently become established as a drug essential for treating pulmonary arterial hypertension(PAH). β-arrestin was originally identified as a regulator of G-protein coupled receptor recycling, but it recently became apparent that β-arrestins act as scaffolds in their own signaling pathway. In this study, we examined the role of β-arrestin in ET-R signaling and explored its possible role in the pathogenesis of PAH.
    Methods and Results: The knockdown of β-arrestin1 or β-arrestin2 in human kidney embryonic 293 cells resulted in enhanced extracellular signal-regulated kinase(ERK)1/2 phosphorylation in response to ET. Confocal microscopy showed that, in the absence of stimulation, transiently transfected green fluorescent protein-tagged epidermal growth factor receptors(EGFRs)were located on the plasma membrane, whereas they were internalized in response to ET, as shown by their redistribution into cellular aggregates. Pretreatment with Ro318425(a protein kinase C inhibitor)or AG1478(an EGFR antagonist)suppressed ERK1/2 phosphorylation in response to ET.
    Conclusions: β-arrestins and EGFR transactivation are involved in ET-R signaling. These new insights may contribute to elucidating further layers in the pathogenesis of PAH.
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  • Daichi Ota, Tomoyuki Kudo, Jun Kawaguchi, Hidetomo Niwa, Kazuyoshi Hir ...
    2019 Volume 69 Issue 1-4 Pages 155-162
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    Background: We conducted a single-center retrospective study with propensity score matching to clarify which anesthetic agent, i.e., thiopental or propofol, provides better outcomes for newborns and women undergoing elective and/or urgent cesarean section with general anesthesia.
    Methods: We collected maternal and fetal data (n=935) using obstetric and anesthetic charts of cesarean sections with general anesthesia between 1994 and 2013. After 1:1 propensity score matching with maternal age, body mass index, gestational period, fetal weight, type of surgery, pre-eclampsia, and fetal/maternal indication, we compared thiopental to propofol (n=392) regarding the following outcomes. The fetal primary outcome was their well-being evaluated by Apgar score (APS). The maternal primary outcome was the patient's hemodynamic changes due to tracheal intubation or delivery.
    Results: The only APS at 1 min was significantly higher in the thiopental group. The other fetal outcomes such as APS at 5 minutes, the umbilical cord blood pH, and proportion of neonatal asphyxia after birth were similar between two groups. Regarding maternal outcomes, propofol significantly suppressed the increase in the patients' blood pressure from anesthetic induction to the delivery.
    Conclusions: Our results indicate that propofol induction may be a first choice for cesarean section with general anesthesia.
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  • Nahoko Tanaka, Hiroto Hiraga, Hirotake Sakuraba, Yasuhisa Murai, Takat ...
    2019 Volume 69 Issue 1-4 Pages 163-171
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    Vitamin A is essential for maintenance of homeostasis, and it also regulates various immune mechanisms.Listeria monocytogenes is a gram-positive bacillus that invades the cytoplasm of phagocytes and performs intracellular multiplication, and is often used as a tool for functional analysis of macrophages. In this study, we investigated the changes of macrophages under vitamin A deficiency(VAD)using L. monocytogenes. During L. monocytogenes infection, apoptosis was increased in CD11b-positive splenocytes of VAD mice compared with vitamin A sufficient(VAS) mice. A similar result was obtained with peritoneal exudate cells(PECs). Significant increase of apoptosis due to the administration of Ro41-5253, an inhibitor of retinoic acid receptor, was also observed in the macrophage cell line RAW264.7. Furthermore, in VAD mice, the number of bacteria in the spleens and livers was significantly increased. These results suggest that excessive apoptosis of macrophages occurs under VAD condition, leading to impaired host resistance to L. monocytogenes. Taken together, vitamin A contributes to the maintenance of homeostasis by regulating macrophage functions, indicating the importance of vitamin A supplementation.
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  • Yuki Mikuniya, Shinichi Goto, Akira Sasaki, Reiko Kudo, Kaori Sawada, ...
    2019 Volume 69 Issue 1-4 Pages 172-178
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    Background: The number of aging patients with dementia has been increasing in several countries, and a screening method for the early detection of dementia is needed. Objectives: The aim of this study was to evaluate a simple smell identification test for its ability to detect cognitive decline. Subjects and Methods: A total of 659 participants from the 2016 Iwaki Health Promotion Project aged ≧ 40 years were included. Participants underwent a smell identification test using three odorants, namely, India ink, Japanese cypress wood, and curry, out of the Odor Stick Identification Test for the Japanese (OSIT-J) and mini-mental state examination (MMSE) to examine their cognitive function. Results: In analysis of covariance, a statistically significant trend between the age and scores of the three odorants and between the scores of the three odorants and MMSE scores was observed. In multiple regression analysis, the MMSE scores significantly correlated with the scores of the simple smell identification test. From the viewpoint of sensitivity and positive likelihood, the values were not sufficient for screening. Conclusions: A simple smell identification test using three odorants might be useful for the early detection of dementia.
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  • Satomi Nakashima, Haruka Shimoyama, Hiroko Miyachi, Hiromi Moriyama, Y ...
    2019 Volume 69 Issue 1-4 Pages 179-186
    Published: March 15, 2019
    Released: May 31, 2019
    JOURNAL FREE ACCESS
    This study clarifies the age at which children can recognize for themselves the amount of food they have eaten. The participants were Japanese children aged three to five years and Japanese adults, and the food eaten was rice, a staple in Japanese diets. Participants used a food model to select the portion size closest to the amount that they felt they had eaten. The food model had nine portion options for adults and six for children. The difference between the portion amount selected from the food model and the amount actually consumed was measured to show the difference in perception. The visual validity of the food model and lack of significant visual differences from the actual food were confirmed, and no significant differences were found in perception of food amounts among adults or three groups of children. Therefore, it was suggested that children are able to recognize the amount they have eaten from around the age of three years old.
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Summaries
Scientific Achievement Award, Hirosaki University School of Medicine, 2017
Academic excellence awards
Academic encouragement awards
Abstracts of Meeting of Hirosaki Medical Society
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