During the 1960s, the concentrations of ambient sulfur dioxide (SO2) were extremely high in many industrial cities in Japan, and the prevalence of bronchial asthma and chronic bronchitis increased among residents living in the cities. To evaluate the effects of air pollution on respiratory diseases, many epidemiological studies were conducted, and the findings played an important role in the regulatory control of air pollution. After 1970, the concentration of SO2 has decreased markedly due to the control measures. On the other hand, the increasing automobile traffic in Japan has caused considerable increases in concentrations of air pollutants, such as nitrogen oxides (NOx) and particulate matter (PM). The large-scale epidemiological studies conducted in Japan showed that traffic-related air pollution was associated with the development of asthma in school children and the persistence of asthmatic symptoms in preschool children. In recent years, however, the concentrations of NOx and PM have gradually decreased, since control measures based on the Automobile NOx/PM law were enforced in 2001. At present, the adverse health effects of airborne fine particulate matter (PM2.5) and photochemical oxidants have become a major concern. These air pollutants consist of not only emissions from primary sources but also secondary formations in air, and have spread worldwide. Both short- and long-term exposure to these air pollutants are recognized to increase the risk of respiratory and cardiovascular diseases in the population. Therefore, global efforts are necessary to reduce the health risk of these air pollutants.
Attention-deficit/hyperactivity disorder (ADHD), just like autism, has attracted a considerable social interest not only during childhood and adolescence, but also during adulthood due to its serious concern at workplace. Etiology of ADHD is extremely complex and heterogeneous, including genetic factors, natural environmental factors, and psychosocial environmental factors. Although ADHD can be regarded as multifactorial congenital or early-infancy established developmental disorder into which all of these multiple factors are involved, the clinical features of ADHD are sometimes difficult to grasp due to mutual correlation of these etiological factors. In addition, ADHD is accompanied by a broad range of somatic and psychiatric comorbidities, which often lead patients to clinical setting for the first time. Furthermore, it should be noted that concept of ADHD has changed, being affected by social standard of value at each generation over time. Therefore, biological study within the single ‘category’ of ADHD may have some shortcomings, rather, it might be better to comprehend ADHD as ‘dimension’ of personal traits. In this review, these issues have been discussed from perspective of relationship between genetic and environmental etiological factors.
Objective : This paper aims to evaluate the necessity and possibility of a secondary prevention of COVID-19 by examing the latest findings of its pathology and preventative measures for the new infection.
Methods : Articles relevant to pathologies and measures against COVID-19 were chosen from the databases “Japanese Journal of Clinical Radiology” and “MEDLINE” with the keywords “COVID-19, immune system, treatment” on April 4, 2020.
Results : Thirty-two relevant articles were found on MEDLINE. These articles investigated the treatment of COVID-19 in the following three ways ; treatment focusing the pathology of COVID-19 and the cytokine storm mechanism, the management of the immunity system, and treatment with monoclonal antibody.
Discussion : The findings suggest that the essence of COVID-19’s pathology is the overreacton of the immune system and that it is possible to suppress the severity of COVID-19 symptoms even after the virus has entered the body. Thus, it is necessary to alert ourselves that we have an effective way of secondary prevention as a self-care that can be better by ourselves so as not to incite the social unrest.
This pilot study aimed to determine whether a chair yoga DVD programme could influence physical functions of older female adults in a “home for the aged with moderate fees” (hereinafter “care-house”). The study was a prospective, non-randomized comparative study conducted in a care-house in Chiba city, Japan. Twenty-two older female residents at a care-house were assigned to the chair yoga group (n＝11) and control group (n＝11). The chair yoga programme was recorded on a DVD so that the participants could practice the exercises by watching the video guide. The programme, which involved a weekly 30 minute chair yoga session, was conducted for a period of four weeks. Physical performance was evaluated on the basis of body weight, body mass index (BMI), flexibility, grip strength, and walking-stride length. Pulse and systolic and diastolic blood pressure values were also evaluated as outcome measures.
A two-way repeated measures ANOVA was used to analyse the pre-post intervention differences within and between the control group and intervention of groups. There was an interaction in body weight [F (1, 20) 7.080, p＝0.015] and BMI [F (1, 20)＝6.567, p＝0.019]. There was an effect of body weight and BMI with time (pre-post intervention) for the control group. There was a significant increase in body weight and BMI during the intervention period in the control group, but there was no change in the intervention group. No other significant interactions were observed for other measures. No adverse effects were observed.
Due to the small sample size, no definite conclusion regarding the effects of chair yoga on physical performance could be made, although the results of this study suggest the feasibility, safety, acceptability, and low cost burden of a chair yoga programme DVD in a care-house or any other residential nursing care facility in Japan.
Background : Addressing the needs of the aging population is a common challenge for developed countries. In Japan, there were no observational studies on changes in life expectancy for community-dwelling seniors. We conducted two surveys for older individuals over a 7-year period in a village to examine various factors that influence life expectancy in seniors. Interestingly, the male seniors older than 81 years who were independent in their Activities of Daily Living (ADLs), had the shortest life span. Given this, we compared scores of ADL and Quality of Life (QOL) between first-stage (65-81 years old) and the second-stage (older than 81 years) seniors to clarify the differences between the two groups.
Methods and Findings : We conducted a lifestyle survey with all residents of village Y, aged 6 years or over, in 2007. In 2014, we repeated the survey and examined outcomes at baseline for participants aged 65 years or older. We used a classification tree with four outcomes to examine factors influencing life expectancy. Our dependent variables were survival, and periods of death ; our independent variables were scores on measures of ADLs, QOL, cognitive function, malnutrition risk, and socioeconomic factors. Regarding the comparison between the first-stage and second-stage seniors, we calculated correlation coefficients for life expectancy (4 groups) and for each ADL item score and QOL item. Furthermore, correlation coefficients of male seniors in the first stage group were compared with those in the second stage. Similar inter-group comparison was conducted for females in the two groups. For first-stage male seniors, there was a positive correlation between life expectancy and each ADL item score, whereas for the second-stage seniors there were negative correlation coefficients for each QOL item, excluding pain and mental QOL (0.27). For the first-stage female seniors, life expectancy was not significantly correlated with ADL and QOL. Instead, the ADL items exhibited greater positive correlation coefficients for female participants in the second stage than those in the first stage. For the second-stage male seniors who lost their social roles, mental QOL may be related to life expectancy.
Conclusions : There were qualitative differences in the relationship between ADLs, QOL and life expectancy in both senior men and women over 81 years of age in a rural, mountainous, village in Japan.
This study aimed to clarify the long-term impact of the Noto Peninsula Earthquake by investigating mental health and functioning of older adults residing in Wajima City 11 years after it.
The survey used the Impact of Event Scale-Revised (IES-R), Ten-Item Personality Inventory (TIPI-J), Adolescent Resilience Scale (ARS), and Disuse Syndrome Checklist, in addition to investigating basic attributes of adults aged 65 years or older.
As the results, 1) older adults who do not live with their family had a significantly higher overall score on the IES-R and all subscale scores than those who live with their family. Of the physically active subjects, those who do not live with their family had a significantly higher overall score on the IES-R and subscale score for “avoidance” and “hyperarousal” symptoms. 2) Subjects who are conscientious and have no one to discuss their problems with even though they scored 24 points or less on the IES-R are at a risk of developing mental health disorders, such as PTSD. 3) Older adults whose house was totally destroyed or severely damaged by the disaster and those who used temporary housing after the disaster had a significantly higher overall score on the IES-R and subscale score for “intrusion” symptoms. 4) The results suggest a correlation between disuse syndrome and the IES-R, as well as the interaction between mental symptoms and a decline in activities of daily living.
The survey results revealed that there are still some older adults who have mental symptoms even though 11 years have passed since the disaster. For those who are “older adults”, “live on their own”, whose “house was damaged”, and “have no one to discuss their problems with”, it is necessary to examine ways to promote mutual support within a limited community network during non-disaster times. After a disaster, immediate and long-term support is important, facilitated by collaboration among public administration, local governments, healthcare institutions, and welfare organizations.
In the present study, the healthcare support services provided by the nursing professionals to the examinees in comprehensive medical examination were discussed. A total of 40 persons who received members-only comprehensive medical examination and 2 relevant nursing professionals were asked to evaluate the status of provision of each selected service. Both parties recognized the provision of and placed greater importance on the following services : “the introduction of medical doctors other than consultants or cooperative physicians,” “discussion regarding hospitals introduced to examinees,” “taking into consideration examinees’ requests for hospitals introduced to them,” “the utilization of health consultation over telephone,” and “explanation using brochures.”
The healthcare support services expected to be provided by nursing professionals in the comprehensive medical examination are as follows : (1) helping the examinees receive effective and efficient examination by supplementing the physicians’ explanation and coordinating the examinees’ behaviors regarding receiving examination and (2) helping the examinees take better health-promoting actions by encouraging them to utilize health consultation over the telephone as appropriate and using brochures to provide additional information to supplement the physicians’ explanation. The examinees occasionally do not recognize telephone-aided health consultation as a healthcare support. However, if the nursing professionals instruct the examinees in advance to take notes on the important points of their consultation, then the relevant information may be clearly communicated to the examinees, thus improving the effectiveness of the telephone consultation and increasing its recognition as a healthcare support. These study results indicated that under the circumstances in which knowledge regarding health behavior has recently become more advanced and complicated, the nursing professionals may provide effective healthcare support through (1) having good prior understanding about the health information of the examinees, (2) being with the examinees when the physicians provide them with explanation, and (3) establishing good relation with the examinees through repeated support in face-to-face meetings, all of which make continued advice and guidance effective.
This study was designed to evaluate the relationship between defensive pessimism and work-related stress, which is focused on mental health in the workplace, among female hospital nurses in a private general hospital. A self-administered questionnaire survey on the related determinants was performed among 318 female nurses with the occupational career of one year or more (age : 35.4±10.9 years). The subjects were divided into three sub-groups based on the defensive pessimism scale : defensive pessimist (DP) group, 50 points or above ; strategic optimist (SO) group, less than 30 points ; and indefinable group, 30-49 points. Score of burn out was the highest in the DP group and the lowest in the SO group (p<0.01). Score of qualitative job overload in the DP group was significantly higher than that in the SO group (p<0.05). Scores of “anxiety” and “depression” were the highest in the DP group and the lowest in the SO group (p<0.01 or p<0.05). Scores of support from “physicians” and “medical care professionals except physicians” in the DP group were significantly lower than those in the SO group (p<0.01 or p<0.05). There were no significant differences in any of the scores of work-engagement or job-crafting among the DP group and the SO group. From these results, it is possible that work-related stress in the DP group might be higher than that in the SO group.
Excess intake of inorganic phosphate is concerning due to increasing consumption of processed food products, in which it is used as an additive. Inorganic phosphate is found in the form of orthophosphate or polyphosphate salts. Previous studies suggest that diets containing high tripolyphosphate salts, as compared to diets containing high phosphate salts, are associated with elevated levels of phosphorus (P) and calcium (Ca) as well as calcification of the kidney. However, no studies have been conducted on the effects of tripolyphosphate salts on P and Ca balance in rats fed diets differing in P content. In this study, we investigated the impact of dietary sodium tripolyphosphate concentration on mineral balance, expression of mineral transporters, and kidney function in rats. Male Wistar rats (4 weeks old) were divided into five groups and fed diets containing 0.3, 0.6, 0.9, 1.2, or 1.5% P in the form of sodium tripolyphosphate for 3 weeks. Weight, P and Ca contents, and calcification levels of kidney tissue were significantly higher in rats fed 1.2 or 1.5% P diets than in those fed 0.3 or 0.6% P diets. In addition, urinary N-acetyl-β-D-glucosaminidase activity and serum creatinine levels were also significantly higher in the former. Compared to rats fed 0.3, 0.6, or 0.9% P diets, rats fed 1.2% or 1.5% P diets exhibited increased levels of P in excreted urine and reduced expression of the renal sodium-dependent phosphate transporters, Slc34a1 and Slc34a3. Taken together, these results suggest that diets containing 1.2 and 1.5% P in the form of sodium tripolyphosphate have potentially adverse effects on phosphorus homeostasis in rats.
We conducted a questionnaire survey with 704 medical students with the aim of examining the reliability and validity of a learning motivation scale for medical students, modified from the learning motivation scale created for nursing students. The questionnaire consisted of questions about the learning motivation scale for medical students, the apathy scale, and respondents’ characteristics. The survey was conducted from April to August 2016. In this study, we examined the internal consistency factor for testing reliability, and criteria-related and conceptual validity factors for testing validity.
We received responses from 480 medical students (Recovery rate 68.2%). The Cronbach’s alpha of the learning motivation scale was 0.912. The Cronbach’s alpha of obtained subscales were as follows : α=0.844 for understanding the current situation of learning, α=0.847 for positive feelings about medicine, α=0.826 for autonomous learning behavior, and α=0.855 for confidence resultant from the interaction with friends. It can be inferred from exploratory factor and confirmatory factor analyses that these four factors obtained were exactly the same in terms of questions and number of items as in the Faculty of Nursing. Since the obtained model had GFI=0.876, AGFI=0.845 and RMSEA=0.070, it can be considered to be highly effective. The correlation between the learning motivation scale score and the apathy scale score was r=－0.255. These results suggest that the learning motivation scale for medical students has high internal consistency and validity.
The use of Kelly pads is a less physical burden for hair shampooing in a supine position on a bed, but it is not clear how much flexion of the knee joint is comfortable for the subject. To clarify the appropriate posture for assisting hair shampooing in the supine position using the Kelly pad, the comfortable hip and knee flexion angles were examined for 51 healthy elderly people. In addition, the relationship between the angles and height, weight, BMI, body fat percentage, thigh length, or lower leg length was also examined.
1) The flexion angle of the hip joint, which felt comfortable, was 34.7±9.6 degrees, and the flexion angle of the knee joint was 73.2±20.1 degrees.
2) There was a positive correlation (r=0.907) between the flexion angles of the hip and knee joints, which felt comfortable, and the flexion angle of the knee joint was 2.1±0.3 times the flexion angle of the hip joint.
3) Hip and knee flexion angles were not associated with sex, age, height, weight, BMI, body fat percentage, or lower leg length.
4) The thigh length high value group showed a significantly (p<0.05) smaller hip flexion angle than the low value group.
These results can be used to determine the flexion angles of the hip and knee joints when assisting hair shampooing in the supine position using the Kelly pad.
The study’s aim was to examine the influence of implementing a medical insurance policy wherein visiting nursing professionals could provide medical care to schools.
The implementation of a medical care policy in a school was reviewed based on reading of the Diet minutes; and details of the considerations relating to social background and medical care were deliberated upon.
A legal revision whereby schools could use visiting nursing professionals for implementation of medical care was proposed, but not approved. According to our estimates, even if medical care insurance benefits are expanded by providing visiting nursing professionals’ assistance to locations other than homes, there will be no significant impact on national medical expenses.
We believe that if medical insurance permits use of visiting nursing professionals at other locations, in addition to homes, it will expand the range of choices pertaining to school attendance and medical care providers, and thereby improve the quality of life of children and families needing medical care.