Current issues in dementia and dementia care in East Asia

Current issues in dementia and dementia care in East Asi

日本語版クリティカルシンキング気質スケールの改良

金沢大学医学部米国哲学協会がデルファイ法で、クリティカルシンキングに必要な7つの気質(資質)を抽出し、これらの気質を測定するため米国のFacione博士等がCalifornia Critical Thinking Dispositions Inventory (CCTDI)を開発した。牧本等は日本語版CCTDIを作成し、平成9年度に16の看護系大学で実施した日本語版CCTDIの予備テストを実施した。その結果下位尺度の「CT自己自身」と「探究心」は信頼係数が高く使用可能であったが、その他の下位尺度の信頼係数、特に「真実の追究」と「偏見のない見方」の改善が必要であった。改良の問題点としては、答えにばらつきが少なく質問項目間の相関が少ないことや、日本の文化になじみのない質問も含まれていた。そこで平成10年8月に8大学から10名の教官が参加して、気質スケール改良について討議した。まず75の質問項目を下位尺度別に並び替え、信頼係数の低い下位尺度を中心に日本人の学生の文化や生活に近い表現に置き換えるようにした。例えば項目29番\u27銀行は貯金通帳の記載をもっと分かりやすくすべきです\u27という内容を\u27クレジットカードや携帯電話の使用明細書は、もっと分かりやすくすべきです\u27に変更した。米国の研究グループが、改訂版と英語版との一致性をチェックした。改訂版を看護系と工学系の2つの大学で実施し、下位尺度の点数や信頼係数を比較した。「真実の追究」と「偏見のない見方」の信頼係数は改善したが、係数は0.4から0.6でスケールとして使うには低かった。異なる地域における異なる専攻の学生を比較したが、下位尺度の平均点や信頼係数は殆ど変わらなかった。このスケールの開発された米国と日本とは、分化や教育制度が大きく異なり、これ以上改良することは困難であることが示唆された。研究課題/領域番号:10877399, 研究期間(年度):1998 – 1999出典：研究課題「日本語版クリティカルシンキング気質スケールの改良」課題番号10877399（KAKEN：科学研究費助成事業データベース（国立情報学研究所）） （https://kaken.nii.ac.jp/ja/grant/KAKENHI-PROJECT-10877399/）を加工して作

The impact of sleep on ambulatory blood pressure of female caregivers providing home care in Japan: An observational study

金沢大学医薬保健研究域保健学系Background: Elderly family caregivers are presumed to be susceptible to having various health problems. However, biomedical indicators of health in these caregivers are rarely examined. Objective: To examine the effect of sleep quality, measured by hours of sleep and the number of times leaving bed, on various blood pressure parameters in elderly caregivers. Design: Observational study. Setting: Northern Japan. Participants: Seventy-eight female family caregivers. Methods: Ambulatory blood pressure was monitored at 30-60-min intervals for a 24-h period. An actigraph was used to determine sleep/wake status. Face-to-face interviews were conducted to obtain home care and demographic information, and self-administered questionnaires were used to collect information on activities in a 24-h period. Results: The mean age of the caregivers was 62.5 ± 9.6 years, and the mean hours of sleep were 7.3. Out of 78 caregivers, 19 were on antihypertensive medication. Of the remaining 59, this study found 45.8% to be hypertensive, with the mean maximum systolic pressure exceeding 180 mmHg. The hours of sleep at night and for the 24-h period were inversely associated with the mean systolic blood pressure. The majority of caregivers on antihypertensive medication also had high blood pressure. Conclusions: This study suggests the importance of 24-h ambulatory blood pressure monitoring for elderly caregivers, so as to screen for hypertension as well as to monitor the effectiveness of antihypertensive medication. © 2008 Elsevier Ltd. All rights reserved.This article has not been published yet

自発的ドック受診者群と企業健診受診者群の脳MRIにおけるT2高信号域個数の比較

he purpose of this study was to evaluate the difference in T2-elongated spots (T2ES) between self-referred and third party-referred subjects.The brain MRI studies of 814 healthy adults were assessed. The subjects were categorized into two groups. Group A included 312 self-referred subjects ranging in age from 49 to 65 years (mean age, 56.5 years). Group B included 502 third party-referred subjects same ranging in age (mean age, 54.3 years). All subjects were asked to complete an interview sheet dealing with current and past diseases. To compare the two groups, an ‘Age-related Grading System\u27 was created.Grade 4 was defined as including patients who had 10 to 14 more T2ESs than their age minus 49; 20.027771275620f Group B and 13.51111400240f Group A (P<0.05) were classified as Grade 4. Diabetes mellitus was present in 15.016010062550f Group A and 9.615734071165f Group B (P<0.05). Hyperlipidemia was present in 18.015710062563f Group A and 9.015035020146f Group B (P<0.01).Although diabetes mellitus and hyperlipidemia were more common in Group A, these diseases were considered to be well controlled. It would appear that the patients in Group A were more health conscious than those in Group B

Epidemiology of perinatal mortality: Birthweight, crown-heel length, gestational age, and weight-for-height

Studies suggest that slim infants (low weight-for-height) experienced higher mortality rates than average or high weight-for-height infants (Miller and Hassanein, 1973; Hoffman, Meirik, and Bakketeig, 1984). In this study, the 1980 National Natality Survey and the National Fetal Mortality Survey were used to examine the association of weight, height and perinatal mortality. All singleton births to white married mothers, between 18 and 34 years of age and of parity less than 4, for whom both mother\u27s and hospital questionnaires were completed in those two surveys (3796 live births and 2043 fetal deaths) were selected for analysis. Overall, low weight and height infants had excess mortality rates. However, after adjustment for low birthweight and preterm birth status, low weight and height infants had only slightly higher mortality rates than their medium or high weight and height counterparts. The current study consists of relatively well-educated white married mothers of optimal reproductive age and low parity. Therefore, lower than expected mortality rates for slim infants may be attributed to these favorable demographic factors in this sample as compared with previous studies, or because of advances in perinatal medicine, slim infants may be prevented from achieving the high mortality seen in earlier studies

Impact of breastfeeding and/or bottle-feeding on surgical wound dehiscence after cleft lip repair in infants: A systematic review

Immediately after cleft lip repair, breastfeeding and bottle-feeding are generally restricted to avoid placing tension on the surgical incision. However, no consensus about feeding methods after cleft lip repair has been reached. The objective of this systematic review was to examine the impact of breastfeeding and/or bottle-feeding on surgical wound dehiscence after cleft lip repair in infants.We searched PubMed, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Mednar from October to November 2017. Two reviewers independently assessed eligibility for inclusion and checked critical appraisal of the study quality.Three randomized controlled trials and two cohort studies involving 342 infants were included in this review. Two cases of surgical wound dehiscence occurred in the control group of alternative feeding. In three of five studies, surgical wound dehiscence did not occur in either the intervention or control group within the first week postoperatively.This review showed no increased risk of surgical wound dehiscence in infants with breastfeeding and/or bottle-feeding after cleft lip repair compared with infants with alternative feeding methods. It may not be necessary to restrict breastfeeding and/or bottle-feeding immediately after cleft lip repair.Immediately after cleft lip repair, breastfeeding and bottle-feeding are generally restricted to avoid placing tension on the surgical incision. However, no consensus about feeding methods after cleft lip repair has been reached. The objective of this systematic review was to examine the impact of breastfeeding and/or bottle-feeding on surgical wound dehiscence after cleft lip repair in infants.We searched PubMed, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Mednar from October to November 2017. Two reviewers independently assessed eligibility for inclusion and checked critical appraisal of the study quality.Three randomized controlled trials and two cohort studies involving 342 infants were included in this review. Two cases of surgical wound dehiscence occurred in the control group of alternative feeding. In three of five studies, surgical wound dehiscence did not occur in either the intervention or control group within the first week postoperatively.This review showed no increased risk of surgical wound dehiscence in infants with breastfeeding and/or bottle-feeding after cleft lip repair compared with infants with alternative feeding methods. It may not be necessary to restrict breastfeeding and/or bottle-feeding immediately after cleft lip repair