Gender differences in the relationship between informal caregiving and subjective health: the mediating role of health promoting behaviors

Abstract Background In most of developed societies, the prevalence of informal care is on the rise due to rapid population ageing. This study investigates longitudinal associations between informal caregiving and health among caregivers and potential gender differences in this relationship. Moreover, drawing on the Health Promotion Model, this study examines the mediating role of health promoting behaviors in the link between informal caregiving and caregivers health. Methods Seven waves of a large-scale (N = 9,608), a nationally representative longitudinal study of middle- and old-aged adults in Korea between 2006 and 2018, were used. To address the possibility of omitted variable bias, this study employed ordinary least squares models with lagged dependent variables (OLS-LDV) as well as fixed effects (FE) models. Univariate Sobel-Goodman mediation tests were used. Results Findings from OLS-LDV models showed that transition into informal caregiving is negatively associated with health satisfaction and self-rated health. FE results also suggest that our results are robust to controlling for unobserved heterogeneity. In the model where informal caregiving is interacted with gender, we found that these associations were largely driven by women caregivers. Results from Sobel-Goodman tests revealed that a decrease in regular exercise partially explains the observed association between informal caregiving and subjective health outcomes (11% for health satisfaction and 8% for self-rated health). Conclusions Although informal caregiving can be a rewarding role, it poses a threat to caregivers subjective health. Findings of this hold important implications and provide evidence in support of a gender-conscious approach to improve the health and well-being of informal caregivers

Do caregivers’ involvement in Type 2 diabetes education affect patients’ health outcomes?: A systematic review and meta-analysis

Introduction: The prevalence of Type 2 diabetes mellitus (T2DM) is rising worldwide. Patients frequently struggle with controlling their diabetes and need the assistance of caregivers for effective self-management because managing diabetes requires a variety of strategies, including diet, glucose monitoring, and exercise. This study aimed to examine the effect of caregiver involvement in T2DM education within a community on patients’ diabetes care outcomes. Methods: Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review of all published studies from the earliest record to May 2022 that reported adult caregivers of T2DM patients who participated in educational interventions concerning diabetes management and that reported one or more outcomes of the interventions were conducted. Four databases were used, including PubMed, Cochrane Library, EMBASE, and CINAHL. The meta-analysis focused on glycated hemoglobin (HbA1c) levels among randomized controlled trials (RCTs), with additional attention to lipid levels. Review Manager 5.4 was used to perform this meta-analysis. Results: A total of 17 out of 683 studies were synthesized. Involvement of caregivers in T2DM education is shown to reduce body mass index and HbA1c. This involvement also improves patients’ knowledge, physical activity, and self-efficacy, but the effect on medication adherence varies. A meta-analysis of six RCT studies shows that caregiver involvement in T2DM education reduced pooled HbA1c levels by 0.83 (95% Confidence interval: −1.27–−0.38) compared to involvement (p = 0.0003). Meta-analysis of three types of lipids (low-density lipoprotein, total cholesterol, and high-density lipoprotein) showed no strong evidence that caregiver participation in diabetes education improved lipid levels. Conclusions: Caregivers play key roles in diabetes management and can contribute to improving patient HbA1c levels. Future research should focus on enhancing caregiver participation in T2DM education

「グローカル化」と農業補助金 : 日本と韓国における農業補助金体制の変化の比較

学位の種別: 課程博士審査委員会委員 : （主査）東京大学教授 古城 佳子, 東京大学教授 内山 融, 東京大学准教授 鹿毛 利枝子, 東京大学教授 木宮 正史, 政策大学院大学特別教授 恒川 惠市University of Tokyo(東京大学

Pedigree reconstruction and spatial analysis for genetic testing and selection in a Larix kaempferi (Lamb.) Carrière plantation

Larix kaempferi is one of the major timber species in Northeast Asia. Demand for the reforestation of the species is rising in South Korea due to an increase in large timber production and utilization. However, progeny trials for the species have not been explored, making it challenging to foster advanced generations of tree improvement. In the present study, genetic testing and selection for diameter growth were conducted using pedigree reconstruction and phenotypic spatial distribution analysis in a plantation of L. kaempferi. The aim of the present study was to select the superior larch individuals using the pedigree reconstruction and phenotypic spatial distribution to substitute progeny trials. The plantation of seed orchard crops was established in 1990 and one-hundred and eighty-eight trees were selected as the study material. Genetic variation was investigated first to validate its adequacy as breeding material. Genetic testing was carried out using a model considering pedigree information and spatial autoregression of the phenotypes. The expected heterozygosity of the mother trees and offspring were 0.672 and 0.681 presenting the corresponding level of genetic variation between two groups. The pedigree reconstruction using maternity analysis assigned one to six progenies to ninety-two candidate mothers. The accuracy of genetic testing was exceedingly increased with the animal model considering AR1 ⊗ AR1 structure compared to the animal model only. The estimated genetic variance of the former was 9.086 whereas that of the latter was 4.9E-5 for DBH. The predicted breeding values of the offspring for DBH were ranged from -5.937cm to 5.655cm and the estimated heritability of diameter growth was 0.344. The genetic testing approach based on pedigree reconstruction and phenotypic spatial distribution analysis was considered a useful analytical scheme that could replace or supplement progeny trials.K L and I-S K have a grant from the National Institute of Forest Science (NIFoS), Korea and K-S has a fnancial support (2020182B10-2022-BB01) from the Korea Forest Service

GPR-Based Landmine Detection and Identification Using Multiple Features

This paper presents a method to identify landmines in various burial conditions. A ground penetration radar is used to generate data set, which is then processed to reduce the ground effect and noise to obtain landmine signals. Principal components and Fourier coefficients of the landmine signals are computed, which are used as features of each landmine for detection and identification. A database is constructed based on the features of various types of landmines and the ground conditions, including the different levels of moisture and types of ground and the burial depths of the landmines. Detection and identification is performed by searching for features in the database. For a robust decision, the counting method and the Mahalanobis distance-based likelihood ratio test method are employed. Four landmines, different in size and material, are considered as examples that demonstrate the efficiency of the proposed method for detecting and identifying landmines

The associations between bone mineral density and cerebral white matter hyperintensity in elderly stroke patients

Purpose Osteoporosis is an important senile disease and has significant relationship with ischemic stroke and cerebral small vessel disease (SVD). Correlation between bone mineral density (BMD) and cerebral white matter hyperintensity on magnetic resonance imaging were analyzed to investigate the relationship between osteoporosis and cerebral SVD. Methods Medical records of acute stroke patients with age ≥ 65 years were retrospectively collected from single center. Cerebral white matter hyperintensity was classified into two categories, periventricular white matter hyperintensity (PWMH) and deep white matter hyperintensity (DWMH), and the severity was graded according to maximal lesion size. Association between the clinical factors including BMD and the severity of cerebral white matter hyperintensity was analyzed. Results Four hundred eight patients were included in the study. High severity grade of both MWMH and DWMH was independently correlated with low BMD. Additionally, high PWMH grade was correlated with old age and high serum homocysteine. High DWMH grade was correlated with old age, atrial fibrillation history and high serum total calcium. Conclusion Low BMD was associated with a high severity of cerebral white matter hyperintensity in elderly Asian stroke patients, independent of other clinical factors

Reduced radiation exposure to circulating blood cells in proton therapy compared with X-ray therapy in locally advanced lung cancer: Computational simulation based on circulating blood cells

BackgroundWe estimated the dose of circulating blood cells (CBCs) in patients with locally advanced non-small cell lung cancer for predicting severe radiation-induced lymphopenia (SRIL) and compared pencil-beam scanning proton therapy (PBSPT) and intensity-modulated (photon) radiotherapy (IMRT).Materials and methodsAfter reviewing 325 patients who received definitive chemoradiotherapy with PBSPT (n = 37) or IMRT (n = 164). SRIL was diagnosed when two or more events of an absolute lymphocyte count < 200 µL occurred during the treatment course. Dose information for the heart and lungs was utilized for the time-dependent computational dose calculation of CBCs.ResultsThe dose distribution of CBCs was significantly lesser in the PBSPT group than that in the IMRT group. Overall, 75 (37.3%) patients experienced SRIL during the treatment course; 72 and 3 patients were treated with IMRT and PBSPT, respectively. SRIL was associated with poor progression-free and overall survival outcomes. Upon incorporating the dose information of CBCs for predicting SRIL, CBC D90% > 2.6 GyE was associated with the development of SRIL with the baseline lymphocyte count and target volume. Furthermore, PBSPT significantly reduced the dose of CBC D90% (odds ratio = 0.11; p = 0.004) compared with IMRT.ConclusionThe results of this study demonstrate the significance of the dose distribution of CBCs in predicting SRIL. Furthermore, reducing the dose of CBCs after PBSPT minimized the risk of SRIL. Lymphocyte-sparing radiotherapy in PBSPT could improve outcomes, particularly in the setting of maintenance immunotherapy