Dietary counseling for hyperuricemia

In Japan, hyperuricemia is on the rise. The guideline for the management of hyperuricemia and gout recommends lifestyle changes before beginning drug therapy. This study aimed to evaluate the effectiveness of dietary counseling following the guideline. Thirty-three subjects (24 men and 9 women) with asymptomatic hyperuricemia underwent dietary counseling for 6 months based on the following recommendations : (1) prevent excessive purine intake, (2) prevent excessive fructose intake, (3) limit alcohol drinking, and (4) drink sufficient water. Obese subjects were counseled on adequate energy intake. Blood sampling, anthropometric measurements, dietary surveys, and 24-h urine collection were performed at baseline and at 6 months. Serum uric acid (S-UA) levels were significantly lower at 6 months compared to baseline. Water intake and urine volume were considerably higher at 6 months than at baseline. When compared to baseline, urine UA (U-UA) levels were significantly lower, and renal fractional excretion of UA (FEUA) was significantly higher at 6 months. Changes in renal function (serum creatinine, estimated glomerular filtration rate, and FEUA) were significantly associated with ΔS-UA level. In this study, S-UA level was significantly decreased by dietary counseling in line with the guideline. This study illustrates the effectiveness of dietary counseling for asymptomatic hyperuricemia

ザイタク デ ショウガイシャ ヲ カイゴ スル コウレイ ノ カイゴシャ ニ カカワル セイカツ カイゴ ジギョウショ ショクイン ニ オケル アドバンス ケア プランニング ニンチド ト ソノ カンレン ヨウイン オウダンテキ ケンキュウ

原著論文Original Articles目的：在宅で障がい者を介護する高齢の介護者に関わる生活介護事業所職員におけるアドバンスケアプランニング（ACP）の認知度とその関連要因を調査した。方法：2022年8～10月に無記名郵送で、生活介護事業所職員を対象として調査した。従属変数は、ACPの認知の有無、独立変数は管理者か否か、年齢、性別、資格、ACP 教育・研修の有無等とした。単変量解析でP < 0.05 の有意差であった12変数に対して、ロジスティック回帰分析を行った。結果: 調査票を486事業所1,500名の対象者に配布し、69事業所141名から回収（回答率 9.4%）した。職員全体で12.1%、施設管理者が16.1%、資格別では、介護福祉士13.6%、社会福祉士17.9%、精神保健福祉士38.5%、看護師20.0%がACPを認知していた。認知度の関連要因は「精神保健福祉士の資格」（OR 7.8）「親亡き後の不安を把握」（OR 14.9）等であった。結論: 先行研究では、ACP認知度は7%で、本研究で、やや改善していたが、まだ低い状態であり、啓発が必要である。ACPを知っている職員は、管理職・医療・福祉の有資格者で、高齢の介護者に寄り添い、親亡き後の不安を把握していた。今後は、高齢の介護者支援でACPを活用する必要がある。Introduction: In Japan, support for advanced care planning (ACP) for families, including older caregivers and people with disabilities, is important. After the death of caregivers, ongoing support for decision-making for the remaining family and the socially vulnerable with unmet needs is lacking. Welfare facility staff, the cornerstone of social networks, can play a role in promoting ACP for families. Objective: A study aimed to measure awareness of ACP by administering a survey to welfare facility employees. Methods: An anonymous survey was conducted at 486 welfare facilities from August-October 2022 through the cooperation of employees. The survey investigated factors related to awareness of ACP and ACP training for support staff. Participants included managers and persons in charge of disability welfare offices, Results: The survey was distributed to 1,500 participants. One hundred forty-one responses were obtained (9.4% response rate). Of the participants, 12.1% answered that they knew about ACP; among care workers, 13.6%, social care workers, 17.9%, mental health social workers, 38.5%, and nurses, 20.0%. Factors of ACP awareness are, e.g. qualified as a mental health social worker Odds ratio (OR) 7.8, I understand the anxiety after the death of a parent OR 14.9 Conclusion: The ACP recognition rate of the participants was 7% in 2020. Thus, recognition has slightly increased. However, the overall rate remains low and must be improved. Improving the low recognition rate, analyzing the factors, and spreading are necessary. Further, we should promote better

SALON: Simplified Sensing System for Activity of Daily Living in Ordinary Home

As aging populations continue to grow, primarily in developed countries, there are increasing demands for the system that monitors the activities of elderly people while continuing to allow them to pursue their individual, healthy, and independent lifestyles. Therefore, it is required to develop the activity of daily living (ADL) sensing systems that are based on high-performance sensors and information technologies. However, most of the systems that have been proposed to date have only been investigated and/or evaluated in experimental environments. When considering the spread of such systems to typical homes inhabited by elderly people, it is clear that such sensing systems will need to meet the following five requirements: (1) be inexpensive; (2) provide robustness; (3) protect privacy; (4) be maintenance-free; and, (5) work with a simple user interface. In this paper, we propose a novel senior-friendly ADL sensing system that can fulfill these requirements. More specifically, we achieve an easy collection of ADL data from elderly people while using a proposed system that consists of a small number of inexpensive energy harvesting sensors and simple annotation buttons, without the need for privacy-invasive cameras or microphones. In order to evaluate the practicality of our proposed system, we installed it in ten typical homes with elderly residents and collected the ADL data over a two-month period. We then visualized the collected data and performed activity recognition using a long short-term memory (LSTM) model. From the collected results, we confirmed that our proposed system, which is inexpensive and non-invasive, can correctly collect resident ADL data and could recognize activities from the collected data with a high recall rate of 72.3% on average. This result shows a high potential of our proposed system for application to services for elderly people

Serotonergic modulation of nicotine-induced kinetic tremor in mice

We previously demonstrated that nicotine elicited kinetic tremor by elevating the neural activity of the inferior olive via α7 nicotinic acetylcholine (nACh) receptors. Since α7 nACh receptors reportedly facilitate synaptic monoamine release, we explored the role of 5-HT receptors in induction and/or modulation of nicotine tremor. Treatment of mice with nicotine induced kinetic tremor that normally appeared during movement. The 5-HT1A agonist, 8-hydroxydipropylaminotetraline (8-OH-DPAT), significantly enhanced nicotine-induced tremor and the action of 8-OH-DPAT was antagonized by WAY-100135 (5-HT1A antagonist). In addition, the cerebral 5-HT depletion by repeated treatment with p-chlorophenylalanine did not reduce, but rather potentiated the facilitatory effects of 8-OH-DPAT. In contrast, the 5-HT2 agonist, 2,5-dimethoxy-4-iodoamphetamine (DOI), significantly attenuated nicotine tremor, which was antagonized by ritanserin (5-HT2 antagonist). The 5-HT3 agonist SR-57227 did not affect nicotine-induced tremor. Furthermore, when testing the direct actions of 5-HT antagonists, nicotine tremor was inhibited by WAY-100135, but was unaffected by ritanserin, ondansetron (5-HT3 antagonist) or SB-258585 (5-HT6 antagonist). These results suggest that postsynaptic 5-HT1A receptors are involved in induction of nicotine tremor mediated by α7 nACh receptors. In addition, 5-HT2 receptors have an inhibitory modulatory role in induction of nicotine tremor