Factors Affecting Home Care of Elders Report 1. Support Expected by the Elderly and Family

For the rapid increase of the elders in population in Japan after the 2nd world war, the arrangement of medical care for aged persons, both therapeutic and preventive, has become the serious social problem. To estimate the possibility of care at home and needs of elders and their family for public and volunteer services, questionnaire survey was carried out at Konko town in Okayama prefecture, Japan, in August 1990. More than half of the 105 elders older than 65 years and living alone (group A, 9 males and 96 females) replied to want to be cared for at home and 178 families with elders (group B) wanted to care for them at home. As for services they would wish to be offered when they would become bedridden at home, while group A wished to be visited and cared for by 'physician', 'home helper' and 'neighbor' in order of high rate group B 'physician', 'public health nurse' and 'nurse'. As for facility or assistance services, the former wanted 'purchasing, sweeping and washing', food delivery' and 'calling on' and the latter 'care consultation', 'assist of body bath' and 'economic aid'. Other supports or cares were also hopefully expected by both groups. The results shows that well-arrangement and promotion of a variety of constitional and personal support for home cares for elders in the community must be urged

Needle and syringe sharing practices of injecting drug users participating in an outreach HIV prevention program in Tehran, Iran: A cross-sectional study

HIV infection rates have reached epidemic proportions amongst injecting drug users (IDUs) in Iran. Although a number of community-based interventions have being implemented in the country, there is little information on the risk behaviors of IDU participants in these programs. This cross-sectional report aimed to compare the risk behaviors of injecting drug users with differential exposure rates to an HIV outreach program in Tehran, Iran. Results indicated that shared use of needle/syringe in the past month was significantly lower among IDUs who received estimated ≥ 7 syringes per week than those who did not [adjusted odds ratio (OR) = 14.36, 95% confidence interval (CI) 2.30–89.56]. While the effectiveness of this outreach program needs further evaluation through a longitudinal investigation, our preliminary findings suggest that the outreach program in Tehran may have been beneficial in reducing direct sharing among those who received more than several needles/syringes from the program

Parkinson\u27s disease showing progressive conduction aphasia

Patients with Parkinson\u27s disease (PD) may develop progressive dementia late in their clinical course. Dementia in PD is mostly related to neuropathological findings of extensive Lewy bodies (LBs), with or without the coexistence of Alzheimer\u27s disease (AD) pathology. Aphasia has been reported in patients with LB diseases with AD pathology; however, there have been no reports of typical PD patients developing progressive aphasia during their clinical course. We describe a female PD patient who later developed progressive conduction aphasia characterized by phonemic paraphasia and disturbance in repetition of short sentences without disturbance in writing or auditory comprehension. No episodes of fluctuations of attention, memory complaints, or planning errors were observed. She experienced episodes of visual hallucination. Her low scores on the Mini-Mental State Examination suggested impairment of orientation and attention, and her scores on Raven\u27s Coloured Progressive Matrices test indicated impaired visuospatial functions. However, her cognitive deficits were not sufficiently severe to impair her daily life. Brain magnetic resonance images revealed atrophy of the left superior temporal gyrus and widening of the left sylvian fissure. [18F]-fluorodeoxyglucose positron emission tomography revealed glucose hypometabolism in the left cerebral hemisphere. These findings may be related to conduction aphasia. During the progression of PD lesions, the brainstem LB is assumed to take an upward course, extend to the limbic system, and then extend to the neocortex. Conduction aphasia observed in our patient may be associated with an unusual progression of the LB pathology from the brainstem to the left temporoparietal lobe. © 2011 Springer-Verlag

Discrepancies between pathological examination and imaging analysis after primary systemic chemotherapy for breast cancer: report of two cases

Primary systemic chemotherapy (PSC) in breast cancer prolongs disease-free survival in patients who have obtained pathological complete remission (pCR). In combination with pathological examination, CT and MRI have been used to evaluate the efficacy of PSC, they generally coincide well with pathological evaluation. We here present two cases showing discrepancies between pathological examination and imaging analysis after PSC in breast cancer. We should keep such discrepancies in mind to determine the ideal treatment after PSC. An accurate method of evaluating cellular damage by PSC is needed

看護学生のがん患者に対するイメージと影響する背景 : 大学生と養成校生のアンケート調査

看護学生のがん患者に対するイメージと影響する背景を明らかにする目的で、平成19年度に在学中の看護大学生と3年制看護師養成学校生、計134名を対象として、がん看護に関する経験や関心とがん患者のイメージを解析した。さらに、教育進度の違う学年間で検討し以下の結果を得た。1. 学生の7割はがん患者の看護や介護の経験がなく、学生の8割はがん看護への関心があると答えていた。2. がん患者のイメージは、否定的であると答えた項目が15項目中8項目であった。2年生の否定的項目は1年生よりも4項目多かった。3. イメージ合計点は、2年生が有意に低く否定的イメージを持っていた。以上のことから、学生ががん患者に否定的イメージを持っていると患者とのかかわりに悩みや葛藤、戸惑いを生ずると予想された。そのため、肯定的イメージに変化する知識教授内容の検討、臨地実習で苦悩する学生を察知し、主体的に患者と関われる様に支え、指導していくことが重要である。In order to clarify perceptions of cancer patients among nursing students and to better understand how such perceptions are shaped, we surveyed 134 nursing students enrolled in either a 3-year nursing school or a 4-year university program and compared the images of cancer patients held by students with their interest and past experience in cancer care. Results, as follow, were tabulated and compared between cohorts grouped by year. 1.70% of students had no prior experience with cancer patient care while 80% of students expressed an interest incancer nursing. 2)The perception of cancer patients was negative in 8 out of 15 items. Second-year students responded negatively tofour more items than did first-year students. 3)Overall, second-year students had a significantly negative image of cancer patients. If students view cancer patients negatively, it can be expected to give rise to uncertainty, confusion and conflict in their relations with patients. Therefore it is important for teachers to re-evaluate awareness education practices so that they contribute to the formation of more positive images, to be more sensitive to signs of distress from students during their nursing practicums, and to support students in their efforts to relate more independently with patients

Hypertension, its correlates and differences in access to healthcare services by gender among rural Zambian residents: a cross-sectional study

[Objectives] To examine the prevalence of hypertension and access to related healthcare services among rural residents of Mumbwa district in Zambia. [Design] Cross-sectional study with probability cluster sampling. [Setting] Rural Zambia. [Participants] We recruited 690 residents from Mumbwa district aged 25–64 years who had been living in the study area for ≥6 months and had adopted the lifestyle of the study area. Pregnant women and women who had given birth in the past 6 months were excluded. The data collection—questionnaire survey and anthropometric and biological measurements—was conducted between May and July 2016. [Results] In the overall sample, 39.7% and 33.5% of the men and women had hypertension (systolic blood pressure (BP)≥140 or diastolic BP ≥90 mm Hg), respectively. Among the participants without a previous diagnosis of hypertension, 30.3% presented with hypertension at the time of measurement. In the multivariable analysis, alcohol intake and urban residence in men, and older age group, higher education and body mass index ≥25 kg/m2 in women were significantly associated with hypertension. Among the 21.8% who never had their BP measured, 83.8% were men; among these men, older age (adjusted OR (AOR), 0.43; 95% CI 0.25 to 0.73) and HIV positive status (AOR, 0.37; 95% CI 0.14 to 0.97) were negatively associated, while current smoker status (AOR, 2.09; 95% CI 1.19 to 3.66) was positively associated with the lack of BP measurements. [Conclusion] We found that hypertension is prevalent in the target rural area. However, many were not aware of their hypertension status and many never had their BP measured, indicating a serious gap in cardiovascular disease prevention services in Zambia. There is an urgent need for health promotion and screening for hypertension, especially in the primary health services of rural Zambia. Issues related to healthcare accessibility in men require particular attention

Prevalence of gambling disorder and its correlates among homeless men in Osaka city, Japan

Internationally, the prevalence of gambling disorder has been reported to be higher among homeless people than the general population; however, little is known about the factors associated with gambling disorder in this population. The present study aimed to investigate the prevalence of gambling disorder and its associated factors among homeless men using shelters in Osaka City. A cross-sectional survey was conducted from 30 to 2018 to 4 January 2019, using the 2017 Japanese National Survey of Gambling (JNSG) questionnaire, supplemented with questions about homeless experiences, drinking, and smoking. Using the South Oaks Gambling Screen, the presence of gambling disorder was determined by a score ≥ 5 out of 20. Multivariate logistic regression was conducted to explore factors associated with lifetime gambling disorder. Lifetime and past-year prevalence of gambling disorder among 103 participants was 43.7% (95% confidence interval [CI]: 34.5–53.3) and 3.9% (95% CI: 1.5–9.6), respectively, which are higher than the 6.7% and 1.5% found among men in the 2017 JNSG. Reasons reported for currently gambling less were primarily financial. Factors associated with lifetime GD included “more than 20 years since the first incidence of homelessness” (adjusted odds ratio [AOR]: 4.97, 95% CI: 1.50–16.45) and “more than five incidences of homelessness” (AOR: 4.51, 95% CI: 1.06–19.26). When homeless individuals with gambling disorder try to rebuild and stabilize their lives, the presence or resurgence of gambling disorder may hinder the process and pose a risk of recurring homelessness. Comprehensive support services for homeless individuals with gambling disorder are required. (250 words

Duct lavage cytology for the detection of breast cancer: report of a case

Although many modalities have been established to diagnose breast cancers, it is sometimes difficult to reveal nonpalpable cases. Duct lavage cytology was originally established to reveal groups at high risk for breast cancers by detecting metaplastic ductal cells. We report here a case where duct lavage was useful for revealing a small cancer that had been undetected by repeated bloody nipple discharge and cytological examinations. Duct lavage cytology may be of use in cases where nipple discharge of unknown origin persists

Serial Assessment of Immune Status by Circulating CD8+ Effector T Cell Frequencies for Posttransplant Infectious Complications

To clarify the role of CD8+ effector T cells for infectious complications, 92 recipients were classified according to the hierarchical clustering of preoperative CD8+CD45 isoforms: Group I was naive, Group II was effector memory, and Group III was effector (E) T cell-dominant. The posttransplant infection rates progressively increased from 29% in Group I to 64.3% in Group III recipients. The posttransplant immune status was compared with the pretransplant status, based on the measure (% difference) and its graphical form (scatter plot). In Groups I and II, both approaches showed a strong upward deviation from pretransplant status upon posttransplant infection, indicating an enhanced clearance of pathogens. In Group III, in contrast, both approaches showed a clear downward deviation from preoperative status, indicating deficient cytotoxicity. The % E difference and scatter plot can be used as a useful indicator of a posttransplant infectious complication