Association between Oral Health Status and Diabetic Nephropathy-Related Indices in Japanese Middle-Aged Men

Oral health status is known to be associated with lifestyle-related diseases such as diabetes and chronic kidney disease. In Japan, around 40% of hemodialysis cases are patients with diabetic nephropathy. The aim of this study was to clarify the association between oral health status and diabetic nephropathy-related indices in Japanese middle-aged men. Sixty-six men (age range: 55–64 years) with ≥20 remaining teeth and who received public medical checkups and oral examinations were enrolled. We examined correlations of age, body mass index, HbA1c, HDL-C, LDL-C, neutral fat, serum creatinine, and the estimated glomerular filtration rate (eGFR) with the number of remaining teeth or the community periodontal index (CPI) score (periodontal pocket < 4mm: 0, 4–6 mm: 1, ≥6 mm: 2). A positive correlation between the CPI score and serum creatinine and a negative correlation between CPI score and eGFR (Spearman’s rank correlation coefficient, r = 0.459, p < 0.01, and r = −0.460, p < 0.01, respectively) were observed. The mean eGFR in the CPI score 0 group was significantly higher than that in the CPI score 1/2 group (82.6 vs. 70.7, Student’s t-test, p < 0.01). Logistic regression analysis using eGFR as a dependent variable and age, CPI score, body mass index, HbA1c, and neutral fat as independent variables suggested that low eGFR (<60) could be attributed to CPI score (OR = 3.169, 95% CI: 1.031–9.742, p = 0.044). These results suggest a possible association between periodontal status and renal function in Japanese middle-aged men. Periodontal condition is controlled by oral prophylaxis, and periodontal disease and chronic kidney disease have some common risk factors. Thus, periodontal management can contribute to the prevention of severe chronic kidney disease

Difficulty in the family relationship of Asian women married to Japanese men during child rearing

目的：日本人男性を夫にもつ子育て中のアジア系外国人女性を対象に、家族との関係で抱く困難感を明らかにすることを目的とした。方法：日本人男性を夫にもつ未就学児を養育するアジア系外国人女性 11 名にインタビューガイドに準じた半構造化面接を行い、質的記述的に分析を行った。語られた内容は意味のあるまとまりごとに抽出し、それらを要約してコード化し、コード間の共通性や差異性に注目して分類・統合しながら、サブカテゴリー、カテゴリーを生成した。結果：分析の結果、日本人男性を夫にもつ子育て中のアジア系外国人女性が家族との関係で抱く困難感として、≪母国と異なる家事や子育て文化の違いへの戸惑い≫≪異文化の壁により表出できない本音≫≪日本人である義母の考えを優先≫≪受け入れてもらえない自身の価値≫≪夫と子どもへの期待を支えとしての日本での生活≫の 5 つのカテゴリーが見出された。考察：養育期に、母親が外国人ゆえに、母国言語の伝承が許されず、家族から閉め出されたという思いをもつ事態は、母親の精神的ストレスや育児、家族内の人間関係にも影響するため、アジア系外国人女性が家族の中で尊重されることが大切であると考える。保健師などの支援者は、夫婦が相互に習慣や文化、価値観を理解し、尊重し合えるよう、他のアジア系外国人女性やその夫から話を聞けるような機会や日本人家族のアジア系外国人女性に対する態度を変える働きかけとして、異文化の理解ができるような場の提供を行うことも大切であると考える。Objectives: This study was performed to clarify difficulties in family relationships of Asian women married to Japanese men in relation to child rearing.Methods: We collected data through semi-structured interviews from 11 Asian women married to Japanese men while rearing pre-school-age children. Using the recorded content, codes were created for statements. Subcategories were established from the codes, and categories were created from each of the subcategories.Results: Five categories of difficulties experienced in the family relationships were as follows: they were bewildered at cultural differences with regard to child rearing and housework; they felt that they could not show their real feelings because of consciousness of cross-cultural barriers; they have to obey the instructions of their Japanese mother-in-law; their Japanese family does not accept their values; they can live in Japan only for the sake of their children and husband.Discussion: In the child rearing period, when a woman feels that her mother has been excluded from her family’s language because of her foreign nationality, and her family is locked out, this has a negative effect on her mental well-being, parenting, and family relations. It is important that foreign Asian women are respected in their families in Japan. To gain an understanding and respect for each other’s habits, cultures, and values, it is important to provide opportunities to hear from other Asian foreign women and their husbands and develop ways to change Japanese families’ attitudes toward foreign Asian women in Japan

Clarification of parentsʼ recognition of children\u27s condition with developmental disorder and feelings about school enrollment before attending consultation session and after admission

本研究の目的は A 市就学サポート相談会（以下、相談会）に参加した発達障害児を持つ保護者の、相談会前と就学後における子どもの状態の捉えと就学に関する思いを明らかにすることである。　研究対象は、Ａ市発達相談センターの継続相談者で、２016 年度相談会に参加した発達障害児（疑いを含む）を持つ保護者 ２0 ケースの相談支援記録で、保護者の語った子どもの状態の捉えと就学への思いの記述を質的記述的に分析した。分析は相談会前と就学後のそれぞれにおいて行った。本研究は、金沢大学医学倫理審査委員会の承認を得て実施した。　相談会前における保護者の子どもの状態の捉えとして【子どもの発達に生活する上で支障となる特性がある】【学校生活でやっていけないかもしれない】【自分の子どもは相談の対象ではない】、就学に関する思いとして【通常学級・地域の学校への強い希望】【子どもに合わせた就学環境を整えたい】【生活力が付く就学先を選びたい】のカテゴリが抽出された。就学後では子どもの状態の捉えとして【学校生活に適応できている】【学校で適切な行動がとれていない】、就学に関する思いとして【情報共有による学校生活への安心【】順調に学校生活が送れそうな予感】【就学先への不満】のカテゴリが抽出された。　発達障害の子どもに適した就学環境を整えていくためには、保護者自身が子どもの特性を把握するとともに、就学先への申し送りを行う力を付けられるよう支援していくことが必要と考える。This study was performed to clarify parents’ recognition of their child’s conditions of developmental disorder and feelings about school enrollment before attending consultation sessions and after school admission.Consultation support records of ２0 parents of children with developmental disorders (including children suspected to be developmentally disabled) who had attended multiple consultation meetings in A city were examined. The parents’ descriptions of their child’s condition and feelings about the child’s school admission were analyzed qualitatively. The analysis was conducted before the consultation session and after school admission. This study was conducted with the approval of the Medical Ethics Committee of Kanazawa University.Before the consultation, the parents’ recognized the following: “The child has developmental characteristics that interfere with quality of life,” “Worried about the child’s school life,” and “Consultations do not pertain to my child.” Their feelings about school enrollment were as follows: “Strong desire for entrance to normal classes/local school,” “Want a suitable school environment for the child,” “Want to choose a school where the child can acquire life skills.” After admission, the parents recognized the following: “The child can adapt to school life” and “The child does not behave appropriately at school.” Their feelings about school enrollment were as follows: “Peace of mind about school life through information sharing,” “Feel that school life will go smoothly,” and “Dissatisfaction with school.”To prepare for enrollment of a child with a developmental disability in a school with a suitable environment, parents must recognize the particular characteristics of their child. It is necessary to support the parents to enable them to describe and inform the school of their child’s condition

特定健康診査受診者の保健指導受講の有無と3 年後の健診・医療データとの関連の検討

This study was performed to examine whether specific medical examinees’ attendance at a health guidance program influenced the results of health checkups conducted 3 years later and other medical service data. The study population consisted of 250 individuals residing in Town B, Prefecture A, who were enrolled in the national health insurance plan; had received a specific medical checkup in 2012 and subsequently became eligible for health guidance; had received another specific medical checkup in 2015; and for whom relevant medical service data were available. The main variables were age, gender, results of both checkups, annual medical fees, and whether they had received consultations on lifestyle-related diseases at a medical institution. Participants were grouped according to whether they had attended health guidance during the 3-year study period (attendance vs. non-attendance), and ensured that all participant data were anonymized. After 3 years, significant decreases in diastolic blood pressure (DBP) (p < 0.001) and low-density lipoprotein cholesterol (LDL-C) (p = 0.005) were observed among males in the attendance group, while the females in the same group showed significant decreases in body weight (p = 0.043), DBP (p = 0.011), and LDL-C (p = 0.002). To examine how the changes in health checkup results differed between groups, we calculated difference scores by subtracting the 2012 data from the 2015 data. The males in the attendance group showed a significantly greater decrease in DBP ( − 4.12 ± 7.20, p = 0.014) than the males in the non-attendance group. The females in the non-attendance group showed a significantly greater increase in high-density lipoprotein cholesterol (HDL-C) than the females in the attendance group (2.95 ± 8.33, p = 0.042). The number of patients who consulted medical institutions for hypertension (p = 0.039) and hyperlipidemia (p = 0.010) were also significantly increased in the females in the non-attendance group. The significant decrease in DBP among males in the attendance group may have been because these individuals reviewed their lifestyle habits after receiving health guidance. The increase in HDL-C among the females in the non-attendance group could be attributed to their participation in exercise therapy during consultations with other medical institutions. The results of this study clearly indicated the importance of organizing health guidance with collaboration between municipality and medical institutions

在日中国人母親の産後うつ傾向の実態及び関連要因

Background and Purpose: Postnatal depression （PND） is prevalent in the generalpopulation in Japan. However, there are no data on the actual condition and relatedfactors for PND in Chinese women in Japan, which is the largest group of foreign womenliving in Japan. This study was performed to clarify the tendency of PND and its relatedfactors in Chinese mothers living in Japan. Methods: We carried out a mailed selfadministeredquestionnaire survey among Chinese mothers living in Japan who had givenbirth to a baby in the previous 3-4 months. Survey items included the status of mothersand children, family support, and the Edinburgh Postpartum Depression Scale （EPDS）.Logistic regression analysis was utilized for statistical analysis. Results: The proportion ofhigh-PND-risk respondents among the 80 participants was 36.3%. The results indicatedthat the factors affecting PND risk are parenting loneliness （Odds ratio: 7.416, p=0.003）and support from the husband（ Odds ratio: 0.357, p=0.047）. Conclusion: The loneliness ofchild-rearing and the support status of the husband in the 3rd-4th month after childbirthare DNP risk factors for Chinese mothers in Japan. The presence of support from thehusband will not only be helpful in housework and childcare, but will also support themother’s spirit and alleviate the loneliness of child-rearing. In addition, as the PND riskof Chinese mothers is high in the 3rd- 4th month after childbirth, it is necessary tostrengthen mental support during this period

従業員が若年認知症と診断された場合の就労継続に対する事業所の意向

Objective: The purpose of the present study was to clarify and identify the factors related to the intentions of workplaces to retain employees diagnosed with young onset dementia (YOD). Methods: An anonymous self-administrated questionnaire survey was sent by mail to all １,２9３ workplaces with 50 or more employees in A Prefecture. In addition to providing demographic data for the workplace, employers were asked to answer freely about their intention of continuing to employ employees in the case of their being diagnosed with young onset dementia. Intention regarding continuous employment was analyzed qualitatively using encoded descriptive data. Results: Responses were received from ３5７ workplaces, and ２9２ valid responses were used for analysis. Workplaces intended to consider continuing employment for employees diagnosed with young onset dementia, with a view to offering continued non-discriminatory employment and staying legally compliant. In addition, while considering offering job accommodations and keeping their employees safe according to their abilities, there was also an intention on the part of the business establishment to demand meeting their obligations to customers such as assuring customer safety and satisfaction. In addition, they stated the need for a offering systematic support for workplace personnel and company departments, and wrote that they would consult with their attending physician / industrial physician to identifying dementia-related symptoms and to make decisions with regard to employment continuation and placement. Discussion: Workplaces should understand YOD at an Young stage. It is necessary to provide training and information to businesses so that they can consider continuation of employment

The status of parenting acquaintances and factors related to the presence orabsence of parenting acquaintances among motherswith 18-month-old children.

目的： 1 歳6 か月児を持つ母親の育児仲間の実態と育児仲間の有無に関連する要因を明らかにすることである。対象と方法：A 県B 市の1 歳6 か月児健康診査を受診した母親を対象として，無記名自記式質問紙調査を行った。調査項目は基本属性，育児の状況，育児ストレス，対人態度（内的作業モデル），育児仲間の有無とし，育児仲間の有無に関連する要因をロジステイック回帰分析した。結果：分析対象者105 名のうち，育児仲間がいない者（なし群）は10 名（9.6％），なし群の平均年齢は33.4 歳，子どもの出生順位は第一子70.0％，育児仲間が必要であると回答した者は80.0％であった。育児仲間に最も期待することは手段的サポート（情報交換・子どもを預け合う等）と回答した者は，育児仲間なし群は60.0% で，あり群の20.0％より有意に高かった(p<0.01)。育児ストレス尺度得点の合計は，育児仲間なし群が有意に高く(p<0.01)，内的作業モデル（安定型）の得点は，育児仲間なし群が有意に低かった（ｐ＜0.05）。育児仲間の有無に関連する要因は，育児仲間に最も期待すること（手段的サポート／情緒的サポート）（P=0.015，オッズ比5.443），内的作業モデル（安定型）(P=0.007，オッズ比0.831)であった。考察･結論： 1 歳6 か月児は歩行が確立し外出の機会が増え育児仲間と出会う機会も増えることが予想されるが，育児仲間がいない者が約1 割存在し，それらは育児仲間に手段的サポート（情報交換・子どもを預け合う等）を期待しつつも他者との関係に苦手意識があることから，母親同士の交流が促進される育児仲間づくりの支援が必要である