Distribution of Lenticular Astigmatism in a Pre-Cataract Surgery Population

Recently custom ablation of LASIK (laserin situ keratomileusis) has rapidly evolved. It could achieve supervision temporarily, but we suspect that the vision could deteriorate due to against-the rule astigmatism decades after the operation. To clarify this concern, we evaluated distribution of the total and corneal astigmatism of 101 eyes of 65 pre-cataract surgery patients (meanage:73 years). Then we calculated the lenticular astigrlatism by vector analysis. The mean amounts of total and corneal astigmatism were 1.22±1.50D and 0.97±0.84D each. The percentages of no astigmatism: oblique: with-the-rule: against-the-rule were 32: 4: 15: 50 and 7: 28: 26: 40, respectively. The mean amount of lenticular astigrlatism measured by vector analysis was 1.6± 1.4D. The percentage of no astigmatism: oblique: with-the-rule: against-the-rule was 2: 0: 39: 59. This biased distribution of astigmatism might have contributed to the biased distribution (no and against-the-rule) of total astigmatism. These data indicate that in a pre-cataract surgery population against-the-rule astigmatism is predominant in both corneal and lenticular astigmatism. We suspect that custom correction of adolescent eyes, in which with-the-rule astigmatism is predominant, might elicit more against-the-rule astigmatism when they reach pre-cataract surgery age population, leading to a decline in quality of vision

How and when do middle-aged women learn about menopause?

＜Aim＞ We investigated the knowledge and image of menopause among middle aged women．＜Procedures＞ We administrated questionnaires to 76 outpatients with climacteric disorder and 49 healthy middle-aged women. The questionnaire consisted of items on demographics, questions about the knowledge and image of menopause, and the Scale of Menopause Knowledge（SMK）which we developed. ＜Results＞ The rates of women who responded they knew menopause well were 89.3 ％ in the patient group and 65.3 ％ in the healthy group respectively. Patients got the knowledge more through books, doctors and health care professionals than the healthy women did. The women who got the knowledge mainly when they were under thirties were more knowledgeable than those who got it mainly when they were over forty. The scores in the former group were higher than the later group in the subscales of “decrease of estrogen” and “health issues related to the aging process” in the SMK. Regarding images of menopause, few women had positive image. ＜Conclusion＞ Health education about menopause for women in their early life stage is required to deal with menopause

Study of Views on Posthumous Reproduction, Focusing on Its Relation with Views on Family and Religion in Modern Japan

Posthumous reproduction has been performed in Japan several times, without sufficient civic discussion on its appropriateness or legislative regulation. There have even been several lawsuits on posthumous acknowledgment (in which a baby born to a deceased father has the same birthright as a baby born to a living father), and some judgments have proposed the need to develop societal agreement on posthumous reproduction and suggested legislative settlement. With this background, this study aims to clarify the views of the Japanese people regarding posthumous reproduction. In December 2007, we distributed a questionnaire on posthumous reproduction in relation to beliefs about family and religion to 32 universities across the country, and received 3,719 replies. It was found that about 60&#65397; of respondents agreed with posthumous reproduction. Statistical analysis was applied to the relationship between this overall position on posthumous reproduction and views on assisted reproduction technologies, family, religion, and so on. The degree of support for posthumous reproduction was strongly correlated with the degree of affirmation of assisted reproduction technologies and a liberal worldview with emphasis on self-determination. On the other hand, there was also a strong correlation with having a traditional view of family, such as family succession. The degree of support for posthumous reproduction was also highly correlated with the intimacy among family members, underlying which was a strong connection to the traditional religious belief in Japan that deceased family members watch the living ones. The view on posthumous reproduction is culturally complex and cannot be explained by a simple dichotomy between traditional conservatives and liberals.</p

Fulfillment of the premenstrual dysphoric disorder criteria confirmed using a self-rating questionnaire among Japanese women with depressive disorders

<p>Abstract</p> <p>Background</p> <p>Some women with depressive disorders experience severe premenstrual symptoms. However, there have been few studies in which premenstrual symptoms in women suffering from depressive disorders were assessed. In this study, we aimed to investigate premenstrual symptoms in women with depressive disorders using the premenstrual dysphoric disorder (PMDD) scale.</p> <p>Methods</p> <p>We administered questionnaires to 65 Japanese female outpatients who had been diagnosed with a major depressive disorder or dysthymic disorder and to 303 healthy women as control subjects. The questionnaire consisted of items on demographics and the PMDD scale, which was modified from the premenstrual symptoms screening tool (PSST) developed by Steiner et al. (<it>Arch Womens Ment Health </it>2003, <b>6</b>:203-209).</p> <p>Results</p> <p>Twenty-eight women (43.1%) with depressive disorder fulfilled certain items of the PMDD scale. These women are considered to have coexisting PMDD and a depressive disorder, or to have premenstrual exacerbation (PME) of a depressive disorder. On the other hand, 18 women (5.9%) in the control group were diagnosed as having PMDD. The depressive disorder group who fulfilled the PMDD criteria had more knowledge of the term premenstrual syndrome (PMS) and took more actions to attenuate premenstrual symptoms than the control group with PMDD.</p> <p>Conclusions</p> <p>Our findings demonstrated that the occurrence of severe premenstrual symptoms is much higher in women with depressive disorders than in healthy subjects. This is partially due to this group containing women with PME, but mainly due to it containing women with PMDD. The higher percentage of PMDD suggests similarity between PMDD and other depressive disorders. Furthermore, educating healthy Japanese women and women with depressive disorders about premenstrual symptoms and evidence-based treatment for them is necessary.</p

Pembelajaran Berbasis Projek dengan Pendekatan Jelajah Alam Sekitar sebagai Model Perkuliahan Fisiologi Hewan

Penelitian ini dilakukan dengan tujuan untuk menguji efektivitas penerapan model pembelajaran berbasis projek (Project Based Learning/PBL) dengan pendekatan Jelajah Alam Sekitar (JAS) pada perkuliahan Fisiologi Hewan bagi mahasiswa Program Studi Pendidikan Biologi. Penelitian ini merupakan quasi eksperimen dengan desain one shot case study. Populasi dalam penelitian ini adalah mahasiswa Program Studi Pendidikan Biologi dan sebagai sampel adalah mahasiswa semester 4 Prodi Pendidikan Biologi rombel 1,2,dan 3 tahun ajaran 2010 / 2011 yang mengambil mata kuliah Fisiologi Hewan. Pengambilan sampel dengan teknik purposive random sampling. Sebagai variabel bebas adalah penerapan model PBL dengan pendekatan JAS, sedangkan sebagai variabel terikat adalah efektivitas model pembelajaran yang diterapkan dilihat dari hasil belajar, aktivitas siswa dan keterlaksanaan kegiatan yang diprogramkan. Sumber data penelitian adalah mahasiswa. Data yang diambil adalah nilai ujian tulis, nilai laporan, nilai presentasi , aktivitas mahasiswa serta tanggapan keterlaksanaan PBL dengan pendekatan JAS. Hasil penelitian menunjukkan bahwa penerapan model PBL dengan pendekatan JAS telah dapat mencapai indikator-indikator yang ditetapkan yaitu mahasiswa yang memperoleh nilai minimal B mencapai 70%, tanpa nilai D dan E, mahasiswa dengan kriteria keaktifan pada kategori tinggi dan sangat tinggi mencapai minimal 80%, dan tingkat keterlaksanaan kegiatan dalam pembelajaran berbasis projek dengan pendekatan JAS mencapai 80%. Simpulan yang dapat diambil dari penelitian ini adalah model pembelajaran berbasis projek dengan pendekatan JAS pada perkuliahan Fisiologi Hewan efektif diterapkan

Difficulties nurses face in clinical practice in supporting consensus decision-making by cancer patients and their families.

【目的】日々臨床で行われている患者・家族と医療者間の合意形成による意思決定支援における看護師の困難を明らかにし，その上で看護師が合意形成による意思決定支援に積極的に取り組めるようにしていくための今後の課題を検討した．【方法】がん診療連携拠点病院２病院に勤務する看護師12名を４グループに分け，フォーカスグループインタビューを実施し，質的帰納的に分析した．データ収集期間は2015年10月～2016年３月であった．【倫理的配慮】大分大学医学部倫理審査委員会（承認番号979）と大分県立病院研究倫理委員会（受付番号28-4）の承認を得た．【結果】がん患者と家族の意思決定支援を行う上で看護師が抱えている困難は，【家族の意向が重視され患者の主体的な意思決定が阻害される】【患者や家族の心情や意向を把握できず合意形成による意思決定支援に踏み出せない】【患者が主体的な意思決定をしたのかわからないまま治療が進むことに悩む】【終末期患者が家族や医療者との合意形成のないまま治療することが良い選択だったのか悩む】【BSCの状況での治療選択において医療者と患者・家族の合意を得ることが難しい】【患者・家族と医療者間のコミュニケーションが十分に図れず合意形成による意思決定支援が成り立たない】【看護ケアチームとして継続的に合意形成による意思決定支援ができない】【スキル不足で変化する患者の状況に合わせて合意形成による意思決定支援のプロセスが辿れない】の８カテゴリーであった．【考察】看護師は，がん患者の権利や意向が尊重されていない状況に疑問を感じたり悩んだりしているが，問題解決に向けてアプローチできない現状が見いだされた．がん医療における意思決定支援の質を向上させるためには，看護師自身が担う役割があることを認識し，実践を積み重ねて，患者や医師が看護師の役割を認知できることが重要であると考えられる．The purpose of this study was to clarify the difficulties nurses face in consensus decision support between patients/families and health care providers, and to examine the implications for education to enable nurses to actively engage in consensus decision support. Focus group interviews were conducted with 12 nurses working at two cancer treatment base hospitals. Respondents were divided into four groups and analyzed qualitatively and inductively. The difficulties nurses face in providing decision support to cancer patients and their families were classified into eight categories: ［Family intentions are emphasized and patient's independent decision-making is hindered］, ［Unable to grasp the feelings and intentions of the patient and family and unable to step forward to support decision-making through consensus building］, ［Distressed that treatment proceeds without knowing whether the patient has made an independent decision］, ［Wonder if it was a good choice for a terminally ill patient to be treated without consensus by family and healthcare providers］, ［Difficulty in obtaining agreement between healthcare providers and patients/families on treatment choices in BSC situations］, ［Communication between patients/family members and medical staff is not sufficient, and decision-making support through consensus building cannot be established］, ［As a nursing care team, we cannot continuously support decision-making through consensus building］, and ［Lack of skills makes it impossible to follow the process of decision support through consensus building in accordance with the changing patient's situation］. We found that nurses are concerned about situations in which the rights and intentions of cancer patients are not respected, but they are unable to approach patients to solve the problem. To improve the quality of decision-making support in cancer care, it is important for nurses to recognize that they themselves have a role to play, to accumulate practice, and to make patients and physicians aware of the role of nurses