1.Housing Projects for Comfortable and Independent Life of Aged People. A Report Concerning Housing with Services for Aged People.
Shigeo TOMURA ; Reiko MIGITA ; Hisako YANAGI ; Hideyuki SAITO ; Chiaki HIRANO ; Shigeru TSUCHIYA
Journal of the Japanese Association of Rural Medicine 1999;48(4):650-656
In Japan, the number of people 65 and over is increasing while the number of children is decreasing. A greater number of senior citizens live by themselves or husband and wife alone than before.
To realize comfortable and independent life for aged people, it is important to prepare housing and environment which have special services for them.
We would like to explain two housing projects which were planned and are being put into execution in Japan. One is ‘Silver Housing’ multiunit dwellings for the aged built by the Ministry of Construction and the Ministry of Health and Welfare since 1987. The other is ‘Silver Peer’ project which has been pushed forward by the Tokyo Metropolitan Government since 1987.
2.A Study on the Education Effects of Medical Team Care Practice at the University of Tsukuba: Analysis of Reports on the Practice.
Yoshie MORI ; Yoko EMORI ; Katsuko KAMIYA ; Shigeo TOMURA ; Hisako YANAGI ; Shigeru TSUCHIYA ; Naoko OKADA ; Yoko AKAZAWA
Medical Education 1999;30(1):37-41
The need for medical team care is increasing because of advances in medical care and changing national needs. For more than 20 years medical students at the University of Tsukuba have participated in medical team care practice before bedside learning during the third trimester of their 4th year. The objective of this practice is to understand patients from the nurses' point of view and to learn cooperation between doctors and co-medical staff. We analyzed students reports to study what they had learned. A total of 326 items in 11 categories were specified in the free-response part of the reports. The largest category was “nursing/nurses” and the second largest was “communication/human relations.” The results show that the students learned points other than the General Instruction Objectives and that the practice was extremely effective.
3.Community study on the integration of medical care, health care and social welfare in the rural district of Japan. Experiment and evaluation of a comprehensive health care, "the Service Package System for the Bedridden Elderly".
Tetsuhito FUKUSHIMA ; Yoneatsu OSAKI ; Kenji ABE ; Akio NAKAGAWA ; Hisako TSUCHIYA ; Eisaku TANIGUCHI ; Yosuke YAMANE
Journal of the Japanese Association of Rural Medicine 1986;35(4):830-838
The rise of the average age of the population in Shimane Prefecture has become more and more conspicuous in these years. According to the estimation of the future population the aging phenome-non in Shimane Prefecture is going about fifteen years ahead of the average of Japan. Therefore it is significant to perform a community experiment of the comprehensive health care for the elderly in this prefecture, in the sense that its results will offer many useful experiences to other districts of Japan, where the aging of the population is proceeding a little more slowly.
We carried out an experiment called “the Service Package System for the Bedridden Elderly”, in Sada-cho, Shimane Prefecture in cooperation with Sada-cho, Izumo Health Center and Izumo Medical Association. It is an improvement on the health care system for the bedridden elderly and their family, which has been performed in Scandinavian countries.
The results of our experiment obviously showed the existence of many problems stemming from the lack of integration among different fields such as health care, medical care, social welfare, working and cultural life. To establish the comprehensivehealth service system for the elderly and their family the integration of these fields is most urgently demanded.
4.Determination of Bone Mass for Diagnosis of Osteoporosis: Comparison of Computed X-Ray Densitometry(CXD) with Quantitative Computed Tomography(QCT).
Shigeo TOMURA ; Kimika KAWANAMI ; Miwa HOSOKAWA ; Kimiko TANAKA ; Hisako YANAGI ; Shigeru TSUCHIYA ; Hitoshi AMAGAI ; Kunihiko KATO ; Tatsuo SHIIGAI
Journal of the Japanese Association of Rural Medicine 1997;46(2):142-147
Measurement of bone mass (BM), especially in the lumbar vertebrae, is very important for diagnosis of osteoporosis. In this study, we compared BM values measured by computed X-ray densitometry (CXD) with those by quantitative computed tomography (QCT), and discussed differences between the two methods.
The subjects were 90 women and 3 men, aged 42-86 years, who visited our outpatient department of osteoporosis. Metacarpal bone density (ΣGS/D) and metacarpal index (MCI) in the second metacarpal bone were measured by CXD. QCT was uesd for measurement of bone mineral density (BMD) in the lumbar trabecular bone, where pronounced osteoporotic changes occur early. The mineral values of L3 were expressed as mineral equivalent of CaCO3 in mg/ cm3, and≤75 mg/cm3 of L3 values were judged to be loss of lumbar BMD.
There were negative correlations between age and ΣGS/D, MCI or L3 value, and positive correlations were found between ΣGS/D or MCI and L3 value. Based on the above criterion of lumbar BMD loss, sensitivity and specificity of ΣGS/D for lumbar bone loss were examined. If ΣGS /D of 2.30 (T score -2.7) was used as the cut-off point, the sensitivity was 69.8% and the specificity was 75.0%, and if ΣGS/D of 2.37 (T score -2.3) and 2.40 (T score -2.1) were employed, the sensitivity was 79.1% and 79.1%, while the specificity was 64.5% and 62.5%, respectively. We concluded that BM values of cortical bone and trabecular bone decrease with age, and that sensitivity and specificity of GS/D for diagnosis of lumbar BMD loss are not very high.