1.Factors Related to Dizziness/vertigo Experienced by Elderly People in Their Daily Lives -Assessment of Effect Size Using Meta-analysis-
Akihiro ARAKI ; Hitomi MATSUDA ; Noriko OKAMOTO ; Toshifumi TAKAO ; Naoki MAKI ; Georg Von FINGERHUT ; Xiaochen WANG
An Official Journal of the Japan Primary Care Association 2020;43(3):82-89
Introduction: This study used a meta-analysis to investigate factors related to dizziness/vertigo and their effect size in community-dwelling elderly people.Methods: The search terms "elderly," "dizzy," "community dwelling," and others were used, and a database search was conducted using Ichushi Web and PubMed.Result: In total, 10 studies were extracted. Meta-analysis calculated 28 items as significantly related factors: anxiety, fatigue, taking nitric acid drugs, taking anxiolytics, low self-rated health, memory impairment, depression, sleep disorder, dementia, cancer, balance failure, gait disturbance, physical dysfunction, taking diuretics, living alone, heart disease, fall history, rheumatoid arthritis, stroke, taking sleeping pills, taking multiple drugs, visual impairment, female, ADL impairment, osteoporosis, taking antihypertensive drugs, hypertension, and low education level.Conclusion: The above items may be key variables for investigating dizziness/vertigo in the future.
2.Preventive Home Visit Practicum by Nursing Students during the COVID-19 Pandemic: Challenges to Continuing Nursing Practice in the Community
Aya SHINOHARA ; Akihiro ARAKI ; Takayuki KAGEYAMA ; Hiromi FUKUDA ; Yuko KAI ; Izumi NAGAMATSU ; Megumi KAMIYA ; Sachiyo MURASHIMA
An Official Journal of the Japan Primary Care Association 2024;47(3):111-115
The Preventive Home Visit Practicum is a nursing training program where students, grouped in teams of four or five (comprising a freshman, sophomore, junior, and senior), regularly visit a community-dwelling older adult. Due to the COVID-19 pandemic, the practicum was conducted with various infection control measures, and alternative activities were attempted when home visits were suspended. The experience of responding to the pandemic highlighted the importance of this practicum, which transcends the school year and underscores the necessity of cooperation of the community.
3.Experiences of developing competency in a network of nurse executives working at rural medical facilities: an ethnographic qualitative study
Hiromi FUKUDA ; Chizuru HARADA ; Akihiro ARAKI ; Yuta HIMENO ; Akiko YANO ; Sachiyo MURASHIMA
Journal of Rural Medicine 2025;20(2):78-87
Objective: Nurse executives (NEs) working at rural medical facilities encounter challenges, including nursing quality and management, due to a shortage of nurses; this requires them to develop their competencies. A previous study reported that managers working in rural medical institutions gather nearby to learn about management. However, no research has focused on NEs working in rural areas or clarified their experiences in developing competency through learning networks. This study focused on the learning networks of NEs working in rural medical facilities and aimed to clarify their experiences with competency development.Patients/Materials and Methods: In this study, we conducted competency development for NEs through the learning networks in Japan. An ethnographic qualitative study design was used. Twenty NEs participated in the study. Data were collected through participant observation and ethnographic interviews, and analyzed using thematic analysis.Results: This study revealed the following three themes: (1) aiming to provide medical care that contributes to the rural community; (2) work efficiency by a small number of staff; and (3) development as NEs. The NEs in this study improved as NEs by promoting efficiency in their work with a small group, while aiming to provide medical care that contributes to the rural community through participation in a learning network.Conclusion: A learning network of NEs develops their competencies by helping them improve their practice through dialogue and reflection on their nursing management. Therefore, even in an environment with limited resources, NEs might be able to improve the services of their organization through the learning network.
4.Prognosis of biopsy-confirmed metabolic dysfunction- associated steatotic liver disease: A sub-analysis of the CLIONE study
Michihiro IWAKI ; Hideki FUJII ; Hideki HAYASHI ; Hidenori TOYODA ; Satoshi OEDA ; Hideyuki HYOGO ; Miwa KAWANAKA ; Asahiro MORISHITA ; Kensuke MUNEKAGE ; Kazuhito KAWATA ; Tsubasa TSUTSUMI ; Koji SAWADA ; Tatsuji MAESHIRO ; Hiroshi TOBITA ; Yuichi YOSHIDA ; Masafumi NAITO ; Asuka ARAKI ; Shingo ARAKAKI ; Takumi KAWAGUCHI ; Hidenao NORITAKE ; Masafumi ONO ; Tsutomu MASAKI ; Satoshi YASUDA ; Eiichi TOMITA ; Masato YONEDA ; Akihiro TOKUSHIGE ; Yoshihiro KAMADA ; Hirokazu TAKAHASHI ; Shinichiro UEDA ; Shinichi AISHIMA ; Yoshio SUMIDA ; Atsushi NAKAJIMA ; Takeshi OKANOUE ;
Clinical and Molecular Hepatology 2024;30(2):225-234
Background/Aims:
Metabolic dysfunction-associated steatotic liver disease (MASLD) was recently proposed as an alternative disease concept to nonalcoholic fatty liver disease (NAFLD). We aimed to investigate the prognosis of patients with biopsy-confirmed MASLD using data from a multicenter study.
Methods:
This was a sub-analysis of the Clinical Outcome Nonalcoholic Fatty Liver Disease (CLIONE) study that included 1,398 patients with NAFLD. Liver biopsy specimens were pathologically diagnosed and histologically scored using the NASH Clinical Research Network system, the FLIP algorithm, and the SAF score. Patients who met at least one cardiometabolic criterion were diagnosed with MASLD.
Results:
Approximately 99% of cases (n=1,381) were classified as MASLD. Patients with no cardiometabolic risk (n=17) had a significantly lower BMI than patients with MASLD (20.9 kg/m2 vs. 28.0 kg/m2, P<0.001), in addition to significantly lower levels of inflammation, ballooning, NAFLD activity score, and fibrosis stage based on liver histology. These 17 patients had a median follow-up of 5.9 years, equivalent to 115 person-years, with no deaths, liver-related events, cardiovascular events, or extrahepatic cancers. The results showed that the prognosis for pure MASLD was similar to that for the original CLIONE cohort, with 47 deaths and one patient who underwent orthotopic liver transplantation. The leading cause of death was extrahepatic cancer (n=10), while the leading causes of liver-related death were liver failure (n=9), hepatocellular carcinoma (n=8), and cholangiocarcinoma (n=4).
Conclusions
Approximately 99% of NAFLD cases were considered MASLD based on the 2023 liver disease nomenclature. The NAFLD-only group, which is not encompassed by MASLD, had a relatively mild histopathologic severity and a favorable prognosis. Consequently, the prognosis of MASLD is similar to that previously reported for NAFLD.