The aim of this study was to evaluate the relationship between severity of dementia and hand dexterity in patients with Alzheimer's disease (AD) using the Purdue Pegboard test including both simple and complex dexterity tasks. Eighty-four patients with AD and 32 non-demented subjects (controls) who were registered in a senior day-care center participated in this study. All of the subjects in this study were right-handed. The AD group consisted of 36 patients with a Clinical Dementia Rating of 1 (CDR 1), 35 with a CDR of 2 (CDR 2), and 13 with the CDR of 3 (CDR 3). For the simple task, right hand scores in the CDR 1, CDR 2, and CDR 3 groups were significantly lower than those of the controls whereas left hand scores were not lower than the controls. While the right hand scores were higher than the left hand scores in the controls and the CDR 1 group, no significant difference was observed between the right and left hand scores in the CDR 2 and 3 groups. Moreover, left hand scores were higher than right hand scores in 19 % of the CDR 1 group, 34% of the CDR 2 group, and 23 % of the CDR 3 group. Differences between right and left hand scores, which is a measure of handedness superiority, were decreased in order from the control group to the CDR 1 group and to the CDR 2 group. There was a relationship between “memory” subscale in the CDR and the differences in right and left hand scores. These results indicated that handedness superiority became unclear or disappeared as memory impairment progressed.

INTRODUCTION: Intravenous sedation is performed to ensure smooth and safe surgery. Dental anxiety is a reaction to an unknown danger. The Spielberger's state-trait anxiety inventory (STAI) can be used to simultaneously evaluate the levels of state and trait anxiety. State anxiety is defined as subjective feelings of nervousness. This study assessed the presurgical anxiety using STAI and performed intravenous sedation for patients whose level of state anxiety was > stage IV. Based on our clinical experience, it is believed that higher doses of sedatives are needed to induce the desired levels of sedation in patients with a high level of state anxiety. OBJECTIVES: This study examined whether the sedative consumption of the patient with a high anxiety level increased. PATIENTS AND METHODS: Patients with state anxiety scores of > or =51 were included in Group V, and those with state anxiety scores ranging from 42 to 50 were placed in Group IV. To induce sedation, intravenous access was established, and a bolus dose of 3.0 mg midazolam was administered intravenously. Sedation was maintained by administering a continuous infusion of propofol, which was aimed at achieving an Observer's Assessment of Alertness/Sedation scale of 10-12/20. In this study, midazolam was initially administered when the body movements appeared to occur or the blood pressure increased. This was followed by the administration of higher doses of propofol if low sedation was observed. RESULTS: There were no significant differences in the patient demographics, duration of sedation, and doses of local anaesthetic agents between Groups IV and V. The midazolam dose and mean propofol dose needed to maintain comparable levels of sedation were significantly higher in Group V than in Group IV. CONCLUSION: In female patients, whose level of preoperative state anxiety is more than Stage V of STAI, a large quantity of sedatives is needed for intravenous sedation.
Anxiety ; Blood Pressure ; Demography ; Dental Anxiety ; Dietary Sucrose ; Female ; Humans ; Hypnotics and Sedatives ; Midazolam ; Molar, Third ; Propofol

Cardiovascular surgeons have strong preferences regarding basic surgical skills. However, those basic skills have never been discussed great detail. The aim of this study is to survey the approach methods for axillary and subclavian artery targeting cardiovascular surgeons in Japan aged under 40, and to share the results of those basic skills.

BACKGROUND: Natural disasters have long-term negative impacts on the health and socioenvironmental conditions of a population, affecting the physical environment as well as the relationships within the community, including social networks. Mothers in post-disaster communities may have difficulty receiving social support not only from family members and relatives but also from members of their community, such as people in their neighborhoods. This study focused on mothers with infants and preschool-aged children in post-disaster communities. The associations of social support with sociodemographic characteristics and socioenvironmental conditions related to child-rearing among mothers in post-disaster communities were assessed. METHODS: An anonymous self-administered questionnaire survey was conducted in October 2015 in 988 households in areas affected by the Great East Japan Earthquake and Tsunami. The data collected on sociodemographic and socioenvironmental characteristics included the presence of pre-disaster acquaintances in the neighborhood and social support for child-rearing. The associations of sociodemographic and socioenvironmental characteristics with social support were examined. RESULTS: We analyzed 215 completed questionnaires from mothers living in different houses from those they lived in before the disaster to reflect continuous relationships with people from the pre-disaster communities. Social support was significantly associated with infant sex, extended family, support obtained from relatives not living together, pre-disaster acquaintances, use of child support resources, and no perceived difficulties in child-rearing. In addition, the presence of pre-disaster acquaintances was associated with categories of mental/physical place of comfort and child-rearing support, with adjusted odds ratios of 1.88 (95% CI 1.03-3.44) and 2.84 (95% CI 1.46-5.52) compared with mothers who did not have any pre-disaster acquaintances. CONCLUSIONS Factors associated with the obtainment of social support in child-rearing among mothers in post-disaster communities were attributed not only to mothers themselves and family members but also to socioenvironmental factors such as the presence of pre-disaster acquaintances. The presence of pre-disaster acquaintances promoted rich social support in child-rearing in post-disaster communities. When reconstructing a community following changes in residence location after a disaster, the pre-disaster relationships among the community dwellers should be considered from the viewpoint of child-rearing support.
Child Rearing ; Child, Preschool ; Disasters ; statistics & numerical data ; Earthquakes ; statistics & numerical data ; Female ; Humans ; Infant ; Japan ; Male ; Mothers ; psychology ; statistics & numerical data ; Social Support ; Tsunamis ; statistics & numerical data

Although cardiac rehabilitation (CR) has been shown to improve exercise tolerance and prognosis in patients with cardiovascular diseases, there remains low participation in outpatient CR. This may be attributed to the patients’ busy schedules and difficulty in visiting the hospital due to distance, cost, avoidance of exercise, and severity of coronary disease. To overcome these challenges, many countries are exploring the possibility of remote CR. Specifically, there is increasing attention on the development of remote CR devices, which allow transmission of vital information to the hospital via a remote CR application linked to a wearable device for telemonitoring by dedicated hospital staff. In addition, remote CR programs can support return to work after hospitalization. Previous studies have demonstrated the effects of remote CR on exercise tolerance. However, the preventive effects of remote CR on cardiac events and mortality remain controversial. Thus, safe and effective remote CR requires exercise risk stratification for each patient, telenursing by skilled staff, and multidisciplinary interventions. Therefore, quality assurance of telenursing and multi-disciplinary interventions will be essential for remote CR. Remote CR may become an important part of cardiac management in the future. However, issues such as costeffectiveness and insurance coverage still persist.

Objective: In order to increase the efficiency and effectiveness of pharmacotherapy and maximize the benefit/risk ratio, patient follow-up after medication is imperative. Such follow-up includes medical adherence, drug efficacy, early detection and treatment of adverse events. All pharmacy pharmacists should, at their service counter, select and correctly identify the most noticeable symptoms of adverse drug reactions for the patient, especially with their other roles and responsibilities. Thus, we evaluated the usefulness of M*Adhere SPEHEC® in pharmaceutical management.Methods: During the month of April 2019, 21 pharmacists at six pharmacies responded to the survey.Results: Of 21 pharmacists, 18 (85.7%) stated that the efficiency and/or quality of pharmacotherapy management had improved. The system enabled evidence-based identification of drug adverse event symptoms, and the time for pharmaceutical care was reduced by an average of 2 min.Conclusion: Based on these results, M*Adhere SPEHEC® was confirmed to be highly useful in improving the efficiency and quality of pharmaceutical management for patient follow-up.