Search PubMed⌕ Search

Biomedical subjects

M Washio

Publications and source records attributed to M Washio.

At least 19 recordsLinked to original sources
PubMed2002

Patterns of outcome of caregiving for the impaired elderly: a longitudinal study in rural Japan.

This longitudinal study investigates the experiences among Japanese caregivers who provide informal care at home to the impaired elderly over one year. Little is known about longitudinal changes in caregivers' burden in Japan. Between 1998-1999, 47 pairs of impaired elderly and their caregivers were followed in Matsuyama Town in a rural area of northern Japan. Caregivers were interviewed initially and then again 12 months later. Findings indicated that the mean score of the Zarit Burden Interview at Time 2 was significantly lower than that of Time 1, suggesting that caregivers adapted to their role over time. Outcomes were further categorized as successful and unsuccessful, depending on the pattern of change over one year. Two factors were related to the outcome in univariate analyses: caring for someone with dementia, and caregiver being a spouse. Logistic regression demonstrated that caring for someone with dementia was five times more likely to be associated with an unsuccessful outcome. The caregiver spouse was five times more likely to be associated with a successful outcome, while daughters-in-law were more likely to have an unsuccessful outcome. The present study suggests that (1) changes in well-being among caregivers in Japan are similar to those observed in most studies in the West, and (2) there was evidence of both the adaptation and wear-and-tear models among caregivers over time.

Aged↗
PubMed2001

Alcohol consumption and severity of angiographically determined coronary artery disease in Japanese men and women.

The relation of alcohol consumption to the severity of coronary atherosclerosis was examined among 323 men and 220 women who underwent coronary arteriography. Severity of coronary atherosclerosis was assessed by the number of vessels obstructed > or =75% in diameter and Gensini's severity score. Alcohol consumption was divided into 5 categories in men (never, past, 1-24, 25-49, and > or =50 ml per day) and 3 categories in women (never, past, and current). Among men, odds ratios of severe stenosis (multiple-vessel disease or Gensini's score >15) decreased substantially and significantly in all current drinking categories but without dose-response effect. There was a weak, inverse association of current alcohol consumption with one-vessel disease, but not with moderate stenosis in terms of Gensini's score (< or =15). Past drinkers showed a fairly large, but statistically nonsignificant, decrease in the odds ratios of not only severe stenosis but also of moderate stenosis. Among women, current drinkers showed a small, statistically nonsignificant decrease in the risk of severe stenosis in terms of Gensini's score. These associations with alcohol use did not change after adjustment for known coronary risk factors. The present findings add to evidence that alcohol drinking confers protection against coronary atherosclerosis.

Adult↗
PubMed2001

Obesity, body fat distribution and coronary atherosclerosis among Japanese men and women.

OBJECTIVE: To investigate the relation of the obesity and body-fat distribution with angiographically defined coronary atherosclerosis. DESIGN: Cross-sectional study in a clinical setting. SUBJECTS: Three hundred and twenty men (median age, 59 y) and 212 women (median age, 67 y) who underwent coronary angiography for suspected or known coronary heart disease at 5 cardiology departments between September 1996 and August 1997. Patients with disease duration >1 y were excluded. MEASUREMENTS: The body mass index (BMI) and the waist to hip circumference ratio (WHR) were used as main exposure variables, and either the presence of significant coronary stenosis or the Gensini's score (> or =10 vs<10) as an outcome variable, in a sex-specific multiple logistic regression analysis controlling for age, hospital, and other coronary risk factors. RESULTS: Among male patients, BMI was progressively higher with an increasing number of vessels involved (P trend=0.05); the adjusted odds ratios for the presence of significant stenosis across quartiles of BMI were 1.0 (reference), 1.1, 1.9 and 2.5 (P trend=0.02), and the positive association was more pronounced for younger patients. Among females, however, such associations were not evident. Employing the Gensini's score as an outcome gave similar results. WHR was not significantly associated with either outcome regardless of sex. CONCLUSION: These results suggested that BMI was predictive of coronary stenosis among male patients, but not among female patients. Unlike most previous studies, this study failed to detect a positive association with WHR.

Adipose Tissue↗
PubMed2001

Caregiver depression predicts early discontinuation of care for disabled elderly at home.

This longitudinal study investigates the caregiving experiences among Japanese caregivers who provided informal care at home for disabled elderly between 1998 and 1999. Forty-seven caregivers of the impaired elderly continued caregiving at home in Matsuyama Town, a rural area of northern Japan, while 18 caregivers discontinued it. The mean score of the Center for Epidemiologic Studies Depression Scale in 1998 among those who gave up caregiving was significantly higher than that of those who continued caregiving, indicating that depression predicts early discontinuation of care in the home. This is one of the few studies in Japan to suggest that initial caregiver depression is a factor in the decision to terminate care for the disabled elderly at home.

Activities of Daily Living↗
PubMed2001

Role of hypertension, dyslipidemia and diabetes mellitus in the development of coronary atherosclerosis in Japan.

The present study evaluated the effect of hypertension (HT), dyslipidemia and diabetes mellitus (DM) on the development of coronary atherosclerosis in the Japanese population, using a cross-sectional study of 433 patients (254 men and 179 women) aged 30 years or older who underwent coronary angiography for suspected or known coronary heart disease angina at 5 cardiology departments in the Fukuoka area between September 1996 and August 1997. Patients with a disease duration of 6 months or more were excluded. The main outcome measure was angiographically defined coronary artery stenosis and was found to a significant degree in 146 patients (33.7%). HT, DM, low levels of high-density lipoprotein cholesterol (HDL-C) and hypertriglyceridemia remained as significant coronary artery disease (CAD) risk factors even after controlling for age, sex, hospital, smoking, alcohol use, body mass index and leisure time physical activity. However, hypercholesterolemia was not a significant risk factor after adjusting for these variables. After controlling for these variables, DM, low HDL-C and hypertriglyceridemia were significant CAD risk factors for men, but only DM was a significant CAD risk factor in women. These results indicate that in Japan DM, low HDL-C and hypertriglyceridemia may be more important CAD risk factors than hypercholesterolemia.

Adult↗
PubMed2001

An international comparison of the involvement of epidemiology in the most frequently cited publications in the field of clinical medicine.

The objectivity, validity and credibility of research in clinical medicine can be enhanced by the appropriate involvement of epidemiology. However, the overall contribution of epidemiology to clinical research, either as a methodology or as a resource for research, has been poorly quantified. We therefore assessed the involvement of epidemiology in influential publications in the field of clinical medicine, and made an international comparison on a quantitative basis. The 500 most frequently cited papers published during 1981-96 in the field of clinical medicine in the US, the UK, and Japan were compared in terms of epidemiological involvement using predetermined criteria. The three criteria were based on the indexing of relevant MeSH keywords, publication types, or the departmental affiliations of the authors. For all three criteria, the proportion of clinical papers with epidemiological involvement was the highest in the US, followed by the UK, whereas it was the lowest in Japan. The difference was almost four-fold between the US and Japan. There was also an increasing trend of epidemiological involvement in publications of clinical medicine over the years, which was more apparent in the US than in either the UK or Japan. These findings may reflect inter-country differences in resources as well as in the stance towards evidence-based health sciences.

Bibliometrics↗
PubMed2001

[Effects of acupuncture therapy on low back pain and/or knee pain in elderly patients].

In April 1999, 75 elderly patients (mean age: 79 years old) with low back pain and/or knee pain visited an acupuncture and physical therapy unit in a geriatric hospital. A cross-sectional study was carried out in order to evaluate the effects of acupuncture therapy on low back pain and/or knee pain in elderly patients. Among them, 60 patients answered that their pain diminished following their therapy. The proportion of patients who were treated with acupuncture therapy were higher in these 60 patients than the other 15 patients (55.5% vs. 26.7%, p = 0.05). The result suggests that acupuncture therapy may be able to relieve low back pain and/or knee pain in elderly patients. However, 46% of the patients with acupuncture therapy were also treated with other types of physical therapy. Further studies should be recommended to confirm the effects of acupuncture therapy on low back pain and/or knee pain.

Acupuncture Therapy↗
PubMed2001

The new public long-term care insurance system and feeling of burden among caregivers of the frail elderly in rural Japan.

The present study was conducted to investigate the factors related to the feelings of burden (i.e., stress) among caregivers of the frail elderly in rural Japan after the introduction of the new public long-term care insurance system in 2000. Forty-one out of 42 caregivers answered a self-administered questionnaire (i.e., the Japanese version of the Zarit Caregiver Burden Interview (ZBI)) regarding their caregiving situation. Compared with lightly burdened caregivers (n = 20; ZBI > or = 41), those heavily burdened (n = 21; ZBI < or = 40) attended the frail elderly with greater numbers of behavioral disturbances (2.2 +/- 2.6 vs. 0.6 +/- 1.0, p = 0.02) and those with dementia (60.9% vs. 39.1%, p = 0.08). Heavily burdened caregivers spent a longer time with the elderly (17.9 +/- 6.1 hours vs. 11.8 +/- 8.4 hours, p = 0.01) as well as in providing for their physically care (14.0 +/- 7.9 hours vs. 8.6 +/- 8.2 hours, p = 0.04), thus having less time to go out unaccompanied by their patients (1.1 +/- 1.6 hours vs. 2.4 +/- 2.3 hours, p = 0.04). Such caregivers tended to be depressed (70.0% vs. 42.9%, p = 0.08), although they used more social services (5.2 +/- 2.0 vs. 3.7 +/- 2.1, p = 0.03) than the lightly burdened caregivers. In addition, more than half of caregivers (56.1%) in the present study were depressed. This rate was higher than the rates in our studies before the introduction of the new public long-term care insurance system (a rural town: 53.3%, an urban town 46.6%). Furthermore, the number of social services used by caregivers did not seem to increase after the introduction of this insurance system (before: 4.1 +/- 2.0, after: 4.4 +/- 2.1). These findings suggest that the quantity and quality of social services for the frail elderly and their caregivers may not suffice even after the introduction of the new public long-term care insurance system.

Aged↗
PubMed2001

Depression among caregivers of elderly patients on chronic hemodialysis.

The present study was conducted to investigate depression in caregivers of elderly hemodialysis patients. Caregivers answered a self-administered questionnaire about various factors that may affect their depression, and also completed a Center for Epidemiologic Studies Depression Scale evaluation (CESD). The frail elderly who received regular nurse visits were used as controls. Compared with the caregivers of controls, those of hemodialysis patients spent less time on caregiving and had more time to go out unaccompanied by their patients. Males were numerous among hemodialysis patients than in the controls. Compared with the controls, hemodialysis patients were less likely to be older old (80 years old and more), diagnosed as demented or severely limited in activities of daily living (ADL). On the other hand, we did not find any significant difference between the two groups with regard to either the prevalence of depression, the rate of those who experienced any life event such as to cause depression within 6 months (e.g., death of family member), duration of caregiving or time looking after patients. Caregivers of hemodialyis patients may feel a heavy burden because they are obliged to play an important role in supporting patients on dialysis. They seem to need more social support regardless of whether or not their patients suffer from dementia.

Aged↗
PubMed2001

Burden among caregivers of frail elderly in Japan.

The present study was conducted in order to investigate the factors related to the feelings of psychological stress, called heavy burden, in caregivers who took care of frail elderly in the eastern part of Fukuoka Prefecture, Kyushu, Japan. Fifty-eight caregivers answered a self-administered questionnaire, involving the Japanese version of the Zarit Caregiver Burden Interview (ZBI) and thus described their own caregiving situation. Compared to caregivers with a light burden, heavily burdened caregivers were less likely to have time to go out without patients, but were more likely to consult physicians. Heavily burdened caregivers spent a longer time on looking after the elderly as well as on physical caregiving, and also used more social services than lightly burdened caregivers. However, the physical disabilities of the patients did not differ between the two groups. Even after controlling for confounding factors, the time spent on looking after frail elderly was found to be a significant factor related to the caregivers' heavy burden (10-24 hrs vs. 0-9 hrs; odds ratio: 5.35, 95% confidence interval: 1.17-25.58). These findings suggest that looking after frail elderly for a long time seems to be an important factor related to caregivers' developing psychological feelings of heavy burden.

Aged↗
PubMed2001

Awareness of the new long-term care insurance system and social services for elderly care in non-medical junior college students.

The present study was conducted in order to investigate the awareness of the new long-term care insurance and social services for the elderly care among young people. Non-medical junior college students answered a self-administered questionnaire about the new long-term insurance and other related matters. The present study revealed that only a small percentage of students knew about "the new public long-term care insurance system" (13% for males and 11% for females), "care-manager" (11% and 8%), or "care-plan" (9% and 5%) in 1999, just one year before this insurance system took effect. In contrast, more than one third of the students knew about "home-help service" (41% and 47%), "long-term care institution for the elderly" (33% and 35%), and "elderly care nursing home" (33% and 36%). However, these rates were much lower than the rates among nursing students in 1998. An educational program for non-medical students should be recommended to help them to understand our rapidly aging society and to take an interest in public policies and social services for the elderly in Japan.

Adolescent↗
PubMed2001

Recognition of the deleterious effects of smoking among senior high school male students.

The purpose of this study was to evaluate the prevalence of, attitudes towards, and knowledge about cigarette smoking among senior high school male students with different levels of academic ability. Self-administered anonymous questionnaires were distributed to 2014 students in July 2001. The prevalence of current smokers was 10.9% overall. The percentage of nonsmokers increased with academic ability level in both first and second graders. Students who recognize that cigarette smoking is associated with various diseases were more numerous than those reported in a nationwide Japan survey. Their recognition regarding the deleterious effects of smoking inclined toward diseases of the respiratory system. Correct knowledge concerning the detrimental effects of smoking on 10 selected diseases differed according to academic ability levels. They also thought that environmental tobacco smoke exposure was harmful to nonsmokers' health (86.6%). Although they fully understood the harmful effects of smoking, the percentage of current smokers who wanted to quit smoking (24.7%) was somewhat lower than that of those who did not (30.1%). A considerable number of current smokers, 95 of 219, had not made up their mind to quit smoking. To reduce the numbers of adult smokers, it is important not only to prevent students from starting to smoke or to encourage smokers to quit but also to guide undecided smokers in how to quit.

Adolescent↗
PubMed2000

Undue concern for others' opinions deters caregivers of impaired elderly from using public services in rural Japan.

OBJECTIVE: To determine whether opinions of others may discourage the use of public services for the elderly. DESIGN: Users and non-users were compared regarding several variables including caregivers' concerns about opinions of others. SETTING: Matsuyama Town, located in a rural area of northern Japan. SUBJECTS: Seventy pairs of (1) elderly persons in need of care assessed by the procedure employed by the Ministry of Health and Welfare, and (2) their respective family caregivers. MEASURES: Cognitive function (Hasegawa Dementia Rating Scale), diagnosis of dementia, activities of daily living (ADL: Barthel Index), caregivers' burden (Zarit Caregiver Burden Interview), behavioral disturbances (Dementia Behavioural Disturbance Scale), caregiver interviews. RESULTS: A logistic regression analysis revealed that those who looked after the elderly with severe dependency in ADL were three times more likely to use public services (OR = 3.33, 95% CI = 1.02 - 10.88, p = 0.04). Those concerned about what others think or say were less likely to use public services (OR = 0.22, 95% CI = 0.06 - 0.78, p = 0.01) than those who did not. CONCLUSIONS: Caregivers' undue concern for the opinions of others apparently deterred them from using public services. The overriding notion of care for the elderly as a family duty is still prevalent in rural Japan. It would be useful for the government to launch a public awareness programme to help caregivers understand the benefits of services available for the elderly.

Aged↗
PubMed2000

Job strain, Type A behavior pattern, and the prevalence of coronary atherosclerosis in Japanese working men.

OBJECTIVE: To examine the relation of type A behavior pattern and job strain to angiographically documented coronary stenosis. METHODS: Subjects were 197 male Japanese patients with a full-time job. A questionnaire-based interview elicited psychosocial and other factors. Type A behavior pattern was measured by 12 questions, and job strain by the method of Karasek. Significant coronary stenosis was defined when a 75% or greater luminal narrowing occurred at one or more major coronary arteries or when a 50% or greater narrowing occurred at the left main artery. Logistic regression analysis was used to calculate odds ratio (OR) and 95% confidence interval (CI) with adjustment for traditional coronary risk factors and job type. RESULTS: Type A behavior pattern was related to a statistically non-significant lower prevalence of the coronary stenosis especially in the absence of job strain (adjusted OR 0.6, 95% CI 0.3-1.2). Job strain was non-significantly associated with a modestly increased prevalence of coronary stenosis (OR 1.7, 95% CI 0.6-5.2). CONCLUSION: These findings suggest that both the behavioral pattern and psychosocial work environment may be related to coronary artery stenosis.

Adult↗
PubMed2000

Relation between green tea consumption and the severity of coronary atherosclerosis among Japanese men and women.

PURPOSE: To examine the relation between green tea consumption and arteriographically determined coronary atherosclerosis. METHODS: Study subjects were 512 patients (302 men and 210 women) aged 30 years or older who underwent coronary arteriography for the first time at four hospitals in Fukuoka City or one hospital in an adjacent city between September 1996 and August 1997. Lifestyle characteristics including green tea consumption were ascertained before arteriography by a questionnaire supported with interview. RESULTS: 117 men (38.7%) and 50 women (23.8%) had significant stenosis of one or more coronary arteries. Green tea consumption tended to be inversely associated with coronary atherosclerosis in men, but not in women. An evident, protective association between green tea and coronary atherosclerosis was observed in a subgroup of 262 men excluding those under dietary or drug treatment for diabetes mellitus. In this subgroup, after adjustment for traditional coronary risk factors and coffee, odds ratios of significant stenosis for consumption of 2-3 cups and 4 or more cups per day were 0.5 (95% confidence interval 0.2-1.2) and 0.4 (0.2-0.9), respectively, as compared with a consumption of one cup per day or less. CONCLUSIONS: The results indicate that green tea may be protective against coronary atherosclerosis at least in men.

Adult↗