[Sleep quality and mental well-being of mothers caring for children with disabilities and requiring oxygen therapy and night care at home]

Objectives　This study aimed to 1) determine what kind of care for children with disabilities is related to the mothers' sleep and mental well-being and 2) objectively measure the sleep state of mothers responsible for children with disabilities.Methods　A self-administered questionnaire was distributed to 180 mothers of children enrolled in the Special Needs Education School in prefecture A. Amongst these, nine who provided consent underwent objective sleep measurements using actigraphy. The questionnaire investigated the lifestyle and the type of care needed for children with disabilities and their influence on the mothers. Subjective sleep quality (Pittsburgh Sleep Quality Index) and mental well-being status (General Health Questionnaire) of the mothers were also evaluated. Logistic regression analysis was performed to analyze the background factors affecting sleep quality and mental health.Results　Of the 180 participants, 84 (46.7%) provided valid responses. Fifty-two (64.2%) and 34 (42.0%) individuals subjectively reported poor sleep quality and poor mental well-being, respectively. Mothers having responsibilities of oxygen therapy and night care reported significantly poor sleep quality and mental well-being. Moreover, objective sleep measurements showed that the changes in the child's physical condition, such as ventilator management, epileptic seizures, and fever, resulted in prolonged waking times and affected the sleep efficiency of the mother.Conclusion　Responsibilities toward providing oxygen therapy and night care for their children with disabilities influenced the sleep quality and mental well-being of the mothers. Thus, it is important to provide support to mothers caring such disabled children.

Prevalence of Helicobacter pylori among residents and their environments in the Nara prefecture, Japan

BACKGROUND

Chronic infection with Helicobacter pylori, specifically cagA-positive strains, is associated with gastric cancer. Thus, measures to prevent H. pylori infection are required. This study was conducted to clarify the prevalence of H. pylori in the community to identify the infection source and comprehensively assess the risk of H. pylori infection.

METHODS

We collected 90 human faecal samples and 73 environmental samples (water, vegetable, and animal faecal samples) from the residents in an area with a high incidence of gastric cancer in Japan. Polymerase chain reaction assay was performed to detect the glmM housekeeping gene and the cagA virulence gene of H. pylori. A questionnaire survey was conducted, and the responses were analyzed statistically.

RESULTS

The glmM gene was detected in 18 of 90 (20%) faecal samples obtained from residents; among them, the cagA gene was detected in 33.3% (6/18), and in all who had undergone eradication therapy. H. pylori was not detected in environmental samples. However, contact with dogs (OR 3.89, 95% CI 1.15-13.15, P < 0.05) was associated with higher odds for glmM gene positivity in the questionnaire survey.

CONCLUSIONS

The prevalence of H. pylori and cagA-positive strains among the residents was low. However, the study results suggest a correlation between recurrent infection and cagA-positive H. pylori strains. Although H. pylori genes were not detected in living environments, an association between contact with dogs and a glmM positive status was revealed. Further investigations targeting community-dwelling healthy people and their living environments would be required for H. pylori infection control.

The interaction effect between physical and cultural leisure activities on the subsequent decline of instrumental ADL: the Fujiwara-kyo study

Background

Maintenance of instrumental activities of daily living (IADL) and social role (SR) is crucial to keep independent life because the decline in SR and IADL was a significant predictor of dependence in basic ADL in later. The independent effect of physical and cultural leisure activities and their effect modification on the IADL remains unknown.

Methods

We prospectively observed 3241 elderly with intact IADL at baseline for 5 years. Higher level functional capacity such as IADL and SR was assessed using the Tokyo Metropolitan Institute of Gerontology Index of competence (TMIG index).

Results

The mean age of the participants was 72.3 years (standard deviation 5.1), and 46.9% were male, and 90.9% of them received a follow-up assessment. Of the participants, 10.4% developed an IADL decline. Engagement in leisure physical activity was associated with a significantly lower risk of IADL decline (adjusted risk ratio, 0.73; 95% confidence interval [CI], 0.60 to 0.89), and cultural leisure activity was also associated with lower risk of IADL decline (adjusted risk ratio, 0.77; 95% CI, 0.63 to 0.95) independent of potential confounders. We also found significant and positive interaction between physical and cultural leisure activities at risk for IADL decline (P = 0.024) and SR decline (P = 0.004).

Conclusions

We found an independent association of physical and cultural leisure activities with a lower risk for functional decline in IADL and SR with positive interaction. Combined engagement in physical and cultural activities may effectively prevent from IADL decline and SR decline.

Development of a loop-mediated isothermal amplification assay for rapid Helicobacter pylori detection

Infection with cagA-positive Helicobacter pylori is associated with gastric cancer. Molecular techniques are vital for accurate H. pylori diagnosis. We developed a loop-mediated isothermal amplification (LAMP) for detecting the H. pylori cagA gene and evaluated its use for clinical diagnosis. A LAMP primer set was designed to recognize the homologous regions of cagA gene sequences of 6 H. pylori strains. LAMP sensitivity was evaluated with serial dilutions of H. pylori ATCC 43504 and fecal specimens; specificity was evaluated with H. pylori ATCC 49396 and CIP 104086. The LAMP sensitivity for H. pylori specimens was 10^-1 cfu/tube (reaction time, 37 min), which was 10-fold more sensitive than polymerase chain reaction. LAMP was also highly sensitive and rapid for fecal specimens. It detected cagA gene from ATCC 49396 and CIP 104086. The findings suggest LAMP can be used for diagnosing and screening of H. pylori infections to decrease gastric cancer incidence.

Identifying Residents' Health Issues Six Weeks after the Great East Japan Earthquake

OBJECTIVE

The aim of this study was to identify the characteristics and health issues of residents in need of assistance in a town affected by the Great East Japan Earthquake, six weeks after the disaster, through an outreach initiative.

DESIGN AND SAMPLE

A cross-sectional qualitative design was used. Public health nurses conducted comprehensive semi-structured interviews during home visits with residents. A total of 5,082 residents from the affected town.

MEASURES

These included demographic information, public records of the extent of the damages, and qualitative interview data to determine the urgency of the necessary interventions.

RESULTS

A total of 281 residents needed some kind of assistance and were identified as "requiring early intervention (within two weeks)" or "requiring assistance (within 12 weeks)." The most common health issue requiring early intervention was "interruption of treatment" (25.0%), followed by "need for mental care." The most frequent health issue requiring assistance within 12 weeks was the "need for mental health care" (39.7%), followed by "interruption of treatment," and "need for nursing care."

CONCLUSIONS

During a disaster, it is imperative to identify cases requiring early intervention. Home-visit interviews were necessary to identify existing health concerns to prevent the development of more serious health problems.

The tsunami's impact on mortality in a town severely damaged by the 2011 Great East Japan Earthquake

This study identifies the relationship between tsunami damage and mortality through a demographic pyramid of a town severely damaged by the tsunami following the Great East Japan Earthquake of 11 March 2011. It uses cross-sectional data collection. Volunteers visited all households, including shelters, and asked residents about the whereabouts of family members and neighbours. The information was collated with lists of evacuees and the dead to confirm the whereabouts of all residents about 50 days after the disaster. Demographic pyramids for the whole population based on pre- and post-disaster data were drawn. In all, 1,412 (8.8 per cent) were dead or missing, 60.2 per cent of whom were aged 65 and over and 37.5 per cent aged 75 and over, suggesting that the very old should be located beyond the reach of tsunamis. The mortality rate of children was lower than that in other studies, which may indicate the efficacy of disaster evacuation drills.

Association between first airborne cedar pollen level peak and pollinosis symptom onset: a web-based survey

Cedar pollinosis in Japan affects nearly 25 % of Japanese citizens. To develop a treatment for cedar pollinosis, it is necessary to understand the relationship between the time of its occurrence and the amount of airborne cedar pollen. In the spring of 2009, we conducted daily Internet-based epidemiologic surveys, which included 1453 individuals. We examined the relationship between initial date of onset of pollinosis symptoms and daily amount of airborne cedar pollen to which subjects were exposed. Approximately 35.2 % of the subjects experienced the onset of pollinosis during a one-week interval in which the middle day coincided with the peak pollen count. The odds ratio for this one-week time interval was 4.03 (95 % confidence interval: 3.34-4.86). The predicted date of the cedar pollen peak can be used to determine the appropriate date for initiation of self-medication with anti-allergy drugs and thus avoid development of sustained and severe pollinosis.

Prevalence of insomnia among residents of Tokyo and osaka after the great East Japan earthquake: a prospective study

Background

The Great East Japan Earthquake occurred on March 11, 2011. Tokyo and Osaka, which are located 375 km and 750 km, respectively, from the epicenter, experienced tremors of 5.0 lower and 3.0 seismic intensity on the Japan Meteorological Agency scale. The Great East Japan Earthquake was the fourth largest earthquake in the world and was accompanied by a radioactive leak at a nuclear power plant and a tsunami. In the aftermath of a disaster, some affected individuals presented to mental health facilities with acute stress disorder (ASD) and/or post-traumatic stress disorder (PTSD). However, few studies have addressed mental stress problems other than ASD or PTSD among the general public immediately after a disaster. Further, the effects of such a disaster on residents living at considerable distances from the most severely affected area have not been examined.

Objective

This study aimed to prospectively analyze the effect of a major earthquake on the prevalence of insomnia among residents of Tokyo and Osaka.

Methods

A prospective online questionnaire study was conducted in Tokyo and Osaka from January 20 to April 30, 2011. An Internet-based questionnaire, intended to be completed daily for a period of 101 days, was used to collect the data. All of the study participants lived in Tokyo or Osaka and were Consumers’ Co-operative Union (CO-OP) members who used an Internet-based food-ordering system. The presence or absence of insomnia was determined before and after the earthquake. These data were compared after stratification for the region and participants’ age. Multivariate analyses were conducted using logistic regression and a generalized estimating equation. This study was conducted with the assistance of the Japanese CO-OP.

Results

The prevalence of insomnia among adults and minors in Tokyo and adults in Osaka increased significantly after the earthquake. No such increase was observed among minors in Osaka. The overall adjusted odds ratios for the risk of insomnia post-earthquake versus pre-earthquake were 1.998 (95% CI 1.571–2.542) for Tokyo, 1.558 (95% CI 1.106–2.196) for Osaka, and 1.842 (95% CI,1.514–2.242) for both areas combined.

Conclusions

The prevalence of insomnia increased even in regions that were at a considerable distance from the epicenter. Both adults and minors in Tokyo, where the seismic intensity was greater, experienced stress after the earthquake. In Osaka, where the earthquake impact was milder, disturbing video images may have exacerbated insomnia among adults.