Chieko Sugishita

Development of a Japanese Quality of Life Instrument for Older Adults Experiencing Dementia (QLDJ).

This study develops a quality of life instrument for older Japanese people experiencing dementia (QLDJ). Quality of life (QL) for these older adults is defined as a three dimensional construct including 1) interacting with surroundings, 2) expressing self, and 3) experiencing minimum negative behaviors. From 53 items in the initial item pool, 24 were selected based on item reliability and validity using data from 3 studies that involve ten dementia-care experts (Study A) and 36 and 623 older persons and their formal caregivers in various care settings (Study B & C). Factor analysis of these items identified three domains that correspond to the conceptual definition of QL for older adults with dementia. The domain and total QL scores were calculated considering the relative weights of each item. Resultant domain and total scores of the QLDJ showed satisfactory reliability and evidence of validity.

NOVEL MUTANT MICE SECRETING SOLUBLE CD4 WITHOUT EXPRESSION OF MEMBRANE-BOUND CD4

Mutant mice derived from C57BR/cdJ mice were found to have a novel genetic defect in CD4 expression. Flow‐cytometric analysis demonstrated that there were no CD4+ cells in either the thymus or the peripheral lymphoid organs of the mutant mice. Thymocytes of the mutant mice expressed an amount of CD4 mRNA comparable to normal mouse thymocytes, but the mutant CD4 mRNA was slightly smaller in size than normal CD4 mRNA. The sequence analysis of the mutant CD4 cDNA obtained from thymic RNA revealed that the defect in the CD4 expression was attributable to the deletion of the entire exon VIII, encoding a transmembrane domain of the CD4 molecule. Moreover, soluble CD4 was detected both in the culture supernatant of thymocytes and sera from mutant mice. The analysis of the genomic DNA sequence elucidated that one thymine was substituted for 14 base pairs at the junction between exon VIII and intron VIII in the mutant mice, which could possibly account for the alternative splicing of CD4 mRNA. These mutant mice showed reduced delayed‐type hypersensitivity reactions against sheep red blood cells and antibody production against T‐dependent antigen but not against T‐independent antigen. Thus, these mutant mice have a novel defect in CD4 expression where CD4 mRNA is alternatively spliced to delete a transmembrane domain, giving rise to secretion of soluble CD4 instead of expression of membrane‐bound CD4.

Development of Family Nursing in Japan—Present and Future Perspectives:

This article describes the evolution of family nursing in Japan. It situates the unfolding of practice, education, and theory development of family nursing in Japan in relationship with development of family nursing in other countries.

Effects of compression stockings on blood pressure and its orthostatic change in female subjects

Abstract We investigated in female non-hypertensive subjects whether compression stockings affected systolic (SBP) and diastolic blood pressures (DBP) and heart rate (HR) and whether they were effective in reducing changes in SBP induced by active standing. Using an automatic ambulatory recording system, these hemodynamic parameters were measured during the Schellong test in 82 females between 23 and 78 years of age (46±2 years; mean±S.E.). Measurement was carried out every 2 min according to the following protocol which was repeated with and without stockings: (1) while in a supine position for 10 min, (2) immediately on assuming a standing position and while maintaining this standing position for 15 min, (3) immediately on reassuming a supine position, and (4) while maintaining this supine position for 5 min. Wearing compression stockings significantly elevated SBP in the supine position of the hypotensive (SBP≤100 mmHg; n =24) but not normotensive groups (140 mmHg>SBP>100 mmHg; n =58). DBP and HR were not significantly altered in either group. Active standing resulted in either an increase or decrease in SBP of various degrees. Therefore, subjects were divided into the following three subgroups depending on the orthostatic change in SBP (∠SBP) calculated as the difference between SBP immediately after active standing and supine SBP:∠SBP≥20 mmHg ( n =10), 20>∠SBP≥0 mmHg ( n =57), and 0 mmHg>∠SBP ( n =15). In all the three groups, the absolute value of ∠SBP was significantly attenuated by the use of compression stockings. These effects of wearing stockings are not critically dependent on the age. We thus conclude that compression stockings are effective in elevating supine SBP of hypotensive subjects and in reducing the orthostatic response of SBP to active standing.

Quantitative analysis of autonomic nervous activity during passive leg cycle exercise

We investigated whether passive leg cycle exercise (PLE) for the elderly and patients with spinal cord injuries leads to the modulation of autonomic nervous activity in healthy female subjects. To evaluate changes in autonomic nervous activity during PLE, we used autoregressive (AR) power spectra of pulse interval variability (PIV) corresponded to R-R interval variability and systolic blood pressure variability (SPV). Our results showed that LF and HF powers and the ratio power (LF/HF) of PIV reflecting cardiac sympathetic, parasympathetic tone and sympathovagal balance were not changed during PLE, but during recovery period immediately after PLE, LF and HF powers and total power of PIV was significantly (p<0.05) increased. On the other side, LF power of SPV showing vasomotor sympathetic tone was significantly (p<0.05) decreased. We conclude that PLE causes to modulate the autonomic nervous activity in healthy subjects with normal autonomic function, and may be used as the useful exercise for the elderly who need some therapeutics without the abrupt modulation of autonomic nervous activity.