Sachiko Shimizu

Lugol-Voiding Lesions Are an Important Risk Factor for a Second Primary Squamous Cell Carcinoma in Patients With Esosphageal Cancer or Head and Neck Cancer

OBJECTIVES:Lugol-voiding lesions (LVLs), detected by chromoendoscopy using iodine dye in patients with esophageal squamous cell carcinoma (EC) or head and neck squamous cell carcinoma (HNC), are associated with a second primary carcinoma in the other organ. We undertook a cross-sectional and retrospective cohort study to assess the risk for second primary carcinomas according to the severity of LVLs, on the basis of their number and size.METHODS:A total of 1,060 patients with only EC, only HNC, or both EC and HNC (EC+HNC) underwent esophageal endoscopic examination between January 1994 and January 2010. The patients were classified according to the number of LVLs in an endoscopic visual field and the size of the largest LVLs. Factors associated with the second primary EC or HNC were analyzed.RESULTS:Univariate analysis showed that a larger number and size of LVLs increased the risk for synchronous and early metachronous second primary cancer (P value for trend <0.0001). Multivariate analysis showed that a number of LVLs ≥20 (EC+HNC vs. only HNC, odds ratio (OR)=15.7; EC+HNC vs. only EC, 3.5) and a size ≥10 mm (EC+HNC vs. only HNC, OR=3.1; EC+HNC vs. only EC, 3.2) were independent risk factors for synchronous and early metachronous second primary cancer. A larger number of LVLs was a risk factor for metachronous EC and HNC, and a size ≥10 mm was a risk factor for late metachronous EC.CONCLUSIONS:The severity of LVLs in patients with HNC or EC closely correlated with a second primary carcinoma in the other organ. Patients with LVLs must be followed closely for development of a second primary carcinoma.

Daytime physical activity and sleep in pre-schoolers with developmental disorders

This study aims to investigate the association between daytime physical activity (PA) and sleep in pre‐schoolers with or without autism spectrum disorders (ASDs).

Body movement analysis during sleep for children with ADHD using video image processing

In recent years, the amount of children with sleep disorders that cause arousal during sleep or light sleep is increasing. Attention-deficit hyperactivity disorder (ADHD) is a cause of this sleep disorder; children with ADHD have frequent body movement during sleep. Therefore, we investigated the body movement during sleep of children with and without ADHD using video imaging. We analysed large gross body movements (GM) that occur and obtained the GM rate and the rest duration. There were differences between the body movements of children with ADHD and normally developed children. The children with ADHD moved frequently, so their rest duration was shorter than that of the normally developed children. Additionally, the rate of gross body movement indicated a significant difference in REM sleep (p <; 0.05). In the future, we will develop a new device that can easily diagnose children with ADHD, using video image processing.

Comparison between Overall, Cause-specific, and Relative Survival Rates Based on Data from a Population-based Cancer Registry

Three kinds of survival rates are generally used depending on the purpose of the investigation: overall, cause-specific, and relative. The differences among these 3 survival rates are derived from their respective formulas; however, reports based on actual cancer registry data are few because of incomplete information and short follow-up duration recorded on cancer registration. The aim of this study was to numerically and visually compare these 3 survival rates on the basis of data from the Nagasaki Prefecture Cancer Registry. Subjects were patients diagnosed with cancer and registered in the registry between 1999 and 2003. We calculated the proportion of cause of death and 5-year survival rates. For lung, liver, or advanced stage cancers, the proportions of cancer-related death were high and the differences in survival rates were small. For prostate or early stage cancers, the proportions of death from other causes were high and the differences in survival rates were large. We concluded that the differences among the 3 survival rates increased when the proportion of death from other causes increased.

Psychometric properties and population-based score distributions of the Japanese Sleep Questionnaire for Preschoolers

OBJECTIVE We aimed to present psychometric properties and describe the score distributions of the Japanese Sleep Questionnaire for Preschoolers (JSQ-P), a guardian-reported survey questionnaire for assessing sleep disturbances and problematic sleep habits among preschool children. METHODS Guardians of 2998 toddlers in three communities and guardians of 102 patients diagnosed with sleep disorders in two clinics completed the JSQ-P. RESULTS Exploratory factor analysis (EFA) revealed the 10 domains of the JSQ-P to be similar to our previous small-scale study and confirmed the robustness of the JSQ-P. The JSQ-P showed acceptable internal consistency; α coefficients ranged from 0.622 (insufficient sleep) to 0.912 (restless legs syndrome [RLS], motor) for the community sample and 0.696 (insufficient sleep) to 0.959 (RLS, motor) for the clinical sample. The score differentiations between the community and clinical samples associated with RLS, obstructive sleep apnea syndrome (OSAS), morning symptoms, parasomnias, excessive daytime sleepiness, and daytime behaviors were demonstrated in our study. The distributions of percentile T scores for each subscale and age and gender differentiation of scores also were evaluated. CONCLUSIONS We confirmed that the JSQ-P is a valid and reliable instrument to evaluate Japanese sleep habits using a large population-based sample. The JSQ-P may be useful in both clinical and academic settings.

Cost-effectiveness analysis of a pertussis vaccination programme for Japan considering intergenerational infection

OBJECTIVE The incidence of pertussis in adolescence and adulthood has been increasing, and pertussis outbreaks have occurred sporadically in Japan. The risk of intergenerational infection of pertussis is of concern. The aim of this study is to assess the cost-effectiveness of alternative vaccination programmes for replacing the conventional diphtheria-tetanus (DT) vaccine programme administered in adolescence, considering the risk of intergenerational infection. METHODS We examined the cost-effectiveness of 4 pertussis vaccination programmes: (1) one-time adolescent DT vaccination (DT); (2) one-time adolescent DT-acellular pertussis (DTaP) vaccination; (3) one-time adolescent DTaP with decennial booster (DTaP+booster); and (4) one-time adolescent DTaP with additional vaccination targeted at parents with infants (additional DTaP for parents). We adapted a state-transition Markov model to estimate the costs and effectiveness of vaccination in the adolescent and adult cohorts and then considered intergenerational infection from adolescents/adults to infants. We assumed a societal perspective to estimate results and expressed these in terms of cost, life expectancy, quality-adjusted life expectancy, benefit-cost ratio (BCR), and incremental cost-effectiveness ratio (ICER). RESULTS At an incidence of 25 per 100,000, the ICERs of the DTaP and additional DTaP for parents strategies were 3,576,072 JPY and 240,055,273 JPY, respectively, when intergenerational transmission of infection was considered. The ICER for the DTaP+booster strategy was dominated. MAJOR CONCLUSION Alternative vaccination programmes are not currently cost-effective. If intergenerational infection considered, one-time adolescent DTaP vaccination is cost-effective. More accurate reports of pertussis incidence are required as the results of cost-effectiveness analyses of vaccination vary greatly depending on incidence.

The Cleaning Effect of Shampooing Care by Adenosine Triphosphate Bioluminescence System

This paper discusses the cleaning effect of shampooing care by using Adenosine Triphosphate (ATP) bioluminescence system. Shampooing care is an important nursing one for patients who are difficult to care oneself. It is necessary to perform effective and comfortable care. So, we need to evaluate these effects quantitatively and qualitatively. We measured ATP, blood pressure, heart rate, heart rate variability, peripheral skin temperature and Visual Analog Scale (VAS) before and after shampooing. When we analyzed ATP adhering to head as “contamination” to evaluate that effect quantitatively, it found that the contamination of the scalp after shampooing decreased by 31%, and that of the hair decreased by 22%. The correlation between ATP and VAS showed that the more ATP decreased, the more subjects felt refresh. The physiological index was stable, and it found that the shampoo method in this study had little load on the body. We were able to clarify the cleaning effect of shampooing using rapid and simple method. These results showed can be the basic data that evaluated the effect by shampooing comprehensively.

Cancer incidence and mortality in Osaka, Japan: future trends estimation with an age-period-cohort model.

In previous studies we predicted future trends in cancer incidence for each prefecture in order to plan cancer control. Those predictions, however, did not take into account the characteristics of each prefecture. We therefore used the results of age-period-cohort analysis of incidence and mortality data of Osaka, and estimated the incidence and mortality of cancers at all sites and selected sites. The results reflect the characteristics of Osaka, which has and is expected to have large number of patients with liver cancer. We believe our results to be useful for planning and evaluating cancer control activities in Osaka. It would be worthwhile to base the estimation of cancer incidence and mortality in each prefecture on each population-based cancer registry.

Nursing Business Modeling with UML: From Time and Motion Study to Business Modeling

A nurse is an autonomous, decentralized worker who recognizes goals, his or her environment, the conditions and actions of patients and other staff members, and determines his or her own actions. Put another way, the nurse makes decisions flexibly in the midst of uncertainty. Because of this, nursing work differs from individual nurse to nurse, and understanding this process theoretically is considered to be difficult. Concerning nursing work analysis, research has been done on task load (time required for tasks). However, there has been scant academic research on work processes in nursing compared with research that has accumulated in other industrial fields, including research on structuralizing work, i.e., defining and visualizing work processes. To improve work processes, it is necessary to understand and clarify work as a chain of theoretically related activities. Thus in this study, using time and motion study techniques, a method used to measure jobs, we clarify the structure of the work of transporting patients by nurses. We also attempt to visualize it. We use objected-oriented modeling to express the operation visually.

Comparison of Gross Body Movements during Sleep between Normally Developed Children and ADHD Children Using Video Images

In recent years, it is known that childhood behavioral disorders are related to sleep quality. Thus it is important to monitor the childhood sleep to monitor their normal develop. It is said that there is a tight relationship between sleep quality and body movements, especially gross body movements (GMs). Thus, this study focused on the relationship to sleep quality and GMs. Hence, we investigated the GMs measurement technique using video analysis. We can measure the GMs in noninvasive and non-contact way by using this technique. We applied this technique for comparison of GMs during sleep between normally developed children and children with ADHD. We calculated the rate of body movement and rest duration in each sleep stage by video analysis. As the result, children with ADHD did not have inhibition of GMs in SWS (Slow Wave Sleep). Especially in Stage 3, there were significant differences in the rate of GMs. In addition, rest duration in children with ADHD was shorter than in the control children in Stage 2, Stage 3, Stage 4, and REM. This findings show the possibility that degree of childhood development could be assessed by this technique.