Tetsuya Tanioka

Gender differences in association of plasma adiponectin with obesity reflect resultant insulin resistance in non‐diabetic Japanese patients with schizophrenia

Abstract  Adipose tissues poorly produce adiponectin in the population with increased body fat mass and diabetes mellitus. It was investigated whether hypoadiponectinemia is associated with obesity and insulin resistance in patients with chronically medicated schizophrenia. A cross‐sectional study was designed for 73 non‐diabetic Japanese patients with schizophrenia. The patients aged <70 years with body mass index (BMI) ≥18.5 were selected. Anthropometrics and blood parameters including fat‐derived cytokines were measured, and then the BMI and homeostasis model assessment – insulin resistance (HOMA‐IR) was calculated. The variables were compared between the non‐obesity (BMI, 18.5–24.9) and obesity (≥25.0) groups, and between genders. Plasma adiponectin negatively correlated with BMI (r = −0.554, P < 0.0003) and HOMA‐IR (r = −0.380, P = 0.007) in men, but not in women. The obesity group in men, as compared with the non‐obesity group, showed significantly lower plasma adiponectin (P = 0.008) and higher HOMA‐IR (P < 0.05), but not in women. Plasma leptin showed a significant positive correlation with BMI (r = 0.604, P < 0.0001 in men; r = 0.763, P < 0.0001 in women) and HOMA‐IR (r = 0.618, P < 0.0001 in men; r = 0.679, P < 0.0001 in women). The mean plasma leptin in the obesity group was significantly higher than that in the non‐obesity group (P < 0.01 in men; P < 0.01 in women). In contrast to plasma leptin, plasma adiponectin showed gender difference in relation to BMI and HOMA‐IR.

Factors Associated with Discharge of Long-Term Inpatients with Schizophrenia in Japan: A Retrospective Study

Deinstitutionalization for people with mental disorders has only begun to be implemented in Japan. The purpose of this retrospective study was to examine factors associated with discharge for long-term patients with schizophrenia. Seventy patients were judged capable of discharge with psychiatric rehabilitation (special staff service). As a result of rehabilitation efforts, 37 patients were discharged and 33 patients remained in the hospital. Significant differences were found in age, level of family agreement about patients disability, and length of the special staff service. These factors might be important to predict patients’ potential for discharge.

Measuring quality of sleep and autonomic nervous function in healthy Japanese women

The purpose of this study was to determine the relationship between quality of sleep and autonomic nervous functioning in healthy adult Japanese women using three measures, namely, the Pittsburgh Sleep Quality Index (PSQI) for subjective assessment of sleep quality, actigraphy for objective assessment of sleep, and heart rate variability using high frequency and low frequency domains. Participants were 31 healthy women in their 20s to 40s who met the selection criteria, including having normal monthly menstrual periods. Participants were categorized as good or poor sleepers according to their PSQI score. Median correlation coefficients of activity count and high frequency were −0.62 (range −0.43 to −0.84) for good sleepers and −0.45 (range 0.003 to −0.64) for poor sleepers. Good sleepers showed a significantly higher correlation of activity count and high frequency (Z=−2.11, P<0.05). Median correlation coefficients of activity count and low frequency/high frequency were 0.54 (range 0.29–0.73) for good sleepers and 0.41 (range 0.11–0.63) for poor sleepers. The PSQI, actigraphy data, and heart rate variability results showed positive correlations between sleep time as measured by PSQI and duration of inactivity as measured by actigraphy (r=0.446, P<0.05) and sleep time as measured by actigraphy (r=0.377, P<0.05), and a negative correlation between sleep time as measured by PSQI and the correlation coefficients of activity count and high frequency (r=−0.460, P<0.01). These results support the finding that sleep-wake rhythms can be monitored efficiently with actigraphy, providing accurate data that can support the diagnosis of sleeping disorders. Furthermore, actigraphy data were associated with heart rate variability and PSQI findings, but only in subjects who were poor sleepers. Actigraphy is an accurate, efficient, rapid, and inexpensive test for determining objective and subjective sleeping problems, and can also be used in clinical tests for sleep assessment.

The Development of the Transactive Relationship Theory of Nursing (TRETON): A Nursing Engagement Model for Persons and Humanoid Nursing Robots

Background: Precise nursing actions assure quality human health care. However, such actions are often identified as low-level health care work thereby delegated as tasks that only need completion. With the Japanese elderly population increasing at a phenomenal rate, these types of nursing actions are critically demanded. As a health care practice problem leading to labor shortages in health care settings specifically among nurses and direct health caregivers, Japan has made a national commitment focused on developing healthcare robots to respond to the nursing care demands of the older adult population. Transactive relationships are necessary in human and robot nurse-patient interactions. How will human persons and humanoid nursing robots (HNRs) relate with each other? Research on robots assisting patient care is needed to reduce human-dependent activities thereby sanctioning human nurses’ focus on direct human caring relationships. Aim: The purpose of this paper is to describe the development of the Transactive Relationship Theory of Nursing (TRETON) for nursing engagements between HNRs and human persons. Methods: Theory development and Systematic Review of Literature focused on the phenomenon of healthcare engagements, humanoid robots, and nursing practice. Specifically, the metaparadigms of Nursing provided the procedural theoretical structures. Results/Findings: The TRETON is the product of theory development. Nursing encounters between humanoid nursing robots and human persons in transactive interactions were described within the metaparadigms of person, nursing, environment, and health. Conclusion: The TRETON is a middle-range theory of nursing guiding nursing practice focused on the relationship between human persons and humanoid nursing robots. It endorses two critical nursing questions, i.e., if the nature of HNRs is to assume human caring practices to promote human health and well-being, will this nature matter to nursing care of human persons? What will engender the nature of the transaction between human persons and HNRs in 21st century ontology of nursing?

Gender differences of the influential factors on the mental health condition of teachers in the A university

The purpose of this research was to investigate the gender differences of the influential factors on the mental health condition among university teachers in the A university in Japan. A questionnaire survey was mailed to 924 university teachers in Japan, with a survey return rate of 43.8% (N=405). The General Health Questionnaire 28 (GHQ-28), Multidimensional Scale of Perceived Social Support (MSPSS), the Japanese version of the Brief Coping Orientation to Problems Experienced (COPE) and the Work Situation Questionnaire (WSQ) developed by the authors were administered to subjects. The GHQ-28 total score and all of sub-score of the woman was significantly higher than men. In the correlated factor of mental health, level of job satisfaction and job control, social support of significant others was observed in the both sexes. However, gender differences was observed in the coping style. Some copings including self-distraction and self-blame were related to the men, but the woman was related to the substance use. University teachers had some gender differences in the factors affecting their mental health condition. In order to improve university teachers mental health condition, it is necessary to increase their level of job satisfaction and feeling of job control in the workplace. Especially, it was considered womens coping using substance use was important.

Research on the possibility of humanoid robots to assist in medical activities in nursing homes and convalescent wards

In Japan, increasing attention has been given to using humanoid robots to solve problems concerning personnel shortage and to reduce duty workload in clinical and nursing situations. Currently, the development of robots is not yet at the level where they can function like human medical and health care professionals. For this reason, it is imperative to discover ways in which humanoid robots can be used to solve the issues of personnel shortage and duty workload. The aim of this research is to clarify the impressions nurse and care staff has toward humanoid robots. The research focuses on 1) whether there are any duties humanoids can undertake and 2) what is required of humanoids to perform clinical functions. This research was approved by the ethical review board of University Hospital A, and a mail survey was conducted between August and September, 2010. The respondents were 939 members of nurse and care staff working in nursing homes and convalescent wards. Among the reasons given by respondents who think that humanoids cannot do any clinical duty, the most common was “Not clear what and how much ability humanoids have,” chosen by 70.41 percent of respondents. Regarding the qualities required of humanoid robots on the aspect of ethical considerations, 63.79 percent chose “Not causing harm to humans,” making it the most common response. From the above results, it appears that personnel working in nursing homes and convalescent wards do not have enough accurate information on humanoid robots. It is therefore necessary that for future engagement of humanoid robots in clinical duty, advanced and detailed information on the ability and performance of humanoid robots be disseminated, so that not only patients but also medical staff can accept them without difficulty.

Estimating emotion changes using electroencephalographic activities and its clinical application

In the care, the communication based empathetic understanding is important. We have examined how to grasp empathetic understanding. We presume that the measurement of electroencephalographic (EEG) changes, those activities that are considered physiological indicators, enables an objective understanding of changes in emotions of those who have difficulty in expressing these through facial expression or physical action. Generally, EEG is used in the hospital to examine encephalopathy and brain disorder. Using an electroencephalograph device to acquire digital data we propose a method to objectively capture changes in the recognition state of people from changes in EEG activities (action potential), and a way to apply it into a clinical situation.

Needs and challenges of care robots in nursing care setting: A literature review

This study aims to identify needs and challenges of care robot in nursing care setting through an extensive search of the literature. As the result shows, there exists a shortage of information about results of the introduction of care robots, the needs of recipients and care providers, and relevant ethical problems. To advance our research and to introduce care robots into setting, there are so many things to do; consider the application of natural language processing technology by collaborating with researchers in the robotics field, carry out an investigation, extract the needs, clarify ethical problems and seek solutions, conduct the on-site experiment study, and so on.

Outcome management and morphologic variance analysis using psychoms TM for patient care in psychiatric hospitals

In 2003, the Japanese government set an approximate goal of 72,000 social hospitalization in-patients being discharged in 10 years from psychiatric hospitals to the community. To meet this challenge, the clinical pathway (CP) is a useful model for managing the teams progress in providing health care services. High quality discharge planning for patients requires continuous refinement of CP including the collection and analysis of variance data, i.e., information not listed in the CP model. The purpose of this study is to analyze variance data gathered using PsychomsTM to find unidentified issues with keyword sorting (keyword variance analyses system) and text-mining (text mining variance analyses system). Using morphological analysis to detect word occurrences in variance data, it may be possible to identify problems needing solution by developing automatic rankings to analysis outcomes. To achieve this, however, specialized experience is required for variance analysis. Also, there must be high congruence between the results of text mining variance analyses and keyword variance analyses systems.

Temperament, character, and eating attitudes in Japanese college women

The present study investigated associations between dimensions of personality characteristics and eating attitudes in Japanese college women. 91 college women with a mean age of 20.7 yr. (SD ! 2.3 yr.), attending a School of Nursing or a School for Kindergarten Teachers, voluntarily responded to the Japanese version of the Temperament and Character Inventory and the Eating Attitudes Test. A significant positive correlation was found between the scores on the Temperament and Character Inventory subscale of Harm Avoidance and the Eating Attitudes Test total scores (Spearman ρ = .24, p ! .02) and the scores on the Eating Attitudes Test subscale of Food Preoccupation (Spearman ρ = .33, p ! .002). The scores on the Temperament and Character Inventory subscale of Self-directedness showed significant negative correlations with the Eating Attitudes Test total scores (Spearman ρ = –.35, p ! .001) and the scores on the Eating Attitudes Test subscales of Dieting (Spearman ρ = –.29, p ! .005) and Food Preoccupation (Spearman ρ = –.43, p = .0001). The present results suggest that Japanese college women who score high on Harm Avoidance and low on Self-directedness may be more likely to develop inappropriate eating attitudes.