Toshiko Tada

Effectiveness of Mammographic Screening for Breast Cancer in Women Aged over 50 Years in Japan

The optimal age for effective screening of subjects for breast cancer by mammography in Japan was studied based on the results of two mammograpbic screening systems (systems I and II) in Tokushima Prefecture, System I consisted of visit screening using a bus equipped with a mammographic apparatus. System II consisted of central screening performed at Tokushima Health Screening Center. The examinees numbered 2,500 and 3,707 in systems I and II, respectively. There was a significant difference between the two screening systems in the age distribution of the examinees. The detection rates of breast cancer were 0.6% and 0.24% in systems I and II, respectively, which are 2–5 times higher than that (0.12%) obtained by conventional screening using physical examination alone. The detection rate increased especially in the sixth and seventh decades of life. The sensitivity of mammography screening was 93.3% in system I and 81.1% in system II. Higher sensitivity (100%) than that (73%) of screening by physical examination was obtained in women aged over 50. The proportion of stage I was 60% in system I and 66.7% in system II, compared with 32–65% in the United States and Europe. The rates of no nodal involvement were high, being 77.8% and 83.3% in systems I and II, respectively, compared with 57–71% in other countries. Breast‐conserving therapy was applied to 18 of the 24 patients with breast cancer detected by the two screening systems. In addition, in Wolfes classification of mammograms, the proportion of DY (mammary dysplasia) pattern was remarkably low, being 3.2% in the sixth decade and 0.8% in the seventh decade, compared with 16.6% in women aged 49 years. These results indicate that mammographic screening is effective in women aged over 50 years in Japan, as has been found in other countries.

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.

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.

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.

Empathetic Understanding as Caring in Nursing Using Electroencephalographic Data as Evidence

Technological competency is an expression of caring in nursing. Nurses need to understand patients’ emotions and understand patients’ worlds as if these were their own. This is “empathic understanding.” Electroencephalograms (EEGs) were performed on five healthy participants while viewing an emotionally charged “sentimental” movie. EEG changes were collected and compared with data during a less emotionally charged situation. Apower map and spectrogram analyses of EEGs showed that alpha bands at the occipital region were specifically pronounced during the emotionally charged state. This study suggests that expressions of empathic understanding exists and are evidenced by EEG data, and that technological competency as caring in nursing is an expression of caring in nursing.

Clarification of Caring Behaviors by the Family of Elderly Relations Living in Rural Japan

Nursing technology is being continually developed to maintain and improve quality of life for the elderly who live in rapidly aging rural communities. However, it can be said that everyone performs acts of caring in some way or another. As such, informal caring exists in this context through the sense of trust in a mutual relationship andlor the harmonious feeling of self in relation to others. The purpose of this study is to describe the caring competency of those living in uals who have family members in need of nursing care. Interviews were used for data collection. For the purpose of this presentation we have used the case study of a lady suffering from dementia and the relationship with her daughter. The ladys daughter had been caring for her mothers behavioral disturbances (mania of garbage collecting, binge eating, and mysophilia). During the interview, the daughter told that throughout the caring relationship she rural areas. The research focuses on individhad asked herself what was the underlying meaning of her mothers problematic behavior. She also explained that she could tind meaning by sharing the experience of caring for her mother with others. The process of telling her stories enabled her to reconsider her personal experience in caring for her elderly mother and, by sharing this experience, she felt enabled to provide further care for her mother. The care provider appeared to look forward to talking to public health nurses who work in areas of behavioral disturbance and who understand the situation. In this paper we describe caring behavior for the elderly. Findings indicate that the family caregiver grows and develops through providing care and that being involved in the care process appears to facilitate diverse forms of self-realization.