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In recent years, robotic pets have been used by many countries worldwide as a method for treating behavioral and psychological symptoms of dementia (BPSD). The seal robot PARO was loaned intermittently to a distributed layout elderly housing with services over a seven-month period, during which it was observed that three residents with cognitive dysfunctions showed improvements in their BPSD and the nursing care load of the staff was reduced during the periods when PARO was present. The objective of this study is to investigate, through a case study, the effects of intermittent interaction with PARO on those with cognitive dysfunctions and the staff workers. The short version of the Dementia Behavior Disturbance Scale (DBD-13) was used as the medical outcome index, and the KJ method was used to analyze the qualitative data, such as staff reports and interviews. The results show that the DBD-13 total scores reduced during the periods when PARO was present and increased during the periods when PARO was absent. The KJ method yielded similar findings. The use of DBD-13 and the KJ method complemented the results of each other and increased the persuasive power of the findings. By using the KJ method, it was further determined that the workload of the staff was reduced, allowing them to recuperate, which reconfirmed the value of PARO. Further case studies will be undertaken in the future with the aim of constructing a methodology for implementing case studies. [ABSTRACT FROM AUTHOR]

Aims and objectives. To examine the characteristics of hypertension-related factors in female family caregivers in Japan who provide care in the home, in comparison with general community non-caregivers. Background. Hypertension is more frequently encountered in female caregivers than in non-caregivers. Lifestyle factors including sleep and eating habits differ in Japanese female caregivers and the general population. Therefore, hypertension-related factors in caregivers may also differ from those in the general population. Design. A cross-sectional study. Methods. The subjects were 150 female caregivers (aged 62·4, SD 12·2 years) who provided home care for persons with physical impairments and/or dementia and 154 female controls (aged 62·7, SD 2·2 years) who did not provide home care. Persons with a history of ischaemic heart disease or cerebral stroke were excluded. Subjects were examined using a self-reporting questionnaire that included a food frequency questionnaire and the tri-axial coping scale. Urine examinations and blood pressure measurements were also done. Logistic regression analysis was conducted for each group with the same variables as explanatory variables. Results. Hypertension was present in 46·7% of caregivers and 34·4% of controls ( p < 0·05). Menopause was a factor related to hypertension in both the caregivers and controls. In the caregiver group, hypertension was associated with the estimated 24-h Na excretion in urine and the carbohydrate-energy ratio for nutriti. BMI was associated with hypertension in the control group, but not in the caregiver group. Conclusions. Hypertension was associated with nutritional factors, such as greater Na excretion in urine and higher carbohydrate energy ratio, in Japanese female caregivers and with obesity in non-caregivers. Relevance to clinical practice. To prevent hypertension, it is necessary to carefully monitor salt intake and nutritional balance in female caregivers in Japan. [ABSTRACT FROM AUTHOR]

The effect of the mastoid pneumatization on sound transmission from the nasopharyngeal cavity to the inner ear, which is one of the important factors to indicate the severity of the patulous eustachian tube (ET), are investigated in patients with patulous ET. Twenty ears of 13 subjects with patulous ET were retrospectively analyzed. Sound transmission from the nasopharyngeal cavity to the inner ear was evaluated by observing the masking effects of noise presented in the nasopharyngeal cavity on the auditory threshold (nasal noise masking audiometry). The relationship between this masking effect and mastoid pneumatization were examined among the patients with similar conditions of ET patency. The masking effect of nasally presented noise was greater with less developed mastoid pneumatization. The present results indicate that the symptoms associated with patulous ET may be more distressful in patients with poorly developed mastoid cavity than in those with well-aerated mastoid under similar conditions of ET patency. [ABSTRACT FROM AUTHOR]

The objective of the present study is to evaluate the Eustachian tube (ET) acoustic patency during phonation. The sound level in the EAC during phonation of the “A” and ”N” sounds was measured by microphones in the bilateral EACs of nine normal subjects and 31 patients with patulous ET. The measured sound pressure differences between the right and left ears were correlated with the differences in severity of autophony between the bilateral ears assessed by a visual analogue scale (VAS). The patulous condition was often remarkable when the “N” sound was phonated. In some patients with patulous ET, the patulous condition was indicated only by the present method, and not by conventional ET function tests such as tubo-tympano-aerodynamic-graphy or sonotubometry. [ABSTRACT FROM AUTHOR]

The objective of the present study is to demonstrate that hemodialysis (HD) is a possible causal factor for patulous Eustachian tube (ET). We present a representative case report and results of a mass examination in the HD unit. The present patient (a 55-year-old woman) reported aural fullness and autophony were often experienced after HD. The findings of eardrum and ET function tests revealed that her patulous ET condition was observed soon after HD and then disappeared until the next HD. A survey in the HD unit was carried out to identify patients who noticed patulous symptoms after HD. Patients underwent further examination, including detailed interview, otoscopy, and ET function tests with sonotubometry and tubo-tympano aerodynamic-graphy just before and soon after HD. The survey at the HD unit found 13 of 147 HD patients (8.8%) had HD-related patulous ET. Aural symptoms occurring after HD are frequently caused by patulous ET. [ABSTRACT FROM AUTHOR]

This cross-sectional study aims to clarify the relationship between the number of behavioral and psychological symptoms in long-term care recipients and family caregivers' depressive states. Participants were 38 family caregivers who had provided care for their relatives for 6 years or more; they were recruited from in-home care settings in Aichi, Gifu, and Shiga Prefectures, Japan. Participants answered a self-administered questionnaire assessing their depressive state using the Japanese version of the Center for Epidemiologic Studies for Depression Scale (CES-D). They also answered questions inquiring about behavioral and psychological symptoms of care recipients, including resistance to care, irritability, and feelings of persecution. Using CES-D scores, 11 participants were categorized as depressed and 27 as non-depressed. Depressive symptoms were significantly greater in those with more behavioral and psychological symptoms, following adjustment for confounding factors. The odds ratio of being in a depressive state was 9.43 higher for those with more than 4 behavioral and psychological symptoms compared to those with none, showing a distinct threshold for the influence of behavioral and psychological symptoms on depressive state. Knowing the number of behavioral and psychological symptoms of care recipients may help quickly identify depressed caregivers and alleviate depressive symptoms. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate the relationship between family caregivers' health‐related quality of life and health outcomes in care recipients. Methods: A total of 160 female caregivers in Japan were initially assessed using self‐reported baseline questionnaires to determine physical and mental aspects of their health‐related quality of life. Based on these scores, they were divided into three groups: lower, middle, and higher quality of life. We followed up with the 133 participants (after excluding those that did not respond) 6 years later to assess the health of their care recipients; 36 caregivers continued to provide home care, while 97 reported that their care recipient had died or been admitted into institutionalized care. Results: Statistically, a higher risk for care recipients' health deterioration was strongly associated with the mental component score in the lower caregivers' quality of life group of than for the middle group, after adjusting for the care recipients' age, health status, and caregivers' age at baseline. There was no significant association between deterioration of health of care recipients and physical component scores of the caregivers. Conclusion: Caregivers' poor health‐related quality of life, particularly poor mental health, may be linked to the deterioration of care recipients' health. Summary statement: What is already known about this topic? Family caregivers reportedly have lower quality of life than noncaregivers.While factors associated with decreased quality of life of caregivers such as high caregiving burden and longer care duration are being identified, they remain difficult to prevent.Lower caregiver quality of life may negatively influence the care recipients. What this paper adds? Poor mental health in caregivers, calculated with health‐related quality of life scores, is associated with health deterioration of care recipients.Physical health in caregivers is not associated with health deterioration of care recipients. The implications of this paper: Support for improving the health‐related quality of life of caregivers is necessary, especially in relation to their mental health, from the viewpoint of maintaining the health status of care recipients. [ABSTRACT FROM AUTHOR]

Conclusion. No useful examination was available for morphological assessment of the eustachian tube cartilage (ETC) in living subjects, but evaluation of magnetic resonance (MR) imaging enables useful assessment of the eustachian tube (ET) and ETC during preoperative examination before ET surgery. Objectives. The objective of this study was to investigate the usefulness of MR imaging for analysis and assessment of the ETC. Subjects and methods. Analysis of MR images. Results. The ETC could be demonstrated by oblique parasagittal MR imaging in most subjects, but was poorly defined in others, particularly in aged subjects. The ETC appeared as a hook-shaped structure with wide variability. [ABSTRACT FROM AUTHOR]

Abstract: Urokinase plasminogen activator (uPA) plays important physiological and pathological roles in fibrinolysis, cancer metastasis, and atherosclerosis. One study suggested that uPA also has a major role in cholesterol biosynthesis in humans via its receptor uPAR. Thus, we investigated the associations of functional uPA polymorphism (plasminogen activator, urokinase; PLAU Pro141Leu, rs2227564) with serum lipid profiles in a Japanese cohort. The study included 5152 participants (1465 male, 3687 female; age range, 35–69years) of the Daiko Study, a part of the Japan Multi-Institutional Collaborative Cohort Study (J-MICC Study). Subjects were enrolled at the Daiko Medical Center from June 2008 to May 2010. Low-density lipoprotein cholesterol (LDL-C) and non-HDL-C (subtraction of high-density lipoprotein cholesterol from total cholesterol) in fasting blood of participants were each classified into two groups, < or ≥140mg/dL, and < or ≥170mg/dL, respectively. Genotype frequencies of PLAU Pro141Leu (rs2227564) were 59.1% for ProPro, 35.6% for ProLeu, and 5.3% for LeuLeu, and were in Hardy–Weinberg equilibrium (p =0.789). The allele frequencies were 0.769 for Pro and 0.231 for Leu. The multivariate-adjusted odd ratios (ORs) and 95% confidence intervals (CIs) for high LDL-C and non-HDL-C were 1.11 (95%CI; 1.00–1.23) and 1.16 (95%CI; 1.03–1.30) for those with Leu allele relative to ProPro. This study suggested that PLAU Pro141Leu (rs2227564) is significantly associated with serum lipid levels in a Japanese population. [Copyright &y& Elsevier]

Conclusions. The pterygoid venous plexus (PVP) is an important factor in the mechanism of eustachian tube (ET) closure under conditions that can cause increased venous pressure in the head, such as during neck compression and postural change from the sitting/standing to the recumbent position. Objectives. The symptoms of patulous ET are usually improved by neck compression or postural change (from sitting/standing to recumbent position). Venous congestion around the ET and/or gravitational change may be involved in the changing degree of symptoms, but its mechanism is not understood. This study investigated whether the PVP is involved. Materials and methods. The dimensions of soft tissues surrounding ET were measured on magnetic resonance images before and after neck compression. Results. The lateral pterygoid muscle became enlarged after neck compression. Simultaneously, the volume of venous plexus observed between the medial pterygoid muscle and tensor veli palatini muscle was increased. Such enlargement was probably due to blood pooling in the PVP, resulting in protrusion of the ET anterior wall to the luminal side, and decreased ET patency. [ABSTRACT FROM AUTHOR]

Conclusions. Quality of hearing is one of the key conditions promoting habitual sniffing associated with closing failure of the Eustachian tube and sniffing may stop with deterioration of hearing due to progression of the disease. Objective: To examine habitual sniffing associated with closing failure of the Eustachian tube and hearing level in patients with cholesteatoma. Patients and methods. A total of 171 patients with middle ear cholesteatoma treated in Tohoku University Hospital (106 sides in 101 patients, 63 males and 38 females, mean age 43.3 years), and Sendai Ear Surgi Center (70 sides in 70 patients, 37 males and 33 females, mean age 42.7 years) were included. The patients were divided into two groups based on the presence or absence of habitual sniffing, and pre- and postoperative hearing was compared between the two groups. Results. Habitual sniffing was not found in patients with air conduction hearing level worse than 60 dB or air–bone gap larger than 40 dB. Habitual sniffing disappeared in all patients with expanded air–bone gaps in lower frequency regions after surgery. [ABSTRACT FROM AUTHOR]

Presents letters to the editor regarding the findings that subjects with low fasting plasma glucose levels have a high risk of cardiovascular disease and cause mortality.