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This study aimed to clarify the use of computer simulations in educating caregivers of elderly people with dementia. Thesaurus words in articles indexed in Ichushi and PubMed were analyzed using commercially available “Trend Search” text-mining software developed by FUJITSU. The analysis maps relational words in the articles, with line size and distance between words showing the strength of the relation. For ethical purposes, articles were anonymized for analysis. The search was conducted using the query phrases “elderly people with dementia AND simulation”, and retrieved four articles from Ichushi (2007-2010) and 16 from PubMed (1992-2012). The search results revealed that little research has been done on this subject, and highlighted opportunities to further investigate the use of ICT tools in educating caregivers of elderly people with dementia.

Purpose: This study aimed to develop an ethical dilemma scale for nurses faced with the use of physical restraint when caring for elderly patients with dementia. Methods: We used a previously established 20-item dilemma scale. The objective and method of the study were explained to the head of nursing at 17 selected hospitals, and 121 nurses working in the general wards of 14 hospitals (excluding emergency department wards of psychiatry, pediatrics, obstetrics, outpatients, operating rooms and intensive care units) who agreed to participate were enrolled in 2000. Seventy-six nurses from one of the hospitals were selected after eight years (2008) to provide a comparison. Ethical considerations: The study was conducted with the approval of the ethics committee at Meiji University of Integrative Medicine. Results and discussion: Four factors were compared between 2000 and 2008: “execution of treatment and security”, “characteristic features in nursing of elderly patients with dementia”, “cooperative relationship in nursing”, and “priorities in nursing”. The cumulative contribution ratio was 65.3% (KMO = 0.77, p = 0.000) in 2000 and 72.5% (KMO = 0.78, p = 0.000) in 2008. Therefore, the scale dilemma nurse faced physical restraints to elderly patients with dementia in Japan was developed 4 facoters from 17-delremmas items of 20 items.

Among patients who receive heart transplantation (HTx) after long-term mechanical circulatory support (MCS), some show executive cognitive dysfunction without a history of stroke. Fifty HTx patients (19 patients on MCS for longer than 3 months before HTx and 31 patients without MCS as control group) were enrolled in the study. All subjects were men aged between 20 and 59 years without a history of stroke. Patients with MCS were divided into two groups: the AH-Thr group (n = 11), in which thrombus was detected in the left ventricular assist device (LVAD) and quickly removed (mean 3.3 times); and the AH group (n = 8), in which there was no detectable thrombus in the LVAD. The Trail Making Test (TMT) and the Wisconsin Card Sorting Test (WCST) were administered. The AH-Thr group showed poorer cognitive performance both in the TMT part B, with longer completion time (p < 0.05 versus the other two groups), and in the WCST, with more perseverative errors (p < 0.001 versus the other two groups). These data indicate that patients in the AH-Thr group showed executive cognitive dysfunction in set-shifting ability, suggesting frontal lobe damage. The conditions that facilitate thrombus formation in the LVAD may induce executive cognitive dysfunction without stroke.

Suicidal incidences are known to be high in patients manifesting alcoholism. We attempted to characterize suicidal ideation in Japanese patients with alcoholism in relation to alexithymia.Eighty-five male alcoholic patients, hospitalized in the alcoholics ward of a mental hospital and aged between 40 to 69 (52.9 +/- 8.3 years), and 79 nonalcoholic males in the same age range (54.9 +/- 7.1 years) recruited from a municipal garbage disposal plant were included in the study. The patients were evaluated using the Scale of Suicidal Ideation (SSI) and the Toronto Alexithymia Scale (TAS) during 2002.Of the alcoholic patients, 76.6% belonged to the high-risk group of suicidal ideation (SSI2), and 66.6% of the high-risk patients were alexithymic. In contrast, 86.1% of the nonalcoholic controls showed no suicidal ideation and only 17.7% of those without suicidal ideation were alexithymic. When the alcoholic patients with intensive suicidal ideation were compared with nonalcoholic patients without suicidal ideation, the scores of factor 1 and factor 2 were significantly higher in the former group (p0.001).Alcoholic patients with intensive suicidal ideation accompanied with alexithymia are characterized by the inability to communicate feelings. Therefore, the possibility of a suicidal attempt in those patients should always be kept in mind even though no suicide message is expressed.

We have demonstrated recently that treatment with N(G)-monomethyl-L-arginine (L-NMMA) accelerates electrophysiological recovery after transient spinal cord ischaemia in anaesthetized cats. To determine whether nitric oxide synthase (NOS) inhibition in the acute phase of spinal cord injury results in better functional recovery in the chronic phase, we evaluated the influence of L-NMMA on the time course of changes of neurological function and the histopathological changes after spinal cord compression in rats. Experimental spinal cord injury was produced in anaesthetized rats by short-term (5 min) compression with a thread placed around the spinal cord at T13. The recovery of motor function was assessed by a treadmill test 10, 20 and 30 days after spinal cord compression. The latency of potentials evoked by hindlimb stimulation was measured at the funiculus posterior at C1 10 days after the spinal cord injury in anaesthetized rats. Histological examinations were also performed at the same time. The compression-induced spinal cord injury resulted in motor dysfunction of hindlimbs, an increase in the latency of the evoked potentials and neuronal degeneration in funiculus posterior at T13. Repeated administration of L-NMMA for 1 day significantly accelerated the recovery of the motor function, shortened the latency of the evoked potentials and attenuated the myelin vacuolization in the spinal cord. These beneficial effects of L-NMMA on neurological function and histopathological changes were abolished by coadministration of L- but not D-arginine. These results suggest that NOS inhibition during the early stage of spinal cord injury has beneficial effects on the recovery of neurological function and the histopathological changes in the chronic stage.