"Quartile" screening method to analyze the relationship between HIS and "AEROS" in Japan.

Atmospheric pollution affects the health through complex mechanisms and to varying degrees. However, even by secondary usage of retrospective HIS and "AEROS" data, screening can be performed for specific ICD10 diseases caused by environmental factors. Our screening method showed good agreement with doctors' common knowledge on the relationship between atmospheric data and disease. Examples include the higher incidence of influenza at low temperatures and dry skin caused by low humidity, etc. We need to examine the method further in order to make it simpler, easier and more robust.

[Cross-validation of the short version of the Japanese version of the Zarit Caregiver Burden Interview (J-ZBI_8)].

This study was aimed at confirming the cross-validity and construct validity of the short version of the Japanese version of the Zarit Caregiver Burden Interview (J-ZBI_8) developed by Arai and colleagues. A total of 169 family members caring for disabled elderly were assessed by a self-administered questionnaire which included the Japanese version of the Zarit Caregiver Burden Interview (J-ZBI). Cronbach's alpha of the J-ZBI_8 was 0.88, indicating a high reliability of this instrument. A confirmatory factor analysis revealed that the two factor model of J-ZBI_8 fitted the data. Pearson's correlation coefficient between J-ZBI_8 and J-ZBI was 0.92; and the correlation coefficient between J-ZBI_8 and item 22 (a single global burden) was 0.66. These data indicated that J-ZBI_8 had a high concurrent validity. The J-ZBI_8 was found to be significantly correlated with Barthel Index, duration of caring, hours of caregiving/day, physical fatigue and mental fatigue among caregivers, but not with the duration of caring (months). Caregivers of disabled elderly who did not have any behavioral disturbances had a significantly lower J-ZBI_8 score than those who were caring for elderly with such behaviors. Also, caregivers who declared that they did not abuse disabled elderly had a significantly lower J-ZBI_8 score than those who replied they abused them, when compared by t-test. These results indicated that J-ZBI_8 had a high construct validity. It is concluded that the J-ZBI_8 had a high cross-validity and construct validity. This instrument can thus facilitate the assessment of family caregiver burden in clinical settings.

Comparative research between Australia and Japan: a comparison of the quality of health care in nursing facilities using actigraphy.

AIM: Aging in Japan is advancing at a globally unprecedented rate. In Japan, the provision of high quality nursing care for aged people is needed. In the present study, we clarify the effect of different environments and nursing care service on the life rhythm of aged people in Japan and Australia. METHODS: In Australia, cognitive rehabilitation with activities offered at nursing facilities focuses on resident care needs and the promotion of independence through Diversional Therapy (DT). The participants were nine nursing facility residents in Australia where DT is practiced (ANF). In Japan, 10 nursing facility residents (JNF) and 11 people living independently (JLI). Upon explanation of the research objective to the three groups and obtaining their consent, participants were equipped with wristwatch-style actigraphs that were attached to the non-dominant hand for 3 days. results: The time period of most activity for ANF was 13.00-14.00 hours at 224.6 +/- 75.5 counts/min, which was significantly higher when compared with the 136.8 +/- 63.8 for JNF (P < 0.05). Wake after onset of sleep, defined as minutes awake at night after falling asleep, was 48.8 +/- 40.1 for ANF, 102.2 +/- 82.6 for JNF and 18.5 +/- 11.7 min for JLI. The JNF group was observed to have the longest night wake time (P < 0.05). CONCLUSION: Employing actigraphs, sleep-wake assessments were conducted on aged people in three different lifestyle environments. This lifestyle difference was clear from the activity rhythm detected. Then, from a comparison of both countries, we were able to offer suggestions on life patterns of aged people brought about by the differences embodied in culture, environment and economic background.

Factors related to feelings of burden among caregivers looking after impaired elderly in Japan under the Long-Term Care insurance system.

Since the 1970s, the burden of caregiving has been the subject of rather intense study, a trend that will continue with the rapid graying of populations worldwide. Since the Long-Term Care insurance system began in 2000, few cross-sectional studies have attempted to identify factors related to the feelings of burden among caregivers looking after the impaired elderly in Japan. In the present report, among 46 pairs of caregivers and impaired elderly, the elderly receiving regular nurses' visits in Kyoto Prefecture, Japan were assessed for problems with activities of daily living, the severity of dementia, the presence of behavioral disturbance, and cognitive impairment. The caregivers were asked to complete questionnaires in relation to their feelings of burden and caregiving situation. The results indicated that caregivers of impaired elderly with behavioral disturbances were more likely to feel a 'heavier burden.' Those temporarily relieved of caregiving three or more hours a day were less likely to experience 'heavier' caregiver burden than those who were not. Moreover, caregivers who found it 'inconvenient' to use care services tended to be more likely to feel a 'heavier' caregiver burden than those who did not. Recourse to respite services, which are ideally positioned to help, proved inconvenient because of their advance reservation system. More ready access to respite services in emergencies could do much to reduce caregiver burden.