A retrospective study on the diagnosis and treatment of dementia in patients referred to the Sagamihara Municipal Medical Center for Dementia for consultation.

AIM: In Japan, the Orange Plan was formulated in 2013 to promote community-based integrated care systems, and in 2015, it was revised as the New Orange Plan. Since the introduction of these programmes, adequate research has not been carried out on how these measures affect regional dementia care. The aim of this study was to investigate the state of community-based dementia treatment through a survey of medical consultation pathways, including dementia diagnosis, at the Sagamihara Municipal Medical Center for Dementia. METHODS: The participants included 1480 patients (585 men, 895 women) who presented for consultation at the Sagamihara Municipal Medical Center for Dementia for a differential diagnosis or treatment of dementia. The relationship between the path leading to medical consultation before pharmacotherapy and post-consultation diagnosis was investigated. RESULTS: Significantly more participants who presented for consultation without a referral were not diagnosed with dementia than diagnosed. Furthermore, among participants referred from a non-psychiatric clinic, significantly more patients were diagnosed with dementia than not. A significant difference was observed in a comparison of facility types and the use or non-use of anti-dementia drugs. Notably, the rate of anti-dementia drug prescriptions was significantly higher in psychiatric hospitals and non-psychiatric clinics. Furthermore, it is possible that approximately 30% of anti-dementia drugs prescribed at each facility were not covered by insurance. CONCLUSION: Community-based integrated care systems aim to promote collaboration within each region aimed. However, appropriate pharmacotherapy methods for dementia patients have not been adequately communicated to non-specialist physicians and local residents. For this reason, human resource solutions are needed to help medical staff deepen their understanding of dementia so that they can better provide dementia support to patients.

Modelling of intracranial behaviour on occiput impact in judo.

Acute subdural hematoma (ASDH) sometimes occurred in judo because of the bridging veins' failure by rotation of the brain in the skull. However, the relationship between intracranial behaviour and the motion of the body on occiput impact has not yet been clarified. In this study, we developed an intracranial mechanical model based on multibody dynamics and compared it with experimental results. The results show the importance of modelling bridging veins and cerebral spinal fluid to the relative displacement between brain and skull. The proposed model will contribute to accident analyses or the optimum design of supporting devices.