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Variations in the mental health and sense of coherence (SOC) of new graduate nurses and the effects of SOC on variations in mental health  [PDF]
Tomoko Takeuchi, Taisuke Togari, Makoto Oe, Yukie Takemura, Hiromi Sanada
Open Journal of Nursing (OJN) , 2013, DOI: 10.4236/ojn.2013.31016

The current research conducted a longitudinal study of new graduate nurses at 3 times-prior to their employment as nurses and 3 months and 1 year afterward. This study yielded 3 findings. 1) The mental health of new graduate nurses significantly worsens 3 months after employment as a nurse and mental health 1 year after employment as a nurse was significantly worse than that before employment. 2) A sense of coherence (SOC) is the ability to cope with stressors, and the 3 components of SOC decreased significantly in the year after employment as a nurse. 3) The mental health of new graduate nurses was significantly affected by a low SOC and by previous diminishing of SOC. Findings suggested the importance of support to sustain and improve the mental health of new graduate nurses and the importance of approaches in the workplace to encourage the development of SOC.

Pelvic floor function and advanced maternal age at first vaginal delivery  [PDF]
Mikako Yoshida, Ryoko Murayama, Maki Nakata, Megumi Haruna, Masayo Matsuzaki, Mie Shiraishi, Hiromi Sanada
Open Journal of Obstetrics and Gynecology (OJOG) , 2013, DOI: 10.4236/ojog.2013.34A005

Purpose: The study aimed to show differences in temporal recovery of pelvic floor function within 6 months postpartum between women having their first delivery at an advanced age and those having their first delivery at a younger age. Methods: Seventeen women (age: 35.5 ± 3.5, BMI: 21.1 ± 3.2) were studied at about 6 weeks, 3 months, and 6 months after vaginal delivery. Urinary incontinence was assessed by the International Consultation on Incontinence Questionnaire-Short Form. Pelvic floor function was assessed by the anteroposterior diameter of the levator hiatus using transperineal ultrasound. Women who delivered for the first time at 35 years and/or older were defined as being of advanced maternal age. Results: Nine of 17 women (52.9%) were of advanced maternal age and 5 experienced postpartum stress urinary incontinence. Four of these 5 women (80.0%) were of advanced maternal age. The anteroposterior diameter of the levator hiatus at rest was significantly greater in the advanced maternal age women than in the younger maternal age women at 3 and 6 months postpartum (p < 0.01). Among the continent women, the anteroposterior diameter of the levator hiatus at rest was significantly greater in the advanced maternal age women than in the younger maternal age women at 6 months postpartum (p = 0.004). However, among the advanced maternal age women, all parameters of the anteroposterior diameter of the levator hiatus were not significantly different between the women with and without stress urinary continence. Conclusion: Recovery of pelvic floor function following delivery may be delayed in women of advanced maternal age at first delivery because of the damage to the pelvic floor during pregnancy and vaginal delivery, resulting in increase in the incidence of stress urinary incontinence.

Prevalence and Risk Factor of Diabetic Foot Ulcers in a Regional Hospital, Eastern Indonesia  [PDF]
Saldy Yusuf, Mayumi Okuwa, Muhammad Irwan, Saipullah Rassa, Baharia Laitung, Abdul Thalib, Sukmawati Kasim, Hiromi Sanada, Toshio Nakatani, Junko Sugama
Open Journal of Nursing (OJN) , 2016, DOI: 10.4236/ojn.2016.61001
Abstract: Indonesia is one of the top ten diabetes mellittus (DM) countries. However as the main complication of DM, there was lack of studies related to diabetic foot ulcer (DFU). Thus, the aim of this study was to survey the prevalence of DFU risk factors and DFU among type 2 diabetes mellitus (T2DM) patients. An epidemiological study was conducted at an outpatient endocrine clinic in a regional hospital, eastern Indonesia. All T2DM participants attending research setting that were ≥ 18 years were included. Demographic and foot care behavior were assessed using minimum data sheet (MDS). Meanwhile, presence of risk factors was evaluated by using 5.07/10 g Semmes-Weinsten Monofilament (SWM) for neuropathy and presence of angiopathy was evaluated with Ankle Brachial Index (ABI) by using a hand held Doppler (Bidop ES-100V3, Hadeco-Kawasaki, Japan) both dorsal and posterior tibialis foot. At the end of study, 249 T2DM participants were enrolled. The prevalence of DFU risk factors was 55.4% (95% CI: 53.7% - 57.0%), and prevalence of DFU was 12% (95% CI: 10.3% - 13.6%). Based on a logistic regression, predictors for DFU risk factors included age (OR: 1.04; 95% CI: 1.005 - 1.074) and daily foot inspection (OR: 0.36; 95% CI: 0.186 - 0.703). Meanwhile, the predictors for presence of DFU were insulin (OR: 9.37; 95% CI: 2.240 - 39.182), shoes (OR: 0.05; 95% CI: 0.007 - 0.294), spiritual belief that DM was a disease (OR: 0.04; 95% CI: 0.004 - 0.326) and belief that DM was a temptation from God (OR: 0.13; 95% CI: 0.027 - 0.598). In conclusion, we recommend to educate high risk patients to understand positive foot care behavior as essentially preventive strategies to prevent presence risk and DFU.
Relationship between Dermal Structural Changes on Ultrasonographic Images and Skin Viscoelasticity in Overweight and Obese Japanese Males  [PDF]
Masaru Matsumoto, Kazuhiro Ogai, Miku Aoki, Masami Yokogawa, Mariko Tawara, Junko Sugama, Takeo Minematsu, Misako Dai, Hiromi Sanada
Health (Health) , 2016, DOI: 10.4236/health.2016.811106
Abstract: It has been reported that overweight Japanese males have poorly organised dermis and their skin may be fragile to external forces because of decreased dermal echogenicity. However, it is unknown whether the changes in the dermal structure actually affect the dermal function. The objective of this study was to clarify the relationship between dermal structural parameters and dermal functional parameters in overweight and obese Japanese males. A cross-sectional, observational study was conducted on Japanese male volunteers. Two ultrasound scanners, a 20-MHz Dermascan C and an 18-MHz MylabTM five were used to evaluate dermal structure. Echogenicity of the lower dermis and dermal thickness of the participants’ abdomens and thighs were measured. A Cutometer MPA580 was used to evaluate skin viscoelasticity, skin deformation (R0) and elasticity (R2, R7). The correlation between dermal structural parameters and skin viscoelasticity were validated using Pearson’s correlation coefficient or Spearman’s correlation coefficient by rank test. A total of 79 male volunteers were recruited of which 43 were control subjects with BMI <25 (age, 22 - 63 years), 25 were overweight subjects with BMI ≥ 25 to <30 (age, 23 - 64 years) and the 11 obese subjects had a BMI ≥ 30 (age, 26 - 47 years). There was no correlation between dermal structural parameters and skin viscoelasticity in the abdomens or thighs of all 79 participants. On the other hand, in the 36 overweight and obese participants, thigh dermal echogenicity was significantly and negatively correlated with R0 (r = -0.456, p < 0.01) and dermal thickness in the abdomen was significantly and positively correlated with R0 (r = 0.464, p < 0.01). The dermal functional parameter was significantly correlated with dermal structural parameters in overweight and obese males; in other words, a decrease in dermal function may be caused by structural changes in the dermis during obesity.
Efficacy of an improved absorbent pad on incontinence-associated dermatitis in older women: cluster randomized controlled trial
Junko Sugama, Hiromi Sanada, Yoshie Shigeta, Gojiro Nakagami, Chizuko Konya
BMC Geriatrics , 2012, DOI: 10.1186/1471-2318-12-22
Abstract: A cluster randomized controlled design was used to compare the efficacy of two absorbent pads. Female inpatients aged ≥65?years who had IAD and used an absorbent pad or diaper all day were enrolled. Healing rate of IAD and variables of skin barrier function such as skin pH and skin moisture were compared between the usual absorbent pad group (n?=?30) and the test absorbent pad group (n?=?30).Thirteen patients (43.3%) from the test absorbent pad group and 4 patients (13.3%) from the usual absorbent pad group recovered completely from IAD. Moreover, the test absorbent pad group healed significantly faster than the usual absorbent pad group (p?=?0.009). On the other hand, there were no significant differences between the two groups in skin barrier function.The test absorbent pad for older adults with urinary incontinence might be more efficacious against IAD than usual absorbent pad.UMIN-CTR: UMIN000006188
Screening for Osteomyelitis Using Thermography in Patients with Diabetic Foot
Makoto Oe,Rie Roselyne Yotsu,Hiromi Sanada,Takashi Nagase
Ulcers , 2013, DOI: 10.1155/2013/284294
Screening for Osteomyelitis Using Thermography in Patients with Diabetic Foot
Makoto Oe,Rie Roselyne Yotsu,Hiromi Sanada,Takashi Nagase,Takeshi Tamaki
Ulcers , 2013, DOI: 10.1155/2013/284294
Abstract: One of the most serious complications of diabetic foot (DF) is osteomyelitis, and early detection is important. To assess the validity of thermography to screen for osteomyelitis, we investigated thermographic findings in patients with both DF and osteomyelitis. The subjects were 18 diabetic patients with 20 occurrences of DF who visited a dermatology department at a hospital in Tokyo and underwent evaluation by magnetic resonance imaging (MRI) and thermography between June 2010 and July 2012. Osteomyelitis was identified by MRI. Thermographs were taken of the wounds and legs after bed rest of more than 15?minutes. Two wound management researchers evaluated the range of increased skin temperature. There were three types of distribution of increased skin temperature: the periwound, ankle, and knee patterns. Fisher’s exact test revealed that the ankle pattern was significantly more common in the group with osteomyelitis than in the group without osteomyelitis ( ). The positive predictive value was 100%, and the negative predictive value was 71.4%. Our results suggest that an area of increased skin temperature extending to the ankle can be a sign of osteomyelitis. Thermography might therefore be useful for screening for osteomyelitis in patients with DF. 1. Introduction Diabetic foot (DF) is defined as infection, ulceration, and/or destruction of deep tissue associated with neurological abnormalities and various degrees of peripheral vascular disease in the lower limb [1]. The prevalence of foot ulcers is 4% to 10% in patients with diabetes mellitus (DM) [2]. DF severely affects a patient’s physical condition, long-term prognosis [3, 4], and quality of life [5, 6]. Therefore, early healing of DF is important. One of the most serious complications of DF is osteomyelitis, and its diagnosis and treatment (surgery and/or long-term antibiotics) have been long-standing controversies [7–9]. Therefore, early detection of osteomyelitis is important. Although swelling and warmth are associated with osteomyelitis, it is difficult to diagnose the presence of osteomyelitis in DF by physical examination because the plantar skin has an especially thick layer of stratum corneum. Furthermore, inflammatory pain may occasionally be overlooked in diabetic patients due to sensory disturbance. Although biopsy or magnetic resonance imaging (MRI) is the gold standard for diagnosing osteomyelitis [7–9], it is accompanied by disadvantages such as invasiveness, a high cost, and non-real-time diagnosis. One of the possible tools for detecting inflammation or infection in DF is
Hydrocellular Foam Dressing Promotes Wound Healing along with Increases in Hyaluronan Synthase 3 and PPARα Gene Expression in Epidermis
Takumi Yamane, Gojiro Nakagami, Sawako Yoshino, Aimi Muramatsu, Sho Matsui, Yuichi Oishi, Toshiki Kanazawa, Takeo Minematsu, Hiromi Sanada
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0073988
Abstract: Background Hydrocellular foam dressing, modern wound dressing, induces moist wound environment and promotes wound healing: however, the regulatory mechanisms responsible for these effects are poorly understood. This study was aimed to reveal the effect of hydrocellular foam dressing on hyaluronan, which has been shown to have positive effects on wound healing, and examined its regulatory mechanisms in rat skin. Methodology/Principal Findings We created two full-thickness wounds on the dorsolateral skin of rats. Each wound was covered with either a hydrocellular foam dressing or a film dressing and hyaluronan levels in the periwound skin was measured. We also investigated the mechanism by which the hydrocellular foam dressing regulates hyaluronan production by measuring the gene expression of hyaluronan synthase 3 (Has3), peroxisome proliferator-activated receptor α (PPARα), and CD44. Hydrocellular foam dressing promoted wound healing and upregulated hyaluronan synthesis, along with an increase in the mRNA levels of Has3, which plays a primary role in hyaluronan synthesis in epidermis. In addition, hydrocellular foam dressing enhanced the mRNA levels of PPARα, which upregulates Has3 gene expression, and the major hyaluronan receptor CD44. Conclusions/Significance These findings suggests that hydrocellular foam dressing may be beneficial for wound healing along with increases in hyaluronan synthase 3 and PPARα gene expression in epidermis. We believe that the present study would contribute to the elucidation of the mechanisms underlying the effects of hydrocellular foam dressing-induced moist environment on wound healing and practice evidence-based wound care.
An Empirical Analysis of Women’s Promotion in Japanese Companies: Comparison with Chinese and Korean Cases  [PDF]
Hiromi Ishizuka
Theoretical Economics Letters (TEL) , 2016, DOI: 10.4236/tel.2016.63063
Abstract: The purpose of this study is to contribute to the economic revitalization of Japan by learning from other countries through a consideration of diversity. From Chinese urban areas, we study an example of a fluid labor market, and a firmly rooted movement of women into the workplace. From Korea, even though the male-female disparities are greater than those in Japan, we study a concrete case in terms of the rapid speed of the changing workplace. The framework includes not only promotion at the company level, but also lifestyle at the household level. The study uses the numerical values and analysis is through the Negative Binominal Regression Model. Findings include: 1) in Japan, there is “slow promotion” in the both case of men and women and a “glass ceiling” for women; 2) in China, the decisive male-female disparity is the difference in the “age of fixed retirement”. Gender gaps in working conditions are uncommon. Home factors slightly disturb promotions. Tenure is short and there is a fluid labor market. There is a “sticky floor” for women; 3) in Korea, the gender gap of graduate’s with more than a bachelor’s degree is small. Men with no official title are concentrated in the low rank, and have long tenures. There is a “sticky floor” for men. There are two years of compulsory military service for young men. Despite this, many men are promoted to higher managerial positions in their lifetimes.
An Empirical Analysis of Substitution and Complementarity of Gender Labor Demand of Enterprises in Japan, Korea, and China: With a Factor Decomposition of Gender Wage Differentials  [PDF]
Hiromi Ishizuka
Theoretical Economics Letters (TEL) , 2018, DOI: 10.4236/tel.2018.810125
Abstract: The purpose of this study is the effect of expansion of female labor demand on male labor demand for labor market reform to facilitate Japanese economic development. Firstly, the estimates using Hicks’ (1970) partial elasticity of complementarity and Allen’s (1938) partial elasticity of substitution revealed an increase in male labor demand when female labor demand increased in all three countries. The results were a relationship of complementarity in labor demand between male and female regular employees in the order of China, South Korea, Japan. However, a push factor or a pull factor is assumed to make up a complementarity relationship. Therefore secondly, the factor decomposition analysis of wage gap is used to investigate which factors are applicable. The gender wage gap consists of economic rationality and economic irrational discriminatory [Neumark (1988); Oaxaca and Ransom (1994)]. The gap was confirmed in all three countries. Although the actual gender average wage difference was small in China, “discriminatory preference theory” was suggested that there is underpayment of women in Japan and Korea. In Japan, as women have a high potential labor force participation rate, expansion of female labor demand seems promising as an economic policy, not least because of the declining population. Labor-related economic policies are needed, such as the creation of a fluid labor market in China, or the implementation of effective
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