Analysis of Topophilia in the Elderly Living in Mountainous Area / 日本農村医学会雑誌

　　The aim of this study was to examine topophilia in the elderly living in mountainous areas. Topophilia, which is the geographical concept invented by Yi-Fu Tuan in 1999, is defined as the affective bond between people and place or environmental setting. A total of 120 elderly subjects living in a mountainous area responded to a standardized, validated 9-item Life Satisfaction Index K (subjective well-being) developed by Wataru Koyano and a new structured 6-item questionnaire on topophilia. Factor analyses revealed two domains of topophilia (public emotion and private emotion toward the living place). Public emotion was the emotion of being hard to leave the living place. Private emotion was the emotion of not loving the living place. There were areas where the elderly had a lesser degree of attachment toward the present state of the elderly could hardly have a sense of well-being and attachments to the current domicile. It is considered that not only physical but also mental approach is necessary to support the daily life of the elderly living in the mountainous area. Also, we examined the influences of aging and the living place on a subjective well-being and topophilia. There was no significant correlation between age and subjective well-being, but there was significant positive correlation between age and the degree of topophilia (r＝0.234, p‹0.01). On the other hand, the degree of subjective well-being by the place of residence was significantly different (p‹0.001; ANOVA), and the degree of topophilia by the place of residence was not significantly different. These findings suggest that subjective well-being is not influenced by age but influenced by the place of residence, and topophillia is not influenced by the place of residence but influenced by age.

Assessment of Cognitive Function in the Elderly Using the Soundcell Method / 日本農村医学会雑誌

　　A soundcell is defined as a musical unit of meaning with short period of phrase. The soundcell method (SCM) is a musical procedure that decomposes a musical piece into several soundcells and subsequently recomposes the original music with the soundcells arbitrarily scattered. The present investigation aimed to assess cognitive function in the elderly using the SCM. An electronic system realizing the concept and methodology of the SCM was developed, and SCM examination with the school song “Furusato” as the musical piece was performed on18aged females. Four clinical tests were also carried out before or after the SCM examination to screen cognitive function: Mini-Mental State Examination (MMSE), Kana Pick-out Test, and Trail Making Tests A and B. The performance in the SCM examination was compared with the score in the clinical tests. The scores in all four clinical tests were significantly different between subjects who passed and failed the SCM examination. The individuals who passed the SCM examination were not suspected of dementia on the basis of the MMSE and seemed to execute successfully the Kana Pick-out Test. The number of acts and mean act time in the SCM examination were strongly correlated not only with the total score in the MMSE but also with the scores of the two sub-items: attention/calculation and memory recall. The results suggest that the SCM reflects a subject's short-term and recent memory and provides useful supplementary information for early diagnosis of mild cognitive impairment and Alzheimer’s disease since impairment of memory is frequently observed in the early stage of the diseases. In addition, most subjects enjoyed the SCM examination incorporating the element of musical amusement. The SCM is thus expected to allow repetitive and participatory assessment of cognitive function without imposing a large psychological burden on the subject.

Geographical Information Analysis of Difficulty of Access to Hospital to the Elderly Living in Mountainous Areas / 日本農村医学会雑誌

  We examined how difficult it would be for the elderly living in mountainous areas to go to the nearest hospital using a Voronoi tessellation representing the mathematical concept of neighborhood. We defined the index of the nursing-care capacity for the elderly as the ratio of the number of caregivers to the number of the elderly receiving nursing-care.<br>  The mean age of those who drive to the hospital by themselves worked out at 70±9.8 years. Meanwhile, that of those who go to the hospital by bus or taken to hospital in a car driven by a family member came to 80±7.0years. The latter was significantly older than the former.<br>  The areas of the Voronoi tessellation generated by patients' places of residence were divided into three groups according to the size. The plots of these three groups of the the places of residence on the map had a three-layer and doughnut-like structure, i. e., inner-, middle-, and outer-layer.<br>  The index of the nursing-care capacity in 2008 was less than 1.0 for the patients under 80 years of age. This means that when those who were at the age of 50 in 2008 become old and need nursing-care, access to the hospital will become harder to them than at present. For those who are over 80 years of age and live in the outer layer that is far away from arterial road, it will be almost impossible.<br>  These findings suggest that outpatient care with transportation assistance by a family member at present should be reconsidered because of the future lack of care personnel. It would also be necessary to consider the welfare of older people from the geographical point of view in order to manage the problems concerning the various physical and sociological difficulties of the elderly.

Actual Status of Death at Home in Eldery Patients who Received Home Care Service in Rural Area in Aichi Prefecture / 日本農村医学会雑誌

To clarify what are contributing factors associated with the place to die (home or hospital) in a rural area, we investigated several background factors of 107 patients who died at home or in hospital after receiving home care service during the period of four years from July 1995 to June 2000. The subjects were divided into two group those who died at home (39 cases, 36%) and those who died in our hospital (68 cases, 64%). The ratio of deaths at home increased every year, and reached a half of those who died after receiving home care service. The average age in those who died at home were 87.1±9.5 years, that was higher than that of those who died in our hospital (82.2±9.8 years). There was no difference betwe two groups about sex, basic diseases and the time required to get to the hospital by car. Death at home was more preferred by patients, whereas death in the hospital was preferred by patients' families. The level of activities of daily living (ADL) in those who died at home was lower compared with that in those who died in the hospital. Those who died at home significantly had lesser complaints (pain, dyspnea and so on) and had more care-givers in the family, than those who died in the hospital. These results revealed that the major factors in death at home are: 1) low level of ADL, 2) preference to death at home expressed by patients, 3) presence of additional care-givers, and 4) no complaint of symptoms from patients.

Imported Mycoses in Japan / 대한의진균학회지

The authors surveyed the present situation for imported (introduced) mycoses from papers published in Japan by the end of December, 2001. The results revealed 31 cases of coccidioidomycosis, 33 of histoplasmosis, 17 of paracoccidioidomycosis and one of penicilliosis marneffei. In coccidioidomycosis the ages ranged from 12 to 55, for 27 males and 4 females of which 2 were fatal. For histoplasmosis, the ages ranged from 17 to 74 of which 24 cases were male and 8 female. All of the patients with paracoccidioidomycosis were infected in Latin American countries. They consisted of 15 males and 2 females, and the ages ranged from 24 to 68. A single case of penicilliosis marneffei (38 years old, male) was reported very recently. The case was complicated by AIDS and became critical. Blastomycosis has not yet been reported. This survey indicates that the number of the imported mycoses in Japan is increasing. It is necessary for the persons concerned to counter measures to cope with this situation.

Imported Mycoses in Japan / 대한의진균학회지

The authors surveyed the present situation for imported (introduced) mycoses from papers published in Japan by the end of December, 2001. The results revealed 31 cases of coccidioidomycosis, 33 of histoplasmosis, 17 of paracoccidioidomycosis and one of penicilliosis marneffei. In coccidioidomycosis the ages ranged from 12 to 55, for 27 males and 4 females of which 2 were fatal. For histoplasmosis, the ages ranged from 17 to 74 of which 24 cases were male and 8 female. All of the patients with paracoccidioidomycosis were infected in Latin American countries. They consisted of 15 males and 2 females, and the ages ranged from 24 to 68. A single case of penicilliosis marneffei (38 years old, male) was reported very recently. The case was complicated by AIDS and became critical. Blastomycosis has not yet been reported. This survey indicates that the number of the imported mycoses in Japan is increasing. It is necessary for the persons concerned to counter measures to cope with this situation.

Identification of Trichophyton tonsurans by Random Amplified Polymorphic DNA

BACKGROUND: T. tonsurans is an anthropophilic dermatophyte mostly causing tinea capitis and tinea corporis. In East Asian countries, it has rarely been isolated until now. However, it is necessary for researchers in Asian countries to be more accustomed to T. tonsurans than before because of frequent international sports exchanges nowadays. OBJECTIVES: This study was performed to identify T. tonsurans by random amplified polymorphic DNA (RAPD) analysis. METHODS: Fifteen strains which were tentatively identified as T. tonsurans in Brazil were identified again by several conventional mycological tests and RAPD analysis. RESULTS: Among 15 Brazilian strains, 3 were identified as T. tonsurans, 8 T. mentagrophytes, 3 T. nJmwn and 1 T. raubitschekii by conventional mycological tests. This result was examined again by RAPD analysis. CONCLUSION: RAPD analysis is considered a rapid and reliable method for identification of T. tonsurans if the procedure is carefully standardized with adequate-primers.