Diagnostic model for preschool workers' unwillingness to continue working: Developed using machine-learning techniques.

The turnover of kindergarten teachers has drastically increased in the past 10 years. Reducing the turnover rates among preschool workers has become an important issue worldwide. Parents have avoided enrolling children in preschools due to insufficient care, which affects their ability to work. Therefore, this study developed a diagnostic model to understand preschool workers' unwillingness to continue working. A total of 1002 full-time preschool workers were divided into 2 groups. Predictors were drawn from general questionnaires, including those for mental health. We compared 3 algorithms: the least absolute shrinkage and selection operator, eXtreme Gradient Boosting, and logistic regression. Additionally, the SHapley Additive exPlanation was used to visualize the relationship between years of work experience and intention to continue working. The logistic regression model was adopted as the diagnostic model, and the predictors were "not living with children," "human relation problems with boss," "high risk of mental distress," and "work experience." The developed risk score and the optimal cutoff value were 14 points. By using the diagnostic model to determine workers' unwillingness to continue working, supervisors can intervene with workers who are experiencing difficulties at work and can help resolve their problems.

Preventive Effects of Group Cognitive Behavioral Therapy in First-Year University Students at Risk for Depression: A Non-Randomized Controlled Trial.

High scores on Harm Avoidance (HA) on Cloniger's Temperament and Character Inventory (TCI) have been identified as a risk factor for depression. Group cognitive-behavioral therapy (GCBT) has been found effective in preventing depression and improving depressive symptoms among university students. However, no randomized controlled trials of GCBT have been conducted with university students with high HA. Although we initiated a randomized controlled trial in this study, some participants submitted incomplete questionnaires at baseline interfering with assured randomization; therefore, we report this study as a non-randomized controlled trial. We evaluated whether a GCBT intervention would be effective at reducing HA and, thereby, preventing depression in university students with high HA. We performed final analysis of data on 59 participants in the intervention group and 60 in a control group. We used scores on the Beck Depression Inventory-II (BDI-II) as the primary outcome measure and analysis of covariance to assess group differences on mean BDI-II change scores before the intervention and at six months and one year after the intervention. The intervention group had lower BDI-II scores than the control group at six months after the intervention. GCBT may have facilitated cognitive modification in individuals with high HA, or GCBT may have fostered mutual modeling by group participants. Thus, GCBT may contribute to reducing depressive symptoms in university students with high HA, and associated risk for developing depression.

Burnout among kindergarten teachers and associated factors.

Burnout among kindergarten teachers is a subject of great concern. Although burnout is reported to be significantly associated with turnover intention and work engagement, few studies have examined factors associated with burnout among these teachers. Therefore, in the present study, we performed a cross-sectional survey of burnout and associated factors among kindergarten teachers. We distributed 3363 questionnaires to all 205 authorized kindergartens and childcare institutions in Nagasaki Prefecture and received 1086 responses (response rate: 32.3%). The participants were limited to full-time female class teachers. After excluding survey forms with incomplete content, we ultimately examined valid responses from 442 participants. The survey examined burnout (Maslach Burnout Inventory, MBI), teacher stress (Nursery Teacher's Stress Scale, NTSS), coping behaviors (Brief Scales for Coping Profile, BSCP), and social support (Social Support Scale, SSS). A multiple regression analysis revealed that all 3 MBI subscales were positively associated with "understanding of how to handle children" on the NTSS and negatively associated with "superiors" on the SSS. "Emotional exhaustion" was significantly associated with "interpersonal relations at work" and "lack of time" on the NTSS, and "avoidance and suppression" on the BSCP. "Depersonalization" was significantly associated with age, "disconnect in working conditions" on the NTSS, and "proactive problem solving" and "venting emotions to others" on the BSCP. "Diminished professional accomplishment" was significantly associated with age, "lack of time" on the NTSS, and "proactive problem solving" and "change in perspective" on the BSCP. These results suggest that support from superiors that enables teachers to better understand children and handle them appropriately is necessary to prevent burnout.

Factors associated with kindergarten teachers' willingness to continue working.

ABSTRACT: The turnover rate among kindergarten teachers in advanced countries is extremely high. As such, there is an urgent need to determine the reasons for this turnover and to identify ways to prevent it. The current study investigates the individual and environmental factors that impact kindergarten teachers' willingness to continue working.A total of 600 kindergarten teachers in Japan participated in this study. Participants responded to questionnaires regarding their willingness to continue working, mental health, work engagement, and the availability of social support. Multiple logistic regression analysis was used to analyze participants' data, with willingness to continue working for 5 or more years as the dependent variable. Additionally, Spearman rank correlation was used to examine the correlations between factors associated with willingness to continue working.Factors such as older age, living with a spouse, caring for younger children (up to 2 years old) at work, good mental health, and higher work engagement were significantly associated with teachers' higher willingness to continue working. Factors such as marriage, health and family problems, overtime work, issues with workplace childcare, and education policy, working time/day problems, human relations, and difficulties taking care of children were correlated with teachers' lack of willingness to continue working.The findings of this cross-sectional study suggest that welfare benefits and individual support systems could be key elements to encourage kindergarten teachers to continue working and could lead to their improved job satisfaction and mental health. Balanced work conditions and workers' high agreement with their workplace's overall childcare or educational policies may lead to lower turnover. Some programs - such as relationship counselling - could have a positive impact on teachers' mental health and job satisfaction.

Personality traits and BMI trends over three years in Japanese university students.

In Europe and America, associations between personality traits and body-mass index (BMI) have been reported. However, in Japan, the association between personality traits and BMI (i.e., thinness and obesity) has not been well studied. In this study, we investigated the relationship between Temperament and Character Inventory (TCI) personality traits and changes in BMI status among Japanese students during their university attendance. We measured the height and weight of 5,340 students in a Japanese university during annual medical checkups and calculated their BMI. The students' personality traits were measured using the short Japanese version of the TCI at university admission. The participants were divided into seven groups based on how BMI changed from the first year to the fourth year at university. In men, compared to the group that maintained normal BMI status (N = 2,189) over time (i.e., the control group), the group that maintained thinness status (N = 226) were lower in Reward Dependence, and the group whose status improved from thinness to normal (N = 117) were higher in Harm Avoidance. In women, compared with the control group (N = 1,510), the group that maintained thinness status (N = 302) was lower in Novelty Seeking, and the group whose status worsened from normal to thinness (N = 127) was higher in Harm Avoidance. Weak associations were found between thinness and TCI personality traits among Japanese university students. Further elaboration of the relationship between obesity or thinness and personality traits may help to provide effective preventive interventions in these areas.

Intra-abdominal fat accumulation is an important predictor of metabolic syndrome in young adults.

Metabolic syndrome (MetS), mainly caused by intra-abdominal fat (IAF) accumulation, is an important risk factor for cardiovascular disease. The prevalence of MetS increases rapidly after the age of 40 years, and it is presumed that there is a substantial proportion of MetS in younger age groups. However, the association of IAF with MetS in adults aged 20 to 30 years has not been fully investigated.This study aimed to determine the prevalence of MetS and to verify whether IAF accumulation is associated with other MetS-related metabolic disorders including dyslipidemia, high blood pressure, and high blood glucose among the Japanese population in their 20s.In this cross-sectional study, IAF area (IAFA) and MetS-related metabolic parameters were evaluated in university students in their 20s (n = 1822, 21.5 ±â€Š1.5 years). IAFA was measured using a non-invasive device, DUALSCAN, which can be readily measured through the dual impedance method. The participants were divided into four groups according to IAFA: 0-49.9, 50-74.9, 75-99.9, and ≥100 cm.MetS was prevalent in 3.3% and 0.0% of the males and females, respectively, according to the Japanese criteria of MetS. The sex- and lifestyle-adjusted odds ratios (ORs) for the three metabolic component levels of Mets were elevated in the larger IAFA groups compared to the smallest IAFA group, according to the level of IAFA. The levels particularly increased in participants with abdominal obesity, defined by both, IAFA and waist circumference rather than by waist circumference alone.IAF accumulation was significantly associated with MetS-related metabolic disorders in young adults. An evaluation of IAFA may contribute to the early prediction of the risk of developing MetS in the future.

Factors associated with preschool workers' willingness to continue working.

In industrialized countries, the turnover rate of preschool workers is extremely high and now represents a social problem. Consequently, it has become important to promote stable early care and educational environments for this population. Several factors related to working environments are known to affect turnover intention; however, the specific factors related to turnover intention among preschool workers have not yet been identified. Considering this, the objective of the present study was to determine factors associated with preschool workers' willingness to continue working.The participants of this study were 1137 preschool workers based in Nagasaki Prefecture, Japan. Multivariate logistic regression analysis was used to analyze the participants' data, with willingness to continue working for 5 years or more set as the dependent variable.Analysis of the results for all subjects clearly showed that male sex, older age, good mental health, high number of social supports, and good work engagement have a positive effect on willingness to continue working. Further, stratifying the participants in terms of age revealed that for preschool workers under 39 years, male sex, good mental health, high number of social supports, and good work engagement act positively in regard to willingness to continue working. Meanwhile, for those over 40 years, it was found that permanent employment and good work engagement act positively in this regard. Thus, work engagement was the only common factor between preschool workers under 39 and over 40.The findings of this cross-sectional study demonstrate that the factors associated with willingness to continue working among preschool workers differ between younger and older professionals. These findings underline the importance of considering age categories when attempting to maximize such professionals' willingness to continue working.

Prevention of depression in first-year university students with high harm avoidance: Evaluation of the effects of group cognitive behavioral therapy at 1-year follow-up.

High harm avoidance (HA) scores on the temperament and character inventory appear to be a risk factor for depressive disorders and suicide. Since 2012, we have conducted group cognitive behavioral therapy (G-CBT) interventions for students at Nagasaki University with high HA and without depressive disorders, with the aim of preventing depression. Here, we report on the effects of the G-CBT at 1-year follow-up for the 2012 to 2015 period.Forty-two participants with high HA were included in the final analysis. Outcomes were measured with the Beck Depression Inventory II, Manifest Anxiety Scale, 28-item General Health Questionnaire, and Brief Core Schema Scales at baseline, and at 6-month, and 1-year follow-ups.Repeated-measures analyses of variance revealed a significant decrease in mean depressive symptom scores at the 6-month follow-up point; this decrease was maintained at 1 year. Improvements in cognitive schemas were also seen at 6 months and 1 year.We observed improvements in cognitive schemas associated with depression as a result of the G-CBT intervention, with effects maintained at 1 year post-intervention. This intervention may be effective in positively modifying the cognitions of students with HA and preventing future depression.

Item response theory-based validation of a short form of the Eating Behavior Scale for Japanese adults.

Obesity has become a serious social problem in industrialized countries in recent years. Clinically, although the evaluation of dietary behavior abnormalities is as important as any method of risk assessment for obesity, almost all the existing scales with many items may have numerous practical clinical difficulties. In this study, we aimed to prepare a short questionnaire to assess the dietary behavior abnormalities related to obesity. A total of 1032 individuals aged 20 to 59 years participated in the present study. Using item response theory (IRT), we selected the items for a short version from among 30 items of Sakata Eating Behavior Scale (EBS), which is widely used in Japan. As a result of the IRT-based analysis on the original 30-item version, 7 items were adopted as the short version. The correlation between the total score of the original EBS and the EBS short form was extremely high (r = 0.93, P = .001). In examining the criterion validity, for all participants (n = 1032), male (n = 516), and female (n = 516), the correlation coefficients between the total score of the EBS short form and body mass index (BMI) were r = 0.26, r = 0.28, and r = 0.28, respectively. The results of the receiver operating characteristic analysis was performed with obesity BMI > 25 kg/m as a dependent variable, the value of the area under the curve in the ROC was significantly higher in the 7-item version than in the total score of the original items (P = .0005). In conclusion, the 7-item EBS short form was created. Furthermore, it was found that the EBS short form is a reliable and valid measure that can be used as an indicator of obesity in both clinical and research settings.

Psychological effects of Helicobacter pylori-associated atrophic gastritis in patients under 50 years: A cross-sectional study.

BACKGROUND: While gastrointestinal function is known to be closely related to psychological status, the influence of Helicobacter pylori-associated atrophic gastritis is currently unknown. We aimed to determine whether atrophic gastritis status or H. pylori infection is associated with psychological distress or depressed mood. MATERIALS AND METHODS: We performed a cross-sectional, observational study involving 975 Japanese individuals (503 females; mean age, 44 ± 8 years) who underwent a health checkup. Psychological distress was defined as a Kessler-6 Scale score ≥13 and depressive mood as a Center for Epidemiological Studies Depression Scale score ≥ 16. The odds ratios with 95% confidence intervals assessing the risk of psychological distress or depressive mood associated with H. pylori infection (H. pylori-specific immunoglobulin G levels >10 U/mL) and atrophic gastritis status (pepsinogen I levels < 70 µg/L and pepsinogen I/II ratio < 3) were calculated using multiple logistic analysis adjusting for several covariates. RESULTS: Individuals with atrophic gastritis had a significantly higher risk of experiencing psychological distress, with younger females (<50 years) displaying the highest risk for psychological distress and depressive mood regardless of H. pylori infection status. Among females aged <50 years, H. pylori-seropositive participants with atrophic gastritis (HP+AG+) showed the highest risk of psychological distress (OR, 16.4; 95% CI, 3.45-94.9) and depression (OR, 2.86; 95% CI, 1.31-6.05), using HP-AG- status as the reference. CONCLUSIONS: Our findings support the results of previous animal studies regarding the psychological response to gastritis in humans. Further studies are needed to elucidate whether H. pylori eradication provides psychological benefits.

Intra-abdominal fat accumulation is a hypertension risk factor in young adulthood: A cross-sectional study.

Accumulation of intra-abdominal fat is related to hypertension. Despite this, a relationship between hypertension and intra-abdominal fat in young adulthood is not clear. In this study, we verify whether intra-abdominal fat accumulation increases a hypertension risk in young adult subjects.In a cross-sectional study, intra-abdominal fat area was measured using a dual bioelectrical impedance analysis instrument in 697 university students (20.3 ±â€Š0.7 years, 425 men). Blood pressure and anthropometric factors were measured. Lifestyle variables including smoking, drinking, physical activity, and eating behavior were assessed with questionnaire. High blood pressure risk (systolic blood pressure ≥130 mm Hg and/or diastolic blood pressure ≥85 mm Hg) with increasing intra-abdominal fat area was evaluated.Participants were divided into 5 groups according to their intra-abdominal fat area (≤24.9, 25-49.9, 50-74.9, 75-99.9, and ≥100 cm). As compared with the values of the smallest intra-abdominal fat area group, the crude and lifestyle-adjusted odds ratios (ORs) were elevated in larger intra-abdominal fat area groups [OR 1.31, 95% confidence interval (CI) 0.66-2.80; OR 3.38, 95% CI 1.60-7.57; OR 7.71, 95% CI 2.75-22.22; OR 18.74, 95% CI 3.93-105.64, respectively). The risk increase was observed only in men.Intra-abdominal fat accumulation is related to high blood pressure in men around 20 years of age. These results indicate the importance of evaluation and reduction of intra-abdominal fat to prevent hypertension.

Impact of Helicobacter pylori Immunoglobulin G Levels and Atrophic Gastritis Status on Risk of Metabolic Syndrome.

BACKGROUND: Helicobacter pylori (HP) infection is implicated in gastric and extra-gastric diseases. While gastritis-related chronic inflammation represents a known trigger of metabolic disturbances, whether metabolic syndrome (MetS) is affected by gastritis status remains unclear. We aimed to clarify the effect of HP-related gastritis on the risk of MetS. MATERIALS AND METHODS: We retrospectively enrolled patients undergoing screening for MetS between 2014 and 2015. Investigations included HP-specific immunoglobulin G (IgG) antibody assays to detect HP infection, and serum pepsinogen assays to evaluate atrophic gastritis status. The risk of MetS was evaluated via multiple logistic regression analyses with two covariates: serum HP infection status (IgG levels) and atrophic gastritis status (two criteria were applied; pepsinogen I/II ratio < 3 or both pepsinogen I levels ≤ 70 µg/L and pepsinogen I/II ratio < 3). RESULTS: Of 1,044 participants, 247 (23.7%) were HP seropositive, and 62 (6.0%) had MetS. HP seronegative and seropositive patients had similar risks of MetS. On the other hand, AG (defined in terms of serum PG I/II <3) was significant risk of MetS (OR of 2.52 [95% CI 1.05-7.52]). After stratification according to HP IgG concentration, patients with low HP infection status had the lowest MetS risk (defined as an odds ratio [OR] adjusted for age, sex, smoking, drinking and physical activity status). Taking this result as a reference, patients with negative, moderate, and high HP infection status had ORs (with 95% confidence intervals [CI]) of 2.15 (1.06-4.16), 3.69 (1.12-16.7), and 4.05 (1.05-26.8). CONCLUSIONS: HP-associated gastritis represents a risk factor for MetS. Research should determine why low and not negative HP infection status is associated with the lowest MetS risk.

Validation of the Japanese Version of the Body Vigilance Scale.

The Body Vigilance Scale is a self-report measure of attention to bodily sensations. The measure was translated into Japanese and its reliability, validity, and factor structure were verified. Participants comprised 286 university students (age: 19 ± 1 years). All participants were administered the scale, along with several indices of anxiety (i.e., Anxiety Sensitivity Index, Short Health Anxiety Inventory Illness Likelihood Scale, Social Interaction Anxiety Scale, and Hospital Anxiety and Depression Scale). The Japanese version of the Body Vigilance Scale exhibited a unidimensional factor structure and strong internal consistency. Construct validity was demonstrated by significant correlations with the above measures. Results suggest that the Japanese version of the scale is a reliable, valid tool for measuring body vigilance in Japanese university students.

Maladjustment to Academic Life and Employment Anxiety in University Students with Irritable Bowel Syndrome.

The present study tested our hypothesis that university students with irritable bowel syndrome (IBS) may experience less satisfactory academic lives than those of students without IBS. We also verified the hypothesis that university students with IBS might have higher employment anxiety than students without IBS might. We conducted a cross-sectional study of 1,686 university students. Presence or absence of IBS was assessed via the Rome III Questionnaire. Two original items were used to evaluate academic life. The prevalence rates of IBS with diarrhea, IBS with constipation, mixed IBS, and unsubtyped IBS in the study population were 5%, 2%, 10%, and 3%, respectively. Regarding academic life, the proportions of participants who experienced maladjustment and employment anxiety were 29% and 50%, respectively. After adjusting for age, sex, and faculty, the odds ratios for maladjustment and employment anxiety were significantly higher in students who screened positively, relative to those who screened negatively, for IBS (OR, 1.62; 95% CI, 1.24-2.21; OR, 2.16; 95% CI, 1.68-2.81, respectively). In conclusion, maladjustment and anxiety over future employment were higher in university students with IBS relative to those without.

Gastrointestinal specific anxiety in irritable bowel syndrome: validation of the Japanese version of the visceral sensitivity index for university students.

OBJECTIVE: The visceral sensitivity index (VSI) is a useful self-report measure of the gastrointestinal symptom-specific anxiety (GSA) of patients with irritable bowel syndrome (IBS). Previous research has shown that worsening GSA in IBS patients is related to the severity of GI symptoms, suggesting that GSA is an important endpoint for intervention. However, there is currently no Japanese version of the VSI. We therefore translated the VSI into Japanese (VSI-J) and verified its reliability and validity. MATERIAL AND METHODS: Participants were 349 university students aged 18 and 19 years and recruited from an academic class. We analyzed data from the VSI-J, Anxiety Sensitivity Index (ASI), Hospital Anxiety and Depression scale (HAD), and Irritable Bowel Syndrome Severity Index (IBS-SI). The internal consistency, stability, and factor structure of the VSI-J and its associations with anxiety, depression and severity measures were investigated. RESULTS: The factor structure of the VSI-J is unidimensional and similar to that of the original VSI (Cronbach's α = 0.93). Construct validity was demonstrated by significant correlations with ASI (r = 0.43, p < 0.0001), HAD-ANX (r = 0.19, p = 0.0003), and IBS-SI scores (r = 0.45, p < 0.0001). Furthermore, the VSI-J was a significant predictor of severity scores on the IBS-SI and demonstrated good discriminant (p < 0.0001) and incremental (p < 0.0001) validity. CONCLUSION: These findings suggest that the VSI-J is a reliable and valid measure of visceral sensitivity.

Relationships between clinicopathological features and cerebrospinal fluid biomarkers in Japanese patients with genetic prion diseases.

A national system for surveillance of prion diseases (PrDs) was established in Japan in April 1999. Here, we analyzed the relationships among prion protein gene (PRNP) mutations and the clinical features, cerebrospinal fluid (CSF) markers, and pathological characteristics of the major genotypes of genetic PrDs (gPrDs). We retrospectively analyzed age at onset and disease duration; the concentrations and incidences of 14-3-3 protein, tau protein, and abnormal prion protein (PrP(Sc)) in the CSF of 309 gPrD patients with P102L, P105L, E200K, V180I, or M232R mutations; and brain pathology in 32 autopsied patients. Three clinical phenotypes were seen: rapidly progressive Creutzfeldt-Jakob disease (CJD), which included 100% of E200K cases, 70% of M232R, and 21% of P102L; slowly progressive CJD, which included 100% of V180I and 30% of M232R; and Gerstmann-Sträussler-Scheinker disease, which included 100% of P105L and 79% of P102L. PrP(Sc) was detected in the CSF of more than 80% of patients with E200K, M232R, or P102L mutations but in only 39% of patients with V180I. V180I was accompanied by weak PrP immunoreactivity in the brain. Patients negative for PrP(Sc) in the CSF were older at disease onset than positive patients. Patients with mutations associated with high 14-3-3 protein levels in the CSF typically had synaptic deposition of PrP in the brain and a rapid course of disease. The presence of small PrP protein fragments in brain homogenates was not correlated with other clinicopathological features. Positivity for PrP(Sc) in the CSF may reflect the pathological process before or at disease onset, or abnormality in the secretion or metabolism of PrP(Sc). The amount of 14-3-3 protein in the CSF likely indicates the severity of the pathological process and accompanying neuronal damage. These characteristic features of the CSF in cases of gPrD will likely facilitate accurate diagnosis and clinicopathological study of the various disease subtypes.

Effects of personality traits on the manifestations of irritable bowel syndrome.

OBJECTIVE: Previous studies have reported that patients with irritable bowel syndrome (IBS) show high neuroticism. However, the precise association between the IBS subtypes and the degree of neuroticism in younger populations is largely unknown. We tested our hypothesis that subjects with diarrhea-predominant IBS may have a higher degree of neuroticism than subjects without IBS or those with other subtypes of IBS. We also verified the additional hypothesis that the severity of neuroticism might be correlated with the severity of IBS in younger populations. METHODS: We conducted a cross-sectional survey of 557 university students, ranging in age from 18 to 21 years. Presence/ absence of IBS and determination of the IBS subtype was by the Rome II Modular Questionnaire, while the severity of IBS was determined by the IBS severity index (IBS-SI). The degree of neuroticism was evaluated using the Maudsely Personality Inventory (MPI). The presence/absence of psychological distress was measured with the K6 scale. RESULTS: Neuroticism scores in the subjects with diarrhea-predominant IBS were significantly higher than those in the non-IBS subjects or subjects with constipation-predominant IBS. The neuroticism scores were significantly correlated with the IBS-SI scores in all subjects with IBS. CONCLUSION: These results suggest that neuroticism is involved in the pathophysiology of IBS in young subjects, especially in that of the diarrhea-predominant subtype.

Effect of baseline self-efficacy on physical activity and psychological stress after a one-week pedometer intervention.

Physical activity and psychological stress were hypothesized to improve more in participants with high self-efficacy than in those with low and medium self-efficacy after a one-week intervention. 39 female university students participated. The intervention had two steps: a lecture on self-monitoring and goal setting (160 min.) and a one-week pedometer intervention. Analyses were conducted on tertile groups according to self-efficacy at baseline. Pedometer step counts were higher in the high self-efficacy group than in the low self-efficacy group after intervention. Helplessness decreased time dependently after intervention only in the high-self-efficacy group. Because physical activity improved more in the high self-efficacy group after a one-week intervention, one hypothesis was supported.

Multicentre multiobserver study of diffusion-weighted and fluid-attenuated inversion recovery MRI for the diagnosis of sporadic Creutzfeldt-Jakob disease: a reliability and agreement study.

Objectives To assess the utility of the display standardisation of diffusion-weighted MRI (DWI) and to compare the effectiveness of DWI and fluid-attenuated inversion recovery (FLAIR) MRI for the diagnosis of sporadic Creutzfeldt-Jakob disease (sCJD). Design A reliability and agreement study. Setting Thirteen MRI observers comprising eight neurologists and five radiologists at two universities in Japan. Participants Data of 1.5-Tesla DWI and FLAIR were obtained from 29 patients with sCJD and 13 controls. Outcome measures Standardisation of DWI display was performed utilising b0 imaging. The observers participated in standardised DWI, variable DWI (the display adjustment was observer dependent) and FLAIR sessions. The observers independently assessed each MRI for CJD-related lesions, that is, hyperintensity in the cerebral cortex or striatum, using a continuous rating scale. Performance was evaluated by the area under the receiver operating characteristics curve (AUC). Results The mean AUC values were 0.84 (95% CI 0.81 to 0.87) for standardised DWI, 0.85 (95% CI 0.82 to 0.88) for variable DWI and 0.68 (95% CI 0.63 to 0.72) for FLAIR, demonstrating the superiority of DWI (p<0.05). There was a trend for higher intraclass correlations of standardised DWI (0.74, 95% CI 0.66 to 0.83) and variable DWI (0.72, 95% CI 0.62 to 0.81) than that of FLAIR (0.63, 95% CI 0.53 to 0.74), although the differences were not statistically significant. Conclusions Standardised DWI is as reliable as variable DWI, and the two DWI displays are superior to FLAIR for the diagnosis of sCJD. The authors propose that hyperintensity in the cerebral cortex or striatum on 1.5-Tesla DWI but not FLAIR can be a reliable diagnostic marker for sCJD.