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Research on Supports for Those Who Require Special Care to Prevent Disuse Syndrome in Disasters and Disaster-related Death Using Telemedicine
- Tomoki Gomi, Shizuko Gomi, Shoko Nomura, Yumi Hashizume, Naoki Maki, Hisako Yanagi
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- Journal:
- Prehospital and Disaster Medicine / Volume 38 / Issue S1 / May 2023
- Published online by Cambridge University Press:
- 13 July 2023, pp. s174-s175
- Print publication:
- May 2023
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- Article
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Introduction:
In Japan, natural disasters such as earthquakes and typhoons are extremely frequent. It is predicted that Tokyo Inland earthquakes will occur within the next 30 years. Disuse syndrome and Disaster-related deaths have increased in disasters. It has been reported that Disuse syndrome and Disaster-related deaths are particularly prevalent among those who require special care. Therefore, it is necessary to consider support for them in the future disaster. Telemedicine has become increasingly popular in recent years. Previous researches using telemedicine have reported that it is useful for rehabilitation and management of chronic diseases. This study aimed telemedicine would be useful to prevent Disuse syndrome and Disaster-related deaths.
Method:The subjects were physicians, nurses, physical therapists, occupational therapists, and speech therapists. Semi-structured interviews were conducted with the subjects on how telemedicine could be used to assist them. The data were analyzed using Krippendorff's content analysis.
Results:The research interviewed medical staff including physical therapists and occupational therapists with knowledge about disaster medicine. Thirteen categories of problems with telemedicine were identified, including problems with infrastructure and operation by the elderly. Eight categories of support that could be provided were generated that were common to all rehabilitation professionals, two categories for physical therapists, two categories for occupational therapists, and five categories for speech therapists.
Conclusion:This study examined what kind of support can be provided using telemedicine to prevent Disuse syndrome and Disaster-related deaths. Common support by rehabilitation professionals included instruction in exercises and prevention of economy class syndrome. It was suggested that speech therapists could provide oral swallowing exercises and support for those with dysphagia. However, the handling of communication devices by the elderly, and the interaction of medical personnel were cited as problems. In response to these issues, there was a possibility to support the victims by collaborating with remote and local medical professionals.
15 - Analysis of genes associated with hypercholesterolaemia in the Japanese population
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- By Hideo Hamaguchi, University of Tsukuba, Yuka Watanabe, University of Tsukuba, Yasuko Yamanouchi, University of Tsukuba, Hisako Yanagi, University of Tsukuba, Tadao Arinami, University of Tsukuba, Ryunosuke Miyazaki, Kudanzaka Hospital, Shigeru Tsuchiya, University of Tsukuba, Kimiko Kobayashi, University of Tsukuba
- Edited by Derek F. Roberts, University of Newcastle upon Tyne, N. Fujiki, Department of Internal Medicine and Medical Genetics, Fukui Medical School, Japan, K. Torizuka, Fukui Medical School, Japan
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- Book:
- Isolation, Migration and Health
- Published online:
- 05 March 2012
- Print publication:
- 10 September 1992, pp 154-166
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Summary
Genes associated with hypercholesterolaemia have been detected and characterised at the loci for low density lipoprotein (LDL) receptor, apolipoprotein B, apolipoprotein E, and apolipoprotein (a) (Goldstein & Brown, 1989; Soria et al., 1989; Mahley & Rail, 1989; Utermann, 1989). Among them, genes at the loci for apolipoprotein E and apolipoprotein (a) are polymorphic and act as polymeric genes for multifactorial hypercholesterolaemia. These polymorphic genes have been identified by the analysis of proteins using electrophoretic methods. It is interesting to examine whether these polymorphic and seemingly deleterious genes are identical at the DNA and amino acid sequence levels among different ethnic groups. On the other hand, deleterious genes detected at the loci for LDL receptor and apolipoprotein B are not polymorphic but act as major genes which cause autosomal dominant hypercholesterolaemia. These genes have been shown to be a cause of premature coronary heart disease (Goldstein & Brown, 1989; Soria et al., 1989). The data obtained by the analysis of DNA suggest the same mutational origin for some of these deleterious genes (Goldstein & Brown, 1989) and their subsequent spread in populations.
This communication reports the results of molecular genetic studies on the phenotype E4 determined by the alleles at the locus for apolipoprotein E and on familial hypercholesterolaemia caused by the mutant LDL receptor gene in the Japanese population.
Apolipoprotein E4 in the Japanese population
Apolipoprotein E is a protein constituent of plasma lipoproteins and plays an important role in lipoprotein metabolism (Mahley, 1988). The genetic polymorphism of apolipoprotein E is under the control of three common alleles (ε2, ε3, ε4) that specify isoforms apolipoprotein E2, E3 and E4 respectively (Mahley & Rail, 1989).