JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE
Online ISSN : 1349-7421
Print ISSN : 0468-2513
ISSN-L : 0468-2513
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Volume 72, Issue 6
Displaying 1-19 of 19 articles from this issue
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The 72nd Annual Meeting of the Japanese Association of Rural Medicine
LECTURE BY CONGRESS PRESIDENT
  • Considering Sustainable Health care From the Frontline in an Aging Society With a Declining Birthrate
    Akira KAMIYA
    2024 Volume 72 Issue 6 Pages 445-452
    Published: 2024
    Released on J-STAGE: May 10, 2024
    DOIhttps://doi.org/10.2185/jjrm.72.445
    JOURNAL FREE ACCESS
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    　Kitaakita Municipal Hospital is located in Kitaakita City in the northern inland area of Akita Prefecture. When I started my new post at the former JA Akita Koseiren Hokusyu Central Hospital in 2002, there were two other hospitals in the area. Both were small to medium-sized hospitals with management problems and a shortage of doctors. Kitaakita City, which was already experiencing a wave of declining birthrates and an aging population, recognized the need for functional integration of its three hospitals, and in 2010, under the designated administrator system, established Kitaakita Municipal Hospital as an institution founded by the city and administered by JA Akita Koseiren. The Kitaakita district, located in a rural part of Akita Prefecture far from the Tokyo Metropolitan Area, can be seen as a forerunner of where Japan is headed in the future. The theme of this conference is “Healthcare in an Aging Society with a Declining Birthrate: Make Akita Bloom” and is intended to help people think about how to develop sustainable health care in an era of declining birthrates and aging populations.
    　Japan's population has entered a phase of decline, with an aging society and a declining birthrate. It is expected that elderly patients will continue to account for larger proportions of hospitalized patients into the future. As more and more patients become frail and show signs of senility, it is necessary to train general practitioners who are able to treat patients systemically. Also, as the number of patients requiring high levels of nursing care increases, the hospitalization system must be improved so that it can accommodate them. Although the differentiation and concentration of healthcare functions is necessary to maintain the quality of healthcare amid a declining population, especially in rural areas, we continue to need hospitals that treat the elderly as well as a healthcare system that fully accounts for comprehensive community-based care.
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SPECIAL LECTURE 1
SPECIAL LECTURE 2
SPECIAL LECTURE 3
SPECIAL LECTURE 4
SPECIAL LECTURE 5
EDUCATIONAL LECTURE 1
EDUCATIONAL LECTURE 2
CULTURAL LECTURE
KANAI PRIZE WINNER'S LECTURE
SYMPOSIUM 1
SYMPOSIUM 2
ORIGINALS
  • Relationship Between Lumbosacral Alignment and Lumbar Motor Control Determined by the Sahrmann Core Stability Test in Adolescents With Lumbar Spondylolysis
    Yoshiyuki IMOO, Masaki TATSUMURA, Kodai TOBITA, Shunji TAKEI, Manabu Y ...
    2024 Volume 72 Issue 6 Pages 528-534
    Published: 2024
    Released on J-STAGE: May 10, 2024
    DOIhttps://doi.org/10.2185/jjrm.72.528
    JOURNAL FREE ACCESS
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    　Patients with lumbar spondylolysis may have poor lumbo-pelvic function and improving lumbar segmental stability may take time. It is assumed that the stronger the lordosis, the poorer the lumbo-pelvic function; however, to our knowledge, evidence of this relationship is lacking. To clarify the relationship between lumbosacral alignment and lumbo-pelvic function in lumbar spondylolysis, we assessed lumbar lordosis and sacral slope in the standing lateral view on plain X-rays and Sahrmann Core Stability Test (SCST) results in 66 adolescents with lumbar spondylolysis with bone marrow edema. Based on SCST results, the patients were divided into those with level 1 or 2 core stability (low group) and those with level 3 or higher core stability (high group). No significant difference was found in lumbosacral alignment between the two groups. In adult patients with spondylolisthesis, the lumbar lordosis angle and sacral slope increases to maintain the center of gravity, but no such increase in compensation was evident in our patients who were young and without slip. These findings suggest that lumbo-pelvic function does not affect lumbosacral alignment in adolescents with spondylolysis. It should be noted that using the SCST alone to evaluate motor control may not be precise enough to determine the relationship between lumbosacral alignment and lumbo-pelvic function because the SCST may not have high enough sensitivity to assess trunk extensor muscles.
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  • Psychological Conflict Among Men Aged 80 Years or Older Living Alone in Depopulated Communities in Japan
    Kimie FUJIKAWA, Hiroshi OGATA, Maki HAYASHI, Haitang XIE, Akihito UEZA ...
    2024 Volume 72 Issue 6 Pages 535-543
    Published: 2024
    Released on J-STAGE: May 10, 2024
    DOIhttps://doi.org/10.2185/jjrm.72.535
    JOURNAL FREE ACCESS
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    　The aim of this study was to clarify the nature of psychological conflict among men aged 80 years or older who were living alone in eight depopulated municipalities designated by Japan's Ministry of Internal Affairs and Communications. Semi-structured interviews were conducted with 34 elderly men who were living alone. Text-mining analysis revealed that elderly men living alone in depopulated villages were feeling lonely because they [did not have anyone to talk to] but did not want to leave their homes. They were aware of [progressive decline in physical functions] after the age of 80 and thought that [it would be the end if no longer being able to walk]. Because they needed to drive a car in order to continue living their lives, they were [conflicted about continuing to drive] and [anxious that they would not be able to go shopping] if they were to stop driving. The elderly men living in depopulated villages had developed human relationships and attachments to their hometowns, and they wanted to continue living in the homes they were born and raised in until the end of their lives. At the same time, they were struggling with conflicts related to loneliness caused by the weakening of human relationships, feelings of self-deficiency due to physical decline, and a sense of crisis stemming from the decline of the community. On the other hand, one factor supporting them was their motivation to protect the community. These findings suggest the need for a community care system that helps older people feel a sense of solidarity with, and a sense of contribution to, the community.
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CASE REPORT
  • A Case of Right Caudate Hemorrhage During Delivery
    Mari SHIBATA, Ayaka NAGAI, Yuta KATO, Keika YAMAUCHI, Yasushi MATSUKAW ...
    2024 Volume 72 Issue 6 Pages 544-548
    Published: 2024
    Released on J-STAGE: May 10, 2024
    DOIhttps://doi.org/10.2185/jjrm.72.544
    JOURNAL FREE ACCESS
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    　The patient was a 36-year-old primipara with no comorbidities such as diabetes or hypertension. At 35 weeks and 3 days of pregnancy, she was admitted for rupture of membranes. She vomited often during the expulsive stage of labor, so a vacuum extraction was performed. Her vital signs were normal throughout the delivery. She vomited repeatedly after the delivery but did not complain of headache or arm weakness and her level of consciousness was Japan Coma Scale I-1. Head CT revealed right caudate hemorrhage and cerebral ventricular rupture. Head MRI showed no obvious cerebrovascular abnormality, so she was followed up with symptomatic treatment. Recovery was uneventful, without neurological sequelae, and she was discharged on postpartum day 27. Cerebral hemorrhage during pregnancy is caused in many cases by comorbidities such as cerebral aneurysm, cerebral artery malformation, and pregnancyinduced hypertension syndrome. Cerebral hemorrhage may occur in pregnant women with no risk factors, even when their vital signs are stable. It is necessary to pay attention to the appearance of new symptoms, such as vomiting, around the time of delivery.
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