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This study aimed to determine which instrumental activities of daily living (IADL) are associated with health deterioration from the "support level" to the "care level" among users of the long-term care insurance system in Japan. From April 2017 to March 2020, we conducted a retrospective follow-up survey on 178 Japanese community-dwelling older adults (64 men, 114 women) newly certified as support level. Independent variable was 8 IADL items and the outcome defined as the "support level maintenance time." Cox models were used to assess the risk of health deterioration, with adjustments for age group, family composition, dementia status, and frailty status by gender. Dependence on 5 items, "laundry" (hazard ratio [HR] =2.5; 95% confidence interval [CI]: 1.1-5.8), "cooking" (HR = 3.7; 95% CI: 1.1-12.2), "telephone use" (HR = 2.4; 95% CI: 1.2-4.7), "financial management" (HR = 2.5; 95% CI: 1.2-5.0), and "medication management" (HR = 2.4; 95% CI: 1.2-4.8), was independently associated with a worse outcome among men, whereas dependence on "financial management" (HR = 2.6; 95% CI: 1.5-4.7) and "medication management" (HR = 2.0; 95% CI: 1.1-3.5) was independently associated with a worse outcome among women. These findings suggest that difficulties in "financial management" and "medication management" are common factors associated with health deterioration from the support to the care level among both genders. An association with household tasks was also seen among men, indicating that a paradigm shift is needed to increase the participation of men in household tasks. [ABSTRACT FROM AUTHOR]

Objective: The development of a dysphagia screening test is an urgent issue in the field of frailty prevention among community‐dwelling older people. The purpose of this study was to evaluate the screening performance of a 100‐mL water swallowing test (WST). Methods: The study employed a cross‐sectional design. Participants were 304 (65 men and 239 women, mean age = 80 years) Japanese community‐dwelling older adults aged over 65 years. We investigated swallowing disorder using the 10‐item Eating Assessment Tool (EAT‐10), and compared choking signs, swallowing time and number of swallows, and their combination in the 100‐mL WST. We calculated the sensitivity and specificity of these indices. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut‐off value of swallowing time and number of swallows in the 100‐mL WST based on the Youden Index among participants without choking signs. Results: The sensitivity and specificity of choking signs in the 100‐mL WST were 20% and 91%, respectively. The discriminating ability of swallowing time and number of swallows among participants without any choking signs was.76 and.72, respectively, in the area under the ROC curve. Diagnostic sensitivity and specificity to discriminate dysphagia from normal swallowing ability were 65% and 74% when the cut‐off was >10 s based on maximisation of the Youden Index. The 100‐mL WST performed best when the indices of choking signs and swallowing time were combined, with a sensitivity and specificity of 72% and 68%, respectively. Conclusions: The 100‐mL WST would be an adequate screening tool when compared to the EAT‐10. [ABSTRACT FROM AUTHOR]

We focused on the effects of tides on storm surge deviations. According to previous studies, storm surge deviations depend on when the typhoon strikes in the tidal phase because the water depth of a bay varies with tides. The previous studies concluded that the dependence can be explained by the conventional formula. However, the results of our numerical simulations could not be explained quantitatively by the conventional formula and require a development mechanism for storm surges that are not expressed in the formula, to explain the dependency. Therefore, we focused on the water depth gradient, and confirmed from the numerical simulation results that the depth gradient greatly influenced the development characteristics of storm surges. Moreover, a new formula considering the depth gradient was derived, and the tidal dependence of storm surge deviations was investigated. Based on the new formula, two indexes that indicate the effect of the water depth gradient and the effect of tides on storm surges were derived. We examined the indexes to clearly understand the development characteristics of storm surges. Finally, the validity of the derived indexes was investigated by comparing the computed surge heights based on the indexes with the results of the numerical simulations. [ABSTRACT FROM AUTHOR]

A two-dimensional bay and river coupled numerical model in Cartesian coordinates was developed to find the impact of the river on the simulated water levels associated with a storm along the coast of Bangladesh. The shallow water models developed for both the bay and river were discretized by the finite difference method with forward in time and central in space. The boundaries for the coast and islands were approximated through proper stair steps representation and solved by a conditionally stable semi-implicit manner on a staggered Arakawa C-grid. A one-way nested scheme technique was used in the bay model to include coastal complexities as well as to save computational costs. A stable tidal condition was made by forcing the sea levels with the most energetic tidal constituent, M2, along with the southern open boundary of the bay model omitting wind stress. The developed model was then applied to foresee the sea-surface elevation associated with the catastrophic cyclone of 1991 and cyclone MORA. A comparative study of the water levels associated with a storm was made through model simulations with and without the inclusion of the river system. We found that the surge height in the bay-river junction area decreased by 20% and the surge height reduced by about 3–8% outside the junction area from this study. The obtained results were found to have a satisfactory similarity with some of the observed data. [ABSTRACT FROM AUTHOR]