The number of elderly diabetic patients has continued to increase year by year. Home-visit nursing care is beneficial to homebound elderly diabetic patients and there is a large number of senior citizens utilizing this form of health service. We conducted a questionnaire survey of home-visit nursing care of elderly diabetic patients. Those queried were participants in the diabetes workshop. Eighty-five of them responded to our questionnaire.The results showed that 87% of the respondents experienced care of diabetic patients and acute complications of hypoglycemia and hyperglycemia as well. It was also found that many home helpers extended assistance in drug compliance, indicating that home helpers play an important role in the medical care of elderly diabetic patients.On the other hand, many problems became apparent such as lack of observation of foot care, lack of knowledge of methods of treating hypoglycemia, and inadequate observation of drug compliance due to the limited availability of home visit time.Training and collaboration of local home-visit nursing care personnel are considered necessary in the future in order to improve on the home care of elderly diabetic patients.
Elderly ; Care given by nurses ; Questionnaires ; Home ; Surveys

Introduction: The career support system was introduced in Okayama University Hospital in 2008, and the number of users has exceeded 150. Methods: To examine changes in perceptions of the system and its users, we conducted a questionnaire survey of supervisors and the colleagues of system users in FY2011 and FY2018. Results: Compared to 2011, the following items were significantly higher in FY2018: "I have experience working with users of the support system", "I think this system is useful for the medical office", and "This system makes the medical office more appealing". In the analysis of the colleagues of system users only, in addition to the aforementioned three items, the item "Users of the system are able to do their jobs to the degree expected" was significantly higher in FY2018. Conclusion: The effectiveness of the career support system is becoming more recognized, and the evaluation of the work content of the system's users has improved.

Objectives: A survey was conducted to investigate the usability and safety of fentanyl sublingual tablets (FST) and to examine problems associated with their proper use.

Methods: Subjects were 18 cancer inpatients who received FST for breakthrough pain in their pharmacological cancer pain management. Changes in the pain score and the occurrence of adverse effects (nausea, vomiting and somnolence) were compared before and after FST administration.

Results: The pain score before FST administration was 6.4±2.4, and this was significantly improved to 3.4±2.8 at 30 min after administration (p<0.01). Somnolence occurred significantly more often 30 min and 2 h after FST administration than immediately before administration (p<0.05). There were no differences in the occurrence of nausea and vomiting before or after FST administration. Nine patients receiving FST therapy developed xerostomia, but there were no significant changes in the pain score or occurrence of adverse effects while they had xerostomia.

Conclusion: It is essential to observe the oral condition to judge whether FST therapy is indicated, and FST should be administered after providing sufficient oral care. The results indicate the possibility of increased occurrence of somnolence as an adverse effect.

Purpose  In a series of our recent studies, systematic mild hyperthermia treatments, such as sauna, hot spring and a special bath for medical treatment, were found to activate leucocytes and to enhance immunity. Although they are known to be effective for health promotion, it is not easy for general people to regularly take these conventional hyperthermia. It would be advantageous for elderly persons, sick people and pregnant women as well as pressed business persons if it is able to minimize stress which might be induced by the conventional hyperthermia, such as high temperature heat, water pressure and humidity. To pursue a further study of the effect of hyperthermia itself, in this research, we utilized nano-mist sauna (NMS), a new hyperthermia treatment. NMS, a new type sauna, is characterized by the ability to produce ultra small fog-shaped hot water called nano-mist, which hardly condenses dew. And we studied the effect of NMS on body temperature, leukocytes, autonomic nerve function and energy production. Method  We obtained peripheral blood from six healthy male volunteers (age, 46.5±8.5 years) before and after NMS hyperthermia (20min, 40°C, 100%RH) for lactate and blood glucose measurement and flowcytometric analysis. Body temperature (hypoglossal) and pulse rates were also measured. The statistical analysis difference between the values was determined by paired t-test and Kruskal-Wallis test. Result  After NMS hyperthermia body temperature and the level of PO2 rose (36.8→37.2°C), (52→61mmHg) (p<0.05). On the other hand, the level of lactate showed decrease in all subjects. The ratio and the numbers of NK cells decreased (21.8→17.7%, 498→436/μL) (p<0.05) while those of B cells increased (9.5→12.1%, 261→349/μL) (p<0.05). Discussion  Several investigators report that the conventional hyperthermia enhances the primordial immune system (i.e. extrathymic T cells, NK cells, NKT cells and granulocytes) via dominance of sympathetic nerve system function (SNS) . Conversely, in our study, those of the conventional immune system (i.e. T and B cells) was enhanced, suggesting suppression of SNS function. It is reported that the expression level of HLA-DR on the B cells was elevated during hyperthermia (body temperature rose). SNS function (hypothermia) is stimulated by stress and it is suppressed by relaxing (hyperthermia) in the opposite. And it is considered that NMS hyperthermia suppressed SNS and that it was also consistent with our result of lactate decrease. It is possible to consider that NMS hyperthermia may impact on autonomic nerve activating leucocytes. Therefore NMS may be a kind of effective health promotion for valetudinarian (ie an infant, a female) and both a caregiver and a caretaker.

BACKGROUND/AIMS: Although studies using conventional animal models have shown that specific stressors cause irritable bowel syndrome (IBS), it is unclear whether depression itself causes IBS. Our aim was to establish a rat model to determine if depression itself promotes the onset of IBS and to elucidate the role of gut microbiota in brain-gut axis pathogenesis during coincident depression and IBS. METHODS: Rat models of depression were induced using our shuttle box method of learned helplessness. Visceral hypersensitivity was evaluated by colorectal distension (CRD) to diagnose IBS. Gut microbiota compositions were analyzed using high-throughput sequencing. In the subanalysis of rats without depression-like symptoms, rats with posttraumatic stress disorder (PTSD) were also examined. RESULTS: The threshold value of CRD in depressed rats was significantly lower than that in control rats. Microbial community analysis of cecal microbiota showed that the relative abundance of Clostridiales incertae sedis, the most prevalent microbe, was significantly lower in depressed rats than in control rats. The distribution pattern of the microbiota clearly differed between depressed rats and control rats. Neither visceral hypersensitivity nor the composition of gut microbiota was altered in rats with PTSD-like phenotypes. CONCLUSIONS: Our rat model of depression is useful for clarifying the effect of depression on IBS and suggests that depression itself, rather than specific stressors, promotes the onset of IBS. Further, we provided evidence that various psychiatric diseases, viz., depression and PTSD, are associated with unique gut microbiota profiles, which could differentially affect the onset and progression of coincident IBS.
Animals ; Clostridiales ; Depression ; Dysbiosis ; Gastrointestinal Microbiome ; Helplessness, Learned ; Hypersensitivity ; Irritable Bowel Syndrome ; Methods ; Microbiota ; Models, Animal ; Phenotype ; Rats ; Stress Disorders, Post-Traumatic