Objective: The purposes of this study are to explore current status and tasks of a pamphlet for families of terminally ill patients at home. Methods: We sent out the questionnaire to 419 home-visit nursing administrators, and obtained an answer from 118. Results: About 42% administrators used the pamphlet. Most pamphlet users were considering as follow: degree of worry and anxiety of the family, the family’s and the patient’s hope of being home death (each more than 82.6%). Usefulness of the pamphlet; the families could prepare for their patient’s death, understand the present condition of the patient, etc. However, 67% users were feeling difficulty to decide the timing to hand the pamphlet to the families. As a reason without the pamphlet, there are not any pamphlets available (64.1%). Conclusion: Nursing administrators who used the pamphlet have recognized the usefulness, but have felt difficulty of the use.

With innovations of “Courses of Study” in high school, the number of medical students who have not studied biology has increased rapidly and has created problems for medical education. Therefore, we started a course entitled “Science for a Healthy Life” for medical school freshmen. In traditional lectures, students often lose interest and start talking among themselves. For these reasons, we introduced new interactive education techniques into lectures for “Science for a Healthy Life.” Most students were interested in the visual aids and the performance of simple experiments. The students could discuss subjects and present results. With these new educational techniques, most student learned actively and efficiently. Many students learned by themselves with visual aids and reference books outside class, for example, after school and during summer and winter vacation. Finally, we found no significant difference in examination results for “Science for a Healthy Life” between students who had studied biology in high school or those who had not.

Dementia of the Alzheimer's type, in which cognitive impairment slowly progresses, accounts for more than half of dementia cases. Symptoms develop slowly and worsen over time, and there is no cure for Alzheimer's type dementia. We conducted a study on the efficacy of hangebyakujutsutemmato for cognitive impairment in dementia of the Alzheimer's type. Seventy-two patients with Alzheimer's type dementia were enrolled in our study. Hasegawa dementia scale-revised (HDS-R) was implemented for all patients, for whom hangebyakujutsutemmato medication was started at the initial visit. After 4-weeks' treatment the HDS-R was implemented again. Sixty-four patients were assessable and 8 patients dropped out from the study. In these 64 patients, mean age ± standard deviation was 79.9 ± 6.0, and 33 patients were male, and 31 patients were female. After 4 weeks of hangebyakujutsutemmato treatment, HDS-R scores were increased significantly compared with baseline (from 15.5 ± 5.2 to 16.9 ± 6.2, p < 0.01). In taking histories from families, clinical presentation was shown to have improved in 13 patients (20.3%). To our knowledge, this is the first report demonstrating that hangebyakujutsutemmato is effective for patients with dementia of the Alzheimer's type. In conclusion, hangebyakujutsutemmato is a useful option for the treatment of cognitive impairment in Alzheimer's type dementia.

Blepharospasm is classified as a focal dystonia, and involves involuntary contraction of muscles such as the orbicularis oculi muscle and the corrugator muscle, which are associated with eyelid movement. Thus blepharospasm involves difficulties to eyelid opening. A 61-year-old woman came to our hospital complaining of a sense of discomfort of the eyes since a half year earlier. Blepharospasm was diagnosed based on current medical history and neurological examination. Oral saikokaryukotsuboreito was started and the blepharospasm improved gradually. After a week, oral treatment with one-third of the amount of shakuyakukanzoto was added and the blepharospasm further improved. The patient wanted to increase the dose of shakuyakukanzoto and to stop the saikokaryukotsuboreito. Once oral shakuyakukanzoto monotherapy was started, however, the blepharospasm worsened. Oral saikokaryukotsuboreito and low dose shakuyakukanzoto was started again, and her blepharospasm improved again.
The mechanism behind a focal dystonia such as blepharospasm is explained as a disorder of the basal ganglia motor loop. Saikokaryukotsuboreito is used for the diseases of the central nervous system. Thus there is the possibility that, here, saikokaryukotsuboreito improved a central nervous system disorder, and the blepharospasm. To our knowledge, this is the first report demonstrating that saikokaryukotsuboreito is effective for blepharospasm. It suggests that saikokaryukotsuboreito is a useful option for the treatment of blepharospasm.

This study examined the association of physical activity (PA) and sedentary behavior (SB) with chronic low back pain (CLBP) in older adults. Cross-sectional data were collected from 715 elders aged 65 years and over living in Dazaifu, Japan. CLBP was defined as pain that sustains more than 1-3 months within the past year. PA and SB were objectively measured using a triaxial accelerometer (Omron Healthcare, Active style Pro (HJA 350IT)). Participants were categorized into four groups (2 groups of PA×2 groups of SB) according to their levels of PA and SB (divided into 2 levels; low and high levels around the median). Logistic regression analysis was used to examine effect of PA/SB with CLBP. In the analyses, sex, age, body mass index, smoking, educational attainment, falls, handgrip strength, knee pain and non-locomotive activities were treated as potential confounders. The prevalence of CLBP was 35%. After adjustment of confounding factors, significantly higher risk of CLBP was shown only in Low PA/High SB group (odds ratio : 1.66, 95% confidence interval : 1.02-2.70), compared with that of the reference group (High PA/Low SB group). These results suggest that the combination of low PA and high SB might be the risk of CLBP. Future studies should try to clarify whether CLBP is a cause or a consequence of inactivity.

As part of the curriculum of the Introduction to Medicine course, a questionnaire designed to clarify the images of physicians ten years after graduation was distributed to 120 young physicians affiliated with the Department of Internal Medicine, Nihon University School of Medicine, in order to analyze the prevailing self-image of physicians and their professional identity.
Answers from 14 of the physicians suggested that their self-images and hopes related to private lifewere me same as those typically of non-physicians, that is having a happy family life, enjoying hobbies and cars, and owning real estate. However, their identity as professionals was based on not only specialist qualifications and a M.D. degree, but also “new” criteria such as conducting research, publication of articles, and presentations at academic meetings.
The findings of this survey prompted us to discuss our images of ourselves as physicians and our hopes for the future.