After 1985, the decrease in domestic nursing power progressed gradually. The care for the elderly shifted from domestic private nursing to public nursing-care services when the long-term nursing-care insurance law was enacted in 2000. Because many of the elderly receiving nursing care suffer from chronic ailments of hypertension or the consequences of cerebrovascular disease, etc., cooperation between hospitals and nursing homes is necessary and indispensable. We began exchanging information by E-mail on a trial basis with a special elderly nursing home in April 2009. We aimed to integrate medical care and nursing by sharing medical and nursing information. We concluded that the use of E-mail could serve our purpose. The reason why we reached this conclusion is as follows:The mechanism of the information transmission by E-mail, that also relates to semiotics and narratology, is related to the essence of the description. This mechanism functions as a tool for mutual understanding among hospitals, nursing homes, and families. This also functions as a device to make the medical and nursing experience join. As a result, this mechanism enables the elderly to escape death as dying of sickness in the hospital and to die a natural death in the course of nursing. It is an easy method that can be introduced at a low cost for the purpose of establishing cooperation in medical and nursing care among hospitals, clinics, nursing homes, and nursing support centers, etc. especially in medically underserved remote areas.

　　The aim of this study was to examine topophilia in the elderly living in mountainous areas. Topophilia, which is the geographical concept invented by Yi-Fu Tuan in 1999, is defined as the affective bond between people and place or environmental setting. A total of 120 elderly subjects living in a mountainous area responded to a standardized, validated 9-item Life Satisfaction Index K (subjective well-being) developed by Wataru Koyano and a new structured 6-item questionnaire on topophilia. Factor analyses revealed two domains of topophilia (public emotion and private emotion toward the living place). Public emotion was the emotion of being hard to leave the living place. Private emotion was the emotion of not loving the living place. There were areas where the elderly had a lesser degree of attachment toward the present state of the elderly could hardly have a sense of well-being and attachments to the current domicile. It is considered that not only physical but also mental approach is necessary to support the daily life of the elderly living in the mountainous area. Also, we examined the influences of aging and the living place on a subjective well-being and topophilia. There was no significant correlation between age and subjective well-being, but there was significant positive correlation between age and the degree of topophilia (r＝0.234, p‹0.01). On the other hand, the degree of subjective well-being by the place of residence was significantly different (p‹0.001; ANOVA), and the degree of topophilia by the place of residence was not significantly different. These findings suggest that subjective well-being is not influenced by age but influenced by the place of residence, and topophillia is not influenced by the place of residence but influenced by age.

  To assess the effect of pre-germinated brown rice on metabolism of glucose and lipids, blood parameters of glucose and lipids were measured before and after 3 months of intake of test rice, which was mixed with pre-germinated brown rice (PGBR) and white rice in a ratio of 1:1, in patients with diabetes mellitus type 2 (DM). Glycosylated hemoglobin A1c (HbA1c) was significantly decreased from 6.40±0.23% to 6.23±0.19 after 3 months of intake of PGBR. The fasting plasma glucose level was not changed by intake of PGBR, but serum insulin level and HOMA-IR were decreased slightly. As the decrease of LDL-cholesterol (LDL-c) and the increase of HDL-cholesterol (HDL-c) were slightly observed after 3 months of intake of PGBR, the LDL-c/HDL-c ratio was decreased significantly from 2.03±0.13 to 1.83±0.12. These changes were significantly larger in the high PGBR in take group than in the low PGBR in take group. These results suggested that the PGBR intake might have potentialities as one of therapeutic methods for diabetes mellitus type 2 and also be useful in the freatment of hypercholesterolemia.

  We examined how difficult it would be for the elderly living in mountainous areas to go to the nearest hospital using a Voronoi tessellation representing the mathematical concept of neighborhood. We defined the index of the nursing-care capacity for the elderly as the ratio of the number of caregivers to the number of the elderly receiving nursing-care.
  The mean age of those who drive to the hospital by themselves worked out at 70±9.8 years. Meanwhile, that of those who go to the hospital by bus or taken to hospital in a car driven by a family member came to 80±7.0years. The latter was significantly older than the former.
  The areas of the Voronoi tessellation generated by patients' places of residence were divided into three groups according to the size. The plots of these three groups of the the places of residence on the map had a three-layer and doughnut-like structure, i. e., inner-, middle-, and outer-layer.
  The index of the nursing-care capacity in 2008 was less than 1.0 for the patients under 80 years of age. This means that when those who were at the age of 50 in 2008 become old and need nursing-care, access to the hospital will become harder to them than at present. For those who are over 80 years of age and live in the outer layer that is far away from arterial road, it will be almost impossible.
  These findings suggest that outpatient care with transportation assistance by a family member at present should be reconsidered because of the future lack of care personnel. It would also be necessary to consider the welfare of older people from the geographical point of view in order to manage the problems concerning the various physical and sociological difficulties of the elderly.