Introduction
Large-scale natural disasters occur often all over the world. Japan participates in international disaster relief (IDR) operations regularly. Effective IDR medical recording procedures are very important in confusing disaster situations. IDR medical records must be succinct, only containing what is necessary. However, they must have enough information for patients' analysis and evaluation later.
The authors investigated what contents are important for effective IDR medical records, and offer a proposal for a standardized record format.
Methods
In 2005 and 2006, the authors mailed a self-administered questionnaire to survey 51 doctors and nurses who had participated in IDR in the past about what is important for IDR medical records. The IDR Medical Record 2008 format was produced using the results. To evaluate its usefulness, the authors later interviewed 10 specialists of disaster medicine regarding their assessment of the previously proposed IDR Medical Record 2008 format.
Results
In the first investigation, focused on people who responded to the survey, more than half valued the following features of IDR medical records: "Well organized," "Simple and easy," "Entry language," "Easy to read," "Meets international standards," "Body diagram," "Easy symptom entry," "Durability" and "Combined with prescription." On the other hand, less than half of the participants indicated that they valued: "Compatibility with other organizations," "Electronic file," and "Combined with examination records."
For the second investigation, the authors prepared the IDR Medical Record 2008 format by using the result of the first investigation. Then, the authors made the IDR Medical Record 2012 format based on the results of the interviews.
Conclusions
The authors proposed the IDR Medical Record 2012 format, which is a practical and effective medical record format for IDR operations.

Objective : Carvedilol is a non-selective β blocker with an α blocking activity. Since this drug is highly fat-soluble, it can pass through the blood-brain barrier, and thus may induce depression and lower QOL. In the present study, physicians and pharmacists collaborated to evaluate the antihypertension effect of carvedilol and post-administration changes in QOL. Furthermore, the relationship between QOL and antihypertension effect was analyzed.
Design : Self-controlled study.
Patients and Methods : Subjects were outpatients with hypertension above the age of 70 years who visited one of 42 medical institutions in Japan between April 1995 and March 1996. A total of 243 patients were registered, and 10-20 mg of carvedilol was administered once a day for six months. Pharmacists assessed the QOL of these patients by asking 82 questions on three separate occasions : before administration and one and six months after administration. The antihypertensive effect of this drug was investigated in patients in whom all three QOL questionnaires were collected. The main test items were antihypertensive effect, changes in QOL (subjective QOL with a special emphasis on patient psychology), and the relationship between antihypertensive effect and QOL. The antihypertensive effect of this drug was statistically analyzed by a paired t-test, and changes in QOL were statistically analyzed using generalized estimating equations.
Results : All three QOL questionnaires were collected from a total of 146 patients. Their pre-administration systolic blood pressure was 159.6±1.4 mmHg, and diastolic blood pressure 94.0±0.9 mmHg, and their blood pressure decreased significantly one month after the start of administration. This antihypertensive effect of carvedilol persisted, and the systolic and diastolic blood pressure of these patients six months after the start of administration was 141.1±1.2 and 85.2±0.7 mmHg, respectively (significant decreases when compared to pre-administration levels ; both p<0.05).
Subjective QOL improved significantly after carvedilol administration. And, changes were not seen in sexual function. Changes in the five categories of subjective QOL were as follows : psychological stability, disease-induced inconvenience, and independence improved significantly after carvedilol administration, but changes were not seen in gratification or vitality. However, improvements in subjective QOL did not correlate with improvements in blood pressure.
Conclusions : The results of the present study showed that carvedilol improved QOL without negatively affecting sexual function. Subjective QOL reflects the psychological well-being of patients. In the present study, psychological stability, disease-induced inconvenience, and independence improved significantly, but changes were not seen in gratification or vitality. Since β blockers can suppress the central nervous system, they can reduce psychological stability, gratification and vitality. Even though carvedilol is highly fat-soluble, the results of non-clinical studies have shown that it does not suppress the central nervous system as much as propranolol. The results of the present study showed that carvedilol does not strongly suppress the central nervous system of humans. Moreover, significant changes in QOL were not seen between one and six months after the start of administration of carvedilol, suggesting that it is possible to estimate the QOL of patients on antihypertensive therapy after six months of administration by assessing their QOL one month after administration.

BACKGROUND: In view of the increasing prevalence of food allergies, there has been an associated increase in frequency of situations requiring an emergency response for anaphylaxis at the home, childcare facilities and educational institutions. OBJECTIVE: To clarify the situation of adrenaline auto-injector administration in nursery/kindergarten/school, we carried out a questionnaire survey on pediatric physicians in Western Japan. METHODS: In 2015, self-reported questionnaires were mailed to 421 physicians who are members of the West Japan Research Society Pediatric Clinical Allergy and Shikoku Research Society Pediatric Clinical Allergy. RESULTS: The response rate was 44% (185 physicians) where 160 physicians had a prescription registration for the adrenaline auto-injector. In the past year, 1,330 patients were prescribed the adrenaline auto-injector where 83 patients (6% of the prescribed patients) actually administered the adrenaline auto-injector, of which 14 patients (17% of the administered patients) self-administered the adrenaline auto-injector. “Guardians” at the nursery/kindergarten and elementary school were found to have administered the adrenaline auto-injector the most. Among 117 adrenaline auto-injector prescription-registered physicians, 79% had experienced nonadministration of adrenaline auto-injector at nursery/kindergarten/school when anaphylaxis has occurred. The most frequent reason cited for not administering the adrenaline auto-injector was “hesitation about the timing of administration.” CONCLUSION: If the adrenaline auto-injector was administered after the guardian arrived at the nursery/kindergarten/school, it may lead to delayed treatment of anaphylaxis in which symptoms develop in minutes. Education and cooperation among physicians and nursery/kindergarten/school staff will reduce the number of children suffering unfortunate outcomes due to anaphylaxis.
Anaphylaxis ; Child ; Education ; Emergencies ; Epinephrine ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Japan ; Nurseries ; Postal Service ; Prescriptions ; Prevalence

In this study, we aimed to clarify awareness regarding genetic testing among pharmacists in Hiroshima City to contribute to regional medical care provided in pharmacies. Pharmacists should consider the advantages and disadvantages of being able to easily receive genetic tests. We conducted an awareness survey on genetic testing among pharmacists belonging to the Hiroshima Pharmaceutical Association, at 645 pharmacies in Hiroshima City. Responses were received from 674 pharmacists, yielding a response rate of 43.4% (280 pharmacies). In response to the question, “Can you perform genetic testing at a pharmacy?”, 6.7% of pharmacists answered yes and 65.4% said this was impossible. Among the 92.4% of pharmacists other than those available, 79.6% answered “I am worried about my knowledge of genetic testing,” followed by 39.3% “cannot take the time,” 29.2% “hurdles for new business,” 28.1% “problems such as pharmacy facilities to protect personal information,” and 15.7% “ethical difficulties.” From the age difference, pharmacists do not carry out genetic testing even if they have knowledge; they need to make an ethical judgment to determine whether to conduct genetic testing. Additionally, although pharmacies provide medication guidance and protect personal information, 28.1% of pharmacists answered that there are problems with their pharmacy’s ability to protect personal information when handling “genetic information.” Pharmacists should consider it critical to treat “genetic information” as personal information, with the utmost care and understanding.