To determine the need of guidelines for judgment of the bathing advisability for the aged in Councils of Social Welfare, we had a cross-sectional study in 1999.
A questionnaire survey by mail for Councils of Social Welfare which were extracted by systematic sampling (n=828, extraction rate was 25%) was conducted. The response rate was 83% and the proportion of respondents who answered the guidelines were necessary was 86% (n=642). Chi-square tests and logistic regressions analyses showed that bathing service in facility, existence of guidelines for judgment of the bathing advisability by body temperature, and respondents judging were independent factors associated with the need of guidelines for judgment on the bathing advisability in aged. Our results suggest the necessity to make guidelines for judgment of the bathing advisability in the aged.

A conducted to determine 1) the effect of high-velocity movement in resistance training with a constant load on the velocity of movement after training and 2) the differences in the effect on muscle hypertrophy according to training velocity. Fourteen of the total subjects (male; n=10, female ; n=7) were placed in the experimental group and agreed to participate in 8 weeks of training sessions (4 times a week) . Five of the 17 subjects were in control a group before the training session. Subjects performed elbow extension and flexion exercise using 50% of one repetition maximum (% 1 RM) load. The exercise session consisted of 6 sets of 10 repetitions and 30s of rest was taken between the sets. The subjects in the experimental group trained their arms using two different protocols ; one was high-velocity movement performed as rapidly as possible (Type R), the other was low-velocity movement performed at a constant and slow velocity (Type S) . Isokinetic torque in elbow flexion was measured at angular velocities of 60, 180, 300 deg/s, respectively, during elbow flexion performed under different constant loads of 0, 30, 50% 1 RM, and the muscle cross-sectional area (CSA) of the elbow flexor was determined before and after training. It was found that Type R did not increased isokinetic torque at 300 deg/s significantly after training. However, the increase in angular velocity of elbow flexion in Type R exercise tended to be higher than in Type S exercise. The increase in CSA [Type S; 11.2%, Type R ; 14.2%] was significantly higher in Type R exercise (p<0.05) . These results suggest that high-velocity movement with a constant load in resistance training might increase the angular velocity of movement in the same mode, but might not produce a change in isokinetic strength, which involves a different mode of muscle contraction. Muscle hypertrophy would be induced to a greater extent by high-velocity movement than by low-velocity movement in resistance training with a constant load.

To determine the background of aged people who need bathing assistance, we analyzed data of the Survey on Demand for Health and Welfare Services of Japan as of 1997. The survey covered 21, 723 persons aged 65 years or older, and 1, 193 caregivers who provide care to persons 65 years or older throughout Japan. The main parameters were aged people's sex, age, marital status, health condition, degree of bed rest, and needs of care in daily life; relation between caregivers and aged people; life with care giver; job; family composition; use of home care services; demand for home care services; caregivers' sex, age, health condition, and employment status; and demand for home care services. Subjects were divided into three groups, those who need bathing assistance, those who do not need bathing assistance, and those who do not need care in daily life, and the rate was shown for each item. The results indicated that the rate of those who need bathing assistance was higher among (1) aged people who were older, have poor health, and are in bed alweys or almost alweys, (2) aged people who needed care in daily life, used home care service, and required home care service, and (3) aged people whose caregivers required home care services.
Aged people who need bathing assistance are subject to frequent bathing accidents, so we need to pay attention to safe bathing service.

An investigation on the efficacy of preoperative autologous blood donation in open-heart surgery was made using frozen red blood cells and MAP red blood cells in cooperation with the Red Cross Blood Center. In 109 cases which received the donation, the rate of cases which received no homologous blood transfusion was 93.6% (35.3% in the cases without donation). Even in the cases of redo operation or aortic surgery, in which extensive blood loss is expected, 75% of those given a donation of 1600-2000ml frozen blood required no homologous blood transfusion. The hemoglobin concentration in the cases which received blood donation for more than 4 weeks did not decrease, indicating that safe donation is feasible. The aforementioned frozen and MAP blood preparations can be preserved for a long period so that blood donation can be started even before deciding on the date of operation. Also, its usefulness is not affected by the postponement of the operation. Furthermore, there was no problem in safety with respect to transfer, treatment, and storage of the autologous blood in cooperation with the Red Cross Blood Center, suggesting that this is useful as a preoperative donation method, especially in small- and middle-scale hospitals, which have no separate blood centers. However, there were 2 cases in which aggravated symptoms were noted after blood collection. Therefore, it is important to carefully select cases for autologous blood donation in open-heart surgery and it is desirable to set up appropriate donation schedules.

Introduction: The importance of estimating the prognosis of advanced cancer patients is well known, but clinicians do not estimate survival time accurately. Since there is a need for an objective index to estimate survival time, the utility of the Prognostic Nutritional Index (PNI), which depends only on objective factors, was evaluated. Methods: The PNI was calculated using the following formula, PNI=10×serum albumin value (g/dL)+0.005×lymphocyte count in peripheral blood, at 3 months, 2 months, 1 month, 3 weeks, 2 weeks, 1 week, and within 3 days before death in 278 cancer patients (166 men, 112 women; age range, 33-99 years; mean age, 69.8 years) who died in a hospital surgical unit. Results: Sites of primary diseases included lung, breast, esophagus, stomach, colorectum, liver, biliary tract, and pancreas. The PNI values showed a gradual decrease over time. Changes in the PNI values were lower in non-gastrointestinal cancer patients than in gastrointestinal cancer patients. The mean PNI value was significantly higher in patients who lived >3 weeks (38.8) than in those who died within 3 weeks (32.4). When the PNI cut-off point was set at 35, and it was assumed that the life expectancy was within 3 weeks in cases with PNI <35, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 74.8%, 62.2%, 68.1%, and 69.6%, respectively. Discussion: The PNI appears to be a useful and simple parameter to predict clinical outcomes of patients with terminal stage cancer. Particularly, the PNI is considered feasible for gastrointestinal cancer patients.

　　In Japan, few reports have discussed adverse events and safety after simultaneous vaccination during infancy. The purpose of this study was to elucidate adverse events after simultaneous vaccination of inactivated vaccines in infants in comparison with those after single vaccination. Selected for this study were infants aged ≥2 months who received subcutaneous injections of inactivated vaccines between July 2012 and June 2013. These subjects were divided into two groups: a single-vaccination group (46 subjects) and simultaneous-vaccination group (42 subjects). The presence or absence of severe adverse events that required hospitalization was investigated. We also checked up on subject background and systemic [fever (transitional and highest body temperature)] and local (dermatological, respiratory, gastrointestinal, neurological, and other organs’ symptoms) adverse events. Questionnaires to investigate if adverse events occurred during one week after simultaneous vaccination, questionnaires were distributed to the parents of all the subjects. “We performed vaccination in 162 subjects, and the collect rate of questionnaires was 57% (97/162).” The percentage of effective answers to the questionnaire survey was 91% (88/97). Among simultaneous-vaccination group subjects, 14 (32%) received Haemophilus influenzae type b (Hib) + 7-valent pneumococcal vaccine (PCV7) and 12 (27%) received Hib + PCV7 + Diphtheria-Pertussis-Tetanus vaccine. No subject developed severe adverse events that required hospitalization. The body temperatures taken on the day following the injection in the simultaneous-vaccination group were significantly higher than those in the single-vaccination group (p=0.049). However, the incidence of other systemic and local adverse events in the simultaneous-vaccination group was not significantly different from that in the single-vaccination group. Compared with single vaccination, simultaneous vaccination of inactivated vaccines in infants resulted in a significant rise in body temperature on the day following vaccination; however, no severe adverse events occurred.

  In Japan, few health care professionals have a basic understanding（core competency）of the design of clinical research and statistical analysis. We developed a blended distance–learning program comprising face–to–face lectures with e–learning for busy health care professionals who work in the clinical settings to achieve core competency in clinical research. The purpose of this study was to examine the educational effects of this program.
1）Four months after the end of the program, 64％ of the participants had started to conduct clinical research.
2）This program may increase the number of research colleagues that can discuss clinical research.
3）This program could enhance the confidence（self–efficacy）of health care professionals in clinical research.

Methods: Consecutive patients diagnosed with OFs at Fujieda Heisei Memorial Hospital were divided into three groups: nonsurgical therapy, balloon kyphoplasty (BKP), and open surgery groups. The mOF score was calculated, and the levels of independence and posttreatment imaging data were compared between patients treated and not treated according to the mOF score-based treatment recommendation. Results: In total, 118 patients were included (nonsurgical therapy, n=57; BKP, n=48; open surgery, n=13), of whom 100 (85%) received treatment consistent with the mOF score-based treatment recommendation. In the BKP and open surgery groups, the mOF scorebased treatment recommendations were consistent with the actual treatment in 93% of the patients. However, in the nonsurgical group, the mOF score-based treatment recommendation was not consistent with the actual treatment in 25% of the patients. In this group, patients not treated according to the mOF score had significantly shorter vertebral body height, greater local kyphosis, and smaller sacral slope after treatment than patients treated according to the mOF score-based treatment recommendation. Conclusions In the BKP and open surgery groups, the mOF scores were consistent with actual clinical selection. In the nonsurgical therapy group, patients not treated according to the mOF score-based treatment recommendation exhibited severe vertebral body deformity and a less well-balanced spine shape after treatment. The mOF score may help in selecting suitable treatments for OFs.

In the areas of home medical care and self-medication, the role of the pharmacist is growing, partly as a result of Japan’s aging society and the need to reduce medical costs. In response, the Kinki University Faculty of Pharmacy implemented a physical assessment practical training seminar in order to improve the physical assessment skills of practicing pharmacists. A series of questionnaires were conducted among pharmacists to investigate their perceptions of physical assessment practical training seminars. The results of the questionnaires were analyzed using Customer Satisfaction (CS) analysis and text mining. Based on a 5-point scale (1-low∼5-high), questionnaires revealed satisfaction for physical assessment practical training seminars was 4.6±0.6 (Ave.±S.D.). CS analysis revealed that the items “lectures” and “case seminars” had the highest level of satisfaction. However, items showing low levels of satisfaction were “auscultation of respiratory sounds” and “SBAR (Situation, Background, Assessment, Recommendation).” Results of text mining suggested a relationship between “physical assessment” and “difficult”. Analysis of the questionnaires showed a high level satisfaction with physical assessment practical training seminars, notably physical assessment practice methods. However, CS analysis and text mining indicate the finer techniques of physical assessment were difficult to acquire.

Among lots of lifestyle factors thought to be related to the Japanese health status, bathing in hot water, utilizing onsen (hot spring) facilities, and drinking green tea are very special in Japan. With this study we aimed to determine the contribution of these lifestyle factors to Japanese health condition estimated by self-rated health (SRH), sleep quality and rest, and stress level as the dependent variable. A cross-sectional questionnaire survey was conducted of 5,000 residents in Shizuoka prefecture aged≥20 years in 2011. Using unconditional logistic models, odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated for several factors that were considered to affect SRH. The lifestyle habits of bathing in hot water every day, utilizing onsen facilities often, and drinking green tea a lot showed a strong association with good SRH. Bathing in hot water was also related to lower perceived stress. In conclusion, the promotion of daily bathing in hot water, utilizing onsen facilities often, consuming a lot of green tea examined in this study may help to enhance people’s own perception of their general health. It is possible that these lifestyle habits may contribute to good health status of the Japanese.