It was February 2007 that the pediatric surgery department was established in our hospital. Since then, the number of surgical cases of inguinal hernia has been increasing year after year. During 2013, a total of 48 patients underwent hernia surgery. Operations were performed mostly on the day the patients were hospitalized. Before the surgery, the patients and their relatives were told about the nature of the disease and treatment by word of mouth. Actually, however, we were to busy to take much time to talk with them. After surgery, members of patients’ families, being all anxiety, frequently asked us such questions as: - how soon will the patient be allowed to have a cup of tea or juice?; when can the patient do without the IV drip?; and how should the family take care of the patient at home? We presumed that the anxiety might stem from the inadequate explanation given orally by inexperienced nurses. To improve the situation, we, staffers in charge of pediatric inpatient care, and physicians in the outpatient clinic of the pediatric surgery department teamed up to prepare a pamphlet including a list of standardized answers to supposedly most frequently asked questions in the hospitalization setting. The draft of the pamphlet was shown to ward nurses to sound out their opinion on the contents. Based on the results of this survey, the pamphlet was completed. This paper deals with the pamphlet and a summary of nurses’s views on it.

PORPOSE: This study aimed to compare the prevalence of metabolic syndrome (MS) risk factors and its components in different levels of aerobic fitness established by “Exercise and Physical Activity Reference for Health Promotion 2006 (EPAR2006)” in Japanese middle-aged and elderly people.METHOD: Men (n=102) and women (n=133), aged 30-69yrs, participated in this study. The prevalence of MS risk factors was evaluated as the number of MS risk factors, according to the diagnostic criterion for Japanese-specific MS. Aerobic fitness was quantified as maximal oxygen uptake (VO₂max). Subjects were classified into the three groups by aerobic fitness level based on “Reference values” and “Reference range” established in EPAR2006; 1) High fitness group (H); VO₂max (mL/kg/min) is higher than “Reference values”, 2) Medium fitness group (M); VO₂max is below “Reference values” but within “Reference range”, 3) Low fitness group (L); VO₂max is lower than “Reference range”.RESULTS: In men, M and L groups showed significantly higher frequency of risk factors for MS than H group (H: 1.09±0.98, M: 1.81±1.07, L: 2.27±0.70, P＜0.01). In women, L group showed significantly higher frequency of risk factors for MS than H and M groups (H: 0.57±0.80, M: 0.81±1.01, L: 1.53±1.07, P＜0.01).CONCLUSION: These results suggest that higher MS risk appears when the VO₂max is lower than “Reference values” in men, and below “Reference range” in women, and that particularly, men with low aerobic fitness have higher MS risk.

PORPOSE: This study aimed to investigate the relation between cardiorespiratory fitness(CRF) and physical activity, especially vigorous physical activity, in Japanese middle-aged and elderly men.METHODS: Eighty-five men aged 30-69 years participated in this study. CRF was assessed by measuring the maximal oxygen uptake based on weight (VO₂max/wt) in an incremental test on a bicycle ergometer. METs·h/week was measured as the parameter of physical activity by using accelerometers. We defined the amount of physical activity higher than 3 METs as “Physical activity ; PA”in this study. Then, PA was divided into “Moderate physical activity ; MPA”(higher than 3 METs and below 6 METs)and “Vigorous physical activity ; VPA”(higher than 6 METs).RESULTS : CRF was positively correlated with PA(r=0.318, P<0.01), MPA(r=0.230, P<0.05), and VPA(r=0.301, P<0.01) and negatively correlated with age(r=-0.607, P<0.001), BMI(r=-0.369, P<0.01), and waist circumference(WC)(r=-0.486, P<0.001). After adjusting for age and WC, the multiple regression analysis revealed that PA was positively correlated with CRF(P<0.01). VPA was positively correlated with CRF(P<0.05) after adjusting for age, WC, and MPA. MPA was not correlated with CRF in the case of adjusting for age and WC.CONCLUSION : This study suggested that physical activity higher than 3 METs was positively associated with cardiorespiratory fitness independently of age and waist circumference, and particularly vigorous physical activity may contribute to increased cardiorespiratory fitness in middle-aged and elderly men. Thus physically active life with maintenance of adequate waist circumference may help to prevent age-related decline in cardiorespiratory fitness.

BACKGROUNDObesity is the most common metabolic disease in the world. However, the relationship between obesity and lung function is not fully understood. Although several longitudinal studies have shown that increases in body weight can lead to reductions in pulmonary function, whether this is the case with the Japanese population and whether high body mass index (BMI) status alone represents an appropriate predictor of obstructive lung dysfunction remains unclear. The purpose of present study was to estimate the effect of BMI on lung function measured by spirometry of Japanese patients in general clinics. We measured BMI and performed spirometry on screening patients who had consulted general clinics.

METHODSSubjects comprised 1231 patients ≥ 40 years of age (mean age (65.0 ± 12.0) years, 525 men, 706 women) who had consulted clinics in Nagasaki Prefecture, Japan, for non-respiratory disease. BMI was calculated and lung function was measured by spirometry.

RESULTSBMI was found to be positively correlated with forced expiratory volume in 1 second (FEV(1))/forced vital capacity (FVC) in men and with maximum mid-expiratory flow (MMF) in all subjects. Following adjustment for relevant factors, a significant positive correlation between BMI and FEV(1)/FVC was identified for all subjects. Comparison between subjects with normal BMI (18.5 - 25.0) and higher BMI (25.1 - 30.0) also demonstrated that FEV(1)/FVC and percentage of predicted maximum mid-expiratory flow (%MMF) were significantly higher in the latter subjects.

CONCLUSIONSIn a population without marked respiratory disease, higher BMI subjects showed less obstructive pulmonary dysfunction compared to normal BMI subjects. High BMI status alone may be inappropriate as a predictor of obstructive lung dysfunction, particularly in populations with a low prevalence of obesity.

Adult ; Aged ; Body Mass Index ; Female ; Forced Expiratory Volume ; Humans ; Linear Models ; Male ; Middle Aged ; Obesity ; epidemiology ; physiopathology ; Vital Capacity

BACKGROUND: Following the increase in the number of children with food allergies, support systems are now required for school lunches, but a large-scale factual investigation has not been carried out. OBJECTIVE: We evaluated the features of elimination diet due to food allergy and the support system in kindergartens and schools. METHODS: A prefecture-based questionnaire survey regarding measures for food allergies in school lunches of all kindergartens, public elementary schools, and public junior high schools (631 facilities) was conducted in Oita Prefecture, Japan. RESULTS: The recovery rate of the questionnaire was 99.5%, which included 106,008 students in total. A total of 1,562 children (1.5%) required elimination diets. The rate of children on elimination diets in kindergartens and elementary/junior high schools that required medical certification by a physician was 1.2% (324 among 27,761 children), which was significantly lower than the 1.8% of children (1,227 among 68,576 students) on elimination diets at the request of guardians without the need for medical certification (p < 0.0001). A total of 43.9% of the kindergartens and schools said that they would contact guardians if symptoms were observed after accidental ingestion, while a low 8.1% stated that they provided support to children themselves, including the administration of adrenaline auto-injectors. CONCLUSION: Medical certification reduces the number of children requiring elimination diets, but it has not been adequately implemented. Furthermore, waiting to contact guardians after symptoms are observed may lead to the delayed treatment of anaphylaxis. Cooperation between physicians and teachers is desired to avoid the overdiagnosis and undertreatment of children with food allergies.
Anaphylaxis ; Certification ; Child ; Diet ; Eating ; Epinephrine ; Food Hypersensitivity ; Humans ; Japan ; Lunch ; Medical Overuse