Background: Palliative care has been advocated to be administered in the early phase of cancer treatment. However, little is known concerning the recognition of palliative care in general citizens. We have conducted promotional activities for palliative care as “Nonohana Project” since 2009. The aim of the current study was to investigate the awareness of palliative care in the general public in Okayama Prefecture. Methods: We performed telephone questionnaire survey about palliative care for a total of 600 general citizens aged 20 or over in Okayama Prefecture. This survey was conducted in 2009 and 2010, and we compared those results. Results: Two hundred twenty four people (37.3%) have heard of the phrase “palliative care” in 2009 and 219 people (36.5%) in 2010. The recognition of palliative care stayed at the same level as in the previous fiscal year. In those with a history of cancer of themselves or their family, the recognition was slightly increased (41.6% in 2009 and 43.2% in 2010). There were many people who were interested in palliative care in both 2009 (87.9%) and 2010 (86.3%). Conclusion: Our study indicated that many people still had no idea of palliative care in Okayama Prefecture, despite of our promotion and effort for 1 year. However, many were interested in palliative care, suggesting a need for continuous promotion to increase the understanding of palliative care.

Overactive bladder (OAB) is a symptom-based syndrome defined by urinary urgency, frequency, and nocturia with or without urge incontinence. The causative pathology is diverse; including bladder outlet obstruction (BOO), bladder ischemia, aging, metabolic syndrome, psychological stress, affective disorder, urinary microbiome, localized and systemic inflammatory responses, etc. Several hypotheses have been suggested as mechanisms of OAB generation; among them, neurogenic, myogenic, and urothelial mechanisms are well-known hypotheses. Also, a series of local signals called autonomous myogenic contraction, micromotion, or afferent noises, which can occur during bladder filling, may be induced by the leak of acetylcholine (ACh) or urothelial release of adenosine triphosphate (ATP). They can be transmitted to the central nervous system through afferent fibers to trigger coordinated urgency-related detrusor contractions. Antimuscarinics, commonly known to induce smooth muscle relaxation by competitive blockage of muscarinic receptors in the parasympathetic postganglionic nerve, have a minimal effect on detrusor contraction within therapeutic doses. In fact, they have a predominant role in preventing signals in the afferent nerve transmission process. β3-adrenergic receptor (AR) agonists inhibit afferent signals by predominant inhibition of mechanosensitive Aδ-fibers in the normal bladder. However, in pathologic conditions such as spinal cord injury, it seems to inhibit capsaicin-sensitive C-fibers. Particularly, mirabegron, a β3-agonist, prevents ACh release in the BOO-induced detrusor overactivity model by parasympathetic prejunctional mechanisms. A recent study also revealed that vibegron may have 2 mechanisms of action: inhibition of ACh from cholinergic efferent nerves in the detrusor and afferent inhibition via urothelial β3-AR.