1.The effect of thyrotropin releasing hormone on rehabilitation of stroke patients.
Tomiyoshi CHIDA ; Shigeto ABE ; Ryuichi NAKAMURA ; Kenji KOSAKA
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1987;50(4):175-181
In order to analyze the influence of thyrotropin releasing hormone (TRH) on rehabilitation process of stroke Patients, the comparison of functional gain and length of hospital stay was made between eight patients treated with TRH (TRH group) and 11 age and sex matched ones without TRH (control group). Using Social Maturation Scale (Takenshiki, SMS) and Motor Age Test for trunk and lower extremities (MoA), the patients were assessed at the admission, 2 and 3 months after the admission and the discharge, respectively. TRH of 2mg was administered once a day by intravenous drip injection for 10 days between 2 and 3 months after the admission. The gain of SMS score between 2 and 3 months after the admission was larger in the TRH group than in the control group, especially that of interpersonal skills. The gain of MoA score was not different between the two groups. Compared to the control group (5.3 months), the length of hospital stay was significantly short in the TRH group (4.2 months). However, functional gain during inpatient-rehabilitation was not different between the two groups. It is assumed that TRH is effective to shorten the course of stroke rehabilitation.
2.Promotion of the health care for farmers working in factories in rural district.
Akio NAKAGAWA ; Kenji ABE ; Tetsuhito FUKUSHIMA ; Yoneatsu OSAKI ; Yosuke YAMANE
Journal of the Japanese Association of Rural Medicine 1987;36(2):61-68
Today's one of the most important problems both in the industrial hygiene and the community health care is the health protection of farmers who are working in factories. There are many such farmers in the San'in rural districts. We surveyed the working conditions of 370 factories in Shimane Prefecture and found that they had many problems to be solved. The problems in the factories, mostly small-scale factories, are summarized as aging of workers, long working hours, insufficient rest, harmful work and night work.
Even in Sada-cho, where the local government is promoting the comprehensive community health care and encouraging the health care activity of inhabitants, the health care for factory workers is performed insufficiently. Some factories do not carry out even a periodical health examination of the workers.
We established the Sada-cho Occupational Health Association in cooperation with the local government, Izumo Health Center, Shimane Labor Standard Inspection Office and the factories in Sada-cho for the purpose of promoting the unified activity of the industrial hygiene and the community health care.
3.The educational practice and the evaluation of health care for the elderly in a commnuity where the aged population has been increasing.
Yosuke Yamane ; Kuninori Shiwaku ; Kenji Abe ; Tetsuhito Fukushima ; Tsutao Okamoto ; Akio Isobe ; Manabu Tada ; Yoichiro Fukuzawa ; Takuji Kishimoto ; Miyoko Abe
Medical Education 1991;22(2):71-76
4.Experience with new community-based curriculum in environmental medicine. (3). Effective trial of co-medical workers' participation in improvement of medical education.
Yoichiro FUKHZAWA ; Takuji KISHIMOTO ; Miyoko OKAZAKI ; Manabu TADA ; Yosuke YAMANE ; Kuninori SHIWAHU ; Kenji ABE ; Tetsuhito FUKUSHIMA
Medical Education 1990;21(2):88-94
The new community-based curriculum in Shimane Medical University, Japan, which are mainly based on family health practice and community health approach, is useful for students to understand the comprehensive medicine and holistic approach to community-based primary health care.
It is important to introduce district health workers in the preventive education for medical students to obtain to humanistic attitude and to change their value and behavior.
The importance of the exposure to the community health activities organized with man power and social resources should be more stressed in the improvement of the medical education curriculum and also of educational methodology to learn the essential physicians' nature such as humanity, responsibility, cooperation, positive attitude, and ability of problem solving.
7.Actual conditions of the health care of school personnel in rural districts of Shimane prefecture, Japan.
Tomoko SHIMIZU ; Kenji ABE ; Tetsuhito FUKUSHIMA ; Akio NAKAGAWA ; Nobuo YOSHIDA ; Yosuke YAMANE
Journal of the Japanese Association of Rural Medicine 1984;33(4):775-779
Actual conditions of the health care of school personnel in rural districts of Shimane Prefecture were investigated, concentrating our attention on the structure of diseases, the contents of health examination, factors impeding health, and so forth.
As a result of our investigation we found that the incidence of adult diseases among school personnel is considerably high. Health examinations with complete contents should be practised in the near future.
Further, the establishment of health care system in the work place, the improvement of working conditions considering sufficiently the peculiarity of mental work and of femininity, the independence of school nurses as specialist should be realized on the basis of the understanding of actual problems, which are obtained by examinations of health care conditions at each work place including epidemiological examination.
8.A study of current primary health care in rural district, Japan - Problmes of community-based school health.
Kenji ABE ; Tetsuhito FUKUSHIMA ; Akio NAKAGAWA ; Nobuo YOSHIDA ; Tomoko TAGAWA ; Yosuke YAMANE
Journal of the Japanese Association of Rural Medicine 1986;35(2):165-171
The recent urbanization of rural communities and the associated changes of the living environments influenced the health conditions of children in rural districts of Shimane Prefecture, Japan. It obliged therefore to review the usual school health approach and to evaluate the care system to new trends of critical health problems of children.
A questionnaire was sent to school nurses asking their worries and problems about each step of the scientific school health procedure to recognize the health needs, to analyse the health problems, to plan the appropriate counterplans, to practice and to evaluate.
As a result of our investigations, the following remedies were necessary for the development of rural school health activities.
Firstly, the specialization of school nurses should be established without delay, and their working conditions should be more improved.
Secondary, school nurses should strengthen the contacts with teachers, parents and other school staffs to organize the developed school health system.
Finally, school nurses should make their efforts to delop the community-based school health care which connected the comprehensive community health care.
9.Community study on the integration of medical care, health care and social welfare in the rural district of Japan. Experiment and evaluation of a comprehensive health care, "the Service Package System for the Bedridden Elderly".
Tetsuhito FUKUSHIMA ; Yoneatsu OSAKI ; Kenji ABE ; Akio NAKAGAWA ; Hisako TSUCHIYA ; Eisaku TANIGUCHI ; Yosuke YAMANE
Journal of the Japanese Association of Rural Medicine 1986;35(4):830-838
The rise of the average age of the population in Shimane Prefecture has become more and more conspicuous in these years. According to the estimation of the future population the aging phenome-non in Shimane Prefecture is going about fifteen years ahead of the average of Japan. Therefore it is significant to perform a community experiment of the comprehensive health care for the elderly in this prefecture, in the sense that its results will offer many useful experiences to other districts of Japan, where the aging of the population is proceeding a little more slowly.
We carried out an experiment called “the Service Package System for the Bedridden Elderly”, in Sada-cho, Shimane Prefecture in cooperation with Sada-cho, Izumo Health Center and Izumo Medical Association. It is an improvement on the health care system for the bedridden elderly and their family, which has been performed in Scandinavian countries.
The results of our experiment obviously showed the existence of many problems stemming from the lack of integration among different fields such as health care, medical care, social welfare, working and cultural life. To establish the comprehensivehealth service system for the elderly and their family the integration of these fields is most urgently demanded.
10.Community study of the integration of health care, medical care and social welfare systems for the elderly. Fundamental analysis of the aging of population in Shimane prefecture, Japan.
Kenji ABE ; Tetsuhito FUKUSHIMA ; Yoneatsu OSAKI ; Akio NAKAGAWA ; Nobuo YOSHIDA ; Yosuke YAMANE ; Eisaku TANIGUCHI
Journal of the Japanese Association of Rural Medicine 1987;35(5):867-874
In order to develop the health care system for the elderly we need to analyse fundamentally the phenomenon that the average age of population in each community is rapidly becoming older, as well as we have to grasp life conditions and health needs of old people. We investigated the rate of increase or decrease of population, rate of the elderly living by themselves and the index of the aging of population of each community, classified these communities into several types, and presented the points necessary to develop a community-based comprehensive health care for the elderly as to each type by considering the meanings the indices of health care, medical care and social welfare of the communities disclose.