In this study, the states of obesity, physical activity, and diet of 4 th-6 th graders were examined in an agricultural area of the Tohoku region, where many pupils are driven to and from school. The physique (height, weight), physical activity level (Select 2 ; Kenz), and nutritional intake were investigated in 32 elementary school pupils for one week.The subjects showed the following characteristics : 1) A high percentage of obese pupils, 2) a small number of walking steps, and 3) a lower percentage of obese pupils than non-obese pupils participating in sports activities. Therefore, efforts to increase the physical activity level are considered to be necessary for the prevention of obesity. For this purpose, in addition to administrative measures to increase exercise opportunities in the community such as the establishment of a general sports club, local movements such as encouraging pupils to walk to school may be effective.

On the nursing front, there is no limit to demands for care services. Although efforts are being made to train the staff, letters from former inpatients showed that they left the hospital with a lot of discontent. To have them leave the hospital pleasantly, we have started holding an interview with the inpatients just before they are discharged since 2000. To grasp the results of the interviews accomplished during the 2-years period after the implementation of this program, we carried out a survey by distributing questionnaires to the nursing staff. At the same time, we conducted a survey on expatients and analyzed what they actually told the interviewers. It was found that about 60% of the outgoing patients were interviewed.More than 89% of the ex-patients surveyed said that they could calm themselves after they realized the nurses understood what it is to be painful. Asked if they want the interview to be continued, 94% answered in the affirmative. Meanwhile, many nurses said that what the patients told them was encouraging and gave them an incentive to carry out their duty. Some said that they were given an opportunity to reflect on their past conduct. All in all, we found that the interviews had the healing effect on the nursing staff as well as the patients.
Interview ; nursing therapy ; Discharge from hospital ; Effective ; Surveys

We encountered a terminally ill patient, who had resigned as hospital nurse soon after she had fallen ill. As a former health professional, she was acting the good patient and performing her part as a member of the family. The patient was suffering social pain, so much so that she seemed to be unable to express what was really on her mind. One day, the ex-nurse gave us her precious nurse pin. It was when it occurred to us that what the patient had said and behaved was an expression of spiritual pain. Then, we started exploring the meaning of what she had said and done and tried to get at the structure of her spiritual pain referring to Murata's three structures of the spiritual pain of terminally ill patients: “time existence,” “relational existence” and “autogenic existence.” Eventually, we found that her behavior to respond to the wish of her family and to keep a good relationship with her physicians, which she herself regarded as social pain, was to sweep away uneasiness about and fear of being left alone, that is, the spiritual pain associated with “relational existence.” We also found that the spiritual pain associated with “time existence” intermingled with her wish to continue to be a nurse as expressed in the handing over of her nurse's pin.
Pain ; Patients ; Nurses ; seconds ; SOCIAL

Purpose: To identify the nature of personal growth of family primary caregivers after bereavement and to explore the association between such growth and the experience of caring for a terminally ill cancer patient at home. Methods: A self-administered questionnaire survey was mailed to 112 bereaved family primary caregivers who, with assistance from a palliative care service, had cared for a terminally ill cancer patient at home. The main outcomes were measured using the After Bereavement Growth Inventory, previously developed. Results: Responses from 73 questionnaires were analyzed (effective response rate, 66%). The post-bereavement growth score was significantly higher among the study group than among the general population who had experienced bereavement due to illness-related death. Multiple regression analysis revealed that post-bereavement growth was more likely to occur among those family members who, "at the time they chose to provide home palliative care, intended to care for a patient at home until the time of death" and when "the patient desired home palliative care", those who "felt a deepening of their bond with the patient", and those who "felt the death was peaceful". Conclusion: Our findings suggest that for primary family caregiver's to experience personal growth after bereavement, medical professionals should support patients' preference of place at the end of life and caregivers' preparation for the expected home death, respect the family's bond with the patient, and through appropriate symptom management in home palliative care to maintain the patient's sense of peacefulness until the end of life.

Purpose: Patients with gastric cancer experience several challenges in regaining self-efficacy, including postoperative gastric dysfunction and psychosocial problems, after undergoing gastrectomy. This study aimed to describe the process of regaining self-efficacy in cancer survivors who underwent gastrectomy. Methods: This study enrolled adults, employed a modified grounded theory approach, and targeted participants by theoretical sampling. Data were collected via semi-structured interviews and analyzed by qualitative and inductive methods. Results: The participants included 10 post-gastrectomy patients with gastric cancer. The analysis yielded 28 concepts, eight categories, and four core categories. Regaining self-efficacy in cancer survivors began with “Facing gastric cancer and surgery.” After a period of being “At the mercy of gastrectomy and eating habits,” it changed to “Reclaiming life while accepting the loss of gastric function” through trial-and-error, and finally reached the stage of “Aiming for a better future than that before gastric cancer” after a long period. Conclusion Despite a crisis and repeated trial-and-error circumstances that could change abruptly, the patients demonstrated a flexible and resilient attitude in regaining self-efficacy. This study presented a time axis of the difficult process of regaining self-efficacy and explained the stages at which nursing intervention becomes important.

OBJECTIVE: The purpose of this study was to compare the treatment duration and dentoskeletal changes between two different anchorage systems used to treat maxillary dentoalveolar protrusion and to examine the effectiveness of en-masse retraction using two miniscrews placed in the midpalatal suture. METHODS: Fifty-seven patients (9 men, 48 women), who had undergone level anchorage system treatment at Aichi-Gakuin University Dental Hospital (Nagoya, Japan) were divided into two groups according to the method of maxillary posterior anchorage reinforcement: midpalatal miniscrews (25 patients, mean age 22 years) and conventional anchorage (32 patients, mean age 19 years). The en-masse retraction period, overall treatment duration, pre-treatment effective ANB angle, and change in the effective ANB angle were compared with an independent-samples t-test. RESULTS: Compared to the headgear group, the duration of en-masse retraction was longer by approximately 4 months in the miniscrew group (p < 0.001). However, we found no significant difference in the total treatment duration between the groups. Moreover, a greater change in the effective ANB angle was observed in patients treated with miniscrews than in those treated with the conventional method (p < 0.05). CONCLUSIONS: The level anchorage system treatment using miniscrews placed in the midpalatal area will allow orthodontists more time to control the anterior teeth during en-masse retraction, without increasing the total treatment duration. Furthermore, it achieves better dentoskeletal control than does the conventional anchorage method, thereby improving the quality of the treatment results.
Humans ; Male ; Sutures ; Tooth

PURPOSE: Few studies have compared fractional exhaled nitric oxide (FeNO) measurement by NIOX VERO® (NOV) and other devices in children. Moreover, there is no agreement between differences in FeNO values obtained using different devices in adults. Here, we compared FeNO values obtained using NOV and NObreath® (NOB) systems to derive a correction equation for children. METHODS: Eighty-eight participants (age 7–15 years) who were diagnosed with atopic bronchial asthma and visited Sagamihara National Hospital as outpatients between January and April of 2017 were included. We measured FeNO values obtained using NOB and NOV, and analyzed them using Wilcoxon tests and Altman-Bland plots. RESULTS: The median age of the participants was 11.5 years, and the scored Asthma Control Test (ACT) or Childhood ACT (C-ACT) was 25 (interquartile range, 24–25) or 26 (24–27). NOB and NOV values were significantly different (31 [14–52] versus 36 [20–59] ppb; P = 0.020) and strongly correlated (r = 0.92). An equation to convert NOB values into NOV values was derived using linear regression as follows: log NOV = 0.7329 × log NOB + 0.4704; NOB for 20, 40, 58, 80 and 100 ppb corresponded to NOV for 27, 44, 59, 73 and 86 ppb. Thus, NOB < 58 ppb suggested NOB < NOV, whereas NOB > 58 ppb suggested NOB > NOV. CONCLUSIONS: NOB and NOV values were strongly correlated. Participants whose FeNO values were relatively low represented NOB < NOV, whereas those whose FeNO values were relatively high represented NOB > NOV.
Adult ; Asthma ; Child* ; Exhalation ; Humans ; Linear Models ; Nitric Oxide* ; Outpatients

A 3-month alcoholism rehabilitation program at psychiatric hospitals is common in Japan for patients with alcohol use disorder (AUD). However, many AUD patients are often hospitalized for the treatment of digestive disorders due to alcohol-related liver diseases and pancreatitis. In this sense, AUD patients need to be better supported by professionals and departments in general hospitals. Here we analyzed the problems in alcohol-related medical care in Japan and examined the measures to be taken at general hospitals.

Medical technologists at our hospital have begun to conduct tests before outpatient appointments for memory loss and dementia. They administer the Mini-Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS-15), take patients' medical history, and perform auxiliary diagnostic tests for cognitive function. Technologists at our hospital assessed 365 patients (mean age 80 years; 172 men and 193 women) in this way between May 2018 and May 2019. We determined a cutoff value for the MMSE and tested the validity of the technologists’ assessments of these patients by comparing them against physicians' clinical diagnosis. Our hospital sees many patients with Alzheimer’s disease, and 85% of patients diagnosed with dementia had an MMSE score of 23 or lower. The MMSE is a highly reliable screening test for dementia, and technologists scored it similarly to physicians. Addition of the GDS-15 showed that outpatients with dementia had underlying anxiety symptoms and depression. It is important that technologists continue their involvement in outpatient care as certified dementia specialists while also continuing to consider which tests they should conduct.

Objective: To investigate the factors that make observed survival of patients with terminal cancer shorter than oncologists’ estimation. Methods: We retrospectively surveyed the medical records of terminal cancer patients who were referred to our palliative care unit with a predicted survival of 1–3 months and discharged dead from hospital within 3 months. Results: A total of 249 patients were eligible for analysis. One hundred and two patients (41%) had observed survival of less than one month (OS1), and 147 (59%) lived for 1–3 months (OS1–3) as expected. Depressed level of consciousness above Japan Coma Scale II and severely reduced oral intake (a few mouthfuls or less) were associated with unexpected shorter survival. The number of patients who died within two days after sudden deterioration of general condition was significantly higher in OS1 than OS1–3. Conclusion: Although survival of patients with the above factors may be shorter than oncologists’ estimation, it is necessary to examine the physician-side factors that contribute to the inaccuracy of prognosis.