Objective: The purpose of this study was to examine the effects of Coenzyme Q10 (CoQ10) supplementation on salivary secretory immunoglobulin A (SIgA) and health-related Quality of Life (QOL) in middle-aged and elderly individuals. Methods: Sixty healthy middle-aged and elderly individuals were assigned randomly to a CoQ10 supplementation group (n = 30) or a placebo supplementation group (n = 30) using a double blind method. Subjects took 150 mg CoQ10 or placebo per day for 8 weeks. Salivary SIgA secretion rate and SF-36 test (physical and mental health-related QOL) were determined before and after the intervention. Results: CoQ10 group showed that a tendency to increase of salivary SIgA secretion rate (p = 0.08), although placebo group did not show significant change. Physical health-related QOL did not significantly change in both groups. Vitality and mental health scores, which were subscale of mental health-related QOL, were significantly increased after the intervention in CoQ10 group (p < 0.05), although placebo group did not show significant change. Conclusion: 8 weeks of CoQ10 supplementation may bolster SIgA-mediated oral immunity and mental health-related QOL in middle-aged and elderly individuals.

This study examined the content validity and issues in the program management of a comprehensive support program for cancer patients. The program included a seminar for patients, a newsletter, a support cafe, support group, a yoga and stretching class, and a hand and foot care class. Program evaluation was conducted three times (before program, During program: 6 months later, After program) using an original questionnaire, MAC, and FACIT-SP. Forty subjects were included in the study. Subjects responded that they were satisfied with the knowledge and information obtained through the program, as well as the personal connections established with medical personnel. The physical intervention portion of the program was positively evaluated, and the emotional and spiritual QOL of patients improved significantly after the program. These results suggest that the program effectively supports the active lives of cancer patients. Palliat Care Res 2011; 6(1): 201-208

Effects of anti-oketsu drug, Keishibukuryogan (Gui-zhi-fu-ling-wan) and Tokishakuyakusan (Dang-gui-shao-yao-san) in vivo and in vitro on platelet aggregation were investigated in normal volunteers.
Of 20 volunteers who were given Keishibukuryogan, there were 6, 3 and 11 subjects whose dose-response curves of collagen-induced aggregations were shifted to the right, to the left, or who had no shift, respectively. The control aggregations of these 20 people were in the same range. In ADP-induced aggregation, there were 5 curves shifted to the right. Their potencies in the control aggregation were higher than those of 9 subjects who were not affected by the drug. There were 6 curves shifted to the left, and their potencies were lower than those of the 9 unaffected subjects. Of 12 volunteers who were given Tokishakuyakusan, there were 2, 2 and 8 subjects whose dose-response curves in collagen-induced aggregation were shifted to the right, the left, or who had no shift respectively. With ADP-induced aggregation, there were 1, 1 and 10 subjects whose doseresponse curves were shifted likewise. In vitro, Keishibukuryogan caused inhibition of ADP-induced aggregation but not that of collagen-induced aggregation.

Objective: To establish work environments that prevent Japanese nursing assistants from leaving their jobs, we investigated the associations between their job satisfaction levels and intentions to remain on their jobs.Materials and Methods: We distributed anonymous self-administered questionnaires to Japanese female nursing assistants in 30 different hospitals. Regarding job satisfaction, we investigated various items relevant to both intrinsic facets (e.g., gaining various experiences) and extrinsic facets (e.g., salary), and conducted factor analyses of those items. Standardized partial regression coefficients were then calculated using multiple regression analyses. Intention to remain on the job was the dependent variable for this study. The factor scores calculated by the factor analyses of job satisfaction and respondents’ characteristics were the independent variables. Since multicollinearity occurred, we utilized two types of statistical models. After questionnaires with one or more missing values were excluded, 618 questionnaires were analyzed.Results: Using factor analyses, we discovered six factors related to job satisfaction among nursing assistants: “Intrinsic motivation”, “Salary”, “Relationships among nursing assistants”, “Registered nurses’ attitudes”, “Fatigue reduction”, and “Opportunities for vocational skills”. In statistical model 1, “Intrinsic motivation”, “Salary”, “Fatigue reduction”, “Age”, “Employment status”, and “Certified care worker status” were significantly associated with “Intention to remain on the job”. In statistical model 2, “Salary”, “Registered nurses’ attitudes”, “Fatigue reduction”, “Opportunities for vocational skills”, “Age”, and “Employment status” were significantly associated with “Intention to remain on the job”.Conclusion: “Intrinsic motivation” and “Opportunities for vocational skills” are included in intrinsic facets. To prevent nursing assistants from leaving their jobs, raising only their extrinsic job satisfaction levels is insufficient. Because nursing assistants have not received formal nursing education, they cannot take pride in having the same skills and expertise as registered nurses. However, hospital managers must respect their feelings and establish an appropriate working environment.

At Saitama Medical University, experience training for first-year medical students was conducted for the purpose of communicating with people who live in an institution and have severe motor and intellectual disabilities. However, due to the spread of COVID-19, training at this institution has been suspended completely, which has led us to conduct the training remotely. In the remote training sessions, people with disabilities who only had nonverbal communication tools joined a Zoom meeting where they were able to communicate with students from inside the institution. In the past, there have been other times when training was suspended due to infectious disease outbreaks. Despite this, remote training has made it possible to carry out training without being affected by the environment. Compared to conventional training, remote training did not allow students to experience the atmosphere of the institution or interaction with the people on-site. However, it did have other advantages in that it enabled students to understand the disabilities at a deep level, making them realize the importance of nonverbal communication, and increasing their motivation to learn.

Introduction: In patients receiving opioids, relief of cancer pain by palliative radiation therapy or other means can lead to opioid discontinuation and subsequent withdrawal symptoms, such as agitation, insomnia, and diarrhea, due to opioid-related physical dependence. Appropriate steps should be taken to prevent these symptoms. Case: A 72-year-old man underwent surgery for esophageal cancer. He developed low back pain and right lower limb pain, and was diagnosed with sacral and right iliac bone metastases. His pain was resistant to oxycodone (OXC), so he was simultaneously treated with methadone (MDN) and palliative radiotherapy. His pain gradually decreased, and MDN was tapered and switched to OXC, which was in turn discontinued at 20 mg/day at the patient's strong request. After OXC discontinuation, akathisia, anxiety, and diarrhea appeared as withdrawal symptoms. These were treated with immediate-release OXC, transdermal fentanyl, and suvorexant. Discussion: When discontinuing opioids, dose reduction below 10% per week is recommended, de-escalation to the lowest possible dose should be followed by cessation. In case of withdrawal symptoms, immediate-release opioids may be used, and opioid tapering should be attempted in parallel with symptom control.

Objective: This study aimed to investigate the feasibility of a patient registry system for assessing PCT (palliative care team) by PRO (Patient-reported outcome) in Japan. Methods: We operated a patient registry system with electronic data collection at eight hospitals in 2021 in Japan. We consecutively included newly referred patients for a month and followed up with them for a month. IPOS or ESAS obtained as PRO at the start of the intervention, three days later, and every week after. The primary endpoint was the response rate to the symptom rating scale by patients and providers. Results: 318 patients were enrolled. The patient response rate was 59.1% at intervention and 37.0% after intervention, and the medical provider response rate was 98.4% at intervention and 70.3% after intervention. Interviews with PCT members indicated that participants required support to input PRO responses required support and paper questionnaire was better and that managing the survey date and overall management was burdensome. Discussion: Although only about half of the patients were able to respond to the PRO, this was the same level as in previous studies. The system and its operation method have many problems. We found that improvements such as reducing items and making the patient interviews paper-based are necessary to expand the system nationwide.