Purpose: The prefered location for recuperation of cancer patients is constantly changing. In order to meet the request of the patients and their family that they want to stay at home, our answer is to provide a “back-up bed” on the role for our palliative care unit. We developed a 24-hr hot line (Bethel Hospice Hotline; HL), and carried out HL from April 2010. For the purpose of future enhancement of cooperation, we examined the case of HL history over 3 years. Methods: Palliative care physicians interviewed patients and their families, explained the mechanism of cooperation to their family doctors. With their consent patients were registered to the HL. Results: 75 cases of HL registration from April 2010 to April 2013, 63 cases were supported by home care supporting clinics, 7 by other clinics, 3 by other hospitals and 2 others. The demands of family doctors upon HL: 69 cases were back bed and 14 cases required consultation for symptom relief. Our results show 42 (21 were emergency) patients admitted to our hospital, 18 received care at home supported family doctors, 4 were admitted to other hospitals, and 11 are ongoing. Conclusion: Since half of the admissions (21/42 cases, 6 were off hours) to our hospital were emergency, it is necessary to promote efficient cooperation to reduce the burden of the family doctors and the palliative care unit. Thus, it is expected to relieve the symptoms from early stages of the illness and to facilitate timely hospitalization.

Background: We began conducting pain screenings using an in-house version of the “Ease of Living Questionnaire” for patients undergoing initial radiotherapy. Purpose: The purpose of this study was to classify patients undergoing radiotherapy for different medical purposes and to verify the differences in the responses between the groups identified. Methods: The “Ease of Living Questionnaire” was administered to all adult patients with cancer undergoing initial radiotherapy , and the responses were analyzed together with data concerning the patients’ background characteristics that were extracted from medical records. Results: A total of 543 responses to the questionnaire were collected, and the patients were divided into a palliative group (177), curative group (189), preoperative group (19), and postoperative group (158); statistical differences were observed with respect to patient gender, age, and target disease. Mental and physical distresses were more pronounced in the palliative group compared to the other three groups. Although psychosocial need was high with respect to the questionnaire items concerning symptoms and treatments/activities of daily living, the independent sensitivity values of the check fields were 0.29-0.65 and 0.08-0.38, respectively. Intergroup differences were observed with respect to symptoms and treatment/economic need as well as social security/occupational need. Conclusion: In order to gain an understanding of patient needs, we believe that it is necessary to take sufficient action in consideration of the content of free-response answers based on differences in background by treatment purpose.

Objectives  High gestational weight gain (GWG) is associated with perinatal risks to mother and child. Research shows that non-Japanese Asian women have higher GWG than Japanese women. However, no studies have compared GWG in these two populations using GWG recommendations in accordance with Japanese and Institute of Medicine (IOM) guidelines. The study aim was to compare GWG in non-Japanese Asian and Japanese pregnant women.Methods  This was a retrospective observational study. All participants were aged ≥20 years and gave birth between September 2019 and the end of October 2020 at one perinatal medical center in Japan. Medical record data were analyzed for 170 non-Japanese Asian and 316 Japanese pregnant women. We used t-tests and chi-square tests to examine differences in age, parity, smoking status, antenatal checkups, pre-pregnancy body mass index, and GWG. Logistic regression analysis was used to estimate odds ratios (95% confidence intervals) for above- and below-recommended GWG by non-Japanese Asian and Japanese status. We also analyzed differences in delivery type, abnormal blood loss, and birth size according to GWG.Results  After adjustment for confounding factors, the multivariable-adjusted OR and 95% CI for GWG above the Japanese guidelines recommendations was 1.86 (1.23-2.81) and that for GWG above IOM guidelines recommendations was 2.46 (1.45-4.16) for non-Japanese Asian women, as compared with Japanese women. Conversely, the multivariable-adjusted OR and 95% CI for GWG below Japanese guidelines recommendations was 1.55 (1.03-2.32) and that for GWG below IOM guidelines recommendations was 1.87 (1.26-2.76) for Japanese women, compared with non-Japanese Asian women. Conclusion  Because Japanese women tend to be below recommended GWG and non-Japanese Asian women tend to be above recommended GWG, midwives need to provide careful guidance to reduce perinatal risks.