1.Raising the Level of Emergency Medical Services
Akimi TAMAKOSHI ; Kyoko IKEDA ; Yumi ISHIKOSHI
Journal of the Japanese Association of Rural Medicine 2015;63(5):792-796
Hospital A, nestled among hills, plays a central role in providing health services in the region with a population of about 150,000. Designated as a secondary emergency care hospital, it has no independent emergency care team, but has made every arrangement to provide emergency medical services around the clock: In the daytime on weekdays, clinical department physicians and nurses, and in the night time and on holidays, one doctor and two nurses on duty are in charge. Nurses on night duty and on holidays vary in clinical experience and ability to cope with emergencies. Apparently, they are struggling to maintain their presence of mind when they are receiving patients requiring immediate attention or when they are answering to emergency telephone calls. In May 2012, the hospital moved to the place within easy access of the main road and a heliport was built. It was expected that the number ofpatients rushed to the hospital in ambulances would increase. Against this background, there arouse an urgent need for every paramedic and nurse to make an right assessment of the conditions of the patients promptly and sort them rightly according to the emergency of their need for care. To meet this need, we started to work on standards of triage categorization and practice according symptoms, and classification of severity. Moreover, to develop the ability of the staff to deal with the emergencies, study meetings were held and case reviews took place.
2.Physical Load of Labors upon the Farmers Engaged in Raising Silk Worms
Masashi Nakamura ; Koichi Yukawa ; Humio Hirata ; Takashi Ikeda ; Yumi Ishihara ; Masashi Sugawara ; Haruaki Chirifu ; Kazue Morimoto ; Nobuko Noda ; Mutsuyoshi Tsuchimoto ; Kazuo Sugawara
Journal of the Japanese Association of Rural Medicine 1981;30(4):763-772
Investigation on the working time, energy expenditure and fatigue were carried out for members of three families engaged principally in raising silk worms.
Group examinations of physical conditions and blood constituents and survey of nutritional intake were performed on the residents, including the above families, in a community in Fukueisland, Nagasaki-prefecture.
The results were as follows;
1) The average values of energy expenditure on a most busy day in a raising period of silk worm calculated to be 3150 kcal (max. 3500 kcal) for males, 2340 kcal (max. 2890 kcal) for females of the above three families. Their working times on this day were about 14 hours.
2) The physical fatigue of the subjects was estimated by means of Fliker frequency, near point and threshold of patellar reflex. Remarkable changes of these values were found, suggesting the heavy physical load of the raising works, and the changes were more remarkable in olders and females than in youngers and males.
3) Donaggio's reaction and Na/K in the first urine of morning were investigated at an interval of five days during one period of silk worm raising.
The Donaggio's reaction values were increased about two times higher in the latter term, on the other hand Na/K dropped in the former term of the period.
4) The group examinations of the inhabitants in the community showed that the body fat of silk raising farmers were fewer than that of the farmers engaged in other kinds of farming reported by the present authors.
Blood values (Ht, Hb and TP) of them in 1975 were lower than in 1974, because one more raising period was added and so the physical load of them might be greater in '75 than in '74.
5) The nutritional intakes of silk raising farmers were almost as same as these of the farmers in other districts.
3.Experience on an Education Method for Medical Psychology for Medical Students with Approach of Behavioral Science.
Kumiko YAMAZAKI ; Michinari KANEKO ; Wakana FURUSHIMA ; Tatsushi KAWAGUCHI ; Kaori IKEDA ; Kiyo OOTANI ; Eiichiro KANDA ; Yoshihide NISHIYAMA ; Miho FUKUHARA ; Sanae YOKOMIZO ; Yumi MADARAME ; Mutsumi TSUKADA ; Masami MOTEGI ; Yasuko NAKAYAMA ; Tomoko OKANO ; Ichin YUU ; Mariko MIYAMOTO ; Satoshi OOURA ; Akio SHIROKI ; Atsushi YOSHIOKA ; Mako YOKOTA
Medical Education 1994;25(4):216-220
4.Verification of the Effectiveness of the Health Support Pharmacy “Toyonaka Model,” an Industry-Government-Academia Collaboration Project Aiming to Promote Community Health through the Information from Community Pharmacies via Digital Signages
Tamaki SAWADA ; Kazuyuki NIKI ; Nichika ONISHI ; Kozo TADA ; Akiyo NISHIDA ; Koji DOHI ; Takashi KOZAI ; Yaeko OKUDA ; Yukiji MORIKAWA ; Takehiko MAE ; Mitsuyo KUROKI ; Yumi TAKAOKA ; Taro MATSUOKA ; Yasuhiro ASHIDA ; Kenji IKEDA ; Mikiko UEDA
Japanese Journal of Social Pharmacy 2022;41(2):175-186
Advances in information and communication technology (ICT)-especially, the spread of social networking services (SNSs)-have facilitated the dissemination of information and an explosion of health information lacking scientific evidence. Therefore, we believe that community pharmacies are the most suitable bases for distributing health information. In 2019, we launched the health support pharmacy “Toyonaka Model” in collaboration with the pharmaceutical association, municipal government, and university. Touch-panel digital signage (DS) was used for real-time distribution of ever-changing information and a rapid grasp of pharmacy users’ responses to various types of information. Between September 2019 and August 2021, one DS was installed in a pharmacy in each of Toyonaka City’s seven areas along with 14 questions on the usefulness of the delivered information. Respondents answered the 14 questions by a tablet or questionnaire; touch logs for DS were collected. When a pharmacy user consulted with a pharmacist about information delivered via DS, the contents were recorded and described by the pharmacist on a 4-point scale (e.g., “inquiry only,” “went through to execution”). From the 850 completed questionnaires and 61,565 touches, 88.7% of the respondents indicated that the information was useful, and 90.0% expressed interest in receiving more health information in the future. Thus, health information provided by DS may be useful to pharmacy users, as demonstrated by 113 cases in which the pharmacist was consulted regarding such information. In 62 of these cases, there were indications that the DS information might have influenced users’ behavior and intended actions.
5.Characteristics and Efforts of Discharge Coordination for Patients with Pediatric Cancer toward End-of-Life—Focus Group Interviews with Staff Involved in Discharge Coordination—
Yuko NAGOYA ; Nobuyuki YOTANI ; Yuko CHO ; Tomoko YOKOSUKA ; Mariko SHIMIZU ; Aya SUZUKI ; Yumi IKEDA ; Tomoo OSUMI
Palliative Care Research 2025;20(1):29-36
In this study, we conducted interviews with staff members who had experience in discharge coordination to clarify the characteristics and efforts of discharge coordination for patients with pediatric cancer toward end-of-life. Focus group interviews were conducted with 11 individuals, including six medical social workers and five nurses (acceptance rate: 84.6%) and a qualitative inductive analysis was conducted. Seven categories were identified as characteristics of discharge coordination for patients with pediatric cancer toward the end-of-life, such as “few home physicians and home health care nurses who could accept terminally ill children” and “a small number of cases and lack of accumulated experience”. Seven categories were identified as efforts of discharge coordination, including “maintaining connections with the community” in three situations: coordination with home physicians and home-visit nursing care, coordination with children and their families, and coordination in hospitals. The number of children who spend their end-of-life days at home is increasing, and we believe that it is necessary to consider expanding the role of pediatric cancer base hospitals in the future, such as collecting information in the community and sharing good practices.