When participating in international disaster relief operations (IDR), medical staff must work under limited human resources and medical equipment. The actual role of a nurse in IDR has not yet been clarified, while the role of a doctor is relatively clear.
In this study, we have examined the actual role of nurses in IDR through a survey by questionnaire to 61 medical staff who have worked in past IDR. Full usable responses were received from 50 (82%) of them. These 50 were consisted of 24 doctors, 17 nurses, and 9 medical coordinators. The questionnaire was distributed from September 1 to December 31 in 2005. We investigated 17 activities reported variously in the literature;-setting up temporary medical facilities, inside arrangements, health care of the medical staff, coordination within the team, keeping medical records, performing triage, wound irrigation, debridement, performing incisions, removing stitches, suturing, reception of patients, medical interview of patients, assisting a doctor performing medical examination and treatment, management of commodities, management of medical waste, management of medical records, and conventional nursing care. The questionnaire asked the respondent to indicate a level of appropriate for a nurse to perform each of the activities in IDR.
Provided that the nurse had a basic national licence in nursing and IDR education and training, then triage and wound irrigation were each considered appropriate during IDR with a doctor supervising, beyond the conventional nursing role. But suturing, performing incisions, removing stitches, and debridement were each considered to be problematic for nurses.

Although previous studies have investigated the relationship between agricultural work and health conditions in older adults, little attention has been paid to crop handling. In this study, we aimed to clarify the relationship between agricultural work, crop handling/sales, and health. A survey was conducted of older adults attending health examinations in Tosa Town, Kochi Prefecture. To clarify the relationship among comprehensive geriatric assessment items, the t-test was used for comparisons between two groups according to the presence or absence of agricultural work, and one-way analysis of variance with multiple comparisons was used for comparison among three groups according to the presence or absence of crop handling and agricultural work. The analyses were performed separately for men and women. The analysis results showed that male participants who were engaged in agricultural work had significantly better indicators of ability to walk and stand up as well as higher scores for social roles on the Tokyo Metropolitan Institute of Gerontology Index of Competence compared with those who were not engaged in agricultural work. No significant differences were found between the two groups of women. In three-group comparisons, the subjective well-being and social roles of men and women who did agricultural work and distributed their crops were significantly higher than those who did not do agricultural work and those who did agricultural work but did not distribute their crops.

An abdominal advancement flap (AAF) is a flap that pulls the elevated abdominal skin up and creates the shape of the inferior portion of the breast by making a neo-inframammary fold. Seven patients underwent remodeling using an AAF or a method combining an AAF with other volume displacement techniques after partial mastectomy. The excision volume ranged from 15% to 35%. AAF with only mobilization of the gland flaps was performed in two cases, with lateral mammoplasty in one case, with the round block technique (RBT) in one case, with a modified RBT in one case, and with medial mammoplasty in two cases. Although one patient treated with a RBT had a partial blood-flow insufficiency of the nipple-areola complex, it improved with conservative treatment. The cosmetic results were found to be excellent in three cases, good in three, and fair in one case.
Breast ; Cosmetics ; Displacement (Psychology) ; Female ; Humans ; Mammaplasty ; Mastectomy, Segmental ; Skin ; Surgical Procedures, Operative

We introduce a method combining two oncoplastic techniques for breast-conserving reconstruction. The procedure is as follows: first, an extended glandular flap is made by undermining the breast from both the skin and the pectoralis fascia to the upper edge of the breast at the subclavicular area. After modeling the breast mound with the extended glandular flap, an inframammary adipofascial flap is made. The flap is reflected back to the breast area remodeled using the extended glandular flap. After reshaping the breast, the inframammary line is then re-shaped. This method is indicated for patients with breast cancer in the outer portion of the breast, who have small dense breasts, and have undergone a large excision of about 40% of their breast volume. We treated four patients, all of whom had either excellent or good cosmetic results with no fat necrosis.
Breast ; Breast Neoplasms ; Cosmetics ; Fascia ; Fat Necrosis ; Female ; Humans ; Mammaplasty ; Mastectomy, Segmental ; Skin

PURPOSE: Although various strategies have been reported, there are no defined criteria for cosmetic evaluation methods after breast-conserving surgery (BCS). Since Asians tend to have smaller breasts, indistinct inframammary folds, and conspicuous scars, differences in the cosmetic results are expected. So we examined two subjective methods and one objective method to determine the differences, and elements necessary for a cosmetic evaluation after BCS. METHODS: Frontal photographs of 190 Japanese were evaluated using the Harris scale (Harris) and the evaluation method proposed by the Japanese Breast Cancer Society Sawai group (Sawai group) as the subjective methods, and the Breast Cancer Conservation Treatment cosmetic results (BCCT.core) as the objective method, respectively. In order to examine the necessary elements for developing a new ideal method, 100 out of 190 were selected and assessed separately by six raters using both the Harris and modified Sawai group methods in the observer assessment. The correlation between the two methods was examined using the Spearman rank-correlation coefficient. RESULTS: The results of the BCCT.core and the other two methods were clearly different. In the observer assessment, the consensuses of the six raters were evaluated as follows: 27, 27, 26, and 20 cases were evaluated as "excellent," "good," "fair," and "poor," respectively. For the Spearman rank-correlation coefficient, values higher than 0.7 indicated a strong correlation, as seen by the values of 0.909 for the breast shape and 0.345 for the scar. The breast shape accounted for the most significant part of the evaluation, and the scar had very little correlation. CONCLUSION: In this study, we recognized a clear difference between the subjective and objective evaluation methods, and identified the necessary elements for cosmetic evaluation. We would like to continue developing an ideal cosmetic evaluation that is similar to subjective one and is independent from raters.
Asian Continental Ancestry Group* ; Breast ; Breast Neoplasms ; Cicatrix ; Consensus ; Esthetics ; Humans ; Mastectomy, Segmental*

Bovine abortion, diarrhea, and respiratory disease complexes, caused by infectious agents, result in high and significant economic losses for the cattle industry. These pathogens are likely transmitted by various vectors and reservoirs including insects, birds, and rodents. However, experimental data supporting this possibility are scarce. We collected 117 samples and screened them for 44 bovine abortive, diarrheal, and respiratory disease complex pathogens by using Dembo polymerase chain reaction (PCR), which is based on TaqMan real-time PCR. Fifty-seven samples were positive for at least one pathogen, including bovine viral diarrhea virus, bovine enterovirus, Salmonella enterica ser. Dublin, Salmonella enterica ser. Typhimurium, and Neospora caninum; some samples were positive for multiple pathogens. Bovine viral diarrhea virus and bovine enterovirus were the most frequently detected pathogens, especially in flies, suggesting an important role of flies in the transmission of these viruses. Additionally, we detected the N. caninum genome from a cockroach sample for the first time. Our data suggest that insects (particularly flies), birds, and rodents are potential vectors and reservoirs of abortion, diarrhea, and respiratory infectious agents, and that they may transmit more than one pathogen at the same time.
Animals ; Birds ; Cattle ; Cockroaches ; Diarrhea Viruses, Bovine Viral ; Diarrhea ; Diptera ; Disease Reservoirs ; Disease Vectors ; Enterovirus ; Enterovirus, Bovine ; Genome ; Insects ; Neospora ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Rodentia ; Salmonella enterica ; Virulence Factors