This study aimed to explore, identify, and classify the strengths of elderly individuals living in rural areas from their own perspectives, using an asset-based approach. A qualitative analysis was conducted through group interviews. The study included two groups of four elderly individuals who resided in District D of Area C, City B, Prefecture A, and three groups of five to six elderly individuals from District E in the same city. As a result, 133 key items related to the strengths of elderly individuals were identified. These items were further classified into 39 subcategories, which were grouped into three major categories: individuals (personal strengths), associations (organizations/groups), and institutions (environments/resources that support strengths). Specifically, 18 subcategories were classified into the individuals category, 11 into the associations category, and 10 into the institutions category. These findings revealed that elderly individuals in rural areas actively take on various roles within their communities, utilizing their rural environment both as individuals and as part of a group. The rural setting itself was found to significantly influence their engagement, while intergenerational support and assistance from public institutions also played a crucial role. In the future, we aim to utilize these “strengths of elderly individuals” to develop strategies that empower community residents to lead vibrant, active, and secure lives in their familiar environments.

Purpose: To examine the feasibility of the Integrated Palliative care Outcome Scale (IPOS), a comprehensive palliative care scale, for non-cancer patients. Methods: Twenty non-cancer patients and 20 healthcare providers who provide care to the participating patients were asked to complete the IPOS questionnaire, and cognitive interviews were conducted with them. The interviews were analysed using content analysis, a qualitative analysis method. Results: About half to 90% of both patients and healthcare providers answered that they did not find it difficult to answer or understand all items of the IPOS. Therefore, we confirmed its surface validity, and the content validity of the IPOS was confirmed. Conclusion: The surface validity and content validity of the IPOS for non-cancer patients were confirmed, and it became clear that the IPOS can be used as a comprehensive assessment tool for the palliative care of non-cancer patients.

Tohoku Medical and Pharmaceutical University Hospital uses an information form created by doctors and pharmacists to provide postoperative information to patients who undergo nephrectomy at the Department of Urology. The form recommends that patients' physicians change prescriptions and adjust medication doses considering post-nephrectomy deterioration of renal function in patients with a single remaining kidney. Of the 7 patients who used this information form, prescription changes were made in 4 patients. An information form jointly created by a physician and pharmacist may affect prescription changes.

Purpose: Palliative care implementation should take into account the perceptions and acceptability of healthcare providers. This study aimed to identify physicians’ perceptions of palliative care and barriers to palliative care practice in the critical care setting. Methods: A nationwide, self-administered questionnaire was distributed to physicians working in intensive care units, and free-text data were qualitatively analyzed. Results: The questionnaire was sent to 873 respondents, and 436 responded (50% response rate). Of these, 95 (11%) who responded to the open-ended sections were included in the analysis. Conclusion: Japanese physicians working in ICUs recognized that palliative care was their role and practiced it as part of their usual care. They felt, however, that the practice was difficult and not sufficient. Barriers to practice included the lack of human resources and availability of palliative care teams, and the lack of uniformity in the perception of palliative care in the critical care setting.

Purpose: To clarify current status of nurses in support of children with parents with cancer in Akita Prefecture. Method: Questionnaire surveys were administered on nurses in Akita prefecture. Their experiences, educational backgrounds, and ability to recognize the need for support were examined. Descriptive statistics were used for the attributes, and chi-square test or Fisher’s exact Test or Wilcoxon rank sum test was used to examine the relationship between the support experience and the attributes (p<0.05). The contents of their open comments were then analyzed using a qualitative integration method. Results: Responses were obtained from 141 nurses at 10 facilities (collection rate: 43.9%). Of the 141 nurses, 135 (96%) recognized the necessity of support for children, and 28 (20%) already had experience supporting them. The contents of support were [direct support for children] [support for children through parents] [support through coordination and coordination with resources]. Most apparent difficulties in support were “Intervene for children” and “to have a connection with children”. Conclusion: The results indicate that nurses recognize that children need support. However, they lack experience in providing such support. It is necessary to enhance support by learning support methods and sharing information with other occupations. Support from parents is important when children cannot be met.

Cryptosporidium is the most common protozoan that can infect a wide range of animals, including mammals and birds. Avian Cryptosporidium spp. can cause enteric and respiratory diseases which can be fatal in birds and some species are zoonotic. Companion birds have the potential as reservoir due to their close contact with humans. Pet shops are the major source of companion birds. However, few reports are available regarding Cryptosporidium spp. infection among companion birds kept in pet shops. The present study reports the prevalence and molecular characteristics of Cryptosporidium spp. among companion birds kept in pet shops in Japan. A total of 265 fresh fecal samples were obtained from birds kept in 4 pet shops; these birds belonged to 41 species in 3 bird orders. A nested polymerase chain reaction (PCR) assay targeting the small subunit rRNA gene was employed for the detection of Cryptosporidium spp. A total of 24 samples (9.1%) were positive, and Cryptosporidium spp. were detected from all pet shops. The prevalence of Cryptosporidium spp. in each of the bird orders was 6.5% (10/153) in Psittaciformes, 14.4% (13/90) in Passeriformes, and 4.5% (1/22) in Galliformes. Based on sequence analysis, 13 (54.2%) isolates were classified to C. galli, 8 (33.3%) were avian genotype III, and the remaining 3 (12.5%) were C. baileyi. No infection with zoonotic C. meleagridis and no coinfection with multiple Cryptosporidium spp. and/or genotypes were observed. The zoonotic potential of Cryptosporidium spp. infecting companion birds kept in pet shops in Japan is likely to be low.
Animals ; Birds ; Coinfection ; Cryptosporidium ; Friends ; Galliformes ; Genes, rRNA ; Genotype ; Humans ; Japan ; Mammals ; Passeriformes ; Polymerase Chain Reaction ; Pregnancy ; Prevalence ; Psittaciformes ; Sequence Analysis

A 54-year-old female had left femoral incarcerated hernia. One month later, she received a radical operation for it, but was admitted to our hospital twice because of ileus. Various tests showed no mechanical intestinal obstruction, but small-intestinal edema. She was transferred to our department to receive Kampo medicine. She could not eat any food and her weight decreased from 47 to 37.5 kg. We therefore administered intravenous hyperalimentation. She had a cold sweat on her face and was prone to bed rest because of severe abdominal pain as if in labor, and general fatigue. Her skin was dry, her radial pulse was weak and her abdominal tonus was weak. In addition, lower abdominal tension was more intense than upper and we could observe bowel movements from her skin. At first, we administered bushikobeito, but it had no effect. Referring to her abdominal findings, we considered that daikenchuto and tokikenchuto were compatible in her case, and after changing to chukenchutokatoki her abdominal pain disappeared in 5 days. Thus, Kampo medicine was effective for post-operative pseudo-obstruction.

　　The aim of this study was to examine topophilia in the elderly living in mountainous areas. Topophilia, which is the geographical concept invented by Yi-Fu Tuan in 1999, is defined as the affective bond between people and place or environmental setting. A total of 120 elderly subjects living in a mountainous area responded to a standardized, validated 9-item Life Satisfaction Index K (subjective well-being) developed by Wataru Koyano and a new structured 6-item questionnaire on topophilia. Factor analyses revealed two domains of topophilia (public emotion and private emotion toward the living place). Public emotion was the emotion of being hard to leave the living place. Private emotion was the emotion of not loving the living place. There were areas where the elderly had a lesser degree of attachment toward the present state of the elderly could hardly have a sense of well-being and attachments to the current domicile. It is considered that not only physical but also mental approach is necessary to support the daily life of the elderly living in the mountainous area. Also, we examined the influences of aging and the living place on a subjective well-being and topophilia. There was no significant correlation between age and subjective well-being, but there was significant positive correlation between age and the degree of topophilia (r＝0.234, p‹0.01). On the other hand, the degree of subjective well-being by the place of residence was significantly different (p‹0.001; ANOVA), and the degree of topophilia by the place of residence was not significantly different. These findings suggest that subjective well-being is not influenced by age but influenced by the place of residence, and topophillia is not influenced by the place of residence but influenced by age.

Purpose: The aim of this study was to develop a nursing intervention program for use in enhancing the self-care abilities of cancer patients receiving treatment on an outpatient basis. Method: Four-week-long combined group therapies were conducted on 15 subjects. The effects of these therapies were then examined. Results: Subjects' mean age was 56.86±11.52 years; mean duration of disease was 28.6±18.14 months. Between before and after the intervention, two scales showed significant improvements: EORTC QLQ-C30 Global health status (p<0.023) and STAI state anxiety scale (p<0.022). As a result of field note data analysis, "change of attitude toward cancer treatment at home" and "response to the program" were identified. Conclusion: Because the subjects were highly motivated individuals, with substantial self-care ability from the beginning, their ESCA scores did not show any change between before and after intervention. Nevertheless, the inner changes that occurred to the subjects indicated that their self-care ability had improved. Palliat Care Res 2009; 4(1): 201-206

1) We compiled lists of accredited training hospitals for postgraduate education from the matching program list and of hospitals that employ board-certified specialists in emergency medicine.We then evaluated the number of training hospitals that employ board-certified specialists.
2) There are 1072 accredited hospitals for postgraduate education. However, only 546 (50.8%) of these hospitals employ board-certified specialists in emergency medicine.
3) Accredited training hospitals with emergency-medicine specialists are prevalent in Okinawa, Tokushima, and Kagawa prefectures.However, the prevalence of these hospitals is surprisingly low in metropolitan areas.