This study aimed to examine characteristics of physical functions, physical activity, and cognitive functions among community-dwelling older people who stopped driving automobiles. Participants were 589 community-dwelling older people (age: 65–89, 71.4 ± 5.1 years; 403 men, 186 women). The participants underwent nine physical assessments—hand grip strength, knee extension strength, timed up-and-go test, chair stand, one leg standing with open eyes, functional reach, vertical jump, preferred gait speed, maximal gait speed—and were evaluated for physical activity; and five cognitive assessments—the Mini-Mental State Examination (MMSE), Logical Memory I and II (WMS-R LM-I, LM-II) subtests of the Wechsler Memory Scale-Revised; and Trail Making Test A and B (TMT-A, TMT-B). They were divided into current driver (379 men, 169 women) and driving cessation (24 men, 17 women) groups. Among men, the driving cessation group had poorer vertical jump, TMT-A, and TMT-B results, while women had poorer hand grip strength, one leg standing with open eyes, WMS-R LM-II, and LM-II results, and longer inactivity time, compared with the current driver group and adjusted for covariates (P < 0.05 for all). The findings suggest driving cessation among community-dwelling older people is significantly associated with poorer physical functions, physical activity, and cognitive functions compared with those in current drivers.

As for the clinical condition to be called “cold stagnating in the liver vessel” (寒滞肝脈kantaikanmyaku),cold invades a liver-­meridian (肝経絡) and causes pain. We report a case of 7-­year-­old boy that reached the difficulty in walking for agreed pain of lower extremities in a liver-­meridian by cold house environment after the diarrhea. There was no abnormality in a blood test and the MR imaging in Western medicine. The treat­ment principle was to warm the meridian and reduce the pain. We chose the infusion of “dankanzen­-based prescription” (暖肝煎加味方) to warm the meridian and to remove the pain. The symptom improved. And the bathing therapy to warm a body relieved pain too. The case report of children of kantaikanmyaku was not found as far as we examined it. However, we believe that such cases are latent in Japan where air conditioners are widely used.

Ibi Welfare Hospital covers a local town that has an aging population, and the development of a community-based integrated care system is an important issue. We have established and are operating a regional integrated NST system to maintain oral nutrition intake essential for daily life and prevention of pneumonia in this area, and here we report on outcomes and future issues. In this study, we investigated the regional integrated NST system (NST outpatient · NST hospitalization · NST visit) and examined dissemination of its service. Data was collected from February 2016 to March 2017. The investigation involved the following: (1) extraction of survey results of latent NST subjects and retrospective investigation of medical records; (2) expansion of NST outpatient services (examinations by surgeons, endoscopic evaluation of swallowing function, blood tests, dental examination, and evaluation by a dietician speech-language-hearing therapist, and return of a joint report created by the individual professionals to the introducing professional); and (3) introduction of NST hospitalization (2-week hospital stay for local inclusion sickbed care, introduction of swallowing passport, initiation of rehabilitation, oral care roundtrip, NST roundtrip, personnel care meetings with home staff, and introduction of visiting speechlanguage-hearing therapist rehabilitation to support home care after discharge). To increase awareness of this system, we visited the local nursing care insurance agency and welfare hospitals and tried to obtain cooperation through transparency. Introducing and initiating this regional integrated NST system “Ibi Model” revealed that the system is greatly needed in our region. We think that it has the potential to become a key supporting tool for the home-based medical care system within the regional comprehensive care system. Further verification is needed to assess real outcome changes such as a decrease in the incidence of pneumonia and improvement in quality of life.

No abstract available.
Crohn Disease* ; Food, Formulated* ; Humans ; Infliximab*

BACKGROUND/AIMS: The influences of Helicobacter pylori eradication therapy on the disease course of inflammatory bowel disease (IBD) are still unclear. We therefore conducted a multicenter, retrospective cohort study to evaluate the safety of H. pylori eradication therapy for IBD patients. METHODS: IBD patients with H. pylori eradication from 2005 to 2015 (eradication group) and control patients (non-eradication group; 2 paired IBD patients without H. pylori eradication matched with each eradicated patient) were included. IBD exacerbation (increased/additional IBD drug or IBD-associated hospitalization/surgery) and disease improvement based on the physicians’ global assessment were investigated at baseline, and at 2 and 6 months after eradication or observation. RESULTS: A total of 429 IBD (378 ulcerative colitis, 51 Crohn’s disease) patients, comprising 144 patients in the eradication group and 285 patients in the non-eradication group, were enrolled at 25 institutions. IBD exacerbation was comparable between groups (eradication group: 8.3% at 2 months [odds ratio, 1.76; 95% confidence interval, 0.78–3.92; P=0.170], 11.8% at 6 months [odds ratio, 1.60; 95% confidence interval, 0.81–3.11; P=0.172]). Based on the physicians’ global assessment at 2 months, none of the patients in the eradication group improved, whereas 3.2% of the patients in the non-eradication group improved (P=0.019). Multivariate analysis revealed that active disease at baseline, but not H. pylori eradication, was an independent factor for IBD exacerbation during 2 months’ observation period. The overall eradication rate was 84.0%–comparable to previous reports in non-IBD patients. CONCLUSIONS: H. pylori eradication therapy does not alter the short-term disease activity of IBD.
Clarithromycin ; Cohort Studies ; Colitis, Ulcerative ; Helicobacter pylori* ; Helicobacter* ; Humans ; Inflammatory Bowel Diseases* ; Metronidazole ; Multivariate Analysis ; Retrospective Studies

　　This study was designed to clarify the factors affecting hospital staff behavior toward participation in lectures and workshops held in our hospital. A questionnaire survey was conducted to evaluate staff background and staff participation in these events. The survey revealed that in the past year, 78.7% of staff had attended lectures or workshops at least once. The participation rate in lectures and workshops associated with medical safety and infection control was 50.4% and 38.4%, respectively. Additionally, the participation rate was dependent on job type. Of interest, staff behavior toward participation was strongly influenced by factors related to the training content, such as medical safety and infection control, but not by environmental factors, such as marital status and familial status (with or without children). The survey results also showed that factors related to “hassle”, such as rearranging their work hours to allow for participation, negatively affected active participation in meeting events. These results suggest that factors affecting hospital staff participating in these events may, in part, be implicated in professionalism as medical staff, and that this can be influenced by job type and motivation, rather than by environmental factors.

　　This study sought to examine the impact of the approaches being taken to deal with current problems between the hospital and staff from the viewpoint of organizational identity. First, we devised educational strategies that allowed staff to speak directly to the hospital director. Next, the director spoke to staff about the background and history, the basic philosophy, and the vision of the hospital, as well as their place and mission in the community. We also conducted a 7-item questionnaire survey (1-5 graded Likert scale) of 894 staff from November 2012 to September 2013. Collection and response rates were 80.3% each. Regarding the direct communication between our hospital director with staff, response to the items “background and history of our hospital”, “espoused the basic philosophy of our hospital”, “had a collective vision our hospital”, and “understood one's place and mission in the community” were significantly increased after the on-the-job training compared with before receiving the training. We confirmed that about 90% of staff understood the items “background and history of our hospital”, “espoused the basic philosophy of our hospital”, “had a collective vision our hospital”, and “understood their place and mission in the community”. Also, two factors, “organizational identity” and “a sense of distance from the hospital organization”, were extracted from the 7 questions for factor analysis. The reliability of this scale was high and showed high internal consistency (Cronbach's α coefficient＝0.837 and 0.670, respectively). The results of these tests for validity of the scale indicate its high content validity. Together, these results suggest that direct communication between our hospital director and staff was extremely useful for penetrating the organizational environment and enhancing staff's organizational identity.

　　This study sought to elucidate factors that affect the cultivation of organizational identity among our hospital staff. We conducted a questionnaire survey among hospital staff (N＝894) from November 2012 to September 2013. The following items were queried: job category, age, sex, marital status, with or without children, participation in lectures or workshops in the previous year, and experience in clinical research and related data analysis. The response rate for the survey was 80.3%. Univariate analysis showed that all abovementioned parameters affected the cultivation of organizational identity. Further study using multivariate logistic regression analysis was performed to clarify which factors are significantly involved in the cultivation of organizational identity. Our results show that job category, participation in lectures or workshops in the previous year, and experience in clinical research and related data analysis are effective in cultivating organizational identity. These results suggest that a sense of professionalism as medical staff may play a critical role in the cultivation of organizational identity.

　The number of medical staff who can conduct clinical research in our hospital has been decreasing every year, and thus education that enhances medical staff's understanding of the importance of clinical research is an important factor in improving patient management. Although staff education has begun to develop infrastructure necessary for conducting clinical research, it is unclear whether medical staff who must play a critical role in clinical research are actually interested in conducting research and participating in research-related educational programs. We carried out a cross-sectional questionnaire survey of medical staff to determine their interest in clinical research activities and related education. Of 894 medical staff who participated in a workshop at Anjo-Kosei Hospital, 718 responded to the survey (response rate: 80.3%), 24.9% of whom had experience in clinical research and 51.0% had an interest in the field and related data analysis. Furthermore, 51.0% of respondents showed demonstrable intention to participate in staff education. Such intention to participate was particularly obvious among clinicians, pharmacists, registered dietitians, radiologists, and rehabilitation therapists. Also, staff in their 30s and 40s were frequently interested in conducting clinical research and related data analysis. This suggests that these staff prefer a research environment where they can undertake clinical research soon after completing clinical training. Moreover, regarding the question of specific educational areas, statistical methods for data analysis garnered the highest interest, followed by methods of writing a research paper, use of statistical software, data interpretation, designing research, and identifying research topics. Therefore, such educational programs should be flexible to suit medical staff who perform data analysis as well as clinical research.

History of Mongolian medicine could be traced back to 2000 years ago. Mongolian traditional medicine has been built over many years. We traveled Mongolia to visit a hospital and a private clinic where traditional Mongolian medicine is in practice, and visited National University of Medical Sciences. In this paper, we report the current status of traditional medicine in Mongolia. We visited Mongolian National University of Medical Sciences and conversed with the president, vicepresident, and director of the traditional medical department. We visited a clinic where Mongolian traditional medicine is performed and a hospital where mainly traditional therapies and practical development are carried out. In the hospital, they mainly provide acupuncture and moxibustion treatment, cupping therapy, herbal therapy, and thermotherapy. It cannot be denied that moxibustion treatment came from Mongolia, because it is also said that ‘the north' in “Huangdi Neijing Suwen” chapter 12 means Mongolia. However, as there is a background once traditional medicine has been kept away from the national health care system, it is difficult to find a specific medical practice for Mongolian medicine as far as we have viewed the present status of medical practice in Mongolia. Considering that the cultural exchange with Japan is being carried out in many other fields, we expect that a number of new facts will come to light in the near future.