Sleep disturbances are common among women during menopause. Hormone replacement therapy (HRT) using micronized progesterone (MP) may improve sleep, owing to its neurosteroid effects. Studies on the impact of oral MP on sleep quality in Japanese women are limited, given the recent introduction of MP in Japan. We conducted a single-arm, open-label study to examine the effects of HRT with estradiol (E2) and oral MP on sleep quality in 15 peri- and postmenopausal Japanese women who chose HRT to address their menopausal symptoms. The participants completed the Pittsburgh Sleep Quality Index (PSQI) and menopausal symptoms questionnaires at baseline, 1 month, and 3 months after HRT. The changes in PSQI scores were evaluated. Responders were defined as those with a ≥ 25% reduction in the PSQI global score at 1 month. The PSQI components and menopausal symptoms at baseline were compared between responders and non-responders. Initially, 86.7% of the participants were categorized as poor sleepers. The PSQI global score and sleep quality significantly improved at 1 and 3 months after HRT (baseline to 3rd month mean scores: from 7.8 to 6.1 to 6.5 and from 1.7 to 1.0 to 1.2, respectively). Responders (n = 5) exhibited poorer habitual sleep efficiency before treatment than the non-responders.However, menopausal symptoms did not differ significantly between the groups at baseline. The results indicate that HRT with E2 and MP is a promising treatment option for peri- and postmenopausal Japanese women experiencing sleep disturbances, especially those with poor sleep efficiency.

Sleep disturbances are common among women during menopause. Hormone replacement therapy (HRT) using micronized progesterone (MP) may improve sleep, owing to its neurosteroid effects. Studies on the impact of oral MP on sleep quality in Japanese women are limited, given the recent introduction of MP in Japan. We conducted a single-arm, open-label study to examine the effects of HRT with estradiol (E2) and oral MP on sleep quality in 15 peri- and postmenopausal Japanese women who chose HRT to address their menopausal symptoms. The participants completed the Pittsburgh Sleep Quality Index (PSQI) and menopausal symptoms questionnaires at baseline, 1 month, and 3 months after HRT. The changes in PSQI scores were evaluated. Responders were defined as those with a ≥ 25% reduction in the PSQI global score at 1 month. The PSQI components and menopausal symptoms at baseline were compared between responders and non-responders. Initially, 86.7% of the participants were categorized as poor sleepers. The PSQI global score and sleep quality significantly improved at 1 and 3 months after HRT (baseline to 3rd month mean scores: from 7.8 to 6.1 to 6.5 and from 1.7 to 1.0 to 1.2, respectively). Responders (n = 5) exhibited poorer habitual sleep efficiency before treatment than the non-responders.However, menopausal symptoms did not differ significantly between the groups at baseline. The results indicate that HRT with E2 and MP is a promising treatment option for peri- and postmenopausal Japanese women experiencing sleep disturbances, especially those with poor sleep efficiency.

Sleep disturbances are common among women during menopause. Hormone replacement therapy (HRT) using micronized progesterone (MP) may improve sleep, owing to its neurosteroid effects. Studies on the impact of oral MP on sleep quality in Japanese women are limited, given the recent introduction of MP in Japan. We conducted a single-arm, open-label study to examine the effects of HRT with estradiol (E2) and oral MP on sleep quality in 15 peri- and postmenopausal Japanese women who chose HRT to address their menopausal symptoms. The participants completed the Pittsburgh Sleep Quality Index (PSQI) and menopausal symptoms questionnaires at baseline, 1 month, and 3 months after HRT. The changes in PSQI scores were evaluated. Responders were defined as those with a ≥ 25% reduction in the PSQI global score at 1 month. The PSQI components and menopausal symptoms at baseline were compared between responders and non-responders. Initially, 86.7% of the participants were categorized as poor sleepers. The PSQI global score and sleep quality significantly improved at 1 and 3 months after HRT (baseline to 3rd month mean scores: from 7.8 to 6.1 to 6.5 and from 1.7 to 1.0 to 1.2, respectively). Responders (n = 5) exhibited poorer habitual sleep efficiency before treatment than the non-responders.However, menopausal symptoms did not differ significantly between the groups at baseline. The results indicate that HRT with E2 and MP is a promising treatment option for peri- and postmenopausal Japanese women experiencing sleep disturbances, especially those with poor sleep efficiency.

JA Omagari Kosei Medical Center is an acute hospital located in Daisen City, Akita Prefecture, and we have two comprehensive community-based care wards. Falls and fall incidents are always ranked high in acute hospitals. Injuries caused by falls such as fracture, may lead to decline in activities of daily living / quality of life in patients and / or their families, which may then prolong the hospitalization period. Therefore, prevention of falls and falling is beneficial. Previous studies have reported that the activities of the ‘falls and falling’ teams contribute to reducing the fall rate. However, few studies have been conducted in acute hospital settings. Therefore, in this study we summarized the characteristics and current status of hospitalized patients in terms of falls and falling incidents in our hospital from medical records and incident accident reports. 　　Among 230 patients, 291 falls and falling incidents were reported in 1 year; falls and falling accounted for 32.9％ of all incidents. In addition, the fall rate was 2.1 cases / 1,000 patients / day, average age was 77 years, and there was a higher tendency in men. Furthermore, falls and falling occurred on a median 13 days from hospitalization; in 124 cases (42.6％) within 10 days after hospitalization and in 60 cases (20.6％) from 10 days to 20 days. A similar tendency was seen in patients who were moved to the comprehensive community-based care ward. Therefore, we considered that the patient would require continuous attention after moving to that ward. Ultimately, falls and falling occurred in the late-night period (from midnight to 8 a.m.), and many were at the bedside (58.4％), and the purpose of movement was bowel motion (54.3％).

Purpose and method: The aim of this study was to explore the child-care and housework difficulties experienced by fathers during their wife’s cancer treatment. 7 men who had 0 to 15-year-old children when their wife was diagnosed with cancer were interviewed using a semi-structured interview format. Main results: Subjects’ report of their difficulties was assessed using the following 3 categories: 1) burden of housework 2) stress from life together with the in-laws 3) contact with schools and nurseries. The influence of background factors was considered: a) experience of housework in the family prior to his wife’s illness; b) experience of living with in-laws; c) degree of cooperation with their parents; d) degree of trust in their relationship with their in-laws; e) child’s/children’s age; f) availability of childcare resources; and g) assistance prepared by their wife. Providing information on child care and housework support or opportunities for exchanging information with other husbands in similar situations can be considered valid forms of assistance for fathers whose background factors may predispose them to a greater degree of hardship in child care and housework during their wife’s illness.

Physical performance measures, such as gait speed, one-legged stance and hand-grip strength, are known as assessment measures of motor function and predictors for adverse health outcomes, and widely used for assessing motor function in preventive programs for long-term care or screening of frail elderly. However, there is no standard assessment sheet for feedback of the results. In the present study, an assessment sheet on physical performance measures for community-dwelling older adults was developed. A pooled analysis of data from six cohort studies, including urban and rural areas was conducted as part of the Tokyo Metropolitan Institute of Gerontology Longitudinal Interdisciplinary Study on Aging. The pooled analysis included cross-sectional data from 4683 nondisabled, community-dwelling adults aged 65 years or older. Quintiles were derived according to age and sex group for six physical performance measures, i.e., hand-grip strength, one-legged stance, and gait speed and step length at both usual and maximum paces. The assessment sheets, which indicated the physical performance level according to age and sex, were developed by fitting third order polynomial curves to the data. The reference values in the present assessment sheet were considered to be derived from better represented community-dwelling older adults by using more large-scale population-based cohort data than that in the previous study. The assessment sheet should be useful for feeding back results on physical performance measures to elderly individuals and help them better understand their own physical performance levels.

This study clarified practices in end-of-life care for non-malignant chronic illness patients by expert nurses in general hospitals. Interviews with 7 chronic illness specialist nurses on practice cases were conducted, and final labels were elicited using a qualitative synthesis method（KJ method）. As patients’ conditions deteriorated, nurses defined the necessary interactions to support patients’ decision-making for living their own way of life and accompany patients and families based on their experience, and using patients’ restoration of self-esteem, sense of satisfaction, and acceptance as indices. In general hospitals, measures to cope with pain for patients not receiving life-prolonging treatment were insufficient;and while it was difficult to agree on care between medical professionals and to maintain care in other facilities, expert nurses grasped patients’ wishes on a daily basis and made arrangements for them to permeate through family and community care systems. In end-of-life care in treatment settings, it is necessary to be supportive so that the family and medical professionals can continue the patient’s care. Medical professionals who have been involved from the initial diagnosis stage need to improve their awareness and support skills as medical professionals to be involved purposefully from an early stage to the final stage.

The Fukushima Daiichi Nuclear Power Plant (FDNPP) Accident happened in Fukushima prefecture in March, 2011 and various efforts have been carried out to prevent health damage, including thyroid cancer, caused by radioactive-iodide. In this present report, we tried to discover whether stable-iodide for the prevention against the development of thyroid cancer was properly administered to radioactive-iodide-exposed persons or not. Since pharmacists play an important role in the treatment of stable-iodide, we investigated how the pharmacists in Fukushima contributed to the treatment of stable iodide in the FDNPP accident. In addition, we introduce a new revised method for the treatment of stable iodide published by the Nuclear Regulation Authority, discuss the important role of pharmacists in the Nuclear Power Plant Accident, and propose possible ways of preparation to protect the health of citizens.

A special Students' Committee on Medical Education was established by the Student Union of Nippon Medical School. The members of this committee are all volunteers and have carried out several plans to improve the educational environment at our school. In 1999, the Students' Committee on Medical Education proposed holding joint meetings with the Education Committee of Nippon Medical School. The meeting was to allow communication between students and teachers for improving the curriculum. The volunteer faculty members of the Education Committee and students have held joint meetings seven times from November 1999 through February 2001. Discussions between students and teachers have changed ideas on both sides and have led to improvements in some educational programs, such as clinical internship during the summer vacation.