Abstract
Objective : The purpose of this study was to compare the effects of the emotional response to “pleasant conversation” and “reading aloud”, on the autonomic nervous system of elderly subjects, in addition to the value of conversational exchange and its usefulness as part of a care strategy in the elderly.
Methods : Twelve elderly subjects aged 65 years and over were included in this study. Three kinds of interventions were used including : (1) reading aloud, (2) pleasant conversation and (3) silent reading, respectively. Each task was carried out daily and the resulting effects were recorded. A task typically lasted 20 minutes in duration followed by 10 minutes of rest after which, the task was repeated for another 5 minutes followed by 5 minutes of rest. We examined changes in the autonomic nervous system by using a power spectrum analysis of heart rate variability.
Results : Strong stimulation of the autonomic nervous system occurred with the implementation of the five-minutes of “pleasant conversation” in keeping with the results of previous studies. Following completion of this task, the sympathetic activity decreased with a subsequent increase in parasympathetic nervous activity which was different compared to “reading aloud”. It is considered that changes of parasympathetic activity impact on the relaxation and satisfaction centers of the brain in the elderly.
Conclusion : This study identified that the introduction of “pleasant conversation”, activates a function of the autonomic nervous system involved in stimulating brain relaxation and satisfaction centers within a short time period compared to “reading aloud”. It is considered that changes in emotion brought about by the interventions in this study occurred in a short period of time and can potentially be used in clinical practice. It is suggested that “pleasant conversation” is introduced as part of a comprehensive care plan in the elderly.

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Abstract
Objective : The purpose of this study was to verify characteristics, including changes in emotional state and finger motor function, in elderly subjects over the course of piano lessons.
Methods : Fifty-five healthy elderly subjects took part in this study. Subjects were assigned to either a “piano group” (total no. 32) or a “control group” (total no. 22), respectively. Piano group subjects participated in piano lessons for 3 months (total of 6 sessions). Characteristics of the elderly piano-learning subjects were analysed by noting the frequency and length of practice, by a tapping speed test and an emotion scale (the Mood Check List-Short Form 1 : MCL-S1 and the Face Scale).
Results : A significant difference was found when comparing the pre-score and post-score results of the piano group with those of control group in both the MCL-S1 “anxiety” test (p=0.04) and the rapid finger tapping test (p<0.01), with the latter test results being significantly better in the piano group, with four kinds of assessment. Comparing the difference between the pre-score and post-score results for Face Scale in the piano group with that of the control group, revealed no statistically significant difference (p=0.16).
Conclusion : In elderly subjects, learning piano is effective for relieving anxiety and improving finger motor tapping speed.

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Abstract
 The aim of this report is to understand the characteristics of medical care for Japanese people particularly following the recent earthquake disaster. In view of this, Japanese culture has now attached much greater importance on interpersonal relationships than ever before. Unfortunately, Japanese culture has not fully accepted the concept of professionalism from the Western cultures of Europe and the United States, but instead has put more stress on actions concerning law and humanity. Japan needs to create its own professionalism based on its unique culture.

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Abstract
Introduction : There are few reports of long-term medical support activities in disaster areas. We analyzed drug-related data using medical records and prescriptions obtained during the long-term medical support of patients impacted by the Great East Japan Earthquake, which occurred on March 11, 2011.
Methods : Using medical records and prescriptions, the dispensing frequency of each drug was calculated and usage trends of the top three most frequently dispensed drugs are described here. All data was collected from March 26, 2011 onwards after the medical support activity commenced.
Results : In the first week of data acquisition, a total of 166 patients visited the medical support team (median 48.5, range 14-166). Following that, the number of patients decreased with a median of 24 people per day (range 0-47). The number of prescriptions for common cold medication was the highest, followed by antihypertensive and anti-allergic medications, respectively. The usage of antihypertensive drugs and common cold medications decreased over time, whereas anti-allergic medications were prescribed on a continuous basis.
Conclusion : Disaster medical support teams should not only be prepared to support the acute phase but also long-term phase, which depends heavily on the restoration of local medical services. The earlier the intervention to provide support, the greater the likelihood that the disaster medical support team will require to provide treatment for both acute and chronic illness.

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Abstract
Objective : We investigated the usefulness of providing medical students with demonstrations and education for commonly used medical devices focusing on medical and nursing care for the elderly. Educational materials were also distributed, in addition to the input from the participation of paramedic assistants as various strategies for providing instruction, prior to formal on-site practical training at our clinic.
Methods : Forty-two 5th year medical students undertook a questionnaire survey regarding the education provided prior to on-site practical training, and which was performed after training was completed at our clinic.
Results : All students responded that demonstrations of medical devices were “easy to understand”, while 81% responded that the distribution of materials was “necessary” and 97.6% responded that explanations from paramedics were either “important” or “necessary”. In addition, 95.2% reported that the explanations given prior to training “enhanced” their understanding of nursing care insurance facilities. In respect of medical procedures such as percutaneous endoscopic gastrostomy (PEG) tube management, while 97.6% of students reported that “the explanations given prior to practical training were adequate”, nevertheless 50% reported that “they still did not feel comfortable in actual practice even though the explanations given prior to training were adequate” .
Conclusion : The approaches used at our clinic for education given prior to on-site practical training, were considered beneficial for medical students. However, some of them did not feel comfortable performing medical procedures even though adequate explanations had been provided, indicating the need to create a program that promotes greater confidence in performing practical procedures among medical students in the future.

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[in Japanese]

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[in Japanese]

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