The purpose of this interdisciplinary and longitudinal study was to clarify the factors influencing the
burden on caregivers of patients at one month after their hospitalization in the convalescent ward. The study
participants were 25 pairs of family caregivers and care receivers who were living at home under their family's care.
Basic characteristics, cognitive function, and activities of daily living （ADL） were evaluated in the care receivers,
Characteristics, ADL, burden, and the difference between the expected and actual amount of care provided at one
month after hospitalization were evaluated in caregivers. The results suggested that the factors affecting caregiver
burden are sleeping hours per day, which is consistent with findings in previous studies, and the difference between
the expected and actual amount of care provided, which to our knowledge, is reported here for the first time.
Therefore, to reduce caregiver burden, caregivers should get adequate sleep and be given a concrete framework
regarding patient care.
We examined the factors influencing subjective quality of life （QOL） at different postoperative stages in
62 patients with rectal cancer who had undergone intersphincteric resection （ISR） or low anterior resection （LAR）. I
also examined nursing interventions aimed at improving the patients' subjective QOL. Subjective QOL was analyzed
by using the Schedule for the Evaluation of the Individual Quality of Life – Direct Weighting （SEIQoL-DW）.
In all patients （ISR and LAR groups combined）, the mean SEIQoL-DW index values were 57.7 （patients less than
1 year after surgery）, 66.6 （patients 1 to less than 2 years after surgery）, and 68.7 （patients 2 or more years after
surgery）; the SEIQoL-DW index was significantly lower in patients in the first postoperative year than in those 2 or
more years after surgery. These results suggest that subjective QOL is lowest during the first postoperative year
and improves with time.
Analysis of components of QOL and their indices, as measured by SEIQoL-DW, revealed that family, hobbies
（outdoor）, health, friends, and hobbies （indoor） were the primary determinants of subjective QOL. Analysis of
cues with low levels of satisfaction despite high importance in the SEIQoL-DW revealed that, to provide nursing
interventions to improve subjective QOL, it is important to focus on interventions that 1） manage the dyschezia
affecting the postoperative health of patients who have undergone LAR; and 2） provide lifestyle counseling to
increase fulfillment in work or hobbies among patients who have undergone LAR.
The International Commission on Radiological Protection (ICRP) recommends that the exposure dose
from radiological examinations should be as small as possible (as low as reasonably achievable, ALARA). However,
some patients transported to the emergency center were subject to multiple radiological examinations such as mobile
X-ray, computed tomography (CT) examination and digital subtraction angiography (DSA).
Increased radiation exposure is a concern for patients. By inserting a thermoluminescent dosimeter (TLD) into a tissue-equivalent phantom, the equivalent dose and effective dose of each radiological examination were determined at each anatomical region. According to the total equivalent doses of radiological imaging (mobile X-ray, head-to-pelvis CT, head DSA), the head equivalent dose was 267.26 mGy. This value is lower than the threshold (3 Gy) for temporary hair loss proposed in ICRP Publication 59. The head dose was 0.05 mSv for head mobile X-ray, 60.43 mSv for head-to-pelvis CT, and 8.42 mSv for head DSA. The total effective dose was 68.9 mSv.
To optimize ALARA measurements as well as the radiation dose, it is necessary to know the exposure dose of radiological examination. The dose data evaluated in this study will be useful for the estimation of radiation risks for patients of emergency centers who undergo multiple radiation examinations.
Wearable cardioverter-defibrillator (WCD) is an external device capable of automatic detection and
treatment of ventricular tachycardia (VT)/ventricular fibrillation (VF). We examined whether WCD use for patients
at high risk for VT/VF is associated with shortening the length of stay in the intensive care unit (ICU) and safe
management in the general ward until implantable cardioverter-defibrillator (ICD) implantation.
From June 2012 to May 2014, ICD was implanted in 44 patients for secondary prevention of VT/VF (control group). From June 2014 to May 2016, WCD was prescribed in 50 patients for secondary prevention, of which 29 patients had ICD implantation (WCD group). The median length (25th-75th percentiles) of the ICU stay was 3 (1–7) days in the control and 0 (0-1.5) days in the WCD group (p<0.05). The period until ICD implantation in the general
ward was 0 (0–3) days in the control and 10 (5–19) days in the WCD group (p<0.05). No sudden cardiac death and
no readmission to the ICU were reported in both groups before ICD implantation.
In patients with indication for ICD implantation for secondary prevention, WCD use can shorten the length of ICU stay and provide a safe management in a general ward.
Objectives: This study aimed to clarify the health status of women with gestational diabetes mellitus
(GDM) in Tsugaru District, Aomori Prefecture, Japan, and provide information for establishing a long-term follow-up
system for women with a history of GDM. Methods: Questionnaires were mailed to women diagnosed with GDM who gave birth between 2006 and 2015 at four general hospitals in Tsugaru District. Subjects were grouped according to progression or non-progression of GDM to type 2 diabetes mellitus (DM), and clinical characteristics between both groups during pregnancy were compared. A health survey was performed in women with GDM. Results: There were a total of 10,681 deliveries, and 516 women were diagnosed with GDM. Out of those, 452 women were eligible for the study. The questionnaires were mailed to them, and 227 women returned the questionnaire. The number of women with progression of GDM to DM was 14, but only 5 out of those returned the questionnaires. Although the current age of women who developed DM was under 40 years old, women with a history of GDM who had not had health checkups were significantly younger than those who had had health checkups, with a larger proportion being younger than 40 years. Conclusions: Women with a history of GDM of less than 40 years old in Aomori Prefecture had less opportunity of their health checkups. Therefore, it is preferable to provide medical checkup recommendation system for the women with a history of GDM even if the current age is under 40 years old.