Background： No ecological study has yet been performed on the associations between various medical/social indicators and pure “attended deaths at home,” excluding unattended or abnormal deaths subjected to a postmortem examination．Therefore, in this study, we investigated these associations in order to provide reference data for the future development of home health care.

Methods： We divided deaths that occurred in each municipality in Kanagawa Prefecture into two categories: “examined deaths” and “attended deaths,” which were also stratified by the place of death．Furthermore, we performed statistical analyses to elucidate the 23 associations between the proportion of attended deaths at home and major medical/social indicators according to the secondary medical care region.

Results： In 2014, home deaths accounted for 15.7% of all deaths in the prefecture，whereas the overall proportion of attended deaths at home was 6.9%．According to the multiple regression analysis, the number of general clinics that did not support home care but provided home visiting medical services（per capita）had a significant, independent association with the proportion of attended deaths at home．

Conclusions：It is possible general clinics that do not specialize in home care can still have considerable influence on home health care in each region．

The purpose of this study was to investigate the relevant factors affecting the risk of malnutrition among residents of disaster public housing. From June to July 2018, a nutrition survey was conducted on 255 residents. Chi-square test was performed on the risk of nutritional disorders and the survey items. The chi-square test and significant items were evaluated by binomial logistic regression analysis (p <0.05). The risk factors for malnutrition were undernutrition 26 (23.6%), obesity 30 (27.3%), weight loss 14 (12.7%), and anorexia 56 (50.9 %). Factors that affected the risk of malnutrition were thirst, living alone, restricted diet, reduced activity in daily life, and decreased subjective health (p <0.05). The relationship between the relevant factors and the new lifestyle resulting from relocation needs to be further investigated.

This study aims to contribute to visiting nurses' education by analyzing the nursing care provided to home-visit service users based on their disease. For data collection, questionnaires were distributed by postal mail to 68 home-visit nursing stations in Prefecture A Japan in September 2018. The response rate was 54.5%. In total, 1,872 home-visit nursing care users were recruited. Approximately 21% of all respondents had cerebrovascular disease, and about 15% had cardiovascular disease or cancer. The most common type of additional nursing care that needed to be provided by home-visit nurses and specialist care teams was prescription drug management, followed by the monitoring of living conditions and the maintenance of a healthy physical condition. Home-visit nursing users with cancer, intractable neurological diseases, or cerebrovascular disease required substantially more nursing care. In addition, patients with comorbidities such as dementia required the measurement of urine volume. Those with psychiatric disorders required additional nursing care for the treatment of pressure ulcers, the prevention of disuse syndrome, and the carrying out of daily activities. The results of this study clarified the characteristics of pedagogical content based on the medical needs of home-visit nursing service users and identified factors that could contribute to improving the curriculum of home-visit nursing education.

This study aimed to clarify the state of muscle weakness in seniors currently receiving treatment as clinic outpatients. The subjects were 103 patients aged 65 years and older who visited the clinic. We compared and examined the characteristics affecting decreased grip strength by gender with anthropometric values, blood test values, nutritional status and dietary survey. We also examined the muscle mass (lower leg circumference). The male low grip strength group and low grip strength/low muscle mass group showed significant differences in iron, folic acid, potassium, vitamin B2 and vitamin K, and tended to consume less protein and vegetables. In the comparison of grip strength and muscle mass, there were significant differences in upper arm muscle mass and mini nutritional assessment-short form, but no significant differences in serum albumin. These suggested the need to measure grip strength, muscle mass and nutritional status, and to understand dietary intake.

In mid-April 2020, there was a second wave of COVID-19 in Sapporo City, and an outbreak occurred at a long-term-care-facility for the elderly. Medical doctors were dispatched at the request of Sapporo Public Health Center. For the shortage of medical human resources, we secured human resources and established medical guidelines. During the trial-and-error period, we assisted in gathering information for referal to the hospital, examined the norms for referal to the hospital, and reduced medication. A headquarters was set up and the situation in the facility was calmed down by the transportation of 30 residents to the hospital, and the outbreak was converging. Intervention and advice from a home-visiting physician has a certain effect. It is necessary to establish a headquarters and take measures against the collapse of care. It is important to take measures for "self-help", "mutual-help", "medical insurance-help", and "public-help" without relying only on the administration.

In Japan, an increasing number of patients are spending their final days of cancer at home, and the continuous administration of medical narcotic injections using a patient-controlled analgesia(PCA) pump is attracting attention as a way to relieve pain. In collaboration with a physician and nurses, we report a case of high-dose medical narcotic administration using a PCA pump, and the patient was end-of-life at home after a long period of home treatment of about 6 months. The patient, a woman in her 60s, was being treated at home due to recurrent ovarian cancer with abdominal wall metastasis.