Progression of edema in patients with lymphedema is caused by internal factors and external factors, e.g., maintaining the same posture. We aimed to determine the bathing method for self-care that would best improve lower-limb swelling caused by standing in a constrained position in the same posture. Three different bathing methods, mist sauna, whole-body bath, and shower were tested. After a task was performed in the upright position, changes in lower-limb swelling were examined during and after bathing. Subjective evaluation and calf circumference measured improvement in swelling. We found that after bathing, the increase in calf circumference was not restored to the value observed at the end of the task in the upright position. However, bathing helped to eliminate subjective discomfort. Further, it was found that significant reduction in the maximum calf circumference was seen following mist sauna, which significantly affected the swelling by accumulation of venous blood owing to vasodilation and contraction in response to thermal stimulation. The bathing method has different effects, mainly on swelling by accumulation of venous blood. Therefore, the effects of bathing method on objective improvement in swelling over longer recovery periods may be recognized.

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Approximately 80% of hospital-based childbirth in Japan takes place in mixed obstetric wards, which comprise a mix of the obstetrics department and other departments. Although mixed obstetric wards treat patients from multiple departments, previous studies have not clarified the procedures used by nursing staff in the ward, or nursing by night-time nurses. The purpose of this study was to reveal the actual status of night-shift nurses in a mixed obstetrics ward that treats severe patients. This time motion study used smartphones and beacons to measure the place and duration of stay for night-shift nurses working in a mixed obstetric ward. We found that nurses' mean bedside stay time per patient in a general patient room was 31.9 minutes on days when there were severe patients hospitalized in the severe patient room, and 33.6 minutes on days when there were no severe patients. Furthermore, the mean stay time in each place during a nurse's 13-hour shift was 39.2% in the nurse station, 34.4% in the general patient room, and 1.7% in the severe patient room. We believe that these results can be used as data for the placement of nursing staff involved in operating a safe mixed ward.

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The aim of this study was to compare labor pain-alleviating effects of lumbar hot compresses (hot compress) and lumbar massage during the first stage of labor. This quasi-experimental study that included 15 primiparous and multiparous women at ≥37 weeks of gestation. Parturient women were divided into 2 groups and treated with hot compress or lumbar massage continuously, in the order in which they began the first stage of labor. The first group received hot compresses, whereas the second received massages. Group 1 comprised 7 subjects and group 2 comprised 8. A visual analog scale (VAS) was used before and after the first intervention to measure pain. The groups were compared in a mixed model with the period (before and after intervention) and intervention (hot compress/massage) as the 2 factors; VAS scores were the independent variables. Comparison of the group VAS scores revealed a primary effect in this period (p <0.001). Post-intervention VAS scores decreased compared to pre-intervention VAS scores. A primary intervention effect was not observed (p=0.982). Both interventions reduced pain with no significant difference. Our findings suggest that hot compress is equivalent to massage for alleviating labor pain.

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In this paper, we analyze gait changes by simulating left knee disorders in participants. Healthy participants wear knee brace. We compared the normal and simulated disordered walking (while wearing the knee brace) to analyze what changes occur in their gait due to physical disorders. For analysis, we focus on two factors: balance and kinematics. In the balance analysis, we use margin of stability (MoS) for evaluating balance during walking. In the kinematics analysis, we calculate poses of the body parts and compare the poses between normal and disordered walking. Analysis results show that 1) the effects caused by wearing brace can be observed in the torso and waist, 2) the effects to the arms can be observed only when sudden changes in balance occur, and 3) the effects to the head are small.

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This study aimed to elucidate the pelvic floor muscle strength of women at postpartum month 1 and the relationship between pelvic floor muscle strength and delivery-related factors. We measured the pelvic floor muscle strength of 92 women at postpartum month 1 and investigated factors related to delivery. The study found that the maximum contraction force and duration were 0.74 kgf and 3.29 seconds, respectively. Of 92 women, 9.7% found it difficult to voluntarily contract the pelvic floor muscle and 17.4% could voluntarily contract the muscle but had difficulty with prolonged contraction. Moreover, a significant relationship was observed between pelvic floor muscle strength at postpartum month 1 and pre-pregnancy urinary incontinence. The above-mentioned findings suggest that collecting information about pre-pregnancy urinary incontinence rather than delivery-related factors is necessary to predict pelvic floor muscle strength at postpartum month 1. In addition, it is also suggested that in order to provide appropriate care for the pelvic floor of postpartum women, their pelvic floor muscle strength must be evaluated, as well as estimation of high-risk from delivery-related factors.

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This study aims to obtain basic data to study care for prevention of gestational diabetes and to connect to specific guidance at the clinical site. Activity levels were objectively measured using an activity meter equipped with a tri-axis accelerometer, and dietary intake details were examined concurrently, followed by an investigation into the relationship with glucose levels four weeks thereafter. The participants’ average daily step count was 3407.4, which was lower than that of general adult women. The difference in step counts may be because of in the means of transport as well as weather; therefore, further investigation is required. Pre-pregnancy BMI, BMI at the time of conducting the 50g glucose challenge test (GCT), and employment were factors associated with step counts. In future research, it is necessary to investigate what type of movement increases activity levels in pregnant women in employment, which accounts for a large part of their physical activity. No correlation was observed between activity levels and blood glucose levels, which are an index of glucometabolic, for total energy consumption (r=-.15) or energy amounts for everyday activities (r=-.09); however, a slightly negative correlation was found with step counts (r=-.22).

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The aim of this study was to identify the morphological characteristics of skin tears（STs）associated with specific external forces for preventing skin tear recurrence. This was a qualitative descriptive study. To investigate the relationship between ST morphology and causative external forces, we conducted semi-structured interviews concerning of development for 23 STs on their arms. First, we described data related to morphological characteristics of STs by sketching from photographs for developing a draft morphological classification. Next, we compared the codes for similarities and differences and extracted subcategories representing the external force factor. Categories of the morphological characteristics were follows: anatomical location, shape, skin flap, purpura, and size. Interviews identified two categories of external forces that cause STs: “ origin ” had three subcategories (caregiver, patient, and skin-contacting medical implements), and “type of external forces” with six subcategories (bumping, wiping, pulling, fingernail lacerations, scratching, and friction). We identified morphological characteristics of STs according to nine external force subcategories by comparing within and across each category and subcategory of external forces. Four characteristics (purpura, shape, depth of arc, and size) were identified as factors that could estimate the cause of STs.

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Aim:This study compared how blood pressure and cerebral blood flow changed in young and elderly individuals when actively standing up (standing up from a sitting position on a 40 cm-high chair), when passively standing up with assistance from others, and when standing up with the aid of a lower-limb power-assisted robot or Hybrid Assistive Limb (HAL). Methods: Twelve young (22.3 ± 2.1) and elderly (69.6 ± 3.5) healthy individuals participated in this experiment. Participants were asked to stand up under 3 different conditions and blood pressure and cerebral blood flow were measured by monitoring changes in the concentration of oxygenated hemoglobin. Results and Conclusion: As decrease in mean blood pressure, the main effect of age was noted. The standing method did not have any main effect. As decreased cerebral blood flow, the standing method was noted although the effect size was small. No main effect of age was noted, but its effect size was medium. These findings indicate that the decrease in blood flow was greater in younger individuals than in elderly individuals. Regardless of age, the decrease in cerebral blood flow was relatively small for assisted standing and relatively large for assisted standing with HAL.

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Early detection of extravasation is important due to possible drug leakage, which can cause severe tissue damage. However, its signs and symptoms are difficult to be assessed, and objective assessment is necessary. Given that fluid accumulation provides a low skin-surface temperature, a thermosensitive liquid crystal film was developed to be used as a noninvasive, continuous, and safe extravasation assessment tool. This study aimed to confirm its usability, safety, and feasibility for visualizing skin temperature in the clinical setting. This study included clinical nurses and outpatients who received chemotherapy. No extravasation occurred. Forty patients and 8 nurses were included. All patients responded that they did not mind using the film, and they did not experience any side effects due to using the film, such as itching, tightened feeling, or other discomfort. Nurses placed the film on a catheter securement film and routinely administered drugs. Nurses evaluated the usability of the film after every use. The frequency of observation remained unchanged, according to 80% of the nurses’ answers. It suggested that additional treatment time due to film use was acceptable. During treatment, the skin-surface temperature distribution pattern was recorded using a camera. The temperature distribution patterns were classified into six. The thermosensitive liquid crystal film can be a potential assessment tool to early detect extravasation.

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The authors are developing a new shape walker. The purpose of this walker is to allow quantitative training of walking with a crutch safely. For this reason, it is highly necessary to examine the influence of a walker on human walking. We measured the changes in stride length, stride, and pelvic sway during use to confirm safety. However, it is necessary to evaluate the delay time during walking to examine the influence and operability of the walking walker on human walking. In this paper, we calculated the delay time between human and walker by cross correlating the acceleration in the direction of travel between human and walker and evaluated the influence of walker. As a result, it was found that neither of the two walkers with different frame sizes had a dangerous movement that pulled the human body. It was also found that the delay time increases as the size increases. Besides, it was found that the lag time was significantly longer and the variance tended to be larger in walking with a cane than with normal walking.

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　This study was conducted in a long-term care hospital where communication robots have been continuously used for elderly with dementia. The aim of the present study was to explore the following: 1. factors related to the establishment of patients-communication robot relationship, 2. factors related to the continuous use of robots, and 3. nursing staff expect regarding robots. We conducted semi-structured interview with six hospital staff and analyzed the records qualitatively. The factor related to the establishment of the relationship between patients and robots was {robot characteristics match patient characteristics and patient conditions and care environment that change}. The factor related to the continuous use of robots was {staff face to introduce and use robots, finding their activity rewarding}. The staff expectation regarding robots was {robots become beings that live together with patients and staff}. These results indicated that establishing the patients-robots relationship was as important as introducing robots, and that establishing staff-robots relationship was as important as using robots continuously.

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　[Introduction] The number of mixed obstetric wards, which combine obstetric and non-obstetric patients, is increasing in Japan. The nurses and midwives working in these wards are concerned with their work process and sharing of roles. [Purpose] This study aimed to clarify how nurses and midwives work and share roles by measuring the location and duration of their work-related movements in mixed obstetric wards with critical patients. [Methods] We conducted a prospective observational study of nurses and midwives working in a mixed obstetric ward and measured times in various tasks according to a time-motion design using a smartphone and a beacon. [Results] The mean bedside time for nurses and midwives per patient in a general patient room did not differ significantly between days with and without critical patients in the ward (p=0.092). When critical patients were hospitalized, the nurses and midwives spent less time at the nurses’ station. [Conclusion] Nurses’ stay time per patient in general rooms was stable regardless of admission of critical patients. This staffing, which defined the role of nurses and midwives working in a mixed obstetric ward, secured nursing time for critical, general, and obstetric patients despite the mixed ward.

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　There is a great need for the development of self-monitoring blood glucose (SMBG) devices adapted for the aged and educational methods to support the aged to conduct SMBG in super aging societies. The purpose of this study was to clarify the difficulties associated with conducting SMBG among the aged with diabetes based on observations of SMBG procedures. A qualitative study was carried out involving observations of video-recorded SMBG procedures. The participants were 29 patients with diabetes aged 65 years and older. The video data were transcribed verbatim, and then difficulties were extracted. The aged were found to have difficulties regarding “Preparation”, “Insertion of the electrode”, “Attaching and removing the needle”, and “Puncturing”, and experienced failures such as “The amount of blood sampling is inadequate” and “The needle does not come out”. After learning the SMBG procedures, the aged still had difficulties conducting SMBG properly. Although they used the wrong buttons and levers and did not have sufficient skillfulness, they continued conducting SMBG using a variety of approaches. Regular checking and feedback may help the aged conduct SMBG properly. These findings suggest that the development of new and more user-friendly SMBG devices for the aged is needed.

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The present study aims to verify the validity of the newly developed method of measuring activity level based on optical flow. 1 subject wore on his chest an action camera for capturing video images and a smartphone for measuring acceleration. Video shooting and acceleration measurement were performed under several preset conditions such as walking, while stationary, etc. The activity level was calculated from the video images using optical flow and its correlation with acceleration was examined. The change in activity level based on the subject's optical flow was found to have significant correlation with acceleration under several of the preset conditions. The correlation with acceleration obtained from the results of this study suggests that the newly developed method is capable of reflecting the activity level of the subject. Future studies must include verification under more complex conditions such as verification of differences in terms of characteristics from acceleration in addition to further comparison with external standards related to activity levels.

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In this research, we propose the oral care simulator using a force sensor. The basic algorithm of measuring contact point and brushing force were constructed. In the proposed simulator, only one force sensor is installed at the bottom of the oral model. Therefore, it is possible to reduce the number of signal wiring and sensors compared with a previous oral care simulator. Firstly, focusing on a line of action of force and shape of oral model, the locations that can be the contact point are calculated. Next, the direction of the force and the velocity at each candidate of contact point are compared, and these points are narrowed down to the theoretically possible contact points. Finally, the brushing force at the contact point is derived and feed back to the user. The prototype of oral care simulator was produceted, the proposed algorism was experimentally verified. The results show that the contact point of brush can estimated, normal and tangential force could be measured. In the next step of research, we will improve the measurement accuracy of simulator, and then the full system of oral care simulator will be developed.

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A newly developed perspective glasses that could match convergence and accommodation according to the focal intent of the eye was described in this paper. The target age was 70 years old, and the developed glasses were designed by gradually changing the diopter of a progressive lens horizontally in accordance with convergence. In accordance with this design, the optical components were placed, stereo images were taken and qualitatively evaluated. As a result, the developed perspective glasses enabled more natural observation and reduced image distortion compared to conventional perspective glasses. The progressive value of lens versus the distance between pupils table for the lens was created as a quantitative evaluation. Tables with the distances of 55×10^-3, 58×10^-3, 61×10^-3, 64×10^-3, 67×10^-3, 70×10^-3 (m) were got. The feasibility of perspective glasses was quantitatively suggested. In addition, the reproducibility of wearing glasses was evaluated. As a result, the displacement of the glasses wearing position was 0.113×10^-3 (m), and the effect of the reproducibility of glasses wearing on the newly developed perspective glasses was about 3.4 years younger than the target age of 70 years old.

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To prevent diabetic foot ulcers, the nurses teach the patient to select correct shoe size and shape. However, this education is less effective for the people with diabetic neuropathy, because the patient cannot feel contact between shoe and foot. To resolve this problem, we propose the 3D computer graphic visualization of contact between shoe and foot using 3D scanner. Bare feet of three participants were scanned by a portable 3D scanner. Their own shoes were also scanned. The small shoes were prepared as typical ill-fitting shoes, and they were scanned. Contact area between bare foot and shoe 3D models were visualized by our developed 3D visualization software as red color. In their own shoes, red areas were not observed. On the contrary, in the small shoes, the tip of thumb or side of foot were visualized at the toe of shoe or side of shoe. This visualized areas were matched with the feelings of the participants. The result indicated that 3D portable scanner has capability of measurement of 3D foot and shoe contour. This pilot study results also demonstrated that our visualization concept has potential to contribute the education of correct shoe size and shape.

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The decline in motivation for inpatient rehabilitation among older adults after the acute stage of an illness has become an urgent issue. Repeated encouragement and structured verbal feedback during inpatient rehabilitation has been shown to result in sufficient motivation. This study aims to verify whether a human-shaped customizable communication robot (Pepper) can encourage elderly individuals to seek inpatient rehabilitation after the acute phase of an illness. The patient in this study was a 67-year-old man who lacked motivation for rehabilitation and often preferred experienced nurses to inexperienced ones. First, we created a key construct of encouraging phrases used by experienced nurses on a daily basis, which were subsequently integrated into Pepper. Phrases were updated daily for a more targeted behavior. The patient communicated with Pepper and was satisfied with Pepper’s comments. He underwent rehabilitation daily and stopped refusing routine communication with inexperienced nurses. Pepper did not jeopardize his self-respect, because it did not evaluate the patient’s basic conversations. Furthermore, Pepper not only enhanced motivation, but also helped establish a good relationship with inexperienced nurses. The encouragement and structured verbal feedback during inpatient rehabilitation provided by Pepper contributed to the patient’s recovery by enhancing his motivation for rehabilitation.

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