Aim: We examined the change of body temperature during ablation therapy for atrial fibrillation with either cryoballoon (CB) or radiofrequency (RF) catheters.

Methods and Results: We retrospectively examined 18 patients who underwent CB ablation (CB group) and 18 patients who underwent RF ablation (RF group) for pulmonary vein isolation using propofol for their sedation during procedure. While body temperature at the entry into the cardiac catheterization laboratory was similar between the two groups, the body temperature at the exit of laboratory was lower in the CB group than the RF group (p=0.001). The difference of body temperature between entry and exit was 1.6℃ and 0.9℃, in the CB group and the RF group, respectively, and this difference between the two groups was statistically significant (p<0.001).

Conclusions: The CB ablation decreased the body temperature significantly more than the RF ablation during procedures when patients were sedated with propofol.

Objective: A gastrointestinal function management protocol was introduced in April 2018 to the intensive care unit of A hospital. Our objective was to study whether the protocol was effective for defecation control. Method: One hundred patients who were given enteral nutrition in the intensive care unit were included. This retrospective study investigated defecation status, use of gastrointestinal drugs, and occurrence of gastrointestinal complications. Results: Constipation decreased, and the number of days of constipation was significantly lower in patients who were treated by the protocol (p<0.05). Diarrhea tended to decrease, but there was no significant difference in the number of days of diarrhea (p=0.519). There was no significant difference in the number of days in the intensive care unit until the first defecation (p=0.130). The percentage of patients requiring nutritional dose reduction due to gastrointestinal complications tended to be lower in patients on the protocol. The number of days until reaching maximum calories tended to be less in patients on the protocol (p=0.206). Conclusion: There were no adverse events due to the gastrointestinal function management protocol, and the period of constipation was significantly shortened. In addition, the ability of nurses to assess the gastrointestinal function of critically ill patients has improved. We aim to improve the quality of the protocol.

Aim: This study was conducted to evaluate the level of understanding and practice of community-based integrated nursing fourth-year students who graduated in 2015 and 2018. This paper will also discuss the achievement of nursing education based on community-based integrated nursing and future challenges facing undergraduate nursing education.

Methods: A self-administered questionnaire survey regarding the level of understanding and practice of community-based integrated nursing was conducted on 4^th year students who graduated in 2015 and 2018. The data were analyzed using the Mann-Whitney U test.

Results: 59 responded in 2015 (response rate 73%) and 65 in 2018 (response rate 88%). The rate of students responding that they were competent was significantly higher among the 4^th year students of 2018 than 2015 in both understanding and practice of community-based integrated nursing. However, the rate of responses stating that they were competent in life skills and outpatient nursing was low.

Conclusion: The higher levels of self-evaluation by 4^th year students on understanding and practice in 2018 than in 2015 suggest the beneficial outcome of four years of accumulated education centered on community-based integrated nursing. An improved curriculum designed to improve life skills and outpatient nursing practice will be required in the future.

Aim: To assess the physical and mental health status and daily activities of nurse with infants, and to investigate the relationships among the factors.

Methods: A self-administered questionnaire survey was conducted on the working nurses with infants. The questions included an individual attribute,the health-related QOL scale (SF36; as a measure of physical and mental health), level of difficulties in daily activities, lifestyle and presence of disease. The relationship between eight sub-scales of SF-36 and other factors was determined using statistical tests.

Results: A total of 53 nurses responded. Their scores on the SF-36 subscales were lower than the national standard, showing them to be experiencing, among their daily activities, considerable difficulty with housework and childcare. The relationship between physical and mental health and daily activities showed that all of the SF-36 subscale scores declined with increasing difficulty in accomplishing housework and childcare.

Conclusions: Working nurses with infants had poor physical and mental health and tended to experience high levels of difficulty in accomplishing housework and childcare. For working nurses with infants to continue working, focused support for nurses in their 20’s, work environments that can make use of flexible work schedules and hospital leave, and consideration for stress management are likely to be effective.

This case is of a male in his 70s who had been undergoing hemodialysis treatment for the past 17 years due to chronic renal failure. He had been receiving steroid treatment for organized pneumonia since April X. He was diagnosed with pneumocystis pneumonia in June and underwent inpatient hospital care. He experienced sudden fever and abdominal distension in July, and since CT confirmed intraabdominal free air and ascites, the absence of gastrointestinal perforation could not be ruled out, and surgery was performed. However, no gastrointestinal perforations were found, despite careful examination; hence, the surgery was completed after cleaning and drainage of the abdominal area. The patient showed signs of improvement, but his symptoms reappeared 19 days after surgery, which were ameliorated with antibiotic treatment. Elimination of pneumoperitoneum was finally confirmed 49 days after surgery. Because the ascites cultures at both, the time of surgery and reappearance of symptoms tested positive in our case, we suspect that ascites can potentially cause bacterial peritonitis as a secondary disease. In conclusion, antibiotic treatment during both, surgical and conservative intervention is desirable for the management of idiopathic pneumoperitoneum.

Objective: To describe and analyze current literature in Japan on natural disaster preparedness for families of children with special needs.

Methods: We reviewed and analyzed 13 references that described current preparation by families of children with special needs, and preparation that the children and their families may need in the future.

Results: Current preparation was categorized as that to “protect the life of the child with special needs,” “protect the physical condition of the child with special needs,” “heighten the selfcare abilities of the child with special needs,” and “connect with the community.”

Preparation thought to be needed in the future were categorized as that to “protect the life of the child with special needs,” “protect the physical condition of the child with special needs,” “heighten the selfcare abilities of the child with special needs,” “connect with the community” and that to be “made by appropriate organizations.”

Conclusion: Professionals in the organization involved with children with special needs should create opportunities to discuss preparation for natural disasters. Discussion should include professionals, the children's families, and the children themselves.