【Purpose】The aim of this study was to use a sensory test to select“a chewy solid food”that could be incorporated into a new chewing and swallowing function maintenance and improvement program we developed for daily use by community-dwelling older Japanese.

【Method】We measured the ingestion time and amount of pre- and post- ingestion salivary secretion on the same day for five foods（chewing candy, gum, gummi, kelp, dried cuttlefish），and performed a sensory test for each food.

【Result】Among 20 participants, average intake time was significantly different（р＜.001）between the five foods. Dried cuttlefish required the longest time, but two participants could not eat it all. Kelp produced the largest increase in salivary secretion after intake. As a result of the sensory test, kelp had the highest evaluation for hardness, deliciousness, umami, chewiness, easy to consumption, odor, and feeling of less pressure on the oral cavity.

【Conclusion】Kelp was chosen as“a chewy solid food”that was most suitable for continuous consumption by a wide range of older Japanese.

Purpose：The purpose of this study was to clarify involvement of preceptors who support the experience and reflection of novice public health nurses.

Method：A focus group interview was performed for local public health nurses in Prefecture A who have experience as a preceptor. The collected data were analyzed qualitatively and descriptively.

Results：Total 12 public health nurses cooperated with the study. As for involvement of preceptors who promote the reflection of novice public health nurses, quality experience of public health nurses' activities consisted of［Transmit public health nurses' activities through practice］，［Increase experience of novice public health nurse］，［Support practice process of novice public health nurses］and［Watch the practice of novice public health nurses］．Moreover, reflection of experience consisted of［Develop environment to promote reflection］，［Remind of practice content］，［Promote novice public health nurses' thinking for assessment］，［Get closer to desirable public health nurses' activities］and［Give meaning to public health nurses' practice］．

Discussion：It is important for preceptors to share the practice scenes of public health nurses' activities with novice public health nurses, confirm their understanding degrees and verbalize things to be presented to them. Moreover, the importance of promoting independent reflection by novice public health nurses.

The aim of the present study was to clarify temporal trends in the incidence and clinical characteristics of hydrocephalus requiring cerebrospinal fluid shunt. A total of 164 patients（75 men and 89 women; mean age of 64.3 years）with hydrocephalus undergoing cerebrospinal fluid shunt during a 15-year period from April 2002 to March 2017 at Kanmon Medical Center were identified, and their medical records were reviewed, dividing into three periods（early, middle, and late）of 5 years each. Seventy-nine, 44, and 58 cerebrospinal fluid shunts were performed during these periods, respectively. We identified an abrupt increase in patients with idiopathic normal pressure hydrocephalus in the late period and a decrease in patients with hydrocephalus after subarachnoid hemorrhage and congenital or pediatric hydrocephalus in the middle and late periods. The occurrence of hydrocephalus after　subarachnoid hemorrhage showed a tendency to decrease, especially in patients undergoing neuroendovascular therapy for ruptured intracranial aneurysms in the middle and late periods. The increase in patients with idiopathic normal pressure hydrocephalus and the decrease in patients with congenital or pediatric hydrocephalus would have been attributable to aging of the population and the decreasing birthrate. The decrease in patients with hydrocephalus after subarachnoid hemorrhage might have been associated with neuroendovascular therapy.

Fibrin glue is used across most surgical specialties. We report a case of anaphylactic shock attributable to intraoperative fibrin glue application.

An 83-year-old woman with suspected primary lung cancer（clinical stage IA）underwent video-assisted partial resection of the right upper lobe. She developed air leakage after the procedure, and fibrin glue was applied to seal the site of leakage. The patient showed a sudden reduction in blood pressure and developed skin rash within a few minutes, which were attributable to fibrin glue-induced anaphylactic shock. She was immediately treated with rapid infusion and catecholamine administration. We removed as much of the fibrin glue as possible, resulting in improvement in her general condition.

Clinicians should be aware that intraoperative use of biological tissues can precipitate anaphylactic shock.