The aim of this study was to investigate body sway in 3 axial directions while walking under multitask conditions to assess the effects of task type and aging associated with the risk of falling. Body sway was measured with a single 3-axis acceleration sensor attached to the hip. Ten healthy young and 11 elderly individuals participated the experiment. The task conditions were 1) normal walking, walking with the following additional tasks: 2) a visual task, 3) an auditory task, 4) a calculation task, 5) visual and calculation tasks, and 6) auditory and calculation tasks. Significant differences in left-right direction body sway in condition 5 and forward-backward direction body sway in condition 3 were observed between elderly and young people. These results imply that, compared to young people, postural control in elderly individuals is more visually dependent and route changes based on sound prompts lead to excessive attentional load in elderly individuals.

The authors have developed an assistive device that allows patients with hemiplegia to train natural walk in early after injury. In this study, we develop a lower limb orthosis with a joint that can dorsiflex the MP joint without elasticity by dividing the sole into three layers and making a cut in the middle layer. In this paper, we compared normal walk and walking with a short leg brace that had two types of plantar parts with joints on the sole and a flat type. We first measured the time taken to walk 5 meters, and then measured the range of movement of the sole pressure center. As a result, it was found that the lower limb orthosis with joints in the sole can walk faster than the flat type lower limb orthosis, and that the center of foot pressure can be moved naturally. In addition, it was clarified that the joint position provided on the sole of the foot matches the human MP joint to produce efficient walking.

【Objective】Previous case studies reported that bed exit alarms used for fall prevention cause uncomfortable feelings and emotions in patients. This study aimed to identify the recognitions by nurses for the reactions of patients under the bed exit alarm system.【Methods】Author-developed questionnaires were distributed to registered nurses and licensed practical nurses working at 211 general hospitals in Japan. The participating nurses were asked about notable experiences with patients in terms of facial expressions and verbalizations in reaction to bed exit alarms. For text analysis, free-text responses were analyzed using morphological analysis software.【Results】A total of 77 hospitals participated in this study. Of the returned responses, 498 valid responses were analyzed. These responses were categorized into 4 categories:“trying to escape from the bed exit alarm,”“unpleasant expression following the bed exit alarm,”“it looks strange that a nurse visits a room without a patient calling for one,”and“apologizing for nurses that frequently visit the rooms.”【Conclusions】It is important to educate nurses about that bed exit alarm can cause distress to patients as a common understanding and to build a system of fall prevention by collaborative care.

Women with premenstrual syndrome (PMS) regularly experience mental and physical symptoms that negatively affect their quality of life. An association between PMS and working memory deficits in premenstrual women has been suggested but remains unclear. The present study assessed the effects of PMS on working memory in 15 women with and 26 without PMS. To assess working memory performance, candidates were asked to perform n-back (0-, 1-, and 2-back) tasks in the luteal and follicular phases of their cycle. In the 2-back task, the correct response rate in the PMS group was 85.9±2.0%, which was marginally lower than the without PMS group (p=.07). In the Profile of Mood States questionnaire, there were significant differences in the total mood disturbance (p=.006) and“depression-dejection”(p=.043) scores between the groups. There were no significant differences in self-rated depression scale scores or sex hormone levels between these groups during the luteal and follicular phases. Our findings suggest that the negative mood in the luteal phase may be a trigger for reduced working memory performance in women with PMS.

This study aimed to clarify whether the use of a peripheral intravenous catheter with a backflow prevention valve reduces the operator〓s fear level or catheterization difficulty and contributes to venipuncture success. We performed an interventional study at an urban university hospital. The participants were nurses who completed a questionnaire that included questions about the number of puncture attempts, their subjective experience of venipuncture, and the State-Trait Anxiety Inventory (STAI). The control group comprised 26 nurses who performed patient catheterizations with a conventional catheter (307 catheterizations), while the intervention group comprised 25 nurses who performed catheterizations with a peripheral intravenous catheter with a backflow prevention valve (292 catheterizations). The intervention group felt less fear and discomfort associated with venipuncture than the control group. There were no significant differences between the intervention and control groups in the STAI and the number of puncture attempts. Several evaluations of catheter manipulation were worse in the intervention group than in the control group. However, the subjective experiences of fear of blood exposure and fear of contaminating the catheter junction were reduced in the intervention group. Our findings suggest that using the catheter with a backflow prevention valve reduced the participants〓 level of fear and discomfort, and that the effectiveness of such catheterization may help prevent infection, although catheter manipulation requires improvement.

This study aimed to determine whether ultrasound (US) guidance with an originally developed probe holder improved the success rate of peripheral intravenous (IV) access among clinical nurses compared to the standard techniques. After confirming that clinical nurses could perform simulated IV access for difficult veins using US guidance with the probe holder, we examined the difference in success rates between US-guided IV (USGIV) access with probe holder and the standard method in a single-case alternate-treatment design. Five nurses who worked in a general hospital participated. For patients without visible veins, they performed 5 standard IV accesses in the baseline phase and also underwent 9 sessions that included two methods per session. The primary outcome was the overall and first-attempt success rate of each IV access. The randomization test revealed that the possibility of success of USGIV access was significantly higher than that of the standard method in 2 out of 5 nurses. Logistic regression analysis showed that the odds ratio was 3.48 (95% confidence interval: 1.33〓9.14) and USGIV access was higher than by the standard method. These results suggest that the USGIV access with the probe holder was superior to the standard method in Japanese clinical settings.

Objective: To elucidate the effect on sleep that tactile massage, a form of tactile therapy, has on female cancer patients undergoing in-hospital treatment. Methods: The participants were 11 cancer patients (mean age: 58.5±23.2 years) undergoing in-hospital therapy. The participants did not receive a massage (non-intervention days=pre intervention). Then, thirty-minute tactile massages were performed daily (intervention days=post intervention). Quantitative data on the participants’ sleep and wakefulness were obtained using actigraphy and their Pittsburgh Sleep Quality Index (PSQI) scores were compared using the Wilcoxon signed-rank test. Results: Intervention significantly increased the number of naps taken during wakeful periods of time (p<0.05), decreased wake time after sleep onset (p<0.05), and increased sleep efficiency (p<0.05). Investigation of the total PSQI scores indicated that that intervention caused significant decreases (p<0.05). Conclusion: The use of actigraphy and the PSQI indicated that tactile massage intervention performed on female cancer patients undergoing in-hospital treatment improved the patients’ sleep.

Purpose: With the increase in the number of elderly patients with diabetes, there is a need for education of self-monitoring of blood glucose (SMBG) skills, as well as for the device development for SMBG suitable for the elderly. This study aims to explore the nursing care given and the factors affecting SMBG skill acquisition for elderly patients. Methods: Focus group interviews with nurses was conducted for data collection, and an inductive analysis was performed. Results: The following parameters were reported as factors influencing the acquisition of the SMBG skills: physical response or deterioration (such as eyesight, hearing ability, and dexterity), adaptability to acquiring a new skill, inadequacy of the educational environment, and a person-device mismatch. The clinical nurses provided care for (1) difficult factors in acquiring SMBG skills, (2) difficulties in acquiring the SMBG skill, and (3) challenges produced by difficulties in acquiring the SMBG skill. Repeatedly facing difficulties might lead to the manifestation of negative emotions, such as frustration, sorrow, and a decreased motivation to learn the SMBG skill. Conclusions: It is important to encourage patients to participate in planning education or evaluation, and provide nursing care to enhance their self-efficacy.

Peripheral intravenous catheterization hinders various daily activities, including sleeping. We aimed to examine the relationship between peripheral intravenous catheter placement and sleep quality by assessing sleep parameters including body movement and subjective sleep quality. An observational study was conducted at an ophthalmic ward of a university hospital in Tokyo. Participants were catheterized in preparation for a surgical procedure the following day (catheterization group). Sleep parameters were observed using a sheet-shaped body vibrometer device, and a sleep quality questionnaire was completed; 53 and 55 participants were present in the catheterization and non-catheterization groups, respectively. No significant differences were noted in sleep parameters or subjective sleep quality between the two groups. However, 36.5% of participants in the catheterization group awoke during the night and worried about their inserted catheter, primarily because of 'pain associated with movement' (63.2%). According to the subgroup analysis, the fragmentation index was higher in participants who experienced pain than in participants who did not experience pain associated with movement (p=0.004), and three of the five subjective sleep quality factors were lower in those experiencing pain compared with the other participants. The comparison of the catheterization and non-catherization groups revealed that peripheral intravenous catheter placement did not reduce sleep quality. Catheter placement influenced the sleep quality of patients who experienced pain associated with body movement due to stimulus from the catheter.

Aim: To clarify changes in physical activity (PA) and sedentary behavior (SB) among pregnant women according to employment status. Methods: A prospective study was conducted on healthy primiparous women. PA and SB were measured by an accelerometer for about one week during weeks 24〓27 (T1) and 32-35 (T2) of gestation. The participants were classified into three employment status groups during both trials; “Full-time housewives,” “currently working,” and “stopped working.” Results: Thirty-four women (mean age 33.6±4.8 years; pre-pregnancy BMI 21.6±2.9 kg/m2) provided two points of activity data. Changes in the cumulative SB time were significantly different among the three groups (F=3.34, p=0.049): the cumulative SB among the stopped-working group tended to increase compared with the currently-working group (F=4.16, p=0.056). In the stopped-working group, the frequency of medium SB duration significantly decreased from T1 to T2 (11.9 to 10.2 times/day, t=3.18, p=0.008), while the frequency of long SB duration significantly increased (4.2 to 4.7 times/day, t=-2.85, p=0.015). Conclusion: Changes in SB during pregnancy differed depending on employment status and stopping work was a risk factor for increased SB.

Accurate measurement of subcutaneous thickness is important for correctly performing subcutaneous and intramuscular injections. The objective of the present study was to confirm the validity of subjects with no experience in ultrasonography measuring subcutaneous thickness using an ultrasound device. Subjects were 46 nursing university students, randomly assigned to a manual group (n=23) and an ultrasonic group (n=23). Subcutaneous thickness over the deltoid muscle in 23 healthy adult volunteers was measured manually and using ultrasonic measurements. Subcutaneous thickness as measured by a researcher with expertise in operating ultrasound devices was used as the criterion value. Median values for the criterion value, ultrasonic group, and manual group were 0.8 cm (0.5〓2.0 cm), 0.9 cm (0.5〓1.6 cm), and 2.0 cm (1.3〓5.5 cm), respectively. Intraclass correlation coefficients (ICCs) of the criterion value compared to the ultrasound group and manual group were .86 (.69〓.97) and .40 (.01〓.69) respectively. Linear regression equations of the criterion value compared to the ultrasound group and manual group were y=1.232x-0.218 (R2=.809) and y=0.235x+0.411 (R2=.296), respectively. An ultrasound device is therefore an effective device for inexperienced students to accurately measure subcutaneous thickness in clinical practice.

In general practice and small-scale health screening centers where the introduction of an automatic urine analyzer is difficult, the urine analysis test papers are judged visually and, therefore, the observer makes a subjective judgment. No method has so far has been established for objective visual evaluation of urine analysis test papers. In this study, we developed a color comparison program using the CIE DE2000 color-difference formula using images taken with a smartphone camera to objectively judge the color of the urine analysis test paper. The color difference between the standard color sample and the part of the image selected by the mouse was calculated using the color comparison program. The color with the smallest color difference was output as the judgment result. The results of the color comparison program were compared with the results of the automatic urine analyzer. On the judgment of the normal values using the urine qualitative control solution level I, all items of comparison were consistent between the two methods. The judgment of abnormal values using level II was consistent except for the items of glucose, occult blood, and creatinine. In conclusion, we validated the possibility of developing an inexpensive and simple screening test.

The purpose of this study was to compare the longitudinal changes and differences between skilled and novice bed-makers by measuring the amount of activity based on video (hereinafter referred to as“video activity”), and to evaluate the usefulness of the video activity in assessing the subject’s level of skill. METHODS: One expert and eight novices were included in the study. The subject wore a wearable camera on her chest and performed bed making. In order to calculate the video activity, we used optical flow, cumulative video activity and entropy of video activity, as well as hierarchical cluster analysis. RESULTS: Both cumulative video activity and video activity entropy decreased in many beginners on the second occasion. Skilled participants had the lowest entropy of video activity in both the first and second sessions. CONCLUSION: The fact that there were changes over time and differences between novices and experts in the values calculated from the amount of video activity suggested that the video activity has potential as an indicator of“proficiency”in nursing techniques.

To evaluate edema, the depth of surface imprint is measured. The depth is influenced by the amount of the counterforce generated by the body. We devised a method to quantify the presence of the interstitial fluid using the counterforce generated from the body surface during compression. This study used a pressure sensor to detect the counterforce. The “elderly group” comprised 27 elderly people, and the “young group” comprised 12 young people. The pressure sensor was strapped on the legs with a cuff. Air was gradually pumped into the cuff, and the counterforce received by the pressure sensor was output. The increase in the counterforce at lower pressures was 2.15 N in the elderly group and 1.09 N in the young group (P<0.01). The increase in the counterforce at medium pressures was 1.92 N in the elderly group and 1.38 N in the young group (P<0.01). The increase in the counterforce at higher pressures was 1.91 N in the elderly group and 1.61 N in the young group (P=0.14). All values are average values. Our findings indicate that it is possible to quantify the presence of the interstitial fluid by observing the counterforce generated from the body surface during compression.

The purpose of this study was to investigate the effect of pelvic floor muscle training (PFMT) in postpartum women using a magnetic resonance (MR) image-based video clip that can clearly confirm the elevation in the position of the bladder neck during voluntary contraction of pelvic floor muscles. Seventy-four women, who had vaginal delivery 3〓6 months earlier, were randomized into 3 groups: observation group without intervention (A), conventional PFMT group using a leaflet (B), and the group using an MR video clip (C). Women in groups B and C continued PFMT at home for 12 weeks after receiving instructions concerning the PFMT. We compared the maximum force and duration of contraction of the pelvic floor muscles, measured using an external biofeedback device, before and after the 12-week intervention. The maximum force and duration of contraction were significantly increased in three groups after the intervention. Moreover, the maximum contraction force in group C was significantly stronger than that in groups A and B (P<0.001 in both groups). The MR video clip might be a useful instructive tool for PFMT.

Detection of veins is a very important technique in the medical practice. Recently, vein visualization using near-infrared (NIR) imaging have been used to detect veins. Different researchers have set different wavelengths for the process. We explored the most suitable near-infrared light wavelengths and the effectiveness of using narrow bands for visualizing invisible peripheral veins for venipuncture. An observational study was performed on the invisible veins of healthy female volunteers in the age range 20-39. We then acquired images of invisible veins using a halogen lamp and hyperspectral camera. We analyzed 4,640 images of 58 invisible veins acquired using light in the range 700-1100 nm; image analysis software was used for the analysis. The optimal wavelength for the visualization of invisible veins according to the contrast ratio between the invisible veins and the surrounding skin tissue was approximately 950-1000 nm; a narrow band of light in that range was effective for the average contrast ratio. We expect that a device based on a narrow band in the wavelength range 950-1000 nm will be useful for the visualization of invisible veins.

Incontinence-associated dermatitis (IAD) is caused from the repeated exposure to urine/faeces and reduces quality of life. However, the underlying mechanisms are poorly understood. This study explored the effects of urine on the growth and motility of common uropathogens. Pseudomonas aeruginosa, Proteus mirabilis, Escherichia coli and Klebsiella pneumoniae were grown for 24 hrs at 37℃ in Luria-Bertani (LB) medium supplemented with various concentrations of synthetic urine. Bacterial growth was monitored over time by measuring absorbance at 600nm. Swimming, swarming, and twitching motilities were determined in cultures of LB with (1:1 ratio) and without synthetic urine. Results demonstrated that bacterial growth was inhibited during early phase (0-6 hrs), and enhanced after 8 hrs. For P. mirabilis and K. pneumoniae, the increase in growth was in a dose-dependent manner. Swimming motility of P. mirabilis was inhibited. This study suggested the different effect of fresh and infectious urine on the bacterial growth, which is important to understand the mechanisms of IAD development due to urine incontinence.

The aim of this study is to investigate body rotation around the three trunk axes with respect to the hip while walking under multitask conditions, and to clarify the relationship between body sway and the influence of the axis in which the sway occurs, task conditions, and aging. The Inertia Measurement Unit sensors were attached to the hip and shoulder of the subjects and the shoulder rotation with respect the hip was examined. Ten healthy young and 11 older individuals participated the experiment. The task conditions were 1) normal walking, 2) walking with a visual task, 3) walking with an auditory task, 4) walking with a calculation task, 5) walking with visual and calculation tasks, and 6) walking with auditory and calculation tasks. When comparing the gait of older people and young people under task conditions including the change of walking path, the aging effects were observed in at least two directions: trunk twist and front-back rotation. When comparing walking under multiple tasks with normal walking for older people and young people separately, older people showed significant differences at least in the forward-backward and left-right rotation, while the younger showed significant differences appeared in the single rotation direction only under triple task conditions.

Aim: This study compared changes in autonomic nerve indicators of high frequency (HF) norm and low frequency (LF)/HF ratio among young and elderly participants before and after standing: when actively standing up, when passively standing up with assistance from others, and when standing up with the aid of a lower-limb power-assisted robot (HAL) from a sitting position on a 40 cm-high chair. Methods: The sample comprised 11 healthy young and 14 elderly individuals aged 20〓26 years (mean: 22.5±2.2) and 66〓77 years (mean: 70.3±3.5), participants were asked to stand up under 3 different conditions and electrocardiogram measurements and blood pressure were measured. Results and Conclusion: Young and elderly participants showed decreased RRI across all conditions and no significant differences in average blood pressure were found before or after standing. Decreased HF norm and increased LF/HF ratio showed excitation of the sympathetic nerves, increasing blood pressure to compensate for and prevent orthostatic hypotension. Such compensation was likely not due to age although significant differences were found in the coefficient variance of RRI between young and elderly participants. HAL standing proved to have a marginal impact on young and elderly persons' circulatory dynamics.

Purpose: This study aims to assess video-based activity (hereinafter referred to as“video activity”) and acceleration for bed-making techniques simultaneously and compare the differences between expert and novice participants. It also investigates the characteristics of video activity. Methods: An expert nurse (nursing faculty member) and three novices (nursing students) were included in the study. The subjects used a wearable camera and smartphone on their chest and were asked to perform bed-making. Optical flow was used to calculate the video activity. Results: Video activity and acceleration were lower in skilled participants, and work time was shorter in the expert participant. The entropy of video activity and acceleration was the lowest for the expert participant, and a level of proficiency was exhibited by the novice participants. Conclusion: The values calculated from video activity and acceleration differed between expert and novice participants. It was suggested that this could be used as an indicator of proficiency in nursing techniques.

Objective: To evaluate whether fabrics with attached lavender oil microcapsules effectively increase the sleep quality. Methods: A before-after comparative study was conducted at the participants’ homes to monitor their sleep patterns. Five consecutive weekdays were followed as the control, and the following five consecutive weekdays were followed as the aromatherapy intervention using fabrics attached with lavender oil microcapsules. Primary outcomes were objective measures of sleep qualities, such as sleep latency, waking time after sleep onset, sleep efficiency, and light sleep. Secondary outcomes were subjective measures of sleep qualities, such as“ease in falling asleep”and“feeling of deep sleep”scored from 1 (“very bad”) to 5 (“very good”). Results: A total of 15 participants were analyzed. The difference in objective parameters was not statistically significant, whereas“ease in falling asleep”and“feeling of deep sleep”as subjective parameters were statistically significant. Effect sizes showed in this study were found from d=0.20 to 0.39, and the required total sample sizes were found from 54 to 207 in objective parameters. Conclusions: Since this sheet may be effective in improving sleep quality, verification with expanded sample size is required in the future.

Objective: This study aimed to determine the differences between the core body and peripheral temperatures of young women with hie using deep temperature, and to demonstrate an objective and simple method for hie evaluation. Methods: This study measured the deep body and skin temperatures of 24 young women from July to October 2018. We divided the participants into two groups: a hie group who has awareness of cold sensation and a non-hie group. We compared the deep temperature difference between the forehead and the instep in the two groups. We calculated the ratio of the number of pixels below a specific temperature to the total number of pixels in the instep based on a thermographic image. Results: Nine participants were in the hie group and 15 were in the non-hie group. The deep temperature difference of the hie group was significantly larger than that of the non-hie group (p=0.030). The temperature difference positively correlated with the ratio of pixels for the temperature distribution 〓31.0 ℃ on the instep (rs=0.869, p<0.001). Conclusion: Young women with a large deep temperature difference can be simply screened by thermography based on the ratio of the low-temperature region of the instep.

Aims and methods: Chemotherapy agents cause damage to the scalp, including hair matrix cells, an inflammatory response activating c-fibers, or basal cells, and induce pain and itching on the scalp. We preliminarily investigated the relationship between epidermal thickness and scalp pain and itching in breast cancer patients undergoing chemotherapy. Epidermal thickness was measured as the depth from the top level of the stratum granulosum using in vivo reflectance confocal microscopy (RCM). Results: Case 1: A 33-year-old Japanese woman complained of scalp itching from baseline to 24 weeks later. Her epidermal thickness decreased during chemotherapy. Case 2: A 37-year-old Japanese woman exhibited scalp pain and itching three weeks later. Her epidermal thickness decreased during chemotherapy. Case 3: A 44-year-old Japanese woman complained of scalp pain and itching during hair loss. Erythema and eczema simultaneously appeared on her scalp. Her epidermal thickness decreased during chemotherapy. Conclusion: This study confirmed the relationship between epidermal thickness and scalp pain and itching during chemotherapy. RCM measurements are non-invasive methods and may be useful in predicting scalp symptoms.