Physical Activity and Activities of Daily Living in Older Adult Patients With Heart Failure Admitted for Subacute Musculoskeletal Disease

Objective@#To examine activities of daily living (ADL) and physical activity in older adults with heart failure admitted to a rehabilitation ward for subacute musculoskeletal disease. @*Methods@#This study included patients with musculoskeletal disease (aged ≥75 years) who were admitted to the rehabilitation ward. Data on age, ADL, and time for physical activity (metabolic equivalents [METs]) were collected. Patients were divided into groups with or without heart failure, and the differences were compared using Mann–Whitney U-test. @*Results@#This study included 84 musculoskeletal patients, including 25 with heart failure. The heart-failure group had similar levels of ADL independence compared to the without-heart-failure group (p=0.28) but had shorter duration of continuous and sustained physical activities and less total time (p<0.01) of light-intensity physical activity or higher. @*Conclusion@#Older adults with subacute musculoskeletal disease with heart failure do not necessarily require a large amount of physical activity to maintain ADL at the time of discharge. But very low physical activity may increase the risk for developing hospitalization-associated disability. Physical activity in older adults with subacute musculoskeletal disease with heart failure should be monitored separately from ADL.

Effects of Stress on Mouse beta-Defensin-3 Expression in the Upper Digestive Mucosa

PURPOSE: Gastrointestinal integrity and immune surveillance are affected by stress. Stress also adversely affects mucosal barrier function. beta-defensins constitute an integral component of the innate immune system as antimicrobial peptides, serving as the first line of defense against microbial pathogens at the epithelial surfaces of the upper digestive mucosa. The primary objective of this study was to determine the effects of stress on the expression profile of mouse beta-defensin-3 in the upper digestive mucosa of mice with diabetes. MATERIALS AND METHODS: We established a mouse model of restraint stress by using NSY/Hos mice with type 2 diabetes mellitus. We used real-time polymerase chain reaction, in situ hybridization, and immunohistochemistry to investigate the effects of stress and glucocorticoid administration on mouse beta-defensin-3 expression in the upper digestive mucosa of the gingiva, esophagus, and stomach. RESULTS: Mouse beta-defensin-3 mRNA expression was higher in the esophagus than in the gingiva or stomach (p<0.05). In the esophagus, mouse beta-defensin-3 mRNA expression was lower in stressed mice than in non-stressed mice (p<0.05). Furthermore, immunoreactivity to mouse beta-defensin-3 protein was lower in the esophagus of stressed mice than non-stressed mice, consistent with the results of mRNA expression analysis. Systemic glucocorticoid administration also downregulated esophageal mouse beta-defensin-3 mRNA expression. CONCLUSION: Our novel findings show that stress decreases mouse beta-defensin-3 expression in the esophagus of mice with diabetes, possibly due to increased endogenous glucocorticoid production. It appears to be highly likely that stress management may normalize mucosal antimicrobial defenses in patients with diabetes.

Community Study of the Health Care System of Children in Rural Districts of Shimane Prefecture, Japan / 日本農村医学会雑誌

Problems in the school health care system of children were studied in rural districts of Shimane Prefecture, Japan. Questionaires which were concerned with the policy and the evaluation of school health care, present situation of health examination in schools, and cooperative activities in the field of school health care between schools and communities were sent to school nurses.<BR>Owing to the recent changes of the general life conditions in rural districts, the life style and the health conditions of children in rural districts became somewhat similar to those in cities. Psychological complaints, psychosomatic diseases, school phobia, obesity and adult diseases such as peptic duodenal ulcer became common in many schools in rural districts.<BR>An inadequate understanding about school health care in teachers and in families, lack of specialists and school nurses in school health care system, few epidemiological studies on the health conditions of children, and the insufficient cooperative activities among schools, families and communities were revealed as important problems to be solved. The scientific health education in schools, adequate health counselling system and the complete health care should be established on the basis of actual living conditions of children and cooperation between school health care and community health care.

Community Health Approach to the Health Conditions of Children in Rural Districts of Shimane Prefecture / 日本農村医学会雑誌

A questionnaire was sent to school health nurses in rural districts of Shimane Prefecture asking them about health conditions and emergency accidents of children, problems of the health care, and safety administration in schools.<BR>The health conditions of children in rural districts were almost common with those of children in cities of Japan. It was suggested that the increase of psychosomatic complaints and disorders of children was directly or indirectly affected by the changes of life conditions in households of side-work farmers, the inhumane competition in education and the drastic urbanization of life style.<BR>The cooperative approach to comprehensive health care of children by the participants of school health and community health is urgently needed to promote the health level.

Actual conditions of the health care of school personnel in rural districts of Shimane prefecture, Japan / 日本農村医学会雑誌

Actual conditions of the health care of school personnel in rural districts of Shimane Prefecture were investigated, concentrating our attention on the structure of diseases, the contents of health examination, factors impeding health, and so forth.<BR>As a result of our investigation we found that the incidence of adult diseases among school personnel is considerably high. Health examinations with complete contents should be practised in the near future.<BR>Further, the establishment of health care system in the work place, the improvement of working conditions considering sufficiently the peculiarity of mental work and of femininity, the independence of school nurses as specialist should be realized on the basis of the understanding of actual problems, which are obtained by examinations of health care conditions at each work place including epidemiological examination.

Community study of the school health education in rural districts of Shimane Prefecture / 日本農村医学会雑誌

A questionaire was sent to school nurses in rural districts of Shimane Prefecture asking them about the problems in the school health education and the school health guidance.<BR>The quantitative and qualitative improvement of the working conditions of school health nurses, and the effective co-operation between domestic education and school education based on the understanding of the changes of rural society is needed for the future development of health education. Above all the amplification of the “problem-oriented school health education” in each school is needed to establish a scientific point of view of school children.