RESUMO
Ibi Welfare Hospital covers a local town that has an aging population, and the development of a community-based integrated care system is an important issue. We have established and are operating a regional integrated NST system to maintain oral nutrition intake essential for daily life and prevention of pneumonia in this area, and here we report on outcomes and future issues. In this study, we investigated the regional integrated NST system (NST outpatient · NST hospitalization · NST visit) and examined dissemination of its service. Data was collected from February 2016 to March 2017. The investigation involved the following: (1) extraction of survey results of latent NST subjects and retrospective investigation of medical records; (2) expansion of NST outpatient services (examinations by surgeons, endoscopic evaluation of swallowing function, blood tests, dental examination, and evaluation by a dietician speech-language-hearing therapist, and return of a joint report created by the individual professionals to the introducing professional); and (3) introduction of NST hospitalization (2-week hospital stay for local inclusion sickbed care, introduction of swallowing passport, initiation of rehabilitation, oral care roundtrip, NST roundtrip, personnel care meetings with home staff, and introduction of visiting speechlanguage-hearing therapist rehabilitation to support home care after discharge). To increase awareness of this system, we visited the local nursing care insurance agency and welfare hospitals and tried to obtain cooperation through transparency. Introducing and initiating this regional integrated NST system “Ibi Model” revealed that the system is greatly needed in our region. We think that it has the potential to become a key supporting tool for the home-based medical care system within the regional comprehensive care system. Further verification is needed to assess real outcome changes such as a decrease in the incidence of pneumonia and improvement in quality of life.
RESUMO
There is a limitation to estimate vitamin B12 intake due to lack of data on vitamin B12 content in many Korean foods. In this study, vitamin B12 content was determined in some soybean or vegetable-fermented foods, edible seaweeds and other frequently consumed foods in Korea by microbioassay using Lactobacillus delbruecki ATCC 7830. The traditional type of Doenjang and Chungkookjang contained 1.85 microgram/100 g and 0.69 microgram/100 g of vitamin B12, respectively, while the factory-type of Doenjang and Chungkookjang contained 0.04-0.86 microgram/100 g and 0.06-0.15 microgram/100 g. Vitamin B12 was not detected in steamed soybeans and Tofu which is a not-fermented soybean product, indicating that vitamin B12 in Doenjang and Chungkookjang might be produced during the fermentation process. The Korean-style soy sauce contained 0.04 microgram vitamin B12/100 mL, but vitamin B12 was not detected in Japanese-style soy sauce and white miso. Commercial Kimchi, a representative Korean vegetable- fermented food, made of Korean cabbage, Yeolmu, or Mustard leaves contained 0.013-0.03 microgram vitamin B12/100 g, while Kimchi without red pepper and fermented fish sauce (White Kimchi) did not. Vitamin B12 content was very high in some edible seaweeds such as laver (66.76 microgram/ 100 g dry weight) and sea lettuce (84.74 microgram/100 g dry weight), and it was 17.12 microgram/100 g of dried small anchovy, 1.07 microgram/100 g of whole egg, and 0.02 microgram/100 g of coffee mix. From these results, it is assumed that Koreans take substantial amount of vitamin B12 from plant-origin foods. And, with these data, we will be able to calculate dietary vitamin B12 content more correctly than before. In conclusion, soybean-fermented foods, Kimchi, laver and sea lettuce are recommendable as good sources of vitamin B12 for vegetarians or Korean elderly on grain and vegetable based diet.