The physical signs of impending dehydration among elderly people in nursing homes: The association with axillary skin temperature, humidity, intraoral moisture content, and salivary components.

PURPOSE: The aim of the present study was to examine the association between impending dehydration among elderly people in nursing homes and physical signs, including the axillary skin temperature, humidity, intraoral moisture content, and salivary components. METHODS: The study included 78 elderly individuals who required long-term care in a nursing home (11 men and 67 women; average age, 86.6±7.3 years). The elderly subjects were classified in two groups according to their serum osmolality levels: those with levels between the upper limit reference value (292 mOsm/kg H2O) and the diagnostic reference value of dehydration (300 mOsm/kg H2O) were classified into the boundary zone group and those with levels of <292 mOsm/kg H2O were classified into the normal range group. The following parameters were measured: basic attributes (age, gender and level of care required), body mass index, diet, daily fluid intake per kilogram of body weight, physiological indicators (blood pressure, pulse rate, body temperature, axillary skin temperature, humidity, total body water, body water rate, internal liquid rate, external solution rate, blood components, intraoral water amount, and salivary components), and the indoor environment (room temperature and humidity). We then performed a statistical analysis to compare the boundary zone group with the normal range group. After adjusting for age and the daily fluid intake per kilogram of body weight (<25 ml/≥25 ml), we performed a logistic regression analysis (the boundary zone group was used as an independent variable) for variables that had significance levels of <0.05 (except for blood components). RESULTS: The univariate analysis revealed significant differences in the following parameters: the serum sodium, chloride, and creatinine levels; the blood sugar level; the urea nitrogen/creatinine ratio; the axillary skin temperature; and room humidity. Only the axillary skin temperature showed a significant association in the final model of the logistic regression analysis (odds ratio, 3.664; 95% confidence interval, 1.101-12.197; p = 0.034). CONCLUSION: As the axillary skin temperature increased by 1°C, there was a 3.67-fold risk of being classified into the boundary zone group instead of the normal range group. Thus, the axillary skin temperature was associated with impending dehydration.

Identifying Residents' Health Issues Six Weeks after the Great East Japan Earthquake.

OBJECTIVE: The aim of this study was to identify the characteristics and health issues of residents in need of assistance in a town affected by the Great East Japan Earthquake, six weeks after the disaster, through an outreach initiative. DESIGN AND SAMPLE: A cross-sectional qualitative design was used. Public health nurses conducted comprehensive semi-structured interviews during home visits with residents. A total of 5,082 residents from the affected town. MEASURES: These included demographic information, public records of the extent of the damages, and qualitative interview data to determine the urgency of the necessary interventions. RESULTS: A total of 281 residents needed some kind of assistance and were identified as "requiring early intervention (within two weeks)" or "requiring assistance (within 12 weeks)." The most common health issue requiring early intervention was "interruption of treatment" (25.0%), followed by "need for mental care." The most frequent health issue requiring assistance within 12 weeks was the "need for mental health care" (39.7%), followed by "interruption of treatment," and "need for nursing care." CONCLUSIONS: During a disaster, it is imperative to identify cases requiring early intervention. Home-visit interviews were necessary to identify existing health concerns to prevent the development of more serious health problems.

[Classification of nurse and caregiver evaluation criteria for activity care in elderly people with dementia].

AIM: This study aimed to classify evaluation criteria for activity care perceived by nurses and caregivers at long-term care insurance facilities to be important. METHODS: We distributed questionnaires by mail to chief nurses and caregivers at all special nursing homes and elderly healthcare facilities in five prefectures in the Chugoku region and enrolled 657 subjects in the analysis. Answers were given on a five-point scale indicating the perceived degree of importance of the evaluation criteria. Multidimensional scaling combined with a cluster analysis was used to examine similarities. RESULTS: Clusters were identified in the following categories: 1) comfort, 2) spontaneity, 3) elimination of tension and 4) interactions with others. Mean values were allocated to clusters in order of the highest category: cluster 1 (4.48), cluster 2 (4.23), cluster 3 (3.95) and cluster 4 (3.48). The two-dimensional model exhibited good relevance (RSQ of 0.948). For dimension 1, "complexity," clusters representing simple-to-complex behavior were arranged based on the highest mean values. For dimension 2, "openness," the mean values were high for clusters 1 and 2, which were close to the middle. In contrast, cluster 3, which was at the upper end, and cluster 4, which was below the middle, exhibited low values. CONCLUSIONS: A two-dimensional structure and four clusters that could not be understood based on conventional activity care classifications were identified, thereby clarifying future directions for evaluation criteria. The subjective importance of evaluation criteria focused on the complexity of behavior and individual openness. Versatility, comprising visual comprehension and measurability, appeared to be used as a reference.

The tsunami's impact on mortality in a town severely damaged by the 2011 Great East Japan Earthquake.

This study identifies the relationship between tsunami damage and mortality through a demographic pyramid of a town severely damaged by the tsunami following the Great East Japan Earthquake of 11 March 2011. It uses cross-sectional data collection. Volunteers visited all households, including shelters, and asked residents about the whereabouts of family members and neighbours. The information was collated with lists of evacuees and the dead to confirm the whereabouts of all residents about 50 days after the disaster. Demographic pyramids for the whole population based on pre- and post-disaster data were drawn. In all, 1,412 (8.8 per cent) were dead or missing, 60.2 per cent of whom were aged 65 and over and 37.5 per cent aged 75 and over, suggesting that the very old should be located beyond the reach of tsunamis. The mortality rate of children was lower than that in other studies, which may indicate the efficacy of disaster evacuation drills.

[A study on the factors influencing the acceptance of disability and depression of home oxygen therapy patients].

The purpose of this study was to clarify the factors which affect the acceptance of disability and depression of home oxygen therapy (HOT) patients. Subjects consisted of 74 male and 29 female HOT patients, for a total of 103 subjects with chronic respiratory problems. The mean age was 72.1 years (SD = 9.3). A questionnaire survey consisting if the following independent variables 1) demography factor 2) disease specific factor 3) psycho-sociological factor was implemented. The Linkowski AD scale was used to assess the acceptance of disability and the CES-D scale for the assessment of depression. Multiple regression analysis was applied in order to extract the factors which affect acceptance of disability and depression. The following are the results. The psycho-sociological factor items'depression (beta = -.273)', 'interpersonal exchange with individuals other than family members (beta = .270)', 'the range of activity (beta = .203)' were found to be significant variables influencing the acceptance of disability, accounting for 48.3% of the explained variance. As for the factors influencing depression, the demographic factor item'age (beta = -.174)', disease specific factor item'dyspnea (beta = .284)', psycho -sociological factor items'being worried about oxygen inhalation in public (beta = .218)', 'mental support from family (beta = -.228)', 'interpersonal exchange with individuals other than family members (beta = -.205)', 'the degree of exchange with individuals with the same disease (beta = -.170)' 'the range of activity (beta = -.201)' were found to be significant variables accounting for 48.9% of the explained variance. For acceptance of disability and get over depression, we suggest the importance of the intervention for keep a sociality.