Urinary incontinence in aged women, related to female specific life events, such as pregnancy and child birth, is a common disorder injuring their quality of life. Subjective evaluation of urinary incontinence using a questionnaire is an important parameter, but objective parameters and medical imaging play more important roles considering adequate instructions and treatments. Among medical imaging modalities, ultrasonography is a convenient tool having a high temporal resolution, but, for detailed image observations of the pelvic floor, trans-peritoneal approach or intra-vaginal approach is often required. On the other hand, magnetic resonance（MR）imaging is free from ionizing irradiation and noninvasively shows detailed anatomical structures of the pelvic floor with high soft tissue contrasts. Dynamic study at rest, strain, and contraction is also available to show the changes in location and shape of the lower urinary tract. Especially, an open configuration MR system with a vertical gap, in which MR images of the pelvic floor in a sitting position can be acquired with gravity loads, will be a powerful tool to investigate urinary incontinence. It is strongly expected that such a noninvasive imaging modality is widely used in the nursing research field.

Modern medical care and treatment rely on the use of various mechanical devices, such as orally inserted tracheal tubes. Therefore, in a clinical setting, nursing staff are required to have some advanced skills and knowledge about the mechanical function, components and materials of such medical devices in order to perform their duties with acceptable levels of skill and safety. Medical workers do not usually consider that glycerin enemas delivered using disposable devices for constipation might be associated with medical accidents, as they are used so commonly on a daily basis. However, such accidents have occurred due to poor nursing skills, and so there is a need to investigate nursing skills and safety based on existing evidence. The present investigation was performed to assess the nursing skills necessary for prevention of medical accidents by examining knowledge of anatomical science, toxicologic pathology, general science and engineering among nursing staff. It was found that better knowledge of science and engineering would produce staff with more advanced and safe scientific nursing skills. The authors believe that science and engineering research has a major role to play in the field of nursing science as an interdisciplinary profession.

Monitor test using KEIROKA（Fatigue-reduction）brace“Smart Suit Lite”was conducted for the investigation of its assistive effect and influence on physical fitness. KEIROKA is a concept of assistive technologies which reduce fatigue by supporting a part of human physical abilities. The assistive devices have the possibility to decrease user’s own strength by their support. Therefore, the changes in physical strength by the assistive devices need to be quantitatively evaluated. In this study, we conducted a monitor test of four weeks（including two weeks trial period）with a total of thirty care workers working in nursing home. The participants wore Smart Suit Lite for two weeks, and their subjective fatigue and physical performance were evaluated. The result shows that feeling of fatigue on the visual analog scale were decreased by an average of 16% by using Smart Suit Lite. On the other hand, there were no significant difference in physical fitness levels（back strength, grip strength, chair-stand test, standing long jump, one-legged standing with eyes closed）. This result means that there were no decrease in physical strength due to the use of Smart Suit Lite during normal work for two weeks.

Biopsy sampling can cause wound infection and pain in older or diabetic patients, although histological examination of biopsy samples is the gold standard of structural analysis of the skin. High-frequency ultrasonography is a promising tool for noninvasive skin assessment. However, its applicability for structural analysis of the skin is unknown. In the present study, we compared the images of high-frequency ultrasonography with histological examination of pig skin, which is the most validated model of human skin. Ear and dorsal skin were harvested from a pig cadaver, and scanned in three positions with a 20-MHz linear ultrasonography probe. The scanned position was accurately marked and trimmed for histological examination with Mallory-Azan staining. The distribution of hypoechoic regions in the ultrasonographic images mostly corresponded to the sweat glands and hair follicles in the histological sections in the ear skin. Sweat-duct- and blood-vessel-like structures and the papillary dermis were partially depicted. These results suggest the applicability of high-frequency ultrasonography for structural analysis of normal skin.

To prevent callus development in diabetics, plantar pressures and shear force need to be controlled, and these are related to gait and foot muscular strength. We verified relationships between foot muscular strength and plantar pressure, shear force and hip and foot angular velocity using a new system we developed to measure these parameters simultaneously. Plantar pressures, shear force and angular velocities of the dorsum pedis and sacral parts of 4 diabetics hospitalized for education in exercise therapy and diet therapy were measured while walking on admission and at discharge. Checker-kun（Nisshin Sangyo CO., LTD, Saitama, Japan）was used to measure the pressure between the first toe and the second toe to estimate muscular strength under the knee. Two patients with increased foot muscular strength showed lower yaw angle velocity at the lumbar part, and one patient with decreased foot muscular strength had higher yaw angle velocity at the lumbar part. Regardless of changes in foot muscular strength, pitch angle velocity at the dorsum pedis and shear force were increased. Decreased pitch angle velocity at the dorsum pedis might indicate steady walking. To secure steady walking, increasing foot muscular strength may be effective. The results suggest that controlling the manner of walking and selecting shoes as well as increasing muscle strength should relieve shear force to prevent callus development in diabetics.

In the aging society, increasing number of elderly patients with diabetes are growing where self-monitoring of blood glucose（SMBG）is often adopted. It is necessary to develop both SMBG devices adaptable for the elderly and educational methods relating to introducing SMBG. We examined the medical records to understand the current status of adopting of SMBG in elderly diabetic patients, and the difficulties of introducing SMBG. One hundred and twenty eight diabetic patients admitted to the diabetic metabolism internal medicine ward from May to July 2013 were the eligible subjects. The proportions of people who had SMBG introduction did not differ among patients under 65 years old, the early-stage geriatrics, and the later-stage geriatrics. However, difficulties extracted from the medical records of 26 diabetes patients who had initial SMBG introduction upon administration varied among patients under 65 years old and the elderly. This suggests the possible impacts from decreased dexterity in the elderly, and decreased cognitive function in the later-stage geriatrics. For the elderly, improvements are required for the electrode portions of blood glucose meters, which dexterity is required. In addition, development of devices with fewer steps and avoiding the parallel training of insulin self-injection when implementing SMBG are required.

Background/purpose: Impaired skin barrier function is a major skin problem and poses a risk for pressure ulcers, which are due to decreased levels of intercellular lipids. This study aimed to investigate the effect of supplementation of a ceramide dressing to the skin for repair of skin barrier function. Methods: We investigated whether ceramide dressing can deliver ceramide to the skin using different concentrations of dressings on the skin of volunteers. We then assessed the effect of ceramide supplementation by a ceramide-containing hydrocolloid dressing on artificially disrupted skin barrier function in forearm skin of volunteers. Results: The ceramide was delivered from the dressing onto the stratum corneum. Ceramide supplementation significantly reduced transepidermal water loss at day 3 and day 6 after applying the ceramide-containing dressing compared with the dressing without ceramide and no application of dressing（P＝0.047, P＝0.009, respectively on day 3; P＝0.048, P＜0.001, respectively on day 6）. Conclusion: Ceramide supplementation using a dressing containing ceramide is beneficial for improving skin barrier function and a promising option for preventing pressure ulcers.

Falling accidents can occur when individuals suddenly stand up from a sitting position. Rapid orthostatic hypotension can occur and impair the blood supply to the brain. We tried to verify whether“prior notice”affect the change in blood pressure. This study investigated the effects of anticipatory control on changes in the circulatory system. Eight healthy adults（mean age, 21.5 years; range, 19-23 years, 163±2 cm, 58±4 kg）were asked to stand up with or without prior notification from chairs of two different heights（20 or 40 cm）. Electroencephalography and cerebral circulation were monitored continuously, and blood pressure was compared before and after standing. Though no statistically significant differences were observed for individual indices of heart rate, blood pressure, and cerebral blood flow between the presence and absence of prior notice, a significant difference was found for sympathetic nerve activity which can be expected to buffer any rapid changes in hemodynamics. In addition, the effects of chair height had a remarkable impact in this study. The 20-cm chair height significantly caused a larger load on hemodynamics than the 40-cm height. In conclusion, sitting-standing position in daily living space is thought to be important for any people, and anticipatory control may be help for avoiding orthostatic hypotension in clinical settings.