Factors associated with overall satisfaction level of older people regarding medical-health and long-term care service within residential areas

Purpose: This study examined the factors related to the overall satisfaction level of older people treated at home, regarding medical and welfare services in their area of residence.Method: The survey targeted older people who reported using the services at a day rehabilitation center in Nagasaki Prefecture. The survey investigated the individuals’ backgrounds of, including their age, sex, period of long-term care insurance use, living environment, details and anxiety. It also indicated, through a self-rate system, the extent of information sharing among medical personnel and long-term care workers. The Japanese version of the Client Satisfaction Questionnaire 8-item version (CSQ-8J) was used to measure their level of satisfaction with medical and long-term care services. Results: Data from 205 people were analyzed, which included 73 men (35.6%) and 132 women (64.4%). The mean age was 81.2 ± 7.6(mean±standard deviation) years, the mean period of long-term care insurance was 38.1 ± 38.2 months, and the mean CSQ-8J score was 24.8 ± 5.7 points. The results of the multiple regression analysis (backward stepwise method) showed that only the item “information on illness and treatment is shared among medical personnel and long-term care workers” was significantly associated with the CSQ-8J score (p = 0.007). The results suggest the need to determine the details of the information regarding illness and treatment that should be shared among concerned parties

Tissue engineering of corneal stroma with rabbit fibroblast precursors and gelatin hydrogels

PURPOSE: To isolate fibroblast precursors from rabbit corneal stroma using a sphere-forming assay, to engineer corneal stroma with the precursors and gelatin, and to establish the therapeutic application of precursors in a rabbit corneal stroma. METHODS: In the in vitro study, a sphere-forming assay was performed to produce precursors from rabbit corneal stroma. Corneal stroma was engineered by cultivating precursors in porous gelatin for one week. In the in vivo study, the engineered corneal stromal sheet with precursors (precursor/gelatin group) or with fibroblasts (fibroblast /gelatin group) or without cells (gelatin group) was transplanted to a pocket of rabbit corneal stroma. Gene expression and extracellular matrix production were examined immunohistochemically in each group one week and four weeks after surgery. RESULTS: In the in vitro study, cells in the spheres were BrdU-positive, and their progeny were keratocan-positive. The study also showed that the corneas transplanted with a porous gelatin sheet did not show any opacity four weeks after transplantation in any group. In the gelatin sheet of the precursor/gelatin group, a more intense expression of type I collagen was observed relative to the other two groups four weeks after the surgery. CONCLUSIONS: Our findings demonstrate that the transplantation of fibroblast precursors combined with gelatin hydrogel into the corneal stroma is a possible treatment strategy for corneal stromal regeneration

Progression of microstructural deterioration in load-bearing immobilization osteopenia

PurposeImmobilization osteopenia is a major healthcare problem in clinical and social medicine. However, the mechanisms underlying this bone pathology caused by immobilization under load-bearing conditions are not yet fully understood. This study aimed to evaluate sequential changes to the three-dimensional microstructure of bone in load-bearing immobilization osteopenia using a fixed-limb rat model.Materials and methodEight-week-old specific-pathogen-free male Wistar rats were divided into an immobilized group and a control group (n = 60 each). Hind limbs in the immobilized group were fixed using orthopedic casts with fixation periods of 1, 2, 4, 8, and 12 weeks. Feeding and weight-bearing were freely permitted. Length of the right femur was measured after each fixation period and bone microstructure was analyzed by micro-computed tomography. The architectural parameters of cortical and cancellous bone were analyzed statistically.ResultsFemoral length was significantly shorter in the immobilized group than in the control group after 2 weeks. Total area and marrow area were significantly lower in the immobilized group than in the control group from 1 to 12 weeks. Cortical bone area, cortical thickness, and polar moment of inertia decreased significantly after 2 weeks. Some cancellous bone parameters showed osteoporotic changes at 2 weeks after immobilization and the gap with the control group widened as the fixation period extended (P < 0.05).ConclusionThe present results indicate that load-bearing immobilization triggers early deterioration of microstructure in both cortical and cancellous bone after 2 weeks