Surface pressures and shear forces were measured in order to clarify the mechanism leading to the development of a pressure ulcer at five sites on the body during the operation of a bed (bed) using a device for simultaneously measuring pressure and shear force. Changes of shear force and pressure when three body types adopted different supine positions, with or without raising/bending the knees (raising the knees), were investigated and analyzed. The results are as follows: a slender body type tends to have the highest shear force at the coccygeal bone site and also has a higher surface pressure at the coccygeal and at the lateral sacral bone sites than an obese body type. On the other hand, an obese body type has a higher surface pressure at the other sites than the slender type. Shear forces at the sacrum and coccygeal bone sites can be reduced during a bed operation by raising the knees. Furthermore, shear forces can be reduced during a bed operation in a supine position by matching the body's bending points with those of the bed or by shifting the subjects 10 cm toward the head of the bed. These new findings are clinically useful in the treatment and the prevention of the onset of pressure ulcers.

For the purpose of achieving ABC-type periodic terpolymers, various vinyl ethers (VEs), oxiranes, and ketones were examined in the cationic vinyl-addition, ring-opening, and carbonyl-addition terpolymerization and suitable reaction conditions were identified. When the appropriate monomers are employed, the terpolymerization proceeds via a one-way cycle of crossover reactions, similar to “rock-paper-scissors”. Homopropagation reactions of VE and oxirane need to be completely suppressed while attaining highly selective crossover reactions to achieve ABC-type periodic sequence control. By screening various monomers, VEs and oxiranes with moderate but sufficiently high reactivities were found to be appropriate for both the frequent crossover reactions and the polymerization itself. Appropriate ketones were also important for achieving efficient terpolymerization. In addition, more frequent crossover reactions occurred in the terpolymerizations conducted in less polar solvents at lower temperatures. Under the optimized conditions, the cationic terpolymerization of ethyl VE, 4-vinyl-1,2-cyclohexene oxide, and methyl ethyl ketone proceeded via frequent crossover reactions, and this process yielded an ABC pseudo-periodic terpolymer with averages of 1.2, 1.4, and 1.0 monomer units per block, respectively.

The present pilot study examined the effectiveness of self-help therapy (SHT) in hospital nurses in Japan. Twenty-five hospital nurses (22 female, mean age 39.7 ± 14.6 years) participated in a 90-min workshop covering sleep hygiene education and brief stress management. After the workshop, participants in the SHT group (n = 10) were asked to practice good sleep habits, relaxation techniques, and keep a sleep diary, whereas participants in the control group (n = 15) were not. Pre- and post-test questionnaires, including the Japanese version of the Pittsburgh Sleep Quality Index (J-PSQI), were administered at a 2-week interval to assess subjective sleep quality, sleepiness, depressive symptoms, burnout, and quality of life. Changes in outcomes by treatment conditions were compared using linear mixed models. We found significant improvement in subjective sleep quality (global PSQI scores) in the SHT group, with Cohen’s d of 0.40. Participants with sleep problems at pre-test in the SHT group (scoring above the PSQI-J cut-off point) showed significant reduction in sleep latency and sleep disturbance, while those in the control group did not (Cohen’s d of 0.48 and 0.15, respectively). No significant improvement was found in the SHT group for sleepiness, although a clinically significant change was observed for subjective sleep quality and sleepiness in this group. No significant improvement was observed in either group for depressive symptoms, burnout, and quality of life. Our results provide preliminary evidence for the effectiveness of SHT for sleep problems in hospital nurses in Japan.