The aim of this study was to investigate whether consumption of probiotic fermented milk containing Bifidobacterium bifidum YIT 10347 improves symptoms in patients with functional gastrointestinal disorders (FGID). Thirty-seven FGID patients (18 male, 19 female) aged 12–80 years (mean ± SD, 52.6 ± 17.5 years) whose condition had not improved despite being seen at several medical institutions consumed 100 mL/day of B. bifidum YIT 10347 fermented milk for 4 weeks. Symptoms were evaluated after the enrollment period (BL: baseline), sample consumption period (CP) and 4 weeks after the CP (FP: follow-up period). Gastrointestinal symptoms were evaluated using the Gastrointestinal Symptom Rating Scale (GSRS) and the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease (FSSG); psychological symptoms were evaluated using the Profile of Mood States (POMS) short form. Concentrations of salivary stress markers and the oxidative stress marker urinary 8-hydroxy-2’-deoxyguanosine (8-OHdG) were measured. GSRS subscale scores for abdominal pain, diarrhea, and constipation significantly improved relative to BL after consumption of the fermented milk, as did FSSG subscale scores for symptoms of acid-related dyspepsia. Some subjective psychological symptoms improved. POMS scores significantly improved, and “Anger-Hostility” subscale scores significantly decreased after the consumption period, while “Vigor” subscale scores marginally increased during the consumption period. The concentrations of urinary 8-OHdG and the stress marker salivary cortisol were significantly lower at CP but returned to baseline levels at FP. Continuous consumption of B. bifidum YIT 10347 fermented milk is expected to improve gastrointestinal symptoms and reduce psychological stress in FGID patients.

The frequency of doctor home-visits was the only factor identified that was positively associated with the occurrence of home death in home medical care settings.

Promotion of home medical care is absolutely necessary in Japan where is a rapidly aging society. In home medical care settings, triadic communications among the doctor, patient and the family are common. And "communications just between the doctor and the patient without the family" (doctor-patient communication without family, "DPC without family") is considered important for the patient to frankly communicate with the doctor without consideration for the family. However, the circumstances associated with DPC without family are unclear. Therefore, to identify the factors of the occurrence of DPC without family, we conducted a cross-sectional mail-in survey targeting 271 families of Japanese patients who had previously received home medical care. Among 227 respondents (83.8%), we eventually analyzed data from 143, excluding families of patients with severe hearing or cognitive impairment and severe verbal communication dysfunction. DPC without family occurred in 26.6% (n = 38) of the families analyzed. A multivariable logistic regression analysis was performed using a model including Primary disease, Daily activity, Duration of home medical care, Interval between doctor visits, Duration of doctor's stay, Existence of another room, and Spouse as primary caregiver. As a result, DPC without family was significantly associated with malignant tumor as primary disease (OR, 3.165; 95% CI, 1.180-8.486; P = 0.022). In conclusion, the visiting doctors should bear in mind that the background factor of the occurrence of DPC without family is patient's malignant tumors.

Aim Home medical care is currently a topic of discussion in Japan. It is reported that the key to the success of home medical care is communication. The aim of the present study was to elucidate the characteristics of communication during home medical care of patients with intractable neurological diseases (IND patients) by comparing them with patients with malignant tumors, the representative common disease for home medical care. Methods A questionnaire survey was sent out in June and July 2011 to 295 families of patients who had previously received home medical care. The response rate was 83.8% (n = 227). Communication backgrounds were compared between those patients whose primary disease was either IND or malignant tumor. Results Analysis of responses from 104 families (IND, 30 and malignant tumors, 74). was undertaken The number of families that experienced “doctor‐patient communication without family” was 15% (n = 4) in the IND group and 35% (n = 24) in the malignant tumor group (P < 0.05). The number of families who had experienced “doctor‐family communication without patient” was 44% (n = 12) in the IND group and 83% (n = 54) in the malignant tumor group (P < 0.01). No statistically significant differences in doctors' stay duration were observed. Conclusion It is suggested that communication with the patient in the presence of their family is characteristic of communication during home medical care of IND patients, because this was observed to be more frequent than that for malignant tumor patients.

Background: In home medical care settings, some patients' families always attend provider visits, and others only do so when needed. The clinical background behind this difference is not well defined. Methods: A cross‐sectional mail survey of families of Japanese patients who had previously received home medical care, asking whether the family had always been present the patient during home healthcare visits and their reasons. Survey results were analyzed with a multivariable adjusted logistic regression model based on the explanatory variables, for aspects related to the family's attendance at provider visits. Results: Among the 271 families contacted, 190 families who finally met the selection criteria were divided into two groups : 155 families (81.6%) who had always been present with the patient ; and 35 families (18.4%) who had done so only when needed. Constant attendance by family members was significantly associated with the level of care required (odds ratio [OR] : 1.40, 95% confidence interval [CI] : 1.05–1.89, p = 0.02) and age of the primary caregiver (OR : 1.05, 95% CI : 1.02–1.09, p = 0.03). However, when the family had difficulty communicating with the provider owing to the patient's presence, families tended not to be present during visits by providers (OR : 0.41, 95% CI : 0.17–1.02, p = 0.06). Conclusions: In home medical care settings, visiting healthcare providers should bear in mind that if the family is not always present with the patient, there is a possibility that the family is experiencing difficulty communicating with the provider owing to the patient's presence.