No abstract

For improving the QOL of patients diagnosed with cancer, early palliative care is recommended, aiming to minimize pain and opioid-induced side effects. Herein, we evaluated the effect of continuous interventions for pain management and opioid-induced side effects in outpatients with cancer. Pharmacists continuously performed interventions on patients on their hospital visits, starting from the first visit for opioid introduction to intervention via telephone. We recorded their pain patterns and intensities, use of rescue doses, and types and degrees of side effects during these interventions. The physicians were suggested appropriate recommendations for increased doses or alternative opioids when the pharmacists considered the analgesic dose should be titrated. During the study period, palliative care pharmacists conducted 105 interviews for 27 patients (male: 19 and female: 8) with cancer pain. Pain intensities significantly decreased after the pharmacists' continuous intervention, including those from telephone interviews, with their appropriate recommendations and increased opioid doses. Side effects such as nausea and constipation increased or remained unaffected even after the intervention, likely due to the increased opioid doses. Approximately 90% of recommendations for pain control were accepted by the physicians and helped to control the pain intensities. Before starting physician consultations, pharmacists informed the patients that adequate pain control and side effect management were achievable through regular interviews, wherein patient symptoms were monitored and patients received detailed explanations of pharmaceutical care and courteous and continuous counseling.

Background: Recent studies have shown that intake of n-3 polyunsaturated fatty acids (PUFAs) is associated with reduced risk of cognitive impairment and coronary artery disease (CAD); however, it is currently unknown whether reduced serum n-3 PUFA is associated with cognitive impairment in patients with CAD.

A comprehensive analysis of gened relativistic spacetimes which admit a shearfree, irrotational and geodesic time-like coogruence is presented. The equations governing the models for a gened energy-momentum tensor are wrilten down. Coordinates in which the metric of such spacetimes takes on a simplified form are established. The general subwses of 'zero anisotropic stress', 'zero heat-flux vector' and 'two-component Ruids' are investigated. In particular, perfect-fluid Friedmann-Robertson-Walker models and spatially homogeneous models are discussed. Models with a variety of physically relevant energy-momentum tensors are considered. Anisowopic fluid models and viscous fluid models with heat conduction are examined. Also. models with B perfect Ruid plus a magnetic field or with pure radiation. and models with two non-collinw perfect fluids (satisfying a variety of physical conditions) are inwtigated. In particular. models with a (single) perfect Ruid which is tilting with respect to the shem-free, vorticity-free and acceleration-free time-like congruence are discussed.PACS numbers: 0420J. 9880H

Women with mental illness generally have normal fertility rates. Mothers with mental illness think that their children are important for their lives but also experience difficulties in relating to their children. Therefore, it is important to understand the mothers' perception of what experiences influence them or their parenting practices in relationships with their children. We conducted narrative interviews with 20 Japanese mothers who were being treated for either schizophrenia or mood disorders. The data were analyzed using the Modified Grounded Theory Approach. For the mothers, their feelings toward their children and their perception of their children's feelings toward them or their illness influenced the mothers and their parenting practices. Implications for support are discussed and directions for future research are presented.