Research Promotion in Nursing, Physiotherapy, Occupational Therapy and Medical Engineering - Appeal and Recommendation to the Colleague -

[Summary] Despite of the severe situations of insufficient money, labor, time, and communication, we want to promote the research activity in our university to the level of major institutions. The first step we propose is to acquire the external research grants from public resources. The specific proposal is described in grant application to increase the probability of successful adoption of the grant from the Ministry of Education and Science of Japan

Genetic Variants of Human Granzyme B Predict Transplant Outcomes after HLA Matched Unrelated Bone Marrow Transplantation for Myeloid Malignancies

Serine protease granzyme B plays important roles in infections, autoimmunity, transplant rejection, and antitumor immunity. A triple-mutated granzyme B variant that encodes three amino substitutions (Q48R, P88A, and Y245H) has been reported to have altered biological functions. In the polymorphism rs8192917 (2364A>G), the A and G alleles represent wild type QPY and RAH mutant variants, respectively. In this study, we analyzed the impact of granzyme B polymorphisms on transplant outcomes in recipients undergoing unrelated HLA-fully matched T-cell-replete bone marrow transplantation (BMT) through the Japan Donor Marrow Program. The granzyme B genotypes were retrospectively analyzed in a cohort of 613 pairs of recipients with hematological malignancies and their unrelated donors. In patients with myeloid malignancies consisting of acute myeloid leukemia and myelodysplastic syndrome, the donor G/G or A/G genotype was associated with improved overall survival (OS; adjusted hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.41–0.89; P = 0.01) as well as transplant related mortality (TRM; adjusted HR, 0.48; 95% CI, 0.27–0.86, P = 0.01). The recipient G/G or A/G genotype was associated with a better OS (adjusted HR, 0.68; 95% CI, 0.47–0.99; P = 0.05) and a trend toward a reduced TRM (adjusted HR, 0.61; 95% CI, 0.35–1.06; P = 0.08). Granzyme B polymorphism did not have any effect on the transplant outcomes in patients with lymphoid malignancies consisting of acute lymphoid leukemia and malignant lymphoma. These data suggest that there is an association between the granzyme B genotype and better clinical outcomes in patients with myeloid malignancies after unrelated BMT

Research Activities in the Department of Nursing

Research activity at the Department of Nursing is overviewed from the point of research topics, the theme of the projects admitted for grant from the Ministry of Education and Science of Japan, and expected research topics, trying to clarify the needs and challenges of the Department from multilateral aspects in future research activities. The Department of Nursing, Aino University is currently divided into the five areas and further into 12 fields. On the other hand, according to the Scientific Research Grant Program (2015 fiscal year), the research topics in nursing science is subdivided into the five areas; a) basic nursing, b) clinical nursing, c) lifelong developmental nursing, d) elderly nursing, and e) community health nursing

A literature review on neonate's brain activity for sensory experience <Review>

目的: 脳科学的手法の1つである近赤外分光法(near infrared spectroscopy : NIRS)を測定用具とした感覚刺激に対する新生児の大脳皮質の神経活動に関する研究を概観し, 大脳皮質の神経活動と看護ケアの関連を検討することの意義と課題を明らかにすること. 方法: 医中誌Web, PubMed(収載: 1993～2008年)をデータベースとし, 検索式(新生児OR早産児)AND(近赤外分光法), (neonates OR infants)AND(near infrared spectroscopy)を用いて収集した文献のうちNIRS指標を大脳皮質の神経活動指標として用いていた15文献について検討した. 結果: 検討された感覚刺激は「聴覚刺激」「視覚刺激」「侵害受容性刺激(採血)」「嗅覚刺激」「受動運動」で, 刺激に対する神経活動の測定部位は関連する感覚野か前頭葉であった. 対象は正常新生児又はNICU入院児で, 早産児を対象とした研究は侵害受容性刺激(採血)に関する研究が多かった. 刺激に対する神経活動時の測定部位での反応として, 酸化型ヘモグロビンや総ヘモグロビンの上昇が見られていたが, 研究間で刺激や測定部位が一定でなく, 刺激に対するNIRS指標の変化は十分に明らかではなかった. 結論: NIRSは既存の測定用具では評価できなかった新生児の感覚的経験を客観的に評価できることから, 新しい測定方法として期待されている一方, 測定用具としての感度を検討している段階であり, 既存の生理・行動指標と合わせた観察研究などの基礎的な研究の積み重ねが必要であると考えられた.Aim: The aim of this study was to survey neonate's brain activity for sensory experience and to clarify the meaning and issue of using cerebral monitoring technique for developmental care research. Method: A literature review covering the period from 1993 to 2008 was carried out using electronic database (Ichushi Web, PubMed), using the flowing formula; (neonates OR infants) AND (near infrared spectroscopy: NIRS). Fifteen researches were selected and organized. Result: The articles ware classified into five categories: the response to auditory stimulation, the response to visual stimulation, the response to pain stimulation, the response to olfactory stimulation, and the response to passive movement. Measurement regions were sensory parts of stimulation or frontal lobe. Subjects were normal or sick neonates, particularly preterm infants were surveyed about pain response. In many articles, oxy-hemoglobin and total-hemoglobin increased at brain activity for sensory stimulation, however it was unclear the well-defined pattern of regional brain activation as there were many kinds of stimulation and different measurement regions among articles. Conclusion: NIRS was thought as a new objective method of measuring sensory experience among neonates. However, the sensitivity of NIRS was not established. It was thought that fundamental research such as observational researches were required to establish well-defined brain responses of using NIRS

Utility of a Japanese version of the Premature Infant Pain Profile <Materials>

【背景】適切な疼痛管理には評価尺度が必要であるが, わが国には信頼性・妥当性が検証された新生児の疼痛評価尺度がない. 【目的】日本語版Premature Infant Pain Profile PIPPの信頼性・妥当性を検証し, 臨床及び研究で利用可能かを検討すること. 【方法】101名の早産児及び正期産児を対象に採血時にデータ収集を行った. 日本語版PIPPを用いて安静時, 接触時, 穿刺時, 終了時の反応を評価した. 分析は評価者間信頼性, 内的整合性, 構成概念妥当性を検討するために, 級内相関係数の算出, クロンバックa係数の算出, 繰り返しのある分散分析を行った. 【結果】30名の同一穿刺場面を4名の採点者が別々に評価した各項目の級内相関係数は, 0.87-0.93と高く, 内的整合性を示すクロンバックa係数は0.71であり信頼性は保たれていた. また穿刺時の得点は安静時, 接触時, 終了時のいずれの得点よりも有意に高く, 構成概念妥当性をも保たれていた。【結論】日本語版PIPPは, 新生児の疼痛評価尺度として国内での臨床及び研究で, 利用可能であると考えられた.Background: Assessment of neonatal infant pain is important for effective pain control; however, there is no pain scale for neonates in Japan. Purpose: To establish inter-rater reliability, internal consistency and construct validity of a Japanese version of the Premature Infant Pain Profile (PIPP). Method: 101 preterm and term neonates were measured under four conditions using the Japanese version of the PIPP; baseline, handling, skin puncture and after the procedure. Result: Inter-rater reliability analysis among 4 nurses of the pain event score of the PIPP had an intraclass correlation coefficient of 0.87-0.93. Cronbach's alpha for the six items was 0.71, suggesting that the measurements demonstrated acceptable internal consistency. The mean total PIPP score for the pain condition (skin puncture) was significantly different from other conditions (baseline, handling and after the procedure), suggesting that the scale accurately discriminating between pain and nonpain conditions. Conclusion: The Japanese version of the Premature Infant Pain Profile reliable and so a valid instrument for pain assessment in neonates

Investigation of an Equivalence of Pain Assessment by a ]apanese Version of the Premature Infant Pain Profile among Neonatal Nurses

日本語版 Premature Infant Pain Profile (PIPP)の臨床での活用可能性を検討することを目的として,異なる施設に所属する Neonatal Intensive Care Unit (NICU)看護師8名を対象とし,28の同一採血場面を日本語版PIPPで採点した場合の評価者間信頼性を検討した。また,NICU勤務経験5年以上の群と5年未満の群で疼痛評価に違いがあるのかも検討した。評価者間信頼性は先行研究よりも低かったが,NICU勤務経験5年以上の群と5年未満の群でPIPP総得点の有意な違いはなかった。これらのことから,日本語版PIPPは臨床における新生児の疼痛評価に有用であると考えられた