在宅看護過程における看護計画立案の基盤となる能力 : 熟練の訪問看護ステーション管理者のインタビューから

近年、在宅ケアの需要が高まり、在宅看護教育の重要性が増しているが、在宅看護過程の計画立案の教育には大きな課題があることが報告されている。そこで本研究では、在宅看護計画立案の基盤となる能力を明らかにすることを目的とした。対象者は熟練の訪問看護ステーション管理者9名である。半構成的インタビューにて、在宅看護計画立案の基盤となる能力、知識、態度について質問し、得られたデータを質的帰納的に分析した。結果、在宅看護計画立案の基盤となる能力としては、療養者と家族のアセスメントを行うための【見て感じて把握する力】【情報を引き出す力】【察する力】と、生活の質を向上させる看護計画を立案するための【生活の質への着想力】と、これらの能力を支える【疾患と生活を探求する力】が必要であることが明らかになった。今後、これらの能力を向上させるための教育プログラムの検討が必要と考えられる。In recent years, the demand for home care has been increasing, and home care nursing education has become more important. However, it is reported that educational programs for planning in the home care nursing process have critical issues. Therefore, this study aimed to describe the basic abilities required to plan the home care nursing process. In this study, nine expert home-visit nursing station managers were interviewed regarding the basic abilities, knowledge, and attitude necessary to perform home care nursing planning through semi-structured methods. The results were analyzed using an inductive approach, which indicated the following five abilities required to perform home care nursing planning: the ability to identify physical conditions by observing and feeling, the ability to obtain information, the ability to deduce, knowledge of quality of life, and the ability to research about diseases and household skills. Three abilities, the ability to identify physical conditions by observing and feeling, ability to obtain information, and ability to deduce, are necessary to asses a home care patient and his/her family. Knowledge of quality of life is required for designing a nursing care plan to improve quality of life. The ability to research about diseases and household skills is suggested to supports other abilities. Therefore, development of educational programs to improve these abilities is necessary in the future

ANTIHEPATITIS C VIRUS ACTIVITY OF INDONESIAN MAHOGANY (TOONA SURENI)

 Objective: Toona sureni (Indonesian mahogany) is a member of Meliaceae family and locally known as suren. Previous study reported that T. sureni leaves extract exhibited antiviral activity with 50% inhibitory concentration (IC50) value of 13.9 ± 1.6 μg/ml against hepatitis C virus (HCV) J6/JFH1. Cytotoxicity analysis of T. sureni leaves extract did not reveal any cytotoxicity effect; therefore, further study was taken to investigate the active substances from the extract.Methods: Bioassay-guided isolation of anti-HCV was conducted using Huh-7.5 cells infected with HCV J6/JFH1 in the presence of extracts, fractions, or compounds from the plant.Results: Ethyl acetate fraction (Fr E) exhibited high anti-HCV activity with IC50 value of 1.7 μg/ml. Further, separation of Fr E by open column chromatography resulted in nine sub-fractions (sub-Fr E1-E9). Sub-Fr E3 and E4 have IC50 value of 29.90 μg/ml and 7.68 μg/ml, respectively. Polyphenols compounds have been isolated from sub-Fr E3 and E4. The structures have been determined to be ethyl gallate (1), methyl gallate (2), catechin (3), gallic acid (4), and quercetin 3-O-rhamnoside (5). Among the isolated compounds, gallic acid showed to possess strong anti-HCV activity with IC50 value of 15.9 μg/ml.Conclusion: T. sureni and its isolated compound, gallic acid, may be good candidates to develop for alternative and/or complementary agents of anti-HCV infection

Antiviral Activities of Indonesian Medicinal Plants in the East Java Region Against Hepatitis C Virus

Background Hepatitis C virus (HCV) is a major cause of liver disease and a potential cause of substantial morbidity and mortality worldwide. The overall prevalence of HCV infection is 2%, representing 120 million people worldwide. Current standard treatment using pegylated interferon and ribavirin is effective in only 50% of the patients infected with HCV genotype 1, and is associated with significant side effects. Therefore, it is still of importance to develop new drugs for treatment of HCV. Antiviral substances obtained from natural products, including medicinal plants, are potentially good targets to study. In this study, we evaluated Indonesian medicinal plants for their anti-HCV activities. Methods Ethanol extracts of 21 samples derived from 17 species of medicinal plants explored in the East Java region were tested. Anti-HCV activities were determined by a cell culture method using Huh7.5 cells and HCV strains of 9 different genotypes (1a to 7a, 1b and 2b). Results Four of the 21 samples tested showed antiviral activities against HCV: Toona sureni leaves (TSL) with 50% inhibitory concentrations (IC50) of 13.9 and 2.0 μg/ml against the HCV J6/JFH1-P47 and -P1 strains, respectively, Melicope latifolia leaves (MLL) with IC50 of 3.5 and 2.1 μg/ml, respectively, Melanolepis multiglandulosa stem (MMS) with IC50 of 17.1 and 6.2 μg/ml, respectively, and Ficus fistulosa leaves (FFL) with IC50 of 15.0 and 5.7 μg/ml, respectively. Time-of-addition experiments revealed that TSL and MLL inhibited both at the entry and post-entry steps while MMS and FFL principally at the entry step. TSL and MLL inhibited all of 11 HCV strains of all the genotypes tested to the same extent. On the other hand, FFL showed significantly weaker inhibitory activities against the HCV genotype 1a strain, and MMS against the HCV strains of genotypes 2b and 7a to a lesser extent, compared to the other HCV genotypes. Conclusions Ethanol extracts of TSL, MLL, MMS and FFL showed antiviral activities against all the HCV genotypes tested with the exception that some genotype(s) showed significant resistance to FFL and to MMS to a lesser extent. These plant extracts may be good candidates for the development of anti-HCV drug

虐待的行為指標の妥当性の検討 : 母親の虐待的行為得点と社会経済的状況・育児感情の関連

児童虐待の予防対策の充実は喫緊の課題となっているが、そのために必要な虐待の前段階を含む連続的な虐待の評価指標はこれまで開発されていない。このため本研究では、母親の虐待的行為の項目数と頻度からなる得点について、虐待の前段階を含む虐待評価指標としての妥当性を検討することを目的とした。本研究では、3-6歳の子どもを持つ母親を対象としてアンケート調査を実施し、虐待的行為得点と虐待の強力なリスク要因である社会経済的状況並びに育児感情との関連性を分析した。結果、虐待的行為得点は、十分な内的整合性を有するとともに、母子家庭、世帯収入の低さ、母親の低学歴と関連することが示された。また、虐待的行為得点は、育児負担感、育児不安と関係することが示された。したがって、本得点は、虐待の前段階を含む連続的な虐待の実態を把握するための指標として、一定の妥当性を有することが示唆された。Although taking some substantial prophylactic measures against maltreatment of children is an important subject, the index for prophylactic measures that can evaluate both the maltreatment and the preceding phase of maltreatment has not been developed so far. This study aimed to evaluate the validity of a score generated from a number of items and frequency of abusive maternal behavior as an index of both maltreatment and its preceding phase. An anonymous questionnaire survey of mothers rearing 3-6 year-old children was conducted, and relevance of abusive maternal behavior score and powerful risk factors of maltreatment was examined. As a result, the score of abusive maternal behavior had sufficient inner compatibility, and had the relationship with the following socioeconomic states: the single-mother family, the low household income and the mother\u27s low educational background. Moreover, it was shown that the score was related to burden of child-rearing and anxiety about child-rearing. Therefore, it was suggested that the abusive maternal behavior score have a certain validity to grasp the actual conditions of the maltreatment and the preceding phase of maltreatment

Inhibition of hepatitis C virus replication by chalepin and pseudane IX isolated from Ruta angustifolia leaves

Hepatitis C virus (HCV) infection is highly prevalent among global populations, with an estimated number of infected patients being 170 million. Approximately 70–80% of patients acutely infected with HCV will progress to chronic liver disease, such as liver cirrhosis and hepatocellular carcinoma, which is a substantial cause of morbidity and mortality worldwide. New therapies for HCV infection have been developed, however, the therapeutic efficacies still need to be improved. Medicinal plants are promising sources for antivirals against HCV. A variety of plants have been tested and proven to be beneficial as antiviral drug candidates against HCV. In this study, we examined extracts, their subfractions and isolated compounds of Ruta angustifolia leaves for antiviral activities against HCV in cell culture. We isolated six compounds, chalepin, scopoletin, γ-fagarine, arborinine, kokusaginine and pseudane IX. Among them, chalepin and pseudane IX showed strong anti-HCV activities with 50% inhibitory concentration (IC50) of 1.7 ± 0.5 and 1.4 ± 0.2 μg/ml, respectively, without apparent cytotoxicity. Their anti-HCV activities were stronger than that of ribavirin (2.8 ± 0.4 μg/ml), which has been widely used for the treatment of HCV infection. Mode-of-action analyses revealed that chalepin and pseudane IX inhibited HCV at the post-entry step and decreased the levels of HCV RNA replication and viral protein synthesis. We also observed that arborinine, kokusaginine and γ-fagarine possessed moderate levels of anti-HCV activities with IC50 values being 6.4 ± 0.7, 6.4 ± 1.6 and 20.4 ± 0.4 μg/ml, respectively, whereas scopoletin did not exert significant anti-HCV activities at 30 μg/ml

看護学生の新卒での訪問看護への就業に対する意識 : 在宅看護に興味関心を持つ学生のインタビュー調査から

目的： 本研究では在宅看護に興味関心を持つ看護学生のインタビュー調査から新卒での訪問看護への就業に対する意識を明らかにする。方法： 卒業研究または分野選択制実習を在宅看護分野としている看護学生11名にグループインタビューを実施し、質的帰納的分析を行った。結果： 学生の新卒での訪問看護への就業に対する意識として、【病院で多様な経験を積んでから訪問看護への就業を考えたい】【十分な卒後教育を受けたい】【新卒訪問看護就業の情報が少ない】【希少ゆえハードルが高い】【生活をみる視点を身につけやすい】の5カテゴリが明らかとなった。考察： 学生は、看護師としての多様な経験と学習の機会のニーズ、新卒での訪問看護就業に関する情報不足と不達、新卒訪問看護のメリットを感じていた。今後、学生の新卒での訪問看護就業を促進するための方策として、教育体制の充実、新卒での訪問看護就業に関する情報発信、新卒訪問看護の利点の提示が示唆された。Objective: This study clarifies the attitudes of nursing students toward working in home-visit nursing immediately after graduating by interviews with interested students.Method: Group interviews were held with 11 nursing students who had selected the home care nursing field for their graduation research or for their elective training course, and qualitative and inductive analyses were performed.Result: Attitudes regarding home visit nursing as a career immediately after graduating were abstracted into the five categories of: “Wanting to consider to work in home-visit nursing after gain many experiences in hospital,” “Wanting to receive sufficient postgraduate education,” “Scarcity of information regarding home visit nursing jobs for graduating students,” “Barriers to entry due to its being an unusual profession,” and “Ease of developing a perspective based on seeing how patients live.