Impact of carotid atherosclerosis on long-term mortality in chronic hemodialysis patients

Impact of carotid atherosclerosis on long-term mortality in chronic hemodialysis patients.BackgroundCardiovascular event is the major cause of mortality in patients on maintenance hemodialysis. We prospectively tested the predictive values of atherosclerotic parameters for all-cause and cardiovascular outcomes in 219 hemodialysis patients (age, 58 ± 13 years; time on hemodialysis, 13 ± 7 years; male/female, 144/75).MethodsWe measured blood homocysteine (Hcy), ultrasound carotid artery intima media thickness (IMT) and % aortic wall calcification at L2/3 region [% of calcification index in the abdominal aortic wall (%ACI)] by computed tomography (CT) scan, and followed all patients for 5 years.ResultsDuring the follow-up periods, 54 patients (25%) died, 40 (74%) of them of cardiovascular causes. IMT was significantly higher in patients who expired (0.75 ± 0.02mm) than in those who survived (0.62 ± 0.01mm). IMT was significantly correlated with age (r = 0.47, P < 0.01) and %ACI (r = 0.27, P < 0.01). The survival rate during the observation was significantly lower in the final IMT third (58%) than in the first (90%) and the middle IMT third (80%) (P < 0.01). Multivariate Cox proportional hazards analysis revealed that diabetes and IMT became independent determinants of all-cause and cardiovascular death. Adjusted hazards ratios of all-cause and cardiovascular mortality for an increase of 0.1mm in IMT were 1.31 (95% CI, 1.07 to 1.59) and 1.41 (95% CI, 1.12 to 1.76). In contrast, %ACI at abdominal aorta and blood Hcy did not affect their 5-year mortality.ConclusionThese findings suggested that measurement of carotid artery IMT is useful for predicting long-term mortality in patients receiving maintenance hemodialysis

Nutritional Intakes of Obese Elementary School Children Residing in the Shimokita Peninsula of Aomori, Japan

This research examined the lifestyles and eating habits of 42 elementary school fifth graders(20 boys and 22 girls) over a 3-day period; these children resided in theShimokita Peninsula, Aomori prefecture, which has the highest childhood obesityrate in Japan. The children’s nutritionalintakes were recorded via questionnaires and self-documented meal recorddiaries overa 3-day period (1 weekday and the weekend). The meal record diaries recorded which meals the children ate (including snacks) during the 3-day period. A regular feature of these children’s lifestyle was theviewing of at least 3 hours of television per day. Compared with the National Health and Nutrition Survey conductedby the Japanese government, the nutritionaland energy intake levels were the same but when we examined food group intakes,the vegetable intake was lower on weekends in comparison to the weekdays whenthe children were provided school lunches. In addition, salt intake exceededthe recommended standard in more than 80% of the study sample. We suggest thatthe pattern of reduced vegetable intake juxtaposed with high salt intake stemsfrom childhood and is repeated and passed down through generations; therefore, theguardians of these children require nutritional guidance and education

Nutritional Intakes of Obese Elementary School Children Residing in the Shimokita Peninsula of Aomori, Japan

This researchexamined the lifestyles and eating habits of 42 elementary school fifth graders(20 boys and 22 girls) over a 3-day period; these children resided in theShimokita Peninsula, Aomori prefecture, which has the highest childhood obesityrate in Japan. The childrens nutritionalintakes were recorded via questionnaires and self-documented meal recorddiaries overa 3-day period (1 weekday and the weekend). The meal record diaries recorded which meals the children ate (including snacks) during the 3-day period. A regular feature of these childrens lifestyle was theviewing of at least 3 hours of television per day. Compared with the National Health and Nutrition Survey conductedby the Japanese government, the nutritionaland energy intake levels were the same but when we examined food group intakes,the vegetable intake was lower on weekends in comparison to the weekdays whenthe children were provided school lunches. In addition, salt intake exceededthe recommended standard in more than 80% of the study sample. We suggest thatthe pattern of reduced vegetable intake juxtaposed with high salt intake stemsfrom childhood and is repeated and passed down through generations; therefore, theguardians of these children require nutritional guidance and education

Cyclin D1 activation through ATF-2 in Reg-induced pancreatic β-cell regeneration

AbstractRegenerating gene product (Reg) is induced in pancreatic β-cells and acts as an autocrine/paracrine growth factor for regeneration via a cell surface Reg receptor. However, the manner by which Reg induces β-cell regeneration was unknown. In the present study, we found that Reg increased phospho-ATF-2, which binds to −57 to −52 of the cyclin D1 gene to activate the promoter. The Reg/ATF-2-induced cyclin D1 promoter activation was attenuated by PI(3)K inhibitors such as LY294002 and wortmannin. In Reg knockout mouse islets, the levels of phospho-ATF-2, cyclin D1, and phospho-Rb were greatly decreased. These results indicate that the Reg–Reg receptor system stimulates the PI(3)K/ATF-2/cyclin D1 signaling pathway to induce β-cell regeneration

介護福祉士養成における在宅介護実習の位置づけ

本研究は，在宅介護実習（介護実習Ⅲ）で獲得した在宅支援の視点が，施設をフィールドとし，介護過程の展開実習となる施設介護実習（介護実習Ⅳ）において，個別ケアを実践できる利用者本位の介護への実現にどの程度効果を発揮しているかを明らかにすることを目的としたものである．医療介護福祉科2年次生で介護実習Ⅲ及び介護実習Ⅳを終了した学生を対象に質問紙調査及びインタビュー調査を行った．その結果は，①介護実習Ⅲの学びとなる利用者の在宅への想いや物理的環境への意識の高まり，すなわち利用者本位に向かうアセスメントの視点が介護実習Ⅳへとつながっていること，②利用者との良好な関係形成を築くためのコミュニケーション力が介護実習Ⅳで発揮されていることが説明できた．介護実習Ⅲは，介護実習Ⅳで個別ケアを実践できる利用者本位の介護への実現に活かされていた

学生の視点から考える介護のやりがいとは : 介護実習IIを通して学んだ学生の気づきから

本稿では，1年次に行われる介護実習IIの施設介護実習（高齢者施設14日間）後の振り返りとして，実習直後に学生がまとめたレポート（指導者，職員からの指導，対人援助職として指導を受けたこと，実習を終えて介護福祉士としてのやりがい）を分析し，学生の視点から介護現場のやりがいとは何かを把握することを目的とした．結果，学生は，個別的な介護をする上でメモを活用すること，メモを見て確認すること，メモを基に目標を明確にし，実習で学びたいことを指導者に伝えていた．学生は，実習生として敬語を使う，メモをとるなど基本的な指導が介護を学ぶ上で重要であるか気づくことのできた実習であった．また，介護技術の手技だけでなく，尊厳を守りながらも安全に配慮するといった介護の基本理念を基に一人ひとりに合った介護技術をアセスメントし実践していた．利用者の気持ちを察すると，その想いに応えきれないときストレスを抱えやすい仕事でもある．しかしその反面，学生は，利用者に直接かかわるからこそ，利用者からの「ありがとう」という感謝の言葉に歓喜し，利用者の笑顔を引き出すことがやりがいにつながると感じていた

Evi1 is essential for hematopoietic stem cell self-renewal, and its expression marks hematopoietic cells with long-term multilineage repopulating activity

A new mouse in which an IRES-GFP cassette is knocked-in to the Evi1 locus reveals that HSC long-term multilineage repopulating activity specifically segregates with expression of the Evi1 transcription factor

The immunoreceptor adapter protein DAP12 suppresses B lymphocyte–driven adaptive immune responses

Human and mouse B cells lacking functional DAP12 are hyperresponsive, and DAP12 works with MAIR-II (CD300d) to negatively regulate B cell activity