A study on the cost and willingness to recruit EPA foreign nurses and care workers in Japan: from the angle of hospitals and care facilities

Japan started accepting foreign nurses and care workers under the Economic Partnership Agreement（ EPA） in FY 2008. However, the number has been declining since FY2009 despite improved conditions. Many pointed out that the decline occurred mainly due to the constraints of supply side because the conditionality set by the EPA looked so strict for foreign workers. This paper highlights a problem of demand side ? economic cost for the hospitals and care facilities（ the employers）. A questionnaire survey was conducted and used for examining a hypothesis that high costs for the employers were a major cause of the decline. The survey revealed that employing the candidates required high economic costs including additional staff labor. Majority of employers indicated unwillingness to recruit further EPA candidates. However, statistical tests proved no significant relations between the costs and the willingness for nurses, while some positive relationships were confirmed for care workers. It suggests that non-economic factors exert strong influence on the demand for nurses. The current EPA system needs substantial modifications including easing conditionality and reducing economic costs for employers

Loss of maspin is a negative prognostic factor for invasion and metastasis in oral squamous cell carcinoma

金沢大学附属病院歯科口腔外科Objective: Maspin, a 42-kDa protein, belongs to the serpin family of protease inhibitors and is known to have tumor-suppressor function. In this study, we investigated the interrelationship between clinicopathologic findings and maspin expression in oral squamous cell carcinoma (OSCC). Methods: Using immunohistochemical techniques to examine the expression levels of maspin in OSCC, maspin expression in OSCC was detected in 46 (64.8%) of 71 cases. We also compared the clonicopathologic features of OSCC cases with maspin expression levels. Moreover, we examined expression of maspin in eight cell lines derived from OSCC using reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blotting. Results: There was a significant correlation between decreased maspin expression and T-category (P < 0.01), lymph metastasis (P < 0.0001), and mode of invasion (P < 0.0001). Patients with positive maspin expression had a significantly better prognosis (P < 0.001). Lower expression of maspin was also seen in cell lines derived from grade 4D, which shows stronger invasive potential than other grades of OSCC. Conclusion: Maspin may be a useful marker to identify the potential for progression in OSCC. © 2008 Blackwell Munksgaard

Enhanced AKT Phosphorylation of Circulating B Cells in Patients With Activated PI3Kδ Syndrome

Activated PI3Kδ syndrome (APDS) is a primary immunodeficiency characterized by recurrent respiratory tract infections, lymphoproliferation, and defective IgG production. Heterozygous mutations in PIK3CD, PIK3R1, or PTEN, which are related to the hyperactive phosphoinositide 3-kinase (PI3K) signaling, were recently presented to cause APDS1 or APDS2 (APDSs), or APDS-like (APDS-L) disorder. In this study, we examined the AKT phosphorylation of peripheral blood lymphocytes and monocytes in patients with APDSs and APDS-L by using flow cytometry. CD19+ B cells of peripheral blood in APDS2 patients showed the enhanced phosphorylation of AKT at Ser473 (pAKT) without any specific stimulation. The enhanced pAKT in CD19+ B cells was normalized by the addition of a p110δ inhibitor. In contrast, CD3+ T cells and CD14+ monocytes did not show the enhanced pAKT in the absence of stimulation. These findings were similarly observed in patients with APDS1 and APDS-L. Among CD19+ B cells, enhanced pAKT was prominently detected in CD10+ immature B cells compared with CD10− mature B cells. Enhanced pAKT was not observed in B cells of healthy controls, patients with common variable immunodeficiency, and hyper IgM syndrome due to CD40L deficiency. These results suggest that the enhanced pAKT in circulating B cells may be useful for the discrimination of APDS1, APDS2, and APDS-L from other antibody deficiencies.The Supplementary Material for this article can be found online at https://www.frontiersin.org/articles/10.3389/fimmu.2018.00568/full#supplementary-material.This study was supported in part by Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (16H05355 and 16K15528 to SO, 17H04233 to SN), the Ministry of Health, Labour and Welfare, Japan (17933299 to SN), and Practical Research Project for Rare/Intractable Diseases from Japan Agency for Medical Research and Development, AMED

A study on the cost and willingness to recruit EPA foreign nurses and care workers in Japan: from the angle of hospitals and care facilities

Japan started accepting foreign nurses and care workers under the Economic Partnership Agreement（ EPA） in FY 2008. However, the number has been declining since FY2009 despite improved conditions. Many pointed out that the decline occurred mainly due to the constraints of supply side because the conditionality set by the EPA looked so strict for foreign workers. This paper highlights a problem of demand side ? economic cost for the hospitals and care facilities（ the employers）. A questionnaire survey was conducted and used for examining a hypothesis that high costs for the employers were a major cause of the decline. The survey revealed that employing the candidates required high economic costs including additional staff labor. Majority of employers indicated unwillingness to recruit further EPA candidates. However, statistical tests proved no significant relations between the costs and the willingness for nurses, while some positive relationships were confirmed for care workers. It suggests that non-economic factors exert strong influence on the demand for nurses. The current EPA system needs substantial modifications including easing conditionality and reducing economic costs for employers