Effectiveness of simulation learning program for mastering public health nursing skills to enhance strength of community: A quasi-experimental design

Purpose: The purpose of this study is to develop a simulation learning program for mastering public health nursing skills to enhance strength of community, and to verify its effectiveness. Methods: The program is one-day session to master the skills from three exercises. This study adopts a quasi-experimental design. We selected unbiased 34 participants in intervention group and 30 participants in control group, and conducted self-administered questionnaire surveys at three points in time: pre, post 1 and post 2. Three tools were used to measure the required outcome. For the outcome evaluation, we calculated the changes in the mean value of each tool between pre and post 1 and between pre and post 2, and compared them between the two groups. Results: The change of intervention group in the total score at the post 1 stage from the pre stage was significantly higher than control group regarding each of the scales (P < .05). Conclusions: The program was found to be effective in upgrading the skills of less-experienced public health nurses to enhance strength of community

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

イギリス児童法（1908）成立過程における子ども像の統合 : 「子ども期の科学化」の内実

はじめに / 1.児童法（1908）の成立 : 「すべての子ども」の対象化 / 2. 生命と健康をめぐる子ども像の統合 / 3. 子ども像の基準となる身体 : 喫煙の問題化 / おわり

体力衰退に関する部局間委員会報告書（1904）にみる子どもの生命への着目

はじめに / １．国民の「体力衰退」問題への着目と調査の開始 / ２．「子どもの生命に関わる状況」（Conditions Attending Life of Juvenile Population）において見出された「体力衰退」の原因 / おわり

大学における教員養成の展開をめぐる研究動向

はじめに / 1.教育刷新委員会における戦後教員養成制度の成立 / 2.国立大学における「教育学部」の成立 / おわり

The influence of residual apixaban on bleeding complications during and after catheter ablation of atrial fibrillation

Background: The periprocedural protocol for atrial fibrillation (AF) ablation commonly includes anticoagulation therapy. Apixaban, a direct oral anticoagulant, is currently approved for clinical use; however, little is known about the effects of residual apixaban concentration on bleeding complications during/after AF ablation. Therefore, we measured residual apixaban concentration by using mass spectrometry and examined the anticoagulant's residual effects on bleeding complications. Methods: Fifty-eight patients (Mean age of 64.7±12.5 years; 31 males, 27 females) were enrolled and administered apixaban twice daily. We analyzed trough apixaban concentration, activated clotting time (ACT), heparin dose, and bleeding complications during/after AF ablation. Apixaban concentrations were directly measured using mass spectrometry. Results: Bleeding complications were observed in 19 patients (delayed hemostasis at the puncture site, 16; hematuria, 3; hemosputum, 1). No patient required blood transfusion. The mean trough apixaban concentration was significantly lower in patients with bleeding complications than without (152.4±73.1 vs. 206.8±98.8 ng/mL respectively, P=0.037), while the heparin dose to achieve ACT>300 s was significantly higher in patients with bleeding complications (9368.4±2929.0 vs. 7987.2±2135.2 U/body respectively, P=0.046). Interestingly, a negative correlation was found between the trough apixaban concentration and the heparin dose to achieve ACT>300 s (P=0.033, R=-0.281). Conclusions: Low residual plasma apixaban is associated with a higher incidence of bleeding complications during/after AF ablation, potentially because of a greater heparin requirement during AF ablation

教職課程における「学校と地域との連携」に関する理解と基礎知識に関する考察 : 「教育に関する社会的、制度的又は経営的事項」における指導法の開発に向けて

1. 問題の所在：教職課程コアカリキュラムに意図 / 2. 先行研究：「学校と地域との連携」に関する研究の状況 / 3. 「開かれた学校づくり」に関する政策の展開 / 4. 地域との連携・協働による学校教育活動の方法例1：地域におけるボランティア活動 / 5. 地域との連携・協働による学校教育活動の方法例2：地域資源を活用する / 6. 「学校と地域との連携」関する指導案の提案 / 7. 結語：教職課程を踏まえた地域との連携関係の構築の必要