A Comparative Study Of Nursing Educational System In Indonesia And Japan

According to Economic Partnership Agreement (EPA) between Indonesia and Japanese governments, Japanese government plans to recruit Indonesian nurses and caregivers to fulfill the demand of those positions at the hospital and health centers. However, to be a qualified worker in Japan, one has to pass a national examination that is conducted by the Minister of Health, Labor and Welfare for a license of a registered nurse within 3 or 4 years of working as a nurse or caregivers, respectively. Having considered that matter, a comparative study of the background of educational systems in Indonesia and Japan is discussed in this paper, with particular reference to the Diploma 3 nursing program. There is no specific difference between Indonesian and Japanese nursing educational systems. However, current health condition of the countries remains as the focus of the curriculums where Indonesian nursing education is focusing on communicable disease and surgery nursing, whereas Japanese is focusing on gerontology and chronic disease nursing. In case of qualification method, Japanese nurses should undertake national board examination to be a qualified nurse. On the other hand, there is no national board examination for Indonesian nurses

保育者の長期的なアイデンティティの変化と 自伝的記憶との関係

This study stands on long-term longitudinal research of 12 years from the training stage to the initial and middle terms. The study traced the changes in childcare worker identities and clarified the relationship between long-term changes in childcare worker identities and autobiographical memories. To be more specific, the study continuously applied the Multidimensional Ego Identity Scale (Tani, 2001a) to the training school graduation period, the initial term, and the transition from initial form to mid-career. Also, the study looked back on the past from the mid-career period. The childcare worker was subsequently asked for descriptions of childcare episodes as autobiographical memories. As a result, it turned out that there were four patterns of changes in the identities of childcare workers: “descending group,” “ascending group,” “low sustaining group,” and “high sustaining group.” These change patterns appeared to match the descriptions of the corresponding autobiographical memories. The study sorted out each group using extracted keywords and the like

Actual states of assistance for eating and expected roles of nursing professionals in intensive-care nursing homes for the elderly

The purpose of this study was to elucidate the conditions of mealtime assistance in intensive- care nursing homes for the elderly in Tottori prefecture and to examine the roles of nursing professionals. A questionnaire survey was conducted on managers and staff of 14 facilities from which consents were obtained. The analyzed subjects were 89 staff members of 12 facilities that responded. Comprehensive skills of mealtime assistance (5 categories, 21 items) were analyzed using (1) descriptive statistics on the type of work mainly performed and type of work preferably performed by certain professionals and (2) text-mining on the anxiety/burden of mealtime assistance. Caregiving was selected in 20 items for the main work performed. The following professionals were selected as those who should preferably perform certain care: nursing professionals performing care directly/immediately affecting lives, “observation of respiratory status”; rehabilitation professionals performing care for “posture maintenance and device use”; and nutrition professionals performing care related to “selection of food form” and “observation of nutritional status.” Mealtime anxiety/burden involved difficulty of determining swallowing status, aspiration, and choking. There was an expectation on nursing professionals, regarding their roles, to advise from a medical perspective based on their observations and assessment of patients’ respiratory and swallowing statuses

Energy Metabolism in Japanese Patients with Crohn’s Disease

We investigated energy expenditure in hospitalized patients with Crohn’s disease (CD), and determined optimal energy requirements for nutritional therapy. Sixteen patients (5 women and 11 men, mean age 36 year old, mean BMI 18.7 kg/m2) and 8 healthy volunteers were enrolled in this study. Measured resting energy expenditure (mREE) levels were determined by indirect calorimetry. The mREEs in CD patients were significantly higher than those of healthy controls (24.4 ± 2.4 kcal/kg/day vs 21.3 ± 1.7 kcal/kg/day). However, mREEs in CD patients were significantly lower than predicted REEs (pREEs) calculated by the Harris-Benedict equation (26.4 ± 2.5 kcal/kg/day). Furthermore, mREE/pREE values were lower in undernourished patients than in well-nourished patients. CD patients had hyper-metabolic statuses evaluated by mREE/body weight, but increased energy expenditure did not contribute to weight loss in these patients. In conclusion, nutritional therapy with 25–30 kcal/ideal body weight/day (calculated by mREE × active factor) may be optimal for active CD patients, while higher energy intake values pose the risk of overfeeding

Prevalence of Dementia and Mild Cognitive Impairment in the Rural Island Town of Ama-cho, Japan

Aims: In order to determine the prevalence of dementia and mild cognitive impairment (MCI), we conducted a population-based study in Japan. Methods: Participants included 924 subjects aged 65 years or older who resided in the town of Ama-cho. In phase 1 of the study, the Mini-Mental State Examination and Clinical Dementia Rating were administered for screening purposes. In phase 2 of the study, the subjects who screened positive were further examined by neurologists. Dementia and MCI were diagnosed by means of DSM-IV and International Working Group on MCI criteria, respectively. Results: By the prevalence date of June 1, 2010, 24 subjects had deceased or lived outside the town. In total, 723 of the remaining 900 subjects received a phase 1 test. In phase 2, 98 subjects were diagnosed with amnestic MCI, 113 subjects with non-amnestic MCI, and 82 subjects with dementia. Of the subjects who did not receive the phase 1 test, 66 subjects were diagnosed as having dementia according to data from their town medical card or the Long-term Care Insurance System. The crude prevalence of amnestic MCI, non-amnestic MCI, and dementia were 10.9, 12.6, and 16.4%, respectively. Conclusion: Consistent with the striking increase in the number of elderly individuals, we report higher prevalence of MCI and dementia in Japan than previously described

Increased serum HO-1 in hemophagocytic syndrome and adult-onset Still's disease: use in the differential diagnosis of hyperferritinemia

Heme oxygenase-1 (HO-1), an inducible heme-degrading enzyme, is expressed by macrophages and endothelial cells in response to various stresses. Because ferritin synthesis is stimulated by Fe(2+), which is a product of heme degradation, we examined the relation between HO-1 and ferritin levels in the serum of patients with hemophagocytic syndrome (HPS), adult-onset Still's disease (ASD), and other diseases that may cause hyperferritinemia. Seven patients with HPS, 10 with ASD, 73 with other rheumatic diseases, 20 with liver diseases, 10 recipients of repeated blood transfusion because of hematological disorders, and 22 healthy volunteers were enrolled. Serum HO-1 and ferritin levels were determined by ELISA. Expression of HO-1 mRNA and protein by peripheral blood mononuclear cells (PBMCs) was determined by real-time PCR and immunocytochemical techniques, respectively. Serum levels of HO-1 were significantly higher in patients with active HPS and ASD than in the other groups (P < 0.01). HO-1 levels were not elevated in patients with other causes of hyperferritinemia but were moderately elevated in patients with dermatomyositis/polymyositis. Among patients with HPS and ASD, serum HO-1 levels correlated closely with serum ferritin levels, and the levels of both returned to normal after therapy had induced remission. Increased expression of HO-1 mRNA was confirmed in PBMCs from some patients with HPS and ASD. Hyperferritinemia correlated closely with increased serum HO-1 in patients with HPS and ASD but not other conditions, indicating that measurement of serum HO-1 and ferritin levels would be useful in the differential diagnosis of hyperferritinemia and perhaps also in monitoring disease activity in HPS and ASD

Energy Expenditure in Japanese Patients with Severe or Moderate Ulcerative Colitis

We investigated the energy expenditure in hospitalized patients with severe or moderate ulcerative colitis (UC), and compared them to healthy controls. Thirteen patients (5 women and 8 men; mean age 31.8 years; mean BMI 19.0 kg/m2) and 10 healthy volunteers were enrolled in this study. The resting energy expenditure (mREE) levels were determined by indirect calorimetry. The mREEs of the UC patients were significantly higher than those of healthy controls (26.4 ± 3.6 vs 21.8 ± 1.7 kcal/kg/day), although the mREEs of the UC patients were almost the same as the predicted REEs (pREEs) calculated by the Harris-Benedict equation (26.4 ± 2.4 kcal/kg/day vs 26.5 ± 2.6 kcal/kg/day). The mREE/pREE ratio, which reflects stress, was 1.0 ± 0.15. In the UC patients, a significant correlation was observed between the mREEs and the clinical activity index. In conclusion, UC patients showed a hyper-metabolic status as evaluated by their mREE/body weight. Energy expenditure was significantly correlated with disease activity. From our observations, we recommend that nutritional management with more than 30–35 kcal/ideal body weight/day (calculated by the mREE × activity factor) may be optimal for active severe or moderate ulcerative colitis

Lack of Connexin43-Mediated Bergmann Glial Gap Junctional Coupling does not Affect Cerebellar Long-Term Depression, Motor Coordination, or Eyeblink Conditioning

Bergmann glial cells are specialized astrocytes in the cerebellum. In the mature cerebellar molecular layer, Bergmann glial processes are closely associated with Purkinje cells, enclosing Purkinje cell dendritic synapses with a glial sheath. There is intensive gap junctional coupling between Bergmann glial processes, but their significance in cerebellar functions is not known. Connexin43 (Cx43), a major component of astrocytic gap junction channels, is abundantly expressed in Bergmann glial cells. To examine the role of Cx43-mediated gap junctions between Bergmann glial cells in cerebellar functions, we generated Cx43 conditional knockout mice with the S100b-Cre transgenic line (Cx43fl/fl:S100b-Cre), which exhibited a significant loss of Cx43 in the Bergmann glial cells and astrocytes in the cerebellum with a postnatal onset. The Cx43fl/fl:S100b-Cre mice had normal cerebellar architecture. Although gap junctional coupling between the Bergmann glial cells measured by spreading of microinjected Lucifer yellow was virtually abolished in Cx43fl/fl:S100b-Cre mice, electrophysiologic analysis revealed that cerebellar long-term depression could be induced and maintained normally in their cerebellar slices. In addition, at the behavioral level, Cx43fl/fl:S100b-Cre mice had normal motor coordination in the rotarod task and normal conditioned eyelid response. Our findings suggest that Cx43-mediated gap junctional coupling between Bergmann glial cells is not necessary for the neuron-glia interactions required for cerebellum-dependent motor coordination and motor learning