日本の地域におけるナースプラクショナーの導入による健康上及び医療サービス利用上の効果に関する研究

学位の種別: 課程博士審査委員会委員 : （主査）東京大学教授 橋本 英樹, 東京大学教授 神馬 征峰, 東京大学講師 大西 弘高, 東京大学准教授 永田 智子, 東京大学准教授 武村 雪絵University of Tokyo(東京大学

Eosinophilic Granulomatosis with Polyangiitis Presenting with Myocarditis as an Initial Symptom: A Case Report and Review of the Literature

A 66-year-old woman with a history of bronchial asthma had shortness of breath and fatigue upon mild exercise. She was diagnosed as congestive heart failure. A blood test showed eosinophilia without the presence of anti-neutrophil cytoplasmic antibody (ANCA), and a myocardial biopsy specimen revealed eosinophilic infiltration in the myocardium. Eosinophilia was improved when she was administered short-term methylprednisolone. After that, she had numbness and pain in her lower limbs with re-elevation of eosinophils. She had dysesthesia and hypalgesia in the distal part of the limbs. Sural nerve biopsy revealed axonal degeneration and thickness of the arterial wall, indicating a diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA). Two courses of steroid pulse therapy were performed, resulting in marked improvement of her sensory symptoms. ANCA-negative EGPA might be associated with myocarditis and peripheral neuropathy. A sufficient immunotherapy should have been considered to prevent rapid progression

Research Activities in the Department of Nursing

Research activity at the Department of Nursing is overviewed from the point of research topics, the theme of the projects admitted for grant from the Ministry of Education and Science of Japan, and expected research topics, trying to clarify the needs and challenges of the Department from multilateral aspects in future research activities. The Department of Nursing, Aino University is currently divided into the five areas and further into 12 fields. On the other hand, according to the Scientific Research Grant Program (2015 fiscal year), the research topics in nursing science is subdivided into the five areas; a) basic nursing, b) clinical nursing, c) lifelong developmental nursing, d) elderly nursing, and e) community health nursing

住民による高齢者サロン運営の課題と対策

一般高齢者の介護予防推進事業である高齢者サロン運営の課題と対策を検討する目的で島根県出雲市C地区の高齢者サロンに参加して実態把握をするとともに、サロンの世話役・福祉委員・参加者等に実施したインタビュー結果をサロン活動の継続の困難さに視点を当て分析した。課題は①独居高齢者等の不参加②参加意欲維持の困難さ③働き盛り男性福祉委員の活動の困難性④世話役の高齢化と人材不足による活動の困難性⑤企画内容の工夫の困難性⑥活動記録等の保存と活用の不徹底⑦社会資源等の情報伝達と周知不足⑧予算確保の困難性・助成金の使途制限による使用の困難性⑨実施場所と回数の不足⑩実施場所の環境整備不足であった。対策として社会福祉協議会、自治協会・保健師などがサロン運営の課題を共有する機会を持ち、サロンを運営する世話役や福祉委員への情報提供や必要な支援することが重要である。また、高齢者が主体的に参加できるよう協力を求めながら実施していく必要がある

An assessment of the characteristics and quality of diagnostic accuracy studies for positron emission tomography conducted in Japan:a systematic review

BACKGROUND: Systematic evaluations of the diagnostic accuracy of positron emission tomography (PET) imaging have been widely conducted in many countries. Although Japan’s total number of PET units is the second highest in the world, very limited effort has been made to systematically assess the methodological quality of PET studies in Japan. We performed a systematic review to assess the characteristics and quality of PET diagnostic accuracy studies conducted in Japan and to analyze the factors related to their quality. METHODS: All PET studies conducted in Japan were identified using MEDLINE and the Japan Medical Abstract Society Database. The characteristics of the Japanese studies were examined and their methodological quality evaluated by the standardized quality assessment of diagnostic accuracy studies (QUADAS) tool. We compared the quality of studies indexed in MEDLINE with non-indexed studies, followed by a comparison of the studies’ conclusions with those of international health technology assessment (HTA) reports. RESULTS: A total of 138 studies were identified. Half of them were not indexed in MEDLINE. The mean quality score of the Japanese studies was 6.7 and the proportion of high-quality studies (with a quality score higher than 8) was 32.6%. A significant difference was observed in several quality items between MEDLINE-indexed and non-indexed studies, although there was no difference in total quality score. Three variables (i.e., target diseases, publication year, and study type) were identified as factors related to the quality of the studies. Conclusions of Japanese studies relating to several target diseases were relatively consistent with international assessments. CONCLUSIONS: Although a considerable number of diagnostic accuracy studies of PET have been conducted in Japan, a substantial proportion of high-quality studies were not indexed in international databases. High-quality Japanese studies, therefore, should be searched using Japanese databases and assessed by systematic reviews and HTA conducted internationally. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13550-015-0084-4) contains supplementary material, which is available to authorized users