Implementation of Home Health Care Nursing Education in Japan

In Japan, the focus of health care has been shifted from hospital-based to community-based care. In nursing fields, home health care nursing is expected to well implemented. Although our society is facing a problem of care of the elderly population, the target patients of home health care nursing are children to the elderly. In home health care nursing education, geriatric nursing focuses on various nursing care techniques in home care settings rather than management skills and leadership. In 1997, the new home health care nursing curriculum was mandated by a committee appointed by the Japanese Government. How have nursing junior colleges incorporated the new curriculum? We expected that the new curriculum might cause changes in nursing lectures and clinical practicum, so-far run on the 3-year associate degree program in Japanese national junior colleges of nursing. We analyzed the results of the survey, with a discussion of current problems: Among 17 junior colleges studied, 4 (23.5%) had incorporated the new curriculum, and the rest had made a plan of implementation. The methods of implementations varied among the colleges probably due to the lack of a common definition. Among many problems recognized, the main were: i) shortage of faculty members who can be in charge, ii) problems related with clinical sites, iii) absence of common background among the faculty members and iv) limitation of lecture hours. Training of faculty members in this fields was an immediate concern to the colleges

Relationship Between the Quality of Life in Patients with Intractable Diseases and the Information Telecommunication Service

This study evaluated the relationship of the quality of life (QOL) of home-care patients having intractable diseases with motor disabilities and the use of information telecommunication services. The investigation was carried out primarily with a questionnaire and interviewing for those incapable of writing. From the answers, the 171 patients were divided into high- and low-QOL groups based on the mean (32.5) and the median (33.0) values. Using a 2-by-2 contingency table, the activities of daily living (ADL), depression score and accessibility of information telecommunication services were compared. Both groups showed significant differences in the QOL, ADL and depression scores. The study suggested that the QOL of home-care patients with intractable diseases were related to ADL and depression. If ADL and depression are maintained at an adequate level, patients can be engaged in outside activities, receive stimulation and increase their motivation. In providing information about subjects familiar to patients with intractable diseases, such sources as the circulating neighborhood newsboard (kairanban), newspapers and mass media are very useful to improve their QOL. Furthermore, devices that support their living should also be developed with regard to their private likes and dislikes

The Necessity of Ethical Education for Clinical Nurses in Japan

In complex and diversified clinical settings, social needs for patients' rights are increasingly demanded. Although clinical nurses have not received systematic ethics education, they will face ethical problems on a daily basis. To solve these problems, we are required to offer ethics education to clinical nurses. We have conducted a seminar on ethics for clinical nurses at Tottori University Hospital. The purpose of this study is to clarify the current status of nursing ethics. Sixty-six clinical nurses attended this seminar from Tottori University Hospital. A questionnaire was used to collect data from 61 nurses. The following data were found: i) 56% had experience with ethical problems, ii) 49% have criteria for ethical judgment, iii) 83% answered that their understanding of ethics has deepened through this seminar and iv) almost all nurses who attended this seminar realized that nurses play an important role in advocating patients' self determination. Based on the results, we concluded that a seminar on nursing ethics provides opportunities for nurses to review his or her practice, to look back on their own nursing and to think about what ethical problems are. These findings also indicated the importance of continuing education on this problem for clinical nurses

Tumour resistance in induced pluripotent stem cells derived from naked mole-rats

The naked mole-rat (NMR, Heterocephalus glaber), which is the longest-lived rodent species, exhibits extraordinary resistance to cancer. Here we report that NMR somatic cells exhibit a unique tumour-suppressor response to reprogramming induction. In this study, we generate NMR-induced pluripotent stem cells (NMR-iPSCs) and find that NMR-iPSCs do not exhibit teratoma-forming tumorigenicity due to the species-specific activation of tumour-suppressor alternative reading frame (ARF) and a disruption mutation of the oncogene ES cell-expressed Ras (ERAS). The forced expression of Arf in mouse iPSCs markedly reduces tumorigenicity. Furthermore, we identify an NMR-specific tumour-suppression phenotype—ARF suppression-induced senescence (ASIS)—that may protect iPSCs and somatic cells from ARF suppression and, as a consequence, tumorigenicity. Thus, NMR-specific ARF regulation and the disruption of ERAS regulate tumour resistance in NMR-iPSCs. Our findings obtained from studies of NMR-iPSCs provide new insight into the mechanisms of tumorigenicity in iPSCs and cancer resistance in the NMR

Full characterization of GPCR monomer–dimer dynamic equilibrium by single molecule imaging

A single-molecule tracking technique coupled with mathematical modeling was developed for fully determining the dynamic monomer–dimer equilibrium of molecules in or on the plasma membrane, which will provide a framework for understanding signal transduction pathways initiated and regulated by dynamic dimers of membrane-localized receptors

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension