実親と暮らせない虐待被害児の養育上の課題および看護支援に関する研究： 児童養護施設・ファミリーホーム・里親への全国調査を通して

京都府立医科大学医学部看護学科滋賀医科大学医学部看護学科福岡女学院看護大学看護学部看護学科名古屋学芸大学看護学部看護学科長崎大学大学院医歯薬学総合研究科School of Nursing, Kyoto Prefecture University of MedicinSchool of Nursing, Shiga University of Medical ScienceFukuoka Jo-Gakuin Nursing UniversityFaculty of Nursing, Nagoya University of Arts and SciencesGraduate School of Biomedical Sciences, Nagasaki University　本研究は、実親と暮らせない児童の養育を担う児童養護施設およびファミリーホーム、里親を対象に、虐待被害児の自立と生活支援の観点から、養育上の課題、看護師への相談・支援ニーズの検討を目的とした。　全国の児童養護施設593ヵ所、ファミリーホーム136ヵ所、里親1050ヵ所、計1779ヵ所を対象に485ヵ所から回答を得た。全体の回収率は27.3% で、調査の結果、児童養護施設における虐待被害児の養育困難な事柄として、①コミュニケーションの学習、②ストレス対処の学習、③年齢相応の学力の習得、④家族としてのルールの習得、⑤基本的生活習慣の獲得などが高い割合を占めた。　さらに、障害や慢性疾患をもつ児童の養育経験は児童養護施設、ファミリーホーム、里親の全てにおいて高い割合を示し、養育上の課題が浮き彫りになった。看護師による相談支援では「児童の身体や健康状態・病気」、「児童の精神的な問題」といったニーズが高い割合を占めた

Effects and Nursing Considerations for Equine-Assisted Activities and Therapies for Children with Autism Spectrum Disorders: A Literature Review

This literature review aimed to analyze the effects and nursing challenges associated with equine-assisted activities and therapies (EAATs) for children with autism spectrum disorders (ASD). The study utilized the PubMed, CINAHL, and MEDLINE databases to identify 24 relevant articles. The effective contents were classified into two major categories: effects on interpersonal relationships, and effects attributable to the physical and emotional aspects of the lives of the children. The medical staff involved were mainly occupational therapists, followed by physical therapists and speech-language pathologists. The included studies also mention the involvement of trained equine therapists and volunteers, but not the involvement of nurses. Considering the unique characteristics of EAATs in various settings and the individual needs of the recipients of the therapy, this study highlights the importance of tailoring therapy to individual needs. Nurses should be aware of the potential benefits of EAATs in improving the overall well-being of children with ASD and should consider collaborating with other health care professionals to provide comprehensive care

Treatment and Effective Removal of Metal Fine Particles from Waste Cutting Fluids by Flotation via Microbubbles and Skimming

Cutting fluids (CFs) are chemical liquids or aqueous emulsions of mineral (or synthetic) oil widely used in metal-machining processes. They contain toxic organic compounds and petroleum products, and spent CFs contain numerous small metal particles derived from the processing of metal workpieces. The iron fine particles (IFPs) in CFs can diminish the quality and precision of machine products. Machining industries purchase large amounts of CFs, which they must treat appropriately and from which they must remove the IFPs; therefore, cost-effective ways to treat spent CFs are needed. In this study, we evaluated the effectiveness of collecting and separating the IFPs and treating organic matter in spent CFs using microbubbles (MiBs). We found that numerous IFPs with sizes of ~1 μm were suspended in spent CFs and that they could be very effectively removed by bubbling with MiBs and skimming the surface of the CFs. The lifetime of the CFs could be doubled via this treatment. The cost for treating spent CFs using MiBs was 12% lower than the cost of traditional treatment. These results strongly suggest that bubbling with MiBs is a cost-effective and eco-friendly way to treat spent CFs

Impaired brain fractalkine-CX3CR1 signaling is implicated in cognitive dysfunction in diet-induced obese mice

Introduction A diet high in saturated fat is well known to affect neuronal function and contribute to cognitive decline in experimental animals and humans. Fractalkine released from neurons acts on its receptor, CX3C chemokine receptor 1 (CX3CR1), in the microglia to regulate several brain functions. The present study addressed whether fractalkine-CX3CR1 signaling in the brain, especially the hippocampus, contributes to the cognitive deficits observed in diet-induced obese (DIO) mice.Research design and methods Mice were given 60% high-fat diet for 16 weeks. The expression of fractalkine and CX3CR1 in the hippocampus, amygdala and prefrontal cortex of DIO mice was analyzed. Cognitive ability in the Y-maze test and hippocampal glutamate receptors and synaptic markers were observed in DIO and CX3CR1 antagonist-treated mice. Regulation of fractalkine and CX3CR1 expression in the hippocampus was examined following administration of a selective insulin-like growth factor-1 (IGF-1) receptor inhibitor and a tyrosine receptor kinase B (TrkB) antagonist in normal mice.Results DIO mice exhibited significant cognitive deficits in the Y-maze test and decrease in fractalkine and CX3CR1 in the hippocampus and amygdala compared with mice fed a control diet (CD mice). Administration of the CX3CR1 antagonist 18a in normal mice induced significant cognitive deficits in the Y-maze test. DIO mice and CX3CR1 antagonist-treated mice exhibited significant decreases in protein levels of NMDA (N-methyl-D-aspartate) receptor subunit (NR2A), AMPA (α-amino-5-methyl-3-hydroxy-4-isoxazole propionate) receptor subunit (GluR1) and postsynaptic density protein 95 in the hippocampus compared with their respective controls. Furthermore, plasma IGF-1 and hippocampal brain-derived neurotrophic factor were significantly decreased in DIO mice compared with CD mice. Administration of a selective IGF-1 receptor inhibitor and a TrkB antagonist in normal mice significantly decreased fractalkine and CX3CR1 in the hippocampus.Conclusions These findings indicate that the cognitive decline observed in DIO mice is due, in part, to reduced fractalkine-CX3CR1 signaling in the corticolimbic system

Association between physical activity and change in renal function in patients after acute myocardial infarction.

BackgroundCombined renal dysfunction worsens the subsequent prognosis in patients after acute myocardial infarction (AMI). Therefore, establishing a therapeutic modality to maintain or improve renal function in AMI patients is necessary. This study aimed to elucidate the association between physical activity level and change in renal function in such patients.DesignProspective and observational study.MethodsWe enrolled 41 patients (35 men; average age, 67.5 ± 12.6 years) after AMI onset. Blood biochemistry, urinalysis, and physical function tests were conducted at discharge and 3 months after discharge. Renal function was evaluated based on cystatin C based-estimated glomerular filtration rate (eGFRcys). The number of steps was recorded for 3 months post-discharge. Generalized estimating equations (GEE) was used to test the association between physical activity level and within-patient changes in eGFRcys.ResultsPatients were stratified into low (n = 21; number of steps, 2335 ± 1219 steps/day) and high groups (n = 20; number of steps, 7102 ± 2365 steps/day). eGFRcys significantly increased from baseline to after 3 months in the high group (76.5 ± 13.8 to 83.2 ± 16.0 mL/min/1.73 m2, q = 0.004), whereas no significant change was observed in the low group (65.1 ± 15.9 to 62.2 ± 20.2 mL/min/1.73 m2, q = 0.125). Result of GEE adjusted for potential confounding variables showed a significant positive association between physical activity level and within-patient changes in eGFRcys (p = 0.003). Changes in eGFRcys was -2.9 mL/min/1.73 m2 among low group versus +6.7 mL/min/1.73 m2 among high group.ConclusionsPhysical activity level was positively associated with changes in renal function, demonstrating that high physical activity may suppress renal function decline in patients after AMI

精神科病棟に勤務する看護師の患者-看護師関係における「巻き込まれ」の体験

　本研究は精神科病棟に勤務する看護師の「巻き込まれ」の体験を明らかにすることを目的とする。Z県内の精神科単科病院に勤務する精神科での看護師経験年数が5年以上の看護師6名に1人につき2回の半構造化面接を行った。データの分析には質的帰納的手法を用いた。インタビューから「巻き込まれ」の体験に関するコードを525語抽出し、4の大カテゴリ、14の中カテゴリ、37の小カテゴリを生成した。精神科病棟に勤務する看護師の「巻き込まれ」の体験は、[患者のニーズを捉えられない]、[患者を理解できない苦痛]、[自分一人の力によって解決しなくてはいけないという思い込み]、[患者の状況や自分の傾向を振り返ることによる客観的視点の獲得]であった。「巻き込まれ」の体験は、事態を可視化し状況の整理を図ることにより、看護師としての成長を促す体験になると示唆された。This study aimed to explore the over—involvement experience in nurse—patient relationships in a psychiatric ward.The study involved six nurses, each with ≥ 5 years of experience as a psychiatric nurse, who took part in two semi—structured interviews. The data were categorized qualitatively by classifying 525 types of nurse—patient connections into four categories: 1) failing to recognize the patient\u27s needs; 2) feeling distress from not understanding the patient; 3) a strong opinion that things should be solved by oneself; and 4) acquiring an objective perspective by reviewing a patient\u27s situation and one\u27s own tendencies. The overinvolvement experience could encourage professional growth by visualizing that situation

終末期の看護における看護師の困難感に関する文献検討

本研究の目的は、終末期看護における看護師の困難感に関する国内の文献の動向を把握し、困難感の内容を明らかにすることである。文献は、医学中央雑誌Web版を用いて検索し、2015年から2020年（検索日2020年11月26日）までに掲載された文献より、研究目的に合致すると確認した28件を研究対象とした。その結果、看護師の困難に影響する要因として、1）ケアに影響を与える看護師個人の要因、2）患者・医療者との関係に起因する要因の2つに大別された。結果から、看護師は悲嘆する患者や家族を支援するなかで、自身の感情マネジメントをすることに困難を抱いていることが捉えられた。今後、看護師自身が終末期の患者や家族の看護をする中で得る感情や課題に向き合うことができるよう、継続的な支援が求められると考える。This study purposed to understand the literature trends regarding the distress experienced by nurses during Endof-Life care and to clarify the significance of this stress. A literature search was performed using the ICHUSHI web and, among articles published from 2015 to 2020 (search date: November 26, 2020), 28 articles deemed suitable for the research purpose were selected as subjects. Consequently, the issues experienced by nurses were classified into the following two categories: 1) factors attributable to the nurses themselves, and 2) factors attributable to relationships with patients and medical care providers. The results revealed that nurses experienced difficulty in managing their emotions while providing support to grieving patients and their families. Therefore, continuous support to the nurses is required to enable them to deal with the emotional challenges they face while caring for patients and their families during End-of-Life care

Role of musclin in the pathogenesis of hypertension in rat.

Musclin is a novel skeletal muscle-derived secretory factor found in the signal sequence trap of mouse skeletal muscle cDNAs. Musclin possesses a region homologous to the natriuretic peptide family. Thus, musclin is found to bind with the natriuretic peptide clearance receptors. However, the role of musclin in vascular regulation remains unclear. In this study, we aim to investigate the direct effect of musclin on vascular tone and to analyze its role in hypertension using the spontaneously hypertensive rats (SHR). In aortic strips isolated from SHR, musclin induced contractions in a dose-dependent manner. We found that the musclin-induced vasoconstriction was more marked in SHR than in normal rats (WKY). Moreover, this contraction was reduced by blockade of natriuretic peptide receptor C using the ab14355 antibody. Therefore, mediation of the natriuretic peptide receptor in musclin-induced vasoconstriction can be considered. In addition, similar to the natriuretic peptide receptor, expression of the musclin gene in blood vessels was higher in SHR than in WKY. Injection of musclin markedly increased the blood pressure in rats that can be inhibited by anti-musclin antibodies. Musclin-induced vasoconstriction was more pronounced in SHR than in WKY as in its expression. Taken together, these results suggest that musclin is involved in blood pressure regulation. The higher expression of musclin in hypertension indicates that musclin could be used as a new target for the treatment of hypertension in the future