Pediatric Refugee Health Care Delivery in the Community Setting: An Educational Workshop for Multidisciplinary Family-Centered Care During Resettlement

Introduction: With 70.8 million people displaced worldwide, there is an increasing need for medical professionals to provide medical care to refugees. Insufficient training on refugee health poses a barrier to effective care delivery. Methods: This workshop addressed common challenges in providing family-centered pediatric refugee care in community settings as well as barriers related to policy changes. Presentations covered prearrival experiences, medical screening, and trauma-based care. In small groups, participants discussed cases that featured medical, behavioral health, social, and cultural factors impacting the provision of family-centered pediatric care that was culturally respectful and included shared decision-making. After the breakout session, each small group informed the larger group of topics discussed. Facilitators identified themes and reinforced key learning points. At the workshop\u27s conclusion, participants were guided to create their own personalized action plan. Results: This workshop was presented at two international conferences to more than 47 participants, including clinicians, nurse practitioners, pediatric residents, and medical students. Evaluations were completed by 34 individuals. Participants\u27 overall comfort level with taking care of refugee patients increased from 3.3 to 4.0 (on a 5-point scale, p = .24) during the 3-hour version of the workshop and from 3.8 to 4.0 (p = .43) in the 1-hour version of the workshop. Mean overall ratings of the 3- and 1-hour workshop versions on conference-administered evaluations were 4.8 and 4.2, respectively, on a 5-point scale. Discussions: This workshop was well received and equipped participants with knowledge, tools, and strategies regarding pediatric refugee health in a community setting

Autophagy controls centrosome number by degrading Cep63

Centrosome number is associated with the chromosome segregation and genomic stability. The ubiquitin–proteasome system is considered to be the main regulator of centrosome number. However, here we show that autophagy also regulates the number of centrosomes. Autophagy-deficient cells carry extra centrosomes. The autophagic regulation of centrosome number is dependent on a centrosomal protein of 63 (Cep63) given that cells lacking autophagy contain multiple Cep63 dots that are engulfed and digested by autophagy in wild-type cells, and that the upregulation of Cep63 increases centrosome number. Cep63 is recruited to autophagosomes via interaction with p62, a molecule crucial for selective autophagy. In vivo, hematopoietic cells from autophagy-deficient and p62−/− mice also contained multiple centrosomes. These results indicate that autophagy controls centrosome number by degrading Cep63

FXYD3 functionally demarcates an ancestral breast cancer stem cell subpopulation with features of drug-tolerant persisters

乳がんの再発を起こす原因細胞を解明. 京都大学プレスリリース. 2023-11-16.The heterogeneity of cancer stem cells (CSCs) within tumors presents a challenge in therapeutic targeting. To decipher the cellular plasticity that fuels phenotypic heterogeneity, we undertook single-cell transcriptomics analysis in triple-negative breast cancer (TNBC) to identify subpopulations in CSCs. We found a subpopulation of CSCs with ancestral features that is marked by FXYD domain–containing ion transport regulator 3 (FXYD3), a component of the Na⁺/K⁺ pump. Accordingly, FXYD3⁺ CSCs evolve and proliferate, while displaying traits of alveolar progenitors that are normally induced during pregnancy. Clinically, FXYD3⁺ CSCs were persistent during neoadjuvant chemotherapy, hence linking them to drug-tolerant persisters (DTPs) and identifying them as crucial therapeutic targets. Importantly, FXYD3⁺ CSCs were sensitive to senolytic Na⁺/K⁺ pump inhibitors, such as cardiac glycosides. Together, our data indicate that FXYD3⁺ CSCs with ancestral features are drivers of plasticity and chemoresistance in TNBC. Targeting the Na⁺/K⁺ pump could be an effective strategy to eliminate CSCs with ancestral and DTP features that could improve TNBC prognosis

Evaluation of an Education Program on Community Orientation among Community Health Nurses in Fiji

Abstract Aim The study objective was to evaluate the effectiveness of an education program to improve community orientation among community health nurses in Fiji. A 1.5‐day education program was developed that enabled participants to learn a concept through discussion, as they reviewed their experiences. Design This study used mixed methods research. Methods The education program involving 78 community health nurses and supervisors was conducted. The 30‐item Community Orientation among Community Health Nurses scale, six‐item program evaluation questionnaire, and participant reflection sheets were analyzed using both quantitative and qualitative methods. Results Program evaluations demonstrated high satisfaction among participants. The content analysis of participant views on community orientation revealed three categories; utilizing community intelligence in community activities, relationships with community members as a community health nurses, and human resource development tool. Our findings suggest that this education program should be held regularly, in conjunction with on‐the‐job and off‐site training

Application of Lactobaillus salivarius WB21 to the Oral Care of Healthy Older Adults: A Randomized, Double-Blind, Placebo-Controlled Crossover Comparative Study

Objective: A randomized, double-blind, placebo-controlled crossover comparative study was conducted in a healthy older population to assess the usefulness of Lactobacillus salivarius WB21 (WB21) ingestion for oral self-care. Methods: The study population included 33 healthy older individuals who were randomly divided into two groups (A and B). Group A consumed WB21 tablets during the first two months and placebo tablets during the following two months. Group B consumed placebo tablets during the first two months and WB21 tablets during the following two months. Before and after ingestion, oral examination, mouth odor test, and saliva collection were performed a total of four times. In addition, health conditions were obtained from a questionnaire survey at the study’s midpoint. Results: Two people in group A and one person in group B dropped out of the study. Thus, 15 people in group A and 15 people in group B were included in the analysis. Over two months of WB21 ingestion, salivary secretory IgA increased significantly (p = 0.047) and tongue coating score decreased significantly (p = 0.013). The plaque index, bleeding on probing, and mouth odor levels (H2S and CH3SH concentrations) did not change. During the 6-month study period, no caries, deterioration of periodontitis, or changes in oral health or systemic subjective symptoms were observed. Conclusion: Continuous ingestion of WB21-containing tablets may promote self-care of the teeth and mouths of healthy older adults. Trial registration: R000028335 (UMIN-CTR)

The state of current use of Home Visiting Nurse Station for home medical care for child and support for child care education

本研究では,小児のための訪問看護ステーションの活用及び,訪問看護ステーションと他施設間の連携・協働に関する現状と課題を明らかにすることを目的とした.調査対象は訪問看護ステーションを利用している子どもの親7名であった.調査方法は半構成型の面接調査とし,結果は記述的に分析した.子どもの主病名は低出生体重児,先天性表皮水泡症,低酵素性虚血脳症,喉頭軟化症,全前脳泡症であり,年齢は3ヶ月以上8歳8ヶ月以下,訪問看護ステーション利用期間は1ヶ月以上2年8ヶ月以下であった.調査結果から次の課題が明らかとなった : 1)退院直後から適切な訪問看護を提供するため,退院前の病院での子どもの状態観察や家族との話し合い,家族への訪問,病棟スタッフとの情報交換を行う必要がある.; 2)訪問看護師は医療面だけではなく,育児支援･指導や両親･家族の援助など幅広い看護ケアを提供していくことが重要である.; 3)各施設間での連携･協働が十分に確立していない状況下で,家族は各職種に対する役割を判断･選択していた.今後各施設間における連携･協働体制を確立していくことが不可欠である.Purposes of this qualitative study were to clarify the state of current use of Home Visiting Nurse Station (HVNSt) for children and cooperation and collaboration between HVNSt and related institutions.Subject population was 7 who used HVNSt for children. Diagnosis of children were very low birth weight, congenital epidermolysis bullosa, hypoxic ischemic encephalopathy or laryngomalacia. Age of them was from 3 months to 8 years 8 months. Period of use HVNSt were from 1 month to 2 years 8 months.Result were as follows: 1) Visiting Nurse should communicate with family and medical staff in hospital to get much information and provide good home medical care after discharge; 2)It is important for parent, brother and sister; 3)When communication and collaboration were not established with related institutions, family decided the role of each profession; thus connection with Visiting Nurse Station and related institutions must be established