地域生活を継続している慢性心不全患者のセルフケア －外来患者のセルフケア影響要因に注目して－

目的：外来治療を受けながら，地域生活を継続している慢性心不全患者のセルフケアを明らかにし，外来での看護援助の方向性を検討する．方法：研究参加者7 名を対象に，半構成的面接法によりデータ収集し，帰納的質的分析を行った．結果：【他者との相互関係の影響をうけるセルフケア】【病状理解の影響をうけるセルフケア】【生活習慣に影響を与えるセルフケア】の3 カテゴリーが抽出され，セルフケアの維持を強化している要因と継続を阻害する恐れがある要因が明らかになった．結論：外来での慢性心不全患者の看護では①患者の信頼を得るだけでなく，患者を信頼し更なる継続が期待できる医療者としての姿勢，②患者とともに病いと向き合う家族員との調整，③患者自身が様々な情報の中から，適切な情報を取捨選択していけるようになるための支援，④病状の正しい理解のための支援⑤緊急時の受診システムの確保のための支援など，患者・家族の背景に合わせて支援していくことが重要である．Objective: The objective of this study was to investigate the Self-Care of patients with chronic heart failure continuously living in an outpatient community setting.Methods: Seven patients underwent semi-structured interviews. The interview data were analyzed qualitatively and inductively.Results: Three categories: Self-Care under the influence of having interactions with other people, Self-Care under the influence of having an understanding of one’s disease condition, and Self-Care influencing the patient’s lifestyle were studied. Also, the factors which has strengthened the ability to maintain Self-Care and the factors which may inhibit the ability to maintain Self-Care were clarified.Conclusions: The results of this study showed that it is important in outpatient nursing for patients with chronic heart failure to support them in what is described below according to the situation of the patients and their family: 1) The attitude of the medical staff who can not only obtain reliability from a patient, but can trust a patient, 2) consultation with patients’ families for facing up to the disease with the patient, 3) support for the patients to make an appropriate choice concerning the various information about the disease, 4) support for the patients to correctly understand the clinical conditions and 5) support to secure a consultation system in an emergency

Development of a cluster of LXC containers

The consensus algorithms were designed to reach agreements in distributed systems trying to maintain a certain tolerance to failures. An application derived from these algorithms is ETCD, a type of key-value storage that provides a safe and reliable way to save data shared in a network of servers, allowing the preser- vation of the information in spite of the possible fall of the involved nodes . My thesis shows the design and operation of these algorithms, and addresses the question of how to man- age the ETCD database and which features involves, as well as recommendations of configuration settings to achieve the best performance of the system. Finally, an academic practice is presented, aimed to network students that would want to have a deeper knowledge about consensus algorithms applications in a distributed system

Pharmacokinetic aspects of retinal drug delivery

Drug delivery to the posterior eye segment is an important challenge in ophthalmology, because many diseases affect the retina and choroid leading to impaired vision or blindness. Currently, intravitreal injections are the method of choice to administer drugs to the retina, but this approach is applicable only in selected cases (e.g. anti-VEGF antibodies and soluble receptors). There are two basic approaches that can be adopted to improve retinal drug delivery: prolonged and/or retina targeted delivery of intravitreal drugs and use of other routes of drug administration, such as periocular, suprachoroidal, sub-retinal, systemic, or topical. Properties of the administration route, drug and delivery system determine the efficacy and safety of these approaches. Pharmacokinetic and pharmacodynamic factors determine the required dosing rates and doses that are needed for drug action. In addition, tolerability factors limit the use of many materials in ocular drug delivery. This review article provides a critical discussion of retinal drug delivery, particularly from the pharmacokinetic point of view. This article does not include an extensive review of drug delivery technologies, because they have already been reviewed several times recently. Instead, we aim to provide a systematic and quantitative view on the pharmacokinetic factors in drug delivery to the posterior eye segment. This review is based on the literature and unpublished data from the authors' laboratory.Peer reviewe

A Proposal for a High School Semester Course Entitled "The Intercultural Gap"

To Darren, the Japanese countryside was simply unbelievable. To think that these people still live as their relatives generations ago did was difficulty for a Honolulu boy like Darren to grasp in four weeks. And the little turn of events (meeting Ayake, to be exact) only added to the hustle and bustle of his brief trip. Indoctrinating Ayake into the good old American tradition of making a met, he intertwined his baby finger with hers: "Ayake, I'll bet that we will meet again.

日本における薬剤師による薬学的疑義照会の医療経済的有用性

東京理科大学201