一般病院における外来看護師の在宅療養患者支援の課題

一般病院の外来看護師の在宅療養指導実態を把握した。結果、在宅療養指導は半数も実施されておらず、看護業務以外の事務に時間を要することから時間がないことを実感している実態が明らかになった。一方、400床以下の中・小規模病院においては指導対象者や指導方法について模索している姿が明らかになった。今後、在宅療養指導対象者の選定や院内外の連携システムの構築が必要である

Using GIS to simulate tsunami evacuation guidance signs for the hearing impaired.

The Nankai Trough in Japan has been identified as a geological feature that could cause extensive damage in the event of a major earthquake. In this study, we investigated the impact of effective guidance signs for hearing-impaired individuals requiring special care when escaping to a tsunami evacuation building (emergency evacuation location) using geographical information system (GIS) and viewshed analysis. We selected an area we considered would suffer severe damage following a major earthquake and tsunami; we identified difficulties in the provision of escape routes. Using GIS, we determined the time required for escape and tsunami arrival time if effective signs were installed; we undertook such analysis using the height data of buildings in the target area. With effectively installed guidance signs, the average required evacuation time was 36.88 minutes; without such signs (which is currently the case in the target area), the average time was 47.10 minutes: that would result in citizens getting caught by the tsunami. Installing effective guidance signs would allow hearing-impaired individuals to escape to an evacuation building before being hit by the tsunami

Cell wall N-glycan of Candida albicans ameliorates early hyper- and late hypo-immunoreactivity in sepsis

Severe infection often causes a septic cytokine storm followed by immune exhaustion/paralysis. Not surprisingly, many pathogens are equipped with various anti-inflammatory mechanisms. Such mechanisms might be leveraged clinically to control septic cytokine storms. Here we show that N-glycan from pathogenic C. albicans ameliorates mouse sepsis through immunosuppressive cytokine IL-10. In a sepsis model using lipopolysaccharide (LPS), injection of the N-glycan upregulated serum IL-10, and suppressed pro-inflammatory IL-1 beta, TNF-alpha and IFN-gamma. The N-glycan also improved the survival of mice challenged by LPS. Analyses of structurally defined N-glycans from several yeast strains revealed that the mannose core is key to the upregulation of IL-10. Knocking out the C-type lectin Dectin-2 abrogated the N-glycan-mediated IL-10 augmentation. Furthermore, C. albicans N-glycan ameliorated immune exhaustion/immune paralysis after acute inflammation. Our results suggest a strategy where the immunosuppressive mechanism of one pathogen can be applied to attenuate a severe inflammation/cytokine storm caused by another pathogen

心の健康問題と成長曲線との関連について

出版社版平成16年に経験した倦怠感や頭痛,腹痛により不登校となった8例の成長曲線を記録し,どの段階で身長・体重増加率に変化が生じるかを検討した.心の健康問題が明らかにあった6例のうち,5例では身体症状が出現する前から体重増加率の減少があり,表向きの理由の背景には学業不振や両親の不和などが潜んでいた.しかし,6例とも身長増加率の低下はなかった.心の健康問題が明らかではない2例では,身体症状が出現する以前の成長曲線に問題はなかった.不登校児に対しても,成長曲線に変化が出現した時期を示して病歴の聴取やカウンセリングを行うことは隠されたライフイベントを探ることに有用であると考えられ