[実践報告] 認知症看護認定看護師に求める資質能力を探る取り組み

本取り組みは、認知症看護認定看護師（以下、DCN）に求める資質や能力を明らかにし、認定看護師教育を検討することを目的とした。　ＤＣＮ26名によるグループワークの結果、認定看護師に求める資質能力は「多角的な対象理解」「ケアによる貢献」「スタッフとの高い親和性」「柔軟な対応力」「他者への説明」「自らの能力の把握」「現状に対する問題意識」「ピアレビューへの参加」「個性発揮能力」「高い知識技術による指導」「モデルとなる実践の例示」「スタッフへの良い波及効果」の12項目が抽出された。　ＤＣＮが認知症者に対するケアの方向性を統一し、スタッフの認知症者に対して抱くネガティブな感情のサポート、さらに多職種連携を行うにあたり「スタッフとの高い親和性」は重要である。今後の認定看護師教育において、DCNがスタッフとの関係性を向上させるような教育支援の検討が必要である。This study aimed to examine certified nursing education through clarifying the performance abilities and personal characteristics required for certified nurses who hold the Dementia Nursing Certification Nurse（called “DCN-certified nurses”）．Group work was conducted with 26 DCN-certified nurses, and based on their group work experiences, the following 12 items were extracted as performance abilities and personal characteristics required for certified nurses: “a multidimensional understanding of people with dementia,” “their contribution to care,” “a good relationship with staff members,” “the ability to be flexible in their response,” “the ability to provide explanation to other people,” “an understanding of their own abilities, “awareness of the existing situation,” “their participation in peer review,” “the ability to demonstrate originality,” “a high level of leadership knowledge and skills,” “the ability to effectively model practical examples,” and “positive spillover eff ects on staff members”. “A good relationship with staff members” is considered highly important in standardizing the direction of care for people with dementia, alleviating negative feelings of staff members towards people with dementia, and moreover collaborating with a variety of professionals. In the vision for certified nursing education in the future, it is necessary to examine educational support in which DCN-certified nurses can help improve relationships with staff members

SNPs and interaction analyses of noelin 2, myocilin, and optineurin genes in Japanese patients with open-angle glaucoma. Invest Ophthalmol Vis Sci 47

PURPOSE. To evaluate the noelin 2 gene as a disease-causing factor for open-angle glaucoma (OAG) and the interactions between the noelin 2 (OLFM2), optineurin (OPTN), and myocilin (MYOC) genes. METHODS. OLFM2 was analyzed in 770 Japanese subjects including 215 patients with elevated intraocular pressure (IOP), 277 with normal IOP, 38 with juvenile open-angle glaucoma, and 240 control subjects. Two single-nucleotide polymorphisms (SNPs) in OPTN (c.412G3 A and c.603T3 A) and one SNP in MYOC (c.227G3 A) were examined. Single genes were investigated by univariate analysis and the gene-gene interactions by logistic regression analysis. Associations between genotypes and clinical characteristics at the time of diagnosis were examined. RESULTS. In OLFM2, 12 sequence variants were identified in 770 Japanese subjects. Arg144Gln (exon 4) was identified in two (0.3%) of the patients and in none of the control subjects. Combinations of OLFM2/317A and OPTN/412A or OLFM2/ 1281T and OPTN/412A were associated with patients with elevated IOP (P ϭ 0.018 or P ϭ 0.012, respectively). The combination of OLFM2/317G and OPTN/603A was significantly associated with elevated IOP (P ϭ 0.018). No significant association was detected between SNPs in OLFM2 and in MYOC. Patients with normal IOP and with OLFM2/ 678AϩOPTN/412G or OLFM2/1281CϩOPTN/412G had significantly worse visual field scores (P ϭ 0.022 or 0.030, respectively). CONCLUSIONS. The Arg144Gln mutation in OLFM2 is a possible disease-causing mutation in Japanese patients with OAG. Common polymorphisms in OLFM2 and OPTN may interactively contribute to the development of OAG, indicating a polygenic etiology. (Invest Ophthalmol Vis Sci. 2006;47:5368 -5375) DOI:10.1167/iovs.06-0196 G laucoma is the second leading cause of blindness worldwide, and is estimated to affect more than 60 million people. Open-angle glaucoma (OAG), the most common form, is present in almost 2% of the world's population older than 40 years. 1 Glaucoma includes a group of conditions that is characterized by progressive optic neuropathy with visual field changes corresponding to the damage of the retinal nerve fibers. These changes are usually associated with an elevation of intraocular pressure (IOP). Elevated IOP is generally accepted to be a major risk factor for glaucomatous changes. Genetic factors also play a major role in the etiology of OAG. 3 The first gene to be characterized was the trabecular meshwork-inducible glucocorticoid response (TIGR) gene on 1q. 14 Most of the mutations in MYOC are located in the olfactomedin domain. Olfactomedin is a secreted polymeric glycoprotein of unknown function with an evolutionarily conserved C-terminal motif. 5 Mukhopadhyay et al. 19 identified myocilin-related human proteins having a conserved olfactomedin domain using bioinformatics approaches and examined the expression patterns in the eye. Myocilin-related proteins with homology to human myocilin were selected by BLASTp

Changes in the quality of democracy from 1970 to 2020

Bakalaura darba nosaukums ir “Demokrātijas kvalitātes izmaiņas no 1970.gada līdz 2020.gadam”. Izvirzītais pētnieciskais jautājums ir: kādi apstākļi rada izmaiņas valsts demokrātiskās kvalitātes līmenī? Darba mērķis ir analizēt demokrātijas kvalitātes līmeņa izmaiņas septiņās valstīs laika posmā no 1970.gada līdz 2020.gadam. Darba teorētiskajā pamatā ir Roberta Dāla darbs “Polyarchy” un Semuela Hantingtona “Trešais vilnis”. Darba gadījuma pētniecība balstās uz Freedom House veikto apskatu par atbilstošo valsti un tās padziļinātu vēstures apskatu. Kopumā, tiek apskatītas sešas Eiropas valstis un Amerikas Savienotās valstis, kas sniegs informāciju par demokrātijas kvalitāti un mainošajiem apstākļiem. Darba rezultātā tiek noskaidrots, ka demokrātijas kvalitāti ietekmē sabiedrības pieredze ar demokrātisku sistēmu, terorisma draudi, konstitūcija un sabiedrības mainošie uzskati.The name of this paper is “Changes in the quality of democracy from 1970 to 2020”. The paper raises a research question: what circumstances cause change in a state’s level of democratic quality? The aim of this paper is to analyze the changes in the quality of democracy within seven countries between 1970 and 2020. The theoretical basis of this work formed from Robert Dahl’s work “Polyarchy” and Samuel Huntington’s work “The Third Wave”. The paper uses the case study method to inspect each country’s political history and Freedom House to attach a reliable score to its relative situation. The paper draws the conclusion that countries with long term democratic experience have less problems with threats to its systems or faster recoveries from a sudden stop of its democracy system, terrorism affects the quality of democracy and so does a state’s constitution. Changes in views are also a factor of change in the quality of democracy

On-chip in vitro cell-network pre-clinical cardiac toxicity using spatiotemporal human cardiomyocyte measurement on a chip

To overcome the limitations and misjudgments of conventional prediction of arrhythmic cardiotoxicity, we have developed an on-chip in vitro predictive cardiotoxicity assay using cardiomyocytes derived from human stem cells employing a constructive spatiotemporal two step measurement of fluctuation (short-term variability; STV) of cells repolarization and cell-to-cell conduction time, representing two origins of lethal arrhythmia. Temporal STV of field potential duration (FPD) showed a potential to predict the risks of lethal arrhythmia originated from repolarization dispersion for false negative compounds, which was not correctly predicted by conventional measurements using animal cells, even for non-QT prolonging clinical positive compounds. Spatial STV of conduction time delay also unveiled the proarrhythmic risk of asynchronous propagation in cell networks, whose risk cannot be correctly predicted by single-cell-based measurements, indicating the importance of the spatiotemporal fluctuation viewpoint of in vitro cell networks for precise prediction of lethal arrhythmia reaching clinical assessment such as thorough QT assay

Transition of the intestinal microbiota of cats with age.

The transition of intestinal microbiota with age has been well described in humans. However, the age-related changes in intestinal microbiota of cats have not been well studied. In the present study, we investigated the composition of intestinal microbiota of cats in 5 different age groups (pre-weanling, weanling, young, aged, senile) with a culture-based method. For lactobacilli and bifidobacteria, we also quantified with molecular-based method, real-time PCR. The results suggested that the composition of the feline intestinal microbiota changes with age, while the changes were different from those of humans and dogs. Bifidobacteria which are predominant in human intestine or lactobacilli which are predominant in dog intestine, did not appear to be important in cat intestines. Enterococci, instead, seem to be major lactic acid producing bacteria in cats. We also identified lactobacilli and bifidobacteria at the species level based on 16S rRNA gene sequences and found that the species composition of Lactobacillus also changed with age

Association of HK2 and NCK2 with normal tension glaucoma in the Japanese population.

Although family studies and genome-wide association studies have shown that genetic factors play a role in glaucoma, it has been difficult to identify the specific genetic variants involved. We tested 669 single nucleotide polymorphisms (SNPs) from the region of chromosome 2 that includes the GLC1B glaucoma locus for association with primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG) in the Japanese population. We performed a two-stage case-control study. The first cohort consisted of 123 POAG cases, 121 NTG cases and 120 controls: the second cohort consisted of 187 POAG cases, 286 NTG cases, and 271 controls. Out of six SNPs showing significant association with POAG in the first round screening, seven SNPs were tested in the second round. Rs678350 in the HK2 gene coding sequence showed significant allelic (p=0.0027 in Stage Two, 2.7XE-4 in meta-analysis) association with POAG, and significant allelic (p=4.7XE-4 in Stage Two, 1.0XE-5 in meta-analysis) association with NTG. Although alleles in the TMEM182 gene did not show significant association with glaucoma in the second round, subjects with the A/A allele in TMEM182 rs869833 showed worse visual field mean deviation (p=0.01). Even though rs2033008 in the NCK2 gene coding sequence did not show significant association in the first round, it had previously shown association with NTG so it was tested for association with NTG in round 2 (p=0.0053 in Stage Two). Immunohistochemistry showed that both HK2 and NCK2 are expressed in the retinal ganglion cell layer. Once multi-testing was taken into account, only HK2 showed significant association with POAG and NTG in Stage Two. Our data also support previous reports of NCK2 association with NTG, and raise questions about what role TMEM182 might play in phenotypic variability. Our data suggest that HK2 may play an important role in NTG in the Japanese population