Home caregivers of the elderly: their motivation andpositive feedback in caregiving

高齢者の在宅介護者7名に対して質問紙を用いた面接を行い,介護継続理由と介護より得たものの二側面について尋ねた｡その中で特に,それらがどのように介護者と高齢者のQOLを向上させるかに注目した｡介護継続理由については,愛情と家族の杵が最も重要であり,被介護者の健康の悪化が,しばしば在宅介護を中断させていた｡また家父長制に基づく性的役割が,介護者の義務感や伝統観に強く影響していることも明らかになった｡介護が始まった時期における被介護者からの希望や宗教的影響は,継続理由とはならないことが分かった｡また,介護から得るものが多いと感じていた2人の嫁は,介護に高い意欲を持っており,介護が価値ある体験であるという認識が,介護の動機付けを行っている可能性が示唆された。Seven home caregivers of the elderly were interviewed using questionnaires in two aspects; i.e. motivation to continue the care and positive feedback from the care itself. In particular, we focused on how these two aspects improve the quality of lives (QOL) of caregivers and the elderly. In terms of motivation, the affection and family bond are the most important factors and that deterioration of the elderly often make the caregivers to discontinue the care at home. Traditional view and gender roles based on the Japanese patriarchy have strong influence on the sense of obligation. Wish to be cared from the elderly in the early stage of the care and religious influence are not sources of strong motivations to continue. Two daughters-in laws who felt the feedback from the care have higher motivation, suggesting that positive recognition that the care gives a worthwhile experience, possibly provides a motivation for the care

Carbon-Ion Irradiation Suppresses Migration and Invasiveness of Human Pancreatic Carcinoma Cells MIAPaCa-2 via Rac1 and RhoA Degradation

PurposeTo investigate the mechanisms underlying the inhibition of cancer cell migration and invasion by carbon (C)-ion irradiation.Methods and MaterialsHuman pancreatic cancer cells MIAPaCa-2, AsPC-1, and BxPC-3 were treated by x-ray (4 Gy) or C-ion (0.5, 1, 2, or 4 Gy) irradiation, and their migration and invasion were assessed 2 days later. The levels of guanosine triphosphate (GTP)-bound Rac1 and RhoA were determined by the active GTPase pull-down assay with or without a proteasome inhibitor, and the binding of E3 ubiquitin ligase to GTP-bound Rac1 was examined by immunoprecipitation.ResultsCarbon-ion irradiation reduced the levels of GTP-bound Rac1 and RhoA, 2 major regulators of cell motility, in MIAPaCa-2 cells and GTP-bound Rac1 in AsPC-1 and BxPC-3 cells. Proteasome inhibition reversed the effect, indicating that C-ion irradiation induced Rac1 and RhoA degradation via the ubiquitin (Ub)-proteasome pathway. E3 Ub ligase X-linked inhibitor of apoptosis protein (XIAP), which directly targets Rac1, was selectively induced in C-ion–irradiated MIAPaCa-2 cells and coprecipitated with GTP-bound Rac1 in C-ion–irradiated cells, which was associated with Rac1 ubiquitination. Cell migration and invasion reduced by C-ion radiation were restored by short interfering RNA–mediated XIAP knockdown, indicating that XIAP is involved in C-ion–induced inhibition of cell motility.ConclusionIn contrast to x-ray irradiation, C-ion treatment inhibited the activity of Rac1 and RhoA in MIAPaCa-2 cells and Rac1 in AsPC-1 and BxPC-3 cells via Ub-mediated proteasomal degradation, thereby blocking the motility of these pancreatic cancer cells

Spermatic Cord Lymphoma: A Case Report and Literature Review

Spermatic cord lymphoma is a rare lethal disease. It has a poor prognosis even in stage I or II disease when treated locally, therefore, multidisciplinary treatment for early stage is recommended. On the other hand, the treatment of choice for stage III or IV spermatic cord lymphoma remains to be determined. It is said that spermatic cord lymphoma is clinicopathologically similar to primary testicular lymphoma, therefore the treatment of spermatic cord lymphoma has often been determined by reference to the recommended treatment for primary testicular lymphoma. Here we report a new case of spermatic cord lymphoma, which was found in stage IV disease. We also review thirty-three cases which have been reported as spermatic cord lymphoma to date, and discuss treatment options

Draft genome of the brown alga, Nemacystus decipiens, Onna-1 strain: Fusion of genes involved in the sulfated fucan biosynthesis pathway

The brown alga, Nemacystus decipiens ("ito-mozuku" in Japanese), is one of the major edible seaweeds, cultivated principally in Okinawa, Japan. N. decipiens is also a significant source of fucoidan, which has various physiological activities. To facilitate brown algal studies, we decoded the ~154 Mbp draft genome of N. decipiens Onna-1 strain. The genome is estimated to contain 15,156 protein-coding genes, ~78% of which are substantiated by corresponding mRNAs. Mitochondrial genes analysis showed a close relationship between N. decipiens and Cladosiphon okamuranus. Comparisons with the C. okamuranus and Ectocarpus siliculosus genomes identified a set of N. decipiens-specific genes. Gene ontology annotation showed more than half of these are classified as molecular function, enzymatic activity, and/or biological process. Extracellular matrix analysis revealed domains shared among three brown algae. Characterization of genes that encode enzymes involved in the biosynthetic pathway for sulfated fucan showed two sets of genes fused in the genome. One is a fusion of L-fucokinase and GDP-fucose pyrophosphorylase genes, a feature shared with C. okamuranus. Another fusion is between an ST-domain-containing gene and an alpha/beta hydrolase gene. Although the function of fused genes should be examined in future, these results suggest that N. decipiens is another promising source of fucoidan

看護師資格を有する医療安全管理者の医療事故対応におけるコンピテンシー：ナラティヴ分析

Background and Purpose: When a medical accident occurs, risk managers must respond, and because there is no time for them to take adequate physical and mental rest, they become exhausted. On the other hand, risk managers with nursing experience perform their duties based on nursing management expertise and skills, using the ability to build interpersonal relationships that they have cultivated in the course of their nursing duties. However, the competency with which nurses perform their duties in response to accidents has not been clarified. The purpose of this study was to identify the types of competencies demonstrated by risk managers in responding to medical accidents． Methods: We conducted unstructured interviews with seven nurse risk managers in seven acute hospitals, and their responses were reviewed. Narrative analysis was used in this study. Theme analysis was performed using structural analysis elements defined by Riessman. Results: Six themes were identified as competencies used in responding to medical accidents, namely: “the ability to get to the heart of the problem,” “the ability to identify the lead clinician,” “the ability to have sympathy in responding to the patient and family members,” “the ability to arrange opportunities for all parties involved in saving the patient’s life,” “the ability to introduce the perspective of care in a situation in which all parties involved refuse to compromise, ” “the ability to not be controlled by emotions and maintain objectivity.” Conclusion: The competencies demonstrated by nurse risk managers in responding to medical accidents were based on the nursing philosophy of responding to medical accidents with patient-centered care, and drew on nursing management skills accumulated through experience as a nurse manager. It is necessary to develop a training system for developing human resources capable of using nursing skills to respond to medical accidents

洗面ボウルの大きさと使いやすさに関する一実験

This study investigated the problems concerning the usability of washbowls. The questionnaires distributed before the experiment revealed frequent complaints by users that washbowls were narrow and that there was excessive splashing. The experiment was conducted to confirm the usability and splashing as a function of bowl size using three females subjects (21 to 23 years of age). Four washbowl sizes were selected from the results of the questionnaires : 34cm wide and 24cm long, 39cm wide and 28cm long, 50cm wide and 33.5cm long, and 65cm wide and 37cm long. Using these sizes and two shapes (elliptical and square), the splashing area during face washing was measured as an index of usability. Four sizes and two shapes were made clipping the shape out of the filter papers. The area of splashing for each size and shape was calculated from the weight of the splashing area traced and cut from non-woven fabric. As a result, the 39cm wide and 28cm long washbowl was most popular and had the widest splashing area. Washbowls over 50cm wide exhibited less splashing area. The splashing area did not differ significantly between 50cm wide and 65cm wide washbowls, or between elliptical and square shapes. The experiment demonstrated that washbowls should be at least 50cm wide

開発モデルにおける糖尿病高齢患者の家族介護者の介護負担要因の検討

The present study aimed to examine the factors contributing to burden among family caregivers of older adults with diabetes mellitus (DM), with regard to the characteristics of older adults as well as those of caregivers, caregiving self-efficacy and caregiver behavior toward diabetes support and social supports based on a conceptual development model. In total, １5１ family caregivers who were children or spouses responded (9３.8%). In this cross-sectional study, primary family caregivers were personally interviewed using a set of anonymous structured questionnaires for data collection from one hospital in Northern Vietnam. We examined the factors contributing to caregiver burden via linear regression analysis and pathway analysis. Most family caregivers were under 60 years old (66.9%) and female (７４.２%). Linear regression analysis indicated that family caregivers with chronic illness status (β = .２0), the number of hours of caring for older adults (β = .１5), self-efficacy (β =－.１6), and caregiver behavior toward DM care support (β =－.３9) were all significant factors contributing to caregiver burden (F = １0.３95, p < .00１, AdjR２ = .４１). Pathway analysis showed that chronic illness status was a significant direct predictor of caregiver burden, whereas the number of hours of caring for older adults both directly and indirectly predicted caregiver burden via mediators including self-efficacy and caregiver behavior toward DM care support (χ２ = １.0２１, df=１, p = .３１２, CFI = １.000, GFI = .99７, SRMR =.000, and RMSEA = .000). The characteristics of caregivers and their responsibility for older adults should be considered to decrease the burden of caregivers. Nursing intervention, social support, increased self-care and the acquisition of caregiving knowledge and skills might help in reducing family caregiver burden

Erlotinib デ induction therapy オ オコナッタ IIIAキ ヒショウサイボウ ハイガン ノ 1シュジュツレイ

［Background ］Erlotinib, epidermal growth factor receptor-tyrosine kinase inhibitor（EGFR-TKI）, is effective for advanced and metastatic non-small cell lung cancer（NSCLC）with EGFR mutation. However, the report of Erlotinib as induction therapy is rare. We report a surgical case of NSCLC with Erlotinib as induction therapy. ［Case ］A４１-years-old man, diagnosed left lung adenocarcinoma with EGFR mutation（exon１９deletion）, was referred to our hospital. CT showed that the tumor was ３５mm in S８ of the left lung and ＃７ lymphnode was swelling markedly（cT２aN２M０ stage ⅢA）. He took Erlotinib（１５０mg／day）for１２weeks at first because of EGFR mutation positive. The evaluation of Erlotinib was partial response in RESIST. He could take radical operation as lower lobe and lingual segment resection, because CT showed bulky ＃７got smaller significantly. There was no postoperative complication. The pathological finding was adenocarcinoma（papillary& acinartype）, PL０, v（＋）, ly（＋）, br（－）, pa（－）, pv（－）, Ef :１b,（ypT１aN２M０stage ⅢA）. He has taken adjuvant therapy（Erlotinib１５０mg／day）for２８weeks. There is no recurrence six months after operation. ［Conclusion ］It is possible that Erlotinib as induction-therapy is very effective in patients with EGFR mutation like this case ; however there is no evidence of EGFR-TKI as induction therapy. It is necessary to validate the effectiveness of Erlotinib as induction therapy