急性期脳卒中ユニットにおける脳卒中ケアの看護師の認識と実際の看護実践状況 : 日本の横断的Webベースのアンケート調査

The awareness of care provided by stroke care unit (SCU) nurses in Japan to patients with an acute cerebrovascular accident (CVA) and the characteristic differences in their actual nursing practice were evaluated. A cross-sectional web-based questionnaire survey was administered to 1040 SCU nurses. Data collection and reporting procedures followed the STROBE Statement Checklist for cross-sectional studies. Exploratory factor analysis, using 52 observation items, identified eight factors with a factor loading > 0.4. For all factors, the actual practice was significantly lower than the awareness of the importance of nursing care for patients with acute CVA. Awareness and actual practice of recognition of patients’ physical changes (RPPCs) were high. The actual practice of RPPCs and preventing the worsening of acute stroke and related symptoms varied, depending on years of experience in acute phase stroke care. RPPCs in actual practice had a significantly higher score among certified nurses or certified nurse specialists. Their awareness of the importance of collaborating with therapists was low. On-the-job training can improve nurses’ competence and prevent worsening conditions in patients with CVA. An emphasis on enhancing practice experience toward patients with acute CVA and facilitating the deployment of certified nurses in SCUs can improve nursing care practice

Key Points of Nursing Care for Patients with Acute Stroke

In patients with stroke, it has been proven that management by a specialized medical team for stroke treatment for several days immediately after stroke onset significantly reduces mortality, improves return-to-home rates, and positively impacts activities of daily living and quality of life after discharge. This chapter describes the key points of nursing care for patients with acute stroke, which include “Recognition of patients’ physical changes,” “Prevention of the worsening of acute stroke and related Symptoms,” “Reduction of patients’ physical distress,” “Appropriate management of patients’ physical conditions,” “Reacquisition of activities of daily living,” “Collaboration with rehabilitation therapists,” “Reduction of mental and social distress in patients and their families,” and “Reduction of the risk of recurrence and requirement of discharge support.” These points will have a positive impact on patients with stroke by improving the nurses’ competence to practice nursing and enhancing the quality of team care

An Advanced Training Program Development for School Teachers and Staff: Purposes and Activities of Okayama Center, National Institute for School Teachers and Staff Development (NITS Okayama Center)

本論文では，これからの教師の学びの在り方を明らかにしたうえで，教師の学びを保障する場やその特質について考察する。具体的には，まず，近年の教員政策のなかで求められる教師像をもとに，教師の学びがどのように意味づけられるかを明らかにする。そのうえで，既存の教師の学びの場である教育委員会等が企画運営する研修，教職大学院，各学校で行われる校内研修等との比較により，（独）教職員支援機構岡山大学センターが構想する研修プログラムの特色を描出し，教職員の学びが深化するためのしくみを構築することの必要性と重要性を指摘したい。と同時に，教職員の学びの成果を可視化していくためには，研修プログラムに対するアウトカム重視の評価の開発が求められる。この点については今後の課題とする。This paper discusses the issues related to school teachers and staff development towards the future, including matters that how they gradually secure their learning opportunities in each stage of their careers and experiences and how university centers systematically ensure them professional development training programs. NITS Okayama Center has started to provide several training programs, in novelty and requirement distinguished from others: programs by local public bodies, local schools and teaching profession graduate schools. Through an inspection of our pilot programs, we basically point out that, first, the necessity to construct a system of making school teachers and staff’s learning process and outcome visible, and second, the importance to improve an evaluation method for training programs and to design that as an outcome model

Nurses’ Awareness and Actual Nursing Practice Situation of Stroke Care in Acute Stroke Units: A Japanese Cross-Sectional Web-Based Questionnaire Survey

The awareness of care provided by stroke care unit (SCU) nurses in Japan to patients with an acute cerebrovascular accident (CVA) and the characteristic differences in their actual nursing practice were evaluated. A cross-sectional web-based questionnaire survey was administered to 1040 SCU nurses. Data collection and reporting procedures followed the STROBE Statement Checklist for cross-sectional studies. Exploratory factor analysis, using 52 observation items, identified eight factors with a factor loading > 0.4. For all factors, the actual practice was significantly lower than the awareness of the importance of nursing care for patients with acute CVA. Awareness and actual practice of recognition of patients’ physical changes (RPPCs) were high. The actual practice of RPPCs and preventing the worsening of acute stroke and related symptoms varied, depending on years of experience in acute phase stroke care. RPPCs in actual practice had a significantly higher score among certified nurses or certified nurse specialists. Their awareness of the importance of collaborating with therapists was low. On-the-job training can improve nurses’ competence and prevent worsening conditions in patients with CVA. An emphasis on enhancing practice experience toward patients with acute CVA and facilitating the deployment of certified nurses in SCUs can improve nursing care practice

Cross-reactivity between major IgE core epitopes on Cry j 2 allergen of Japanese cedar pollen and relevant sequences on Cha o 2 allergen of Japanese cypress pollen

Background: Cry j 2 and Cha o 2 are major allergens in Japanese cedar (Cryptomeria japonica; CJ) and Japanese cypress (Chamaecyparis obtusa; CO) pollen, respectively. Here, we assessed the epitopes related to the cross-reactivity between Cry j 2 and Cha o 2 using in vitro analyses. Methods: Peptides were synthesized based on Cry j 2 sequential epitopes and relevant Cha o 2 amino acid sequences. Four representative monoclonal antibodies (mAbs) against Cry j 2 were used according to their epitope recognitions. Serum samples were collected from 31 patients with CJ pollinosis. To investigate cross-reactivity between Cry j 2 and Cha o 2, ELISA and inhibition ELISA were performed with mAbs and sera from patients with CJ pollinosis. Results: Two of four mAbs had reactivity to both Cry j 2 and Cha o 2. Of these two mAbs, one mAb (T27) recognized the amino acid sequence 169KVVNGRTV176 on Cha o 2. This is related to the core epitope 169KWVNGREI176 on Cry j 2, which is an important IgE epitope. In addition, we found that these correlative sequences and purified allergens showed cross-reactivity between Cry j 2 and Cha o 2 in IgE of CJ patients. Conclusions: We demonstrated the importance of 169KVVNGRTV176 in Cha o 2 for cross-reactivity with the Cry j 2 epitope 169KWVNGREI176, which plays an important role in allergenicity in CJ pollinosis. Our results are useful for the development of safer and more efficient therapeutic strategies for the treatment of CJ and CO pollen allergies

AFLP (Amplified Fragment Length Polymorphism:増幅断片長多型)解析による3倍性ギンブナ(Carassius auratus langsdorfi)に特徴的なゲノムマーカーの探索

The Japanese silver crucian carp (so-called ginbuna, Carassius auratus langsdrofi) has two reproduction systems; one is a sexual reproduction practiced by diploid individuals and the other is gynogenetic reproduction by triploid individuals. In this study, AFLP (Amplified Fragment Length Polymorphism) analysis was carried out to isolate and characterize genomic DNA markers for triploid ginbuna, as a step toward revealing the genomic makeup and origin of triploid ginbuna. Two valuable DNA markers were isolated from 14 fragments cloned from 3 AFLP fragments in the triploid ginbuna genome. Specific PCR analyses to these DNA markers and their sequencing analyses allowed us to divide the triploid ginbuna DNA into 6 genomic types (type A～F). The PCR products from many triploid ginbuna individuals comprising type A, C, D and E were shared with those from diploid ginbuna and those from the continental silver crucian carp, C. a. gibelio. The triploid ginbuna of type B appears to be derived from the gibelio crucian carp. These data provide additional evidence for the multiple origins of the triploid ginbuna and the genomic contribution made by the diploid ginbuna and the gibelio crucian carp to the triploid hybrid ginbuna

Isoform-specific monoclonal antibodies against 3β-hydroxysteroid dehydrogenase/isomerase family provide markers for subclassification of human primary aldosteronism.

[Context]: Therapeutic management of primary aldosteronism requires accurate differentiation between aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA). However, little is known about the molecular features that delineate the difference between APA and IHA. Two different isoforms of 3β-hydroxysteroid dehydrogenase (HSD3B1 and HSD3B2) are thought to be expressed in the human adrenal gland, but the lack of isoform-specific antibody has so far hampered mapping of these isoforms in APA and IHA. [Objectives]: The aim of our study is to develop and characterize isoform-specific monoclonal antibodies against HSD3B1 and HSD3B2. Using these antibodies, we determined for the first time the immunolocalization of HSD3B1 and HSD3B2 in normal human adrenal cortex as well as in adrenal specimens from APA and IHA. [Results]: Immunohistochemical analysis with isoform-specific antibodies revealed zone-specific expression of HSD3B1 and HSD3B2 in the adrenal cortex. HSD3B1 immunoreactivities were essentially confined to the zona glomerulosa (ZG), in which aldosterone is produced. In contrast, HSD3B2 was not confined to the ZG but was found across the zona fasciculata, which is where cortisol is produced. Moreover, immunohistopathological analysis of primary aldosteronism revealed a previously uncharacterized difference between APA and IHA. Notably, hyperplasia of ZG seen for IHA was accompanied by a robust expression of ZG isoform HSD3B1. In contrast, tumor cells in APA were not immunopositive to HSD3B1. Rather, a strong and dominant expression of HSD3B2 characterized APA. Moreover, perhaps due to compensatory responses to excess aldosterone, APA had an adjacent ZG whose immunoreactivities to HSD3B1 and HSD3B2 were profoundly reduced. [Conclusions]: Isoform-specific monoclonal antibodies against HSD3B1 and HSD3B2 may be of great value for immunohistochemical differentiation between APA and IHA