継続看護を学ぶ外来実習場面の研究 : 継続看護実践モデルを用いて

In recent years. visitors have many special fields of study, and the number of foreign patients is increasing.It is guessed that the training by visitors is many scenes in a short time.The foreign scene which can study continuous nursing is clarified in this research

International differences in gradients in early childhood overweight and obesity : the role of maternal employment and formal childcare attendance

Background There are significant cross-country differences in socio-economic gradients in later childhood and adulthood overweight/obesity; few studies assess whether this cross-national variation is evident from early childhood. Furthermore, the role of childcare in explaining overweight/obesity gradients might vary across countries, given differences in access, quality and heterogeneity within. Additionally, childcare is linked to parental characteristics such as maternal employment. The interplay between childcare and employment in producing early overweight/obesity gradients has received little attention, and might vary cross-nationally. Methods Using harmonized data from six high-quality, large datasets, we explore the variation in gradients in early overweight/obesity (at age 3–4 years old) by parental education across several high-income countries (USA, UK, France, the Netherlands, Germany and Japan). We then assess whether differential formal group care use attenuates some of these gradients, and whether this varies across maternal employment. Results Gradients in early childhood overweight/obesity by parental education are evident across several developed countries. Countries with higher overall prevalence of early overweight/obesity did not have the largest inequalities across education groups. The contribution of formal group care to producing these gradients varied across countries and across maternal employment status. Conclusion Early childhood inequalities in overweight/obesity are pervasive across developed countries, as noted for older children and adults. However, mechanisms producing these gradients vary across national contexts. Our study shows that, given the right context, quality childcare and maternal employment can successfully support healthy weight trajectories and not contribute (or even reduce) social inequalities in early overweight/obesity

Cross-national differences in socioeconomic achievement inequality in early primary school : the role of parental education and income in six countries

This paper presents comparative information on the socioeconomic status (SES) gradients in literacy skills at age 6-8, drawing on harmonized national datasets from France, Germany, Japan, the Netherlands, the United Kingdom, and the United States. We investigate whether understanding of comparative SES gradients in early-to-mid childhood depends on the operationalization of SES (parental education, income, or both); and whether differences in inequalities at the end of lower secondary schooling documented in international large-scale assessments are already present when children have experienced at most two years of formal compulsory schooling. We find marked differences in the SES gradient in early achievement across countries that are largely insensitive to the way SES is measured, and that seem to mirror inequalities reported for older students. We conclude that country context shapes the link between parental SES and children’s educational achievement, with country differences rooted in the early childhood period

In vivo partial cellular reprogramming enhances liver plasticity and regeneration.

Mammals have limited regenerative capacity, whereas some vertebrates, like fish and salamanders, are able to regenerate their organs efficiently. The regeneration in these species depends on cell dedifferentiation followed by proliferation. We generate a mouse model that enables the inducible expression of the four Yamanaka factors (Oct-3/4, Sox2, Klf4, and c-Myc, or 4F) specifically in hepatocytes. Transient in vivo 4F expression induces partial reprogramming of adult hepatocytes to a progenitor state and concomitantly increases cell proliferation. This is indicated by reduced expression of differentiated hepatic-lineage markers, an increase in markers of proliferation and chromatin modifiers, global changes in DNA accessibility, and an acquisition of liver stem and progenitor cell markers. Functionally, short-term expression of 4F enhances liver regenerative capacity through topoisomerase2-mediated partial reprogramming. Our results reveal that liver-specific 4F expression in vivo induces cellular plasticity and counteracts liver failure, suggesting that partial reprogramming may represent an avenue for enhancing tissue regeneration

Mutations in foregut SOX2+ cells induce efficient proliferation via CXCR2 pathway

Identification of the precise molecular pathways involved in oncogene-induced transformation may help us gain a better understanding of tumor initiation and promotion. Here, we demonstrate that SOX2+ foregut epithelial cells are prone to oncogenic transformation upon mutagenic insults, such as KrasG12D and p53 deletion. GFP-based lineage-tracing experiments indicate that SOX2+ cells are the cells-of-origin of esophagus and stomach hyperplasia. Our observations indicate distinct roles for oncogenic KRAS mutation and P53 deletion. p53 homozygous deletion is required for the acquisition of an invasive potential, and KrasG12D expression, but not p53 deletion, suffices for tumor formation. Global gene expression analysis reveals secreting factors upregulated in the hyperplasia induced by oncogenic KRAS and highlights a crucial role for the CXCR2 pathway in driving hyperplasia. Collectively, the array of genetic models presented here demonstrate that stratified epithelial cells are susceptible to oncogenic insults, which may lead to a better understanding of tumor initiation and aid in the design of new cancer therapeutics

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension