Reactive 2-Quinolones Dearomatized by Steric Repulsion between 1-Methyl and 8-Substited Groups

Usual 1-methyl-2-quinolone (MeQone) derivatives are not reactive because of aromatic property in the heterocyclic ring. On the other hand, 8-substituted MeQones have been proved to be highly reactive, which is caused by steric repulsion between the 1-methyl and the 8-substituted groups. When 1-methyl-3,6,8-trinitro-2-quinolone was treated with potassium (or trimethylsilyl) cyanide, cyanation proceeded at the 4-position regioselectively as a result of cine-substitution. This reaction is initiated with addition of cyanide species, and the cyanoquinolone is formed by the protonation of the resultant anionic intermediate followed by elimination of nitrous acid. The high reactivity was maintained even when one of the nitro groups on the benzene moiety was replaced by a methyl group, which afforded corresponding cine-substituted products upon treatment with potassium cyanide

Toward Advanced Nursing Practice along with People-Centered Care Partnership Model for Sustainable Universal Health Coverage and Universal Access to Health

Objective: this study developed a people-centered care (PCC) partnership model for the aging society to address the challenges of social changes affecting people’s health and the new role of advanced practice nurses to sustain universal health coverage. Method: a people-centered care partnership model was developed on the basis of qualitative meta-synthesis of the literature and assessment of 14 related projects. The ongoing projects resulted in individual and social transformation by improving community health literacy and behaviors using people-centered care and enhancing partnership between healthcare providers and community members through advanced practice nurses. Results: people-centered care starts when community members and healthcare providers foreground health and social issues among community members and families. This model tackles these issues, creating new values concerning health and forming a social system that improves quality of life and social support to sustain universal health care through the process of building partnership with communities. Conclusion: a PCC partnership model addresses the challenges of social changes affecting general health and the new role of advanced practice nurses in sustaining UHC.Objetivo: este estudio desarrolló un modelo de alianza para el cuidado centrado en las personas (CCP) para una sociedad envejecida, que haga frente a los retos de los cambios sociales que afectan a la salud de las personas y el nuevo papel de las enfermeras de práctica avanzada para apoyar la cobertura universal de salud. Método: un modelo de alianza para el cuidado centrado en las personas fue desarrollado sobre la base de la meta-síntesis cualitativa de la literatura y la evaluación de 14 proyectos relacionados. Los proyectos en curso dieron lugar a la transformación individual y social mejorando la “alfabetización sanitaria” de la comunidad y los comportamientos, utilizando los cuidados centrados en las personas y aumentando la colaboración entre los profesionales sanitarios y miembros de la comunidad a través de las enfermeras de práctica avanzada. Resultados: el cuidado centrado en las personas comienza cuando los miembros de la comunidad y los profesionales sanitarios ponen en primer plano a la salud y las cuestiones sociales entre los miembros de la comunidad y las familias. Este modelo aborda estas cuestiones, creando nuevos valores relativos a la salud y formando un sistema social que mejora la calidad de vida y el apoyo social para hacer sostenible la atención sanitaria universal a través del proceso de construcción de alianzas con las comunidades. Conclusión: un modelo de alianza para CCP responde a los desafíos de los cambios sociales que afectan a la salud en general y al nuevo papel de las enfermeras de práctica avanzada en el sostenimiento de la Cobertura Universal en Salud (CUS).Objetivo: o estudo desenvolveu um modelo de parceria de cuidados centrados nas pessoas (CCP) para uma sociedade que está envelhecendo, com o fim de enfrentar os desafios das mudanças sociais que afetam a saúde das pessoas e o novo papel da prática avançada de enfermagem para sustentar a cobertura universal de saúde. Método: um modelo de parceria de cuidados centrados nas pessoas foi desenvolvido com base na meta-síntese qualitativa da literatura e a avaliação de 14 projetos relacionados. Os projetos em curso resultaram na transformação individual e social, melhorando a alfabetização de saúde da comunidade e comportamentos que usam o cuidado centrado nas pessoas e aumentando a parceria entre os profissionais de saúde e membros da comunidade por meio da prática avançada de enfermagem. Resultados: o cuidado centrado nas pessoas começa quando os membros da comunidade e os profissionais de saúde colocam em primeiro plano as questões sociais entre os membros da comunidade e das famílias. Esse modelo aborda essas questões, a criação de novos valores relativos à saúde e forma um sistema social que melhora a qualidade de vida e dá apoio social para sustentar o sistema de saúde universal por meio da construção de parcerias com as comunidades. Conclusão: um modelo de parceria CCP aborda os desafios das mudanças sociais que afetam a saúde geral e o novo papel das enfermeiras de prática avançada em sustentar a UHC

Long-Term Care Insurance in Japan: Its Frameworks, Issues and Roles

In response to an increase in the number of elderly people and increasing medical costs, the Japanese government implemented the Long-Term Care Insurance (LTCI) system for the elderly in April 2000. Three years have passed since the LTCI was initiated. The purpose of this paper is to describe the framework, current situation and issues of this system, and the challenges and roles of the LTCI in the future. The numbers of service agencies, institutions, and LTCI service users have been steadily increasing. The waiting list for institutions has also increased, and only half of the users have reached the upper cost limit. Most users were satisfied with the LTCI services. However, the decisions made by the elderly on the types of services to use within the LTCI system are sometimes influenced by their families. The system has some problems regarding the lack of support that is provided to the elderly with respect to their access, choice and use of the LTCI services. Often, care managers cannot devote enough time to the care management process. As a result, important elements of care management, such as conducting home visits to assess users Although there have been amendments to the system, several challenges of the LTCI system must be considered: (i) ensuring the future financing of LTCI services is met; (ii) providing countermeasures to promote the use of home-care services and to alleviate the care burden to family caregivers; (iii) providing adequate support and advocacy of rights and decision-making for the elderly; (iv) providing educational activities to disseminate knowledge about LTCI programs; and (v) ensuring the availability of activities to promote health for the elderly and to prevent them from becoming bedridden.Elderly, Health-policy, Healthcare-expenditure, Reimbursement

Toward Advanced Nursing Practice along with People-Centered Care Partnership Model for Sustainable Universal Health Coverage and Universal Access to Health

ABSTRACT Objective: this study developed a people-centered care (PCC) partnership model for the aging society to address the challenges of social changes affecting people’s health and the new role of advanced practice nurses to sustain universal health coverage. Method: a people-centered care partnership model was developed on the basis of qualitative meta-synthesis of the literature and assessment of 14 related projects. The ongoing projects resulted in individual and social transformation by improving community health literacy and behaviors using people-centered care and enhancing partnership between healthcare providers and community members through advanced practice nurses. Results: people-centered care starts when community members and healthcare providers foreground health and social issues among community members and families. This model tackles these issues, creating new values concerning health and forming a social system that improves quality of life and social support to sustain universal health care through the process of building partnership with communities. Conclusion: a PCC partnership model addresses the challenges of social changes affecting general health and the new role of advanced practice nurses in sustaining UHC