小児看護学教育の実践方法と今後の課題についての文献検討

本研究の目的は、小児看護学教育に関する先行研究を概観することで、小児看護学教育の実践内容と方法を明らかにし、今後の課題について検討することである。31件の文献を分析対象とした。小児看護学教育の実践としては、能動的な授業の構築や模擬患者やシミュレーションを使用した演習、臨地実習での倫理教育、小児看護の現状に応じた実習場所の選択等が行われていた。今後は、講義・演習・実習を一連とした教育への取り組み、実践能力を向上させるための教育方法の工夫、多様化する実習施設に対応する方策等の検討およびそれらの教育内容を客観的に評価する方法の構築が課題である

Latitudinal cline in the foraging dichotomy of loggerhead sea turtles reveals the importance of East China Sea for priority conservation

Special Issue: Biological traits, geographic distributions and species conservation in aquatic ecosystems[Aim]Quantifying the importance of habitat areas for conservation of highly migratory marine species with complex life histories can be challenging. For example loggerhead turtles (Caretta caretta) nesting in Japan forage both oceanically and neritically after their reproductive period. Here, we aimed to quantify the proportions of turtles using these two contrasting habitats (foraging dichotomy) to suggest priority conservation areas. [Location]North Pacific Ocean. [Methods]We examined the occurrence of foraging dichotomy at three nesting sites (Ishigaki, Okinoerabu Islands and Ichinomiya) based on stable isotope analysis of the egg yolks for 82 turtles and satellite tracking of post-nesting migration for 12 turtles. Moreover, we used the data of three other sites from previous studies (Yakushima Island, Minabe and Omaezaki). [Results]Two neritic foraging grounds (East China Sea and the coastal area of the Japanese archipelago), and an oceanic ground (North Pacific Ocean) were identified. We found a latitudinal cline with respect to the occurrence of foraging dichotomy; >84% of the females nesting at southern sites (Ishigaki and Okinoerabu Islands), 73% at middle sites (Yakushima Island and Minabe) and <46% at northern sites (Omaezaki and Ichinomiya) were neritic foragers; the proportion of oceanic foragers increased at northern sites. Based on the annual number of nests in the entire nesting region of Japan, satellite tracking and the latitudinal cline of foraging dichotomy, we estimated that 70% and 9% of annual nesting females in Japan utilize the neritic foraging habitat in the East China Sea and the coastal area of the Japanese archipelago, respectively, and that and 22% utilize the oceanic habitat of the North Pacific Ocean. [Main conclusions]The East China Sea represents a critical foraging habitat for the North Pacific populations of endangered loggerhead sea turtles. Our findings emphasize the need for international management to ensure their protection

重度脳損傷児の微細な反応の意味を読み解こうとするケア提供者の生きられた経験 : 現象学的研究

京都大学0048新制・課程博士博士(人間健康科学)甲第21035号人健博第51号新制||人健||4(附属図書館)京都大学大学院医学研究科人間健康科学系専攻(主査)教授 田村 恵子, 教授 十一 元三, 教授 中山 健夫学位規則第4条第1項該当Doctor of Human Health SciencesKyoto UniversityDFA

Caffeine acutely activates 5'adenosine monophosphate-activated protein kinase and increases insulin-independent glucose transport in rat skeletal muscles

Caffeine (1, 3, 7-trimethylxanthine) has been implicated in the regulation of glucose and lipid metabolism including actions such as insulin-independent glucose transport, glucose transporter 4 expression, and fatty acid utilization in skeletal muscle. These effects are similar to the exercise-induced and 5′adenosine monophosphate–activated protein kinase (AMPK)–mediated metabolic changes in skeletal muscle, suggesting that caffeine is involved in the regulation of muscle metabolism through AMPK activation. We explored whether caffeine acts on skeletal muscle to stimulate AMPK. Incubation of rat epitrochlearis and soleus muscles with Krebs buffer containing caffeine (≥3 mmol/L, ≥15 minutes) increased the phosphorylation of AMPKα Thr[172], an essential step for full kinase activation, and acetyl–coenzyme A carboxylase Ser79, a downstream target of AMPK, in dose- and time-dependent manners. Analysis of isoform-specific AMPK activity revealed that both AMPKα1 and α2 activities increased significantly. This enzyme activation was associated with a reduction in phosphocreatine content and an increased rate of 3-O-methyl-d-glucose transport activity in the absence of insulin. These results suggest that caffeine has similar actions to exercise by acutely stimulating skeletal muscle AMPK activity and insulin-independent glucose transport with a reduction of the intracellular energy status

Lymphocytic panhypophysitis and anti-rabphilin-3A antibody with pulmonary sarcoidosis

Purpose To explore the clinical significance of anti-rabphillin-3A antibody for the differential diagnosis of lymphocytic panhypophysitis. Methods and results A 58-year-old Japanese man developed uveitis of unknown cause in 2017. In 2019, he became aware of polyuria. In August 2020, he noticed transient diplopia and was diagnosed with right abducens nerve palsy. At the same time, he complained of fatigue and loss of appetite. Head magnetic resonance imaging demonstrated enlargement of the pituitary stalk and pituitary gland, corresponding to hypophysitis. Hormone stimulation tests showed blunted responses with respect to all anterior pituitary hormones. Central diabetes insipidus was diagnosed on the basis of a hypertonic saline loading test. Taking these findings together, a diagnosis of panhypopituitarism was made. Computed tomography showed enlargement of hilar lymph nodes. Biopsies of the hilar lymph nodes revealed non-caseating epithelioid cell granulomas that were consistent with sarcoidosis. Biopsy of the anterior pituitary revealed mild lymphocyte infiltration in the absence of IgG4-positive cells, non-caseating granulomas, or neoplasia. Western blotting revealed the presence of anti-rabphilin-3A antibody, supporting a diagnosis of lymphocytic panhypophysitis. Because the patient had no visual impairment or severe uveitis, we continued physiological hormone replacement therapy and topical steroid therapy for the uveitis. Conclusion To the best of our knowledge, this is the first case of anti-rabphilin 3A antibody positive lymphocytic panhypophysitis comorbid with sarcoidosis, diagnosed by both pituitary and hilar lymph node biopsy. The utility of anti-rabphilin-3A antibody for the differential diagnosis of hypophysitis like this case should be clarified with further case studies