看護技術における洗髪時の体位が対象の心身に及ぼす影響に関する文献検討

To shed light on previous research trends and future challenges regarding the effect of body position during hair washing on the mental and physical state of the subject, we conducted a literature review on “body position during hair washing” and “the effect on the mental and physical state of the subject of hair washing based on the body position during that process.” Using an online repository of major medical journals (Igaku Chuo Zasshi—WEB), we performed a search for “hair washing” and “body position or posture” without specifying a date range. When we excluded conference proceedings, meeting minutes, reviews, and commentaries and focused on papers describing the mental and physical effects on the subject of hair washing, we found 24 relevant papers. The results of our analysis revealed the following: 1) half of the research subjects were in a healthy group and half were in a disease group, with the most common conditions of those in the latter group being heart disease, threatened premature delivery/miscarriage, and anemia; 2) the body position used the most during hair washing was the supine position; 3) measurement variables were related to objective and subjective aspects, with the most common objective variables being pulse, heart rate, blood pressure, and the electromyogram, whereas the most common subjective variables were suffering, exhilaration,and fatigue; and 4) in patient subject groups, subjective factors, objective factors, and adjustments in the hair washing position according to the patientʼs illness or condition were used to investigate the physical and mental effects on the patient.Based on the trends in prior studies, it is hoped that in the future, there will be an increase in the amount of clinical data and further investigations toward generalization.洗髪の体位が対象者の心身に及ぼす影響について、これまでの研究結果と今後の課題を明らかにすることを目的とし、「洗髪の体位」と「その体位で洗髪をした際、洗髪を受ける対象者の心身に及ぼす影響」に関する文献検討を行った。医学中央雑誌WEB 版を用いて発行年の制限は行わず、「洗髪」、「体位or 姿勢」でキーワード検索を行い、会議録、議事録、総説、解説を除き、洗髪を受ける対象者の心身への影響を扱った文献に絞ったところ、24 件が該当した。結果、1）研究対象者は、健康群と疾患群、半数ずつであり、疾患群としては、心疾患、切迫流早産、貧血の割合が多かった、2）洗髪体位として、仰臥位を選択している研究が多かった、3）測定項目は客観的指標と主観的指標があり、客観的指標では脈拍、心拍数、血圧、筋電図が、主観的指標では苦痛、爽快感、疲労感の割合が多かった、4）研究内容では、疾患群において対象の疾患や状態に合わせた洗髪の体位や主観的・客観的指標から、患者の心身への影響を検討していた。今後、これら先行研究における検討結果を踏まえ、さらに、実際に洗髪援助が必要な者を対象として臨床などにおいてデータ数を増やし一般化に向け検討を行うことが必要であると考えられた。論

放射線皮膚炎に対するスキンケアに関する文献レビュー

The aim of this study was to identify future challenges and trends of Japanese nursingrelated research to date regarding skin care for radiotherapy-induced dermatitis.We conducted a literature review on “skin care” performed by nurses for radiation dermatitis. Using an online repository of major medical journals (Igaku Chuo Zasshi ―WEB), we performed a search for “radiation therapy”, “dermatitis” (or “radiation dermatitis”), and “skincare” without specifying a date range. When we excluded conference proceedings and meeting minutes and focused on papers describing nursing, we found 14 relevant papers.The results of our analysis of these papers revealed the following:1) There were six case studies (42.9%), and many papers dealt with head and neck cancer patients.2) In terms of observation and evaluation items, there were eight papers (64.3%) that used the Common Terms for Adverse Events (CTCAE ver.4, Japanese translation JCOG version) as is; 14 (100.0%) that used skin conditions, such as redness, erosion, dryness, and desquamation as evaluative items; and 11 (78.6%) that observed subjective patient symptoms, such as pain and itching.3) Regarding skin care, there were 11 papers (78.6%) relating to washing, with many describing specific washing methods, such as, “Wash using low pH soap,” “Use soap that has been lathered well,” Rinse with warm water,” and “Wash by gently stroking and not rubbing.” There were 12 papers (85.7%) relating to moisturizing and wound management.4) Although there were many papers that stated that carrying out skin care improved dermatitis and prevented worsening, there was scant evidence illustrating such results.There is a need to investigate evaluative methods and increase the number of case studies in the future in order to make it possible for nurses to deliver skincare suited to the patient’s condition; based on accurate observation and assessment; and in accordance with radiation dermatitis skin conditions, attributes of radiation dermatitis patients, and risk factors. It is hoped that we will build evidence in terms of skin care for radiation dermatitis.放射線療法により引き起こされる皮膚炎に対するスキンケアついて、これまでわが国で検討されている看護に関連した研究の傾向や今後の課題を明らかにすることを目的とし、放射線皮膚炎に対するスキンケアについて文献検討を行った。具体的には、医学中央雑誌WEB 版を用いて発行年の制限は行わず、「放射線療法」、「皮膚炎」、（または、「放射線皮膚炎」）、「スキンケア」でキーワード検索を行い、会議録、議事録を除き、看護に関連する文献に絞ったところ、14件が該当した。　結果、以下のことが明らかとなった。１）症例研究が６件（42.9％）を占めた。頭頸部がん患者を扱った文献が多かった。２）放射線皮膚炎の観察・評価項目は、有害事象共通用語基準（CTCAE ver.4、日本語訳JCOG 版）におけるGrade 分類をそのまま活用していた文献が８件（57.1％）、「発赤」、「びらん」、「乾燥」、「落屑」など皮膚の観察状態を評価項目として活用していた文献は14件（100.0％）、「疼痛」、「掻痒感」などの患者の自覚症状を観察していた文献は11件（78.6％）であった。３）スキンケアは、洗浄に関する文献が11件（78.6％）であり、その洗浄方法では「弱酸性の刺激の少ない洗浄剤（または石鹸）で洗う」「ぬるめのお湯で流す」、「擦らず撫でるように洗う」といった基本的な洗浄方法について記述されている文献が多かった。保湿や創傷管理に関する文献は12件（85.7％）であった。４）スキンケアを実施することで、皮膚炎の改善や悪化を防ぐことができたと記述している文献は12件（85.7％）と多かったが、その成果を示す根拠は乏しかった。　今後、放射線皮膚炎の患者の属性やリスク要因、放射線皮膚炎の皮膚状態に応じて、看護師が的確な観察やアセスメントを行った上で、患者の状態に合わせたスキンケア方法が実施できるように、さらに症例数を増やし評価方法を検討することが必要であると考えられた。放射線皮膚炎に対するスキンケアにおけるエビデンスの構築が求められる。論

Applicability of the Leiden Convention and the Lipton classification in patients with a single coronary artery in the setting of congenital heart disease

Background In single coronary artery (SCA) anatomy, all coronary tributaries arise from a single ostium, providing perfusion to the entire myocardium. Coronary classification systems can facilitate the description of SCA anatomy. Aim: Evaluation of the applicability of Lipton classification and the Leiden Convention coronary coding system in SCA. Methods: All patients (n = 6209) who underwent computed tomography (CT) scanning between 2014 and 2018 were retrospectively examined for the presence of SCA and classified, according to Lipton classification and the Leiden Convention coronary coding system. Results: The prevalence of SCA was 0.51% (32/6209). Twenty-eight patients (87.5%) had coexisting congenital heart disease (CHD), most frequently pulmonary atresia (9/32, 28.1%). Ten patients (10/32, 31.25%) could not be classified with either the Leiden Convention or Lipton classification (pulmonary atresia n = 9, common arterial trunk (CAT) n = 1). In one case with CAT, Lipton classification, but not the Leiden Convention, could be applied. In two cases with the transposition of the great arteries and in two cases of double outlet right ventricle, the Leiden Convention, but not the Lipton classification, could be applied. Conclusions: Both classifications are useful to detail information about SCA. As Lipton classification was not developed for structural heart disease cases, in complex CHD with abnormal position of the great arteries, the Leiden Convention is better applicable. The use of both systems is limited in pulmonary atresia. In this scenario, it is better to provide a precise description of the coronary origin and associated characteristics that might affect treatment and prognosis.Cardiolog

2020 年におけるCOVID-19 の状況と看護学部の臨地実習への対応

教育活動報

KAGRA: 2.5 Generation Interferometric Gravitational Wave Detector

The recent detections of gravitational waves (GWs) reported by LIGO/Virgocollaborations have made significant impact on physics and astronomy. A globalnetwork of GW detectors will play a key role to solve the unknown nature of thesources in coordinated observations with astronomical telescopes and detectors.Here we introduce KAGRA (former name LCGT; Large-scale Cryogenic Gravitationalwave Telescope), a new GW detector with two 3-km baseline arms arranged in theshape of an "L", located inside the Mt. Ikenoyama, Kamioka, Gifu, Japan.KAGRA's design is similar to those of the second generations such as AdvancedLIGO/Virgo, but it will be operating at the cryogenic temperature with sapphiremirrors. This low temperature feature is advantageous for improving thesensitivity around 100 Hz and is considered as an important feature for thethird generation GW detector concept (e.g. Einstein Telescope of Europe orCosmic Explorer of USA). Hence, KAGRA is often called as a 2.5 generation GWdetector based on laser interferometry. The installation and commissioning ofKAGRA is underway and its cryogenic systems have been successfully tested inMay, 2018. KAGRA's first observation run is scheduled in late 2019, aiming tojoin the third observation run (O3) of the advanced LIGO/Virgo network. In thiswork, we describe a brief history of KAGRA and highlights of main feature. Wealso discuss the prospects of GW observation with KAGRA in the era of O3. Whenoperating along with the existing GW detectors, KAGRA will be helpful to locatea GW source more accurately and to determine the source parameters with higherprecision, providing information for follow-up observations of a GW triggercandidate