Methionine Metabolism Regulates Maintenance and Differentiation of Human Pluripotent Stem Cells

SummaryMouse embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) are in a high-flux metabolic state, with a high dependence on threonine catabolism. However, little is known regarding amino acid metabolism in human ESCs/iPSCs. We show that human ESCs/iPSCs require high amounts of methionine (Met) and express high levels of enzymes involved in Met metabolism. Met deprivation results in a rapid decrease in intracellular S-adenosylmethionine (SAM), triggering the activation of p53-p38 signaling, reducing NANOG expression, and poising human iPSC/ESCs for differentiation, follow by potentiated differentiation into all three germ layers. However, when exposed to prolonged Met deprivation, the cells undergo apoptosis. We also show that human ESCs/iPSCs have regulatory systems to maintain constant intracellular Met and SAM levels. Our findings show that SAM is a key regulator for maintaining undifferentiated pluripotent stem cells and regulating their differentiation

褥瘡ケア研修後における褥瘡ケアに関する基礎知識の定着と活用状況の検討

【目的】褥瘡ケア研修後の基礎知識の定着の状況と褥瘡ケア研修の活用状況について明らかにする。【方法】 A 病院の褥瘡ケア研修受講者22 名に対し、自作のフォローアップテストの反復実施とテスト後の構成的面接を実施した。【結果】 1 回目と2 回目のフォローアップテストの正答数及び正答率ともに有意差はなかった。また、1 回目と2 回目の正答率に有意な相関は見られなかった。褥瘡ケア研修の活用状況では、予防的ケアの実践や自発的な思考に基づくケア、褥瘡ケアの理解と実践、教育的役割の担当等、研修内容を実践の場で活かしているという受講者の認識であった。【考察】 1 回目の基礎知識の習得度が2 回目の知識に影響することが推測され、研修直後に理解度を把握すると共に不足部分を補う支援が必要と考えられる。今後は、研修内容・方法の工夫や研修評価の観点から実践場面の活用実態を観察していくことが必要であると考える

看護師長と副看護師長の働き方改革に関する認識

　働き方改革推進に向け、看護師長と副看護師長の働き方改革に関する認識を明らかにするため急性期病院1施設の看護師長5名と副看護師長5名を対象に質的記述的研究を行った。看護師長の『働き方改革』に関する認識は【肯定的な働き方改革の受け止め】【否定的な働き方改革の受け止め】【時間外勤務の要因に対する捉え方】など9カテゴリーが明らかにされた。副看護師長の『働き方改革』に関する認識は【肯定的な働き方改革の受け止め】【否定的な働き方改革の受け止め】【働き方改革を阻害する要因】など7カテゴリーが明らかにされた。両者の認識には、働き方改革の肯定的な受け止め、導入に対する困難さや不安などの共通性を認めたが、サブカテゴリーでは異なる内容も見られた。働き方改革という共通の目標のためには、看護管理者としての役割による認識の特徴を相互に把握し、連携して看護の質を維持できるように進める必要性が示唆された

中堅看護師のキャリアビジョン形成に影響を及ぼした経験と支援

［目的］中堅看護師のキャリアビジョン形成に影響を及ぼした経験と支援を明らかにする。［方法］ キャリアビジョンが明確になっている看護師経験年数が5 ～ 10 年で管理職ではない病院勤務の中堅看護師8 名に対して、自身のキャリアビジョン形成に影響した経験と支援について半構成的面接を実施し、内容分析法を用いて分析した。［結果］ キャリアビジョン形成に影響を及ぼした経験は、【部署異動の経験】【日々の看護実践や看護ケアを意識した感情体験】【ロールモデルとの出会い】等の5 カテゴリーが抽出された。キャリアビジョン形成に影響を及ぼした支援は、【同僚からの内省支援】【上司からの内省支援】【上司からの精神的支援】等の6 カテゴリーが抽出された。［考察］ 部署異動や日々の看護実践から得た経験、同僚や上司による内省支援等が中堅看護師のキャリアビジョン形成に影響し、看護管理者は中堅看護師に意図的に関わることが重要であると示唆された

Nursing Students’ Attitudes Towards Nursing Process / Diagnosis Instruction Across a Multi-Year Academic Curriculum

We performed a cross-sectional analysis of nursing students’ attitudes towards a curriculum that continuously incorporated opportunities to study the nursing process and nursing diagnosis (through lectures and unfolding case study practicums) from year 1 to the first semester of year 3 of their studies, and, having identified those attitudes, we investigated how best to educate students on these topics. Specifically, we determined nursing students’ awareness, self-assessed learning attainment, difficulties, and preparedness regarding the nursing process/nursing diagnosis, and then analyzed the associations between these constructs in order to determine the current state of instructional content. A self-administered anonymous questionnaire study was carried out a total of four times: once after the introductory course for first-year students (Group 1), once each before and after the intermediate course for secondyear students (Groups 2 and 3), and once after the applied course for third-year students (Group 4). We determined nursing students’ actual level of awareness, self-assessed learning attainment, self-assessed difficulties in studying, and preparedness regarding the nursing process/nursing diagnosis. Then, we analyzed the correlations among these measures. Regarding awareness, significantly greater percentages of respondents responded to items in such a way as to indicate that they were highly aware of the nursing process/nursing diagnosis in Groups 1 and 3 than in Groups 2 and 4. In Group 4, a significant positive correlation was found between preparedness and self-assessment. The poor awareness rate in Group 2 suggests that although learning about the nursing process and nursing diagnosis at a stage in which understanding remains at a purely theoretical level can boost student awareness, the effect is not long lasting. The results suggest that introducing nursing diagnosis while students are still learning about the nursing process might confuse them, thus pointing to the need for better integrated education of the nursing process and nursing diagnosis

A Review of Educational Support Approaches According to the Characteristics of Candidate Diagnoses and Queries Considered during Nursing Diagnosis Case Study Review Meetings

In this study, we investigated candidate nursing diagnoses and queries raised during nursing diagnosis case study review meetings by considering the characteristics of the types of queries raised, their underlying circumstances, and the thought process involved. We also identified differences in queries between earlier and later case review meetings and trends during these two periods, and considered future approaches to educational support. We carried out analysis of summary records of discussions during case study review meetings held at Hospital A. The queries raised at the case study review meetings were classified according to thought processes rather than actual case contents. A total of 12 case studies were discussed, six during the first part and six during the second part of the study period. Fisher’s exact test was used to compare the types of queries raised during each period. The Egawa diagnosis-oriented process (E-DOP) was used as the conceptual model for investigating differences in the types of query and their characteristics, and issues in the thought process were isolated. We found that the types of queries raised concerned clinical assessments of patients’ conditions, interrelated diagnoses that might occur simultaneously, candidate diagnoses at the screening stage, diagnoses indicating similar mental and physical functions or conditions, the distinction between nursing diagnoses and medical problems (complications), how to understand self-care deficit, and diagnoses for which guidance with a view to hospital discharge or family intervention would be appropriate. Our results suggest that these queries were associated with stages 3 (interpretation), 5 (analysis), and 6 (integration) in the E-DOP. Our results suggest that conceptual learning connected to case studies and a review of the content of case studies may be necessary, together with support for integrated approaches that account for the characteristics of each medical institution

ターミナルキ ニ アル ガンカンジャ ノ クツウ ノ ブンセキ カンゴ キロク ニ ヨル ターミナルキ ショキ ト シュウマツキ ノ クツウ ノ ヒカク

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Implementasi Permendagri Nomor 15 Tahun 2008 Tentang Pengarusutamaan Gender pada Jenjang Pendidikan Dasar di Kota Malang

Windra Rizkiyana1 & Wahyu Widodo21 Mahasiswa & 2Staf Pengajar Program Pasca Sarjana, Universitas Muhammadiyah MalangAlamat Korespondensi : Jl. Bandung No.1 MalangEmail: [email protected] education, still found a gender gap regarding both aspects of the expansion of educationalaccess and equity, quality and relevance of education and management. The purpose of this studywere: (1) describe the substance Permendagri No. 15 of 2008 on Gender Mainstreaming; (2) describethe implementation of Permendagri No. 15 of 2008 on Gender Mainstreaming in Elementary Educationin Malang; (3) Analyze the obstacles encountered in implementation Permendagri No. 15 of 2008 onGender Mainstreaming in Elementary Education in Malang. This type of research is a descriptiveanalysis, using a qualitative approach that is supported by a quantitative approach. And the techniquesof data acolllection through by interviews and the documents. Study sites are in Malang EducationDepartment. Analysis of the data used is descriptive analysis of qualitative and quantitative theorysupported by Gender Analysis Pathway (GAP), Content Analysis and Root Analysis. Implementationof Permendagri No 15 of 2008 about gender mainstreaming in basic education levels in Malang hasnot been optimal. These proved by the remains of gender inequality or gap that occurs in all threeaspects, that access and educational equity, quality and relevance of education, as well as accountabilityand governance. Constraints encountered in implementation Permendagri No. 15 of 2008 on gendermainstreaming in elementary education in Malang include: (a) Outreach activities that are specificallyabout the PUG in primary education has not been done; (b) The budget is not specifically formainstreaming activities; (c) newly formed working group PUG.Key word: Permendagri No. 15 of 2008, gender mainstreaming, basic educatio

キソ カンゴガク キョウイク ニ オケル リンショウ バメン ヘ ノ ソウキ バクロ ト グループワーク ヲ カンレンヅケル コト ニ ヨル ガクシュウ コウカ

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