Development of a novel COMPAssion focused online psyChoTherapy for bereaved informal caregivers: the COMPACT feasibility trial protocol

Introduction An easy-to-access and effective psychotherapy for bereaved informal caregivers has not been established. People with higher self-compassion status tend to have lower bereavement related grief, psychotherapy focused on self-compassion can be promising for this population. This study aimed to examine the feasibility of online self-compassion focused psychotherapy for bereaved informal caregivers.Method and analysis A total of 60 study participants will undergo an intervention programme comprising online sessions of 2 hours per week for five consecutive weeks and undertake postsession work. The intervention personnel will comprise psychologists who have received more than 10 hours of structured training. The primary endpoint will be assessed on the intervention completion rate, with secondary endpoints consisting of the Complicated Grief Questionnaire, Patient Health Questionnaire-9, Generalised Anxiety Disorder-7, Brief Resilience Scale and Self-Compassion Scale. Evaluations will be conducted preintervention, immediately after intervention, and 4 and 12 weeks after intervention.Ethics and dissemination This study has been reviewed and approved by the Ethics Committee of the Kyoto University Graduate School and Faculty of Medicine, Kyoto University Hospital, Japan (Approved ID: C1565). The results of this study will be disseminated through publication in a peer-reviewed journal and conference presentations.Trial registration number UMIN000048554

Analysis of the Timing of Evacuation and Associated Factors Among Home Health Care Patients During Flooding: A Single-Clinic-Based Mixed Methods Study

Home health care patients (HHPs) are vulnerable to flooding and may face evacuation difficulties. Previous studies reported that HHPs and their families are more susceptible to disasters than non-HHPs. Our prior research revealed that many HHPs in Fukui, Japan, were at risk for flooding and landslides, requiring evacuation assistance, yet few were aware of the exact risks. This study analyzed survey data to identify barriers to evacuation during floods and assess the assistance needed among HHPs. A concurrent nested design of mixed-method research was employed. We calculated the percentage of the 87 HHPs at risk likely to delay evacuation and constructed univariable and multivariable logistic regression models to identify factors associated with delayed evacuation, and employed a thematic analysis to identify concerns and needs during evacuation. Family members responded to the questionnaire for patients unable to respond. The study found that 69.0 % of patients delayed evacuation, with 61.7 % incorrectly perceiving disaster risks and 20.0 % considering evacuation unimportant. Those with incorrect risk perceptions were slower to evacuate than those with accurate perceptions (OR: 1.35, 95 % confidence interval: 1.06–6.99, p-value: 0.036). Seven themes about flood preparedness needs were extracted from open-ended statements. Factors contributing to delayed evacuation included assumptions of vertical evacuation due to mobility challenges and concerns about evacuation site environments. Few Japanese HHPs at risk of flooding and landslides would plan an early evacuation, often due to misperceived disaster risks. Specific measures are needed to address these issues, and further investigation is required as flooding may also affect patient supporters

Establishment of an experimental model for MHC homo-to-hetero transplantation

Preventing rejection is a major challenge in transplantation medicine, even when using pluripotent stem cell-derived grafts. In iPS cell (iPSC)-based transplantation, to reduce the risk of rejection, it is thought to be optimal that preparing the cells from donors whose human leukocyte antigen-haplotype are homozygous. Generally, this approach is referred to as major histocompatibility complex (MHC) homo-to-hetero transplantation, which is MHC-matched but minor antigen-mismatched. To investigate the immune response in the MHC homo-to-hetero transplantation, we established a murine experimental system in which MHC-matched but minor antigen-mismatched tissue (skin) grafts were transplanted into MHC-heterozygous recipients. Unexpectedly, only minor antigen-mismatched grafts were rejected at the same time points as rejection of fully allogeneic grafts. A vigorous anti-donor type T cell response was detected in vitro and conventional immunosuppressants targeting T cell activation had limited effects on controlling rejection. However, anti-donor antibodies were not detected only in the minor antigen-mismatched transplantation. This murine transplantation model can be used to further analyze immunological subjects for MHC homo-to-hetero iPSC-based transplantation