The role of forensic psychiatric nursing in foreign nations

本論文は,諸外国における司法精神看護(forensic psychiatric nursing)について文献学的に概観し,司法精神看護の役割について明らかにすることを目的とした｡司法精神看護師の役割としては,法的知識と看護の知識を持った上で,犯罪者が法廷に出る前の精神症状のアセスメントをし,適切な治療やケアを受けることができるように調整していくこと､また性的暴力を受けた被害者を検査し､フォローアップケアを行うこと等があった｡司法精神看護の対象は,重大な罪を犯した精神障害者(触法精神障害者)だけでなく,触法精神障害者の家族,被害者が含まれていた｡触法精神障害者に対しては,投薬,薬の効果･副作用の教育,社会的能力のトレーニングを行い,触法精神障害者の家族や犯罪被害者に対しては,感情のアセスメント,心理的危機介入,行動面等の評価を行う役割を担っていた｡This paper overviews the role of forensic psychiatric nursing, focusing on the situation overseas. Forensic nursing is primarily involved with the investigation and evaluation of an individual's mental state to determine whether the criminal justice system or the health care system most equitably meets their needs. From an American perspective, Lynch describes different areas of forensic nursing. 'Clinical forensic nursing' involves the application of clinical and scientific knowledge to questions of law and the criminal and civil investigation of survivors of traumatic injury and also includes court-related issues associated with patient treatment. The American system also utilizes a 'sexual assault nurse examiner,' this role is concerned with the clinical examination of sexually assaulted victims and the employment of therapeutic interventions to enable the process of healing. In the UK, this area of work has primarily emerged within the criminal justice system with specially trained police officers engaging with adult individuals who have been the victims of sexual assault, and working in partnership with medical interventions and investigation. Another specialty in the UK is 'forensic psychiatric nursing', concerning the assessment of criminal defendants before their court hearing. In the area of forensic nursing, the subjects are offenders with mental disorders, their families, and victims. The important roles in forensic psychiatric nursing are summarized as follows: assessment of mood and psychiatric symptoms, medication management, risk management, training in social skills, crisis intervention, and evaluation of behavioral or mental disorder

Balance of Autonomic Nervous Activity, Exercise, and Sleep Status in Older Adults : A Review of the Literature

While older people are frequently known to experience sleep disturbances, there are also many older people who have a good quality of sleep. However, little is known about the balance of autonomic nervous activity, exercise habits, and sleep status in healthy older adults. This study reviews the literature regarding balance of the autonomic nervous activity, exercise, and sleep in healthy older adults. Relevant articles were searched from electronic databases using the combination of the following keywords: “Autonomic nervous activity”, “sleep status”, “sleep”, “healthy older adults”, “aging”, “heart rate variability (HRV)” and “exercise”. Articles were included if they met inclusion criteria: (1) Published in English, (2) Article types: research and review articles, (3) Main outcome was related to the autonomic nervous activity, lifestyle, sleep, and/or healthy aging, and (4) Fully accessed. From 877 articles that were identified, 16 articles were included for review. Results showed that the autonomic nervous activity changes with increasing age, particularly a constant decline in cardiac vagal modulation due to the significant decrease in the nocturnal parasympathetic activity. In addition, the autonomic nervous activity was also related to sleep status and lifestyle, particularly the capability to exercise. In preparing older people toward a healthy aging, maintaining good sleep quality and exercise is suggested

A water channel closely related to rat brain aquaporin 4 is expressed in acid- and pepsinogen-secretory cells of human stomach

AbstractWe isolated a cDNA clone encoding a water channel protein, aquaporin (AQP), from human stomach. The encoded protein consisted of 323 amino acid residues, containing six putative transmembrane domains. The protein was designated human aquaporin 4 (hAQP4) because of its 94% sequence similarity to rat brain AQP4. Expression of hAQP4 cRNA in Xenopus oocytes resulted in a significant increase in osmotic water permeability, indicating that this protein functions as a water channel. Northern blot analysis demonstrated a strong signal of hAQP4 mRNA in brain, lung, and skeletal muscle as well as in stomach. Immunohistochemical experiments with human stomach tissues showed that hAQP4 as a protein is expressed mainly in cells located in the glandular portion of the fundic mucosa. These include chief cells which secrete pepsinogen and parietal cells which secrete hydrochloric acid. These results strongly indicate that hAQP4 is a principal factor involved in the osmotic regulation of pepsinogen and acid secretion in the stomach

ジアシルグリセロールの乳化特性 : O/W型エマルションの油水界面における吸着タンパク質量の測定

In an earlier study, mayonnaise-like o/w emulsions prepared with diacylglycerol(DAG)showed higher viscosity than those prepared with triacylglycerol(TAG)under the same conditions. A similar tendency was observed even for preparations of oil droplets with approximately the same interface area, indicating that the amount of adsorbed proteins of DAG emulsions was higher than that of TAG emulsions. Thus, this study attempted to clarify the amount of adsorbed proteins on the emulsion prepared with DAG. The viscosity and oil droplet size of DAG and TAG emulsions with varying oil-volume fractions were measured, and the amount of adsorbed proteins on the interface of DAG and TAG emulsions were measured. DAG emulsions were found to contain less adsorbed proteins on the oil-water interface than TAG emulsions, suggesting that DAG and TAG differ with respect to their intermolecular interactions and structural changes following protein adsorption on the oil-water interface

Healthy Lifestyle, Autonomic Nervous System Activity, and Sleep Status for Healthy Aging

With the super-aging society, it is important to pay attention to the quality of life of older people so that they can face healthy aging. Lifestyle, particularly exercise, autonomic nervous system activities, and sleep status are factors that affect the quality of aging. This chapter explores how those three variables are related and what strategies can be employed to maintain and enhance these variables to prepare. (1) The combination of healthy lifestyles, adequate physical activity, healthy dietary patterns, moderate alcohol consumption, and nonsmoking were related to the risk of cardiovascular diseases. (2) For older people, being physically active is important to the improvement of their physical and mental functions and keeping them independent and mobile. The increasing HRV after exercise might be caused by increasing vagal tone and decreasing sympathetic activity. (3) To reach healthy aging, people should maintain the proper function of autonomic balance activities. This is important because slowing down the decline in sympathetic status might delay many geriatric complaints. (4) To achieve healthy aging, maintaining a healthy sleep is essential. Thus, the key to a lifestyle that facilitates healthy aging is a balance of regular physical exercise and adequate sleep, which mediates and is mediated by autonomic nervous system activity

Fish oil-enriched nutrition combined with systemic chemotherapy for gastrointestinal cancer patients with cancer cachexia

Despite recent advances in chemotherapy for gastrointestinal cancer, a crucial factor related to poor prognosis is reduced tolerance to chemotherapy induced by cancer cachexia. Fish oil (FO)-derived eicosapentaenoic acid (EPA) modulates inflammation in patients with various malignancies; however, the impact of FO-enriched nutrition as a combined modality therapy on clinical outcomes remains controversial. We systemically analysed chronological changes in biochemical and physiological status using bioelectrical impedance analysis in 128 gastrointestinal cancer patients provided with or without FO-enriched nutrition during chemotherapy. Furthermore, we evaluated the clinical significance of FO-enriched nutrition and clarified appropriate patient groups that receive prognostic benefits from FO-enriched nutrition during treatment of gastrointestinal cancer. The control group showed significant up-regulation of serum CRP) levels and no significant difference in both skeletal muscle mass and lean body mass. In contrast, the FO-enriched nutrition group showed no changes in serum CRP concentration and significantly increased skeletal muscle mass and lean body mass over time. Furthermore, high CRP levels significantly correlated with reduced tolerance to chemotherapy, and FO-enriched nutrition improved chemotherapy tolerance and prognosis, particularly in gastrointestinal cancer patients with a modified Glasgow prognostic score (mGPS) of 1 or 2. We conclude that FO-enriched nutrition may improve the prognosis of patients with cancer cachexia and systemic inflammation (i.e., those with a mGPS of 1 or 2)

トクシマ ダイガク ビョウイン ノウソッチュウ センター デノ ナイケイドウミャク キュウセイ ヘイソク ニ タイスル チリョウ センリャク

Objective : Strokes related to acute internal carotid artery （ICA） occlusion are associated with extremely poor prognosis. Recently, some studies have reported that the prognosis has been getting better by treating with intra-arterial endovascular therapy. We sought to evaluate clinical outcomes in patients with acute ischemic stroke attributable to ICA occlusion treated with intraarterial endovascular therapy or otherwise. Methods : We reviewed ４４ patients who underwent treatment with intra-arterial endovascular therapy or otherwise in our stroke care unit （SCU） from January, ２０１１ to May, ２０１４. We compared the prognosis of patients in the ２ treatment groups （endovascular group, n＝２３ vs nonendovascular group, n＝２１）. Results : The rate of good prognosis （modified Rankin Score of ≦２） was significantly higher in the endovascular group than non-endovascular group （１７．４％ vs０％，p＝０．０４５）. The rate of patients who had extreme improvements of National Institutes of Health Stroke Scale （NIHSS） ≧８ was higher in the endovascular group than non-endovascular group （３０．４％ vs１４．３％）. Concerning the improvement of NIHSS ≧８, recombinant tissue-type plasminogen activator （rt-PA） or the left side ICA occlusion were associated significantly （p＝０．０１９, p＝０．０４２, respectively）. Although the hypothesis that endovascular therapy could contribute to extreme improvements of NIHSS wasn’t proved （p＝０．２０２）, there was one case that NIHSS was dramatically improved from ２２ to ０ by endovascular therapy. Conclusions : Intra-arterial endovascular therapy of ICA occlusion might result in improved clinical outcomes for indicated cases

Encounter of Pepper-CPGE

In Japan, humanoid robots has been introduced in the medical and elderly care environment. The application program of Care Prevention Gymnastics Exercises for Pepper (Pepper-CPGE) made by Xing Company, Japan is a body-brain gymnastics recreation program for 40 minutes tailored to the elderly's functional level. It consists of moving, watching/healing, and playing. “Move the body” exercise and other active range of motion activities are done according to the music. Pepper-CPGE was introduced as a clinical trial at the Mifune hospital, beginning in May 2018. At the units where clinical trials are done, 80% of the patients are with mental illness diagnosis with decreased physical functions often moving by wheelchair only. When Pepper-CPGE was introduced, the following changes were observed : (1) communication between patients and nurses during rehabilitation care using Pepper-CPGE was increased ; (2) patients were interactive, engaged, and actively participated in the Care Prevention Gymnastic Exercises using Pepper-CPGE ; (3) patients had fun and enjoyed talking to Pepper-CPGE. Interventions using Pepper-CPGE appear to be an effective rehabilitation strategy to increase engagement and participation of elderly patients who require long-term care and rehabilitation