センザイ カンゴシ ガ サイシュウショク シエン コウシュウカイ ニ サンカ シテ フッキスル プロセス

背景 臨床現場のおいては, 少子高齢化により看護職員の不足が深刻化している.目的 潜在看護師が再就職支援講習会を受講するに至ったきっかけ, 受講して得られたもの, 講習会に望むもの, 再就職への考えを明らかにすることを目的とした.方法 再就職支援講習会に参加した看護職7名に半構造化面接を行った.結果 再就業支援講習会に参加する看護職は, 結婚や出産, 育児などの理由で離職し, 離職期間が5年以上であり, 非常勤での復帰を希望している. 講習会の受講は, 復帰に躊躇するという逆効果もあるが, 現場の勘を取り戻すことや刺激を受けることで復帰への効果がある.結論 看護職においては女性が多いということから, 女性のライフイベント面からの影響を検討し, 潜在看護師が医療現場に復帰するために, 家庭生活との両立に向けた支援がより一層求められる.Background The aging society and declining birth rate is causing a worsening of a shortage of nursing staff in the clinical workplace.Objective The objective was to clarify what triggered latent nurses to attend outplacement workshops, what they gained from attending these workshops, what they expected from the workshops, and their own opinions with regards to re-employment .Method Semi-structured interviews were held with seven nurses who participated in a lecture offering support for returning to work.Results Nurses participating in lectures offering support for returning to work have left employment due to marriage, childbirth, childrearing, etc., and have been out of the workplace for five years or more, but tend to be looking to return to work on a part-time basis. Participation in a lecture can have the negative effect of making them more hesitant about returning to work, but can also enable them to recapture their instincts regarding the workplace, and provide a stimulus that is ultimately effective in their returning to work. Conclusion Since the nursing profession is made up of a majority of women, it is therefore necessary to consider the impact of life events in the lives of women, and to provide a further level of support to assist women to achieve a work-life-balance

カンゴシ ノ センモンショク テキ ジリツセイ ト キホン テキゾクセイ トノ カンケイ

背景 近年, 高齢化による疾病構造の変化に伴い, 人々の医療に対するニーズはますます高まっている. このような現状の中で, 看護は専門職として, その役割を遂行することが求められている. 目的 看護師の専門職自律性と基本的属性との関係を明らかにすることを目的とした. 方法 菊池が開発した看護の専門職的自律性尺度 (菊池 1996) を用い, 高度医療専門機関の看護師1757名を対象にし, 年齢, 臨床経験年数, 設置主体, 臨床領域, との関連を探った. 結果 専門職的自律性の因子分析の結果5つの因子 「看護の実践能力」 「看護の展開能力」 「アセスメント能力」 「自立的判断能力」 「予測能力」 が抽出された. 専門職的自律性と最も関係が見られたのは経験年数で5つの因子とすべてにおいて有意差がみられた. 設置主体, 臨床領域は 「予測能力」 のみに有意差があった. 考察 経験数6～10年未満の看護師は看護の実践能力, 看護の展開能力, アセスメント能力, 自立的判断能力, 予測能力とも3～6年未満の看護師に比べ平均点は有意に高かった. 理由として, 10年前に比べ, 結婚し出産しても, 働くことができるような環境が整ってきたこと, 継続教育の充実, キャリアアップの教育の整備, また, 看護基礎教育においても1995年以降, 看護系大学の増加, 大学化による研究者の養成, 学問的研究活動の推進などが図られてきたことも影響していると考える. 結語 平成22年度より厚生労働省で新人看護職員の卒後研修が努力義務化されている. 早期離職, 医療安全, 看護の質の向上のため臨床では忙しい中で研修を行っている. こうした取り組みが今後の看護の自律性に良い影響を与えることを臨まずにはいられない.Background Due to changes in the diversity of diseases in increasingly aged patients, there has been a corresponding need to diversify medical care and treatment in recent years, and nursing methods have become more demanding and nurses are often expected to perform as specialists.Purpose To identify the relationships between autonomous judgment and the quality of nurses Method In order to identify the relationship between nurses\u27 performance and their age, years of clinical experience, the institution to which they are attached, and their area of clinical expertise, a test was given to 1,757 nurses at higher medical institutions based on the Scale for Measuring Nurses\u27 Autonomy as Specialists, developed by Dr. Kikuchi in 1996.Results After analyzing issues affecting nurses\u27 autonomy as specialists, five factors were identified: actual nursing ability, developmental ability, assessment ability, independent judgment ability, and foresight. Their ability to make autonomous judgments was found to be most closely related to length of clinical experience, which had significant relevance to all five factors. The institution to which nurses are attached and their area of clinical expertise area had relevance only to assessment ability.Discussion The following social factors can be identified as reasons for the positive result of the test. - More nurses are able to continue working after marriage and having a family thanks to an improved social environment compared with 10 years ago. - Opportunities for continuing nursing education have increased. - Opportunities for higher nursing education to upgrade nurses\u27 careers have increased. - With regard to basic nursing education, the number of nursing universities has increased since 1995, and thus more researchers in the nursing sphere at university level and stronger promotion of academic research activities are also significant supportive factors.Conclusion In 2010, the Ministry of Health, Labour and Welfare required that newly licensed nurse

The ability to appropriately distinguish throws for different target positions

Repeated and accurate throwing of an object to a target position is a special human motor skill. It is particularly important to understand accuracy, which has received less attention than speed due to difficulties in measurement. Accuracy has been studied in terms of reducing errors against a single target, but also in terms of distinguishing appropriate throws for targets in different positions. In this study, this ability was investigated by evaluating the two-dimensional distributions of the pitch locations of 15 pitches to three target positions in university students with and without baseball experience. The center, major and minor axis length, major and minor axis ratio, slope, area, and percentage of overlapping area of the 95% confidence ellipse were compared between target positions and participants using a two-way repeated-measures analysis of variance (ANOVA). The center and area of the ellipse indicate the mean and variability of the error, respectively. The lengths of the major axes correspond to the variability of the release timing, and the minor axes correspond to the variability of the release point in space. Therefore, the ratio of the major and minor axes indicates how the variability of the pitching motion is controlled. The slope of the ellipse corresponds to the throwing arm's trajectory, and the percentage of overlap area means the ability to distinguish throws at different target positions. The result showed a main effect of participants on all indices except the center of the ellipse. This indicates that participants can generally distinguish throws by target positions regardless of their baseball experience, although participants with baseball experience may naturally reduce variability. Furthermore, participants with baseball experience demonstrated a decrease variability in release timing, which is a primary contributor to the pitch location variability, relative to the spatial variability of the pitching movements. This reduction in timing variability may be attributed to advanced motor control mechanisms

A ケン ニ オケル ホウモン カンゴ ステーション ノ 24ジカン オンコール タイセイ ノ ジッタイ : カンリシャ ヘノ アンケート チョウサ カラ

背景 近年, 看護職において, 長く働き続けられる環境づくりを進めるために, ワーク・ライフ・バランスの実現に向けての取り組みが行なわれている. 目的 A県における訪問看護ステーションのオンコール体制の実態を明らかにし, ワーク・ライフ・バランスを検討するための基礎的資料とすることを目的とした. 方法 A県にある70か所の訪問看護ステーションの管理者宛てに, 無記名自記式質問紙調査を送付し, 39か所 (55.7%) から有効回答を得た. 結果 A県にある39か所のステーションにおける1事業所当たりの平均看護師数は6.0±5.6人であり, 全国平均の4.2人と比べると多く, 規模別においては, 中規模事業所が77%を占めていた. 24時間対応体制加算は, 34か所 (87%) が取られているが, オンコール体制に関する規約や手当がない事業所もあった. また, オンコール体制はほとんどが常勤職員で担っており, 管理者の待機日数は, 大規模事業所に比べて小規模および中規模事業所の方が多かった. 考察 オンコール体制が, 在宅看護の重要な機能として捉えている一方で, 訪問看護師の高い離職率や人材確保の難しさの一因となっていることが考えられた. 今後は, 法的根拠に基づいた規約の整備が望まれる. また, 管理者個人が意識化し, 個々のステーションでワーク・ライフ・バランスの取り組みが必要である. 結論 オンコール体制のあり方や職員への指導等を考える資料を得ることができたので, 待機手当のないステーションに手当を提案し, 継続した調査を行う.Background As for the nurse, an action for the realization of the work-life balance is carried out to push forward the making of environment where it is continued acting on for a long time.Purpose To study the actual conditions of home-visit nursing care stations that extend services on an on-call around-the-clock basis, and to make the investigation results available for study of the workers\u27 work-life balance.Methods nvestigations were made by means of sending questionnaires to managers of 70 nursing care stations located in Prefecture A, of which 39 managers, 55.7%, responded on an anonymous basis.Results The average number of nurses per station at 39 nursing care stations in Prefecture A was 6.2, more than the national average of 4.2.Middle-size nursing care stations occupied 77% of the total respondents. Thirty-four stations, or 87%, adopted an additional payment system for around-the-clock services, but there were some that had no internal regulations or additional service charge system for around-the-clock services. Most stations used full-time nurses for around-the-clock services. As for the number of days when managers were on duty for around-the-clock services, small-sized and middle-sized stations had more days than large-sized stations.Discussion The around-the-clock on-call service is an important factor for functioning home-visit nursing care. However, it is also a reason for which home-visit nurses tend to leave the job after a short period and it is getting more difficult to obtain capable nurses. Stipulating legally effective work regulations to improve the working conditions for home-visit nurses is desired in the near future. It is also necessary for each care manager to realize the importance of improving the work-life balance of nurses

Loss of the coxsackie and adenovirus receptor contributes to gastric cancer progression

Loss of the coxsackie and adenovirus receptor (CAR) has previously been observed in gastric cancer. The role of CAR in gastric cancer pathobiology, however, is unclear. We therefore analysed CAR in 196 R0-resected gastric adenocarcinomas and non-cancerous gastric mucosa samples using immunohistochemistry and immunofluorescence. Coxsackie and adenovirus receptor was found at the surface and foveolar epithelium of all non-neoplastic gastric mucosa samples (n=175), whereas only 56% of gastric cancer specimens showed CAR positivity (P<0.0001). Loss of CAR correlated significantly with decreased differentiation, increased infiltrative depths, presence of distant metastases, and was also associated with reduced carcinoma-specific survival. To clarify whether CAR impacts the tumorbiologic properties of gastric cancer, we subsequently determined the role of CAR in proliferation, migration, and invasion of gastric cancer cell lines by application of specific CAR siRNA or ectopic expression of a human full-length CAR cDNA. These experiments showed that RNAi-mediated CAR knock down resulted in increased proliferation, migration, and invasion of gastric cancer cell lines, whereas enforced ectopic CAR expression led to opposite effects. We conclude that the association of reduced presence of CAR in more severe disease states, together with our findings in gastric cancer cell lines, suggests that CAR functionally contributes to gastric cancer pathogenesis, showing features of a tumour suppressor

Loss of Tet1 associated 5-hydroxymethylcytosine is concomitant with aberrant promoter hypermethylation in liver cancer

Aberrant hypermethylation of CpG islands (CGI) in human tumors occurs predominantly at repressed genes in the host tissue, but the preceding events driving this phenomenon are poorly understood. In this study, we temporally tracked epigenetic and transcriptomic perturbations which occur in a mouse model of liver carcinogenesis. Hypermethylated CGI events in the model were predicted by enrichment of the DNA modification 5-hydroxymethylcytosine (5hmC) and the histone H3 modification H3K27me3 at silenced promoters in the host tissue. During cancer progression, CGI underwent hypo-hydroxymethylation prior to hypermethylation, whilst retaining H3K27me3. In livers from mice deficient in Tet1, a tumor suppressor involved in cytosine demethylation, we observed a similar loss of promoter core 5hmC, suggesting that reduced Tet1 activity at CGI may contribute to epigenetic dysregulation observed during hepatocarcinogenesis. Consistent with this possibility, mouse liver tumors exhibited reduced Tet1 protein levels. Similar to humans, DNA methylation changes at CGI in mice did not appear to be direct drivers of hepatocellular carcinoma progression, rather, dynamic changes in H3K27me3 promoter deposition correlated strongly with tumor-specific activation and repression of transcription. Overall, our results suggest that loss of promoter-associated 5hmC in liver tumors licenses reprogramming of DNA methylation at silent CGI during progression

Inorganic sulfur reduces the motility and invasion of MDA-MB-231 human breast cancer cells

This study investigated the effects of inorganic sulfur on metastasis in MDA-MB-231 human breast cancer cells. MDA-MB-231 cells were cultured in the absence or presence of various concentrations (12.5, 25, or 50 µmol/L) of inorganic sulfur. Cell motility, invasion, and the activity and mRNA expression of matrix metalloproteases (MMPs) were examined. Numbers of viable MDA-MB-231 cells did not differ by inorganic sulfur treatment from 0 to 50 µmol/L within 48 h. Inorganic sulfur significantly decreased cell motility and invasion in the MDA-MB-231 cells in a dose-dependent manner (P < 0.05), as determined using a Boyden chamber assay and a Matrigel chamber. The activities of MMP-2 and MMP-9 were significantly reduced by inorganic sulfur in a dose-dependent manner (P < 0.05). The inorganic sulfur also significantly inhibited MMP-2 and MMP-9 expression in the cells (P < 0.05). These data suggest that inorganic sulfur can suppress cancer cell motility and invasion by inhibiting MMP-2 and MMP-9 activity and gene expression in MDA-MB-231 cells