<strong><em>Background</em>:</strong> Increasing the number of DC (Death Conference) experiences, nurses are expected to improve the quality of nurses’ terminal care and developing nursing min...<strong><em>Background</em>:</strong> Increasing the number of DC (Death Conference) experiences, nurses are expected to improve the quality of nurses’ terminal care and developing nursing minds. Therefore, there is a need for further evidence on the impact of repeated DC experiences on nurses’ terminal care. <strong><em>Aim</em>:</strong> This study aims to clarify the impact of repeated DC experiences on nurses’ terminal care and nursing in DC using the prepared Death Conference Nursing Self-Assessment Sheet. <strong><em>Method</em>:</strong> The study is approved by the Ethics Review Board of St. Mary’s College, Chukyo Gakuin University, and the hospital where the survey was conducted. This study was an observational and cross-sectional study using an anonymous, self-completed questionnaire composed of the newly created Death Conference Nursing Self-Assessment Sheet. Its evaluation items in the Death Conference Nursing Self-Assessment sheet consist of four categories (Cooperation, Future direction of nursing, Specific measures for nursing, and Feeling of the nurse) and 14 questions. The questionnaires were conducted on 144 nurses in the ER, ICU, and Palliative Care Ward (Hospice Ward) in a general hospital in Japan. For analysis, JMP ver.14.2 was used to perform Fisher’s exact test, Wilcoxon/Mann Whitney test, univariate, and multivariate logistic regression analysis. <strong><em>Results</em>:</strong> Thirty-four participants (23.6%) who answered the number of DC experiences were included in the final analysis. Seventeen nurses had DC experiences, and 17 had no experience. There were significant differences in all of the above categories impacting nurses’ terminal care and nursing in DC. <strong><em>Conclusion</em>:</strong> Repeated DC affected nurses’ terminal care and nursing in DC using the Death Conference Nursing Self-Assessment Sheet. In the future, verification of the reliability, validity of the questionnaire, and more evidence of the way of terminal concerns by raising the quality of DC for developing nursing minds will be needed.展开更多
Background: The experiences of death conference (DC) are regarded as improving the quality of nurses’ terminal care and developing nursing minds. Few studies in Japan clarify quantitatively how nurses’ participation...Background: The experiences of death conference (DC) are regarded as improving the quality of nurses’ terminal care and developing nursing minds. Few studies in Japan clarify quantitatively how nurses’ participation in DC is related to nurses’ terminal care. Aim: This study aims to clarify the relationship between DC experiences and nurses’ terminal care using the prepared Terminal Care Nursing Self-Assessment Sheet. Method: The study is approved by the Ethics Review Board of St. Mary’s College, and the hospital where the survey was conducted. This study was an observational and cross-sectional study using an anonymous, self-completed questionnaire composed of the newly created Terminal Care Nursing Self-Assessment Sheet. Its evaluation items consist of six categories (Reflection, Cooperation, Response to patients, Response to patients’ family, Specific measures for nursing, and Feelings of the nurse), and 14 questions. The questionnaires were conducted for 144 nurses in the ER, ICU, and Palliative Care Ward (Hospice Ward) in a general hospital in Japan. For analysis, JMP ver.14.2 was used to perform a Chi-square test, Wilcoxon/Mann Whitney test, univariate, and multivariate logistic regression analysis. Results: One hundred thirty-nine participants (97%) were included in the final analysis. Forty-three nurses had DC experiences, and 96 had no experience. The median number (IQR;interquartile range) of DC experiences was 5.5 (2 - 22.5). There were significant differences in five of the above categories;however, there was no significant association in the five questions of the nurse’s stress on response to patients and patients’ family and specific measures for nursing regarding postmortem treatment for patients between DC experiences and Nurses’ terminal care. Conclusion: DC that looks back on terminal care has significance as an opportunity to consider the way of terminal concerns and direction of future care. It is required to raise the quality of DC for focusing on reducing nurses’ stress on terminal care and anxiety about postmortem treatment for patients.展开更多
Aim: To identify evidence in the literature on the significance of death conferences for nurses. Method: This is an integrative literature review, consisting of scientific articles published on “Ichushi-Web”, an Int...Aim: To identify evidence in the literature on the significance of death conferences for nurses. Method: This is an integrative literature review, consisting of scientific articles published on “Ichushi-Web”, an Internet-based retrieval service by the Japan Medical Abstracts Society (JAMAS), PubMed, Medline, Cochrane library, and Google Scholar for ‘the whole year,’ combining the keywords “death conference”, “nurse”, and “KJ method”. The significance of death conferences was reviewed by comparison of prior qualitative studies analyzed by the KJ method. Result: Seven studies, all from Japanese, were identified. The significance of death conferences showed “refraction”, “cooperation”, “directionality of nursing”, “caring for patient”, “caring for family”, “specific methods of nursing”, and “feelings of nurses”. Conclusion: The significance of death conferences is considered to be the effect on nurses for amelioration in the quality of patient and family care, development of human relations, and growth as a nurse. The quality of death conferences should be enhanced based on the guidelines for its clear definition.展开更多
Pseudomonas syringae pv. tomato DC3000 (Pst DC3000) is a bacterial pathogen of tomato and of the model plants Arabidopsis and Nicotiana benthamiana (N. benthamiana). Like numerous Gram-negative bacterial pathogens of ...Pseudomonas syringae pv. tomato DC3000 (Pst DC3000) is a bacterial pathogen of tomato and of the model plants Arabidopsis and Nicotiana benthamiana (N. benthamiana). Like numerous Gram-negative bacterial pathogens of animals and plants, Pst DC3000 exploits the conserved type III secretion system (TTSS) to deliver multiple virulence effectors directly into the host cells. Type III effectors (T3Es) collectively participate in causing disease, by mechanisms that are not well clarity. Elucidating the virulence function of individual effector is fundamental for understanding bacterial infection of plants. Here, we focused on studying one of these effectors, HopAA1-1, and analyzed its potential function and subcellular localization in N. benthamiana. Using an Agrobacterium-mediated transient expression system, we found that HopAA1-1 can trigger domain-dependent cell death in N. benthamiana. The observation using confocal microscopy showed that the YFP-tagged HopAA1-1 localizes to diverse cellular components containing nucleus, cytoplasm and cell membrane, which was demonstrated through immunoblot analysis of membrane fractionation and nuclear separation. Enforced HopAA1-1 subcellular localization, by tagging with a nuclear localization sequence (NLS) or a nuclear export sequence (NES), shows that HopAA1-1-induced cell death in N. benthamiana is suppressed in the nucleus but enhanced in the cytoplasm. Our research is lay a foundation for revealed the molecular pathogenesis of Pseudomonas syringae pv. tomato.展开更多
死亡与并发症病例讨论会(Mortality and Morbidity Conferences,MMC)在欧美国家广泛应用于医学教育与质量改进。标准化的MMC包括会前准备分析、会议介绍、病例介绍、讨论分析、制定行动项目及会后总结与反馈等过程。在我国医疗高质量发...死亡与并发症病例讨论会(Mortality and Morbidity Conferences,MMC)在欧美国家广泛应用于医学教育与质量改进。标准化的MMC包括会前准备分析、会议介绍、病例介绍、讨论分析、制定行动项目及会后总结与反馈等过程。在我国医疗高质量发展的背景下,会议制度给我国死亡病例讨论制度的改进带来了新的思考。我国有能力的三级医院应该积极探索建立标准化的病例讨论流程,扩大讨论范围,规范关注对象,并强调质量改进与医学教育并重。展开更多
While the central nervous system (CNS) was once thought to be immune privileged, more recent data support that certain areas of the healthy CNS are routinely patrolled by immune cells. Further, antigen drainage is ano...While the central nervous system (CNS) was once thought to be immune privileged, more recent data support that certain areas of the healthy CNS are routinely patrolled by immune cells. Further, antigen drainage is another means by which the adaptive arm of the immune system can gain information about the health of the CNS. Altogether these ensure that the CNS is not beyond the scope of immune protection against viruses and tumors. However, immune surveillance in the CNS has to be tightly regulated, as CNS autoimmune disease and inflammation may arise from increased immune cell infiltration. In this review we discuss the concept and implications of CNS immune surveillance and introduce the CNS antigen-presenting cells (APCs) that potentially regulate neuroinflammation and autoimmunity. We also discuss novel animal models in which CNS disease initiation and the role of APCs in disease regulation can be tested.展开更多
Objective： The aim of this study was to study the expression and the clinical significance of B7-H1 on dendritic cells （DCs） in peripheral blood from patients with bladder cancer. Methods： Peripheral blood mononuc...Objective： The aim of this study was to study the expression and the clinical significance of B7-H1 on dendritic cells （DCs） in peripheral blood from patients with bladder cancer. Methods： Peripheral blood mononuclear cell were disparted from 30 bladder cancer patients and 7 healthy controls by density gradient centfifugation and then co-cultured. The expres- sion of B7-H1 on DCs were analyzed by flow cytometry. Results： Expression of BT-H1 on DCs in bladder cancer was higher than healthy controls （P 〈 0.01）. And the expression were strongly associated with the pathological grade and clinical stage of bladder cancer （P 〈 0,05）. Conclusion： The up-regulation of B7-H1 on DCs was strongly associated with neoplastic progres-sion of bladder cancer. B7-H1/programmed death （PD）-1 signal pathway may also play an important role in immune escape of bladder cancer during initial phase of T cell immune response.展开更多
文摘<strong><em>Background</em>:</strong> Increasing the number of DC (Death Conference) experiences, nurses are expected to improve the quality of nurses’ terminal care and developing nursing minds. Therefore, there is a need for further evidence on the impact of repeated DC experiences on nurses’ terminal care. <strong><em>Aim</em>:</strong> This study aims to clarify the impact of repeated DC experiences on nurses’ terminal care and nursing in DC using the prepared Death Conference Nursing Self-Assessment Sheet. <strong><em>Method</em>:</strong> The study is approved by the Ethics Review Board of St. Mary’s College, Chukyo Gakuin University, and the hospital where the survey was conducted. This study was an observational and cross-sectional study using an anonymous, self-completed questionnaire composed of the newly created Death Conference Nursing Self-Assessment Sheet. Its evaluation items in the Death Conference Nursing Self-Assessment sheet consist of four categories (Cooperation, Future direction of nursing, Specific measures for nursing, and Feeling of the nurse) and 14 questions. The questionnaires were conducted on 144 nurses in the ER, ICU, and Palliative Care Ward (Hospice Ward) in a general hospital in Japan. For analysis, JMP ver.14.2 was used to perform Fisher’s exact test, Wilcoxon/Mann Whitney test, univariate, and multivariate logistic regression analysis. <strong><em>Results</em>:</strong> Thirty-four participants (23.6%) who answered the number of DC experiences were included in the final analysis. Seventeen nurses had DC experiences, and 17 had no experience. There were significant differences in all of the above categories impacting nurses’ terminal care and nursing in DC. <strong><em>Conclusion</em>:</strong> Repeated DC affected nurses’ terminal care and nursing in DC using the Death Conference Nursing Self-Assessment Sheet. In the future, verification of the reliability, validity of the questionnaire, and more evidence of the way of terminal concerns by raising the quality of DC for developing nursing minds will be needed.
文摘Background: The experiences of death conference (DC) are regarded as improving the quality of nurses’ terminal care and developing nursing minds. Few studies in Japan clarify quantitatively how nurses’ participation in DC is related to nurses’ terminal care. Aim: This study aims to clarify the relationship between DC experiences and nurses’ terminal care using the prepared Terminal Care Nursing Self-Assessment Sheet. Method: The study is approved by the Ethics Review Board of St. Mary’s College, and the hospital where the survey was conducted. This study was an observational and cross-sectional study using an anonymous, self-completed questionnaire composed of the newly created Terminal Care Nursing Self-Assessment Sheet. Its evaluation items consist of six categories (Reflection, Cooperation, Response to patients, Response to patients’ family, Specific measures for nursing, and Feelings of the nurse), and 14 questions. The questionnaires were conducted for 144 nurses in the ER, ICU, and Palliative Care Ward (Hospice Ward) in a general hospital in Japan. For analysis, JMP ver.14.2 was used to perform a Chi-square test, Wilcoxon/Mann Whitney test, univariate, and multivariate logistic regression analysis. Results: One hundred thirty-nine participants (97%) were included in the final analysis. Forty-three nurses had DC experiences, and 96 had no experience. The median number (IQR;interquartile range) of DC experiences was 5.5 (2 - 22.5). There were significant differences in five of the above categories;however, there was no significant association in the five questions of the nurse’s stress on response to patients and patients’ family and specific measures for nursing regarding postmortem treatment for patients between DC experiences and Nurses’ terminal care. Conclusion: DC that looks back on terminal care has significance as an opportunity to consider the way of terminal concerns and direction of future care. It is required to raise the quality of DC for focusing on reducing nurses’ stress on terminal care and anxiety about postmortem treatment for patients.
文摘Aim: To identify evidence in the literature on the significance of death conferences for nurses. Method: This is an integrative literature review, consisting of scientific articles published on “Ichushi-Web”, an Internet-based retrieval service by the Japan Medical Abstracts Society (JAMAS), PubMed, Medline, Cochrane library, and Google Scholar for ‘the whole year,’ combining the keywords “death conference”, “nurse”, and “KJ method”. The significance of death conferences was reviewed by comparison of prior qualitative studies analyzed by the KJ method. Result: Seven studies, all from Japanese, were identified. The significance of death conferences showed “refraction”, “cooperation”, “directionality of nursing”, “caring for patient”, “caring for family”, “specific methods of nursing”, and “feelings of nurses”. Conclusion: The significance of death conferences is considered to be the effect on nurses for amelioration in the quality of patient and family care, development of human relations, and growth as a nurse. The quality of death conferences should be enhanced based on the guidelines for its clear definition.
文摘Pseudomonas syringae pv. tomato DC3000 (Pst DC3000) is a bacterial pathogen of tomato and of the model plants Arabidopsis and Nicotiana benthamiana (N. benthamiana). Like numerous Gram-negative bacterial pathogens of animals and plants, Pst DC3000 exploits the conserved type III secretion system (TTSS) to deliver multiple virulence effectors directly into the host cells. Type III effectors (T3Es) collectively participate in causing disease, by mechanisms that are not well clarity. Elucidating the virulence function of individual effector is fundamental for understanding bacterial infection of plants. Here, we focused on studying one of these effectors, HopAA1-1, and analyzed its potential function and subcellular localization in N. benthamiana. Using an Agrobacterium-mediated transient expression system, we found that HopAA1-1 can trigger domain-dependent cell death in N. benthamiana. The observation using confocal microscopy showed that the YFP-tagged HopAA1-1 localizes to diverse cellular components containing nucleus, cytoplasm and cell membrane, which was demonstrated through immunoblot analysis of membrane fractionation and nuclear separation. Enforced HopAA1-1 subcellular localization, by tagging with a nuclear localization sequence (NLS) or a nuclear export sequence (NES), shows that HopAA1-1-induced cell death in N. benthamiana is suppressed in the nucleus but enhanced in the cytoplasm. Our research is lay a foundation for revealed the molecular pathogenesis of Pseudomonas syringae pv. tomato.
文摘死亡与并发症病例讨论会(Mortality and Morbidity Conferences,MMC)在欧美国家广泛应用于医学教育与质量改进。标准化的MMC包括会前准备分析、会议介绍、病例介绍、讨论分析、制定行动项目及会后总结与反馈等过程。在我国医疗高质量发展的背景下,会议制度给我国死亡病例讨论制度的改进带来了新的思考。我国有能力的三级医院应该积极探索建立标准化的病例讨论流程,扩大讨论范围,规范关注对象,并强调质量改进与医学教育并重。
文摘While the central nervous system (CNS) was once thought to be immune privileged, more recent data support that certain areas of the healthy CNS are routinely patrolled by immune cells. Further, antigen drainage is another means by which the adaptive arm of the immune system can gain information about the health of the CNS. Altogether these ensure that the CNS is not beyond the scope of immune protection against viruses and tumors. However, immune surveillance in the CNS has to be tightly regulated, as CNS autoimmune disease and inflammation may arise from increased immune cell infiltration. In this review we discuss the concept and implications of CNS immune surveillance and introduce the CNS antigen-presenting cells (APCs) that potentially regulate neuroinflammation and autoimmunity. We also discuss novel animal models in which CNS disease initiation and the role of APCs in disease regulation can be tested.
文摘Objective： The aim of this study was to study the expression and the clinical significance of B7-H1 on dendritic cells （DCs） in peripheral blood from patients with bladder cancer. Methods： Peripheral blood mononuclear cell were disparted from 30 bladder cancer patients and 7 healthy controls by density gradient centfifugation and then co-cultured. The expres- sion of B7-H1 on DCs were analyzed by flow cytometry. Results： Expression of BT-H1 on DCs in bladder cancer was higher than healthy controls （P 〈 0.01）. And the expression were strongly associated with the pathological grade and clinical stage of bladder cancer （P 〈 0,05）. Conclusion： The up-regulation of B7-H1 on DCs was strongly associated with neoplastic progres-sion of bladder cancer. B7-H1/programmed death （PD）-1 signal pathway may also play an important role in immune escape of bladder cancer during initial phase of T cell immune response.
