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Difficulties Experienced in Trauma Nursing Practice by Expert Emergency Nurses in Japan

Open Journal of Nursing 2019年第10期9卷 1073-1087页

作者： Natsuko Makino keiko nakamura Koji Ishikawa Miki Sugawara Department of Nursing School of Health Sciences Sapporo Medical University Sapporo Japan Graduate School of Nursing Sapporo City University Sapporo Japan Department of Nursing Hokkaido University of Science Sapporo Japan School of Nursing Sapporo City University Sapporo Japan

The objective of this study was to determine the difficulties experienced in trauma nursing practice by expert emergency nurses in Japan. Ten nurses who worked at emergency and critical care centers in Japan were directly involved in nursing patients were selected by purposive sampling and underwent semi-structured interviews regarding the difficulties they experienced in trauma nursing. The nurses were specialists in critical care nursing or were certified emergency nurses. The interview responses were analyzed by the qualitative descriptive method. The following six categories of difficulties associated with the direct care of trauma patients and their family members encountered in trauma nursing practice were identified: [Initial handling of highly urgent trauma patients], [Understanding and observing the condition of patients who are in the treatment stage], [Judging when to transition to end-stage care for patients difficult to save], [Mitigating suffering and expanding safe activities of daily living for trauma patients], [Transitional care with a long-term perspective for trauma patients], and [Relationships with the family members of patients who died]. Three categories of difficulties related to the role of the expert nurse in trauma nursing practice were identified: [Person-to-person coordination and cooperation for a trauma patient], [Playing an educational role for the nursing staff], and [Pursuing expertise in trauma nursing and gaining empirical knowledge]. The findings suggested a need to establish systems for training and consultative support and opportunities to create meaning by reflecting on fulfillment and nursing practice.

关键词： Trauma Nursing Practice Difficulties Expert Nurse Emergency Care

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Health Status and Health Facility Utilization of Community-Dwelling Elderly Living Alone in the Philippines: A Nationwide Cross-Sectional Study

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Health 2019年第11期11卷 1554-1572页

作者： TJ Robinson Moncatar keiko nakamura Mosiur Rahman Kaoruko Seino Department of Global Health Entrepreneurship Division of Public Health Graduate School of Tokyo Medical and Dental University Tokyo 113-8519 Japan

Background: Increase of elderly people living alone has been a concern even in the Philippines where filial piety is widely practiced with the support of large number of young people. Objectives of this study were to examine the relationships between living alone with self-reported illness among community elderly and living alone with health facility utilization among sick community elderly in the Philippines. Methods: Data of 5577 elderly (aged ≥ 60 years) from the 2013 Philippines National Demographic and Health Survey were retrieved. Variables on living arrangements, self-reported illness, frequency of health facility visits, and admission to a health facility were used for analysis. Results: Among the elderly included in the analysis, 5.0% of them were living alone. Percentage of living alone was larger among rural elderly (6.0%) compared with urban elderly (3.6%);and among poor elderly (9.0%) compared with rich elderly (2.8%). Results of adjusted multivariate logistic regression analysis showed that the elderly living alone were more likely to report suffering from common colds (AOR 2.12;95% CI 1.57 - 2.86) or non-communicable diseases (AOR 2.18;95% CI 1.55 - 3.06), regardless of their socioeconomic status or insurance coverage. Among those who reported illness, the elderly living alone were more likely to visit a health facility with non-communicable disease (AOR 1.95;95% CI 1.22 - 3.14), after adjustment of other variables. Although elderly living alone who reported illness were likely to be admitted in a health facility, statistically significant association was not observed. Conclusion: Elderly living alone are more likely to report self-reported illness and use health facilities when they recognize their illness.

关键词： Aging Living Alone Health Status Health Facility Utilization Philippines

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Lipid and Diabetic Profiles of School Teachers in Afghanistan Facing Food Insecurity and Their Association with Knowledge Relating to Healthy Lifestyle

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Food and Nutrition Sciences 2019年第6期10卷 678-693页

作者： Ahmad Shekib Arab keiko nakamura Kaoruko Seino Shafiqullah Hemat Mohammad Omar Mashal Yuri Tashiro Department of Global Health Entrepreneurship Division of Public Health Tokyo Medical and Dental University Tokyo Japan Ministry of Public Health Kabul Afghanistan

Objectives: To investigate lipid and diabetic profiles of school teachers in Kabul, Afghanistan, who face food insecurity, and examine the association of those with the teachers’ knowledge of non-communicable diseases (NCDs). Methods: A survey to examine biochemical indicators of NCDs (triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), hemoglobin A1c (HbA1c), blood pressure, height, weight, waist circumference), food insecurity, lifestyle and knowledge of NCDs was conducted among 600 school teachers. Analyses were made of biochemical indicators of NCDs, blood pressure, metabolic syndrome, obesity, and subject’s lifestyle in relation to food security and the subject’s knowledge of NCDs. Results: Thirty-nine percent of school teachers experienced food insecurity. The percentage of TC ≥ 200 mg/dL;HbA1c ≥ 5.5%;hypertension and metabolic syndrome were 20.2%, 29.7%, 32.2% and 33.7%, respectively. Food insecurity was associated with lower fruit and vegetable consumption and higher potato consumption. Food insecurity was associated with increased TC (AOR 2.03;95%CI: 1.23 - 3.34), decreased HDL (AOR 1.70;95%CI: 1.12 - 2.58), increased HbA1c (AOR 1.73;95%CI: 1.14 - 2.64), hypertension (AOR 1.68;95%CI: 1.01 - 2.80) and diagnosis of metabolic syndrome (AOR 1.78;95%CI: 1.18 - 2.68), after adjustment by demographic, socioeconomic and lifestyle variables. Among people living under condition of food insecurity, greater NCD knowledge was associated with smaller prevalence of TG ≥ 150 mg/dL, HDL Conclusions: Under conditions of food insecurity, diets have less variety and individuals are more likely to exhibit biomedical risk factors of NCDs. Even under conditions of food insecurity, people with knowledge of NCDs may have better coping strategies for their choice of lifestyles and exhibited a lower percentage of risk factors of NCDs.

关键词： Food Insecurity Afghanistan Non-Communicable Diseases Metabolic Syndrome School Teachers

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Changes in Texture, Structure and Pectin of Peach during Pressurization, Heating or Processing of High-pressure-induced and Heat-induced Jam

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Journal of Food Science and Engineering 2013年第1期3卷 1-8页

作者： Hiroko Kuwada Yuri Jibu keiko nakamura Mayumi Tabuchi Ai Teramoto Kayoko Ishii Yasumi Kimura Michiko Fuchigami Department of Nutrition and Life Science Fukuyama University Fukuyama Hirosima-ken 729-0292 Japan Department of Nutritional Science Okayama Prefectural University Soja Okayama-ken 719-1197 Japan Department of Health and Nutrition Kanto Gakuin University Yokohama Kanagawa-ken 236-8501 Japan

The objectives of this study are to research the relationship between pectin and the softening of peach by soaking in citric acid solutions for 24 h at 35 ℃, pressurizing for 30 rain at 500 MPa or heating for 10 min. Also, comparing high-pressure-induced jam （HP-jam） and heat-induced jam （H-jam） were evaluated. It was found that firmness of the peach decreased greatly when soaked at pH 2.0 〉 heated 〉 soaked at pH 2.2 or 2.5 〉 pressurized, respectively. About 88% of the peach pectin was water-soluble-pectin and high-methoxyl pectin, while low-methoxyl pectin was slight. During pressurization, the pectin did not change. However, pectin degraded through hydrolysis during heating; consequently, the middle lamella separated. Also, eight kinds of peach jam （65% sugar, pH 2.0 or pH 2.2, and 50% or 60% sugar, pH 2.5） were compared. Both color and flavor of HP-jam were better than H-jam. As the pH values were lower, L-, a-, b-values of jam became higher, and the jam became pinker. Raw peach contained about 0.3%-0.4% pectin, therefore, an addition of 0.6% pectin was needed for both HP- and H-jams. However, there was no great difference in rheology or sensory evaluation between HP- and H-jams.

关键词： Peach pectin high pressure processing jam texture structure.

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Social Activity Patterns Drive High Rates of Latent Tuberculosis Infection among Adolescents in Urban Tanzania<br/>—Latent TB Infection in Adolescents, Tanzania

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Journal of Tuberculosis Research 2018年第1期6卷 81-95页

作者： Isaac I. Maro keiko nakamura Kaoruko Seino Kisali Pallangyo Patricia Munseri Mecky Matee Charles Fordham von Reyn Department of Global Health Entrepreneurship Tokyo Medical and Dental University Tokyo Japan Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania Department of Internal Medicine Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania Department of Microbiology and Immunology School of Medicine Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania Geisel School of Medicine at Dartmouth Hanover NH USA

SETTING: Dar es Salaam, Tanzania. OBJECTIVE: To determine the prevalence of latent tuberculosis (TB) infection (LTBI) among adolescents in a country with a high TB burden, and examine risks of LTBI according to their social activity patterns. METHODS: A cross-sectional study nested within a phase 2b randomised, placebo controlled, double blind study and consisted of 824 adolescents, 13 - 15 years old who had received Bacillus Calmette-Guérin (BCG) vaccine, were attending public secondary schools and had no evidence of active tuberculosis (TB). Anthropometric measurements were obtained, a questionnaire administered, and phlebotomy performed for a T spot interferon-γ?release assay (IGRA) to detect LTBI. RESULTS: Among 824 subjects, 149 (18%) had a positive IGRA. After adjusting for the influence of household socioeconomic status, history of TB contact, living environment and nutritional status, LTBI risk was higher in subjects with than without regular informal encounters with traditional alcoholic beverage drinkers (AOR, 6.37 [1.84 - 22.00]). Other significant factors for LTBI risk included contact with TB patient at school (AOR, 3.34 [1.14 - 9.80]), and living close to a health facility, as was observed among those from houses within a 10 - 30-minute walking distance to the nearest health facility, who were less likely to be IGRA-positive than those who were living within a 10-minute walking distance (AOR, 0.30 [95%CI, 0.13 - 0.69]). CONCLUSION: This IGRA study revealed a high prevalence of LTBI among adolescents in Dar es Salaam, Tanzania with prior BCG immunization. Informal social encounters were identified as independent risk factors for LTBI, along with a history of contact with TB patients, living environment characteristics and household socioeconomic status. Efforts focusing on risk of MTB transmission in adolescents at informal social gatherings will improve interventions to reduce LTBI in this population and consequently the subsequent risk of developing a

关键词： Dar es Salaam Social Factors IGRA T Spot Adolescents BCG DAR 901

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Geographical Patterns of Tuberculosis Notification Rates and Their Associations with Sociodemographic Characteristics in Communes in Phnom Penh, Cambodia

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Journal of Tuberculosis Research 2019年第2期7卷 118-129页

作者： Ayano Miyashita Aya Hiraki keiko nakamura Takehito Takano Kaoruko Seino Saber Al-Sobaihi Ngy Mean Heng Koeut Pichenda Department of Global Health Entrepreneurship Division of Public Health Tokyo Medical and Dental University Tokyo Japan Phnom Penh Municipality Health Department Phnom Penh Cambodia Ministry of Public Health National Institute for Tuberculosis and Leprosy Phnom Penh Cambodia

Objective: To identify the patterns of tuberculosis (TB) notification rates in Phnom Penh and examine their relationships with the population density, socioeconomic, residential and occupational characteristics. Methods: The numbers of total TB and smear-positive pulmonary TB cases reported between January 1, 2010 and December 31, 2012 in Phnom Penh were counted for 76 communes in Cambodia according to TB registration records filed under the national TB programme. Population, socioeconomic, residential and occupational characteristics for the communes were obtained from the 2008 General Population Census of Cambodia. The following indicators were developed for individual communes: smear-positive pulmonary TB notification rate (SPTB-NR) (per 100,000 population, in 36 months), population density (per km2), socioeconomic indicators, residential characteristics and occupational characteristics. Geographic patterns of these indicators and characteristics were analysed using ArcGIS. Associations between SPTB-NR and characteristics were analysed. Results: A total of 4102 TB cases were reported in 36 months, including 2046 SPTB cases. SPTB-NR for Phnom Penh was 135 cases per 100,000;median SPTB-NR by commune was 100. SPTB-NR was higher in outlying areas than in city centre communes;population density was high in the centre and low in the outlying areas. SPTB-NR was associated with larger percentage of household members per room (PR: 2.81, 95%CI: 2.68 - 2.93), percentage of population resident in the same commune Conclusions: The SPTB-NR in Phnom Penh did not follow the pattern of population density. Socioeconomic, residential and occupational characteristics by commune were associated with SPTB-NR. Development of prevention and control programmes by considering commune level characteristics is encouraged.

关键词： TB Notification Rate National Tuberculosis Programme Census Data Area-Based Approaches Cambodia

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中国护士参加日本护理专家研讨班的效果评价

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护理实践与研究 2011年第12期8卷 109-110页

作者：段亚梅田素斋 Sumiko OTA keiko nakamura Noriko FUNAKI Yasuko OKABAYASHI Tomo TUNOKAWA 日本兵库大学健康科学部护理学科石家庄市河北医科大学第二医院护理部日本北海道医科大学日本朴幌城市大学日本北海道大学附属医院日本Seiaikai Hassamuchuo医院

中国北方一个大城市的两家医院的护士,参加日本护理专家讲师团举办的研讨班,分析中国护士参加由日本护理专家举办的护理管理知识讲座研讨会后,对日本的护理知识和信息有什么回应(在兴趣范围和理解程度方面),确定中国和日本之间理想的交... 详细信息

中国北方一个大城市的两家医院的护士,参加日本护理专家讲师团举办的研讨班,分析中国护士参加由日本护理专家举办的护理管理知识讲座研讨会后,对日本的护理知识和信息有什么回应(在兴趣范围和理解程度方面),确定中国和日本之间理想的交流护理知识的形式。这个研讨班的主题和内容由日本专家讲师根据主办方要求准备。提前准备中文版的简介幻灯片(演示资料)和其他材料,这些内容会在研讨班上进行中文翻译。

关键词：国际交流中国日本护士

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Two cases of childhood absence epilepsy who showed seizure disappearance after ethosuximide drug eruption

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Acta Epileptologica 2022年第4期5卷 281-285页

作者： Takuji nakamura keiko Uda Muneaki Matsuo Masafumi Zaitsu Department of Pediatrics Faculty of MedicineSaga UniversitySagaJapan Department of Pediatrics National Hospital Organization Ureshino Medical Center4279-3 Shimojuku KouUreshino CitySaga843-0393Japan

Background Recent studies suggest potential roles of immune response in the pathophysiology of ***-seizure medications(ASMs)are known to have side effects of drug eruption caused by immune responses.A few reports in adults have demonstrated disappearance of seizures after an ASM drug eruption *** this paper,we described 2 cases of childhood absence epilepsy(CAE)who showed seizure disappearance after ethosuximide(ESM)drug eruption,suggesting the possibility that the epilepsy disappears due to immune responses to *** presentation Case 1 was an 8-year-old girl diagnosed with *** was treated with valproate acid(VPA)initially,and then ESM was administered as an additional *** epileptic seizure disappeared 4 days after initiation of ***,drug eruption appeared 1 week after the administration of *** after discontinuation of ESM administration,she maintains no seizure after the drug *** 2 was a 5-year-old boy diagnosed as *** was treated with VPA initially,and ESM was administered *** eruption appeared 1 month after the administration of *** after ESM was terminated,he maintained seizure freedom after the appearance of *** Epileptic seizures may have been suppressed due to the immune responses caused by ASM *** studies are needed to elucidate the pathophysiologic effects of drug eruption on epilepsy through immune responses.

关键词： Childhood absence epilepsy Drug eruption Ethosuximide Seizure disappearance

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Neurorehabilitation using a voluntary driven exoskeletal robot improves trunk function in patients with chronic spinal cord injury: a single-arm study

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Neural Regeneration Research 2022年第2期17卷 427-432页

作者： Hiroki Okawara Syoichi Tashiro Tomonori Sawada keiko Sugai Kohei Matsubayashi Michiyuki Kawakami Satoshi Nori Osahiko Tsuji Narihito Nagoshi Morio Matsumoto Masaya nakamura Department of Orthopaedic Surgery Keio University School of MedicineTokyoJapan Department of Rehabilitation Medicine Keio University School of MedicineTokyoJapan Department of Orthopedic Surgery National Hospital OrganizationMurayama Medical CenterTokyoJapan

Body weight-supported treadmill training with the voluntary driven exoskeleton(VDE-BWSTT) has been shown to improve the gait function of patients with chronic spinal cord injury. However, little is known whether VDE-BWSTT can effectively improve the trunk function of patients with chronic spinal cord injury. In this open-label, single-arm study, nine patients with chronic spinal cord injury at the cervical or thoracic level(six males and three females, aged 37.8 ± 15.6 years, and time since injury 51.1 ± 31.8 months) who underwent outpatient VDE-BWSTT training program at Keio University Hospital, Japan from September 2017 to March 2019 were included. All patients underwent twenty 60-minute gait training sessions using VDE. Trunk muscular strength, i.e., the maximum force against which patient could maintain a sitting posture without any support, was evaluated in four directions: anterior, posterior, and lateral(right and left) after 10 and 20 training sessions. After intervention, lateral muscular strength significantly improved. In addition, a significant positive correlation was detected between the change in lateral trunk muscular strength after 20 training sessions relative to baseline and gait speed. The change in trunk muscular strength after 20 training sessions relative to baseline was greatly correlated with patient age. This suggests that older adult patients with chronic spinal cord injury achieved a greater improvement in trunk muscle strength following VDE-BWSTT. All these findings suggest that VDE-BWSTT can improve the trunk function of patients with chronic spinal cord injury and the effect might be greater in older adult patients. The study was approved by the Keio University of Medicine Ethics Committee(IRB No. 20150355-3) on September 26, 2017.

关键词： body weight-supported treadmill training gait disorders hybrid assistive limb neurologic neurophysiotherapy postural balance precision medicine robot-assisted gait training robotics spinal cord injury trunk

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A Feasibility Study of an Individualized Voiding Program in Japan to Improve the Sense of Control in Older People with Functional Urinary Incontinence

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Health 2021年第3期13卷 253-272页

作者： Satsuki nakamura Masakazu Kubota Chiharu Akazawa keiko Suyama Department of Nursing Faculty of Human Health and Welfare St. Catherine University Ehime Japan Graduate School of Nursing Osaka Medical College Osaka Japan Department of Nursing Graduate School of Medicine Ehime University Ehime Japan

Purpose: This study intended to assess the feasibility of an individualized voiding program in Japan aimed at improving the sense of micturition control in older people with functional urinary incontinence. Method: Following the interview guide, FGIs were conducted in two groups (4 - 6 participants) consisting of nurses and care workers with more than 5 years of experience as practitioners of urination care. Data were analyzed using a qualitative descriptive approach. Results: We determined that the program purpose is to “enable caregivers to work as a well-coordinated team to humanely facilitate excretion independence in older people, which is essential for living with dignity”, as this confirmed the importance of maintaining the sense of micturition control in older people for their well-being. In the program outline, we extracted the following five categories: 1) setting selection criteria for recipients considering the status of micturition induction, 2) careful collection of information and assessment of lower urinary tract symptoms in older people in case of environmental changes, 3) examination of methods used for assessing lower urinary tract symptoms according to the facility environment, 4) confirmation of the recipient’s micturition habits and request for assistance, and 5) conducting necessary examination for setting the intervention period and evaluation period according to the target condition. The feedback on the program guide was summarized in the statement—specific successful cases help frame and implement the micturition induction plan. Conclusion: We confirmed the feasibility of the micturition induction plan for improving the sense of control in older people with functional urinary incontinence. Upon evaluating the program guide, we deemed that referring to specific successful cases helps frame and implement the micturition induction plan. It is extremely important to verify the

关键词： Individualized Voiding Program Functional Urinary Incontinence Sense of Control Facility for Older People

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