Intracerebroventricular 2-hydroxypropyl-γ-cyclodextrin alleviates hepatic manifestations without distributing to the liver in a murine model of Niemann-Pick disease type C.

Niemann-Pick disease type C (NPC) is a lysosomal lipid storage disorder characterized by progressive neurodegeneration and hepatic dysfunction. A cyclic heptasaccharide, 2-hydroxypropyl-ß-cyclodextrin (HP-ß-CD), is currently under clinical investigation for NPC, but its adverse events remain problematic. We previously identified that a cyclic octasaccharide, 2-hydroxypropyl-γ-cyclodextrin (HP-γ-CD), also ameliorated NPC manifestations with higher biocompatibility than HP-ß-CD. However, preclinical studies describing the associations between the biodistribution and pharmacodynamics of these compounds, which are essential for clinical application, are still lacking. Here, we investigated these properties of HP-γ-CD by measuring its organ biodistribution and therapeutic effect after systemic and central administration. The effect of HP-γ-CD on disturbed cholesterol homeostasis appeared within several hours after exposure and persisted for several days in NPC model cells and mice. Tissue distribution indicated that only a small fraction of subcutaneously administered HP-γ-CD rapidly distributed to peripheral organs and contributed to disease amelioration. We found that a subcutaneous dose of HP-γ-CD negligibly ameliorated neurological characteristics because it has limited penetration of the blood-brain barrier; however, an intracerebroventricular microdose unexpectedly attenuated hepatic dysfunction without the detection of HP-γ-CD in the liver. These results demonstrate that central administration of HP-γ-CD can indirectly attenuate peripheral manifestations of NPC.

Nursing students' self-assessed level of nursing skills at the time of graduation in a Japanese University: A retrospective observational study.

Objective: This study aimed to clarify nursing students' self-assessed levels of nursing skills at a nursing university at graduation and discuss how education and clinical experiences for students and post-licensure nurses should be improved, especially focusing on oncology nursing. Methods: The study population comprised fourth-year students from 2017 to 2019 at the Faculty of Health Science and Nursing, Juntendo University, who had completed all stipulated clinical placements. The Japanese government determined 141 nursing skills and their target levels. Students subjectively evaluated their achieved levels for the 141 nursing skills after the final clinical placement. Results: Of the 141 nursing skills, 81 (57%) were rated as "skills with easy-to-achieve targets" and five were rated as "skills with difficult-to-achieve targets." All nursing skills in the two subcategories of environmental adjustment skills and comfort management skills were rated as "skills with easy-to-achieve targets." Nursing skills with low target achievement rates were for patients with oral intake difficulties, unstable respiratory status, and those requiring glycemic control. These skills are also important in oncology nursing. Conclusions: It cannot be concluded that the nursing university students fully achieved the target levels of nursing skills, as determined by the Japanese government. These findings may facilitate discussions on teaching nursing skills and their target levels at the time of graduation from nursing universities or post-employment.

Age at first birth and long-term mortality for mothers: the Ohsaki cohort study.

BACKGROUND: Although maternal age at first birth has been rising in many developed countries, its long-term effects on the health of the mothers themselves are unclear. In this study, we investigated the relationship between maternal age at first birth and long-term mortality. METHODS: We conducted a cohort study of 20,624 parous Japanese women aged between 40 and 79 years in 1994 and followed up their survival for 14 years. Based on maternal age at first birth, the women were divided into four groups: ≤19 years, 20-24 years, 25-29 years, and ≥30 years. Using the 20-24 years group as a reference, hazards ratios (HRs) for all-cause and cause-specific mortality were calculated. RESULTS: Multivariate HRs for all-cause mortality were 1.17 in the ≤19 years group, 1.09 in the 25-29 years group, and 1.33 in the ≥30 years group. A U-shaped relationship was apparent between maternal age at first birth and mortality. This relationship was also observed for mortality attributable to cancer, cardiovascular disease and other diseases. This U-shaped relationship was observed only for women born before 1935 and the birth year of the first child before 1960. CONCLUSION: A U-shaped relationship was apparent between maternal age at first birth and mortality. As maternal age at first birth is rising worldwide, the risk it imposes appears to have significance in the context of public health.

Errata: Developing a scale to measure "attachment to the local community" in late middle aged individuals.

Nihon Koshu Eisei Zasshi(JAPANESE JOURNAL OF PUBLIC HEALTH), Vol. 63 (2016) No. 11 p. 664-674: p668(Table 2).

Developing a scale to measure "attachment to the local community" in late middle aged individuals.

Objectives This study was conducted to develop a scale for measuring "attachment to the local community" for its use in health services. The scale is also intended to nurture new social relationships in late middle-aged individuals.Methods Thirty items were initially planned to be included in the scale to measure "attachment to the local community", according to a previous study that identified the concept. The study subjects were late middle-aged residents of City B in Prefecture A, located in Tokyo suburbs. From the basic resident register data, 1,000 individuals (local residents in the 50-69 year age group) were selected by a multi-stage random sampling technique, on the basis of their residential area, age, and sex (while maintaining the male to female ratio). An unsigned self-administered questionnaire was distributed to the subjects, and the responses were collected by postal mail. The collected data was analyzed using psychometric study of scale.Results Valid responses were obtained from 583 subjects, and the response rate was 58.3%. In an item analysis, none of the items were rejected. In a subsequent factor analysis, 7 items were eliminated. These items included 2 items with a factor loading of <0.40, 3 items loading on multiple factors and showing a factor loading of ≥0.40, and 2 items with a low factor correlation (0.04-0.16). These items included factors that related to only these 2 items. Consequently, 23 items in the following 4-factor structure were selected as the scale items: "Source of vitality to live life," "Intention to cherish ties with people," "Place where one can be oneself," and "Pride of being a resident." Cronbach's coefficient α for the entire scale of "attachment to the local community" was 0.95, demonstrating internal consistency. We then examined the correlation with an existing scale to measure social support; the results revealed a statistically significant correlation and confirmed criterion-related validity (P<0.001). In addition, the fit indices in a covariance structure analysis showed adequate values.Conclusions The developed scale was considered reliable and appropriate for measuring "attachment to the local community."

Function and practice of public health nursing in Japan: a trial to develop the Japanese Purpose-Focused Public Health Nursing Model.

AIM: To clarify the significance of public health nurses' practice, we introduced the activities of Japanese public health nurses and tried to develop a model based on the purpose of their work. BACKGROUND: Despite international efforts toward clarifying public health nurses' practice, earlier models based on the purpose of their activities were underdeveloped. METHOD: Japanese terms describing public health nurses' activities were gathered from the literature, nine researchers analysed and brainstormed the activities to develop a model. Seven municipality public health nurses and three researchers in both Japan and the USA validated the model. RESULTS: The model includes three categories: creating the basis for support; working with individuals, families to enhance their health; and enhancing the health of individuals, families, groups, communities/regions by working with the community. CONCLUSION: The Japanese Purpose-Focused Public Health Nursing Model was based on the purpose of public health nurses' practice which was considered significant for assisting public health nurses to explain the meaning of their work.