[Utilization of the standard questionnaire in specific health checkups].

Objectives　Interviewing people about their health behaviour in specific health checkups (SHCs) is thought to promote awareness of and help improve such behaviour. The standard questionnaire (SQ) for SHCs consists of 22 items presented in the guidelines of the Ministry of Health, Labour, and Welfare. However, using items other than those necessary for stratification for specific health guidance (SHG) is optional. We believe that clarifying the actual utilization of SQ items could contribute to improving the procedure used for the fourth SHCs and SHG, which will be initiated in 2024.　This study seeks to clarify the actual utilization of the SQ for (1) conducting SHCs, (2) planning, implementing, and evaluating SHG and health programs aimed at preventing lifestyle-related diseases, and (3) planning, implementing, and evaluating the data health plan.Methods　We enrolled 3,179 people from 1,741 departments in charge of national health insurance, 47 Japan Health Insurance Association branches, and 1,391 health insurance societies across all municipalities in Japan. One participant among the study participants was the main person in charge of SHCs and SHG at each facility. We conducted a self-reported survey on the implementation of SHCs and SHG in February 2022. This study was approved by the ethics review board of the institution to which the first author belongs.Results　A total of 1,221 (38.4%) were received. The proportions of valid responses from national health insurance departments, Japan Health Insurance Association branches, and health insurance societies were 816 (46.9%), 47 (100%), and 358 (25.7%), respectively. Over 96% of responders used the group SHCs method, and over 93% of those adopting the individual SHCs method used each of the 22 SQ items. However, 187 (18.2%) responders found it difficult to use the item "If you had the opportunity to receive health guidance for lifestyle improvement, would you take it?" The reason was that the on-request SHG system was misunderstood. Additionally, only approximately 50% of respondents used the SQ to develop, implement, and evaluate their health program.Conclusion　We believe there will be no problem in implementing the SQ even if using all its component items is required. However, the aforementioned item needs to be revised. Methods to encourage health insurers and their supporters to use the SQ for health-related data collection and health program planning should be devised.

[Implementing nursing education based on the revision of rules for the designation of public health nurses, midwives, nursing schools, and training schools among nursing universities in Japan].

In 2020, the number of nursing universities in Japan increased to 274. One out of three universities has a nursing school, and the number of nursing universities continues to increase. The Ministry of Education, Culture, Sports, Science and Technology introduced the "Model Core Curriculum for Nursing Science Education in Japan" (MCCNSE) in 2017. The MCCNSE aims to include indispensable nursing competencies to the undergraduate course, enumerating the learning targets that will be useful for students. The MCCNSE includes seven aspects that aim to develop the qualities and abilities of a nurse for a lifetime. A consists of the basic qualities/abilities required by nursing professionals. B comprises social and nursing science. C consists of the basic knowledge necessary for understanding the objectives of nursing, including pharmacological science. D includes basic knowledge of the specialty underlying nursing practice. E comprises the basic knowledge necessary for nursing practice in various settings. F relates to clinical and regional training practice, and G includes research in nursing science. Nursing universities are required to comply with both the School Education Act and the Act on Public Health Nurses, Midwives, and Nurses. Nursing universities are expected to formulate a more complete and original curriculum based on the revision of Rules for the Designation of Public Health Nurses, Midwives, Nursing Schools, and Training Schools.

Detection of AFP mRNA-expressing cells in the peripheral blood for prediction of HCC recurrence after living donor liver transplantation.

The aim of this study was to evaluate the hypothesis that the detection of alpha-fetoprotein (AFP) mRNA-expressing cells could be a novel, direct and accurate method for predicting tumor recurrence after living donor liver transplantation (LDLT) in patients with hepatocellular carcinoma (HCC). The test group consisted of 32 patients who underwent LDLT for end-stage liver disease with HCC. Quantitative real-time reverse transcription polymerase chain reaction was used for the detection of AFP mRNA-expressing cells in the peripheral blood. Nine (28.1%) of the 32 patients developed tumor recurrences during the follow-up period (mean, 27.9 months). The test for the presence of AFP mRNA in the peripheral blood was positive either preoperatively or postoperatively in 11 (34.3%) of the 32 patients, and positive preoperatively in three patients (9.4%). Univariate analysis revealed that a positive preoperative test for peripheral blood AFP mRNA, as well as exceeding Milan criteria and microscopic evidence of vascular invasion were significant predictors for the recurrence of HCC (P = 0.002, 0.049, and 0.001, respectively). Multivariate analysis using Cox's proportional hazards model revealed that a positive preoperative test for peripheral blood AFP mRNA was an independent risk factor for the recurrence of HCC. We concluded that the presence of AFP mRNA-expressing cells preoperatively could be a useful predictor of the recurrence of HCC in liver transplant patients.