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Tsuji H, Terao C, Yano K, Ikari K, Hashimoto M, Furu M, Ito H, Fujii T, Yamamoto W, Yamakawa N, Ohmura K, Taniguchi A, Momohara S, Yamanaka H, Matsuda F, Mimori T. FRI0573 Integration of Time-Averaged DAS28 Fits Better Joint Destruction In Rheumatoid Arthritis Than One-Time DAS28 and Identifies A Significant Joint-Destructive Association of HLA-DRB1*04:05 Which is Independent of ACPA and DAS28. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Furuya T, Momohara S, Taniguchi A, Yamanaka H. THU0459 Comparison between The American Recommendations and The Japanese Guidelines for Glucocorticoid-Induced Osteoporosis in Japanese Patients with Rheumatoid Arthritis:. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Espinosa-Jeffrey A, Arrazola RA, Chu B, Taniguchi A, Barajas SM, Bokhoor P, Garcia J, Feria-Velasco A, de Vellis J. Trophic factors intervention regenerates the nestin-expressing cell population in a model of perinatal excitotoxicity: Implications for perinatal brain injury and prematurity. INTEGRATIVE MOLECULAR MEDICINE 2016; 3:703-715. [PMID: 35558521 PMCID: PMC9094396 DOI: 10.15761/imm.1000228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We previously showed that TSC1 (a combination of transferrin and IGF-1) is a potent inductor of myelinogenesis in myelin deficient rats and in demyelinated adult mice. More recently, we demonstrated that regeneration of oligodendrocyte progenitors and myelin are possible with a single dose of TSC1 in a mouse model of Premature birth. Here, using the same mouse model of perinatal white matter damage due to glutamate excitotoxicity (GME), we tested the hypothesis that regeneration of endogenous nestin-expressing neural progenitors improves the outcome of prematurity. Treatments: N-methyl-D-aspartate (NMDA), saline, NMDA+TSC1 together or NMDA followed byTSC1 3 days later, were stereotaxically delivered into the corpus callosum of P4 mouse pups. Fluorescence analysis showed an intense enrichment of nestin-expressing cells in groups injected with NMDA+TSC1 from which many were generated by proliferation. Moreover, when TSC1 was injected three days after the primary insult it was still able to reduce ventricular enlargement and extensively rescue nestin-expressing progenitors. Cells co-expressing the proliferation marker Ki67, CNPase and faint nestin label were more abundant in groups injected with MNDA+TSC1 at 35 days after injection. Stereological analysis showed that the number of nestin-expressing cells in the sub-ventricular zone correlated inversely with the volume of the ventricle. A delayed administration of TSC1 after excitotoxicity reduced ventriculomegaly but not as much as, when NMDA and TSC1 were injected simultaneously. Thus, the earliest TSC1 was administered, the more tissue was rescued as shown by reduced ventriculomegaly. Astrocytes responded to GME by upregulating the expression of estrogen receptor and this expression was attenuated in the presence of TSC1 suggesting a decreased inflammation and a lesser need for estrogen-mediated central nervous system (CNS) neuroprotection.
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Sugimoto N, Tanaka E, Inoue E, Shimizu Y, Shidara K, Nakajima A, Taniguchi A, Momohara S, Yamanaka H. FRI0143 Risk Factors for Malignancy in Japanese Patients with Rheumatoid Arthritis Based on The IORRA Cohort during A 14-Year Observation Period. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Tanaka E, Inoue E, Yamaguchi R, Shimizu Y, Sugimoto N, Hoshi D, Shidara K, Sato E, Seto Y, Nakajima A, Momohara S, Taniguchi A, Yamanaka H. THU0046 A 3-Year Study of Work Impairment in Patients with Rheumatoid Arthritis Based on The IORRA Cohort. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Shidara K, Tanaka E, Inoue E, Yamaguchi R, Shimizu Y, Hoshi D, Sugimoto N, Nakajima A, Momohara S, Taniguchi A, Yamanaka H. AB0211 Which Disease Activity Score 28 (DAS28) Based Flare Criteria Impact on Functional Disability in Patients with Ra in Das28 Remission State Using The IORRA Cohort. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ishida O, Ikari K, Taniguchi A, Yamanaka H, Momohara S. AB0231 Higher Peak Disease Activity was Implicated as A Risk Factor in The Development of Vertical Subluxation in RA Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kuramoto N, Terao C, Ohmura K, Ikari K, Furu M, Yamakawa N, Yano K, Hashimoto M, Ito H, Fujii T, Murakami K, Sasai R, Imura Y, Yoshihuji H, Yukawa N, Taniguchi A, Momohara S, Yamanaka H, Matsuda F, Mimori T. AB0230 Centromere Pattern Exhibits A Specific Distribution of Titers among Anti-Nuclear Antibodies (ANAS) and Characterizes A Distinct Subset in Rheumatoid Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kim K, Bang SY, Ikari K, Yoo D, Cho SK, Choi CB, Sung YK, Kim TH, Jun JB, Kang Y, Suh CH, Shim SC, Lee SS, Lee J, Chung W, Kim SK, Momohara S, Taniguchi A, Yamanaka H, Nath S, Lee HS, Bae SC. AB0107 Association Heterogeneity Mapping Identifies An Asian-Specific Association of The GTF2I Locus with Rheumatoid Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ishikawa H, Kawada N, Taniguchi A, Odachi K, Mizutani A, Asahi M, Tomimoto H. Paraneoplastic neurological syndrome due to burned-out testicular tumor showing hot cross-bun sign. Acta Neurol Scand 2016; 133:398-402. [PMID: 26248690 DOI: 10.1111/ane.12469] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Paraneoplastic neurological syndromes (PNS) are rare remote effect of cancer. The antibodies and tumors associated with PNS have been well described, but there are still many clinically suspected cases in which no tumor or antibody can be identified. This is the first report of PNS showing hot cross-bun sign and caused by exceptionally rare underlying malignancy, such as burned-out testicular tumor. CASE PRESENTATION A 42-year-old man presented subacute progression of hearing loss and cerebellar ataxia. Cerebrospinal fluid showed continuous inflammation and magnetic resonance imaging (MRI) revealed cerebellar atrophy and hot cross-bun sign. Resection of tumors improved both laboratory findings and neurological signs and their pathology was seminoma. CONCLUSION Seminoma can cause PNS showing 8th cranial nerve palsy, cerebellar, and brainstem atrophy with hot cross-bun sign on MRI study. Extensive screening for onconeural antibodies was negative and thereby suggested that unknown antibodies worked for both antitumor immunity and induction of PNS.
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Abstract
Objective To evaluate some risk factors for cardiovascular diseases in feeding and eating disorders, the degree of lipid abnormalities was investigated in a large Japanese cohort of different groups of feeding and eating disorders, according to the Japan Atherosclerosis Society Guidelines for the Prevention of Atherosclerotic Cardiovascular Diseases 2012 (JAS Guidelines 2012). Methods Participants in the current study included 732 women divided into four groups of feeding and eating disorders: anorexia nervosa, restricting type (AN-R); anorexia nervosa, binge-eating/purging type; bulimia nervosa (BN); and binge-eating disorder (BED). We measured the serum levels of total cholesterol, high-density-lipoprotein (HDL) cholesterol, and triglyceride in these participants. Low-density-lipoprotein (LDL) cholesterol and non-HDL cholesterol levels were also calculated. Results The concentrations of LDL cholesterol and non-HDL cholesterol were widely distributed in all groups. When the LDL cholesterol risk was defined as ≥120 mg/dL and the non-HDL cholesterol risk as ≥150 mg/dL, according to the JAS Guidelines 2012, the proportion of LDL cholesterol risk ranged from 29.6% (BN) to 38.6% (AN-R), and the proportion of non-HDL cholesterol risk ranged from 17.8% (BN) to 30.1% (BED). Conclusion The present findings suggest the existence of LDL cholesterol risk and non-HDL cholesterol risk in all groups of eating disorders. Given the chronicity of this condition, the development of elevated concentrations of LDL cholesterol and non-HDL cholesterol at an early age may increase the risk of cardiovascular diseases.
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Aoyama-Sasabe S, Fukushima M, Xin X, Taniguchi A, Nakai Y, Mitsui R, Takahashi Y, Tsuji H, Yabe D, Yasuda K, Kurose T, Inagaki N, Seino Y. Insulin Secretory Defect and Insulin Resistance in Isolated Impaired Fasting Glucose and Isolated Impaired Glucose Tolerance. J Diabetes Res 2016; 2016:1298601. [PMID: 26788515 PMCID: PMC4693016 DOI: 10.1155/2016/1298601] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 08/18/2015] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE To investigate the characteristics of isolated impaired glucose tolerance (IGT) and isolated impaired fasting glucose (IFG), we analyzed the factors responsible for elevation of 2-hour postchallenge plasma glucose (2 h PG) and fasting plasma glucose (FPG) levels. METHODS We investigated the relationship between 2 h PG and FPG levels who underwent 75 g OGTT in 5620 Japanese subjects at initial examination for medical check-up. We compared clinical characteristics between isolated IGT and isolated IFG and analyzed the relationships of 2 h PG and FPG with clinical characteristics, the indices of insulin secretory capacity, and insulin sensitivity. RESULTS In a comparison between isolated IGT and isolated IFG, insulinogenic index was lower in isolated IGT than that of isolated IFG (0.43 ± 0.34 versus 0.50 ± 0.47, resp.; p < 0.01). ISI composite was lower in isolated IFG than that of isolated IGT (6.87 ± 3.38 versus 7.98 ± 4.03, resp.; p < 0.0001). In isolated IGT group, insulinogenic index showed a significant correlation with 2 h PG (r = -0.245, p < 0.0001) and had the strongest correlation with 2 h PG (β = -0.290). In isolated IFG group, ISI composite showed a significant correlation with FPG (r = -0.162, p < 0.0001) and had the strongest correlation with FPG (β = -0.214). CONCLUSIONS We have elucidated that decreased early-phase insulin secretion is the most important factor responsible for elevation of 2 h PG levels in isolated IGT subjects, and decreased insulin sensitivity is the most important factor responsible for elevation of FPG levels in isolated IFG subjects.
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Araki E, Tanizawa Y, Tanaka Y, Taniguchi A, Koiwai K, Kim G, Salsali A, Woerle HJ, Broedl UC. Long-term treatment with empagliflozin as add-on to oral antidiabetes therapy in Japanese patients with type 2 diabetes mellitus. Diabetes Obes Metab 2015; 17:665-74. [PMID: 25772548 DOI: 10.1111/dom.12464] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 03/06/2015] [Accepted: 03/10/2015] [Indexed: 01/11/2023]
Abstract
AIMS To evaluate the safety and efficacy of empagliflozin for 52 weeks as add-on to one other oral antidiabetes therapy in Japanese patients with type 2 diabetes mellitus (T2DM). METHODS Patients on biguanide (n = 133), thiazolidinedione (n = 273), α-glucosidase inhibitor (n = 139), dipeptidyl-peptidase-4 inhibitor (n = 139) or glinide (n = 140) were randomized 1 : 1 to receive empagliflozin 10 or 25 mg double-blind as add-on therapy for 52 weeks. Patients on sulphonylurea (SU; n = 336) were randomized 2 : 2 : 1 to receive empagliflozin 10 or 25 mg double-blind or open-label metformin as add-on therapy for 52 weeks. The primary objective was to evaluate safety. Change from baseline in glycated haemoglobin (HbA1c) at week 52 was a secondary endpoint. RESULTS Adverse events (AEs) were reported in 67.6-84.6% of patients receiving empagliflozin. Confirmed hypoglycaemic AEs (plasma glucose ≤70 mg/dl and/or requiring assistance) were reported in 4.4 and 6.6%, respectively, of patients receiving empagliflozin 10 and 25 mg as add-on to SU and in 0.0 to 2.9%, respectively, of patients receiving empagliflozin 10 and 25 mg as add-on to other therapies. Baseline mean ± standard deviation HbA1c ranged from 7.51 ± 0.73 to 8.06 ± 0.76% across background therapy groups. At week 52, adjusted mean ± standard error changes from baseline in HbA1c ranged from -0.77 ± 0.06 to -1.00 ± 0.06% in patients receiving empagliflozin. CONCLUSIONS In Japanese patients with T2DM, empagliflozin 10 and 25 mg as add-on to one other oral antidiabetes therapy for 52 weeks were well tolerated and were associated with clinically meaningful reductions in HbA1c.
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Tanaka E, Inoue E, Yamaguchi R, Shimizu Y, Sugimoto N, Hoshi D, Shidara K, Sato E, Seto Y, Nakajima A, Momohara S, Taniguchi A, Yamanaka H. SAT0068 A Longitudinal Study of Factors Contributing to the Worsening of Absenteeism in Patients with Rheumatoid Arthritis Based on the Iorra Cohort. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Furuya T, Momohara S, Taniguchi A, Yamanaka H. AB0911 Dental History and Complications in Japanese Patients with Rheumatoid Arthritis: Results From the Iorra Cohort Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sugimoto N, Tanaka E, Inoue E, Yamaguchi R, Shimizu Y, Kobayashi A, Shidara K, Hoshi D, Nakajima A, Taniguchi A, Momohara S, Yamanaka H. THU0161 The Incidence of Malignancies in Japanese Patients with Rheumatoid Arthritis Enrolled in the Iorra Cohort During a 14-Year Observation Period. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Yamaguchi R, Shidara K, Tanaka E, Inoue E, Shimizu Y, Kobayashi A, Sugimoto N, Hoshi D, Sato E, Seto Y, Nakajima A, Momohara S, Taniguchi A, Yamanaka H. AB0387 Incidence and Risk Factors for Tuberculosis in Japanese Patients with Rheumatoid Arthritis During a 12-Year Observational Period Using the Iorra Cohort. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Yoshida S, Ikari K, Furuya T, Taniguchi A, Yamanaka H, Momohara S. THU0004 The C677T Polymorphism in the Mthfr Gene Contributes to an Increased Risk of HIP Fracture in Japanese Patients with Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Tanaka E, Inoue E, Yamaguchi R, Shimizu Y, Sugimoto N, Hoshi D, Shidara K, Sato E, Seto Y, Nakajima A, Momohara S, Taniguchi A, Yamanaka H. FRI0074 Status of Disease Activity, Functional Impairment and Treatment in Patients with Rheumatoid Arthritis and Comorbidities. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Shidara K, Inoue E, Tanaka E, Yamaguchi R, Shimizu Y, Hoshi D, Sugimoto N, Nakajima A, Momohara S, Taniguchi A, Yamanaka H. FRI0046 Methotrexate Dose Reduction During DAS28 Remission was a Significant Factor Associated with Early Deterioration in Patients with Rheumatoid Arthritis from the Iorra Cohort. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Shimizu Y, Shidara K, Tanaka E, Inoue E, Yamaguchi R, Sugimoto N, Hoshi D, Nakajima A, Momohara S, Taniguchi A, Yamanaka H. SAT0093 Association of Alcohol Consumption with Disease Activity in Patients with Rheumatoid Arthritis Using the Institute of Rheumatology, Rheumatoid Arthritis (IORRA) Cohort. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ochi K, Inoue E, Furuya T, Ikari K, Toyama Y, Taniguchi A, Yamanaka H, Momohara S. Ten-year incidences of self-reported non-vertebral fractures in Japanese patients with rheumatoid arthritis: discrepancy between disease activity control and the incidence of non-vertebral fracture. Osteoporos Int 2015; 26:961-8. [PMID: 25294026 DOI: 10.1007/s00198-014-2911-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 09/19/2014] [Indexed: 01/05/2023]
Abstract
UNLABELLED Despite improvements in rheumatoid arthritis disease activity of in the past 10 years, the incidence of self-reported non-vertebral fractures did not decrease in our cohort of 9,987 patients. This study may indicate that osteoporosis treatment and non-vertebral fracture prevention remain important regardless of the rheumatoid arthritis disease activity. INTRODUCTION Although rheumatoid arthritis (RA) is a risk factor for osteoporosis and fractures, few studies have described the association between disease activity and the fracture incidence in patients with RA. This study aimed to investigate changes in the non-vertebral fracture incidence between 2001 and 2010 in our Institute of Rheumatology Rheumatoid Arthritis (IORRA) cohort. METHODS The IORRA is a prospective observational cohort study of Japanese RA patients. A total of 9,987 patients with RA were enrolled in this cohort from 2000 to 2010. The clinical parameter and non-vertebral fracture occurrence data were collected biannually through self-reported questionnaires. Incidences of self-reported non-vertebral fractures were also analyzed via standardization according to gender, age, and disease activity during each 2-year period. RESULTS From 2001 to 2010, the percentage of patients with 28-joint disease activity score remission increased from 7.8 to 39.7%, prednisolone intake decreased from 51.4 to 41.3%, and bisphosphonate intake increased from 5.0 to 23.4%. The non-vertebral fracture incidence rates were 24.6/1,000 person-years in 2001 and 35.5/1,000 person-years in 2010, with no apparent change even after standardization. The overall non-vertebral fracture incidence was significantly higher in the autumn/winter than in the spring/summer (p = 0.02). CONCLUSION Despite improvements in disease activity and functional disability, the non-vertebral fracture incidence exhibited no apparent change between 2001 and 2010 in our patients with RA. Osteoporosis treatment and non-vertebral fracture prevention remain important regardless of the disease control in patients with RA.
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Nakai Y, Nin K, Fukushima M, Nakamura K, Noma S, Teramukai S, Taniguchi A, Wonderlich S. Eating Disorder Examination Questionnaire (EDE-Q): Norms for Undergraduate Japanese Women. EUROPEAN EATING DISORDERS REVIEW 2014; 22:439-42. [DOI: 10.1002/erv.2324] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 07/30/2014] [Accepted: 09/04/2014] [Indexed: 11/11/2022]
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Kaasalainen S, Brazil K, Williams A, Wilson D, Willison K, Marshall D, Taniguchi A, Phillips C. Nurses' experiences providing palliative care to individuals living in rural communities: aspects of the physical residential setting. Rural Remote Health 2014; 14:2728. [PMID: 24965671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Efforts are needed to improve palliative care in rural communities, given the unique characteristics and inherent challenges with respect to working within the physical aspects of residential settings. Nurses who work in rural communities play a key role in the delivery of palliative care services. Hence, the purpose of this study was to explore nurses' experiences of providing palliative care in rural communities, with a particular focus on the impact of the physical residential setting. METHODS This study was grounded in a qualitative approach utilizing an exploratory descriptive design. Individual telephone interviews were conducted with 21 community nurses. Data were analyzed by thematic content analysis. RESULTS Nurses described the characteristics of working in a rural community and how it influences their perception of their role, highlighting the strong sense of community that exists but how system changes over the past decade have changed the way they provide care. They also described the key role that they play, which was often termed a 'jack of all trades', but focused on providing emotional, physical, and spiritual care while trying to manage many challenges related to transitioning and working with other healthcare providers. Finally, nurses described how the challenges of working within the physical constraints of a rural residential setting impeded their care provision to clients who are dying in the community, specifically related to the long distances that they travel while dealing with bad weather. CONCLUSIONS These study findings contribute to our understanding of the experiences of nurses working in rural communities in terms of the provision of palliative care and the influence of the physical residential setting that surrounds them. These findings are important since nurses play a major role in caring for community-dwelling clients who are dying, but they are confronted with many obstacles. As such, these results may help inform future decisions about how to best improve access to important services and ways to support them while providing palliative care to rural individuals.
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Yoshida S, Ikari K, Yano K, Toyama Y, Taniguchi A, Yamanaka H, Momohara S. AB0017 Impact of Disease Susceptibility Genes on Progression of Joint Destruction in Japanese Patients with Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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