Establishment of the National Consortium for Regenerative Medicine and National Regenerative Medicine Database in Japan

With its aim to regain the function of organs that are damaged by illness or injury, regenerative medicine has become the global focus of research. To accelerate the development and establishment of sufficient safety measures in regenerative medicine in Japan, the Pharmaceuticals and Medical Devices Act and the Act on Safety of Regenerative Medicine were enacted in 2014. Advancements in regenerative medicine are anticipated to draw attention toward the development of a system that consolidates and uses valuable data from studies performed from premarketing to postmarketing stages. Data gathered from premarketing to postmarketing stages of clinical research would promote new development avenues that would lead to the establishment of appropriate evaluation methods for new regenerative medical products by data validation. Against this background, the Japanese Society for Regenerative Medicine has been working to establish a national consortium for promoting regenerative medicine and constructing a large-scale clinical data registry, called the National Regenerative Medicine Database. This article aims to introduce the current framework of regenerative medicine in Japan, with a particular focus on the activity for establishment of a national consortium for regenerative medicine and the National Regenerative Medicine Database.     

Intellectual Property in the Field of Regenerative Medicine in Japan

Purpose

Although most pharmaceutical companies and bio-ventures have not yet created a practical business model or a credible exit thus far, most are expecting potential new business to be derived from regenerative medicine. This article discusses and proposes some ideas regarding a patent strategy for regenerative medicine.

A Japanese Bioventure Company's Application of Stem Cell Technology in Regenerative Medicine

Regenerative medicine mediated by the transplantation of somatic stem cells and functional cells derived from induced pluripotent stem cells has great potential in the treatment of currently incurable diseases and thus has attracted significant public attention. To put this into practice, several functional cell lines were developed and laws regarding regenerative medicine were put in force in Japan. In this report, we introduce recent efforts of a bioventure company with special attention to the case of Healios K.K.     

The Business of Emergency Medicine: A Nonclinical Curriculum Proposal for Emergency Medicine Residency Programs

Over the course of their postgraduate medical education, physicians are expected not only to acquire an extensive knowledge of clinical medicine and sound procedural skills, but also to develop competence in their other professional roles as communicator, collaborator, mediator, manager, teacher, and patient advocate. Although the need for physicians to develop stronger service delivery skills is well recognized, residency programs may underemphasize formal training in nonclinical proficiencies. As a result, graduates can begin their professional careers with an incomplete understanding of the operation of health care systems and how to utilize system resources in the manner best suited to their patients' needs. This article proposes the content, educational strategy, and needs assessment for an academic program entitled The Business of Emergency Medicine (BOEM). Developed as an adjunct to the (predominantly) clinical content of traditional emergency medicine (EM) training programs, BOEM is designed to enhance the existing academic curricula with additional learning opportunities by which EM residents can acquire a fundamental understanding of the nonclinical skills of their specialty.     

再生疗法和康复治疗的联合应用对神经疾病运动功能的康复效果：Scoping综述

目的 综述再生疗法和康复治疗联合应用于神经疾病运动功能的康复效果。方法 检索建库至2021年4月1日PubMed、Web of Science、中国知网、万方数据库中有关再生疗法和康复治疗相结合作用于神经疾病的相关研究,提取文献内容并进行Scoping综述。结果 共检索文献2567篇,最终纳入26篇,其中3篇为人类临床研究,23篇为动物基础研究。研究设计主要为随机或非随机对照试验、病例系列研究。研究主要涉及再生疗法和康复治疗的联合干预对脑卒中、脊髓损伤、脑性瘫痪等神经疾病运动功能的治疗效果。结论 本文从范畴上界定了再生康复在神经疾病的相关研究和应用,发现再生疗法和康复治疗的结合对于神经疾病运动功能的恢复具有一定的协同效应。未来需要更多的科研工作来支持其临床实践。     

Regenerative therapy for the management of a large skin wound in a dog

Extensive full‐thickness skin wounds are quite common in domestic animals. In these report, following the failure of reconstructive surgery, adipose tissue‐derived mesenchymal stem cells, and platelet‐rich plasma were successfully used in a dog to improve speed and quality of skin tissue healing, avoiding suffering, and debilitating effects.     

Mesenchymal Stem Cells in Cardiac Repair: Effects on Myocytes,Vasculature, and Fibroblasts

PurposeCardiac pathologies remain a dominant cause of morbidity and mortality within the community. The drive to develop therapies capable of repairing damaged heart tissue to achieve clinically significant restoration of function has motivated the pursuit of novel approaches such as cell therapy. To this end, evidence of therapeutic benefits achieved by using mesenchymal stem cells (MSCs) has captured considerable interest despite a relative lack of information regarding the mechanisms involved. This narrative review synthesizes and interprets the current literature describing mechanisms by which MSCs can elicit cardiac repair, thereby directing attention to avenues of further inquiry.MethodsOVID versions of MEDLINE and EMBASE were searched for studies describing the role of MSCs in mammalian cardiac repair. Additional studies were sourced from the reference lists of relevant articles and other personal files.FindingsMSCs elicit cardiac repair in a range of in vitro systems and animal models of diseases such as myocardial infarction and heart failure. Important mechanisms include the preservation of myocardial contractility, the promotion of angiogenesis, and the modulation of fibrosis. Exposing in vitro MSCs to a microenvironment reflective of that encountered in the injured heart seems to potentiate these therapeutic mechanisms.ImplicationsPromising results in animal studies warrant continuation of clinical MSC cardiac therapy studies. Paracrine functions of MSCs seem to be the dominant mechanism of cardiac repair over direct cellular effects. Although integral, the MSC secretome remains poorly defined. In addition, most of the mechanistic data within the literature have been derived from animal MSC research, necessitating more human MSC-based work.     

The development of advanced practice roles: implications in the international nursing community

This article examined the critical elements that have been identified in the development of advanced practice roles of nurses in four countries: Brazil, Thailand, the United Kingdom and the United States of America. Several sociopolitical and professional forces were examined for possible insights and ways in which they may have shaped the development and evolution of the roles of advanced practice nurses (APNs). These forces were: the socio-political environment; the health needs of society; the health workforce supply and demand; governmental policy and support; intra- and interprofessional collaboration; the development of nursing education; and documentation of effectiveness of the advanced role. The development of APN roles in the four social systems was reviewed to illustrate how socio-political and professional forces may have shaped nursing roles in each health care delivery system. Commonalities and distinguishing features across the four health and social systems were analysed to assess the predictive forces that may be identified as advanced roles in nursing have evolved in the global community.     

Pharmacist prescribing in the UK - a literature review of current practice and research

OBJECTIVE: To review the research literature to date on pharmacist prescribing in the United Kingdom (UK) and to explore the main areas of care and practice settings including any benefits and limitations. FINDINGS: There are two models of pharmacist prescribing in the UK: pharma\cist supplementary prescribing (SP) introduced in 2003, involving a voluntary partnership between the responsible independent prescriber (a physician or a dentist), the supplementary prescriber and the patient, to implement an agreed patient-specific clinical management plan; and pharmacist independent prescribing (IP) introduced in 2006, responsible for the assessment and consequent management, including prescribing of both undiagnosed and diagnosed conditions. There have been narrative reports of pharmacist SP in different health care settings including primary care, community pharmacies, secondary care and at the primary/secondary care interface; published research within these areas of care is conflicting as to which setting is more suitable for pharmacist prescribing. Initial research reports that almost 50% of pharmacist supplementary prescribers self-reported prescribing with both benefits of and barriers to implementing SP. Research involving other healthcare professionals has indicated that encroachment of traditional roles is likely to occur because of the advent of pharmacist prescribing. A small-scale study has concluded that patients are likely to accept pharmacist prescribing favourably, with another study showing pharmacist prescribing leading to improved adherence to guidelines. There is no published research yet available about practices involving pharmacist IP. DISCUSSION: Most of the literature focuses on pharmacists' perceptions of SP, with little information referring to other stakeholders, including patients. There is also limited published research focusing on clinical and economic outcomes of pharmacist SP. CONCLUSION: This is a rapidly changing aspect of pharmacy practice in the UK, particularly with the more recent introduction of pharmacist IP. It is likely that this area of research will expand rapidly over the coming years.     

Evolutionary change in the use of skills within the district nursing team: a study in two Health Board areas in Scotland

Grade mix within the district nursing team in the United Kingdom has changed markedly over the last 10 years but the relationship between grade mix and skill mix has received only intermittent research attention. This study adopted an ethnographic approach and aimed to explore the way in which grade and skill are taken into account in the delegation of nursing care. After gaining ethical approval, a total of 76 members of 21 district nursing teams in two areas were observed and interviewed. Delegation practices were found to vary both within and between areas and considerable differences were uncovered in the responsibilities allocated to more junior and unqualified team members. The developing role of nursing auxiliaries is discussed in relation to the role of the G grade sister, resource constraints and the standards of patient care. The paper concludes by arguing that the supervision and leadership role provided by the G grade sister should be fully recognized and safeguarded.     

An Overview of Current Position on Cell Therapy in Transfusion Science and Medicine: From Fictional Promises to Factual and Perspectives from Red Cell Substitution to Stem Cell Therapy

Stem cell therapy is a relatively novel field of investigation, in which either differentiated cells or stem cells capable of differentiation are transplanted into an individual with the objective of yielding specific cell types in the damaged tissue and consequently restoring its function. The most successful example of cell therapy is hematopoietic stem cell transplantation, leading to regeneration of a patient’s blood cells, now a widely established procedure for many oncologic and non–oncologic diseases. Innovative cell-based therapies are being developed to replace, regenerate or repair injured, absent, or diseased tissues and organs. However, cell therapy bioproducts are based on their inherent biological features such as proliferation, migratory, capability, plasticity, and capacity of self-renewal, posing serious challenges during such bioproduct development. The extraordinary promise of stem cells for future treatments of otherwise intractable diseases has raised great hope and expectations in patients, advocates, physicians, and researchers alike. However, despite thousands of scientific publications and research programs, increased efforts need to be put into the identification of the factors involved, biological mechanisms and materials that affect safety/ efficacy, and into the design of cost-effective methods for the harvesting, expansion, manipulation and purification of the cells.     

Experiences of African nurses in the UK National Health Service: a literature review

Aim. This review aims to highlight the experiences of black African nurses in the United Kingdom. Background. There is an acute shortage of trained nurses in the United Kingdom, which has occurred because of several factors including ageing of the nurse population and increasing demand due to an ageing population as well as under investment in nurse education during the 1980s. Government initiatives have included recruiting nurses trained overseas to meet present and future demands. Among these internationally recruited nurses, a large number came from Africa, but little is known about the experience of nurses once they are in the United Kingdom. Although it is known that ethnic minority nurses suffer discrimination in the National Health Service, experiences of internationally recruited nurses and nurses from African countries, in particular, merit attention as their nursing practices and culture in general are different from those of developed countries. Methods. A literature search was conducted using CINAHL, Medline and Cochrane databases by using the following terms in various combinations: Experiences, African nurses, international nurses, ethnic minorities, discrimination, equal opportunities, United Kingdom and NHS. Conclusions. There is very little research into the experiences of African nurses in the United Kingdom. Research has concentrated on the experience of internationally recruited nurses and ethnic minority nurses in general. There is agreement that most foreign nurses have a negative experience of working in the United Kingdom. Nurses face discrimination in pay and conditions of service and most are exploited by managers. There are also ethical questions surrounding the recruitment of nurses form developing countries and their treatment once they come to the United Kingdom. Relevance to clinical practice. As the nursing workforce in the United Kingdom becomes increasingly diverse through international recruitment, it is important to have knowledge of experiences of different groups of nurses. This helps to devise adaptation programs for smooth transition tailored to particular groups and training that will help United Kingdom nurses to work in harmony with their foreign colleagues.     

The Influence of Critical Care Medicine on the Development of the Specialty of Emergency Medicine: A Historical Perspective

Through their largely concurrent development, the specialties of emergency medicine and critical care medicine have exerted a great deal of influence on each other. In this article, the authors trace the commonalities that emergency medicine and critical care medicine have shared and report on the historical relationship between the two specialties. As issues between emergency medicine and critical care medicine continue to emerge, the authors hope to inform the current discussion by bringing to light the controversies and questions that have been debated in the past.     

Review Article: Genetic competence of midwives in the UK and Japan

In the UK and Japan, midwives provide health services for women with concerns about a genetic condition or who are considering antenatal screening. In both countries, competences related to genetic health care have been devised but there is little evidence about midwifery competence in practice. A systematic literature review was undertaken to determine the extent to which midwives are achieving the genetic competences that are prescribed for their practice. English and Japanese literature from January 1999 to March 2009 was retrieved. Original studies or reviews, in which an aspect of midwifery practice was related to genetic competences, were eligible for inclusion. After a critical appraisal, six UK and five Japanese papers were eligible for inclusion. The findings indicated that midwives are not achieving the competences, nor are they confident about their genetics knowledge. Moreover, women are not being supported to make informed decisions regarding antenatal screening. We have confirmed that little research is being undertaken in both countries regarding competency achievement in practice. Changes to midwifery curricula and further continuing education are required to ensure that midwives are able to provide effective care regarding genetics.     

心血管内科老年患者实施睡眠护理干预的效果

目的:对心血管内科老年患者实施睡眠护理干预的效果进行探讨.方法:选取2018年6月至2019年6月蚌埠市第一人民医院收治的心血管内科患者80例作为研究对象,采取随机数字表法随机分为对照组和观察组,每组40例,对照组采用常规护理,观察组采用睡眠护理干预.结果:2组患者在护理前其匹斯堡睡眠质量评分和生命质量评分差异均无统计...     

Limitations, frustrations and opportunities: a follow-up study of nursing graduates from the University of Birmingham, England

This paper reports an ongoing study of the progress of nursing graduates from the University of Birmingham, England. The aim of the research was to follow-up early graduates from the programme, to assess their progress and study feedback indicators that could help further the development of this relatively new programme. The study also aims to contribute to the growing body of knowledge about United Kingdom nursing graduates, following the recent shift of nurse education from Schools/Colleges of Nursing into universities. Due to objection from some quarters as to the value of a university education for nurses, even such a small-scale study is considered to be important. A questionnaire was sent to the first three cohorts of graduates. It revealed interesting findings in relation to work patterns, continuing professional and academic development and perceptions of the value of the degree in practice. The graduates made recommendations regarding changes that might enhance the quality of the Birmingham degree and nursing practice generally.