[Assessment Items Emphasized by Visiting Nurses in How Older Patients Treated at Home and Their Families Decide the Place of Death].

Although 70% of people in Japan wish to die at home, only 13.6% do, and 72.9% die in hospitals. This study aimed to clarify, from the perspective of visiting nurses, the factors influencing patients and their families in deciding the place of death and their satisfaction with end-of-life care at the chosen place. We conducted a survey of 70 visiting nurses with over a year of home nursing experience. They responded to the key factors influencing the decisions of patients and their families regarding place of death, either hospital or home, and the satisfaction at each place of death on a 10-point scale. 67 nurses valued the following two items when the place of death was a hospital: "Less burden of care on the family" and "Specialized treatment to alleviate suffering." The following four items were emphasized in the home: "I can live my own life as I want," "I can have my family be there when I want them to be," "I can receive extensive nursing care," and "I can be seen by my family doctor." The nurses also rated the satisfaction of patients and their families much higher when they die at home than in a hospital. Therefore, improving the treatment environment based on the features of the place of death, and enhancing community-based end-of-life care support, would allow patients and their families to spend their own time in the hospital and get specialized treatment at home, resulting in greater satisfaction with end-of-life care.

Unbiased compound screening with a reporter gene assay highlights the role of p13 in the cardiac cellular stress response.

We recently showed that a 13-kDa protein (p13), the homolog protein of formation of mitochondrial complex V assembly factor 1 in yeast, acts as a potential protective factor in pancreatic islets under diabetes. Here, we aimed to identify known compounds regulating p13 mRNA expression to obtain therapeutic insight into the cellular stress response. A luciferase reporter system was developed using the putative promoter region of the human p13 gene. Overexpression of peroxisome proliferator-activated receptor gamma coactivator 1α, a master player regulating mitochondrial metabolism, increased both reporter activity and p13 expression. Following unbiased screening with 2320 known compounds in HeLa cells, 12 pharmacological agents (including 8 cardiotonics and 2 anthracyclines) that elicited >2-fold changes in p13 mRNA expression were identified. Among them, four cardiac glycosides decreased p13 expression and concomitantly elevated cellular oxidative stress. Additional database analyses showed highest p13 expression in heart, with typically decreased expression in cardiac disease. Accordingly, our results illustrate the usefulness of unbiased compound screening as a method for identifying novel functional roles of unfamiliar genes. Our findings also highlight the importance of p13 in the cellular stress response in heart.