[Issues and efforts regarding community care meetings managed by community-based comprehensive support center staff].

Objectives Due to the revision of the Public Nursing Care Insurance Law in 2015, social insurance services became obliged to conduct community care meetings. However, staff members of community-based comprehensive support centers (henceforth, community support centers) have difficulty planning and managing such meetings. The present study aimed to clarify the issues regarding community care meetings planned and managed by these staff members, as well as their efforts to manage them, and to discuss effective management strategies.Methods To examine staff members' process of conducting community care meetings, difficulties and challenges faced by them, and effective approaches from their viewpoint, group interviews were conducted with 30 staff members managing community care meetings. They were divided into 3 outsourced community support center groups and 1 social insurance service group, each of which comprised 5-9 persons. The results of the interviews were qualitatively and inductively analyzed according to the group, based on their issues and efforts regarding the management of community care meetings. Similarities and differences among the 4 groups were also analyzed to obtain overall findings.Results The analysis yielded 91 subcategories, and 29 medium, 11 major, and 4 core categories from 454 codes. Concerning the issues regarding the planning and management of community care meetings, the following core categories were extracted: [roles of community care meetings and indecisiveness about goal setting], [burdens associated with a lack of skills for meeting management], [difficulty with community establishment that involves outsourced chief care managers (CM) and residents]. Further, associations were observed among these categories. The core-category [realizing the effectiveness of approaches adopted to conduct productive meetings] recounted the favorable outcomes of the staff members' approaches to overcome these difficulties and challenges. Such realization may have been a result of the structuring of community care meetings, skill improvements through accumulated experience, training for CMs to promote community care, and enhanced recognition of community care meetings as opportunities to collaborate with residents.Conclusion In order to effectively manage community care meetings, social insurance services need to systematize them, clarify their goals, and improve comprehensive community staff's skills to facilitate them. In addition, it is necessary to strengthen the functions of insurers in order to collect/analyze data related to the results of meetings, and to use them to develop appropriate community policies.

Psb30 contributes to structurally stabilise the Photosystem II complex in the thermophilic cyanobacterium Thermosynechococcus elongatus.

A deletion mutant that lacks the Psb30 protein, one of the small subunits of Photosystem II, was constructed in a Thermosynechococcus elongatus strain in which the D1 protein is expressed from the psbA(3) gene (WT*). The DeltaPsb30 mutant appears more susceptible to photodamage, has a cytochrome b(559) that is converted into the low potential form, and probably also lacks the PsbY subunit. In the presence of an inhibitor of protein synthesis, the Psb30 lost more rapidly the water oxidation function than the WT* under the high light conditions. These results suggest that Psb30 contributes to structurally and functionally stabilise the Photosystem II complex in preventing the conversion of cytochrome b(559) into the low potential form. Structural reasons for such effects are discussed.