Family Caregiving in Japan: The Influence of Cultural Constructs in the Care of Adults With Cancer.

Caring culture is a concept embodying the perceptions and caring practices of caregivers, acknowledging the unique role of cultural beliefs in shaping behavior. A qualitative descriptive study with 13 caregivers of adult family members with a cancer diagnosis in Japan was conducted to gain insight into perceptions and experiences surrounding caregiving. Several major categories were identified, representing rarely reported cultural constructs of high cultural value for the Japanese: On-repayment for what the patient has given, Caregiving as performing a socially expected role, Enryo/meiwaku-restraint in asking for help, Family decision making reflecting strong bonds, Omoiyari-empathizing with the patient's feelings, and Inori-praying to myriad gods and ancestors. The Japanese cultural construct of ie (the strong relationship to family lineage and spiritual connection to past and future generations) is helpful in understanding these categories. Invisible yet powerful cultural constructs permeated caregiving practices. Insights from Japanese cultural concepts and beliefs may foster sensitivity and individualized care in diverse settings, cultures, and societies.

Increased incidence of pre-diabetes mellitus at a department of rheumatology: a retrospective study.

We aimed to retrospectively review the incidence of pre-diabetes mellitus (preDM), one of the factors in metabolic syndrome screening, in patients with rheumatic diseases. We examined the levels of hemoglobin A1c (HbA1c) in a total of 498 patients with rheumatic diseases between April 2007 and March 2008 at the Department of Rheumatology in Nagasaki University Hospital. Of the 498 patients, 409 (82.1%) had HbA1c levels higher than 5.6% (National Glycohemoglobin Standardization Program; NGSP) and were recommended for health guidance with a focus on metabolic syndrome. Serum HbA1c levels higher than 6.0%, a possible indicator of DM, were seen in 227 patients (45.6%). Serum HbA1c levels higher than 6.5%, which constitute a high risk for DM, were found in 115 patients (23.1%). PreDM increased gradually with age. Our results suggest that the incidence of preDM may be higher in patients with rheumatic diseases than in patients with other diseases and that these patients should receive healthcare guidance to prevent metabolic syndrome.

Japanese graduate nursing students' perceptions of the teaching performance of an intercultural teacher.

This paper reports the results of a survey conducted to explore the perceptions of Japanese graduate nursing students about the teaching performance of an American teacher. The impact of cultural differences on classroom behavior and communication between Japanese graduate nursing students and the American teacher are also explored. Students were enrolled in a nursing education course in the first semester of the graduate program. Data for the analysis were the student opinion surveys, which included Likert scale items and space for narrative responses. Results of the survey are reported as well as the results of a follow-up meeting that was held with the students. The students emphasized the importance of the quality of the interpretation.

Role of nm23 in the regulation of cell shape and migration via Rho family GTPase signals.

Rho family small GTPase plays a key role in the regulation of cell shape and migration in mammalian cells. Constitutive activation of Rho GTPase leads to the aberrant cell morphology and migration. We identified nm23-H2 as a binding partner of Lbc proto-oncogene product, which specifically activates RhoA, and revealed that nm23-H2 could act as a negative regulator of Rho activity. Furthermore, we found that Lbc, nm23-H2 and ICAP1-alpha could form tertial complex in cells, and this complex formation was thought to be critical for cell migration stimulated by integrin. It is reported that nm23-H1 bound to Tiam1 and Dbl, which activates Rac and Cdc42 small GTPase, respectively. We discuss the role of nm23 in the regulation of cell morphology and cell migration via Rho family GTPases.

Nursing culture of an operating theater in Italy.

Sociocultural and organizational factors that influence the work culture of nurses in an Italian operating theater were the subject of the present qualitative explorative study. Italy is one of the world's wealthiest, most powerful countries. Yet little is known outside its borders about the unique culture of Italian nurses at work in hospitals and its effect on health care. Throughout this Japanese author's first hand experience of the microculture of Italian nursing, using a microethnographic design with focus groups for cultural interpretation, data were collected during 2000-2001 from 25 staff nurses working full-time in one regional hospital. Nurses in the operating theater, considerably less educated than doctors and accustomed to the power and status of medicine, were directed in nearly all activities by physicians. Finding little leadership from management, the nurses developed solid defenses against change and conflict through concerted allegiance to one another. The findings suggest that with Italian nurses questioning tradition and seeking university education, there may be gradual recognition by medicine, management and the public of their contribution to health system performance, improved patient care outcomes, and the value of the nursing profession.