Yuichi Ishikawa

Effects of EPA on coronary artery disease in hypercholesterolemic patients with multiple risk factors: sub-analysis of primary prevention cases from the Japan EPA Lipid Intervention Study (JELIS).

BACKGROUNDnJapan EPA Lipid Intervention Study (JELIS) was a large-scale clinical trial examining the effects of eicosapentaenoic acid (EPA) on coronary artery disease (CAD) in hypercholesterolemic patients. Herein, we focused on risk factors other than low-density lipoprotein cholesterol (LDL-C) to investigate the effects of EPA on CAD among JELIS primary prevention cases.nnnMETHODSnHypercholesterolemic patients on statin therapy but without evidence of CAD (n=14,981) were randomly assigned to an EPA group (n=7503) or a control group (n=7478). The relationships between incident CAD, the number of CAD risk factors (hypercholesterolemia; obesity; high triglyceride (TG) or low high-density lipoprotein cholesterol (HDL-C); diabetes; and hypertension) and EPA treatment were investigated.nnnRESULTSnFor the control and EPA groups combined, a higher number of risk factors was directly associated with an increased incidence of CAD. Incidence was lower for the EPA group than for the control group regardless of the numbers of risk factors. Compared to patients with normal serum TG and HDL-C levels, those with abnormal levels (TG >or=150 mg/dL; HDL-C <40 mg/dL) had significantly higher CAD hazard ratio (HR: 1.71; 95% CI: 1.11-2.64; P=0.014). In this higher risk group, EPA treatment suppressed the risk of CAD by 53% (HR: 0.47; 95% CI: 0.23-0.98; P=0.043).nnnCONCLUSIONSnMultiple risk factors besides cholesterol are associated with markedly increased incidence of CAD. High TG with low HDL-C represents a particularly potent risk factor. EPA was effective in reducing the incidence of CAD events for patients with this dyslipidemic pattern, suggesting that EPA may be especially beneficial in patients who with abnormal TG and HDL-C levels.

Confidence-weighted testing: a descriptive study of Japanese nursing students.

Nurses lack of self-confidence in their own nursing skills is one of the main reasons that novice nurses leave the profession in Japan. Nursing education must help students gain self-confidence in their nursing skills in order to allow more novice nurses to stay in their profession. In this study, we evaluated whether confidence-weighted testing feedback actually improves students self-confidence in their basic nursing skills. Confidence-weighted testing, which provides quantifiable results, might allow students to objectively assess their skill-related self-confidence. Sixty-seven first-year nursing students took two confidence-rating examinations on the knowledge and practical skills related to pulse and blood pressure measurement of immobile patients. Feedback was given to each participant after the first examination. After the first examination with confidence-weighted testing feedback, students showed higher levels of self-confidence in their practical skills, but not in knowledge. The improvement of self-confidence in practical skills suggests that there is still room for improvement in confidence-weighted testing feedback in knowledge. Further research is required to identify more effective feedback methods to improve students self-confidence levels in knowledge using the results of confidence-weighted testing.

Becoming Interprofessional at Kobe University

The importance of collaborative practice and its education have been widely reported globally and nationally. At a local level, staff members’ experiences in the field after a natural disaster and their clinical work contributed significantly to the development of an interprofessional education/learning (IPE/L) program at Kobe University. From the first pilot classes in 2002, an IPE program evolved. This program is now fully integrated into the 4-year undergraduate curriculum at the Faculty of Health Sciences and into the 6-year curriculum of the School of Medicine. Student learning in this IPE/L program is interactive, experientially based, and predominantly conducted in interprofessional group settings.

P-250 Quality of Life and Mood Disturbance During the First Year of Patients with Implantable Cardioverter Defibrillators

Method: (1) A total of 43 patients with CHF treated at home for 2 years were enrolled in the study from among 115 patients admitted to the CCU of A Hospital due to acute CHF. Patients were treated with drugs, moved to an internal medicine ward, and then discharged. (2) The SF-36 questionnaire was used to measure health-related QOL at discharge and at 1 year (1 year) and 2 years after discharge (2 years). Self-care activities of patients were observed at the same time QOL was measured. Result: (1) At 1 year and 2 years, seven (physical functioning, bodily pain, general health perception, vitality, social functioning, role-emotional, and mental health) of the eight SF-36 subscales were significantly lower than the scores at discharge. (2) Self-care items related to regular exercise and abstaining from smoking were improved at 2 years. Until now, it was thought that QOL in patients with CHF gradually deteriorated after discharge due to repeated hospital admissions. In the present study, patients with CHF practiced self-care activities at home for 2 years after discharge; however, QOL in these patients at 2 years was not improved compared to QOL at discharge. Patients’ self-care activities should be more closely studied in order to identify practices that can effectively improve QOL in patients with CHF receiving at-home care.