Few studies have been performed to examine the effects of educational intervention for oncologists in Japan, to update their knowledge and skills regarding palliative care. This study is aimed to evaluate not only the improvement in trainees’ knowledge and self-complacency, but also to focus on the factors associated with the actual clinical practices of trainees. In one year, 323 trainees from the Hiroshima prefecture joined palliative care workshop using the Palliative Emphasis program on symptom management and Assessment for Continuous medical Education (PEACE), and they were included as subjects in the present study. Referring to the contents of the program, a questionnaire was developed to estimate the extent of change in the trainees’ attitude towards clinical practice. Each of the 26 items included a five point Likert scale ranging from “mostly take responsibility for symptom management” to “depends mostly on the experts for direct intervention”. The questionnaire survey was conducted before and after the implementation of the PEACE program. From the 206 valid responses, most of the data items showed a significant and positive shift in the trainees’ attitude toward palliative care in a clinical setting. Items that did not show this change pertained to adjustment of antidepressants and tranquilizers for delirium and depression. These results suggest that the PEACE program may be effective in improving physicians’ attitudes regarding palliative care.

Neuronal plasticity induced by changes in synaptic morphology and function is well known to play a pivotal role in leaning and memory as well as adaptation to stress. It is suggested that these plastic changes are due to orchestration of alterations in gene expression in the brain. Recent advances in molecular biology have provided evidence that epigenetic mechanisms, such as DNA methylation and histone modification, are crucial to gene transcription in the mammalian brain. Our research group has recently investigated the involvement of histone actylation at the promoter of the brain-derived neurotrophic factor (BDNF) gene in stress-induced reduction in BDNF, as well as in fear conditioning-induced enhancement of BDNF, in the rat hippocampus. The results of the stress study demonstrated that single-immobilization stress significantly reduced the levels of total, exon I, and exon IV BDNF mRNA, and also significantly reduced acetylation levels of histone H3, but not H4, at the promoter of exons I, IV, and VI. The results of the fear conditioning study showed that footshock stress significantly increased the levels of total, exon I, and exon IV BDNF mRNA, with significantly increased acetylation levels of both histone H3 and H4, at the promoter of exons I and IV, followed by enhanced freezing to fear-context exposure. These findings suggest that changes in BDNF transcription in the rat hippocampus in response to stressful stimuli are, at least in part, regulated by histone acetylation status.
Acetylation ; Animals ; Brain ; Brain-Derived Neurotrophic Factor ; DNA Methylation ; Epigenomics ; Exons ; Freezing ; Gene Expression ; Hippocampus ; Histones ; Memory ; Molecular Biology ; Neuronal Plasticity ; Plastics ; Rats ; RNA, Messenger

No abstract available.
Neurosciences* ; Psychopharmacology*

Palliative care is sometimes difficult for medical staff to say to patients with cancer and their families. The late of using the term “palliative care” decrease the opportunity to know about palliative care for the patients and their families. The primary aims of this study were to reveal physicians’ and nurses’ usage of the term “palliative care”, time to use the term for the first time, and a synonym. We conducted a questionnaire survey to 387 physicians and 518 floor nurses at Hiroshima University Hospital in February, 2010. We analyzed the results of physicians and nurses separately. Two hundred and seventy-two physicians (response rate 70.3%) and 284 nurses (54.8%) answered the questionnaire. Many physicians (77.2%) and the majority of nurses (56.0%) explain with the term “palliative care”. the majority of physicians use the term when cancer cause any symptoms and at early stage. Some nurses (31.4%) couldn’t use the term “palliative care” before physicians explained the term. Nurses having longer experience tend to use the term regardless of physicians’ use. Many physicians use the term “palliative care” at early stage of cancer. Many nurses also use the term at early stage of cancer, but some nurses couldn’t use before physicians’ use.