This study sought to determine whether the Japanese version of the Liverpool Care Pathway （LCP-J） could improve nurses’ practice in dying-phase and difficulties with palliative care in a general ward. Between July 2014 and June 2015, LCP-J intervention and educational program for nurse were introduced in a general ward. The primary aims of this study were to clarify the changes in self-reported practice and difficulties of nurse before and after the interventions. Self-reported practice and difficulties were measured using Palliative Care Self-Reported Practice Scale （PCPS） and Palliative Care Difficulty Scale （PCDS）, respectively. The secondary aim was to clarify the defference in treatment, care and examination within last 48 hours between LCP-J patients and non-LCP-J patients. We obtained 21 responses in pre-intervention and 22 responses in post-intervention surveys from eligible nurses. Significant improvements were noted on domain of dying-phase care in PCPS and domain of alleviation of symptom in PCDS （3.00±1.16 versus 3.52±0.61 [p=0.042], 3.56±0.78 versus 3.10±0.63 [p=0.015], respectively）. LCP-J was used for 9 dying cancer patients （40%）, and no significant difference in treatment and examination within last 48 hours between LCP-J patients and non-LCP-J patients. LCP-J in general ward may improve nurses’ practice in dying-phase and difficulties with alleviation of symptom. In addition, considering the burden of LCP-J, to develop a useful checklist and educational interventions for dying patients is promising.

Oral infection with Porphyromonas (P.) gingivalis causes periodontitis that is manifested by the destruction of gingival connective tissues. Although a few types of antibiotics are effective against the infection, its use induces the appearance of drug-resistant bacteria. The present study shows that the fermented product of Aspergillus (A.) oryzae S-03, cultivated on the fat-removed soybean, inhibits the cell growth of the P. gingivalis. Likewise, the fermented product of the S-03 strain cultured for 26~42 h displays an inhibitory activity to gingipain as a virulence factor of P. gingivalis. The activity is not lost even with heat treatment at 100degrees C for 15 min. We also demonstrate that the S-03 strain exhibits high protease activity. In addition, the strain does not produce aflatoxin because of the loss of a regulatory gene, aflR, necessary for the toxin biosynthesis.
Aflatoxins ; Anti-Bacterial Agents ; Aspergillus ; Aspergillus oryzae* ; Bacteria ; Connective Tissue ; Genes, Regulator ; Hot Temperature ; Oryza ; Periodontitis ; Porphyromonas ; Porphyromonas gingivalis* ; Soybeans ; Virulence*