department of 老年看護学 創傷看護学分野 ライフサポート技術開 … · 2019. 5....
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老年看護学/創傷看護学分野 ライフサポート技術開発学(モルテン)寄付講座 社会連携講座アドバンストナーシングテクノロジー
社会連携講座スキンケアサイエンス 社会連携講座イメージング看護学
老年看護学に必要な重点技術を集結し、世界に発信します。 そして年をとるのも悪くないなと思える社会を一緒に目指してみませんか!!
Department of Gerontological Nursing and Wound Care Management
We wish to create a society that respects the beauty of aging
and recognizes it to be a joyful process in life
Tel/Fax: +81-(0)3-5841-3419 E-mail: [email protected]
Edition 2019
Message from Prof. Hiromi Sanada, PhD, RN, CWOCN
Aging is regarded as a natural process of human development and maturity. Our purpose is to promote
education and research to enhance the self-dignity, ability for self-care, and self-actualization of elderly
population in Japan so they can play an active role in society. We respectfully hope that society continues
to learn from the accumulation of life experience and wisdom of the elderly, to realize a prosperous
community which does not rely solely on material productivity.
The Department of Gerontological Nursing was established in June 2003 as the newest department
of the Health Sciences and Nursing Division of the Graduate School of Medicine, the University of
Tokyo. Shortly thereafter, in 2006, Wound Care Management was added an advanced nursing course
and housed together in the Department of Gerontological Nursing. Within this structure, the Department
of Life Support Technology was established in 2010, through a generous sponsorship by Molten
Corporation. This group intends to reveal the cause of lifestyle health issues, as well as to develop new
monitoring systems and preventive measures to avoid disease. Finally, the Department of Advanced
Nursing Technology was created in 2012, in order to adapt the art of nursing based on current clinical
needs and with the cooperation of clinical staff in hospitals, companies, and the university.
Our main study involves the development of gerontological nursing and wound care management in
clinical settings and innovation of evidence-based practices. We are striving to create new nursing
techniques and instruments by means of translational research, which has potential of translating expert
knowledge and techniques in basic science and engineering, and developing evidence-based
methodology to contribute to the prevention, prediction, diagnosis and treatment of health problems in
the vulnerable elderly, such as pressure ulcer, incontinence, swallowing disorder, malnutrition, pain and
dementia. We hope that our research helps the elderly people to live independently with best physical
functioning and self-esteem, and to enhance their active life in the world.
Our mission from the position of an educator is to assist new
clinical researchers and coaches who desire to innovate the practice
for geriatric syndrome to maximize their potential. We hope to share
our outcomes with the rest of the world.
1
Framework for advanced nursing research
We intend to use the results of our research for the benefit of society. Our approach starts with field
investigation to grasp and clarify the latent or current problems in clinical settings. The research that
follows will be carried out with the cooperation of several academic and clinical fields. Consider our
research process in bioengineering nursing which requires input from both basic biology and
engineering, and which results in new device development and methods for clinical evaluation In this
way, we promote innovative multi-disciplinary research that combines translational research and
nursing.
Our main research theme is the development of prevention, diagnosis and treatment technology for
wounds including pressure ulcer, leg ulcer and diabetic foot ulcer associated with essential activities of
daily living. Elucidation of pathogenic mechanism is essential to developing technologies and must be
verified in clinical research. We cover a wide range of research from basic research to clinical research
and aim for medical innovation through development or use of novel technologies.
2
Ken
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lari
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Qu
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Pro
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and C
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3
Air Cell Cushion for
Wheelchairs, Medi-Air®
Wound-therapeutic Vibrator
RelaWave®
Pad for Loose Stool
TakeCare®Loose Stool Absorbent Pad
Portable Contact Pressure Indicator
Palm Q®
Wound Preventive Skin Layer
REMOIS®Pad
Pressure Sensing/Monitoring
Mattress, LEIOS®
Research activities in our departments
We aim to develop new technologies and devices that maintain or improve the abilities of elderly people to meet
their needs built on their independence and autonomy. We try to enrich the life of elderly people by helping to establish
care programs and systems whereby they can lead independent lives with respect to their diversity in their values and
lifestyle.
1. Research themes
Basic science:
・Biomarkers for assessment of pressure ulcers
・Development of non-invasive methods to analyze wound exudate: wound blotting
・Development of non-invasive method to detect physiological state of skin: skin blotting
・Development of technologies to promote wound healing
・Development of technologies to evaluate wound pain
・Development of technologies to promote incontinence-associated skin lesions
・Development of technologies to promote hair growth in case of alopecia
Nursing engineering:
・Development of new air-mattresses equipped with interface pressure sensing and monitoring system
・Studies on the gait in diabetes patients
・Studies to prevent medical device pressure ulcers associated with NPPV
・Development of techniques to evaluate the swallowing function in the elderly
・Development of wound diagnostic assessment techniques using ultra-
sonography and thermography
Field surveys:
・Cross-sectional study of diabetic foot ulceration and its risk factors
・Cross-sectional study of skin properties in elderly patients
・Cross-sectional study of intravenous catheter failure
・Cross-sectional study of drug-induced alopecia
・Cross-sectional study of urinary incontinence in patients treated with radical prostatectomy
Clinical evaluations:
・Evaluation of dressings for the prevention and treatment of pressure ulcers
・Evaluation of air-mattresses equipped with interface pressure sensing and monitoring system
Nursing administration/management:
・Evaluating quality indicators for pressure ulcer management in specialized hospitals
2. Our products
・Interface pressure sensor
・Pressure ulcer preventive/healing promoting devices
・Dressing to prevent/promote healing pressure ulcer
・Skin cleanser
・Skin moisturizer
・Diaper pad
Thermographic examination
for diabetic foot
Ultrasonographic assessment for pressure ulcers
Engineering experiments
Animal experiments
4
3. Education
Graduate courses:
・Advanced gerontological nursing I, II (each 2 credits)
・Advanced wound care management I, II (each 2 credits)
・Gerontological nursing seminar I, II (each 4 credits)
・Gerontological nursing practical training I, II (each 4 credits)
・Wound care management seminar I, II (each 4 credits)
・Wound care management practical training I, II (each 4 credits)
Undergraduate courses:
・Clinical practice in health support (1 credit)
・Nosography (2 credits)
・Anatomy (1 credit)
・Gerontological nursing (2 credits)
・Clinical practice in life science (1 credit)
・Clinical practice in gerontological nursing (2 credits)
・Bioengineering nursing (2 credits)
4. Seminar
・Dissertation supervision
・Journal club
・Presentation rehearsal
・Report on academic conferences
・Clinical training: Pressure ulcer round, outpatient clinic for ostomates, outpatient clinic of foot care for diabetics,
outpatient clinic of pelvic floor rehabilitation
5. Members
Professor; Hiromi Sanada
Project Professor; Taketoshi Mori
Associate Professor; Gojiro Nakagami
Project Associate Professor; Ryoko Murayama, Takeo Minematsu,
Makoto Oe, Nao Tamai
Project Lecturer; Hiroshi Noguchi, Misako Dai, Masaru Matsumoto
Assistant professor; Yuko Mugita, Aya Kitamura
Project Assistant professor; Toshiaki Takahashi, Mari Abe, Yuka Miura,
Kenneth Scott Barton
Post-Doctoral Fellow; Sofoclis Koudounas
Research Support Staff; Sanai Tomida
Research Fellow; Shiho Higashimura
Cooperative Researcher; Mikihiko Karube, Mayumi Handa
Laboratory Assistant Technician; Akiko Hamada
Part-time lecturer; Junko Sugama, Masatoshi Abe, Etsuko Tadaka, Atsuo Kawamoto, Tomoko Akase,
Kenji Omura, Masako Yamada, Yayoi Kamakura, Rei Ogawa
Visiting researcher; Kazuyuki Komichi, Hidenori Tanabe, Daichi Araki, Kazuhiro Ogai, Yoshie Ichikawa, Miho Oba,
Toshihiro Ogura, Taichi Goto, Mitsuo Neya, Satoshi Yoshida, Mikako Yoshida, Tame Urai, Kimie
Takehara
Administrator; Yukiko Watanabe, Akiko Katano, Eriko Ikeda
Students; seven PhDs, ten masters, two undergraduates
Practice for undergraduate
students
All laboratory members 2019, under cherry blossoms
Students’ seminar
5
6. Recent articles
・ Tanaka S, Yabunaka K, Matsumoto M, Tamai N, Noguchi H, Yoshida M, Nakagami G, Sugama J, Sanada H. Fecal
Distribution Changes Using Colorectal Ultrasonography in Older People with Physical and Cognitive Impairment
Living in Long-Term Care Facilities: A Longitudinal Observational Study. Healthcare. 2018;6(2):55.
・ Nakai A, Minematsu T, Tamai N, Sugama J, Urai T, Sanada H. Prediction of healing in category I pressure ulcers
by skin blotting with plasminogen activator inhibitor 1, interleukin-1α, vascular endothelial growth factor C, and
heat shock protein 90α: A pilot study. Journal of Tissue Viability. 2019; doi: 10.1016/j.jtv.2019.02.002.
・ Abe-Doi M, Oe M, Murayama R, Takahashi M, Zushi Y, Tanabe H, Takamoto I, Suzuki R, Yamauchi T, Kadowaki
T, Komiyama C, Sanada H. Development of an automatic puncturing and sampling system for a self-monitoring
blood glucose device. Diabetes Technology and Theraputics. 2017;19(11).
・ Watanabe A, Noguchi H, Oe M, Sanada H, Mori T. Development of a Plantar Load Estimation Algorithm for
Evaluation of Forefoot Load of Diabetic Patients during Daily Walks Using a Foot Motion Sensor. Journal of
Diabetes Research. 2017;2017:1-8.
7. Recent Books
・Sanada H, Mori T. Bioengineering Nursing: New Horizons of Nursing Research. New York:
Nova Science Publishers Inc. 2014. ISBN-13: 978-1631173363
The future development of nursing studies requires Bioengineering Nursing, because it
enables us to recognize potential seeds in clinical settings on the basis of pathophysiology,
perform evaluations using devices and engineering technology, and create tools while
accurately reflecting clinical needs. This book is the first textbook of Bioengineering Nursing
in the world.
・Oe M, Sanada H, Nagase T, Minematsu T, Ohashi Y, Kadono T, Ueki K, Kadowaki T.
Chapter 4 Foot fissures in the patients with diabetes. In: Pavlovich D, Ivanovich S, eds.
Fistulas and Fissures: Types, Symptoms, Causes, and Treatment. New York: Nova Science
Publishers Inc. 2013;63-78.
This textbook focuses on every kind of fistula and fissure, each pathophysiology, cause and
treatment. Specialists in each field describe these topics respectively, and our Project
Associate Professor Makoto Oe, introduces important factors that contribute to developing
fissures in the diabetic foot.
・Nagase T, Sanada H, Oe M, Takehara K, Nishide K, Kadowaki T. Screening of foot
inflammation in diabetic patients by non-invasive imaging modalities. In: Dinh T eds.
Global Perspective on Diabetic Foot Ulcerations. Rijeka: InTech, 2011;27-46.
This book is a collection of the latest findings by specialists about the diabetic foot, its
prevention, diagnosis and treatment. Takashi Nagase who performed his enthusiastic research
in our laboratory, introduces the non-invasive assessment measures with thermography and
ultrasonography on the inflammation of the diabetic foot.
6
Department of Life Support Technology (Molten):
Sensor Technology Enhances Health and Comfort in Human Life
Introduction
Department of Life Support Technology (Molten) is a laboratory in the Division of Health
Sciences and Nursing, with in the Graduate School of Medicine. The aim of the laboratory is to
establish life support technology, which includes not only pathophysiology investigation of
diseases and symptoms caused by daily life activities but also development of direct intervention
methods based on nursing approaches and methodology establishment for supporting daily life
widely. The department was founded in 2010 by Molten Corporation under strong support of
Professor Sanada and the members of this department include Department of Gerontological
Nursing and Wound Care Management. One project professor, one project lecturer, and one
project assistant professor. The department actively accepts students from foreign countries.
Research of Laboratory
Our research themes are sensorized medical information technology and robotics nursing where are attempt to
investigate causes of diseases and/or wounds due to daily life activity, and to develop instrument for effective
monitoring and prevention of diseases and/or wounds. We study science and technology of natural human monitoring,
nursing engineering, nursing big data analysis, and human behavior sensing thoroughly. We are seeking a new
interdisciplinary research domain between engineering and nursing, and willing to realize comfortable daily life
through these researches. We are developing the methodology to support healthy and comfortable daily life by 1)
monitoring daily life naturally, 2) understanding the typical behaviors, and 3) predicting diseases, injuries, and
accidents using various sensing technology.
2019 main research themes
・Robot communication technology for robotic nursing
・Development of bedside vital sign monitoring systems and image processing technology
・On-site real-time image processing for ultrasonography and thermography
(i.e. ultrasonography for bladder, pelvis, swallowing and pressure ulcer; thermography for lower leg)
・Monitoring technology to support nursing at hospital and home, Large-scale nursing data analysis
・4D gait modeling system and gait reform training system
・Design of behavior database, and contrastive database for health-related and daily activity data
Collaborative research themes
・Probabilistic modeling and statistical clustering of human behavior and mobility operation
・Next generation motion capture system and marker-less motion capture system
・Human position measurement and behavior estimation using laser range scanners
・Assistance and support of personal mobility operation
Project Professor
Taketoshi Mori
Natural Behavior
Monitoring
Meal
preparation
Preparation for
going out
Preparation
before sleeping
Nursing
Engineering
Pressure sensor
Air-cell
Pressure monitor screen
Analysis of indoor behaviorEarly detection of anomalous behavior
Trajectory measurement of human behavior
(the red line in the picture)
using laser range scanners
Development of air mattress
with the pressure sensorPressure monitoring and automatic control
The next generation motion capture
Estimate human posture by visible imageUpper : Image taken by 2 of 8 video cameras
Left : 3D voxel data
Right : Image estimated from human posture
Human Behavior
Sensing
7
Department of Advanced Nursing Technology (Social Cooperation Program):
Nursing Technology to seek ‘Never let patients endure suffering in health care’
Overviews
Technology in the field of medical diagnosis and treatment has made great strides in recent years, and nursing
technology needs to evolve accordingly. Until now, nurses in hospitals and universities have frequently worked
separately. The university setting, while contributing to the development of nursing through research has found it
difficult to simulate the clinical setting. On the other hand, in the hospital environment, nurses have tended to
progress professionally thorough their experience rather than through gaining scientific knowledge. Therefore, at the
University of Tokyo, “Social Cooperation Program: Advanced Nursing Technology’’ was established to aim at
advancing nursing technology to promote team medical treatment and research involving clinical divisions, the
nursing department, and the graduate nursing school.
Research Scheme
We will develop this new nursing scheme aimed at clinical needs (i.e., “Never let patients endure in health care.’’),
and we intend to introduce it globally. Through this program, nurses can study the subject of nursing scientifically,
including research in epidemiology and molecule- and gene-related topics in cooperation with university professors.
Furthermore, the technology and medical equipment developed by companies can now be evaluated in the hospital,
offering new nursing technology suitable for needs at clinical sites.
Research Themes in 2019
・Development of a new intravenous catheter for the prevention of extravasation.
・Evaluation of thermo film for the early detection of extravasation.
・Development of a catheterization program for the teaching skills of peripheral intravenous catheters, guided by
ultrasonography.
Project Associate Professor
Ryoko Murayama
Clinical site
Social Cooperation Program‘’Advanced Nursing Technology’’
A new study on pathophysiological mechanism.
Development ofnursing technologies and medical devices.
Identify ofthe Clinical Needs.
We will develop this new nursing scheme aimed at clinical needs.‘’Never let patients endure in health care.’’
Identification of clinical needs
We will develop this new nursing scheme aimed at clinical needs. “Never let patients endure suffering in health care.”
8
Department of Skincare Science (Social Cooperation Program):
Skincare technologies to protect vulnerable skin
Introduction
The skin is a unique organ which we can directly see and touch. Because several sensory systems are distributed
in the skin, skin disorders have unique physical and mental influences. Therefore, healthy skin is a foundation of
healthy life. This department was founded to improve skincare for people with vulnerable skin due to aging and
dermopathy, supported by funding from Saraya Co., Ltd. since February 1, 2017. The Dept. of Skincare Science
consists of one Project Associate Prof., Takeo Minematsu, and one Project senior assistant professor, Misako Dai.
Research overview
We perform “biological nursing” research, which is the unified science of basic biology
understand the nature of a problem and practical nursing science to apply it to the clinical
field.
Skin blotting is our original technique for skin assessment. Conventionally, the skin
physiological status could only be examined by invasive biopsy sampling. Skin blotting
realized the non-invasive sampling for the examination. Our current work includes the
general improvement of skin blotting, as well as establishing the reliability and validity,
of this technique. Beyond that we are working to establish biomarkers the play a role in
skin disorders.
Our main areas of research focus have been the prevention of pressure ulcer in wheel
chair athletes and lymphedema following cancer operations.
Firstly, our topic is the occurrence of pressure ulcers in wheelchair athletes.
In their pursuit of reaching top performance, many wheelchairs
athletes push their bodies to the limit, often including placing excessive pressure on their
buttocks and lower back that ultimately reduces their performance and compels them to rest.
We are committed to developing technologies to protect wheelchair athlete and to educate them about pressure
injuries. We believe that our efforts will help these athletes realize their peak performance and improve their quality
of life.
Second topic is the relationship between lymphedema and cellulitis. Cellulitis is an acute skin infection and
easy to recur due to chronic inflammation status in lymphedema affected limbs. It’s severe problems
for patients’ daily life. We will reveal the relationship between chronic inflammation and recurrent cellulitis using
nursing science and engineering including biology.
Major research themes for in this fiscal year
► Development of a method for the prediction of pressure
ulcers by skin blotting
► Lymphedema and recurrent cellulitis
► Prevention of pressure ulcers in wheelchair athletes
► Exploring gene polymorphism associated to the pressure
ulcer occurrence.
► Development of novel materials for skin regeneration
Project Associate Professor
Takeo, Minematsu
Project Senior assistant Prof.
Misako, Dai
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Department of Imaging Nursing Science (Social Cooperation Program):
Visualization devices for physical assessments
Overviews
Our vision is to realize a ‘safe, secure, and comfortable medical care experience” through visualized nursing
technology. Currently, Japan is experiencing a “super-aging” society, with an increasing number of older adults who
are bedridden, have dementia, or conditions that could keep them from voicing their needs. Therefore, it is necessary
to introduce telemedicine and nursing care using technologies in home care settings. Given nurses’ historical role
conducting a wide variety of physical assessments such as interviews, inspections, percussions, auscultations and
palpations, the Department of Imaging Nursing Science seeks to expand the development of physical assessment
techniques using ultrasound devices and promote clinical research for visualized nursing.
Research Scheme
We collaborate with the Department of Gerontological Nursing/Wound Care Management, and develop and
implement nursing care/skills/systems for improving individual well-being. Especially, we focus on ultrasound
devices as physical assessment tools. In addition, we evaluate these new nursing care/skills/systems using ultrasound
devices and implement translational research. Finally, we educate nurse scientists who can provide nursing care
using new visualization technologies.
Research Themes in 2019
➢ Development of educational programs and automatic recognition tools for deep tissue injuries
➢ Standardization of nursing assessment techniques (e.g., for deep venous thrombosis, pleural effusion/ascitic
fluid, or pneumonia) using ultrasound devices
➢ Development of education programs and leader training for constipation assessment using ultrasound devices
➢ Development of a system for determining the occurrence of aspiration using artificial intelligence
Project associate professor
Nao Tamai
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Division of Care Innovation, Global Nursing Research Center:
Promoting multi-disciplinary and innovative nursing research
Overview of the Global Nursing Research Center
Against this backdrop of the population issues that Japan is facing,
there are many voices calling for a transformation from a treatment
that “cures” to treatment that “supports,” as well as a change in nursing
research. Specifically, we require the development of a multi-
disciplinary research and educational environment that aims to foster
young nursing care specialists who can lead innovations in medical
care.
Global Nursing Research Center will start both the Division of Care
Innovation and the Division of Nursing System to promote a cutting-
edge, multi-disciplinary research model led by both full-time and visiting instructors. Moreover, we will design and
develop educational courses to foster young researchers.
Overview of the Division of Care Innovation
In collaboration with scientists, engineers, and partners in the private sector, this division seeks to develop and
disseminate medical care products that address some of the daily inconveniences experienced by individuals with
health issues. The Division of Care Innovation is comprised of the following five fields:
Robotics Nursing: Professor Hiromi Sanada and Project Professor Taketoshi Mori
We will develop, prototype, and test nursing care equipment and monitoring devices in our research for practical
applications. One example of our work in this area includes developing and testing software for communication
robots, as well as monitoring their movements and interactions.
Biological Nursing: Professor Hiromi Sanada, Associate Professor Gojiro Nakagami, and Project Associate Professor Takeo
Minematsu
We will develop the field of Biological Nursing, which is a unified science combining the power of basic biology
to understand the nature of a problem with practical nursing science to apply results to the clinical field.
Visualized Nursing: Professor Hiromi Sanada, Associate Professor Gojiro Nakagami, and Project Associate Professor Nao Tamai
To realize a safe and comfortable recovery, we will focus on the practice of nursing care and propose new
technologies and care applications that leverage advanced imaging technologies.
Clinical Nursing Technology: Professor Hiromi Sanada and Project Associate Professor Ryoko Murayama
Through various collaborative efforts with specialists from diverse backgrounds, we will work to resolve issue in
clinical nursing care at hospitals and other clinical settings.
Reverse Translational Research: Professor Hiromi Sanada and Project Associate Professor Makoto Oe
We conduct studies that bridge the gap between existing basic research and clinical application, but we also work
to realize needs-oriented care through understanding the data that has been made available through clinical research
and product development. Further explanation of this group’s activities continues to the next page.
Model for care innovation
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Department of Reverse Translational Research:
Development of Need-oriented Care
Overview of the Department of Reverse Translational Research
To realize a medical care that “supports,” we must pursue multi-disciplinary research and develop products that
address daily inconveniences experienced by individuals with health issues. Previous research has focused on
translational research, which analyzed all processes from the development of pharmaceuticals and medical
equipment to clinical research. Although useful, it is impossible for the results of basic research to be applied
completely to humans. Therefore, development sometimes came to a halt before any products were realized. In
particular, in the field of nursing research, not all the fruits of basic research can be applied to nursing care products.
Instead, we must take an approach that addresses the needs of both the people who require nursing care and the
contexts in which such care is practiced. In the Department of Reverse Translational Research, we not only seek to
conduct research that bridges the gap between existing basic research and clinical application, but we also aim to
realize need-oriented care through understanding the data made available by clinical research and by developing
products. Our department was created simultaneously with the opening of the Global Nursing Research Center in
April 2017, and at that time, was comprised of one professor and one full-time project associate professor.
Research
Our department seeks to conduct reverse translational research on topics such as wound care and prevention,
including diabetic foot ulcers. It also seeks to offer a model for this type of research into nursing studies. Furthermore,
it will disseminate research results internationally to promote the globalization of nursing care. Specifically, the
studies will focus on developing dressing materials, assessment scales, and prevention support systems for diabetic
foot ulcers.
To demonstrate the efficacy of the caring methods developed, we will develop assessment scales that enable us
to objectively evaluate the treatment progress of diabetic foot ulcers. These scales have been developed in a
collaborative study conducted with researchers in Indonesia, a country that seeks to immediately resolve this issue
as they have experienced a rapid rise in patients suffering from diabetic foot ulcers. Once the scales are determined,
the resulting caring methods can be assessed in other countries, enabling us to make a global contribution to nursing
care in this specific field.
Once serious complications occur, diabetic foot ulcers may necessitate amputation which impact the patient’s
prognosis. In this department, we will leverage the knowledge and skills gained from outpatient clinical care offered
for this condition at the university hospital to further develop preventive care. One possible objective may be to
develop a preventive support system using thermography.
Research Subjects in the academic year of 2019
▶ Development of support systems to prevent diabetic foot ulcers using thermography
▶ Development of an assessment scale for diabetic foot ulcers
Makoto OE Research based on clinical activities with globalization
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Tel/Fax: +81-(0)3-5841-3419 E-mail: [email protected]
Edition 2019