研究者詳細 - 宮川　祥子

論文 - 宮川　祥子

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Machine learning-enhanced soft robotic system inspired by rectal functions to investigate fecal incontinence

Mao Z., Suzuki S., Nabae H., Miyagawa S., Suzumori K., Maeda S.

Bio-Design and Manufacturing 8 （ 3 ） 482 - 494 2025年05月

筆頭著者, 責任著者, 査読有り, ISSN 20965524

Fecal incontinence (FI), which can arise from various pathogenic mechanisms, has attracted considerable attention worldwide. Despite its importance, the reproduction of the defecatory system to study the mechanisms of FI remains limited, largely because of social stigma and being considered inappropriate. Inspired by the rectum’s functionalities, we developed a soft robotic system that includes a power supply, pressure sensors, data acquisition systems, a flushing mechanism, stages, and a rectal module. Specifically, the innovative soft rectal module includes actuators inspired by sphincter muscles, both soft and rigid covers, and a soft rectum mold. The rectal mold, which was fabricated from materials that mimic human rectal tissue, was produced using a mold replication fabrication method. Both the soft and rigid components of the mold were created using three-dimensional (3D) printing technology. In addition, the sphincter muscle-inspired actuators featured double-layer pouch structures that were modeled and optimized based on multilayer perceptron methods to obtain a high contraction ratio (100%), generate high pressure (9.8 kPa), and have a short recovery time (3 s). Upon assembly, this defecation robot could smoothly expel liquid feces, perform controlled solid fecal cutting, and defecate extremely solid long feces, thus closely replicating the functions of the human rectum and anal canal. This defecation robot has the potential to facilitate human understanding of the complex defecation system and contribute to the development of improved quality-of-life devices related to defecation. (Figure presented.)

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Theory development of under what circumstances and what works for promoting disaster preparedness among long-term care facility (LTCF) stakeholders: Protocol for realist review

Mitani S., Ogawara H., Miyagawa S., Doorenbos A.Z., Fukahori H.

BMJ Open 15 （ 3 ） e087837 2025年03月

筆頭著者, 責任著者, 査読有り

Introduction The incidence of severe natural disasters has been increasing worldwide. The residents of long-term care facilities (LTCFs) are particularly vulnerable to such events. Therefore, promoting disaster preparedness among LTCF stakeholders is urgent. However, the optimal preparedness process remains unclear. To close this gap, we use a realist review (RR) to promote an understanding of under what circumstances and what works for promoting the disaster preparedness among LTCF stakeholders and develop theories for the process. Methods and analysis RR will be guided by the Realist and Meta-Narrative Evidence Synthesis: Evolving Standard. The following five steps will be employed: (1) literature review and search for evidence, (2) study selection, (3) data extraction, (4) data synthesis and (5) development of the initial programme theory (IPT). Evidence will be searched using MEDLINE, CINAHL, PsycINFO, Web of Science, Cochrane Library, Scopus and ICHUSHI (a Japanese database). Grey literature and citation tracking will also be used. Documents of any design or publication type will be included. The study selection, coding and synthesis will be conducted independently by two authors. An IPT will be developed in the Context-Mechanism-Outcome configuration to understand how to promote disaster preparedness among LTCF stakeholders. The developed IPT will be verified by experts or stakeholders to enhance its validity. Ethics and dissemination Ethical approval will not be required because this is a review of published literature. The results will be disseminated at scientific conferences and peer-reviewed journals. The developed IPT will be used in subsequent research and iteratively tested or refined to better explain under what circumstances and what works for promoting disaster preparedness among LTCF stakeholders.

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A practical program for responding to epileptic seizures including buccal midazolam administration in schools: Effectiveness evaluation for Yogo teachers in Japan

Ozawa N., Tomisaki E., Sou H., Miyagawa S., Yoshioka J., Horie H., Kandatsu A., Deguchi N.K., Soeda E.

Epilepsy and Behavior 163 2025年02月

ISSN 15255050

Early response to epileptic seizures is critical. In children, epileptic seizures can occur at school, and practical programs are required to enable teachers to respond. In Japan, schoolteachers may administer buccal midazolam orally under certain conditions; however, there are no established training programs for responding to epileptic seizures in schools. In this study, we aimed to develop a training program on how to respond to seizures, including buccal midazolam administration, and evaluate its effectiveness. We conducted a training program for Yogo teachers at special needs schools and evaluated the differences in confidence in responding to epileptic seizures and administering oral buccal midazolam before and after the program. The results demonstrated that confidence in responding to epileptic seizures and administering oral buccal midazolam significantly improved after the program. We concluded that this training program can help special needs Yogo teachers gain confidence in administering buccal midazolam and responding to epileptic seizures in the school setting.

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保健師活動におけるICT活用の促進要因・阻害要因　文献レビュー

赤塚永貴, 佐野葵, 和田涼花, 宮川祥子, 杉山大典, 田口敦子

日本臨床知識学会誌（日本臨床知識学会） 5 66 - 68 2024年12月

筆頭著者, 責任著者, 査読有り

保健師活動におけるICT(Information and Communication Technology)活用の推進へ向け、本邦の地方自治体における保健師活動へのICT活用の促進要因と阻害要因を整理することを目的に、医学中央雑誌Web版を用いて、情報通信技術に関する国および地方公共団体の責務について定めた法律である高度情報通信ネットワーク社会形成基本法が制定された2000年から2023年3月の文献を対象に検索を行い、得られた9件を分析した。その結果、保健師活動におけるICT活用の促進要因として、保健師個人の要因では「業務の効率化」「住民の健康管理・健康増進」が、保健師が所属する組織の要因では「目的が明確化できていること」「必要性が認識されていること」「ICT専門職を含めた連携体制」に加え「国や制度によるデジタル推進の流れ」が挙げられた。ここから、保健師活動におけるICT活用の推進へ向け、組織内での合意形成とともに、事務職やICT専門職等との連携・協力体制構築の必要性が示された。ICT活用の阻害要因では、保健師個人の要因である「ICTへの無関心さ」「苦手意識」「ネガティブな認識」「ICTの活用状況やスキルの差」などが、保健師が所属する組織の要因として「職場のICT環境の不十分さ」「予算・マンパワーの課題」などが挙げられていたほか、電子記録システム自体の整備や標準化も課題として挙げられていた。

令和6年能登半島地震における1.5次避難所の運営と課題

宮川祥子, 畑山満則, 佐藤大

自然災害科学（日本自然災害学会） 43 （ 3 ） 665 - 678 2024年11月

筆頭著者, 責任著者, 査読有り, ISSN 02866021

本稿では，2024年1月に発生した令和6 年能登半島地震において，広域2次避難のための一時滞在施設として設置された1.5次避難所に焦点を当てる。運営主体，提供された支援，運営方法，入所者の推移について概観した上で，県による避難所運営の課題，および，ケア関連情報の共有の課題という2 つの運営上の課題について報告し，今後の災害における1.5次避難所の運営にかかる知見を提供する。

Bio-inspired circular soft actuators for simulating defecation process of human rectum

Mao Z., Suzuki S., Wiranata A., Zheng Y., Miyagawa S.

Journal of Artificial Organs 28 （ 2 ） 252 - 261 2024年10月

査読有り, ISSN 1434-7229

Soft robots have found extensive applications in the medical field, particularly in rehabilitation exercises, assisted grasping, and artificial organs. Despite significant advancements in simulating various components of the digestive system, the rectum has been largely neglected due to societal stigma. This study seeks to address this gap by developing soft circular muscle actuators (CMAs) and rectum models to replicate the defecation process. Using soft materials, both the rectum and the actuators were fabricated to enable seamless integration and attachment. We designed, fabricated, and tested three types of CMAs and compared them to the simulated results. A pneumatic system was employed to control the actuators, and simulated stool was synthesized using sodium alginate and calcium chloride. Experimental results indicated that the third type of actuator exhibited superior performance in pressure generation, enabling the area contraction to reach a maximum value of 1. The successful simulation of the defecation process highlights the potential of these soft actuators in biomedical applications, providing a foundation for further research and development in the field of soft robotics.

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The Safety Implications of Information Technology in Nursing: Japanese Incident Data Analysis

Miyagawa S., Urata Y., Watanabe S., Sugihara H., Mitani S., Fukahori H., Topaz M.

Studies in Health Technology and Informatics 315 69 - 73 2024年07月

ISSN 09269630

This study delves into the impact of Information Technology (IT) on nursing practice in Japan, focusing on patient safety within the 2021-2022 Japanese Medical Accident Report Data. The research aims to understand how IT factors contribute to nursing-related medical incidents in a healthcare landscape rapidly integrating IT. The study identifies IT-related incidents through a retrospective analysis of medical incident reports, primarily in nursing, by analyzing categorized data and free-text descriptions for IT-related keywords. The findings indicate significant IT-related issues, with 'Other EHR Related' problems (36%) and 'EHR Reporting' errors (25%) being the most prevalent. These incidents often involve challenges in patient identification and medication management. The study suggests improvements like enhanced verification processes and automated systems to mitigate these risks. Conclusively, it underscores the dual nature of IT in nursing: while it holds the potential to enhance patient care, it also introduces challenges that necessitate specialized informatics expertise to ensure its beneficial integration into nursing practices.

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看護ケアにおける3Dプリント技術の展開

宮川祥子

精密工学会誌（公益社団法人精密工学会） 90 （ 6 ） 446 - 449 2024年06月

筆頭著者, 責任著者, 査読有り, ISSN 09120289

連載日本の災害と公衆衛生--過去・現在・未来・12 情報活用

宮川祥子

公衆衛生（株式会社医学書院） 87 （ 10 ） 1042 - 1048 2023年10月

筆頭著者, 責任著者, 査読有り, ISSN 03685187

特集保健師活動におけるICT化の推進介護予防を促進するためのGIS活用-古賀市のDX推進における保健師の視点と展望

吉田直美, 内裕治, 近藤翼, 宮川祥子

保健師ジャーナル（株式会社医学書院） 79 （ 5 ） 382 - 390 2023年10月

筆頭著者, 責任著者, 査読有り, ISSN 13488333

A Simulation Model of Escapable and Non-Escapable Areas from Which Pregnant Women Can Reach Tsunami Evacuation Buildings: The Case in 110 Elementary School Districts in Nagoya City, Aichi, Japan

Miyagawa S., Hattori R., Hattori K.

Disaster Medicine and Public Health Preparedness （Disaster Medicine and Public Health Preparedness） 17 （ 3 ） 1 - 9 2023年09月

査読有り, ISSN 19357893

Objective: The objective of this study was to establish a method for evaluating the possibility of pregnant women evacuating to tsunami evacuation buildings in coastal areas affected by tsunami. Methods: We used data published by the Japanese government and a general-purpose geographic information system to develop a simulation method for evaluating the possibility of evacuation. The data included the number of pregnant women in each elementary school district, tsunami inundation forecast maps, location information of tsunami evacuation buildings, and the number of ordinary buildings. We used our method to conduct a tsunami evacuation possibility simulation for pregnant women in each elementary school district in 7 wards of Nagoya, Japan. Results: Dense population areas at low elevations are high-risk areas from which many pregnant women may not be able to evacuate. Districts with evenly distributed tsunami evacuation buildings tend to have a lower risk. Conclusions: The proposed simulation method was able to determine the risk in elementary school districts in densely populated low-lying areas. However, it is suggested that the risk tends to be estimated higher in school districts where there are differences in elevation and the building distribution is not uniform.

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What To Do When The Requirements Are Unknown? - Development of a Simulator for Excretory Care

Shoko Miyagawa, Yong Ah Seong, Zebing Mao, Tatsuhiro Horii, Hiroyuki Nabae, Shingo Maeda, Toshinori Fujie, Kenjiro Tadakuma, Hideyuki Sawada, Koichi Suzumori

AHFE International （AHFE International） 2023年09月

筆頭著者, 責任著者, 査読有り, ISSN 2771-0718

We developed a simulator to practice the digital disimpaction technique, a kind of excretory care that is commonly performed by home-care nurses in Japan. The key point of this study is that the requirements for creating a simulation model were not known in advance, so we adopted a rapid prototyping method, in which product development is carried out by repeatedly creating and testing simple prototypes and a user-participatory design method, where feedback is obtained directly from users. We proceeded with the development of the simulator and the definition of requirements simultaneously, repeating the process of creation, trial use, and feedback from interviews with skilled nurses. Digital disimpaction is a complex procedure involving interaction with a living body, in which a finger stimulates the rectum and facilitates the excretion of feces leveraging the rectum's natural biological response. Digital disimpaction is performed primarily by a nurse. Since digital disimpaction is an embarrassing and sometimes painful procedure for the patient, a smooth and comfortable technique is desirable. On the other hand, only a limited set of circumstances are provided to learn the digital disimpaction technique. The requirement for a "procedure requiring non-visible interaction," such as digital disimpaction, is hard to acquire through a simple interview because it is performed based on subjective sensation. Further, while the movement of the finger within the body is crucial, it is essentially impossible to learn through observation of a skilled nurse as it is not visible from the outside. For this reason, we created a simple rectal model as a first prototype. We improved the model by extracting requirements from observations and feedback on actual trial use by skilled nurses. From the first user experience of the simple 3D printed model, requirements were extracted regarding the texture of the rectum, the interaction between finger movement and rectal response, and the characteristics of the feces. A rectal model with a mucosal structure and a fecal model was created based on the obtained requirements. Through the second user experience, the process was repeated, where requirements were again extracted regarding the shape of the rectal model, the characteristics of the mucosa, and the rectal response with the finger movement. We redesigned the model to meet these refined requirements and developed a buttock model covering the rectal model.The results of the third user experience confirmed that the simulator mostly reproduced the intestinal setting as perceived by the nurses during the actual digital disimpaction procedure. This study suggests that the combination of rapid prototyping and user-participatory design can be used to systemize subjects for which requirements are hard to define in advance, such as care procedures based on tacit knowledge.

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Difficulties and innovations in teaching anatomy and physiology in nursing

Satoh M., Fujimura A., Miyagawa S.

Nurse Education in Practice （Nurse Education in Practice） 67 103551 - 103551 2023年02月

査読有り, ISSN 14715953

Aim: This study aimed to clarify the difficulties and innovations in anatomy and physiology education from the perspective of faculty members in charge of anatomy and physiology education in Japanese nursing universities. Background: Many nursing students have difficulty acquiring anatomy and physiology knowledge and applying it in clinical situations; therefore, effective teaching and learning methods for anatomy and physiology must be provided in nursing education. Design: This study followed a cross-sectional observational design using a web-based self-administered questionnaire. Methods: A web-based self-administered open-ended survey regarding the difficulties and innovations in teaching anatomy and physiology in nursing was conducted involving nursing faculty members at universities in Japan. After inviting 280 nursing universities to participate in the survey, 37 completed questionnaires were collected and descriptively analyzed. Results: In approximately 30% of the universities, multiple professions were involved in collaboratively teaching anatomy and physiology. Furthermore, 59.5% of the universities offered a combination of didactic lectures and laboratory learning. Difficulties in teaching anatomy and physiology included the limitations of the physical teaching environment, the difficulty of teaching the importance of anatomy and physiology in nursing practice, the difficulty of adjusting educational content to learner readiness, and the difficulty of terminology and concepts specific to anatomy and physiology. Innovations used in teaching anatomy and physiology from a nursing perspective included integrating anatomy and physiology with related disciplines, encouraging students to visualize human anatomy in three dimensions, and linking anatomy and physiology to clinical nursing practice. Conclusion: Despite some difficulties in teaching the subjects, faculty members have implemented effective educational methods on their own. Due to the various constraints of the learning environment, it is difficult for students to learn anatomy and physiology on campus in depth and acquire a deep understanding of its significance in clinical practice. Therefore, educational involvement that fosters students’ self-directed learning skills and encourages flexible learning is expected. In addition, by collaborating with multiple disciplines to provide anatomy and physiology education, the participants of this study innovated pedagogies for teaching nursing students about the usefulness of anatomy and physiology and motivated their students. Moving forward, teachers need to relate their knowledge of anatomy and physiology to actual nursing care and clinical cases and convey the importance of deeply understanding anatomy and physiology in nursing practice to support their students’ active learning.