The Moment of Establishing Transpersonal Caring in a Grieving Adolescent Daughter beside Her Mother’s Deathbed and Hansen’s Disease Survivors Sharing Their Life Review

Evidence-based nursing (EBN) ensures the science of nursing practice, while the philosophical and ethical aspects of nursing practice are based on caring. Caring not only leads to the patient and their family’s healing but also to the nurse’s professional and personal growth since caring includes mutual approval and reciprocity. In the latter half of the chapter, we explain how to establish Dr. Jean Watson’s transpersonal caring using the following two events: ① case study: An expert nurse unintentionally says, “Your mother continues to be near and protect you,” to a crying daughter beside her mother’s deathbed; and ② our project: sanatorium’s nurses listen to Hansen’s disease survivors’ life review

Preliminary Survey to Establish Indicator for Screening of Primary School-age Children Who Require Welfare Assistance

小学校において被虐待児にみられる行動特徴から要保護児童をスクリーニングできる質問紙を作成するために，教職員にとって判断が容易で信頼性の高い回答が得られる項目を厳選するための基礎調査を行った。64名の小学校の教職員に，35項目からなる同じ内容の質問紙に2週間の間隔をあけ， 2回回答してもらった結果を照合し，質問内容の判断の容易さ回答の再現性，および文章表現について検討した。 1. 学校現場で教職員が判断するのが難しい質問項目は，「トイレの後に手を洗わない」，「行事の時の弁当が手作り弁当ではない」，「保護者と目を合わさず，おどおどする」，「家族関係に変化があった」，「年齢にそぐわない性的な言動がみられる」，「病気になっても病院に行かない」，および「過度な警戒心を持つ」であった。 2. 回答の信頼性の低い質問項目は「やせすぎている」，「行事の時の弁当が手作り弁当ではない」，「よく教室から離れる」，および「保護者と目を合わさず，おどおどする」であった。 3. 表現が不適切であると指摘された質間項目は「時々嘘をつく」，「友達をいじめる」，および「集団になじめないところがある」であった。 今後は，上記の質問項目を除いた質問項目からなる質問紙を作成し，実際に児童を対象とした調査を行い，要保護児童のスクリーニング指標としての有効性について検証する必要があると考えられる。We conducted a survey to select questions that teachers could easily and reliably answer as part of a basic research project to create a questionnaire based on characteristic behaviors exhibited by abused children at primary school for screening of those who may need welfare assistance. Questionnaires comprised of 35 items were sent to 64 primary school teachers, with the same questionnaire sent again 2 weeks later. Responses to both were compared to examine ease of assessing the contents of the questions, reproducibility of the responses, and written expressions. 1) Items that teachers found difficult to assess at school were "Does not wash hands after using the toilet," "Does not bring homemade lunch to events," "Does not meet guardian's eyes; appears apprehensive," "Has experienced a change in familial relations," "Uses sexual speech and behavior that is not age appropriate," "Does not see a doctor despite being sick," and "Is excessively wary." 2) Items that showed responses with low reliability were "ls too thin," "Does not bring homemade lunch to events," "Is often absent from the classroom," and "Does not meet guardian's eyes; appears apprehensive." 3) Items indicated to use inappropriate expressions were "Sometimes tells lies," "ls bullied by friends," and "Does not fit in with group in some ways." Next, use of a questionnaire that does not include the above items should be done with actual children to examine its effectiveness as an indicator for screening children who require welfare assistance

Interleukin-18 Induces Acute Biphasic Reduction in the Levels of Circulating Leukocytes in Mice

We investigated the acute hematological changes caused by interleukin-18 (IL-18) in mice. Intraperitoneal administration of IL-18 (2 μg/mouse) resulted in biphasic decreases in the number of leukocytes in the blood. The first phase of decrease occurred within 2 h of IL-18 administration and was followed by a transient increase at 5 h. The second phase of decrease occurred at around 6 h, reaching a nadir which lasted for more than 24 h. In mice deficient in inducible nitric oxide (NO) synthase, the first phase of reduction of leukocytes did not occur although the second phase of decrease was observed. In mice deficient in gamma interferon (IFN-γ) or in mice depleted of natural killer cells and incapable of producing IFN-γ, IL-18 had no effect on the number of circulating leukocytes. Levels of nitrite and/or nitrate in the serum were elevated within 2 h after administration of IL-18, reaching a peak at 4 h and then decreasing gradually to the basal level over a 24-h period of time. On the other hand, serum IFN-γ levels changed in a biphasic manner, reaching a peak at 2 h after IL-18 administration, followed by a decrease in the basal level and a second increase at 6 h. Levels of IL-18 receptor mRNAs also showed biphasic changes in correlation with the changes in serum IFN-γ levels. These results suggest that the changes in the leukocyte number following IL-18 administration are mediated by NO and IFN-γ, with NO being involved in the first phase of reduction and IFN-γ being involved in both phases