高齢者看護学実習における学生の高齢患者の理解の実態

The purpose of this study was to clarify how the students understand the older patients based on Orem’s nursing theory in Geriatric Nursing Training. The participants were１７nursing students in third grade. The interview was carried out using semi-structured interview with students for how they felt older patients. As a result, two categories were extracted ; ［ they need limited care for deficient parts］and［they have toughness cultivated through their long life］. The students understood the older patients as having self-caring abilities and thought that limited care should be provided only for deficient parts of patients. Also, they understood older patients as having strength cultivated through their long life. It is necessary for teachers to assess the Self-care agency more severely for students to get hold of mature elements characteristic of older patients

Psychological Adjustment in Lung Cancer Patients

The purpose of study was to clarify the psychological adjustment and related factors in lung cancer patients with recurrence/metastasis after curative surgery. Forty-one with lung cancer who were informed of a recurrence/metastasis after curative surgery completed a questionnaire comprised of the Mental Adjustment to Cancer Scale (MAC), Psychological Adjustment scale for Cancer Survivors (PACS), and information pertaining to demographic variables. When healthcare providers intervene in patients with lung cancer that has recurred/metastasized after curative surgery, it is necessary to assess patients’ psychological adjustment based on demographic information, such as age, sex, marital status, and employment status, and to provide effective support promptly. Factors associated with psychological adjustment with recurrent/metastatic lung cancer after curative surgery were 1) female, 2) having a job, 3) over 65 years of age, 4) having a spouse, and 5) advanced-stage cancer. There was no difference in psychological adjustment between treatment and the period from cancer incidence to recurrence/metastatic

Does Clear Cornea Cataract Surgery Influence Conjunctivochalasis?

This is a Letter to the Editor and does not have an abstract

Children with unilateral aural atresia

The effects of FM system fitted into the normal hearing ear (NHE) or a cartilage conduction hearing aid (CCHA) fitted into the affected ear (AE) on the speech recognition ability in noise were examined in children with unilateral congenital aural atresia (UCAA). In children with bilateral normal hearing (BNH), speech recognition score (SRS) was significantly decreased in the noisy environment of -5 dB signal-to-noise ratio (SNR), compared with those in quiet. In children with UCAA, SRS was significantly decreased in noisy environments of 0 and -5 dB SNR, compared with those in quiet. In noisy environments of 0 and -5 dB SNR, SRS in children with UCAA was significantly decreased, compared those in children with BNH. In the noisy environment of -5 dB SNR, SRS in UCAA children aided by FM system fitted into NHE was significantly better than those in unaided children in the same group. In the noisy environment of 0 dB SNR, SRS in UCAA children aided by CCHA into AE tended to be higher than those in unaided children in the same group. FM system and CCHA can be recommended as an audiological management for the improvement of speech recognition in children with UCHL in classrooms

学生が捉えた手術見学実習体験の術後看護への影響

Aim：To clarify the effects of observing surgery during clinical adult nursing practicum on postoperative nursing from the perspective of students. Methods：Semi-structured interviews were conducted with１０students in their third year at a nursing college. The obtained data were qualitatively and inductively analyzed. Results：When observing surgery for the patients they were caring for, the students were aware of［the importance of observing and assessment with the influence of surgery and anesthesia taken into account］. Subsequently, they performed［postoperative pain management based on findings from the observation of actual surgical settings］, while providing various approaches, including［Approaches to the promotion of patients’ awareness of the current situation in order to prevent postoperative confusion and to protect safety］. Through this process, they developed［a sense of responsibility for nursing care inspired by patients・families’ coping behaviors］． Discussion：The experience of observing surgery during clinical training was suggested to help students develop practical insights for care to promote postoperative recovery and a sense of responsibility for nursing care inspired by patients・families’ coping behaviors

看護学生が理解するパワー構成要素

The purpose of this study was to analyze trends in nursing students' assessments of the 10 powers of self-care agency in Gerontological Nursing and to identify educational support for students. The subjects were the practice records of 66 third-year nursing students who completed Gerontological Nursing from September 2019 to February 2020. The results showed that they had a perspective of directing their attention to the patient's interest, will, motivation, and reasoning among 10 power items that all students were able to assess, and that they approached their care with a respectful attitude toward the patient's perceptions and intentions for self-care. In addition, it could be inferred that they understood self-care in terms of patients' behaviors and activities by appearance. Conversely, from the items that more than half of the students were unable to assess, it could be inferred that they were unable to assess how to apply self-care agency to the patient's prospect and lives in future

多重聴性定常反応で評価した滲出性中耳炎児の気導骨導差

Objective: Multiple auditory steady-state responses (ASSRs) to air- and bone-conduction stimuli were recorded in young children with otitis media with effusion (OME). After treatment for OME, differences between pre-treatment bone-conduction ASSR levels and post-treatment conditioned orientation reflex (COR) or air-conduction ASSR levels were examined, and compared with ASSR-estimated air-bone gap (ABG) before treatment. Methods: Navigator Pro with Master was used to assess the threshold of air- and bone-conduction ASSR in both ears at 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz. For bone-conduction ASSR, RadioEar B-71 bone-vibrator placed on the mastoid was used with white-noise masking on the contralateral ear. Results: After ventilation tube placement, the thresholds of COR got closer to those of pre-treatment bone-conduction ASSR in young children with OME. Moreover, post-treatment air-conduction ASSR thresholds also got closer to those of pre-treatment bone-conduction ASSR. The differences between pre-treatment bone-conduction ASSR thresholds and post-treatment COR or air-conduction ASSR thresholds became much smaller than ASSR-estimated ABG before treatment. Conclusion: These findings suggest that bone-conduction ASSR can assess the normal or near normal cochlear sensitivity in young children with conductive hearing loss. It is also suggested that ASSR-estimated ABG can be used clinically to predict their accurate ABG

Liver autophagy-induced valine and leucine in plasma reflect the metabolic effect of sodium glucose co-transporter 2 inhibitor dapagliflozin

BACKGROUND: Sodium glucose co-transporter 2 (SGLT2) inhibitors are anti-diabetic drugs for type 2 diabetes that lower blood glucose levels and body weight. It is of special interest that SGLT2 inhibitors also improve liver metabolism and fatty liver. Liver is an important organ in regulation of energy metabolism, but the metabolic action of SGLT inhibitors in liver remains unclear. METHODS: We investigated the factors associated with the beneficial effects of dapagliflozin, a SGLT2 inhibitor, in the liver after confirming its glucose-lowering and weight loss effects using an obesity and diabetes mouse model. We also performed clinical study of patients with type 2 diabetes to explore candidate biomarkers that reflect the beneficial action of dapagliflozin in the liver. FINDINGS: In animal study, dapagliflozin induced autophagy in the liver (LC3-II to LC3-I expression ratio: P < 0·05 vs. control), and valine and leucine levels were increased in plasma (P < 0·01 vs. control) as well as in liver (P < 0·05 vs. control). Thus, increased plasma valine and leucine levels are potential biomarkers for improved liver metabolism. Clinical study found that valine and leucine levels were markedly higher in patients treated with dapagliflozin (valine: P < 0·05 vs. control, leucine: P < 0·01 vs. control) than those not treated after one week intervention. INTERPRETATION: Dapagliflozin improves liver metabolism via hepatic autophagy, and plasma valine and leucine levels may reflect its metabolic effect. FUNDING: AstraZeneca K.K., Ono Pharmaceutical Co., Ltd., Ministry of Education, Culture, Sports, Science and Technology (MEXT), Japan Society for the Promotion of Science (JSPS), Japan Agency for Medical Research and Development (AMED), Novo Nordisk Pharma Ltd., and Japan Foundation for Applied Enzymology, and MSD Life Science Foundation International

Role of Tumor-Associated Macrophages in Sarcomas

Simple Summary Recent studies have shown the pro-tumoral role of tumor-associated macrophages (TAMs) not only in major types of carcinomas but also in sarcomas. Several types of TAM-targeted drugs have been investigated under clinical trials, which may represent a novel therapeutic approach for bone and soft-tissue sarcomas. Sarcomas are complex tissues in which sarcoma cells maintain intricate interactions with their tumor microenvironment. Tumor-associated macrophages (TAMs) are a major component of tumor-infiltrating immune cells in the tumor microenvironment and have a dominant role as orchestrators of tumor-related inflammation. TAMs promote tumor growth and metastasis, stimulate angiogenesis, mediate immune suppression, and limit the antitumor activity of conventional chemotherapy and radiotherapy. Evidence suggests that the increased infiltration of TAMs and elevated expression of macrophage-related genes are associated with poor prognoses in most solid tumors, whereas evidence of this in sarcomas is limited. Based on these findings, TAM-targeted therapeutic strategies, such as inhibition of CSF-1/CSF-1R, CCL2/CCR2, and CD47/SIRP alpha, have been developed and are currently being evaluated in clinical trials. While most of the therapeutic challenges that target sarcoma cells have been unsuccessful and the prognosis of sarcomas has plateaued since the 1990s, several clinical trials of these strategies have yielded promising results and warrant further investigation to determine their translational benefit in sarcoma patients. This review summarizes the roles of TAMs in sarcomas and provides a rationale and update of TAM-targeted therapy as a novel treatment approach for sarcomas

治療を中止したがん患者の回復への希望に対する看護師のジレンマ

In this study, the authors clarified experience of nurses with the dilemma toward the wish for recovery of cancer patients who discontinued treatment. An interview survey was performed for 14 nurses who had ever care cancer patients who discontinued their treatment. Experience of nurses with the dilemma toward the wish for recovery of cancer patients who discontinued treatment consisted of the following categories ;［ I am not able to respond to the patient’s wish though I want to］,［There is difference how to spend the time remained between the patient and me］,［I do not have a sufficient power to support the end of the patient’s life］,［I feel disconsolate being unable to realize the patient’s wish for recover］and［I’m a nurse. I never run from my patients］. The nurses with dilemma had experience in facing nursing cares driven by the sense of responsibility as a nurse while holding pain in their heart. Ethical problems may be underlying in this experience, and the need of team work, not individual responses, has been suggested. Therefore, support to reveal experience of nurses in daily nursing care is needed