Breast cancer patients’ perceptions of appeasement and care needs

The purpose of this study was to clarify breast cancer patients’ perceptions of appearance and support. An anonymous self-administered survey was performed on 100 female breast cancer outpatients at five facilities in Tottori Prefecture. The survey included: 1） painfulness from the change in appearance, 2） impact on continuing treatment, work, and personal relationships, 3） need for coping and care, 4） readiness for coping and care, and 5） desire for information about coping and care. The results showed that most of the subjects recognized that the change in appearance was unavoidable. On the other hand, they also recognized that the way other people looked at them was the most painful thing and affected their relationships; they needed coping skills and care. Therefore, they wanted to be informed and prepared from the time the treatment plan was decided. Friends and acquaintances were not the target of their expectations as informants, and they expected nurses to play that role. Nurses are expected to play a role as supporters to help breast cancer patients rebuild their sense of self-worth and lead a peaceful life

Impact of Organization and Career Commitment on Clinical Nursing Competency

Background: The majority of nurses are employed at medical institutions and acquire clinical competency through their work within their organization. Hands-on experience in the clinical setting is essential to enhance a nurse’s clinical competence. The objective of this study was to determine the impact of commitment to the practical skills of nurses within Tottori prefecture. Methods: We studied data from 916 nurses employed at 7 publicly-funded medical facilities (national and other public institutions). Data on basic information, clinical nursing competence, and commitment were collected via an anonymous self-administered questionnaire. Results: A total of 672 valid questionnaires were analyzed. Mean clinical nursing competence scores showed a tendency to increase with years of experience. Scores increased from years 1 to 4, and then tended to plateau or decrease slightly thereafter up to around year 9. Mean commitment scores decreased from 1 to 2 years of experience to 3 to 4 years of experience. Other than “normative factors,” mean scores tended to increase after 5 to 10 years of experience. Multiple regression analysis showed that “job involvement” at 1 to 2 years; “overall job satisfaction” at 5 to 9 years; “career commitment” at 10 to 19 years; and “job involvement” and “career commitment” at ? 20 years impacted results. No factors appeared to have an influence on nurses in their 3rd to 4th year of experience. Conclusion: Based on the concepts described above, self-assessment of nursing competence scores tended to improve with years of experience. Mean commitment scores tended to decrease after 3 to 4 years of experience and thereafter plateaued or increased. Organizational commitment has not clearly been shown to affect nursing competency, but the factors that affect this parameter changed with the length of experience. Results suggest support is needed in the 1st and 2nd years to help nurses adapt to the organization while in years 5 through 9, support that takes work-life balance into consideration is needed. This indicates support should change to meet the needs of each stage in a nurse’s career. In years 3 to 4, it was suspected that the nurses’ relationship with the organization weakened. Helping nurses forge a good relationship with their organization is believed to be effective in improving clinical competency in nurses with 5 or more years of experience

A Path Model Analysis of the Causal Relationship between Self-care Agency and Healthy Behavior in Community-dwelling Older People from the GAINA Study

[Background] Self-care agency is an important determinant of self-care behavior. The purpose of this study was to identify the causal relationship between self-care agency and healthy behavior, and to construct a conceptual model of healthy behavior among older people living in a rural community. [Methods] This study was conducted as a cross-sectional survey at the Hino, a town in western Tottori Prefecture, Japan. Participants who were enrolled in the Good Ageing and Intervention against Nursing Care and Activity Decline (GAINA) study from 2014 to 2018 (467 new participants) were initially investigated. Of 398 participants aged ? 65 years, 5 were excluded due to missing data, and thus 393 were analyzed. Nurse researchers conducted face-to-face interviews with participants to check the accuracy of data obtained from a self-administered questionnaire, which included demographic information, physical condition (comorbidities, knee pain, low back pain, and locomotive syndrome), healthy behavior, and self-care agency. Correlations among variables were investigated by Pearson’s correlation coefficient analysis, and path analysis was performed to assess causal relationships. [Results] A total of 393 persons (160 men and 233 women) were investigated, ranging in age from 65 to 92 years, with a mean age of 75.1 years (SD: 6.9 years). Path analysis revealed poor fit of a model in which pain and locomotive syndrome were factors inhibiting healthy behavior. When the model included only self-care agency, the indices of model fit were almost satisfactory (Goodness-of-fit index = 0.967, Adjusted goodness-of-fit index = 0.900, Comparative fit index = 0.951, and Root mean square error of approximation = 0.088), and the coefficient of determination (R2) was 0.38. The self-care agency items with the greatest influence on healthy behavior were the ability to “grasp the techniques/tips needed to maintain health,” and the ability to “persist with healthy behavior.” [Conclusion] Self-care agency can promote healthy behavior among community-dwelling older people. Regardless of physical problems such as pain and locomotive syndrome, older people have the potential to adopt positive healthy behavior if they acquire self-care agency

Evaluation of Prognosis of Juvenile Differentiated Thyroid Carcinoma

Differentiated thyroid carcinoma (DTC) in juvenile patients is often an extensive and aggressive disease with a high frequency of recurrence. However, the prognosis is excellent, with a low mortality rate even when advanced disease is present, although prognostic factors and treatment strategy remain uncertain. Between April 2004 and March 2017, 33 juvenile patients (< 30 years old) were diagnosed with DTC and treated at our institution. We retrospectively investigated prognosis and factors including sex, reason for discovery, treatment, pathological factors and treatment progress to clarify the risk factors. All patients underwent curative surgical treatment. Pathologically, lymph node metastasis was identified in 25 patients (75%). Thirteen patients (39%) had bilateral cervical metastasis. In addition, 9 (27%) had more than 10 metastatic lymph nodes. The 2 patients with more than 20 metastatic lymph nodes were treated with radioactive iodine (RAI). Five patients (15%) had local recurrences and received surgery. There have been no further recurrences or deaths. However, no factors were determined to significantly predict the recurrence of juvenile DTC. Local recurrent disease was treated with surgery and/or RAI until remission, and survival was excellent in juvenile DTC

胃がん患者における嗅覚変化が胃切除後の体重減少に与える影響

Patients undergoing gastrectomy for gastric cancer may experience alterations in olfaction, yet the association between olfactory changes and postoperative weight loss remains uncertain. This study aimed to elucidate the relationship between olfactory changes and postoperative weight loss in patients with gastric cancer. Patients who underwent radical gastrectomy for gastric cancer between February 2022 and August 2022 were included in the study. Those experiencing a higher Visual Analog Scale (VAS) score postoperatively compared to preoperatively were deemed to have undergone olfactory changes. Postoperative weight loss was determined using the 75th percentile as a cutoff value, designating patients surpassing this threshold as experiencing significant weight loss. Multivariate logistic regression analysis was employed to identify risk factors for postoperative weight loss, with statistical significance set at p < 0.05. Out of 58 patients, 10 (17.2%) exhibited olfactory changes. The rate of postoperative weight loss at one month was markedly higher in the group with olfactory changes compared to those without (9.6% versus 6.2%, respectively; p = 0.002). In addition, the group experiencing olfactory changes demonstrated significantly lower energy intake compared to the group without such changes (1050 kcal versus 1250 kcal, respectively; p = 0.029). Logistic regression analysis revealed olfactory changes as an independent risk factor for significant weight loss at one month postoperatively (odds ratio: 7.64, 95% confidence interval: 1.09–71.85, p = 0.048). In conclusion, olfactory changes emerged as an independent risk factor for postoperative weight loss at one month in patients with gastric cancer following gastrectomy

Current Performance and On-Going Improvements of the 8.2 m Subaru Telescope

An overview of the current status of the 8.2 m Subaru Telescope constructed and operated at Mauna Kea, Hawaii, by the National Astronomical Observatory of Japan is presented. The basic design concept and the verified performance of the telescope system are described. Also given are the status of the instrument package offered to the astronomical community, the status of operation, and some of the future plans. The status of the telescope reported in a number of SPIE papers as of the summer of 2002 are incorporated with some updates included as of 2004 February. However, readers are encouraged to check the most updated status of the telescope through the home page, http://subarutelescope.org/index.html, and/or the direct contact with the observatory staff.Comment: 18 pages (17 pages in published version), 29 figures (GIF format), This is the version before the galley proo

シュウキョウガ ノ カンショウ キョウイク カツドウ ニ ノゾム : ソノ ケイカク ウンエイ ト タントウ ガクセイ ノ ヘンカ

In 2009, we held an educational art workshop on stories from the Old Testament at the Otsuka Museum of Art in Naruto City. This workshop is one of the activities of N＊CAP（Naruto Children’s Art Park）. The purpose is for local children to become more familiar with and appreciate the art. During this activity, children showed interest towards the paintings related to biblical stories and showed no reluctance towards them, which was our initial concern. However there is some room for improvement such as increasing the motivation of the university students and allocating time properly for children to be focused throughout the workshop. These are the main points that can be improved. Using the improvement points from the 2010 workshop, we held another activity using the theme of the New Testament. This time, our coordinator only gave the university students the theme and let them delegate the activities. They let two students who were in charge of organizing the event handle all matters. These students improved the plan with their classmates taking into consideration previous workshops and carried out the plan on their own. They held a craft workshop making pseudo stained glass using vinyl sheets which is safer and easier for children to use. In this workshop, children showed no sign of fatigue, and enjoyed doing the crafts very much while completing work of their own. The high motivation of the students led to the success of this workshop. One of the benefits of this workshop is that the students were able to appreciate the paintings with a deeper perception. They are now able to seek out small details of biblical paintings of the Medieval Gothic Period and cherish the meanings of them.

Crystal structure of 4,4′-dimethoxy-2,2′-bipyridine

In the title compound, C12H12N2O2, the dihedral angle between the planes of the two pyridine rings is 5.8 (1)°. Neighbouring molecules are linked via C(Me)—H...N interactions, generating a two-dimensional sheet structure; C—H...π interactions further link the molecules into a three-dimensional network. An overlapped arrangement of parallel pyridine rings in neighbouring molecules [centroid-to-centroid distance = 3.6655 (15) Å] is observed in the crystal structure

Crystal structure of fac-trichlorido[tris(pyridin-2-yl-N)amine]chromium(III)

In the neutral complex molecule of the title compound, fac-[CrCl3(tpa)] [tpa is tris(pyridin-2-yl)amine; C15H12N4], the CrIII ion is bonded to three N atoms that are constrained to a facial arrangement by the tpa ligand and by three chloride ligands, leading to a distorted octahedral coordination sphere. The average Cr—N and Cr—Cl bond lengths are 2.086 (5) and 2.296 (4) Å, respectively. The complex molecule is located on a mirror plane. In the crystal, a combination of C—H...N and C—H...Cl hydrogen-bonding interactions connect the molecules into a three-dimensional network