群馬県訪問看護事業所における医療処置及び人工呼吸療法の事故発生状況，安全対策への取組の実態調査

目的：群馬県訪問看護事業所における医療処置及び人工呼吸器装着者の事故発生状況，安全対策への取組を明らかにし，地域における安全対策の体制整備を検討する． 方法：群馬県の訪問看護事業所の管理者421人を対象に自記式質問紙調査を実施した．有効回答は67人（15.9％），記述統計量を算出し，自由記述は類似性に基づき整理した． 結果：医療処置の事故は訪問看護提供時間内に14件（n＝31），影響度はレベル3以下，人工呼吸療法に関する事故は介護者在宅時が11件（n＝25），影響度はレベル4が1件（4.0％），レベル5が3件（12.0％）であった．発生時の対応は，介護職のケア時間に発生した事故の検討47.4％，地域の多機関で話し合う30.6％であった． 結論：人工呼吸器装着者の安全対策は，介護者のみの時間の療養者・家族が行う対策が重要であり，支援チーム，地域の多機関での事故に関する情報共有・検討が課題である．Purpose: This study examined the development of local safety measure systems by clarifying the incidence of accidents in medical procedures and among users of ventilators, as well as initiatives for safety measures at home-visit nursing stations in Gunma Prefecture. Methods: A self-administered questionnaire was distributed to 421 administrators of home-visit nursing stations in Gunma Prefecture and valid responses were obtained from 67 respondents (15.9％). Each item was subject to descriptive statistics and open-ended answers were organized based on similarities. Results: The respondents reported 14 (45.2％) medical procedure accidents that occurred during home-visit nursing hours with an impact level on patients of 3 or lower, and 11 (44.0％) ventilation therapy accidents that occurred while the caregiver was home, one of which had an impact level of 4 (4.0％) and three of which had an impact level of 5 (12.0％). Measures taken to address accidents were investigations into accidents that occurred during care hours by care workers in 47.4％ of cases and discussions among various local agencies in 30.6％ of cases. Conclusions: Regarding safety measures for users of ventilators, measures carried out by the patient and their family while only the caregiver was home were important. In the future, it is necessary to address the sharing and review of information on accidents among support teams and various local agencies.報

カンゴショクシャ ノ ショクギョウ キャリア セイジュク ソクテイ シャクド ニ カンスル コウセイ ガイネン ダトウセイ ノ ケントウ

キャリア成熟は、Super,D.E.(1957)が提唱している職業的発達 vocational development の概念を発展的に継承したものであり、「発達課題に取り組もうとする個人の態度的、認知的レディネス」(Crites、1978)と定義されている。本研究においては、坂柳(1990)が開発した「成人キャリア成熟尺度(Adult Career Maturity Scales : ACMS)」を基礎に、看護師508名のデータを用いて項目反応理論による項目選定と構造方程式モデリングによる確証的因子分析を行い、看護師用の職業キャリア成熟の測定に寄与する適切な項目配置を検討した。その結果、あらかじめ仮定した3因子斜交モデルのデータへの適合性は、CFIが0.921、RMSEAが0.081であり、また看護職者の職業キャリア成熟における「関心性」「自律性」「計画性」の3因子各4項目で測定できることを明らかにした。本研究においては、看護職者における「職業キャリア成熟」の測定尺度が開発できたが、今後はさらに、前記因子モデルの不変性について検討を継続すると同時に、「職業キャリア成熟」の影響要因やインパクトについての検討が必要なことが推察された。The theory of career maturity advanced by Super (1957) developed out of the concept of occupational development. It is defined as an individuals\u27 attitudinal and cognitive read-iness for developmental challenges (Crites,1978). The present study reviewed the Adult Career Maturity Scales: ACMS developed by Sakayanagi (1990) and examined its construct validity using item response thelry. A confirmatory factor analysis (structural equation modeling) was performed based on the data of 508 nurses. The research questions checkd the number of reliable and interpretable factors in the data set, and clarified the nature of the factors. The fitness of the model was confirmed (CFI = 0.91; SRMR = 0.081) and a three factor model of "concern","autonomy",and "planning" was determined. Future research will test the reliability of this model and examine the causes and effects of career maturity

Chromosome Studies in Mouse Neuroblastoma Cells

Chromosome studies were carried out in cultured cells from a mouse neuroblastoma. C1300 tissue and in three clones established from this tumor. They possessed characteristic karyotypes with remarkable markers. Double minutes (DMs) were demonstrated in all cell lines, in addition to some other chromosomes aberrations, such as microchromosomes and chromosome pulverization

Post-extubation dysphagia in pediatric trauma patients: a single-center case-series study

Abstract We aimed to investigate whether ventilator support time influences the occurrence of dysphagia in pediatric trauma patients. This case-series study was conducted in a single pediatric emergency and critical care center from April 2012 to March 2022. Trauma patients aged < 16 years who underwent tracheal intubation were divided into two groups based on the occurrence of dysphagia within 72 h after extubation, and their data were analyzed. Tracheal intubation was performed in 75 pediatric trauma patients, and 53 of them were included in the analysis. A total of 22 patients had post-extubation dysphagia and head trauma. The dysphagia group tended to have more severe head injuries (Abbreviated Injury Scale (AIS) 4 [4–5] vs. 4 [0–4]; p < 0.05), a longer ventilator support time (7 days [4–11] vs. 1 day [1–2.5]; p < 0.05), and a longer length of hospital stay (27 days [18.0–40.3] vs. 11 days [10.0–21.0]; p < 0.05). Severe head trauma and a long duration of tracheal intubation may be risk factors for dysphagia in pediatric trauma patients. Therefore, early recognition of these risk factors could assist in treatment planning for speech-language pathologist intervention and nutritional routes of administration