The reality investigation of stresses which the new figure nurses employed after one month hold

看護教育カリキュラムの改正により，臨床での実習時間はますます減る傾向にある。一方，臨床現場では，医療の高度化，複雑化が進み，看護基礎教育と現場のギャップは大きくなる傾向にある。今回38名の新人看護婦にアンケート調査を行い，新人看護婦の抱えるストレスについて明らかにした。その結果，新人看護婦の抱えるストレスは，看護技術に関するストレスが最も多く（94％），ついで，3交代勤務による不規則な生活（14％），患者とのコミュニケーション（11％）であった。この結果には教育課程の違いによる差は認められなかった。多くのストレスの中で働く新人看護婦は，32.3％が，体調についてあまりよくない，あるいは良くないと回答していた。また，様々なストレスにより，就職後1ヶ月で退職を考えているものが6名（17.6％）いた。看護婦になってよかったと答えたものは8名（82％）あり，その多くが，患者との関わりがうまくいったときにそのように感じていた。新人看護婦が，今後の看護基礎教育に望むことは，技術面の体験をさらに増やすこと，移植医療，ME機器の取り扱いなどであった。Revision of curriculum makes reduce the practice time in clinical more and more. On the other hand, in clinical site, the gap between the nursing base education and the clinical site shows the tendency to enlarge because of high-developed medicine and complicated situation. This time, I put into practice the questionnaire survey for 38 new figure nurses to make their having stresses clear. Consequently, they expressed mainly three causes of their stress. They were about the nursing skills (94%), irregular life due to three shifts (14%) and the way of the communication to the patient. There weren't any differences among each nursing curriculum. 32.3% of the new figure nurses having much stresses said about their physical condition that they were not good or not so good. The 6 new figure nurses (17.6%) thought that they wanted to quit their job only one month after being nurse. The 8 new figure nurses (82%) thought that they were satisfied with being nurse. When many new figure nurses could make good communication with their patients, they thought that. The new figure nurses said that they wanted to study about more nursing skills, medicine of transplantation and ME equipments

A study on patient's difficult experiences' and coping methods for them that patients go through following laryngectomy

本研究の目的は,喉頭切除術を受けた患者が体験している困難とそれへの対処方法を明らかにすることである｡自宅で生活する1名の喉頭切除術後患者に対して行った半構成面接により得られたデータを質的帰納的に分析した結果,喉頭切除術を受けた患者が体験している困難な体験としては,【転移に対する恐怖を持ち続けて生活していかなければならない不安】【うまく意思疎通できないことへの苛立ち】【元通りの生活ができない煩わしさ】【変化した機能を補いながら生きていかなくてはならない不便さ】【予測できない症状に対する恐怖】【役割を果たせないことに対する自己嫌悪】【気管ロを特異な目で見られることの不快感】【生活を再構築するための時間の必要性】の8のカテゴリーが抽出された｡また,困難な体験に対する患者の対処方法としては,の13のカテゴリーが抽出された｡という対処方法は,その他12の対処方法の根底として存在し,このという対処方法が,困難な体験を乗り越えていくための原動力になっていることが明らかとなった｡The objective of the present study is to clarify difficult experiences and coping methods for them that patients go through following laryngectomy. A semi-structured interview was conducted on a patient who had undergone laryngectomy and was living at home. The results of qualitative induction analysis identified the following eight categories for difficult experiences: 1) Uneasiness to have to live with fear of metastasis, 2) Being frustrated about not being able to communicate weel, 3) Annoyingness not to be able to do former life, 4) Inconvenience to have to live supporting changing function, 5) Have fear of unexpected symptoms, 6) Self-hatred for not playing a role, 7) Being uncomfortable when people look at the tracheal stoma, and 8) Needing time to reconstruct life. And the results of qualitative induction analysis identified the following twelve categories for coping methods: 1) Have mental images postoperative situation, 2) Continue treatment, 3) Switch to communication method except for speaking, 4) Eat while figuring out a good way in the daily life, 5) Soak in the bathtub until at tracheostomy and wipe out other part of body when taking a bath, 6) Buy new clothes not cover tracheostomy, 7)Replace tracheostomy tube without attachment to live, and making the airway clean, 8) Receive information about the smell from the family, 9) Consult a doctor, 10) Master coping method on his own, 11) Practice what I can now, 12) Keep usual not hiding under a cover according to his sense, 13) Brings it close to former life spending time. 'Have mental images postoperative situation' was based on other coping methods. The results clarified that, in order to allow laryngectomized patients to overcome these difficult experiences, it is important for them to have mental images of situations that they will face following surgery

Usefulness of NIRS for medication adherence

The symptoms of attention deficit hyperactivity disorder (ADHD) are inattention, hyperactivity, and impulsiveness. Physicians often prescribe methylphenidate (MPH) for children with ADHD for long periods of time. The purpose of the present study was to investigate the usefulness of near-infrared spectroscopy (NIRS) for evaluating drug effects and improvements in medication adherence in children with ADHD. Subjects were 10 male children diagnosed with ADHD : average age, 9.3 years, and 10 boys with typical development : average age 9.5 years. Children with intellectual disability, autism, and obvious depressive symptoms were excluded. The present study revealed that in the ADHD group, oxy-Hb concentrations in the left and right lateral prefrontal cortex significantly increased during the execution of the Stroop color-word test in both channels when taking MPH. This method was considered to be useful for assessing drug effects on ADHD because NIRS is an objective indicator for evaluating ADHD executive dysfunction and visualizes the activation of frontal lobe function by MPH. A pediatric neurologist explained the results of NIRS while presenting images to the ADHD group, and medication adherence and the drug-taking ratio both markedly improved. Therefore, this therapeutic explanation is an effective strategy for improving medication compliance and adherence among patients

“Reinversión por beneficios tributarios y desarrollo empresarial – caso I.E.P. Jose María Eguren, periodo 2013-2017”

La tesis titulada “Reinversión por Beneficios tributarios y desarrollo empresarial - caso I.E.P. José María Eguren, periodo 2013 al 2017”, tuvo como objetivo determinar en qué medida la reinversión derivada de los beneficios tributarios que se establece en el Decreto Legislativo 882 Ley de Promoción de la inversión en la Educación vigente al 09 de noviembre de 1996, repercute en el desarrollo empresarial de la Institución Educativa Privada materia de análisis. Se recurrió a fuentes directas de información a fin de evaluar la repercusión positiva en la calidad del servicio educativo y del desarrollo empresarial. Se desarrolló la presente tesis considerando la investigación Aplicada, proceso que comprendió la descripción, registro y análisis e interpretación del grado de relación existente entre variables de estudio. Dentro de las conclusiones se verifico que los beneficios tributarios repercute positivamente en el desarrollo empresarial de la institución educativa, una correcta aplicación de dichos beneficios repercute en menor pago de impuesto a la renta, repercute en una mejora en la infraestructura, en la adquisición de material educativo y las becas de estudio. Los promotores o accionistas de la Institución educativa por desconocimiento no aplicaron el beneficio tributario de acuerdo a lo previsto en el Decreto Legislativo Nº 882 Ley de Promoción de la Inversión en la Educación.Tesi

Accuracy of Articulation Rate Control with Visual Feedback in Persons who do and do not Stutter

AbstractThe ability to control speech rate with real-time visual feedback was compared between people who do and do not stutter (PWS/PWNS). Nine PWS and 7 PWNS participated in the study. Fifteen sentences were read aloud after repeating a played-back sentence twice in each of 6 trials at 6 different target speeds. The 6 trials comprise a session, and there were 3 sessions (A1, B, A2) with only the second session (B) accompanied by real-time visual feedback of the subject's speech rate and the target speed. The speech rate excluding pauses or dysfluencies was significantly reduced in B and A2 from that in session A1. Although there was no difference in speech rate between B and A2, (a) there was an interaction between the target rate and the group in session B, and (b) the variability in the error of the PWS was larger than that of the PWNS in the retention session (A2). These results suggests (a) that at least some of the PWS use a different strategy in controlling their speech rate than PWNS, and (b) that some of the PWS were less accurate in retaining the learned speech rate in the previous session B with visual feedback than the PWNS, although they did use the visual feedback information and learned the speech rate, to a similar averaged accuracy during the feedback

Study on the difficulties experienced in daily life by esophageal cancer patients who underwent esophagectomy

本研究の目的は,食道がん切除術を受け,自宅で生活する患者が直面している生活上の困難及びそれらへの対処の実態を明らかにすることである｡対象は,研究参加へ同意が得られた12名の外来通院中の患者とした｡対象12名の食道再建経路は, 6名が胸壁前皮下経路,6名が後縦隔経路であった｡患者の許可を得て録音した面接内容を逐語訳し,内容分析の手法を用いて質的･帰納的分析を行った｡その結果,患者は術式に関係なく,【予想をはるかに超えて苦痛と化した摂食行動】および【生活圏の狭小化】の2つの困難を抱えていることが明らかとなった｡患者は,前者には≪生きるために自分に見合った食べ方を体得する≫ ことで,後者には,≪命と引き換えに変化を受け入れる≫≪時間をかけて変化に慣れる≫ ことで対処し,術後の生活を再構築していた。The purpose of this study is to clarify the difficulties faced in daily life by patients who have undergone esophagectomy due to esophageal cancer and now reside at home, as well as the actual conditions how to cope with such difficulties. 12 patients gave their consent to participate in the study, and semi-structured interview was conducted using open-ended questions. 6 of them had undergone reconstruction of the esophagus via the subcutaneous route anterior to the thoracic wall, and the other 6 via the posterior mediastinal route. The contents of the recorded interviews were transcribed into verbatim record, and a qualitative, inductive analysis was conducted using the content analysis method. As a result, it was found that the patients were suffering from two difficulties: "that eating activities had become a far greater hardship than had been expected" and "the narrowing of social life". Patients experiencing the former difficulty dealt with it by "learning eating methods suited to them personally in order to survive" and patients experiencing the latter difficulty dealt with it by "accepting the change to save their life" or "becoming accustomed to the change slowly", and then restructure their postoperative lives