Aspects of advanced beginner’s reflection on their experience in clinical practice: Analysis of interviews with post-graduate nurses in third years

This study investigated the aspects of reflection on clinical practice of advanced beginners and examined factors that facilitate reflection. We conducted semi-structured individual interviews with selected post-graduate third year nurses who took a reflection training course at Tottori University Hospital. The data were analyzed using a qualitative synthesis method. Advanced beginners made use of their learning experience in reflection, kept in mind “independent learning”, and deepened their own reflection with the support of senior nurses in“ a safe place to talk”．Reflection provided“ deeper self-understanding” and“ giving new meaning through others’ involvement” and advanced beginners gained“ a sense of growth” by applying what they learned to “returning to practice”．In addition, through the role of preceptor, advanced beginners were able to experience “going back to basics” and remember the learning from past experiences, which led to “return to practice”．Also, advanced beginners tried to provide “a safe place to talk” for beginners. In order to promote reflection among advanced beginners, it was suggested that it is necessary to create an image of a target nurse, the presence of others who support reflection, the workplace culture in providing a safe place to talk, and learning reflection from basic nursing education

Impact of individual factors and personality trait on psychological problems of family members living with staff of a COVID‐19 frontline hospital: A cross‐sectional self‐administered anonymous questionnaire survey

Abstract Aim This study aims to evaluate the association between individual factors/personality traits and depression and anxiety in family members living with staff working on the frontline of COVID‐19 care. Methods The subjects were family members over the age of 15 years living with staff members of a COVID‐19 frontline hospital. Between March 27 and April 11, 2021, 204 self‐administered anonymous questionnaires were distributed, and 149 responses were received. Symptoms of depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS). Personality trait was assessed using the Big Five personality traits, and fear of COVID‐19 was assessed using the Fear of COVID‐19 Scale. We examined associations between HADS depression or anxiety scores with individual background factors, scores of Big Five personality traits, and Fear of COVID‐19 Scale. Results The participants with anxiety had significantly higher scores for neuroticism and for the Fear of COVID‐19 Scale. The participants with depression had significantly lower scores for extraversion and higher scores for the Fear of COVID‐19 Scale. No individual background factors were significantly associated with HADS depression or anxiety scores. Conclusion Among family members of staff of a COVID‐19 frontline hospital, lower extraversion, higher neuroticism, and fear of COVID‐19 were associated with anxiety and depression. This questionnaire survey was conducted before wide‐spread rollout of COVID‐19 vaccination, so the findings of this study are expected to be applicable to other future novel infectious outbreaks

All primitive and definitive hematopoietic progenitor cells emerging before E10 in the mouse embryo are products of the yolk sac

The relative contribution of yolk sac (YS)–derived cells to the circulating definitive hematopoietic progenitor cell (HPC) pool that seeds the fetal liver remains controversial due to the presence of systemic circulation and the onset of hematopoiesis within the embryo proper (EP) before liver seeding. Ncx1−/− embryos fail to initiate a heartbeat on embryonic day (E) 8.25, but continue to develop through E10. We detected normal numbers of primitive erythroid progenitors in Ncx1−/− versus wild type (WT) YS, but primitive erythroblasts did not circulate in the Ncx1−/− EP. While there was no significant difference in the number of definitive HPCs in Ncx1−/− versus WT YS through E9.5, the Ncx1−/− EP was nearly devoid of HPCs. Thus, primitive erythroblasts and essentially all definitive HPCs destined to initially seed the fetal liver after E9.5 are generated in the YS between E7.0-E9.5 and are redistributed into the EP via the systemic circulation

Characterizations of a neutralizing antibody broadly reactive to multiple gluten peptide:HLA-DQ2.5 complexes in the context of celiac disease

Abstract In human celiac disease (CeD) HLA-DQ2.5 presents gluten peptides to antigen-specific CD4+ T cells, thereby instigating immune activation and enteropathy. Targeting HLA-DQ2.5 with neutralizing antibody for treating CeD may be plausible, yet using pan-HLA-DQ antibody risks affecting systemic immunity, while targeting selected gluten peptide:HLA-DQ2.5 complex (pHLA-DQ2.5) may be insufficient. Here we generate a TCR-like, neutralizing antibody (DONQ52) that broadly recognizes more than twenty-five distinct gluten pHLA-DQ2.5 through rabbit immunization with multi-epitope gluten pHLA-DQ2.5 and multidimensional optimization. Structural analyses show that the proline-rich and glutamine-rich motif of gluten epitopes critical for pathogenesis is flexibly recognized by multiple tyrosine residues present in the antibody paratope, implicating the mechanisms for the broad reactivity. In HLA-DQ2.5 transgenic mice, DONQ52 demonstrates favorable pharmacokinetics with high subcutaneous bioavailability, and blocks immunity to gluten while not affecting systemic immunity. Our results thus provide a rationale for clinical testing of DONQ52 in CeD