Factorial Structure of Nursing Practices Related to Support for Decision-Making Regarding Consent for Surgery in Elderly Patients with Dementia

Background: When elderly patients with dementia require highly invasive treatment or surgery for life-threatening conditions, decisions regarding consent for surgery are made based on informed consent provided by the family, which excludes the patient whose decision-making ability is deemed impaired due to the dementia. This study aimed to clarify the factorial structure of nursing practices related to support for decision-making regarding consent for surgery in elderly patients with dementia. Methods: An anonymous self-administered questionnaire survey was completed by nurses with three or more years of experience working in orthopedic surgery wards at secondary emergency hospitals in the Kinki area. The survey collected data on participant attributes and nursing practices related to decision-making support. Data were analyzed by exploratory factor analysis (promax rotation) using nursing practice items related to decision-making support as variables. Internal consistency was examined. Results: Participants were 112 nurses including 108 women (96.4%) and four men (3.6%), with a mean age of 38.3 (±SD 9.8) years. Exploratory factor analysis of the nursing practice items related to decision-making support demonstrated the validity of the observed 24 variables, with a Kaiser-Meyer-Olkin value of 0.858 and a significant Bartlett’s test of sphericity (P < 0.001). Five components with eigenvalues of 1 or more were extracted, including “achieving advocacy for elderly patients with dementia through cooperation among medical professionals,” “advice considering the lifestyles and values of patients and their families,” “support with a deeper understanding of elderly patients with dementia,” “support that helps elderly patients with dementia to express their intentions,” and “nurses’ attendance in IC sessions for elderly patients with dementia.” The Cronbach’s α coefficient for the 24 nursing practice items related to decision-making support was high, at 0.926. Conclusion: The factorial structure of nursing practice related to support for decision-making regarding consent for surgery in elderly patients with dementia included five factors and 24 items. The reliability and construct validity of the factorial structure were also confirmed

The effects of color stimulus on autonomic nervous system activity and subjective arousal state

Aim: This research examines the hypothesis that colors adopted for the home environment impact autonomic nervous system activity and subjective arousal.MethodsSubjects: Seventeen healthy adult women consented to participate in this research project.Experimental requirement: A room at our school, built to simulate a model standard home. We changed only the color of the tablecloth. For the colors used in the experiment, we used chromatic colors from the Munsell hue circle. We selected red, yellow and blue with high chroma. For the achromatic colors, we selected black and white.Measurement item: 1) Autonomic nervous system activity evaluation index: The evaluation was HF and LF/HF. 2) Subjective awareness: We collected data using the Japanese UWIST Mood Adjective Checklist ( JUMACL ). Outcomes are Tense Arousal ( TA ) and Energetic Arousal ( EA ). Before and after subjects looked at each color, we collected the data. And after five experiments with each subject, we asked each which of the five colors had the highest degree of impact on her consciousnessResultsAutonomic nervous system activity evaluation index: 1) HF: HF value decrease was significantly in black. 2) LF/HF:The proportional increase was significant in black and white, and activation of sympathetic nervous system activity was found. Yellow also showed a marginal significance.Subjective arousal (JUMACL) : A pre- and post-trial comparison of TA scores showed that post-trial scores were significantly lower for blue and white. The post-trial EA scores were significantly lower for all colors except red.Conclusions: Significant activation of autonomic nervous system activity was found in an object that was commonly used in daily life, a tablecloth in black, yellow, or white. At the same time, colors except red have a tension reducing effect. We believe that color stimulation can use to adjust physical and mental activity in daily nursing

Horikawa Sen-Nin Chosatai(HSC) (Horikawa River Thousand-Citizen Survey Network 2010)

Source: ICHE Conference Archive - https://mdi-de.baw.de/icheArchiv

Host genetics highlights IFN-γ-dependent Toxoplasma genes encoding secreted and non-secreted virulence factors in in vivo CRISPR screens

Secreted virulence factors of Toxoplasma to survive in immune-competent hosts have been extensively explored by classical genetics and in vivo CRISPR screen methods, whereas their requirements in immune-deficient hosts are incompletely understood. Those of non-secreted virulence factors are further enigmatic. Here we develop an in vivo CRISPR screen system to enrich not only secreted but also non-secreted virulence factors in virulent Toxoplasma-infected C57BL/6 mice. Notably, combined usage of immune-deficient Ifngr1−/− mice highlights genes encoding various non-secreted proteins as well as well-known effectors such as ROP5, ROP18, GRA12, and GRA45 as interferon-γ (IFN-γ)-dependent virulence genes. The screen results suggest a role of GRA72 for normal GRA17/GRA23 localization and the IFN-γ-dependent role of UFMylation-related genes. Collectively, our study demonstrates that host genetics can complement in vivo CRISPR screens to highlight genes encoding IFN-γ-dependent secreted and non-secreted virulence factors in Toxoplasma.Tachibana Y., Hashizaki E., Sasai M., et al. Host genetics highlights IFN-γ-dependent Toxoplasma genes encoding secreted and non-secreted virulence factors in in vivo CRISPR screens. Cell Reports 42, 112592 (2023); https://doi.org/10.1016/j.celrep.2023.112592

Tumor-targeting Salmonella typhimurium A1-R prevents experimental human breast cancer bone metastasis in nude mice.

Bone metastasis is a lethal and morbid late stage of breast cancer that is currently treatment resistant. More effective mouse models and treatment are necessary. High bone-metastatic variants of human breast cancer cells were selected in nude mice by cardiac injection. After cardiac injection of a high bone-metastatic variant of breast cancer, all untreated mice had bone metastases compared to only 20% with parental cells. Treatment with tumor-targeting Salmonella typhimurium A1-R completely prevented the appearance of bone metastasis of the high metastatic variant in nude mice (P &lt; 0.001). After injection of the highly bone-metastatic breast cancer variant to the tibia of nude mice, S. typhimurium A1-R treatment significantly reduced tumor growth in the bone (P &lt; 0.001). These data indicated that S. typhimurium A1-R is useful to prevent and inhibit breast cancer bone metastasis and should be of future clinical use for breast cancer in the adjuvant setting

Inhibition of spontaneous and experimental lung metastasis of soft-tissue sarcoma by tumor-targeting Salmonella typhimurium A1-R.

Prognosis of patients with lung metastases of soft-tissue sarcoma is still poor. Therefore, novel systemic therapy is needed to improve the survival of soft-tissue sarcoma. In the present study, tumor-targeting therapy with a genetically-modified auxotrophic strain of Salmonella typhimurium, termed A1-R, was evaluated. Mouse models of primary soft tissue sarcoma and spontaneous lung metastasis were obtained by orthotopic intra-muscular injection of HT1080-RFP human fibrosarcoma cells. S. typhimurium A1-R was administered from day 14, once a week for two weeks. On day 28, lung samples were excised and observed with a fluorescence imaging system. The number of lung metastasis was 8.8 ± 3.4 in the untreated group and 0.8 ± 0.8 in the treated group (P = 0.024). A mouse model of experimental lung metastasis was obtained by tail vein injection of HT1080-RFP cells. The mice were treated with S. typhimurium A1-R (i.v.) on day 7, once a week for three weeks. S. typhimurium A1-R significantly reduced lung metastases and improved overall survival (P = 0.004). S. typhimurium A1-R bacterial therapy has future potential for treating advanced soft tissue sarcoma and improving prognosis of patients with lung metastasis

The meaning of life for an elderly man living alone : a narrative approach

Aim: To improve nursing care for the elderly in order to allow them to live independently. This study has used the narrative of an elderly man to learn about what has given his life meaning.Method: Fifteen key concepts were extracted from interviews using the narrative approach.Results and Conclusions: Mr. A, now near the end of his life, has found meaning in living his life, not only for himself, but also for those around him. The elderly support their own physical and mental health,and adjust to day-to-day life. Nursing care for the elderly should watch for and support these self-supporting efforts

Análise espacial de condições de estresse em galpão de frango de corte usando ventilação tipo túnel

Broiler building typology associated with the local characteristics (climate, topography and surrounding vegetation) and handling systems (stocking density, curtains, equipment and nutrition) influence the inside environment. A spatial distribution analysis of these conditions may indicate stress zones in the house. The aim of this research was to apply spatial analysis of thermal, aerial and acoustic environmental conditions inside a tunnel ventilated broiler housing, with a stocking density of 18 birds m-2. This study was carried out in Rio Claro, SP, Brazil, in a 12 m &times; 115 m house divided into three equal sections (East, center and West), East-West oriented, and virtually divided on 132 cells, each one measuring 3.0 m &times; 3.5 m. At the geometric center of each cell the following variables were monitored: dry bulb temperature, relative humidity, air velocity, noise level and light intensity. Average broiler mortality was recorded in each of the three sections. Data collection was made systematically from West to East, opposite to the air flow produced by the tunnel ventilation system, during the warmest period of the day. Measurements took place during the sixth week of production. A geostatistics software tool was used to build spatial distribution maps of the recorded variables in order to infer intermediate stress conditions. It was concluded that the stress zones were located at both ends of the house and the highest mortality index was found at the West sector where the exhaust fans were placed.A tipologia de edificações para abrigo de frangos de corte associada a características do local (clima, topografia e vegetação dos arredores) e os sistemas de manejo (densidade de aves, cortinas, equipamentos e nutrição) influencia as condições internas. A distribuição espacial destas variáveis pode indicar zona de estresse dentro do galpão. O objetivo da pesquisa foi aplicar a análise espacial das condições do ambiente térmico, aéreo e acústico dentro de galpão de produção de frango de corte, usando sistema de ventilação tipo túnel e densidade de 18 aves m-2. O estudo foi conduzido em Rio Claro, SP, em uma edificação com 12 m &times; 115 m, dividida em três setores (leste, centro e oeste), orientada leste-oeste, contendo virtualmente 132 células, cada uma medindo 3,0 m &times; 3,5 m. No centro geométrico de cada célula as seguintes variáveis foram medidas instantaneamente: temperatura de bulbo seco, umidade relativa, velocidade do ar, nível de ruído e intensidade de luz. Os dados foram coletados sistematicamente a partir do lado oeste para o lado leste, em direção oposta ao fluxo de ar produzido pela ventilação tipo túnel, no período mais crítico do dia. As medidas foram tomadas quando as aves estavam na sexta semana de produção. A mortalidade média dos frangos foi registrada nos três setores. A ferramenta geostatística foi usada para construir mapas de distribuição espacial das variáveis resultantes de maneira a possibilitar a inferência de posições intermediárias. Concluiu-se que as zonas de estresse estão localizadas nos extremos do galpão e o maior índice de mortalidade foi encontrado no setor oeste, onde estavam os exaustores

A Case of Liposarcoma With Peritonitis Due to Jejunal Perforation

A 21-year-old man, who had been treated for congenital dilatation of the bile duct 13 years previously, presented with an acute abdomen. The physical examination suggested peritonitis, and an emergent laparotomy was performed. A perforation was foundin the jejunum approximately 100 cm distal to the ligament of Treitz, followed by resection of a 60-cm jejunal segment. No tumorous lesions were found during the operation, and the resected jejunal segment showed only focal myxomatous thickening of the serosa. Despite intensive therapy, he died of uncontrollable septic shock 2 days after the operation. Unexpectedly, however, histological examination revealed a liposarcoma, showing an unclassifiable histology. From the distribution of the lesion and the histological findings, it is thought that a primary lesion was somewhere else, covered by severe adhesions due to the previous operation, and that the tumor cells spreading from it could have caused the jejunal perforation through vascular involvement. Although extremely rare, liposarcomas in the abdomen can cause intestinal perforation. It is important for both clinicians andpathologists to carefully investigate the cause of an unusual clinical presentation such as intestinal perforation