看護技術における洗髪時の体位が対象の心身に及ぼす影響に関する文献検討

To shed light on previous research trends and future challenges regarding the effect of body position during hair washing on the mental and physical state of the subject, we conducted a literature review on “body position during hair washing” and “the effect on the mental and physical state of the subject of hair washing based on the body position during that process.” Using an online repository of major medical journals (Igaku Chuo Zasshi—WEB), we performed a search for “hair washing” and “body position or posture” without specifying a date range. When we excluded conference proceedings, meeting minutes, reviews, and commentaries and focused on papers describing the mental and physical effects on the subject of hair washing, we found 24 relevant papers. The results of our analysis revealed the following: 1) half of the research subjects were in a healthy group and half were in a disease group, with the most common conditions of those in the latter group being heart disease, threatened premature delivery/miscarriage, and anemia; 2) the body position used the most during hair washing was the supine position; 3) measurement variables were related to objective and subjective aspects, with the most common objective variables being pulse, heart rate, blood pressure, and the electromyogram, whereas the most common subjective variables were suffering, exhilaration,and fatigue; and 4) in patient subject groups, subjective factors, objective factors, and adjustments in the hair washing position according to the patientʼs illness or condition were used to investigate the physical and mental effects on the patient.Based on the trends in prior studies, it is hoped that in the future, there will be an increase in the amount of clinical data and further investigations toward generalization.洗髪の体位が対象者の心身に及ぼす影響について、これまでの研究結果と今後の課題を明らかにすることを目的とし、「洗髪の体位」と「その体位で洗髪をした際、洗髪を受ける対象者の心身に及ぼす影響」に関する文献検討を行った。医学中央雑誌WEB 版を用いて発行年の制限は行わず、「洗髪」、「体位or 姿勢」でキーワード検索を行い、会議録、議事録、総説、解説を除き、洗髪を受ける対象者の心身への影響を扱った文献に絞ったところ、24 件が該当した。結果、1）研究対象者は、健康群と疾患群、半数ずつであり、疾患群としては、心疾患、切迫流早産、貧血の割合が多かった、2）洗髪体位として、仰臥位を選択している研究が多かった、3）測定項目は客観的指標と主観的指標があり、客観的指標では脈拍、心拍数、血圧、筋電図が、主観的指標では苦痛、爽快感、疲労感の割合が多かった、4）研究内容では、疾患群において対象の疾患や状態に合わせた洗髪の体位や主観的・客観的指標から、患者の心身への影響を検討していた。今後、これら先行研究における検討結果を踏まえ、さらに、実際に洗髪援助が必要な者を対象として臨床などにおいてデータ数を増やし一般化に向け検討を行うことが必要であると考えられた。論

ガイライ カガクリョウホウ ヲ ウケル カンジャ ニ トッテ ノ アクセイ リンパシュ ト トモ ニ イキル タイケン

原

放射線皮膚炎に対するスキンケアに関する文献レビュー

The aim of this study was to identify future challenges and trends of Japanese nursingrelated research to date regarding skin care for radiotherapy-induced dermatitis.We conducted a literature review on “skin care” performed by nurses for radiation dermatitis. Using an online repository of major medical journals (Igaku Chuo Zasshi ―WEB), we performed a search for “radiation therapy”, “dermatitis” (or “radiation dermatitis”), and “skincare” without specifying a date range. When we excluded conference proceedings and meeting minutes and focused on papers describing nursing, we found 14 relevant papers.The results of our analysis of these papers revealed the following:1) There were six case studies (42.9%), and many papers dealt with head and neck cancer patients.2) In terms of observation and evaluation items, there were eight papers (64.3%) that used the Common Terms for Adverse Events (CTCAE ver.4, Japanese translation JCOG version) as is; 14 (100.0%) that used skin conditions, such as redness, erosion, dryness, and desquamation as evaluative items; and 11 (78.6%) that observed subjective patient symptoms, such as pain and itching.3) Regarding skin care, there were 11 papers (78.6%) relating to washing, with many describing specific washing methods, such as, “Wash using low pH soap,” “Use soap that has been lathered well,” Rinse with warm water,” and “Wash by gently stroking and not rubbing.” There were 12 papers (85.7%) relating to moisturizing and wound management.4) Although there were many papers that stated that carrying out skin care improved dermatitis and prevented worsening, there was scant evidence illustrating such results.There is a need to investigate evaluative methods and increase the number of case studies in the future in order to make it possible for nurses to deliver skincare suited to the patient’s condition; based on accurate observation and assessment; and in accordance with radiation dermatitis skin conditions, attributes of radiation dermatitis patients, and risk factors. It is hoped that we will build evidence in terms of skin care for radiation dermatitis.放射線療法により引き起こされる皮膚炎に対するスキンケアついて、これまでわが国で検討されている看護に関連した研究の傾向や今後の課題を明らかにすることを目的とし、放射線皮膚炎に対するスキンケアについて文献検討を行った。具体的には、医学中央雑誌WEB 版を用いて発行年の制限は行わず、「放射線療法」、「皮膚炎」、（または、「放射線皮膚炎」）、「スキンケア」でキーワード検索を行い、会議録、議事録を除き、看護に関連する文献に絞ったところ、14件が該当した。　結果、以下のことが明らかとなった。１）症例研究が６件（42.9％）を占めた。頭頸部がん患者を扱った文献が多かった。２）放射線皮膚炎の観察・評価項目は、有害事象共通用語基準（CTCAE ver.4、日本語訳JCOG 版）におけるGrade 分類をそのまま活用していた文献が８件（57.1％）、「発赤」、「びらん」、「乾燥」、「落屑」など皮膚の観察状態を評価項目として活用していた文献は14件（100.0％）、「疼痛」、「掻痒感」などの患者の自覚症状を観察していた文献は11件（78.6％）であった。３）スキンケアは、洗浄に関する文献が11件（78.6％）であり、その洗浄方法では「弱酸性の刺激の少ない洗浄剤（または石鹸）で洗う」「ぬるめのお湯で流す」、「擦らず撫でるように洗う」といった基本的な洗浄方法について記述されている文献が多かった。保湿や創傷管理に関する文献は12件（85.7％）であった。４）スキンケアを実施することで、皮膚炎の改善や悪化を防ぐことができたと記述している文献は12件（85.7％）と多かったが、その成果を示す根拠は乏しかった。　今後、放射線皮膚炎の患者の属性やリスク要因、放射線皮膚炎の皮膚状態に応じて、看護師が的確な観察やアセスメントを行った上で、患者の状態に合わせたスキンケア方法が実施できるように、さらに症例数を増やし評価方法を検討することが必要であると考えられた。放射線皮膚炎に対するスキンケアにおけるエビデンスの構築が求められる。論

看護学生が臨床場面を観察する時のアセスメント力を視覚情報から可視化する試み

Objective：To investigate whether the assessment capabilities of nursing students can be clarified from the observation contents of a questionnaire-based survey and the descriptive contents of thought processes using visual information to visualize the trajectories of their cognitive processes for patient observation.　Methods：Still images of model dummies receiving oxygen therapy and fluid therapy were shown to five third-year nursing college students who had taken all courses prior to practical training in different areas of nursing，and gaze measurements and a questionnaire-based survey were conducted.　Results：The students fixed their gazes the longest and the most frequently on intravenous（ IV）infusions，followed by oxygen inhalation and aspiration. Gaze trajectories followed a pattern of first looking at the face，perfunctorily checking all areas，and then carefully looking at each area considered necessary for observation，such as IV infusions，oxygen inhalation and aspiration. Four of the five students began by looking at the face and all of the students stopped to observe IVinfusions，oxygen inhalation，and aspiration for 2 seconds or longer.　In the studentsʼ descriptions of IV infusions，on which students fixated the longest and the most frequently，four students described noticing that “an IV infusion was attached” and thought that “drugs and other fluids were being fed into the body,” “a risk of IV infusion-related complications existed,” and “they would check for loosening of the needle or any bleeding.” Furthermore，“infusion management” and “ensuring reliable IV infusion management and an IV route” were described by the students as necessary support.　Discussion：The students surveyed in this study appeared to recognize that oxygen inhalation and IV infusions are areas that must be observed. Current practical training in nursing is aprocess of acquiring knowledge and experience; however，the findings of this study suggest that “the ability to anticipate,” “the ability to estimate safety and pain,” and “the ability to predict risks” are also being nurtured in students. These abilities allow students to use observations to recognize problems，such as the possibility that an IV needle may have come loose or that a patient may be receiving insufficient oxygen.The assessment capabilities of nursing students could conceivably be understood by visualizing the gazes fixed on focused images　and analyzing in conjunction with the observation contents of a questionnaire-based survey and the descriptive contents of thought processes. 　Increasing opportunities for students to observe nursing care through clinical images and increasing experiences that confirm knowledge，skills，and coping strategies that are necessary together with teachers could enhance studentsʼ assessment capabilities.目　的：本研究の目的は，動作を伴う視線計測に関する先行研究から，視線の測定方法，分析方法，対象者数の妥当性を明らかにすることである。方　法：文献の選定には，CiNii Articles，医学中央雑誌Web 版（Ver.5），Medical Online を用い，キーワードは「視線計測」「アイマークレコーダ」「注視」とした。得られた文献のうち，選定基準に合致した文献23 件を分析対象とした。帰納的に内容を分析し，機器の条件設定，対象者数，分析指標等をマトリックスシートに整理し，視線の測定方法や分析方法の妥当性を検討した。結　果：視線計測機器の条件設定において，眼球運動の測定には瞳孔角膜反射法が多く用いられており，視野カメラレンズには水平角92°のレンズが最も多く用いられていた。対象者と分析処理方法について，対象者5 名以下では視線パターンを把握することを目的としており，統計的検定は行われていなかった。一方で，11 名以上を対象とした文献では，若齢者と比較した高齢者の視線，非熟練者と比較した熟練者の視線の特徴を統計学的検定から明らかにしていた。分析指標としては「注視時間」「注視回数」「注視項目変化表」「視線軌跡」が多く用いられていた。考　察：動作を伴う視線計測から熟練者の技の可視化，新人看護師や看護学生の技術習得，患者教育に繋げるためには，モバイル型視線計測機器を用い，動作環境に合わせた視野カメラレンズ，キャリブレーション方法を選択する必要がある。また，10 名以上を対象とした注視時間や注視回数の比較，注視項目変化表の分析より，動作中の思考や認知のプロセスを推定することが可能になると示された原

2020 年におけるCOVID-19 の状況と看護学部の臨地実習への対応

教育活動報

Search for eccentric black hole coalescences during the third observing run of LIGO and Virgo

Despite the growing number of confident binary black hole coalescences observed through gravitational waves so far, the astrophysical origin of these binaries remains uncertain. Orbital eccentricity is one of the clearest tracers of binary formation channels. Identifying binary eccentricity, however, remains challenging due to the limited availability of gravitational waveforms that include effects of eccentricity. Here, we present observational results for a waveform-independent search sensitive to eccentric black hole coalescences, covering the third observing run (O3) of the LIGO and Virgo detectors. We identified no new high-significance candidates beyond those that were already identified with searches focusing on quasi-circular binaries. We determine the sensitivity of our search to high-mass (total mass M>70 M⊙) binaries covering eccentricities up to 0.3 at 15 Hz orbital frequency, and use this to compare model predictions to search results. Assuming all detections are indeed quasi-circular, for our fiducial population model, we place an upper limit for the merger rate density of high-mass binaries with eccentricities 0<e≤0.3 at 0.33 Gpc−3 yr−1 at 90\% confidence level

Ultralight vector dark matter search using data from the KAGRA O3GK run

Among the various candidates for dark matter (DM), ultralight vector DM can be probed by laser interferometric gravitational wave detectors through the measurement of oscillating length changes in the arm cavities. In this context, KAGRA has a unique feature due to differing compositions of its mirrors, enhancing the signal of vector DM in the length change in the auxiliary channels. Here we present the result of a search for U(1)B−L gauge boson DM using the KAGRA data from auxiliary length channels during the first joint observation run together with GEO600. By applying our search pipeline, which takes into account the stochastic nature of ultralight DM, upper bounds on the coupling strength between the U(1)B−L gauge boson and ordinary matter are obtained for a range of DM masses. While our constraints are less stringent than those derived from previous experiments, this study demonstrates the applicability of our method to the lower-mass vector DM search, which is made difficult in this measurement by the short observation time compared to the auto-correlation time scale of DM

Uniparental inheritance of chloroplast DNA is strict in the isogamous volvocalean Gonium.

A problem has remained unresolved regarding the exceptions to the unilateral inheritance of chloroplast DNA (cpDNA) from MT+/female in Chlamydomonas and other volvocaleans demonstrated by the previous genetic analyses. For identification of the parental types of cpDNA, these studies used parents that have differences in restriction fragment length polymorphisms and exhibit partial sexual incompatibility.In the present study, we used sexually compatible parents of the isogamous colonial volvocalean Gonium maiaprilis that seemed an ideal species to identify the pattern of cpDNA inheritance based on the length difference in the putative group I intron interrupted in the Rubisco large subunit gene and objective identification of mating types by the presence or absence of the minus-dominance (MID) gene. We examined patterns of inheritance of cpDNA and presence/absence of a MID ortholog (GmMID) in 107 F(1) progeny of G. maiaprilis that were obtained by inducing germination of separated single zygotes. The results demonstrated no exception of the uniparental inheritance of cpDNA from the MT+ parent (lacking GmMID) in sexually compatible or genetically less divergent strains of G. maiaprilis.The present data suggest that the uniparental inheritance of cpDNA is likely more strict in crossings of less diverged strains or sexually compatible parental volvocaleans, and some genetic inconsistency between the parents may cause exceptional uniparental inheritance of cpDNA