A Study to Optimize Heterogeneous Resources for Open IoT

Recently, IoT technologies have been progressed, and many sensors and actuators are connected to networks. Previously, IoT services were developed by vertical integration style. But now Open IoT concept has attracted attentions which achieves various IoT services by integrating horizontal separated devices and services. For Open IoT era, we have proposed the Tacit Computing technology to discover the devices with necessary data for users on demand and use them dynamically. We also implemented elemental technologies of Tacit Computing. In this paper, we propose three layers optimizations to reduce operation cost and improve performance of Tacit computing service, in order to make as a continuous service of discovered devices by Tacit Computing. In optimization process, appropriate function allocation or offloading specific functions are calculated on device, network and cloud layer before full-scale operation.Comment: 3 pages, 1 figure, 2017 Fifth International Symposium on Computing and Networking (CANDAR2017), Nov. 201

Plasma brain natriuretic peptide and the evaluation of volume overload in infants and children with congenital heart disease.

This study was designed to explore whether it was possible to evaluate the severity of VSD, PDA, and ASD by measuring brain natriuretic peptide (BNP) levels. We also investigated normal BNP levels in children to provide a baseline for our study. We measured BNP levels in 253 normal children, including 11 normal neonates, and in 91 VSD patients, 29 PDA patients, and 34 ASD patients. BNP levels showed no age-related differences in normal children (the mean value: 5.3 +/- 3.8 pg/ml). In the healthy neonates, BNP levels rose from 10.4 +/- 11.9 pg/ml in cord blood to 118.8 +/- 83.2 pg/ml on day 0, then fell to 15.3 +/- 7.8 pg/ml by day 7. In VSD and PDA patients, BNP levels correlated significantly with Qp/Qs, LVEDV, and peak RVP/LVP. In ASD patients, BNP levels correlated with Qp/Qs and RVEDV. Especially, in VSD patients, as an index corresponding to 1.5-2.0 of the Qp/Qs ratio, BNP levels of 20-35 pg/ml were found to be best with regard to both sensitivity and specificity. In the healthy neonates, BNP levels changed rapidly after birth. In VSD, PDA, and ASD patients, BNP levels were well-correlated with the severity of the disease. Especially, in VSD patients, it that appears BNP levels may be useful in evaluating surgical indications, with 20-35 pg/ml levels being the appropriate cut-off value.</p

The role of nurse administrators and managers in quality psychiatric care

Psychiatric healthcare services in Japan demand continuous improvement to ensure quality care. Psychiatric nurse administrators and managers greatly influence the quality of services. To improve treatment, the following are considered necessary : clarification of service goal, proper assessment of treatment outcome, shortening of hospitalization, patient-centered care, establishment of trust relationships based on open communication with patients, and effective interdisciplinary teamwork. Additionally, administrators and managers must evaluate the clinical competence of individual nurses and appropriately assign them, especially when personnel shortage is an issue. Furthermore, in collaboration with other healthcare professionals, nurse managers must provide optimal care by setting goals of psychiatric services for patients in acute, sub-acute, or convalescent phases. This article presents the roles of nurse administrators and managers in improving the quality of Japanese psychiatric healthcare services

シコク チホウ ニオケル セイシンカ ビョウイン ノ シンソツ カンゴシ サイヨウ ニ カンスル ジッタイ

It is important for psychiatric hospitals （PHs） to have experienced nurses who are interested in nursing patients with psychiatric/mental health problems. Recruitment of newly graduated nurses who share a passion for patients with these conditions is critical to both the profession and to the nurses. In doing so, it is critical that these nurses are nurtured and valued, who can show a high level of practical nursing ability. However, at present, it is difficult to employ experienced psychiatric nurses especially those newly graduated nurses. Therefore, an inquiry survey was conducted to determine the situation and condition concerning the employment of newly graduated nurses by PHs in Shikoku region. Participants were nurse administrators of PHs, institutions that are concerned with the psychiatric patient care within the Shikoku Region. There are ６２ PHs that are members of the Japanese Psychiatric Hospitals Association in the Shikoku region. Administrators of ６１ of these hospitals were provided with the survey forms, however, only ５８ survey forms were returned. Results of the survey showed that twenty-four PHs （４１．４％） have not hired any new nurses for more than several years now, and forty-six PHs （７９．３％） have not hired any new nurses in ２０１４. The PHs that hired the most new nurses hired only one to two nurses. Regarding the employment of newly graduated nurses, findings revealed that nursing administrators wanted nurses to feel attracted to psychiatric nursing and that they wanted to nurture and retain them. However, they also believed that they were not positioned to accept newly graduated nurses and that they could only accept experienced nurses. Since it is believed that the present conditions, where hiring newly graduated nurses is difficult, will continue in the future, further efforts will be required to secure jobs for new nurses

シンソツ カンゴシ ガ ニュウショク スル セイシンカ ビョウイン ノ トクチョウ

The current state of employment of nursing staff at psychiatric hospitals is beset with patient care problems such as of shortage of nurses and the increasing number of older nurses.Considering these situations, Nurse administrators in psychiatric hospitals are challenged to increase the number of younger nurses as a solution towards improving the staffing shortage thereby enhancing quality of nursing services. The purpose of this study was to clarify the characteristics of psychiatric hospitals that newly graduated nurses found to be a good place to practice their profession. A survey was conducted using a questionnaire which was provided to 277 sychiatric hospital nurse administrators. About 40％ of the 234 hospitals administrators who responded employed newly graduated nurses. Employment of newly graduated nurses was significantly related to hospitals with 200 beds or more than 200 beds or less（x2 ＝35.37～13.75,φ＝0.40～0.25, p＜0.001）. The characteristics of a psychiatric hospital where newly graduated nurse found to be a good place to practice their profession enters are as follow（: 1）Hospital Nursing staff taught courses in psychiatric nursing at the newly-graduated nurses nursing school/nursing college（ 2）The students had their clinical experience at the particular psychiatric hospital and（3）The hospital has employed a Certified Nurse Specialist or Certified Nurse in Psychiatric Mental Health Nursing. A useful approach to the employment of newly graduated nurses in psychiatric hospitals were suggested as follow（: 1）To establish a procedure in which the essence and appeal of psychiatric nursing are recognized, such as promoting psychiatric clinical practice settings and providing staff to conduct lectures at particular nursing education institutions and（2）To nurture and recognize nurses who have become excellent role models

精神科病院の看護職員の獲得のための魅力ある職場環境の特徴

Purpose: The purpose of this study is to identify characteristics of work environments in psychiatric hospitals which are appealing to nurses. Understanding characteristics of work environments of psychiatric hospital nurses can lead to attracting nurses to work in this environment, thereby increasing human resources and alleviating nurse-staffing problems. Methods: Questionnaire copies focusing on staffing shortages of nurses in psychiatric hospitals were provided to 277 psychiatric hospital nurse administrators in Japan from May-April 2016. Data analyses included descriptive and multivariate statistics. Factor analysis together with the Kaiser-Meyer-Olkin and the Bartlett’s test of Sphericity were used to assess adaptive validity. Factor loadings were set at 0.4 or more for the configuration of items, while internal consistency and reliability of the assessment data scores were done using Cronbach’s alpha coefficient. Mean factor points were calculated and student's t-test and one-way analysis of variance were performed. Significance probability level was set at 0.001. Results: Factor analysis revealed nine factors: (1) Educational system, (2) Reputation at hospitals, (3) Support system for acquisition of certificate of clinical nurse specialist/certified nurse, (4) Reputation at hospitals as places of employment, (5) Knowledge of nursing philosophy and of culture of working places, (6) Reputation of teaching for students’ clinical practice, (7) Working hours and leave privileges, (8) Salary and other allowances, (9) Support system for license acquisition. Data revealed that nurse administrators who employed new graduate registered nurses found their hospitals' attractive points were: educational system, support system to acquire certificate of clinical nurse specialist, reputation of hospital as place of employment, knowledge of nursing philosophy and culture of working places, teaching students' clinical practice, and salary and other allowances. Conclusion: Nurse administrators who have no difficulty recruiting nursing staff recognized that their hospital environments were considered appealing based on working hours and leave privileges

The Development of the Perceived Inventory of Technological Competency as Caring in Nursing

The purpose of this research was to develop the Perceived Inventory of Technological Competency as Caring in Nursing（PITCCN）for Intensive Care Unit（ICU）nurses. The inventory has twenty three item statements derived from Locsin’s theory on caring. The research study received approval from the University of Tokushima Hospital Clinical Study Ethical Review Board （Approval No.２５８５）. The time frame was from September２０１６to November２０１６. Copies of the Inventory were sent to４２６ICU nurses working in hospitals in Japan. Only３０８questionnaire copies were returned with no missing value（response rate was７２％）. Factor analysis（principal factor analysis, varimax rotation）, the Kaiser-Meyer-Olkin（KMO）and the Bartlett’s test of Sphericity were used to assess the adaptive validity of the factor analysis. Factor loadings were set at０．４or more for the configuration of items. Internal consistency and reliability were established using Cronbach’s alpha coefficient. Statistical significance was at０．０５level. Four factors were extracted and labelled as（１）Training of nurses to provide optimal care,（２）empirical knowledge and whole human knowing,（３）Utilization of information obtained from technology and continuous knowing, and（４）Intentional and ethical nursing of persons. Cronbach’s alpha was ０．８９４ for the questionnaire（２０ items）and ０．８６９, ０．８７２, ０．８７６, and ０．７３４, for the four factors respectively. This showed that the over-all data obtained high internal consistency for each factor. The KMO sample adequacy was０．８８and the Bartlett’s test of sphericity was p＜０．００１. These results showed that the Perceived Inventory of Technological Competency as Caring in Nursing was reliable

日本の精神科病院における患者に対する看護に必要なアセスメント分類システムの開発

The purpose of this study was to develop the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS)©. This study used the on-line survey method from February to April 2015. There were 644 respondents comprised of professional nurses with minimum qualification of 3 years’ experience being in a psychiatric unit of a stand-alone 200-bed or more Psychiatric Hospital in Japan. Assessment items were derived from 211 specific items selected from nursing textbooks, excluding the North-American-Nursing-Diagnosis-Association (NANDA). The questionnaire contained Cover Letter, Demographic Data Sheet, and the PsyNACS© questionnaire. There were 644 questionnaires accessed but only 435 were completed and valid. Item levels of importance were evaluated: 1) Unnecessary, 2) Not very important, 3) Important and 4) Very important. Data analysis used descriptive and multivariate statistics. Factor analysis (principal factor analysis, varimax rotation), the Kaiser-Meyer-Olkin (KMO) and the Bartlett’s test of Sphericity assessed the adaptive validity of the factor analysis. Factor loadings were set at 0.4 or more for the configuration of items. Internal consistency and reliability were established using Cronbach’s alpha coefficient. Mean factor points were calculated, including standard deviation, range, and confidence interval at 95%. Statistical significance was at 0.05 level. Nine Patient Assessment Data (PAD) with 2 to 5 Cluster Assessment Data (CAD) each were categorized. Thirty one CADs comprised the Patient Assessment Data: (PAD1) Psychological symptom and stress, (PAD2) Information about treatment, (PAD3) Function of eating and balance of water, (PAD4) Life and value, (PAD5) Vital signs and health assessment, (PAD6) Self-care, (PAD7) Social support, (PAD8) Activity, sleeping and mobility capability, and (PAD9) Sexual function and sexual behavior. The PsyNACS© is a classification of items assessing health care needs within the Japanese psychiatric nursing care environment, and also can be used in various psychiatric patient care situations in all psychiatric units