The Effect of Inter-professional Education on Health Science Students

It is important that inter-professional team work is established as the cooperation and collaboration of members in order to provide high-quality care. The purpose of this research was to describe the changes in the awareness of students in nursing science and radiological science regarding their clinical practice activities of body positioning and transfer care through interprofessional education. In ２０１５, first grade nursing students and third grade radiological students in a local university jointly practiced changing body positions and transfer care of patients. They answered a fourteen-item questionnaire about inter-professional education before and after the changing activities. This research was approved by the Clinical Research Ethics Review Committee of the Tokushima University Hospital. Of the １０５ questionnaire copies distributed, １０２ copies were returned but only ８９ copies were complete with no missing values and were analyzed using the paired t-test statistic. Inter-professional education provided the following effects : understanding of the ethics of other professions, understanding rational behavior of other occupations, usefulness of educational conference, the necessity of trusting other occupations, understanding the need to work hard on their own jobs, understanding mutual and complementary work, awareness of incompetence, awareness of the importance of team approach, and the usefulness of multi-disciplinary cooperative practice. This study illuminated the necessity of providing opportunities for engagements among students of other professions through lectures and practice of skills using inter-professional education values prior to professional practice in the hospital

急性期脳卒中ユニットにおける脳卒中ケアの看護師の認識と実際の看護実践状況 : 日本の横断的Webベースのアンケート調査

The awareness of care provided by stroke care unit (SCU) nurses in Japan to patients with an acute cerebrovascular accident (CVA) and the characteristic differences in their actual nursing practice were evaluated. A cross-sectional web-based questionnaire survey was administered to 1040 SCU nurses. Data collection and reporting procedures followed the STROBE Statement Checklist for cross-sectional studies. Exploratory factor analysis, using 52 observation items, identified eight factors with a factor loading > 0.4. For all factors, the actual practice was significantly lower than the awareness of the importance of nursing care for patients with acute CVA. Awareness and actual practice of recognition of patients’ physical changes (RPPCs) were high. The actual practice of RPPCs and preventing the worsening of acute stroke and related symptoms varied, depending on years of experience in acute phase stroke care. RPPCs in actual practice had a significantly higher score among certified nurses or certified nurse specialists. Their awareness of the importance of collaborating with therapists was low. On-the-job training can improve nurses’ competence and prevent worsening conditions in patients with CVA. An emphasis on enhancing practice experience toward patients with acute CVA and facilitating the deployment of certified nurses in SCUs can improve nursing care practice

Uncertainty in action-value estimation affects both action choice and learning rate of the choice behaviors of rats

The estimation of reward outcomes for action candidates is essential for decision making. In this study, we examined whether and how the uncertainty in reward outcome estimation affects the action choice and learning rate. We designed a choice task in which rats selected either the left-poking or right-poking hole and received a reward of a food pellet stochastically. The reward probabilities of the left and right holes were chosen from six settings (high, 100% vs. 66%; mid, 66% vs. 33%; low, 33% vs. 0% for the left vs. right holes, and the opposites) in every 20–549 trials. We used Bayesian Q-learning models to estimate the time course of the probability distribution of action values and tested if they better explain the behaviors of rats than standard Q-learning models that estimate only the mean of action values. Model comparison by cross-validation revealed that a Bayesian Q-learning model with an asymmetric update for reward and non-reward outcomes fit the choice time course of the rats best. In the action-choice equation of the Bayesian Q-learning model, the estimated coefficient for the variance of action value was positive, meaning that rats were uncertainty seeking. Further analysis of the Bayesian Q-learning model suggested that the uncertainty facilitated the effective learning rate. These results suggest that the rats consider uncertainty in action-value estimation and that they have an uncertainty-seeking action policy and uncertainty-dependent modulation of the effective learning rate

日本の保健師が期待する発達障害児とその家族を支援する民生委員の役割と能力

Background: Public Health Nurses (PHNs) collaborate with community volunteer welfare commissioners to support children with developmental disorders and their families lead a life without isolation. Objective: This study aims to clarify the roles and competencies that PHNs expect of welfare commissioners in supporting children with developmental disorders and their families. Methods: An online survey was administered through Survey Monkey© to 220 PHNs working in Japanese municipalities using an independently developed questionnaire regarding the roles and competencies of welfare commissioners supporting children with developmental disorders and their families expected by PHNs. Exploratory Factor Analysis (EFA) was performed to simplify the data structure and enhance understanding. The reliability of the scale was confirmed using Cronbach’s α. Differences due to PHN attributes (e.g., experience collaborating with welfare commissioners) were analyzed using Welch’s t-test. This study was conducted between April and September 2021. Results:The highest scoring items were, for the role, “a welfare commissioner’s role is to pass on accurate information to their successor,” and for competencies, “a necessary competency for a welfare commissioner is to protect the information about children with developmental disorders, and their families learned during one’s work.” The EFA results revealed a two-factor structure for role items: Factor 1, “Supporting children with developmental disorders and their families and preventing abuse,” and Factor 2, “Connecting to social resources.” Competency items were also found to have a two-factor structure: Factor 1, “Understanding the position of children with developmental disorders and their families and connecting with local residents,” and Factor 2, “Understanding developmental disorders and supporting them based on assessment.” A comparison of the attributes of PHNs showed no significant differences. Conclusion: PHNs feel welfare commissioners should pass on the information and protect confidentiality when supporting children with developmental disorders and their families. Furthermore, PHNs expect welfare commissioners to connect children with developmental disorders and their families to the community, prevent abuse, and provide support based on assessment. PHNs had the same expectations regarding the roles and competencies of welfare commissioners regardless of their own attributes

Examining Factors Associated with Dynapenia/Sarcopenia in Patients with Schizophrenia : A Pilot Case-Control Study

Sedentary behavior in patients with schizophrenia causes muscle weakness, is associated with a higher risk of metabolic syndrome, and contributes to mortality risk. This pilot case-control study aims to examine the associated factors for dynapenia/sarcopenia in patients with schizophrenia. The participants were 30 healthy individuals (healthy group) and 30 patients with schizophrenia (patient group), who were matched for age and sex. Descriptive statistics, Welch’s t-test, cross-tabulations, adjusted residuals, Fisher’s exact probability test (extended), and/or odds ratios (ORs) were calculated. In this study, dynapenia was significantly more prevalent in patients with schizophrenia than in healthy individuals. Regarding body water, Pearson’s chi-square value was 4.41 (p = 0.04), and significantly more patients with dynapenia were below the normal range. In particular, body water and dynapenia showed a significant association, with an OR = 3.42 and 95% confidence interval [1.06, 11.09]. Notably, compared with participants of the healthy group, patients with schizophrenia were overweight, had less body water, and were at a higher risk for dynapenia. The impedance method and the digital grip dynamometer used in this study were simple and useful tools for evaluating muscle quality. To improve health conditions for patients with schizophrenia, additional attention should be paid to muscle weakness, nutritional status, and physical rehabilitation

Failure to Capture Value Because of Commoditization - the Case of Digital Home Electronics (Japanese)

The Japanese digital home electronics industry provides DVDs, digital cameras, flat-screen TVs and many other major products which were developed through innovations in Japan and provided for the world market. Nevertheless, the value added and profits realized from these products are being limited by rapid declines in their market prices (commoditization). This paper analyzes the mechanism and present conditions of the commoditization of digital home electronics, and offers some recommendations for Japanese firms. The mechanism of commoditization is discussed from three perspectives: (1) modularization, (2) establishment of an intermediate goods market, and (3) the topping out of customer values. In particular, discussion of the establishment of an intermediate goods market, both theoretically and empirically, as a core concept linking modularization with commoditization is a novel approach. The recommendations include (1) pursuing a platform leader strategy to gain stable revenues from module sales, (2) the need for strategies that break through the contradictions in pursuing both module and finished product sales, and (3) the pursuit of symbolic value for customers.

Social studies in Elementary and Junior High Consistency Type to Foster International Qualities : The Point of View of Legal Literacy

本研究を実践することで，他者の異なる意見に耳を傾け，具体的な根拠を挙げて議論できるようになり，同時に自由や平等，公正といった基本的価値に留意しつつ，関連する法制度や具体的な問題を理解・評価できるようになると考える。本研究は，小中それぞれの授業実践を通して，社会生活における消費者教育の意義と役割及び消費者問題の具体的被害例や対応策について，消費者の権利と義務，企業の社会的責任と関連付けて考え，また手続的な正義といった基本的な考え方も合わせて，身に付けさせるものである。この経験は，グローバル社会の中でも希望を持って生き抜くことのできる国際的な資質を育成する上で求められるリーガルリテラシーの視点から見ても，意義あることだと考える。成果としては，具体的な事象を通して考えることで，事実をつかみ，思考・判断することで，自分の考えを構築し，さらに他の意見と比較考量しながら，より望ましい消費者市民社会を形成していくことの重要性を理解することができた。今後は，実践の更なる積み重ねを通じて，児童・生徒がより効果的にリーガルマインドを育てることのできるカリキュラム開発を行っていきたい。The purpose of this study was to encourage elementary school and junior high school students to listen to the opinions of others, for the specific reason of discussing the original Practice through, to think about the damage example and measures of consumer issues and the significance and role of consumer education in association with the corporate social responsibility. At the same time, it will be possible to understand and evaluate the legal system and the specific problems associated with fundamental values such as freedom, equality and fairness. In addition, basic idea, such as procedural justice is also intended to equip at the same time. The results, to understand the facts to think through specific events, were constructed their thoughts by thinking and judgment. Furthermore, it was able to understand the importance of forming a consumer civil society desirable thinking as compared to the views of others

Relationship between assertiveness of new nursing staff and their perceptions of their working environment : Systematic Review

本研究は，新人看護師のアサーティブと職場環境認識の関係性を明らかにすることを目的にシステマティックレビューを行った． システマティックレビューは，PRISMA（Preferred Reporting Items for Systematic Reviews and Meta-Analyses）ガイドラインに従って行った．医中誌（医学中央雑誌），PubMed（PubMedⓇ）にて「新人看護師」「アサーティブ」「職場環境」又は「new nurses」「assertive communication」「work environment」を検索キーワードに用いた．抽出された２７２１件（医中誌８２件，PubMed２６３９件）から，採択基準を満たした１０文献を分析した． 新人看護師のアサーティブを測定している尺度は２つあった．日本独自の看護師のアサーティブを捉えることや分析結果の解釈が難しいことが課題であった．職場環境認識において特定の尺度は使用されておらず，相談相手の有無や仕事量などについて調査していた． アサーティブ下位尺度得点の「個人的達成」が低い新人看護師は，オッズ比（OR）が２．６２倍高く，リアリティショックのOR は１．８７であり，非職業コミットメントは１．５５であった．このような新人看護師は，他者の意見を優先し自分の意見を堪える傾向があるため，精神的負担がかかりバーンアウトに陥りやすい．またアサーティブな態度の一つである受け入れるという行動が苦手なために職場環境も受け入れにくく仕事への意味を見出しにくい可能性が指摘された．さらに，職場環境において職場に相談相手がいない新人看護師の職場環境認識とバーンアウト，リアリティショック，非職業コミットメントとの関連があった． 新人看護師のアサーティブと職場環境認識の関連を調べた論文はなかった．しかし，バーンアウトやリアリティショック，非職業コミットメントには新人看護師のアサーティブもしくは新人看護師の職場環境認識が関係していたことから，新人看護師がアサーティブになれるかどうかは職場環境認識と関係している可能性が示唆された．This review clarifies the relationship between assertiveness of new nursing staff and their perception of the work environment. A systematic review was described in Ichushi（Igaku Chuo Zasshi, Japan Medical Abstracts Society） and PubMed （PubMedⓇ） in ２０２０ in accordance with PRISMA （Preferred Reporting Items for Systematic Reviews and Meta-Analyses）guidelines. The search keywords used were “new nurses,” “assertiveness,” and “work environment.” From the ２７２１ articles extracted（８２ Ichushi cases and ２６３９ PubMed cases）, ten met the selection criteria and were analyzed. While there are two existing scales to measure the assertiveness of new nursing staff, measuring the assertiveness unique to Japanese nurses and interpreting the analyzed results is difficult. Moreover, there is no specific scale to evaluate their work environment. Therefore, questionnaires were used to inquire about their amount of work and whether they had advisers. New nurses with low assertiveness scores on “personal accomplishment” showed high burnout scores, with an odds ratio of ２．６２, reality shock score of １．８７, and non-occupational commitment score of１．５５. Such new nurses tend to prioritize the opinion of others while holding back their own, which is considered mentally burdensome and makes them prone to burnouts. Furthermore, their poor acceptance skill—one of the assertive attitudes—-makes it difficult for them to accept their work environment and find meaning in their work. In addition, an association was observed among the work environment perception of new nursing staff who had no advisers, burnout, reality shock, and non-occupational commitment. This review suggests that the assertiveness of new nursing staff may be related to their perception of the work environment

2D Video Analysis for Active shoulder ROM

Aging and its associated problems related to movement impacts the care of people with psychiatric disorders. This study sought to clarify the usefulness of 2D video analysis for evaluating shoulder range of motion (ROM) during upper limb exercises in patients with psychiatric disorders. Subjects (N=54) were patients with psychiatric disorders categorized as the following : having either a high or low activities of daily living (ADL) score using the Barthel Index ; experiencing shoulder ROM limitation, and whether or not compensatory movements were exhibited. Compensatory movement was also considered in patients with Parkinsonism, cerebrovascular disease, and cognitive dysfunction. Shoulder joint ROM was measured using a goniometer and active ROM was captured using ImageJ. No significant difference between passive ROM measured by a goniometer and active ROM measured by ImageJ considering disease groups, ADL level, and shoulder ROM limitation was found. Factoring in compensatory movements, however, significant differences were found between passive and active ROM : existence compensatory movement group, left side (z=-2.30, p=0.02) ; nonexistence compensatory movement group, right side (z=-2.63, p<0.001). Image-evaluating devices help assess ROM in patients with psychiatric disorders, enhancing the development of physical rehabilitation programs to regain critical ADL, sustaining self-care capabilities