Effectiveness of a learning support program for respiratory physical assessment: A quasi-experimental study.

BACKGROUND:Although the need for physical assessment in home nursing care has been shown, little research has examined the development of visiting nurses' physical assessment capabilities. OBJECTIVES:This study aimed to evaluate the effectiveness of a learning support program to help working visiting nurses utilize their respiratory physical assessment skills. DESIGN:This study used a quasi-experimental design of two groups with pre-test, post-test measurements of training and follow-up test 8 weeks practice in their work place after the training. METHODS:57 currently working visiting nurses were assigned to 1 of 2 groups: a control group in which nurses would not receive any special support after respiratory physical assessment training, and an experimental group in which nurses would receive support to utilize the knowledge and skills they had learned during the training. RESULTS:The average practical examination score was significantly higher after the training. In the experimental group, the average score 8 weeks after training was not significantly higher than that obtained just after training. Further, after 8 weeks, the experimental group's average score was not significantly higher than that of the control group. Practice evaluation scores obtained by an investigation of daily clinical practice were not significantly higher seventh weeks compared to third weeks after training for either the experimental or control groups. Seventh weeks after training, the average practice evaluation score of the experimental group was significantly higher than that of control groups. The mean learning support program satisfaction score was higher among the experimental group than the control group. CONCLUSIONS:The results suggested that support from others was effective in maintaining motivation for learning and making use in the regular practice of the knowledge and skills acquired in the respiratory physical assessment training

THE DESIGN FEATURES OF INTEGRATED MODULAR WATER REACTOR (IMR)

ABSTRACT Small-to-medium-sized (300-600MWe) reactors are required for the electric power market in the near future . The main theme in the development of small-tomedium-sized reactor is how to realize competitive cost against other energy sources. As measures to this disadvantage, greatly simplified and downsized design is needed. From such point of view, Integrated Modular Water Reactor (IMR), which electric output power is 350 MWe, adopts integrated and high temperature two-phase natural circulation system for the primary system. In this design, main coolant pipes, a pressurizer, and reactor coolant pumps are not needed, and the sizes of a reactor vessel and steam generators are minimized. Additionally, to enhance the economy of the whole plant, fluid system, and Instrumentation & Control system of IMR have also been reviewed to make them simplest and smallest taking the advantage of the IMR concept and the state of the art technologies. For example, the integrated primary system and the stand-alone direct heat removal system make the safety system very simple, i.e., no injection, no containment spray, no emergency AC power, etc. The chemical and volume control system is also simplified by eliminating the boron control system and the seal water system of reactor coolant pumps. In this paper, the status of the IMR development and the outline of the IMR design efforts to achieve the simplest and smallest plant are presented

Regulation of gene expression in response to brain injury: Enhanced expression and alternative splicing of rat prosaposin (SGP-1) mRNA in injured brain

Prosaposin, the precursor of saposins or saps, is an injury-repair protein that acts on both neurons and glia. Previous studies identified the prosaposin gene as one of differentially expressed genes following nerve injury. In the present study, we investigated expression of prosaposin mRNA in injured brain utilizing rat models of focal cerebral ischemia and cortical stab wound in order to explore the significance of prosaposin in nerve injury. In ischemic brain, the level of prosaposin mRNA was elevated greater than 400% over controls within 5 days after ischemic insults. Importantly, this induction was accompanied by a 9-base splicing consistent with the alternative Exon-8 splicing of human prosaposin mRNA. In normal brain, two prosaposin mRNA species with and without the 9-base insertion were expressed at a ratio of 85:15; however, this equilibrium reverted to 5:95 following ischemic injury. Similar inductions were observed in stab wound brains. Immunohistochemical staining and in situ hybridization demonstrated an enhanced signal distribution of prosaposin mRNA and injury-induced prosaposin protein around the lesion. The data suggest the expression and processing of prosaposin mRNA may be crucially regulated not only for cerebral homeostasis but also during nerve regenerative and degenerative processes