Psychometric evaluation of the Ethical Caring Competency Scale in nursing.

BACKGROUND: An ethical competence list for nurses could guide educators and managers in the field of health care to both support the development of ethical conduct and improve the assessment of ethical competence in health care. AIM: This study aimed to verify the reliability and validity of the Ethical Caring Competency Scale (ECCS) and to obtain suggestions for its use as an evaluation form in rubric format among a sample of Japanese nurses. RESEARCH DESIGN: This research employed a descriptive and cross-sectional design. PARTICIPANTS AND RESEARCH CONTEXT: A self-administered questionnaire was distributed to 1157 nurses working in two hospitals in Japan. The contents of the survey were demographic data, a draft of the ECCS consisting of 22 competencies from four core competencies, questions regarding experience in learning about medical/nursing ethics, and the Work Motivation Measurement Scale for Nurses. Three levels of difficulty for the 22 items were established using relative comparisons of the mean scores within the four core competencies. Three groups, namely, an expert group, a middle group, and a beginner group, were categorized according to the quartiles of the total ECCS score. ETHICAL CONSIDERATIONS: This study was approved by the Clinical Research Ethics Committee of Hamamatsu University School of Medicine (Decision no. 18-267). The ethical principles of voluntary participation, anonymity, and confidentiality were considered. FINDINGS: A total of 962 valid responses were analyzed. The ECCS scores for the three levels of difficulty were significantly different from each other. Stability was confirmed by the test-retest of the total ECCS scores (r = .900, p < .0001). The total ECCS scores for the three groups showed significant differences in all pairs. The Cronbach's α coefficient ranged from .72 to .89 for each core competency, and internal consistency was confirmed. CONCLUSION: The reliability and validity of the ECCS as a scale were statistically verified, and we were able to obtain suggestions for its application as a form of evaluation in rubric format.

Polyoxometalate-Assisted, One-Pot Synthesis of a Pentakis[(triphenylphosphane)gold]ammonium(2+) Cation Containing Regular Trigonal-Bipyramidal Geometries of Five Bonds to Nitrogen.

Novel intercluster compounds consisting of pentakis[(triphenylphosphane)gold]ammonium(2+) cation (1) and Keggin polyoxometalate (POM) anions, i.e., {[Au(PPh3)]5(µ5-N)}3[α-PM12O40]2 (1-PW for M = W; 1-PMo for M = Mo), were synthesized in 30-36% yield by one-pot reaction of the protonic acid form of the Keggin POMs, H3[α-PM12O40]·nH2O (n = 13 for M = W; n = 15 for M = Mo) with monomeric (triphenylphosphane)gold(I) carboxylate [Au(RS-pyrrld)(PPh3)] [RS-Hpyrrld = (RS)-2-pyrrolidone-5-carboxylic acid] in the presence of aqueous NH3 at a molar ratio of 2:15:x (x = 3 for 1-PW; x = 7.5 for 1-PMo). These compounds resulted from the nitrogen-centered phosphanegold(I) clusterization of in situ generated monomeric phosphanegold(I) units, [Au(PPh3)]+ or [Au(L)(PPh3)]+ (L = NH3 or solvent), during the carboxylate elimination of [Au(RS-pyrrld)(PPh3)] in the presence of the Keggin POMs and aqueous NH3. The products 1-PW and 1-PMo were characterized by elemental analysis, Fourier transform infrared, thermogravimetric and differential thermal analyses (TGA/DTA), X-ray crystallography, and solid-state cross-polarization magic-angle-spinning (CPMAS) (31P and 15N) and solution (31P{1H} and 1H) NMR spectroscopy. The lattice contained three independent {[Au(PPh3)]5(µ5-N)}2+ cations, of which two took regular trigonal-bipyramidal (TBP) geometries and the third took a distorted, square-pyramidal (SP) geometry. These geometries are in contrast to those reported by Schmidbaur's group for {[Au(PPh3)]5(µ5-N)}2+ cations as BF4 salts. Density functional theory and ONIOM calculations for {[(L3P)Au]nN}(n-3)+ (L = H or Ph; n = 4-6) showed that the pentacoordinate cluster is energetically most stable and its TBP structure is only 1.6 kcal mol-1 more stable than its SP structure, in accordance with the experimental facts.

The effect of counteranions on the molecular structures of phosphanegold(i) cluster cations formed by polyoxometalate (POM)-mediated clusterization.

The effect of counteranions on the molecular structures of phosphanegold(i) cluster cations formed by polyoxometalate (POM)-mediated clusterization was investigated. A novel intercluster compound, [{(AuLCl)2(µ-OH)}2]3[α-PMo12O40]2·3EtOH (1-PMo12), was obtained as orange-yellow plate crystals in 12.0% yield from a 6 : 1 molar ratio reaction of the monomeric phosphanegold(i) carboxylato complex [Au(RS-pyrrld)(LCl)] (RS-Hpyrrld = RS-2-pyrrolidone-5-carboxylic acid; LCl = tris(4-chlorophenyl)phosphane) in CH2Cl2 with the free acid-form of Keggin polyoxometalate (POM), H3[α-PMo12O40]·14H2O. An EtOH/H2O (5 : 1, v/v) solvent mixture was used. The dimeric cation [{(AuLCl)2(µ-OH)}2](2+) in 1-PMo12 was in a parallel-edge arrangement that was formed by self-assembly through the inter-cationic aurophilic interactions of the µ-OH-bridged dinuclear phosphanegold(i) cation. The POM anion in 1-PMo12 was successfully exchanged with a smaller PF6(-) anion by the use of an anion-exchange resin. POM-free, colorless block crystals of [{(AuLCl)3(µ3-O)}2](PF6)2·4CH2Cl2 (2-PF6) were obtained by vapor diffusion in 14.1% yield. During the synthesis of 2-PF6, a compound with mixed counteranions (one POM and one PF6(-) anion), i.e. [{(AuLCl)4(µ4-O)}]2[α-PMo12O40]PF6 (3-PMo12PF6), was obtained in 66.4% yield. Both products were characterized by elemental analysis, TG/DTA, FT-IR, (31)P{(1)H} NMR, (1)H NMR, and X-ray crystallography. X-ray crystallography revealed that the countercation in 2-PF6 was the dimeric cation of the µ3-O-bridged tris{phosphanegold(i)} species, whereas that in 3-PMo12PF6 consisted of an unusual µ4-O-bridged tetragonal-pyramidal tetrakis{phosphanegold(i)} cation. Therefore, we concluded that the POM anion significantly contributed to the stabilization of these countercations (parallel-edged arrangement in 1-PMo12 and µ4-O-bridged tetragonal-pyramid in 3-PMo12PF6). Moreover, the previously reported yellow crystals of [{(AuLF)2(µ-OH)}2]3[PMo12O40]2·3EtOH (4-PMo12: LF = tris(4-fluoro phenyl)phosphane) were successfully converted to the POM-free crystalline OTf(-) salt [{(AuLF)2(µ-OH)}2](OTf)2·0.5Et2O (4-OTf) by the use of an anion-exchange resin. X-ray crystallography also revealed that the parallel-edge arrangement of the dimeric cation in 4-PMo12 was converted to the crossed-edge arrangement of that in 4-OTf. These results illustrate that the AuOPOM and hydrogen-bonding (C-HOPOM and O-HOPOM) interactions between the phosphanegold(i) cluster cation and the Keggin POM anion in the solid state significantly contribute to the structure, composition, and stability of the phosphane gold(i) cluster cations in 4-PMo12.

Two young female patients with anorexia nervosa complicated by Mycobacterium tuberculosis infection.

Patients with anorexia nervosa (AN) seldom present with infectious illness, despite malnutrition-induced immunodeficiency. We described two young women who had a long-standing history of severe emaciation and pulmonary or lymph node tuberculosis discovered during the treatment of AN. Both patients reported a positive history of BCG vaccination. Contact tracing failed to reveal sources of infection, although the tuberculosis was considered transferred. Since the decline of notification rates for tuberculosis have been stagnant and outbreaks in schools or hospitals have been increasing in Japan, special attention must be given to the possibility of opportunistic infections in AN patients.