Usefulness of an online learning program for new nursing faculty members.

The purpose of this study was to examine the usefulness of an online learning program, Learning Program for New Faculty Members, in conveying knowledge of educational practice to newly appointed nursing faculty members. The study participants were assistant professors and research associates from nursing programs in Japan, with less than 5 years of educational experience. In total, 99 people participated in this study, and data from 97 were analyzed. Participants in the control group (43) were frequency matched to those in the intervention group (54) for sex, age, final degree, clinical experience, and academic experience. A pre-test was conducted using an original questionnaire, and there were no significant differences between the two groups in knowledge about educational practice. The intervention group then participated in the Learning Program for New Faculty Members online, at their convenience. After the intervention, a post-test was conducted. In the intervention group, post-test scores were significantly higher for all items except Item 3 (Conducting Class). The intervention and control groups' post-test scores were 23.55 vs 16.90 for Item 1 (Student Understanding and Support), 28.20 vs 22.17 for Item 2 (Syllabus and Class Design) and 5.40 vs 2.97 for Item 4 (Understanding of Educational Theories). The Learning Program for New Faculty Members was therefore considered to be effective in helping newly appointed nursing faculty members to acquire knowledge. The program was able to overcome the time and environmental constraints of newly appointed nursing faculty members.

Effectiveness of a new interactive web teaching material for improving lung auscultation skills: randomized controlled trial for clinical nurses.

We developed a new interactive web-based teaching material to improve lung auscultation skills. Our objective was to investigate the effectiveness of the web-based teaching material on nurses with less than one-year work experience, using a prospective, open-label, stratified block randomized controlled trial. Of the 69 participants, 23, 22, and 24 participants were assigned to the web-based, paper-based, and control (with no intervention) groups, respectively. Using a simulator, a discrimination test on seven lung sounds, such as "normal," "wheeze," "rhonchi," "coarse crackles," "fine crackles," "left lung diminish," and "right lung absent," was conducted. Next, a post-test was conducted after one-week of training. Answers with formal names were considered "correct"; those with common names, misspellings, and without left and right parts were considered "insufficient"; and wrong answers were considered "incorrect." The control group showed no significant difference between the pre-test and post-test for any lung sounds. The paper-based group showed significant improvement in performance for "wheeze" (p=0.004) and "coarse crackles" (p=0.035). The web-based group showed a significant improvement in performance for "fine crackles" (p=0.026). The number of correct answers in the post-test was higher in the paper- and web-based groups than the control group (p=0.023). The web-based teaching materials that we had developed effectively improved the ability of new graduate nurses to auscultate lung sounds. Additionally, the results suggest that the combined use of web- and paper-based teaching materials may be more effective since the sounds that each method enhanced their ability to auscultate different lung sounds.

Status of research and development conducted by the International Research Institute for Nuclear Decommissioning.

Since the International Research Institute for Nuclear Decommissioning (IRID) was established as a technology research association in August 2013, it has been engaged in research and development (R&D) for decommissioning the Fukushima Daiichi nuclear power plant, which is currently an urgent issue, to strengthen the platform for decommissioning technology for the future. The work of IRID R&D is classified into three main pillars: removal of spent nuclear fuel from the pool; retrieval of fuel debris; and technological development for treatment and disposal of solid radioactive waste. This article describes an overview of R&D as of the first half of the fiscal year 2020, mainly focusing on investigation inside primary containment vessels and retrieval of fuel debris.

Nurse perceptions of physical assessment skills for detecting acute progression of heart failure.

PURPOSE: The study purpose was to investigate whether years of clinical experience and experience of encountering heart failure affect perceptions of the need for physical assessment, and the nature of the association between perceptions and years of clinical experience. METHODS: This study was survey-based. Of hospitals in Japan with ≥200 beds, 298 hospitals were randomly selected as candidate research sites. Ultimately, 44 hospitals agreed to participate in this study. A self-administered questionnaire measuring 48 physical assessment skills was developed and distributed to nurses. The questionnaire rated the perceived need for 48 skills assessing acute progression of heart failure. RESULTS: Of 1,113 nurses sampled, 373 (33.5%) responded. Of these, 347 completed questionnaires (response rate: 93.0%). Nurses' perceived need for skills involving systematic or cardiovascular system assessment decreased with clinical experience. Nurses' perceived need for skills involving cardiovascular symptoms and circulatory failure assessment increased with clinical experience. We found four patterns of change for nurses' perceptions of physical assessment skills according to clinical experience. CONCLUSIONS: The findings showed that differences in nurses' perceived need for physical assessment skills were associated with differences in clinical experience. Nurses with more experience selected more suitable skills for detecting acute progression of heart failure. Nurses' perceptions of the need for specific skills were proportional to years of clinical experience, and there may be a threshold value of years of experience.

Nursing activities at clinics in rural areas in Japan: gaps between recognition of importance and implementation.

This study determined the level of implementation and the importance placed on various nursing activities at clinics in rural areas of Japan in order to explore the achievement and perceived importance of implementing certain nursing roles and activities at such clinics. To identify these items, a questionnaire was administered to 40 nurses working in rural clinics. The results showed that activities related to "Basic Nursing Practice" and "Community Understanding" were recognized as important and were performed by almost all nurses. Some activities related to "Administration and Operation" and "Cooperation with Local Government" were recognized as important, but were not implemented, thereby hampering the continuum of care across the health system. These activities, which are related to collaboration with hospitals and local governments that support the clinics, included adjustment of staff inside and outside the facilities to guarantee the use of paid holidays, as well as collaboration with acute care, remote medical systems, and local governments during emergencies and for disaster preparation. Additional support for nurses in collaboration between clinics in rural areas, hospitals, and regional administrations that support the clinics remains a challenge to be addressed.

Guiding patients to appropriate care: developing Japanese outpatient triage nurse competencies.

Japanese patients often seek hospital services without a primary provider's referral. A triage nurse who is the initial point of contact for a patient is challenged with the task of expertly evaluating the urgency of the condition and selecting the appropriate specialty service for every patient's needs. A triage nurse must also recognize any conditions requiring emergency medical services instead of a specialty outpatient service. A modified Delphi method was used to establish expert consensus regarding triage nursing competencies for secondary and higher-level health care facilities in Japan. The initial Delphi round was completed using a questionnaire of 80 competencies that were evaluated by 85 Japanese nurse experts with in-depth knowledge of triage and/or the current Japanese hospital system. Four additional competency items were added based on the experts' suggestions for a total of 84 items. The experts rated these items on a 7-point Likert scale based on importance. Minimal attrition rate yielded consistent and rich results. The results were analyzed to identify items rated as very important by the majority. Twenty-two items were included in the final list of competencies. The authors then refined the language and reorganized the items into four proposed domains. The proposed domains and the refined list of competencies provide a foundation for the development of training programs for outpatient triage nurses in the current Japanese health care system.

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.

Development and validation of a new instrument for testing functional health literacy in Japanese adults.

This study aimed to develop a reliable and valid measure of functional health literacy in a Japanese clinical setting. Test development consisted of three phases: generation of an item pool, consultation with experts to assess content validity, and comparison with external criteria (the Japanese Health Knowledge Test) to assess criterion validity. A trial version of the test was administered to 535 Japanese outpatients. Internal consistency reliability, calculated by Cronbach's alpha, was 0.81, and concurrent validity was moderate. Receiver Operating Characteristics and Item Response Theory were used to classify patients as having adequate, marginal, or inadequate functional health literacy. Both inadequate and marginal functional health literacy were associated with older age, lower income, lower educational attainment, and poor health knowledge. The time required to complete the test was 10-15 min. This test should enable health workers to better identify patients with inadequate health literacy.

Biochemistry and neurobiology of prosaposin: a potential therapeutic neuro-effector.

Prosaposin, a 66 kDa glycoprotein, was identified initially as the precursor of the sphingolipid activator proteins, saposins A-D, which are required for the enzymatic hydrolysis of certain sphingolipids by lysosomal hydrolases. While mature saposins are distributed to lysosomes, prosaposin exists in secretory body fluids and plasma membranes. In addition to its role as the precursor, prosaposin shows a variety of neurotrophic and myelinotrophic activities through a receptor-mediated mechanism. In studies in vivo, prosaposin was demonstrated to exert a variety of neuro-efficacies capable of preventing neuro-degeneration following neuro-injury and promoting the amelioration of allodynia and hyperalgesia in pain models. Collective findings indicate that prosaposin is not a simple house-keeping precursor protein; instead, it is a protein essentially required for the development and maintenance of the central and peripheral nervous systems. Accumulating evidence over the last decade has attracted interests in exploring and developing new therapeutic approaches using prosaposin for human disorders associated with neuro-degeneration. In this review we detail the structure characteristics, cell biological feature, in vivo efficacy, and neuro-therapeutic potential of prosaposin, thereby providing future prospective in clinical application of this multifunctional protein.

Caregiver suctioning education for Japanese patients with an invasive home ventilator.

In Japan, more people require care activities at home. In particular, patients with an invasive mechanical ventilator in the home require extensive care by family caregivers. Collaboration between their nurses and paid caregivers in the provision of care activities, especially tracheal suctioning, is necessary. This three-round Delphi study identifies the essential items required by nurses to instruct the paid caregivers in how to carry out tracheal suctioning on patients with an invasive mechanical ventilator in the home. By the final round, three competencies were found to be important by the home-visit nurses and paid caregivers: the anticipation of risk, the manner of handling an emergency situation, and the observation of a patient's breathing. The Delphi technique was used to obtain consensus between the home-visit nurses and the paid caregivers regarding the essential knowledge, skills, and attitudes required to carry out tracheal suctioning for patients with an invasive mechanical ventilator in the home.

Nursing competencies for physical assessment of the respiratory system in Japan.

The purpose of this study was to establish the minimum essential Japanese nursing education health assessment competency levels, with particular emphasis on the respiratory system, from the viewpoint of clinical nurses and nurse educators. The design of this study was a quantitative descriptive study using the Delphi technique. The participants consisted of two groups, including 210 clinical nurses and 76 nurse educators. Questionnaires were sent three times to each group, along with summaries of each previous result. The respondents selected 29 competency items in the following categories: five structure and function items; six interview items; eight inspection items; one palpation item; six auscultation items; and three diagnostic test items. By releasing the results of this survey to nurse educators, it might be possible to improve the nursing curriculum. For clinical nurses, knowing these results will help them to bridge the gap between essential nursing education and clinical practice.

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.