Ambient fine particulate matter and daily mortality: a comparative analysis of observed and estimated exposure in 347 cities.

BACKGROUND: Model-estimated air pollution exposure products have been widely used in epidemiological studies to assess the health risks of particulate matter with diameters of ≤2.5 µm (PM2.5). However, few studies have assessed the disparities in health effects between model-estimated and station-observed PM2.5 exposures. METHODS: We collected daily all-cause, respiratory and cardiovascular mortality data in 347 cities across 15 countries and regions worldwide based on the Multi-City Multi-Country collaborative research network. The station-observed PM2.5 data were obtained from official monitoring stations. The model-estimated global PM2.5 product was developed using a machine-learning approach. The associations between daily exposure to PM2.5 and mortality were evaluated using a two-stage analytical approach. RESULTS: We included 15.8 million all-cause, 1.5 million respiratory and 4.5 million cardiovascular deaths from 2000 to 2018. Short-term exposure to PM2.5 was associated with a relative risk increase (RRI) of mortality from both station-observed and model-estimated exposures. Every 10-µg/m3 increase in the 2-day moving average PM2.5 was associated with overall RRIs of 0.67% (95% CI: 0.49 to 0.85), 0.68% (95% CI: -0.03 to 1.39) and 0.45% (95% CI: 0.08 to 0.82) for all-cause, respiratory, and cardiovascular mortality based on station-observed PM2.5 and RRIs of 0.87% (95% CI: 0.68 to 1.06), 0.81% (95% CI: 0.08 to 1.55) and 0.71% (95% CI: 0.32 to 1.09) based on model-estimated exposure, respectively. CONCLUSIONS: Mortality risks associated with daily PM2.5 exposure were consistent for both station-observed and model-estimated exposures, suggesting the reliability and potential applicability of the global PM2.5 product in epidemiological studies.

A comparison of visual attention to pictures in the Autism Diagnostic Observation Schedule in children and adolescents with ADHD and/or autism.

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are neurodevelopmental conditions which frequently co-occur. The Autism Diagnostic Observation Schedule (ADOS) is commonly used to aid with diagnostic assessment of ASD but was not originally designed for use in those with comorbid ADHD. Visual attention to social stimuli has been often studied in ASD using eye-tracking, to obtain quantitative indices of how attention is deployed to different parts of a social image/scene. As the ADOS includes tasks that rely on attending to and processing images of social scenes, these measures of visual attention could provide useful additional objective measurement alongside ADOS scores to enhance the characterisation of autistic symptoms in those with ADHD. Methods: Children with ASD, comorbid ASD and ADHD, ADHD and Neurotypical (NT) controls were recruited (n=84). Visual attention was measured using eye-tracking during free viewing of social scenes selected from the ADOS. The full ADOS was then administered. Stimulant medication was temporarily withdrawn during this assessment. Research diagnoses were based on the Development and Wellbeing Assessment (DAWBA), ADOS, Social Communication Questionnaire (SCQ, a measure of ASD severity) and Conners' Rating Scales (CRS-3, a measure of ADHD severity) following clinical consensus. Results: Using factorial ANOVAs to model ADHD, Autism and their interaction, we found that fixation duration to faces was reduced in those with ASD (ASD and ASD+ADHD) compared to those without ASD (ADHD and NT). Reduced visual attention to faces in the whole sample was associated with Autism symptom severity (SCQ subscale scores) but not ADHD symptom severity (CRS-3 scores). Discussion: Our findings provide preliminary evidence in support of implementing visual attention measurement during assessment of ASD in the context of comorbidity with ADHD. For example, if a child with ADHD was found to reduce attention to faces in ADOS pictures this may suggest additive difficulties on the autism spectrum. Replication across a larger sample would be informative. This work has future potential in the clinic to help with complex cases, including those with co-occurring ADHD and ASD.

Development and Validation of the Combined Action Observation and Motor Imagery Ability Questionnaire.

Combined use of action observation and motor imagery (AOMI) is an increasingly popular motor-simulation intervention, which involves observing movements on video while simultaneously imagining the feeling of movement execution. Measuring and reporting participant imagery-ability characteristics are essential in motor-simulation research, but no measure of AOMI ability currently exists. Accordingly, the AOMI Ability Questionnaire (AOMI-AQ) was developed to address this gap in the literature. In Study 1, two hundred eleven participants completed the AOMI-AQ and the kinesthetic imagery subscales of the Movement Imagery Questionnaire-3 and Vividness of Motor Imagery Questionnaire-2. Following exploratory factor analysis, an 8-item AOMI-AQ was found to correlate positively with existing motor-imagery measures. In Study 2, one hundred seventy-four participants completed the AOMI-AQ for a second time after a period of 7-10 days. Results indicate a good test-retest reliability for the AOMI-AQ. The new AOMI-AQ measure provides a valid and reliable tool for researchers and practitioners wishing to assess AOMI ability.

[Post-hospital support for families: current situation and outlook]. / L'accompagnement posthospitalier des familles : état des lieux et perspectives.

After neonatal hospitalization, our healthcare system offers multidisciplinary care for premature babies and their families during the first years of life. However, there are disparities and gaps, particularly in the case of medium prematurity. Maternal and child protection, a major player in early prevention and family follow-up, is a partner likely to be able to deploy post-hospital support perspectives in favor of child development and parenting support.

Ethiopian Crop Type 2020 (EthCT2020) dataset: Crop type data for environmental and agricultural remote sensing applications in complex Ethiopian smallholder wheat-based farming systems (Meher season 2020/21).

Crop type observation is crucial for various environmental and agricultural remote sensing applications including land use and land cover mapping, crop growth monitoring, crop modelling, yield forecasting, disease surveillance, and climate modelling. Quality-controlled georeferenced crop type information is essential for calibrating and validating machine learning algorithms. However, publicly available field data is scarce, particularly in the highly dynamic smallholder farming systems of sub-Saharan Africa. For the 2020/21 main cropping season (Meher), the Ethiopian Crop Type 2020 (EthCT2020) dataset compiled from multiple sources provides 2,793 harmonized, quality-controlled, and georeferenced in-situ samples on annual crop types (7 crop groups; 22 crop classes) at smallholder field level across the complex and highly fragmented agricultural landscape of Ethiopia. The focus was on rainfed, wheat-based farming systems. A nationwide ground data collection campaign (GDCC; Source 1) was designed using a stratification approach based on wheat crop calendar information, and 1,263 in-situ data samples were collected in selected sampling regions. This in-situ data pool was enriched with 1,530 wheat samples extracted from a) the Wheat Rust Toolbox (WRTB; Source 2; 734 samples), a database for wheat disease surveillance data [1] and b) an inhouse farm household survey database (FHSD; Source 3; 796 samples). Obtained field data was labelled according to the Joint Experiment for Crop Assessment and Monitoring (JECAM) guidelines for cropland and crop type definition and field data collection [2] and the FAO Indicative Crop Classification [3]. The EthCT2020 dataset underwent extensive processing including data harmonization, mixed pixel assessment through visual interpretation using 5 m Planet satellite image composites, and quality-control using Sentinel-2 NDVI homogeneity analysis. The EthCT2020 dataset is unique in terms of crop diversity, pixel purity, and spatial accuracy while targeting a countrywide distribution. It is representative of Ethiopia's complex and highly fragmented agricultural landscape and can be useful for developing new machine learning algorithms for land use land cover mapping, crop type mapping, agricultural monitoring, and yield forecasting in smallholder cropping systems. The dataset can also serve as a baseline input parameter for crop models, climate models, and crop disease and pest forecasting systems.

Parent-child interactive behavior in a German sample of parents with and without a mental illness: model replication and adaption of the Coding Interactive Behavior system.

Studies using observational measures often fail to meet statistical standards for both reliability and validity. The present study examined the psychometric properties of the Coding Interactive Behavior (CIB) System within a German sample of parent-child dyads. The sample consisted of 149 parents with and without a mental illness and their children [n experimental group (EG) = 75, n control group (CG) = 74] who participated in the larger Children of Mentally Ill Parents at Risk Evaluation (COMPARE) study. The age of the children ranged from 3 to 12 years (M = 7.99, SD = 2.5). Exploratory factor analysis supported a five-factor model of the CIB with items describing 1) parental sensitivity/reciprocity, 2) parental intrusiveness, 3) child withdrawal, 4) child involvement, and 5) parent limit setting/child compliance. Compared to international samples, the model was reduced by two independent dyadic factors. Testing for predictive validity identified seven items with predictive power to differentiate parental group membership. The CIB factors did not seem to be sufficiently sensitive to illustrate differences in interaction within a sample of parents with various mental illnesses. To apply the CIB to the described sample or similar ones in the future, additional measurement instruments may be necessary.

The Mental Health Toll of the COVID-19 Pandemic on Adolescents Receiving Inpatient Psychiatric Treatment.

Objective: During the COVID-19 pandemic, the prevalence of depression and anxiety among children and adolescents significantly increased, along with the number of visits to emergency departments due to suicidality and/or suicide attempts. Relatedly, health care workers experienced significant burnout and symptoms of anxiety, depression, and posttraumatic stress disorder during this time. However, the corresponding impact on psychiatric inpatient treatment has not yet been researched. We hypothesized that during the pandemic, adolescents hospitalized in an acute care psychiatric inpatient unit had increased incidents of suicide attempts and nonsuicidal self-injurious behaviors and of aggressive behaviors toward others, resulting in greater use of constant observation and restraints. Method: This study was a retrospective chart review based on electronic medical record data examining use of restraints and constant observation one year before the pandemic (March 2019 to February 2020) and 1 year following the onset of the pandemic (March 2020 to February 2021) in an acute-care adolescent (12 to 17 years old) psychiatric inpatient unit. Results: There were 571 admissions during the year before the pandemic and 500 admissions during the pandemic. The number of patients who were restrained (χ2 = 7.86, p = 0.005), number of patients who were placed on constant observation (χ2 = 13.41, p < 0.001), and number of constant observation orders per patient (χ2 = 91.90, p < 0.001) were all significantly greater during the pandemic. Conclusion: Psychiatrically hospitalized adolescents during the pandemic received more intensive interventions such as restraints and constant observation. Severe patient psychopathology and staff shortages, as well as limitations of and decreases to the dialectical behavior therapy program, may have been the contributing factor.

Neuropsychological mechanisms of observational learning in human placebo effects.

Scientific evidence indicates that placebo effects are psychoneurobiological events involving the contribution of distinct central nervous systems and peripheral physiological mechanisms that influence pain perception and other symptoms. Placebo effects can occur without formal conditioning and direct prior experience because crucial information can be acquired through observational learning. Observation of benefits in another person results in placebo effects of a magnitude like those induced by directly experiencing an analgesic benefit. Understanding the psychological mechanisms of observationally induced placebo effects is a complex and multifaceted endeavor. While previous reviews have highlighted various frameworks and models to understand these phenomena, the underlying biological mechanisms have been overlooked. We summarize critically current understanding of its behavioral and neural mechanisms. Understanding the neural mechanisms of hypoalgesia driven by observation can serve as a foundation for future development of novel theoretical and methodological approaches and ultimately, applications.

Unpacking interactions among student teams in a practice-based IPE setting: a qualitative evaluation study.

In many healthcare settings, teams change composition regularly, so healthcare students must be trained to function effectively in dynamic teams before entering the workforce. Interprofessional clinical rotations provide an ideal venue for learners to practice these skills, but little is known about how student teams interact in such settings. In this qualitative observational evaluation, learners from multiple health professions at a single institution participated in scheduled clinics in low-income housing communities for older adults. Interprofessional student teams met with program participants for care coordination, health and wellness assessments, and assistance in setting and achieving health goals; team composition changed from week-to-week. A purposive sample was selected from video-recorded encounters between student teams and their program participants. The aim of this study was to explore team interactions and document learner behaviors. Two researchers independently reviewed discrete segments of each video, recorded their observations and reflections, and then the team discussed, categorized, and identified relevant examples of both effective and ineffective behaviors. Four major themes were observed: inclusiveness, leadership, joy of practice, and sharing of clinical knowledge. Students demonstrated both positive and negative examples of behaviors that aligned with each theme. Understanding how students behave on teams in dynamic settings where patient care is taking place can help educators establish practice-based interprofessional education models that better prepare learners to function effectively and strategies that may improve team interactions.

Multidimensional neural representations of social features during movie viewing.

The social world is dynamic and contextually embedded. Yet, most studies utilize simple stimuli that do not capture the complexity of everyday social episodes. To address this, we implemented a movie viewing paradigm and investigated how the everyday social episodes are processed in the brain. Participants watched one of two movies during an MRI scan. Neural patterns from brain regions involved in social perception, mentalization, action observation, and sensory processing were extracted. Representational similarity analysis results revealed that several labeled social features (including social interaction, mentalization, the actions of others, characters talking about themselves, talking about others, and talking about objects) were represented in superior temporal gyrus (STG) and middle temporal gyrus (MTG). The mentalization feature was also represented throughout the theory of mind network, and characters talking about others engaged the temporoparietal junction (TPJ), suggesting that listeners may spontaneously infer the mental state of those being talked about. In contrast, we did not observe the action representations in frontoparietal regions of the action observation network. The current findings indicate that STG and MTG serve as key regions for social processing, and that listening to characters talk about others elicits spontaneous mental state inference in TPJ during natural movie viewing.

The use and potential of artificial intelligence for supporting clinical observation of child behaviour.

BACKGROUND: Observation of child behaviour provides valuable clinical information but often requires rigorous, tedious, repetitive and time expensive protocols. For this reason, tests requiring significant time for administration and rating are rarely used in clinical practice, however useful and effective they are. This article shows that Artificial Intelligence (AI), designed to capture and store the human ability to perform standardised tasks consistently, can alleviate this problem. CASE STUDY: We demonstrate how an AI-powered version of the Manchester Child Attachment Story Task can identify, with over 80% concordance, children with insecure attachment aged between 5 and 9 years. DISCUSSION: We discuss ethical issues to be considered if AI technology is to become a useful part of child mental health assessment and recommend practical next steps for the field.

Learning to observe art to better understand the patients: A pilot study.

OBJECTIVES: We describe an artwork observation training program proposed to the first-year psychiatry residents in the school of medicine of Montpellier-Nîmes (Université de Montpellier). This course aimed at improving the ability to observe, tolerate ambiguity in healthcare, work as a team, communicate, and develop empathy. We also evaluated the impact of this program on the enhancement of emotional and communication skills in a pilot study. MATERIALS AND METHODS: The artwork observation program based on Visual Thinking Strategies consisted of three sessions of ninety minutes involving two groups of eight medical students. First-year volunteer psychiatry residents were recruited. Before the sessions participants completed the Groningen Reflection ability Scale to evaluate reflection skills. Then, all the participants examined paintings and drawings of the Atger collection, were encouraged to observe carefully, and to engage in active group discussion by means of a structured questioning. Following the session, participants responded to a short survey to assess potential improvement of socio-emotional and communication skills. RESULTS: Fifteen psychiatry residents participated in the pilot study, eight were males. The median age was twenty-five years. The artwork observation program was well accepted by the participants. All the respondents reported improvement of emotional and communication skills, except regarding three empathy items, including the ability to feel the suffering of others which was increased only for 62% of respondents. DISCUSSION: Our program relying on Visual Thinking Strategies may improve the ability to observe carefully, to perceive the mental states of others, and to tolerate uncertainty. Training of such skills may encourage the adoption of self-reflective attitudes. CONCLUSIONS: Such an artistic innovative program should be extended to undergraduate students in medical curriculum.

Mother-blaming revisited: Gender, cinematography, and infant research in the heyday of psychoanalysis.

This article examines cinematographic observational studies of infants conducted by a loosely connected group of female psychologists and physicians in the USA from the 1930s to the 1960s. Largely forgotten today, these practitioners realized detailed and carefully planned research projects about infant behavior in a variety of settings-from the laboratory to the well-baby clinic. Although their studies were in conversation with better-known works, such as John Bowlby's research on attachment and René Spitz's films on institutionalized infants, they differed in a close examination of individual characteristics of babies and a critical attitude toward contemporary notions of 'pathological mothering'. In closely following the work of several researchers, including but not limited to pediatrician Margaret Fries (1898-1987), the clinical psychologist Sibylle Escalona (1915-96) and her team members-child psychiatrist Mary Leitch (1914-?) and avant-garde photographer Ellen Auerbach (1906-2004)-and psychologist Anneliese Korner (1918-2010), I argue that their cinematographic works shed a more nuanced light on the landscape of infant research and child psychiatry in the mid 20th century, and open a way for alternative readings of gender, psychoanalysis, and scientific observation at that time.

Combining environmental DNA and remote sensing for efficient, fine-scale mapping of arthropod biodiversity.

Arthropods contribute importantly to ecosystem functioning but remain understudied. This undermines the validity of conservation decisions. Modern methods are now making arthropods easier to study, since arthropods can be mass-trapped, mass-identified, and semi-mass-quantified into 'many-row (observation), many-column (species)' datasets, with homogeneous error, high resolution, and copious environmental-covariate information. These 'novel community datasets' let us efficiently generate information on arthropod species distributions, conservation values, uncertainty, and the magnitude and direction of human impacts. We use a DNA-based method (barcode mapping) to produce an arthropod-community dataset from 121 Malaise-trap samples, and combine it with 29 remote-imagery layers using a deep neural net in a joint species distribution model. With this approach, we generate distribution maps for 76 arthropod species across a 225 km2 temperate-zone forested landscape. We combine the maps to visualize the fine-scale spatial distributions of species richness, community composition, and site irreplaceability. Old-growth forests show distinct community composition and higher species richness, and stream courses have the highest site-irreplaceability values. With this 'sideways biodiversity modelling' method, we demonstrate the feasibility of biodiversity mapping at sufficient spatial resolution to inform local management choices, while also being efficient enough to scale up to thousands of square kilometres. This article is part of the theme issue 'Towards a toolkit for global insect biodiversity monitoring'.

Association between pathological characteristics and recurrence score by OncotypeDX in resected T1-3 and N0-1 breast cancer: a real-life experience of a North Hungarian regional center.

Introduction: The 21-gene analysis (OncotypeDX) is validated test for pT1-3, pN0-1 with hormone receptor (HR) positive and normal expression of human epidermal growth factor receptor-2 (HER2) breast cancer (BC) to determine the aggressiveness of the disease based on the calculation of Recurrence Score (RS). Methods: In this retrospective study the authors correlated pathological characteristics and Recurrence Score (RS) by traditional statistical methods and Observed Oriented Modeling (OOM) in a realistic cohort of BC patients. Results: OncotypeDX tests were performed in 94 tumour specimens of 90 BC patients. >83% of node-negative (pN0) and >72% of node-positive (pN1) cases could avoid chemotherapy. For pN0 cases, non-parametric correlation and tests demonstrated significant association in eight types of characteristics [progesterone receptor (PR) expression, Ki-67 value, Ki-67 group, PR group, grade, estrogen receptor (ER) expression, Nottingham Prognostic Index (NPI) and Clinical Risk]. For pN1 cases, parametric correlation and tests showed significant association in six characteristic types (number of positive nodes, ER and PR expression, PR group, Ki-67 group and NPI). Based on OOM for pN0 cases, significant associations were established in three characteristics (Ki-67 group, grade and NPI group). For pN1 cases OOM found significant associations in seven characteristics (PR group, PNI, LVI, Ki-67 group, grade, NPI group and number of positive nodes). Conclusion: First in oncology, OOM was applied, which found some other significant characteristics associated with RS than traditional statistical methods. There were few patients, where no clinical associations were found between characteristics and RS contrary to statistically significant differences. Therefore, the results of these statistical analyses can be neither applied for individual cases nor able to provide the bases for screening patients, i.e., whether they need for OncotypeDX testing or not. OncotypeDX still provides a personalised approach in BC.

Beyond technology acceptance-a focused ethnography on the implementation, acceptance and use of new nursing technology in a German hospital.

Introduction: Hospitalised patients could benefit from the emergence of novel technologies for nursing care. There are numerous technical products available, but these rarely find their way into practice. Further knowledge is required about the circumstances under which technology in nursing is accepted and used. In the research project "Centre for Implementing Nursing Care Innovations", technical innovations are implemented on a trauma surgery inpatient ward in Germany. After implementation, it was investigated: Which implemented technologies are accepted/rejected, and which factors influence the acceptance/rejection of technology for nurses? Material and methods: A focused ethnography was used, containing two approaches: First, participant observation was conducted to examine nurses' and patients' interaction with technologies. Observations were fixed in a field research diary and analysed using evaluative qualitative content analysis. Second, a questionnaire was used by nurses to provide information about the use frequency and technology suitability. The results of the study were consolidated and analysed using the UTAUT model. Results: Seven studied technologies can be summarised in four result categories: (1) A Mobilising mattress, a Special projector and a Sound pillow are accepted and used by nurses and patients, because they offer a way to provide high quality care with little additional effort. (2) A Fall prevention system is consistently used in patient care as a work obligation, but since nurses consider the system error-prone, acceptance is low. (3) An Interactive therapy ball is accepted but nurses cannot use it due to the high workload. (4) An App for nurse-patient communication and a work-equipment tracking system are not used or accepted because nurses do not see a practical benefit in the systems. Discussion: Acceptance or rejection of a product does not necessarily equate to use or non-use of the technology. Before implementation, technology acceptance among users occurs as prejudice-when users are given time to experiment with technology, intention-to-use can stabilize into sustained use. Accepted and used technologies can serve to mask problems (such as staff shortages) and encourage problematic developments, such as the reduction of contact time at the bedside. Therefore, technology acceptance should be qualified in asking to what accepted technology contributes.

Shared genetic architecture highlights the bidirectional association between major depressive disorder and fracture risk.

Background: There is limited evidence suggesting that osteoporosis might exacerbate depressive symptoms, while more studies demonstrate that depression negatively affects bone density and increases fracture risk. Aims: To explore the relationship between major depressive disorder (MDD) and fracture risk. Methods: We conducted a nested case-control analysis (32 670 patients with fracture and 397 017 individuals without fracture) and a matched cohort analysis (16 496 patients with MDD and 435 492 individuals without MDD) in the same prospective UK Biobank data set. Further, we investigated the shared genetic architecture between MDD and fracture with linkage disequilibrium score regression and the MiXeR statistical tools. We used the conditional/conjunctional false discovery rate approach to identify the specific shared loci. We calculated the weighted genetic risk score for individuals in the UK Biobank and logistic regression was used to confirm the association observed in the prospective study. Results: We found that MDD was associated with a 14% increase in fracture risk (hazard ratio (HR) 1.14, 95% CI 1.14 to 1.15, p<0.001) in the nested case-control analysis, while fracture was associated with a 72% increase in MDD risk (HR 1.72, 95% CI 1.64 to 1.79, p<0.001) in the matched cohort analysis, suggesting a longitudinal and bidirectional relationship. Further, genetic summary data suggested a genetic overlap between MDD and fracture. Specifically, we identified four shared genomic loci, with the top signal (rs7554101) near SGIP1. The protein encoded by SGIP1 is involved in cannabinoid receptor type 1 signalling. We found that genetically predicted MDD was associated with a higher risk of fracture and vice versa. In addition, we found that the higher expression level of SGIP1 in the spinal cord and muscle was associated with an increased risk of fracture and MDD. Conclusions: The genetic pleiotropy between MDD and fracture highlights the bidirectional association observed in the epidemiological analysis. The shared genetic components (such as SGIP1) between the diseases suggest that modulating the endocannabinoid system could be a potential therapeutic strategy for both MDD and bone loss.

The Impact of Various Cockpit Display Interfaces on Novice Pilots' Mental Workload and Situational Awareness: A Comparative Study.

Future airspace is expected to become more congested with additional in-service cargo and commercial flights. Pilots will face additional burdens in such an environment, given the increasing number of factors that they must simultaneously consider while completing their work activities. Therefore, care and attention must be paid to the mental workload (MWL) experienced by operating pilots. If left unaddressed, a state of mental overload could affect the pilot's ability to complete his or her work activities in a safe and correct manner. This study examines the impact of two different cockpit display interfaces (CDIs), the Steam Gauge panel and the G1000 Glass panel, on novice pilots' MWL and situational awareness (SA) in a flight simulator-based setting. A combination of objective (EEG and HRV) and subjective (NASA-TLX) assessments is used to assess novice pilots' cognitive states during this study. Our results indicate that the gauge design of the CDI affects novice pilots' SA and MWL, with the G1000 Glass panel being more effective in reducing the MWL and improving SA compared with the Steam Gauge panel. The results of this study have implications for the design of future flight deck interfaces and the training of future pilots.

Clarification of Psychiatric Nurses' Intentions and Analysis Contents in Observing Schizophrenia Patient.

The purpose of this study was to clarify what psychiatric nurses intended to observe when observing schizophrenia patient and what they analyzed from their observations. Twenty-one experienced nurses were included in the study. Data were collected through semi-structured interviews, and content analysis was conducted. The results were as follows:Nurses' intentions in observing patient were [Observation of psychiatric symptoms], [Observation of normality or abnormality], [Possibility of self-harm or harming others], [Side effects of antipsychotics], [Degree of communication disorder], [Degree of self-care], [Observation of nutritional status], [Effects of external stimuli on patient], and [Less importance of observing doctor]. Nurses' analysis contents were [Analysis of psychiatric symptoms], [No risk of self-harm or harming others], [Effects of antipsychotics], [Presence of communication disorder], [Lack of trust in doctor], [Problems in daily life], [Consideration of future nursing intervention], [Assessment of normality or abnormality], [Unhealthy physical state], and [Unnecessary analysis]. The results of this study revealed the nurses' observational process. J. Med. Invest. 71 : 54-61, February, 2024.

Plateau-linear reaction norm model analysis of number born alive in purebred Landrace pigs using meteorological data in Japan.

We performed a plateau-linear reaction norm model (RNM) analysis of number born alive (NBA) in purebred Landrace pigs, where breeding value changes according to maximum temperature at mating day, using public meteorological observation data in Japan. We analysed 52,668 NBA records obtained from 10,320 Landrace sows. Pedigree data contained 99,201 animals. Off-farm daily temperature data at the nearest weather station from each of the farms were downloaded from the Japan Meteorological Agency website. A plateau-linear RNM analysis based on daily maximum temperature on mating day (threshold temperature of 16.6°C) was performed. The percentage of the records with daily maximum temperatures at mating days of ≤16.6, ≥25.0, ≥30.0 and ≥35.0°C were 34.3%, 33.6%, 14.0% and 0.8%, respectively. The value of Akaike's information criterion for the plateau-linear RNM was lower than that for a simple repeatability model (RM). With the plateau-linear RNM, estimated value of heritability ranged from 0.14 to 0.15, while that from the RM analysis was 0.15. Additive genetic correlation between intercept and slope terms was estimated to be -0.52 from the plateau-linear RNM analysis. Estimated additive genetic correlations were >0.9 between NBA at different temperatures ranging from 16.6 to 37.6°C. For the 10,320 sows, average values of prediction reliability of the intercept and slope terms for breeding values in the plateau-linear RNM were 0.47 and 0.16, respectively. Increasing weight for slope term in linear selection index could bring positive genetic gain in the slope part, but prediction accuracy would decrease. Our results imply that genetically improving heat tolerance in sows reared in Japan focusing on NBA using RNM is possible, while RNM is more complex to implement and interpret. Therefore, further study should be encouraged to make genetic improvement for heat tolerance in sows more efficient.