Background & Aims: Medical safety measures for nurses are an important issue. The present study aimed to clarify the human factors affecting the frequency of incidents by years of experience.
Methods: The participants were 1,489 nurses working in acute care hospitals with more than 400 beds. An anonymous, self-administered questionnaire survey was conducted. The survey included the frequency of incidents in the last six months and a “Questionnaire on Work Situations Commonly Associated with Nursing-Related Incidents.” Multiple logistic regression analysis was performed. Explanatory variables were extracted from the questionnaire items through principal component analysis. The objective variable was incident frequency. The analysis was conducted by years of experience.
Results: Valid responses were obtained from 716 nurses. Extracted variables were: unsafe execution of work, psychological stress, physical stress, busy work environment. Significant associations with incident frequency was found for busy work environment, psychological stress, and unsafe execution of work for nurses with up to 1 year, 4-10 years, and 11 or more years of experience, respectively.
Conclusion: The human factors affecting incident frequency were shown to differ depending on the nurses’ years of experience. Thus, preventive measures based on nursing experience are necessary: improving support systems to reduce busyness, improve psychological support, and address role familiarity for nurses with up to 1 year, 4-10 years, and 11 or more years of experience, respectively.
Background and aims: Recently, genome-wide analyses have revealed mutations in spliceosome machinery associated with myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML). Single-nucleotide polymorphisms (SNPs) of serine/arginine-rich splicing factor 2 (SRSF2) and splicing factor 3a subunit 1 (SF3A1) were investigated in a Japanese population of patients and healthy control group. We aimed to find associations with prognosis and pathology.
Methods: We obtained genomic DNA from 99 patients with MDS, 92 patients with AML, and 172 healthy controls and detected SRSF2 (rs237057) and SF3A1 (rs2074733) genotypes using polymerase chain reaction–restriction fragment length polymorphism.
Results: There was no statistical significance to associate these polymorphisms with susceptibility to MDS/AML. However, the SF3A1 rs2074733 TC was significantly associated with higher hemoglobin level, compared to the TT genotype (mean±standard deviation, 10.6±1.63 vs 9.09±2.19 g/dL; P＝0.022). In addition, patients with rs2074733 TC showed a significantly lower frequency of chromosomal abnormality [2 (18.2%) vs. 46 (53.5%), P＝0.027]. We observed no statistical significance between these polymorphisms and clinical variables for AML, or the prognosis of MDS and AML.
Conclusions: Our study indicates that the SF3A1 rs2074733 TC genotype is associated with some clinical features of MDS.
We report the case of a 60-year-old man with pneumaturia due to gas production by Klebsiella pneumoniae in the bladder. Diabetes mellitus is a major risk factor, and K. pneumoniae produces carbon dioxide by fermenting glucose under anaerobic conditions. Antibiotic therapy successfully improved cystitis and pneumaturia. However, in the presence of urinary tract obstruction and/or emphysematous upper urinary tract infections, other interventions may be needed.
A left upper lobectomy was performed in an 80-year-old man with lung cancer. There was no air leakage after surgery, but on the evening of the next day severe subcutaneous emphysema and a massive air leakage developed after he had suffered bouts of coughing. In response to his worsening symptoms, he underwent surgery, which identified a subpleural pocket-like tear on the remaining lower lobe. There had been no evidence of emphysematous changes in his preoperative findings. This case demonstrates the need to consider reinforcing the pulmonary surface facing a large dead space to avoid coughing-induced pulmonary barotrauma.
We had previously experienced a case involving prolonged cardiopulmonary resuscitation (CPR) on Mt. Fuji (3,776 m), demanding strenuous work by the rescuers. The objective of this study was to examine the effectiveness of a wearable electrocardiogram (ECG) with 10 electrodes for the assessment of cardiac condition during exercise at hypobaric hypoxic environment. The traces of ECG during CPR action were obtained in a hypobaric chamber with barometric pressure adjusted to be equivalent to 3,700 m above sea level (630-640 hPa). Two volunteers performed CPR with or without breaths using a CPR mannequin. In a 3,700-m-equivalent environment, the percentage of recordings with clear signal qualities were 26% at V1 position, and 31% at V4 position, respectively. Although wearable ECG monitoring is still under development, removing electromyogram artefact may improve the signal quality and make the wearable 12-lead ECG monitoring useful in preventing cardiac problems at high altitudes and in wilderness environments.
Background & Aims: With the development of radiology, the demand for medical physicists is increasing, and the training of new medical physicists is becoming a necessity. Although a few questionnaire surveys regarding medical physicists and medical physicist training courses have been conducted, no survey reports have yet been conducted on examinees. This study is the first survey of general examinees.
Methods: Gunma University has a webpage for test preparation, and we conducted a survey on examinees using this page, through a questionnaire and access analyses.
Results: Approximately 80% of the users qualified as technologists. Considering the percentage of users by region, the number of medical physicists and accredited facilities were strongly correlated. The proportion of females was extremely low. Exam papers on “science and technology” and “radiation physics” were accessed more than those on “medical and biology” field. Thus, physics may be a shortcoming of many examinees; science and engineering majors were less likely to take exams and have lower pass rates.
Conclusion: Recruitment and provision of learning environments for science and engineering graduates are required. To increase the number of students, while improving the quality of medical physicists, it is necessary to investigate current conditions of students in greater detail.