Neonatal hypernatremia often occurs in poorly breastfeeding infants, and rehydration without complications is the primary treatment. However, the etiologies and management for neonates who present with hypernatremia immediately after birth are not well reported. In this case report, we describe a neonate with hypernatremia and hyperosmolality, born to a mother with oligohydramnios of unknown etiology. Meticulous fluid therapies considering the time to physiologic diuresis were successfully performed, and the underlying cause was determined to be an uncontrolled maternal central diabetes insipidus.

Purpose: Nursing students are future healthcare workers responsible for maintaining public health. Owing to the increase in early resignation among new nurses, nursing education outcomes must be evaluated by investigating students' practice readiness. Methods: Using convenience sampling, we recruited fourth-year students from two nursing colleges to participate in a cross-sectional online survey in November 2023. The Casey-Fink Readiness for Practice Survey was used to assess practice readiness and the data were analyzed using descriptive statistics, independent t-tests, and ANOVA. Results: Among the 157 participants (female, 77.7%; mean age, 23.12±1.93 yrs), the overall practice readiness score was 63.53±8.30 (range: 20~80) and the mean subscale score was 23.14±3.73 for clinical problem-solving (range: 7~28), 6.69±1.25 for learning techniques (range: 2~8), 16.87±2.46 for professional identity (range: 5~20), and 16.82±3.46 for trials and tribulations (range: 6~24). Practice readiness did not differ significantly by gender or age and was greater among subgroups with high grades and satisfaction with the major, classroom practice, simulation practice, clinical practice, and lectures. Conclusion Universities must improve the quality of classes and practical education to enhance fourth-year nursing students’ practice readiness.Nursing education programs incorporating problem-based learning must be developed and evaluated to strengthen students’ clinical inference and critical-thinking skills.

Purpose: Nursing students are future healthcare workers responsible for maintaining public health. Owing to the increase in early resignation among new nurses, nursing education outcomes must be evaluated by investigating students' practice readiness. Methods: Using convenience sampling, we recruited fourth-year students from two nursing colleges to participate in a cross-sectional online survey in November 2023. The Casey-Fink Readiness for Practice Survey was used to assess practice readiness and the data were analyzed using descriptive statistics, independent t-tests, and ANOVA. Results: Among the 157 participants (female, 77.7%; mean age, 23.12±1.93 yrs), the overall practice readiness score was 63.53±8.30 (range: 20~80) and the mean subscale score was 23.14±3.73 for clinical problem-solving (range: 7~28), 6.69±1.25 for learning techniques (range: 2~8), 16.87±2.46 for professional identity (range: 5~20), and 16.82±3.46 for trials and tribulations (range: 6~24). Practice readiness did not differ significantly by gender or age and was greater among subgroups with high grades and satisfaction with the major, classroom practice, simulation practice, clinical practice, and lectures. Conclusion Universities must improve the quality of classes and practical education to enhance fourth-year nursing students’ practice readiness.Nursing education programs incorporating problem-based learning must be developed and evaluated to strengthen students’ clinical inference and critical-thinking skills.

Purpose: Nursing students are future healthcare workers responsible for maintaining public health. Owing to the increase in early resignation among new nurses, nursing education outcomes must be evaluated by investigating students' practice readiness. Methods: Using convenience sampling, we recruited fourth-year students from two nursing colleges to participate in a cross-sectional online survey in November 2023. The Casey-Fink Readiness for Practice Survey was used to assess practice readiness and the data were analyzed using descriptive statistics, independent t-tests, and ANOVA. Results: Among the 157 participants (female, 77.7%; mean age, 23.12±1.93 yrs), the overall practice readiness score was 63.53±8.30 (range: 20~80) and the mean subscale score was 23.14±3.73 for clinical problem-solving (range: 7~28), 6.69±1.25 for learning techniques (range: 2~8), 16.87±2.46 for professional identity (range: 5~20), and 16.82±3.46 for trials and tribulations (range: 6~24). Practice readiness did not differ significantly by gender or age and was greater among subgroups with high grades and satisfaction with the major, classroom practice, simulation practice, clinical practice, and lectures. Conclusion Universities must improve the quality of classes and practical education to enhance fourth-year nursing students’ practice readiness.Nursing education programs incorporating problem-based learning must be developed and evaluated to strengthen students’ clinical inference and critical-thinking skills.

Purpose: Nursing students are future healthcare workers responsible for maintaining public health. Owing to the increase in early resignation among new nurses, nursing education outcomes must be evaluated by investigating students' practice readiness. Methods: Using convenience sampling, we recruited fourth-year students from two nursing colleges to participate in a cross-sectional online survey in November 2023. The Casey-Fink Readiness for Practice Survey was used to assess practice readiness and the data were analyzed using descriptive statistics, independent t-tests, and ANOVA. Results: Among the 157 participants (female, 77.7%; mean age, 23.12±1.93 yrs), the overall practice readiness score was 63.53±8.30 (range: 20~80) and the mean subscale score was 23.14±3.73 for clinical problem-solving (range: 7~28), 6.69±1.25 for learning techniques (range: 2~8), 16.87±2.46 for professional identity (range: 5~20), and 16.82±3.46 for trials and tribulations (range: 6~24). Practice readiness did not differ significantly by gender or age and was greater among subgroups with high grades and satisfaction with the major, classroom practice, simulation practice, clinical practice, and lectures. Conclusion Universities must improve the quality of classes and practical education to enhance fourth-year nursing students’ practice readiness.Nursing education programs incorporating problem-based learning must be developed and evaluated to strengthen students’ clinical inference and critical-thinking skills.

The prevalence of unruptured intracranial aneurysm varies between 3.6% and 6%.Aneurysms in the posterior circulation, inaccessible by normothermic surgical clipping and giant aneurysms require direct surgical clipping under hypothermic circulatory arrest for cerebral protection.The authors describe a case of giant basilar aneurysm clipping requiring deep hypothermic total circulatory arrest under total intravenous anesthesia.The patient was a 43-year-old female with a giant aneurysm at the tip of the basilar artery.Total intravenous anesthesia with propofol (average effect site concentration 4 mcg/ml) and remifentanil (average effect site concentration 3 ng/ml) and deep hypothermic total circulatory arrest were performed.Neurophysiologic function was monitored by electroencephalography, and somatosensory and motor evoked potentials. Cardiac and coagulation profiles showed no significant changes. The aneurysm was successfully clipped but the patient expired. Further collations of clinical experiences should enable the identification of an optimal means of anesthetic management during complex cerebrovascular surgery.
Adult ; Anesthesia, Intravenous ; Aneurysm ; Circulatory Arrest, Deep Hypothermia Induced ; Electroencephalography ; Evoked Potentials, Motor ; Female ; Humans ; Intracranial Aneurysm ; Piperidines ; Prevalence ; Propofol ; Surgical Instruments

Purpose: Most of the currently used concepts and measurements of social support have been relevant for general population. The main purpose of this study is to conduct the concept analysis of perceived social support(PSS) of family caregivers for people with dementia. Methods: This study adopted the Walker and Avant concept analysis methodology. Results: Findings from this concept analysis suggested four defining attributes of PSS of family caregivers for people with dementia: 1) PSS is help or assistance that family caregivers perceive as available when needed; 2) PSS is offered through socio-ecological structure; 3) PSS has a specific function to meet the needs of family caregivers; and 4) PSS includes quality aspects where family caregivers choose, use, or evaluate it. Borrowing from the socio-ecological model, this study proposed the structural aspects of PSS. This study also identified functional aspects of PSS, such as emotional support, informational support, appraisal support, and practical support. Finally, this study assessed quality aspects of PSS, such as satisfaction, timeliness, usefulness, accessibility, and coordination. Conclusion Focusing on family caregivers for people with dementia, we proposed a new model of PSS. The present study helped refine and clarify the concept of PSS of family caregivers for people with dementia. The results of this study may also contribute to promoting the development of more effective instruments for the concept.

Bilateral midbrain infarctions are often associated with basilar artery (BA) steno-occlusion, but identifying the stroke etiology is difficult when large vessels appear normal. We present a 90-year-old female with wall-eyed bilateral internuclear ophthalmoplegia. Initial diffusion-weighted imaging showed subtle bilateral midbrain lesions, while computed tomography angiography produced normal findings. Vessel-wall imaging and diagnostic angiography identified an abnormal single perforator from the distal BA supplying both sides. This case highlights the importance of these techniques in detecting perforator abnormalities in stroke with unclear etiology.

Bilateral midbrain infarctions are often associated with basilar artery (BA) steno-occlusion, but identifying the stroke etiology is difficult when large vessels appear normal. We present a 90-year-old female with wall-eyed bilateral internuclear ophthalmoplegia. Initial diffusion-weighted imaging showed subtle bilateral midbrain lesions, while computed tomography angiography produced normal findings. Vessel-wall imaging and diagnostic angiography identified an abnormal single perforator from the distal BA supplying both sides. This case highlights the importance of these techniques in detecting perforator abnormalities in stroke with unclear etiology.

Bilateral midbrain infarctions are often associated with basilar artery (BA) steno-occlusion, but identifying the stroke etiology is difficult when large vessels appear normal. We present a 90-year-old female with wall-eyed bilateral internuclear ophthalmoplegia. Initial diffusion-weighted imaging showed subtle bilateral midbrain lesions, while computed tomography angiography produced normal findings. Vessel-wall imaging and diagnostic angiography identified an abnormal single perforator from the distal BA supplying both sides. This case highlights the importance of these techniques in detecting perforator abnormalities in stroke with unclear etiology.