PURPOSE: This study aimed to explore professional autonomy, nursing work environment, and clinical decision making ability and to determine predictors of clinical decision making ability among clinical nurses. METHODS: A cross-sectional design was used in this study and 263 clinical nurses were selected from advanced-level hospitals with over 500 beds located in D metropolitan city. Independent t-test, ANOVA, Pearson's correlation coefficients and hierarchical multiple regression analyses were done with the SPSS/WIN 20.0 program. RESULTS: Clinical nurses reported moderate levels of professional autonomy, nursing work environment and clinical decision making ability. Marital status, professional autonomy and nursing work environment accounted for 25% of variance in clinical decision making ability required in various clinical settings. Importantly, being married, higher level of professional autonomy, and greater satisfaction with work environment were significantly associated with better decision making ability. CONCLUSION: Findings indicate that improving the quality of decision making in the healthcare settings requires awareness of the multiple effects of individual, occupational and environmental features. Nurses' ability to make effective clinical decisions may rely on personal characteristics, the degree of autonomy in their job, and nurses' satisfaction with their work environment.
Decision Making* ; Delivery of Health Care ; Humans ; Marital Status ; Nursing* ; Professional Autonomy*

PURPOSE: This study aimed to explore professional autonomy, nursing work environment, and clinical decision making ability and to determine predictors of clinical decision making ability among clinical nurses. METHODS: A cross-sectional design was used in this study and 263 clinical nurses were selected from advanced-level hospitals with over 500 beds located in D metropolitan city. Independent t-test, ANOVA, Pearson's correlation coefficients and hierarchical multiple regression analyses were done with the SPSS/WIN 20.0 program. RESULTS: Clinical nurses reported moderate levels of professional autonomy, nursing work environment and clinical decision making ability. Marital status, professional autonomy and nursing work environment accounted for 25% of variance in clinical decision making ability required in various clinical settings. Importantly, being married, higher level of professional autonomy, and greater satisfaction with work environment were significantly associated with better decision making ability. CONCLUSION: Findings indicate that improving the quality of decision making in the healthcare settings requires awareness of the multiple effects of individual, occupational and environmental features. Nurses' ability to make effective clinical decisions may rely on personal characteristics, the degree of autonomy in their job, and nurses' satisfaction with their work environment.
Decision Making ; Delivery of Health Care ; Humans ; Marital Status ; Nursing ; Professional Autonomy

DNP (2,4-dinitrophenol) has been commonly used as a weight loss aid; in particular, it has been used by body builders to achieve significant fat loss while maintaining muscle mass. The sale of DNP was banned due to some cases of fatal poisoning. We describe an autopsy case of a 39-year-old man who died from taking DNP to treat obesity. He was 183 cm tall and weighed 101 kg (body mass index of 31). External examination did not reveal any specific findings implicating the cause of death. Gross examination revealed that the heart weight was 450 g, and there were no significant findings in the coronary arteries and myocardium, except for a few petechiae of the epicardium. The DNP concentration in the subject’s blood was 38.28 mg/L. According to references, a DNP blood concentration of 28 mg/L or higher would result in death. Therefore, the cause of death in this autopsy case was DNP toxicity.

Background: Transfusion reactions have been under-reported, and the laboratory tests to evaluate the causes of the reactions are unfamiliar to physicians other than transfusion specialists. The paper-based transfusion reaction reporting system previously used in our hospital was one-way, with physicians submitting it to the Department of Transfusion Management. To address this, we developed an electronic reporting system that improves communication with physicians to identify the cause of transfusion reactions and recommend appropriate blood components. Methods: To assess the status of transfusion reaction reporting, transfusion reaction reports and transfusion nursing records of 5 years from 2019 to 2023 were analyzed. The transfusion reaction reporting system comprises two parts: the physician's report and the response from the Department of Transfusion Management. If physicians order blood products for patients with a history of prior transfusion reactions, a pop-up alert appears, warning them to check the details of the previous report. Results: From 2019 to 2023, 2.5% cases of transfusion-related symptoms occurred annually and only 2.6% of transfusion reactions were reported. In 21 out of the 31 cases, the cause was difficult to determine due to inadequate laboratory tests.The attending physicians of 12 cases were given a recommendation to use blood products or to conduct further laboratory tests by the Department of Transfusion Management to reduce recurrence, but the advice was followed only in 4 cases. Conclusion The electronic transfusion reaction reporting system could help physicians conduct appropriate investigations for transfusion reactions and inform physicians regarding the laboratory tests required to be undertaken. It is expected to enhance blood transfusion safety and management by improving communication with physicians.

Background: Transfusion reactions have been under-reported, and the laboratory tests to evaluate the causes of the reactions are unfamiliar to physicians other than transfusion specialists. The paper-based transfusion reaction reporting system previously used in our hospital was one-way, with physicians submitting it to the Department of Transfusion Management. To address this, we developed an electronic reporting system that improves communication with physicians to identify the cause of transfusion reactions and recommend appropriate blood components. Methods: To assess the status of transfusion reaction reporting, transfusion reaction reports and transfusion nursing records of 5 years from 2019 to 2023 were analyzed. The transfusion reaction reporting system comprises two parts: the physician's report and the response from the Department of Transfusion Management. If physicians order blood products for patients with a history of prior transfusion reactions, a pop-up alert appears, warning them to check the details of the previous report. Results: From 2019 to 2023, 2.5% cases of transfusion-related symptoms occurred annually and only 2.6% of transfusion reactions were reported. In 21 out of the 31 cases, the cause was difficult to determine due to inadequate laboratory tests.The attending physicians of 12 cases were given a recommendation to use blood products or to conduct further laboratory tests by the Department of Transfusion Management to reduce recurrence, but the advice was followed only in 4 cases. Conclusion The electronic transfusion reaction reporting system could help physicians conduct appropriate investigations for transfusion reactions and inform physicians regarding the laboratory tests required to be undertaken. It is expected to enhance blood transfusion safety and management by improving communication with physicians.

Background: Transfusion reactions have been under-reported, and the laboratory tests to evaluate the causes of the reactions are unfamiliar to physicians other than transfusion specialists. The paper-based transfusion reaction reporting system previously used in our hospital was one-way, with physicians submitting it to the Department of Transfusion Management. To address this, we developed an electronic reporting system that improves communication with physicians to identify the cause of transfusion reactions and recommend appropriate blood components. Methods: To assess the status of transfusion reaction reporting, transfusion reaction reports and transfusion nursing records of 5 years from 2019 to 2023 were analyzed. The transfusion reaction reporting system comprises two parts: the physician's report and the response from the Department of Transfusion Management. If physicians order blood products for patients with a history of prior transfusion reactions, a pop-up alert appears, warning them to check the details of the previous report. Results: From 2019 to 2023, 2.5% cases of transfusion-related symptoms occurred annually and only 2.6% of transfusion reactions were reported. In 21 out of the 31 cases, the cause was difficult to determine due to inadequate laboratory tests.The attending physicians of 12 cases were given a recommendation to use blood products or to conduct further laboratory tests by the Department of Transfusion Management to reduce recurrence, but the advice was followed only in 4 cases. Conclusion The electronic transfusion reaction reporting system could help physicians conduct appropriate investigations for transfusion reactions and inform physicians regarding the laboratory tests required to be undertaken. It is expected to enhance blood transfusion safety and management by improving communication with physicians.

Background: Transfusion reactions have been under-reported, and the laboratory tests to evaluate the causes of the reactions are unfamiliar to physicians other than transfusion specialists. The paper-based transfusion reaction reporting system previously used in our hospital was one-way, with physicians submitting it to the Department of Transfusion Management. To address this, we developed an electronic reporting system that improves communication with physicians to identify the cause of transfusion reactions and recommend appropriate blood components. Methods: To assess the status of transfusion reaction reporting, transfusion reaction reports and transfusion nursing records of 5 years from 2019 to 2023 were analyzed. The transfusion reaction reporting system comprises two parts: the physician's report and the response from the Department of Transfusion Management. If physicians order blood products for patients with a history of prior transfusion reactions, a pop-up alert appears, warning them to check the details of the previous report. Results: From 2019 to 2023, 2.5% cases of transfusion-related symptoms occurred annually and only 2.6% of transfusion reactions were reported. In 21 out of the 31 cases, the cause was difficult to determine due to inadequate laboratory tests.The attending physicians of 12 cases were given a recommendation to use blood products or to conduct further laboratory tests by the Department of Transfusion Management to reduce recurrence, but the advice was followed only in 4 cases. Conclusion The electronic transfusion reaction reporting system could help physicians conduct appropriate investigations for transfusion reactions and inform physicians regarding the laboratory tests required to be undertaken. It is expected to enhance blood transfusion safety and management by improving communication with physicians.

Natural killer (NK) cells play have a crucial role in the early phase of immune responses against various pathogens. We compared characteristics of canine NK cells against two canine mammary carcinoma cell lines, REM134 and CF41.Mg. REM134 showed higher expression of progesterone receptor, proliferative cell nuclear antigen, Ki67, multiple drug resistance, Bmi-1, c-myc, E-cadherin, and human epidermal growth factor receptor type-2 than that of CF41.Mg. For specific expansion and activation of NK cells, we isolated CD5 negative cells from canine peripheral blood mononuclear cells and co-cultured K562 cells in the presence of interleukin (IL)-2, IL-15, and IL-21 for 21 days. As a result, we found that expression markers of activated NK cells such as NKp30, NKp44, NKp46, NKG2D, CD244, perforin, granzyme B, and tumor necrosis factor alpha were highly upregulated. In addition, we found there was upregulated production of interferon gamma of activated NK cells against target cells such as REM134 and CF41.Mg.Specifically, we observed that cytotoxicity of NK cells against target cells was more sensitively reacted to CF41.Mg than REM134. Based on the results of this study, we recommend the development of an experimental application of CF41Mg, which has not been reported in canine mammary carcinoma research.