Hospitals and their affiliated institutions established by the same organization (hereinafter, Organization A) provide level-specific training programs to cultivate nurses who are independent professionals and continuously perform high-quality nursing practice, but no program has been developed for mid-level nurses. In this study, the current status of continuing education for mid-level nurses and the educational content and teaching method required by mid-level nurses were investigated in order to develop basic educational materials for them. We conducted an anonymous self-administered questionnaire survey of 355 nurses who had ≥10 years of experience in nursing (excluding those in management) and were working at hospitals established by Organization A. A qualitative descriptive analysis of 192 survey responses (response rate, 54.0%) was conducted by simply summarizing qualitative answers and by categorizing written answers through inductive classification in content analysis. The rate of participation in workshops held inside and outside the hospitals in the past 1 year was 92.5% and 69.2%, respectively. When asked about their feeling toward workshops, 56% of the nurses answered by saying “they wanted to attend workshops if attendance was considered as a part of the job”. When asked about whether their preference on educational content and teaching method had been incorporated, 56% of the nurses answered “unsure”. Among the nurses surveyed, 25% did not attend in-hospital workshops because “they were tired” and 24% did not attend out-of-hospital workshops because “the venues were far away”. In addition, 61% of the nurses wanted to attend workshops that help improve professional skills as a mid-level nurse, 54% selected “nursing practice skills” as educational content, and 47% preferred “lecture/practice”, all for the reason that “practice is the mother of all skills”. Our future challenge is to establish a training program for nursing practice skills that teaches how to perform the skills.

Cross-sectional study.

Cross-sectional study.

BACKGROUND: Recently, the prevalence of food allergies during childhood is increasing, with fruits being common allergens. However, data on allergens that cause fruit and vegetable allergies and pollen-food allergy syndrome (PFAS) in childhood are relatively few. This study aimed to examine the allergens in fruit and vegetable allergies in pediatric patients and to determine the association between fruit and vegetable allergies and PFAS.OBJECTIVE: This study aimed to examine the current status of fruit and vegetable allergies in Japanese children.METHODS: This was a multicenter case series observational study. The participants included children aged <15 years who developed allergic symptoms after eating fruits and vegetables and subsequently received treatment in the Pediatric Department of 6 hospitals in the Osaka Prefecture in Japan during the study period from August 2016 to July 2017. Participants' information was obtained using a questionnaire, and data were obtained by performing several types of allergy tests using blood samples.RESULTS: A total of 97 children (median age, 9 years; 56 males) were included in the study. Apple was the most common allergen, followed by peach, kiwi, cantaloupe, and watermelon. A total of 74 participants (76%) exhibited allergic symptoms due to PFAS; moreover, pathogenesis-related protein-10 (PR-10) was the most common allergen superfamily. On the contrary, in the group where neither PR-10 nor profilin was sensitized, kiwi and banana were the most common allergens, and the age of onset was lower than that in the PFAS group. Specific antibody titer was significantly associated with Birch for Bet v1 and latex for Bet v2 (r = 0.99 and r = 0.89).CONCLUSION: When we examine patients with fruit and vegetable allergies, we should first consider PFAS even in childhood specifically for children greater than 4 years old.
Age of Onset ; Allergens ; Asian Continental Ancestry Group ; Betula ; Child ; Citrullus ; Clinical Study ; Cucumis melo ; Eating ; Food Hypersensitivity ; Fruit ; Humans ; Hypersensitivity ; Japan ; Latex ; Musa ; Observational Study ; Prevalence ; Profilins ; Prunus persica ; Rhinitis ; Rhinitis, Allergic, Seasonal ; Vegetables

Methods: LSS patients who underwent decompression surgery with or without fusion were included. Clinical outcomes were measured before surgery and 6 months postoperatively using the Zurich Claudication Questionnaire (ZCQ); Visual Analog Scale (VAS) of low back pain, leg pain, and leg numbness; Japanese Orthopaedic Association Back Pain Evaluation Questionnaire; and the Medical Outcomes Study 36-item Short-Form General Health Survey (SF-36). The Hospital Anxiety and Depression Scale (HADS), Pain Catastrophizing Scale, and Pain Anxiety Symptoms Scale were used to evaluate psychological status before surgery. Patients were classified as satisfied or dissatisfied with surgery based on a ZCQ satisfaction subscale cutoff score of 2.5. Results: The satisfied and dissatisfied groups contained 128 and 29 patients, respectively. Six months postoperatively, outcome scores for the dissatisfied group were unchanged or worse than preoperative scores (p>0.05). Multivariate logistic regression analysis showed significant associations between dissatisfaction and preoperative low back pain VAS score ≥ median (odds ratio [OR], 0.27; 95% confidence interval [CI], 0.10–0.74; p=0.01), preoperative mental health SF-36 score ≥ median (OR, 0.26; 95% CI, 0.08–0.89; p=0.03), and preoperative anxiety HADS score ≥ median (OR, 3.95; 95% CI, 1.16–13.46; p=0.03). Conclusions Preoperative less severe low back pain, lower mental health, and higher anxiety are associated with patient dissatisfaction with lumbar surgery, not depression, pain catastrophizing, or fear-avoidance beliefs. Pre- and postoperative psychological status should be assessed carefully and managed appropriately.

To improve resident performance in clinical practice, the R2C2 model was developed for supervisors who need to guide their residents’ reflection. It consists of four stages: Relationship building, exploring Reactions, exploring Content, and Coaching. It has been shown to effectively engage residents in reflective, goal-oriented discussions and in developing a Learning Change Plan with their supervisors. This paper introduces the Japanese translated version of the model and the evidence of its use.