Children with severe multiple disabilities face numerous possibilities for enjoying music and participating in performance activities; however, the research practice for realizing these possibilities ...involves various difficulties. To understand the disabilities of children and their engagement with music, awareness of one’s perception of disability is necessary for each practitioner–researcher. The researchers of the current study reflected on their personal views about disability and life histories and described and analyzed them through collaborative autoethnography (CAE). The study was conducted through the practice of combining electronic music equipment and traditional instruments as a music education project for children with severe multiple disabilities. The results demonstrated that the perceptions of the researchers about disability and their life histories interacted with and transformed their research practice. Additionally, the study highlighted how endeavors in CAE encouraged dialogue among researchers and deepened mutual understanding. The suggestions for researchers of music education practice with children with disabilities include analysis of disability from the first-person perspective and sharing of views among co-researchers.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
ABSTRACT
The objective of this study was to evaluate the effects of nutrition intervention on nutritional states and healing of pressure ulcers by standardizing or unified factors including nursing, ...care and treatment in a multicenter open randomized trial. Tube‐fed patients with Stage III–IV pressure ulcers were selected. The control group (30 patients) received the same nutrition management as before participating in this trial, whereas the intervention group (30 patients) was given calories in the range of Basal Energy Expenditure (BEE) × 1.1 × 1.3 to 1.5. The intervention period was 12 weeks. The efficacy and safety were evaluated based on the nutritional states and the sizes of ulcers (length × width), and on the incidence of adverse events related to the study, respectively. The calories administered to the control and intervention groups were 29.1±4.9 and 37.9±6.5 kcal/kg/day, respectively. Significant interactions between the presence or absence of the intervention and the intervention period were noted for nutritional states (p<0.001 for body weight, p<0.05 for prealbumin). Similarly, the size of ulcers differed significantly between subjects in the intervention group and in the control group (p<0.001). The results suggest that nutrition intervention could directly enhance the healing process in pressure ulcer patients.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Objectives
To identify factors predicting the presence of extrarenal feeders to renal angiomyolipomas (AMLs)
Methods
This is a retrospective study of 44 patients with 58 renal AMLs embolized in our ...department. Arteriography obtained during embolization and CT angiography obtained before and after embolization were reviewed to characterize AMLs with and without extrarenal feeders. Tumor characteristics were compared between the two groups. Simple logistic regression and ROC curve analysis were performed.
P
< 0.05 was considered to be statistically significant.
Results
Of the 58 AMLs reviewed, 29% had extrarenal arteries and 71% did not. AMLs with extrarenal feeders were significantly larger than those without, in terms of volume (median, 368 mL versus 109 mL,
p
< 0.0002) and the largest diameter (mean, 12.0 cm versus 7.7 cm,
p
< 0.0001). Patient age, presence of tuberous sclerosis complex or sporadic lymphangioleiomyomatosis, and tumor location did not differ between the groups. The largest diameter and volume had similar predictive values for the presence of extrarenal feeders (AUC, 0.83 versus 0.82,
p
= 0.673). Extrarenal feeders were present in 0%, 21%, and 79% of the AMLs ≤ 6.5 cm, AMLs 6.6–10.5 cm, and AMLs > 10.5 cm, respectively.
Conclusions
AML size correlates with the presence of extrarenal feeders, with the largest diameter and volume being significant predictors. AMLs > 10.5 cm had a high chance of extrarenal feeders, making it mandatory to search for feeders to them in order to avoid incomplete embolization; AMLs ≤ 6.5 cm did not have extrarenal feeders, making a search for them unnecessary in these cases.
Key Points
• The presence of extrarenal feeders to renal angiomyolipoma is associated with tumor size, but not with patient age, concomitant disease, or tumor location.
• The largest diameter and volume predict the presence of extrarenal feeders to AML, with similar predictive values.
• AMLs > 10.5 cm have a high chance (79%) of extrarenal feeders, making it mandatory to search for feeders to them in order to avoid incomplete embolization; AMLs ≤ 6.5 cm do not have extrarenal feeders, making a search for them unnecessary in these cases.
This letter describes the multi-rate locally implicit block leapfrog scheme (LIBLS) for the fast transient analysis of multi-layered power/ground planes. LIBLS is the numerical method constructed by ...applying a locally implicit scheme to the existing scheme, which is based on an explicit leapfrog scheme. The proposed method improves LIBLS with introducing a multi-rate technique in the time domain, and using different time step sizes for a variety of sub-circuits, and is applicable to the multi-layered network with many coupling elements.
Aim
To verify the efficacy of defecation care based on handheld ultrasonographic observations for functional constipation by visiting nurses skilled in bowel ultrasonography.
Methods
Home‐care ...patients with suspected functional constipation receiving nursing visits were recruited in this multiple‐baseline, single‐case experiment with intervention points shifted by 1 week. A total of 15 older adults were categorized into 3‐, 4‐, 5‐ or 6‐week intervention phases. Ultrasonographic observations of fecal retention in the colorectum and defecation care based on observations during the ordinal physical assessment were reviewed. Tau‐U was used for confirming the efficacy of the intervention by measuring the number of non‐artificial and artificial defecations, as well as hard stools per week, and the amount of non‐stimulant and stimulant laxatives, enemas and suppositories per week. For evaluating safety, adverse events, such as bowel obstruction and incontinence‐associated dermatitis, were confirmed.
Results
No adverse events were observed. Statistical analysis showed that hard stools and artificial defecation reduced, and that their effect sizes were significant (Tau = −0.48, P < 0.01; Tau = −0.53, P < 0.01). Even the amounts of stimulant laxative and glycerin enema reduced, and their effect sizes were significant (Tau = −0.56, P < 0.01; Tau = −0.34, P = 0.04).
Conclusions
Thus, defecation care based on ultrasonographic assessment by nurses in home‐care settings is safe and effective for improving constipation symptoms and reducing laxative use. Geriatr Gerontol Int 2020; ••: ••–••.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
A novel poly(l-lysine) macromonomer was successfully prepared via a click reaction between vinyl benzyl azide and propargyl-terminated poly(l-lysine), and it was used as a functional stabilizer for ...the dispersion polymerization of styrene; narrowly distributed polystyrene particles were produced as a result, onto which cationic poly(l-lysine) chains were grafted. The resulting particles exhibited a pH-responsive dispersion behavior in aqueous solutions due to the properties of the poly(l-lysine) chains at the particle surface. It was found that the particle size and the surface density of the resultant particles could be varied by tuning the concentrations of the macromonomer, styrene, and initiator used in the initial solution of the dispersion polymerization. The poly(l-lysine) macromonomer was also found to be effective when used as a stabilizer for the dispersion polymerization of both methyl methacrylate and a styrene/acrylonitrile mixture.
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•Direct preparation of surface-cationic polymer particles from various monomers.•Development of a novel cationic macromonomer composed of poly(l-lysine).•Poly(l-lysine) macromonomer as an efficient stabilizer for dispersion polymerizations.•Controllable size and surface density of cationic polymer particles.•pH-Responsive behavior of polymer particles in aqueous solutions.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Aim
The present study aimed to analyze the use of machine learning in ultrasound (US)‐based fecal retention assessment.
Methods
The accuracy of deep learning techniques and conventional US methods ...for the evaluation of fecal properties was compared. The presence or absence of rectal feces was analyzed in 42 patients. Eleven patients without rectal fecal retention on US images were excluded from the analysis; thus, fecal properties were analyzed in 31 patients. Deep learning was used to classify the transverse US images into three types: absence of feces, hyperechoic area, and strong hyperechoic area in the rectum.
Results
Of the 42 patients, 31 tested positive for the presence of rectal feces, zero were false positive, zero were false negative, and 11 were negative, indicating a sensitivity of 100% and a specificity of 100% for the detection of rectal feces in the rectum. Of the 31 positive patients, 14 had hard stools and 17 had other types. Hard stool was detected by US findings in 100% of the patients (14/14), whereas deep learning‐based classification detected hard stool in 85.7% of the patients (12/14). Other stool types were detected by US findings in 88.2% of the patients (15/17), while deep learning‐based classification also detected other stool types in 88.2% of the patients (15/17).
Conclusions
The results showed that US findings and deep learning‐based classification can detect rectal fecal retention in older adult patients and distinguish between the types of fecal retention.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Objective
This study investigated the efficacy and safety of superselective transcatheter arterial embolization for angiomyolipoma at the renal hilum.
Methods
Between August 2012 and January 2015, 13 ...patients with 16 angiomyolipomas at the renal hilum underwent initial, prophylactic, superselective transcatheter arterial embolization. The patients were followed by computed tomography or magnetic resonance imaging, and volume-reduction ratios after embolization were measured.
Results
The mean or median post-embolization volume reduction ratios were 23% (follow-up duration, 1–2 months), 55% (3–6 months), 55% (7–12 months), 66% (1–2 years), 67% (2–3 years), and 54% (>3 years). After initial embolization, none of the 16 tumors bled or required surgery; two (13%) tumors recurred; and three (19%) tumors received repeat embolization. Estimated glomerular filtration rates were not decreased at medians of 7 days (near the time of discharge) and 39 days (first clinical follow-up) post-procedure, compared with baseline. Except for post-embolization syndrome, no procedure-related complications occurred.
Conclusions
Superselective embolization for renal hilar angiomyolipoma is safe and kidney-preserving, with good tumor volume reduction and bleeding prevention.
Aim
Nurses have difficulty assessing the type of constipation by ordinal assessment methods and may therefore struggle to select an appropriate defecation care. Although previous studies described ...the safety and effectiveness of defecation care based on ultrasonographic observations in the colorectum, no standardized educational program has been established. This study aimed to determine the feasibility of the constipation point‐of‐care ultrasound (POCUS) educational program regarding the use of ultrasonography as an assessment tool to determine different types of constipation.
Methods
This descriptive study was conducted for visiting nurses working in Japan. The constipation POCUS educational program that nurses can learn in as short as 7 days comprised four elements: E‐learning, a hands‐on seminar, self‐learning, and objective structured clinical examinations (OSCEs). The nurses were asked to complete a questionnaire regarding the education materials. OSCEs were used to assess the participants' skills in assessing patients based on the use of ultrasound observation in the colorectum.
Results
Of the 44 participants who enrolled, 40 were able to complete the program. All the 40 participants (100.0%) who took the OSCEs were able to pass at the first attempt. Moreover, 94.9% of the trainees indicated that this program was able to cover the content necessary to use ultrasonography in home care settings.
Conclusions
The results of this study suggest that the 7‐day constipation POCUS educational program provided trainees with a foundational knowledge and skills to observe fecal retention in the colorectum. Thus, further educational program enhancements and clinical skill evaluations are needed to maximize the program's effectiveness in the future.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK, VSZLJ
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