Comparative evaluation of the sleep quality metrics between a cardboard bed and a camp cot: a randomized controlled crossover study.

Background: Health-beneficial emergency bedding has become increasingly important for dealing with natural disasters such as the anticipated Nankai Trough earthquake in Japan. When the Great East Japan Earthquake occurred, cardboard beds were provided to evacuees. However, there were concerns about lower back pain and sleep disturbances, as cardboard beds offer insufficient pressure distribution. This study aimed to compare the effects of cardboard beds with those of foldable camp cots on sleep quality. Methods: A randomized controlled crossover study involving 20 healthy participants aged 18-45 years was conducted between June 2022 and January 2023. Participants were asked to sleep for one night on a camp cot and for another night on a cardboard bed, with a minimum three-day washout period between the two nights. Body pressure distribution and sleep metrics obtained from polysomnography (PSG) and questionnaires were compared between the two-bed types (P < 0.05). Results: The camp cot exhibited better body pressure distribution than a cardboard bed, leading to improved sleep satisfaction, bedding comfort, and reduced morning sleepiness. Nevertheless, polysomnography revealed no notable differences in sleep metrics or sleep architecture between the two types of beds. Conclusions: Our findings indicate that cardboard beds have lower pressure dispersion capabilities than camp cots, leading to an increased number of position changes during sleep. Additionally, subjective sleep quality, such as alertness on waking, sleep comfort, and sleep satisfaction, was lower for cardboard beds, suggesting that camp cots might offer a more comfortable bedding option for evacuees. However, there were no discernible differences between the two-bed types in terms of objective sleep metrics derived from PSG. The potential for sleep disturbances caused by lower back pain from a hard mattress has been noted, and it is possible that a single night's experience in healthy individuals might not be enough for sleep issues to manifest.

How has the COVID-19 pandemic influenced nursing students' academic experience and career choices? A qualitative descriptive analysis.

COVID-19 control measures influenced education and training environments and profoundly impacted nursing students' career prospects and academic lives. This study intends to elucidate the impact of the COVID-19 pandemic on nursing students' academic experience and career choices. A qualitative descriptive study was conducted at a 4-year university in Japan, using semi-structured interviews with 14 nursing students. Sandelowski's qualitative descriptive analysis was conducted. We identified 11 categories that summarize COVID-19's influence on students' academic experience and career choices: "Forced change to a new learning system," "Difficult learning thoroughly with restricted face-to-face interactions," "Worries regarding teacher evaluations when face-to-face interactions are restricted," "Adapting to changes in the learning environment," "Finding new ways to learn due to the different learning environment," "Worries regarding career decision-making after losing opportunities to obtain career information," "Fully utilizing limited information resources in deciding where to work while being influenced by others," "Coping with a confusing new job hunting system," "Worries about becoming a nurse without enough practical experience," "Conscious of working as a nurse while facing infections," and "Support from those around me is helpful in an unfamiliar environment." The categories comprised four elements: academic impact, employment/career impact, future impact on working as a nurse, and environmental support. Building an online education/training program, ensuring the availability of regular psychological support, providing abundant information on employment, installing an information desk, and providing regular feedback were considered imperative for supporting nursing students.

Impact of the COVID-19 pandemic on the mental health of nursing students in Japan: a cross-sectional study.

BACKGROUND: The effect of the prolonged coronavirus disease (COVID-19) pandemic on the mental health of nursing students is unclear. This study assesses the prevalence of anxiety, depression, and insomnia among nursing students in Japan during the pandemic and determines the risk factors associated with such symptoms. METHODS: An online survey-based cross-sectional study was conducted from August 16 to October 16, 2021. Participants were first- to fourth-year nursing students enrolled in undergraduate programs at the eight universities in Japan. Anxiety, depression, and insomnia were assessed using the Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Insomnia Severity Index-7, respectively. We calculated descriptive statistics for each measurement item and performed univariate and logistic regression analyses to evaluate the potential risk factors. RESULTS: We received responses from 1,222 of 3,056 nursing students (response rate: 40.0%). After 25 participants were excluded due to missing outcome values, 1,197 students (valid response rate: 98.0%) were included in the analysis. The prevalence of anxiety, depression, and insomnia was 4.8%, 12.4%, and 18.0%, respectively. The risk of anxiety was lower among participants who did not have any relatives or friends who had been infected with SARS-CoV-2 than among those who did (aOR 0.36, 95% CI 0.14-0.94). The risk of depression was higher among participants whose financial status had worsened during the pandemic than among those whose financial status had not changed (aOR 3.44; 95% CI 1.98-5.96). Common factors that increased the risk of anxiety, depression, and insomnia were life satisfaction and fear of COVID-19. CONCLUSION: Mental health-related symptoms among nursing students in Japan have not necessarily worsened with the spread of COVID-19 but were exacerbated by the intensity of changes in daily living and fear, which are psychosocial effects associated with the pandemic.

Accuracy of the Data of Biochemical Parameters in Blood Collected Above the Infusion Insertion Site.

The authors aimed to investigate the possibility of collecting blood samples from above patient intravenous infusion sites by temporarily stopping the infusions while collecting the blood. A hypotonic infusion solution was administered to 5 male patients through the cephalic veins in the forearms of their left upper limbs. The biochemical data of blood collected from the median cubital veins of both patients' arms were compared. The results showed that infusions could change some biochemical test parameters, such as potassium and glucose, to higher levels, even if the infusion was interrupted temporarily during the blood collection from above the insertion site. Blood counts remained unchanged under the same conditions. If the evaluation is performed solely to assess blood counts, using a blood collection site above the insertion site by temporarily interrupting the infusion is feasible.

Impact of the COVID-19 pandemic on mental health of nursing students in Japan: protocol for a cross-sectional study.

INTRODUCTION: The COVID-19 pandemic is spreading globally with a high risk of mortality. It is also significantly affecting mental health. For nursing students, the impact of COVID-19 on mental health is predicted to be significant; however, sufficient data have not been obtained. Therefore, this study will aim to assess the mental health of nursing students and evaluate the related factors. METHODS AND ANALYSIS: This proposed study is a cross-sectional survey using a self-report questionnaire. An online questionnaire will be distributed among all nursing students of eight universities in Japan. The survey questionnaire will consist of questions related to demography, life satisfaction, fear of COVID-19, mental health and physical activities. The target sample size is 1300 nursing students. We will calculate descriptive statistics for each measurement item and perform univariate and logistic regression analyses to evaluate the potential risk factors for anxiety, depression and insomnia symptoms in nursing students. The strength of association will be assessed using the OR and its 95% CIs. Statistical significance will be set at a p<0.05. ETHICS AND DISSEMINATION: The protocol was approved by the Institutional Review Board (IRB) of the University of Hyogo on 22 March 2021 (ID: 2020F29). In addition, all of the participating facilities required ethical approval from their local IRBs. The findings will be disseminated through peer-reviewed publications and conference presentations. We believe that the proposed large-scale investigation of the mental health of nursing students during the COVID-19 pandemic and the relationship between mental health and fear of COVID-19 are novel and will be a strength of this study.

Tapping enhances vasodilation for venipuncture even in individuals with veins that are relatively difficult to palpate.

INTRODUCTION: This study evaluated whether tapping enhances vasodilation in individuals with veins that are relatively difficult to palpate. MATERIALS AND METHODS: Twenty participants (4 men and 16 women, aged 19-22 years) with cutaneous veins that were relatively difficult to palpate even after tourniquet application were recruited. A crossover trial with/without tapping (10 times in 5 s) was performed under tourniquet inflation on the upper arm. Vasodilation was evaluated by venous cross-sectional area, depth of the vein, and elevation of the overlying skin by ultrasonography. Venous palpation scores were also measured. The degree of improvement was estimated by simulation. RESULTS: In total, 60% of participants "sometimes" or "often" experienced unsuccessful venipuncture. After the tapping procedure, the venous cross-sectional area significantly increased (14.6 ± 9.12 mm2 for control and 15.2 ± 9.79 mm2 for tapping) and venous depth significantly decreased (4.57 ± 2.31 mm for control and 4.23 ± 2.41 mm for tapping). A simulation study using these values suggested that tapping increased the longitudinal and crosswise successful ranges of venipuncture by 5-6%. CONCLUSIONS: Tapping in this study enhanced the vasodilation of cutaneous veins that are relatively difficult to palpate. The effectiveness of various vasodilation methods may be compared through the estimation of improvement.

Tapping but not massage enhances vasodilation and improves venous palpation of cutaneous veins.

This paper investigated whether tapping on the median cubital vein or massaging the forearm was more effective in obtaining better venous palpation for venipuncture. Forty healthy volunteers in their twenties were subjected to tapping (10 times in 5 sec) or massage (10 strokes in 20 sec from the wrist to the cubital fossa) under tourniquet inflation on the upper arm. Venous palpation was assessed using the venous palpation score (0-6, with 0 being impalpable). Three venous factors-venous depth, cross-sectional area, and elevation-were also measured using ultrasonography. The venous palpation score increased significantly by tapping but not by massage. Moreover, all 3 venous measurements changed significantly by tapping, while only the depth decreased significantly by massage. The three venous measurements correlated significantly with the venous palpation score, indicating that they are useful objective indicators for evaluating vasodilation. We suggest that tapping is an effective vasodilation technique.

Water-insoluble material from apple pomace makes changes in intracellular NAD⁺/NADH ratio and pyrophosphate content and stimulates fermentative production of hydrogen.

Apple pomace is one of the major agricultural residues in Aomori prefecture, Japan, and it would be useful to develop effective applications for it. As apple pomace contains easily fermentable sugars such as glucose, fructose and sucrose, it can be used as a feedstock for the fermentation of fuels and chemicals. We previously isolated a new hydrogen-producing bacterium, Clostridium beijerinckii HU-1, which could produce H2 at a production rate of 14.5 mmol of H2/L/h in a fed-batch culture at 37 °C, pH 6.0. In this work we found that the HU-1 strain produces H2 at an approximately 20% greater rate when the fermentation medium contains the water-insoluble material from apple pomace. The water-insoluble material from apple pomace caused a metabolic shift that stimulated H2 production. HU-1 showed a decrease of lactate production, which consumes NADH, accompanied by an increase of the intracellular pyrophosphate content, which is an inhibitor of lactate dehydrogenase. The intracellular NAD(+)/NADH ratios of HU-1 during H2 fermentation were maintained in a more reductive state than those observed without the addition of the water insoluble material. To correct the abnormal intracellular redox balance, caused by the repression of lactate production, H2 production with NADH oxidation must be stimulated.

The characteristics of healthy adults with hardly palpable vein--Relations between easy venous palpation and physical factors.

This study aimed to investigate relations between ease of venous palpation and various venous factors, and to elucidate characteristics of hardly palpable veins. Healthy adult volunteers (n = 110) were enrolled. The ease of venous palpation was scored from 0: impalpable to 3: well palpable. Venous factors, namely venous depth, elevation, area and minimal pressure that starts to collapse vein, were measured using an ultrasonography before and after tourniquet inflation at 60 mmHg for 60 s. Tourniquet inflation significantly increased the venous area and venous palpation score. The four venous factors correlated significantly with venous palpation score with the following correlation coefficient: Depth (r = -0.542), Elevation (0.486), area (0.258) and start-to-collapse pressure (-0.220). The characteristics of hardly palpable veins were small size, deep location and little elevation. Although vasodilatation facilitated venous palpation, venous depth and elevation were also important and should be included in future studies in which vasodilatation methods are evaluated.

Relationship between tourniquet pressure and a cross-section area of superficial vein of forearm.

This study investigated the appropriate tourniquet pressure (TP) and duration of tourniquet application for venipuncture by calculating the venous cross-section (VCS) area on ultrasonography. Twenty healthy volunteers without cardiovascular risk factors were enrolled in this study. A target vein (either a cephalic or median cubital vein) was selected on ultrasonography. The pneumatic tourniquet was inflated using a rapid cuff inflator system at setting pressure for 120 sec. TP strength was varied from 20 mmHg to 100 mmHg, in 20 mmHg increments. The order of TP was randomized. Comparisons among more than 3 groups were performed by one-way repeated-measures ANOVA and the Bonferroni method. The VCS area increased rapidly until 10 sec after tourniquet inflation. The VCS area then increased gradually until 30 sec after tourniquet inflation. After that, the VCS area did not increase remarkably. The VCS area increased with TP strength up to 80 mmHg, but the VCS area at TP 100 mmHg decreased to less than that at TP 40 mmHg. Based on these results, we recommend a tourniquet pressure of 60 mmHg, and duration of tourniquet application is 30 to 60 sec for venipuncture.

A family of autosomal dominant hypocalcemia with an activating mutation of calcium-sensing receptor gene.

Autosomal dominant hypocalcemia (ADH) caused by activating mutations of calcium-sensing receptor (CaSR) is characterized by hypocalcemia with inappropriately low concentration of PTH and relative hypercalciuria. Active vitamin D treatment often leads to nephrolithiasis and renal impairment in patients with ADH. However, differential diagnosis between ADH and idiopathic hypoparathyroidism is sometimes very difficult. Here, we report a mutation of CaSR and its functional property found in three generations of a Japanese family. The proband developed seizures at 7 days of age. His mother and elder sister were discovered to have hypoparathyroidism by family survey, but his father was normocalcemic. His grandfather developed heart failure and was found to have hypoparathyroidism. All affected members had been treated with active vitamin D3 and bilateral nephrolithiasis were detected in three of them. DNA sequencing revealed that all affected patients had a heterozygous mutation in CaSR gene that causes proline to leucine substitution at codon 221 (P221L). In vitro functional analysis of the mutant CaSR by measuring inositol 1,4,5-trisphosphate production in response to changes of extracellular Ca indicated that this mutation is an activating one and responsible for ADH in this family. Therefore, careful monitoring of urinary Ca excretion before and during treatment of PTH-deficient hypoparathyroidism is very important, and screening of CaSR mutation should be considered in patients with relative hypercalciuria or with a family history of hypocalcemia.