Problems Perceived by Skilled Nurses regarding the Independence of Children with Congenital Heart Disease.

This study was conducted to determine how skilled nurses perceive the independence of children with congenital heart disease. A questionnaire survey was administered to elicit responses to questions such as whether the skilled nurses noticed problems with the independence of children with congenital heart disease, and whether they thought that support from adults close to the children was needed to foster independence. More than 60% of the 84 nurses perceived problems regarding the independence of children with congenital heart disease. Situations in which skilled nurses noticed problems, in addition to difficulties and limitations in understanding of the disease, included instances of family members making decisions and answering questions and of the child being unable to communicate easily. Nearly all of the skilled nurses felt that support from adults close to children with congenital heart disease was needed to foster their independence.

Factor Structure of Behaviors Demonstrating "Ganbatta" in Young Children Undergoing Blood Sampling/Vaccine Injection Perceived by Nurses: Exploratory Factor Analysis by a Cross-Sectional Survey in Japan.

GANBATTA: ("Well done!") is a term used frequently in Japan to praise children in medical settings when they have worked hard or made a courageous attempt. Therefore, the aim of this study was to clarify the factor structure of behaviors associated with ganbatta in young children (age 3-7 years) undergoing blood sampling or vaccine injection. A cross-sectional questionnaire survey was carried out on 150 selected pediatric nursing educators holding a nursing license (age ≥20 years). An exploratory factor analysis was then conducted using the principal factor method with promax rotation to confirm the construct validity. Cronbach's α coefficients were calculated for each identified factor to verify the internal consistency of the item. The mean (standard deviation) lengths of pediatric nursing and pediatric nursing education experience were 7.8 (4.7) and 9.9 (8.1) years, respectively. The cumulative contribution rate was 70.4%. The KMO measure of sampling adequacy was 0.927. The p value of Bartlett's test of sphericity was <0.001%. Finally, among the children's behaviors, 5 factors were identified and 25 items were selected: Factor 1, Proactive participation, containing 7 items; Factor 2, Sense of relief and joy after needle removal, 6 items; Factor 3, Negative emotional expression, 4 items; Factor 4, Information-seeking, 5 items; and Factor 5, Moving on from the needle procedure, 3 items. These findings indicate that ganbatta is a complex concept that encompasses a variety of aspects in young children in relation to needle procedures. Evaluating a young child's ganbatta behaviors during a needle procedure can serve as an indicator to evaluate the quality of care provided by nurses. Sharing the evaluated results with children and their parents may serve as a foundation to open discussions in regard to higher-quality care. In addition, observing ganbatta behaviors during a needle procedure and providing feedback to the child could help them feel like they have done a good job.

Care of Preschoolers with Congenital Heart Disease by Kindergarten and Nursery Teachers in Japan.

The purpose of this study was to elucidate the involvement of kindergarten and nursery school teachers with young children with congenital heart disease. The study was designed as a qualitative descriptive study. Interviews of kindergarten and nursery school teachers with experience in the care and education of young children with congenital heart disease were conducted, during which they described their experience. Verbatim transcripts of the interviews were prepared, and the content was categorized. The study participants were 11 kindergarten and nursery school teachers. Extracted from the content of the interviews of the study participants were 282 codes, 33 subcategories, 6 categories, and 2 major categories. In their responses, the teachers indicated that they had been "Providing care for the children while seeking ways to avoid special treatment in a group setting." In addition, they established a "Framework for school-parent cooperation in order to promptly accommodate the wishes of parents" of these children. The study showed that the kindergarten and nursery school teachers involved other pupils and monitored the condition of children with congenital heart disease to avoid special treatment of the children in the group setting. In addition, the teachers established a framework for cooperation between the school and parents. In the future, these findings will be used to create a nursing support model for the group life of young children with congenital heart disease.

Effect of oxidative stress during repeated ovulation on the structure and functions of the ovary, oocytes, and their mitochondria.

We previously reported that superoxide generated in the ovary induces apoptosis of granulosa cells to break down follicular walls, thereby supporting ovulation in rodents, and suggested that oxidative stress underlies the mechanism of ovarian aging. To test this hypothesis, we successfully induced ovulation repeatedly in mice by sequentially administrating pregnant mare serum gonadotropin, human chorionic gonadotropin, and prostaglandin F2alpha. Kinetic analysis revealed that the number of ovulated oocytes decreased significantly with repeated cycles of ovulation with a concomitant decrease in the gene expression of mitochondrial transcription factor A and nuclear respiratory factor 1 and an increase in oocytes having abnormally distributed mitochondria. Repeated ovulation decreased the amounts of mitochondrial DNA and increased 8-hydroxydeoxyguanosine in oocytes. Cell culture analysis of the in vivo fertilized oocytes revealed that their maturation from two cells to blastocyst was inhibited significantly by repeated ovulation. All these events induced by repeated ovulation were suppressed by oral administration of L-carnitine. These results suggest that oxidative stress associated with ovulation underlies the mechanism of ovarian aging and that L-carnitine may have therapeutic potential in patients with infertility and increased incidence of aneuploidy and to suppress impaired maturation of zygotes frequently observed in childbearing at an advanced age.