Background:To prevent stent migration during endoscopic ultrasound-guided hepaticogastrostomy(EUS-HGS),intra-scope channel release technique is important,but is unfamiliar to non-expert hands.The self-expandable metal...Background:To prevent stent migration during endoscopic ultrasound-guided hepaticogastrostomy(EUS-HGS),intra-scope channel release technique is important,but is unfamiliar to non-expert hands.The self-expandable metal stent(SEMS)is an additional factor to prevent stent migration.However,no compara-tive studies of laser-cut-type and braided-type during EUS-HGS have been reported.The aim of this study was to compare the distance between the intrahepatic bile duct and stomach wall after EUS-HGS among laser-cut-type and braided-type SEMS.Methods:To evaluate stent anchoring function,we measured the distance between the hepatic parenchyma and stomach wall before EUS-HGS,one day after EUS-HGS,and 7 days after EUS-HGS.Also,propensity score matching was performed to create a propensity score for using laser-cut-type group and braided-type group.Results:A total of 142 patients were enrolled in this study.Among them,24 patients underwent EUS-HGS using a laser-cut-type SEMS,and 118 patients underwent EUS-HGS using a braided-type SEMS.EUS-HGS using the laser-cut-type SEMS was mainly performed by non-expert endoscopists(n=21);EUS-HGS using braided-type SEMS was mainly performed by expert endoscopists(n=98).The distance after 1 day was significantly shorter in the laser-cut-type group than that in the braided-type group[2.00(1.70-3.75)vs.6.90(3.72-11.70)mm,P<0.001].In addition,this distance remained significantly shorter in the laser-cut-type group after 7 days.Although these results were similar after propensity score matching analysis,the distance between hepatic parenchyma and stomach after 7 days was increased by 4 mm compared with the distance after 1 day in the braided-type group.On the other hand,in the laser-cut-type group,the distance after 1 day and 7 days was almost the same.Conclusions:EUS-HGS using a laser-cut-type SEMS may be safe to prevent stent migration,even in non-expert hands.展开更多
To the Editor:Endoscopic sphincterotomy(EST)is an established technique for removal of bile duct stones and self-expandable metal stent(SEMS)deployment.However,bleeding can be considered an adverse event after EST,par...To the Editor:Endoscopic sphincterotomy(EST)is an established technique for removal of bile duct stones and self-expandable metal stent(SEMS)deployment.However,bleeding can be considered an adverse event after EST,particularly for patients with high risk of bleeding such as those on hemodialysis.Among the various techniques reported for obtaining endoscopic hemostasis[1-3].展开更多
Background: The coronavirus disease (COVID-19) pandemic has impacted perinatal women’s mental health. However, protective factors associated with depression among pregnant Japanese women during the pandemic have not ...Background: The coronavirus disease (COVID-19) pandemic has impacted perinatal women’s mental health. However, protective factors associated with depression among pregnant Japanese women during the pandemic have not been reported. Purpose: The present study investigated the risk and protective factors associated with depression and anxiety among pregnant women during the COVID-19 pandemic. Methods: An online questionnaire was administered to 157 pregnant women between October 2022 and May 2023 at two general hospitals in Japan. The Japanese versions of the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to assess symptoms of depression and anxiety. The χ<sup>2</sup> test or Fisher’s exact test and multivariate logistic regression model were used to examine factors associated with depression and anxiety among pregnant women. Results: Overall, 47.1% and 35.7% of the pregnant women reported depressive and anxiety symptoms, respectively. A “history of mental illness” was a risk factor for depression and anxiety among pregnant women during the COVID-19 pandemic. Additionally, unmarried status was a risk factor for anxiety among pregnant women, whereas outdoor and indoor exercises were protective factors against depression and anxiety, respectively. Conclusions: Exercise may have protected pregnant women from depression and anxiety during the COVID-19 pandemic. Encouraging exercise may help maintain the mental health of pregnant women who do not have exercise restrictions.展开更多
Purpose: To clarify the effectiveness of 3-D delivery animation software for the mother’s and husband’s satisfaction with delivery. Subjects and Method: We independently developed a software application used to disp...Purpose: To clarify the effectiveness of 3-D delivery animation software for the mother’s and husband’s satisfaction with delivery. Subjects and Method: We independently developed a software application used to display the pelvic region and explain the labor process. The study involved a collaboration with hospital staff who recruited 18 primiparous and 18 multiparous mothers who were hospitalized for delivery at Facility A. The midwife explained the process of delivery using the “Delivery Animation Software”. A self-administered, anonymous questionnaire was distributed and analyzed separately for primiparous and multiparous mothers and their husbands. Results: 1) For both primiparous and multiparous couples, both mothers and their husbands gained a significantly higher level of understanding after delivery than during pregnancy. 2) The Self-Evaluation Scale for Experience of Delivery results were as follows: “I did my best for the baby even if it was painful” was selected more often for “birth coping skills”;“reliable medical staff” was selected more often for “physiological birth process”;“the birth progressed as I expected” was selected frequently by primiparous mothers;and “the birth progressed smoothly” was selected often by multiparous mothers. 3) In terms of husbands’ satisfaction with the delivery, “I was satisfied with the delivery”, “I was given an easy-to-understand explanation”, and “They explained the process to me” was selected of primiparous and multiparous fathers. 4) All primiparous and multiparous mothers positively evaluated whether the delivery animation was helpful in understanding the process of delivery. Conclusion: The delivery animation was effective in improving the understanding and satisfaction of both the mothers and their husbands.展开更多
The brain’s blood microvessels restrict the exchange of substances between the blood and brain tissue through the blood-brain barrier (BBB). Methyl-glyoxal (MG), a byproduct of glucose metabolism, contributes to the ...The brain’s blood microvessels restrict the exchange of substances between the blood and brain tissue through the blood-brain barrier (BBB). Methyl-glyoxal (MG), a byproduct of glucose metabolism, contributes to the formation of advanced glycation end products (AGEs) and disrupts the BBB, which is associated with neurodegenerative diseases. L-Theanine (TA), an amino acid found in green tea with antioxidant properties, may protect the BBB. This study aimed to determine whether MG increases reactive oxygen species (ROS) and permeability by reducing tight junction proteins in human cerebral microvascular endothelial cells (hCMEC/d3), and whether TA pretreatment can counteract these effects. Our findings demonstrated that MG treatment led to increased BBB permeability, decreased transendothelial electrical resistance (TEER) values to 39% of control levels, reduced expression of Claudin-5 to 53% and Occludin to 69% of control levels, and elevated intracellular ROS levels. TA pretreatment restored barrier integrity, preserved tight junction protein expression, and decreased ROS accumulation to levels comparable to control levels. These findings suggest that TA effectively prevents MG-induced BBB dysfunction by reducing oxidative stress and maintaining tight junction proteins, showing promise as a protective agent for the BBB in conditions associated with elevated MG and AGEs.展开更多
To the Editor:Obstructive jaundice due to unresectable malignant hilar obstruction can be treated by deployment of bilateral uncovered self-expandable metal stents(UCSEMSs),which enable longer stent patency to be obta...To the Editor:Obstructive jaundice due to unresectable malignant hilar obstruction can be treated by deployment of bilateral uncovered self-expandable metal stents(UCSEMSs),which enable longer stent patency to be obtained compared with multiple plastic stents[1-3].However,re-intervention is needed if obstructive jaundice occurs after bilateral UCSEMS deployment.During re-intervention procedures,insertion of the stent delivery system across the mesh of a UCSEMS and into the bile duct can be challenging.A novel drill dilator has recently become available in Japan(Tornus ES;Asahi Intecc,Nagoya,Japan)(Fig.1)[4].The tract is easily dilated using a clockwise rotation.We herein describe a successful re-intervention using this device for a patient with occluded bilateral UCSEMSs.展开更多
Purpose: To determine the incidence of depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature search was conducted on July 2022 through PubMed, CINAHL, MEDLINE, CiNii...Purpose: To determine the incidence of depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature search was conducted on July 2022 through PubMed, CINAHL, MEDLINE, CiNii, and the Japan Medical Abstract Society using the keywords “COVID-19”, “Pregnant Women” and “Depression”. The titles/abstracts were screened based on three selection criteria: 1) inclusion of pregnant women;2) description of depression;3) description of COVID-19. Results: Of the 213 articles that were extracted, 104 were excluded owing to duplication and 14 were excluded because they comprised other article types, including reviews and commentaries. Finally, 49 were excluded by title, abstract, and full-text screening. Among the 46 articles that met the inclusion criteria, 13 articles (28.3%) were from China, 8 (17.4%) were from Turkey, 4 (8.7%) were from the United States, and 3 (6.5%) were from Japan. The most common scales used to measure depression were the Edinburgh Postnatal Depression Scale (EPDS) used in 18 articles (39.1%), followed by the Patient Health Questionnaire (PHQ-9) used in 11 articles (23.9%). Furthermore, 46 sources reported a suspected depression rate of 30.0% (20,338/67,860 pregnant women). The rate of depression was 15.1% - 33.5% using EPDS ≥ 9 in three articles and 12.0% - 43.2% using EPDS ≥ 13 in nine articles. The five articles using PHQ-9 ≥ 5 reported 25.8% - 48.7%, and seven articles reported 5.3% - 59.2% using PHQ-9 ≥ 10. Conclusion: Depression was a concern for one out of every three to four pregnant women during the COVID-19 pandemic. This suggests that depression among pregnant women during COVID-19 might have worsened, highlighting the need for mental health support for them.展开更多
Purpose: This study aimed to develop teaching materials to prevent the dangers of ablution and bathing infants, based on the dangerous experiences of mothers and family members, and examine their appropriateness. Meth...Purpose: This study aimed to develop teaching materials to prevent the dangers of ablution and bathing infants, based on the dangerous experiences of mothers and family members, and examine their appropriateness. Methods: A total of 20 midwives and public health nurses were selected as participants. Teaching materials and anonymous self-administered questionnaires were distributed, and the participants were asked to view the teaching materials and fill in the questionnaires. Retrieval was done by mail. The teaching materials included digital content, such as videos, sounds, and characters, which incorporated dangerous situations, preventions, and innovations in ablution and bathing procedures. The analysis was conducted by simple tabulation for each survey item. The free description was coded to preserve anonymity. This study was conducted with the approval of the Research Ethics Review Board of the authors’ affiliated university. Results: The teaching materials were found to be appropriate in terms of suitability to purpose, degree of difficulty of content, ease of viewing the videos, validity of time, appropriateness of expression, and usability. Conclusions: Ablution teaching materials that are used at the present time do not focus on dangers, and to date, no resources on bathing have been used as teaching materials. The created teaching materials in this study can be viewed multiple times, and mothers and family members who are unfamiliar with ablution and bathing can acquire knowledge regarding dangers and danger prevention. The addition of specific preventive measures and countermeasures for the occurrence of danger, along with practice, would result in the development of further appropriate teaching materials to reduce danger and alleviate anxiety.展开更多
This study examined the situation of raising a four-month-old baby after pregnancy and childbirth during the COVID-19 pandemic. A fact-finding survey was conducted using an anonymous self-administered questionnaire fo...This study examined the situation of raising a four-month-old baby after pregnancy and childbirth during the COVID-19 pandemic. A fact-finding survey was conducted using an anonymous self-administered questionnaire for mothers and their husbands (hereinafter referred to as fathers) who came to A City, Osaka Prefecture, for health checkups of their four-month-old infants. The questionnaire was distributed to 733 mothers (252 responses). Valid responses were received from 247 participants (33.7%). The questionnaire was distributed to 733 fathers (191 responses). Valid responses were received from 184 participants (25.1%). Most participants belonged to nuclear family households. Sixty percent parents were primiparous. More than 90% parents did not participate in online parenting classes or attend childbirth. In addition, more than 80% mothers did not participate in face-to-face or online maternity classes, postpartum face-to-face visits from grandparents in the hospital, online home visits, telephone conversations, or support from non-relatives. Parents could not obtain information about childcare due to COVID-19. There were restrictions on prenatal checkups, visits, and use of facilities. Most of them resolved these problems via social media platforms, cooperating and communicating with their respective partners and relatives, and devising ways to play with their child. Health of nearly 30% mothers was affected by childcare stress and the pandemic, and they were either depressed or despondent. Approximately 70% experienced positive changes in family relationships and mindsets, such as time spent with family and cooperation received in childcare. During the COVID-19 pandemic, parents coped with various changes and problems they experienced during pregnancy, childbirth, and childcare by devising solutions based on their personal perspectives.展开更多
Purpose: This purpose of the study was to investigate the factors both risk and protective associated with depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature sear...Purpose: This purpose of the study was to investigate the factors both risk and protective associated with depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature search was conducted on July 2022, through PubMed, CINAHL, MEDLINE, CiNii, and the Japan Medical Abstract Society databases, with the keywords “COVID-19”, “pregnant women”, and “depression”. The titles/abstracts were screened based on three selection criteria: 1) inclusion of pregnant women;2) description of depression;and 3) description of the factors associated with depression among pregnant women during the COVID-19 pandemic. Results: Of the 213 articles extracted, 104 were excluded owing to duplication, and 14 were excluded because they comprised other article types, including reviews and commentaries. Finally, 40 were excluded by title, abstract, and full-text screening. Among the 45 articles for a total of 59,329 pregnant women that met the inclusion criteria, the risk factors were “distress from COVID-19-related experiences”, “reduced/low income”, “unemployment”, “anxiety”, “history of mental illness”, “lack of social support”, and “reduced/no exercise”. The protective factors “greater/increased social support”, “higher education level”, “higher resilience”, and “healthy lifestyle behaviors” were much less frequently reported than risk factors, and none were reported to be relevant for Japanese pregnant women. Conclusion: The findings indicate that preventive interventions should begin during pregnancy with a focus on these risk factors. In addition, the protective factors need to be strengthened. Further research is required to identify the protective factors associated with depression among Japanese pregnant women.展开更多
Background and Objective: Anma is a traditional Japanese bodywork therapy that has not been widely known and used in the West. There have been only a few Anma studies published in English journals. To study the effect...Background and Objective: Anma is a traditional Japanese bodywork therapy that has not been widely known and used in the West. There have been only a few Anma studies published in English journals. To study the effect of Anma (traditional Japanese massage) among participants who have neck and shoulder stiffness symptoms (so-called Katakori, in Japanese). Methods: The study participants consisted of seventy-seven (Study 1), thirteen (Study 2), and twenty (Study 3) adults with “Katakori” symptoms. The research design is as follows: (Study1) Randomized, Parallel-Group, Controlled Trial. (Study 2) Crossover Clinical Trial. (Study 3) Randomized, Parallel-Group, Controlled Trial. And we conducted Anma treatment for 45 minutes (Treatment) or rest in lying position for 45 minutes (Control). Results: In study 1, the symptom of “Katakori” was relieved after Anma treatment in Anma group (p d: 2.2). There was a significant interaction between the Anma group and the control group (p < 0.001). In study 2, MBV significantly increased following Anma treatment. There was a significant interaction between the Anma group and the control group (p = 0.022). In study 3, the symptom of “Katakori” was relieved after Anma treatment in the treatment group. There were no significant interactions between the groups in VAS and MBV values. Discussion and Conclusions: The study demonstrated that Anma therapy decreases “Katakori” symptoms while increasing MBV in the shoulder region.展开更多
<strong>Purpose:</strong> The purpose of this study is to explore the dangers experienced by mothers and families of infants aged 3 - 4 months in Japan during ablution and bathing.<strong> Method:<...<strong>Purpose:</strong> The purpose of this study is to explore the dangers experienced by mothers and families of infants aged 3 - 4 months in Japan during ablution and bathing.<strong> Method:</strong> We distributed an anonymous, self-reported questionnaire at infants’ 3 - 4-month health checkup, which was collected via postal service. 170 valid responses were received and formed our sample data. Descriptive statistical analysis was performed for each category surveyed. Inferential statistics were used to compare the dangerous incidents experienced with regard to differences between primi/multipara and the presence/absence of guidance concerning such incidents. This study was approved by the research ethics committees of the affiliated university. <strong>Results:</strong> 60.0% of mothers and families experienced dangers while washing their infant in a baby tub or similar apparatus (ablution), and 64.9% did while bathing their infant in the normal bath. For ablution, the most common dangers were, in order, nearly dropping the infant in the water and nearly getting soap suds in the mouth. For bathing, these were nearly getting soap suds in the mouth, near submersion of the face, and nearly dropping the infant in the water. The percentage of mothers and families who did not receive instruction regarding potential dangers and their prevention was 55.9% for ablution and 81.8% for bathing. <strong>Conclusion:</strong> This study revealed the dangers experienced by mothers and families of infants aged 3 - 4 months in Japan during ablution and bathing. Further consideration into the prevention of these dangers is necessary.展开更多
Purpose: The purpose of this study was to investigate the effects of Micro Vibrational therapy (MVT) on muscle stiffness and blood flow in the skin before and after Micro Vibrational therapy in healthy subjects in ord...Purpose: The purpose of this study was to investigate the effects of Micro Vibrational therapy (MVT) on muscle stiffness and blood flow in the skin before and after Micro Vibrational therapy in healthy subjects in order to scientifically verify the effects of MVT. Methods: Micro Vibrational therapy is nurse care use in Japan. It was performed on the backs of 30 subjects (8 males and 22 females) in their 20 s to 50 s according to the eligibility criteria. The resting state before implementation was set as the baseline for the control group, and after 30 seconds of MVT was set as the intervention group. The effects of the MVT were statistically analyzed by these factors and subjective sensation by Visual Analog Scale. Results: The muscle hardness of the area where the MVT was applied for 30 seconds decreased to 29.54 (SD 5.04) after the application, compared to 30.45 (SD 5.05) before. A corresponding t-test showed a significant difference (p = 0.019). Skin blood flow increased from a median of 0.76 (variance 0.062) before to a median of 0.86 (variance 0.16) after the procedure. The Wilcoxon rank test showed a significant difference (p = 0.000). Circulatory response was confirmed by SBP, DBP, and HR. SBP of 108.6 mmHg (SD 14.8) before the study decreased to 105.7 mmHg (SD 15.0) after the study, and DBP of 65.6 mmHg (SD 11.1) before the study decreased to 62.7 mmHg (SD 11.8) after the study. HR decreased from 71.6 beats per minute (SD 10.3) before to 69.2 beats per minute (SD 11.7) after. There was a significant difference in all cardiovascular indices (p < 0.05). VAS (pain, stiffness, and fatigue) was significantly decreased after MVT (p < 0.05). Conclusion: Micro Vibrational therapy tended to decrease muscle hardness and increase skin blood flow even in the short time of 30 seconds. The results suggest that local vibration stimulation is not likely to cause a sudden increase in blood pressure or pulse rate fluctuation. These results suggest that hand vibration nursing care may be applicable to acute patients with unstable circulatory conditions.展开更多
<strong>Purpose</strong><strong>:</strong> The purpose is to identify what difficulties fathers have with the roles of fatherhood during pregnancy and early infancy, and to make apparent what t...<strong>Purpose</strong><strong>:</strong> The purpose is to identify what difficulties fathers have with the roles of fatherhood during pregnancy and early infancy, and to make apparent what their educational support needs are. <strong>Methods:</strong> This study follows a qualitative descriptive design. The subjects were new first-time fathers of Japanese nationality. Subjects participated in semi-structured interviews administered according to interview guidelines. <strong>Results:</strong> There were 15 subjects in total. The average age of the subjects’ children was 5.5 months. Fathers’ difficulties with their new roles were abstracted in to five main categories: < Difficulties during early engagement with child >, < Difficulties related to child crying >, < Difficulties arising after getting through the early engagement stage >, < Difficulties related to support of partner >, and < Mental burdens associated with childrearing >. Additionally, the types of support fathers requested to help maintain their mental health after the birth of their infants were abstracted into three main categories: < Support with childcare knowledge/acquiring skills >, < Support in building a positive marital relationship >, and < Support in maintaining own mental health >. <strong>Conclusions:</strong> 1) The stress experienced by fathers from the birth of their child through early infancy, originating in two elements of fatherhood (engagement with the child and spousal support), placed a great mental burden upon them in a multi-layered structure;2) The support that needs fathers expressed to maintain their mental health pre- and postpartum is based on the difficulties they experienced with paternal roles;3) There is a disparity between the needs of fathers expressed through the results of this study and current paternal support practices in Japan. The supplementation and revision of existing paternal support practices is an issue that merits further consideration. Furthermore, the existing group interview method suffers from low attendance, and attending has become increasingly difficult due to the COVID-19 pandemic spreading throughout Japan. It is necessary to consider alternative methods of educational support moving forward.展开更多
<strong>Purpose:</strong> The potential dangers of infant bathing have an effect not only on the infant’s body and life but also on the formation of emotional bonds in the parent-child relationship. This ...<strong>Purpose:</strong> The potential dangers of infant bathing have an effect not only on the infant’s body and life but also on the formation of emotional bonds in the parent-child relationship. This study will explore actual dangers experienced by mothers and families. <strong>Method: </strong>We distributed an anonymous, self-reported questionnaire at infants’ 18-month health checkup, which was collected via postal service. 304 valid responses were received and formed our sample data. Descriptive statistical analysis was performed for each category surveyed. Inferential statistics were used to compare the dangerous incidents experienced with regard to differences between primipara/multipara and the presence/absence of guidance concerning such incidents. This study was approved by the research ethics committees of the affiliated university. <strong>Results:</strong> 70% of mothers and families experienced incidents while bathing their infants, with the most common incidents consisting of, in order of frequency, near immersion of the face, actual immersion of the face, and falling into the bath. The most common situations reported when incidents occurred were bathing the infant by oneself, the infant moving unexpectedly, or taking care of other children, in that order. Approximately 70% of mothers and families had not received instruction on the potential dangers or how to prevent them. <strong>C</strong><strong>onclusion:</strong> This study has elucidated the dangerous situations experienced in the course of bathing infants in the home and the measures taken to prevent such situations. Instructive tools are needed which can be used to easily provide mothers and families with correct information.展开更多
Objective: This study aimed to identify whether mothers who had undergone their one-month checkup at obstetrical care facilities and were raising infants up to four months of age recognized child maltreatment, the cop...Objective: This study aimed to identify whether mothers who had undergone their one-month checkup at obstetrical care facilities and were raising infants up to four months of age recognized child maltreatment, the coping strategies that they used to calm their emotions during those moments, and types of support felt necessary. Method: This was a qualitative, descriptive design study conducted from July 2022 to March 2023. Semi-structured interviews based on an interview guideline of 21 first-time mothers raising infants up to four months of age were conducted. The responses were classified into categories. Results: Situations that mothers caring for infants up to four months of age recognized as child maltreatment were classified into 11 categories, such as [Becoming emotional for not understanding the child’s needs or the reason for their crying, and reacting confrontationally towards the child]. Coping strategies that helped mothers calm their emotions during those moments were classified into 10 categories, such as [Conversing with adults around them]. Types of support that mothers felt necessary were classified into 14 categories, such as [Guidance from experts on the growth and development of their children, even after leaving the maternity facility]. Discussion: Maltreatment recognized by postpartum mothers up to four months after birth was classified into two categories: situations involving actions taken towards the child, although not at a serious level, and situations where no actual actions were taken. Even acts that do not actually constitute maltreatment were considered maltreatment. During parenting, every mother may experience negative feelings towards her child and may face moments when she feels incapable of engaging with her child. The importance of socially supporting mothers who are often alone with their children and having preventive approaches for all postpartum mothers were suggested as supportive measures needed to prevent the occurrence of maltreatment.展开更多
Boron neutron capture therapy(BNCT)is a cancer treatment modality based on the nuclear capture and fission reactions that occur when boron-10,a stable isotope,is irradiated with neutrons of the appropriate energy to p...Boron neutron capture therapy(BNCT)is a cancer treatment modality based on the nuclear capture and fission reactions that occur when boron-10,a stable isotope,is irradiated with neutrons of the appropriate energy to produce boron-11 in an unstable form,which undergoes instantaneous nuclear fission to produce high-energy,tumoricidal alpha particles.The primary purpose of this review is to provide an update on the first drug used clinically,sodium borocaptate(BSH),by the Japanese neurosurgeon Hiroshi Hatanaka to treat patients with brain tumors and the second drug,boronophenylalanine(BPA),which first was used clinically by the Japanese dermatologist Yutaka Mishima to treat patients with cutaneous melanomas.Subsequently,BPA has become the primary drug used as a boron delivery agent to treat patients with several types of cancers,specifically brain tumors and recurrent tumors of the head and neck region.The focus of this review will be on the initial studies that were carried out to define the pharmacokinetics and pharmacodynamics of BSH and BPA and their biodistribution in tumor and normal tissues following administration to patients with high-grade gliomas and their subsequent clinical use to treat patients with highgrade gliomas.First,wewill summarize the studies thatwere carried out in Japan with BSH and subsequently at our own institution,The Ohio State University,and those of several other groups.Second,we will describe studies carried out in Japan with BPA and then in the United States that have led to its use as the primary drug that is being used clinically for BNCT.Third,although there have been intense efforts to develop new and better boron delivery agents for BNCT,none of these have yet been evaluated clinically.The present reportwill provide a guide to the future clinical evaluation of new boron delivery agents prior to their clinical use for BNCT.展开更多
Background: Little is known about what the experience of “taking antipsychotics” means in a patient’s life. Therefore, this study aims to identify what it means for patients with schizophrenia living in the communi...Background: Little is known about what the experience of “taking antipsychotics” means in a patient’s life. Therefore, this study aims to identify what it means for patients with schizophrenia living in the community to remain on medication. Methods: The participants were five residents of communities, who had been discharged from a psychiatric hospital, but were currently visiting a private psychiatric hospital. In this study, we used participants’ narratives as data and analyzed them according to the procedures described in “An Application of Phenomenological Method in Psychology” (Giorgi, 1975), and “Practice of analyzing materials describing experiences” (Giorgi, 2004). Results: The study results are as follows. 1) The drug may be effective, but Subject (below, S) still wants to take it as little as possible. Meanwhile, S has people who care about S and a person who S can rely on nearby, to manage S’s life. The people above tell S to take medicine, and S takes it. 2) S does not know what kind of medication S is consuming, but recently S has been having a hard time walking;S has people who care for S’s foot and look after S. S thinks taking medicine is for living. 3) S feel some drugs is ineffective. However, S met some people S could trust who passionately recommended the medication to S. S started being careful in remembering to take it. 4) S does not think drugs are necessary for S, but S can interact with people and spend S’s days. S has people who accept S as S is. S continues living in the community while taking medicine that a doctor offers. 5) S was skeptical about the drugs. However, S has a person S can trust, who recommended a way to take the medication in a way that S does not feel overwhelmed. S thinks that it may be a good idea to take it. Conclusions: Based on the analysis of the narratives of each of the five participants, the essential structure was read from the perspective of a third party regarding participants’ medication adherence. A generalized reading of the structure common to the above five essential structures reveals a structure that includes the following three opportunities: 1) Patients realize the importance of people;2) They sometimes entrust themselves to people or follow people’s opinions when taking actions;3) They have come to terms with their initial negative feelings about antipsychotic drugs, subsequently continuing to take antipsychotic drugs. This suggests that the following are important attitudes of supporters of patients with schizophrenia who continue to live in the community: To accept what is happening to the patients, to talk to them with encouragement and compassion, and to be there for them. It is also important for supporters to make patients feel comfortable in opening up while the patients reside in the community and to support patients in making decisions.展开更多
Background: Our previous research concerned the relation between Sense of Coherence, workplace stress, and burnout for nurses in their first three years of work. We found that their psychological state in the first th...Background: Our previous research concerned the relation between Sense of Coherence, workplace stress, and burnout for nurses in their first three years of work. We found that their psychological state in the first three months on the job was particularly critical to their success and retention. As workplace stress increased over their first three years, their Sense of Coherence declined, and their burnout increased. Follow-up interviews after five years revealed the importance of identifying role models early on and feeling their own growth in the responses of their patients. Based on these findings, in 2015 we instituted a program to improve new nurses’ Sense of Coherence. The present research was to evaluate the effectiveness of this training program. Purpose: The purpose of this study was to evaluate the effectiveness of a training program in raising Sense of Coherence. Method: From June of 2015 to March of 2017, we surveyed Sense of Coherence of 137 new nurses who completed our training program, comparing them to a cohort of 960 nurses whom we had studied in 2010-11 without such a training program. We analyzed their responses using SPSS Version 24.0, taking a probability of less than 5% to be significant. Results: In terms of Sense of Coherence, the training program improved new nurses’ “comprehensibility” and “manageability” in the first three months, but both dropped to levels comparable to the untrained nurses after six months. There was no significant difference in “meaningfulness”, which dropped over the first year in both groups. Categorized into three groups according to SOC score at the time of employment in the intervention group, 36 participants were classified into the low score group, 41 participants were classified into the medium score group, and 44 participants were classified into the high score group. Then changes in SOC in each group were then compared. In the LOW group, the scores for “comprehensibility”, “manageability”, and “meaningfulness” increased significantly throughout the year, while in the HIGH group, scores decreased significantly. Conclusions: Our training program did raise new nurses’ sense of growth over the first year, and significantly improved their “comprehensibility” and “manageability” over the first three months. However, the fact that their Sense of Coherence dropped to control group levels after six months suggests the need for further intervention to maintain “comprehensibility” and “manageability” over the longer term. In the LOW group, the scores for “comprehensibility”, “manageability”, and “meaningfulness” increased significantly throughout the year, however, the total SOC score for the LOW group remained low throughout the year. Thus, additional support is needed over-and-above the training presented in this study for those nurses with low SOC scores at time of employment.展开更多
Objective: To determine whether patients with unresponsive wakefulness syndrome respond to auditory stimuli based on changes in facial expressions. Participants: Six patients diagnosed with disorders of consciousness ...Objective: To determine whether patients with unresponsive wakefulness syndrome respond to auditory stimuli based on changes in facial expressions. Participants: Six patients diagnosed with disorders of consciousness due to brain injury with permission for participation from their doctor. Design: In this hypothesis-driven observational study, the facial expressions of patients with unresponsive wakefulness syndrome were video-recorded for 5 min before and during auditory stimulation in three consecutive weekly sessions. Main Measures: Facial muscle movement was quantified using FaceReader<sup>®</sup> software (Noldus, Wageningen, Netherlands). Valence/action unit values were plotted to detail facial expression changes. Heart rate values were also plotted. These parameters were compared before and after stimulation. Results: No significant differences in valence integral values or average heart rate were observed between the pre- and intra-stimulus conditions. However, valence signals increased in approximately half of the sessions, indicating that some patients with unresponsive wakefulness syndrome may exhibit emotional responses to auditory stimuli. Analysis of action unit integral values indicated that movement of the eyebrows and eyelids on the upper part of the face occurred during auditory stimulation. Furthermore, the types of auditory stimuli differed depending on the session for the 12 sessions of voice stimuli, whereas the changes in average heart rate differed in each of nine sessions of music stimuli. Because the changes in average heart rate were similar, it is possible that musical stimuli are more suitable than voice stimuli. Conclusion: Some patients with unresponsive wakefulness syndrome may have an emotional response to auditory stimuli. Our findings indicate that it may be possible to distinguish the emotional expression response of a patient based on their facial expression.展开更多
文摘Background:To prevent stent migration during endoscopic ultrasound-guided hepaticogastrostomy(EUS-HGS),intra-scope channel release technique is important,but is unfamiliar to non-expert hands.The self-expandable metal stent(SEMS)is an additional factor to prevent stent migration.However,no compara-tive studies of laser-cut-type and braided-type during EUS-HGS have been reported.The aim of this study was to compare the distance between the intrahepatic bile duct and stomach wall after EUS-HGS among laser-cut-type and braided-type SEMS.Methods:To evaluate stent anchoring function,we measured the distance between the hepatic parenchyma and stomach wall before EUS-HGS,one day after EUS-HGS,and 7 days after EUS-HGS.Also,propensity score matching was performed to create a propensity score for using laser-cut-type group and braided-type group.Results:A total of 142 patients were enrolled in this study.Among them,24 patients underwent EUS-HGS using a laser-cut-type SEMS,and 118 patients underwent EUS-HGS using a braided-type SEMS.EUS-HGS using the laser-cut-type SEMS was mainly performed by non-expert endoscopists(n=21);EUS-HGS using braided-type SEMS was mainly performed by expert endoscopists(n=98).The distance after 1 day was significantly shorter in the laser-cut-type group than that in the braided-type group[2.00(1.70-3.75)vs.6.90(3.72-11.70)mm,P<0.001].In addition,this distance remained significantly shorter in the laser-cut-type group after 7 days.Although these results were similar after propensity score matching analysis,the distance between hepatic parenchyma and stomach after 7 days was increased by 4 mm compared with the distance after 1 day in the braided-type group.On the other hand,in the laser-cut-type group,the distance after 1 day and 7 days was almost the same.Conclusions:EUS-HGS using a laser-cut-type SEMS may be safe to prevent stent migration,even in non-expert hands.
文摘To the Editor:Endoscopic sphincterotomy(EST)is an established technique for removal of bile duct stones and self-expandable metal stent(SEMS)deployment.However,bleeding can be considered an adverse event after EST,particularly for patients with high risk of bleeding such as those on hemodialysis.Among the various techniques reported for obtaining endoscopic hemostasis[1-3].
文摘Background: The coronavirus disease (COVID-19) pandemic has impacted perinatal women’s mental health. However, protective factors associated with depression among pregnant Japanese women during the pandemic have not been reported. Purpose: The present study investigated the risk and protective factors associated with depression and anxiety among pregnant women during the COVID-19 pandemic. Methods: An online questionnaire was administered to 157 pregnant women between October 2022 and May 2023 at two general hospitals in Japan. The Japanese versions of the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to assess symptoms of depression and anxiety. The χ<sup>2</sup> test or Fisher’s exact test and multivariate logistic regression model were used to examine factors associated with depression and anxiety among pregnant women. Results: Overall, 47.1% and 35.7% of the pregnant women reported depressive and anxiety symptoms, respectively. A “history of mental illness” was a risk factor for depression and anxiety among pregnant women during the COVID-19 pandemic. Additionally, unmarried status was a risk factor for anxiety among pregnant women, whereas outdoor and indoor exercises were protective factors against depression and anxiety, respectively. Conclusions: Exercise may have protected pregnant women from depression and anxiety during the COVID-19 pandemic. Encouraging exercise may help maintain the mental health of pregnant women who do not have exercise restrictions.
文摘Purpose: To clarify the effectiveness of 3-D delivery animation software for the mother’s and husband’s satisfaction with delivery. Subjects and Method: We independently developed a software application used to display the pelvic region and explain the labor process. The study involved a collaboration with hospital staff who recruited 18 primiparous and 18 multiparous mothers who were hospitalized for delivery at Facility A. The midwife explained the process of delivery using the “Delivery Animation Software”. A self-administered, anonymous questionnaire was distributed and analyzed separately for primiparous and multiparous mothers and their husbands. Results: 1) For both primiparous and multiparous couples, both mothers and their husbands gained a significantly higher level of understanding after delivery than during pregnancy. 2) The Self-Evaluation Scale for Experience of Delivery results were as follows: “I did my best for the baby even if it was painful” was selected more often for “birth coping skills”;“reliable medical staff” was selected more often for “physiological birth process”;“the birth progressed as I expected” was selected frequently by primiparous mothers;and “the birth progressed smoothly” was selected often by multiparous mothers. 3) In terms of husbands’ satisfaction with the delivery, “I was satisfied with the delivery”, “I was given an easy-to-understand explanation”, and “They explained the process to me” was selected of primiparous and multiparous fathers. 4) All primiparous and multiparous mothers positively evaluated whether the delivery animation was helpful in understanding the process of delivery. Conclusion: The delivery animation was effective in improving the understanding and satisfaction of both the mothers and their husbands.
文摘The brain’s blood microvessels restrict the exchange of substances between the blood and brain tissue through the blood-brain barrier (BBB). Methyl-glyoxal (MG), a byproduct of glucose metabolism, contributes to the formation of advanced glycation end products (AGEs) and disrupts the BBB, which is associated with neurodegenerative diseases. L-Theanine (TA), an amino acid found in green tea with antioxidant properties, may protect the BBB. This study aimed to determine whether MG increases reactive oxygen species (ROS) and permeability by reducing tight junction proteins in human cerebral microvascular endothelial cells (hCMEC/d3), and whether TA pretreatment can counteract these effects. Our findings demonstrated that MG treatment led to increased BBB permeability, decreased transendothelial electrical resistance (TEER) values to 39% of control levels, reduced expression of Claudin-5 to 53% and Occludin to 69% of control levels, and elevated intracellular ROS levels. TA pretreatment restored barrier integrity, preserved tight junction protein expression, and decreased ROS accumulation to levels comparable to control levels. These findings suggest that TA effectively prevents MG-induced BBB dysfunction by reducing oxidative stress and maintaining tight junction proteins, showing promise as a protective agent for the BBB in conditions associated with elevated MG and AGEs.
文摘To the Editor:Obstructive jaundice due to unresectable malignant hilar obstruction can be treated by deployment of bilateral uncovered self-expandable metal stents(UCSEMSs),which enable longer stent patency to be obtained compared with multiple plastic stents[1-3].However,re-intervention is needed if obstructive jaundice occurs after bilateral UCSEMS deployment.During re-intervention procedures,insertion of the stent delivery system across the mesh of a UCSEMS and into the bile duct can be challenging.A novel drill dilator has recently become available in Japan(Tornus ES;Asahi Intecc,Nagoya,Japan)(Fig.1)[4].The tract is easily dilated using a clockwise rotation.We herein describe a successful re-intervention using this device for a patient with occluded bilateral UCSEMSs.
文摘Purpose: To determine the incidence of depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature search was conducted on July 2022 through PubMed, CINAHL, MEDLINE, CiNii, and the Japan Medical Abstract Society using the keywords “COVID-19”, “Pregnant Women” and “Depression”. The titles/abstracts were screened based on three selection criteria: 1) inclusion of pregnant women;2) description of depression;3) description of COVID-19. Results: Of the 213 articles that were extracted, 104 were excluded owing to duplication and 14 were excluded because they comprised other article types, including reviews and commentaries. Finally, 49 were excluded by title, abstract, and full-text screening. Among the 46 articles that met the inclusion criteria, 13 articles (28.3%) were from China, 8 (17.4%) were from Turkey, 4 (8.7%) were from the United States, and 3 (6.5%) were from Japan. The most common scales used to measure depression were the Edinburgh Postnatal Depression Scale (EPDS) used in 18 articles (39.1%), followed by the Patient Health Questionnaire (PHQ-9) used in 11 articles (23.9%). Furthermore, 46 sources reported a suspected depression rate of 30.0% (20,338/67,860 pregnant women). The rate of depression was 15.1% - 33.5% using EPDS ≥ 9 in three articles and 12.0% - 43.2% using EPDS ≥ 13 in nine articles. The five articles using PHQ-9 ≥ 5 reported 25.8% - 48.7%, and seven articles reported 5.3% - 59.2% using PHQ-9 ≥ 10. Conclusion: Depression was a concern for one out of every three to four pregnant women during the COVID-19 pandemic. This suggests that depression among pregnant women during COVID-19 might have worsened, highlighting the need for mental health support for them.
文摘Purpose: This study aimed to develop teaching materials to prevent the dangers of ablution and bathing infants, based on the dangerous experiences of mothers and family members, and examine their appropriateness. Methods: A total of 20 midwives and public health nurses were selected as participants. Teaching materials and anonymous self-administered questionnaires were distributed, and the participants were asked to view the teaching materials and fill in the questionnaires. Retrieval was done by mail. The teaching materials included digital content, such as videos, sounds, and characters, which incorporated dangerous situations, preventions, and innovations in ablution and bathing procedures. The analysis was conducted by simple tabulation for each survey item. The free description was coded to preserve anonymity. This study was conducted with the approval of the Research Ethics Review Board of the authors’ affiliated university. Results: The teaching materials were found to be appropriate in terms of suitability to purpose, degree of difficulty of content, ease of viewing the videos, validity of time, appropriateness of expression, and usability. Conclusions: Ablution teaching materials that are used at the present time do not focus on dangers, and to date, no resources on bathing have been used as teaching materials. The created teaching materials in this study can be viewed multiple times, and mothers and family members who are unfamiliar with ablution and bathing can acquire knowledge regarding dangers and danger prevention. The addition of specific preventive measures and countermeasures for the occurrence of danger, along with practice, would result in the development of further appropriate teaching materials to reduce danger and alleviate anxiety.
文摘This study examined the situation of raising a four-month-old baby after pregnancy and childbirth during the COVID-19 pandemic. A fact-finding survey was conducted using an anonymous self-administered questionnaire for mothers and their husbands (hereinafter referred to as fathers) who came to A City, Osaka Prefecture, for health checkups of their four-month-old infants. The questionnaire was distributed to 733 mothers (252 responses). Valid responses were received from 247 participants (33.7%). The questionnaire was distributed to 733 fathers (191 responses). Valid responses were received from 184 participants (25.1%). Most participants belonged to nuclear family households. Sixty percent parents were primiparous. More than 90% parents did not participate in online parenting classes or attend childbirth. In addition, more than 80% mothers did not participate in face-to-face or online maternity classes, postpartum face-to-face visits from grandparents in the hospital, online home visits, telephone conversations, or support from non-relatives. Parents could not obtain information about childcare due to COVID-19. There were restrictions on prenatal checkups, visits, and use of facilities. Most of them resolved these problems via social media platforms, cooperating and communicating with their respective partners and relatives, and devising ways to play with their child. Health of nearly 30% mothers was affected by childcare stress and the pandemic, and they were either depressed or despondent. Approximately 70% experienced positive changes in family relationships and mindsets, such as time spent with family and cooperation received in childcare. During the COVID-19 pandemic, parents coped with various changes and problems they experienced during pregnancy, childbirth, and childcare by devising solutions based on their personal perspectives.
文摘Purpose: This purpose of the study was to investigate the factors both risk and protective associated with depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature search was conducted on July 2022, through PubMed, CINAHL, MEDLINE, CiNii, and the Japan Medical Abstract Society databases, with the keywords “COVID-19”, “pregnant women”, and “depression”. The titles/abstracts were screened based on three selection criteria: 1) inclusion of pregnant women;2) description of depression;and 3) description of the factors associated with depression among pregnant women during the COVID-19 pandemic. Results: Of the 213 articles extracted, 104 were excluded owing to duplication, and 14 were excluded because they comprised other article types, including reviews and commentaries. Finally, 40 were excluded by title, abstract, and full-text screening. Among the 45 articles for a total of 59,329 pregnant women that met the inclusion criteria, the risk factors were “distress from COVID-19-related experiences”, “reduced/low income”, “unemployment”, “anxiety”, “history of mental illness”, “lack of social support”, and “reduced/no exercise”. The protective factors “greater/increased social support”, “higher education level”, “higher resilience”, and “healthy lifestyle behaviors” were much less frequently reported than risk factors, and none were reported to be relevant for Japanese pregnant women. Conclusion: The findings indicate that preventive interventions should begin during pregnancy with a focus on these risk factors. In addition, the protective factors need to be strengthened. Further research is required to identify the protective factors associated with depression among Japanese pregnant women.
文摘Background and Objective: Anma is a traditional Japanese bodywork therapy that has not been widely known and used in the West. There have been only a few Anma studies published in English journals. To study the effect of Anma (traditional Japanese massage) among participants who have neck and shoulder stiffness symptoms (so-called Katakori, in Japanese). Methods: The study participants consisted of seventy-seven (Study 1), thirteen (Study 2), and twenty (Study 3) adults with “Katakori” symptoms. The research design is as follows: (Study1) Randomized, Parallel-Group, Controlled Trial. (Study 2) Crossover Clinical Trial. (Study 3) Randomized, Parallel-Group, Controlled Trial. And we conducted Anma treatment for 45 minutes (Treatment) or rest in lying position for 45 minutes (Control). Results: In study 1, the symptom of “Katakori” was relieved after Anma treatment in Anma group (p d: 2.2). There was a significant interaction between the Anma group and the control group (p < 0.001). In study 2, MBV significantly increased following Anma treatment. There was a significant interaction between the Anma group and the control group (p = 0.022). In study 3, the symptom of “Katakori” was relieved after Anma treatment in the treatment group. There were no significant interactions between the groups in VAS and MBV values. Discussion and Conclusions: The study demonstrated that Anma therapy decreases “Katakori” symptoms while increasing MBV in the shoulder region.
文摘<strong>Purpose:</strong> The purpose of this study is to explore the dangers experienced by mothers and families of infants aged 3 - 4 months in Japan during ablution and bathing.<strong> Method:</strong> We distributed an anonymous, self-reported questionnaire at infants’ 3 - 4-month health checkup, which was collected via postal service. 170 valid responses were received and formed our sample data. Descriptive statistical analysis was performed for each category surveyed. Inferential statistics were used to compare the dangerous incidents experienced with regard to differences between primi/multipara and the presence/absence of guidance concerning such incidents. This study was approved by the research ethics committees of the affiliated university. <strong>Results:</strong> 60.0% of mothers and families experienced dangers while washing their infant in a baby tub or similar apparatus (ablution), and 64.9% did while bathing their infant in the normal bath. For ablution, the most common dangers were, in order, nearly dropping the infant in the water and nearly getting soap suds in the mouth. For bathing, these were nearly getting soap suds in the mouth, near submersion of the face, and nearly dropping the infant in the water. The percentage of mothers and families who did not receive instruction regarding potential dangers and their prevention was 55.9% for ablution and 81.8% for bathing. <strong>Conclusion:</strong> This study revealed the dangers experienced by mothers and families of infants aged 3 - 4 months in Japan during ablution and bathing. Further consideration into the prevention of these dangers is necessary.
文摘Purpose: The purpose of this study was to investigate the effects of Micro Vibrational therapy (MVT) on muscle stiffness and blood flow in the skin before and after Micro Vibrational therapy in healthy subjects in order to scientifically verify the effects of MVT. Methods: Micro Vibrational therapy is nurse care use in Japan. It was performed on the backs of 30 subjects (8 males and 22 females) in their 20 s to 50 s according to the eligibility criteria. The resting state before implementation was set as the baseline for the control group, and after 30 seconds of MVT was set as the intervention group. The effects of the MVT were statistically analyzed by these factors and subjective sensation by Visual Analog Scale. Results: The muscle hardness of the area where the MVT was applied for 30 seconds decreased to 29.54 (SD 5.04) after the application, compared to 30.45 (SD 5.05) before. A corresponding t-test showed a significant difference (p = 0.019). Skin blood flow increased from a median of 0.76 (variance 0.062) before to a median of 0.86 (variance 0.16) after the procedure. The Wilcoxon rank test showed a significant difference (p = 0.000). Circulatory response was confirmed by SBP, DBP, and HR. SBP of 108.6 mmHg (SD 14.8) before the study decreased to 105.7 mmHg (SD 15.0) after the study, and DBP of 65.6 mmHg (SD 11.1) before the study decreased to 62.7 mmHg (SD 11.8) after the study. HR decreased from 71.6 beats per minute (SD 10.3) before to 69.2 beats per minute (SD 11.7) after. There was a significant difference in all cardiovascular indices (p < 0.05). VAS (pain, stiffness, and fatigue) was significantly decreased after MVT (p < 0.05). Conclusion: Micro Vibrational therapy tended to decrease muscle hardness and increase skin blood flow even in the short time of 30 seconds. The results suggest that local vibration stimulation is not likely to cause a sudden increase in blood pressure or pulse rate fluctuation. These results suggest that hand vibration nursing care may be applicable to acute patients with unstable circulatory conditions.
文摘<strong>Purpose</strong><strong>:</strong> The purpose is to identify what difficulties fathers have with the roles of fatherhood during pregnancy and early infancy, and to make apparent what their educational support needs are. <strong>Methods:</strong> This study follows a qualitative descriptive design. The subjects were new first-time fathers of Japanese nationality. Subjects participated in semi-structured interviews administered according to interview guidelines. <strong>Results:</strong> There were 15 subjects in total. The average age of the subjects’ children was 5.5 months. Fathers’ difficulties with their new roles were abstracted in to five main categories: < Difficulties during early engagement with child >, < Difficulties related to child crying >, < Difficulties arising after getting through the early engagement stage >, < Difficulties related to support of partner >, and < Mental burdens associated with childrearing >. Additionally, the types of support fathers requested to help maintain their mental health after the birth of their infants were abstracted into three main categories: < Support with childcare knowledge/acquiring skills >, < Support in building a positive marital relationship >, and < Support in maintaining own mental health >. <strong>Conclusions:</strong> 1) The stress experienced by fathers from the birth of their child through early infancy, originating in two elements of fatherhood (engagement with the child and spousal support), placed a great mental burden upon them in a multi-layered structure;2) The support that needs fathers expressed to maintain their mental health pre- and postpartum is based on the difficulties they experienced with paternal roles;3) There is a disparity between the needs of fathers expressed through the results of this study and current paternal support practices in Japan. The supplementation and revision of existing paternal support practices is an issue that merits further consideration. Furthermore, the existing group interview method suffers from low attendance, and attending has become increasingly difficult due to the COVID-19 pandemic spreading throughout Japan. It is necessary to consider alternative methods of educational support moving forward.
文摘<strong>Purpose:</strong> The potential dangers of infant bathing have an effect not only on the infant’s body and life but also on the formation of emotional bonds in the parent-child relationship. This study will explore actual dangers experienced by mothers and families. <strong>Method: </strong>We distributed an anonymous, self-reported questionnaire at infants’ 18-month health checkup, which was collected via postal service. 304 valid responses were received and formed our sample data. Descriptive statistical analysis was performed for each category surveyed. Inferential statistics were used to compare the dangerous incidents experienced with regard to differences between primipara/multipara and the presence/absence of guidance concerning such incidents. This study was approved by the research ethics committees of the affiliated university. <strong>Results:</strong> 70% of mothers and families experienced incidents while bathing their infants, with the most common incidents consisting of, in order of frequency, near immersion of the face, actual immersion of the face, and falling into the bath. The most common situations reported when incidents occurred were bathing the infant by oneself, the infant moving unexpectedly, or taking care of other children, in that order. Approximately 70% of mothers and families had not received instruction on the potential dangers or how to prevent them. <strong>C</strong><strong>onclusion:</strong> This study has elucidated the dangerous situations experienced in the course of bathing infants in the home and the measures taken to prevent such situations. Instructive tools are needed which can be used to easily provide mothers and families with correct information.
文摘Objective: This study aimed to identify whether mothers who had undergone their one-month checkup at obstetrical care facilities and were raising infants up to four months of age recognized child maltreatment, the coping strategies that they used to calm their emotions during those moments, and types of support felt necessary. Method: This was a qualitative, descriptive design study conducted from July 2022 to March 2023. Semi-structured interviews based on an interview guideline of 21 first-time mothers raising infants up to four months of age were conducted. The responses were classified into categories. Results: Situations that mothers caring for infants up to four months of age recognized as child maltreatment were classified into 11 categories, such as [Becoming emotional for not understanding the child’s needs or the reason for their crying, and reacting confrontationally towards the child]. Coping strategies that helped mothers calm their emotions during those moments were classified into 10 categories, such as [Conversing with adults around them]. Types of support that mothers felt necessary were classified into 14 categories, such as [Guidance from experts on the growth and development of their children, even after leaving the maternity facility]. Discussion: Maltreatment recognized by postpartum mothers up to four months after birth was classified into two categories: situations involving actions taken towards the child, although not at a serious level, and situations where no actual actions were taken. Even acts that do not actually constitute maltreatment were considered maltreatment. During parenting, every mother may experience negative feelings towards her child and may face moments when she feels incapable of engaging with her child. The importance of socially supporting mothers who are often alone with their children and having preventive approaches for all postpartum mothers were suggested as supportive measures needed to prevent the occurrence of maltreatment.
文摘Boron neutron capture therapy(BNCT)is a cancer treatment modality based on the nuclear capture and fission reactions that occur when boron-10,a stable isotope,is irradiated with neutrons of the appropriate energy to produce boron-11 in an unstable form,which undergoes instantaneous nuclear fission to produce high-energy,tumoricidal alpha particles.The primary purpose of this review is to provide an update on the first drug used clinically,sodium borocaptate(BSH),by the Japanese neurosurgeon Hiroshi Hatanaka to treat patients with brain tumors and the second drug,boronophenylalanine(BPA),which first was used clinically by the Japanese dermatologist Yutaka Mishima to treat patients with cutaneous melanomas.Subsequently,BPA has become the primary drug used as a boron delivery agent to treat patients with several types of cancers,specifically brain tumors and recurrent tumors of the head and neck region.The focus of this review will be on the initial studies that were carried out to define the pharmacokinetics and pharmacodynamics of BSH and BPA and their biodistribution in tumor and normal tissues following administration to patients with high-grade gliomas and their subsequent clinical use to treat patients with highgrade gliomas.First,wewill summarize the studies thatwere carried out in Japan with BSH and subsequently at our own institution,The Ohio State University,and those of several other groups.Second,we will describe studies carried out in Japan with BPA and then in the United States that have led to its use as the primary drug that is being used clinically for BNCT.Third,although there have been intense efforts to develop new and better boron delivery agents for BNCT,none of these have yet been evaluated clinically.The present reportwill provide a guide to the future clinical evaluation of new boron delivery agents prior to their clinical use for BNCT.
文摘Background: Little is known about what the experience of “taking antipsychotics” means in a patient’s life. Therefore, this study aims to identify what it means for patients with schizophrenia living in the community to remain on medication. Methods: The participants were five residents of communities, who had been discharged from a psychiatric hospital, but were currently visiting a private psychiatric hospital. In this study, we used participants’ narratives as data and analyzed them according to the procedures described in “An Application of Phenomenological Method in Psychology” (Giorgi, 1975), and “Practice of analyzing materials describing experiences” (Giorgi, 2004). Results: The study results are as follows. 1) The drug may be effective, but Subject (below, S) still wants to take it as little as possible. Meanwhile, S has people who care about S and a person who S can rely on nearby, to manage S’s life. The people above tell S to take medicine, and S takes it. 2) S does not know what kind of medication S is consuming, but recently S has been having a hard time walking;S has people who care for S’s foot and look after S. S thinks taking medicine is for living. 3) S feel some drugs is ineffective. However, S met some people S could trust who passionately recommended the medication to S. S started being careful in remembering to take it. 4) S does not think drugs are necessary for S, but S can interact with people and spend S’s days. S has people who accept S as S is. S continues living in the community while taking medicine that a doctor offers. 5) S was skeptical about the drugs. However, S has a person S can trust, who recommended a way to take the medication in a way that S does not feel overwhelmed. S thinks that it may be a good idea to take it. Conclusions: Based on the analysis of the narratives of each of the five participants, the essential structure was read from the perspective of a third party regarding participants’ medication adherence. A generalized reading of the structure common to the above five essential structures reveals a structure that includes the following three opportunities: 1) Patients realize the importance of people;2) They sometimes entrust themselves to people or follow people’s opinions when taking actions;3) They have come to terms with their initial negative feelings about antipsychotic drugs, subsequently continuing to take antipsychotic drugs. This suggests that the following are important attitudes of supporters of patients with schizophrenia who continue to live in the community: To accept what is happening to the patients, to talk to them with encouragement and compassion, and to be there for them. It is also important for supporters to make patients feel comfortable in opening up while the patients reside in the community and to support patients in making decisions.
文摘Background: Our previous research concerned the relation between Sense of Coherence, workplace stress, and burnout for nurses in their first three years of work. We found that their psychological state in the first three months on the job was particularly critical to their success and retention. As workplace stress increased over their first three years, their Sense of Coherence declined, and their burnout increased. Follow-up interviews after five years revealed the importance of identifying role models early on and feeling their own growth in the responses of their patients. Based on these findings, in 2015 we instituted a program to improve new nurses’ Sense of Coherence. The present research was to evaluate the effectiveness of this training program. Purpose: The purpose of this study was to evaluate the effectiveness of a training program in raising Sense of Coherence. Method: From June of 2015 to March of 2017, we surveyed Sense of Coherence of 137 new nurses who completed our training program, comparing them to a cohort of 960 nurses whom we had studied in 2010-11 without such a training program. We analyzed their responses using SPSS Version 24.0, taking a probability of less than 5% to be significant. Results: In terms of Sense of Coherence, the training program improved new nurses’ “comprehensibility” and “manageability” in the first three months, but both dropped to levels comparable to the untrained nurses after six months. There was no significant difference in “meaningfulness”, which dropped over the first year in both groups. Categorized into three groups according to SOC score at the time of employment in the intervention group, 36 participants were classified into the low score group, 41 participants were classified into the medium score group, and 44 participants were classified into the high score group. Then changes in SOC in each group were then compared. In the LOW group, the scores for “comprehensibility”, “manageability”, and “meaningfulness” increased significantly throughout the year, while in the HIGH group, scores decreased significantly. Conclusions: Our training program did raise new nurses’ sense of growth over the first year, and significantly improved their “comprehensibility” and “manageability” over the first three months. However, the fact that their Sense of Coherence dropped to control group levels after six months suggests the need for further intervention to maintain “comprehensibility” and “manageability” over the longer term. In the LOW group, the scores for “comprehensibility”, “manageability”, and “meaningfulness” increased significantly throughout the year, however, the total SOC score for the LOW group remained low throughout the year. Thus, additional support is needed over-and-above the training presented in this study for those nurses with low SOC scores at time of employment.
文摘Objective: To determine whether patients with unresponsive wakefulness syndrome respond to auditory stimuli based on changes in facial expressions. Participants: Six patients diagnosed with disorders of consciousness due to brain injury with permission for participation from their doctor. Design: In this hypothesis-driven observational study, the facial expressions of patients with unresponsive wakefulness syndrome were video-recorded for 5 min before and during auditory stimulation in three consecutive weekly sessions. Main Measures: Facial muscle movement was quantified using FaceReader<sup>®</sup> software (Noldus, Wageningen, Netherlands). Valence/action unit values were plotted to detail facial expression changes. Heart rate values were also plotted. These parameters were compared before and after stimulation. Results: No significant differences in valence integral values or average heart rate were observed between the pre- and intra-stimulus conditions. However, valence signals increased in approximately half of the sessions, indicating that some patients with unresponsive wakefulness syndrome may exhibit emotional responses to auditory stimuli. Analysis of action unit integral values indicated that movement of the eyebrows and eyelids on the upper part of the face occurred during auditory stimulation. Furthermore, the types of auditory stimuli differed depending on the session for the 12 sessions of voice stimuli, whereas the changes in average heart rate differed in each of nine sessions of music stimuli. Because the changes in average heart rate were similar, it is possible that musical stimuli are more suitable than voice stimuli. Conclusion: Some patients with unresponsive wakefulness syndrome may have an emotional response to auditory stimuli. Our findings indicate that it may be possible to distinguish the emotional expression response of a patient based on their facial expression.
