日本における産前産後骨盤帯痛を有する女性の経験とその治療に対する認識について

研究報告Original Articles　妊娠・出産により30 パーセント以上の女性は骨盤帯痛を経験する．骨盤帯痛は日常生活に支障をきたし，育児や女性の生活の質の低下につながる．従って，妊娠期からの理学療法士の関わりは重要であると考える．本研究の目的は，産前産後の女性の骨盤帯痛の経験とその骨盤帯痛に対する治療についてどのような認識を持ち，どのような治療を経験しているのかを明らかにすることである．現象学に基づいた質的研究を実施し，帰納的セオリー（thematic analysis）アプローチで分析を行った．結果，「骨盤帯痛の経験」「骨盤帯痛に対する治療の認識」「骨盤帯痛に対する治療の情報供給」「病院・医療機関に対する認識」の4 つのカテゴリーに分類された．治療に対する認識では，「骨盤ベルトの使用」「運動が必要」であると認識されていた．しかし，育児のために，その治療行動は阻害されていた．更に，骨盤帯痛に対する適切な治療は，医療機関や運動療法から得るのではなく，身近な「情報誌」，「インターネット」や「ママ友」を通してアクセスしていた．また，治療のために医療機関を受診するという認識も低かった．　Pregnancy-related pelvic girdle pain is reported to occur in more than 30% of women worldwide. Pelvic girdle pain is likely to cause difficulties in carrying out activities of daily living and childcare, and to result in a lower quality of life. Therefore, physical therapists need to care for pregnant women in order to treat and prevent severe pain. The purpose of this study was to deepen understanding regarding the perceptions and experiences of, as well as the belief in treatment for, pelvic girdle pain caused by pregnancy among postnatal women. A qualitative study design based on phenomenology was used, and the data were analyzed using thematic analysis. The results revealed the following four categories: “experiences of pelvic girdle pain”, “perceptions of treatment for pelvic girdle pain”, “collecting information about treatment”, and “perceptions of hospitals and medical institutions”. Regarding the perception of treatment, postnatal women believed that pelvic girdle belts could ease their pain, and that exercise was very important for pain prevention; however, they seldom wore pelvic girdle belts or engaged in exercise due the pressure associated with childcare and being too busy. Furthermore, they did not perceive the role of medical specialists, who can provide appropriate treatment information. The postnatal women in the present study tended to obtain information through magazines, the Internet, and friends in a mom’s group. They also had a poor perception of going to see doctors and physical therapists for treatment

The gastrin-releasing peptide/bombesin system revisited by a reverse-evolutionary study considering Xenopus

Bombesin is a putative antibacterial peptide isolated from the skin of the frog, Bombina bombina. Two related (bombesin-like) peptides, gastrin-releasing peptide (GRP) and neuromedin B (NMB) have been found in mammals. The history of GRP/bombesin discovery has caused little attention to be paid to the evolutionary relationship of GRP/bombesin and their receptors in vertebrates. We have classified the peptides and their receptors from the phylogenetic viewpoint using a newly established genetic database and bioinformatics. Here we show, by using a clawed frog (Xenopus tropicalis), that GRP is not a mammalian counterpart of bombesin and also that, whereas the GRP system is widely conserved among vertebrates, the NMB/bombesin system has diversified in certain lineages, in particular in frog species. To understand the derivation of GRP system in the ancestor of mammals, we have focused on the GRP system in Xenopus. Gene expression analyses combined with immunohistochemistry and Western blotting experiments demonstrated that GRP peptides and their receptors are distributed in the brain and stomach of Xenopus. We conclude that GRP peptides and their receptors have evolved from ancestral (GRP-like peptide) homologues to play multiple roles in both the gut and the brain as one of the 'gut-brain peptide' systems

妊娠・出産による女性の身体的・精神的健康問題の経験と認識：Meta-synthesis を用いて

研究報告Original Articles　近年，妊産婦の妊娠・出産に関係するマイナートラブルは，リハビリテーション分野においても，予防・治療すべき重大な障害である．妊産婦がどのような身体的・心理的な健康問題を経験し，その健康問題についてどのように認識し，行動をとっているかを，私たち医療従事者が深く理解することは，治療を行う上で重要なことである．本稿では，Meta-Synthesis を用いて，妊産婦の身体的・精神的健康問題について質的研究の文献レビューを行った．4 つの主なテーマとして，①妊娠・出産と関係がある身体的・精神的健康問題の経験, ②その健康問題のリスクや原因についての認識, ③解決策, ④生活の変化についての予測を抽出した．妊産婦の身体的・心理的健康問題は独立して生じるだけでなく，深く関わりあっており，共通して，夫や家族，知人の支援は，その障害を軽減するために重要な要因であることがわかった．医療従事者は，心身障害の奥にある重要な問題と向き合い，その解決に取り組む必要もある．　Pregnancy is the most important event of women’s life. Pregnancy and labor may affect a woman’s physical and mental health. Moreover, pregancy can impact on quality of life, including each individual’s role as mother, wife, working status, and/or social relationships. The purpose of this study was to deepen our understanding of women’s experiences and perception of their physical and mental problems related to pregnancy and labor through a meta-analysis. The meta-analysis focused on studies dealing with experiences and perceptions of physical and mental issues among pregnant and postpartum women in qualitative studies. Eight qualitative studies relating to women’s physical and mental health problems through pregnancy and labor from 2012 to 2014 met the inclusion criteria. Each article was evaluated with the Critical Appraisal Skills Program (CASP) to obtain CASP scores. All qualitative studies were examined for four common themes: 1) Experience of physical and mental issues related to pregnancy and labor; 2) Perception of risks and their causes; 3) Solution of issues related to pregnancy; and, 4) The expectation for further negative change. A meta-synthesis contributed to a further clarification of additional salient factors relevant to women’s physical and mental health problems resulting from pregnancy and labor. The findings will offer medical specialists and health providers a better understanding of pregnant and postpartum women’s experiences, including physical and mental health problems. We hope the study will also lead to consideration of appropriate strategies and care for the women improving their quality of life

リズム統制した連続リバウンドジャンプを用いたSSC運動能力の評価

This research aimed to develop a new index showing the effect of rebound jumping with rhythm control on the stretch-shortening cycle（ SSC）. Rebound jumping with maximum effort or rhythm control was performed by 115 healthy female subjects. The rhythm control rate was set for 6 conditions, ranging from 60 to 110 beats per minute（ bpm）, at intervals of 10 bpm. Under each condition, subjects performed about 12 consecutive rebound jumps, and five sets of stable and continuous data were used for analysis. The contact time（ CT）, air time（ AIR）, and rebound height were measured with a multi-jump tester. Jump time（ CT and AIR） became shorter as the rhythm control rate increased, and longer if the rhythm slowed. However, an increase in jump time did not necessarily permit a higher jump, and it became clear that the highest jump was associated with an optimal rhythm. As the rhythm slowed, the CT was longer than the AIR for each jump. The estimated rhythm at which the ratio of CT to AIR approached 50% was lower for those with higher jumping ability. This estimated rhythm can be used to determine whether it is possible to achieve shorter CT with rhythm control. It has been suggested that rhythm control can be used for training and that training can effectively improve exercise efficiency. These results showed the effect of continuous rebound jumping with rhythm control on SSC

リハビリテーション専門科目への接続と学習モチベーションの維持を目的とする自学自習用物理学習プログラムの開発

報告report　大学入学前あるいは入学直後の学生向けに開発を行っている物理学の自学自習用プログラムに関する報告を行う．運動学等のリハビリテーション専門科目の理解のためには物理学の基礎的な知識の習得が望まれるが，高等学校の物理科目を履修していない学生も多く，大学レベルの物理学授業の実施に支障をきたしている．入学前教育や反転授業等により事前に必要な知識を補完する方法もあるが，物理に対する苦手意識の強い学生が多く，既存の学習プログラムを用いた従来の学習方法では学習モチベーションを維持することが難しい．本研究の自学自習プログラムの特徴は，運動学分野の単元とそれに関連する物理学の単元を楔形に配置して両者を交互に学習するような方法を採ったことである．このことにより，学習者がリハビリテーション専門科目の理解に物理学の知識が不可欠であることを認識し，学習モチベーションを維持しながら基礎的な物理の知識を習得することが期待される．　This paper reports on a self-study material for physics that has been developed for students before or just after entering university. The acquisition of basic knowledge of physics is desirable in order to understand specialized rehabilitation subjects such as kinesiology. However, there are many students who have not taken physics courses in high school, which hinders the implementation of physics courses at universities. There are also known methods to supplement the necessary knowledge in advance, such as pre-entrance education and flipped classroom teaching. But many students have a strong sense of dislike for physics, and it is difficult to maintain their motivation for learning with conventional learning methods using existing learning materials. One of the features of the teaching materials in this study is that the unit on kinesiology and the related unit on physics (mechanics) are arranged in a wedge shape and designed so that students can study them alternately. The aim of this study is to make learners realize that knowledge of physics is indispensable for understanding rehabilitation subjects, and to help them acquire basic learning items while maintaining their motivation for learning

写真に見る夕食食卓配膳の現状(第2報) : 調理法と食材別主菜の配置

This time we investigated the position of the main dish according to cooking methods and ingredients. The results are as follows. Classifying the main dishes, meat is broiled in most occaision and fish is grilled as a Japanese dish. 1. As for cooking methods, broiling the ingredients using oil is mostly adopted, which is penetrated into most Japanese. 2. In Hyogo area, the position of the main dish of fish is mostly in the front on the right and, followed by the back on the right. In Fukuoka area, it is just opposite. As for meat, it is in the front on the right and the back position comes next in both areas. 3. We examined the position of the main dish from the view point of cooking methods. The result is as follows. 40% of fried main dish and 35% of boiled main dish are in the front on the right. 4. More than one third of the cases don\u27t belong to any of these classifications. This implies that many people have diversity of table setting and there is disorder in their way of setting table

Associations between Chest CT Abnormalities and Clinical Features in Patients with the Severe Fever with Thrombocytopenia Syndrome

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by the SFTS virus. It involves multiple organ systems, including the lungs. However, the significance of the lung involvement in SFTS remains unclear. In the present study, we aimed to investigate the relationship between the clinical findings and abnormalities noted in the chest computed tomography (CT) of patients with SFTS. The medical records of 22 confirmed SFTS patients hospitalized in five hospitals in Nagasaki, Japan, between April 2013 and September 2019, were reviewed retrospectively. Interstitial septal thickening and ground-glass opacity (GGO) were the most common findings in 15 (68.1%) and 12 (54.5%) patients, respectively, and lung GGOs were associated with fatalities. The SFTS patients with a GGO pattern were elderly, had a disturbance of the conscious and tachycardia, and had higher c-reactive protein levels at admission (p = 0.009, 0.006, 0.002, and 0.038, respectively). These results suggested that the GGO pattern in patients with SFTS displayed disseminated inflammation in multiple organs and that cardiac stress was linked to higher mortality. Chest CT evaluations may be useful for hospitalized patients with SFTS to predict their severity and as early triage for the need of intensive care