多様なニーズを抱える母子への切れ目ない支援

産前産後の母子にとって切れ目ない支援とは何かを明らかにすることを目的に、多様な困 難を抱えながら切れ目ない支援を受け続けることを可能とするケースについて検討した。質 的記述的研究デザイン。研究参加者は、研究参加同意が得られた出産１回経験者で、産後の 育児や生活による様々な困難感から出産した医院の助産師を中心とした支援を継続して受け 続けている30 歳台女性。インタビューを行い、育児の困難感や生活上での出来事とその時 に支援を求めた場面ごとに、助産師支援に対する女性の気持ちに焦点を当てて、支援を受け ることそれを継続して受けることの認識や動機などを抽出した。対象者は、妊娠前から精神 疾患既往歴や家族関係の難しさなど様々な困難を抱えていが、助産師による育児の行動の「モ デリング」、母乳栄養や子どもの成長を「相談」することと「支援」を受けることへの効果や、 「寄り添い」を受け「アドボケイト」されたと感じたこと、「傾聴」、「受容的態度」などを経 験したことで、専門職への「信頼」を感じたことが、支援を継続的に受け続けることを選択 の契機となっていた。早期産褥期のかかわりによる関係性の持ち方、アンカー的な態度によ る支援の方法が切れ目ない支援を展開するために必要であることが明らかになった

Socio-spatial cognition in cats: Mentally mapping owner’s location from voice

予期せぬ場所から聞こえる飼い主の声にびっくり --ネコは耳で飼い主の位置を捉えている--. 京都大学プレスリリース. 2021-11-22.Many animals probably hold mental representations about the whereabouts of others; this is a form of socio-spatial cognition. We tested whether cats mentally map the spatial position of their owner or a familiar cat to the source of the owner’s or familiar cat’s vocalization. In Experiment 1, we placed one speaker outside a familiar room (speaker 1) and another (speaker 2) inside the room, as far as possible from speaker 1, then we left the subject alone in the room. In the habituation phase, the cat heard its owner’s voice calling its name five times from speaker 1. In the test phase, shortly after the 5th habituation phase vocalization, one of the two speakers played either the owner’s voice or a stranger’s voice calling the cat’s name once. There were four test combinations of speaker location and sound: Same[sound] Same[location], Same[sound] Diff[location], Diff[sound] Same[location], Diff[sound] Diff[location]. In line with our prediction, cats showed most surprise in the Same[sound] Diff[location] condition, where the owner suddenly seemed to be in a new place. This reaction disappeared when we used cat vocalizations (Experiment 2) or non-vocal sounds (Experiment 3) as the auditory stimuli. Our results suggest that cats have mental representations about their out-of-sight owner linked to hearing the owner’s voice, indicating a previously unidentified socio-spatial cognitive ability

Diagnostic Utility of SOX4 Expression in Adult T-Cell Leukemia/Lymphoma

Differentiation between adult T-cell leukemia/lymphoma (ATLL) and peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), is often challenging based on pathological findings alone. Although serum anti-HTLV-1 antibody positivity is required for ATLL diagnosis, this information is often not available at the time of pathological diagnosis. Therefore, we examined whether the expression of SOX4 and p16 would be helpful for differentiating the two disease entities. We immunohistochemically examined SOX4 and p16 expression (which have been implicated in ATLL carcinogenesis) in 11 ATLL patients and 20 PTCL-NOS patients and classified them into four stages according to the percentage of positive cells. Among the ATLL cases, 8/11 (73%) were SOX4-positive, while only 2/20 (10%) PTCL-NOS cases expressed SOX4. The mean total score was 4.2 (standard deviation (SD): 0.61) in the ATLL group and 0.50 (SD: 0.46) in the PTCL-NOS group (p < 0.001). Positive expression of p16 was noted in 4/11 (36%) patients with ATLL and 3/20 (15%) patients with PTCL-NOS, with mean total scores of 1.9 (SD: 0.64) and 0.70 (SD: 0.48) in the ATLL and PTCL-NOS groups, respectively (p = 0.141). These results suggest that SOX4 may be strongly expressed in ATLL compared to PTCL-NOS cases. Therefore, it may be helpful to perform immunohistochemical staining of SOX4 when pathologists face challenges discriminating between ATLL and PTCL-NOS

Evaluating the Safety of Simultaneous Intracranial Electroencephalography and Functional Magnetic Resonance Imaging Acquisition Using a 3 Tesla Magnetic Resonance Imaging Scanner

Background: The unsurpassed sensitivity of intracranial electroencephalography (icEEG) and the growing interest in understanding human brain networks and ongoing activities in health and disease have make the simultaneous icEEG and functional magnetic resonance imaging acquisition (icEEG-fMRI) an attractive investigation tool. However, safety remains a crucial consideration, particularly due to the impact of the specific characteristics of icEEG and MRI technologies that were safe when used separately but may risk health when combined. Using a clinical 3-T scanner with body transmit and head-receive coils, we assessed the safety and feasibility of our icEEG-fMRI protocol. Methods: Using platinum and platinum-iridium grid and depth electrodes implanted in a custom-made acrylic-gel phantom, we assessed safety by focusing on three factors. First, we measured radio frequency (RF)-induced heating of the electrodes during fast spin echo (FSE, as a control) and the three sequences in our icEEG-fMRI protocol. Heating was evaluated with electrodes placed orthogonal or parallel to the static magnetic field. Using the configuration with the greatest heating observed, we then measured the total heating induced in our protocol, which is a continuous 70-min icEEG-fMRI session comprising localizer, echo-planar imaging (EPI), and magnetization-prepared rapid gradient-echo sequences. Second, we measured the gradient switching-induced voltage using configurations mimicking electrode implantation in the frontal and temporal lobes. Third, we assessed the gradient switching-induced electrode movement by direct visual detection and image analyses. Results: On average, RF-induced local heating on the icEEG electrode contacts tested were greater in the orthogonal than parallel configuration, with a maximum increase of 0.2°C during EPI and 1.9°C during FSE. The total local heating was below the 1°C safety limit across all contacts tested during the 70-min icEEG-fMRI session. The induced voltage was within the 100-mV safety limit regardless of the configuration. No gradient switching-induced electrode displacement was observed. Conclusion: We provide evidence that the additional health risks associated with heating, neuronal stimulation, or device movement are low when acquiring fMRI at 3 T in the presence of clinical icEEG electrodes under the conditions reported in this study. High specific absorption ratio sequences such as FSE should be avoided to prevent potential inadvertent tissue heating

ジョセイ ロウドウ ニ オケル Mジガタ カーブ カラ ミタ ガクドウ ホイク シドウイン ノ ロウドウ

本研究では、学童保育指導員についての労働の実態を明らかにし、学童保育および指導員の在るべき姿を検討する。女性労働特有のM 字型カーブについての分析を加え、学童保育指導員の役割の重要性とその課題について考察を行うことにある。性別役割分業が定着したのは高度経済成長期であるが、それ以降大きな変化がみられない。多くの女性の働き方が、家族生活の展開を軸としている傾向が強く、年齢階級別に見た労働力率がM 字型を示している。学童保育は、子どもの発達保障と保護者の就労を支援する両側面から必要である。一方で学童保育指導員は、最初に保育士や幼稚園教諭として就労するが、出産・育児期を中心に労働市場から退出をし、40 歳前後に指導員として再就業している者が多い。男性指導員は極めて少数派である。学童保育指導員の資格制度導入と安定した労働条件整備が急務である。全国の大学・短大において学童保育指導員養成カリキュラムに合わせた授業の開始が喫緊の課題と考える。The purpose of this study is to consider the importance of the role of after-school carers and their work,adding an analysis of the characteristics of the M-shaped labor force participation of women. The working style of many women tends to strongly depend on their own family lives. The ratio of their labor-force classified by ageshows the M-shaped labor force. After-school care for children is needed to not only assure the growth of children, but also to support the labor of their parents. On the other hand, although after-school carers previously worked as nurses at nursery schools or teachers at kindergartens, they quit working because of the birth of children or to care for children. There are many women who return to work as carers but few men. It is urgent to introduce a career system for carers and to provide stable labor conditions. Suitable curricula to educate after-school carers should beintroduced immediately at universities and colleges in Japan

Differential effects of human neutrophil peptide-1 on growth factor and interleukin-8 production by human lung fibroblasts and epithelial cells.

alpha-Defensins, antimicrobial peptides produced mainly by neutrophils, have been reported to be associated with a wide variety of lung diseases, including idiopathic pulmonary fibrosis (IPF), cystic fibrosis (CF), and diffuse panbronchiolitis (DPB). In each disease, alpha-defensins are located in different areas, such as around the alveolar septa in IPF and around the airways in CF and DPB, suggesting that alpha-defensins play different roles. Meanwhile, growth factors are known to contribute to IPF, CF, and DPB. alpha-Defensins are known to induce interleukin (IL)-8 in airway epithelial cells, but the effects of alpha-defensins on the release of growth factors from various components in the lung have not been sufficiently investigated. In the present study, the in vitro effects of human neutrophil peptide (HNP)-1 (a subtype of alpha-defensin) on the expressions of IL-8 and growth factors in lung fibroblasts, bronchial epithelial cells, and alveolar epithelial cells were examined. HNP-1 mainly enhanced the expression of IL-8 in epithelial cells, whereas it enhanced transforming growth factor-beta and vascular endothelial growth factor expressions in lung fibroblasts. These results suggest that alpha-defensins play different roles in the pathogenesis of IPF, CF, and DPB according to the location in the lung where the alpha-defensins are mainly produced

Distinct Incidence of Takotsubo Syndrome Between Amyotrophic Lateral Sclerosis and Synucleinopathies: A Cohort Study

Takotsubo syndrome (TTS) is an acute cardiac syndrome characterized by regional left ventricular dysfunction with a peculiar circumferential pattern, which typically results in apical ballooning. Evidence indicates a pivotal role of catecholamines in TTS, and researchers have discussed multiple hypotheses on the etiology, including multivessel coronary spasm, myocardial stunning, excessive transient ventricular afterload, and cardiac sympathetic overactivity with local noradrenaline spillover. Although central nervous system disorders, such as stroke and epilepsy, are known to trigger TTS, the incidence and clinical features of TTS in neurodegenerative disorders are poorly understood. Here, we retrospectively examined TTS cases in a single-center cohort composed of 250 patients with amyotrophic lateral sclerosis (ALS) and 870 patients with synucleinopathies [582 patients with Parkinson's disease (PD), 125 patients with dementia with Lewy bodies (DLB), and 163 patients with multiple system atrophy (MSA)] and identified 4 (1.6%, including 2 women) cases with ALS and no cases with synucleinopathies. Two ALS patients underwent autopsy and the pathological findings were compatible with the chronological changes identified in catecholamine-induced cardiomyopathy. A literature review identified 16 TTS cases with ALS, 1 case each with PD and DLB, and no cases with MSA. When current and previous TTS cases with ALS were concatenated: 55% (11/20) were female; 35% (7/20) had a bulbar-onset and 45% (9/20) had a limb-onset; the mean age of TTS onset was 63.3 ± 9.0 years and the mean interval time from ALS onset to TTS development was 4.9 ± 3.0 years; no (0/16) patients developed TTS within 12 months after ALS onset; 50% (10/20) underwent artificial ventilations; the mortality was 17% (3/18); and most cases had precipitating factors, and TTS development was associated with gastrostomy, tracheostomy, or infections in 45% (9/20) of the patients. This study demonstrated that ALS is a considerable predisposing factor of TTS and that synucleinopathies rarely cause TTS. The distinct TTS incidence between ALS and synucleinopathies may be due to cardiac sympathetic overactivity in ALS and may also be affected by cardiac sympathetic denervation in synucleinopathies. Moreover, the etiology of TTS in ALS may be reasonably explained by the two-hit theory