Burnout and related factors among consultation support specialists

Although the field of consultation support has contributed substantially toward promoting independence among persons with disabilities, indepth studies regarding the mental health of consultation support specialists (CSSs) have been lacking. The present study examined tendency toward burnout among CSSs, and determined factors that aggravate and mitigate any such tendency that was detected. The Maslach Burnout Inventory (Japanese version) (MBI-JV) was used to analyze data from 297 of 416 CSSs (71.4% survey response rate) from 180 agencies nationwide. The results showed that 37.4% of CSSs required attention for burnout. The MBI-JV scores were converted into an objective variable by designating subjects scoring at or above the first quartile to the high burnout group and subjects scoring at or below the third quartile to the low burnout group. Multiple regression with a factor analysis model was applied to 19 items (12 items from basic subject characteristics and seven items related to workplace conditions and job duties from the Human Resource Management (HRM) checklist compiled by the Japan Institute for Labour Policy and Training); these were adopted as explanatory variables. The number of CSSs working at a given agency (p < 0.05) and age (p < 0.05) were found to be aggravating factors,while relationships with consultees (p < 0.05), personal life considerations (p < 0.01), and career path (p < 0.001) were found to be mitigating factors. These findings suggest that development of countermeasures against burnout among CSSs might be needed. Furthermore, the study verified that burnout prevention not only combats career stagnation and turnover, but also can improve service quality

3D-Computational Mesh Generation around a Propell by Elliptic Differential Equation Systen

The recent rapid progress of large scale super-computers enables us to solve Euler equations and even Navier-Stokes equations numerically. Almost all methods of solution adopt finite difference calculations and, therefore, the generation technique of computational mesh largely affects the stability and convergence of the solutions. In this paper, an analytic method is applied for the generation of a 3D mesh system for Navier-Stokes equations around ATP (Propfan). One of the advantages of this method is that the mesh lines have strong differentiabilities. The differential equation used is the Poisson type, and the right hand side is called the control function because it is able to control the degree of mesh line clustering. Here, the form of the control function was contrived to cluster near the solid surfaces. By this method, several mesh lines are laid in the boundary layer above the blade surfaces

相談支援専門員におけるバーンアウトとその関連要因

Niigata Journal of Health and Welfare. 2017, 17(1), 12-24.博士(保健学)新潟医療福祉大

Stress reactions and their correlated factors in consultation support specialists : The Brief Job Stress Questionnaire

相談支援専門員は障害者の自立支援に大きく寄与しているが、相談支援専門員のメンタルヘルスに関する先行研究は深められていない現状にある。そこで職業性ストレス簡易調査票を用いて相談支援専門員のストレスの評価を行った。本研究の目的は相談支援専門員のストレス状態を検討し、そして高ストレス者となる要因を明らかにすることである。調査は全国180事業所416名の相談支援専門員を対象とし、計275名を分析対象とした（有効回答率66.1％）。その結果、相談支援専門員は職業性ストレス簡易調査票の標準集団と比較して「心理的な仕事の負担（量）」「心理的な仕事の負担（質）」「自覚的な身体的負担度」「疲労感」「不安感」「家族・友人からのサポート」の点数が高く悪い状態であった。また男性のみ「抑うつ感」「身体愁訴」の点数が高く悪い状態であった。高ストレス者となる要因は、基本属性では常勤の勤務形態の方が、職業性ストレス簡易調査票の項目では「同僚からのサポート」「上司からのサポート」「抑うつ感」「仕事のコントロール度」「自覚的な身体的負担度」「家族・友人からのサポート」「心理的な仕事の負担（量）」の点数が高く悪くなるほど高ストレス者となる結果であった。事業所として一次予防の観点から上述した項目について取り組みが必要であり、二次予防の観点では「抑うつ感」を感じている者のケアを検討する必要性が明らかになった。Although consultation support specialists（ CSSs） have been making major contributions toward promoting independence among persons with disabilities, in-depth studies regarding the mental health of such workers are few. Therefore, the present study attempts to evaluate stress among CSSs using the Brief Job Stress Questionnaire（ BJSQ）. It aims to examine the stress levels among CSSs and identify factors that can lead to high stress in individuals. From a population of 416 CSSs working in 180 consultation offices nationwide, data from 275 individuals were analyzed （valid response rate, 66.1%）. Compared to a control group that also completed the BJSQ, CSSs scored higher, and were thus worse off in quantitative workload, qualitative workload, physical burden, fatigue, anxiety, and support from family/friends. Male CSSs scored higher, and were thus worse off, in depression and physical complaints. Factors associated with high stress were as follows : in terms of basic attributes, full-time employment status; and in terms of items on the BJSQ, high scores on support from colleagues, support from superiors, depression, job control, physical burden, support from family/friends, and quantitative workload. The results indicate that consultation offices should address the items mentioned above from the perspective of primary prevention, and that care for CSSs experiencing depression should be considered from the perspective of secondary prevention

Prognostic factors for squamous cell carcinoma of the temporal bone: Extensive bone involvement or extensive soft tissue involvement?

金沢大学医薬保健研究域医学系Conclusion: Extensive bone erosion correlated with a worse prognosis of the squamous cell carcinoma (SCC) of the temporal bone but extensive soft tissue involvement did not correlate with prognosis in this study. Resectability of the tumor seems to be major prognostic factor of temporal bone SCC. Objective: Prognostic factors for SCC of the temporal bone were evaluated regarding initial clinical symptoms and radiographic imaging. Patients and methods: Clinical symptoms of the patients with primary SCC of the external auditory canal (EAC) or middle ear (ME) were reviewed based on medical records. Correlation of clinical symptoms and cancer severity staging using the modified Pittsburgh classification was analyzed, along with disease-specific survival (DSS). Results: Sixteen patients with primary SCC of the EAC (n=13) or ME (n=3) were included in the study population. DSS was not influenced by whether a hearing disturbance or otalgia was noted at the first medical examination. Extended bone involvement identified with imaging studies significantly correlated with worse prognosis (p<0.05). Prognoses of patients without extensive bone erosion were good, and extensive (≥0.5 cm) soft tissue involvement did not correlate with prognosis in this study. Prognoses of patients with insufficient bone resection or no surgery were significantly poor (p<0.01)

Retrograde mastoidectomy on demand with soft-wall reconstruction in pediatric cholesteatoma

金沢大学医薬保健研究域医学系Conclusion: Retrograde mastoidectomy with soft-wall reconstruction is an effective technique that can be used to lower the recurrence rate of cholesteatoma in the pediatric population. Objective: To evaluate surgical outcomes of retrograde mastoidectomy when using soft-wall reconstruction in pediatric cholesteatoma. Methods: A total of 25 children underwent cholesteatoma removal surgery employing soft-wall reconstruction. The cases were retrospectively reviewed. Average follow-up time was 48.7 months. In order to fully expose and extirpate the disease, the bony canal wall was removed in association with a retrograde-type mastoidectomy in all cases. The posterior ear canal defect was then reconstructed using soft tissue; i.e. temporal fascia and canal wall skin. The incidence and localization of residual and recurrent cholesteatoma, preoperative and postoperative audiogram results, pure-tone average (PTA), and airbone gap (ABG) were assessed. Results: Residual cholesteatoma was detected in 5 (20%) of 25 ears while recurrent cholesteatoma occurred in 1 (4%) of 25 ears. The mean preoperative PTA of air conduction (AC) was 39.1 dB, while the preoperative PTA of the ABGs was 28.8 dB. The mean postoperative PTA-AC and PTA-ABG were 20.9 dB and 11.7 dB, respectively. The mean hearing gain was 18.2 dB. The differences between the pre- and postoperative values were statistically significant (p < 0.05). © 2010 Informa Healthcare

Changes in calbindin-D28k and parvalbumin expression in the superior olivary complex following unilateral cochlear ablation in neonatal rats

金沢大学医薬保健研究域医学系Conclusion. Unilateral congenital deafness with a volume reduction in cochlear nucleus (CN) induced changes in the calcium-binding proteins (CaBPs) in the contralateral superior olivary complex (SOC) in the rat. With the loss of neurons and a volume reduction in the CN, a decrease in the input to the contralateral SOC may occur, which results in the down-regulation of CaBPs in these nuclei. This study may provide some implications regarding the neurochemistry in the auditory brainstem of deaf children. Objective. Hearing loss produced by cochlear damage during early development can result in persistent changes in the organization of the central auditory system in adults. The purpose of the present study was to investigate the neurochemical changes produced in the auditory brainstem of rats with unilateral cochlear ablation conducted before the onset of hearing. Materials and methods. Following unilateral cochlear ablation during early development, we examined the changes in the distribution of two CaBPs, calbindin-D28k (CB) and parvalbumin (PV), in the SOC. Results. Upon reaching adulthood, a marked decrease in CB- and PV-immunoreactive neurons was observed in the contralateral SOC, particularly in the medial nucleus of the trapezoid body (MNTB), although no neuronal cell death was observed. A volume reduction in the ipsilateral CN was also observed. © 2009 Informa UK Ltd

Pharmacological treatment for bipolar mania: a systematic review and network meta-analysis of double-blind randomized controlled trials

A systematic review and random-effects model network meta-analysis was conducted to compare the efficacy, acceptability, tolerability, and safety of pharmacological interventions for adults with acute bipolar mania. We searched PubMed, the Cochrane Library, and Embase databases for eligible studies published before March 14, 2021. Randomized controlled trials (RCTs) of oral medication monotherapy lasting ≥10 days in adults with mania were included, and studies that allowed the use of antipsychotics as a rescue medication during a trial were excluded. The primary outcomes were response to treatment (efficacy) and all-cause discontinuation (acceptability). The secondary outcomes were the improvement of mania symptoms and discontinuation due to inefficacy. Of the 79 eligible RCTs, 72 double-blind RCTs of 23 drugs and a placebo were included in the meta-analysis (mean study duration = 3.96 ± 2.39 weeks, n = 16442, mean age = 39.55 years, with 50.93% males). Compared with the placebo, aripiprazole, asenapine, carbamazepine, cariprazine, haloperidol, lithium, olanzapine, paliperidone, quetiapine, risperidone, tamoxifen, valproate, and ziprasidone outperformed response to treatment (N = 56, n = 14503); aripiprazole, olanzapine, quetiapine, and risperidone had lower all-cause discontinuation; however, topiramate had higher all-cause discontinuation (N = 70, n = 16324). Compared with the placebo, aripiprazole, asenapine, carbamazepine, cariprazine, haloperidol, lithium, olanzapine, paliperidone, quetiapine, risperidone, tamoxifen, valproate, and ziprasidone outperformed the improvement of mania symptoms (N = 61, n = 15466), and aripiprazole, asenapine, carbamazepine, cariprazine, haloperidol, lithium, olanzapine, paliperidone, quetiapine, risperidone, valproate, and ziprasidone had lower discontinuation due to inefficacy (N = 50, n = 14284). In conclusions, these antipsychotics, carbamazepine, lithium, tamoxifen, and valproate were effective for acute mania. However, only aripiprazole, olanzapine, quetiapine, and risperidone had better acceptability than the placebo

Anatomical plasticity in brainstem auditory nuclei following unilateral ablation of the inferior colliculus in neonatal rats

金沢大学附属病院耳鼻咽喉科Anatomical plasticity of projections from brainstem auditory structures to the inferior colliculus (IC) was examined in albino rats to determine the effects of unilateral destruction of the IC during early development. The IC in the right hemisphere was destroyed by aspiration on postnatal day 3. Upon reaching adulthood, the rats were examined by retrograde tract tracing methods with fluoro-gold (FG) and [3H]-glycine to determine patterns of brainstem projections to the undamaged left IC. In our FG experiments, the results confirmed the presence of aberrant crossed projections from the right medial superior olive (MSO) to the undamaged left IC. Following injections of [3H]-glycine or FG into the undamaged left IC, however, no other aberrant projections were found in the superior olive, including those from the ipsilateral lateral superior olive (LSO) or the superior paraolivary nucleus (SPN). These results suggest that projections from the MSO to the IC may have the latent ability to create aberrant crossed projections during development. On the other hand, the neurons in LSO and SPN do not form aberrant projections following early unilateral IC lesions. © 2008 Elsevier B.V. All rights reserved