The relationship between physical signs of aging and social functioning in persons with Down syndrome in Japan

Background: In Japan, there have been no substantial studies of social function and physical aging in adults with Down syndrome. The aim of the present study was to examine social functions (movement, conversation, and daily living skills) and physical signs of aging in adults with Down syndrome in Japan, and to analyze the relationship between changes in social function and age.Methods: A cross-sectional survey of persons with Down syndrome who were 15 years of age or older (15-65 years old) was conducted. The survey was conducted in patients associations, institutes, group homes, and workplaces from July to December 2009. Primary caregivers, such as family members and institute staff, were asked to complete a questionnaire on the subjects’ living situation, movement ability, conversational skills, daily living skills, and 10 characteristics of physical aging at the time of the survey.Results: The total number of subjects was 315. Subjects’ movement ability, conversational ability, and daily living skills declined as a function of age. Canities (40.6%) were the most prevalent physical sign of aging, followed by missing teeth, hump back, and skin wrinkling. Further, physical aging was related to a decline in social functions (p < 0.001).Conclusion: The present study showed that adults with Down syndrome exhibit signs of physical aging earlier than do the general population, and that physical aging is associated with social functioning. Thus, the appearance of physical aging might indicate a decline in social functioning

Integrated genetic and epigenetic analysis defines novel molecular subgroups in rhabdomyosarcoma.

横紋筋肉腫におけるゲノム・エピゲノム異常の全体図を解明 -横紋筋肉腫を4群に分類-. 京都大学プレスリリース. 2015-07-03.Rhabdomyosarcoma (RMS) is the most common soft-tissue sarcoma in childhood. Here we studied 60 RMSs using whole-exome/-transcriptome sequencing, copy number (CN) and DNA methylome analyses to unravel the genetic/epigenetic basis of RMS. On the basis of methylation patterns, RMS is clustered into four distinct subtypes, which exhibits remarkable correlation with mutation/CN profiles, histological phenotypes and clinical behaviours. A1 and A2 subtypes, especially A1, largely correspond to alveolar histology with frequent PAX3/7 fusions and alterations in cell cycle regulators. In contrast, mostly showing embryonal histology, both E1 and E2 subtypes are characterized by high frequency of CN alterations and/or allelic imbalances, FGFR4/RAS/AKT pathway mutations and PTEN mutations/methylation and in E2, also by p53 inactivation. Despite the better prognosis of embryonal RMS, patients in the E2 are likely to have a poor prognosis. Our results highlight the close relationships of the methylation status and gene mutations with the biological behaviour in RMS

実親と暮らせない虐待被害児の養育上の課題および看護支援に関する研究： 児童養護施設・ファミリーホーム・里親への全国調査を通して

京都府立医科大学医学部看護学科滋賀医科大学医学部看護学科福岡女学院看護大学看護学部看護学科名古屋学芸大学看護学部看護学科長崎大学大学院医歯薬学総合研究科School of Nursing, Kyoto Prefecture University of MedicinSchool of Nursing, Shiga University of Medical ScienceFukuoka Jo-Gakuin Nursing UniversityFaculty of Nursing, Nagoya University of Arts and SciencesGraduate School of Biomedical Sciences, Nagasaki University　本研究は、実親と暮らせない児童の養育を担う児童養護施設およびファミリーホーム、里親を対象に、虐待被害児の自立と生活支援の観点から、養育上の課題、看護師への相談・支援ニーズの検討を目的とした。　全国の児童養護施設593ヵ所、ファミリーホーム136ヵ所、里親1050ヵ所、計1779ヵ所を対象に485ヵ所から回答を得た。全体の回収率は27.3% で、調査の結果、児童養護施設における虐待被害児の養育困難な事柄として、①コミュニケーションの学習、②ストレス対処の学習、③年齢相応の学力の習得、④家族としてのルールの習得、⑤基本的生活習慣の獲得などが高い割合を占めた。　さらに、障害や慢性疾患をもつ児童の養育経験は児童養護施設、ファミリーホーム、里親の全てにおいて高い割合を示し、養育上の課題が浮き彫りになった。看護師による相談支援では「児童の身体や健康状態・病気」、「児童の精神的な問題」といったニーズが高い割合を占めた

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016)

Background and purposeThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 and published in the Journal of JSICM, [2017; Volume 24 (supplement 2)] https://doi.org/10.3918/jsicm.24S0001 and Journal of Japanese Association for Acute Medicine [2017; Volume 28, (supplement 1)] http://onlinelibrary.wiley.com/doi/10.1002/jja2.2017.28.issue-S1/issuetoc.This abridged English edition of the J-SSCG 2016 was produced with permission from the Japanese Association of Acute Medicine and the Japanese Society for Intensive Care Medicine.MethodsMembers of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ) and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two-thirds (> 66.6%) majority vote of each of the 19 committee members.ResultsA total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J-SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation, and its supporting evidence were also added to each recommendation statement. We conducted meta-analyses for 29 CQs. Thirty-seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for five CQs.ConclusionsBased on the evidence gathered, we were able to formulate Japanese-specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non-specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020)

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high-quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J-SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU-acquired weakness [ICU-AW], post-intensive care syndrome [PICS], and body temperature management). The J-SSCG 2020 covered a total of 22 areas with four additional new areas (patient- and family-centered care, sepsis treatment system, neuro-intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large-scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members.other authors: Yasuhiro Norisue, Satoru Hashimoto, Daisuke Hasegawa, Junji Hatakeyama, Naoki Hara, Naoki Higashibeppu, Nana Furushima, Hirotaka Furusono, Yujiro Matsuishi, Tasuku Matsuyama, Yusuke Minematsu, Ryoichi Miyashita, Yuji Miyatake, Megumi Moriyasu, Toru Yamada, Hiroyuki Yamada, Ryo Yamamoto, Takeshi Yoshida, Yuhei Yoshida, Jumpei Yoshimura, Ryuichi Yotsumoto, Hiroshi Yonekura, Takeshi Wada, Eizo Watanabe, Makoto Aoki, Hideki Asai, Takakuni Abe, Yutaka Igarashi, Naoya Iguchi, Masami Ishikawa, Go Ishimaru, Shutaro Isokawa, Ryuta Itakura, Hisashi Imahase, Haruki Imura, Takashi Irinoda, Kenji Uehara, Noritaka Ushio, Takeshi Umegaki, Yuko Egawa, Yuki Enomoto, Kohei Ota, Yoshifumi Ohchi, Takanori Ohno, Hiroyuki Ohbe, Kazuyuki Oka, Nobunaga Okada, Yohei Okada, Hiromu Okano, Jun Okamoto, Hiroshi Okuda, Takayuki Ogura, Yu Onodera, Yuhta Oyama, Motoshi Kainuma, Eisuke Kako, Masahiro Kashiura, Hiromi Kato, Akihiro Kanaya, Tadashi Kaneko, Keita Kanehata, Ken-ichi Kano, Hiroyuki Kawano, Kazuya Kikutani, Hitoshi Kikuchi, Takahiro Kido, Sho Kimura, Hiroyuki Koami, Daisuke Kobashi, Iwao Saiki, Masahito Sakai, Ayaka Sakamoto, Tetsuya Sato, Yasuhiro Shiga, Manabu Shimoto, Shinya Shimoyama, Tomohisa Shoko, Yoh Sugawara, Atsunori Sugita, Satoshi Suzuki, Yuji Suzuki, Tomohiro Suhara, Kenji Sonota, Shuhei Takauji, Kohei Takashima, Sho Takahashi, Yoko Takahashi, Jun Takeshita, Yuuki Tanaka, Akihito Tampo, Taichiro Tsunoyama, Kenichi Tetsuhara, Kentaro Tokunaga, Yoshihiro Tomioka, Kentaro Tomita, Naoki Tominaga, Mitsunobu Toyosaki, Yukitoshi Toyoda, Hiromichi Naito, Isao Nagata, Tadashi Nagato, Yoshimi Nakamura, Yuki Nakamori, Isao Nahara, Hiromu Naraba, Chihiro Narita, Norihiro Nishioka, Tomoya Nishimura, Kei Nishiyama, Tomohisa Nomura, Taiki Haga, Yoshihiro Hagiwara, Katsuhiko Hashimoto, Takeshi Hatachi, Toshiaki Hamasaki, Takuya Hayashi, Minoru Hayashi, Atsuki Hayamizu, Go Haraguchi, Yohei Hirano, Ryo Fujii, Motoki Fujita, Naoyuki Fujimura, Hiraku Funakoshi, Masahito Horiguchi, Jun Maki, Naohisa Masunaga, Yosuke Matsumura, Takuya Mayumi, Keisuke Minami, Yuya Miyazaki, Kazuyuki Miyamoto, Teppei Murata, Machi Yanai, Takao Yano, Kohei Yamada, Naoki Yamada, Tomonori Yamamoto, Shodai Yoshihiro, Hiroshi Tanaka & Osamu Nishid

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020)

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high-quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J-SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU-acquired weakness [ICU-AW], post-intensive care syndrome [PICS], and body temperature management). The J-SSCG 2020 covered a total of 22 areas with four additional new areas (patient- and family-centered care, sepsis treatment system, neuro-intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large-scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members.As a result, 79 GRADE-based recommendations, 5 Good Practice Statements (GPS), 18 expert consensuses, 27 answers to background questions (BQs), and summaries of definitions and diagnosis of sepsis were created as responses to 118 CQs. We also incorporated visual information for each CQ according to the time course of treatment, and we will also distribute this as an app. The J-SSCG 2020 is expected to be widely used as a useful bedside guideline in the field of sepsis treatment both in Japan and overseas involving multiple disciplines.other authors: Satoru Hashimoto,Daisuke Hasegawa,Junji Hatakeyama,Naoki Hara,Naoki Higashibeppu,Nana Furushima,Hirotaka Furusono,Yujiro Matsuishi,Tasuku Matsuyama,Yusuke Minematsu,Ryoichi Miyashita,Yuji Miyatake,Megumi Moriyasu,Toru Yamada,Hiroyuki Yamada,Ryo Yamamoto,Takeshi Yoshida,Yuhei Yoshida,Jumpei Yoshimura,Ryuichi Yotsumoto,Hiroshi Yonekura,Takeshi Wada,Eizo Watanabe,Makoto Aoki,Hideki Asai,Takakuni Abe,Yutaka Igarashi,Naoya Iguchi,Masami Ishikawa,Go Ishimaru,Shutaro Isokawa,Ryuta Itakura,Hisashi Imahase,Haruki Imura,Takashi Irinoda,Kenji Uehara,Noritaka Ushio,Takeshi Umegaki,Yuko Egawa,Yuki Enomoto,Kohei Ota,Yoshifumi Ohchi,Takanori Ohno,Hiroyuki Ohbe,Kazuyuki Oka,Nobunaga Okada,Yohei Okada,Hiromu Okano,Jun Okamoto,Hiroshi Okuda,Takayuki Ogura,Yu Onodera,Yuhta Oyama,Motoshi Kainuma,Eisuke Kako,Masahiro Kashiura,Hiromi Kato,Akihiro Kanaya,Tadashi Kaneko,Keita Kanehata,Ken-ichi Kano,Hiroyuki Kawano,Kazuya Kikutani,Hitoshi Kikuchi,Takahiro Kido,Sho Kimura,Hiroyuki Koami,Daisuke Kobashi,Iwao Saiki,Masahito Sakai,Ayaka Sakamoto,Tetsuya Sato,Yasuhiro Shiga,Manabu Shimoto,Shinya Shimoyama,Tomohisa Shoko,Yoh Sugawara,Atsunori Sugita,Satoshi Suzuki,Yuji Suzuki,Tomohiro Suhara,Kenji Sonota,Shuhei Takauji,Kohei Takashima,Sho Takahashi,Yoko Takahashi,Jun Takeshita,Yuuki Tanaka,Akihito Tampo,Taichiro Tsunoyama,Kenichi Tetsuhara,Kentaro Tokunaga,Yoshihiro Tomioka,Kentaro Tomita,Naoki Tominaga,Mitsunobu Toyosaki,Yukitoshi Toyoda,Hiromichi Naito,Isao Nagata,Tadashi Nagato,Yoshimi Nakamura,Yuki Nakamori,Isao Nahara,Hiromu Naraba,Chihiro Narita,Norihiro Nishioka,Tomoya Nishimura,Kei Nishiyama,Tomohisa Nomura,Taiki Haga,Yoshihiro Hagiwara,Katsuhiko Hashimoto,Takeshi Hatachi,Toshiaki Hamasaki,Takuya Hayashi,Minoru Hayashi,Atsuki Hayamizu,Go Haraguchi,Yohei Hirano,Ryo Fujii,Motoki Fujita,Naoyuki Fujimura,Hiraku Funakoshi,Masahito Horiguchi,Jun Maki,Naohisa Masunaga,Yosuke Matsumura,Takuya Mayumi,Keisuke Minami,Yuya Miyazaki,Kazuyuki Miyamoto,Teppei Murata,Machi Yanai,Takao Yano,Kohei Yamada,Naoki Yamada,Tomonori Yamamoto,Shodai Yoshihiro,Hiroshi Tanaka,Osamu NishidaGuideline

Differences between sexes in factors influencing awareness of chronic obstructive pulmonary disease

Objectives: In Japan, large-scale natural disasters such as earthquakes, tsunamis and floods frequently occur, often having devastating effects on people's lives. For this reason, it is imperative that people be prepared for disasters at an individual, family and community level in Japan. This study aims to evaluate factors associated to individual disaster preparedness among nursing university students in Japan. Methods: An anonymous self-administered questionnaire survey was conducted among nursing university students in July, 2017 in Japan. The questionnaire was prepared based on questions used in previous studies by the Cabinet Office, which included perception of natural disasters and actual behaviors related to disaster preparedness. Results: The questionnaire was distributed to 215 nursing university students, and 170 were analyzed in this study. Although 91.4% of respondents showed concern for disasters and 81.2% respondents for disaster preparedness, only 50.0% respondents were aware of the location of evacuation area closest to their current residential area and 17.6% respondents had some prearranged communication method with family in the event of disaster. Respondents living alone were less likely to know the location of evacuation area (AOR: 0.217; 95% CI: 0.103, 0.459; P<0.001) than respondents who lived with their family, and respondents with experience of training/lecture on disaster preparedness were more likely to know the location of evacuation area (AOR: 3.418; 95% CI: 1.448, 8.064; P=0.005). Respondents who recognized the importance of disaster preparedness (AOR: 4.084; 95% CI: 1.430, 11.683; P=0.009) were more likely to have arranged with their family how to communicate with each other in the event of disaster. Conclusions: Participating in training/lecture regarding disaster preparedness contributed to actual disaster preparedness such as knowing the location of evacuation area. However, there was no contribution of participation in training/lectures on other behaviors of preparedness such as prearrangement of communication methods with family, preparation of emergency items, and registration in disaster notification services. As persons whose professional skills will be sought in pre- and post-disasters, it is essential to strengthen the capabilities of nursing university students through training on disaster preparation in order that they can effectively prepare for future disasters

Differences between sexes in factors influencing awareness of chronic obstructive pulmonary disease

Objectives: In Japan, large-scale natural disasters such as earthquakes, tsunamis and floods frequently occur, often having devastating effects on people\u27s lives. For this reason, it is imperative that people be prepared for disasters at an individual, family and community level in Japan. This study aims to evaluate factors associated to individual disaster preparedness among nursing university students in Japan. Methods: An anonymous self-administered questionnaire survey was conducted among nursing university students in July, 2017 in Japan. The questionnaire was prepared based on questions used in previous studies by the Cabinet Office, which included perception of natural disasters and actual behaviors related to disaster preparedness. Results: The questionnaire was distributed to 215 nursing university students, and 170 were analyzed in this study. Although 91.4% of respondents showed concern for disasters and 81.2% respondents for disaster preparedness, only 50.0% respondents were aware of the location of evacuation area closest to their current residential area and 17.6% respondents had some prearranged communication method with family in the event of disaster. Respondents living alone were less likely to know the location of evacuation area (AOR: 0.217; 95% CI: 0.103, 0.459; P<0.001) than respondents who lived with their family, and respondents with experience of training/lecture on disaster preparedness were more likely to know the location of evacuation area (AOR: 3.418; 95% CI: 1.448, 8.064; P=0.005). Respondents who recognized the importance of disaster preparedness (AOR: 4.084; 95% CI: 1.430, 11.683; P=0.009) were more likely to have arranged with their family how to communicate with each other in the event of disaster. Conclusions: Participating in training/lecture regarding disaster preparedness contributed to actual disaster preparedness such as knowing the location of evacuation area. However, there was no contribution of participation in training/lectures on other behaviors of preparedness such as prearrangement of communication methods with family, preparation of emergency items, and registration in disaster notification services. As persons whose professional skills will be sought in pre- and post-disasters, it is essential to strengthen the capabilities of nursing university students through training on disaster preparation in order that they can effectively prepare for future disasters