Relationship between the Contentment of Mothers of Infants with Parenting Advice and Their Recognition in Judging Credibility

Background: This study sought to clarify the contentment of mothers of infants with parenting advice, judgment regarding credibility of parenting advice, and the relationship between such contentment and judgment. Methods: We conducted an anonymous, self-reported questionnaire-based survey from April to June 2016, targeting 1,118 mothers of infants in Prefecture A. The questions covered basic attributes, contentment with parenting advice, and judging the credibility of such advice. Descriptive statistics were compiled for each factor. A t-test was performed to examine the relationship between contentment with parenting advice and judging the credibility of parenting advice. This study was conducted with the approval of the Ethics Committee of Tokushima University Hospital. Results: The questionnaires were returned by 272 subjects (collection rate of 24.3%), with 265 determined as valid (valid response rate of 23.7%). The mean score for contentment concerning parenting advice was 6.17 (standard deviation: ±1.69). More than 80% of the subjects indicated being able to select credible parenting advice, and more than 70% had sought professional consultation about childrearing. However, among subjects who had not sought professional consultation, some had wanted to seek professional consultation but had not been able to do so. Relating contentment to judging the credibility of parenting advice, the mean contentment scores of the subjects who felt able to select credible parenting advice were significantly higher than the scores of those who did not (p < 0.01). Conclusion: Although study participants’ contentment relating to parenting advice seemed higher than that of teenage mothers, their levels of contentment appeared insufficient. Additionally, some subjects wanted to seek professional consultation about childrearing but could not. Furthermore, mothers who reported being able to select credible parenting advice were found to obtain and apply sufficient parenting advice, compared to those who did not feel the same confidence

A Japanese literature review on the work continuation of mid-career nurses : Focus on the reasons for leaving and career continuation

目的：本研究は，日本における中堅看護師を対象にした先行文献から，中堅看護師の離職と職業継続に影響を与える要因を明らかにし，職業継続支援への示唆を得ることを目的とする． 方法：文献は，「医学中央雑誌Web(ver.5)」，「メディカルオンライン」，「CiNii」を使用し，「看護師and離職」，「中堅看護師and離職」，「中堅看護師and職業継続」，「中堅看護師and職務継続」というキーワードで検索をした．検索の範囲は，2005年から2017年までとした．対象文献は，「辞めたいと思った理由」と「働き続ける理由」について記載がある21文献で，「辞めたいと思った理由」と「働き続ける理由」を類似性に基づいて帰納的に分類し，カテゴリー化を行った． 結果：中堅看護師が「辞めたいと思った理由」として，【キャリアプランとの不一致】【やりがい不足】【人間関係によるストレス】【労働環境が悪い】【看護実践能力についての不安】【自己効力感の形成阻害】【特に働き続ける理由がない】のコアカテゴリーが抽出された．また，中堅看護師が「働き続ける理由」として，【キャリアプランとの一致】【やりがいがある】【良好な人間関係】【労働環境が良い】【看護実践能力についての自信】【自己効力感を高める体験】【特に辞める理由がない】【ストレス・マネージメント】のコアカテゴリーが抽出された． 考察：看護師が離職を考える要因には，キャリアプランや，仕事のやりがい，職場の人間関係，職場の労働環境，自身の看護実践能力と自己効力感が大きく関わっており，それらは共通して職務継続の要素にもなっていた．しかし，ストレス・マネージメントは，職業継続にだけみられる要因であり，効果的なストレス・マネージメントは，離職を思い留まらせることが示唆された．中堅看護師の職業継続には，ストレス・マネージメントに着目した支援が重要である．Purposes: The aim of the present study was to clarify the factors that affect leaving and career continuation of mid-career nurses from prior literature and to obtain suggestions for vocational continuity support. Method: A literature search of Japan Medical Abstracts Society, Medical Online, and CiNii Articles databases was conducted using the following keywords: “nurse and leaving,” “mid-career nurse and leaving,” “mid-career nurse and occupation continuation,” and “mid-career nurse and duties continuation,” including all studies published between 2005 and 2017. We investigated 21 studies that mentioned “the reason why mid-career nurses wanted to quit work” and “the reason why they continue working.” Further, we classified inductively “the reason why they wanted to quit work” and “the reason why they continue working” based on similarity and categorized them. Result: “The reason why mid-career nurses wanted to quit work” was represented in seven categories, which included the following: [disagreement with the career plan], [lack of worth doing of work], [stress caused by human relations], [bad working environment], [uneasiness about nursing practice ability], [growth restraint of self-efficacy], and [there is no reason that continues working in particular]. In addition, “the reason why mid-career nurses continue working” was represented in the following seven categories: [agreement with the career plan], [with the worth doing], [good human relations], [good working environment], [experience to enhance self-efficacy], [there is not a reason to quit work in particular], and [stress management]. Conclusion: “Career plan,” “worth doing,” “human relations of the workplace,” “work environment,” “nursing practice ability,” and “self-efficacy” were related with the factor that nurses wanted to quit, including reasons for continuing occupation. However, stress management was a factor found in career continuity alone, and effective stress management was suggested as a factor that would change mid-carrier nurses’ feeling of wanting to quit work into wanting to continue work

日本の家畜と畜産農家から分離した mcr-1 によるコリスチン耐性大腸菌の分布状況と関連性について

Colistin is used to treat infectious diseases in humans and livestock; it has also been used as a feed additive for livestock for approximately 50 years. Since the mcr-1 plasmid-mediated colistin resistance gene was discovered in China in 2015, it has been detected worldwide, mainly in livestock. In this study, we investigated the prevalence and characteristics of mcr-mediated colistin-resistant Escherichia coli in livestock and farmers in Japan. We collected fecal samples from 295 healthy livestock (202 cattle and 93 swine) and 62 healthy farmers from 72 livestock farms (58 cattle farms and 14 swine farms) between 2013 and 2015. Twenty-eight mcr-1-harboring E. coli strains were isolated from 25 livestock (six cattle and 19 swine) and three farmers (two cattle farmers and one swine farmer). The prevalence rates of mcr-1-harboring E. coli in livestock and farmers were 8.47 and 4.84%, respectively. Of the 28 strains, the resistance genes of three were transferable via the mcr-1-coding plasmids to E. coli J53 at low frequencies (10-7-10-8). Six strains coharbored mcr-1 with CTX-M β-lactamases (CTX-M-14, CTX-M-27, or CTX-M-156). Of the isolates obtained from livestock and farmers in four farms (farms C, I, N, and P), nine strains had the same genotypical characteristics (sequence types and pulsed-field gel electrophoresis band patterns), plasmid characteristics (incompatibility group and plasmid transferability), and minimum inhibitory concentrations. Thus, the findings suggested that clonal strains could spread among livestock and farmers within farms. To our knowledge, this is the first study to detect clonal relatedness of mcr-1-mediated colistin-resistant E. coli in livestock and farmers. It is suggested that farmers are at a higher risk of acquiring mcr-1-harboring strains, calling for our attention based on the One Health concept.博士（医学）・甲第798号・令和3年9月29日Copyright © 2021 Nakano, Nakano, Nishisouzu, Suzuki, Horiuchi, Kikuchi-Ueda, Ubagai, Ono and Yano. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY https://creativecommons.org/licenses/by/4.0/). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms

日本における基質特異性拡張型β-ラクタマーゼ産生肺炎桿菌の分子遺伝学的特徴：CTX-M-15の優位性と高病原性クローンの出現

Objective: To provide data on the molecular characteristics of extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae clinical isolates in Japan. Methods: A total of 100 clinical isolates of ESBL-producing K. pneumoniae collected throughout Japan between June and July 2018 were studied. ESBL genes were analyzed using PCR and DNA sequencing. Transferability of ESBL genes was investigated by conjugation experiments. Plasmid replicon types, virulence genes (rmpA, rmpA2, iucA, iroB, and peg-344) associated with hypervirulent K. pneumoniae (hvKp), and capsule types were detected using PCR. Genotyping was performed using multilocus sequence typing. Results: All ESBL-producing isolates carried blaCTX-M genes. The most predominant CTX-M-type identified was CTX-M-15 (n=55). We identified 24 sequence types (STs) among the CTX-M-15 producers, with ST25 (n=8) being the most common. Most of the transconjugants carrying blaCTX-M-15 contained the FIIk replicon. Of the 100 ESBL-producing isolates, 31 were hvKp defined by the presence of the virulence genes. These ESBL-producing hvKp isolates belonged to eight STs (STs 23, 25, 36, 65, 86, 268, 412, and 4492), with five capsule types (K1, K2, K20, K57, and undefined). Conclusions: CTX-M-15 was the predominant ESBL among K. pneumoniae isolates from Japan. This study shows that ESBL-producing hvKp strains comprising various clones are emerging in Japan.博士（医学）・甲第769号・令和3年3月15日© 2020 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Plasma level of D-dimer accompanying different types of gynecologic surgery and effects of prophylactic subcutaneous injection of heparin calcium

Background: The standard range of D-dimer level associated with each type of gynecologic surgery is required to note the occurrence of bleeding or thromboembolism.Methods: Plasma levels of D-dimer of patients who underwent different types of gynecologic surgery were measured on the Day of Preoperative Examination (DPE) and the first postoperative day (POD-1). Patients were classified by surgery type: hysterectomy for benign diseases or cervical intraepithelial neoplasia; hysterectomy for uterine cancer; surgery for ovarian cancer; laparoscopic surgery for a benign adnexal mass; laparotomy for a benign adnexal mass; laparotomic myomectomy; cervical conization; transcervical resection of an intrauterine mass; vaginal surgery for prolapse of a pelvic organ.Results: In each type of gynecologic surgery, plasma levels of D-dimer on POD-1 were higher than those on the DPE. Prophylactic subcutaneous injection of heparin calcium for patients who underwent surgery for endometrial cancer showed no significant difference in the plasma level of D-dimer on the sixth postoperative day (POD-6) and the plasma level of D-dimer on POD-6 was in the same level as those on POD-1.Conclusions: Plasma levels of D-dimer on POD-1 were higher than those on the DPE in each type of gynecologic surgery. The D-dimer level remained high even on POD-6, and not changed by prophylactic subcutaneous injection of heparin calcium.

奈良県の地域住民と生活環境におけるピロリ菌の蔓延実態

Background: Chronic infection with Helicobacter pylori, specifically cagA-positive strains, is associated with gastric cancer. Thus, measures to prevent H. pylori infection are required. This study was conducted to clarify the prevalence of H. pylori in the community to identify the infection source and comprehensively assess the risk of H. pylori infection. Methods: We collected 90 human faecal samples and 73 environmental samples (water, vegetable, and animal faecal samples) from the residents in an area with a high incidence of gastric cancer in Japan. Polymerase chain reaction assay was performed to detect the glmM housekeeping gene and the cagA virulence gene of H. pylori. A questionnaire survey was conducted, and the responses were analyzed statistically. Results: The glmM gene was detected in 18 of 90 (20%) faecal samples obtained from residents; among them, the cagA gene was detected in 33.3% (6/18), and in all who had undergone eradication therapy. H. pylori was not detected in environmental samples. However, contact with dogs (OR 3.89, 95% CI 1.15-13.15, P < 0.05) was associated with higher odds for glmM gene positivity in the questionnaire survey. Conclusions: The prevalence of H. pylori and cagA-positive strains among the residents was low. However, the study results suggest a correlation between recurrent infection and cagA-positive H. pylori strains. Although H. pylori genes were not detected in living environments, an association between contact with dogs and a glmM positive status was revealed. Further investigations targeting community-dwelling healthy people and their living environments would be required for H. pylori infection control.博士（医学）・甲第774号・令和3年3月15日© 2020 The Authors. Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

大学生のメタボリックシンドロームへの認識と生活習慣に関する実態調査

2008年度より糖尿病などの生活習慣病の有病者及び予備軍の減少という観点から40歳～74歳を対象に、メタボリックシンドロームの概念を導入した特定健診・特定保健指導が開始された。しかし、生活習慣病の予防は、若い年代からの取り組みが必要である。そこで、本研究では大学生のメタボリックシンドロームヘの認識やその情報源、生活習慣の実態を把握することを目的とし、実態調査を行った。結果、メタボリックシンドロームの学生への認知度は極めて高いということが分かった。情報源ではテレビ、新聞による情報発信が若者の知識普及に効果的であるため、CM等による情報提供や新聞のコラムによる広報を活用する事がよりいっそうの啓発活動に繋がると考えられる。また、メタボリックシンドロームに関する認識はあっても、関連付けて自己の生活習慣を見つめ直し、行動変容に結びつけようとしている大学生が少ない傾向があつた。生活習慣改善の意識では関心期・準備期の者が多く、実際に改善に取り組んでいる学生は少ない。よって、関心期・準備期の者へ積極的にアプローチしていくことが大学生の生活習慣の改善に効果的であり、また若者が好ましい生活習慣を確立するためには、知識の普及だけでなく、意識付け・動機付けに繋がるアプローチが必要であることが明確になった

Root canal treatment with high-frequency waves in rats

The purpose of this study was to develop a high-frequency wave therapy model in rats and to investigate the influence of high-frequency waves on root canal treatment, which may provide a novel strategy for treating apical periodontitis. Root canal treatments with and without high-frequency wave irradiation were performed on the mandibular first molars of 10-week-old male Wistar rats. The mesial roots were evaluated radiologically, bacteriologically, and immunohistochemically. At 3 weeks after root canal treatment, lesion volume had decreased significantly more in the irradiated group than in the non-irradiated group, indicating successful development of the high-frequency therapy model. The use of high-frequency waves provided no additional bactericidal effect after root canal treatment. However, high-frequency wave irradiation was found to promote healing of periapical lesions on the host side through increased expression of fibroblast growth factor 2 and transforming growth factor-β1 and could therefore be useful as an adjuvant nonsurgical treatment for apical periodontitis

Secretory Carcinoma of Salivary Gland with High-Grade Histology Arising in Hard Palate: A Case Report

Secretory carcinoma (SC) is a recently described salivary gland tumor reported in the fourth edition of World Health Organization classification of head and neck tumors. SC is characterized by strong S-100 protein, mammaglobin, and vimentin immunoexpression, and harbors a t(12;15)(p13;q25) translocation which leads to ETV6-NTRK3 fusion product. Histologically, SC displays a lobulated growth pattern and is often composed of microcystic, tubular, and solid structures with abundant eosinophilic homogenous or bubbly secretion. SC is generally recognized as low-grade malignancy with low-grade histopathologic features, and metastasis is relatively uncommon. In this case, we described a SC of hard palate that underwent high grade transformation and metastasis to the cervical lymph node in a 54-year-old patient. In addition, this case showed different histological findings between primary lesion and metastasis lesion. Therefore, the diagnosis was confirmed by the presence of ETV6 translocation. Here, we report a case that occurred SC with high-grade transformation in the palate, and a review of the relevant literature is also presented