Short-term intake of a Japanese-style healthy lunch menu contributes to prevention and/or improvement in metabolic syndrome among middle-aged men: a non-randomized controlled trial

BACKGROUND: Metabolic syndrome is now widely appreciated as a cluster of metabolic abnormalities such as visceral obesity, hypertension, hyperglycemia and dyslipidemia. To date, incidence of metabolic syndrome is continuously increasing worldwide. In addition, low vegetable consumption has recently become a serious issue in Japan. Furthermore, Japan is facing a shortfall in places offering food that can help prevent metabolic syndrome in the first place. Our study is designed to influence these developments. We conducted a non-randomized controlled trial by offering a Japanese-style healthy lunch menu to middle-aged men in a workplace cafeteria. This menu was designed to prevent and reduce metabolic syndrome. METHODS: This intervention study took the form of a non-randomized controlled trial. Participants chose the control or intervention group. The control group consumed their habitual lunches without restriction and only nutrient contents were assessed. The intervention group received a Japanese-style healthy lunch at a workplace cafeteria for 3 months. The participants worked in offices at a city hall and mostly had low levels of physical activity. Data of 35 males (control group: 7 males, intervention group: 28 males, mean age: 47.2 ± 7.9 years) were collected and analyzed. RESULTS: We obtained an effective outcome by demonstrating that ongoing intake of a Japanese-style healthy lunch decreased blood pressure and serum lipids and increased plasma ghrelin levels. The results grew more pronounced as intake of Japanese-style healthy lunches increased in frequency. CONCLUSIONS: This study presents new empirical data as a result of an original intervention program undertaken in Japan. A Japanese-style healthy lunch menu containing many vegetables consumed can help prevent and/or improve metabolic syndrome

Factors associated with the severity of childhood rhinoconjunctivitis

AbstractBackgroundAllergic rhinitis is one of the most common chronic diseases in children. Although it has a large impact on the patient's quality of life, little is known about the factors associated with its severity. The aim of this study was to assess the factors associated with the severity of rhinoconjunctivitis among children in the general population.MethodsA survey was conducted using an online research panel in 2012. Parents were asked to answer an International Study of Asthma and Allergies in Childhood-based questionnaire to identify children with current rhinoconjunctivitis and evaluate factors associated with the severity of its symptoms. Severity was rated according to the degree of impairment caused by the symptoms in the patient's daily life.ResultsAmong 26,725 children aged 6–12 years old, rhinoconjunctivitis was defined in 5175 (19.4%), and of these, 688 children (13.3% of children with current rhinoconjunctivitis) presented severe symptoms. Living in areas with a high cedar and cypress pollen count and having concurrent eczema were associated with severe rhinoconjunctivitis [adjusted OR (95% CI): 1.21 (1.00–1.46) and 1.45 (1.20–1.75), respectively]. Further, a maternal history of asthma and allergic rhinitis was a significant risk factor for severe rhinoconjunctivitis [1.34 (1.04–1.74) and 1.30 (1.10–1.53), respectively]. However, living with fur-bearing animals (pets) before 1 year of age proved to be a protective factor against severe rhinoconjunctivitis [0.70 (0.52–0.94)].ConclusionsEnvironmental factors such as pets and pollen, together with comorbidities and a maternal history of allergic diseases, play an important role in determining the severity of rhinoconjunctivitis

Effects of a high-fat diet on the electrical properties of porcine atria

AbstractBackgroundBecause obesity is an important risk factor for atrial fibrillation (AF), we conducted an animal study to examine the effect of a high-fat diet (HFD) on atrial properties and AF inducibility.MethodsTen 8-week-old pigs (weight, 18–23kg) were divided into two groups. For 18 weeks, five pigs were fed a HFD (HFD group) and five were fed a normal diet (control group). Maps of atrial activation and voltages during sinus rhythm were created for all pigs using the EnSite NavX system. Effective refractory period (ERP) and AF inducibility were also determined. When AF was induced, complex fractionated atrial electrogram (CFAE) mapping was performed. At 18 weeks, hearts were removed for comparing the results of histological analysis between the two groups. Body weight, lipid levels, hemodynamics, cardiac structures, and electrophysiological properties were also compared.ResultsTotal cholesterol levels were significantly higher (347 [191–434] vs. 81 [67–88]mg/dL, P=0.0088), and left atrium pressure was higher (34.5 [25.6–39.5] vs. 24.5 [21.3–27.8]mmHg, P=0.0833) in the HFD group than in the control group, although body weight only increased marginally (89 [78–101] vs. 70 [66–91]kg, P=0.3472). ERPs of the pulmonary vein (PV) were shorter (P<0.05) and AF lasted longer in the HFD group than in the control group (80 [45–1350] vs. 22 [3–30]s, P=0.0212). Neither CFAE site distribution nor histopathological characteristics differed between the two groups.ConclusionsThe shorter ERPs for the PV observed in response to the HFD increased vulnerability to AF, and these electrophysiological characteristics may underlie obesity-related AF

CCR6+ MCAM+ Th17 Cell Numbers Increase in Patients with Psoriasis and Correlate with Disease Severity

Psoriasis is a chronic immune-mediated disease in which the interleukin (IL)-23/IL-17 axis plays a key role in the inflammatory cascade. We recently reported that co-expression of CCR6 and melanoma cell adhesion molecule (MCAM) in effector memory CD4 T cells (TEM) of peripheral blood might be a useful marker for T helper (Th) 17 cells. In this study, we monitored changes in TEM expressing CCR6 and MCAM using the Psoriasis Area and Severity Index (PASI) score during anti-tumor necrosis factor (TNF) therapy. We also studied CCR6+ MCAM+ Th17 cells histologically in skin biopsy samples from psoriasis patients. In psoriasis patients treated with anti-TNF therapy, the PASI score and the percentage of CCR6+ MCAM+ TEM cells in the blood changed almost in parallel. In immunohistochemical analyses, the proportions of IL-17+ T cells and MCAM+ T cells in the lesional skin of severely psoriatic patients were significantly higher than in mildly psoriatic patients (P<0.05), and the number of IL17+ T cells correlated with the PASI score (r=0.400, P<0.05). Taken together, these results indicate that CCR6+ MCAM+ Th17 cells in peripheral blood and lesional skin might play an important role in the pathology of psoriasis

医療的ケアを必要とする子どもの小学校就学に伴う親の思い

【要旨】本研究の目的は、医療的ケアを必要とする子どもの小学校就学に伴う親の思いを明らかにするこ とである。研究協力が得られた医療的ケアを必要とする子どもの親 4 名に半構造化面接を実施し、質的記 述的に分析を行った。その結果、【わが子の将来を考える】【わが子の希望を叶える決意】【 就学後も子ども 達と一緒に育つ期待感】【 家から出られない閉塞感】【希望が通らない就学への困難感】【周囲の人とのつな がりを支えに一歩踏み出す覚悟】のカテゴリーが生成された。親は、わが子の将来を考え、わが子の希望 を叶える決意で行動していた。さらに、その思いを後押ししてくれた幼稚園・保育所時代の子ども達と母 親達の存在が小学校就学を実現するための支えとなっていた。 Abstract : This study aims to understand the feelings of parents of children with medical complexity when the children are to enroll in elementary school. Semi-structured interviews were conducted with four parents of children with medical complexity who expressed consent to the study participation. The interview data were qualitatively and descriptively analyzed. The analysis identified the following categories: ‘thinking about the future of their own child’, ‘decision to fulfill the wishes of their child’, ‘expectation for the child to grow up with other children also after school age’, ‘feelings of obstruction that their children cannot go out from the home’, ‘feelings of difficulty in being unable to let their children go to school as wished’, and ‘preparedness to take steps with support from the people around them’. Parents thought about the future of their children and acted with determination to fulfill the wishes of the children. Further, the parents were emotionally supported by the presence of the children and other mothers from kindergarten and nursery school days who supported the parents in the endeavor to realize the wishes of elementary school enrollment for their children

Analysis of the MYD88 L265P mutation in IgM monoclonal gammopathy by semi-nested polymerase chain reaction-based restriction fragment length polymorphism method

MYD88 L265P mutation causes constitutive activation of NF-κB and possible driver mutation in B-cell lymphoid malignancies. It is frequently detected in Waldenstrom’s macroglobulinemia （WM） （50％-100％）, and its detection is important in diagnostic and therapeutic targets of this syndrome. Standard detection method of MYD88 L265P mutation in clinical practice has yet to be established. We developed semi-nested PCR-based restriction fragment length polymorphism （snPCR-RFLP） to detect the mutation. The snPCR-RFLP method is a modification of the PCR-RFLP method, which uses the restriction enzyme BsiEI that recognizes CGACT/CG, intending to increase detection sensitivity by amplification of mutated allele in the DNA sample using semi-nested PCR before enzyme digestion. The detection sensitivity of snPCR-RFLP was estimated as 0.1％, by detecting mutated allele in wild-type allele in the cloned plasmid DNA, which is comparable with allele-specific （AS） PCR method widely used as sensitive detection method. By analyzing 40 cases with IgM monoclonal gammopathy, snPCR-RFLP detected 29/40 （70％） of all cases, 22/31 （70.9％） of WM, and 6/9 （66.6%） of IgM-type monoclonal gammopathy with undetermined significance （IgMMGUS）, including five cases （three cases of WM and two cases of IgMMGUS） in which the mutation was detected only by snPCR-RFLP but not by Sanger sequencing method. Regarding DNA sample status, particularly five cases, a case was extracted from formalin-fixed paraffin-embedded tissue and four cases were extracted from cells by Ficoll-Hypaque density gradient. In correlation with clinical features, the MYD88 mutation detected by snPCR-RFLP method was associated with the adverse prognostic index （WMIPSS） of WM using patient age, hemoglobin （Hb） level, platelet count, β2MG level, and serum IgM level （p＝0.055）. The snPCR-RFLP method is a clinically useful MYD88 mutation detection method that can be performed in general laboratories

市民を対象としたタッチケア・炭酸浴の効果：指尖脈波と生体情報からの検証

市民60人を対象として、指尖脈波の非線形解析の手法を用いて、炭酸浴と下半身タッチケアの効果を検証した。指尖脈波は、心の外部適応力（元気さ）の指標となる最大リアプノフ指数(LLE：Largest Lyapnov Exponent)が向上したとき、交感神経と副交感神経の状態から自立神経バランス（Autonomic Nerve Balance）がリラックスした時、バランスがとれた時に効果ありと判断する。結果、LLE・ANBの型は各々14のパターンを示した。炭酸浴は、83.3％(25/30)効果があった。その内訳は活性化40.0％（10/25）、リラックス56.0％（14/25）、バランスが良くなる4.0％（1/25）であった。タッチケア（下半身）は82.8％（24/29）効果があった。その内訳は活性化41.7％（10/24）、リラックス45.8％（11/24）、バランスが良くなる12.5％（3/24）であった。今後、ケアを提供する中で、自覚していない心の状態を「見える化」し、ケアの有効性を周知し、対象が生活の中で取り入れやすいケアのあり方を考え、市民の生活の質に寄与できるケア内容について探求したい。The object was 60 citizens. Using the technique of non-linear analysis of Fingertip Pulse Wave, the authors inspected effects of carbon dioxide bath and Lower Leg Touch Care. Concerning fingertip pulse wave, as an indicator of mental adaptability (wellness), if the Largest Lyaponov Exponent (LLE) numerical value showed an increase, it was judged that treatment was effective. When determining whether the sympathetic nerve or parasympathetic nerve was superior, if Autonomic Nerve Balance values were near to a precisely good balance, or if the parasympathetic nerve showed superiority, and it was observed that the participant was in a relaxed state, it was judged that the care treatment was effective. The results of both LLE and Autonomic Nerve Balance each showed 14 patterns. 83.3% of carbon dioxide baths were effective (25 out of 30 persons.) The breakdown of the above data is as follows: Results showing subjects experiencing effective mental activity stimulation were 40.0% (10 out of 25 persons), those showing signs of relaxation were 56.0% (14 out of 25 persons), and improvement to a precisely good balance was 4.0% (1 out of 25 persons). Effectiveness of Lower Leg Touch Care was 82.8% (24 out of 29 persons). The breakdown of this date is as follows: Results showing subjects experiencing effective mental activity stimulation were 41.7% (10 out of 24 persons), those showing sings of relaxation were 45.8% (11 out of 24 persons), and improvement to a precisely good balance was 12.5% (3 out of 24 persons). We will use the term “Visualization” to refer to one’s state of mind, and in the future will publicize in this regard the effectiveness of the care. In consideration of easily implemented care in everyday life, we want to investigate care that contributes to the citizens’ quality of life

妊婦が自覚したマイナートラブルと指尖脈波から明らかにした妊娠前期，中期，後期の特徴

妊婦100 人を対象にマイナートラブルの症状と指尖脈波の非線形解析の手法を用いて，妊娠前期，中期，後期の特徴を検証した。指尖脈波は，心の外部適応力（元気さ）の指標となる最大リアプノフ指数（ LLE： Largest Lyapunov Exponent） と，交感神経と副交感神経の状態から自律神経バランス（ Autonomic Nerve Balance）でストレスとリラックスの状態がわかる。その結果から，「理想ゾーン」36.3％，「準理想ゾーン」51.0％，「憂鬱ゾーン」3.9％，「本能のままゾーン」2.0％ ，「気が張り詰めているゾーン」2.9％，「気が緩んでいるゾーン」3.9％ の6 つの領域に分類できた。高ストレス者は3.0％ が該当した。LLE 値の平均値は，妊娠前期5.18，中期4.84，後期4.05 で，妊娠経過に伴い心の元気度が有意に低下していた（ｐ＝ 0.010）。また，疲労と抑鬱の測定値は有意に増加し（ｐ＝ 0.027， ｐ＝0.006），リスクは増していた。妊娠初期のつわりの症状が，「倦怠感」「胃の不快」「面倒さ」に影響したことが示唆された。妊娠後期，一部の者は，経済的負担感が増していた。過去１か月間の疲労・不安・抑鬱の症状を自覚する割合に比べ， 現在の指尖脈波の測定値の方が有意に高く，疲労・不安・抑鬱のリスクは増していた。妊娠初期から人的・経済的基盤を中心とした支援を強化する必要がある。今後，妊婦健診などで指尖脈波やマイナートラブル評価尺度を活用して，可視化・客観視できる結果をもとに妊婦と共に振り返り，活用することが重要である。As the object for this study, 100 pregnant women were observed, using the technique of non-linear analysis of Fingertip Pulse Wave. The authors inspected features of pregnancy during the early/mid/late terms. Using the Largest Lyapunov Exponent (LLE) as an index, the Fingertip Pulse Wave analysis shows mental adaptability (wellness), and the state of stress and relaxation due to the Autonomic Nerve Balance (ANB) of the sympathetic nerve and parasympathetic nerve. The results of both LLE and ANB showed 6 patterns. Breakdown of the above data is as follows: “ideal zones” were 36.3%, “associate ideal zones” were 51.0%, “depression zones” were 3.9%, “instinct zones” were 2.0%, “strained zones” were 2.9%, and “relaxed zones” were 3.9%. Of the subjects, 3.0% were considered as “high-stress” persons. The average of LLE was 5.18 in early pregnancy, 4.84 in mid-term pregnancy, and 4.05 in late pregnancy. The “wellness”factor showed a significant decrease throughout the progression of the pregnancy (p = 0.010). In addition, the measurements of fatigue and depression showed a marked increase (p = 0.027, p = 0.006), and risk factors increased as well. It was suggested that the symptom of morning sickness in early pregnancy influenced feelings of “physical weariness”, “upset stomach”, and “troublesomeness”. In late pregnancy, some people experienced an additional feeling of financial burden. Compared to measurements from one month past, when observing the ratio of women who felt an awareness of fatigue, uneasiness, and depression, the current Fingertip Pulse Wave readings were markedly higher, and the risks of fatigue, uneasiness, and depression increased. It is necessary to strengthen the support of the core issues of human resources and the economic base from early pregnancy on. In the future, we believe it is important to utilize the Fingertip Pulse Wave and Minor Trouble Evaluation Scale in prenatal examinations, to work together with pregnant women in visualization and objective evaluation of the results as a basis for healthy prenatal care

看護大学生の卒業前看護技術演習の効果

今年度初めて,卒業前の学生に看護技術に対する不安の軽減を図ることを目的とした看護技術演習を行った。演習項目は,「経口薬の与薬」「筋肉注射」「点滴静脈注射」「輸液ポンプ」「採血」「膀胱内留置カテーテル挿入」「聴診」「経管栄養」「気管内吸引」である。指導には,教員の他に卒業生インストラクターが参加した。演習の参加は自由であり,参加した学生には無記名自記式質問紙により演習前の不安の強さと看護技術到達度について,演習後に,不安の変化と看護技術到達度の調査を行った。その結果,演習後に看護技術到達度は上昇し,学生の看護技術に対する不安は軽減した。卒業前の看護技術演習は,学生の看護技術に対する不安の軽減に効果があることが明らかとなった。また,卒業生インストラクターの参加は,学生が臨床に触れる機会となり新人看護職員研修のイメ-ジ化につながり,就職に対する不安を軽減する効果があると考えられた。Health Crisis management duties relating to specific food preparation and distribution facilities managed by Public Health Centres have been announced by the Ministry of Health, Labour and Welfare. According to these guidelines, nutritionally balanced meals should be safely provided, even in disastersituations. Therefore, such facilities should be prepared for disaster at all times and they should not neglect to ensure that they are able to provide help to each other in times of emergency. In this regard, after carrying outan assessment on the disaster preparation of some of these facilities in the city of Hamamatsu in ShizuokaPrefecture, results suggest that the organizational abilities of Registered Dietitians in Public Health Centresplay a very important role in disaster prevention training, which involves both regional and external participants

A市における看護学実習に携わる臨地実習指導者の思い : 学生に対する思い・実習指導への思い

[目 的]臨地実習指導者の思いを明らかにし,臨地実習指導者と教員との効果的な連携と実習の在り方についての示唆を得ることである。[方法]A市内の3病院の臨地実習指導者 8名に非構造化面接を行い,質的帰納的分析を行った。[結果]【指導者としての方針】,【自分の指導方法】,【指導のジレンマ】,【指導者として報われる】 ,【臨地実習の有り様を問う 】,【今時の学生事情を知る】,【スタッフの協力の必要性】,【教員との信頼関係の必要性】,【指導者としての学び】の 9つのカテゴリーを抽出した。[考察]臨地実習指導者は実習指導を通じて自分の実習指導が揺らぎ,【指導のジレンマ】を感じていた。しかし,環境の影響から得られる【指導者として報われる】経験は,指導者としての役割意識の構築につながると考えら れた。【教員との信頼関係の必要性】では,普段から教員は臨地実習指導者と目標を共有し,相談しつつ実習をともに進める信頼関係の構築が必要である。Objective：Aims of this study were to elucidate feelings and thoughts of nurses in charge of clinical training and to obtain suggestions for effectivc cooperation between these nurses and teachers,as well as a clinical training approach.Methods:Unstructured interviews were perfomed with eight nuses in charge of clinical trainig,which were conducted in three hospitals in "A" Citty, and the research data were analyzed qualitatively and inductively.Results:In this research,nine categories were extracted:leadership policy, individual teaching methods,dilemmas in teaching,reward as a nurse in charge of clinical traning,questions on clinical training condtions, knowing students\u27 current environments, necessity of staff cooperation, necessity of relationship of mutual trust with a teacher, and learning as a nurse in charge of clinical training.Discussin:Nurses leading clinical training courses had lost their confidence in their teaching approach in some way and felt a“ leadership dilemma. "Howevery, they obtained experiences where “ they felt rewarded as a nurse in charge of clinical training, "and were influenced by circumstances. It was recognized that these experiences led to the achievement of playing a role of a clnical-training nurse. In "necessity of relationship of mutual trust with a teacher, \u27\u27it is required for a teacher to establish a relationship of mutual trust with these nurses in order to conduct clinical trainings together, regularly sharing the purpose of these trainings and consulting on courses