A Methodology of Estimation on Air Pollution and Its Health Effects in Large Japanese Cities

The correlation between air pollution and health effects in large Japanese cities presents a great challenge owing to the limited availability of data on the exposure to pollution, health effects and the uncertainty of mixed causes. A methodology for quantitative relationships (between the emission volume and air quality, and the air quality and health effects) is analysed with a statistical method in this article; the correlation of air pollution reduction policy in Japan from 1974 to 2007. This chapter discusses a step-by-step methodology of determining the direct correlation between emission volumes, air quality, and health effects. The relationship between total emissions (NOx, PM) (from both stationary and mobile sources) and air quality (NO2, TSP) was found to be significant. The correlation analysis of emission volume, and air quality suggests that NOx and PM levels worsen according to increases in NO2. When the correlation between the air pollutant and the type of health effect (certified, mortality, recovery, and newly registered) was examined according to the certified area, an inverse relationship was observed. The relationship between air quality (NO2) and health effect was found to be significant. When NO2 worsens, certified patients, mortality rates and newly certified patients increase, according to the data from 1989 to 2007 with dummy variable analysis

新卒看護職員の早期離職防止に関する一考察 : 看護学生の職場およびプリセプターに望むことの分析から

本研究は,看護師への予期的社会化を通し得られた職場観やプリセプター像に望むものについての自由記述をBerelson,B.の手法を用いて分析し,新卒看護職員の早期離職予防に関する一考察を得ることを目的とした質的研究である。分析の結果,学生の望む職場観はコアカテゴリー《職場の人間関係が良い》《新人教育体制が充実している》《看護の質を求めている》《看護師ロールモデルが存在する》で構成され,人間関係の良い仲間の基で基看護師ロールモデルを参考にしながら,充実した新人教育体制のバックアップを受け専門能力を発達させていける職場を望んでいることがわかった。又,プリセプターに望むものはコアカテゴリー《指導方法》《精神的な支援》《新人教育・指導の視点》で構成され指導者の視点より援助者の視点を求めていた。新卒看護職員の就業継続には組織内社会化と看護師への社会化の両方を支援することが必要であり,早期離職予防には精神的支援の必要が示唆された。Qualitative analysis was carried out to review data pertaining to the prevention of newly graduated nursing personnel from resigning at an early stage. In the course of this study, which used the method developed by Berelson (1957), we analyzed reports in which nursing students, via a process of anticipatory socialization, freely described their views on the workplace and their expectations regarding preceptors.The results revealed that the students\u27 desires for the workplace are comprised of core categories such as "good interpersonal relationships in the workplace," "enhancement of the educational system for new personnel,""demand for high quality nursing," and "availability of a role model for nurses." Thus, we found that nursing students expect a workplace that enables them to improve their expertise through the support of an enhanced educational system for new personnel, they desire the help of nursing role models, and they hope for an environment in which they can form good interpersonal relationships.As for their hopes regarding their preceptors, they are comprised of core categories such as "instruction method","moral support," and "training for new personnel/educational viewpoints," which shows that they view their preceptors more as supporters or advisors than as supervisors. In order to promote the steady employment of newly graduated nursing personnel,it is suggested that it is necessary to provide support both for socialization within the organization as well as socialization as nurses,and to extend moral support for new nurses in order to avert their leaving the job at an early stage

Unhealthy food intake restriction awareness and mortality

Background: Improving diets requires an awareness of the need to limit foods for which excessive consumption is a health problem. Since there are limited reports on the link between this awareness and mortality risk, we examined the association between awareness of limiting food intake (energy, fat, and sweets) and all-cause mortality in a Japanese cohort study. Methods: Participants comprised 58,772 residents (27,294 men; 31,478 women) aged 35–69 years who completed baseline surveys of the Japan Multi-Institutional Collaborative Cohort Study from 2004 to 2014. Hazard ratios (HRs) for all-cause mortality and 95% confidence intervals (CIs) were estimated by sex using a Cox proportional hazard model, with adjustment for related factors. Mediation analysis with fat intake as a mediator was also conducted. Results: The mean follow-up period was 11 years and 2,516 people died. Estimated energy and fat intakes according to the Food Frequency Questionnaire were lower in those with awareness of limiting food intake than in those without this awareness. Women with awareness of limiting fat intake showed a significant decrease in mortality risk (HR=0.73; 95% CI, 0.55 to 0.94). Mediation analysis revealed that this association was due to the direct effect of the awareness of limiting fat intake and that the total effect was not mediated by actual fat intake. Awareness of limiting energy or sweets intake was not related to mortality risk reduction. Conclusion: Awareness of limiting food intake had a limited effect on reducing all-cause mortality risk

Pediatric differentiated thyroid carcinoma in stage I: risk factor analysis for disease free survival

<p>Abstract</p> <p>Background</p> <p>To examine the outcomes and risk factors in pediatric differentiated thyroid carcinoma (DTC) patients who were defined as TNM stage I because some patients develop disease recurrence but treatment strategy for such stage I pediatric patients is still controversial.</p> <p>Methods</p> <p>We reviewed 57 consecutive TNM stage I patients (15 years or less) with DTC (46 papillary and 11 follicular) who underwent initial treatment at Ito Hospital between 1962 and 2004 (7 males and 50 females; mean age: 13.1 years; mean follow-up: 17.4 years). Clinicopathological results were evaluated in all patients. Multivariate analysis was performed to reveal the risk factors for disease-free survival (DFS) in these 57 patients.</p> <p>Results</p> <p>Extrathyroid extension and clinical lymphadenopathy at diagnosis were found in 7 and 12 patients, respectively. Subtotal/total thyroidectomy was performed in 23 patients, modified neck dissection in 38, and radioactive iodine therapy in 10. Pathological node metastasis was confirmed in 37 patients (64.9%). Fifteen patients (26.3%) exhibited local recurrence and 3 of them also developed metachronous lung metastasis. Ten of these 15 achieved disease-free after further treatments and no patients died of disease. In multivariate analysis, male gender (p = 0.017), advanced tumor (T3, 4a) stage (p = 0.029), and clinical lymphadenopathy (p = 0.006) were risk factors for DFS in stage I pediatric patients.</p> <p>Conclusion</p> <p>Male gender, tumor stage, and lymphadenopathy are risk factors for DFS in stage I pediatric DTC patients. Aggressive treatment (total thyroidectomy, node dissection, and RI therapy) is considered appropriate for patients with risk factors, whereas conservative or stepwise approach may be acceptable for other patients.</p

基礎看護学実習I における学生の学び : 実習アンケートの分析から

基礎看護学実習Iにおける学生の学びや気づき、達成感などを把握するために実習終了後にアンケート調査を行っており、2年間の調査から以下のような結果を得た。実習到達度には年度差がみられたが、患者とかかわる体験を通して「看護への学びを深めていく動機づけとなる」目的は達成されていた。実習に対する満足感は看護あるいは看護師に対する関心を強化し、学習への動機づけを促進していた。今後の課題として(1).基礎看護学実習1での学生の状況を教員が共有し、次の段階の教育に生かすことができるようにすること(2).演習の効果を向上させるために、グループワークのルールや役割についての指導を行い、グループワークの作業過程を評価すること(3).初めて行う看護体験の個人差を少なくすること(4).体験が成功体験となるような支援の必要性が示唆された。In order to better understand what students learn and perceive, and the sense of achievement they gain from Basic Nursing Practicum I, a yearly study is conducted in the form of a self-reported questionnaire of nursing students after completion of this course. This paper looks at results from the past two years. Although there were differences in course achievement levels between the two years, through their experience of interacting with patients, students were able to achieve the goal of "motivation to learn more about nursing". Students found satisfaction in experiential learning in a clinical situation, which reinforced their interest in nursing and nurses, and strengthened their motivation to learn. The results of the present study suggest as follows: 1) All teachers should share student\u27s state of the basic nursing practicum I, and use it to next stages of various education. 2) In order to improve the effectiveness of nursing practice, it is necessary to give students more guidance about the rules of group work and their individual roles, and to assess group work tasks. 3) Efforts should be made to reduce initial disparities in individual performance due to in experience. 4) It is important to provide enough support so that students have a successful first experience in nursing practice

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

コメットアッセイ法を用いた、マウスの固形腫瘍における低酸素細胞の検出 : 従来の放射線生物学的アッセイ法との比較検討

京都大学0048新制・課程博士博士(医学)甲第8508号医博第2258号新制||医||743(附属図書館)UT51-2000-J17京都大学大学院医学研究科内科系専攻(主査)教授 小野 公二, 教授 池永 満生, 教授 平岡 眞寛学位規則第4条第1項該当Doctor of Medical ScienceKyoto UniversityDA