Mother’s motivation to improve childhood obesity

本研究の目的は，子どもの肥満治療に対する母親のモチベーション（動機）の推移や動機に影響を与える要因を明らかにすることであった。複線経路・等至性モデル（Trajectory Equifinality Model：TEM）により動機の推移と影響要因を図式化し，母親への支援を中心に治療者及び支援者の介入を検討した。その結果，母親の動機は，子どもからの反発，家族・親族の肥満治療に対する理解の有無，仕事の負担など様々な影響を受け推移していた。支援について，1）生活習慣の改善は，子どもの意思，家族構成，母親の仕事状況などを考慮し，母子共に継続可能な目標をスモールステップで設定すること，2）家族や親族，学校など，母子の周囲の関係に働きかけて肥満治療の協力者を増やすこと，3）肥満に対処する中で，母子が抱える心労に対するケアを行うこと，などが考えられた。また，これらの支援は多職種が連携して行うことが求められる。The purpose of this study was to elucidate the changes and factors that affect mothers’ motivation for treating obesity in their children. Changes in motivation and the influencing factors were schematized using a Trajectory Equifinality Model (TEM), and interventions by therapists and supporters were examined, focusing on the support for mothers. The results show that the motives of mothers were influenced by various factors, such as opposition from children, understanding of obesity treatment among family members and relatives, and the burden of work. Regarding support, the suggestions included 1) to improve lifestyle habits, set goals that can be sustained by both mother and child in small steps, considering the child’s will, family structure, mother’s work situation, etc. 2) to increase the number of people who support the obesity treatment by working with the relationships around the mother and child, such as families, relatives, schools etc., and 3) to provide care for the mental burden of the mother and child while dealing with obesity. Besides, a multidisciplinary collaboration is required to provide such support

A two-day-old hyperthyroid neonate with thyroid hormone resistance born to a mother with well-controlled Graves’ disease: a case report

<p>Abstract</p> <p>Introduction</p> <p>Resistance to thyroid hormone is a syndrome caused by thyroid hormone receptor β mutations, which are usually inherited in an autosomal-dominant pattern.</p> <p>Case presentation</p> <p>Our patient, a Japanese neonate boy, showed hyperthyroid symptoms at age two days. Although our patient was diagnosed as having resistance to thyroid hormone, his hyperthyroid symptoms continued for two weeks. Therefore, our patient was treated with methimazole and iodine for two weeks from birth, showing no side effects and no symptoms upon treatment. At age 70 days, an R243W mutation in thyroid hormone receptor β was detected in our patient; while absent in his mother, the mutation was present in his father, who never showed any symptoms.</p> <p>Conclusions</p> <p>To the best of our knowledge this is the first case report of a resistance to thyroid hormone in a neonate presenting with hyperthyroid symptoms born to a mother with Graves’ disease and treated with methimazole and iodine. These results suggest that methimazole and iodine may be a good short-term option for treatment.</p