Human T-cell leukemia virus type I (HTLV-I) infection and the onset of adult T-cell leukemia (ATL)

The clinical entity of adult T-cell leukemia (ATL) was established around 1977, and human T-cell leukemia virus type 1 (HTLV-I) was subsequently identified in 1980. In the 25 years since the discovery of HTLV-I, HTLV-I infection and its associated diseases have been extensively studied, and many of their aspects have been clarified. However, the detailed mechanism of leukemogenesis remains unsolved yet, and the prognosis of ATL patients still poor because of its resistance to chemotherapy and immunodeficiency. In this review, I highlight the recent progress and remaining enigmas in HTLV-I infection and its associated diseases, especially ATL

Refleksi Kehidupan Ibu Tunggal yang Memiliki Anak Intellectual Disability

Penelitian ini bertujuan untuk mengetahui bagaimana pemaknaan pengasuhan yang dimiliki oleh ibu tunggal, serta faktor yang dapat mempengaruhi pengasuhan pada anak yang mengalami intellectual disability. Metode penelitian yang digunakan adalah metode kualitatif dengan pendekatan fenomenologi. Partisipan utama penelitian berjumlah dua orang. Pengumpulan data menggunakan wawancara mendalam dan observasi. Pengujian kredibilitas penelitian menggunakan member checking, triangulasi sumber, dan deskripsi secara detail terkait partisipan penelitian. Hasil penelitian menunjukkan bahwa ibu tunggal yang mengasuh anak intellectual disability seorang diri, memaknai pengasuhan sebagai suatu titik balik kehidupan yang membantu ibu tunggal untuk menemukan kapasitas serta intensitas terbesar didalam diri mereka dalam menjalani  kehidupan yang diperoleh melalui serangkaian perilaku yang bersifat evaluatif seperti refleksi diri, memahami kembali nilai hidup yang dimiliki dan menyadari otoritas dirinya dalam menjaga stabilitas keluarga dan pengasuan anak pasca ditinggal oleh suami. Selain itu, pandangan lingkungan sekitar terhadap kondisi anak juga dapat memunculkan pengaruh tertentu terhadap penerapan pengasuhan yang diberikan oleh ibu tunggal kepada anaknya

What are the Factors that Affect the Risk of Parenting Stress in Mothers with Disability Children? A New Evidence from Sukoharjo, Central Java

Background: Mothers play an important role in the care of children with physical and psychological disabilities. However, the role of caring children with disabilities can cause stress for the mother. Parenting stress can lead to anxiety, emotional instability, and avoidance of the environment in mother. This, in turn, may deteriorate the quality of family life. As a result, children with disabilities may experience development and growth disorders. This study aimed to determine the factors that affect the parenting stress in the caring of children with disability in Sukoharjo District, Central Java.Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was conducted at Sanggar Inklusi, Sukoharjo, Central Java, from February to March 2018. A sample of 163 mothers with disabled children was selected for this study by exhaustive sampling. The dependent variable was parenting stress. The independent variables were adversity intelligence, disability level, maternal education, maternal employment status, family income, and family support. The data were collected by questionnaire and analyzed by path analysis.Results: The risk of maternal parenting stress increased with children disability (b= 4.64, SE= 1.72, p= 0.07) and mothers working outside the house (b= 1.68, SE= 0.93, p= 0.069). The risk of maternal parenting stress decreased with high adversity intelligence (b= -0.28, SE= 0.12, p= 0.016), high maternal education (b= -8.50, SE= 0.86, p< 0.001), high family income (b= -0.28, SE= 0.16, p= 0.078), and strong family support (b= -0.22, SE= 0.08, p= 0.007).Conclusion: The risk of maternal parenting stress increases with high children disability and maternal employment status, but decreases with high adversity intelligence, high maternal education, high family income, and strong family support.Keywords: parenting stress, children, disabilityCorrespondence:SyarifatulFikriyyah. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6285642009597Journal of Maternal and Child Health (2018), 3(2): 156-165https://doi.org/10.26911/thejmch.2018.03.02.0

Relationship between home care service use and changes in the care needs level of Japanese elderly

<p>Abstract</p> <p>Background</p> <p>With the introduction of long-term care insurance (LTCI) in Japan, more home care services are available for the community-dwelling elderly. To deliver effective home care services, it is important to know the effects of service use. In this study, as the first step to determine this, we sought to describe different home service use in the sustained/improved group and deteriorated group in their care needs levels, and to report the relationship between the use of home care services and changes in care needs levels.</p> <p>Methods</p> <p>The participants included 624 of a total of 1,474 users of LTCI services in one city in Japan. Home care service users were stratified into a 'lower care needs level subgroup' and a 'higher care needs level subgroup' based on the baseline care needs level. Simple statistical comparison and multiple logistic regression analyses in which the change in care needs level was set as a dependent variable were performed. Gender, age, and baseline care needs level were designated as control variables. Home based services were treated as independent variables. In this study, home care services consisted of home help, home bathing services, a visiting nurse, home rehabilitation, nursing home daycare, health daycare, loan of medical devices, respite stay in a nursing home, respite stay in a health care facility, respite stay in a sanatorium-type medical care facility, and medical management by a physician.</p> <p>Results</p> <p>In the lower care needs level subgroup, age (OR = 1.04, CI, 1.01-1.08), use of respite stay in a nursing home (OR = 2.55; CI, 1.43-4.56), and the number of types of long-term care services (OR = 1.33; CI, 1.02-1.74) used during an 11 month period were significantly related to a deterioration of the user's care needs level. In the higher care needs level subgroup, use of medical management by a physician (OR = 6.99; CI, 1.42-41.25) was significantly related to a deterioration of the user's care needs level. There were no home based services significantly related to sustaining or improving the user's care needs level.</p> <p>Conclusion</p> <p>There were different home service use in two groups (the sustained/improved group and the deteriorated group). Respite stay in a nursing home service use and more types of service use were related to experiencing a deterioration of care needs level in lower care needs level community-dwelling elderly persons in Japan. Further, medical management by a physician service was related to experiencing a deterioration of care needs level in higher care needs level community-dwelling elderly persons.</p

Home healthcare services in Taiwan: a nationwide study among the older population

<p>Abstract</p> <p>Background</p> <p>Home healthcare services are important in aging societies worldwide. The present nationwide study of health insurance data examined the utilization and delivery patterns, including diagnostic indications, for home healthcare services used by seniors in Taiwan.</p> <p>Methods</p> <p>Patients ≥65 years of age who received home healthcare services during 2004 under the Taiwanese National Health Insurance Program were identified and reimbursement claims were analyzed. Age, gender, disease diagnoses, distribution of facilities providing home healthcare services, and patterns of professional visits, including physician and skilled nursing visits, were also explored.</p> <p>Results</p> <p>Among 2,104,978 beneficiaries ≥65 years of age, 19,483 (0.9%) patients received 127,753 home healthcare visits during 2004 with a mean number of 6.0 ± 4.8 visits per person. The highest prevalence of home healthcare services was in the 75-84 year age group in both sexes. Females received more home healthcare services than males in all age groups. Cerebrovascular disease was the most frequent diagnosis in these patients (50.7%). More than half of home healthcare visits and around half of the professional home visits were provided by community home nursing care institutions. The majority of the home skilled nursing services were tube replacements, including nasogastric tubes, Foley catheter, tracheostomy, nephrostomy or cystostomy tubes (95%).</p> <p>Conclusions</p> <p>Nine out of 1,000 older patients in Taiwan received home healthcare services during 2004, which was much lower than the rate of disabled older people in Taiwan. Females used home healthcare services more frequently than males and the majority of skilled nursing services were tube replacements. The rate of tube replacement of home healthcare patients in Taiwan deserves to be paid more attention.</p

Distinct functions of HTLV-1 Tax1 from HTLV-2 Tax2 contribute key roles to viral pathogenesis

While the human T-cell leukemia virus type 1 (HTLV-1) is the etiologic agent of adult T-cell leukemia/lymphoma (ATL), to date, its close relative HTLV-2 is not associated with ATL or other types of malignancies. Accumulating evidence shows that HTLV-1 Tax1 and HTLV-2 Tax2 have many shared activities, but the two proteins have a limited number of significantly distinct activities, and these distinctions appear to play key roles in HTLV-1 specific pathogenesis. In this review, we summarize the functions of Tax1 associated with cell survival, cell proliferation, persistent infection as well as pathogenesis. We emphasize special attention to distinctions between Tax1 and Tax2

Years of sunlight exposure and cataract: a case-control study in a Mediterranean population.

BACKGROUND: We aimed to investigate the relation between sunlight exposure and risk of cataract. METHODS: We carried out a frequency-matched case-control study of 343 cases and 334 controls attending an ophthalmology outpatient clinic at a primary health-care center in a small town near Valencia, Spain. All cases were diagnosed as having a cataract in at least one eye based on the Lens Opacification Classification system (LOCS II). Controls had no opacities in either eye. All cases and controls were interviewed for information on outdoor exposure, "usual" diet, history of severe episodes of diarrhea illness, life-style factors and medical and socio-demographic variables. Blood antioxidant vitamin levels were also analyzed. We used logistic regression models to estimate sex and age-adjusted odds ratios (ORs) by quintiles of years of occupational outdoor exposure, adjusting for potential confounders such as smoking, alcohol consumption, serum antioxidants and education. RESULTS: No association was found between years of outdoor exposure and risk of cataract. However, exploratory analyses suggested a positive association between years of outdoor exposure at younger ages and risk of nuclear cataract later in life. CONCLUSION: Our study does not support an association with cataract and sunlight exposure over adult life

Human T-cell leukemia virus type 1: replication, proliferation and propagation by Tax and HTLV-1 bZIP factor.

Human T-cell leukemia virus type 1 (HTLV-1) spreads primarily by cell-to-cell transmission. Therefore, HTLV-1 promotes the proliferation of infected cells to facilitate transmission. In HTLV-1 infected individuals, the provirus is present mainly in effector/memory T cells and Foxp3+ T cells. Recent study suggests that this immunophenotype is acquired by infected cells through the function of HTLV-1 bZIP factor (HBZ). Tax, which is encoded by the plus strand, is crucial for viral replication and de novo infection, while HBZ, encoded by the minus strand, is important for proliferation of infected cells. Importantly, HBZ and Tax have opposing functions in most transcription pathways. HBZ and Tax cooperate in elaborate ways to permit viral replication, proliferation of infected cells and propagation of the virus

Comprehensive Assessment of Risk Factors of Cause-Specific Infant Deaths in Japan

Background: Public attention is given to infants with socially high risks of child abuse and neglect, while clinical attention is provided to infants with a biologically high risk of diseases. However, few studies have systematically evaluated how biological or social factors cross over and affect cause-specific infant mortality.Methods: We linked birth data with death data from the Japanese national vital statistics database for all infants born from 2003–2010. Using multivariate logistic regression, we examined the association between biological and social factors and infant mortality due to medical causes (internal causes), abuse (intentional external causes), and accidents (unintentional external causes).Results: Of 8,941,501 births, 23,400 (0.26%) infants died by 1 year of age, with 21,884 (93.5%) due to internal causes, 175 (0.75%) due to intentional external causes, and 1,194 (5.1%) due to unintentional external causes. Infants with high social risk (teenage mothers, non-Japanese mothers, single mothers, unemployed household, four or more children in the household, or birth outside of health care facility) had higher risk of death by intentional, unintentional, and internal causes. Infant born with small for gestational age and preterm had higher risks of deaths by internal and unintentional causes, but not by intentional causes.Conclusions: Both biological as well as social factors were associated with infant deaths due to internal and external causes. Interdisciplinary support from both public health and clinical-care professionals is needed for infants with high social or biological risk to prevent disease and injury