小児看護における小児と家族のQOL に関する文献検討

資料Miscellaneous　目的：小児看護におけるQOL に着目して文献検討を行い、小児と家族へのQOL の支援に対する示唆および今後の研究課題を見出すことを目的とした。　方法：小児看護のQOL に関する文献を、「医学中央雑誌Web（ver. ５）」、「最新看護索引Web」、「CiNii」から検索した。検索式：（小児看護and 生活の質/QOL and 小児and 家族）により、原著論文・研究報告から文献を選んだ。　結果・考察：論文38 編を対象とした。研究方法は、文献38 編中で、「質的研究」19 編（50.0％）、「量的研究」13 編(34.2％ )、「質的・量的研究」４編（10.5％）であった。文献検討は２編（5.3％）であった。研究対象の小児の疾患はさまざまで、幅広い疾患が対象とされていた。QOL 評価の文献は少なく、各疾患の小児と家族のQOL について評価の研究がまたれる。小児看護におけるQOL については、複雑な問題をもつ患児・重症心身障害児とその家族へのQOL の向上にむけて、看護の質の向上やニーズに合わせた取り組みの必要性が示唆された

Risk Factors for Duty-Related Posttraumatic Stress Disorder among Police Officers in the Mt. Ontake Eruption Disaster-Support Task Force

Mount Ontake in Nagano Prefecture, Japan erupted on 27 September 2014. Many police officers were called in for duty as a disaster-support task force. We investigated the association between the peritraumatic situation and posttraumatic stress disorder (PTSD) symptoms in these police officers. In January 2015, a health survey (OHS) on disaster stress related to the Mt. Ontake eruption disaster support work was distributed to all of the police officers and staff involved in the disaster support. We analyzed the 213 participants who had PTSD symptoms following the eruption and no missing OHS data. Logistic regression analyses were conducted to clarify the relationship between the participants’ symptom severity and their peritraumatic situation (i.e., stressors and daily support prior to the eruption, disaster-support work duties, and postdisaster stress relief). The symptom severity was associated with ‘more than seven cumulative days at work’ (odds ratio [OR] = 2.47, 1.21–5.06), ‘selecting drinking and/or smoking as stress relief after disaster-support work’ (OR = 2.35, 1.09–5.04), and ‘female’ (OR = 3.58, 1.19–10.77). As disaster-support work, ‘supporting the victims’ families’ (OR = 1.99, 0.95–4.21) tended to be associated with symptom severity. The number of days of disaster-support work, stress-relief behavior, and gender were associated with the severity of PTSD symptoms

The Relationship between Attitudes toward Suicide and Family History of Suicide in Nagano Prefecture, Japan

Certain attitudes toward suicide may be a risk factor for suicide among the bereaved. To explore this possibility, we examined the relationship between attitudes toward suicide and family history of suicide. We focused on two specific attitudes indicating resignation in a survey: #1 “When a person chooses to die by suicide, the suicide is inevitable” (i.e., inevitability belief); and #2 “A suicide cannot be stopped by any person, because suicide is unpreventable” (i.e., unpreventable belief). The data of 5117 fully completed questionnaires were analyzed. Logistic regression analysis revealed that the two attitudes of resignation were significantly associated with a family history of suicide. The adjusted odds ratio for #1 was 1.39 (95% CI, 1.07–1.79) for individuals having experienced suicide by a family member or relative, while that for #2 was 1.57 (95% CI, 1.27–1.95) for experiencing a suicide by a family member or relative and 1.25 (95% CI, 1.05–1.49) for experiencing a suicide by a friend, business associate, partner or other. These two attitudes of resignation toward suicide were significantly associated with a family history of suicide. These attitudes might increase suicide risk among the bereaved

Antigen Protease Activity on Intact or Tape-Stripped Skin Induces Acute Itch and T Helper Sensitization Leading to Airway Eosinophilia in Mice

Respiratory allergen sources such as house dust mites frequently contain proteases. In this study, we demonstrated that the epicutaneous application of a model protease antigen, papain, onto intact or tape-stripped ear skin of mice induced acute scratching behaviors and T helper (Th)2, Th9, Th17/Th22, and/or Th1 sensitization in a protease activity–dependent manner. The protease activity of papain applied onto the skin was also essential for subsequent airway eosinophilia induced by an intranasal challenge with low-dose papain. With tape stripping, papain-treated mice showed barrier dysfunction, the accelerated onset of acute scratching behaviors, and attenuated Th17/Th22 sensitization. In contrast, the protease activity of inhaled papain partially or critically contributed to airway atopic march responses in mice sensitized through intact or tape-stripped skin, respectively. These results indicated that papain protease activity on epicutaneous application through intact skin or skin with mechanical barrier damage is critical to the sensitization phase responses, including acute itch and Th sensitization and progression to the airway atopic march, whereas dependency on the protease activity of inhaled papain in the atopic march differs by the condition of the sensitized skin area. This study suggests that exogenous protease-dependent epicutaneous mechanisms are a target for controlling allergic sensitization and progression to the atopic march

ATM depletion induces proteasomal degradation of FANCD2 and sensitizes neuroblastoma cells to PARP inhibitors

Abstract Background Genomic alterations, including loss of function in chromosome band 11q22-23, are frequently observed in neuroblastoma, which is the most common extracranial childhood tumour. In neuroblastoma, ATM, a DNA damage response-associated gene located on 11q22-23, has been linked to tumorigenicity. Genetic changes in ATM are heterozygous in most tumours. However, it is unclear how ATM is associated with tumorigenesis and cancer aggressiveness. Methods To elucidate its molecular mechanism of action, we established ATM-inactivated NGP and CHP-134 neuroblastoma cell lines using CRISPR/Cas9 genome editing. The knock out cells were rigorously characterized by analyzing proliferation, colony forming abilities and responses to PARP inhibitor (Olaparib). Western blot analyses were performed to detect different protein expression related to DNA repair pathway. ShRNA lentiviral vectors were used to knockdown ATM expression in SK-N-AS and SK-N-SH neuroblastoma cell lines. ATM knock out cells were stably transfected with FANCD2 expression plasmid to over-expressed the FANCD2. Moreover, knock out cells were treated with proteasome inhibitor MG132 to determine the protein stability of FANCD2. FANCD2, RAD51 and γH2AX protein expressions were determined by Immunofluorescence microscopy. Results Haploinsufficient ATM resulted in increased proliferation (p < 0.01) and cell survival following PARP inhibitor (olaparib) treatment. However, complete ATM knockout decreased proliferation (p < 0.01) and promoted cell susceptibility to olaparib (p < 0.01). Complete loss of ATM suppressed the expression of DNA repair-associated molecules FANCD2 and RAD51 and induced DNA damage in neuroblastoma cells. A marked downregulation of FANCD2 expression was also observed in shRNA-mediated ATM-knockdown neuroblastoma cells. Inhibitor experiments demonstrated that the degradation of FANCD2 was regulated at the protein level through the ubiquitin–proteasome pathway. Reintroduction of FANCD2 expression is sufficient to reverse decreased proliferation mediated by ATM depletion. Conclusions Our study revealed the molecular mechanism underlying ATM heterozygosity in neuroblastomas and elucidated that ATM inactivation enhances the susceptibility of neuroblastoma cells to olaparib treatment. These findings might be useful in the treatment of high-risk NB patients showing ATM zygosity and aggressive cancer progression in future

Distinct gene alterations with a high percentage of myeloperoxidase-positive leukemic blasts in de novo acute myeloid leukemia

The myeloperoxidase (MPO)-positivity of blasts in bone marrow smears is an important marker for not only the diagnosis, but also the prognosis of acute myeloid leukemia (AML). To investigate the relationship between genetic alterations and MPO-positivity, we performed targeted sequencing for 51 genes and 10 chimeric gene transcripts in 164 newly diagnosed de novo AML patients; 107 and 57 patients were classified as AML with >50% MPO-positive blasts (MPO-high group) and ?50% MPO-positive blasts, (MPO-low group), respectively. The univariate analysis revealed that RUNX1-RUNX1T1 (P < 0.001), the KIT mutation (P < 0.001), and CEBPA double mutation (P = 0.001) were more likely to be found in the MPO-high group, while the DNMT3A mutation (P = 0.001), FLT3 tyrosine kinase domain mutation (P = 0.004), and TP53 mutation (P = 0.020) were more likely to be present in the MPO-low group. Mutations in genes related to DNA hypermethylation signatures (IDH1, IDH2, TET2, and WT1 genes) were more frequent in the MPO-high group (P = 0.001) when patients with fusion genes of core-binding factors were excluded from the analysis. Our results suggest that MPO-positivity of blasts was related with the distinct gene mutation patterns among de novo AML patients