Attitude of young psychiatrists toward coercive measures in psychiatry: a case vignette study in Japan

<p>Abstract</p> <p>Background</p> <p>Every psychiatrist must pay careful attention to avoid violating human rights when initiating coercive treatments such as seclusion and restraint. However, these interventions are indispensable in clinical psychiatry, and they are often used as strategies to treat agitated patients. In this study, we investigated young psychiatrists' attitudes toward psychiatric coercive measures.</p> <p>Methods</p> <p>A total of 183 young psychiatrists participated as subjects in our study. A questionnaire with a case vignette describing a patient with acute psychosis was sent to the study subjects via the Internet or by mail. This questionnaire included scoring the necessity for hospitalization, and the likelihood of prescribing seclusion and/or restraint, on a 9-point Likert scale (with 9 indicating strong agreement).</p> <p>Results</p> <p>There was general agreement among the study subjects that the case should be admitted to a hospital (8.91 ± 0.3) and secluded (8.43 ± 1.0). The estimated length of hospitalization was 13.53 ± 6.4 weeks. Regarding the likelihood of prescribing restraint, results showed great diversity (5.14 ± 2.5 on 9-point scale); psychiatrists working at general hospitals scored significantly higher (6.25 ± 2.5) than those working at university hospitals (5.02 ± 2.3) or psychiatric hospitals (4.15 ± 2.6). A two-group comparison of the length of inpatient care revealed a significant difference between those psychiatrists who scored 1-3 (n = 55, 14.22 ± 7.4 wks) and those who scored 7-9 (n = 62, 12.22 ± 4.0) regarding the need to use restraint.</p> <p>Conclusion</p> <p>Our results may reflect the current dilemma in Japanese psychiatry wherein psychiatrists must initiate coercive measures to shorten hospitalization stays. This study prompted its subject psychiatrists to consider coercive psychiatric treatments.</p

Genetic Predisposition To Acquire a Polybasic Cleavage Site for Highly Pathogenic Avian Influenza Virus Hemagglutinin

Highly pathogenic avian influenza viruses with H5 and H7 hemagglutinin (HA) subtypes evolve from low-pathogenic precursors through the acquisition of multiple basic amino acid residues at the HA cleavage site. Although this mechanism has been observed to occur naturally only in these HA subtypes, little is known about the genetic basis for the acquisition of the polybasic HA cleavage site. Here we show that consecutive adenine residues and a stem-loop structure, which are frequently found in the viral RNA region encoding amino acids around the cleavage site of low-pathogenic H5 and H7 viruses isolated from waterfowl reservoirs, are important for nucleotide insertions into this RNA region. A reporter assay to detect nontemplated nucleotide insertions and deep-sequencing analysis of viral RNAs revealed that an increased number of adenine residues and enlarged stem-loop structure in the RNA region accelerated the multiple adenine and/or guanine insertions required to create codons for basic amino acids. Interestingly, nucleotide insertions associated with the HA cleavage site motif were not observed principally in the viral RNA of other subtypes tested (H1, H2, H3, and H4). Our findings suggest that the RNA editing-like activity is the key mechanism for nucleotide insertions, providing a clue as to why the acquisition of the polybasic HA cleavage site is restricted to the particular HA subtypes. IMPORTANCE Influenza A viruses are divided into subtypes based on the antigenicity of the viral surface glycoproteins hemagglutinin (HA) and neuraminidase. Of the 16 HA subtypes (H1 to -16) maintained in waterfowl reservoirs of influenza A viruses, H5 and H7 viruses often become highly pathogenic through the acquisition of multiple basic amino acid residues at the HA cleavage site. Although this mechanism has been known since the 1980s, the genetic basis for nucleotide insertions has remained unclear. This study shows the potential role of the viral RNA secondary structure for nucleotide insertions and demonstrates a key mechanism explaining why the acquisition of the polybasic HA cleavage site is restricted to particular HA subtypes in nature. Our findings will contribute to better understanding of the ecology of influenza A viruses and will also be useful for the development of genetically modified vaccines against H5 and H7 influenza A viruses with increased stability

Higher exercise tolerance early after allogeneic hematopoietic stem cell transplantation is the predictive marker for higher probability of later social reintegration

同種造血幹細胞移植後における社会復帰の予測因子を発見 --移植後リハビリテーションがもつ重要性--. 京都大学プレスリリース. 2021-04-09.As the proportion of long-term survivors after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is on the rise, it is essential to consider the significance of quality of life (QOL), including reintegration with society (returning to school or work). This retrospective cohort study aims to illustrate the precise epidemiology of social reintegration later after allo-HSCT and determine its predictive indicators. We enrolled 56 patients, and 40 patients (71%) attained social reintegration at 2 years post-HSCT. Reintegration failure markedly correlated with an inferior performance status and concurrent chronic graft-versus-host disease. In non-reintegrated patients, the physical function at discharge measured by the 6-min walking distance (6MWD) was markedly decreased. On the multivariate risk analyses, sex (female; odds ratio (OR) 0.07; 95% confidence interval (CI) 0.01–0.54; p = 0.01), HCT-CI (≥ 2; OR 0.10; 95% CI 0.01–0.84; p = 0.03), and change in 6MWD (per 5% increase; OR 1.47; 95% CI 1.01–2.13; p = 0.04) were significant predictors of later social reintegration. This study suggests that a multidisciplinary strategy including rehabilitation is essential, especially in patients with poor predictive markers at an early phase, and we should consider suitable rehabilitation programs to prevent a decline in exercise tolerance and improve social reintegration and overall QOL in patients after allo-HSCT

貯蔵澱粉の形態学的研究I : まめ科植物

1)本研究で,マメ科のVicia属のVicia sativa L. (からすのえんどう)と,Pisum属のPisum sativum L. cultivar. France-ozayaendo(仏国大莢豌豆), P. sativum L. cultivar. 2 Turunasi sunakku(つるなしスナック2号)およびP. sativum L. cultivar. Green top(グリーントップ)の貯蔵澱粉粒の形態学的研究を行った。2)種子の大きさは,Vicia属は小粒で,Pisum属は大粒,形はいずれも球形であった。3)澱粉粒の大きさは、仏国大莢豌豆>からすのえんどう>つるなしスナック2号>グリーントップの順であった。4)Vicia属のVicia sativa L.(からすのえんどう)と,Pisum属のPisum sativum L. cultivar. France-ozayaendo(仏国大莢豌豆)の澱粉粒の形態的特徴は,良く一致した。5) Pisum属のPisum sativum L. cultivar. 2 Turunasi sunakku (つるなしスナック2号)とP. sativum L. cultivar. Green top(グリーントップ)の澱粉の形態的特徴は,良く一致した。6) Pisum属の莢を食用とするP. sativum L. cultivar. France-ozayaendo(仏国大莢豌豆)と,実を食用とするP. sativum L. cultivar. 2 Turunasi sunakku(つるなしスナック2号)・P. sativum L. cultivar. Green top(グリーントップ)では,澱粉粒の形態的特徴を若干異にした

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

Estudio de la praxis profesional del terapeuta ocupacional en los centros de atención a personas mayores

El envejecimiento de la población es un fenómeno sociodemográfico de incuestionable repercursión sanitaria, social y económica. El número de personas mayores de 60 años se ha incrementado en todo el mundo en comparación con otros grupos de edad. España es uno de los países que mayor índice de envejecimiento presenta en la actualidad y esta tendencia va a continuar en aumento en los próximos años. La terapia ocupacional es una profesión sociosanitaria de indudable valor en la intervención con personas mayores, y por tanto, en la actualidad es de gran relevancia en la intervención con este colectivo. El objetivo principal de este trabajo es examinar el rol del terapeuta ocupacional en el ámbito de atención sociosanitaria a las personas mayores en España. Para lograr este objetivo se ha utilizado un cuestionario cumplimentado por 139 terapeutas ocupacionales trabajadores de centros sociosanitarios dirigidos a este sector de la población. Los resultados obtenidos en el presente estudio indican que la labor principal del terapeuta ocupacional en los centros de día y las residencias se centra en mejorar la ejecución de las actividades de la vida diaria de las personas mayores