妊婦と夫の次世代育成支援策についての認知と希望する支援策

　本研究の目的は，妊婦健診を受診している妊婦とその夫の次世代育成支援策（子育て支援）についての認知と利用予定，希望する支援策を明らかにすることである．　方法は，都内２病院で妊婦健診を受診した妊婦とその夫250組を対象に，無記名自記式質問紙を用いて調査を行った．調査内容は，対象者の属性，子ども数，職場における支援制度の有無と種類，支援制度利用予定の有無，希望する支援策などである．回収率は妊婦が71.6％，夫は45.2％であった．　妊婦の平均年齢は30.8（SD5.14）歳，夫は32.6（SD5.91）歳であった．有職者は妊婦が46.0％，夫は99.1％であり，夫の職場の従業員数では100人以下が約50％を占めていた．職場における子育て支援制度については，有職妊婦で「ある」と回答した人は59.7％，「ない」が14.3％，「分からない・不明」が26.0％であり，夫では「ある」が33.0％，「ない」が45.0％，「分からない」が22.0％であった．支援制度の種類では，両者とも育児休業制度が多くなっていた．支援制度利用の有無では，妊婦は利用予定者が80.4％，夫は55.6％であった．夫に利用予定者が少ないのは，仕事の多忙さや育児休暇・休業中の無休や減給などの経済的理由からであった．希望する支援制度については，妊婦では保育サービスの充実と託児所の増設・利用に関することが多く，夫では育児手当や子ども数に応じた住宅手当の支給など経済的支援に関することが多くあがっていた．　以上の結果から，支援策についての周知と理解を図ること，夫婦別々の支援策の充実の必要性が示唆された

Need for Flexible Adjustment of the Treatment Schedule for Aprepitant Administration against Erlotinib-Induced Refractory Pruritus and Skin Rush

Common dermatological side-effects associated with erlotinib, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), include pruritus and skin rash, which are mediated by substance P, leading to the occasional discontinuation of cancer treatment. Aprepitant is an antagonist of neurokinin-1 receptor, through which substance P activates the pruritogens. Thus, aprepitant is expected to offer a promising option for the treatment of erlotinib-induced pruritus. However, the appropriate treatment schedule for aprepitant administration is under consideration. Here, we discuss the need for flexible adjustment of the treatment schedule for aprepitant administration against erlotinib-induced refractory pruritus and skin rush. A 71-year-old female smoker presented with stage IV EGFR-mutated lung adenocarcinoma. She was started on erlotinib at 150 mg/day. However, by 28 days, severe pruritus and acneiform skin rush resistant to standard therapies occurred, resulting in the interruption of erlotinib therapy. After recovery, she was restarted on erlotinib at 100 mg/day. However, severe pruritus and skin rush developed again within 2 weeks. Then, we started the first 3-day dose of aprepitant (125 mg on day 1, 80 mg on day 3, and 80 mg on day 5) based on the results of the previous prospective study, which showed the success rate of 100% with at least the second dose of aprepitant. However, the pruritus and skin rush exacerbated again within 4 weeks. Therefore, we started the second 3-day dose of aprepitant, but in vain. At this point, as the patient-centered medicine, bi-weekly schedule of the 3-day dose of aprepitant was considered and, then, adopted. As the results, the pruritus and skin rush remained well-controlled throughout the subsequent treatment with erlotinib

A long-term impact of forest disturbance on spruce seedling regeneration on coarse woody debris

Storm disturbance have huge impacts on subalpine forest ecosystems. However, long-term effects of such disturbance on regeneration of subalpine forests are poorly understood. Picea jezoensis var. hondoensis has limited and discontinuous distributions in subalpine central Japan. Thus, evaluating long-term effects of forest disturbance and their mechanisms have great conservation significance. Picea needs coarse woody debris (CWD) such as logs and stumps for their seedling colonization, and thus their establishment is greatly affected by CWD condition which largely depending on decay activity of decomposer fungal community. Recent studies in Europe found that frequency of occurrence of brown rot fungi, a certain functional group of fungi which decay wood holocellulose without decaying lignin, tends to be increase after forest dieback1), and that CWD decayed by brown rot fungi negatively affects spruce seedling density2). Because the decay process of CWD is known to be several decades long, we hypothesized that the effect of forest disturbance on fungal community and wood decay of CWD, and its negative effect on spruce seedling establishment would be long lasting. To test this hypothesis, we compared fungal communities within CWD and spruce seedling density among forest sites of the three different categories (control old-growth forest, damaged forest with the logs left, and damaged forest with the logs removed) in an old-growth subalpine coniferous forest in Mt. Yastugatake, central Japan. This forest had got a wide-range disturbance by a typhoon in 1959. We surveyed totally 95 logs in 9 sites (5, 2, and 2 sites for the forest categories held in above, respectively). Fungal communities within CWDs were documented using Illumina sequencing. Seedling and epiphytic bryophyte communities were recorded and were analyzed with CWD properties such as wood decay type (white rot, brown rot, and soft rot), pH, moisture, and bryophyte coverage. Illumina sequencing did not show obvious difference in fungal communities among the forest categories. Also, frequencies of the occurrence of wood decay type were not significantly different among the categories. None of these variables had significant association with spruce seedling density. However, experience of the disturbance certainly reduced current spruce seedling density. These results suggested that the forest disturbance do have a long lasting effect on spruces seedling regeneration on CWD, but the effect might not be attributable to their impacts on CWD fungal community and wood decay. 1)Vogel S, Alvarez B, Bassler C Müller J, Thorn S (2017) The Red-belted Bracket (Fomitopsis pinicola) colonizes spruce trees early after bark beetle attack and persists. Fungal Ecology 27:282-288. 2)Bače R, Svoboda M, Pouska V, Janda P, Červenka, J (2012) Natural regeneration in Central-European subalpine spruce forests: Which logs are suitable for seedling recruitment? Forest Ecology and Management 266:254-262.peerReviewe

Monitoring the outcomes of non‐pharmacological treatments for cognitive impairment using magnetoencephalography: A case series

Key Clinical Message Cognitive impairment associated dementia is treatable non‐pharmacologically. Monitoring tools are important to provide proper treatment. The present study showed that the resting‐state brain activity measured using magnetoencephalography reflects their outcomes and captures clinical impressions better than neuropsychological assessments, which have inherent limitations such as the practice effect. Abstract Mild cognitive impairment (MCI) is a prodromal phase of dementia caused by brain diseases. Non‐pharmacological treatments are sometimes effective in improving patient's cognition and quality of life. To provide better treatments, monitoring the treatment outcomes, which is done using neuropsychological assessments, is important. However, these assessments have inherent limitations, such as practice effects. Therefore, complementary assessments are anticipated. Magnetoencephalography (MEG) is a neuroimaging technique that is sensitive to changes in brain activity associated with cognitive impairment. It represents the state of brain activity in terms of MEG spectral parameters associated with neuropsychological assessment scores. MEG spectral parameters could reasonably be used to monitor treatment outcomes without the aforementioned limitations. However, few published longitudinal reports have assessed MEG spectral parameters during the non‐pharmacological treatment period for cognitive impairment associated with dementia. In this study, we retrospectively examined the clinical records of two patients with MCI. Changes in neuropsychological assessment scores and MEG spectral parameters were qualitatively evaluated along with the patients' conditions, as described in the medical records during non‐pharmacological treatments provided for more than 2 years. The changes in neuropsychological assessment scores and MEG spectral parameters showed comparable trends, with some discrepancies. Changes in MEG spectral parameters were more consistent with the subjective reports from caregivers and medical staff in the medical records. Our results suggest that MEG is a promising tool for monitoring patient conditions during treatment

Analysis of multiparous couples' perceptions of husbands' supportiveness for their wives' satisfaction during pregnancy

This study was conducted to clarify the differences and commonalities in perceptions regarding husbands’supportiveness for their wives’satisfaction during pregnancy between husbands and wives with older children. This report also discusses the effect of nursing care that enhances the supportiveness provided by husbands during their wives’pregnancy. Semi-structured interviews were conducted with two multiparous couples during pregnancy. All interviews were transcribed and a qualitative inductive analysis was performed using Berelson's Content Analysis methods. The following five categories were identified regarding the husbands' supportiveness during their multiparous wives' pregnancy:［Increased consciousness of parenthood toward the unborn baby];［Empathy regarding wife’s physical and mental health arising from the previous pregnancy and childbirth , and addition of a new baby]; [Support with housework to show empathy for the multiparous wife]; [Care of older children to show empathy ofr the multiparous wife]; [Akjustment of roles in the parenting older children.] From the discussion about the common and different perceptions between multiparous couples, the following suggestion emerges. Nursing care should focus on enhancing the intimacy of a couple, strengthening the family system, increasing consciousness of parenthood toward an unborn baby, and adjusting the role in the parenting of older children