Long term work continuation of employees with mental disorders: A prospective cohort study of a clinical sample

It is important to investigate the factors that influence how patients with mental disorders, who recover after clinical treatment, are able to continue working after their return to work. This study reports on long-term work continuation in a clinical sample, examining duration of work continuation, timing of sick leave recurrence, and risk factors influencing sick leave recurrence. Study participants comprised 38 employees who took sick leave for mental disorders; participants were followed for five to nine years after return to work. Estimated mean period of work continuation was 4.8 years. Approximately half of all cases of recurrent sick leave took place within one year of returning to work. Educationallevel was significantly associated with work continuation.Long-term work continuation in a clinical sample appears comparable to that of workplace samples. There may be a need to provide focused support for employees with mental disorders, particularly during the first year after return to work

Case report: Novel NIPBL-BEND2 fusion gene identified in osteoblastoma-like phosphaturic mesenchymal tumor of the fibula

Phosphaturic mesenchymal tumor (PMT) is a rare tumor that secretes fibroblast growth factor 23 (FGF23) and causes hypophosphatemia and tumor-induced osteomalacia (TIO). Fusion genes FN1-FGFR1 and FN1-FGF1 have been detected in some PMTs, but the pathogenesis of PMTs without these fusion genes remains unclear. Here, we report a 12-year-old boy with persistent muscle weakness and gait disturbance. Roentgenographic examination revealed a radiolucent lesion with endosteal scalloping in the left fibula, while his serum level of FGF23 was markedly increased. Combined with simple X-ray findings of other body parts, we suspected that TIO was caused by PMT, and resected the tumor. After resection, the serum level of FGF23 started to decrease immediately and normalized within 3 hours after resection, with this being earlier than normalization of the serum phosphorus level. In RNA sequencing, FN1-FGFR1 and FN1-FGF1 were not detected, but a novel NIPBL-BEND2 fusion gene was identified. When we forcedly expressed this fusion gene in HEK293T cells and MG63 cells, cell proliferation was enhanced in both cell lines. Furthermore, Gene set enrichment analysis of HEK293T cells showed significant upregulation of MYC-target genes. Our results suggest that this novel NIPBL-BEND2 fusion gene promotes cell proliferation possibly via the MYC pathway and might be one of the etiologies of PMTs other than FN1-FGFR1 or FN1-FGF1

Two human papillomavirus DNAs molecularly cloned from a patient with epidermodysplasia verruciformis: restriction maps.

Two distinct human papillomavirus (HPV) DNAs (MY-1 and MY-2) were molecularly cloned from the benign skin lesions of a patient with epidermodysplasia verruciformis. The restriction map of MY-1 was the same as that of HPV 3a. The map of MY-2 appeared to be different from those of any HPVs reported in the literature. MY-2 did not cross-hybridize with MY-1 or the DNAs of HPV types 1, 2 and 4 under stringent conditions.</p

A Randomized Placebo-controlled Trial of an Oral Preparation of High Molecular Weight Fucoidan in Patients with Type 2 Diabetes with Evaluation of Taste Sensitivity

[Background] Fucoidan is derived from seaweed widely used in Japanese cuisine, but little is known about its influence on glucose metabolism. To obtain information about the physiological effects of fucoidan on glucose metabolism, the digestive system, and the gustatory system controlling taste sensation in patients with type 2 diabetes, we conducted a randomized, double-blind, placebo-controlled study. [Methods] Thirty patients with type 2 diabetes on diet therapy were recruited from an outpatient clinic (22 men and 8 women aged 59.10 ± 13.24 years, body mass index: 25.18 ± 3.88, hemoglobin A1c: 7.04 ± 1.24%). They were divided into 2 groups and underwent 2 interventions with a 4-week interval. One group received fucoidan for 12 weeks (a daily 60 mL test beverage containing 1,620 mg of fucoidan) and then placebo (60 mL) for the subsequent 12-week period, while the order was reversed in the other group. Evaluation was performed just before and after each intervention. Taste sensitivity was measured for 5 basic tastes by the filter paper disk method and food intake was evaluated with a validated diet questionnaire. [Results] No adverse events occurred during the study period. Despite no change of the diet, stool frequency increased during fucoidan intake (from 7.78 ± 4.64/week in Week 1 to 9.15 ± 5.03/week in Week 5, P < 0.001), and it increased more in lean subjects. In 11 subjects whose stool frequency exceeded the mean value, the thresholds for sweet, salty, bitter and umami tastes were significantly reduced (enhancement of sensitivity) after fucoidan intake. In 14 subjects with normal HOMA-IR (homeostatic model assessment of insulin resistance, < 2.5), hemoglobin A1c decreased after fucoidan intake (from 6.73 ± 1.00 to 6.59 ± 1.00%, P < 0.05), as did the fasting plasma level of GLP-1 (glucagon-like peptide-1, from 6.42 ± 3.52 to 4.93 ± 1.88 pmol/L, P < 0.05). [Conclusion] Sustained fucoidan intake led to alterations of gastrointestinal function, including increased stool frequency and enhanced taste sensitivity, which could contribute to better control of diabetes

看護師の筋・骨格系のフィジカルアセスメントに関する実態調査

報告Reports　本研究は、看護師の筋・骨格系のフィジカルアセスメントに関する知識と実践について質問紙による実態調査を行った。対象は、総合病院勤務の看護師322 名とし、回収数は120 名（37.3％）であった。その結果、112 名（93.3％）の看護師は、フィジカルアセスメントを学んだ経験があった。必要な形態・機能の知識では、「四肢の動脈」を除くすべての項目で「まったくわからない」または「なんとなくわかる」と回答した者が４割以上を占めていた。フィジカルアセスメントの実践では、「臨床での活用の頻度」と「検査：MMT」などに関連を認めた。フィジカルアセスメントを活用している者の方が知識を持ち、実践できる傾向にあった。「実践できない」が最も多かった項目は、「検査：筋トーヌス」27.5％であった。このことから、フィジカルアセスメントに必要な形態・機能の知識を教授する研修が必要である。「臨床での活用の頻度」と関連を認めた「MMT の実践」などは、臨床場面で正確に修得できる可能性がある

A multi-targeted approach to suppress tumor-promoting inflammation

Cancers harbor significant genetic heterogeneity and patterns of relapse following many therapies are due to evolved resistance to treatment. While efforts have been made to combine targeted therapies, significant levels of toxicity have stymied efforts to effectively treat cancer with multi-drug combinations using currently approved therapeutics. We discuss the relationship between tumor-promoting inflammation and cancer as part of a larger effort to develop a broad-spectrum therapeutic approach aimed at a wide range of targets to address this heterogeneity. Specifically, macrophage migration inhibitory factor, cyclooxygenase-2, transcription factor nuclear factor-κB, tumor necrosis factor alpha, inducible nitric oxide synthase, protein kinase B, and CXC chemokines are reviewed as important antiinflammatory targets while curcumin, resveratrol, epigallocatechin gallate, genistein, lycopene, and anthocyanins are reviewed as low-cost, low toxicity means by which these targets might all be reached simultaneously. Future translational work will need to assess the resulting synergies of rationally designed antiinflammatory mixtures (employing low-toxicity constituents), and then combine this with similar approaches targeting the most important pathways across the range of cancer hallmark phenotypes

Genetic and environmental variation in educational attainment : an individual-based analysis of 28 twin cohorts

We investigated the heritability of educational attainment and how it differed between birth cohorts and cultural-geographic regions. A classical twin design was applied to pooled data from 28 cohorts representing 16 countries and including 193,518 twins with information on educational attainment at 25 years of age or older. Genetic factors explained the major part of individual differences in educational attainment (heritability: a(2)=0.43; 0.41-0.44), but also environmental variation shared by co-twins was substantial (c(2)=0.31; 0.30-0.33). The proportions of educational variation explained by genetic and shared environmental factors did not differ between Europe, North America and Australia, and East Asia. When restricted to twins 30 years or older to confirm finalized education, the heritability was higher in the older cohorts born in 1900-1949 (a(2)=0.44; 0.41-0.46) than in the later cohorts born in 1950-1989 (a(2)=0.38; 0.36-0.40), with a corresponding lower influence of common environmental factors (c(2)=0.31; 0.29-0.33 and c(2)=0.34; 0.32-0.36, respectively). In conclusion, both genetic and environmental factors shared by co-twins have an important influence on individual differences in educational attainment. The effect of genetic factors on educational attainment has decreased from the cohorts born before to those born after the 1950s.Peer reviewe

「緩和ケアを推進する看護師教育プログラム」の評価 : 修了者およびその上司への調査から

京都府立医科大学医学部看護学科京都府立医科大学附属病院看護部京都府立医科大学看護実践キャリア開発センター京都府立医科大学附属病院地域医療推進部School of Nursing, Kyoto Prefectural University of MedicineDepartment of Nursing, University Hospital Kyoto Prefectural University of MedicineKyoto Prefectural University of Medicine, Career Development Center for NursingPromotion Division of Regional Medicine, University Hospital Kyoto Prefectural University of Medicine　本研究の目的は、「緩和ケア実践看護師養成コース（以下Aコース）」「在宅緩和ケア推進看護師養成コース（以下Bコース）」を受講した修了者とその上司への調査からプログラム評価および看護実践への活用状況を指標にしてプログラムを評価することである。【方法】平成27～31年度の間に京都府立医科大学看護実践キャリア開発センターが開催する「緩和ケアを推進する看護師教育プログラム」のAコースまたはBコースを受講した修了者25名のうち、調査時点で受講時と同じ施設・病院で就労を継続している21名（Aコース14名、Bコース7名）、とその上司21名（Aコース14名、Bコース7名）を研究対象者とした。修了生の施設・病院に質問紙を郵送し、令和3年7月～8月に無記名の自記式質問紙調査を行った。調査項目は、基本属性、カリキュラムについて、教育目標について、受講内容の適切性について、学習内容の臨床での活用について、とした。なお所属する大学の医学倫理審査委員会の承認を得て実施した（ERB-E-444）。【結果】回答者は、Aコース修了者9名、Aコース上司7名、Bコース修了者5名、Bコース上司3名であった。受講した修了者の評価においては、プログラムの内容についてAコースの8割以上が、Bコースの全員が（とても・まあまあ）適切としている。自己能力の発揮状況について、Aコースは4～6割、Bコースについては4～8割ができているとしている。　上司からの評価では、両コースとも受講した講義・演習・実習が7割程度現在の看護実践に役立っていると答えた。期待される能力については両コースとも8割以上が現在の看護活動に活きていると答えた。【結論】平成27年度から開始された「緩和ケアを推進する看護師教育プログラム」に対して、受講した修了者とその上司に，研修が有用であったかを問うたところ、受講した修了者はプログラムの内容が看護の実践で活かされていると実感していることが明らかとなった。さらに、上司は、受講した修了者が研修を踏まえた看護実践ができていると評価していることが明らかになった。修了者、上司の評価からプログラムの効果を評価することができた

The occupation of downtown by street trading, negotiations and production of urban space

Através do estudo do trabalho ambulante regularizado, a pesquisa discute as transformações na área central influenciadas pela espacialização dos circuitos de produtos que compõem o denominado \"comércio popular\". Cada circuito aciona uma rede de relações específicas, as quais podem existir na mais absoluta legalidade ou estarem ligadas ao contrabando, pirataria e falsificação. O mercado de produtos cuja oferta é criminalizada movimenta outro que transaciona \"mercadorias políticas\" - negociações de caráter político transformadas em valores monetários - tanto no âmbito das normas comerciais, quanto das que regulamentam a apropriação do território. A hipótese é que as negociações observadas no comércio ambulante constituem formas de gestão dos espaços da área central, as quais são compartilhadas entre o Poder Público e outros agentes. Por continuamente transitarem nas liminaridades do ilegal, ilícito e informal; elas caracterizam o território como uma \"zona de indeterminação\" entre o direito e o não-direito, a lei e a norma, o juízo e o arbítrio. Aborda-se a questão tendo como referência o caso de Campinas, cidade sede de uma região metropolitana localizada no interior do estado de São Paulo. A organização dos trabalhadores em ocupações nos espaços públicos - realizada pela Prefeitura desde os anos 1980 - resultou na construção de um imaginário sobre a atividade, no qual tem papel fundamental a negociação monetária da licença de uso. Para compreensão deste processo, foram analisadas especificamente as políticas de regulamentação adotadas de 2001 a 2004, período em que a regularização de novos espaços perpassou o debate sobre os sentidos da revitalização do centro. Os desdobramentos dessas políticas, captados nas falas dos entrevistados de 2005 a 2010, ajudaram a montar um quadro das negociações e a identificar a complexificação da população que vive da atividade. A convivência nas áreas regularizadas entre as dimensões clássicas e as reconfigurações do trabalho ambulante - provenientes do atual papel que a informalidade ocupa nos processos de acumulação - abre novas questões para a análise do chamado centro \"degradado\" e \"decadente\", locus do comércio popular.Through the study of the regularized street trading, the research discusses the transformations in the central area influenced by the spatialization of products circuits that constitute the known \"popular trade\". Each circuit triggers a network of specific relationships which can exist in the strictest legality or be linked to smuggling, piracy and counterfeiting. The market of products whose bid is criminalized moves other which transacts \"political commodities\" - political negotiations converted into monetary values - both in the context of trade rules, as those which regulate the appropriation of the territory. The hypothesis is that the negotiations observed in the spaces of street trading constitute a form of downtown\'s territory management, which is shared between Public Power and other agents. By continually transiting in illegal\'s liminality, illicit and informal, they characterize the territory as a \"zone of indeterminacy\" between right and rightless, law and norm, judge and will. It is addressed taking Campinas as a reference, a regional metropolis located within the state of Sao Paulo. The organization of workers in public territory occupations - held by the Prefecture since the 1980s -resulted in the construction of an ideal about the activity, in which the license\'s monetary negotiation plays a key role. To understand this process, the regulatory policies adopted from 2001 to 2004 are analyzed specifically, during which the regularization of new territories pervaded the debate on the meanings of downtown\'s revitalization. The consequences of these policies, as captured in the words of those interviewed from 2005 to 2010, helped to set up a negotiating framework and to identify the complexification of the population which does this activity for a living. The living in the regularized areas between classical dimension and the reconfiguration of street trading from the current informality role in the process of accumulation opens new questions for analyzing the \"degraded\" and \"decadent\" downtown, locus of the popular trade