This study examined activities that had been conducted until relaxation methods came to be implemented clinically as a nursing intervention in Japan. For about 20 years, the relaxation response was tested in basic research, while the effects of safe and effective relaxation methods were tested and instruction methods were investigated in clinical research. Furthermore, the study explained the sequence of events in the establishment and operation of the relaxation outpatient clinic of Gunma University Hospital, the first relaxation outpatient clinic in Japan. Recently, research on relaxation methods has progressed, and these methods have been increasingly used in clinical practice. Furthermore, our aim is to develop high-quality instructors so that these methods will be used by many people in the future. Relaxation methods as self-care can be used to create health through "the discontinuation of pointless self-attack," which allows improvement of natural biological functions and achieves recovery of the balance of mind and body.
Backgrounds & Aims: X-ray repair cross-complementing group 1 (XRCC1) plays an important role in base excision repair (BER) system, which is critical for genome maintenance. Polymorphisms in XRCC1 that result alteration of DNA repair capacity are reportedly associated with cancer risk and treatment response. However, whether these polymorphisms alter the susceptibility and clinical outcomes of patients with myelodysplastic syndromes (MDS) is unknown. The aim of this study was to evaluate the association of two polymorphisms, XRCC1 Arg194Trp and XRCC1 Arg399Gln, with susceptibility to and clinical outcome of MDS. Methods: Our study included 119 patients with MDS or chronic myelomonocytic leukemia[median 67.9 years, range 17.1-86.5 years; male/female 81/38]and 202 healthy control subjects. Genotypes were determined via PCR-restriction fragment length polymorphism (PCR-RFLP). Results: Differences in allele or genotype frequencies for XRCC1 Arg194Trp or XRCC1 Arg399Gln between patients with MDS and the control group were not significant. However, XRCC1 399 non-Arg/Arg genotypes were significantly associated with previous history of radiotherapy and multiple cancers. Furthermore, XRCC1 194 non-Arg/Arg genotypes and XRCC1 399 Arg/Arg genotype were each significantly associated with poor prognosis for patients with MDS. Conclusions: Our studies suggest that XRCC1 polymorphisms affected clinical features of MDS and may be useful prognostic marker for MDS.
Background & Aims: This study aimed to identify the lifestyle patterns of Japanese working women and their associations with women's characteristics. Methods: The study was conducted based on baseline data from the Japan Nurses' Health Study. Principal component analysis and multivariate regression were used. Results: Five lifestyle patterns were identified and named balanced dietary pattern, health-compromising pattern, cancer prevention pattern, working and short-sleep pattern and pill intake pattern. Nursing license, marriage status, educational degree, work location, history of shift work, parity, body mass index, age, family history of cancer and prior diagnosis of cancer or a gynecological disorder were associated with lifestyle patterns. In particular, currently or previously married women showed a positive association with balanced dietary pattern, cancer prevention pattern and pill intake pattern. Women having one or more child demonstrated a stronger tendency to adhere to the balanced dietary pattern and cancer prevention pattern, as well as showing a lower tendency towards the health-compromising pattern and pill intake pattern. Elderly women were more likely to adhere to the balanced dietary pattern, and the cancer prevention pattern. Conclusions: This study identified five distinct lifestyle patterns and may be useful in providing a basis for further work investigating health outcomes.
Background & Aims: To evaluate the reproducibility and relative validity of a short-form food frequency questionnaire (SF-FFQ) for intake of 11 food items and breakfast in Japanese working women. Methods: The subjects were 40 female nurses. Reproducibility was evaluated by comparing the SF-FFQs (SF-FFQ1 and 2) measured twice at 5- to 7-month intervals. The relative validity of the SF-FFQs was assessed by using the mean weight (mDR, g/day) or mean frequency (mfDR, times/week) of the two 7-consecutive-day dietary records. Results: The kappa statistics (K), proportions in corresponding categories, and the Spearman's rank correlation coefficient (ρ) for the reproducibility were 0.16-0.75, 0.40-0.90, and 0.27-0.86. For the relative validity, the median (range) of energy-adjusted ρ between SF-FFQ2 and mDR for 11 food items was 0.36 (0.00-0.66) and 0.28 (-0.25-0.81) for shift workers. The agreement between SF-FFQ2 and mfDR in corresponding categories was 90% for both breakfast frequency and main staple food. The ρ between SF-FFQ2 and mfDR of breakfast was 0.56 and 0.50 for shift workers, and the K of main staple foods was 0.74 and 0.52 for shift workers. Conclusions: This SF-FFQ has good reproducibility and relative validity for most food items regardless of work schedule.
Background & Aims: The aged society in Japan is rapidly growing, and elderly patients are increasing. Therefore, most doctors have opportunities to treat elderly patients. Even if elderly patients undergo the same emergency medical treatments as younger patients, their treatment outcomes do not always go well. However, it is difficult for doctors to judge whether they should give medical treatment or not. Here, I examined relationships between frailty and outcomes following to emergency transportation in elderly patients in rural area. Methods: Participants were elderly patients aged 65 years or older who lived in Japanese rural area and needed an emergency transportation between April and September 2014. Pre-hospital, post-hospital life style and frailty of the patients were investigated. Results: Seven patients (three men and four women) with a mean age of 84.3 years were analyzed. Five patients were frail. The frail elderly patients died in hospital, or required discharge to an institutional care facility. Conclusion: Frailty may have been related to their bad results after emergency medical treatment. We may be able to predict their post-hospital state by presence or absence of frailty.
Objective: The circumstances of home care agencies undertaking student practice of home care nursing were investigated. Methods: Semi-structured interviews were conducted on managers or staff members in charge of student's practice at eight home care agencies. Results: Selection criteria for homes accepting student's practice were "no selection criteria", "homes at which students had a lot to learn", "homes at which students had no negative experiences", and "effects on the home of the user or family". Student visits were cancelled due to hospitalization or exacerbation of the condition of the user, bad response from user and/or family, protection of students from unreasonable demands of user, and irrelevant home environment for student practice. The reaction when home care patients and family were asked to accept student's practice were "ready consent", "reluctant consent", "clear reply of yes or no", "refusal" and "difficulties to visualize student's practice". The reaction of home care patients and family about students were "favorable reaction", "no complaints", and "dissatisfaction towards student practice". The reactions of visiting nurses toward student's practice included positive reactions as well as negative effects on nurses and the practical aspects of care, students' attitudes, and complaints about lack of student's competence. Difficulties in operating practical training programs were "arrangement of visit schedules", "responses to practices at multiple nursing schools and "transfer of students". Conclusions: Educational issues in practical training programs at home care agencies include the need to enhance the preparedness of students in terms of awareness of actual homecare settings and their understanding of the uniqueness of home care nursing, in order to reduce hindrances to visiting nursing activities, and to strengthen cooperation among nursing faculty in the community.
Background & Aims: Protein phosphatase 1 (PP1) is a member of the phosphoprotein phosphatase (PPP) family which, together with protein phosphatase 2A and protein phosphatase 2B (PP2B), exhibits serine/threonine phosphatase activity. We previously reported that linear alkylbenzenesulfonates (LAS) noncompetitively inhibit the phosphatase activity of calcineurin (CN), also known as PP2B. Here we examined the inhibitory effect of LAS on PP1α activity and determined the mechanism of inhibition. Methods: The inhibitory effect of LAS against PP1α enzymatic activity was confirmed using p -nitrophenylphosphate as a substrate and was further examined by kinetic analysis. Results: C12-LAS to C14-LAS exhibited strong inhibitory effects for PP1α. The half maximal inhibitory concentration (IC50) value of C12-LAS was 13.2μM. Using a double-reciprocal plot, C12-LAS was determined to exhibit uncompetitive inhibitory effects on PP1α activity. Conclusions: LAS analogues containing twelve to fourteen carbons in the alkyl side chain showed strong inhibitory effects against both PP1α and CN. Although LAS shows noncompetitive inhibition for CN, our results demonstrate that it exhibits uncompetitive inhibition for PP1α.
Gastrointestinal (GI) tract perforation is a serious complication in patients with rheumatoid arthritis (RA). This complication has been reported in the eras of both disease-modifying anti-rheumatic drugs (DMARDs) and biologics for RA. However, the etiopathogenesis of this condition has not been satisfactorily clarified to date. We experienced the case of an 83-year-old male treated with adalimumab, methotrexate (MTX) and prednisolone (PSL) who developed hematochezia. The operation demonstrated perforated Meckel's diverticulitis and an ileal ulcer; these complications occurred after the interruption of RA treatment for eight weeks. The pathology showed an artery with organized thrombi in the diverticular wall associated with recanalization and a fresh thrombotic arteriole beneath the ileal ulcer, although there was no evidence of arteriosclerosis, angiitis, amyloidosis or infection. The former site of arterial thrombosis was presumed to play an important role in the pathogenesis of perforated Meckel's diverticulitis and the ileal ulcer in this case. The onset of arterial thrombosis during or shortly after the discontinuation of biologic treatment has rarely been described. However, the potential for arterial thrombosis should thus be considered in patients receiving such treatment who present with perforation or ulcers of the GI tract.
Only 12.2% of workplaces offer non-smoking support and instruction. This study examined the effect of free non-smoking instruction among 117 male smokers working at a private company and surveyed the actual situation of the smokers using a questionnaire before and after the instruction. Ninety-six subjects responded to the questionnaires; those who scored 3 points or lower on the FTND were classified as belonging to a "low-value group, " and those who scored 4 points or higher were classified as belonging to an "average, high-value group. " Subjects who were not interested in quitting were classified as "uninterested stage, " while those who were interested were classified as "interested stage. " The data points between these two groups were then compared. No significant difference in the number of successful quitters was seen between the two groups; however, the FTND scores of the "low-value group" and the "average, high-value group" were significantly different. Smoking stress relief, non-smoking experiences, and other factors are the most likely explanations for these significant differences. In addition, significant differences in the reasons given for quitting smoking (such as bad for health, body odor or bad breath, and financial concerns) were observed between the "interested stage" and the "uninterested stage" groups. The results of this study suggest that the approach to providing future smoking cessation instruction should be reconsidered.
Purpose: The purpose of this study was to clarify the preparations and realities regarding emergency on physical condition among in-home amyotrophic lateral sclerosis (ALS) patients for effective countermeasure. Methods: The participants were 72 patients with ALS who were treated at University Hospital A between 2011 and 2013, and 5 people involved with an ALS patient association. A questionnaire survey was conducted by mail. The study was approved by the University Ethics Committee. Results: Out of 77 participants, 42 responded (55% response rate), of which 41 responses were valid. Seventeen patients had experienced an emergency sudden change in their conditions, and 24 had no such experience. Nine patients who had not had such an experience selected either "Not necessary " or "Not sure " when asked about their advanced directives. Reasons for these responses were "I'm fine at the moment " and "My symptoms are mild ". First contact at emergency was listed as "Not decided " by none who had experienced physical emergency and 10 patients who had not. The number of emergency episode was 1 in 11 patients, 2 in 2 patients, and 3 or more episodes in 2 patients. Conclusions: The study findings showed that patients who had not experienced an emergency in their ALS were less aware and less prepared for their emergency than their counterparts with such an experience. The findings suggest the need for better education on early preparations for emergency in ALS symptoms.