During pregnancy, women experience various emotional changes. Previous research has investigated positive emotion influenced childbirth outcomes positively. This study explored the extent of positive emotion which pregnant women aware of their own pregnancy life subjectively and variables related to the changes thereof. This was an adjunct study of the Japan Environment and Children’s Study which is a nationwide epidemiological study to identify the impact of environmental factors on health and development of children in Miyagi Prefecture. Data were collected at 12 weeks (T1) and 24-28 weeks (T2) of gestation. Participants were 3,513 pregnant women. Women’s degree of positive emotion was assessed through a numeric rating scale. We also measured related variables, including obstetric factors, physical health status, mental health status, and social situation, using the 8-Item Short Form Health Survey, Kessler-6, and family APGAR score, along with demographic data. Analyses included correlations among variables related to the change in positive emotion. The extent of positive emotion was significantly related with health-related quality of life and satisfaction with family relationships during pregnancy. The women whose positive emotion decreased from T1 to T2 tended to have lower morning sickness symptoms, be unemployed, lower physical and mental health status, and a higher risk of psychological distress in middle pregnancy. Importantly, even discomfort like morning sickness, physical symptoms that indicate being pregnant, might make women to confirm pregnancy. Moreover, employment and satisfaction with family relationships are especially crucial for pregnant women to spend comfortable maternity life.
Healthcare workers (HCWs) are often exposed to nosocomial infection when caring for patients with Ebola Virus Disease (EVD). During the 2014-2016 EVD outbreak in West Africa, more than 200 HCWs died of EVD in Sierra Leone. To determine the factors that are important for preventing infection among HCWs during EVD outbreak, we used agent-based modeling and simulation (ABMS) by focusing on education, training and performance of HCWs. Here, we assumed 1, 000 HCWs as “agents” to analyze their behavior within a given condition and selected four parameters (P1-P4) that are important in the prevention of infection: “initially educated HCWs (P1)”, “initially educated trained (P2)”, “probability of seeking training (P3)” and “probability of appropriate care procedure (P4).” After varying each parameter from 0% to 100%, P3 and P4 showed a greater effect on reducing the number of HCWs infected during EVD outbreak, compared with the other two parameters. The numbers of infected HCWs were decreased from 897 to 26 and from 1,000 to 59, respectively, when P3 or P4 was increased from 0% to 100%. When P2 was increased from 0% to 100%, the number of HCWs infected was decreased from 166 to 44. Paradoxically, the number of HCWs infected was increased from 56 to 109, when P1 was increased, indicating that initial education alone cannot prevent nosocomial infection. Our results indicate that effective training and appropriate care procedure play an important role in preventing infection. The present model is useful to manage nosocomial infection among HCWs during EVD outbreak.
Osteocalcin is the non-collagenous protein produced by osteoblasts in bone. When it is released into systemic circulation in its uncarboxylated form, it regulates fat and glucose metabolism. Recent studies have shown that osteocalcin is also involved in male fertility. Because the onset of puberty is determined by ethnic, genetic, environmental, and metabolic factors, we focused on determining the role of osteocalcin in the onset of puberty. Central precocious puberty (CPP) is defined as the activation of the hypothalamic-pituitary-gonadal axis before the age of 8 in girls and 9 in boys. CPP is diagnosed when peak luteinizing hormone (LH) reaches ≥ 5.0 IU/l after stimulation with gonadotropin-releasing hormone (GnRH). This retrospective study included 206 girls who showed breast budding before the age of 8 and whose bone age was more advanced than their chronological age. The CPP group included 100 girls who were diagnosed with CPP, and 106 girls were the non-CPP group whose peak LH did not reach ≥ 5.0 IU/l after GnRH stimulation test. Serum osteocalcin levels were measured to investigate the relationship between osteocalcin and the onset of puberty. Our data showed that serum osteocalcin levels were significantly higher in the CPP group (87.7 ± 24.4 ng/ml vs. 68.3 ± 19.5 ng/ml, P < 0.001). The multivariate analysis revealed that an increase in bone age and peak LH was significantly associated with the serum osteocalcin level. The results of this study suggest that serum osteocalcin is associated with the onset of puberty in girls.
Cerebral hemodynamics plays an important role in cognitive performance, and as such, age-related cognitive dysfunction and cerebral hypoperfusion increase the risk of dementia. However, age-related changes in cerebral oxygenation and cognitive function remain unclear. The aim of this study was to investigate age-related declines in cerebral oxygenation and executive function cross-sectionally. Ninety-eight healthy Japanese adults (age range: 23-79 years; 40 males, 58 females) participated in the present study using local advertisements. The participants were divided into 4 age groups: young (20-39 years; M15/F7), 50s (50-59 years; M10/F12), 60s (60-69 years; M9/F31), and 70s (70-79 years; M6/F8). We measured oxygenated hemoglobin (oxy-Hb) signal change in the prefrontal cortex during the Stroop task, and calculated Stroop interference time in cross-sectional design. This test is widely used to measure the ability to properly control attention and behavior in executing tasks, and to evaluate executive functions mainly associated with the prefrontal cortex. Oxy-Hb signal changes in the left prefrontal cortex in the 60s and 70s groups were significantly lower than those in the young group (both P < 0.05). Additionally, Stroop interference time was significantly longer in the 60s and 70s groups than in the young group (both P < 0.05). Furthermore, differences in oxy-Hb signal change between the left and right prefrontal cortex were evident only in the young group. These results suggest that the age-related decrease in executive function is associated with decrease in the cerebral oxygenation hemodynamics in the left prefrontal cortex.
An important consideration in the quality of end-of-life care is whether the patient’s place of death matches his or her hopes. We aimed to identify topics related to patients’ home death by comparing the occurrence frequency of topics explained by doctors for family caregivers between the home death cases and the hospital death cases. The method of integrating qualitative and quantitative data was adopted in this study. Primary participants were 24 home doctors who specialized home medical care. Enrolled 18 patients received periodical medical care by cooperated doctors, understood their own health situation, and lived with family caregivers. Doctors recorded all their speech during every visit with voice-recorder until the patient died at home or was re-hospitalized. Doctors’ speech was transcribed and converted to the number of occurrences based on number of visits. The occurrence frequency was compared with a χ2 test (Yates’ correction). Speaking records of 227 visits to 18 patients by doctors were collected. Finally, 16 patients died at home and two died at hospital. We measured the occurrence frequency of topics during maximum 26 visits on 16 home death cases and maximum 13 visits on two hospital death cases. The topics of patients’ death, helping daily burden using public insurance, and financial application were more frequently appeared with home death cases than hospital death cases. In conclusion, doctors should explain to family caregivers the topics of patients’ death process and specific measures or procedures for reduction in care burden.
Excessive drinking by college students is a major public health problem in Japan. However, data on heavy episodic drinking (HED) and nomihodai, a several-hour all-you-can-drink system, are scarce. We surveyed the drinking behavior of undergraduate and graduate students at 35 colleges, and examined the association between HED and use of nomihodai. The study used a cross-sectional design conducted by a self-administered questionnaire. From December 2016 to March 2017, we sampled undergraduate and graduate students aged 20 or older at 35 colleges in the Kanto area, including Tokyo. The following items were measured: 1) frequency of drinking; 2) frequency of binge drinking in the past year; 3) nomihodai use; 4) the number of drinks consumed when using or not using nomihodai; and 5) sex and age for demographic data. Paired t-test was used to compare means between use and non-use state of nomihodai. The Fisher’s exact test was used to evaluate the significance of the distribution difference between the two types of states. A total of 511 subjects completed the questionnaire, including 274 men and 237 women. The amount of drinking was increased 1.8-fold (85.9 ± 49.7 g vs. 48.2 ± 29.5 g) among men and 1.7-fold (63.7 ± 39.3 g vs. 36.5 ± 26.7 g) among women during nomihodai use, comapred with non-use states. Among them, 109 (39.8%) men and 71 (30.3%) women reported HED only at nomihodai states. These data suggest that the use of nomihodai system may lead to excessive drinking among college students.
Bacteria have been used for more than a century to treat solid tumors. Because solid tumors generate an anaerobic environment, we evaluated the anti-tumor effect of the obligate anaerobe strain KK378, derived from Lactobacillus casei (L. casei), using mice bearing head and neck cancer. Wild-type L. casei is a nonpathogenic bacterium that is commonly used in foods. Moreover, patients with head and neck squamous cell carcinoma often have multiple cancers and cervical lymph node metastasis that can be directly sensed beneath the skin. To establish the animal model bearing head and neck cancer, we inoculated each of human squamous cell carcinoma cell lines, SAS, HSQ89, and HSC2, on the back skin of BALB/cSlc-nu/nu mice. After tumor formation, L. casei KK378 was administered directly into the tumor, and tumor size and serum cytokine levels were analyzed. Mice injected with 108 cfu of L. casei KK378 showed reduction in tumor growth compared with PBS control; especially, the SAS tumor was significantly reduced (p = 0.008). Administered L. casei KK378 was detected in tumor tissues but not in normal tissues (liver, kidney, and lung) of SAS tumor-bearing mice, which was associated with increased blood cytokines (TNF-α, IFN-γ, IL-5, IL-10, and IL-12). Among these cytokines, the serum levels of IFN-γ and TNF-α were significantly increased (p < 0.05). In conclusion, L. casei KK378 infection may suppress tumor growth by inducing the host immune response. Direct injection of Lactobacillus into the tumor could be a potential strategy to treat head and neck squamous cell carcinoma.