著者
Masahiko Inoue Kazuko Okamoto
出版者
Tottori University Medical Press
雑誌
Yonago Acta Medica (ISSN:13468049)
巻号頁・発行日
pp.2022.08.004, (Released:2022-07-15)
参考文献数
8

This study involved qualitative analyses of the benefits and difficulties of providing home-based Applied Behavior Analysis (ABA) for Japanese parents of young children with autism spectrum disorder (ASD). An open-ended questionnaire survey was administered to 35 parents of children with autism who were implementing home-based ABA. The mean age of the parents was 38.7 years old (SD = 3.80), and the time since initiation of home-based ABA was 25.5 months (SD = 19.58). The mean age of the children with ASD was 64.5 months old (SD = 37.7). Data were analyzed using the KJ method of qualitative analysis. The benefits of implementing home-based ABA were related to growth of the parents themselves and child development. Identified difficulties included balancing work and household responsibilities and psychological problems. These findings were then compared with similar previous studies to discuss support for families implementing in-home ABA programs.
著者
Hisashi Ito Masahiko Inoue
出版者
Tottori University Medical Press
雑誌
Yonago Acta Medica (ISSN:13468049)
巻号頁・発行日
pp.2022.02.004, (Released:2022-01-04)
参考文献数
13

In defecation training, parent-mediated intervention via teleconsultation is helpful because the number of instructions for establishing defecation habits is limited. In the case report of the present study, defecation training was conducted based on gradual target setting and differential reinforcement through teleconsultation via email for a Caucasian 5-year-old boy with autism spectrum disorder (ASD) who lived in Greece. As a result of the intervention, namely the gradual target setting and differential reinforcement, in-bowl defecations increased at home.
著者
Masahiko Inoue
出版者
Tottori University Medical Press
雑誌
Yonago Acta Medica (ISSN:13468049)
巻号頁・発行日
vol.62, no.2, pp.169-181, 2019 (Released:2019-06-20)
参考文献数
85
被引用文献数
6

Intellectual disability and autism spectrum disorder are neurodevelopmental disorders that emerge during the developmental period. A significant barrier that impedes the social adaptation of individuals with these disorders is the exhibition of problem behaviors, such as self-injurious, stereotyped, and aggressive/destructive behaviors. In recent years, these problem behaviors have been collectively referred to as “challenging behavior,” in accordance with the contention that they result from an interaction between the individual and his or her social environment. Evidence-based psychosocial interventions that adopt the functional approach to treating challenging behavior are increasing. However, in order to effectively implement such interventions in educational settings and welfare facilities, it is essential to develop staff training programs and usable psychometric assessments. Accordingly, a brief overview of research studies on challenging behavior that have been conducted in Japan, as well as the various support systems that are available to individuals who exhibit challenging behavior, are presented in this article. The discussion makes it apparent that, in order to improve treatment systems in Japan that are aimed at addressing challenging behavior, it is necessary to establish not only better staff training programs, but also reliable and valid assessments measuring challenging behavior that can be readily used by teachers and parents. On the basis of this discussion, it is proposed that technological advancements must be applied to psychosocial approaches in the study of problem behaviors, in order to develop assessment system using software applications and automatic measurement system of target behaviors using sensing technology.
著者
Tomoyuki Okada Atsushi Yanagitani Takeshi Hashimoto Hajime Isomoto
出版者
Tottori University Medical Press
雑誌
Yonago Acta Medica (ISSN:13468049)
巻号頁・発行日
vol.64, no.1, pp.129-132, 2021 (Released:2021-02-22)
参考文献数
24
被引用文献数
1

Fecal impaction is the impaired excretion of a large fecal mass, and mild cases are treated by enema and osmotic laxatives. However, treatment-resistant cases need more invasive alternatives. A woman in her 60s presented with abdominal discomfort. Her abdomen was soft and without tenderness. Computed tomography revealed a large mass of feces in her sigmoid colon and no intestinal dilatation proximal to the mass. Endoscopy confirmed a fecal mass occupying the lumen. A glycerin enema, oral administration of polyethylene glycol, and enteral administration of amidotrizoic acid during colonoscopy were ineffective. We maneuvered a guidewire to form a loop at the tip of an endoscope, with which we subdivided the mass for successful removal. The patient’s abdominal discomfort disappeared immediately. Endoscopic disimpaction is far less invasive than surgery and should be considered when treating fecal impaction cases, without severe obstructive colitis, which are nonresponsive to conservative treatment.
著者
Toshiki Fukuzaki Noboru Iwata Sawako Ooba Shinya Takeda Masahiko Inoue
出版者
Tottori University Medical Press
雑誌
Yonago Acta Medica (ISSN:13468049)
巻号頁・発行日
vol.64, no.3, pp.269-281, 2021 (Released:2021-08-24)
参考文献数
57

Background This study aimed to examine the effects of nurses’ work–life balance (WLB), job demands and resources, and organizational attachment on their work engagement (WE). The second aim was to shed light on whether the relationships among WLB, job demands, resources, and WE are modulated by organizational attachment.Methods In total, 425 nurses working in a university hospital responded to the questionnaire. The primary statistical analysis method was hierarchical multiple regression with WE as the dependent variable.Results In the model in which all variables were applied, affective commitment (AC) (β = 0.41), family-to-work positive spillover (β = 0.25), and number of children (β = 0.13) were found to have a significant association with WE. Family-to-work negative spillover (FWNS) and AC had significant interaction effects. The result suggests that when AC was low, WE tended to decline further due to FWNS; however, when AC was high, WE did not change due to the effect of FWNS.Conclusion These results confirmed that to improve nurses’ WE, hospital organizations should implement initiatives to facilitate WLB that considers nurses’ household roles. Furthermore, high organizational attachment buffered the home’s negative influence on work, thereby helping nurses work energetically.
著者
Takahiro Matsushige Tomohiko Sakabe Yoshihisa Umekita
出版者
Tottori University Medical Press
雑誌
Yonago Acta Medica (ISSN:13468049)
巻号頁・発行日
pp.2022.02.006, (Released:2022-01-04)
参考文献数
40

Background Mammary serine protease inhibitor (maspin) is well known as a tumor suppressor gene in several types of cancers and its nuclear localization is essential for its tumor-suppressive function. We previously reported that the cytoplasmic-only localization of maspin is significantly correlated with unfavorable prognosis in patients with lung adenocarcinoma (LUAD). To clarify whether maspin in LUAD acts as a tumor promoter or suppressor, we examined the subcellular localization-dependent biological functions of maspin in human LUAD cell lines.Methods The expression levels and subcellular localization of maspin were investigated by performing immunoblotting and immunofluorescence in human LUAD cell lines (PC-9, A549, NCI-H23, RERF-LC-KJ) and human bronchial epithelial cell line (BEAS-2B). We then established stable cell lines overexpressing maspin (A549-maspin and RERF-LC-KJ-maspin) and investigated their subcellular localization. Cell invasion assays of these cell lines were performed to examine their invasiveness. Moreover, the mRNA expression levels between epithelial cell markers (E-cadherin) and mesenchymal cell markers (N-cadherin and vimentin) were compared.Results The expression of maspin in PC-9 cells was comparable to that in BEAS-2B cells, whereas its expression in A549, NCI-H23, and RERF-LC-KJ cells was decreased. The cell invasion capability of A549-maspin cells showing pancellular expression was significantly decreased compared with that of A549-control cells. By contrast, the cell invasion capability of RERF-LC-KJ-maspin cells showing cytoplasmic-only expression was significantly increased compared with that of RERF-LC-KJ-control cells. The mRNA expression levels of N-cadherin, but not E-cadherin and vimentin, in A549-maspin cells was significantly downregulated compared with that in A549-control cells. No significant differences in these markers were observed between RERF-LC-KJ-maspin and RERF-LC-KJ-control cells.Conclusion The invasive capability of LUAD cells is regulated by the intracellular localization of maspin. Clarification of the molecular mechanism underlying the subcellular localization-dependent function of maspin will promote a deeper understanding of LUAD development and progression.
著者
Motoo Yoshimiya Takahiro Ueda Tomofumi Ogoshi Dawa Zangpo Masato Nakatome Morio Iino
出版者
Tottori University Medical Press
雑誌
Yonago Acta Medica (ISSN:13468049)
巻号頁・発行日
pp.2022.02.001, (Released:2022-01-04)
参考文献数
18

Background Intracardiac hypostasis is frequently observed in postmortem computed tomography (PMCT) of acute deaths, and it becomes clearer as the postmortem interval increases. To determine the postcardiac arrest interval (PCAI), we evaluated densities of the right and left atria [anterior part of the right atrium (AR) and posterior part of the left atrium (PL)] using postmortem computed tomographic images.Methods A total of 184 patients were included in the study. Patients with return of spontaneous circulation and those with final alive confirmation time over 1 hour were excluded. We evaluated the density of AR and PL at the level of the right inferior pulmonary vein entry to the left atrium. We defined the interval between the estimated cardiac arrest time and the postmortem CT time as the PCAI.Results There was a negative correlation between AR and PCAI in 59 patients who died owing to cardiovascular disease. The regression equation (PCAI = −1.725 × AR + 132.95) was obtained based on this result. There was no correlation between PL and PCAI.Conclusion The result suggests that the density of the anterior part of the right atrium decreases as postcardiac arrest interval increases in the case of cardiovascular disease. The regression equation may be used as an additional method to estimate postcardiac arrest interval.
著者
Tetsuya Okazaki Kaori Adachi Kaori Matsuura Yoshitaka Oyama Madoka Nose Emi Shirahata Toshiaki Abe Takeshi Hasegawa Toshiro Maihara Yoshihiro Maegaki Eiji Nanba
出版者
Tottori University Medical Press
雑誌
Yonago Acta Medica (ISSN:13468049)
巻号頁・発行日
vol.64, no.1, pp.30-33, 2021 (Released:2021-02-22)
参考文献数
13
被引用文献数
1

Background Fragile X syndrome (FXS) is a well-known X-linked disorder clinically characterized by intellectual disability and autistic features. However, diagnosed Japanese FXS cases have been fewer than expected, and clinical features of Japanese FXS patients remain unknown.Methods We evaluated the clinical features of Japanese FXS patients using the results of a questionnaire-based survey.Results We presented the characteristics of seven patients aged 6 to 20 years. Long face and large ears were observed in five of seven patients. Macrocephaly was observed in four of five patients. The meaningful word was first seen at a certain time point between 18 and 72 months (median = 60 months). Developmental quotient or intellectual quotient ranged between 20 and 48 (median = 29). Behavioral disorders were seen in all patients (autistic spectrum disorder in six patients, hyperactivity in five patients). Five patients were diagnosed by polymerase chain reaction analysis, and two patients were diagnosed by the cytogenetic study. All physicians ordered FXS genetic testing for suspicious cases because of clinical manifestations.Conclusion In the present study, a long face, large ears, macrocephaly, autistic spectrum disorder, and hyperactivity were observed in almost cases, and these characteristics might be common features in Japanese FXS patients. Our finding indicated the importance of clinical manifestations to diagnosis FXS. However, the sample size of the present study is small, and these features are also seen to patients with other disorders. We consider that genetic testing for FXS should be performed on a wider range of intellectually disabled cases.
著者
Yuko Nishina Shin-ichi Yoshioka
出版者
Tottori University Medical Press
雑誌
Yonago Acta Medica (ISSN:13468049)
巻号頁・発行日
vol.61, no.1, pp.019-026, 2018 (Released:2019-03-15)
参考文献数
23
被引用文献数
4 7

Background Comprehensive care is necessary for people with epilepsy (PWE) to lead a fulfilling life at home and in the community. The purpose of this study was to determine the epilepsy-related knowledge, attitudes and practices of home healthcare nurses (HHNs) in the San-in region of Japan.Methods A questionnaire survey was conducted by mail of 546 HHNs working in Tottori and Shimane Prefectures. The questionnaire assessed the epilepsy-related knowledge, attitudes and practices of HHNs. For the analysis, simple and cross tabulation of questionnaire responses were conducted, and the chi-squared test was used for statistical testing.Results A total of 285 HHNs participated in the study. Of the respondents, 43.9% had experience taking care of PWE in a home healthcare nursing setting. Regarding the cause of epilepsy, in descending order the percentage of correct responses were 86.7% for stroke, 85.3% for head injury, and only 13.3% for dementia. Concerning how to respond to an epileptic seizure, almost all respondents answered correctly, but 29.8% gave the incorrect answer of “place something inside the mouth.” Regarding the practices of HHNs in relation to caring for PWE, nurses scored 52.0% for collaborating with the attending physician, indicating the need for improvement. The score for “provide information about social resources” was low at 18.4%. Of the respondents, 95.8% answered that epilepsy-related knowledge and technical skills were necessary for home healthcare nursing practice, and 87.7% were interested in participating in a workshop on epilepsy.Conclusion The study revealed an inadequate level of knowledge of epilepsy with dementia and corresponding epileptic seizures, a low awareness of nursing care in collaboration with physicians, and the importance of providing information about social resources. There is a need to offer information and education on the latest knowledge about epilepsy to HHNs.
著者
Noriko Fujihara Shin-ichi Yoshioka
出版者
Tottori University Medical Press
雑誌
Yonago Acta Medica (ISSN:13468049)
巻号頁・発行日
pp.2020.02.003, (Released:2019-12-23)
参考文献数
24

Background This study attempted to clarify issues regarding difficulties in school life perceived by professional training college students and educational support systems for students including possible developmental disabilities.Methods We surveyed 953 students enrolled at 9 professional training colleges in Japan by using an anonymous self-administered questionnaire to investigate difficulties during school life, help-seeking preferences, and self-esteem. Difficulties were investigated by using the Self-Cognitive Difficulties Scale, help-seeking preferences were assessed with the Help-Seeking Preferences Scale, and self-esteem was assessed by the Rosenberg Self-Esteem Scale. We also investigated the relationship between the Self-Cognitive Difficulties Scale and the sources of advice used by students.Results Responses were obtained from 863 students, and those of 775 students were considered to be valid. In terms of learning scenarios, 271 students (35.0%) responded that written examinations caused the most difficulties. The Rosenberg Self-Esteem Scale and Help-Seeking Preferences Scale were negatively correlated with the Self-Cognitive Difficulties Scale. With respect to the relationship between sub-factors of the Self-Cognitive Difficulties Scale and sources of advice, the students who asked specialists for advice had significantly higher scores for the factors of interpersonal relationships and reading/writing, as well as significantly higher scores for impulsivity and learning-related difficulties. The students who asked their previous high school teachers for advice had significantly higher scores for inattention and reading/writing. Furthermore, the students who asked senior students in the same department for advice had a significantly higher score for learning-related difficulties.Conclusion Our results suggested that professional training college students with a high Self-Cognitive Difficulties Scale score are more likely to choose a specialist as the source of advice. When providing educational support to professional training college students, it is important to consider the possibility that their sources of advice might differ depending on their individual self-perceived difficulty characteristics.