Challenges in Work-Family Balance and Support Needs of Japanese Parents with Nursery School-Aged Children

We aimed to identify the challenges parents face raising preschool-aged children when trying to maintain a good work-family balance. We also highlight how public health nurses can support the community in this regard. Seven Japanese parents volunteered to participate, and individual in-depth interviews were conducted from May to October 2021. We analyzed the recorded interview data using qualitative descriptive methods. Three main themes concerning work-family balance challenges were extracted: 1) conflicts between parents’ childcare and work roles, 2) issues related to institutions and social systems, and 3) a lack of informal support. Factors contributing to the difficulties were a lack of time to spend with their children;an imbalance in the division of housework and childcare roles between married couples;the employment environment in Japan that makes it difficult to pursue a career while raising children;a lack of childcare services, including childcare for sick children;inadequate consultation systems;and an aging grandparents’ generation owing to late marriages. To solve this problem, we suggest that in addition to establishing a reliable system for providing childcare, local public health nurses should work with childcare workers to create an environment in which parents feel comfortable discussing work-family balance, considering the time constraints of parents during the childrearing period, and use nursery schools as a place for parent-child support.

Surgical spacer placement and proton radiotherapy for unresectable hepatocellular carcinoma

Few potentially curative treatment options exist apart from hepatic resection for patients with huge hepatocellular carcinoma (HCC). Proton radiotherapy is a promising new modality which has an inherent antitumor effect against HCC. However, the application of proton radiotherapy for tumors adjacent to the gastrointestinal tract is restricted because the tolerance dose of the intestine is extremely low. A novel two-step treatment was developed with surgical spacer placement and subsequent proton radiotherapy to administer proton radiotherapy with curative intent. This report presents a case of a patient with a huge unresectable HCC treated by this method who achieved disease-free survival of more than 2 years. This new strategy may potentially be an innovative and standard therapy for unresectable HCC in the near future.

Role of phosphorylated Smad3 signal components in intraductal papillary mucinous neoplasm of pancreas

Background:Malignant intraductal papillary mucinous neoplasm(IPMN)has poor prognosis.The carcinogenesis of IPMN is not clear.The aim of this study was to clarify transitions in phosphorylated Smad3 signaling during IPMN carcinogenesis.Methods:By using immunohistochemistry,we examined the expression of pSmad3C and pSmad3L from 51 IPMN surgical specimens resected at our institution between 2010 and 2013.We also examined the expression of Ki-67,c-Myc and p-JNK.Results:The median immunostaining index of pSmad3C was 79.2%in low-grade dysplasia,74.9%in highgrade dysplasia,and 42.0%in invasive carcinoma(P<0.01),whereas that of pSmad3L was 3.4%,4.3%,and 42.4%,respectively(P<0.01).There was a negative relationship between the expression of pSmad3C and c-Myc(P<0.001,r=-0.615)and a positive relationship between the expression of pSmad3L and c-Myc(P<0.001,r=0.696).Negative relationship between the expression of pSmad3C and Ki-67(P<0.01,r=-0.610)and positive relationship between the expression of pSmad3L and Ki-67(P<0.01,r=0.731)were confirmed.p-JNK-positive cells were frequently observed among pSmad3L-positive cancer cells.The median of pSmad3L/pSmad3C ratio in the non-recurrence group and the recurrence group were 0.58(range,0.05–0.93),3.83(range,0.85–5.96),respectively(P=0.02).The median immunostaining index of c-Myc in the non-recurrence group and the recurrence group were 2.91(range,0–36.9)and 82.1(range,46.2–97.1),respectively(P=0.02).The median immunostaining index of Ki-67 in the non-recurrence group and the recurrence group were 12.9(range 5.7–30.8)and 90.9(range 52.9–98.5),respectively(P=0.02).Conclusions:pSmad3L was upregulated in malignant IPMN.pSmad3L/pSmad3C ratio may be a useful prognostic factor in IPMN.

Development of a pendulum machine for measuring contact lens friction

The lubrication ability of a contact lens is one of its most essential properties because high friction on an eyelid causes discomfort during blinking.Friction measurements allow assessment of lubrication ability.So far,several apparatuses have been developed to measure contact lens friction.However,thus far,ocular physiological conditions including sliding speed and area have been imperfectly realised.Herein,a pendulum-type friction tester was developed for the assessment of contact lenses under physiological conditions.A high sliding speed of 90 mm/s was achieved thanks to the short oscillation period of the small pendulum.Physiologically,the sliding surface on a contact lens was realised at the fulcrum of the pendulum.The coefficient of friction for the interaction between a contact lens and plastic hemisphere was directly calculated from the decay in potential energy during the free libration of the pendulum.Friction coefficient of a commercially available contact lens in saline solution,0.1%and 0.3%HA solutions were 0.036,0.039 and 0.050,respectively.These results were reliable because they ranged within the low levels reported by previous studies.It was shown that the present pendulum machine represents a major advancement in the realisation of physiologically realistic contact lens friction measurement.