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.

Support from Healthcare Professionals for Couples/Partners Undergoing Assisted Reproductive Technology in Japan: A Literature Review

Background and Purpose: A growing number of couples/partners have been undergoing assisted reproductive technology (ART) in Japan. The purpose of this study was to clarify the support from healthcare professionals based on the support vectors in the Family Care/Caring Theory proposed by Hohashi (2015) through a literature review. Methods: Using Ichushi-Web, we searched for original articles using the keywords “assisted reproductive technology”, “infertility”, “family”, “couple”, “nursing”, “care”, and “support”. Thirteen articles suitable for the purpose of this study were subjected to content analysis. Family support was encoded and grouped into subcategories and categories, and classified according to support vectors. Results: A total of 21 categories of support from healthcare professionals was extracted. Intervention for family internal environment included seven categories, such as “Nursing professionals stay close to females”. Intervention for family system unit included five categories, such as “Nursing professionals adjust couple/partner relationships”. Intervention for micro system only included “Nursing professionals provide opportunities for peer support to the couples/partners” and intervention for macro system only included “Nursing professionals encourage medical doctors to relate to females”. Intervention for family chrono environment included seven categories, such as “Healthcare professionals resolve female’s anxieties”. Conclusion: The support from healthcare professionals could be organized by the support vectors of Family Care/Caring Theory, but intervention for supra system (culture, religion, etc.) was lacking. Moreover, because most support was directed toward females or couples/partners, male-focused direct and/or indirect support are also needed. .

Critical approaches in the catalytic transformation of sugar isomerization and epimerization after Fischer-History,challenges,and prospects

The transformation of aldose to ketose or common sugars into rare saccharides,including rare ketoses and aldoses,is of great value and interest to the food industry and for saccharidic biomass utilization,medicine,and the synthesis of drugs.Nowadays,high-fructose corn syrup(HFCS)is industrially produced in more than 10 million tons annually using immobilized glucose isomerase.Some low-calorie saccharides such as tagatose and psicose,which are becoming popular sweeteners,have also been produced on a pilot scale in order to replace sucrose and HFCS.However,current catalysts and catalytic processes are still difficult to utilize in biomass conversion and also have strong substrate dependence in producing high-value,rare sugars.Considering the specific reaction properties of saccharides and catalysts,since the pioneering discovery by Fischer,various catalysts and catalytic systems have been discovered or developed in attempts to extend the reaction pathways,improve the reaction efficiency,and to potentially produce commercial products.In this review,we trace the history of sugar isomerization/epimerization reactions and summarize the important breakthroughs for each reaction as well as the difficulties that remain unresolved to date.

Mothers’challenges and experiences of children with cerebral palsy:a qualitative meta-synthesis

Objective:To examine what challenges and experiences a mother faces in caring for children with cerebral palsy(CP).As the main caregiver of children with CP,mothers are under multiple pressures.Even though mothers’challenges and experiences of children with CP will affect their quality of life and the rehabilitation of the children,little is known about their challenges and experiences during the whole care.Methods:A qualitative meta-synthesis was conducted to extract and analyze qualitative research from the PubMed,CINAHL,PsycINFO,Web of Science,Ovid and MEDLINE databases.Thirteen articles were selected and analyzed using thematic syntheses.Results:From 2522 screened abstracts,84 texts were reviewed,and 13 studies met the inclusion criteria.Mothers’challenges and experiences of children with CP include 4 themes,both positive and negative.Conclusions:The mothers of children with CP suffer from physical burden,as well as psychological pressure,in the care experience;social and healthcare support are their main challenges.Interventions to help them face the difficulties and adapt to the role of caregivers as soon as possible should target multiple aspects in order to maximize effectiveness,to promote the healthy growth of children with CP.

Comparison of Gluteal Muscle Intramuscular Injection Sites of Japanese Healthy Subjects: Considerations for Optimal Insertion of Injection Needle Length

Long Acting Injectable (LAI) medications for patients with schizophrenia is commonly administered to relieve their symptoms. Through shared decision-making and clinical evidence-based, psychiatrists should systematically offer LAIs to all patients requiring long-term antipsychotic treatment as a first-line treatment. Gluteal intramuscular (IM) injection requires accurate insertion of needles into the specific muscle area, often the outer upper quadrant of the buttocks, in order to achieve the required blood concentration. The purposes of this study were to compare the “Distance from the Epidermis to the Under-Fascia (DEUF)” and “Distance from the Epidermis to the Iliac Bone (DEB)” of the buttocks IM injection sites at the dorsogluteal and ventrogluteal sites among healthy Japanese volunteer subjects, and to identify the optimal insertion injection needle length. The DEUF and DEB at the gluteal regions were measured by ultrasonography. Welch’s one-way analysis of variance was used to compare the DEUF and the DEB at the gluteal IM injection regions. There was no statistically significant difference observed between the right and left mean values of DEUF for Hochstetter and Clark’s point at the ventrogluteal sites, and the Four and Three-way split or Double Cross point at the dorsogluteal sites. However in the DEB, the Hochstetter’s point (P < 0.01) at ventrogluteal site on the right side, and Clark’s point (P < 0.05) were significantly shorter than the Double Cross point at dorsogluteal sites (F = 4.38). The left buttocks Hochstetter’s point was significantly shorter than the Double Cross point (F = 4.38, P < 0.01). These results, however, did not establish a statistically significant difference in the DEUF among injection sites. It was considered that the difference in the DEB depended on muscle volume and thickness in the gluteal injection sites.

Current Situations and Challenges Concerning Sexual Health among Unmarried Couples Composed of a Mix of Japanese, South Korean Nationals, and Ethnic Koreans Born in Japan (<i>Zainichi</i>): A Qualitative Study

South Korean nationals are heavily represented in Japan’s foreign population, making up around 20% of all foreign residents in the country. Koreans in Japan can be viewed in two groups: Korean nationals who work or study in Japan, and those of Korean ancestry who were born in Japan or otherwise have historical reasons for residency (commonly called zainichi). There are certain differences seen in gender roles and Confucianism-based traditional culture among Japanese, South Korean nationals, and zainichi. This qualitative study examined consciousness and attitudes about marriage, family planning, and work-life balance in unmarried couples among these three groups. Semi- structured interviews were conducted with five unmarried couples comprising two members from the above three groups (age range: 20 - 35 years), residing in the Kinki region of western Japan. Twelve categories, 25 subcategories, and 79 codes were extracted from 636 contexts. Values regarding sexual health were analyzed from four viewpoints: marriage, family planning, work-life ba- lance, and sexual concerns. The results showed that the couples thought positively about marriage and family planning, while they had several sources of anxiety related to Confucian values and problems stemming from their different nationalities/roots. It is possible that gender roles and Confucian beliefs affect their sexual health. The study underscores that health professionals should provide pertinent knowledge and skills about family planning and child rearing, as well as premarital sexual health counselling, for unmarried couples composed of Japanese, South Korean nationals, and zainichi.

Effects of Pre-Schooler Lifestyle on the Circadian Rhythm of Secretory Immunoglobulin A

Assuming that secretory immunoglobulin A (s-IgA) in pre-schoolers is influenced by wake-up time, bedtime, sleeping duration and activity, the current study examined the influence of basic pre-schooler lifestyle on the circadian rhythm of s-IgA. We conducted a questionnaire survey on lifestyle and measured steps, heart rate and salivary s-IgA in 44 pre-schoolers aged 4 or 5 years old. Saliva was collected over 2 days at six time points: bedtime, upon waking up, upon arriving at nursery school, before lunch, after lunch and upon going home. To obtain relatively reliable s-IgA values, the s-IgA concentration/total protein concentration ratio (referred to as s-IgA/T.P.) was calculated. Relationship between the s-IgA/T.P. and heart rate, steps, wake-up time, bedtime and sleeping duration was then examined using Pearson’s correlation coefficient. Accordingly, pre-schooler lifestyle had the following effect on circadian rhythm of s-IgA: 1) s-IgA/T.P. values were higher upon waking up than at other measurement time points;2) pre-schoolers with considerable physical activity had high s-IgA/T.P. at bedtime and upon waking up;and 3) pre-schoolers with long sleeping durations and early bedtime had high s-IgA/T.P. upon waking up. Thus, our results confirmed that pre-schoolers’ lifestyle habits, such as bedtime, sleeping duration, physical activity, had an effect on the circadian rhythm of s-IgA.

Relationship among Health Related Quality of Life, Quality of Sleep, and Oral Health Condition

Japan’s aging rate (ratio of elderly aged 65 and older to total population) has exceeded 20%. The aim of this study was to clarify the relationships between Health Related Quality of Life, Body Mass Index (BMI), and sleep quality. Subjects were 51 adults over 55 years old with chronic disease who living in the community. Instruments and structured interviews were used giving due consideration to privacy. Interviews were conducted within 10 - 20 minutes at the out-patient department. The evaluation instruments included bodymass index, Pittsburgh Sleep Quality Index (PSQI), Health Related Quality of Life (HRQOL), and Oral Health Impact Profile (OHIP-14). A significant positive correlation (ρ = 0.321, p < 0.05) between PSQI and QOL (OHIP-14) scores was confirmed with sleep quality being lower with lower QOL scores. A negative correlation (ρ = ?0.339, p < 0.05) between physical health component summary scores (PCS) and mental health component summary scores (MCS) of HRQOL was confirmed, demonstrating that PCS was low, and the level of MCS was high. Sleep quality was found lower among those with lower oral health-related QOL scores. Moreover, in subjects with lower MCS scores, the PCS scores were found to be higher. Accordingly, it was considered appropriate that dental treatment and care, support the maintenance of activities and sleep, and mental health promotion which are likely requisites critical for elderly persons’ maintenance of independent lifestyles in their familiar community.

Relationship among Sleep Quality Physical Health Conditions and Lifestyle Habits among Elementary School Students

The purpose of this research was to reveal the relationship among students’ sleep quality, body temperature and lifestyle habits, growth and their physical strength. Subjects were 226 elementary school students from first grade to sixth grade, in four elementary schools at the Chugoku and Shikoku areas in Japan. The study period was from October 2014 to December 2015. Evaluation items used were the PSQI (Pittsburgh Sleep Quality Index, Japanese version), body temperature, lifestyle habits, and national physical fitness test. Relationships were analyzed using Pearson’s chi square test, Fisher’s exact test, residual analysis, φ-coefficient, odds ratio and 95% confidence interval, and Spearman’s rank correlation coefficient using SPSS 20 (SPSS Inc., Chicago, IL, USA). The level of statistical significance was set at 0.05. The number of students with good sleep quality who showed less than six-point score at the PSQI was 218 (96.5%), and with poor sleep quality were eight students (3.5%). Especially, “sometimes do not eat breakfast” and “had difficulty sleeping” were independent risk factors for negative arousal. In the lifestyle habits, it was observed significantly that students who had a good sleep ate breakfast every morning. The significant positive correlation was between sleep quality and the time spent watching television, the age and the time using the internet. The significant negative correlation was observed between length of sleep, time spent watching television, using internet and playing games, body temperature and age. The students with temperature of less than 36°C were 35 (15.5%). Those students did not eat breakfast every morning, or ate school lunch. This study revealed that sleep condition and temperature of elementary school students were related to eating breakfast and using media time. It was considered very important to educate the students and their guardians that eating breakfast is a necessity and adjusting the use of multimedia, so that students can acquire desirable lifestyle habits.

Actual Status of Healthy Lifestyle Habits of Public Health Nurses in Japan

Background: The public health nurse should make efforts to keep his/her own mental and physical health good, which is the professional responsibility. However, a variety of challenging issues have been pointed out with regard to well-being of healthcare professionals. Public health nurses are likely to face some difficulties in their habits of leading healthy lifestyles. The purpose of this study was to identify how Japanese public health nurses actually live their healthy lives. Methods: This study covered 1725 public health nurses in the Chugoku/Shikoku Region. We conducted an anonymous self-completed questionnaire survey. As basic attributes, the following 6 categories were set. The health practice indices used in this research consisted of the 7 practices of Breslow’s Health Practice Index (B-HPI), the Morimoto’s 8 practices, and 6 practices related to lifestyle habits that have been developed independently by the authors of this research (Health Lifestyle Index (HLI)), that is, 16 practices in total. The study plan was approved by the Ethics Committee of Okayama University. Results: We analyzed the 960 (55.7%) valid responses. This survey has demonstrated that the healthy life-style practices of public health nurses are generally good. However, there were some practices such as eating between meals, having little physical activity, and not having a good rest/sleep, that need to be improved. None of the assessment tools correlated with the length of experience. Conclusions: This survey has clarified that the healthy lifestyle practices of public health nurses did not correlated with their length of experience, indicating that the healthy lifestyle practices are not intensified by the accumulated career experience as public health nurses.

The Relationship among Chronic Disease, Feeling-for-Their-Age, Sleep Quality, Health-Related Quality of Life and Activities of Daily Living of Community-Dwelling Persons over 55 Years of Age

Japan’s aging population rate is increasing and healthy life expectancy has decreases by 10 years shorter than average life expectancy. The aim of this study is to determine the relationship among chronic disease, sleep quality, health-related quality of life (HRQOL), and activities of daily living in people over 55 years old who live in the community. Subjects were 161 persons aged 57 to 90 years who were treated with chronic disease in the outpatient department of the A hospital. Exclusion criteria included patients with dementia, cancer and severe heart disease. The survey evaluation questionnaires included the Pittsburgh Sleep Quality Index (PSQI), HRQOL by Short-Form 8 Health Survey (SF-8), and activities of daily living. Variables associated with quality of sleep, HRQOL in univariate analysis with p < 0.05 were entered into multivariate analysis using logistic regression with a stepwise forward selection procedure to determine independent variables and their association with major causes. The logistic regression analysis was done using SPSS software and the post-hoc power of the study was estimated using G*power. The level of significance was set at p < 0.05. The risk factor of poor sleep quality was because of history of cancer [odds ratio (OR): 3.53, 95% confidence interval (CI): 1.06 - 11.77], and insomnia (OR: 3.25, 95% CI: 1.55 - 6.79). The risk factors of poor physical HRQOL were motor disease (OR: 2.62, 95% CI: 1.36 - 5.07), respiratory disease (OR: 3.24, 95% CI: 1.27 - 8.26) and having pain (OR: 11.71, 95% CI: 5.35 - 25.66). In addition, anemia was found to be a risk factor of poor mental HRQOL (OR: 4.87, 95% CI: 1.11 - 21.33). The feeling-for-their-body-age (OR: 0.30, 95% CI: 0.15-0.59) was as “younger than actual age” and advanced the risk factor of poor sleep quality. In addition, feeling-for-their-age (OR: 0.44, 95% CI: 0.21 - 0.92) resulted in reduced risk factor of poor physical HRQOL. The risk factor of poor sleep quality was due to a patient with history of cancer. The factor for good sleep quality and the good factor for physical HRQOL were indications of feeling younger than the actual age.

Survey on the Amount of Physical Activity and Self-Esteem of School Age Students in A Town in Japan

This study aimed to clarify the amount of physical activity, lifestyle, and self-esteem of elementary school students living in Aomori Prefecture Japan. The subjects were ninety-one elementary school students in the 4th to 6th grades who live in A town. The subjects were asked to fill out a questionnaire about lifestyles and self-esteem and to wear the lifestyle-related recorder Life Coder GS® (Suzuken, Japan) for a total of four days, two weekdays and two holidays. The results showed the amount of exercise such as the number of steps taken was significantly higher on weekdays than on holidays. There was no difference by gender or classification of obesity. In addition, when they go to school on foot, the number of steps and fast walking time was significantly higher than when using the bus. Screen times of holidays were significantly longer than those of weekdays. The number of steps on holidays was negatively correlated with screen time, and positively correlated with the factor of “self-assertion/self-determination” of self-esteem scale. Health promotion is needed so that the entire community, including family and friends, can develop daily physical activities.

Longitudinal Evaluation Nocturnal Sleep Behaviors of Healthy and Well Developed Children Born Prematurely

The aim of the study is to examine nocturnal sleep measures of healthy and well developed pre-term infants by birth weight when they were averaged 15 corrected months and became elementary school children. Sleep measures were collected by actigraphs (Micro-mini RC, Ambulatory Monitoring Inc., New York, USA). Nocturnal sleep quality of children born as extremely low birth weight (ELBW) was significantly inferior with that of children born as very low birth weight (VLBW) at 15 corrected months [number of night waking: 6.0 (4.5 - 8.0), ELBW 8.5 (7.0 - 10.3) (Z = 2.47, p < 0.01), wake after sleep onset: VLBW 99.0 (73.0 - 115.0) min, ELBW 146.5 (94.8 - 171.3) min (Z = 2.89, p < 0.01)]. However, these measures did not show any significant differences by birth weight at second data collection period [number of night waking: VLBW 0.0 (0.0-1.0), ELBW 1.0 (0.0 - 2.5) (Z = —0.62, n.s.), wake after sleep onset: VLBW 16.0 (8.0 - 27.0) min, ELBW 15.0 (6.0 - 32.5) min (Z = 0.00, n.s.)]. It was assumed that nocturnal measures were affected by the birth weight at the age of 15 corrected months in ELBW infants, but could not predict the future sleep problems at this point.

The Shift of the Ischial Region during Maneuvering the Standard Wheelchair and the Electric Wheelchair in Healthy Adults

Pressure injuries are frequent secondary complications that occur in patients with Spinal Cord Injury (SCI), and the recurrence rate of ischial pressure injury is highest in SCI patients. Most SCI patients use wheelchairs, and some studies have shown a relationship between buttock pressure and sitting posture. However, the pressure distribution during wheelchair maneuvering is unclear. We measured and compared the shift of the ischial region when maneuvering a standard wheelchair or electric wheelchair in healthy adults. The subjects drove wheelchairs on a flat ground of 10 m and the shift of ischial region was measured with a pressure distribution-measuring device. The ischial region shifted forward or backward while maneuvering both the standard wheelchair and the electric wheelchair, and the shift rate of the ischial region was not significantly different between the standard wheelchair and the electric wheelchair. The ischial region shift occurred when the forward head moved by the video while maneuvering both a standard wheelchair and an electric wheelchair. Therefore, the shift might occurred because the pelvis shifted forward in conjunction with head movement during maneuvering of both the standard wheelchair and the electric wheelchair. This result showed that it is important to reduce head and trunk movements when maneuvering a wheelchair to reduce the shear force on the buttocks and prevent pressure injuries.

A Study of Hie and LBP: The First Step to Improve Subjective Well-Being

Backgrounds: Health does not only physical health, therefore, we need to study it from various viewpoints. Many Japanese female complain of a Hie or a low back pain (LBP), which they reduce their subjective well-being. We analyze. Those patients often have acupuncture therapy. In this study, we analyze the characteristics of Hie and LBP, the satisfaction level of alternative therapy and we pursue a tip to improve subjective well-being. Methods: Of 1000 women, Hie (+)/Hie (−) or LBP (+)/LBP (−), we compared their body temperature (BT) (axilla) and body mass index (BMI). Furthermore, the Chi test identified ten factors of “body” and seven “mind” information. Results: In the result of BT (axilla) while LBP indicated a significant difference. Both Hie and LBP showed difference in the opposite direction. Hie did now show such clear differences in “body” information. However, interestingly, all seven questions in the “mind” information showed statistical difference. Discussion and conclusion: One reason why those patients have acupuncture therapy may acupuncture therapy traditionally has not separate “mind” and “body” and it has the concept of “mind-body unity”. To improve subjective well-being, first we need to focus on “Mind” as well as “mind-body unity”. Mental-health support is important for patients with Hie or LBP to reduce physiological stress.

Analysis of Emotions Using Multimodal Data: A Case Study

In this case study, we hypothesized that sympathetic nerve activity would be higher during conversation with PALRO robot, and that conversation would result in an increase in cerebral blood flow near the Broca’s area. The facial expressions of a human subject were recorded, and cerebral blood flow and heart rate variability were measured during interactions with the humanoid robot. These multimodal data were time-synchronized to quantitatively verify the change from the resting baseline by testing facial expression analysis, cerebral blood flow, and heart rate variability. In conclusion, this subject indicated that sympathetic nervous activity was dominant, suggesting that the subject may have enjoyed and been excited while talking to the robot (normalized High Frequency < normalized Low Frequency: 0.22 ± 0.16 < 0.78 ± 0.16). Cerebral blood flow values were higher during conversation and in the resting state after the experiment than in the resting state before the experiment. Talking increased cerebral blood flow in the frontal region. As the subject was left-handed, it was confirmed that the right side of the brain, where the Broca’s area is located, was particularly activated (Left < right: 0.15 ± 0.21 < 1.25 ± 0.17). In the sections where a “happy” facial emotion was recognized, the examiner-judged “happy” faces and the MTCNN “happy” results were also generally consistent.

Involvement of Dectin-2 in the Innate Inflammatory Response Triggered by Influenza Virus Hemagglutinin

C-type lectin receptors (CLRs) are representative pattern recognition receptors that recognize microbial polysaccharides expressed on antigen-presenting cells. In the present study, we carried out further detailed analysis on the involvement of Dectin-2, a CLR that senses high mannose polysaccharide, in innate immune responses induced by influenza virus hemagglutinin (HA). Treatment of HA with periodate or PNGase F induced lower interleukin (IL)-12p40 secretion by conventional dendritic cells (DCs) compared with the untreated group. In contrast, treatment with O-glycosidase did not affect cytokine production. Green fluorescent protein expression in canonical Dectin-2-transducing cells was approximately 3% - 12% following HA stimulation, except with the A/H1N1pdm09 subtype HA. This expression was markedly reduced in cells possessing mutated amino acids in the carbohydrate recognition domain of Dectin-2, especially following stimulation with HA derived from the A/H3N2 subtype. Interferon (IFN)-α production from CD11c+Siglec-H+PDCA-1+ plasmacytoid DCs was significantly increased in Dectin-2 knockout mice compared with wild-type mice upon stimulation with HA except for the B/Yamagata lineage HA. These results suggested that Dectin-2 is involved in initiating inflammatory responses via mannose polysaccharide on HA. However, other mechanisms may function in the antiviral response, including the type I IFN axis.

Effects of Neuromuscular Electrical Stimulation in Combination with Glutamine Administration on Skeletal Muscle Atrophy in Colon-26 Tumor-Bearing Mice

The depressed protein synthetic response,a phenomenon termed anabolic resistance,has been shown to be involved in muscle wasting induced by cancer cachexia.Moreover,a positive relationship between the protein synthetic rate and intracellular glutamine(GLN)concentration has been found in skeletal muscles.This study investigated the effects of neuromuscular electrical stimulation(ES)and GLN administration on muscle wasting and GLN metabolism in colon-26(C-26)tumor-bearing mice.CD2F1 mice were divided into 8 groups:control(CNT),CNT+ES,CNT+GLN,CNT+ES+GLN,C-26,C-26+ES,C-26+GLN,C-26+ES+GLN.Cancer cachexia was induced by subcutaneous injection of C-26 cells and developed for four weeks.ES was performed on the left plantar flexor muscles every other day,and GLN(1 g/kg)was administered daily intraperitoneally starting one day after the C-26 injection.Tumor-free body mass and fast-twitch gastrocnemius(Gas)muscle weight were lower in the C-26 group than in the CNT group(-19%and-17%,respectively).Neither ES training nor GLN administration,alone or in combination,ameliorated the loss of Gas muscle weight in the C-26 mice.However,ES training in combination with GLN administration inhibited the increased expression of GLN synthetase(GS)in the C-26 muscles.Thus,it is likely that GLN plays a critical role in muscle protein metabolism and,therefore,can be targeted as a tentative treatment of cancer cachexia.

Therapeutic Communication Methods Targeting Families and Family Members: A Literature Review

Background and Purpose: Therapeutic communication is a new term in family health care nursing, defined by Hohashi (2019) as a method of family intervention, and characterized by inclusion of not only verbal conversation but also nonverbal interaction. However, specific therapeutic communication methods have not been systematized. The purpose of this study was to clarify therapeutic communication methods for families/family members from the perspectives of verbal communication and non-verbal communication through a review of existing literature. Methods: We conducted a search using the medical literature databases PubMed and Ichushi-Web using the keywords “therapeutic communication”. Analysis was performed on seven articles from PubMed and 14 articles from Ichushi-Web that described therapeutic communication methods performed by healthcare professionals for families/family members. Through directed content analysis, therapeutic communication methods were subcategorized, and classified into three categories: verbal communication, non-verbal communication, and verbal/non-verbal communication. Results: A total of 23 subcategories were extracted. Verbal communication included 11 subcategories, such as “asking questions using the communicatee’s words as they are”. Non-verbal communication included five subcategories, such as “noticing changes in the content of the communicatee’s story”. And verbal/non-verbal communication featured seven subcategories, such as “making the communicatee aware of one’s own beliefs”. Conclusion: Therapeutic communication methods included basic care/caring in family interviews/meetings, as well as verbal communication and non-verbal communication that act on family/family members’ beliefs. It is believed that changes in family/family members’ beliefs can be used to eliminate, reduce, or improve problematic conditions in the family. .

Molecular mechanism underlying the functional loss of cyclindependent kinase inhibitors p16 and p27 in hepatocellular carcinoma

Hepatocellular carcinoma(HCC)is one of the most common human cancers,and its incidence is still increasing in many countries.The prognosis of HCC patients remains poor,and identification of useful molecular prognostic markers is required.Many recent studies have shown that functional alterations of cell-cycle regulators can be observed in HCC.Among the various types of cell-cycle regulators,p16 and p27 are frequently inactivated in HCC and are considered to be potent tumor suppressors.p16,a G1-specific cell-cycle inhibitor that prevents the association of cyclindependent kinase(CDK)4 and CDK6 with cyclin D1,is frequently inactivated in HCC via CpG methylation of its promoter region.p16 may be involved in the early steps of hepatocarcinogenesis,since p16 gene methylation has been detected in subsets of pre-neoplastic liver cirrhosis patients.p27,a negative regulator of the G1-S phase transition through inhibition of the kinase activities of Cdk2/cyclin A and Cdk2/cyclin E complexes,is now considered to be an adverse prognostic factor in HCC.In some cases of HCC with increased cell proliferation,p27 is overexpressed but inactivated by sequestration into cyclin D1-CDK4-containing complexes.Since loss of p16 is closely related to functional inactivation of p27 in HCC, investigating both p16 and p27 may be useful for precise prognostic predictions in individuals with HCC.