Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 139.658
Filtrar
1.
Rinsho Ketsueki ; 62(8): 1060-1069, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-34497192

RESUMO

Myeloproliferative neoplasms (MPN) are caused by somatic mutations in hematopoietic stem/progenitor cells and result in excessive increase in the blood cell mass in the peripheral blood and/or fibrosis in the bone marrow. JAK2, CALR, and MPL mutations are well-known driver mutations of MPN and are widely applied as diagnostic markers of MPN. Moreover, several studies using massive parallel sequencing technologies have shown that mutations in ASXL1, EZH2, SRSF2, and IDH1/2 affect the prognosis of overt primary myelofibrosis and have further clarified that the mutation order may influence the MPN phenotype. More recently, our group identified that CREB3L1 mRNA was overexpressed in a platelet- and megakaryocyte-specific manner in driver mutation positive MPN and that the quantitation of this gene expression can be used as a diagnostic marker for MPN. In this educational lecture, we discuss the clinical impacts of the mutations frequently identified in MPN patients.


Assuntos
Transtornos Mieloproliferativos , Neoplasias , Calreticulina/genética , Humanos , Janus Quinase 2/genética , Japão , Mutação , Transtornos Mieloproliferativos/diagnóstico , Transtornos Mieloproliferativos/genética
2.
Rinsho Ketsueki ; 62(8): 1139-1148, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-34497201

RESUMO

Waldenström's macroglobulinemia or lymphoplasmacytic lymphoma (WM/LPL) is a rare subtype of indolent B-cell lymphoma with plasmacytic differentiation. Owing to its rarity, the pathogenesis, biology, and standard of care have not been established. In 2012 the MYD88 L265P mutation is proven as the major oncogenesis in WM/LPL; therefore, the pathogenesis and underlying biology of WM/LPL have been drastically explored. Furthermore, treatment options have also been developed, and Bruton's tyrosine kinase (BTK) inhibitor has been recently approved for untreated and relapsed/refractory WM/LPL in August 2020 in Japan. In this article, after a brief review of the clinical and biological characteristics of WM/LPL, we discuss the ideal therapeutic algorithm, including novel BTK inhibitor.


Assuntos
Linfoma de Células B , Macroglobulinemia de Waldenstrom , Algoritmos , Humanos , Japão , Mutação , Macroglobulinemia de Waldenstrom/diagnóstico , Macroglobulinemia de Waldenstrom/tratamento farmacológico , Macroglobulinemia de Waldenstrom/genética
3.
Rinsho Ketsueki ; 62(8): 1149-1159, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-34497202

RESUMO

Multiple myeloma has been known as an incurable disease; however, since the approval of bortezomib in Japan in 2006 as the treatment for relapsed and refractory multiple myeloma, novel agents such as immunomodulatory drugs (IMIDs) and antibodies have been introduced one after another. Hence, progression-free survival and overall survival rates have markedly improved, regardless of the transplantation indication, and we have entered an era of a possible cure. Now that long-term survival can be expected, some clinical issues exist: 1) when to start treatment, 2) what regimen to choose for initial treatment, 3) how to continue treatment including maintenance therapy, 4) what to do for supportive care, and 5) what to choose for relapse treatment. The answers to these questions should be revised year-by-year according to the evidence from new clinical trials. This paper will discuss the current state of knowledge based on the latest evidence on treatment strategies for patients with myeloma who are ineligible for transplantation.


Assuntos
Mieloma Múltiplo , Anticorpos Monoclonais/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bortezomib/uso terapêutico , Humanos , Japão , Mieloma Múltiplo/tratamento farmacológico
4.
Rinsho Ketsueki ; 62(8): 1178-1185, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-34497205

RESUMO

During the nosocomial coronavirus disease 2019 (COVID-19) outbreak, patients with hematological disorders showed poorer survival and aggressive course of respiratory failure than patients with other disorders. Two patients with immune thrombocytopenia who were being treated with prednisolone experienced severe respiratory failure related to COVID-19 and finally died. Patients who were yet to achieve remission and those receiving chemotherapy with steroids had a higher risk of death, and the mortality rate was higher in patients with lymphoid malignancies, including lymphoma and myeloma, than in those with myeloid malignancies. We describe the case of a myeloma patient in whom high-dose steroid administration was able to achieve considerable resolution of respiratory failure. In patients with unsuccessful seroconversion of anti-SARS-CoV-2 IgG antibodies, recurrence or re-infection of COVID-19 should be closely monitored.


Assuntos
COVID-19 , Pandemias , Anticorpos Antivirais , Humanos , Japão/epidemiologia , Recidiva Local de Neoplasia , SARS-CoV-2
5.
Rinsho Ketsueki ; 62(8): 1247-1255, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-34497213

RESUMO

Blood transfusion, which has been conducted as a basic medical procedure since 17th century, is a supportive therapy to compensate loss of each blood component. All blood materials are donated, and alive and subject to decay, type-dependent for transfusion, vary in quality, may induce severe adverse reactions, such as anaphylaxis, and may transmit infectious agents. Therefore, not only the scientific and clinical decisions but also ethical considerations should be focused on for their use. All blood products are determined as "Products Derived from Specific Organism" by the Pharmaceutical and Medical Devices Law in Japan. Of note, blood management systems are different among countries; the Japanese Red Cross Society is a unique organization that collects and manufactures blood products under supervision of the Japanese Government. It establishes a hemovigilant system by which it collects all the information concerning transfusion-related adverse events and provides them to the responsible transfusion service staff of each hospital. Physicians should check all the information from the Japanese Red Cross and refer both the "Guidelines for Blood Transfusion" and "Guidelines for the Usage of Blood Products" by the Ministry of Health, Labor and Welfare for transfusion practice.


Assuntos
Anafilaxia , Reação Transfusional , Transfusão de Componentes Sanguíneos , Transfusão de Sangue , Humanos , Japão
6.
Rinsho Ketsueki ; 62(8): 1349-1356, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-34497226

RESUMO

Conflict of interest (COI) is a conflict between related parties, such as researchers, research institutions, academic societies, and third parties (commercial companies and patients). COI sometimes twists research and clinical practice, resulting in the profit instruction of related individuals or organizations. In medical research, high ethical standards are demanded to protect human rights, life, and safety of study participants, and COI must be properly enforced to maintain study fairness and ensure transparency. In Japan, the Japanese Association of Medical Science issued COI guideline in 2017, which formed the basis of many societies in making their common COI guidelines. The Japanese Society of Hematology issued COI management guideline in 2018 and is strictly managing COI of its members, organization, and clinical guideline committee members. As industry-academia collaboration activities become more active, the concept of COI is deepening; therefore, appropriate COI disclosure should be conducted based on recent trends to promote sound research and business activities.


Assuntos
Conflito de Interesses , Hematologia , Revelação , Humanos , Japão , Sociedades Médicas
7.
Rinsho Ketsueki ; 62(8): 914-921, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-34497231

RESUMO

Thalassemia is caused by a reduced production of one globin chain due to a quantitative imbalance between the α-globin and non-α-globin chains that make up the hemoglobin. It is classified into α- and ß-thalassemia and characterized by microcytosis with polycythemia, and a Mentzer index of ≤13 aids in the diagnosis. In the genetic analysis of α-thalassemia, the Southeast Asian type was found to be the most common genetic subtype among Japanese and non-Japanese without a substantial difference. Conversely, the genetic analysis of ß-thalassemia revealed differences in the types and frequencies of mutations between Japanese individuals and foreigners living in Japan, with Japanese-specific mutations such as -31 A→G (TATA box). Acquired α-thalassemia exists in exceptional cases, and cases of myelodysplastic syndrome with acquired Hemoglobin H disease have been reported as α-thalassemia myelodysplastic syndrome. Recent trials using a novel therapeutic agent, luspatercept, for transfusion-dependent ß-thalassemia revealed that luspatercept safely and significantly reduces the transfusion volume.


Assuntos
Talassemia alfa , Talassemia beta , Transfusão de Sangue , Humanos , Japão/epidemiologia , Mutação , Talassemia alfa/diagnóstico , Talassemia alfa/epidemiologia , Talassemia alfa/genética , Talassemia beta/diagnóstico , Talassemia beta/epidemiologia , Talassemia beta/genética
8.
Rinsho Ketsueki ; 62(8): 978-987, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-34497238

RESUMO

Recurrence in acute myeloid leukemia (AML) is a major barrier in patients who achieve complete remission after induction of remission and consolidation therapy and desire long-term survival. Allogeneic hematopoietic stem cell transplantation lowers recurrence risk in patients; however, recurrence is common even after transplantation. Many maintenance therapies for AML aim to lower recurrence risk; therefore, research has focused on identifying drugs with a tolerable adverse-effect profile. Thus far, many trials of cytotoxic anticancer drugs used in maintenance therapy have showed no improvement in survival rates. In contrast, recent studies on immunomodulation, epigenetics, molecular-targeted drugs, etc. have demonstrated promising results. Therefore, we plan to review various maintenance therapies, such as immunotherapy, demethylating agents, and targeted therapies (including fms-like tyrosine kinase 3 inhibitors in particular) based on the current evidence. Moreover, we describe a new strategy that incorporates the assessment of measurable minimal residual disease.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Leucemia Mieloide Aguda , Preparações Farmacêuticas , Humanos , Japão , Leucemia Mieloide Aguda/tratamento farmacológico , Uso Off-Label , Indução de Remissão
9.
Medicine (Baltimore) ; 100(36): e27105, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34516501

RESUMO

ABSTRACT: To assess the general Japanese population's thoughts on coronavirus disease of 2019 related discrimination by Tweets.Tweets were retrieved from search queries using the keywords "health care providers and discrimination (no hashtags)" and "corona and rural area (no hashtags)" via the Twitter application programming interface. Subsequently, a text-mining analysis was conducted on tokenized text data. R version 4.0.2 was used for the analysis.In total, 51,906 tweets for "corona and health care providers", 59,560 tweets for "corona and rural" were obtained between the search period of July 29, 2020 and September 30, 2020. The most common 20 words from the tokenized text data were translated to English. Word clouds with the original Japanese words are presented.Tweets for corona and health care providers did not suggest significant evidence of discrimination toward health care providers on Twitter. Results for corona and rural area, however, showed the unexpected word "murahachibu" (an outmoded word meaning ostracism), suggesting persistent strong social pressure to prevent bringing the disease to the community. This kind of pressure may not be supported by scientific facts. These results demonstrate the need for continued educational efforts to disseminate factual information to the public.


Assuntos
COVID-19/epidemiologia , Mineração de Dados , Pessoal de Saúde , SARS-CoV-2 , Isolamento Social , COVID-19/psicologia , Humanos , Japão/epidemiologia , Pandemias
10.
Math Biosci Eng ; 18(5): 6506-6526, 2021 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-34517543

RESUMO

As of April 2021, the coronavirus disease (COVID-19) continues to spread in Japan. To overcome COVID-19, the Ministry of Health, Labor, and Welfare of the Japanese government developed and released the COVID-19 Contact-Confirming Application (COCOA) on June 19, 2020. COCOA users can know whether they have come into contact with infectors. If persons who receive a contact notification through COCOA undertake self-quarantine, the number of infectors in Japan will decrease. However, the effectiveness of COCOA in reducing the number of infectors depends on the usage rate of COCOA, the rate of fulfillment of contact condition, the rate of undergoing the reverse transcription polymerase chain reaction (RT-PCR) test, the false negative rate of the RT-PCR test, the rate of infection registration, and the self-quarantine rate. Therefore, we developed a Susceptible-Infected-Removed (SIR) model to estimate the effectiveness of COCOA. In this paper, we introduce the SIR model and report the simulation results for different scenarios that were assumed for Japan.


Assuntos
COVID-19 , Simulação por Computador , Humanos , Japão , Quarentena , SARS-CoV-2
11.
BMC Musculoskelet Disord ; 22(1): 786, 2021 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-34517874

RESUMO

BACKGROUND: Hallux rigidus (HR) is a common osteoarthritis of the first metatarsophalangeal joint. However, the epidemiology and risk factors of this pathology have yet to be clarified. METHODS: We have been conducting cohort studies among individuals over 50 years old every 2 years since 1997. This study analyzed data from the 7th to 10th checkups in 2009, 2011, 2013, and 2015. We investigated the prevalence of HR and its risk factors in a total of 604 individuals (mean age, 67.1 ± 6.4 years; 208 men, 396 women). Radiographic HR was defined as Hattrup and Johnson classification grade 1 or higher. Knee osteoarthritis (KOA) was scored according to the Kellgren-Lawrence grading system. Radiographic KOA was defined as grade 2 or higher. Cases with a hallux valgus (HV) angle of 20° or higher were defined as showing HV. Statistical analyses were performed using the Kruskal-Wallis test, Fisher's exact test, logistic regression modeling, and the Cochran-Armitage trend test. All p-values presented are two-sided and values of p < .05 were considered statistically significant. RESULTS: The prevalence of HR was 26.7% (161/604). Rates of grade 0, 1, 2, and 3 HR according to the Hattrup and Johnson classification were 73.3% (443/604), 16.4% (99/604), 8.0% (48/604), and 2.3% (14/604), respectively. Overall ratio of symptomatic HR was 8.1%. Univariate analysis revealed KOA, gout attack (GA), and HV as significantly associated with HR. The same factors were confirmed as independent risk factors for HR in multivariate analysis. All parameters were significantly associated with HR. Odds ratios of KOA, HV, and GA for HR were 1.73, 3.98, and 3.86, respectively. The presence or absence of KOA was significantly associated with severity of HR. CONCLUSIONS: This study revealed that the prevalence of HR in the elderly (≥50 years) was 26.7%. KOA, HV, and GA were independent risk factors for HR. KOA was associated with severity of HR.


Assuntos
Hallux Rigidus , Idoso , Estudos Transversais , Feminino , Hallux Rigidus/diagnóstico por imagem , Hallux Rigidus/epidemiologia , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco
12.
Anal Chem ; 93(36): 12162-12169, 2021 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-34473490

RESUMO

The goal of the qNMR Summit is to take stock of the status quo and the recent developments in qNMR research and applications in a timely and accurate manner. It provides a platform for both advanced and novice qNMR practitioners to receive a well-rounded update and discuss potential qNMR-related applications and collaborations. For over a decade, scientists from academia, industry, nonprofit institutions, and governmental bodies have focused on the standardization of qNMR methodology, as well as its metrological and pharmacopeial utility. This paper reviews key content of qNMR Summits 1.0 to 4.0 and puts into perspective the outcomes and available transcripts of the October 2019 Summit 5.0, with attendees from the United States, Canada, Japan, Korea, and several European countries. Summit presentations focused on qNMR methodology in the pharmaceutical industry, advanced quantitation algorithms, and promising developments.


Assuntos
Tecnologia , Canadá , Japão , Padrões de Referência , Estados Unidos
13.
Artigo em Inglês | MEDLINE | ID: mdl-34494947

RESUMO

Three Gram-positive bacterial strains, BML-BC004, BML-BC017 and BML-BC059, isolated from blood samples from three inpatients in Japan, were identified as members of Bacillus cereus using matrix-assisted laser desorption ionization time-of-flight MS. The 16S rRNA gene sequences of these three strains were more than 97.1 % similar to 18 type strains belonging to the B. cereus group. Whole-genome comparisons, using average nucleotide identity (ANI) and digital DNA-DNA hybridization (dDDH), confirmed that the three strains represented three individual distinct species belonging to the B. cereus group. A phylogenetic tree showed that BML-BC004, BML-BC017 and BML-BC059 were located close to B. luti, B. mobilis and B. paramycoides, respectively. Based on these phylogenetic and phenotypic data, including values below the threshold for ANI and dDDH, the three strains should be classified as representing three different novel species of the B. cereus group: Bacillus sanguinis sp. nov., with type strain BML-BC004T (=DSM 111102T=JCM 34122T), Bacillus paramobilis sp. nov., with type strain BML-BC017T (=DSM 111100T=JCM 34124T) and Bacillus hominis sp. nov., with type strain BML-BC059T (=DSM 111101T=JCM 34125T).


Assuntos
Bacillus cereus/classificação , Sangue/microbiologia , Filogenia , Bacillus cereus/isolamento & purificação , Técnicas de Tipagem Bacteriana , Composição de Bases , DNA Bacteriano/genética , Ácidos Graxos/química , Humanos , Japão , Hibridização de Ácido Nucleico , RNA Ribossômico 16S/genética , Análise de Sequência de DNA
14.
Anticancer Res ; 41(9): 4443-4446, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34475067

RESUMO

BACKGROUND: Androgen deprivation therapy (ADT) is one of the most effective treatments for advanced prostate cancer (PCa). However, it has been reported that the use of ADT is significantly associated with an increased risk of acute kidney injury (AKI) among patients with newly diagnosed non-metastatic PCa. We investigated changes in renal function that occurred in Japanese patients with PCa after ADT was discontinued. PATIENTS AND METHODS: Among 121 patients who underwent prostate biopsies, were pathologically diagnosed with PCa, and received ADT for ≥6 months at our Institution between 2009 and 2014, 60 patients who underwent radiotherapy for stage B or C PCa were eligible for inclusion in this retrospective study. Renal function was assessed using the estimated glomerular filtration rate (eGFR) before treatment and at 1, 3, 6, 9, and 12 months after the initiation of ADT and the rate of change in the eGFR (ΔeGFR) during ADT and after the discontinuation of ADT was investigated. We divided patients into two groups: Group 1 received ADT for 6 months, and group 2 received ADT for 12 months. Age; ΔeGFR; prostate-specific antigen, testosterone and hemoglobin levels; clinical stage; Gleason score; comorbidities; body mass index; heart rate; and the cardiothoracic ratio were analyzed. RESULTS: A total of 60 patients (group 1: n=23, group 2: n=37) were analyzed. The Gleason score of group 2 was higher than that of group 1 (p=0.0011). Regarding clinical stage, group 1 had more patients with stage B disease, and group 2 had more with stage C (p<0.0001). The eGFR decreased with the duration of ADT treatment. At 12 months, renal function had started to recover in group 1, while it had continued to decrease in group 2. CONCLUSION: Discontinuation of ADT tended to result in improvements in renal function. Furthermore, this study indicated that renal dysfunction caused by 6 months of ADT is transient. Normalization of the serum testosterone level seen after the discontinuation of ADT may be associated with improvements in renal function. Thus, intermittent ADT may be a useful treatment for PCa, as it would help to preserve renal function.


Assuntos
Antagonistas de Androgênios/efeitos adversos , Taxa de Filtração Glomerular/efeitos dos fármacos , Rim/fisiopatologia , Neoplasias da Próstata/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Antagonistas de Androgênios/uso terapêutico , Humanos , Japão , Rim/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/patologia , Estudos Retrospectivos , Testosterona/sangue , Fatores de Tempo , Suspensão de Tratamento
15.
Artigo em Inglês | MEDLINE | ID: mdl-34501992

RESUMO

The aim of this study was to examine the association of the duration of visual display terminal (VDT) usage for work and non-work activities with self-rated health (SRH) and psychological distress among office workers during the COVID-19 pandemic in Japan. A cross-sectional data of 7088 office workers from a web-based, self-administered survey conducted from 25 August 2020, to 30 September 2020, was used. Multiple logistic regression analysis was applied. Compared to those who used a VDT for 4-9 h for work, office workers who used a VDT for ≥10 h for work had poor SRH (odds ratio (OR): 1.65; 95% confidence interval (CI): 1.13, 2.41) and severe psychological distress (OR: 2.23; 95% CI: 1.52, 3.28). VDT usage for less than 1 h (OR: 1.37, 95% CI: 1.12, 1.67) and 1-3 h (OR: 1.42, 95% CI: 1.12, 1.80) for work were also associated with severe psychological distress. Stratification analysis by age showed a significant association of VDT usage for work with poor SRH among 30-64-year-olds, while a U-shape association was found between VDT usage for work and psychological distress with the younger age group (15-29 years old). During the COVID-19 pandemic in Japan, the prolonged usage of VDT for work can deteriorate both general and psychological health, while moderate usage of VDT for work can reduce psychological distress.


Assuntos
COVID-19 , Angústia Psicológica , Adulto , Terminais de Computador , Estudos Transversais , Humanos , Japão/epidemiologia , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2
16.
PLoS One ; 16(9): e0256151, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34469429

RESUMO

This study simulates the spread of the coronavirus disease (COVID-19) using a detailed agent-based model and the census data of Japan to provide a comprehensive analysis of the effects of contact-tracing apps. The model assumes two types of response to the app notification: the notified individuals quarantine themselves (type-Q response) or they get tested (type-T response). The results reveal some crucial characteristics of the apps. First, type-Q response is successful in achieving containment; however, type-T response has a limited curve-flattening effect. Second, type-Q response performs better than type-T response because it involves quarantine of those who are infected but have not become infectious yet, and the current testing technology cannot detect the virus in these individuals. Third, if the download rate of the apps is extremely high, type-Q response can achieve virus containment with a small number of quarantined people and thereby high efficiency. Finally, given a fixed download rate, increasing the number of tests per day enhances the effectiveness of the apps, although the degree of improved effectiveness is not proportional to the change in the number of tests.


Assuntos
COVID-19/epidemiologia , Busca de Comunicante , Aplicativos Móveis , Modelos Teóricos , Quarentena , SARS-CoV-2 , Adolescente , Adulto , Idoso , COVID-19/prevenção & controle , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade
17.
BMC Geriatr ; 21(1): 476, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34470612

RESUMO

BACKGROUND: While gait speed, one-leg standing balance, and handgrip strength have been shown to be independent predictors for functional disability, it is unclear whether such simple measures of physical function contribute to improved risk prediction of functional disability in older adults. METHODS: A total of 1,591 adults aged ≥ 65 years and without functional disability at baseline were followed up for up to 7.9 years. Functional disability was identified using the database of Japan's Long-term Care Insurance System. Maximum gait speed, one-leg standing time, and handgrip strength were measured at baseline. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) for the association of physical function and functional disability incidence. The incremental predictive value of each physical function measure for risk prediction was quantified using the difference in overall C-statistic, category-free net reclassification improvement (NRI), and integrated discrimination improvement (IDI) index. RESULTS: During follow-up (median: 7.8 years), functional disability was identified in 384 participants. All of the physical function measures were inversely associated with the risk of functional disability, independent of potential confounding factors. The multivariable adjusted HRs (95 % CIs) for functional disability per one standard deviation increment of maximum gait speed, one-leg-standing time, and hand grip strength were 0.73 (0.65-0.83), 0.68 (0.59-0.79), and 0.72 (0.59-0.86), respectively. Incorporation of each of maximum gait speed, one-leg-stand time, and hand grip strength into a basic model with other risk factors significantly improved C-statistic from 0.770 (95 % CIs, 0.751-0.794) to 0.778 (0.759-0.803), 0.782 (0.760-0.805), and 0.775 (0.756-0.800), respectively (all p < 0.05). A model including all three measures had the highest C-statistic of 0.787 (0.765-0.810). The improvements in risk prediction were also confirmed by category-free NRI and IDI index. CONCLUSIONS: Adding any of the three measures to a basic model with other known risk factors significantly improved the prediction of functional disability and addition of all three measures provided further improvement of the prediction in older Japanese adults. These data provide robust evidence to support the practical utility of incorporating these simple physical function measures into functional disability risk prediction tools.


Assuntos
Força da Mão , Vida Independente , Idoso , Humanos , Japão/epidemiologia , Estudos Prospectivos , Velocidade de Caminhada
18.
Medicine (Baltimore) ; 100(35): e27102, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477148

RESUMO

ABSTRACT: The turnover rate among kindergarten teachers in advanced countries is extremely high. As such, there is an urgent need to determine the reasons for this turnover and to identify ways to prevent it. The current study investigates the individual and environmental factors that impact kindergarten teachers' willingness to continue working.A total of 600 kindergarten teachers in Japan participated in this study. Participants responded to questionnaires regarding their willingness to continue working, mental health, work engagement, and the availability of social support. Multiple logistic regression analysis was used to analyze participants' data, with willingness to continue working for 5 or more years as the dependent variable. Additionally, Spearman rank correlation was used to examine the correlations between factors associated with willingness to continue working.Factors such as older age, living with a spouse, caring for younger children (up to 2 years old) at work, good mental health, and higher work engagement were significantly associated with teachers' higher willingness to continue working. Factors such as marriage, health and family problems, overtime work, issues with workplace childcare, and education policy, working time/day problems, human relations, and difficulties taking care of children were correlated with teachers' lack of willingness to continue working.The findings of this cross-sectional study suggest that welfare benefits and individual support systems could be key elements to encourage kindergarten teachers to continue working and could lead to their improved job satisfaction and mental health. Balanced work conditions and workers' high agreement with their workplace's overall childcare or educational policies may lead to lower turnover. Some programs - such as relationship counselling - could have a positive impact on teachers' mental health and job satisfaction.


Assuntos
Satisfação no Emprego , Professores Escolares/psicologia , Adulto , Distribuição de Qui-Quadrado , Estudos Transversais , Feminino , Humanos , Japão , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Reorganização de Recursos Humanos , Professores Escolares/estatística & dados numéricos , Inquéritos e Questionários , Carga de Trabalho/psicologia , Local de Trabalho/psicologia , Local de Trabalho/normas
19.
BMC Public Health ; 21(1): 1635, 2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34493251

RESUMO

BACKGROUND: Too long work hours of Japanese school teachers, along with an increasing number of teachers taking leave due to mental illness, are well known and recognized as a serious social problem. In order to prevent the spread of COVID-19 by reducing the density in the classroom, the Japanese government has decided to reduce the upper-limit of class size in primary schools after 2021, which is expected to result in lowering the student-teacher ratio. The aim of this study was to examine the association between student-teacher ratio, teacher work hours and teacher stress. METHODS: Data on student-teacher ratio, teacher work hours, and teacher stress were obtained from a large-scale international survey conducted by OECD. The number of teachers participated in the survey was 3308 (primary school) and 3555 (lower-secondary school). After excluding teachers with missing observations, the analytic sample consisted of 2761 (primary school) and 3006 (lower-secondary school) teachers. Multivariate regression analysis was performed. RESULTS: Regression results revealed that student-teacher ratio was positively correlated with total work hours and workload stress of teachers. In particular, teachers working in schools with high student-teacher ratio spent more time on time-consuming tasks such as marking/correcting student work and communication with parents or guardians. The coefficient estimates suggested that, on average, lowering the student-teacher ratio by five in lower-secondary school was associated with 2.8 hours shorter working hours per week (p<0.001). CONCLUSION: Our empirical results suggested that the class-size reduction policy starting in 2021 could reduce teacher stress and long work hours through the consequent decrease in student-teacher ratios.


Assuntos
COVID-19 , Carga de Trabalho , Humanos , Japão/epidemiologia , SARS-CoV-2 , Professores Escolares , Instituições Acadêmicas , Estudantes
20.
F1000Res ; 10: 285, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34457241

RESUMO

Background: There have been many studies conducted on succession, which can be considered as the most important issue in family businesses. However, most of these previous studies have focused only on the early stage of succession, uncovering the role of the predecessor and the successor. Only a few studies have made efforts to examine the total lifecycle of succession. The purpose of this study is to explore the process of the transition in successors' behavior and mindset while managing long-lived small and medium-sized manufacturing enterprises throughout the lifecycle of succession. Methods: Semi-structured interviews were conducted with six successors of small and medium-sized manufacturing companies who are more than half a century old. Their answers were analyzed using the Modified-GTA method to construct a hypothetical model. Results: In total, 46 concepts, four categories, 17 subcategories, and one core category were generated. An analysis result diagram using all concepts and categories was formed. From the observation of this diagram, the successors gained confidence in management through the dilemma between autonomy and constraint in the early stage of succession, which was found in previous research. Following the initial stage, the successors responded to the crisis caused by market constraints and created autonomous strategies in their businesses. Conclusions: By experiencing repetitive crises, the successors tend to acquire new perspectives toward the naturally occurring crises. This change of premise by the successors is considered as the process of double-loop learning. Relationships inside and outside the company influence the generation of this viewpoint. From a long-term perspective, a sense of unity with employees, stable employment, and the pursuit of enjoyment constitute the successors' own values in this model.


Assuntos
Saúde do Trabalhador , Comércio , Japão , Pesquisa Qualitativa
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...