Novel frameshift variant of WNT10A in a Japanese patient with hypodontia.

Congenital tooth agenesis is caused by the impairment of crucial genes related to tooth development, such as Wnt signaling pathway genes. Here, we investigated the genetic causes of sporadic congenital tooth agenesis. Exome sequencing, followed by Sanger sequencing, identified a novel single-nucleotide deletion in WNT10A (NC_000002.12(NM_025216.3):c.802del), which was not found in the healthy parents of the patient. Thus, we concluded that the variant was the genetic cause of the patient's agenesis.

The effects of yoga and mindful meditation on elderly care worker's burnout: a CONSORT-compliant randomized controlled trial.

Objectives: This study aims to investigate the effects of mindful meditation and yoga on reducing burnout and stress in care workers who assist elderly individuals. Knowing how to reduce burnout is important because that of care workers is associated with the quality of client care, worker productivity, and job turnover. Patients and Methods: The participants included 44 care workers who worked for elderly care facilities in rural Fukuoka. They were randomly assigned to one of three intervention groups: control, yoga, or mindfulness. In the yoga intervention group, a certified yoga instructor taught a 60-minute yoga session each week for six weeks. In the mindfulness group, an experienced medical doctor instructed a mindful meditation program for the same length. Participants were asked to complete the Japanese Burnout Scale (JBS), and the research team collected the level of α-amylase in saliva using NIPRO: T-110-N pre- and post-interventions. Results: MANOVA was performed with each intervention (control, yoga, mindfulness) as the independent variable on the three subscales of the JBS (emotional exhaustion, depersonalization, and personal achievement) and a biomarker of stress level (α-amylase). The results indicated a significant main effect of interventions, and a follow-up ANOVA showed a significant effect of interventions on emotional exhaustion and personal achievement. Conclusion: The results indicate that practicing mindful meditation or yoga for 60 minutes once a week for six weeks can reduce care workers' burnout. This study was notable because the biomarker of stress also improved. It is strongly recommended and encouraged that institutions caring for the elderly population provide mindful meditation or yoga intervention to reduce burnout, which benefits not only care workers but also their clients.

The mediating effect of resilience between family functioning and mental well-being in hemodialysis patients in Japan: a cross-sectional design.

BACKGROUND: End-stage kidney disease is highly prevalent worldwide. Currently, one of the most effective treatment modalities is dialysis therapy, which leads to serious side effects. Furthermore, psychiatric illnesses are prevalent among dialysis patients. Recently, researchers asserted that psychological resilience and family support could be helpful to maintain or improve patients' mental well-being. Therefore, the purpose of this study was to examine the mediating effects of resilience on the relationship between family functioning and mental well-being in these patients. METHODS: To investigate the aim of this study, a cross-sectional design was employed. A total of 110 hemodialysis patients, who were receiving outpatient treatment from dialysis units at the University of Fukuoka and St. Maria Health Care Center in Japan, participated. Only the patients who met the criteria and who were willing to participate in this 30-min study were given The General Health Questionnaire-12, Conner-Davidson Resilience Scale, and Family Assessment Device. Structural Equation Modeling (SEM) was performed to test the hypothesis that resilience would mediate the relationship between each subscale of family functioning, namely, cohesion, adaptability, communication, and mental well-being. Then Sobel's test was employed to examine the indirect effect. RESULTS: The results of the SEM showed that the model had an acceptable fit (RMSEA = .077; CFI = .93; and IFI = .94). According to the results, resilience fully mediated the relationship between family functioning, specifically family adaptability and communication, and mental health well-being of the dialysis patients. However, family cohesion was not associated with resilience. CONCLUSIONS: The present study revealed that higher family adaptability and communication resulted in greater resilience, thus associated with better mental health. Given that poor mental health among dialysis patients is significantly associated with a decreased likelihood to adhere to treatment plans, it may lead to a significant risk to therapeutic compliance. As such, patients may experience detrimental consequences, such as death. This study showed that in order to maintain healthy mental well-being, developing resilience is a vital factor for hemodialysis patients.

The Mediating Effects of Resilience, Morale, and Sense of Coherence Between Physical Activity and Perceived Physical/Mental Health Among Japanese Community-Dwelling Older Adults: A Cross-Sectional Study.

The aim of this study was to examine the mediating effects of resilience, morale, and sense of coherence on the relationship between physical activity and respondents' perceived physical/mental health and depression among community-dwelling older adults in Japan. The study included 369 participants with an average age of 74 years from Kasuishimohara District in Fukuoka Prefecture, Japan. They completed a survey that included the Resilience Scale, the Sense of Coherence Scale, the Medical Outcomes Short Form 8, the Philadelphia Geriatric Center Morale Scale, the Geriatric Depression Scale (Short Form), and a demographic questionnaire. The results of the path mediation analyses revealed that resilience and morale fully mediated the relationship between physical activity and perceived physical/mental health and depression. However, sense of coherence was not a significant mediator. Some intervention programs are suggested to maximize the effects of physical activity on one's well-being. At-risk populations who need such programs are also discussed.

Relationships among moral distress, sense of coherence, and job satisfaction.

BACKGROUND: Since moral distress affects psychological aspects of psychiatric nurses, it is an important theme. Previous studies showed relationships between moral distress and job satisfaction; however, there are few studies which investigate relationships between moral distress and other effective variables and then we highlighted relationships among these variables. OBJECTIVE: This study aimed to (1) examine relationships among moral distress, sense of coherence, mental health, and job satisfaction and (2) clarify the most predictive variable to job satisfaction. RESEARCH DESIGN: This study is a cross-sectional study. Participants were 130 psychiatric nurses in a hospital in Japan. They completed the Moral Distress Scale for Psychiatric nurses (Unethical conduct, Low staffing, and Acquiescence to patients' rights violations), the sense of coherence scale (Comprehensibility, Manageability, and Meaning), the General Health Questionnaire, and the Job Satisfaction scale. Ethical consideration: This study was approved by the ethical board of St Mary's College. Nurses participated voluntarily and were anonymous. RESULTS: Results showed that subscales of the Moral Distress Scale for Psychiatric nurses negatively correlated to the sense of coherence and the Job Satisfaction. A multiple regression analysis showed that "Acquiescence to patients' rights violations" of the Moral Distress Scale for Psychiatric nurses and "Meaning" of the sense of coherence influenced the Job Satisfaction much more than other variables. These two variables were correlated to job satisfaction scale, and other variables without them did not significantly correlate to job satisfaction scale. DISCUSSION: These results suggest that moral distress negatively related to sense of coherence and job satisfaction, a subscale of the Moral Distress Scale for Psychiatric nurses and that of the sense of coherence affected the job satisfaction the most. CONCLUSION: Decreasing of acquiescence to patients' rights violations and finding meaning in nursing may improve job satisfaction.

Responses and Results to Ethical Problems by Psychiatric Nurses in Japan.

The aim of this study was to investigate the responses of Japanese psychiatric nurses to ethical problems, and the results of those issues. The participants were 130 nurses who worked in psychiatry wards in a hospital. The nurses answered the question "how did you respond when you faced an ethical problem and what results did you get?" in free description. Seven categories were selected qualitatively from their responses: "Lack of action and no change," "Experiencing problems and feeling gloomy," "Pointing out misconduct and being hurt," "Consultation among staff and resolution or not," "Consultation with physicians and getting positive or negative responses," and "Searching for and providing evidence-based care," and "Thinking for themselves." The facts that some nurses do not cope with ethical problems and some face moral distress without knowing what to do suggest that "improvement of moral efficacy to cope with ethical problems", "proposing resolution methods", and "organizational ethics support" may be useful.

Bereavement life review improves spiritual well-being and ameliorates depression among American caregivers.

OBJECTIVE: The aim of our study was to investigate the utility of bereavement life review (BLR) to elevate spiritual well-being and alleviate depression among Hawaiian-American caregivers, and to identify changes that occur when caring for their loved ones up to the time of death. METHOD: Bereavement life review therapy was provided for 20 bereaved Hawaiian Americans. In the first session, subjects reviewed memories of the deceased with a therapist, who recorded their narratives and collected them into a personal history book. During the second session, subjects discussed the contents of this book. Caregivers completed the Functional Assessment Chronic Illness Therapy-Spiritual (FACIT-Sp) questionnaire and the Beck Depression Inventory, Second Edition (BDI-II) pre- and post-intervention. Subjects also described changes in their views that occurred during the caring process in response to questions. RESULTS: FACIT-Sp scores significantly increased from 34.1 ± 9.63 to 36.3 ± 10.6 (t = -2.6, p < 0.05, and BDI scores significantly decreased from 11.7 ± 7.7 to 8.8 ± 7.0 (t = 2.27, p < 0.05). Five categories were chosen from the narratives on changes that had occurred during caregiving and due to the deceased death: "Learning from practical caring experience," "Positive understanding of patients," "Recognition of appreciation," "Self-change or growth," and "Obtaining a philosophy." SIGNIFICANCE OF RESULTS: These findings show the applicability of bereavement life review therapy for Hawaiian families, including efficacy for spiritual well-being and depression. The comments of the caregivers also indicate the potential of the therapy for identifying the positive aspects of caring for terminally ill patients.

Difficulties in caring for a patient with cancer at the end of life at home and complicated grief.

The present study aimed to investigate difficulties in caring for a patient with cancer at the end of life at home and to examine relationships between difficulties with care and complicated grief. The 45 bereaved family members completed the Family Difficulty Scale (FDS) and the Inventory of Complicated Grief (ICG). The FDS score for "Patient's pain and condition" was the highest, followed by "Caregivers did not want home care" and "No support from others." There was a significant relationship between FDS and ICG scores. These results suggest that the condition of the patient, the view of the caregiver on home care, and the absence of other support are important factors contributing to difficulties of family caregivers, and that these difficulties may lead to complicated grief.

Changes experienced by and the future values of bereaved family members determined using narratives from bereavement life review therapy.

OBJECTIVES: The goals of this study were to investigate the changes experienced by bereaved family members in Japan and to determine what activities they would value in the future based on narratives from a bereavement life review, which is a type of psychotherapy used to treat depression and promote spiritual well-being. METHODS: The participants were 20 bereaved Japanese family members who underwent two sessions of bereavement life review over a period of two weeks. RESULTS: Using qualitative analysis, we identified four areas of changes ("learning from the deceased's death and self-growth," "healing process," "relating with others," "relating with society," and "performing new family roles") and five categories of valued activities ("continuing grief work," "living with a philosophy," "attaining life roles," "keeping good human relationships," and "enjoying life"). SIGNIFICANCE OF RESULTS: "Learning from the deceased's death and self-growth" and "relating with others" are common in Japan and Western countries, whereas "relating with society," "healing process," and "performing new family roles" are more characteristic of Japan. The strength of bonding with the deceased may influence the values of bereaved family members. We concluded that bereavement life review therapy can contribute positively to their grief work.

Universality of bereavement life review for spirituality and depression in bereaved families.

The present study aimed to investigate the effects of the Bereavement Life Review on depression and spiritual well-being of bereaved families in a setting that does not specialize in palliative care. The participants were 20 bereaved family members who underwent the Bereavement Life Review over 2 sessions in 2 weeks. Beck Depression Inventory Second Edition scores significantly decreased from 14.4 ± 9.2 to 11.6 ± 7.4 (t = 2.15, P = .045) and Functional Assessment Chronic Illness Therapy-Spiritual scores increased from 24.3 ± 10.1 to 25.9 ± 11 (t = -1.0, P = .341) from pre- to postintervention. These results show that the Bereavement Life Review can decrease depression and improve spiritual well-being of bereaved families after the death of a family member in a setting without specialized palliative care. The results also suggest the universality of this therapy.

A pilot study of adaptation of the transtheoretical model to narratives of bereaved family members in the bereavement life review.

This study aimed to examine the possibility of adaptation of the transtheoretical model (TTM) to narratives from the Bereavement Life Review. Narratives from 19 bereaved family members were recorded, transcribed into sentences, and allocated into stages based on the TTM criteria. Those who lived in fantasy were allocated to the precontemplation stage and who recognized the patient's death but could not adjust to the death were allocated to the contemplation stage. Those who understood the need for changes and had new plans were allocated to the preparation stage, and those who were coping were allocated to the action stage, and those who had confidence to remember the loved one who died were allocated to the maintenance stage. These results provide deeper understanding of a bereaved family member and suggest that a different intervention method may be useful in each stage.

Development and evaluation of a self-care assessment inventory for workers.

AIM: To develop and evaluate a self-care assessment inventory for workers (SCAI-W). METHODS: A study using a self-care assessment inventory for workers consisting of 27 self-care items, the Japanese version of the Beck Depression Inventory (BDI), and the Japanese version of the University of Wales Institute of Science and Technology Mood Adjective Checklist (JUMACL) was conducted. These questionnaires were distributed to 2297 workers. There were 893 valid responses (39.9%, 584 men and 309 women, mean age 37.2±10.2 years). RESULTS: Three primary and eight secondary factors were established for the conceptual structure of self-care and validated by structural equation modeling. "Positive attitude" comprised the secondary factors, "hope" and "sense of fulfillment", and was influenced by another secondary factor, "social support". "Positive attitude" contributed to "attitude toward health". "Attitude toward health" comprised the secondary factors, "care about one's health" and "correction of bad habits". "Attitude toward health" influenced a primary factor, "everyday behavior", comprised of "wakefulness", "eating in moderation", and "lack of self-control". The primary factors "positive attitude" and "everyday behavior" influenced the BDI scores. A multiple regression analysis indicated that JUMACL subscale scores (energetic arousal and tense arousal), demographic data (living alone, sex, and age) and health-related data (exercise, smoking, body mass index, drinking more than three alcoholic drinks/day, and gambling) predicted the scores of the self-care assessment inventory for workers. CONCLUSION: This assessment inventory could be a useful measure of workers' self-care because it establishes a relationship between psychological and behavioral concepts that are important for health promotion.

[Effects of a short-term life review on spiritual well-being, depression, and anxiety in terminally ill cancer patients].

PURPOSE: This study was done to evaluate the effects of a short-term life review on spiritual well-being, depression, and anxiety in patients with terminal cancer. METHODS: The study used a pre posttest quasi experimental design with a nonequivalent control group. Measurement instruments included the Functional Assessment of Chronic Illness Therapy-Spiritual scale (FACIT-Sp12) and the Hospital Anxiety and Depression Scale (HADS). Participants were 32 patients with terminal cancer who were receiving chemotherapy or palliative care at hospitals or at home. Eighteen patients were assigned to the experimental group and 14 to the control group. A sixty minute short-term life review session was held twice a week as the intervention with the experimental group. RESULTS: There was a statistically significant increase in spiritual well-being in the experimental group compared to the control group. There were also significant decreases in depression and anxiety in the experimental group compared to the control group. CONCLUSION: The results indicate that a short-term life review can be used as a nursing intervention for enhancing the spiritual well-being of patients with terminal cancer.

Factors in narratives to questions in the Short-Term Life Review interviews of terminally ill cancer patients and utility of the questions.

OBJECTIVE: Although the Short-Term Life Review elevated the spiritual well-being of terminally ill cancer patients in our previous study, we have not examined what patients reviewed for each question item of it. We examined factors in narratives to questions in the Short-Term Life Review interviews of terminally ill cancer patients and utility of the questions. METHOD: Thirty-four terminally ill cancer patients received the Short-Term Life Review interview in which there were two sessions. In the first session patients reviewed their lives, and an interviewer made a simple album of the patient based on patients' narrative. After 1 week, there was a second session. Qualitative analysis was conducted on patients' answers to each question using computational word mining, and factors were identified. RESULTS: Twenty patients' narratives were analyzed. "Human relationships" was identified under "important things in life." "Pleasant memories" were associated with "impressive memories." "Illness" and "marriage and divorce" were related to "turning points in the life." "Raising children and education" and "company or work" were identified as "roles in life." "Achievements at work" were identified with "pride." "Message to my children" was identified with "what I want to say to my family." "To live sincerely" and "consideration for others" were identified as "advice for the next generation." Patients reviewed few for topics such as "pride," "what I want to say to my family," "advice for the next generation," and "summing up my life." SIGNIFICANCE OF RESULTS: Factors such as human relationships, raising children, and education as a role and source of pride, and concerns about children's future, were associated with elevating spiritual well-being. Question to which that patients easily answered were selected.

Development of a Japanese Benefit Finding scale (JBFS) for patients with cancer.

The primary aim of this study was to develop a scale to evaluate benefits for patients with cancer under treatment in Japan (the Japan Benefit Finding scale [JBFS]). The participants were 98 patients with cancer who completed the JBFS, which has 26 items, the General Health Questionnaire short version (GHQ 12). Factor analysis, structural equation modeling (SEM), and correlation analysis were performed. Three key domains were identified: ''Recognition of one's role in the family and priorities,'' ''Appreciation for life,'' and ''Faith.'' Validity was confirmed by SEM. There was a significant correlation between the JBFS and GHQ 12. The reliability and validity are adequate, and the JBFS shows that Japanese patients who found benefits in cancer were able to adjust to their disease.

A qualitative study of mindfulness-based meditation therapy in Japanese cancer patients.

PURPOSE: The primary objective of the study was to examine mindfulness-based meditation therapy qualitatively. A secondary goal was to examine the differences in themes selected by Japanese and Western patients receiving this therapy. METHODS: The subjects were 28 patients who were undergoing anti-cancer treatment. The subjects participated in two sessions of mindfulness-based meditation therapy, including breathing, yoga movement, and meditation. Each patient was taught the program in the first session, then exercised at home with a CD, and subsequently met the interviewer in a second session after 2 weeks. Primary physicians recruited the patients and interviews were conducted individually by nurses or psychologists with training in the program. Patients provided answers to pre- and post-intervention interviews about the meaning of their illness. RESULTS: Narrative data from the semi-structured interview were analyzed qualitatively. Pre-intervention, themes such as "Effort to cope," "Looking back," "Spirituality," "Personal growth," and "Suffering" were often chosen. Post-intervention, themes such as "Adapted coping," "Personal growth," "Positive meaning," "Spirituality," and "Negative recognition" were more commonly chosen. CONCLUSIONS: Mindfulness-based meditation therapy may be effective for producing adapted coping, including positive recognition and changes for an adapted lifestyle. There were some common aspects and some differences in the themes selected by patients in this study and Western patients received mindfulness therapy in other studies.

Factors that influence the efficacy of bereavement life review therapy for spiritual well-being: a qualitative analysis.

PURPOSE: We have previously shown that bereavement life review therapy improves the spiritual well-being of a bereaved family, but the factors that influence the efficacy of this therapy have not been determined. Therefore, this study was performed to identify factors associated with improvement of spiritual well-being of bereaved families. METHODS: The participants were 21 bereaved family members who lost a relative who had been treated in a palliative care unit in Japan. The family members received the Bereavement Life Review over two sessions of about 60 min each. In the first session, the bereaved family member reviewed their memories of the deceased relative with a clinical psychologist and answered several questions. After the first session, the psychologist made an album. In the second session, the family member and the psychologist confirmed the accuracy of the contents of the album. Assessment was performed using the Functional Assessment Chronic Illness Therapy-Spiritual score, based on which the participants were separated into effective and non-effective groups. Factors were extracted from the narrative of the therapy using a text-mining software. RESULTS: Factors such as "good memories of family," "loss and reconstruction," and "pleasant memories of last days" were commonly found in the effective group, whereas factors such as "suffering with memories," "regret and sense of guilt," and "disagreement on funeral arrangements" were more common in the non-effective group. CONCLUSIONS: Factors like "good memories of families," "loss and reconstruction," and "pleasant memories of last days" were associated with the improvement of spiritual well-being of bereaved families.

Effects of bereavement life review on spiritual well-being and depression.

CONTEXT: Some bereaved families experience low spiritual well-being, such as lack of meaning of life or purpose and psychological distress like severe depression. OBJECTIVES: The primary aim of this study was to investigate the effects of the Bereavement Life Review on the spiritual well-being of bereaved family members. The secondary aim was to investigate the effects of this therapy on depression. METHODS: Participants were 21 bereaved family members who lost loved ones in various palliative care units in Japan. They received the Bereavement Life Review, which consisted of two sessions for about 60 minutes each. In the first session, a bereaved family member reviewed memories with a clinical psychologist and answered some question. After the first session, the clinical psychologist made an album. In the second session, the family member and the clinical psychologist confirmed the accuracy of the contents of the album. The duration of the therapy was two weeks. The family member was assessed using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) scale and the Beck Depression Inventory-II (BDI-II) pre- and postintervention. RESULTS: FACIT-Sp scores increased from 19.9+/-5.8 to 22.8+/-5.1 (Z=-2.2, P=0.028 by Wilcoxon signed-rank test) and BDI scores decreased from 10.8+/-7.7 to 6.8+/-5.8 (Z=-3.0, P=0.003). CONCLUSIONS: The Bereavement Life Review has the potential to improve spiritual well-being and decrease depression of bereaved family members. A further study with more participants is required to confirm the present findings.

Efficacy of short-term life-review interviews on the spiritual well-being of terminally ill cancer patients.

CONTEXT: There is a little information about effective psychotherapies to enhance the spiritual well-being of terminally ill cancer patients. OBJECTIVES: The primary aim of the study was to examine the efficacy of a one-week Short-Term Life Review for the enhancement of spiritual well-being, using a randomized controlled trial. The secondary aim was to assess the effect of this therapy on anxiety and depression, suffering, and elements of a good death. METHODS: The subjects were 68 terminally ill cancer patients randomly allocated to a Short-Term Life-Review interview group or a control group. The patients completed questionnaires pre- and post-treatment, including the meaning of life domain from the Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp) scale, the Hospital Anxiety and Depression Scale (HADS), a numeric scale for psychological suffering, and items from the Good Death Inventory (Hope, Burden, Life Completion, and Preparation). RESULTS: The FACIT-Sp, Hope, Life Completion, and Preparation scores in the intervention group showed significantly greater improvement compared with those of the control group (FACIT-Sp, P<0.001; Hope, P<0.001; Life Completion, P<0.001; and Preparation, P<0.001). HADS, Burden, and Suffering scores in the intervention group also had suggested greater alleviation of suffering compared with the control group (HADS, P<0.001; Burden, P<0.007; Suffering, P<0.001). CONCLUSION: We conclude that the Short-Term Life Review is effective in improving the spiritual well-being of terminally ill cancer patients, and alleviating psychosocial distress and promoting a good death.

Recognition of asymmetric alterations to pictures of cats: effects of method of alteration and type of change in elderly subjects.

Recognition of environmental changes is essential in everyday life. In this study, recognition of animate objects by elderly people was examined with various methods (introduction, restoration) and types (addition, deletion) of change. For restoration, deletions and additions were produced by eliminating features from pictures and reintroducing the deleted features, respectively. In introduction, additions and deletions were produced by adding and deleting features from original pictures. 37 subjects (M age = 74 yr.) viewed each card for 10 sec. (learning phase) and were then asked (test phase) whether they had viewed the card in the learning phase and to rate their confidence in their answer. Percentage correct rejection and confidence ratings were higher for introductions compared to restorations and for deletions compared to additions. Findings are similar to those in young adults and children, which indicates developmental robustness of asymmetric effects in recognition of animate objects.