Experience with Support at Workplaces for People with Young Onset Dementia: A Qualitative Evaluation of Being Open about Dementia.

Young-onset dementia (YOD) occurs at <65 years of age. Individuals with YOD experience social and psychological disturbances, including a loss of employment. This economic toll affects them, their families, and their caregivers. Employers have an increasing role in supporting affected employees in remaining employed, an important component of the "fight for their dignity". This study aims to clarify the workplace support experiences of employees with YOD. To assess the experiences of employers with at least one affected employee, we interviewed personnel from eight facilities for qualitative analysis. We identified 5 unique categories and 14 subcategories encompassing the following aspects: confusion at the workplace stemming from the uncertainty of the disease, sensitivity when recommending consultation and diagnosis, creating a system that considers safety and security, building consensus among employers, supporting employees with YOD and their families, and assisting the individual with YOD with activities of daily living. Employers should be open to addressing dementia-related issues in the workplace, including obtaining information from employees' physicians so that appropriate support can be provided. Appropriate support can include work accommodations, needs-based support, and meetings with families to build consensus for continued employment. This information can facilitate the creation of new training materials for employers.

[Work environment that support workers with diseases to maintain a work-treatment balance in Ishikawa prefecture: relationship with company scale and type of industry].

OBJECTIVES: We investigated the support environments in companies in Ishikawa prefecture that aim to maintain a balance between work and treatment of their employees' diseases. The relationships between these strategies, company size, and type of industry were examined. METHODS: In 2016, as a part of a survey, questionnaires were sent to 1,491 companies with ≥ 50 employees. Of the 688 companies who responded (response rate, 46.1%), 624 companies who provided complete main survey data were included in the final analysis. The questionnaire acquired responses on systems for arranging working hours and sick leave, the role of occupational health physicians, and the outcomes of support that was offered over the last 3 years. The targeted diseases were mental health problems, such as depression, and physical diseases. Responses were compared according to the size of the company and type of industry. RESULTS: A total of 409 companies (65.5%) reported their experiences of helping employees maintain a balance between treatment and work over the last 3 years. Employees with depression received the most support. In 36.7% of the companies, some employees had retired due to their disease over the last 3 years, with the highest proportion in medical care and welfare businesses. Further, 66% of the companies had a support system to help employees with diseases, and the proportion of companies with flexible working hours and sick leave increased with the number of employees. The proportion of companies with shorter working hours and hourly paid leave was lower in the manufacturing industry and transportation/traffic business. The proportion of companies in which an occupational health physician interviewed employees who took sick leave and returned to work was 22%. CONCLUSIONS: Almost 70% of the companies reported supporting workers during their disease treatment. There were some differences in arranging these support systems between companies of varying sizes and type of industry. The enablement of companies to support workers with diseases so that they keep working and receive treatment requires consideration of company characteristics.

[Workplace preparedness and recognition of the continued employment of employees with early onset dementia].

OBJECTIVES: This study aimed to clarify workplace recognition regarding working continuation of employees with early onset dementia. METHODS: An anonymous self-administrated questionnaire was emailed to a prefecture consisting of 1,293 workplaces with 50 or more employees. Survey items assessed demographics, workplace regulations supporting employees, coworker acceptance of employees with early onset dementia, and recognition and dealing with employees with early onset dementia. The possibility of employees with early onset dementia continuing work was compared for demographics, workplace regulations supporting employees, and cooperation in the workplace. RESULTS: Responses were received from 375 workplaces, and 273 valid responses were analyzed. In total, 133 workplaces (48.7%) answered that there was a high possibility of continuing employment for employees with early onset dementia and 135 workplaces (49.5%) were aware of early onset dementia. Less than 10% of workplaces reported examination of managing employees with early onset dementia, implementation/planning of training and information dissemination to managers or employees. Factors related to the possibility of continuing employment were number of employees (< 100, p = .015, odds ratio = 2.02), workplace regulations supporting employees with early onset dementia (p = .011, odds ratio = 2.22), and workplace coordination with occupational health staff (p = .004, odds ratio = 2.16). CONCLUSIONS: There is a general need for training and information regarding early onset dementia in the workplace. For smaller companies, external advice and support in providing systems suitable to each workplace is necessary.

Survey on chronic disabling low back pain among care workers at nursing care facilities: a multicenter collaborative cross-sectional study.

Purpose: Care workers at nursing care facilities have a high rate of low back pain (LBP). Although increasing evidence has revealed the important role of psychosocial factors in chronic LBP, factors associated with chronic LBP interfering with work have not been fully investigated in Japanese workers at nursing care facilities. The present study aimed to determine the prevalence of chronic LBP interfering with work and related factors of chronic LBP including psychosocial factors, among workers at nursing care facilities. Material and methods: Eligible participants in the present study were Japanese workers at 95 nursing care facilities in Ishikawa Prefecture (n=2,242). Of these, 1,345 participants completed a self-administered questionnaire that included the following items: individual characteristics, severity of LBP, sleep problem, fear-avoidance beliefs (Tampa Scale for Kinesiophobia: TSK), STarT Back Screening Tool (SBST), fatigue, somatizing tendency, and work-related stress such as job satisfaction, job demand, interpersonal stress at work, and social support. The logistic regression analysis was used to assess factors associated with chronic disabling LBP. Results: Of participants who completed the questionnaires, 159 (11.8%) reported chronic LBP that interfered with their work. The multivariable analysis of related-factors of chronic disabling LBP found statistically significant associations with the following: high score of psychological subscale in SBST (adjusted odds ratio [aOR]: 5.83, 95% confidence interval [CI]: 3.55-9.59), high score of TSK (aOR: 1.08, 95% CI: 1.05-1.13), and high somatizing tendency (aOR: 2.07, 95% CI: 1.31-3.23). Conclusion: Psychological factors, including fear-avoidance beliefs or somatizing tendency, showed significant association with chronic LBP that interfered with work, among workers at nursing care facilities. Our results suggest that these factors would need to be considered in addition to screening for the risk factors of LBP chronicity by SBST when evaluating workers with chronic disabling LBP.

Novel semisynthetic antibiotics from caprazamycins A-G: caprazene derivatives and their antibacterial activity.

Acidic treatment of a mixture of caprazamycins (CPZs) A-G isolated from a screen of novel antimycobacterial agents gave caprazene, a core structure of CPZs, in high yield. Chemical modification of the resulting caprazene was performed to give its various derivatives. The structure-activity relationships of the caprazene derivatives against several mycobacterial species and pathogenic Gram-positive and Gram-negative bacteria were studied. Although caprazene showed no antibacterial activity, the antibacterial activity was restored for its 1'''-alkylamide, 1'''-anilide and 1'''-ester derivatives. Compounds 4b (CPZEN-45), 4d (CPZEN-48), 4f and 4g (CPZEN-51) exhibited more potent activities against Mycobacterium tuberculosis and M. avium complex strains than CPZ-B. These results suggest that caprazene would be a good precursor from which novel semisynthetic antibacterial antibiotics can be designed for the treatment of mycobacterial diseases such as tuberculosis and M. avium complex infection.

Occupational class inequalities in behavioral and biological risk factors for cardiovascular disease among workers in medium- and small-scale enterprises.

The aim of this cross-sectional study was to examine whether occupational class inequalities existed in the behavioral and biological risk factors for cardiovascular disease among workers in medium- and small-scale enterprises. We asked 1,900 enterprises in the Ishikawa prefecture who were users of an external heath check-up facility to supply anonymous individual data in 2009. The 446 enterprises consented to the invitation. The study population was 12,625 individuals (8,104 males and 4,521 females) 16-59 yr of age. We compared indices among occupational classes. The indices of lipid and glucose metabolism were used only for subjects 40-59 yr of age. The results of this study revealed occupational class inequalities in the prevalence of current smoking, heavy drinking and hypertension in men. These inequalities were more prominent among men in the younger age group than in the older age group. In men, the most disadvantaged occupational class was transportation workers, followed by laborers. Occupational class inequalities in smoking were also found among female workers. However, the influences of occupational class on obesity and indices of lipid or glucose metabolism were inconsistent. A strategy for health promotion that targets the disadvantaged population is necessary for the prevention of cardiovascular disease.

[Paraneoplastic neurologic syndrome and small-cell lung cancer in a patient positive for anti-Hu antigen].

We encountered a case of small-cell lung cancer with paraneoplastic neurologic syndrome in a 68-year old man. Progressive dysesthesia had developed in his hands and legs over a period of 4 months. Chest radiography and chest CT scanning on admission showed a mass in the hilum of the left lung. Anti-Hu antibody was found in his serum and the subsequent histopathological diagnosis by TBLB was small cell lung cancer. The patient underwent complete remission, in terms of tumor size, as a result of concurrent chemoradiotherapy (cisplatin, etoposid) and the dysesthesia in his legs was alleviated.