Dokkyo Medical University Repository / 獨協医科大学リポジトリ
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The Survey on Career Progress for Career Support among Alumni of Graduate Program of Midwifery, Dokkyo Medical University：A Cross-Sectional Study
Get PDF【目的】 獨協医科大学助産学専攻科修了生の動向を明らかにすることで，キャリア形成に向けたサポート環境を整備するための示唆を得ること．
【方法】 獨協医科大学助産学専攻科を修了した1～10期生87名を対象に調査を実施した．調査の依頼メールを送付し，Google Formsを用いたweb調査で，属性，現在のキャリアへの満足度，今後のキャリアについての希望，助産学専攻科にあればよいと思う支援のデータを収集した．連続値の項目ではMann-WhitneyのU検定を，名義尺度の項目はχ²検定またはFisherの正確確率検定を用いて分析した．
【結果】 Web 調査回答者54名（62.1％）を分析対象とした．現在のキャリアへの満足度は，「満足」12名（24.5％），「どちらかといえば満足」25名（51.0％）であった．現在考える今後のキャリアについて，現在の勤務先での就業継続を希望している者は，それ以外の者（進学や転職等を希望・検討している，分からないと回答）と比べて，有意にキャリアへの満足度が高かった（p＝0.016）．現在のキャリアで「満足」を選んだ者の理由は「仕事と育児の両立ができている」「大学病院でハイリスクを学ぶことができている」「助産師の資格を活かして，臨床経験を積むことができている」であった．
「助産学専攻科にあればよいと思う支援（複数回答可）」では，「研修会」24名（44.4％），キャリア相談22名（40.7％），交流会・ネットワーク作り19名（35.2％）であった．
【結論】 今後のキャリアについて，現在の勤務先での就業継続を希望している者は，それ以外の者（進学や転職等を希望・検討している，分からないと回答）と比べて，有意にキャリアへの満足度が高かった．修了生のニーズをくみ取りながら，助産師基礎教育機関であるからこそ企画できる助産師のキャリアに必要な研修を検討していく必要がある．journal articl
A case of Hypothalamic Hamartoma of the Intrahypothalamic Type
Get PDF視床下部過誤腫は抗てんかん薬治療の反応性が乏しい難治性てんかんとして知られており，外科的加療を検討する上でこれを早期に診断する意義は高い．症例は3歳男児．6か月間の抗てんかん薬治療への反応性が乏しかったため，笑い発作の原因精査としてMRIを撮像した．左視床下部・乳頭体が腫瘤状に腫脹しT1及びT2強調像で大脳皮質と等信号を呈しており，視床下部過誤腫と診断した．視床下部過誤腫は発生部位により症状が異なると言われている．本症例の腫瘍は1cm 程度であり，発生部位を意識して撮像し，読影することで早期診断，治療が可能である．Hypothalamic hamartoma（HH）is known to present with intractable epilepsy or central precocious puberty, which emphasizes the significance of proper diagnosis. Herein, we describe a case of HH associated with gelastic seizures.
The patient was a 3-year-old boy who presented with gelastic seizures that poorly responded to antiepileptic drugs for more than 6 months. Magnetic resonance（MR） imaging revealed a hypothalamic mass within the floor of his third ventricle. The lesion appeared isointense to gray matter on both the T1- and T2-weighted images, concordant with the diagnosis of HH.
Intrahypothalamic HH often presents with typical gelastic seizures. It is visualized in the coronal plane, whereas parahypothamlamic type is more visible on the sagittal imaging, which leads to precocious puberty. This case demonstrates that obtaining the precise clinical information of the patient before imaging and using the suitable MR plane are key to choosing the appropriate diagnosis and treatment of intrahypothalamic HH.journal articl
Relationship between Fatigue and Nocturnal Problems Related to Parkinson's Disease
Get PDFIn patients with Parkinson's disease (PD), fatigue and sleep disturbances are important non-motor symptoms. In this study, we aimed to evaluate the relationship between fatigue and sleep disturbances in patients with Parkinson's disease (PD). A total of 93 outpatients with PD (age, 69.7 ± 8.9 years) and 93 healthy controls (age, 69.6 ± 10.2 years) were included in this study. The participants completed the Parkinson Fatigue Scale (PFS), Epworth Sleepiness Scale (ESS), Parkinson's disease sleep scale (PDSS) -2 and Beck Depression Inventory (BDI) -II. For PD patients, the PD Questionnaire (PDQ-39) was used to evaluate quality of life. Fatigue was defined as a PFS score of 3.3 or greater. Fatigue was observed in 7.5% of healthy controls and 44.0% of PD patients (p < 0.001). In the healthy control group, subjects with fatigue were older than those without fatigue, but there was no difference in the PDSS-2, ESS or BDI-II scores. PD patients with fatigue had significantly higher scores of the ESS, BDI-II, PDQ-39 and PDSS-2 and greater motor symptoms compared with those without fatigue. Fatigue was associated with the PDSS-2 sub-item 2 (Difficulty falling asleep), item 10 (Pain in arms or legs), item 13 (Tremor on waking), item 14 (Tired and sleepy after waking in the morning) and item 15 (Snoring or difficulties in breathing). Logistic regression analysis showed that the PDSS-2 subitem 14 (Tired and sleepy after waking in the morning) and the PDQ-39 summary index were significant determinants for fatigue. In conclusion, we showed the significant relationship between fatigue and various aspects of PD-related nocturnal problems. Our findings emphasize the importance of fatigue assessment in patients with PD.journal articl
