厦门西港和香港维多利亚港表层沉积物中多环芳烃的含量分布和来源分析

厦门西港和香港维多利亚港表层沉积物中多环芳烃的含量分布和来源分析张珞平，陈伟琪，林良牧，洪华生（海洋生态环境国家教委开放研究实验室，厦门大学环境科学研究中心）关键词多环芳烃，沉积物，厦门西港，香港维多利亚港前言多环芳烃（PAHS）主要存在于石油和燃料...国家自然科学基

ガンマグロブリン大量療法とプレドニゾロン併用療法が奏功した妊娠合併急性型特発性血小板減少性紫斑病の１例

We report a case of acute idiopathic thrombocytopenic purpura (ITP) during pregnancy, which was successfully treated by a combination of high-dose γ-globulin and prednisolone (PSL).A 30-year-old female was admitted to our hospital in the 11th week of pregnancy due to bleeding.Laboratory data revealed severe thrombocytopenia (2,000/μl)with normal red blood cell and white blood cell counts,and she was diagnosed as having ITP.Both PSL alone (45mg/day for 4 weeks)and high-doseγ-globulin therapy alone (400mg/kg/day for 5 days)were transiently effective but resulted in a rapid decrease in the platelet count to under 10,000/μl. However,a combination of PSL (45mg/day,for 2 weeks)and high-doseγ-globulin (400mg/kg/day for 5 days) markedly increased her platelet count,which was maintained at over 90,000/μl.She delivered a healthy 2,050g male vaginally without complications in the 39th week of pregnancy. Although PSL was discontinued after delivery, no thrombocytopenia was observed. A combination of PSL and high-dose γ-globulin may be effective for cases of refractory ITP during pregnancy.Article信州医学雑誌 47(4): 309-314(1999)journal articl

一貫性のある看護を目指して : カーデックスの再検討

Article信州大学医学部附属病院看護研究集録 1986 : 190-199 (1986)departmental bulletin pape

一貫性のある看護を目指して : カーデックス使用を試みて

Article信州大学医学部附属病院看護研究集録 1985: 174-188 (1985)departmental bulletin pape

トランスセオレティカルモデルに基づく個別支援による健康行動変容で見られた個人差:「天使健康栄養クリニック」2008と2009からの検討

「天使健康栄養クリニック」は、地域住民を対象にメタボリックシンドロームの予防・改善を目的として開催されている。本クリニックでは、講話並びに個人面談によって健康教育と変容支援を行っている。2008 年度および2009 年度に本クリニックに参加し修了した人たちを対象として、4ヶ月間における運動行動、ストレス対処・休養行動および食行動の変容について、個別に検討した。クリニック全8回のうち1、3、5、7回目に計4回、対象者に実施した質問紙調査から行動変容ステージ(得点)を評価した結果、3種の健康行動は、平均的には第1回目に比べて4回目には行動変容ステージ(得点)が高まり変容がみられた。しかし、個々人でみると第1回目から4回目までの変容は直線的ではない対象者も多かった。第1回目に比べて4回目に変容ステージ(得点)が高まった対象者の他に変化しなかった者、低下した者も見られたので、そのような違いの要因を面談記録から推察した。運動行動変容に関する事例検討から、上昇・改善者では、歩行を中心に運動が継続されていたが、継続しようという強い意欲と支援がうまく関連していたと考えられる。The Tenshi Health and Nutrition Clinic is a health awareness and guidance course offered to local residents for the prevention and alleviation of metabolic syndrome. The clinic, which is run over eight non-consecutive days, comprises lectures and personal interviews, and aims to help participants improve health awareness and progress through the stages of behavioral change. In this study, changes in exercise behavior, stress management and resting behavior, and dietary behavior were individually assessed over a four-monthe period in participants who completed the clinic in 2008 and 2009. Scores indicative of the stage of behavioral change (behavioral change scores) were obtained from questionnaires completed by participants on days one, three, five, and seven of the clinic. On an average, the behavioral change scores for all three types of health-improving behavior were higher in the fourth questionnaire survey than in the first one, suggesting that the participants had progressed through the stages of behavioral change. However, the results of the four questionnaire surveys showed that the time-dependent changes in health-improving behavior are not linear for many participants. When the behavioral change scores of the fourth survey were compared with those of the first survey, they were higher in some participants, but lower or unchanged in others. Information obtained from individual interviews indicated that continuous effort was made to maintain an exercise routine, in particular walking, by participants who made progress in changing their behaviors. The results suggest that with regard to participants who improved their exercise behavior, the support provided was positively linked with the strong will to continue an exercise routine

NOSOLOGICAL DATA ON OUTPATIENTS AND INPATIENTS IN THE DEPARTMENT OF PSYCHIATRIC SERVICE AT NARA MEDICAL UNIVERSITY HOSPITAL IN FISCAL 1999

Nosologlcal data on outpatients and inpatients in the Psychiatric Service of Nara Medical University Hospital in fiscal 1999, are reported in this paper. There were 967 outpatient cases and inpatients were 232 inpatient cases. According to the diagnostic classification using F codes of the ICD-10, F4 (neurotic, stress-related and somatoform disorder) was most frequent (255 cases, 27％) in the outpatients, followed by F3 (mood disorder; 221 cases, 23％), F0 (organic, including symptomatic, mental disorder; 135 cases, 14％) and others. On the other hand, F2 (schizophrenia schizotypal and delusional disorder) was most frequent (69 cases, 30％) in the inpatients, followed by F4 (neurotic, stress-related and somatoform disorder; 51 cases, 22％), F3 (mood disorder; 38 cases, 16％) and others

食行動変容とメタボリックシンドロームの病態改善がQuality of lifeに及ぼす影響

健康づくりの目的は、健康増進のみならず生活の質(Qualify of life: QOL)の向上にある。メタボリックシンドローム (metabolic syndrome: MetS)は生活習慣と密接に関連しており、健康習慣の変容によって改善が可能である一方、病態が進行すると日常生活活動の制限につながりQOL は低下する。本研究では、食行動変容によるMetS の病態改善がQOL の変化にどのように影響しているかを示す構造を明らかにすることを目的とした。「天使健康・栄養クリニック」を受講した平均年齢60.8 歳の87 名(男性35 名、女性52 名)を対象に、トランスセオレティカルモデル(Transtheoretical Model: TTM)に基づいて、3ヶ月間教育的に指導・支援を行った。その結果、食行動変容段階得点やその他の健康関連指標値が高まり、食物エネルギー摂取量が低下し、MetS 診断指標値が改善するとともにQOL 得点が上昇した。QOL の向上には、指導・支援後の食行動社会的支援 (食行動social support: 食行動SS) 得点、腹囲変化率、拡張期血圧変化率が回帰された。さらに、QOL の向上には、食行動SS を介した食行動変容段階の向上によって改善した健康習慣指数(Health practice index: HPI)や腹囲の変化が関連している構造モデルが得られた。MetS の改善がQOL の向上に関連するとともにその向上に至る構造が明らかになった。The purpose of health promotion is not only to enhance health but also to improve the quality of life (QOL). Metabolic syndrome (MetS) can be alleviated through a change in health habits as it is closely linked to lifestyle. However, when left untreated, MetS will limit the daily activities of the affected individual and reduce his/her QOL. This study aims to analyze the structural equation modeling of relationships between QOL, eating behavior change, and MetS. We recruited 87 individuals (35 males, 52 females; mean age 60.8 years) who attended a program conducted by Tenshi Health and Nutrition Clinic. The participants received educational intervention for 3 months; the intervention was based on the transtheoretical model of behavior change. The intervention resulted in improved QOL scores, along with an improvement in the stage of eating behavior change, increased health-related indicator levels, decreased dietary energy intake, and improved MetS index level. After intervention, improvement in QOL was correlated with the scores of social support (SS) for eating behavior change (eating behavior SS) as well as with the changing rates of abdominal circumference and diastolic blood pressure. These results indicated a structural equation modeling that QOL improvement was related to changes in health practice index and abdominal circumference. Both changes resulted from improvement in the stage of eating behavior facilitated by improved eating behavior SS. Further research is required to elucidate the structural modeling involved in the enhancement of QOL associated with the alleviation of MetS