A subjective well-being of the aged - psychological characteristics of elderly people of 90 or older -

高齢化社会の到来に伴い一言で老人といっても幅広い年代が対象となり、一律に老人では説明できない。実際看護をしていると90歳をすぎた老人はその年代迄にはない、穏やかさ、焦りのなさ、人生を達観しているような感じを受けることが多い。そこで90歳以上の老人にみられるイメージや心理面の特徴を明らかにし看護実践の一助としたいと考えた。方法は80歳以上の入院患者50名に身体、生活、家族面からみた現状、他者から見たイメージ、主観的幸福感を調査した。その結果、90歳以上は80歳代にくらべ看護者に肯定的イメージに受け取られる傾向にあった。主観的幸福感を示すモラール得点の総合点では差はなかったが得点する内容に差が見られ、80歳は積極的な生き方で得点しているものが多く90歳代は現状に満足している点で得点している者が多かった。看護者からみたイメージと本人の主観的幸福感は両年代とも肯定的イメージで相関した。The population of the aged is currently increasing with advanced medical science and technology. The aged have become to keep their lives long. In this paper, We especially focused on their psychological characteristics of elderly people of 90 and older to offer high quality of nursing care for them. We interviewed 50 patients of 80 years and older about a subjective well-being, using a questionaire based on Philadelphia Geriatric Center Morale Scale. And also we asked 50 nurses, who took care of them exclusively, a questinaire about their images of the aged. We report as follows : 1. The nurses estimated that their images of the second group (range : 90 years old ~) were better than the first group (range : 80~89 years old). 2. In subjective well-being which Philadelphia Geriatric Center Morale Scale showed, above-mentioned both groups were similar in total scores. However, each item was marked differently by them. 3. In both groups, their subjective well-being correlated with good images for them

Risk for Progression to Overt Hypothyroidism in an Elderly Japanese Population with Subclinical Hypothyroidism

Background: Few population-based studies report the changes with time in thyroid function tests in patients with subclinical hypothyroidism. We compared the risk for developing overt hypothyroidism in patients with subclinical hypothyroidism and euthyroid controls from the same population of elderly Japanese. We also sought associations of selected parameters with the development of overt hypothyroidism in the subclinical hypothyroid and euthyroid groups. Methods: We measured thyrotropin (TSH) and free thyroxine (T4) levels at baseline examinations performed from 2000 to 2003 in the cohort of Japanese atomic-bomb survivors and identified 71 patients with spontaneous subclinical hypothyroidism (normal free T4 and TSH >4.5 mIU/L without a history of thyroid treatment, mean age 70 year) and 562 euthyroid controls. We re-examined TSH and free T4 levels an average of 4.2 years later (range, 1.9-6.9). Results: The risk for progression to overt hypothyroidism was significantly increased in subclinical hypothyroid patients (7.0%) compared with control subjects (1.6%) after adjusting for age and sex (odds ratio, 4.56; p=0.009). Higher baseline TSH levels were associated with progression from subclinical to overt hypothyroidism (p=0.02) in the multivariate analysis, including age, sex, antithyroid peroxidase antibody, and ultrasonography (US) findings. The analysis using binary TSH data suggested that a TSH level >8 mIU/L was a predictive value for development of overt hypothyroidism (p=0.005). On the other hand, serum TSH levels spontaneously normalized in 38 (53.5%) of the patients with subclinical hypothyroidism. In the multivariate analysis, normalization of TSH levels was associated with lower baseline TSH levels (p=0.004) and normal and homogenous thyroid US findings (p=0.04). Atomic-bomb radiation dose was not associated with subclinical hypothyroidism or its course. Conclusions: Subclinical hypothyroidism was four times more likely to be associated with development of overt hypothyroidism than euthyroid controls in the sample population of Japanese elderly. TSH levels in half of the patients normalized spontaneously when assessed after an average follow-up period of 4.2 years. Baseline TSH level and thyroid US findings are potential predictors of future thyroid function in subclinical hypothyroidism

General acts passed by the General Court of Massachusetts

Imprint varies.Vols. for 1915-19 published in 2 v.: General acts; Special acts.Vols. for some years issued in parts.Separate vols. issued for extra session, 1916, and for extra session, 1933.Vol. 12 (May 1831-Mar. 1833) in Jan. session, 1833; Jan. 1834-Apr. 1836 in vol. for extra session 1835/Jan. session 1836; May 1824-Mar. 1828; June 1828-June 1831, Jan. 1832-Apr. 1834, Jan. 1835-Apr. 1838, each bound with corresponding vol.Resolves issued separately, 1780-1838

Fundus autofluorescence imaging in acute posterior multifocal placoid pigment epitheliopathy

Purpose: Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is a disease characterized by multiple yellowish-white placoid lesions. Although most lesions resolve spontaneously, some turn into scars and lead to permanent visual dysfunction. In this report, we found suggestive findings in fundus autofluorescence (FAF) that may be useful for distinguishing severe lesions requiring treatment in APMPPE. Observation: Case 1: A 29-year-old woman was referred to our hospital with multiple yellowish-white placoid lesions on the fundi of both eyes (OU). FAF showed hyperautofluorescence in some of these placoid lesions. Based on the findings of fluorescein angiography, a diagnosis of APMPPE was established, and oral prednisolone (PSL) was initiated, given that some lesions were located in the macula. One week later, exacerbation occurred with the newly developed hyperautofluorescent lesions. Some lesions in the right eye (OD) that were hyperautofluorescent at the first visit became hypoautofluorescent. Afterward, although all hypoautofluorescent lesions persisted, most of the hyperautofluorescent lesions disappeared, so oral PSL could be stopped. Two months later, however, the recurrence occurred along with multiple new placoid lesions. Some lesions located at the macula were hyperautofluorescent on FAF OU, indicating the possibility of becoming scar lesions with hypoautofluorescence. Accordingly, oral PSL was given again. Case 2: A 47-year-old woman noticed decreased vision OD, and she was referred to us. Multiple yellowish-white placoid lesions were seen in the fundi OU. FAF showed hyperautofluorescence both with and without corresponding hypoautofluorescence in the placoid lesions OU. A diagnosis of APMPPE was established, and oral PSL was initiated. Four months later, some lesions that were hyperautofluorescent at the first visit had turned isoautofluorescent, and some lesions OU became hypoautofluorescent. However, all hypoautofluorescent lesions remained hypoautofluorescent OU. Only some hyperautofluorescent lesions recovered to isoautofluorescence without scars. Conclusions and Importance: In APMPPE, lesions showing hyperautofluorescence on FAF may change into hypoautofluorescence indicating scar formation. Therefore, the presence of hyperautofluorescent lesions in the macula may be a good indicator of the need for intensive corticosteroid treatments to avoid leaving hypoautofluorescent scars that are related to irreversible visual dysfunction

子どもの遊びを活性化させるための素材庫（アトリエ）の可能性

街ぐるみで子どものための素材活用を実践的に研究しているレッジョ・エミリアを参考にして，近年，保育現場で素材庫（アトリエ）作りを行ってきた。これからの保育の方向性を見いだすために，保育者志望の「学生」と「素材庫作り未経験保育者」と「経験保育者」の素材庫（アトリエ）に対する意識調査を行った。 「学生」は，子どもの視点に立ち，楽しく使いやすい素材庫（アトリエ）を考えた。「素材庫作り未経験保育者」の回答では，子どもの想像力，発想力の育ちに繋がるという肯定的意見と共に，素材を使う上での気がかりな点や注意点が多くあがった。「経験保育者」は，素材庫（アトリエ）を活用した幼児との遊びの経験に基づいて，遊びの活性化や子どもの繋がりの可能性を見いだした。その時のエピソードの記録を学生に示すことで，学生は子ども達の遊ぶ姿に喜びを感じることができた。大学附属認定こども園と大学の素材を通じた協力・連携の可能性が見えてきた。Based on the activities at Reggio Emilia in Italy where people in the town gather materials for their children, we made a storehouse of materials for the children in our kindergarten. In order to fix the direction of our future education of young children, we performed a questionnaire survey on teachers who had experienced building the storehouse, teachers who had not, and university students, The students thought that the storehouse would be easy and enjoyable for children to use. The unexperienced teachers expressed not only optimism at the prospect that it would increase the imagination of children, but also the anxiety about the usefulness of materials. The survey also revealed that the experienced teachers are convinced of the great possibilities of a storehouse for young children to facilitate their play and interact with each other. As to the university students, they were impressed by the vigorous play of children and are eager to participate in the activity for enriching the contents of a storehouse in the University. We thought it is possible for us to build cooperation between the university-affiliated certified center and the university itself through creating and maintaining a storehouse for young children