多重感覚環境を活用した知的障害のある生徒への学習支援 : アンガーマネジメントと主体的な関わり合いに向けて

近年，日本の教育現場においては，“怒り”によりひきおこされる様々な問題が散見される。児童対象生徒自らが怒りの感情をコントロールする「アンガーマネジメント（Anger management）と呼ばれる実践的研究がなされ，多様な場面で試行されている。本研究では，知的障害のある対象生徒を対象に，多重感覚環境を活用した学習支援を実施した。多重感覚環境下での学習支援セッション終了後の対象生徒の変容について指導者及び対象生徒が在籍する特別支援学校の教員間での協議を行った。対象生徒は，多重感覚環境で用いた教材の一つであるミラーボールを用いて，自分自身の情緒の安定をはかる様子や，友人や教員と関わリ合う様子が観察された。全ての学習支援終了後には，教員の話を落ち着いて聞く様子，課題にじっくりと取り組む様子，友人と関わりあう様子が観察された。多重感覚環境を活用した学習支援が主体的なアンガーマネジメントや友人との関わり合いの一つの方法になりうることが示唆された。In recent years, various problems caused by "anger" have been seen in Japanese education. Practical research called "Anger management", which students themselves control their feelings of anger, has been tried in a variety of situations. In this study, we implemented learning support for students with intellectual disabilities in a multisensory environment. Discussions were conducted between the instructor and the teacher at the special support school, regarding the transformation of the target student after the end of the learning support session in a multi-sensory environment. Using mirror balls, one of the teaching materials used in the environment, We were able to observe the student’s own emotional stability and the relationship with friends and teachers. It was suggested that learning support in a multiple sensory environment may be one of the methods of proactive anger management and relationship with friends

Sacral Stress Fracture Complicated by L5 Radiculopathy in a Patient with Rheumatoid Arthritis

A 60-year-old Japanese woman with severe osteoporosis presented with a history of right buttock pain and right lateral lower leg pain in an L5 distribution. She had been treated with methotrexate and methylprednisolone for rheumatoid arthritis (RA) and interstitial pneumonia. Computed tomography demonstrated a sacral stress fracture in the right sacral ala. The right L5 nerve root was compressed by the fracture site. This case is rare in that L5 radiculopathy was complicated by a sacral stress fracture. Clinicians should suspect sacral stress fractures when RA or osteoporosis is present in women who experiences lumbar pain and lumbar radiculopathy

Rapidly Destructive Arthrosis of Bilateral Humeral Heads Caused by Subchondral Insufficiency Fracture

The bilateral shoulder pain of an 81-year-old Japanese woman due to falls persisted despite celecoxib treatment, and plain X-rays later showed bilateral collapsed humeral heads. After ruling out osteoarthritis, infectious arthritis, crystal-induced arthritis, neuropathic arthropathy, and osteonecrosis, we diagnosed bilateral shoulder joint rapidly destructive arthrosis (RDA). Lumbar bone mineral density showed very low T-score (−4.1). Primary osteoporosis was observed. Histology of biopsied humeral head indicated the features of fracture healing process: callus formation and osteoclasts without empty lacunae. Her history thus included an insufficiency fracture due to severe osteoporosis. Bilateral humeral head replacement was performed; her shoulder joint function improved. This case is extremely rare in that RDA was caused by simultaneous bilateral shoulder joint collapse within a very short time, with minimal or low mechanical stress and severe osteoporosis

シタイ フジユウ ノ アル セイト エノ リンショウ ドウサホウ オ キバン トシタ ガクシュウ シエン : シュタイテキ タイワテキ フカイ マナビ ニ ムケテ

本研究では，臨床動作法に係る心理リハビリテイションキャンプにおける記録より，肢体不自由のある子どもたちの臨床動作法を基盤とした学習支援のあり方について検討することを目的とした。肢体不自由のある生徒（トレイニー）を対象として，動作課題遂行時の時系列記録と本人インタビューを分析対象とした。トレイニーとトレーナーが，相互交渉の成立を契機として，対話を重ねる中で，トレイニーは省察し，動作課題の確認や自らの姿勢保持時間等の情報を活用し，トレーナーに動作課題を行う際の学習方法を提案するなど課題遂行の見通しをもちながら主体的に学習に取り組む様子が確認された。臨床動作法を基盤とするトレイニーとトレーナーとの協働的な学習は，今後の肢体不自由教育における「主体的・対話的で深い学び」につながっていくと考えられる。In this research, we aimed to examine how to support learning based on the clinical dousa-hou for children with physical disabilities from the record in psychological rehabilitation camp of clinical dousa-hou. The target was a student with physical disabilities (trainee). The time series record at the time of performing the dousa task and interview for a student with physical disabilities (trainee) were analyzed. Trainee and trainer repeatedly engaged in dialogue with the formation of mutual negotiations. Trainee was conscious and utilized information such as confirmation of dousa tasks and own posture holding time. Trainer had a prospect of executing the task, such as proposing a learning method when doing a dousa task to the trainer, It was confirmed that trainer focused on learning subjectively. Collaborative learning of trainees and trainers based on clinical dousa-hou will lead to "subjective, interactive and deep learning" in future physically handicapped education

多感覚を用いた教育実践における定性データから定量データへの変換の試み

本研究では，多感覚を用いた教育実践の際に，動画記録を用いて，児童・生徒と教員との相互交渉といった定性データを定量データへと変換する試みについて紹介し，手法の有効性や課題について検討することを目的とした。定性データと定量データを可視化することにより，児童・生徒と教員との相互交渉時の状況理解が進み，教育実践における省察に用いることができる可能性を提示した。今後の課題として，教育実践現場での活用事例とその検証が必要であると考えられる。To clarify more precisely the effect of multisensory teaching method on interactions between students and teachers, it might be necessary to analyze both qualitative and quantitative data obtained from some circumstances, such as their conversation, several behaviors, et al. In this study, moving video recordings of the situation of students and teachers in the multisensory educational practice were done, and the recording data were made an attempt to convert from qualitative to quantitative. The present results show that the analysis combined qualitative with quantitative data promote a better understanding of the situation at the time of mutual negotiation between students and teachers. Our data further provide the possibility that the analysis may serve to consider the effectiveness and improvement in the educational practice

ジュウド チョウフク ショウガイ ノ アル セイト エノ リンショウ ドウサホウ ニ モトズク ガクシュウ シエン ノ イギ : シセイ ヒョウテイヒョウ ニヨル ヒョウカ ト ジリツ カツドウ ノ クブン ニ シテン オ アテテ

This study examines the mutual relevance among six categories of Jiritsu-Katsudou and significance on learning support based on clinical dousa-hou. We suggested task instructions based on clinical dousa-hou for a unstable sitting positioning student with profound and multiple diabilities. Utilizing checklists of postural distortion, we analyzed the student’s behavioral changes. Mutual negotiation between the trainer and the student (trainee) inferred the clue on positioning tasks. The instruction of Jiritsu-Katsudou based on clinical dousa-hou tend to focus on especially body movement. This study suggested that task instructions to repeat based on clinical dousa-hou is important in the instruction for students with profound and multiple disabilities, and the learning support of mutual relevance among six categories of Jiritsu-Katsudou

触覚を活用した学習支援前後の知的障害生徒の応答性

本稿では，知的障害のある生徒を対象に，触覚を活用した学習支援の前後の教員の話しかけに対する生徒の応答性や学習支援終了直後の生徒の様子について行動面から評価した。また，これらの評価に加え，学習支援に関わった教員の施行後の省察や今後の活動における改善点等や先行研究の知見を踏まえ，教育における触覚を活用した学習支援の有効性を検討することを目的とした。触覚を活用する教材として，スライムを活用したが，教員の話しかけに対する生徒の相互交渉成立の頻度が高くなり，コミュニケーションの向上につながること，さらに，学習支援終了直後，生徒は情緒が安定した状態で次の活動への集中度が高まり，教員の話しかけにも安心して応答し，次の行動へ円滑に移行できるようになること，が示唆された。課題として，教育課程上への活動の位置づけやスライムと他の教材・教具との比較分析等の検討，児童生徒と関わりの少ない人との相互交渉の変容の検討，多種多様なデータの集積等が挙げられた。In this paper， we evaluated the responsiveness of students to the teacherʼs talk before and after learning support by touching the tactile stimulus slime of students with intellectual disabilities and the state of the students immediately after the end of learning support. In addition to these evaluations， the purpose is to examine the effectiveness of the use of tactile stimulus slime in education， based on the post-implementation reflections of teachers involved in learning support， points for improvement in future activities， and the findings of previous research. As a result of its usefulness， the use of tactile stimulus slime increases the frequency of mutual negotiations between students in response to teachersʼ talk， leading to improved communication， and the students are in a stable emotional state immediately after the end of learning support. It was suggested that the degree of concentration on the next activity would increase， and that the teachers would be able to respond with peace of mind and move smoothly to the next action. Future tasks include positioning activities in the curriculum， investigating comparative analysis of slime and other materials and materials， investigating changes in interaction with students who have little to do with children， and accumulation of a wide variety of data

Evidence for Ongoing Modeling-Based Bone Formation in Human Femoral Head Trabeculae via Forming Minimodeling Structures: A Study in Patients with Fractures and Arthritis.

Bone modeling is a biological process of bone formation that adapts bone size and shape to mechanical loads, especially during childhood and adolescence. Bone modeling in cortical bone can be easily detected using sequential radiographic images, while its assessment in trabecular bone is challenging. Here, we performed histomorphometric analysis in 21 bone specimens from biopsies collected during hip arthroplasty, and we proposed the criteria for histologically identifying an active modeling-based bone formation, which we call a "forming minimodeling structure" (FMiS). Evidence of FMiSs was found in 9 of 20 specimens (45%). In histomorphometric analysis, bone volume was significant higher in specimens displaying FMiSs compared with the specimens without these structures (BV/TV, 31.7 ± 10.2 vs. 23.1 ± 3.9%; p < 0.05). Osteoid parameters were raised in FMiS-containing bone specimens (OV/BV, 2.1 ± 1.6 vs. 0.6 ± 0.3%; p < 0.001, OS/BS, 23.6 ± 15.5 vs. 7.6 ± 4.2%; p < 0.001, and O.Th, 7.4 µm ± 2.0 vs. 5.2 ± 1.0; p < 0.05). Our results showed that the modeling-based bone formation on trabecular bone surfaces occurs even during adulthood. As FMiSs can represent histological evidence of modeling-based bone formation, understanding of this physiology in relation to bone homeostasis is crucial

Functional tooth number and mortality

Aim: Previous studies on the association between intraoral conditions and mortality in community-dwelling older individuals reported that fewer present teeth (PT) are significant risk factors for mortality. However, how the number of PT relative to the number of functional teeth (FT), including both present and rehabilitated teeth, influences mortality has not been investigated fully. This study examined the impact of the number of FT on mortality among community-dwelling Japanese older adults. Methods: This study was a retrospective, observational and population-based follow-up study, which examined 1188 older individuals who participated in an annual geriatric health examination from 2009 to 2015. The average follow-up period was 1697.0 ± 774.5 days. The primary outcome was all-cause mortality at follow-up. The numbers of PT and FT of each participant were counted during an oral examination. In addition, demographics, clinical variables, blood nutrient markers, physical functions and perceived masticatory function were measured. Results: Kaplan–Meier analysis, followed by a log-rank test, revealed that fewer PT (P < 0.001) and FT (P = 0.002) were significantly associated with a reduced survival rate. Cox's proportional hazard analysis indicated that the number of FT, but not the number of PT, was a significant independent mortality risk factor after adjusting for demographics, clinical variables, nutrient markers and physical functioning (P = 0.036, hazard ratio: 2.089). Conclusions: Current results suggest that the number of FT more strongly predicts all-cause mortality than the number of PT among community-dwelling older adults. Further studies are necessary to consider the confounding of socioeconomic status and disability status

Number of functional teeth more strongly predicts all‐cause mortality than number of present teeth in Japanese older adults

Aim Previous studies on the association between intraoral conditions and mortality in community‐dwelling older individuals reported that fewer present teeth (PT) are significant risk factors for mortality. However, how the number of PT relative to the number of functional teeth (FT), including both present and rehabilitated teeth, influences mortality has not been investigated fully. This study examined the impact of the number of FT on mortality among community‐dwelling Japanese older adults. Methods This study was a retrospective, observational and population‐based follow‐up study, which examined 1188 older individuals who participated in an annual geriatric health examination from 2009 to 2015. The average follow‐up period was 1697.0 ± 774.5 days. The primary outcome was all‐cause mortality at follow‐up. The numbers of PT and FT of each participant were counted during an oral examination. In addition, demographics, clinical variables, blood nutrient markers, physical functions and perceived masticatory function were measured. Results Kaplan–Meier analysis, followed by a log‐rank test, revealed that fewer PT (P  Conclusions Current results suggest that the number of FT more strongly predicts all‐cause mortality than the number of PT among community‐dwelling older adults. Further studies are necessary to consider the confounding of socioeconomic status and disability status