Investigation of collaboration among community-based medical facilities and patient support system in centralcommunity hospitals in Okayama

本研究の目的は, 1)県下中核病院の地域医療連携,患者支援活動の現状について面接調査を行い,その実態を明らかにすること, 2)その結果をもとに,今後の特定機能病院に求められる地域医療連携や患者支援のあり方を検討する上での参考にすること,の2点にあった｡県下10か所の地域中核病院を対象に,地域医療連携業務やその他の患者支援活動に関する質問紙を作成し,面接調査を行った｡その結果,医療連携部門の歴史や業務内容は様々であったが,どの病院も地域医療連携部門を設置することで,開業医との連携を強化し,紹介･逆紹介の円滑化を図ろうとしている状況がうかがえた｡特に連携業務の中 でも,開業医からの紹介患者を病院にスムーズに受け入れる機能を重視している傾向が見られた｡また,すべての対象病院が地域医療連携以外の患者支援活動を行う部門を有しており,医療相談や地域の医療保健施設との連携強化等の業務を主に行っていた｡これらの調査結果をもとに,特定機能病院である大学病院に求められる地域医療連携･患者支援のあり方について考察した｡The purpose of this study was to investigate the current status of collaboration among community-based medical facilities and patient support system in ten central community hospitals in Okayama. Interviews were conducted using a questionnaire regarding the current status of collaboration among community-based medical facilities and patient support system in ten central community hospitals. It was revealed that although the size and position of the sections varied, all hospitals were trying to facilitate collaboration among other community-based medical facilities by developing stronger relationships with family doctors. They mainly focused on improving the quality of services for referred patients and referring physicians. Besides, all hospitals possessed another section providing patient support services such as patient education and counseling. Staffs in the sections were trying to build stronger relationship with other health-related and medical facilities in their communities. Finally, it is discussed regarding how to facilitate collaboration among community-based medical facilities and provide patient support system in a university hospital

Making of A Can-Do lists based on the Course of Study for Upper Secondary Schools

全国の高等学校で,具体的な到達目標をCan-Doリストの形で作成することになっているが,作成されたリストの中には学習指導要領に準拠していないものも見られる。また,既成のリストを見ただけではどのようにして作成したのかがわかりにくい。本小論は,高等学校学習指導要領でどのような能力の育成を目指しているのかを明示し,学習指導要領に準拠したCan-Doリストの作成方法を具体的,かつ,わかりやすく示す。なお,本小論では,4技能のうち,「書くこと」についてのCan-Doリスト作成手順を対象にした。その手順は次の通りである。学習集指導要領で示された,目指す能力の一覧化→ カテゴリー分類→ 仮Can-Doの設定→ 検証テスト→Can-Doリストの編集・確定。この研究で実施した検証テストにより,このCan-Doリストは妥当であるという結果が得られた。Many Can-Do lists are not based on the Course of Study. It is difficult to learn how to make Can-Do lists by evaluating those made by high schools. This study clearly demonstrates the process of making Can-Do lists as follows. The abilities students should have are identified in the Course of Study. These abilities are categorized. A list of tentative can-dos is made. A test determines the reliability of the tentative can-dos. The tentative can-dos are improved according to the test result. The final list of can-dos is determined. The Can-Do lists presented in this thesis were proven to be appropriate by the test

Effective Methods for Teaching “English Expression”

平成25年度より施行されている高等学校学習指導要領において新設された英語表現Ⅰの中で言及されている，「論理構成及び表現の方法を工夫しながら伝える力」を育成するための具体的な実践報告である。実践においては，「論理構成及び表現の方法を工夫しながら伝える力」を，「英語で表現するにあたって，場面や状況，背景，相手の反応などを踏まえた上で，妥当な文章構成を用いる力」と定義した上で，英語の作文を書くための基本的な文章構成や，読み手の注意を引き付ける工夫，説得力のある意見文を書くための工夫を，英作文の比較や，ピアー・レビューなどの手法を織り交ぜながら指導を行った。結果としては，生徒が与えられたトピックについて，場面や目的を考えて，学んだ文章構成の工夫を活用している様子が見られた。The aim of this study is to demonstrate appropriate teaching methods for cultivating students’ ability to write passages in a style suitable for a particular audience and purpose. In the class, students learned the basics of English composition as well as how to attract the interest of readers and how to write in a persuasive style. The results indicated that the lesson taught the students how to write passages implementing their learning

Role of Plasma Proteins in Pharmacokinetics of Micafungin, an Antifungal Antibiotic, in Analbuminemic Rats ▿

There were no significant differences in the pharmacokinetics of micafungin and expression of hepatic multidrug resistance-associated protein 2 (ABCC2/Mrp2) between analbuminemic and Sprague-Dawley rats. Micafungin bound strongly to high-density lipoprotein (HDL) and moderately to gamma globulin. These results suggest that HDL and gamma globulin contribute to the pharmacokinetics of micafungin

X Chromosome Contribution to the Genetic Architecture of Primary Biliary Cholangitis.

BACKGROUND & AIMS: Genome-wide association studies in primary biliary cholangitis (PBC) have failed to find X chromosome (chrX) variants associated with the disease. Here, we specifically explore the chrX contribution to PBC, a sexually dimorphic complex autoimmune disease. METHODS: We performed a chrX-wide association study, including genotype data from 5 genome-wide association studies (from Italy, United Kingdom, Canada, China, and Japan; 5244 case patients and 11,875 control individuals). RESULTS: Single-marker association analyses found approximately 100 loci displaying P < 5 × 10(-4), with the most significant being a signal within the OTUD5 gene (rs3027490; P = 4.80 × 10(-6); odds ratio [OR], 1.39; 95% confidence interval [CI], 1.028-1.88; Japanese cohort). Although the transethnic meta-analysis evidenced only a suggestive signal (rs2239452, mapping within the PIM2 gene; OR, 1.17; 95% CI, 1.09-1.26; P = 9.93 × 10(-8)), the population-specific meta-analysis showed a genome-wide significant locus in East Asian individuals pointing to the same region (rs7059064, mapping within the GRIPAP1 gene; P = 6.2 × 10(-9); OR, 1.33; 95% CI, 1.21-1.46). Indeed, rs7059064 tags a unique linkage disequilibrium block including 7 genes: TIMM17B, PQBP1, PIM2, SLC35A2, OTUD5, KCND1, and GRIPAP1, as well as a superenhancer (GH0XJ048933 within OTUD5) targeting all these genes. GH0XJ048933 is also predicted to target FOXP3, the main T-regulatory cell lineage specification factor. Consistently, OTUD5 and FOXP3 RNA levels were up-regulated in PBC case patients (1.75- and 1.64-fold, respectively). CONCLUSIONS: This work represents the first comprehensive study, to our knowledge, of the chrX contribution to the genetics of an autoimmune liver disease and shows a novel PBC-related genome-wide significant locus.The article is available via Open Access. Click on the 'Additional link' above to access the full-text.Published version, accepted versio