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In this paper we surveyed the concerns of students for practical training in kindergartens, day nurseries and institutions for dependent, neglected, and abused handicapped children. The results showed that most of the students were conscious of being able to attain their goal in practical training and especially some students could experience social welfare institutions through this practical training

Role of Multichance Fission in the Description of Fission-Fragment Mass Distributions at High Energies

Fission-fragment mass distributions were measured for U237-240, Np239-242, and Pu241-244 populated in the excitation-energy range from 10 to 60 MeV by multinucleon transfer channels in the reaction O18+U238 at the Japan Atomic Energy Agency tandem facility. Among them, the data for U240 and Np240,241,242 were observed for the first time. It was found that the mass distributions for all the studied nuclides maintain a double-humped shape up to the highest measured energy in contrast to expectations of predominantly symmetric fission due to the washing out of nuclear shell effects. From a comparison with the dynamical calculation based on the fluctuation-dissipation model, this behavior of the mass distributions was unambiguously attributed to the effect of multichance fission

シンリョウジョ シュッサン シタ ジョセイ ノ ニンシン リスクスコアヲ モチイタ リスク ヒョウカ ノ ケントウ

目的 平成16年に開発された妊娠リスクスコア自己評価表(以下,スコア)を用いて診療所で出産した女性の得点を算出し,リスクレベルの傾向とスコアの特徴,分娩帰結との関連を検討する.方法 対象はA診療所で平成20年1月～ 12月に分娩し協力が得られた124名である.診療録よりスコアの評価項目と分娩帰結の情報を収集し,スコアA(初診時評価点)とスコアB(妊娠後半期評価点),合計スコア(スコアAとスコアBの総合得点)を算出した.次に,スコアA,スコアB,合計スコアそれぞれについて早産,分娩時異常出血(1,000ml以上),低出生体重児,吸引分娩,帝王切開分娩の5項目と低リスク群(0-1点)・中リスク群(2-3点)・高リスク群(4点以上)間の関連をみた.結果 平均年齢30.5±3.45歳,初産婦4割,経産婦6割であった.スコア別リスク群別割合は,スコアAで1点が37.9%と最も多く,低リスク群が半数(58.9%)を占めた.スコアBでは0点が80.6%と最も多く,同群が8割以上(83.1%)を占めた.合計スコアをみると中・高リスク群合わせて全体の50.1%を占めた.分娩帰結に異常がなかった事例は全体の78.2%で,うち診療所が単独で扱えない中・高リスク群は37.1%であった.一方早産,分娩時異常出血,低出生体重児,吸引分娩,帝王切開の帰結をとった事例は全体の21.8%あり,うち低リスク群は3.2%(4件)あった.スコアBで加点された事例を概観すると分娩帰結に大きな影響を及ぼす事例であった.χ2独立性の検定の結果,特に,Bスコアで骨盤位,IUGR,低位胎盤,双胎により2点以上の得点が付いた場合と,帝王切開や低出生体重児である傾向に関連があった.結論 1.スコアAは容易に加点されるが分娩帰結に影響を与える項目は少なく,スコアBは容易に加点されないが加点されると分娩帰結に直結する項目が多かった.2.妊産婦らが忠実にスコアの評価基準を守れば,約半数が二次・三次医療施設での健診・分娩が適切であると判断される.3.リスク得点が分娩帰結を反映していない事例が一部存在した.4.妊婦の後半期の評価において2点以上のリスク得点が付く場合には,帝王切開と低出生体重児などの異常帰結を取る傾向があり,スコアBの有用性が示唆された.Aim To use the pregnancy risk score self-assessment form developed in 2004 to examine the relationship between the risk level of women who delivered at a clinic and the birth result.Method The subjects were 124 women who gave birth from January～December 2008 at Clinic A and from whom consent was obtained.Birth results and scored items were collected from medical records to calculate Score A(first medical examination),Score B(latter half of pregnancy),and the Total Score(A and B).Next, with regard to each score,correlations were sought between five items(premature delivery,intrapartum abnormal bleeding(1,000ml or more),low birth weight infant,vacuum extraction and caesarean delivery) and the low(0-1 points),intermediate(2-3 points)and high(4 or more points)risk groups. Results Subjects\u27 mean age was 30.5±3.45 years with 40% primipara and 60% multipara.Inspection showed a correlation tending toward caesarean section(r=0.506)or low birth weight infant(r=0.409),particularly when two or more points were assigned for breech presentation, IUGR,low lying placenta or twin fetus to Score B. Conclusion When two or more points were assigned to the risk score during the latter half of pregnancy, there was a tendency toward caesarean operation,lower birth weight infant or other abnormal results, suggesting the utility of Score B

Diminished Medial Prefrontal Activity behind Autistic Social Judgments of Incongruent Information

Individuals with autism spectrum disorders (ASD) tend to make inadequate social judgments, particularly when the nonverbal and verbal emotional expressions of other people are incongruent. Although previous behavioral studies have suggested that ASD individuals have difficulty in using nonverbal cues when presented with incongruent verbal-nonverbal information, the neural mechanisms underlying this symptom of ASD remain unclear. In the present functional magnetic resonance imaging study, we compared brain activity in 15 non-medicated adult males with high-functioning ASD to that of 17 age-, parental-background-, socioeconomic-, and intelligence-quotient-matched typically-developed (TD) male participants. Brain activity was measured while each participant made friend or foe judgments of realistic movies in which professional actors spoke with conflicting nonverbal facial expressions and voice prosody. We found that the ASD group made significantly less judgments primarily based on the nonverbal information than the TD group, and they exhibited significantly less brain activity in the right inferior frontal gyrus, bilateral anterior insula, anterior cingulate cortex/ventral medial prefrontal cortex (ACC/vmPFC), and dorsal medial prefrontal cortex (dmPFC) than the TD group. Among these five regions, the ACC/vmPFC and dmPFC were most involved in nonverbal-information-biased judgments in the TD group. Furthermore, the degree of decrease of the brain activity in these two brain regions predicted the severity of autistic communication deficits. The findings indicate that diminished activity in the ACC/vmPFC and dmPFC underlies the impaired abilities of individuals with ASD to use nonverbal content when making judgments regarding other people based on incongruent social information

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries