ガッコウ オ チーム ニ スル ニワ ナニガ ヒツヨウ カ マナビ ツズケル キョウイン シュウダン オ ケイセイ スル タメ ノ ジッセンテキ ケンキュウ

複雑化する学校課題への対応として，学校組織の機能強化が求められている。それは，学校に専門性や経験を有する専門的スタッフを配置し，配置されたメンバーがチームとして機能することである。そこで，学校をチームとするための実践をおこなった。その結果，以下の点が明らかとなった。１．学校をチームにするには，調整的役割を果たす教員の存在が必要なこと ２．その教員の継続的な調整が教職員の意識を変えること ３．調整役の教員にはリーダーシップ行動があったことAs a response to increasingly complicated school issues, functional enhancement of school systems is needed. It means placing a professional staff with expertise and experience throughout a school and allowing members of the staff to function as a team. Based on such recognition, a plan to rebuild a school into a team was implemented. Consequently, the following were identified: 1. The presence of a teacher who plays a coordinating role is necessary for rebuilding a school into a team. 2. Continuous coordinating efforts by that teacher change awareness in other school personnel. 3. Leadership behavior was observed in the coordinating teacher

A case of external carotid artery lateral to the digastric muscle

An external carotid artery lateral to the posterior belly of the digastric, classified as type IV, was found on the right side of a ₇4–year–old male cadaver during a student dissection practice. The external carotid artery bifurcated from the common carotid artery at the level of the upper border of the hyoid bone. The artery gave rise to the superior thyroid artery, linguofacial trunk, and occipital artery, and ran lateral to the digastric. A long styloid process was found and the stylohyoid descended from it to the hyoid bone. The intermediate tendon of the digastric was deep in relation to the stylohyoid. The external carotid artery on the left side bifurcated from the common carotid artery at a level higher than on the right side. The thyroid–linguofacial trunk bifurcated from the level lower than bifurcation of the common carotid artery. The external carotid artery was lateral to the stylohyoid. An embryological consideration of the course of the type IV external carotid artery in the present case is described

Learning Effectiveness in Nursing Skills Education by Designing a Flipped Classroom with ICT

PDF本研究の目的は、反転授業のデザインを基に再構築して展開した「栄養と食事」の看護技術教育の学習効果と課題を検討することである。反転授業に基づき再構築した技術学習を全て受講し、研究の同意が得られた看護学科１年生10 名を対象にグループインタビューをオンラインで実施し、質的帰納的に分析した。オンデマンド授業後に、オンライン授業と援助計画のディスカッションを経て、食事援助演習を行うという学習方法の効果について、研究に参加した学生の語りを分析した結果、122 コードから9 サブカテゴリーと3 カテゴリーが構成された。オンデマンド授業では＜今までよりも疑問を多く感じ解決したいと思う＞ことで＜既習の知識を全部活用する必要性に気づく＞ことや、＜自分のペースで繰り返す学習で理解が深まる＞ことを実感していた。オンライン授業と対面演習では＜仲間とのやり取りで疑問を解消しながら援助を想像する＞ことや、＜授業での理解を踏まえて患者への良いケアを深く思考する＞という、自らの考えを深める様子が示された。学習途上では＜議論が深まらず疑問が残り不安になる＞様子も見られたが、教員の支援や協働的な学習を経て＜患者にとって良いと思う援助方法を試行錯誤しながら探求する＞ことに至り、＜疑問を解消するためにいつもより教員に質問をする＞ことで＜演習でのやり取りを通じて援助方法に自信が持てる＞と感じていた。反転授業では学習途上において学生が抱く不安に課題があるものの、基本知識の習得と既習知識の活用に効果を発揮し、より良い援助方法を探求する機会となっていた。「栄養と食事」の技術教育は、学生自身が日常生活を手掛かりに想起しやすい援助技術であり、反転授業の展開に適していることが考えられた。Objective：We made a "Nutrition and Diet" nursing skills class with a flipped classroom design. The purpose of this study is to examine the effects and challenges of class. Methods：These are the 10 first-year nursing students who agreed to take all the Flippedclassroom classes. Group interviews were conducted online and analyzed qualitatively. This study was approved by the ethics committee of our institution. Results：The learning effects are summarized in 9categories. On demand, students had more questions than ever and wanted to solve them. Therefore, the students found it necessary to use all the knowledge they had already learned. The students also realized that they could repeat the learning at their own pace, which deepened their understanding. In class, students imagine how to help patients while answering questions through interactions with their peers. Students will think deeply about good patient care based on what they understand in class. And the students seemed to deepen their own thoughts. Students are still studying, so they are worried about not being able to have in-depth discussions with their peers.With the help of teachers and collaborative learning with their peers, they are exploring ways to make things better for patients through trial and error. Students will ask more questions than usual to the faculty to clear their doubts. So, students gain confidence in how to help by interacting with their peers in class. Conclusion：Although student anxiety is an issue for the Flipped classroom, it is effective in helping students learn the basics and use the knowledge they already have. And it is an opportunity for students to explore even better ways to help their patients. The "Nutrition and Diet" class is suitable for a Flipped Classroom because students can easily imagine it from their own daily lives.departmental bulletin pape

A case of double inferior vena cava with a literature review and proposal for new classification

Summary We encountered a case of double inferior vena cava (DIVC) in a 76 year old male cadaver during anatomy practice at Matsumoto Dental University in 2015. The left and right internal iliac veins drained into the interiliac vein ran horizontal in front of the cape angle and joined the left and right external iliac veins. Then the inferior vena cava on each side originated.The width of the origin of the inferior vena cava were 13.7 mm and 11.6 mm on the right and left side, respectively. Based on the previous DIVCʼs classifications, we attempted to classify the DIVC and iliac venous system by combining the direction of the internal iliac veins (lateral (l), vertical (s), and medial (m)), the inclination of the interiliac veins (lower left to upper right (L to R), horizontal (H), and lower right to upper left (R to L)),and the width of the right and left IVC (RIVC>LIVC, RIVC=LIVC, and RIVCLIVC, H, l-l. In this case, hemi-azygos vein was not found, and the height of the left kidney was lower than the right one. We therefore investigated the co-existence of the venous system and the height of the kidney to the 53 cases and referred to the embryological relationship between them. The present classification provides basic knowledge for the clinical anatomy and surgery of the pelvic region

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead