Factors Influencing Psychological Independence in Adolescents and Their Relationship to Coaching-based Support from Significant Others

[Background] An increasing number of adolescents are experiencing social maladjustment. This development may be due to serious conflicts regarding psychological independence. This study aimed to elucidate factors that influence psychological independence in adolescents and to clarify the relationship among coaching-based support from significant others, adolescent self-esteem, and adolescent psychological independence, in order to help prevent and treat social maladjustment in adolescents. [Methods] A total of 1814 students in all years at 2 universities and 1 junior college in A Prefecture, Japan, completed an anonymous self-administered questionnaire. The questionnaire asked about the participants’ attributes, support relationships, psychological independence, and self-esteem. Coaching-based support was assessed by the Accelerate your Coaching Effectiveness scale; psychological independence by the Psychological Jiritsu Scale; and self-esteem by the Rosenberg Self-Esteem Scale. [Results] Gender, grade, major, current living situation were found to influence psychological independence of adolescents. The most significant others who had the most influence on psychological independence were mothers, fathers, and friends for male adolescents, and mothers, friends, and fathers for female adolescents, in that order. In female, coaching-based support from significant others increased their self-esteem and promoted all the sub-scales of psychological independence. In male, coaching-based support boosted their self-esteem and promoted the following sub-scales; “future orientation”, “appropriate human relations”, “value judgment and execution”, “responsibility”, and “social perspective”, except for “self-control”. [Conclusion] We believe that coaching-based support from significant others can effectively help adolescents build their self-esteem and can promote their psychological independence

Characteristic multimodal imaging of medication-related osteonecrosis of the jaw : comparison between oral and parenteral routes of medication administration

Background: To assess multimodal imaging features of medication-related osteonecrosis of the jaw (MRONJ) and to analyze the differences between oral and parenteral routes of medication administration. We retrospectively reviewed panoramic radiographs, CT, MRI, and bone scintigraphy of patients with MRONJ. Material/Methods: A retrospective study was conducted in 16 patients with MRONJ who underwent panoramic radiography, CT, MRI, and bone scintigraphy. Statistical analysis for the comparison between routes of medication administration and multimodal imaging features was performed with the Pearson's c2 test. Results: The percentage of cases with sequestrum separation was 25.0% (4/16 cases) on panoramic radiography and 81.3% (13/16 cases) on CT. The percentage of cases with periosteal bone proliferation on CT was 41.7% (5/12 cases) in the oral route of administration vs. 100% (4/4 cases) in the parenteral route of administration (p=0.042). The percentage of cases with spread of soft tissue inflammation to buccal and other spaces on CT and MRI was 33.3% (4/12 cases) in the oral route of administration vs. 100% (4/4 cases) in the parenteral route of administration (p=0.021). Conclusions: The sequestrum separation on panoramic radiography in patients with MRONJ was unclear in comparison to CT. Furthermore, characteristic CT findings of patients with MRONJ in the parenteral administration group were periosteal bone proliferation and spread of soft tissue inflammation to buccal and other spaces

Diffusion-weighted imaging in the oral and maxillofacial region : usefulness of apparent diffusion coefficient maps and maximum intensity projection for characterization of normal structures and lesions

Background: The aim of this study was to investigate diffusion-weighted imaging (DWI) in the oral and maxillofacial region, with a special focus on the usefulness of apparent diffusion coefficient (ADC) maps and maximum intensity projection (MIP) for characterization of normal structures and lesions. Material/Methods: Thirty-five patients who underwent magnetic resonance imaging (MRI) for diagnosis of oral and maxillofacial lesions were included in this prospective study. DWI was performed on a 1.5 T unit, with b factor of 0 and 800 s/mm2; moreover, ADC maps were generated. ADC values were measured for normal structures, odontogenic infections, squamous cell carcinomas (SCC), and hemangiomas. Results: As regards the normal structures, the mean ADC value of the cerebrospinal fluid (3.65±0.60×10-3 mm2/s) in the upper neck area was higher than that of the spinal cord (0.74±0.15×10-3 mm2/s, P=0.000), lymph nodes (0.87±0.17×10-3 mm2/s, P=0.000), and Waldeyer’s ring (0.92±0.29×10-3 mm2/s, P=0.000). The mean ADC value of hemangiomas (1.52±0.31×10-3 mm2/s) was higher than that of odontogenic infections (0.85±0.36×10-3 mm2/s, P=0.034) and SCC (1.38±0.22×10-3 mm2/s, P=0.840). Furthermore, MIP (DWI) showed the normal structures and lesions in the oral and maxillofacial region in an improved way. Conclusions: DWI, ADC maps, and MIP can be used to characterize and differentiate normal structures and lesions in the oral and maxillofacial region

Comparison between squamous cell carcinoma and inflammatory diseases of the oral and maxillofacial region using gallium-67 scintigraphy with computed tomography and magnetic resonance imaging

Purpose: This study aimed to compare squamous cell carcinoma (SCC) with inflammatory diseases of the oral and maxillofacial region using gallium 67 (67Ga) scintigraphy with computed tomography (CT) and magnetic resonance imaging (MRI). Material and methods: Seventy patients with SCC and 15 patients with inflammatory diseases of the oral and maxillofacial region underwent 67Ga scintigraphy with CT and MRI. A comparison between imaging features of 67Ga scintigraphy, CT, and MRI and lesions was performed with the Pearson's chi-squared test. Results: 67Ga scintigraphy was positive for 25 of 39 patients with SCC positive on CT and/or MRI (64.1%) and for 13 of 15 patients with inflammatory diseases positive on CT and/or MRI (86.7%). The detection of inflammatory diseases with 67Ga scintigraphy was higher than that of SCC (p = 0.104). Conclusions: This study compared SCC with inflammatory diseases of the oral and maxillofacial region using 67Ga scintigraphy with CT and MRI. 67Ga scintigraphy is an effective technique for detection of inflammatory diseases of the oral and maxillofacial region

青年期の心理的自立に関する国内文献レビュー

ひきこもりや家庭内暴力など、社会的不適応の背景に存在すると考えられる青年期の心理的自立に関する国内研究の動向や内容を分析し、今後の研究課題を検討した。心理的自立の研究は、 自立の概念研究から始まり、社会・時代的状況に関連させた研究が展開されていた。今後の研究課題は、　1）心理的自立概念の明確化や尺度開発研究の継続、2）青年期の社会問題に対し、心理的自立をキーワードにした研究の実施、3）心理的自立を研究する際は、その背景にある文化、社会・時代的状況、性差、居住環境を考慮すること、4）心理的自立に関連する要因の解明、5）心理的自立に関連する家庭環境について、その基盤である夫婦関係に焦点をあてた研究の実施、以上5点が明らかとなった

Structural variations in parotid glands induced by radiation therapy in patients with oral carcinoma observed on contrast-enhanced computed tomography

Background: Xerostomia is one of the commonest radiation-induced complications in patients with head and neck carcinoma. The aim of this study was to assess structural variations in parotid glands induced by radiation therapy in patients with oral carcinoma with contras-enhanced computed tomography (CECT). Material/Methods: A retrospective study was performed in 41 patients with oral carcinoma who underwent CECT for head and neck malignancies before and after radiotherapy. We analyzed the relationship between parotid density variations, parotid volume change, as seen on CECT, and the mean radiation dose applied to the parotid glands in patients with oral carcinoma immediately after radiotherapy, and 2 and 3 years later. Results: Immediately after radiotherapy, high-density changes on contrast-enhanced CT were observed in 70.5% of the irradiated parotids. Low-density changes due to fat degeneration were seen in 46.2% and 72.2% of the irradiated parotids 2 and 3 years after radiotherapy, respectively. The mean dose applied to the parotids with the low-density changes and without such changes 3 years after radiotherapy was 46.0 Gy and 27.7 Gy, respectively (p=0.049). Furthermore, parotid shrinkage was observed in 63.6% of the irradiated parotids. Conclusions: This study suggests that the structural variations in parotid glands induced by radiotherapy included high-density changes that were observed immediately after radiotherapy and low-density changes that were seen at late follow-up. This study should be useful for clinicians in the assessment of radiation-induced injuries in the parotids with respect to early prediction of xerostomia

自然散策、温泉入浴が女性の自律神経機能へ及ぼす影響

日帰りのヘルスツーリズムの企画において自然散策と温泉入浴を参加者女性に体験してもらい、女性の自律神経機能へ及ぼす影響について科学的検証を行った。対象者は成人女性11 名である。結果、自然散策前後では身体的ストレス得点は自然散策後に散策前より有意に上昇した（p ＜ .01）。ストレス対処能力得点は有意に低下していた（ｐ＜ .01）。疲労度得点は自然散策後で低下していた（ｐ＜ .05）。温泉入浴の前後の自律神経活動において有意差はみられなかった。効果には個人差や女性ホルモンの影響も考慮する必要がある

妊娠後期女性の自律神経活動が温泉入浴を含む ヘルスツーリズムにおいて改善を示した１例

2016年度からメンタルヘルス対策として，成人を対象に日帰りのヘルスツーリズムを企画・実施し，効果の検証を重ねてきた。今回，屋内型日帰りヘルスツーリズム（講話，食事，陶芸，温泉入浴の体験）を企画した。参加申し込みがあった妊娠後期女性において自律神経機能が改善したので報告する。分析対象者は，屋内型日帰りヘルスツーリズム（以後：ヘルスツーリズム）に家族とともに参加した現在産前産後休暇中の妊娠37週女性１名である。ヘルスツーリズム前の自律神経活動反応は安静CVRR 6.94％，着席 ccvHF 3.80％と過剰であり，安静 ccvL/H0.09％，⊿CVRR -1.41，⊿ccvL/H -0.01は低値を示していた。ヘルスツーリズム後は安静CVRR3.75％，⊿CVRR 1.89，⊿ccvL/H 0.08は標準に修正していた。安静ccvL/H 0.07％と着席ccvHF 3.87％に変化はみられなかった。平均心拍および瞬時心拍は測定においてヘルスツーリズム前後で大きな変化は見られなかった。CVRR はヘルスツーリズム前の安静座位で過剰であったが，起立・立位・着席には変化はみられなかった。本調査における１症例の結果，屋内型日帰りヘルスツーリズム（講話，食事，陶芸，温泉入浴の体験）は，妊娠後期女性の自律神経機能を改善に導く可能性が示唆された

地域看護実習指導者が必要とする保健師基礎教育のあり方

本研究は、第一線で活動している保健師の学生の実習をとおした意見をもとに、保健師基礎教育の今後の課題を明らかにすることを目的とした。S県にて就業中の行政保健師を対象とし、実習指導において気づいた点についてアンケート調査を行った。その結果、学生は日頃からの対人関係づくり、目的・問題意識、社会情勢への関心、生活力や積極性の習得、講義内容の再学習、教員は、実習ラウンド時の指導内容強化、現場学習、指導者は、学生実習の業務への位置づけ、実習指導手引きの作成、学生指導からの学びが課題であった。教育体制については、 1年以上の保健師教育の必要性、実習内容の充実、実習指導に関する研修の開催が今後の課題であることが明らかになった