多職種連携と患者特性に配慮したケアを行った高度肥満症の一例

A ４８-year-old man who weighed ２１６ kg was significantly overweight with a body mass index （BMI）of ７５．６kg/m２, and was unable to walk due to disuse syndrome. Because of the psychological and social problems in the background, a psychological examination was performed and the staff took time to build a trusting relationship with the patient, taking into account his characteristics. With diet and rehabilitation, he was able to lose weight to １２４kg and BMI ４３．９kg/m２ over ６００ days, and was able to walk with assistive devices and defecate by himself. The patient was discharged from our hospital after a series of multidisciplinary meetings with medical, nursing, welfare, and governmental agencies to create an environment for home recuperation. The reasons for the improvement to enable him to be discharged from the hospital were due to the multi-disciplinary meetings among the staff inside and outside the hospital, information sharing and advanced coordination, and smooth communication with the patient by taking into account his characteristics from a psychological standpoint

地域活動への住民参加を促すための保健師の支援方法

A地区の地域活動への住民の参加状況と参加条件を明らかにするため、4団体108名を対象に質問紙調査を行った。地域活動への参加条件として重要なのは、健康であること、家族の理解と協力があること、身近な人と一緒に参加できること、活動場所が自宅に近いこと、活動する時間的余裕があること等が明らかとなった。地域活動支援のあり方としては、個人や家族の健康を保持・増進し、地域の人々のつながりを強め、時間・場所・移動手段を工夫し住民が集いやすくすることにより、参加条件を満たすことが有効と考えられた。保健師は、個人や集団が地域活動を活発にするための工夫や連携を図り、個人・集団の力を引き出せるような支援をしていくことが重要であると考えられた

Quantifying the expansion rates of aftershock zones for magnitude-7 class earthquakes around the Japanese archipelago

Abstract Earthquakes (mainshocks) trigger sequences of aftershocks, the frequency of which diminishes following a power-law decay, while the spatial domain of these aftershocks extends logarithmically over time. The delineation of the aftershock zone can be modulated by variables beyond the magnitude of the mainshock, encompassing the location of the fault (whether the fault is at a plate boundary), the depth at which the event occurs, and the prevailing local stress conditions. Here, we evaluate the expansion rate of aftershock zones by analyzing earthquakes of magnitude-7 class in the vicinity of the Japanese archipelago. Prior studies have offered approximate assessments of expansion rates; however, our approach involves the utilization of a straightforward algorithm for the automated estimation of this metric, facilitating the compilation of a catalog. Across the dataset, no pronounced correlations were discerned between the expansion rate and other examined parameters. Yet, an inverse relationship is identified between the expansion rate and the b value of aftershocks for mainshocks occurring at plate boundaries. This observation suggests that the expansion rate of aftershock zones predominantly mirrors the stress field following the mainshock. Such a pattern is not detected in mainshocks occurring within the plate's interior. While the expansion rate of aftershock zones is likely influenced by various factors, aftershock zones may expand more rapidly with higher differential stress in areas surrounding hypocenters of major interplate earthquakes of magnitude 8 or 9