会話の方策としてのくり返し

本稿では，会話における発話のくり返しがコミュニケーション上の方策としてどのように機能しているかを考察する。様々な種類の会話からくり返しの事例を収集し，それらの持つはたらきを①関説的，②心情的，③動能的，④交話的，⑤詩的，⑥メタ言語的，⑦談話構成的の7つのカテゴリーのもとに分類・記述した。また，くり返しのタイプの違い（自分／他者の発話のくり返し，くり返しをするタイミング，再現の現密度）による機能や表現効果の特徴についても検討した。This paper discusses conversational functions served by repetition of utterances as they are used in communicative strategies. Based on the analysis of 1,078 examples of repetition in various kinds of conversation, the functions of repetition are described under the following categories： ① referential, ② emotive, ③ conative, ④ phatic, ⑤ poetic, ⑥ metalinguistic, and ⑦ discourse-structuring. Repetitions apparently serve different functions and expressive effects according to their type, such as self-/allo-repetition, immediate/delayed repetition, and fixity in form ranging from exact repetition to paraphrase.17の書名 : 国立国語研究所研究報告

発話分析の観点 : 多角的な特徴記述のために

談話の構造を考察する際の分析の単位や方法は，研究の目的によって様々な選択の可能性があるであろう。ここでは，談話を発話機能のやりとり，あるいは連なりとしてとらえる。そして，moveを分析の単位としながら個々の発話のはたらきや特徴を検討し，それを通して談話の姿を記述することを目指す。そのために，まず発話行為を表わす，または発話行為に関係する日本語の動詞・連語を分析し，発話を多角的に考察する際の観点を蓄積する。次に，それらの観点をもとに，①発話の誘発要因，②話し手・聞き手および両者の関係，③はたらきかけの仕方，④述べられる命題の種類，⑤談話の他の発話との関わり方，⑥その他，という基本的な軸に沿った分類項目リストを作成し，発話の特徴づけ作業の一つの手段として提案する。A variety of methods and units of analysis are possible for the description of discourse structures, depending on the specific objectives of the study. In the present study, I regard discourse as an exchange or sequence of speech functions and adopt “move” as the unit of analysis. The goal of this study is to describe discourse features through the identification of speech functions and characteristics of the utterance units (moves), which compose the discourse．For this purpose, I analyzed Japanese verbs and phrases which denote speech acts in order to provide viewpoints for a multi-sided investigation of utterance units. Based on these viewpoints, I propose a list of classifying features organized under the following six categories : (1) the impetus for the utterance, (2) characteristics of speaker, hearer and their relationship, (3) the type of illocutionary act, (4) the proposition type, (5) the relationship of the utterance to other utterances in the discourse, and (6) others.17の書名 : 国立国語研究所研究報告

Characterization of Acinetobacter clinical isolates

Members of the genus Acinetobacter are typical opportunistic bacterial pathogens that can survive for a long term even on inanimate surfaces. Acinetobacter species have natural and acquired antibiotic resistance mechanisms that provide resistance against a broad range of antimicrobial agents. Between April 2010 and March 2011, 6 clinical Acinetobacter sp. strains were isolated from expectoration or aspiration sputum samples in a local medical treatment-type hospital in Osaka prefecture. The antibiotic susceptibility breakpoint test showed that all the 6 isolates were ciprofloxacin-resistant. Strain AHU-70, which was identified as A.baumannii by 16S rRNA sequencing and polymerase chain reaction detection of the blaOXA-51-like gene, showed high levels of resistance to ciprofloxacin by the minimum inhibitory concentration (MIC) test. Preliminary research in Japan, based on nationwide susceptibility surveillance of ciprofloxacin against A.baumannii isolates showed that approximately 90% of the isolates were ciprofloxacin-susceptible. Given these results, further strain level identification of isolates is required to determine whether resistance to ciprofloxacin is an overall trait of these bacteria in the sampled local area or is restricted to a specific strain within particular hospitals

Cutoff Values of Serum IgG4 and Histopathological IgG4+ Plasma Cells for Diagnosis of Patients with IgG4-Related Disease

IgG4-related disease is a new disease classification established in Japan in the 21st century. Patients with IgG4-related disease display hyper-IgG4-gammaglobulinemia, massive infiltration of IgG4+ plasma cells into tissue, and good response to glucocorticoids. Since IgG4 overexpression is also observed in other disorders, it is necessary to diagnose IgG4-related disease carefully and correctly. We therefore sought to determine cutoff values for serum IgG4 and IgG4/IgG and for IgG4+/IgG+ plasma cells in tissue diagnostic of IgG4-related disease. Patients and Methods. We retrospectively analyzed serum IgG4 concentrations and IgG4/IgG ratio and IgG4+/IgG+ plasma cell ratio in tissues of 132 patients with IgG4-related disease and 48 patients with other disorders. Result. Serum IgG4 >135  mg/dl demonstrated a sensitivity of 97.0% and a specificity of 79.6% in diagnosing IgG4-related disease, and serum IgG4/IgG ratios >8% had a sensitivity and specificity of 95.5% and 87.5%, respectively. IgG4+cell/IgG+ cell ratio in tissues >40% had a sensitivity and specificity of 94.4% and 85.7%, respectively. However, the number of IgG4+ cells was reduced in severely fibrotic parts of tissues. Conclusion. Although a recent unanimous consensus of all relevant researchers in Japan recently established the diagnostic criteria for IgG4-related disease, findings such as ours indicate that further discussion is needed

The status of parenting acquaintances and factors related to the presence orabsence of parenting acquaintances among motherswith 18-month-old children.

目的： 1 歳6 か月児を持つ母親の育児仲間の実態と育児仲間の有無に関連する要因を明らかにすることである。対象と方法：A 県B 市の1 歳6 か月児健康診査を受診した母親を対象として，無記名自記式質問紙調査を行った。調査項目は基本属性，育児の状況，育児ストレス，対人態度（内的作業モデル），育児仲間の有無とし，育児仲間の有無に関連する要因をロジステイック回帰分析した。結果：分析対象者105 名のうち，育児仲間がいない者（なし群）は10 名（9.6％），なし群の平均年齢は33.4 歳，子どもの出生順位は第一子70.0％，育児仲間が必要であると回答した者は80.0％であった。育児仲間に最も期待することは手段的サポート（情報交換・子どもを預け合う等）と回答した者は，育児仲間なし群は60.0% で，あり群の20.0％より有意に高かった(p<0.01)。育児ストレス尺度得点の合計は，育児仲間なし群が有意に高く(p<0.01)，内的作業モデル（安定型）の得点は，育児仲間なし群が有意に低かった（ｐ＜0.05）。育児仲間の有無に関連する要因は，育児仲間に最も期待すること（手段的サポート／情緒的サポート）（P=0.015，オッズ比5.443），内的作業モデル（安定型）(P=0.007，オッズ比0.831)であった。考察･結論： 1 歳6 か月児は歩行が確立し外出の機会が増え育児仲間と出会う機会も増えることが予想されるが，育児仲間がいない者が約1 割存在し，それらは育児仲間に手段的サポート（情報交換・子どもを預け合う等）を期待しつつも他者との関係に苦手意識があることから，母親同士の交流が促進される育児仲間づくりの支援が必要である

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020)

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high-quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J-SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU-acquired weakness [ICU-AW], post-intensive care syndrome [PICS], and body temperature management). The J-SSCG 2020 covered a total of 22 areas with four additional new areas (patient- and family-centered care, sepsis treatment system, neuro-intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large-scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members.As a result, 79 GRADE-based recommendations, 5 Good Practice Statements (GPS), 18 expert consensuses, 27 answers to background questions (BQs), and summaries of definitions and diagnosis of sepsis were created as responses to 118 CQs. We also incorporated visual information for each CQ according to the time course of treatment, and we will also distribute this as an app. The J-SSCG 2020 is expected to be widely used as a useful bedside guideline in the field of sepsis treatment both in Japan and overseas involving multiple disciplines.other authors: Satoru Hashimoto,Daisuke Hasegawa,Junji Hatakeyama,Naoki Hara,Naoki Higashibeppu,Nana Furushima,Hirotaka Furusono,Yujiro Matsuishi,Tasuku Matsuyama,Yusuke Minematsu,Ryoichi Miyashita,Yuji Miyatake,Megumi Moriyasu,Toru Yamada,Hiroyuki Yamada,Ryo Yamamoto,Takeshi Yoshida,Yuhei Yoshida,Jumpei Yoshimura,Ryuichi Yotsumoto,Hiroshi Yonekura,Takeshi Wada,Eizo Watanabe,Makoto Aoki,Hideki Asai,Takakuni Abe,Yutaka Igarashi,Naoya Iguchi,Masami Ishikawa,Go Ishimaru,Shutaro Isokawa,Ryuta Itakura,Hisashi Imahase,Haruki Imura,Takashi Irinoda,Kenji Uehara,Noritaka Ushio,Takeshi Umegaki,Yuko Egawa,Yuki Enomoto,Kohei Ota,Yoshifumi Ohchi,Takanori Ohno,Hiroyuki Ohbe,Kazuyuki Oka,Nobunaga Okada,Yohei Okada,Hiromu Okano,Jun Okamoto,Hiroshi Okuda,Takayuki Ogura,Yu Onodera,Yuhta Oyama,Motoshi Kainuma,Eisuke Kako,Masahiro Kashiura,Hiromi Kato,Akihiro Kanaya,Tadashi Kaneko,Keita Kanehata,Ken-ichi Kano,Hiroyuki Kawano,Kazuya Kikutani,Hitoshi Kikuchi,Takahiro Kido,Sho Kimura,Hiroyuki Koami,Daisuke Kobashi,Iwao Saiki,Masahito Sakai,Ayaka Sakamoto,Tetsuya Sato,Yasuhiro Shiga,Manabu Shimoto,Shinya Shimoyama,Tomohisa Shoko,Yoh Sugawara,Atsunori Sugita,Satoshi Suzuki,Yuji Suzuki,Tomohiro Suhara,Kenji Sonota,Shuhei Takauji,Kohei Takashima,Sho Takahashi,Yoko Takahashi,Jun Takeshita,Yuuki Tanaka,Akihito Tampo,Taichiro Tsunoyama,Kenichi Tetsuhara,Kentaro Tokunaga,Yoshihiro Tomioka,Kentaro Tomita,Naoki Tominaga,Mitsunobu Toyosaki,Yukitoshi Toyoda,Hiromichi Naito,Isao Nagata,Tadashi Nagato,Yoshimi Nakamura,Yuki Nakamori,Isao Nahara,Hiromu Naraba,Chihiro Narita,Norihiro Nishioka,Tomoya Nishimura,Kei Nishiyama,Tomohisa Nomura,Taiki Haga,Yoshihiro Hagiwara,Katsuhiko Hashimoto,Takeshi Hatachi,Toshiaki Hamasaki,Takuya Hayashi,Minoru Hayashi,Atsuki Hayamizu,Go Haraguchi,Yohei Hirano,Ryo Fujii,Motoki Fujita,Naoyuki Fujimura,Hiraku Funakoshi,Masahito Horiguchi,Jun Maki,Naohisa Masunaga,Yosuke Matsumura,Takuya Mayumi,Keisuke Minami,Yuya Miyazaki,Kazuyuki Miyamoto,Teppei Murata,Machi Yanai,Takao Yano,Kohei Yamada,Naoki Yamada,Tomonori Yamamoto,Shodai Yoshihiro,Hiroshi Tanaka,Osamu NishidaGuideline

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020)

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high-quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J-SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU-acquired weakness [ICU-AW], post-intensive care syndrome [PICS], and body temperature management). The J-SSCG 2020 covered a total of 22 areas with four additional new areas (patient- and family-centered care, sepsis treatment system, neuro-intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large-scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members.other authors: Yasuhiro Norisue, Satoru Hashimoto, Daisuke Hasegawa, Junji Hatakeyama, Naoki Hara, Naoki Higashibeppu, Nana Furushima, Hirotaka Furusono, Yujiro Matsuishi, Tasuku Matsuyama, Yusuke Minematsu, Ryoichi Miyashita, Yuji Miyatake, Megumi Moriyasu, Toru Yamada, Hiroyuki Yamada, Ryo Yamamoto, Takeshi Yoshida, Yuhei Yoshida, Jumpei Yoshimura, Ryuichi Yotsumoto, Hiroshi Yonekura, Takeshi Wada, Eizo Watanabe, Makoto Aoki, Hideki Asai, Takakuni Abe, Yutaka Igarashi, Naoya Iguchi, Masami Ishikawa, Go Ishimaru, Shutaro Isokawa, Ryuta Itakura, Hisashi Imahase, Haruki Imura, Takashi Irinoda, Kenji Uehara, Noritaka Ushio, Takeshi Umegaki, Yuko Egawa, Yuki Enomoto, Kohei Ota, Yoshifumi Ohchi, Takanori Ohno, Hiroyuki Ohbe, Kazuyuki Oka, Nobunaga Okada, Yohei Okada, Hiromu Okano, Jun Okamoto, Hiroshi Okuda, Takayuki Ogura, Yu Onodera, Yuhta Oyama, Motoshi Kainuma, Eisuke Kako, Masahiro Kashiura, Hiromi Kato, Akihiro Kanaya, Tadashi Kaneko, Keita Kanehata, Ken-ichi Kano, Hiroyuki Kawano, Kazuya Kikutani, Hitoshi Kikuchi, Takahiro Kido, Sho Kimura, Hiroyuki Koami, Daisuke Kobashi, Iwao Saiki, Masahito Sakai, Ayaka Sakamoto, Tetsuya Sato, Yasuhiro Shiga, Manabu Shimoto, Shinya Shimoyama, Tomohisa Shoko, Yoh Sugawara, Atsunori Sugita, Satoshi Suzuki, Yuji Suzuki, Tomohiro Suhara, Kenji Sonota, Shuhei Takauji, Kohei Takashima, Sho Takahashi, Yoko Takahashi, Jun Takeshita, Yuuki Tanaka, Akihito Tampo, Taichiro Tsunoyama, Kenichi Tetsuhara, Kentaro Tokunaga, Yoshihiro Tomioka, Kentaro Tomita, Naoki Tominaga, Mitsunobu Toyosaki, Yukitoshi Toyoda, Hiromichi Naito, Isao Nagata, Tadashi Nagato, Yoshimi Nakamura, Yuki Nakamori, Isao Nahara, Hiromu Naraba, Chihiro Narita, Norihiro Nishioka, Tomoya Nishimura, Kei Nishiyama, Tomohisa Nomura, Taiki Haga, Yoshihiro Hagiwara, Katsuhiko Hashimoto, Takeshi Hatachi, Toshiaki Hamasaki, Takuya Hayashi, Minoru Hayashi, Atsuki Hayamizu, Go Haraguchi, Yohei Hirano, Ryo Fujii, Motoki Fujita, Naoyuki Fujimura, Hiraku Funakoshi, Masahito Horiguchi, Jun Maki, Naohisa Masunaga, Yosuke Matsumura, Takuya Mayumi, Keisuke Minami, Yuya Miyazaki, Kazuyuki Miyamoto, Teppei Murata, Machi Yanai, Takao Yano, Kohei Yamada, Naoki Yamada, Tomonori Yamamoto, Shodai Yoshihiro, Hiroshi Tanaka & Osamu Nishid