2017 National survey of adherence to neonatal pain management care guideline in Japanese NICUs

平成29年度日本新生児看護学会受託研究　報告

シャルル・フーリエの建築構想における「循環」

　フランスの思想家シャルル・フーリエ（1772- 1837年）は、その理想社会構想において、新しい社会秩序は新しい建築を必要とするとの発想に基づき、共同体内の個々人の行動を促すような建築案を提示した。たとえば、共同体を構成するメンバー間の紐帯を強めるために、系列房(セリステール)（séristère）や回廊式通路(リュ= ギャルリ)（rue-galerie）など、「流れ」や「循環」を重視した建築空間を構想している。この空間における人の「流れ」や「循環」という発想は、同時代の都市や建築と身体の関係を考察するうえでの鍵語でもあった。フランス革命後の18世紀末から19世紀にかけては、ルーヴル宮グランド・ギャルリやパサージュなど、遊歩のための回廊空間が次々と作られた。また、フーリエとほぼ同世代の思想家サン=シモンに影響を受けた技術者たちは、やがてフランスの都市計画・国土計画において「流れ」や「ネットワーク」を重視してゆくこととなる。　本稿は、建築や都市によって創出される空間の性質と、人間の身体の関係を分析する研究の一部をなすものである。建築・都市空間と身体の関係にはいくつかのレベルがある。フーリエに即して考えるならば、都市や建築の構造と人体とのアナロジー（例えば「循環」の比喩）というレベル、それから空間の構造が人間の身体（身体の規律訓練や身体を伴う活動主体による行動）に及ぼす影響や統制というレベルである。本稿で扱うのは、もっぱら後者の文脈での「身体」である

ユートピア都市の書法 : クロード=ニコラ・ルドゥの建築思想

学位の種別: 課程博士審査委員会委員 : (主査)東京大学教授 田中 純, 東京大学教授 三浦 篤, 東京大学准教授 桑田 光平, 東京大学名誉教授 松浦 寿輝, 福井大学教授 白井 秀和University of Tokyo(東京大学

絵のなかを歩くディドロ：「サロン評」の風景画記述と「歩行」のテーマ系

　フランス啓蒙主義時代の哲学者ドゥニ・ディドロは、その絵画批評のなかでたびたび、「絵画のなかに入り込み、歩き回る、あるいは旅をするという体裁で描写する」ことを行なっている。それは、読者の想像力と趣味（goût）を通して、情景を再構成せしめるための修辞法であった。本論文では、ディドロによる「サロン評」のうち、とりわけ風景画の記述における「絵の中に入り込」み、「絵の中を歩く」描写に着目し、分析と考察を行う。これを、18世紀のテクストと絵画経験における「散歩」や「歩行」というテーマ系の中に位置づけることが、ここでの目的である。　まず、ディドロ「サロン評」の風景画記述の総体を踏まえて、特徴的と思われる部分を抽出する。次に、「歩行」をめぐる同時代の特徴的なテクストとの比較を行う。エクフラシス（視覚芸術の言葉による描写）という修辞学的伝統をはみ出して、「テクスト内空間の想像的な歩行」を行うディドロの絵画批評がその特徴的な一例をなすような、18世紀の思想的基盤を明らかにするのが、本論文の目的にして意義である

N-Cadherin Expressed on Malignant T Cell Lymphoma Cells is Functional, and Promotes Heterotypic Adhesion Between the Lymphoma Cells and Mesenchymal Cells Expressing N-Cadherin

Cadherins are Ca2+-dependent cell–cell adhesion molecules, and are involved in the formation and maintenance of the organocellular architecture. Using a combination of molecular biologic and biochemical methods, we analyzed cadherins expressed on cultured human malignant lymphoma cell lines (adult T cell lymphomas, human T cell leukemia virus type 1-negative T cell lines, and thymus-derived lymphoma cell lines), and obtained evidence that N-cadherin is the major cadherin expressed on these cells. These cells were found to form cell aggregates in a Ca2+-dependent manner, and more importantly to coaggregate and adhere with cells expressing N-cadherin, suggesting that N-cadherin on lymphoma cells is functionally active. Therefore, N-cadherin expressed on lymphoma cells could underlie the frequent invasion of these cells into the mesenchymal tissue in the skin and the central nervous system

NICU nurses' perceptions of nursing practice based on family-centered care

目的 : わが国では，1970年代終わりに新生児看護実践にfamily-centered careが取り入れられ始め，その後，family-centered developmental careの普及とともに，family-centeredであることに関心が向けられるようになった．しかし今日，NICU看護師が，自分自身のFCCに基づいた実践をどのように捉え，かつ，実践を困難にさせる理由をどのように捉えているかは十分明らかにされていない．そこで本研究では，FCCに基づいた看護実践に関するNICU看護師の認識を調査し，FCCを推進するための課題を考察することとした． 方法 : 無記名式の構成型質問紙調査を郵送法によって行った．対象者は日本新生児看護学会員674名とし，平成23年4月と平成24年5月に実施した．質問内容は，回答者の背景,FCCに基づいた看護実践，FCCに基づいた看護実践が困難な理由とした．分析は，基本統計量の算出，t検定，一元配置分散分析によって行った． 結果 : 340名から回答を得た(51.4%)．1)各基本概念の平均得点は，「心がけている」「実践している」とも，有意に「参加」が高く，「協働」が低かった．2)基本概念のいずれにおいても，「実践している」より「心がけている」の得点が有意に高かった．3)FCCに基づいた看護実践が困難な理由は，知識や実務の側面が上位を占め，最も多かったのは「医師，看護スタッフ・師長が，FCCの理念を実践化する方法を知らない」であった．4)FCCに基づいた看護実践が困難な理由は，年齢，総臨床経験年数NICU経験年数，他領域経験年数と関連した． 結論 : FCCの推進には，ガイドラインの作成および教育・訓練が重要な課題であることが考えられた．Objectives: Family-centered care was introduced into neonatal nursing practice in Japan at the end of the 1970s. It attracted much interest with the spread of family-centered development care. Today, however, what NICU nurses think about their practice based on FCC, and the reasons it is difficult to practice are not clearly understood. We therefore surveyed the perceptions of NICU nurses on nursing practice based on FCC, and discussed ways of promoting FCC. Methods: An anonymous structured question survey was sent by mail to 674 members of the Japan Academy of Neonatal Nursing in April 2011 and May 2012. Questions asked were on the respondents' background, nursing practice based on family-centered care, and reasons why practicing FCC was difficult. Data were descriptively analyzed and then a t - test and a one- way ANOVA were carried out. Results: 340 valid responses were received (51.4%). 1) Concerning practicing or being mindful of the basic concept of FCC, "participation" scored significantly highly, while the score for "collaboration" was low. 2) For all the basic concepts, the response "mindful" scored significantly higher than "practice". 3) As for the reasons why nursing practice based on FCC is difficult, most issues were related to knowledge and practice. The most frequent response was "doctors, nursing staff, and head nurses do not know how to practice the concept of FCC". 4) The difficulty of nursing practice based on FCC correlated with age and years of total clinical experience, NICU experience, and experience in other areas. Conclusion: Developing the Guidelines and providing education and training are considered necessary to promote nursing practice based on FCC.本研究は日本学術振興会科学研究費補助金基盤研究(B)22390430の助成を受けた研究の一部である

Factors related to employment in childhood cancer survivors in Japan: A preliminary study

PurposePrevious research has revealed vocational and academic difficulties in childhood cancer survivors, and explored impact of survivors' medical history and physical function on vocational and academic status. However, we often encounter survivors with similar diagnoses and late effects but different academic or employment statuses. This raises the question of what affects academic attainment and employment other than treatment or late effects. This study aimed to explore factors associated with childhood cancer survivors' employment status and academic achievement.MethodsComprehensive health check-up and questionnaire survey were conducted for 69 survivors who were over the age of 18 and participated in St. Luke's Lifetime cohort study. We obtained survivors' biological function using comprehensive health check-up, neurocognitive states, quality of life, transition readiness, and family function. We conducted univariate analysis (Mann–Whitney U tests or chi-square tests) to compare the differences between the regular workers/students and non-regular workers/unemployed groups. The variables with p-values <0.1 were used as independent variables multivariate logistic regression to explore predictors of employment status and academic attainment.ResultsResult of the univariate analysis, intelligence quotient, SF-8 PCS, transition readiness, family function were used for multivariate logistic regression as independent variables. The stepwise likelihood method was conducted; intelligence quotient (odds ratio [OR] = 1.100; 95% confidence interval [CI] 1.015–1.193; p = 0.021), transition readiness (OR = 0.612; 95% CI 0.396–0.974; p = 0.038), and family function (OR = 2.337; 95% CI 1.175–4.645; p = 0.015) were found to be associated with survivors' regular workers/students in the final regression model.ConclusionLong-term follow-up of pediatric cancer survivors requires the provision of total care, which supports physical, psychological, and social functions to improve health, readiness for transition to self-management, and family functioning

X-ray Spectral Study of the extended emission,'the Cap', located 11.6 kpc above the disk of M82

The extended X-ray emission from 'the Cap' region located 11' (11.6 kpc) above the disk of the starburst galaxy M82 has been observed with Suzaku and XMM-Newton. Owing to the good energy resolution and the large collecting area of the XIS on Suzaku, combined with similar properties of the EPIC instrument on XMM-Newton, we have clearly detected K-shell emission lines from O VII, O VIII, Ne X, Mg XI, Mg XII and the Fe-L complex. Two optically-thin thermal plasma components are required to fit the observed X-ray spectra. We have determined the metal abundances of O, Ne, Mg, Si and Fe in this region for the first time. Their metal abundance ratios agree well with those of metal-poor stars and the model prediction of metals synthesized by type-II supernovae, but they are not consistent with the metallicities of type-Ia supernovae. This result is support for the idea that the origin of the metals in the Cap is type-II supernovae explosions occurring in the starburst regions in the M82 galaxy. We discuss the possible contribution from sputtered dust grains to the metals in the Cap. An emission line consistent with the C VI transition of n=4 to 1 at 0.459 keV is marginally detected, although it is not statistically significant at the 99% confidence level; the presence of this line would suggest charge-exchange processes in the Cap.Comment: 16 pages, 10 figuer