子育て知識・行動に関する世代間差異の実態と母親の精神健康度や心理社会因子との相互関係に関する横断研究

学位記番号：博（健）甲第二十二

若者ｿｰｼｬﾙﾜｰｸ論構築に関する基礎研究 ―佐世保市における商店主へのｲﾝﾀﾋﾞｭｰ調査分析から―

本論は､若者ｿｰｼｬﾙﾜｰｸの理論構築の一部として､子どもが育つ環境の変化が若者の暮らしに与える影響について構造を明らかにする｡特に､長崎県佐世保市における｢子ども同士の二つの殺人事件(2004年､2014年)｣の出来事は､若者の生きづらさを持つ地域環境に原因があるのではと仮説をたてた｡そこで､子どもの発達が保障される｢場｣である｢家庭･学校･地域｣のうち､｢地域｣に焦点をあて､商店街の店主にﾌｫｰｶｽ･ｸﾞﾙｰﾌﾟｲﾝﾀﾋﾞｭｰを行い､SCQRM: Structural Construction Qualitative Research Method (西條:2005)を用いて分析した｡子どもを取り巻く環境は､衝撃的な事件によって『｢まち｣が固まり』､心の教育に10年間取り組んでいても､“また佐世保”で事件が起き､『｢まち｣が沈む』という体験をしていた｡子どもたちを取り巻く環境は､情報化と急激な競争の波の影響を受け､『翻弄される子ども』を生み出し『子どもが生きづらい』｢場｣となっていた｡The purpose of this study was to clarify the effects of changes in the environment of young people as they grow up, related to the construction of the Youth Social Work Theory. In particular, we hypothesized that the difficult living environment for youth may have been the cause behind the two incidents of children killing children in Sasebo, Nagasaki Prefecture (2004, 2014). Among the places that influence children\u27s development (home, school, community) , we decided to focus on the community aspect and carried out interviews with shopkeepers in the downtown shopping district. The results were analyzed with SCQRM: Structural Construction Qualitative Research Method (Saijo: 2005). The incidents that occurred in Sasebo left the city in a state of shock that was acutely felt by the city\u27s youth. Even though the city responded by implementing children\u27s mental health care programs, ten years after the initial incident, again a similar incident occurred in Sasebo, and the city and its residents sank deeper into a general feeling of malaise and gloom. In addition, the intrusive nature of information-oriented society and the competitive and unforgiving academic demands imposed on youth in primary and secondary schools deeply affected the city\u27s environment for young people

高齢がん患者の在宅移行期の文献レビュー

The purpose of this study was to characterize periods of hospital-to-home care transition for elderly cancer patients by extracting definitions of such periods and their characteristics as situations from the literature, and to discuss effective nursing support toward hospital-to-home care transition. Relevant research papers published within the period between ２０１０ and ２０２０ were searched for using Ichushi Web and PubMed. Descriptions related to periods of transition, characteristics of situations, and hindering／promoting factors were extracted without any changes and categorized based on descriptive content similarities. In these papers, a period of hospital-to-home care transition was described as １ week to １ year after discharge. As a situation, it was characterized as “a time when the patient rebuilds his／her life”, and therefore, “a time of instability”. Factors hindering and promoting hospital-to-home care transition were represented by６categories, which suggested the following commonalities between them : ［ physical management］,［patients’／families’ intentions］,［home care systems］,［other family members’ commitments to home care］, ［collaboration systems］, and［nurses’ home care experience］

Need for Flexible Adjustment of the Treatment Schedule for Aprepitant Administration against Erlotinib-Induced Refractory Pruritus and Skin Rush

Common dermatological side-effects associated with erlotinib, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), include pruritus and skin rash, which are mediated by substance P, leading to the occasional discontinuation of cancer treatment. Aprepitant is an antagonist of neurokinin-1 receptor, through which substance P activates the pruritogens. Thus, aprepitant is expected to offer a promising option for the treatment of erlotinib-induced pruritus. However, the appropriate treatment schedule for aprepitant administration is under consideration. Here, we discuss the need for flexible adjustment of the treatment schedule for aprepitant administration against erlotinib-induced refractory pruritus and skin rush. A 71-year-old female smoker presented with stage IV EGFR-mutated lung adenocarcinoma. She was started on erlotinib at 150 mg/day. However, by 28 days, severe pruritus and acneiform skin rush resistant to standard therapies occurred, resulting in the interruption of erlotinib therapy. After recovery, she was restarted on erlotinib at 100 mg/day. However, severe pruritus and skin rush developed again within 2 weeks. Then, we started the first 3-day dose of aprepitant (125 mg on day 1, 80 mg on day 3, and 80 mg on day 5) based on the results of the previous prospective study, which showed the success rate of 100% with at least the second dose of aprepitant. However, the pruritus and skin rush exacerbated again within 4 weeks. Therefore, we started the second 3-day dose of aprepitant, but in vain. At this point, as the patient-centered medicine, bi-weekly schedule of the 3-day dose of aprepitant was considered and, then, adopted. As the results, the pruritus and skin rush remained well-controlled throughout the subsequent treatment with erlotinib

Novel SPEF2 Variant in a Japanese Patient with Primary Ciliary Dyskinesia: A Case Report and Literature Review

Primary ciliary dyskinesia (PCD) is a genetic and congenital disease associated with an abnormal ciliary ultrastructure and function and is estimated to affect 1 in 15,000–20,000 individuals. A PCD diagnosis can be achieved by genotyping. Here, we performed whole-exome analysis for the diagnosis of PCD and described the detailed clinical characteristics of the case. A 39-year-old Japanese woman with sinusitis and bronchiectasis without situs inversus had had upper and lower respiratory symptoms since childhood and had received long-term macrolide therapy without an accurate diagnosis. A moderate deterioration of cilia function was observed by high-speed video microscopy analysis; additionally, the number of cells with moving cilia was fewer than that in patients without PCD. Electron microscopy revealed no apparent structural abnormalities. We performedwhole-exome analysis and identified novel biallelic variants of SPEF2 in the homozygous state (c.1860_1861insCT).We confirmed the absence of SPEF2 protein expression in the cilia of the nasal mucosa using fluorescent immunostaining. Accordingly, she was diagnosed as having PCD with the SPEF2 variant. The present case suggests that the deterioration of cilia function is moderate, the number of respiratory cells with moving cilia might be reduced, and the respiratory condition could be severe in patients with PCD with the SPEF2 variant

New Approach to Teaching Japanese Pronunciation in the Digital Era - Challenges and Practices

Pronunciation has been a black hole in the L2 Japanese classroom on account of a lack of class time, teacher\u2019s confidence, and consciousness of the need to teach pronunciation, among other reasons. The absence of pronunciation instruction is reported to result in fossilized pronunciation errors, communication problems, and learner frustration. With an intention of making a contribution to improve such circumstances, this paper aims at three goals. First, it discusses the importance, necessity, and e ectiveness of teaching prosodic aspects of Japanese pronunciation from an early stage in acquisition. Second, it shows that Japanese prosody is challenging because of its typological rareness, regardless of the L1 backgrounds of learners. Third and finally, it introduces a new approach to teaching L2 pronunciation with the goal of developing L2 comprehensibility by focusing on essential prosodic features, which is followed by discussions on key issues concerning how to implement the new approach both inside and outside the classroom in the digital era