介護福祉士養成における在宅介護実習の位置づけ

本研究は，在宅介護実習（介護実習Ⅲ）で獲得した在宅支援の視点が，施設をフィールドとし，介護過程の展開実習となる施設介護実習（介護実習Ⅳ）において，個別ケアを実践できる利用者本位の介護への実現にどの程度効果を発揮しているかを明らかにすることを目的としたものである．医療介護福祉科2年次生で介護実習Ⅲ及び介護実習Ⅳを終了した学生を対象に質問紙調査及びインタビュー調査を行った．その結果は，①介護実習Ⅲの学びとなる利用者の在宅への想いや物理的環境への意識の高まり，すなわち利用者本位に向かうアセスメントの視点が介護実習Ⅳへとつながっていること，②利用者との良好な関係形成を築くためのコミュニケーション力が介護実習Ⅳで発揮されていることが説明できた．介護実習Ⅲは，介護実習Ⅳで個別ケアを実践できる利用者本位の介護への実現に活かされていた

ネパール ニ オケル トキソプラズマショウ ノ ケッセイ エキガク チョウサ

We studied the seroprevalence of anti-Toxoplasma antibodies among inhabitants of the Kathmandu Valley, Nepal (location of the capital, Kathmandu) and inhabitants of a village area in Lekhnath City, Kaski District (central Kathmandu), epal. A total of 376 serum samples were collected from apparently healthy participants. Toxoplasma antibodies (IgM and IgG) were detected by enzyme- linked fluorescent assay (ELFA). In the Kathmandu Valley, positive rates for Toxoplasma IgM and IgG antibodies were 1.4% (2/146) and 35.6% (52/146) respectively. In Lekhnath City, positive rates were 2.6% (6/230) for IgM antibodies and 60.4% for IgG antibodies, i.e., comparatively higher than those in the Kathmandu Valley. The higher prevalence of these antibodies in the Lekhnath City village area was associated with animal keeping in almost all households, while in the Kathmandu Valley only a few households kept animals. However, the seroprevalence of anti-Toxoplasma antibodies in these areas was relatively high in each case. Environmental conditions may be responsible for the transmission of Toxo- plasma parasites in both areas

Analysis of the Nutrient Intake and the Nutritional and Health State of the people in a Nepalese Mountainous Village:Dithal VDC

【目的】世界辺境地区の一つであるネパール山間地方の住民の摂取栄養と健康状態について解析した。【方法】神戸常盤大学を中心に共同調査プロジェクト(JICA 草の根事業)を編成し、ネパールデタール村でのフィールドワークを行った。住民208名(年齢5～82歳、男女比82:126)の健康調査を施行し、身体計測とBIA法を用いた体構成成分測定、および血液検査(TP、Albumin、GPT、BUN、Ca)を行った。また住民の内科診療を行い、下痢などの消化管疾患の有無を調査した。さらに、一般家庭における日々の食事内容をデジタルカメラに撮影し、摂取熱量、摂取栄養素を計測すると同時に、村の採水所30ヵ所での飲水を含めた生活用水の細菌学的検査を行った。【結果】身体計測上、BMI<18.5の比率が50%を超え、12歳以下の子供では80%近くに及んだ。体構成成分測定では、特に子供で体内脂肪、筋肉量の減少と、体内水分量の増加が見られた。また一見肥満体系であっても、栄養障害による浮腫や、筋肉量の減少による下腹部の突出(クワシオルコル)を示す症例も、12歳以下の子供で見られた。血液検査は、血清総タンパク、アルブミンの低下以外は、ほぼ正常値内であった。食事は、ネパール特有のダル・バート・タルカリという炭水化物が中心の料理で、摂取栄養素の80%を占めた。1日2食が標準である現地人の平均摂取熱量は800～1000kcal程度と推計された。飲料水の細菌学的検査では、大腸菌、及び大腸菌群が80～100%の頻度で検出された。【結論】未だカースト制度の現存するネパールの山間地方における栄養状態と衛生環境は劣悪であったが、これは過去に先進国が経た道であり、自らの事として手を差しのべる必要があると考えられた。The research team jointed with Kobe Tokiwa University, Kobe University, and Nepal Medical College has been organized to implement the fieldwork at Dithal Village in Nepalese mountainous area for JICA Kusanone Project. In the fieldwork, the nutritional and health state of 208 village inhabitants (5 to 82 years old : 82 of male and 126 of female) were investigated, and their daily dietary foods were analyzed intake of calories and nutrients. The state of hygiene was also studied including of checking the contamination of drinking water microbiologically. The results showed that the high presence of over 50% of thinness, which is defined as less than 18.5 of BMI, was estimated in all age-groups, however among the age group under 12 years, the rate was much higher up to 75~80%. In body component analysis, the decreased fat and muscle volume and increased body water volume were manifested in children. Some of the children showed the distended abdomen, which is the typical sign of Kwashiorkor type malnutrition. The average calorie intake of daily diet was estimated about 800～1000kcal, and the content of it was 80% of carbohydrate, 10% each of fat and protein. The contaminations of Coliform bacilli and E. coli could be detected 80 to 100% of drinking water at 30 water places. The internal medical check revealed the prevalence of water-borne digestive diseases with abdominal pain, vomiting, and diarrhea. The deteriorated nutritional and public health state in Nepalese mountainous area could be disclosed in this study, but these are the similar paths on which the advanced countries have gone through in their past. We are entrusted to give our hands to them

Type of time management in elementary school students : Home works during winter vacation

長期休暇中に様々な宿題を行わなければならない児童は,計画を立てた上で宿題をしているのだろうか。本研究では,計画を立てた小学生と立てなかった小学生それぞれの宿題の取り組み方について調査した。小学生の宿題の取り組み方は4 タイプに分類された:(a)ほぼ毎日していた“安定型",(b)冬休みの前半で集中的に宿題をするが,後半からペースが落ちる“前半集中型",(c)冬休みの前半では宿題をあまりしないが,後半からペースを上げる“後半集中型",(d)ほとんど宿題をしなかった“逃避型"。計画作成の有無でそれぞれのタイプを分類した結果,計画を立てていなかった小学生には逃避型が多く,計画を立てた小学生には安定型,前半集中型,後半集中型が多いことが示された

Analysis of the response and toxicity to gefitinib of non-small cell lung cancer

Background: Gefitinib is an oral agent that inhibits the tyrosine kinase of epidermal growth factor receptor (EGFR), which had antitumor activity in patients with previously treated non-small cell lung cancer (NSCLC). We analyzed the efficacy, toxicitiy, and overall survival time of gefitinib in patients with NSCLC. Patients and Methods: One hundred and twenty-two patients with NSCLC who received gefitinib between 2002 and 2004 in our institutes were evaluated retrospectively. Results: The objective response rate was 24.6%. The variables identified as significant in univariate analysis included gender and smoking habit. The median overall survival time was 14.4 months. Significant variables associated with improved survival included good performance status (PS), female, adenocarcinoma and never smoked status, and never smoked status and good PS were independent prognostic factors in multivariate analysis. Four patients (3.3%) developed interstitial pneumonitis associated with gefitinib. Conclusion: Gefitinib showed favorable anti-tumor activity in females, never smokers and adenocarcinoma