ショウガッコウ ノ チイキ ガクシュウ プログラム ニ オケル タヨウ ナ シュタイ ノ レンケイ ニ カンスル コウサツ －コウエン ヅクリ ヲ カダイ ト シタ チイキ ガクシュウ ヲ ジレイ ト シテ－

本研究では，砧小学校と喜多見小学校における地域の公園づくりを課題とした小学校の地域学習プログラムの試行を通じて，小学校の立地する地域の大学・行政・専門アドバイザーの多様な主体が連携した地域学習教育の支援体制のあり方を考察することを目的としている。公園づくりでは地域認識，時代認識，そしてストーリー性が重要であることから，「地域認識」・「課題解決（自分で考え，みんなで合意形成）」・「成果発表」の3つのステップで授業を進めた。第1段階「地域認識」では，砧・喜多見地域の豊かな自然環境資源と往古からつながる歴史文化資源を学び，児童に地域の歴史文化，自然環境の認識・理解させるために，専門アドバイザーが指導した。第2段階「課題解決（自分で考え，みんなで合意形成）」では，公園づくりの課題をまず自分で考えたのち，他人と意見を説明し合い合意形成していく力を養うために，児童が主体的，協働的に学ぶグループワークとし，その進行とファシリテーター役を大学教員と大学生が担った。第3段階「成果発表」では，子ども達の自信と誇りにつなげるために，児童1人1人が主体的に自らの公園アイデアを発表し，地域への誇り，愛着を深めてもらうために世田谷区（街づくり課）が児童の個々のアイデアを公園アイデア集として冊子にし，児童個々に配布した。本研究のケーススタディを通じて地域学習では地域の行政・小学校・大学・専門アドバイザー等の多様な主体が関わり，その役割を明確にし，協働連携した教育体制が重要であると考えられた。This study evaluates the effectiveness of a collaborative, student-led approach to park design, during the comprehensive learning period at Kinuta and Kitami elementary schools. We used a three-step design in the program : first, identify the region’s assets and character ; second, develop individual views and group consensus around desired outcomes ; and third, to encourage ownership of the park’s design by the students. The first step of the process is the recognition of the region’s character through the production of a playground map by the students, after learning about the area’s natural resources and heritage through play-oriented tasks from the regional supervisor. The second step aimed to develop students’ analytical skills by encouraging them to think individually about the park’s design, then to build consensus through discussion and negotiation with their peers with the role of facilitator by university teachers and also with students practicing the role of facilitator for the university teacher and students. Finally, the third step aimed to inspire students’ confidence and sense of ownership of their park design, to enhance future engagement with the region’s stewardship. This regional educational program involved local administrations, elementary schools, universities and consultant specialist advisers, whose collective roles and responsibilities need to be clarified to ensure effective collaboration within the wider educational system

Prevention of hypoglycemia by intermittent-scanning continuous glucose monitoring device combined with structured education in patients with type 1 diabetes mellitus : A randomized, crossover trial

Aims: We conducted a randomized, crossover trial to compare intermittent-scanning continuous glucose monitoring (isCGM) device with structured education (Intervention) to self-monitoring of blood glucose (SMBG) (Control) in the reduction of time below range. Methods: This crossover trial involved 104 adults with type 1 diabetes mellitus (T1DM) using multiple daily injections. Participants were randomly allocated to either sequence Intervention/Control or sequence Control/Intervention. During the Intervention period which lasted 84 days, participants used the first-generation FreeStyle Libre (Abbott Diabetes Care, Alameda, CA, USA) and received structured education on how to prevent hypoglycemia based on the trend arrow and by frequent sensor scanning (≥10 times a day). Confirmatory SMBG was conducted before dosing insulin. The Control period lasted 84 days. The primary endpoint was the decrease in the time below range (TBR; <70 mg/dL). Results: The time below range was significantly reduced in the Intervention arm compared to the Control arm (2.42 ± 1.68 h/day [10.1 %±7.0 %] vs 3.10 ± 2.28 h/day [12.9 %±9.5 %], P = 0.012). The ratio of high-risk participants with low blood glucose index >5 was significantly reduced (8.6 % vs 23.7 %, P < 0.001). Conclusions: The use of isCGM combined with structured education significantly reduced the time below range in patients with T1DM

Plywood-Like Structure Of Injection-Moulded Polypropylene

Injection-moulded products having unique structure, in which the direction of molecular orientation in the skin layer is perpendicular to that in the core layer, are developed employing isotactic polypropylene with a nucleating agent. The extraordinary three-layered structure with β trigonal crystal form in the core layer, which shows higher impact strength than the conventional α monoclinic form, leads to high level of toughness. Moreover, an injection-moulded product having five-layered structure is also demonstrated in this paper. Because of the complicated crack propagation nature due to the abrupt change of molecular orientation, which avoids fractured pieces with sharp-edge, the products with plywood-likestructure will be employed in various applications to improve the safety

A clinical study of curative partial breast irradiation for stage I breast cancer using carbon ion radiotherapy

Background and purpose: Our institute initiated carbon ion radiotherapy research for patients with stage I breast cancer in April 2013. The purpose of this article is to evaluate the treatment outcome of cases treated outside clinical trial up to May 2020. Materials and methods: Eligibility criteria of the patients were having untreated stage I breast cancer and being unsuitable for operation for physical or mental reasons. The irradiated volume was defined as the gross tumor including intraductal components. The dose escalation study was initially conducted four times a week for a total of 52.8 Gy [relative biological efficacy (RBE)]. After confirming that adverse effects were within acceptable range, the total dose was increased to 60.0 Gy (RBE). Results: Between April 2013 and November 2015, 14 cases were treated. The median follow up period was 61 months. No adverse toxicities were observed except for grade 1 acute skin reaction in 10 cases. The time required from carbonion radiotherapy to tumor disappearance was 3 months in 1 case, 6 months in 3 cases, 12 months in 4 cases, and 24 months in 5 cases. The third case developed local recurrence 6 months after radiotherapy. Twelve patients with luminal subtype received 5-year endocrine therapy. Thirteen of 14 tumors have been maintaining complete response with excellent cosmetic results. Conclusions: The time from carbon ion radiotherapy to tumor disappearance was longer than expected, but complete tumor disappearance was observed except for one high-grade case. With careful patient selection, carbonion radiotherapy in patients with stage I breast cancer is deemed effective and safe, and further research is recommended

Acute exacerbation of chronic osteomyelitis triggered by aggravation of type 2 diabetes mellitus: a case report

Abstract Background Osteomyelitis is an infection in a bone. Acute osteomyelitis is observed mainly in the long leg bones of children and is usually treated with antibiotics. On the other hand, in adults, subacute or chronic osteomyelitis is more common. Antibiotics therapy is not necessarily effective for chronic osteomyelitis, and sometimes a surgical operation is performed for its remission. Furthermore, in classification of osteomyelitis by cause, type 2 diabetes mellitus is one of most common conditions associated with osteomyelitis. It isCase presentation well known that a variety of complications are induced in patients with type 2 diabetes mellitus due to chronic hyperglycemia, inflammatory reaction, and immunodeficiency, especially when glycemic control is poor. Case presentation A 58-year-old Japanese man had acute exacerbation of chronic osteomyelitis triggered by aggravation of type 2 diabetes mellitus. He had acute osteomyelitis in his right lower leg in his babyhood. After this episode, he did not experience any pain in his leg for approximately 50 years; he felt acute pain in his right lower leg at the age of 50 when his glycemic control was very poor. He then started undergoing medical therapy for type 2 diabetes mellitus and, after an improvement in glycemic control, his pain was gradually mitigated. However, he did not take medicine for approximately 8 months at the age of 58. After the interruption, glycemic control became very poor and he felt the similar acute pain again in the same area. After improving glycemic control, his pain was gradually mitigated again as observed at the age of 50. Conclusions Here we report a case of chronic osteomyelitis under poorly controlled diabetic conditions. Interestingly, chronic osteomyelitis was observed at the same position where acute osteomyelitis was observed in his babyhood. In addition, chronic osteomyelitis was repeatedly observed, and it seemed that its acute exacerbation was closely associated with aggravation of type 2 diabetes mellitus. We should bear in mind that type 2 diabetes mellitus is one of the major risk factors of osteomyelitis and that acute exacerbation of chronic osteomyelitis could be triggered by a disturbance of glycemic control in patients with type 2 diabetes mellitus