What Factors are Involved in the Knowledge Necessary for the Self-Management of Diabetic Patients?

The aim of this study is to obtain data for improving a training program for patients with diabetes mellitus. One hundred eighty-seven patients with non-insulin dependent diabetes mellitus were tested with 20 questions about their knowledge for self-management of diabetes mellitus. Then to draw out factors in their personal backgrounds relating to their correct answers, multiple regression analyses were conducted. As a result, four factors showed significant differences in the following order: Educational careers &#62; ages &#62; duration of disease &#62; socioeconomic strata. The results of the present study have shown for the first time, that these four factors closely concern patients to acquire the necessary knowledge for their self-management of the disease. In addition, this study has raised some fundamental problems regarding the training program for patients: how education should be given to patients.</p

A theatre of alterity : the political actuality of Jean Giraudoux, stage interpretation and critical reception under the French Third Republic

La thèse met en relief la dimension cosmopolite des œuvres dramatiques de Jean Giraudoux, en tenant compte de leurs mises en scène, de l’accueil que leur a réservé la critique et du contexte théâtral de l’époque, la IIIe République durant l’entre-deux-guerres. Responsable de la promotion des échanges culturels au ministère des Affaires étrangères, germaniste et amateur averti de littérature étrangère, Giraudoux considère le théâtre comme un lieu privilégié où différentes « voix » de l’humanité peuvent se faire entendre et composer un chant universel. Cette conception ouverte de l’altérité ne l’empêchera pas de se faire le défenseur des intérêts nationaux à la tête d’un Commissariat général à l'information en 1939-1940, mais aussi de faire écho à des préjugés encore tenaces dans son milieu intellectuel, comme le révèle la lecture de ses écrits politiques. Pour la concrétiser, il se consacrera à la rénovation du langage dramatique en étroite association avec Louis Jouvet à L’Athénée. L’analyse de ses personnages et des thèmes d’actualité sociale que reflètent ses pièces montre que le dramaturge a constamment esquissé des figures de l’Autre et fait référence à des cultures étrangères, au service de sa philosophie du cosmopolitisme. L’exploitation des fonds d’archives concernant les mises en scène produites par Louis Jouvet amène ensuite à penser que le monde dramatique de Giraudoux revêt une apparence à la fois exotique et hétéroclite qui a pu troubler le public parisien. Exporté hors de France lors des tournées de la troupe de Jouvet et adapté dans des langues étrangères par ses amis lettrés, le théâtre de Giraudoux sera néanmoins apprécié et reconnu par divers publics internationaux comme une tentative bien française de représenter la diversité du monde.The thesis highlights the cosmopolitan dimension of Jean Giraudoux’s dramatic works, taking into account their staging, critical reception and the theatrical context of the Third Republic during the interwar period. Being responsible for promoting cultural exchanges at the Ministry of Foreign Affairs, Giraudoux, who was Germanist and an enthusiast of foreign literature, considers the theatre as a privileged means to show the different ‘voices’ of humanity and compose a universal song. Certainly, as the reading of his political writings reveals, Giraudoux defended national interests as the head of General Information Commission in 1939-1940, and echoed stubborn prejudices in his intellectual milieu. But at the same time, to concretize the conception of the theatre of alterity, he devoted himself to the renovation of the dramatic language in close association with Louis Jouvet at L’Athénée. The analysis of his characters and themes shows that Giraudoux has constantly sketched figures of the Other and referred to foreign cultures to demonstrate his philosophy of cosmopolitanism. Exploiting of Louis Jouvet’s archives in the National Library of France, concerning the stages produced by Jouvet, the thesis will think that Giraudoux’s dramatic world takes on an appearance both exotic and heteroclite that could disturb the Parisian public. While, exported outside of France during the tours of Jouvet’s troupe and adapted in foreign languages by his literary friends, Giraudoux’s theatre would be appreciated and recognized by various international audiences as a French attempt to represent the diversity of the world

Basic Guideline for Rehabilitation of Patients with Cleft Palate.

For the last quarter of a century, surgical techniques and speech therapy for the patient with cleft lip and palate have made remarkable progress, as other professional areas. However, recent survey of our patients and their family revealed that their needs and demands for medical and non-medical treatments had developed to a higher level and more comprehensive one. It goes without saying that the goal of rehabilitation for the patient with cleft lip and palate should not be limited to mere acquirement of a normal speech. With the recent advances in medical, surgical, orthodontic, and speech-therapeutic procedures, more attention is being directed to support of the patients and their family in the area of social functioning. Interdisciplinary cooperation is essential to an integrated cleft palate rehabilitation. This paper describes some of our recent steps toward that integrated approach. The subjects for discussion in this paper include 1. counselling techniques designed to promote healthy psychosocial development for parent and adult patients, 2. parent education according to rehabilitation program, 3. training camp, picnic and physical exercises for pre-school and early-school-age children, 4. velopharyngeal function test, i.e. nasoendoscopy, radiovideoscopy, and pneumotachography, and 5. training procedures used in our clinic to facilitate the correction of articulation errors, especially for adult patients

Laryngeal Constriction on Glottal Stops in Cleft Palate Speech

1. Through observation of videotaped recordings of fiberscopic and fluorovideoscopic examinations, abnormal constrictions of the larynx were found to occur following the production of stop consonants. 2. Laryngeal constrictions occurred more frequently in patients who were judged on the basis of auditory perception to produce glottal stops than in those patients who were judged to not produce such stops. 3. Combined fiberscopic observations and sound spectrographic analysis of glottal stops revealed two distinct types of stop consonant production

Dynamic Observation of Passavant's Ridge in Cleft Palates.

Passavant's ridge has a role to compensate the velopharyngeal closure in some cases, although small in numbers. The ridge is formed at the level slightly lower than that of normal velopharyngeal closure. Simultaneous movements of the soft palate, lateral pharyngeal walls and the Passavant's ridge constituted sphincterlike closure of the velopharynx. Their mobility was reduced for nasal sounds as compared with plosives and fricatives. Formation of the ridge was found to be improved as articulation improved by speech therapy

Treatment and Result of Slight Velopharyngeal Incompetence.

Fifty-five patients who had been diagnosed as slight velopharyngeal incompetence due to either repaired cleft palate CP (19 cases), submucous cleft palate SMCP (21) or congenital velopharyngeal incompetence CVPI (15) at our clinic from May 1976 to April 1982 were studied regarding the effect of speech therapy. They were all first placed under trial speech therapy which consisted of ① encouragement of the physical and mental development, ② articulation training without blowing exercise. Twenty-seven out of the 55 subjects underwent further surgery (mostly pharyngeal flap operation) after speech therapy for over 6 months at our clinic. On the other hand, 14 out of the 55 subjects improved velopharyngeal closure from slight incompetence to competence and corrected their faulty articulations through speech therapy alone. The success rate of speech therapy was higher in SMCP and CVPI than in repaired cleft palate. We emphasize that those who are judged as having slight velopharyngeal incompetence should first be placed under speech therapy for at least 6 months. The indication for further surgery are ① over age 5 years, and ② no improvement obtained in slight velopharyngeal incompetence and faulty articulation even by speech therapy for over one year