Authoring the Narrative Self in Dementia Care.: A Bakhtinian Perspective

This article examines the co-creation of narrative self in dementia care and the therapist’s expertise in the process. Applying Bakhtin’s theory of dialogue as the analytical framework, videotaped data were collected through interviews with an experienced occupational therapist as well as direct observation of his care sessions with two women with Alzheimer’s disease in a Japanese nursing home, before they were qualitatively analysed. The result indicated that the therapist created three kinds of voices: the voice of the person’s self, the voices of the actual others, and the voices of the imagined others towards the person. The women actively responded to the voices, jointly created possible and positive selves, and were able to achieve therapeutic activities. As a polyphonic author, the therapist intentionally produced the voices for therapeutic engagement thereby giving appropriate meaning to the therapy, building relationships with others, and expressing the persons’ hope for the therapy, for others, and for themselves

Long-Term Effect of Honeycomb beta-Tricalcium Phosphate on Zygomatic Bone Regeneration in Rats

In recent years, artificial bones with high biocompatibility have been developed for hard tissue reconstruction. However, current bone replacement methods are inadequate for large defects, causing infection, exposure, and damage. We have developed a new honeycomb beta-tricalcium phosphate (TCP) material, which achieved good bone regeneration after implantation in a rat complete zygomatic bone defect. In this study, we further investigated the ability of honeycomb beta- TCP for remodeling after bone regeneration as a long-term result. Bone morphogenic protein (BMP)-2-free honeycomb beta-TCP (TCP group) and honeycomb beta-TCP with BMP-2 (BMP group) were implanted in the zygomatic bone of rats. Micro-computed tomography was performed to track the zygomatic bone morphology, and specimens were histologically examined for osteogenesis and remodeling. In the TCP group, no bone formation was observed at 1 month, but it was observed at 6 months. Bone formation was observed in the BMP group at 1 month, and beta-TCP absorption reproducing the zygomatic bone morphology was observed at 6 months. This honeycomb beta-TCP with BMP-2 may provide appropriate remodeling that reproduces good bone formation in the early stage and good morphology in the long term, offering an alternative bone reconstruction material to vascularized bone grafts

Effect of Honeycomb β-TCP Geometrical Structure on Bone Tissue Regeneration in Skull Defect

The effect of the geometric structure of artificial biomaterials on skull regeneration remains unclear. In a previous study, we succeeded in developing honeycomb beta-tricalcium phosphate (beta-TCP), which has through-and-through holes and is able to provide the optimum bone microenvironment for bone tissue regeneration. We demonstrated that beta-TCP with 300-mu m hole diameters induced vigorous bone formation. In the present study, we investigated how differences in hole directions of honeycomb beta-TCP (horizontal or vertical holes) influence bone tissue regeneration in skull defects. Honeycomb beta-TCP with vertical and horizontal holes was loaded with BMP-2 using Matrigel and Collagen gel as carriers, and transplanted into skull bone defect model rats. The results showed that in each four groups (Collagen alone group, Matrigel alone group, Collagen + BMP group and Matrigel + BMP-2), vigorous bone formation was observed on the vertical beta-TCP compared with horizontal beta-TCP. The osteogenic area was larger in the Matrigel groups (with and without BMP-2) than in the Collagen group (with and without BMP-2) in both vertical beta-TCP and horizontal beta-TCP. However, when BMP-2 was added, the bone formation area was not significantly different between the Collagen group and the Matrigel group in the vertical beta-TCP. Histological finding showed that, in vertical honeycomb beta-TCP, new bone formation extended to the upper part of the holes and was observed from the dura side to the periosteum side as added to the inner walls of the holes. Therefore, we can control efficient bone formation by creating a bone microenvironment provided by vertical honeycomb beta-TCP. Vertical honeycomb beta-TCP has the potential to be an excellent biomaterial for bone tissue regeneration in skull defects and is expected to have clinical applications

The Investigation and the Future Theme of Delivery Practice in the Cource of Midwife : Founded on the examination into the actual condition of delivery practice at the educational institute of midwife cource in Japan

1997年4月から保健婦助産婦看護婦法の指定規則の「分娩介助例数10回以上」が, 「10回程度」と改正された。助産婦教育における望ましい分娩実習のあり方について, 大学, 短大, 専門学校の教育機関に分類し, 実習の現状を把握し検討した。その結果, ほとんどの教育機関は, 分娩介助目標数を10例とし, 望ましいものと位置付け, 異常分娩もふくんでいる。分娩介助1例は, 第1期ケアから第4期ケアまでとすること, 介助目標数達成により期待される能力は, 分娩介助技術, 助産診断, 助産過程とすることは各教育機関とも一致している。実習は, 複数施設で夜間実習, 期間の延長実習が行われ, 教員, 学生とも負担を感じている。量から質の重視, 卒後教育への連携と期待が高まっている。これらの現状から, 看護教育の大学化, 少子という潮流のなかで, 各教育機関における助産婦教育の目的, 目標を明確にし, 実習の再考の必要性が示唆された。Since April 1997,the designated rule of the law of health nurse, midwife and nurse has revised from [more than 10 Cases of delivery practice] to [about 10 cases of delivery practice]. We investigated the existing practices classified by each educational institutions (university, college and business college) and considered what ideal delivery practice should be. Almost all the educational institutions regarded that the number of delivery practices should be achieved is 10 and they recognized desirable (Included abnormal deliveries). One of the delivery practices is to be continuous care from the first term to the forth, and the expected abilities through the achievement of the practices are delivery technique, prognosis and process of deliver are accorded among educational institutions. At present, practices are executed at several facilities. Besides, when night practice and extension of the term of practice are obliged, both instructors and students feel trouble. In the future, the practice will be weighted on quality rather than quantity. Moreover, practices are expected to be in connection with the education after graduation. This study indicates that there is a necessity to reconsider what the delivery practice should be under the situation which birth rate decreases and the place of nurse education changes. For the purpose of doing this, we must make obvious the aim and the purpose of the delivery education at the each educational institutes

Orthodontic Approach to Hemifacial Microsomia

Aim and objective: To present a growing patient with unilateral mandibular hypoplasia and microtia involved in the first and second branchial arch syndrome (FSBAS) treated with functional appliance. Background: The FSBAS comprises several developmental facial hypoplasia in ear and maxillofacial bones, resulting in hemifacial microsomia. Treatment for hemifacial microsomia varies greatly depending on the grade of mandibular deformities. Functional appliance treatment during growth period is available for mild to moderate mandibular deformities. However, there are few reports of hemifacial microsomia treated with functional appliance. Case description: The patient, an 8-year-and-5-month-old girl, had a chief complaint of mandibular deviation. She had been diagnosed with the FSBAS at birth. Her facial profile was straight and panoramic radiograph indicated that the mandibular ramal height of the affected side was about 60.4% compared to the unaffected side. The occlusal cant was 6°, and the right maxilla and mandible showed severe growth deficiency. At the age of 10 years, functional appliance with expander was used; for 2 years 6 months, the maxillomandibular growth was controlled and from panoramic radiograph, the ramus height of the affected side was increased to 65.0% compared to the unaffected left mandibular ramus. At the age of 12 years and 8 months, multibracket treatment was initiated. After 32 months of active treatment, proper occlusion with functional Class I canine and molar relationships was obtained, although facial asymmetry associated with the difference of ramus heights still existed. The resulting occlusion was stable during 1.5-year retention period. Conclusion: Our results indicated the importance of orthopedic treatment during growth period in the patient with hemifacial macrosomia involving the FSBAS. Clinical significance: This report proposes an efficacy of conventional orthodontic treatment for growing patients with hemifacial macrosomia involved in the FSBAS

A treatment case of Sotos syndrome

Sotos syndrome is a genetic disorder characterized by overgrowth in childhood, specific facial manifestations, advanced bone age, and mental retardation. Although only one case report of Sotos syndrome treated with surgical orthodontics has thus far been published, there have also been a few detailed reports of long-term observation of Sotos syndrome through total orthodontic treatment. This article aimed to present the case of a growing patient with skeletal mandibular protrusion and unilateral posterior crossbite as present in Sotos syndrome treated with a non-surgical orthodontic technique. A 10-year-old boy was diagnosed with skeletal mandibular protrusion and posterior crossbite associated with Sotos syndrome. After maxillary lateral expansion, the skeletal Class III relationship with an anterior crossbite improved owing to mandibular clockwise rotation, while the facemask had a marginal effect. At the completion of growth at 16 years, he had a skeletal Class I relationship, and thus, conventional orthodontic treatment with preadjusted edgewise appliances was initiated. After 41 months of multibracket treatment, acceptable occlusion with a functional Class I relationship was obtained. At 12 months postretention, no or few changes in occlusion and facial features were observed. Our results demonstrate that considering the maxillofacial vertical growth during peripubertal period associated with Sotos syndrome, much attention should be paid to the early orthopedic treatment with the facemask and/or chin cap

An elementary school\u27s teacher\u27s recognition change of class atmosphere based on strength approach

子どもたちは，学校生活の中で他者との密接な，そして複雑な関係の中で成長をしていく。しかし近年，他者関係が子どもたちのストレッサーの1つであることや，自他への肯定感の低下もしくは欠如が現代の子どもたちの特徴であることが指摘されている。本研究では，子どもたちが学級の中で自他の良さ，長所であるストレングスを見つけ，お互いを肯定的に捉え合うことを目的に，小学5年生の1クラス（男児17名，女児16名）を対象に2010年1月27日から同年2月25日の期間にストレングスアプローチを実施し，教師の学級雰囲気に対する認識の変化を調査した。その結果，プログラム実施後において，学級雰囲気尺度の「認め合い」，「意欲」，「楽しさ」の3 項目で得点が増加した。また，教師の自由記述においても1人1人の子どもや学級全体を肯定的に捉える記述が多くなっていた。これらのことから，自他の良さを見つけ合うストレングスアプローチが学級雰囲気に改善をもたらし，教師の学級に対する認識の変化につながったことが示唆された

Genetic structure of landraces in foxtail millet (Setaria italica (L.) P. Beauv.) revealed with transposon display and interpretation to crop evolution of foxtail millet

Although the origin and domestication process of foxtail millet (Setaria italica subsp. italica (L.) P. Beauv.) has been studied by several groups, the issue is still ambiguous. It is essential to resolve this issue by studying a large number of accessions with sufficient markers covering the entire genome. Genetic structures were analyzed by transposon display (TD) using 425 accessions of foxtail millet and 12 of the wild ancestor green foxtail (Setaria italica subsp. viridis (L.) P. Beauv.). We used three recently active transposons (TSI-1, TSI-7, and TSI-10) as genome-wide markers and succeeded in demonstrating geographical structures of the foxtail millet. A neighbor-joining dendrogram based on TD grouped the foxtail millet accessions into eight major clusters, each of which consisted of accessions collected from adjacent geographical areas. Eleven out of 12 green foxtail accessions were grouped separately from the clusters of foxtail millet. These results indicated strong regional differentiations and a long history of cultivation in each region. Furthermore, we discuss the relationship between foxtail millet and green foxtail and suggest a monophyletic origin of foxtail millet domestication