教授行動に影響を及ぼす二要因についての考察(2) : 机間巡視及び児童特性(二要因)に関する特徴的傾向と典型的意思決定場面の分析

本研究は，机間巡視中・グループ別学習といった非言動的な行動場面において，教師はどのような情報を得，いかなる意思決定を行っているのか，また，その情報は教授行動やその後の授業展開にどのような影響を及ぼしているのか，両者の相関関係を明らかにすることを目的としている。その際，教師が把握する児童特性（例えば，児童の能力・性格・性差・環境等）という要因が，教師の意思決定にどう影響するのかも検討の対象とした。論考では，前号（第16巻第2号）において設定した課題と方法論に従い，小学校における8つの授業を対象に，非言動的な行動場面44について，教師が収集している情報の内容とそこに関係する児童特性の内容および対応行動の関係を複数のカテゴリー分類を基に明らかにし，その特徴を検討した。加えて，特に典型的であると思われる場面を抽出し，教師の意思決定という観点からその行動背景を事例分析的に考察した上で，教師期待効果という点について先行研究の知見と内容の比較を行った。The purposes of this study were to clarify: 1 ) how the information teachers obtained and their decision-making were correlated, during non-verbal activity scenes, where they walked around the classrooms, paying attention to individual student when the students worked in groups; 2 ) how the information and instructional activities or development were correlated; 3 ) how teachers\u27 decision making was affected by child characteristics, such as, ability, personality, gender, environment and so on. In this article, based on the tasks and method used in the author\u27s previous article (published in the JUEN Bulletin, Vol. 16, No. 2 ), 44 non-verbal activity scenes, extracted from eight classroom instructions were selected. Concerning the scenes, the relations among the information teachers obtained, child characteristics, and their responding activities were categorized. Then, after extracting some representative scenes, the activies included there were analyzed by case study method. Finally, the results from this study were compared with those in previous studies, from the point of teachers\u27 decision making

The lectin‐like domain of thrombomodulin is a drug candidate for both prophylaxis and treatment of liver ischemia and reperfusion injury in mice

Ischemia and reperfusion injury (IRI) can occur in any tissue or organ. With respect to liver transplantation, the liver grafts from donors by definition experience transient ischemia and subsequent blood reflow. IRI is a problem not only in organ transplantation but also in cases of thrombosis or circulatory disorders such as mesenteric ischemia, myocardial, or cerebral infarction. We have reported that recombinant human soluble thrombomodulin (rTM), which is currently used in Japan to treat disseminated intravascular coagulation (DIC), has a protective effect and suppresses liver IRI in mice. However, rTM may not be fully safe to use in humans because of its inherent anticoagulant activity. In the present study, we used a mouse liver IRI model to explore the possibility that the isolated lectin-like domain of rTM (rTMD1), which has no anticoagulant activity, could be effective as a therapeutic modality for IRI. Our results indicated that rTMD1 could suppress ischemia and reperfusion-induced liver damage in a dose-dependent manner without concern of associated hemorrhage. Surprisingly, rTMD1 suppressed the liver damage even after IR insult had occurred. Taken together, we conclude that rTMD1 may be a candidate drug for prevention of and therapy for human liver IRI without the possible risk of hemorrhage

The obesity paradox is not observed in chronic heart failure patients with metabolic syndrome

Although being overweight or obese is a risk factor for cardiovascular disease, obese subjects often live longer than their lean peers, and this is known as the obesity paradox. We investigated the impact of obesity on cardiac prognosis in chronic heart failure (CHF) patients, with or without metabolic syndrome. Design and Methods: We divided 374 consecutive CHF patients into two groups according to their mean body mass index (BMI) and prospectively followed them for 2 years. Results: There were 126 cardiac events, including 32 cardiac deaths and 94 re-hospitalizations. Kaplan-Meier analysis revealed a significantly lower cardiac event rate in the higher BMI group (log-rank test P < 0.001) in all patients and those patients without metabolic syndrome. There was no association between BMI and cardiac prognosis in patients with metabolic syndrome. Cox hazard analysis revealed that a higher BMI was associated with favorable cardiac outcomes in all patients and patients without metabolic syndrome, after adjusting for confounding factors. However, this finding did not extend to patients with metabolic syndrome. Conclusions: The advantages of obesity are not found in CHF patients with metabolic syndrome

Primary Care Education at Kawasaki Medical School

Department of Primary Care Medicine was established in 1981 at Kawasaki Medical School as a first place to educate students about primary care in Japan. Since the history of Department of Primary Care Medicine is so short, many problems which should be resolved were left over. Brief history of primary care activities in Japan was reviewed and strategies for primary care education were discussed

Association of plasma thioredoxin-1 with renal tubular damage and cardiac prognosis in patients with chronic heart failure

AbstractBackgroundThioredoxin-1 (Trx-1) is an abundant 12.5kDa redox protein expressed in almost all eukaryotic cells that protect against the development of heart failure and kidney dysfunction. Plasma Trx-1 levels are considered as a reliable marker for oxidative stress. However, it remains to be determined whether plasma Trx-1 levels can predict cardiac prognosis in patients with chronic heart failure (CHF).Methods and resultsWe measured plasma Trx-1 levels and urinary β2-microglobulin–creatinine ratio (UBCR), a marker for renal tubular damage, in 156 consecutive patients with CHF and 17 control subjects. The patients were prospectively followed for a median follow-up period of 627 days and 46 cardiac events were observed. The patients with cardiac events had significantly higher plasma Trx-1 levels and UBCR levels than the cardiac event-free patients. Multivariate Cox proportional hazard analysis revealed that an elevated Trx-1 level was independently associated with poor outcome in patients with CHF after adjustment for confounding factors (hazard ratio, 1.74; 95% confidence interval, 1.33–2.29; p<0.0001). UBCR was increased with higher plasma Trx-1 levels. Kaplan–Meier analysis demonstrated that the highest Trx-1 tertile was associated with the highest risk of cardiac events.ConclusionPlasma Trx-1 level was associated with renal tubular damage and cardiac prognosis, suggesting that it could be a useful marker to identify patients at high risk for comorbid heart failure and renal tubular damage