閉経後女性における首周囲径の変化がメタボリックシンドローム関連指標に及ぼす影響

広島大学(Hiroshima University)博士(保健学)Doctor of Philosophy in Health Sciencedoctora

Factors Predicting Bone Mineral Density (BMD) Changes in Young Women over A One-year Study:Changes in Body Weight and Bone Metabolic Markers during the Menstrual Cycle and Their Effects on BMD

Currently, 26% of Japanese women in their twenties are under weight, and therefore at risk of developing various metabolic abnormalities due to an inadequate nutrient intake, which in turn affects the acquisition of a peak bone mineral density (BMD). In this study, we aimed to clarify the effects of menstrual cycle-related changes in body weight and bone metabolic marker levels on the BMD changes. The subjects were 42 women (19.6±0.8 years). The levels of osteocalcin (OC), BAP, s-NTx, u-DPD, and E2 in the menstrual and ovulatory phases were measured. The associations between dependent variables (BMD changes/year in the lumbar spine, femur, femoral neck) and explanatory variables (body weight changes/year, the levels of OC, BAP, s-NTx, u-DPD) were evaluated using multiple regression analysis. Analysis of the correlations between the changes in bone metabolic markers and changes in BMD showed a correlation between the OC level in the menstrual phase and changes in the BMD of the entire femur, suggesting that a high OC level protects against BMD reduction, probably by promoting osteoblast activity, and that bone formation activity suppresses the decrease in BMD. These results suggest that, to predict BMD changes from bone metabolic markers in young women, it is necessary to measure OC levels in the menstrual phase

Age-Dependent Contributions of Neck Circumference to Indices of Obesity Among Female College Students Aged 18 to 20 Years

Measurement of neck circumference (NC) is an easy method to assess obesity. Our investigation to estimate risks for metabolic disease in Japanese postmenopausal women indicated that NC is significantly associated with whole-body obesity indices and visceral fat accumulation. To clarify the early stage of metabolic changes and confirm NC validity as a predictor of metabolic syndrome, NC’s association to the four obesity indices, namely, weight, body mass index (BMI), body fat, and waist circumference (WC), was examined in a college student group of 60 females aged 18.7±0.3 years. NC was mainly correlated with weight, followed by BMI, WC, and body fat. It was also significantly associated with weight and BMI, but not with body fat. The participants were divided into two subgroups: “sports-experienced” and “not-sports-experienced,” who had moderate and strong correlation coefficients with NC and WC, respectively. WC value was possibly predicted by NC values using linear functions for the group and its subgroups. The correlation between NC and WC, NC’s association to weight, and substitution of NC to WC were confirmed by the same analyses in another student group composed with 18 females aged 19.7±0.6 years. Our study showed that the distribution of body fat in college students is difficult to assess based on NC alone. Nevertheless, NC measurement is an easy, inexpensive, and reproducible method to assess obesity and a possible predictor to identify the risk for future metabolic diseases in Japanese college students with the four obesity indices, weight, BMI, body fat, and WC

Effect on Blood Pressure of Daily Lemon Ingestion and Walking

Background. Recent studies suggest that the daily intake of lemon (Citrus limon) has a good effect on health, but this has not been confirmed in humans. In our previous studies, it was observed that people who are conscious of their health performed more lemon intake and exercise. An analysis that took this into account was required. Methodology. For 101 middle-aged women in an island area in Hiroshima, Japan, a record of lemon ingestion efforts and the number of steps walked was carried out for five months. The change rates (Δ%) of the physical measurements, blood test, blood pressure, and pulse wave measured value during the observation period were calculated, and correlations with lemon intake and the number of steps walked were considered. As a result, it was suggested that daily lemon intake and walking are effective for high blood pressure because both showed significant negative correlation to systolic blood pressure Δ%. Conclusions. As a result of multiple linear regression analysis, it was possible that lemon ingestion is involved more greatly with the blood citric acid concentration Δ% and the number of steps with blood pressure Δ%, and it was surmised that the number of steps and lemon ingestion are related to blood pressure improvement by different action mechanisms

Learning Effectiveness in Nursing Skills Education by Designing a Flipped Classroom with ICT

PDF本研究の目的は、反転授業のデザインを基に再構築して展開した「栄養と食事」の看護技術教育の学習効果と課題を検討することである。反転授業に基づき再構築した技術学習を全て受講し、研究の同意が得られた看護学科１年生10 名を対象にグループインタビューをオンラインで実施し、質的帰納的に分析した。オンデマンド授業後に、オンライン授業と援助計画のディスカッションを経て、食事援助演習を行うという学習方法の効果について、研究に参加した学生の語りを分析した結果、122 コードから9 サブカテゴリーと3 カテゴリーが構成された。オンデマンド授業では＜今までよりも疑問を多く感じ解決したいと思う＞ことで＜既習の知識を全部活用する必要性に気づく＞ことや、＜自分のペースで繰り返す学習で理解が深まる＞ことを実感していた。オンライン授業と対面演習では＜仲間とのやり取りで疑問を解消しながら援助を想像する＞ことや、＜授業での理解を踏まえて患者への良いケアを深く思考する＞という、自らの考えを深める様子が示された。学習途上では＜議論が深まらず疑問が残り不安になる＞様子も見られたが、教員の支援や協働的な学習を経て＜患者にとって良いと思う援助方法を試行錯誤しながら探求する＞ことに至り、＜疑問を解消するためにいつもより教員に質問をする＞ことで＜演習でのやり取りを通じて援助方法に自信が持てる＞と感じていた。反転授業では学習途上において学生が抱く不安に課題があるものの、基本知識の習得と既習知識の活用に効果を発揮し、より良い援助方法を探求する機会となっていた。「栄養と食事」の技術教育は、学生自身が日常生活を手掛かりに想起しやすい援助技術であり、反転授業の展開に適していることが考えられた。Objective：We made a "Nutrition and Diet" nursing skills class with a flipped classroom design. The purpose of this study is to examine the effects and challenges of class. Methods：These are the 10 first-year nursing students who agreed to take all the Flippedclassroom classes. Group interviews were conducted online and analyzed qualitatively. This study was approved by the ethics committee of our institution. Results：The learning effects are summarized in 9categories. On demand, students had more questions than ever and wanted to solve them. Therefore, the students found it necessary to use all the knowledge they had already learned. The students also realized that they could repeat the learning at their own pace, which deepened their understanding. In class, students imagine how to help patients while answering questions through interactions with their peers. Students will think deeply about good patient care based on what they understand in class. And the students seemed to deepen their own thoughts. Students are still studying, so they are worried about not being able to have in-depth discussions with their peers.With the help of teachers and collaborative learning with their peers, they are exploring ways to make things better for patients through trial and error. Students will ask more questions than usual to the faculty to clear their doubts. So, students gain confidence in how to help by interacting with their peers in class. Conclusion：Although student anxiety is an issue for the Flipped classroom, it is effective in helping students learn the basics and use the knowledge they already have. And it is an opportunity for students to explore even better ways to help their patients. The "Nutrition and Diet" class is suitable for a Flipped Classroom because students can easily imagine it from their own daily lives.departmental bulletin pape

An analysis of teacher behavior in events activities of nursery school

本研究の目的は, 行事場面における保育者の行動特性を組織的観察法を用いて明らかにすることにあった。結果から, 次の3点が明らかとなった。 (1)自由遊び場面に比較して, 行事場面では保育者の働きかけは「支配的」になりやすく, 幼児の「依存的」な反応も多くなる。 (2)保育形態として設定保育を取り入れている園は, 自由保育を取り入れている園よりも行事場面ではより「支配的」になりやすい。 (3)行事場面にも, 幼児の創意工夫が生かされるような保育者の配慮があれば幼児の自立性が出てくるので, 行事の内容及び進め方を工夫する必要がある。 行事の教育的意義を保育に生かすために, 親との提携は必要不可欠である。そのため親の行事に対する考え方を明らかにすることは, 従来の幼稚園・保育所主導の行事を再考するうえで有効であると考えられる。今後, この点を実証的に検討していく予定である。The purpose of this study was to analyze the mutual interactions between teachers and children in annual events activities of nursery school (y#ochien) comparing with play activities. A systematic observation method was adopted in this research. The authors especially devised two kinds of observation categories to check (1) active behaviors of a teacher on young children, (2) responsive behaviors of the teacher to their active behaviors. Annual events, including with "the short trip", "Onigiri (rice ball) party", "Mochitsuki (rice-cake making)", "Yakiimo (baked sweet potatoes)", and "presentation of singing songs, dancing, and operetta. etc.", were conducted to observe the behaviors of the teacher and children. The following are the main results; 1. Compared with play activities, the teacher's behaviors were inclined to directive in events activities. In some events activities that had less strict in schedule, the teachers behaviors were inclined to supportive. 2. Supportive behaviors of teacher, such as praise, suggestion, approval, etc, fostered the independent, supportive behaviors and active interactions among children in events activities. 3. Some modifications of the content of events activities, such as less restricted environment and more freedom in schedule, will draw out and develop children's independent and spontaneous behaviors

The Relationship between Stress Levels and Biological Responses in a Clinical Nursing Practicum

We evaluated the association between the stress levels and biological responses of nursing students in a clinical practicum. The subjects consisted of 28 third-year nursing students at the nursing department of College A. The degree of stress was evaluated using the Japanese version of the State Trait Anxiety Inventory (STAI). As parameters of biological responses, serum estrogen, salivary cortisol, and salivary IgA were measured. These measurements were performed twice (before and during the clinical practicum). Before and during the practicum, the STAI state anxiety score increased from 46.3 ± 8.1 to 52.3 ± 8.9 indicating the nursing students' practicum-associated stress. No changes were observed in the salivary cortisol or IgA level, but the serum estrogen level decreased during the practicum from 36.7 ± 14.7 to 27.0 ± 9.2 suggesting the inhibition of estrogen secretion

Longitudinal Study on Physical Fitness Parameters Influencing Bone Mineral Density Reduction in Middleaged and Elderly Women: Bone mineral density in the lumbar spine, femoral neck, and femur

The prolongation of the average life span of women has been associated with the rapidly aging society. However, serious problem have arisen as a result, such as an increase in the number of bed-ridden elderly patients with osteoporosis-associated femoral neck fracture. As preventive measures against osteoporosis for middle-aged to elderly women, 10,000 steps per day and intense exercise have been reported to inhibit bone mineral density (BMD) reduction. However, only a few studies have concretely reported on the type of physical fitness that is effective for BMD in particular parts of the body. In this study, a one-year longitudinal survey was performed involving generally healthy postmenopausal women to investigate physical fitness parameters influencing BMD in the lumbar spine, femoral neck, and femur. The subjects were 38 female residents of M City, aged 49-73 years. As physical fitness parameters, sit-ups, anteflexion in a sitting position, grip strength, mean amount of exercise (kcal), and area of outer body sway on standing straight with the eyes closed (m2) were measured. The BMD was measured in the lumbar spine (L2-L4), femoral neck, and femur. Logistic regression analysis was performed regarding the physical fitness parameters as explanatory variables and groups with and without BMD reduction over one year as those with and without risk as dependent variables. The number of sit-ups (odds ratio: 0.76, 95% CI: 0.61-0.96, p=0.022) was a preventive factor against BMD reduction of the lumbar spine, and ante flexion in a sitting position was a preventive factor against BMD reduction of the femoral neck (odds ratio: 0.88, 95% CI: 0.78-0.99, p=0.029). Regarding BMD reduction of the femur, the area of outer body sway on standing straight with the eyes closed tended to be not significant to the risk. It is suggested that physical fitness and local muscle strength are associated with BMD reduction in the lumbar spine, femoral neck, and femur

Relationships among stress, coping, and personality in nursing clinical training

本研究は, 看護学生の臨床実習におけるストレスとコーピングおよび性格との関連について検討した. 対象はA大学看護学科3年生の女性28名である. 方法は, ストレスの程度の評価には日本版State Trait Anxiety Inventory (STAI)を, また, コーピングの測定にはコーピング特性簡易尺度(BSCP)を用い, それぞれ実習前と実習中の計2回実施した. 性格の評価は, 矢田部・ギルフォード検査(YG検査)を用いて, 臨床実習のない春期休暇中に実施した. その結果, STAIの状態不安は, 実習前に比べ実習中で高値を示し, 臨床実習で看護学生がストレスを感じていると考えられた. 特に「社会的不適応」, 「劣等感」, 「非協調的」などの性格傾向では, 実習中の状態不安の増強を認めた. また, それらの性格傾向では「他者を巻き込んだ情動発散」などの消極的コーピングスタイルを多用する特徴を認め, 実習ストレスの感じ方やコーピングには, 個々の性格が深く関与することが示唆された.We investigated the relationships among stress, coping, and personality in nursing students during clinical training in a hospital. The subjects were 28 female nursing school students. The State-Trait Anxiety Inventory (STAI) test was used for evaluation of the psychological response to the stress of clinical training. The Brief Scales for Coping Profile (BSCP) test was used for evaluation of coping. These two tests were given before and during clinical training. The Yatabe/Guilford (YG) test was given to students during the spring vacation for assessment of personality. The students experienced stress before and during clinical training, and the state-anxiety levels in the STAI were significantly higher during clinical training. Anxiety level was higher in students with personality traits of "social maladjustment", "feeling of inferiority" and "nonconformism". Furthermore, students with such personality traits tended to have a passive style of coping. The results suggest that there is a close relationship between personality and coping style for nursing students under the stressful conditions of clinical training