Public policy studies in training institute for local government staff

岡本哲和教授還暦記念論文

公共政策の評価における評価結果の新しい報告方法 : 視覚的要素を活用した報告書と日本初の政策評価動画

行政では、何かの結果を報告したり説明したりする場合、文章中心の報告書を作成するのが一般的であり、それは地方自治体の公共政策の評価の制度である自治体評価においても同様である。しかし海外の先行研究では、文章中心の報告書以外にも様々な方法が紹介されており、それらの中には表やグラフ、イラストなどの視覚的な要素のように比較的容易に取り入れることができるものもある。公共政策の評価においては、評価の結果が利用されることが重要であり、そのためには、想定される利用者の目に止まり、よりよく理解されることが重要である。そのためには報告書に視覚的な工夫を凝らしたり、動画を用いたりすることが有効であるが、現状では一般的ではなく例も少ない。そのため、筆者ら（窪田・池田）が行った2 つの評価において試みた先行的な取組みを、評価結果の効果的な報告方法を実践した事例を紹介したい

Successful Treatment in a Case of Massive Hepatocellular Carcinoma with Paraneoplastic Syndrome

Paraneoplastic syndromes of hepatocellular carcinoma (HCC) are not uncommon. However, the prognosis is poor and follow-up and improvement of paraneoplastic syndromes with treatment have been reported rarely. We report a successful case in an aged man of a massive HCC with paraneoplastic syndrome, treated by combined intraarterial chemotherapy and hepatic resection. Paraneoplastic syndrome (erythrocytosis and hyperlipidemia) was monitored throughout the treatment and erythropoietin (EPO) mRNA also was analyzed in the resected liver. The hemoglobin level and serum levels of EPO and total cholesterol (T-cho) decreased dramatically with treatment, along with a decrease in serum levels of α-fetoprotein and protein induced by vitamin vitamin K absence II (PIVKA-II). Semiquantitative reverse transcription polymerase chain reaction (RT-PCR) revealed that the residual cancer expressed EPO RNA but the nontumor tissue did not. This was a rare case of paraneoplastic syndrome of HCC that was treated successfully. This case indicates that paraneoplastic syndrome reflected tumor progression and that serum levels of both EPO and T-cho might be used as tumor markers

A new telestroke network system in northern area of Okayama prefecture

Background Telestroke network can provide rapid access to specialized treatment and improves on‐site management of acute stroke patients through the “hub‐and‐spoke” model. In the northern part of Okayama Prefecture, there has been a regional gap of stroke care due to the shortage of stroke specialists and facilities. In addition, due to the novel coronavirus disease 2019 (COVID‐19), it is required to reduce the unnecessary contact with stroke patients from other hospitals. Aim We organized a novel cost‐free telestroke network with an image and video sharing for neurological diseases in the northern part of Okayama Prefecture to improve the stroke management in the area. Method We prepared the tablet device on which Skype® application was installed for each hospital and recruited the patients who visited or hospitalized in the spoke hospitals and were suspected to have some neurological diseases from April 2019 to May 2020. The patient's clinical data were recorded and analyzed. Results During the study period, 5 patients were recruited including the cases with the initial diagnosis of stroke or brain tumor. Among them, 2 cases were transferred to the hub hospital, 2 cases were transferred to other hospitals, and 1 case was treated on site under specialist's advice. Conclusion The new telestroke network system may be beneficial for acute stroke management and reducing the unnecessary patient's transfer in the rural area, especially under coexistence with COVID‐19

Calibration of the simplified simple biosphere model (SSiB) for Amazonian pasture and forest sites using LBA data

The parameters of the Simplified Simple Biosphere Model - SSiB were validated and subsequently calibrated for the Fazenda Nossa Senhora Aparecida (62º22'W; 10º45'S) pasture site and the Reserva Biológica do Jaru (62º22'W; 10º45'S) forest site, both located in the state of Rondônia. Micrometeorological and hydrological data collected during the dry period of 2001, as part of the Large-Scale Biosphere-Atmosphere Experiment in Amazonia - LBA, were used. The results showed that the model simulated well the net radiation, both at the pasture and at the forest. The latent heat flux was super-estimated in both sites. The model sub-estimated the sensible heat flux at the pasture and at the forest, mainly during the night period; notwithstanding, the values for the forest were nearer to the observed ones. With the calibrated parameters, the model generated better estimations of the latent and the sensible heat fluxes, thus better representing the energy partition both at the forest and at the pasture.", 'enOs parâmetros do "Simplified Simple Biosphere Model"-SSiB foram validados e posteriormente calibrados para os sítios de pastagem da Fazenda Nossa Senhora Aparecida (62º22\'W; 10º45\'S) e de floresta da Reserva Biológica do Jaru (62º22\'W; 10º45\'S), ambos situados no estado de Rondônia. Foram utilizadas medidas micrometeorológicas e hidrológicas obtidas durante o período seco de 2001, como parte do Experimento de Grande Escala da Biosfera-Atmosfera na Amazônia - LBA. Os resultados indicam que o modelo simulou bem o saldo de radiação, tanto na pastagem quanto na floresta. O fluxo de calor latente foi superestimado nos dois sítios nos períodos de simulação, o que deve estar relacionado aos parâmetros utilizados no cálculo dessa variável. O modelo subestimou o fluxo de calor sensível na pastagem e na floresta, principalmente no período noturno; porém, para a floresta, os valores foram mais próximos daqueles observados. Com os parâmetros ajustados, melhores estimativas dos fluxos de calor latente e de calor sensível foram geradas e, conseqüentemente, representou melhor as partições de energia na floresta e na pastagem

Feasibility of Rehabilitation Training With a Newly Developed Wearable Robot for Patients With Limited Mobility

ObjectiveTo investigate the feasibility of rehabilitation training with a new wearable robot.DesignBefore-after clinical intervention.SettingUniversity hospital and private rehabilitation facilities.ParticipantsA convenience sample of patients (N=38) with limited mobility. The underlying diseases were stroke (n=12), spinal cord injuries (n=8), musculoskeletal diseases (n=4), and other diseases (n=14).InterventionsThe patients received 90-minute training with a wearable robot twice per week for 8 weeks (16 sessions).Main Outcome MeasuresFunctional ambulation was assessed with the 10-m walk test (10MWT) and the Timed Up & Go (TUG) test, and balance ability was assessed with the Berg Balance Scale (BBS). Both assessments were performed at baseline and after rehabilitation.ResultsThirty-two patients completed 16 sessions of training with the wearable robot. The results of the 10MWT included significant improvements in gait speed, number of steps, and cadence. Although improvements were observed, as measured with the TUG test and BBS, the results were not statistically significant. No serious adverse events were observed during the training.ConclusionsEight weeks of rehabilitative training with the wearable robot (16 sessions of 90min) could be performed safely and effectively, even many years after the subjects received their diagnosis

Estudo do Desempenho de Dois Códigos de Transferência Radiativa do Modelo WRF para o Sul do Brasil

A radiação solar que atinge a superfície terrestre é amplamente dependente das condições de nebulosidade presentes na atmosfera. Assim, uma boa simulação da nebulosidade pelos modelos regionais de previsão do tempo é fundamental para refinar as condições de radiação descritas pelos códigos radiativos, e consequentemente melhorar a estimativa das principais variáveis meteorológicas. No presente trabalho, foi realizada uma análise da forçante radiativa de nuvens por meio da simulação de dois códigos radiativos do modelo WRF. As simulações foram feitas para a região sul do brasil durante um período de 21 de outubro de 2014 a 30 de outubro de 2014. Ao avaliar os códigos radiativos RRTMG e CAM3, nota-se que a presença de nuvens baixas simuladas pelo modelo altera significativamente a quantidade de radiação que atinge a superfície, provocando um aumento dos erros de temperatura, pressão, umidade relativa, radiação de onda curta a superfície e radiação de onda longa descendente a superfície

Long-term follow-up on the use of vascularized fibular graft for the treatment of congenital pseudarthrosis of the tibia

<p>Abstract</p> <p>Background</p> <p>Congenital pseudoarthrosis of the tibia (CPT) is one of the most difficult conditions to treat.</p> <p>Methods</p> <p>Five girls and 3 boys with CPT were treated by vascularized fibular grafting (VFG). The average age at VFG was 7.0 years (range: 1.9–11.5 years) with an average follow-up term of 11.7 years (range: 4.9–19.6 years). Five of the children had undergone multiple operations before VFG, while the other 3 had no such history.</p> <p>Results</p> <p>Bone consolidation was obtained in all cases after an average term of 6.6 months (range: 4–10 months); this was with the first VFG in 7 cases but with the second VFG in 1 case. Complication of stress fracture and ankle pain occurred in 1 and 3 cases, respectively, only in cases undergoing multiple operations. Leg-length discrepancy was more prominent in the patients with multiple previous operations (mean: 7.5 cm), than in the cases with no prior surgery (mean: 0.7 cm).</p> <p>Conclusion</p> <p>The long-term results of VFG for CPT were excellent, especially in the cases, with no prior surgery. VFG should be considered as a primary treatment option for CPT.</p