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介護老人保健施設における在宅復帰支援に関する研究 : 在宅復帰マネジメントツールの開発
No full text九州保健福祉大学博士（社会福祉学）平成28年度This paper aimed to research the factors related to home discharge from geriatric health service facilities and develop a management tool of to assist those dependent on care and their caregivers. Management for home discharge was defined as multi-disciplinary support in home discharge, provided to those dependent on care and their caregivers, and attempted to develop management tool for home discharge.
Firstly, a postal survey was sent to 542 care managers in geriatric health service facilities in Kyushu and Okinawa, Japan. A total of 147-150 valid responses were received. The date showed that assessment seat was not enough for home discharge and caregivers support. Furthermore, in geriatric health service facilities caregivers support was not provided sufficiently. Using exploratory factor analysis, three factors related to home discharge from geriatric health service facilities were identified. Geriatric health service facilities strengthening home discharge more enthusiastically practiced ADL support for those dependent on care and provided information more often than did the other geriatric health service facilities. When individuals are discharged home from geriatric health service facilities, ADL support is needed for those dependent on care, and educational support is necessary for family caregivers.
Subsequently, a questionnaire survey was conducted with 37 caregivers to investigate their sense of burden. A total of 36 valid responses were received. A large proportion of caregivers worried about care and felt burden when they provided toileting assistance.
Therefore, we identified need for support system that would promote independence during toilet use and examined the efficacy of pulling a lower garment up and down with one upper limb while leaning over a handrail. We analyzed time, sway in the center of gravity, rectangular area, ratio of gravity deviation, and moving distance of the ear lobe for sagittal plane assessment. Sway in the center of gravity, rectangular area, and moving distance of the ear lobe were significantly lower when using the handrail than when not using it. A positive correlation was found between the sway in the center of gravity and the rectangular area while pulling up short pants, and between the rectangular area and the moving distance of the ear lobe while pulling down short pants. These results suggest that pulling a lower garment up and down with one upper limb while leaning on a handrail is effective for hemiplegic patients with a standing balance disorder.
On the basis of the above-mentioned- results, management tool was developed for home discharge from geriatric health service facilities, consisting of eight assessment sheets-:ⅰ) assessment of ADL and IADL in those dependent on care, ⅱ) assessment of elimination in those dependent on care, ⅲ) face sheet for caregivers, ⅳ) assessment of caregivers, ⅴ) assessment of local resources, ⅵ) life pattern comparison of those independent on care and caregivers, ⅶ ) judgment of possible or impossible home discharge from geriatric health service facilities, and ⅷ) planning of support for those dependent on care and caregivers.
A fundamental characteristic of the management tool for home discharge from geriatric health service facilities is the assessment of ADL at home, placing importance on elimination, and assessment and planning for not only those dependent on care but also caregivers.
Cutoff values of for sheet 1 (assessment of ADL and IADL in those dependent on care) and sheet 4 (assessment of caregivers) were obtained from previous research. The cutoff value for sheet 1 was 50 (perfect score: 100), that for seat 4 was 23 (perfect score: 30), and that for the total number of points was 71 (perfect score: 130). We propose the use of objective indexes of home discharge from geriatric health service facilities as a new approach to support those dependent on care. The validity and reliability of the management tool for home discharge need to be tested in futureresearch.doctoral thesi
Relationship between evidence and narrative: A study focusing on social cognition in the elderly with dementia and elderly care professionals
No full textP(論文)ＤＳＭ−5では，認知機能をこれまでの5領域から6領域とし，新たに社会的認知が加わった．また，認知症施策推進総合戦略（新オレンジプラン）の策定に伴い，これまで以上に社会的認知が注目されるようになった．このような背景から，認知症高齢者の社会的認知を，科学的に検討する研究が増加しつつある．一方，高齢者ケア専門職の社会的認知を検討した研究は少ない．本研究では．認知症高齢者と高齢者ケア専門職，双方の社会的認知に着目し，認知症ケアの方法論として有益な知見を提示することを目的とした．本研究の目的を遂行するために，文献研究の手法を用いて，先行研究を踏まえ，本研究における社会的認知を定義するための理路を提示した・認知症ケアの方法論の現状と課題についても言及し，エビデンスとナラティヴに関する先行研究からの知見を援用した．以上の結果を統合し，実践への提言として，社会的認知をＳＯＡＰ形式にて，評価・記録することの可能性をまとめた．The previous edition which included five domains of cognitive function has been updated to the newly revised edition of the Statistical Manual of Mental Disorders (DSM-5) which defines six domains of cognitive function including social cognition. Along with formulation of the Comprehensive Strategy to Accelerate Dementia Measures by the Japanese government (also called “New Orange Plan”), social cognition has drawn more attention. Based on such background, an increasing number of studies on social cognition in elderly people with dementia have been conducted, but only a few studies on social cognition in elderly care professionals have been performed. The present study, based on a literature review, focuses on social cognition in both the elderly with dementia and elderly care professionals, and is aimed at offering findings that are useful for providing dementia care. In order to achieve the objective of this study, a discussion is presented in the following order: a method of defining social cognition based on previous studies is shown; evidence and narrative are cited from previous studies; and recommendations for dementia care practice are provided from these integrated results.departmental bulletin pape
Current Treatment and Support for Alcoholism and Related Issues in Communities : Examining Measures for Alcoholism Based on the Accounts of Specialists
No full textP(論文)We attempted to clarify the current treatment and support for alcoholism and related issues in
communities to examine how to create a society in which alcoholics can live comfortably. We found that
alcoholics struggled with strong denial, mistaken responses from their families, delayed counseling and
medical consultations, difficulty continuing to participate in self-help groups, various prejudices, a lack of
specialist hospitals and staff, and difficulty sharing information. Measures to address these issues included
improving the legal system, acknowledging the need for a budget, activities to raise awareness among
community residents, building mechanisms to connect people, providing school education, establishing
intermediate facilities, and improving team work in communities. In addition, we found that engaging in
treatment and support for alcoholism allowed the supporters to experience personal growth. These
findings suggest that continued efforts by entire communities to address alcoholism allow people to find
hope such that people will continue to nurture their strengths and entire communities will continue to
grow.departmental bulletin pape
Oncolytic Viruses as Cancer Therapeutic agents : Current Status of Oncolytic Viruses
No full textP(論文)Most of anticancer agents used by the chemotherapy of cancer act in the division process of the cell
and show an effect, and cause side effects such as a drop and nausea of the immunity, the hair loss, which
reduce the quality of life （QOL） of the patient. In this article, the history and current status of oncolytic
viruses, which are cancer therapeutic agents that do not cause these side effects and attracting the most
attention now are introduced. An oncolytic virus is a virus that preferentially infects and kills cancer cells.
As the infected cancer cells are destroyed by oncolysis, they release new infectious virus particles to
destroy the remaining tumor. Oncolytic viruses are thought not only to cause direct destruction of the
tumour cells, but also to stimulate host anti-tumour immune responses. In 2015 the first oncolytic virus
was approved by FDA as the cancer therapeutic agent. The clinical trial using the oncolytic virus is
pushed forward now in Japan. It is hoped that the virus therapy for cancer treatment with tumor
solubility virus greatly develops from now on.departmental bulletin pape
ガングリオシドG[M]₃単分子膜中へのカフェ酸エステル類の分布と作用
Get PDFP(論文)The distribution of benzyl caffeate (BC), phenethyl caffeate (PC) and cinnamyl caffeate (CC) in
ganglioside GM3 (GM3) monolayer as a model of a tumor membrane, and the effects of the caffeic acid
esters on the GM3 membrane were observed by atomic force microscopy (AFM). BC and PC distributed
in the GM3 monolayer formed holes in the GM3 matrix. The effects of BC and PC on the GM3 membrane
were similar to those of known antitumor compounds, suggesting that BC and PC may possess antitumor
activitiy. The activity of CC seems to be weaker than that of BC and PC. The effects of caffeic acid esters
on the GM3 membrane were different from those on the GD3 membranes.departmental bulletin pape
Investigation of transporter-mediated interaction between cisplatin and silver sulfadiazine in rats
No full textP(論文)Cisplatin (CDDP) is a platinum complex and is used for treatment of solid tumors. CDDP administered
intravenously is ingested into the cells by copper transporter 1 (CTR1). Silver sulfadiazine (AgSD) is a
topical antibiotic that prevent wound infection. Ag is reported to inhibit the mechanism of CTR1. We
examined transporter-mediated drug-drug interaction using CDDP and AgSD in rats. The serum
concentrations of platinum in blood and in kidney and liver tissues were measured. A blood test was
performed to observe the interactive effects of CDDP and AgSD. AgSD pretreatment significantly
decreased the concentrations of platinum in blood and in kidney tissue compared to the control. AgSD also
diminished the CDDP-induced abnormalities of serum creatinine level but did not affect CTR1 expression.
In contrast, no significant change was observed in platinum concentration in liver tissue after AgSD
pretreatment. However, the level of alanine aminotransferase increased after administration of CDDP
with or without AgSD. These results suggest that CDDP administered intravenously interacts with AgSD
applied to region of wound, in association with changing the platinum concentrations in blood and tissue
distribution. The interactive effects of CDDP may relate to modulate the function of platinum transferring
via CTR1 in the presence of Ag.departmental bulletin pape
A philosophy of ethics in ancient Chinese thought
No full textP(論文)This paper explores ethical ideas in ancient China in terms of their origins and related materials. The
term ethics was a translated word in Meiji Era and Lin li itself can be traced back to Li ji, an old Chinese
book, which used to mean the order of the world in addition to the meaning of morality. “Wu lin” in Meng
zi contributed to its becoming stronger, the essence of which can be found in Zhong yong.
In actual politics, on the other hand, it was supposed to be rulers’ ethics that they obey the law and to
govern their countries where they had to behave so as to coexist in harmony with the natural order.departmental bulletin pape
Effects of pelvic retroversion slant when sitting in a wheel chair on thorax slant
No full textP(論文)Wheelchair seating is a technique to support individuals with disabilities by applying modular wheelchairs
and seating posture-supporting devices to maintain a stable posture and execute functional movements
when using wheelchairs. The clients were 8 individuals with disabilities and 21 young physically
unimpaired persons. The measurement methods were the thorax excursion for a person of disabilities
who adjusted slide ratio 0% (pelvic retroversion slants an angle of 0 degrees) , 5% , 10% and 15% in the
wheelchair . As a result of measurement, It was revealed that changes in posture in the disabled elderly
are different from those of healthy people. In this study, it was inspected about pelvic retroversion slant
and thorax of ratio in the sitting position in a wheelchair, and the association between long-time wrong
sitting position and breathing function disorder was mentioned.departmental bulletin pape
Preliminary consideration about "evacuation with companion animals" after the Kumamoto earthquake : Case of the shelter at Mashiki City General Gymnasium
Get PDFP(論文)The present study examined the “evacuation with companion animals” in areas affected by the
Kumamoto earthquake. I joined the efforts to help refugees with companion animals at Mashiki City
General Gymnasium shelter from April 16th. At this shelter, a facility for refugees with companion
animals, called “Mashiki-machi Wan-Nyan House” was set up. Support for “House” and “Home” were
provided for the refugees and their companion animals at the facility. Based on these practices, the
importance of support for refugees with companion animals was considered.departmental bulletin pape