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A case of using a knuckle cast for a fracture of the proximal phalanx of the left 5th finger
Get PDF手指基節骨骨折は，掌側凸の屈曲変形を呈し整復及びその保持に難渋することが多い．また，骨の周囲
を腱が走行するため骨折部での癒着が起こしやすい．今回我々は，掌側凸変形が著明な左第5指基節骨基
部骨折に対し，早期仕事復帰を目的に早期運動療法（ナックルキャスト）を用いて良好な結果を得た症
例を報告する．本症例は，49歳，男性，歩行時転倒し受傷し，同日当院を受診した．初回レントゲン撮
影写真（X-ray photograph,以下XPとする）で29°の掌側凸変形を認めた．徒手整復を行い，シーネ固定
を行った．整復後のXPで掌側凸変形は0°となった．受傷1週後に環指とのバディーテープとナックルキャ
ストを施行した．キャスト施行後から仕事に復帰，手指の運動を積極的に行うよう指導した．受傷4週後
にXPにて転位がないことを確認し，固定を除去，受傷8週後に骨癒合を認めた．遠位指節間関節（distal
interphalangeal joint，以下DIP関節とする）・近位指節間関節（proximal interphalangeal joint，以下PIP
関節とする）・中手指節関節（metacarpophalangeal joint，以下MP関節とする）関節可動域は，PIP関節
で10°の伸展制限を認めるが，その他関節では屈曲伸展ともに健側対比100％となり，握力は健側40kgと
くらべ30kgと健側に対し10kgの低下を認めた．Visual Analogue Scale（以下VASとする）は，初回受診
時10が最終評価時で0となった．患者が強く望んでいた仕事をしながらの骨癒合の獲得，早期運動療法が
実現でき良好な結果が得られた．Fractures of the proximal phalanx of the fingers present with flexion deformity of the volar side and are often
difficult to reduce and maintain. In addition, since the tendon runs around the bone, adhesion at the fractured part is
likely to occur. Here, we report a case in which good results were obtained by using early exercise therapy (knuckle
cast) for the purpose of early return to work for a fracture of the proximal phalanx of the left fifth finger with
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marked volar convex deformation. This case was a 49-year-old man who fell and was injured while walking and
visited our hospital on the same day. The first X-ray photograph (hereinafter referred to as XP) showed a 29 ° volar
convex deformation. He performed manual reduction and fixed the splint. In XP after reduction, the volar convex
deformation was 0 °. One week after the injury, a buddy tape with the ring finger and a knuckle cast were performed.
After the cast, he returned to work and was instructed to actively exercise his fingers. Four weeks after the injury, XP
confirmed that there was no dislocation, the fixation was removed, and bone fusion was observed 8 weeks after the
injury. Distal interphalangeal joint (hereinafter referred to as DIP joint), proximal interphalangeal joint (hereinafter
referred to as PIP joint), metacarpophalangeal joint (hereinafter referred to as MP joint) Joint range of motion A 10 °
extension restriction was observed in the PIP joint, but in the other joints, both flexion and extension were 100% of
the healthy side, and the grip force was 30 kg compared to the healthy side and 10 kg different from the healthy side.
The Visual Analogue Scale (hereinafter referred to as VAS) at the fractured part was 10 at the first visit, but became
0 at the final evaluation. We were able to obtain bone union and early exercise therapy while doing the work that the
patient strongly wanted, and good results were obtained.departmental bulletin pape
Efforts by the school of nursing of our university to revise the curriculum and future challenges
Get PDF本稿は，本学看護学科における第5次カリキュラム改正への取り組みの過程とその結果をまとめたもの
である．今回のカリキュラム改正の主な趣旨は，コミュニケーション能力向上，臨床判断能力の基盤強化，
地域包括ケアシステムにおける多職種連携であり，社会の変化を念頭に看護の質保証をめざして看護学教
育の教授内容の精選と再構築をした．
カリキュラム改正に向け学科の組織化から始め，教育目的・目標，3つのポリシー，求められる人材像，
教育内容の検討と科目構成，カリキュラム構造図，新規科目の検討と配置および課題等について，カリキュ
ラム改正の趣旨と基本的な考え方を教員間で共有しながら進めた．
今後は，新カリキュラムの枠組みにおいて学生が主体的に学びながら看護実践能力を高め，効果的な実
習体験ができるよう教育環境を整えることである．また，看護学科として評価を多面的継続的に行い，カ
リキュラムデザインの構築，運用上の教育の質を保証していくことが課題である．This report summarizes the process and results of the efforts by the school of nursing of our university to revise the
curriculum for the fifth time. The main purpose of this revision of the curriculum is to improve communication skills,
strengthen the foundation of clinical judgment skills, and develop interdisciplinary cooperation in a comprehensive
community care system. We therefore carefully selected and restructured the teaching content of nursing education
with the aim of ensuring the quality of nursing with social changes in mind.
Revision of the curriculum started with organizing the school of nursing and proceeded while faculty members
shared amongst each other the purpose and basic approach of the curriculum revision, such as educational objectives
and goals, the university’s three main policies，required human resources (nurses), review of educational content
and course structure, a diagram of the curriculum, review and arrangement of new courses, and challenges.
In the future, we will provide an educational environment so that students can improve their practical nursing
skills and have effective practical training experiences while learning independently within the framework of the new
curriculum.
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Furthermore, the school of nursing will face the challenges of continuous, multi-faceted evaluations, building a
curriculum design, and guaranteeing the quality of operational education.departmental bulletin pape
Smoking prevention analysis of post-class impressions by text mining -Looking back on the lesson contents from the students' on-site lessons based on the same teaching plan-
Get PDF本研究の目的は，中学校１年生が喫煙防止教育授業後に回答した自由記述「印象に残った喫煙防止教育
の内容」をテキストマイニングによって分析し，印象に残った授業内容と授業に対する評価などを数量化
されたデータとして可視化し，それをもとに授業改善の検討を試みることである．A中学校，B中学校２
校の中学校１年生計268名のテキストデータを分析対象とした．出現頻度解析では，A中学校，B中学校と
もに類似した語の出現頻度と異なる出現頻度がみられた．講義中使用した語では「誘う」「有害物質」「煙」
「肺」「肺気腫」「お金」が出現した．授業に対する評価の語では「びっくり」「知る」「ありがとう」などが出現した．男女で学校ごと，あるいはクラスごとの関連を見た際，学校によって頻出語の出現回数が違った
り、性別を特徴づける語が出現したりする傾向がみられた．共起ネットワークをみると，授業の感想の全
体像を可視化することができ，印象に残った授業内容，授業に対する評価，印象に残った内容や評価の数
量的なデータが現れた．これらの可視化されたデータに基づいて授業を検討することで，学生の主観的な
検討をできる限り防ぐことができた．そして，入ってきた授業の情報に対して生徒がどのように思考し新
たな認識となったかということを想起させることにつながる発言があった．今後は，個々の授業者の教師
行動，教材の提示の仕方，喫煙防止授業への思いなども加え，それらと生徒の印象に残った授業内容との
関連を検討することが課題である．The purpose of this study is to analyze the free description "contents of smoking prevention education that left an impression" that the first graders of junior high school answered after the lesson of smoking prevention education by text mining, and to quantify the lesson contents that left an impression and the evaluation of the lessons. It is to visualize it as converted data and try to study lesson improvement based on it. The text data of 268 first-year junior high school students from A junior high school and B junior high school were analyzed. In the frequency of occurrence analysis, the frequency of appearance of similar words and the frequency of appearance of similar words were found in both A and B junior high schools. In the words used during the lecture, "invite", "hazardous substance", "smoke", "lung", "emphysema", and "money" appeared. "Surprised", "know", "thank you", etc. appeared in the words of evaluation for the lesson. When looking at the relationships between men and women by school or by class, there was a tendency for the number of frequent words to appear differently depending on the school, and for words that characterize gender to appear. Looking at the co-occurrence network, it was possible to visualize the overall picture of the impressions of the lesson, and the lesson content that left an impression, the evaluation of the lesson, and the quantitative data of the content that left an impression and the evaluation appeared. By examining the lessons based on these visualized data, it was possible to prevent the subjective examination of the students as much as possible. Then, there was a remark that led to reminding the students how they thought about the information of the incoming lesson and became a new recognition. In the future, it will be a challenge to consider the relationship between each teacher's behavior, how to present teaching materials, and thoughts on smoking prevention lessons, and the lesson content that left an impression on the students.departmental bulletin pape
Effects of a self-improvement workshop for four elementary school teachers
Get PDF本研究は，自費で自己研鑽のために受講する研修会を受講した公立学校の教員に対して，受講のきっかけや受講後の変化を調査することを目的とする．第二筆者は，2015年より学校教員向けの研修会を開催している．その内容は，リスクマネジメントについての集団討議，良好なリレーションシップを作る取り組み，リーダーシップを育てる取り組み，チームビルディングのワーク，自分自身を知るためのワークなどである．第二筆者の研修会に継続して参加した経験がある4名の小学校教員を調査協力者としてインタビュー調査を行った．調査協力者それぞれの発言を逐語化して，KJ法を参考にしながら分類・整理した．そして，参加のきっかけや参加後の変化などをモデル化した．この結果，【受講のきっかけ】【受講者の課題・特徴】【ワーク内容】【研修会で得たもの】【受講後の気づき】【受講後の変化】【危機場面での対応例】【今後の研修会への期待】という8個の大カテゴリが抽出された．カテゴリ同士の関係は次の通りであった．①調査協力者4名に共通する受講のきっかけがあった．②調査協力者たちの課題・特徴は様々であった．③受講者には，焦点化のワークおよび講師や他の参加者からのフィードバックから自己変容（気づきや行動の変化）が生まれていた．今後の課題として，校種，年代，校内分掌による共通点や相違点を把握するために，調査協力者をさらに募ることが必要であると考える．The purpose of this study was to investigate motive for the four elementary school teachers to participate in the self-improvement workshop. This study was also to find whether or not there was a change in the participants after attending it. The workshop was held since 2015; it was designed for the school teachers. The contents of the workshop were managing the risks including discussion, establishing desirable relationships, nurturing the leadership skills, learning about the team building and self-discovery. The primary method of the study was to conduct the interviews for the four elementary school teachers after completion of attending the workshop. The remarks of each participant’s verbatim were classified and organized with the reference to the K. J. technigne. As a result, the following eight major categories were established. They were the motive of the participation, the specific issues, the contents to practice, the benefits of the workshop, the elevated conscientiousness, the changes, the crisis response and the expectation for the future workshop. In conclusion, the study could be summarized in the three focuses. First, all four participants attended the workshop for the same reason. Secondly, each participant had the different and specific issues. Finally, all four participants experienced self-transformation; the teachers were able to apply what they learned to their career. Moreover, the feedback from the other participants helped for them to change. Further, a systematic trial might be necessary to invite participants in order to understand the similarities and differences between school types, ages and divisions within the school.departmental bulletin pape
An analysis of position of however in a sentence by Japanese learners of English
Get PDFhoweverの位置は様々である. いくつかの辞書や文法書は, 書き言葉においては文中で最もよく使われると記述している. JEFLL Corpusで調べた結果, 日本人英語学習者のhoweverの使用がほとんど文頭であるということが分かった. 本研究は英語母語話者と比較して, 日本人学習者はhoweverを過度に文頭で用い, 文中での使用が非常に少ないことを発見した. 文頭での過度な使用の理由の一つとして考えられるのは日本語の干渉である.
本研究で日本の中学校と高等学校で用いられている教科書を調べたところ, そこでのhoweverの使用の多くが文頭であった. このことが日本語の干渉を助長する可能性を主張し, 副詞について体系的に指導する必要があると結論付けた.An adverb, however, could be placed in various positions in a sentence. Some dictionaries and grammar books indicated that in writing, it was common to use however in the middle of a sentence. The data from JEFLL Corpus showed that most of the Japanese learners of English wrote however at the beginning of the sentence. This study found that they overused it at the beginning of the sentence and underused it in the middle of the sentence. By comparison, the native English speakers used it more often in the middle of the sentence. One of the possible reasons for this was Japanese interference.
In this research, the Japanese middle and high school English textbooks were studied. The research revealed that however was mostly used at the beginning of the sentences throughout those textbooks. In summary, the Japanese students might be influenced by those textbooks. As a result, the students preferred to put however at the beginning of the sentence. It would be beneficial to teach the students about the various functions of adverbs including however to enhance their writing skills.departmental bulletin pape
Mental health of new university students before the start of the classes during the self-restraint period of the declaration of a state emergency in response to the coronavirus disease 2019 (COVID-19)
Get PDF本研究の目的は，新型コロナウイルス感染症（COVID-19）による緊急事態宣言下の外出自粛期間中における大学新入学生の精神的健康度を調査し，学生対応について省察することで，今後の学生支援体制の強化および構築に向けた取り組みの一助にすることである．精神的健康度は，University Personality Inventory （UPI）用いて調査した．調査後の学生対応は，早期連絡または面談，UPI結果の概略の公表（「身体」，「気分」，「対人関係」に分類してレーダーチャートで視覚化），希望者への個別面談とした．UPIの自覚症状の総得点平均は，8.4点であった．UPIの自覚症状の総得点，領域別（身体，気分，対人関係，陽性項目，key項目）の点数は，性差を認めなかった．設問項目によっては女性が多かった．UPIが低得点であったことは，精神的健康度の良好さを示したが，学生の設問への反応性や自己理解のための自覚が低くなっている可能性もあると考えられた．学生支援体制の強化には，学科内教員や保健管理職員とのさらなる連携および共通理解を図り，持続可能な取り組みとしていくことが必要である．The purpose of this study is to help in future efforts to strengthen and build of the students support system by reflecting on students support after the survey, investigating the mental health of new university students during the outing self-restraint period of the declaration of a state emergency in response to the coronavirus disease 2019 (COVID-19). Mental health assessed using the University Personality Inventory (UPI). Post-survey student support included early contact or interviews, publication of the outline of UPI results (categorized into "physical", "mood", and "interpersonal relationships" and visualized on a radar chart), and individual interviews with students who requested them. The mean of the subjective symptoms of UPI was 8.4 points. There were no gender differences in the total score subjective symptoms and the category scores (physical, mood, interpersonal relationship, positive items, key items) of the UPI. There were many females depending on the questionnaire item. The low scores on the UPI indicated good mental health, but also suggested that students' responsiveness to the questions and self-awareness for self-understanding may have been lower. In order to strength the student support system, it is necessary to promote further cooperation and common understanding with departmental faculty and health care management staff to make it a sustainable effort.departmental bulletin pape
A public health nurse’s high-risk judgment for the first interview of maternity record book
Get PDF保健師が母子健康手帳交付時の面接において，どのような点に継続支援の必要性を感じ，養育ハイリスク妊婦と判断していくのかを明らかにすることである．
母子健康手帳交付面接を実施している自治体保健師11名に対し，妊婦との面接でどのような点に気づき，どのように養育ハイリスク妊婦と判断していくのかについて，半構成的インタビューを行った．
保健師が養育ハイリスク妊婦と判断していく過程として，時間を軸とした段階を経ていた．面接前の第一印象での気づきの段階では【妊婦に対する違和感】，面接を通しての気づきの段階では【ハイリスクな妊娠の経緯】【養育に影響しかねない妊婦に関する気がかり】【養育につながる父親（パートナー）に関する気づき】【妊婦をサポートする情報の捉え】というカテゴリーが抽出された．保健師は最終的に，経済的な情報の探り，養育能力の探り，周囲のサポートの探りという3つの点から養育ハイリスク妊婦について判断し，家庭訪問，見守り，ネットワークの構築という支援につなげていた．To clarify how and on what aspects public health nurses feel necessity of continued support as well as determine pregnant women to have a high-risk in child rearing during interview at the time of maternity record book issuance．
A semi-structured interview was conducted for 11 public health nurses of local governments which conducted interviews for maternity record book issuance regarding aspects they recognized during interviews with pregnant women and way of determination of high-risk in their child rearing．
In the process of determination of high-risk of child rearing in pregnant women, public health nurses passed through stages along the axis of time. While a category of [Feeling of strangeness] was extracted during a stage of awareness by first impression before interview, those of [History of pregnant women with high-risk], [Concern about pregnant women with possible impacts on child rearing], [Awareness regarding father (partner) related to child rearing] and [Capturing of information regarding support for pregnant women] were extracted during a stage of awareness through interviews. Finally, public health nurses determined pregnant women with high-risk in child rearing based on research on three points, i.e., economic information, child rearing capability and support by surrounding people, resulting in providing supports by way of home visit, watching and building of network.departmental bulletin pape