木村　航、辰巳　寛、山本　正彦、黒崎　芳子

　名詞と動詞の喚語能力に乖離を示した失語症患者に対して，名詞と動詞の呼称課題における正答率と誤反応の様相変化について経時的に分析を行った．対象は左側頭- 頭頂葉皮質下出血により超皮質性感覚失語を呈した74 歳の男性である．評価は，失語症語彙検査の名詞・動詞表出検査および名詞・動詞聴覚的理解検査を用いて，意味セラピーによる言語治療介入の前後期に2 回実施した．その結果，呼称課題の正答率は，2 回の評価ともに名詞が動詞に比べて有意に低下し，言語療法による治療効果も乏しかった．呼称課題における誤反応の質的分析では，名詞と動詞ともに語健忘や無関連性錯語が減少した一方，意味性錯語が増加したことから，意味概念水準での賦活と抑制に質的変化が生じている可能性が示唆された．本研究にて，名詞の喚語能力における左側頭- 頭頂葉の重要性と，名詞と動詞の喚語処理過程の相違を再確認した．失語症の喚語訓練においては，呼称課題における誤反応の質的分析を行い，喚語機能に影響を及ぼす意味概念水準の変容を適宜に把握しながら治療計画を立案していくことが重要と考えた．

Tesshin Hachiya, Andrew P Blaber, Mitsuru Saito

Aim: This study tested the hypothesis that maximal intensity conditioning does not alter increased muscle sympathetic nerve activity (MSNA) induced by central command at the same workload using 15-s strenuous intermittent handgrip contractions to evaluate training effects.
Methods: Eleven males participated in this study. Handgrip contractions with 75% maximal voluntary contraction (MVC) were performed to evaluate the training effects on the MSNA responses before and after maximal intermittent handgrip training. The subjects trained three times a day, 4 days per week, for 4 weeks repeating maximal 10-s handgrip exercises 10 times during each session. The MSNA was recorded from the left tibial nerve using a microneurography technique. MSNA, heart rate and blood pressure data during a 15-s contraction were divided into two segments to compare the responses in each portion. The non-dominant hand was trained and the dominant hand used as a control. Results: The MSNA responses induced by central command during a 15-s intermittent contraction increased during the first bout from the baseline through five repetitions, but the enhancement in the MSNA did not change after the training program. Conditioning did not alter the maximal muscle force and heart rate, but did alter the blood pressure response. Conclusion: We found no change in the MSNA increment under the same exercise load with small training effects. The exercise scheme with 75% MVC intermittent strenuous exercise increased the MSNA response with central command involvement, suggesting that 15-s strenuous intermittent contractions were appropriate for evaluating MSNA training effects.

城戸　裕子、中島　健一、小佐々　典靖

　本研究の目的は，障害者ケアマネジメントに従事する相談支援専門員に焦点をあて，専門職の意識や専門職間の連携状況などの調査から相談支援専門員の意識，現状と課題を明らかにすることである．
ケアマネジメントを担当する相談支援事業所の相談支援専門員に調査を行った結果，ケアマネジメント対象者の範疇の差異が介護保険法と障害者総合支援法には存在し，特に障害者ケアマネジメントには幅広い対象者支援が必要であることが明らかとなった．また，ケアマネジメント担当者の資格要件は高齢と障害でほぼ類似しているが，教育プログラムが異なり，相談支援専門員には地域さも生じていることが明らかとなった．望ましい制度政策の仕組みにおいては，重なり合う部分があるが，それぞれ独立している支援を築いているという認識が明らかとなり，障害と高齢を制度として統合することの難しさがケアマネジメントの時点で認識されていることが明らかとなった．
　今後は，相談支援専門員が考える連携の定義と介護支援専門員が考える連携の定義をそれぞれ明らかにすることで，地域生活支援に関わる保健医療福祉専門職が考える専門職間連携に必要不可欠な要素を抽出することが求められる．

Naohito Chino

　This is the revised version of the supplement of the paper which appeared in the proceedings of the workshop on Problem Solving through the Applications of Mathematics to Human Behaviors. In that supplement we added its motivation, tables and figures, and so on to the paper in order to complete it. Various solution curves in the figures suggest that our complex difference equation model covers enormous possible scenarios for the formation and dissolution of affinities among members of informal groups. Since the original model (Chino, 2002) assumes not only the finite-dimensional Hilbert space but also the indefinite metric space as the state space, this model might have wide applicability to all sorts of phenomena in which asymmetric relationships among objects are essential. An extended version of our model is also proposed in that supplement, in which a constant disturbance term is added. It is evident that this term enriches possible scenarios curiously and drastically. Differences between our model and the extant complex difference equation models are also discussed. Finally, we shall consider some open problems to be solved.