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Objectives: The purpose of this study was to examine the short-term effects of the frail prevention project in Yonago City, Tottori Prefecture. Methods: Older adults aged 64 years or older in Nagae, Yonago City, Tottori Prefecture were screened for frailty. A frail prevention program was provided to those who were determined to be frail or pre-frail and wished to participate. The program consisted of a comprehensive intervention and was implemented for 3 months in a twice-weekly group and a once-weekly group, respectively. The primary endpoint was a Kihon checklist and the secondary endpoints were items related to motor function. Results: In total, 531 older adults underwent frail screening. Among them, 148 were pre-frail and 92 were frail. A total of 23 participants who participated in the frail prevention program were included in the analysis. Kihon checklist was significantly improved after the intervention （p

Objectives: The purpose of this study was to examine the short-term effects of the frail prevention project in Yonago City, Tottori Prefecture. Methods: Older adults aged 64 years or older in Nagae, Yonago City, Tottori Prefecture were screened for frailty. A frail prevention program was provided to those who were determined to be frail or pre-frail and wished to participate. The program consisted of a comprehensive intervention and was implemented for 3 months in a twice-weekly group and a once-weekly group, respectively. The primary endpoint was a Kihon checklist and the secondary endpoints were items related to motor function. Results: In total, 531 older adults underwent frail screening. Among them, 148 were pre-frail and 92 were frail. A total of 23 participants who participated in the frail prevention program were included in the analysis. Kihon checklist was significantly improved after the intervention （p

Background: Population-based research and community-based interventions are integral to occupational therapy’s scope of practice, yet they are underdeveloped in actual implementation. Therefore, this paper focuses on some health challenges facing the African American population, guided by the Person-Environment-Occupation-Performance Model. Method: Using data from an observational cross-sectional nationwide telephone survey of African American adults, we examined differences between African Americans who are receiving disability payments (RDP) and those who are employed full time (FTE) on several physical health behaviors and psychosocial health indicators. We further compared the differences between African Americans RDP versus those FTE on those physical health behaviors and psychosocial health indicators across five US regions. Results: Findings suggest that African Americans RDP are engaging in fewer positive physical health behaviors and experiencing worse psychosocial health compared to their counterparts FTE. There are also nuanced regional variations in the differences between African Americans RDP and FTE in physical health behaviors and psychosocial health indicators. Conclusion: This research highlighted some health challenges of African Americans RDP and FTE using a regional lens, demonstrating the value of OT population-based research. There is a need for OT population-specific community-based practice to address the health disparities of underserved and minority populations, such as African Americans.

This article was supported by the German Research Foundation (DFG) and the Open Access Publication Fund of Humboldt-Universität zu Berlin., Situated local knowledge and co-evolutionary processes overtake certitude and formal planning, challenging the way (cultural) heritage is produced in terms of both space and knowledge. This article contributes to the debate surrounding planning education and research by exploring the potential of inquiry-based learning (IBL) in spatial development and heritage conservation. The main argument is that the IBL format presented herein enables interaction and cooperation between various groups and their diverse sets of knowledge. To that end, the IBL approach was implemented both through project work and by creating a specific learning environment encompassing theory, exhibition, places, and people, and in which a research process was realised by students through iteration and reflection. The contribution systematises the results of a 2021 workshop held in Venice and Rome, including at the Corviale housing complex (Rome). In seeking to respond to the title-theme of the Venice Biennale, How will we live together?, initial evidence shows that educational activities stemming from clear research questions and “embedded” ways of inquiry-based learning present remarkable opportunities for participants to improve their ability to navigate into fragile and uncertain futures of the territory, engaging students in a wider process of knowledge-building.

Introduction Little information exists regarding the characteristics of patients with chronic non-cancer pain (CNCP) attending Canadian pain clinics. The study describes the demographics, pain characteristics and the diagnostic classification profile of such patients attending a university-affiliated community-based pain clinic in the Greater Toronto Area. Methods Retrospective descriptive study based on 644 unique consecutive CNCP patients assessed between January 2016 and December 2017. Results The female/male ratio was 1.6:1; 80% were younger than 65 years; 43% held some form of employment (full-time, part-time or self employment); median pain duration was 3 years; car accidents and medical conditions accounted for 28 and 27% of pain onset, respectively; 34% had four or more distinct areas of pain; and low back pain (LBP) was the most prevalent site (66%), but was the sole site of pain in less than a third of these patients. Age was positively associated with LBP prevalence. Self-reported health service utilization (visits to the emergency room, pain physician or psychologist) increased with patient psychopathology. Cannabis was used by 15% of the cohort and opioids by 34.5%, with only one in six opioid users exceeding 90 mg of morphine equivalent dose per day. Comparison of our data to three previously published studies from other Canadian pain clinics demonstrated both similarities and substantial differences between the populations. Conclusion Our study highlights regional differences between CNCP population phenotypes. Recognition of biomedical, psychological and socio-environmental factors affecting pain should be considered for patient stratification and rational approaches to treatment, as “one size treatment does not fit all”.

BACKGROUND: Service learning is used as an educational approach in many undergraduate occupational therapy programmes in South Africa and the rest of the world. Evidence for the impact of occupational therapy service learning engagements in communities, from the perspectives of community partners, is limited AIM: The purpose of this study was to describe the perceptions of community representatives regarding the outcomes of occupational therapy service learning engagements METHODS: A descriptive qualitative enquiry design was used. In-depth interviews were conducted with eight purposively sampled community representatives and analysed using inductive qualitative content analysis RESULTS: This paper reports on the theme related to community outcomes of occupational therapy that emerged from the data, consisting of seven categories, namely: (1) increased knowledge and skills, (2) attitudinal change leading to practice reform, (3) increased access to resources and infrastructure, (4) enhanced community connections, (5) enhanced confidence and dignity, (6) enhanced occupational participation, and (7) non-realisation of partnership goals CONCLUSION: The findings of the study demonstrated that although there were some instances in which partnership goals were not realised, occupational therapy service learning engagements contributed to occupational enablement, occupational justice, health and well-being for community members Key words: Service learning; occupational enablement; community engagement; community-based practice

Aim:The aims of this study were to (1) assess the initial experiences of parenthood amongst mainly disadvantaged mothers; (2) explore their views on the extent to which they felt they had benefitted (or not) from participating in a newly developed, intensive mother and baby support programme in the community; and (3) explore the perspectives of those who delivered the programme (i.e., facilitators), most of whom were Public Health Nurses (PHNs).Background:Positive parent–child interactions and appropriate levels of infant stimulation are essential to promoting a child’s well-being and laying a foundation in the early years for positive developmental outcomes. It is important, therefore, to examine participants’ experiences of community-based, family-focused, early prevention and intervention programmes.Methods:This study was undertaken as part of a larger evaluation of a newly developed parent and infant (PIN) programme which was delivered in two disadvantaged areas in Ireland. One-to-one interviews were conducted with both mothers (n= 22) and facilitators (n= 8) (including three PHNs) plus six focus groups with an additional sub-group of facilitators (n= 17).Findings:The collective findings suggest that mothers found the programme helpful in promoting a greater understanding of their infants’ behaviour and needs, and in alleviating stress and concerns associated with motherhood. Mothers described feeling more knowledgeable about the importance of regular and appropriate infant interaction to encourage learning and development. Facilitators, specifically PHNs, also reported a greater awareness of the value of infant socioemotional development for their clinical practice and observed greater positive communication between mothers and infants.Conclusion:These findings suggest that a community-based, intensive mother and baby programme can help to promote parental competence and enhance infant learning and development. Additional benefits in terms of early intervention and positive changes to public health nursing practice are also discussed.

Objectives To better understand how social pediatric initiatives (SPIs) enact equitable, integrated, embedded approaches with high-needs children and families while facilitating proportionate distribution of health resources. Methods The realist review method incorporated the following steps: (1) identifying the review question, (2) formulating the initial theory, (3) searching for primary studies, (4) selecting and appraising study quality, (5) synthesizing relevant data and (6) refining the theory. Results Our analysis identified four consistent patterns of care that may be effective in social pediatrics: (1) horizontal partnerships based on willingness to share status and power; (2) bridged trust initiated through previously established third party relationships; (3) knowledge support increasing providers’ confidence and skills for engaging community; and (4) increasing vulnerable families’ self-reliance through empowerment strategies. Conclusions This research is unique because it focused on “how” outcomes are achieved and offers insight into the knowledge, skills and philosophical orientation clinicians need to effectively deliver care in SPIs. Research insights offer guidance for organizational leaders with a mandate to address child and youth health inequities and may be applicable to other health initiatives.

Aim: This study aimed to assess the perceived influence that community-working occupational therapists in Norway have on the service goals of their respective organizations. In addition, we aimed to assess sociodemographic and work-related factors associated with the perceived level of influence. Methods: A cross-sectional survey was distributed to occupational therapists in community-based services in Norway (n = 1767), to which 561 (32%) responded. By multivariate regression analysis, factors associated with “self-perceived influence” were assessed. Results: After controlling for all variables, having a master’s degree (β = 0.09, P < .05), being involved in a research and development project (β = 0.25, P < .001), and not working with assistive technology (β = −0.19, P < .001) were associated with higher perceived influence. Conclusions: For occupational therapy to reach its potential in Norwegian community-based health care, the profession needs to establish itself more firmly and increase its influence within the health care services. To do so, it appears important to support occupational therapists’ educational aspirations, their participation in research and development projects, and their autonomous role in relation to the provision of assistive technology equipment. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

In this study, we administered a questionnaire to medical students to evaluate the effect of community-based clinical education on their attitudes to community medicine and medicine in remote area. Questionnaires were given 4 times to all the students from first-year to sixth-year. Of 95 students, 65 students (68.4%) who completed all questionnaires, were used in this study. The intensity of students' attitudes was estimated by using visual analogue scale. The intensity of interest, a sense of fulfillment and passion in medicine of remote area was significantly increased after the community-based practice. On the other hand, the level of understanding in medicine in remote area was increased by the lecture not by the practice. The intensity of desire both to become a generalist and a specialist was significantly increased when the grade went up. Most of sixth-year students desired to have abilities of a generalist and a specialist simultaneously. This study shows that the community-based practice is more meaningful in increasing motivation in medicine in remote area than the lecture, and suggests that it is important to prepare more courses to experience community medicine to increase the number of physicians who desire to work in remote area.

本研究の目的は,住民のもつ力を判断し地域づくりに向けて活用する看護援助方法を明らかにすることである。地域参加型機能訓練事業に関わる住民(閉じこもり・寝たきり予防の必要性の高い者16名,事業への協力者10名)に対し,筆者が保健師の立場で家庭訪問等により援助を実施した内容を調べた。住民のもつ力のうち,セルフケア力と判断された力は「日常生活を営む」「健康を維持・増進する」「自分らしく生きる」,支え手としての力と判断された力は「他者を認める」「他者をどのように支えるかについての考えをもつ」「助力があれば支え手となりうる」「他者を支えるために主体的に考え,行動し活動する」「他者を支える活動を充実させる」であった。住民のもつ力を判断するに至った援助はセルフケア力を高めることに基盤をおいた援助であった。住民のもつ力を地域づくりに向けて活用しようと意図した援助は,直接働きかける住民を通して他の住民に向けた意図をもち,「住民個々の健康意識の向上及び自己管理の促進」「住民同士による問題解決の促進」「地域内で提供する保健福祉サービスの充実」をめざす特徴があった。以上より,住民個々のセルフケア力の向上をめざした生活への援助を基盤におき,セルフケア力と支え手としての力の両面から住民のもつ力を捉えること,住民のもつ力を地域づくりに向けて活用するためには,直接働きかける住民を通して他の住民に向けた援助意図をもち,住民一人ひとりのセルフケア力を高めながら支え手としての力も高めることが重要であると考えられた。, This study aimed to identify nursing care to assess and maximize the potential abilities of local residents for community-based practice. Subjects were 16 elderly persons and 10 supporters who participated in care prevention activity for elderly persons living in the community. Data was collected from the author's own nursing practice as well from a public health nurse. Potential abilities assessed as self-care abilities were: 1)going about one's daily life, 2)promoting one's own health, and 3)living by one's own values. Potential abilities assessed as supportive abilities were: 1)recognizing others, 2)having opinions about support for others, 3)having the ability to become a supporter by someone's help, 4)performing voluntary and creative behaviors and activities to support others, and 5)developing supportive activities. To assess and maximize the potential abilities of local residents for community-based practice, it is necessary fornurses to perform the following: 1)to be based on support to promote the self-care of individual, 2)to assess both of self-care abilities and supportive abilities, 3)to have support intention for the other residents in the community through residents to support directly and 4)to improve supportive abilities through the process of improving self-care abilities.

本研究の目的は,住民のもつ力を判断し地域づくりに向けて活用する看護援助方法を明らかにすることである。地域参加型機能訓練事業に関わる住民(閉じこもり・寝たきり予防の必要性の高い者16名,事業への協力者10名)に対し,筆者が保健師の立場で家庭訪問等により援助を実施した内容を調べた。住民のもつ力のうち,セルフケア力と判断された力は「日常生活を営む」「健康を維持・増進する」「自分らしく生きる」,支え手としての力と判断された力は「他者を認める」「他者をどのように支えるかについての考えをもつ」「助力があれば支え手となりうる」「他者を支えるために主体的に考え,行動し活動する」「他者を支える活動を充実させる」であった。住民のもつ力を判断するに至った援助はセルフケア力を高めることに基盤をおいた援助であった。住民のもつ力を地域づくりに向けて活用しようと意図した援助は,直接働きかける住民を通して他の住民に向けた意図をもち,「住民個々の健康意識の向上及び自己管理の促進」「住民同士による問題解決の促進」「地域内で提供する保健福祉サービスの充実」をめざす特徴があった。以上より,住民個々のセルフケア力の向上をめざした生活への援助を基盤におき,セルフケア力と支え手としての力の両面から住民のもつ力を捉えること,住民のもつ力を地域づくりに向けて活用するためには,直接働きかける住民を通して他の住民に向けた援助意図をもち,住民一人ひとりのセルフケア力を高めながら支え手としての力も高めることが重要であると考えられた。, This study aimed to identify nursing care to assess and maximize the potential abilities of local residents for community-based practice. Subjects were 16 elderly persons and 10 supporters who participated in care prevention activity for elderly persons living in the community. Data was collected from the author's own nursing practice as well from a public health nurse. Potential abilities assessed as self-care abilities were: 1)going about one's daily life, 2)promoting one's own health, and 3)living by one's own values. Potential abilities assessed as supportive abilities were: 1)recognizing others, 2)having opinions about support for others, 3)having the ability to become a supporter by someone's help, 4)performing voluntary and creative behaviors and activities to support others, and 5)developing supportive activities. To assess and maximize the potential abilities of local residents for community-based practice, it is necessary fornurses to perform the following: 1)to be based on support to promote the self-care of individual, 2)to assess both of self-care abilities and supportive abilities, 3)to have support intention for the other residents in the community through residents to support directly and 4)to improve supportive abilities through the process of improving self-care abilities.

This article reports an action-research focused on the improvement of a training program for professionals working with multi-challenged families with at-risk or maltreated children. The program aimed at the implementation of a multi-systemic, collaborative and strength-based family assessment and intervention model. Outcome evaluation results indicate that professionals improved their skills and achieved minimal competence. Process evaluation reveals that participating in the training has been a transformative experience and highlights facilitator and constraining conditions for participants’ learning and changing as well as suggestions for improvement of the training program. Implications for practice and future research are discussed., Este artigo descreve um estudo de avaliação, de investigação-ação, e de casos múltiplos, focado no melhoramento do processo e resultado de um programa de formação para profissionais para a implementação, em contextos comunitários, de um modelo integrador, multissistémico, colaborativo e baseado nas forças, de avaliação e intervenção junto de famílias multidesafiadas com crianças em situação de risco, abusadas ou negligenciadas. Os resultados da avaliação indicam que os profissionais melhoraram as suas competências e que adquiriram um nível mínimo de competência. A avaliação de processo revela que os participantes na formação tiveram uma experiência transformadora e sublinham as condições facilitadoras e constrangedoras para a aprendizagem e mudança dos participantes bem como sugestões para melhoramento do programa de formação. São discutidas implicações para a prática e investigação futuras.

This study's aim is to characterize the significance of nursing care in community 'zukuri' building (Regional Development for the creation of Health and Happiness) by analyzing the intentions of Public Health Nurses (PHN) and the actual care methods that they adopt in their community based practice. When dealing with the resident, regardless of his or her health state, PHNs always regard them not only as a recipient of care, but also as a potential provider of care services. The study finds that the cultivation of a sense of belonging and connections between residents is the most effective nursing care method in the community based practice. In a community 'zukuri' building, it is important to encourage the resident to go out in public where they can meet people, while helping them to learn how to develop relationships they have initiated. The meanings of nursing care are 1) to help the resident become better prepared for possible health problems they may encounter in the future while encouraging them to learn how to be self-reliant. 2) to nurture a stronger sense of community among the residents and help them build a community by themselves. 3) to cultivate reliable human resources needed to achieve the above points. The study also concludes that such nursing care can lead to a model case for the development of a future community where the elderly and the disabled are more self-reliant and active participants., 保健婦の実践活動は,受け持ち地域に住むすべての住民の健康生活を守る地域社会づくりである。本研究は,保健婦がどのように看護援助を展開させて,地域社会づくりに貢献してきたのか,保健婦が長年積み上げてきた一地区の活動実績について,保健婦の援助意図とその方法を分析することにより,地域社会づくりに用いた看護援助方法の特徴を明らかにした。援助対象の捉え方は,住民を障害の有無等にかかわらず,ケアの受領者・提供者の両面を持つ人と位置づけることであった。具体的な方法では,住民と住民,つまり人と人をつなぐことが中核となっていた。つなぐ上では,交流や外出に関わる主体性の確保と交流の条件づくり,つないだ後の継続した援助が大切であった。看護では,対象の自己実現を支えることが大切であるが,このように,住民をケアの受領者と提供者の両面を同時に捉え,働きかける事により,地域社会の中で暮らしていく上での自己実現が追求できていた。そして,看護職は,このように住民を捉え,その理解を深めることにより,援助方針を修正し,さらに地域社会づくりの活動を推進していた。これらの保健婦が用いた看護援助方法の地域づくりにおける意味は,直面している健康課題のみならず将来起こりうる課題を予測して,住民のセルフケアを支えることであった。また,住民同士の相互関係性を構築しながら,地域社会の中でより良く生活する価値観を形成し,それらを通して地域の人的資源づくりを行うことであった。これらの看護職による援助は,高齢者や障害者など対応が困難な人に向けての今後の対応モデルづくりとなり,自立と連帯を理念とした継続的な地域づくりの基盤となるものと考えられた

This study's aim is to characterize the significance of nursing care in community 'zukuri' building (Regional Development for the creation of Health and Happiness) by analyzing the intentions of Public Health Nurses (PHN) and the actual care methods that they adopt in their community based practice. When dealing with the resident, regardless of his or her health state, PHNs always regard them not only as a recipient of care, but also as a potential provider of care services. The study finds that the cultivation of a sense of belonging and connections between residents is the most effective nursing care method in the community based practice. In a community 'zukuri' building, it is important to encourage the resident to go out in public where they can meet people, while helping them to learn how to develop relationships they have initiated. The meanings of nursing care are 1) to help the resident become better prepared for possible health problems they may encounter in the future while encouraging them to learn how to be self-reliant. 2) to nurture a stronger sense of community among the residents and help them build a community by themselves. 3) to cultivate reliable human resources needed to achieve the above points. The study also concludes that such nursing care can lead to a model case for the development of a future community where the elderly and the disabled are more self-reliant and active participants., 保健婦の実践活動は,受け持ち地域に住むすべての住民の健康生活を守る地域社会づくりである。本研究は,保健婦がどのように看護援助を展開させて,地域社会づくりに貢献してきたのか,保健婦が長年積み上げてきた一地区の活動実績について,保健婦の援助意図とその方法を分析することにより,地域社会づくりに用いた看護援助方法の特徴を明らかにした。援助対象の捉え方は,住民を障害の有無等にかかわらず,ケアの受領者・提供者の両面を持つ人と位置づけることであった。具体的な方法では,住民と住民,つまり人と人をつなぐことが中核となっていた。つなぐ上では,交流や外出に関わる主体性の確保と交流の条件づくり,つないだ後の継続した援助が大切であった。看護では,対象の自己実現を支えることが大切であるが,このように,住民をケアの受領者と提供者の両面を同時に捉え,働きかける事により,地域社会の中で暮らしていく上での自己実現が追求できていた。そして,看護職は,このように住民を捉え,その理解を深めることにより,援助方針を修正し,さらに地域社会づくりの活動を推進していた。これらの保健婦が用いた看護援助方法の地域づくりにおける意味は,直面している健康課題のみならず将来起こりうる課題を予測して,住民のセルフケアを支えることであった。また,住民同士の相互関係性を構築しながら,地域社会の中でより良く生活する価値観を形成し,それらを通して地域の人的資源づくりを行うことであった。これらの看護職による援助は,高齢者や障害者など対応が困難な人に向けての今後の対応モデルづくりとなり,自立と連帯を理念とした継続的な地域づくりの基盤となるものと考えられた

The purpose of this study is to identify the characteristics of the health care needs that public health nurses have catched in the commuinity-based practice. This study is planned as the first step to identify the characteristics of nursing function in the administation service. Data was collected through free answer descriptions and interviews from 5 PHNs about the process, the methods, the aims, and the outcomes on their one-best-practice. The descriptions about the health care needs for residents were classified into 9 dimensions as follows: 1. the community and sociality activity, 2. the family function, 3. the self-care behavior, 4. the daily living behavior, 5. the physical health, 6. the psychological health, 7. the intrapopulation minds, 8. the services of public healh, welfare and medical, and 9. the public facilities. These discriptions were analized more from the viewpoints of the consciousness of PHNs against residents about their own-needs and their self-care behavior. They were classified into 3 categories: 1. The residents does not recognize their own-needs, so their selfcare behavior is inadequate, 2. The residents recognize their own-needs, but their selfcare behavior is inadequate, 3. The selfcare behavior is adequate, and they need further support. The characteristics of the health care needs that public health nurses have catched for residents in their commuinity-based practice were as follows: 1. the multiple needs of the health and the daily living. 2. the individual needs of their life, health and happiness, and 3. the administrative needs of the foundation of new social services with which the exist services are not covered., 行政サービスの中で機能する看護の特質を確認するための第一段階の研究として,保健婦(士)が,地域で一つの単位の活動を起こす過程で着目したニーズ(必要性)を分析した。保健婦(士)自身が「保健婦(士)らしい活動」と自己評価する5事例の活動の発端・意図・方法・成果を自由記述,面接調査で回答してもらい,援助が必要と考えた生活の営みの側面,対象,保健婦(士)と当事者の共有の状態,セルフケアの実践の状態を調べた。その結果,「社会生活行動」「家族の機能」「保健行動」「日常生活行動」「身体的健康」「心理的精神的健康」「周囲の人々の価値観・意識」「保健福祉医療サービス」「生活環境」の9つの側面を確認した。援助の必要性に関しての保健婦(士)と当事者との共有の状態,セルフケアの実践の状態によって,1)対象が認識・要望しておらず,従ってセルフケアが不十分な段階,2)対象が認識・要望しているが,セルフケアが十分でない段階,3)自立的な問題解決行動,又はそれに向けた動機付けがある段階,の3つの特徴を確認した。個人や家族のニーズと援助を必要とする人々を支援する周囲の人々のニーズを全ての事例で確認し,全ての地域住民に該当するニーズを3事例に確認した。保健婦(士)の着目したニーズの特質について以下の3点を確認した。1.住民の多側面にわたる健康生活への着目2.個々のその人らしい生活や幸福の追求3.既存の資源では解決できないニーズに着目し必要な資源の創設への行政判断を促す。

The purpose of this study is to identify the characteristics of the health care needs that public health nurses have catched in the commuinity-based practice. This study is planned as the first step to identify the characteristics of nursing function in the administation service. Data was collected through free answer descriptions and interviews from 5 PHNs about the process, the methods, the aims, and the outcomes on their one-best-practice. The descriptions about the health care needs for residents were classified into 9 dimensions as follows: 1. the community and sociality activity, 2. the family function, 3. the self-care behavior, 4. the daily living behavior, 5. the physical health, 6. the psychological health, 7. the intrapopulation minds, 8. the services of public healh, welfare and medical, and 9. the public facilities. These discriptions were analized more from the viewpoints of the consciousness of PHNs against residents about their own-needs and their self-care behavior. They were classified into 3 categories: 1. The residents does not recognize their own-needs, so their selfcare behavior is inadequate, 2. The residents recognize their own-needs, but their selfcare behavior is inadequate, 3. The selfcare behavior is adequate, and they need further support. The characteristics of the health care needs that public health nurses have catched for residents in their commuinity-based practice were as follows: 1. the multiple needs of the health and the daily living. 2. the individual needs of their life, health and happiness, and 3. the administrative needs of the foundation of new social services with which the exist services are not covered., 行政サービスの中で機能する看護の特質を確認するための第一段階の研究として,保健婦(士)が,地域で一つの単位の活動を起こす過程で着目したニーズ(必要性)を分析した。保健婦(士)自身が「保健婦(士)らしい活動」と自己評価する5事例の活動の発端・意図・方法・成果を自由記述,面接調査で回答してもらい,援助が必要と考えた生活の営みの側面,対象,保健婦(士)と当事者の共有の状態,セルフケアの実践の状態を調べた。その結果,「社会生活行動」「家族の機能」「保健行動」「日常生活行動」「身体的健康」「心理的精神的健康」「周囲の人々の価値観・意識」「保健福祉医療サービス」「生活環境」の9つの側面を確認した。援助の必要性に関しての保健婦(士)と当事者との共有の状態,セルフケアの実践の状態によって,1)対象が認識・要望しておらず,従ってセルフケアが不十分な段階,2)対象が認識・要望しているが,セルフケアが十分でない段階,3)自立的な問題解決行動,又はそれに向けた動機付けがある段階,の3つの特徴を確認した。個人や家族のニーズと援助を必要とする人々を支援する周囲の人々のニーズを全ての事例で確認し,全ての地域住民に該当するニーズを3事例に確認した。保健婦(士)の着目したニーズの特質について以下の3点を確認した。1.住民の多側面にわたる健康生活への着目2.個々のその人らしい生活や幸福の追求3.既存の資源では解決できないニーズに着目し必要な資源の創設への行政判断を促す。

This case study explores the opportunities for students of Industrial Design Engineering to engage with direct and indirect stakeholders by making their design process and results into open-ended designed solutions. The reported case study involved 47 students during a two-weeks intensive course on the topic of urban gardening. Observations were collected during three distinctive phases: the co-design phase, the creation of an open design, and the sharing of these design solutions on the online platform Instructables.com.The open sharing of local solutions triggered more global discussions, based on several types of feedback: from simple questions to reference to existing works and from suggestions to critiques. Also, some examples of re-appropriation of the designed solutions were reported. These feedbacks show the possibilities for students to have a global vision on their local solutions, confronting them with a wider and more diverse audience.The case study shows, on the other hand, the difficulty in keeping students engaged in this global discussion, considering how after a few weeks the online discussions dropped to an almost complete silence. It is also very difficult with such online platforms to follow the re-appropriation cycles, losing the possibility of exploring the new local context where the replication/modification of the designed product occurred. The course’s focus on open design is interesting from both the design and educational points of view. It implies a deep change in the teaching approach and learning attitude of students, allowing unknown peers to take part in the design process and fostering a global discussion starting from unique and local solutions.