Empowerment is something that gives people hopes and dreams, brings them courage, and prompts them to be filled with the strength to live. It is a wonderful quality that should be present in everyone.
People are born with splendid abilities. And throughout their lives, they can continue to demonstrate magnificent strengths. It is empowerment that draws out that magnificent power—in the same way that spring water flows steadily out of a natural fountain, it is empowerment that allows the vital force and potential that lie hidden deep within us to flow.
In the practice of health social services, the magnificent potential that each individual initially has is awakened, prompted to manifest, and is leveraged through activities for the good of people’s lives and for the development of society. In groups of people such as in the context of a business enterprise, the potential vigor and capabilities of each employee can be drawn out skillfully and leveraged as energy to be linked to staff development and corporate growth. These are the things that empowerment—needed by organizations, groups, and people—are all about.
Empowerment is one method for realizing a society in which everyone is the hero of his or her life, where they can enjoy the differences between themselves and others and are able to embrace the joys of living alongside one another.
For early detection of neurodevelopmental disorders, it is necessary to look for restless behavior and difficulty with personal relationships in children without developmental delay during child health examinations. To achieve this, a novel medical examination that is able to detect neurodevelopmental disorders without missing cognitive behavior disorders should be developed. Therefore, we devised two methods for use in medical examinations of 5-year-old children.
First, we structured medical examinations divided into the five components of conversation, movement mimicry, coordinated movement, conception and motor impersistence. Second, after findings were detected in the structured medical examination, the universality of the findings was confirmed through interviews with parents. Interviews were divided into the three components of language development, prosocial development and hyperactive/impulsive behavior.
We conducted the above health examinations combined with follow-up consultations. The follow-up consultations were constructed as child care consultations, developmental consultations and educational consultations. These three consultations were remarkably effective in diminishing the medical needs of children. We also found that our health examinations of 5-year-old children contributed to reduced school refusal. In the future, it is expected that this health examination will be held in many regions in Japan.
The Clinical Center of Developmental Disorders was founded at Shirayuri University approximately 20 years ago both as a consultative institution for children with developmental problems and as a clinical research institution for master’s and doctoral programs in developmental psychology.
We reviewed the principles of the establishment as well as clinical research that we conducted with a central focus on developmental disorders over the past 20 years.
As a result, it was clarified that the contents and duration of therapeutic education from early infancy through childhood could greatly influence the development of children with developmental disorders since these periods seem to feature the rapid growth of cognitive abilities. It was also indicated that early diagnosis and continuous therapeutic education are very important.
Therefore, we concluded that it is essential to offer continuous support for people with developmental disorders from early infancy through adulthood and to rearrange and enhance the contents of therapeutic education taking the characteristics of developmental disorders and growth into consideration.
Alzheimer’s disease （AD） is the most common progressive neurodegenerative disorder, and the cause behind the majority （75%） of dementia cases. AD is characterized by the accumulation of senile plaques （deposits of protein fragments called amyloid beta ［Aβ］ in the brain）, neurofibrillary tangles （aggregates of phosphorylated tau protein） and nerve cell degeneration. Although dementia of AD-type dementia is characterized by progressive decline in cognitive abilities, there are treatments available to improve dementia symptoms. Two cholinesterase inhibitors （ChEI）, donepezil and galantamine, prevent the breakdown of a chemical messenger in the brain involved in cognition and are widely used as a first-line therapy to treat mild and moderate dementia. We treated 32 AD with donepezil and galantamine at the time of first clinical diagnosis. The 20 patients treated with donepezil showed improvement on an apathy scale and the 12 patients treated with galantamine showed improved frontal lobe function on the Frontal Assessment Battery after 2 months. Galantamine may affect the nicotinic acetylcholine receptors located in the frontal lobe. Donepezil may have an effect on apathy through the acetylcholine pathway of memory circuits in addition to the dopaminergic pathway. These two ChEIs could be appropriate early treatments for AD on the basis of improvements in apathy and frontal dysfunction.
According to statistics provided by the World Health Organization, one in four people will be affected by some form of mental illness at some stage during their lifetime. In terms of psychiatric welfare, the transition from facility care to community care has been promoted in Japan. One of the main symptoms of schizophrenia, which accounts for 60 percent of psychiatric inpatient admissions, is the impairment of cognitive function, which causes various difficulties in day-to-day living. Although schizophrenia tends to be regarded as having the power to overwhelm those who are affected, individuals with schizophrenia have realistic goals and hopes, with many striving every day to make efforts to improve their lives. There is a need for further enhancement of psychiatric rehabilitation in order to support recovery from illnesses and disabilities that cause those affected to question their own mental state.
Neurodevelopmental disorders are a group of disorders affecting various psychological functions that manifest early in development and often cause difficulties in social, academic and/or occupational functioning throughout life. Disorders in this group are thought to have some kind of neurobiological base. The severity of the symptoms of neurodevelopmental disorders is not always related to the severity of difficulties in social life. Some adults with the symptoms of neurodevelopmental disorders do not require any treatment or welfare support;thus, at least some parts of neurodevelopmental disorders should be regarded as biological variants instead of illness. On the other hand, some people with neurodevelopmental disorders may suffer from various kinds of secondary problems, mostly due to the psychological stress of trauma in their environment, and even people with the slightest symptoms could have very severe difficulties in their daily lives when they come across secondary problems. For diagnosis and assessment of people with neurodevelopmental disorders, we should determine not only whether they have a neurodevelopmental disorder or not, but also the extent to which the symptoms of neurodevelopmental disorders affect their mental state and quality of life.
The cognitive style and trajectories of neurodevelopmental disorders are unique. Former studies tended to focus on how people with neurodevelopmental disorders are inferior to those without. However, future studies should focus on topics such as the specific cognitive styles of neurodevelopmental disorders, and the specific developmental trajectory in order for people with the characteristics of neurodevelopmental disorders to develop and participate in the community without any secondary problems.
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