The case of a 20-year-old female with Cockayne syndrome, presenting with reduced intake of food, is described. At admission, her intake of food and her body weight were low. The patient's food swallowing function was recorded by video fluorography and evaluated. Reduced transfer of food boluses to the posterior site of the oral cavity, incomplete formation of boluses in the oral phase, and residual food after swallowing in the pharynx phase were observed. No aspiration was observed, however, during video fluorography. The patient's nutrition was managed by changing her meals to fluid-type food to shorten the eating time.

The case of a 20-year-old female with Cockayne syndrome, presenting with reduced intake of food, is described. At admission, her intake of food and her body weight were low. The patient's food swallowing function was recorded by video fluorography and evaluated. Reduced transfer of food boluses to the posterior site of the oral cavity, incomplete formation of boluses in the oral phase, and residual food after swallowing in the pharynx phase were observed. No aspiration was observed, however, during video fluorography. The patient's nutrition was managed by changing her meals to fluid-type food to shorten the eating time.

The activities of the community based environmental forum over the past 7 years to maintain the Hii River-Shinji Lake ecosystem were reviewed. The network formation model for environmental safeguard developed in local communities in Shimane and the action targets of a healthy city project were evaluated.
1. Interaction between the development of theme and the increased participation of people from all walks of life.
In 1991, the communities launched “The Chironomidae-outbreak counterplan” named “Shinji Lake Forum” with the participation of various classes of inhabitants around Shinji Lake, including fishermen, biologists and environmental health researchers. The participatory action spread from residents around Shinji Lake to other communities along Hii River, resulting in the formation of an enlarged community network and inter disciplinary research network. The action targets developed as follows:
(1) the Chironomidae-outbreak counterplan, (2) water quality preservation of Shinji Lake, (3) community class for ecology, (4) a community network encompassing the river-lake basin, (5) a healthy city project aimed at cultural development.
2. The objective of the healthy city project
Now the participatory action is developing into the movement of “The Harmony of natural ecosystems”. With linkages between development and ecosystem protection, the healthy city project aimed at cultural development could be pursued in harmony with natural environment.
3. “The network formation model that has gone through processes of opposition and sharing” and participatory action research
In this paper we discuss the formation process of environmental safeguard network. At first, opposition structure such as the fishermen and the agriculturalists, the citizens and the administration, the upperstream area residents and the downstream area residents, was made obvious by making clear differences in interest concerning the environment and living well-being. And the common goals to achieve and roles individuals have to play become clear through the process of sharing a thought on the natural ecosystem and the process of recognizing the different standpoints again. The importance of the cooperation of residents, administrations and researchers, together with participatory action research using the network formation model, was emphasized in order to settle variously complicated problems of ecosystems.