Critical paths (CPs) were developed with the aim of guaranteeing and improving the quality and efficiency of medical care. The purpose of this study was to clarify how CPs were perceived by nurses using CPs on a regular basis. The interview study using semistructured questionnaires was conducted in 15 Japanese nurses with over 5-year clinical experience, who have been using CPs for more than 2 years at medical institutions. The transcribed data were analyzed qualitatively. The results showed that there were 2 major categories, 9 subcategories, and 21 codes. The two categories were: positive effects of CPs and negative effects of CPs. The positive effects of CPs consisted of: 1) medical transparency, 2) medical standardization, 3) promotion of efficiency of care, and 4) effective nursing education. The negative effects of CPs consisted of: 1) lack of nursing viewpoints, 2) vague judgment indexes, 3) artificial variances, 4) difficult information sharing, and 5) stereotyped nursing practice. The study suggested that nurses have found both advantages and disadvantages of using CPs.

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Background. To determine whether or not healthy subjects elevate and descend their dominant and nondominant arms in the same manner is important in understanding the pathology of shoulder diseases: rotator cuff tear; impingement syndrome; stiff shoulder; and loose shoulder. Methods. Twenty young healthy subjects (17 males and 3 females, average age 24 years) were enrolled in this study. They randomly elevated and lowered both arms in the scapular plane 3 times and motion was measured using a three-dimensional motion analyzer. We calculated scapulohumeral rhythm in 10゜ increments and analyzed the setting phase during both elevation and lowering. Findings. There was no statistically significant difference in scapulohumeral rhythm between the dominant and nondominant arms. Scapulohumeral rhythm was stable (3.3) from 70 degrees during elevation to 70゜ in lowering; however, individual variations of scapulohumeral rhythm were identified, except for the previously described angles. The setting phase was identified as below 60゜ during elevation and a similar phase was also observed below 60゜ in lowering. There were two scapular motion patterns in the setting phase: the first started primarily as a scapular upward rotation; the second moved in the glenohumeral joint but less in the scapula. Interpretation. To elevate both arms in the same manner means that we can compare both the glenohumeral joint and scapular motion between affected and non-affected shoulders. The setting phase is defined as below 60゜ in elevation; moreover, a phase similar to the setting phase with variable scapular motion is identified during lowering.

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The Neuro-Pychiatric Institute Interest Checklist (NPIIC) has been widely used and the Interest Checklist of Japanese Elderly Version (ICJEV) was established with the consideration of Japanese culture. However, an Interest Checklist of Korean Elderly Version (ICKEV) has yet to be established. Therefore, this study aimed at establishing the activities for the ICKEV. ICKEV was established based on the data from 101 healthy and elderly Koreans living in a metropolitan area through the preliminary version. As a result of the authorization of Mann-Whitney, the total score of the interest was no significant difference between men and women. Cronbach alpha coefficient for preliminary version was 0.82. The most popular activity items were Television followed by Traveling, Gathering, Singing, Religion etc. It was suggested that the items seemed to reflect participants' preference for Gourmet, Computer, Meditation, Asian playing cards and Yoga etc. because participants gave reasons for those items as health consciousness, social interactions, community, tradition, trend, family interaction and beliefs. The ICKEV reflected the interest of the Elderly Koreans and it was suggested that it be a useful tool.

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The revised Attitudes toward Employment of Psychiatric Disability scale (ATEP II) was developed for the assessment of transport sector employers' attitudes toward employing people with psychiatric disability in order to assist researchers and practitioners in supporting employers. In total, 478 employers representing seven Japanese transport industries classified by the Japan Standard Industrial Classification were surveyed by questionnaire. Factor analysis yielded the following nine factors associated with employment of people with psychiatric disability: employer motivation for hiring, activity limitation, trustworthiness, employer motivation for making preparation of hiring, attention distribution, prejudice and fear, self-efficacy for managing employment, advantages of hiring, and recruitment standards based on capacity. Moderately high or high Cronbach alphas and testretest reliability coefficients indicated that scores from the ATEP II are internally consistent and stable when measuring multidimensional attitudes of transport sector employers. The results of one-way ANOVA or two-tailed t-tests suggested that differences in attitudes differ among transport sector employers according to the organizational characteristics (whether or not employers run businesses other than transport, the number of regular workers, the number of workers with disabilities), regular worker characteristics (length of employment, educational qualifications of regular workers) and individual characteristics (age, whether or not employers are in managerial posts, prior experience employing people with disabilities). Therefore, the seven industrial classifications that comprise the transport industry were not critical factors differentiating employer attitudes within the transport sector. The results of a multiple regression analysis suggested that in the transport sector, employer motivation for employing people with psychiatric disability is correlated with recruitment standards based on capacity, advantages of hiring, fear, prejudice, and whether or not employers run businesses other than transport. In order to provide effective support for employers, future research should include confirmatory factor analysis to ensure the construct validity of ATEP II and an investigation of significant ATEP II subscales.

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For patients with higher cognitive dysfunction, executive dysfunction is an obstructive factor to work. One of the characteristics of executive dysfunction is that those patients are easily affected by environments. For example, they can perform an activity well in training situations but not in workplace. We assumed that executive functions of the patients are affected by interference of functions to recognize an environment and adopt in it. In this study, we selected 87 case examples of job assistance to patients with higher cognitive dysfunction with conditions such as diagnosis of executive dysfunction and systematic intervention by professionals. Then we abstracted and categorized factors such as functional disorder, restricted activities, limited participation or environment factors according to International Classification of Functioning, Disability and Health: ICF and for those functional disorders, we statistically tested proportional homogeneity based on the proportion of the cases of groups with or without executive dysfunction and found out that impairment of attention, insight or judgment and limitations of maintaining social space are the most relevant factors in the example group of executive dysfunction. In the same manner, in example groups with four disorders or restrictions, we identified functional disorder, restricted activities, limited participation or environment factors that shows meaningfully high ratio of occurrence, then examined relationships with executive dysfunction according to Occupational Performance Process Model: OPPM.

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This study addressed whether the results from the Unstructured Assessments (UA) which were fulfilled the following four conditions could be judged to be the UA results with high quality dependability. The following four conditions were considered to make the UA results highly dependable: 1) A third party could share an evaluator's tacit assumptions, 2) Presented realities which were obtained from interviews and observations should show changes through occupational performances, 3) Sentences should be expressed with less omissions and clear concepts and 4) UA results should be focused on an occupational competency and also they were rational and clear. As a result, it was found that occupational therapists judged the UA results which were fulfilled the four conditions to be the UA results with high dependability hence occupational therapists didn't judge the UA results which were not fulfilled the four conditions to be the UA results with high dependability. It was suggested that the UA results which were fulfilled the four conditions could be used as teaching materials to learn high quality UA results, therefore, educators could exercise educational interventions toward learners with the considerations of this study's results.

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The aim of this study was to clarify the present situation and issues on safety and comfortableness about utilization of the wheelchair transportation vehicles (WCTV). In this study, the answers of the questionnaire obtained from the total 274 people WCTV (135drivers and 123caretakers) have been analyzed. The results were as follows: (1) 76 people (28.9%) were encountered some accidents. (2) 202 people (77.1%) were encountered some Hiyari-Hatto (HH). (3) 174 people (67.2%) were felt problems of the hardware side such as WCTV structure. (4) 224 people (85.5%) were felt problems of the software side such as assistance method. (5) 74 people (27.0%) were felt other problems such as license system. (6) 227 (93.0%) people were considered in the institution as well. We analyzed relations with "the some situation of the driving" and "the appearance situation of accidents, HH, problems and considerations". As results, that at first, the pickup driver and caretaker were basically demanded to learns how to use vehicle and the familiarity of the driving route. It is suggested that the safety management and the careful driving were important for WCTV.

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