Background: The aging rate in Japan is 28.1 % and the number of people requiring long- term care support or nursing care is increasing. One major reason is falls. Foot and toenail problems reduce lower limb function and increase fall risk. We devised a foot care program with a cognitive approach for middle-aged adults(aged 45 to 64). We herein report the physiological and psychological effects of foot bathing implemented as part of this program.
 Method: A self-controlled design was applied in a before-after comparison design, and data from 13 women aged 48 to 62 were analyzed. Heart rate(HR), blood pressure(BP), oxy- gen saturation of arterial blood(SpO2), and autonomic nervous activity were used as physio- logical indicators and the Japanese version of the Profile of Mood States Second edition - Adult Short(POMS2)was used for subjective evaluation.
 Results: HR decreased significantly in the intervention group 5 and 10 minutes after the start of the foot bath. Systolic BP decreased significantly during the foot bath in the interven- tion group. SpO2 did not differ significantly between groups. No significant differences were observed in sympathetic nerve activity in either group. Parasympathetic nerve activity was significantly higher than baseline 2.5 minutes after the end of the foot bath in the interven- tion group. Results of the POMS2 showed a significant decrease in anger-hostility, confusion- bewilderment, fatigue-inertia, tension-anxiety, and total mood disturbance in both groups. Vigor-activity increased significantly and friendliness increased noticeably although not sig- nificantly in the intervention group.
 Conclusions: HR and systolic BP decreased significantly and parasympathetic nerve activi- ty increased significantly in the intervention group. Also, positive emotions increased signifi- cantly in the intervention group. This shows that relaxing and mood-stabilizing effects and vigor are physiological and psychological effects of foot bathing in middle-aged adults.

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 The purpose of this study is to research the support that administrators in designated home health nursing offices provide for development of their home health nurses and draw out implications for educating them. Semi-structured interviews were conducted with administrators of six designated home health nursing offices in the Metropolitan area, and data was collected. The data was inductively analyzed, the subcategories for each research participant were pattern coded, and the qualities of supporting development were extracted. The average age of the six female administrators was 50.3 years old, and the average years of experience of the administrators was 14.7 years. As a result of the analysis, three main categories of supporting development were identified: “the administrator’s own system for working”, “support for nurses to be independent in their profession”, “creation of an environment where nurses can work safely and securely”. Eleven qualities of supporting development were identified. It became clear that administrators created a system for working such as a circulation of learning opportunities and mutual instruction between nurses, provided support so nurses can learn from the experiences of other nurses, and created an environment where care for nurses is valued as much as care for patients is and psychological safety is emphasized. Going forward, this can be used for the development of home health nurses.

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【Objective】To validate whether the Health Action Process Approach(HAPA)fits the behavior of women in their 20s and 30s with respect to undergoing cervical cancer screening.
【Methods】A questionnaire survey was conducted twice. In total, 278women aged under 40 years with valid and complete responses were analyzed. The first survey included basic attributes, outcome expectancies(OE), risk perceptions(RP), action self-efficacy(ASE), and intention to undergo screening as psychological variables that we developed for the behavior of undergoing cervical cancer screening. The second survey included maintenance self-efficacy(MSE), recovery self-efficacy(RSE), action planning(AP), coping planning (CP), social support(SS), and behavior of undergoing screening. After verifying the construct validity of each psychological scale, OE, RP, and ASE were associated with the intention to undergo screening based on the HAPA, and ASE, MSE, and RSE were found to affect the behavior of undergoing screening from such an intention through AP and CP. Based on this process model, a covariance structure analysis was conducted with SS and attributes as control variables.
【Results】The process model of the behavior of undergoing cervical cancer screening, hypothesized based on the HAPA, had a root mean square error of approximation of 0.049 and a comparative fit index of 0.942, and fit the data well.
【Discussion】The behavior of undergoing cervical cancer screening based on the HAPA was supported by the goodness of fit index. These results suggest that the HAPA is a useful model for predicting the behavior of women’s undergoing cervical cancer

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Objective: The aim of this study was to examine the psychometric properties(reliability and validity)of the Participation and Environment Measure for Children and Youth(PEM-CY)in children with mobility limitations.
Methods: Parents of 261 children with disabilities were included in a questionnaire survey of their children's age, grade, disease, gross motor function, and PEM-CY. Cronbach's α for internal consistency and ICC(3.1)for retest reliability were calculated and examined. Validity was examined by calculating the main effect by performing a two-way analysis of variance with two factors of motor function limitation and age.
RESULTS: 134 letters were used with valid data; Cronbach's α was greater than or equal to 0.6 for all items; ICC(3.1)was greater than or equal to 0.7 for all items. Analysis of variance revealed significant effects and small-large effect sizes(0.00-0.32)for many items in motor function limitation. For age, no significant effects were identified for many items, with effect sizes ranging from small to medium(0.00-0.04).
CONCLUSION: PEM-CY has moderate to high internal consistency, high retest reliability, and small to large validity in children with mobility limitations and can be used in clinical and research settings.

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 [Purpose]There is no established method for rolling over motion analysis using a quantitative date other than using an optical three-dimensional motion analysis device, but it is not possible to perform complete analysis for rolling over motion where it is difficult to measure markers. There are also limits. In the previous study, we categorized rolling motions by analyzing up to 90 degrees of pelvic rotation, but in clinical practice it is required to develop more convenient and practical measurement and analysis. Therefore, we examined whether it is possible to categorize the motion patterns by analyzing the motion of rolling over to 45 degrees of pelvic rotation.[Method]Rolling over movement was measured by a three-dimensional motion analysis system for 30 healthy men, and rolling over movement was classified by cluster analysis and one -way analysis of variance up to the pelvic 45 degrees rotation. After that, by comparison with previous study, the kappa coefficient was used to calculate the degree of agreement with the rolling motion patterns in the analysis up to 90 degrees of pelvic rotation.[Results]The movement patterns are classified as trunk flexion(n = 18)/extension(n = 4)/rotation(n = 8), and the agreement of the movement patterns compared with the analysis up to 90 degrees of pelvic rotation was κ = 0.66 (p <0.001), which was a sufficient agreement.[Conclusion]The classification of the rolling over movement pattern using a quantitative date is sufficiently possible by analysis up to the pelvic rotation of 45 degrees.

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Background: Self-management after spinal cord injury(SCI)is a key prevention strategy for averting the development and recurrence of secondary complications and their associated consequences. In order to develop a socio-culturally appropriate self-management program, examination of the efficacy of existing programs is necessary. Objective: To review the efficacy of self-management interventions among community-dwelling persons with SCI. Method: We systematically searched four electronic databases[Scopus, EBSCOhost(CINAHL, MEDLINE), Web of Science, and PubMed]and bibliographies for relevant studies published between 2000 and 2019. The review process followed the PRISMA guidelines. Results: Of the initial 1,854 identified articles, 16 met selection criteria and were reviewed. Twelve self-management interventions(SMIs)among sixteen were found to have positive effects on at least one primary outcome. Positive physical health outcomes were good health state and reduction in secondary health complications. Emotional/psychosocial outcomes included improvements in self-efficacy, confidence to manage/prevent secondary health complications, life satisfaction, coping, decreased anxiety and depression. Positive role management outcomes were decreased activity limitations and increased participation. The efficacy of the SMIs did not appear to vary significantly by nature and delivery method of the interventions. Conclusion: The present review found that SMIs were effective for improving physical and emotional outcomes in most studies and role management in several studies. Our findings may aid future SMI development and research to focus more on role management, social barriers, and rights for persons with SCI in the community, especially in lower-middle-income countries, where community support and self-management programs rarely exist.

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