[Objective] The purpose of this study was to examine the correlation between the corporate workers' depression and the workers' lifestyle or results of periodic medical examination that could be useful for occupational health. [Methods] 471 workers in a chemical corporation were examined by SDS (Self-Rating Depression Scale), Morimoto's HPI (Health Practice Index) and period medical examination, and the correlation among the results evaluated. [Results] 39.6% of all workers, concretely 58.7% women and 34.9% man had depression, the difference between women and man being statistically significant. 37.2% research workers and 47.7% factory workers had depression (not significant). 37.5% twenties, 44.1% thirties, 46.0% forties and 26.7% fifties had depression (statistically significant). Evaluation of life style, from Morimoto's HPI, revealed a statistically significant correlation between the depression occurrence and some habits such as having a breakfast every day, a well-balanced diet, not drinking alcohol or sleeping for 7-8 hours. In contrast, no correlation was found between depression occurrence and BMI or blood biochemical markers. [Conclusions] It was concluded that depression occurrence correlates with some life style, such as diet or sleep habits, which are supposed to be useful for early detection of depression among people of different ages and genders.

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The purpose of this study was to explore the factors that facilitate participation in outside activities among patients with Amyotrophic Lateral Sclerosis (ALS) dependent on Home Mechanical Ventilation (HMV). A questionnaire survey regarding patient outings was sent to 477 ALS patients recruited from the patient registry of a Japanese respiratory equipment company. Of 477 questionnaires mailed, 316 (66.2%) were returned ; 68.4% of participants were male (mean age : 62.4 + 10.2 years). Contributing factors relating to outing participation were compared between the "Outing" and "Non-Outing" groups. Comparison of the two groups used univariate analyze and multiple logistic regression, with statistical significance indicated by p values < 0.05. Among 289 patients on tracheostomy positive pressure ventilation (TPPV), 228 (78.9%) reported any experience with activities outside the home. Of this group, 122 (53.4%) indicated that they leave home "one or more times every 2-3 months" while 106 (46.6%) responded that they leave home "less than once every 6 months" or "do not go out at all." Patients who left home "one or more times every 2-3 months" tended to report more diverse motivations for going out, as well as longer durations of outings (in hours), than those who left home less frequently. Comparison of the "Outing" and "Non-Outing" groups revealed the following five factors. The "Outing" group had external ventilator batteries (essential equipment) , expressed greater desire to go out, and were more likely to use a personal computer for communication than "Non-Outing" patients. In addition, patients in the "Outing" group expressed the importance of a barrier-free society in facilitating their participation in outings. Members of the "Non-Outing" group expressed more need for nursing care than did the "Outing" group. Our results suggest the importance of care supportive of factors identified as facilitating participation in outside activities among ALS patients dependent on HMV.

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The purpose of this study was to explore the confidence levels of family members' decisions for medical care of gravely ill patients and the factors related to those confidence levels. Based on past research and the theory of decision-making 11 factors related to the confidence levels were identified. A qualitative study was conducted on five participants who made decisions for their family members who had cerebral vascular disorder (Glasgow Coma Scale 7-14). Using participant observation and semi-structured interview methods, we collected data regarding the states of the decision-making made by family members and analyzed the levels of confidence in their decision-makings and the 11 factors qualitatively. The results revealed that participants showed high level of confidence in four decision-making situations and low level of confidence in five situations. It was suggested that high levels of confidence in the decision-makings were related to the following six factors : 1) conditions of the patient, 2) family member's psychological stability at the time of making the decision, 3) time allowed to make the decision, 4) seeing the patient before making the decision, 5) family member's trust in the medical and nursing staff, and 6) no coercing in the physician's explanation regarding decision-making. The results indicated some strategies for nursing care and support procedures to assist family members making decisions with confidence under difficult emergency medical situations.

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The purpose of this study was to examine the cross-validity of the Social Skill Assessment Scale-12(SSAS-12)in outpatients with mental illnesses. Data were collected from 177 outpatients to examine the factor structure of SSAS-12, and also from 213 subjects including 36 inpatients to assess the external validity of the scale. Social skill status was measured by participating families using Likert scale ratings. Confirmatory factor analysis revealed that the factor model, which used "use of social resources", "personal appearance", "communication skills" and "arrangement of living environment" as primary factor and "social skills" as secondary factor, was consistent with data within the statistically appropriate range. Covariance structure analysis was also conducted to test a model that hypothesizes that social skills are associated with patient place of living residence. As a result, the goodness of fit for this model was statistically acceptable. Results indicate that the cross-validity of SSAS-12 may be vigorously supported.

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The analogy in the Occupational Therapy is valued in the therapeutic practice, and it is educated as Clinical Reasoning. The research papers that how clinical reasoning concept was used in the practice until today were reviewed. As the result of bibliographical search from 1983 to 2005 in Japan, there were 4 researches about clinical reasoning, about the reasoning analysis of therapeutic change in intervention to the case of mentally and developmentally disordered clients and the results of the survey of questionnaire method for teaching effectiveness. As the result of bibliographical search from 1956 to 2005 in Europe and the United States, there were 70 researches about clinical reasoning. The researches up to 1993 discussed the concept and the classification of the clinical reasoning for Occupational Therapy and there was no change in the conceptual classification. Over the half of researches discussed the occupational therapy education and therapeutic intervention and it shows the clinical reasoning has close relations to the education and the practice of Occupational Therapy, and it is supposed that clinical reasoning will take a major part in PBL and PBP. Comparing research papers in the education and practice, a few researches were done in the psychiatric practice. The analogy in the Occupational Therapy is valued in the therapeutic practice, and it is educated as Clinical Reasoning. The research papers that how clinical reasoning concept was used in the practice until today were reviewed. As the result of bibliographical search from 1983 to 2005 in Japan, there were 4 researches about clinical reasoning, about the reasoning analysis of therapeutic change in intervention to the case of mentally and developmentally disordered clients and the results of the survey of questionnaire method for teaching effectiveness. As the result of bibliographical search from 1956 to 2005 in Europe and the United States, there were 70 researches about clinical reasoning. The researches up to 1993 discussed the concept and the classification of the clinical reasoning for Occupational Therapy and there was no change in the conceptual classification. Over the half of researches discussed the occupational therapy education and therapeutic intervention and it shows the clinical reasoning has close relations to the education and the practice of Occupational Therapy, and it is supposed that clinical reasoning will take a major part in PBL and PBP. Comparing research papers in the education and practice, a few researches were done in the psychiatric practice.

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A 25 years old man was found lying unconscious after he got drunk and slept in front of kerosene stove. He was hospitalized for Hyperbaric Oxygen Therapy and high signal in both globus pallidus was observed by diffusion weighted image of head MRI on day 1. On day 13, high signal was also observed in both substantia nigra. Undergoing Hyperbaric Oxygen Therapy for 19 times, he made satisfactory progress and was discharged on day 34. The central nerve lesion caused by carbon monoxide poisoning is associated with iron distribution in brain (e. g. in globus pallidus, substantia nigra, cerebral white matter). The brain tissue damage by carbon monoxide poisoning is assumed to be induced by reduction ability of carbon monoxide which causes ionization of nonheme iron stored in ferritin. Ionized free nonhem iron works as catalyst for Fenton and Harber-Weiss reaction, which convert H_2O_2 to OH. The produced OH is thought to damage oligodendrocyte and myeline sheathe, ending up causing selective nerve cell death.

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