[in Japanese]

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This study analyzed the process of discharge arrangements by discharge planning nurse in hospital by tracing how the conditions necessary for home care are prepared to clarify the structure of the discharge planning process and to get some hints for more effective planning. Concerning the activities of nurses of the medical liaison team of Hospital A(discharge planning nurse from the hospital), we came to the following conclusion as a result of participant observation and analysis of nursing records. 1.The process of the activities of discharge planning nurse changed in terms of the period up to the decision by a client and the family to get treatment at home and the period from the decision to environmental arrangements and the discharge from the hospital. 2.The discharge planning nurse assisted the client and the family by developing conditions necessary for home care and proposing them to client before the patient side decided to home care. 3.After such decision, the client side voluntarily started preparations to leave the hospital. The discharge planning nurse assisted the client by providing related organizations with professional information so that the client's desire would be realized.

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The purpose of this study was to identify the difference, if any, of the techniques used by nursing students("Students") and nurses, to transfer patients from wheelchair to bed, following the study of 1996. The results were as follows : 1.There was no significant time difference between the full wheelchair-to-bed motions of the Nurses and Students. The Nurses, however, took more time during the sit-down motion than the Students. 2.The Nurses straightened their back and utilized their knees during the lifting motion, more than the Students. 3.The Nurses' center of gravity covered longer distances than the Students'. 4.There were three center of gravity patterns showed by the Students', while the Nurses showed many types which employed the proper pattern. 5.Some Students paid attention to safety and comfort of the patient, and body mechanics. The Students' and Nurses' techniques were clear, and the Nurses' proper body mechanics were identified.

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This study is to elucidate relationship between outcome of community mental health service delivered by public health nurses and factors belonging to situation during public health nurses' management of schizophrenic cases. An outcome was classified according to public health nurses' management plan. Three categories are "cases ended as expected", "cases under management at the research", and "cases under unexpected discontinuation(discontinued cases)". We conducted a research on 128 schizophrenic cases by using questionnaire to collect data from public health nurses who were in charge of these cases. An activity of daily living of shizophrenic patients improved significantly except the "discontinued cases(18 case, 14.1%)". The fundamental variables and situational factors during management process, except how many social resources public health nurse collaborate with, have no significant correlation with the outcome. A mean number of social resources public health nurse added to management process in "discontinued cases" was significantly lower than other two groups of cases. This variable might imply an autonomous decision and activity of public health nurses. So, It was suggested that an autonomous decision-making process and activity of public health nurses might lead to continuation of relationship between public health nurse and cases. And, this correlation implies that cases on public health nurses' management plan would improve an activity of daily living.

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The purpose of this study was to investigate a nursing student's patterns of coping under stressful situations and to examine the relationship between a student's personal matters and trait anxiety, as well as between trait anxiety and coping behavior. The sample consisted of 148 nursing students. The results showed that the corelation between trait anxiety and "hospital-experience-anxiety" was α=.45. The following patterns of coping among nursing students were abserved by factor analysis : "problem-solving" coping, "seeking-person" coping, "problem-solving-avoiding" coping, and "withdrawing" coping. Those students enjoying life and health showed positive coping patterns.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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Reciprocal Ia inhibition in man was studied during voluntary contraction of soleus or at rest, and then its antagonist contraction. But, there is no research to investigate the relationship between muscle strengthening and central structure of upper motoneurones in physical therapy. PURPOSE:We would investigate to elucidate Reciprocal Ia inhibition conjunction consisting of Ia neurone and Ia inhibitory interneurone into the muscle strength training. METHODS:Five young adult subjects were studied with their informed consent. Since they were fixed supine with hip and knee angles at 45 and 90 degree, they were asked to move ankle pumping rapidly with 120 deg/sec and to take 10 sets by Cybex machine 6000. Periodically they were examined soleus H-reflex and peak torque among 30, 60, 90 and 120 deg/sec for two months. A test H-reflex in soleus was evoked by electrical stimulation of the tibial nerve in the popliteal fossa. The reflex was conditioned by electrical stimulation of the common peroneal nerve at caput fibulae, maintained close to motor threshold(1.0×MT, rectangular pulse:1msec). The H-reflex and M wave were recorded with bipolar surface electrodes. The effects of reciprocal inhibition were calculated as percentage reduction of the test H-reflex amplitude to the control H-reflex at the rest. Statistical comparison were made using two way layout with repetition in ANOVA and probability values less than 0.05 were contemplated significantly. RESULTS:A reduce of the soleus H-reflex amplitude attributable to Ia inhibition was showed at 2 and 3 msec conditioning-test interval, and there were significant differences(p<0.05) each other among before execise and after 6 weeks and 9 weeks. Considerly there were significant differences(p<0.01) each other among 0, 1 msec and 3 msec conditioning-test interval at after 6 weeks and 9 weeks. However, we cannot have statistical discrepancy between isokinetic examines. CONCLUSION:It would be considered that it might be important for the maturation of Reciprocal Ia inhibition to be maintain theraputic exercise.

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[Objective]The main reason that the elderly fall is their decreased ability to balance. However, there are few methods, which are convenient, reliable and suitable to evaluate the elderly's ability to balance. Therefore, the main purpose of this research is to examine whether Berg's Balance Scale is a useful tool in evaluating the balancing ability of femoral neck fracture patients recently injured by a fall. [Methods]We used BBS and conducted the experiment with 13 patients of full weight bearing with femoral neck fractures to evaluate their ability to balance. Also, we examined the usefulness of BBS relative to age, walking level, walking speed and stabilometry. [Results]A strong correlation was found between BBS and walking level, and the results of stabilometry. However, inconsistencies were found in the BBS categorized achievement rates. [Consideration]We discovered that BBS is a useful method in the evaluation of femoral neck fracture patients ability to balance. Researching more examples of injuries effecting balance and increasing the reliability of the results should be our focus in the future.

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[in Japanese]

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PURPOSE:In order to examine the validity of beats above baseline index (BABI:beats) as an index for energy expenditure, we calculated energy expenditure per unit distance(Ed:mlO_2・m^<-1>・kg^<-1>) directly by oxygen consumption, and compared it with BABI as to the optimal walking speed. METHODS:Subjects consisted of 11 healthy males. The subjects were ordered to walk continuously along an indoor figure "8" -shaped path(30 m/circle) for 200 m. The degree of task difficulty were composed five defferent walking speeds decided voluntarity by each subjects. RESULTS:Relationship with BABI and walking speed(V:m・min^<-1>) was represented with quadratic equation. as follows:BABI=0.0177V^2-2.5073V+148.188. The minimun BABI was 55.7 beats at V of 73.7 m・min^<-1>. On the other hand relationship with energy expenditure per unit time(Et:mlO_2・min^<-1>・kg^<-1>) and V was shown with line regression of Et=6.194+0.001V^2. Ed could be deduced by the following equation, as follows:Ed=Et/V=6.194/V+0.001V. It was found that the minimum Ed of 0.158 mlO_2・m^<-1>・kg^<-1> was obtained at V of 75.0 m・min^<-1>. CONCLUSION:Ed curve becomes the Minimum at V of minimal energy cost, that is, the optimal walking speed. From consequence, V which calculated it from Ed and BABI almost showed equivalence and it was suggested that V which calculated it from minimal value of BABI was equivalent to the optimal walking speed which calculated it from Ed.

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The purpose of this study is to obtain the characteristics from the various type of the movement patterns to understand the impairment objectively. We analyzed the rolling patterns from the spine to the prone position for 46 cerebral palsied children and adults, mean age 17.3 years old(2-36). And we finally found the three characteristics patterns of rolling over ABC(p<0.05). Pattern A:rolling over with flexion of upper and lower extremity. Pattern B:rolling over with extension of neck and upper and lower extremity. Pattern C:rolling over with maximum rotation of neck and truck, and asymmetry of upper and lower extremities. We think the analysis on three patterns of rolling over would helps us understand the impairment.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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The 「Senior Simulator」 Which was deviced by Meiji Financil Research Institution was tested included earmuffs, goggles, a collar, rubber globes, wrist-supporters, and shoes all of which were designed to hinder physical activites to produce such disabilities as those which the elderly experience daily. The degree of a feeling of physical disorder produced and difficulties they felt in performing activities while they were wearing them were rated with the respective subjective five-point scales. To assess difference in their degrees, one-way layout analysis of varianse was used. The results showed that both of a feeling of physical disorder and difficulties produced by the devices were significant. Multiple comparison performd by the method of Bonferroni showed that the earmuffs and the shoes were more feeling physical disorder than the rubber gloves were while they were being worm. With activities, it was significantly more difficult to telephone and walk down stairs.

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One of the major concern of the occupational therapy education in Japan is to develop the post-graduate program at the university level. To get some informations and advice for it, the post-graduate occupational therapy program in Boston university was surveyed. The results were as follows:(1)There were four types(MSOT, MS, CAGS, ScD) of the progurams for the post-graduate students. (2)Wide variety of the occupational therapy related subjects such as school risk managiment, chutorial teaching method and assistive technology were prepaired and most of each subject provied four credits. (3)In the MSOT proguram, the crinical internship provide zero credit. (4)Students can choose the area of the internship by themselves. (5)In the MS proguram, there were two tracks(the educational track and the research track) and the students choose one of them by the advice of the advisor.

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[in Japanese]

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Recently, PDP(Plasma Display Panel) began to be sold as wide field of vision angle, light weight and thin type monitor. There are atill problems at various kinds of points, but is prospective as the monitor of the next generation. I used this as observation system of medical images, and exmained brightness of ambient light that was easy to detect dummy affected part from difference threshold. A device consists of fluorescent lamps of daylight, 21 inches PDP monitor(Fujitsu PSD-2170), and a personal computer(NEC). The subjects observed the images displayed on the monitor. The ambient light was 50, 100, 200, 300 and 400 lx respectively. The method used is constant method. As a result, difference between individuals was recognized by improvement of detectability. It was thought that the effect of these ambient light was more or less.

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Radiosurgery is a procedure that uses high dose smallest external beams for a single treatment of small intracranial lesion. Accurate determination of the absorbed dose is very difficult because the lateral components of secondary electrons are not in equilibrium. In this experiment, the calibration was performed using 6MV-photon beams(Mitsubishi ML-6M LINAC) to a water phantom. Ionization chambers of different size used to evaluate the maximum dose and the peripheral dose in the clinical target volume(CTV) from the depth dose rate on each percentage center dose ratio. From our measurement, it was found that distance of displacement has direct relation to the dose and the degree of displacement depends on the size of the ionization chamber volume.

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A number of malignant tumor of the last stage bring with a pain. The therapy using Beta ray of Strontium-89 is operated to alleviate the pain of osseous matastase. But, we cannot measure from outside whether short range Bate ray Strontium-89 accumulate at tumor area or not. We paid attention to an occurrence of bremsstrahlung on coaction with material of a Beta ray. A Beta ray source used Phosphorus-32 and tried imaging of bremsstrahlung with gamma camera. Then to decide measured subjects matching energy distribution of the bremsstrahlung, we measured the bremsstrahlung spectrum with semiconductor detector and NaI(Tl) scintillation spectrometer. Before we instructed some energy level and picked up images. Besides we did the best selection of collimator. As the result, we successed imaging of the bremsstrahlung. Peak energy 70 KeV, window width were 100% the collection condition which was optimum. Peak energy 70 KeV was same as a peak of bremsstrahlung spectrum. And high sensitivity parallere type collimator was most optimum for the collimator.

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