The state of medical,health and welfare field of Japan has been tremendously changing under the background of rapidly decreasing numbers of children and increasing numbers of elderly persons. Accordingly, the concept of independence or view of independence has been changed from the importance of physical independence toward the importance of the ability to live in their own community self-reliantly by utilizing various kinds of care services from other persons and facilities. As the result, community-based rehabilitation and occupational therapy has been gradually progressing these days as to their systems, manpower fostering and research, because those are aimed for the disabled and the aged to become independent and to participate in their community. Especially, this kind of community-based research should be done with the close contact to clinical ground. The example of the research from this point of view was shown, which has been going on under the leadership by the author titled "rehabilitation-model assessment formula for home care".

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The purpose of this study was to clarify the judgement reaching process of nurses involved in discharge planning, and to establish a flow chart model of the discharge planning process by discharge-planning nurses. A case-study method was employed. The data associated with the discharge planning process for 2 clients by two discharge-planning nurses were collected by on-the-job observation, interview with the discharge-planning nurse and a review of the nursing records over time. The results were as follows: After receiving a request for discharge planning from other medical staff, the discharge planning nurses confirmed the request. Next, the nurses judged the possibility of a successful discharge for the clients, and then confirmed the wishes of the clients and their families. Once this was done, the nurses determined what steps needed to be taken to allow for a successful discharge of the clients. They then arranged a social support system for the clients, and as a final step, the nurses evaluated the quality of the social support systems, and judged the possibility of a quality home life for the client within this system. Once the entire process was complete, clients and their families undertook active arrangements for discharge, and once these were in place, they returned to their homes.

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Quality Assurance of medical equipment has become important as the improvement of medical service and development. According to the International Standards (IEC), the evaluation of quality maintenance process and routine testing in medical imaging department has been standardized all the time, in Japan, in the form of JIS standardization. Here I would like to introduce the main standard "JIS Z4752-1 Evaluation and routine testing in medical imaging departments. Part-l: General Aspect" which will be standardized in 2001, on other circumstances/basic thinking pattern, and quality assurance process. The author attempted to propose in the style of "Responsibility of user and manufacturer" having been the member of IEC WG-10 (Quality Assurance) and "JIS Technical Committee" with full of historical backgrounds, stating relationships to the Federal Regulations of the United States. Acceptance Test and Constancy Test (Periodical Test) are specific processes of quality. Basically, the Acceptance Test is performed by both of user and manufacturer, and the Constancy Test is performed only by user. The standard is effective to gain reliability on handling medical disputes on evaluation of quality administration, routing testing, the equipment performance maintenance, safety, image quality, and minimum radiation dose

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The purpose of this study was to develop a coping questionnaire for stroke patients and evaluate its psychometric properties. The subjects were 169 survivors after stroke (98 males and 71 females), who had adequate cognitive functions and lived in their community. We have already proposed an oblique structure with two first-order factors (control and escape) as a measure of coping, that the construct validity can be supported (Saitoh, et al., 1999). Therefore, we tried to perform an explanatory factor analysis with the items relating the factors in the Ways of Coping Questionnaire (Folkman & Lazarus, 1984). As a result, two factors emerged from the data analysis: control (5 items) and escape (5 items). In addition, the developed factorial model was evaluated with respect to goodness-offit to the data using covariance structure analysis. The indices met with the fit criteria and the reliability coefficient of the items was satisfactory. These findings suggested that the 10item questionnaire has both construct validity and reliability as a measure of coping for stroke patients.

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It is hoped that people, in general, can understand the hardships in daily life caused by aging and the psychological state of the elderly in areas where people live to an advanced age. In such a situation, making use of the elderly simulation program is considered to be beneficial for helping people, in general, gain a better understanding. The purpose of this study is to verify the validity of this program by investigating the change in the participants' attitudes toward the elderly, and their understanding of the elderlys' difficultieS. The study included 323 participants (146 men with an average age of 36.7±9.6./177 women with an average age of 33.8±7.9.). As a result of participation in this program, the participants were better able to understand hardship the elderly have in many activities and behaviors. Moreover, attitudes towards the elderly become more sympathetic. Men showed a greater change in attitude than women. In conclusion, it is thought that the elderly simulation program is effective for better understanding the behavior and psychological state of the elderly.

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[in Japanese]

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Amphiphilic peptides such as mastoparan (MP) lyses erythrocytes, but the mechanism of lytic effect of MP are still unclear. In the present study, we have developed a novel flow injection analysis system to elucidate the dynamics of hemolysis. This system is composed of a flow pump for HPLC, autoinjector, cell-retaining chamber, detector and data processor. At first, erythrocytes from male Wistar rats were injected into a cellcetaining chamber where the erythrocytes were kept on a membrane filter. Hemolytic stimulation was given to the erythrocytes through the autoinjector, and hemoglobin released into the flow stream from erythrocytes was monitored photometrically at 413 nm. This system had a high precision and correlation (r = 0.989) with the bath application method. Using this system, the hemolytic action of MP was analyzed. The hemolytic activity of MP depended upon the number of MP molecules, not upon the reaction time. MP-induced hemolysis proceeded promptly and transiently. The mechanism of MP-induced hemolysis might be different from that of the SDS-induced hemolysis. Because our flow injection analysis system can be anto- mated easily, it will be useful for the clinical or basic research

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