The aim of this study was to identify issues in home palliative care faced by the care managers of patients requiring long-term care. I conducted a questionnaire survey on 151 care managers and received 133 valid responses. I collected data regarding job classification, years of experience as a care manager, experience of home palliative care, and free descriptions of "issues and difficulties in home palliative care". A total of 150 items were recorded in the free descriptions, and the following 4 categories were elicited : "multidisciplinary collaboration", "care for patients and families", "management of care services" and "issues with care managers' skills". The most common category was "multidisciplinary collaboration". Care managers recognized that hospital personnel should be conscious of their collaboration with home care staff and understand long-term care insurance. Furthermore, hospital personnel should be aware of the necessity of collaboration between the hospital and clinic before discharge. In continuing home palliative care, care managers recognized the necessity of day and night treatment by physicians, collaboration between home visit nurses and care managers, timely changes to care plans, and care for anxiety experienced by patients and their families. As for issues with long-term care insurance, care managers identified delayed authorization of care need and the lack of rewards for care managers. To support care managers, it may be necessary to conduct fundamental education on the care for cancer patients.

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The number of diabetic patients has increased continually in recent years. A Multi-faceted Life Stress (MLS) Questionnaire was administered on patients with type 2 diabetes to detect a psychological pathogenesis of diabetes. The same questionnaire was administered also on patients with major depression and on healthy subjects, and the results of the three groups were compared. Next, correlation between HbA1c and each scale was investigated on the group of diabetic subjects to identify the cause of various mental symptoms, pathological characters and deteriorated life satisfaction of diabetic patients, i.e., whether such symptoms are attributed to diabetes or to an incidental result due to the development of diabetes. Furthermore, the new scales such as the serotonergic neurotropic scale, the dopaminergic neurotropic scale and the noradrenergic neurotropic scale were established based on temperaments and behaviors of the subjects figured out from the answers of the questionnaire, and differences between the three groups were investigated for each scale. At the same time, correlation between the new scales and HbA1c was investigated in the diabetic group. The diabetic group and the depression group showed higher pathological scales including a tendency of depression, while showing lower level of life satisfaction that indicates the level of happiness than the healthy group. On the other hand, unlike the depression group, the diabetic group had relatively low level of excessive personality adaptation and high level of aggressive personality. These two personalities were not correlated with the severity of diabetes. As a result of a comparison with the healthy group using the new scale, the diabetic group and the depression group showed lower serotonergic neurotropic scale and dopaminergic neurotropic scale, but showed higher noradrenergic neurotropic scale in diabetes, which was also found to have no correlation with HbA1c. From this investigation, psychological symptoms of diabetes, deteriorated life habits and satisfaction and their degrees can be a secondary effect of diabetes. However, it is considered that the primary causes of psychological pathogenesis of diabetes are attributed to aggressive personality and its associated hyperfunction of noradrenergic nerve. Therefore, a comprehensive approach for each phase of diabetes focusing on behavioral therapy is necessary while administering the (MLS) Questionnaire when we provide diabetic patients with lifestyle guidance and psychological advices.

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As youths with life style diseases have been increasing, obesity is a very serious social problem today. In order to understand the life style and the physical activity of young students, the authors studied the relations of BMI with the number of individual walking steps and their concern about health. The subjects are 29 males and 4 females, whose ages range from 15 to 22. BMI was used for classification such as obese, overweight, normal range and underweight. The number of individual walking steps for 7 days was recorded starting on Monday and the numbers of walking steps on weekdays and weekends were examined according to the body weights of the subjects respectively. The result showed that the number of walking steps on weekdays was 6544 while it was 3094 on weekends. The number on weekends was significantly smaller than that on weekdays, which showed it was far smaller than the numerical target described in 'kenkoo nihon 21 (Health of Japanese in 21^<st> century).' Correlation of obesity with the number of walking steps was noticed on Thursday. The number of walking step of dormitory students was significantly larger than that of commuting obese and overweight students. The questionnaire results indicated that obese students showed less concern about health and that they habitually eat between meals. The concern about health is correlative with the frequency of physical activity and the number of walking steps is also correlative with the duration of physical activity.

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In this research, in order to understand the eating behaviors of young people that may be one of the causes of obesity, the authors surveyed the eating behaviors of 705 young students whose ages range from 15 to 22. We made an original questionnaire with eating behaviors and developed new scales. The results showed that eating behaviors are classified by factor analysis into seven factors as 'balanced diet', 'eating between meals', 'convenience food', 'high calorie food', 'unbalanced diet', 'quick eating' and 'dietary likes and dislikes'. BMI showed significant correlation with the three of these factors that is, 'quick eating', 'eating between meals' and 'dietary likes and dislikes'. The survey clarified that the behavior of 'quick eating' had influence upon the obesity of young people.

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