This paper shows the present situation of the local cities and Japanese-style social workers and the results of the field survey by the author. Then, I examined the viewpoint on how Japanese-style social workers should be educated.

The author thinks that people who were excluded from the community’s help to be distorted the choice on “life and death”. I think that it is necessary to have the happiness place regarding “life and death” of all people. In addition, I think that it is important that the feelings of thinking that the happiness place is necessary are made “culture and education” to be passed on. Japanese-style social workers have to learn such recognition and demonstrate comprehensive consultation support power. To that end, Japanese-style social worker’s new training curriculum should incorporate the practical theory for the community.

Objective: This study examined the influence of different types of portable oxygen delivery systems on the exercise tolerance of patients with chronic obstructive pulmonary disease （COPD） who had received home oxygen therapy （HOT） .

Methods: The study subjects comprised three patients: two patients who were hospitalized due to acute COPD aggravation and then switched to HOT, and one patient who was also hospitalized due to acute COPD aggravation and whose oxygen flow rate was re-measured after exertion. The distance walked during the six-minute walk test （6MWT） and the changes in percutaneous oxygen saturation （SpO₂） were compared in these patients using two types of oxygen delivery systems （wheeled oxygen carrier and walking frame with oxygen tank carrier）, at random. The measurements were performed twice a day for seven days.

Results: The distance walked was longer in all three patients when using the walking frame with the oxygen tank carrier. With regard to the change in SpO₂, the difference between the lowest value and the value obtained when the subjects started walking was calculated. According to the results obtained, the change was not significant in all three subjects when they used the walking frame with an oxygen tank carrier.

Discussion: Use of oxygen delivery systems, such as the walking frame with an oxygen tank carrier, improved the left-right asymmetry posture, supported the upper extremities resulting in a decreased burden on the leg muscles, improved the effectiveness of the accessory respiratory muscles, and enhanced ventilation efficiency at high lung capacity by allowing the trunk to lean forward, which in turn appeared to improve exercise tolerance.

Bilateral medial medullary infarction is an extremely rare type of stroke with a poor prognosis because of medullary respiratory failure and aspiration pneumonia. We report the case of a 65-year-old man with respiratory difficulty and aspiration pneumonia in addition to quadriplegia due to bilateral medial medullary infarction, who had a favorable outcome following early rehabilitation by a multi-disciplinary team. Respiratory therapy was applied continuously by the members of the multi-disciplinary team throughout the rehabilitation to maintain adequate respiratory function, allowing us to perform more proactive physical rehabilitation. Early ambulation resulted in recovery of motor function, leading to the patient’s re-acquiring activities of daily living （ADL） and the reduction of his physical disabilities.

The effects of interprofessional collaboration for fall prevention in a neurosurgery ward were investigated. A fall prevention team consisting of people from five professions was created: the team carried out fall prevention measures including early information sharing, maintenance of the ward environment, unification of terminology, and study sessions. In addition, any time a fall occurred, a case conference was held to analyze the circumstances of the fall and to share information. The evaluation period was five years, beginning one year before the fall prevention team was established, including the three years of its operation, and ending one year after its activities were concluded. The fall incidence was calculated based on the total number of patients hospitalized each year in the ward concerned and the number of fall events. Rates were compared between each year of the program and one year before it, and between the third year of the program and one year after it became inactive. No significant difference in the fall incidence was found for the program’s first year with respect to before its establishment. However, the fall incidence was significantly higher before the program’s establishment than in the second and third years, and no significant difference was found for the year after it became inactive with respect to the third year. These findings suggest that an interprofessional collaboration program performed over several years can effectively prevent falls, and that its efficacy can persist even after the program ends.

Objective: The objective was to examine the economic aspect of the introduction of a comprehensive bedsore care system in an intensive care facility for the elderly.

Method: I investigated the economic aspect related to bedsore care after the system’s introduction, for 759 people who entered the facility during the three-year period from September, 2011.

Results: No changes were found in the total sum, cushion purchase costs, or bedsore committee personnel expenses. There was a decrease in article charges, supplement charges, consultation charges, and consultation attendance charges. In contrast, there was an increase in the personnel expenses of bedsore conferences, photograph costs, and air mattress rental charges.

Discussion: There was no difference in the total sum, but on comparing the individual items, those items where there was an increase, such as air mattress rental charges, photograph costs, and personnel expenses in bedsore conferences, are necessary expenses of bedsore care, and it was thought that the introduction of the system had a positive economic effect.

Patients who present with a femoral neck fracture and have a prosthesis replacement often complain of experiencing respiratory difficulties when walking, and this is often attributed to a decrease in physical strength resulting from aging. It is thought that, with the addition of invasive surgery, because of protein catabolism accentuation caused by hemorrhage and inflammation, since there is a decrease in red blood cells （below, RBC）, which originated as protein, and hemoglobin （below, Hb）, the oxygen transport capacity decreases. In this research, the value of total protein （below, TP）, which indicates the state of nourishment, was classified into two groups of normal value （6.7mg/dl） or above （below, high nourishment group）, and less than normal value （below, low nourishment group）. Motor function, individual characteristics, respiratory function, blood biochemistry tests, and state of nourishment were tested and measured, the relationship between the state of nourishment and the blood biochemistry findings was investigated, and the effect that these exerted on the motor function was examined. Statistical analysis was conducted by the non-paired t-test. The results found a significant difference between the two groups in the C reactive protein （below, CRP）, total protein, albumen （below, Alb.）, RBC, Hb, the six-minute walking distance test （below, 6MD）, SpO₂, and the Borg scale. As a result of the protein catabolism accentuation, with the background of the effect of the invasive surgery, at the same time as showing low nutrition, the oxygen transport capacity decreased, while there was also a drop in the continuous walking distance and an increase in experiencing respiratory difficulties. It was inferred that, as evaluation items after prosthesis replacement surgery, there is a need to be aware of the state of nourishment, inflammation, and oxygen transport capacity from the blood biochemistry findings.

Purpose: The aim of this study was to undertake an overall assessment of physical function, including lower limb strength, grip strength, walking ability, balance function, and cardiorespiratory fitness, and to investigate their relationship with respiratory muscle strength and respiratory function in elderly people who need support.

Subjects: The subjects were 31 elderly women living in a community dwelling of with an average age of 86.1±4.6 years.

Method: We examined the relationships between respiratory muscle strength, respiratory function, and individual items of physical function such as femoris quadriceps strength, one-leg standing time, relaxing or maximum five-m walking speed, six-minute walking distances, timed up and go test （TUG）, and Functional Reach Test.

Results: The items showing a significant correlation with respiratory muscle strength were grip strength and femoris quadriceps strength, and six-minute walking distances. Observations: These results suggest that respiratory muscle strength reflects the gross physical strength, inclusive of lower limb strength, grip strength and cardiorespiratory fitness, of elderly people who need support, and is an easy and useful test method.

Murakami's concept of “fuwa fuwa” has been studied as it appears in picture books and pocket-edition books, although it is uncertain where this concept originated. Meanwhile, “fuwa fuwa” appears in diverse complicated variants, with the texts without pictures being distributed for use as teaching materials or famous children’s stories. Looking at the process of revision from the original to the first release, we can see a significant revision of the last part. The sense of loss, which is pointed out, although without a clear basis, in previous research, originates in the image of death described in the original edition. Similes in Murakami's works project the shadow of death. The revised part explicitly includes the image of life, and a direction towards “rebirth” is seen in the process of revision. “Rebirth,” or the integration of life and death, appears at various levels in Murakami's works, such as in the integration of subject and object, the connection between two different times, and the unification of narrations.

Sentence recollection exercises were performed on aphasic subjects in order to shed light on the syntactical network structures for the case particle “ga” in aphasic subjects. The results of the sentence recollection exercises indicated relatively favorable retention for the prototypical agent usage. Based on these results, proposals were made for analytical and practice methods for the case particle “ga” in aphasic subjects. In the analytical method proposed for the case particle “ga,” the central agent usage was evaluated using syntactic particle fill-in-the-blank exercises with letter and visual stimuli, which was then followed by a transition to peripheral usages. In the practice method proposed, recovery was planned for semantic usages that the analysis results indicated were impeded. Practice would also start with getting the central meaning established while using status diagrams and figures, and then moving on to peripheral usages.