In the keynote speech made at IESJ’s 33rd Annual Conference by Dr. John C. Condon, Professor Emeritus, the University of New Mexico, he posed five questions for educators about the past, present, and future of the field: 1) Where did we come from? 2) Why did we (you) develop interest in this field? What excited you? What sustains that interest? 3) What motivates our students? 4) How do we teach and conduct research? 5) Our vision: where do we want to go?

In his speech, Dr. Condon discussed the responsibilities of educators and researchers to the people who live in our ever-diversifying society. He used examples and analogies to explain the need for the development of active learning methodologies and the need for collaboration and for crossing the boundaries between different disciplines and methodologies.

The central idea of this keynote speech was how we, as educators and researchers, can continue to adapt ourselves and our fields of study to this new era of diversification.

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After an earthquake disaster, the transportation system may completely shut down in urban area, which is very dangerous for workers to

. This problem may influence not only walking people to be injured because of congestion, but also rescue operation to delay. In this study, we define this possibility as risk of jam of walkers to . This risk is quantificated by simulation on the basis of the area of departure and destination of moving. As a result of the analysis, we evaluate which route of going home has higher risk of jam of walkers to . Also, it becomes clear that starting going home with a time difference and proper traffic regulation can reduce risk.

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In a big city, there are many commuters and temporary visitors for shopping, eating and drinking. If they encounter a great earthquake in downtown area, they are left there due to the paralysis of the traffic system. Many of them have to go back home on foot. But it's seems to be difficult for them to

on foot smoothly, due to fire, liquefaction and traffic control on their way home. So, in this study, we focus routes of walker to , and analyze jam of them.

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Objective: The objective of this study is to investigate the outcome-determining factors of stroke patients treated in our hospital which is the largest hospital in Ibaraki Prefecture with more than 1,000 beds.
Methods: Ninety two patients (62 with cerebral infarction and 30 with hemorrhage) who were hospitalized for stroke for the first time between January and June in 2004, and underwent rehabilitation. The patients were classified into two groups according to their outcomes: Group 1 patients who were directly discharged to home and Group 2 patients who were transferred to other hospitals or nursing homes. We investigated the severity of paresis, high cortical functional disorder as complication, functional outcome, and family background of these patients, and analyzed the outcome-determining factors.
Result: Among the patients, 65.2% were directly discharged to home. Their paresis was not severe in most cases, and 70% of them could walk independently (with or without canes and devices). There were no significant differences in age or family size between the two groups. Fifteen patients did not choose to , even though they were physically able to do so. They all had higher brain dysfunction or difficulty in accepting their disability. For such patients, the shortage of caregivers was not necessarily considered as a factor in their decision not to .
Conclusion: The severity of paresis and walking ability (locomotion) are the key factors in determining of whether the patients can be discharged to home or not.

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When a strong earthquake strikes an urban area in the daytime, the railway service would be suspended. Under such situation, massive commuter would concentrate a central station and confusing such people might generate the contingency. Though there have been some studies on this matter so far, they don't target the earthquake that actually occurs. Based on the above-mentioned situation, in order to know how the commuters in Sendai Urban Area behaved to

, we conducted a questionnaires survey for the Sanriku south earthquake to which the railway services of the JR-East were suspended. This paper shows the result of this survey and analyzes the factor behind their way of decision-making, and discusses the counter-measure of this matter.

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When a strong earthquake hits an urban area in the daytime,the traffic system would be paralyzed and massive commuter will be left in their work places.According to some studies,many commuters would face difficulties to

. Although many countermeasures are required for both public and private sectors having offices in the CBD:Central Business District,current level of their program is not enough.To seek a clue to solve this"unavoidable remaining in CBD" issue,we focus on commuters who could be allowed to leave their offices during an earthquake disaster.This paper analyses and discusses factors behind their way of decision-making in countermeasures for the"unavoidable remaining in CBD''.

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It is the prerequisite for outpatients to

after receiving medical care smoothly and safely. The most complicated consultation flow of outpatients is thought in the ophthalmology outpatient department. The reasons are listed as follows: Patient flow is complicated, almost of outpatients are elderly people, and outpatients with abnormal vision are forced movement in such complicated consultation flow. In the present study, we evaluated the enabling effect of the smartphones and tablet devices on the issues described above, changing a from of the nursing service, and the merits of outpatients.

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The actual conditions of food life of senior high school students have been investigated and some problems have been considered. Those are summarized as follws : As food is abundent today, meals taken individually is prevailing and therefore regular food life is disturbed. Individual meal is difficult to prepare and apt to be unbalanced on nutrition. Meals taken with the family must be stressed for the students mantal and physical health. It is recommended that the young in hunger, to drink a bottle of milk and to take green and yellow vegetables everyday. These must be taught in school.

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In this paper, we propose a method to provide the information of rest facility by utilizing Delay Tolerant Network (DTN). When public transport is stopped by the disaster, commuters try to on foot taking a rest at facility. However network infrastructure of the disaster area is disconnected by the disaster damage, commuters cannot get information of rest facility. Therefore we propose a method to exchange information of rest facility in possession between commuters via DTN through mobile device. Commuters can get information of rest facility under the situation without network infrastructure, and they will can take a rest at facility. We made the application to exchange the information of rest facility via DTN. In order to evaluate the application, we verified the communication performance. The experimental results showed the developed application had sufficient performance to exchange the information of rest facility via DTN.

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This study characterizes evacuation behavior in Ibaraki Prefecture in the aftermath of the Great East Japan Earthquake and tsunamis based on geographic information, questionnaires, and interview surveys. We identified several factors on which the starting time of evacuation depended, including awareness of evacuation warnings, understanding of anticipated tsunami inundation areas (hazard maps), and distance from anticipated inundation areas. We found that those who were aware of evacuation sites, hazard maps and/or anticipated inundation areas maps, and who lived in inundated areas tended to evacuate earlier. Conversely, many residents delayed their evacuation because they chose to and take care of their family first. To improve future responses to likely threats, evacuation behavior and local disaster management plans must be reviewed based on the knowledge gained from this disaster.

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Seeking to provide an integrative account of Indonesian nurses’ encounters with a culturally and socially distinctive work environment in Japan, this article provides a number of case studies, especially important among which are the diverse and conflicting interactions between these nurses’ individual socio-cultural backgrounds as represented in their age, marital status, ethnicity, family values and relationship, work experience, self-motivation and expectation on the one hand, and the work culture as well as the institutional underpinnings of their work environment on the other. Probably the most enlightening finding of this study is that such encounters across differences can bring about “friction” — to use Anna Tsing’s felicitous term [2005] — which has turned out to be both enabling and constraining in terms of Indonesian nurses’ adjustment to unfamiliar cultural settings, and this in turn has proved to be sign cant in shaping their decision as to whether they should continue working in Japan or return to their home country.

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The downpour which had occurred in Nagoya city area from September 11 to 12, 2000 had caused severe damage to the city’s traffic network, and highlighted the problem about the method of giving information, traffic management, and driver’s behavior under the downpour. Therefore, in this paper, we focus on automobile traffic, and aim to consider the traffic information and traffic management for promoting driver’s appropriate behavior under a heavy rainfall disaster. Especially, we analyze driver’s consciousness and activity under downpour by using driver’s experience data, and develop departure behavioral models of drivers under downpour in order to analyze the relationship between the driver’s departure behavior and the traffic network and rainfall situation.

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The downpour which had occurred in Nagoya city area from September 11 to 12, 2000 had caused severe damage to the city's traffic network, and highlighted the problem about the method of giving information, traffic management, and driver's behavior under the downpour. Therefore, in this paper, we focus on automobile traffic, and aim to consider the traffic information and traffic management for promoting driver's appropriate behavior under a heavy rainfall disaster. Especially, we analyze driver's consciousness and activity under downpour by using driver's experience data, and develop departure behavioral models of drivers under downpour in order to analyze the relationship between the driver's departure behavior and the traffic network and rainfall situation.

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The health care systems of many developed nations are under close scrutiny today because funding bodies, both government and insurance, are concerned about rapidly increasing costs. Some of this cost increase is, of course, due to the growing demand for services, especially accruing from a rapid escalation in the numbers of elderly persons who tend to be heavy users of health care services. A large measure of the cost increase, however, is due to the professionalisation of the health care workers who demand and receive professional salaries or fees for the work they do. For example, a decade ago an Australian physiotherapist commenced work at a salary equivalent to \1,440,000 today, a new graduate begins at \2,400,000 an in-crease of 67% in ten years. Unfortunately, there is very little evidence available at the present time to demonstrate the value, or cost effectiveness, of these health care professionals. We all believe that we are essential but it is difficult to prove it. Health economists in Australia, and in many other countries, are closely examining organisational budgets and many are using very' large shears to prune all unessential costs. Physical therapy is, sadly, one of many disciplines which is likely to have budgets reduced be-cause it has been very slow to develop objective data bases and to institute objective evaluation pro-grams to show precisely what physical therapists have contributed to the care of clients, to show precisely what the effects of that contribution have been, especially in economic terms. As a manager, a major part of my job is ensuring that the services provided by my staff are guided by strategic plans which conform to the objectives of the hospital, have clear goals, targets and performance measures, and are demonstrably effective and efficient. Thus, we work diligently and constantly at evaluation, especially examining processes and procedures to eliminate any activity which does not contribute to a planned outcome. About 70% of the clients in our rehabilitation programs: inpatient, outpatient and domiciliary, are aged 65+. We need to remind ourselves constantly that the life expectancy of an elderly person after a major episode such as a stroke or amputation is not great, 80% living less than 5 years. Thus, old people do not have time to waste in prolonged rehabilitation programs, they want to achieve a particular functional level which will allow them to as quickly as possible.

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この研究の目的は、わが国の65歳以上の大腿骨近位部骨折患者について、家族と同居していることが入院治療後、自宅への退院と関連があるかどうか、さらに入院期間と関連があるかどうかについて検証することである。
2000年から2002年の間に2つの病院で大腿骨近位部骨折で入院して外科治療を受けた患者の診療記録から後ろ向きにデータを収集した (N=105)。2変量解析にて自宅への退院と入院期間に関連している変数を選択した。自宅への退院と有意であった変数についてロジスティック解析にて調整し、家族との同居が自宅への退院を予測しているかどうか検定した。
ロジスティック回帰分析の結果、家族との同居は、骨折前の居住地、認知症の有無、退院時歩行能力を調整後、独立して自宅への退院と関連していた。しかし、歩行能力の低下を調整した場合は家族との同居と自宅への退院は有意な関連は見られなかった。また、家族との同居と入院期間との関連は見られなかった。自宅に退院した患者は老人ホームに退院した患者に比べて入院期間が長く、退院時の歩行能力も高かった。全体として家族との同居は自宅への退院を予測していたが、入院期間はむしろ増加傾向にあった。娘と同居の場合は入院期間が短縮する傾向にあったが、娘と同居している患者は多くはなく、実際は難しいと考えられる。患者は家族と同居している場合は歩行能力が回復後、自宅に帰ることができると言える。

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“Effects of critical pathways for hip fracture” was reviewed in11articles in 5 developed countries, published from 1993 to 2005. Critical pathway standardizes care and gives patients early ambulation, and reduced complication; consequently, in many cases, it reduces the length of stay (LOS) without degrading patients outcomes. Critical pathway sometimes increases LOS, if the original LOS was short, so that patients can take as much rehabilitation as needed in order to and walk independently. About 23 days is considered to be the possible minimum LOS, as long as the patient has regained ambulatory ability. It would be possible to safely reduce LOS to around 23 days in Japan as well, but it would be necessary to improve rehabilitation programs there, especially early ambulation and early walking exercise without limitation of weight-bearing, in order not to negatively affect outcomes at discharge. It is also necessary to observe the effect on patients' long-term outcomes after discharge, including mortality, readmission, ambulatory ability, and residence especially when LOS is reduced in Japan.

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(1) The political system
The constitutional system of contemporary Japan is a parliamentary government system, in which several political parties contest to garner as many seats as possible in order to make a cabinet. Members of House of Representatives ceaselessly try to maneuver in order to form a majority group, preferably a stable majority group. Many a political drama has been played by professional party politicians, sometimes ending successfully in a formation of new political power, othertimes ending in aborted plots.
On the other hand, party politicians, although fully immersed themselves in the intrigues of party politics, cannot forget the general elections and home constituencies. In the Japanese system constituencies are not assigned to the party politicians by the central authorities of the respective party, but relegated to the free choice of every party politicians. Party politicians usually choose their constituencies by such considerations as family and relative relation, birth place, school background, and business connection. They to their constituencies every weekend, even during the session. Also, the communication networks between party politicians and their supporters in their constituencies are provided by such mass media as newspapers, radio and television networks. Thus, political reporters usually come to know well-organized support relationships between voter groups and party politicians.

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In recent years, demand for nurseries has increased steeply, but the shortage of nursing staff due to early turnover is becoming an urgent issue. It is essential to build comfortaable work environments and to reduce their stress to prevent the early turnover. The purpose of this study was to investigate the current situation of workplace harassment in nursery settings such as nursery schools and preschools, as well as the relationship between workplace harassment and nursery staff stress. Participants were 146 nursery school teachers and 80 preschool teachers. The results of the multiple regression analyses showed that the significant β coefficients of the workplace harassment on the subscales of the stress reaction scale such as “Feeling of uneasiness and uncertainty,” “Fatigue and physical reaction,” “Autonomic nerve symptom,” and “Feeling of depression and insufficiency.” As for the type of job, we found that the level of stress among preschool teachers tends to increase when they hold low positions and the number of program staff is low. Similarly, nursery school teachers in lower positions felt more stress at work. Preschool teachers have long hours of working with their colleagues as preschoolers

early, which may explain teachers’ tendency to have interpersonal stress. Based on the results, we discussed new approaches to improve workplace environment especially for staff in lower teaching positions including provision of consultation service.

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