The Development of the “Monitoring Application for Inappropriate Expressions in Nursing Records”for PsyNACS©

Lengthening periods of hospitalization, increasing numbers of patients with age-related complications, and a shortage of nursing staff have been of great concern in medical psychiatry in Japan. Under these circumstances, countries such as Japan that face a super-aging society and a decline in the working-age population, have been recommended for use of advanced information and communications technology (ICT) to improve the efficiency of medical treatment and care. This study aims to develop the “Monitoring Application for Inappropriate Expressions in Nursing Records” for using PsyNACS©, which will enable psychiatric nursing plans to harness the advantages of ICT. The functions considered necessary are as follows: 1) identification of users who enter information;2) a necessary database for lists of inappropriate expressions;3) development of a matching function to recommend proper writing input and a warning function;and 4) a management function for an inappropriate expression list database. A demonstration experiment for developing the application in this study was conducted at a specialized psychiatric hospital. To introduce them to the application, nurses and nurse managers were informed about the system developed in this study, and a survey regarding their opinions on the functions of the application was conducted with ten nurse managers. The results were evaluated in terms of usefulness for nursing care, documentation, and the education of nurses from an ethical perspective. This study suggests that matching their input with an inappropriate expression database will allow nurses to record more appropriate expressions. From an ethical perspective, the ability to use appropriate expressions makes records more likely to withstand disclosure requests from patients and their families.

Characteristics of Sleep and Autonomic Activity in Active Older Adults Based on Metabolic Age: A Comparative Case Study

Background: The balance of autonomic nervous system activity and its relationship with body composition, sleep quality, and activities of daily living among older people is still unclear. Purpose: This comparative case study examined the characteristics of body composition, sleep quality, and autonomic nerve activity in active older adults with a younger body age-calculated from age trends in body composition and basal metabolic rate. Methods: We selected two cases with a metabolic age younger than their actual age. They had good sleep quality, no sarcopenia, strong muscle and grip strength, and balanced autonomic nervous system activity. They were compared with two other age- and gender-matched cases, who had poor sleep quality, unbalanced autonomic nervous system activity, and had a physical age closer to their actual age. Results: Older adults with more muscle mass and higher basal metabolism were younger than their actual age, had a better sleep status, and had a good balance of autonomic nervous activity during exercise stimulation. They also had lower percentages of body and visceral fat and higher percentages of body water. Conclusion: Two cases had a metabolic age younger than their actual age were found to be much younger than their actual age. However, the older adults with normal muscle mass and basal metabolic rate had poor sleep status and no sympathetic hyperactivity during exercise simulation.

Analysis of Emotions Using Multimodal Data: A Case Study

In this case study, we hypothesized that sympathetic nerve activity would be higher during conversation with PALRO robot, and that conversation would result in an increase in cerebral blood flow near the Broca’s area. The facial expressions of a human subject were recorded, and cerebral blood flow and heart rate variability were measured during interactions with the humanoid robot. These multimodal data were time-synchronized to quantitatively verify the change from the resting baseline by testing facial expression analysis, cerebral blood flow, and heart rate variability. In conclusion, this subject indicated that sympathetic nervous activity was dominant, suggesting that the subject may have enjoyed and been excited while talking to the robot (normalized High Frequency < normalized Low Frequency: 0.22 ± 0.16 < 0.78 ± 0.16). Cerebral blood flow values were higher during conversation and in the resting state after the experiment than in the resting state before the experiment. Talking increased cerebral blood flow in the frontal region. As the subject was left-handed, it was confirmed that the right side of the brain, where the Broca’s area is located, was particularly activated (Left < right: 0.15 ± 0.21 < 1.25 ± 0.17). In the sections where a “happy” facial emotion was recognized, the examiner-judged “happy” faces and the MTCNN “happy” results were also generally consistent.

Comparison of Gluteal Muscle Intramuscular Injection Sites of Japanese Healthy Subjects: Considerations for Optimal Insertion of Injection Needle Length

Long Acting Injectable (LAI) medications for patients with schizophrenia is commonly administered to relieve their symptoms. Through shared decision-making and clinical evidence-based, psychiatrists should systematically offer LAIs to all patients requiring long-term antipsychotic treatment as a first-line treatment. Gluteal intramuscular (IM) injection requires accurate insertion of needles into the specific muscle area, often the outer upper quadrant of the buttocks, in order to achieve the required blood concentration. The purposes of this study were to compare the “Distance from the Epidermis to the Under-Fascia (DEUF)” and “Distance from the Epidermis to the Iliac Bone (DEB)” of the buttocks IM injection sites at the dorsogluteal and ventrogluteal sites among healthy Japanese volunteer subjects, and to identify the optimal insertion injection needle length. The DEUF and DEB at the gluteal regions were measured by ultrasonography. Welch’s one-way analysis of variance was used to compare the DEUF and the DEB at the gluteal IM injection regions. There was no statistically significant difference observed between the right and left mean values of DEUF for Hochstetter and Clark’s point at the ventrogluteal sites, and the Four and Three-way split or Double Cross point at the dorsogluteal sites. However in the DEB, the Hochstetter’s point (P < 0.01) at ventrogluteal site on the right side, and Clark’s point (P < 0.05) were significantly shorter than the Double Cross point at dorsogluteal sites (F = 4.38). The left buttocks Hochstetter’s point was significantly shorter than the Double Cross point (F = 4.38, P < 0.01). These results, however, did not establish a statistically significant difference in the DEUF among injection sites. It was considered that the difference in the DEB depended on muscle volume and thickness in the gluteal injection sites.

Explanatory Variables as Evidence for Precision in Intramuscular Long-Acting Injections of Patients with Schizophrenia

Intramuscular injections can cause damage to arteries, veins and nerves. Achieving maximum effects of medications through precise intramuscular (IM) injections must be assured and with certainty, particularly with long-acting injection drugs (LAI). The purpose of this study is to determine precision in IM LAIs of patients with schizophrenia. These evidences estimate “Distance from the Epidermis to the Under-Fascia” (DEUF) and “Distance from Epidermis to the Upper-Arm Bone” (DEB) of the deltoid muscle. Explanatory variables include body height, weight, body-mass index (BMI), deltoid-muscle circumference, fat percentage and muscle mass measured by body composition monitor. Sixty nine subjects are included based on the Diagnostic Statistical Manual of Mental Disorders (DSM-IV, 1994), and receive treatments of typical and atypical antipsychotic LAI. There are 46 males and 23 females with average age of 51.41 (Standard Deviation = 13.58) and ranging from 21 to 81 years who are all right-handed. Ultrasonographic data and those from explanatory variables are calculated using Spearman’s rank correlation coefficients. Multiple regression analysis (step-wise method/forced input method) is performed assuming DEUF or DEB as dependent variables. Significant correlations are found with highest adjusted R-square. Paired t-tests show differences in average values of actual ultrasonographic measurements assigned to DEUF or DEB, and the regression equations for accuracy. Ultrasonographic values are assigned multiple-regression equations as true values, and the calculated values are compared with those obtained by regression equations. There are no significant differences observed for either the right or left arm. The multiple regression equations for BMI and fat percentages (upper extremity estimation) of DEUF, and for BMI and injection site circumference of estimated DEB, successfully value the DEUF and DEB. By using these multiple regression equations for IM injection to the deltoid-muscle, DEUF can better ensure accurate LAI into the muscle through body monitor, DEB, and measured values of the deltoid-muscle injection site circumference.

Intramuscular Diffusion Status of Risperidone and Aripiprazole Long Acting Injectable (LAI) by Ultrasonography

The aim of this study was to consider the characteristics of intramuscular diffusion status of risperidone and aripiprazole long acting injectable (LAI) by ultrasonography. Subjects were 40 adult subjects diagnosed with schizophrenia and treated with LAI [32 patients were risperidone LAI (RLAI) and 8 patients were aripiprazole LAI (ALAI)]. However, in this paper, only three cases (one RLAI case and 2 ALAI cases) were selected to illustrate the diffusion effects of both LAI. Dorsogluteal intramuscular (IM) injection sites were measured at prone position using the “double cross” method. Before LAI injection, the distance from the epidermis to the under-fascia (DEUF), and distance from the epidermis to the iliac bone (DEI) at the IM injection site were assessed by using ultrasonography: 1) the injection needle was inserted to the gluteus medius, and 2) observed the diffusion status within the muscle injected RLAI and ALAI were confirmed using the B-mode ultrasonography. Both RLAI and ALAI were depicted as high echogenicity with acoustic shadowing. It was considered that the diffusion states of LAIs by ultrasonography were important time course evaluations providing objective evidence.

Characteristic Autonomic Nervous Activity of Institutionalized Elders with Dementia

This study clarified the characteristic autonomic nervous activity of institutionalized elders diagnosed with dementia using Hasegawa’s Dementia Scale-Revised. Twenty-six healthy adult persons (HPs) in their 20 s - 40 s met the inclusion criteria, and 16 persons (27.6 ± 8.2 years old) completed the research procedure. Of 70 persons with dementia (PDs) residing at the one geriatric health services facilities, only 24 persons met the inclusion criteria, and only nine (N = 9, 83.44 ± 9.45 years old) completed the procedure. Actigraph and ambulatory electrocardiographic instruments measuring autonomic nervous activity were attached to the subjects for 24 hours. Activities and behaviors of PDs and HPs were observed by clinically experienced staff nurses and care workers. High frequency (HF) power indicating parasympathetic activity and LF/HF ratio indicating sympathetic activity were calculated. When awake, PDs’ LF/HF ratio was significantly lower than HP’s (Z = -2.60, p < 0.01), showing significant differences in the LF/HF ratios between waking and sleeping, more than those of the PDs (p < 0.001). Similarly, when awake, significant positive correlations were observed in the LF/HF ratio and actigraph activity count (AC) in 11 HPs and 3 PDs (range r = 0.17 to 0.49, p < 0.05);however, significant negative correlation was found in HF and AC of 12 HPs and 3 PDs (range r = -0.55 to -0.18, p < 0.05). While sleeping, significant positive correlations were observed in LF/HF and AC of 3 HPs and 1 PD (range r = 0.35 to 0.42, p < 0.05) and significant negative correlation was found in the HF and AC of 1 HP (r= -0.32, p < 0.001) and 1 PD (r = -0.32, p < 0.05). The mean value of LF/HF in a wakeful state was significantly lower for PDs than HPs. Combined results of behavioral observation, actigrapy and heart rate variability (HRV) analyses suggested that PDs showed positive correlations between LF/HF and AC in a wakeful state. Compared to those who showed no positive correlation, they did not require much nursing care.

Prioritizing Patient Assessment Data (PAD) Using the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS)©

The study identified priorities of the Patient Assessment Data (PAD) using the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS&copy;) derived from 644 psychiatric nurses’ responses who were practicing in specific units: Acute Care Units (ACU), General Care Units (GCU), Long-term Care Units (LCU), physically Complicated Disease Care Units (CDCU), and Dementia Care Units (DCU). Secondary analysis of the PsyNACS&copy;on-line survey data using four levels of “importance” was used to determine the priorities: 1) unnecessary;2) quite important;3) important and 4) very important. The Mean Factor Points (MFP) and the Welch’s ANOVA were calculated. PsyNACS&copy;score of 3 or higher indicates the PAD as priority. The results showed that in the ACU PAD1, “Psychological symptom”, “Stress coping”, and “Mood disorder and aggression”, and PAD2 “Information of adherence”, and “Information of the psychiatry rehabilitation”, and PAD7 “Situation of the family and social life”, “Relationship to the health care providers”, and “Relationships with others” are high priority (high importance). Other PADs showed results below PsyNACS&copy;score of 3. The GCU had PAD 3 “Balance of water”, the LCU had PAD 4 “Intention/Point of view”, and “Thoughts of the patient” and PAD 7 “Disease and family”. The CDCU showed PAD 2 “Blood test”, PAD 3 “Excretion situation”, and PAD 5 “General health condition”, “Respiratory and chest symptom”, and “Vital signs”, and the DCU had PAD 1 “Cognition function”, and “Delirium and derangement capacity to register failure”, PAD 3 “Function of eating”, PAD 6 “Egestion and cleanliness” and PAD 8 “Activity and sleeping”, and “Mobility capability”. These classifications indicated levels of importance in the CAD comprising the PAD below the score of “2”. Japanese psychiatric hospitals specify assessments according to functional areas. By prioritizing the CAD for each PAD, more effective and efficient assessments can be performed according to practice unit.

The Development of the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS©)

The purpose of this study was to develop the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS)©. This study used the on-line survey method from February to April 2015. There were 644 respondents comprised of professional nurses with minimum qualification of 3 years’ experience being in a psychiatric unit of a stand-alone 200-bed or more Psychiatric Hospital in Japan. Assessment items were derived from 211 specific items selected from nursing textbooks, excluding the North-American-Nursing-Diagnosis-Association (NANDA). The questionnaire contained Cover Letter, Demographic Data Sheet, and the PsyNACS© questionnaire. There were 644 questionnaires accessed but only 435 were completed and valid. Item levels of importance were evaluated: 1) Unnecessary, 2) Not very important, 3) Important and 4) Very important. Data analysis used descriptive and multivariate statistics. Factor analysis (principal factor analysis, varimax rotation), the Kaiser-Meyer-Olkin (KMO) and the Bartlett’s test of Sphericity assessed the adaptive validity of the factor analysis. Factor loadings were set at 0.4 or more for the configuration of items. Internal consistency and reliability were established using Cronbach’s alpha coefficient. Mean factor points were calculated, including standard deviation, range, and confidence interval at 95%. Statistical significance was at 0.05 level. Nine Patient Assessment Data (PAD) with 2 to 5 Cluster Assessment Data (CAD) each were categorized. Thirty one CADs comprised the Patient Assessment Data: (PAD1) Psychological symptom and stress, (PAD2) Information about treatment, (PAD3) Function of eating and balance of water, (PAD4) Life and value, (PAD5) Vital signs and health assessment, (PAD6) Self-care, (PAD7) Social support, (PAD8) Activity, sleeping and mobility capability, and (PAD9) Sexual function and sexual behavior. The PsyNACS© is a classification of items assessing health care needs within the Japanese psychiatric nursing care environment, and also can be used in various psychiatric patient care situations in all psychiatric units.

Sleep conditions and quality of life among patients with ischemic heart disease after elective percutaneous coronary intervention

In Japan, percutaneous coronary intervention (PCI) is a major therapeutic intervention for ischemic heart disease (IHD). Previous studies suggested that an association of the risk of IHD caused by sleep duration was related to factors closely associated with daily activities. However, in Japan, there is no study about this relationship objectively measured using the actigraphy in patients with IHD. Moreover, there is little reported data about sleep condition and early outcomes of patient’s Health-Related Quality of Life (QOL) after PCI. This study determines the correlations between sleep conditions and QOL (measured by SF36 version 2) of 25 patients with IHD who underwent elective PCI. Data were collected seven days after PCI using night-sleep condition. Using Spearman’s rank test, the results revealed positive correlation between vitality score and longest sleep duration (ρ = 0.43, p = 0.031): social functioning (SF) score and duration of night-time sleep (ρ = 0.42, p = 0.037);total sleep duration (ρ = 0.45, p = 0.026), and longest sleep duration (ρ = 0.44, p = 0.024);mental health score and longest sleep duration (ρ = 0.54, p = 0.006). However, negative correlation was found between physical functioning score and arousal during sleep (ρ = -0.44, p = 0.027). Sleep condition was significantly correlated with QOL. In particular, SF score was positively related to night-time sleep. This seems to indicate that SF score might be related to night-time sleep condition. Moreover, the longest sleep durations were correlated with the mental component summary. The results of the study suggest that not only the length of whole sleep durations leads to better QOL, but also the increase the amount of uninterrupted sleep.

The relationship between body mass index, thickness of subcutaneous fat, and the gluteus muscle as the intramuscular injection site

An intramuscular injection (IMI) is an injection given directly into the central area of a specific muscle. Certain medicines need to be administered by the gluteal route for these to be effective. The aim of this study was to determine the influence of body mass index (BMI), subcutaneous fat, and muscular thickness of the dorsogluteal IMI site among healthy Japanese women. There were 39 healthy female subjects who volunteered and met the criteria. Their ages ranged from 40s to 60s (50.82 ± 6.04). With the data collected using the B-mode ultrasound images of the dorsogluteal site, it was found that the distance from the epidermis to the under-fascia (DEUF) of the gluteus maximus was dissimilar between the subject’s right and left buttocks. It was found that the distance from the epidermis to the iliac bone (DEI) was significantly more on the right than on the left buttocks. In the case of an adult Japanese woman with a BMI of 21 or more, the DEUF of the gluteus medius was found to be about 30 mm, and the DEI was approximately 50 mm or more. Based on these findings, it is recommended that a needle length of 38 mm (1.5 inches) can be safely used to administer IMIs to the gluteus medius muscle to effectively and efficiently deliver medications through the IMI route.

Daily Activities and Sleep Durations of Patients with Ischemic Heart Disease Who Were Discharged to Their Homes after Elective Percutaneous Coronary Intervention

The purpose of this study was to examine the relationship between daily activities and sleep durations for patients following elective percutaneous coronary intervention (ePCI) and diagnosed with ischemic heart disease (IHD) after discharge to their homes. The actigraph data were used to collect data from twenty five patients. The duration of night-time sleep (minutes from the start to end of night-time) and actual night-time sleep duration (total sleep duration excluding wake-up durations of night-time) on the seventh day after discharge were divided into three groups;less than 360, 360 to 480, and more than 480 minutes (short, optimal and long respectively). Subsequently, among the three groups of patients, the data were analyzed by Kruskal Wallis H-test with multiple comparison procedures using the Scheffé-test in order to compare differences in daytime activity items at seven days after discharge from the hospital. Total daytime nap duration (p p p p < 0.05). However, the duration of night-time sleep and daytime activity did not significantly differ. If actual night-time sleep duration is improved from 360 to 480 minutes, daytime nap could potentially be decreased. Determining objective sleep conditions for patients and treating sleep disorders may improve overall patient health, facilitating appropriate sleep and wake rhythms.

Recommended Design and Direction of Development for Humanoid Nursing Robots Perspective from Nursing Researchers

The purpose of this article is to describe recommendations towards the design and direction of development for Humanoid Nursing Robots (HNRs) from the standpoint of researchers of nursing care practice. Efforts to introduce robot technologies in nursing practice and to use them in elderly and high-tech healthcare environments have begun in developed countries like Japan. Companies are developing various types of robots, although their types and functionalities continue to require a clear identification and definition. Regardless, robot developments for health care purposes are progressing well to meet universal technological demands. While human caring has been a human-to-human relationship, in a nonhuman-to-human relationship in the case of HNRs, it is essential to consider ethical concerns and human safety. If HNRs are to support patients directly, they must be required to have the same level of comprehensive judgment ability and responsiveness as that of human nurses. This includes abilities to genuinely observe, judge, rapidly respond, and conduct human caring practice emphasizing individuality. If HNRs support patients independently, abilities which are much like those of humans will be required of them in addition to the appropriate intelligence and skillfulness to do so. A low level robot nurse exerts work that should be called non-nursing or as a medical aid assistant no matter who thinks and what these technologies can do. Similarly, a higher level HNR with higher level artificial intelligence is expected to exceed the capabilities of human beings. As such, current discourse and debate also include the concern that HNRs may now become one’s superior or rather that the HNR is a subordinate thereby requiring human management.

The relationship between sleep condition and autonomic nervous function in women in their 70s with type 2 diabetes mellitus

The aim of this study was to determine the relationship between sleep condition and autonomic nervous function of women in their 70s with type 2 diabetes mellitus by analyzing the activity counts (AC) on actigraphs and heart rate variability (HRV). Ten healthy women in their 30s to 40s as control and four women patients with type 2 diabetes in their 70s wore the electrocardiograph and an actigraph for 24 hours while keeping a diary of activities, including their sleep and food intake. The Pittsburgh Sleep Quality Index was used to assess subjective sleep conditions. The subjective sleeping results were significantly correlated with those measured by the AC and HRV. However, AC and HRV correlation pattern showed different activity in the patients with type 2 diabetes mellitus. The quality of sleep of those with chronic diabetes was not good even if their HbA1c was well controlled. Furthermore, their automatic nervous function was different from the control group. The sleeping hours of patients with type 2 diabetes were shorter or longer than those of healthy women. Ultimately, this study maintains that it is important to examine automatic nervous functions using objective examination index during the early stage of diabetes mellitus.

Family Environment Factors to Impact on the Effect of the Smoking Prevention Educational Program for Elementary and Junior High School Students

Smoking is a major health problem in many countries. It has been reported on the effects of education on youth with a reduced smoking rate and developed awareness of avoiding smoking verified as a result of educational intervention. The aim of this study was to verify the relationship between sex, school age, and family smoking and the effectiveness of smoking prevention education program (SPEP) as factors that impact the effectiveness of SPEP in elementary school and junior high school students. The participants in this survey were 6676 students, who attended elementary and junior high schools in Tokushima Prefecture between 2011 and 2015, and attended the SPEP. As factors that influence the effectiveness of the SPEP, we examined school types, sex, smokers in the family. Participants were asked the following questions before and after the SPEP to measure awareness of and attitudes toward smoking: “intention not to smoke cigarettes as adults”, “intention to refuse cigarettes when offered”, “attitude of staying away from smokers”, and “desire that their family will not smoke”. The number of survey collected was 6676, with effective responses from 5974 (90%). Among the 5974, there were 2963 (50%) males and 3011 (50%) females, 5106 elementary school students (86%), and 868 junior high school students (15%). In the case of smoker mother, it was difficult to improve these children’s “intention not to smoke as adults”, “intention to refuse cigarettes when offered”, and smoker father, it was difficult to improve these children’s “attitude of staying away from smokers”, and “desire that their family will not smoke”. Especially, in the case of smoker parents, it was particularly difficult for the SPEP to be effective in improving awareness of and attitudes toward smoking among elementary and junior high school students.

Characteristics of Nursing Care for Terminally Ill Patients in Hospice/Palliative Care Unit

The purpose of this study was to clarify the characteristics of nursing care for patient with terminally ill in the hospice/palliative care units. Semi-structured interviews on “communication, care, spiritual pain care and prediction of worsening of symptoms” were conducted, incorporating items indicated as important principles of palliative care by Lugton et al. Sixteen nurses at five hospice/ palliative care facilities in urban areas of Japan were surveyed in 2013, and results were analyzed qualitatively. Following characteristics by hospice/palliative care nurses (HPN) were categorized as [HPN sharing meaningful time with the patient] and [HPN’s continual attempts to understand the world in which the patient lives] in the communication;as [HPN providing comfortable care so that patients can value their last moments] and [HPN’s efforts to attend to patients so they can die as they hope to] in the care;and as [HPN’s observation in a range that does not interfere with the patient’s comfort] and [HPN senses that something is different from before] in the prediction of worsening of symptoms. Common characteristic was 【HPN’s support for patients approaching a natural death】. In this study, spiritual pain care was included in the communication and care, and could not be extracted alone. It was suggested that an HPN provides communication, care and prediction of worsening of symptoms with excellent judgment and technological competency, while placing importance on offering support for the patient’s natural death.

Potential Legal Issues and Care Implications during Care-Prevention Gymnastic Exercises for the Elderly Using Pepper in Long Term Health Care Facilities

In Japan, the shortage of personnel is a problem in long-term care nursing and rehabilitative care prevention. Nevertheless, Japan has taken measures to compensate for these shortages by promoting medical and nursing care activities using robotic technologies, and employing human resources from overseas. The purpose of this study was to determine potential legal issues and subsequent implications for care during prevention gymnastic exercises for the elderly using Pepper in long-term health facilities. The application program of Care-Prevention Gymnastics Exercises for Pepper (Pepper with CPGE) was made by the Xing Company Japan. Currently, care workers become intermediaries for the safe use of Pepper with CPGE. However, it was realized that some legal issues may arise if Pepper with CPGE alone will carry out these preventive care programs for the elderly without the presence of care workers as intermediaries. In this situation, using Pepper with CPGE alone to conduct care prevention gymnastics will require safety measures to prevent these possible practice issues and anticipate implications for care. In this regard, determining detailed target levels of rehabilitation exercise demands and environmental setting safety become essential factors. The use of humanoid robots in healthcare is expected to influence more practice protocols in contemporary and futurist rehabilitative human care. The identification of possible safety issues in performance and environmental situations, and implications for care are critical to ensure safe and valuable rehabilitative health care practices for the elderly population.

Evaluation of Expression Recognition Function in Autism Spectrum Disorder Using Near-Infrared Spectroscopy

One of the characteristics of Autism Spectrum Disorder (ASD) is social disorder. The specificity of facial and expression recognition for people with ASD is gathering attention as a factor of this social disorder. The study examined the hemodynamic activities in the prefrontal cortex using near-infrared spectroscopy (NIRS) when a person with ASD performed an expression recognition task. The subjects were twenty males (18 - 22 years old) with ASD and without intellectual disabilities. Forty-five healthy males matched for age and sex were included as a control group. In both groups, the degree of autistic tendencies was evaluated using the Autism-Spectrum Quotient (AQ). Using eight standard emotional expressions of Japanese people, two expression recognition tasks were set. An NIRS was used to measure the prefrontal cortex blood mobilization during the expression-processing process. The AQ was significantly higher in the ASD group, while the rate of overall correct expression response was significantly lower (p &rho;= &minus;0.40 p < 0.001). In the automatic expression-processing task, no activation in the prefrontal cortex was found in either the ASD or the control group. In the conscious expression-processing task, the activation of the left and right lateral prefrontal cortex was weaker in the ASD group compared to the control group. Unlike in the control group, a mild activation of posterior prefrontal cortex was found in the ASD group. The expression-processing process of the ASD group was found to be different from that of the control group. NIRS was effective in detecting a brain function disorder in people with ASD during an expression-processing process.

Japanese University Teachers’ Depression Status and Its Influence Factors

Risk factors of the depression are the occupational stress. The mental health condition of university teachers who participate in the socialization of diverse students is an important issue;however, there are few studies on depression among university teachers. The purpose of this study is to clarify Japanese university teachers’ depression status assessed by the Patient Health Questionnaire-9 and its influence factors: Japanese university teachers’ depression status depression status, personal background, job situation, social support, and stress coping behavior. The self-administered questionnaire survey was mailed to 924 university teachers in Japan, with a survey return rate of 43.8% (N = 405). A total of 342 surveys were completed and valid. The Patient Health Questionnaire 9 (PHQ-9), Multidimensional Scale of Perceived Social Support (MSPSS), the Japanese version of the Brief Coping Orientation to Problems Experienced (COPE) and the Work Situation Questionnaire (WSQ) were analyzed to clarify the depression status and its influence factors. Multivariate logistic regression analysis was used to examine factors related to the major depression. The subjects included 274 men (80.1%) and 68 women (19.9%), 105 professors (30.7%), 52 associate professors (15.2%), 53 lecturers (15.5%) and 132 assistants (38.6%). The subjects’ mean of age and teaching experiences were 44.1 ± 9.7 years, 15.6 ± 10.1 years. The mean PHQ score was 3.9 ± 4.1, and 307 subjects (89.8%) were 0 - 9 points and 35 subjects (10.2%) were over 10 points (10 points or over). For women [OR = 7.009, 95% CI 2.387 - 20.584;p < 0.001], religion [OR = 1.813, 95% CI 1.175 - 2.798;p = 0.007], self-blame [OR = 1.808, 95% CI 1.280 - 2.556;p = 0.001], substance use [OR = 1.453, 95% CI 1.103 - 1.913;p = 0.008] were risk factors of depression status. On the other hand, high job satisfaction level [OR = 0.945, 95% CI 0.921 - 0.969;p < 0.001], higher age [OR = 0.927, 95% CI 0.873 - 0.984;p =0.014], use of instrumental support [OR = 0.622, 95% CI 0.399 - 0.969;p = 0.036], and use of social support [OR = 0.588, 95% CI 0.376 - 0.921;p = 0.020] were factors that reduced the risk of depression. These findings suggested that in order to improve the depression status of university teachers, and to develop mental health measures for university faculty members based on such risk factors are necessary in the future.

The Optimization of Humanoid Robot’s Dialog in Improving Communication between Humanoid Robot and Older Adults

Older adults with dementia are increasing in Japan. Because of this, “communication robots” are being introduced into nursing settings to substitute for the shortage of nurses and other care workers. Our research group is currently developing a humanoid nursing robot with caring function (HNR), specifically for the functional and practical use of older adults with dementia. The purpose of this study was to clarify improvement points of the current function of humanoid robot’s (Pepper) (SoftBank Robotics) dialog pattern for improving optimal communication between humanoid robot and older adults. Dialog programs were installed in the humanoid robot Pepper, including the application program Care Prevention Gymnastics Exercises for Pepper (Pepper-CPGE) that was made by Xing Company, Japan. Dialogues between older adults and Pepper-CPGE were recorded by video camera. Data from transcriptions of the conversations captured from video and from field notes were analyzed focusing on human-robot interaction. From the recorded scenes and conversations, the following were points to be improved: 1) Intonation of the words vocalized by Pepper-CPGE was different from that expected by the older adult resulted in inappropriate responses by the older adult;2) The timing between Pepper’s questions and the responses of the older adult were not timely and did not match (differences in the question-response time), which lead to confusion among the older adults;and 3) Other surroundings older adults were interested in the dialogue with Pepper-CPGE. However, Pepper-CPGE cannot communicate with multiple older adults. ImprovingPepper-CPGE’s ability to communicate with multiple older adults as an older adult’s dialogue with Pepper-CPGE can cause other older adults to also interact not only with the older adult that Pepper-CPGE is interacting with but also with Pepper-CPGE. This study shows that transactive relations among humanoid robots and older adults can be facilitated. Improving communication between humanoid robots and the older adults by optimizing a structured dialogue is needed to enhance appropriate engagement and participation. It is necessary to create a “Caring dialogue Database” for HNRs in order to know the patient/client and to share the aesthetic experiences of human-robot interactions. Also, it is important to develop a dialog pattern that enables humanoid robots to sympathize with older adults.