Development of the Japanese version of Staff Attitude to Coercion Scale.

Background: An important factor in proceeding the efforts to reduce coercion in psychiatry is the attitudes of clinical staff toward its use. We aimed to develop the Japanese version of the Staff Attitude to Coercion Scale (SACS) and clarify its psychometric properties. Methods: After the translation and back-translation of the SACS, which includes 15 items consisting of three subscales, we conducted an anonymous self-administered questionnaire survey of clinical staffs working in 17 wards in two psychiatric hospitals. We administered the second survey to some of the participants to confirm the test-retest reliability. Additionally, we obtained information regarding the 17 wards from the institutions. Internal consistency was assessed using Cronbach's alpha coefficients. Test-retest reliability was assessed using intraclass correlation coefficients (ICC). Structural validity was examined using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). For construct validity, the correlation of the SACS score within wards and its association with the actual use of seclusion/restraints were explored using multilevel multivariate linear regression analyses. Results: We used 261 (67.1%) responses, 35 responses of which were also used to examine test-retest reliability. Cronbach's alpha coefficients (0.761) and ICC (0.738) indicated good reliability. The results of CFA based on the original three-dimensional structure did not indicate a good fit (CFA = 0.830, RMSEA = 0.088). EFA suggested a four-factor structure, two of which were almost consistent with the original two subscales. The correlation of the SACS score within wards was confirmed while a positive association with the actual use of seclusion/restraints was not identified. Conclusion: While the original three-dimensional structure was not replicated, construct validity was partially confirmed. Reliability of the total scale was good. In Japan, although using the subscales was not recommended, using the total scale of SACS seemed acceptable.

Control of Fine Structure in "Polymer Nanosphere Multilayered Organization" and Enhancement of Its Optical Property.

This paper reports on a new functionality exhibited by "polymer nanosphere multilayered organization", a new type of molecular organization, and the relationship between their structure and function. The polymer nanosphere multilayered organization is a fine structural material formed by the accumulation of single-particle layers of a hydrophobic polymer at the air/water interface; these single-particle layers have uniform height along the c-axis. By employing the "alternate compression-relaxation method", high-density, low-defect particle layers are formed with a clear increase in their crystallite sizes. In the case of a ternary comb copolymer containing a carbazole ring, one particle is formed by the assembly of approximately 60 units of collapsed monolayer-like double layers. This structure is stabilized by the formation of side-chain crystals in the interlayer, with oriented π-π stacking of carbazole rings, resulting in enhanced fluorescence emission intensity.

Morphological transition of a conductive molecular organization with non-covalent from nanonetwork to nanofiber.

The formation of nanofiber morphology at a mesoscopic scale, and molecular level stacking of a tetrathiafulvalene (TTF) derivative with a chiral group were investigated by the one-dimensional growth method in interfacial molecular films. Monomolecular films of a TTF derivative with a chiral borneol group display a two-dimensional phase transition at the air/water interface. At high surface pressures, nanonetwork domains are formed, where the TTF molecular planes are densely packed with an interlayer distance of 4.1 Å. The formation of this network is attributed to the organized aggregation of the TTF derivatives, which is a result of strong intermolecular interactions. Subsequently, the growth of morphology is encouraged by the application of the one-dimensional growth method at low surface pressure conditions, varying compression speeds, and subphase temperatures. At low surface pressure and a subphase temperature of 15 °C, the TTF derivatives aggregated as nanofibers with close packing of molecules. Upon raising the subphase temperature, the thickness of the nanofibers was found to increase and hence, spontaneous morphogenesis at the air/water interface was achieved.

Community outreach for patients who have difficulties in maintaining contact with mental health services: longitudinal retrospective study of the Japanese outreach model project.

BACKGROUND: Japan still has the highest ratio of beds devoted to psychiatric patients in the world. In 2011, in order to reduce re-hospitalization of patients who became disconnected from regular contact with outpatient medical services, the Japanese Ministry established the Japanese Outreach Model Project (JOMP). In this study, we will explicate the JOMP project protocol and investigate the rate and length of hospital admission, impairments of social function and problematic behavior at the follow-up period (6- and 12-month) and time of services provided by JOMP. METHOD: This longitudinal retrospective study used survey data collected from 32 outreach teams of 21 prefectures in Japan during September 2011 to July 2013. The outcome variables were assessed at baseline, 6-month and 12-month as to whether or not participants had been admitted to the hospital. Data from 162 participants with mental illness who had difficulties in maintaining contact with mental health services were analyzed. Repeated measures analysis of variance provided a significant effect of the intervention over time. RESULTS: The rate of hospital admission of JOMP participants was 24.1% at 6-months and 27.2% at the 12-month follow-up. The average length of hospital-stay at baseline and 12-months was 38.7 days (SD 84.7). Compared with the baseline, the average score of the Global Assessment Functioning and the Social Behavioral Schedule were significantly improved after the 6-month and 12-month follow-up. The activity log showed that among the most often delivered JOMP services were to "prevent exacerbation of somatic symptoms" and "care for families". CONCLUSION: These results suggest that JOMP has a strong potential to both reduce readmission rates and the length of hospital stay compared with the Japanese regular outpatient care by public insurance, and improve social function and problematic behavior. The JOMP teams provided long-term support for families. As of April 2014 JOMP was included in the National Health Insurance program in a limited way therefore an evaluation of JOMP team fidelity on readmissions must be examined.

Fabrication and structure of "polymer nanosphere multilayered organization".

We constructed a multiparticle layered organization of aromatic polyamides with rigid main chains and flexible side chains by the Langmuir-Blodgett (LB) technique, which resulted in a highly regular arrangement along the c-axis. The particle arrangement was estimated by performing out-of-plane X-ray diffraction (XRD) analysis and atomic force microscopic (AFM) observation. The results suggest that a double-particle layered structure (Y-type) is formed by the LB technique, forming amphiphilic particles at the air/water interface. Copolymers with highly hydrophobic carbazole contents and both hydrogenated and fluorinated side-chains also formed a single-particle layer at the air/water interface and exhibited multiparticle layers by a LB technique. Therefore, it is possible to control the formation of single- and double-particle layered structure using these techniques. Further, it was found that multiparticle layered organization of polymer nanospheres and polymer nanosheets could be formed simultaneously with the same component material.