Research has documented the influence of ALS patients families’ attitudes on patients’ decision to accept or reject TIV, a treatment that in many cases will allow them to live long enough to experience locked-in syndrome ; under Japanese law the use of a ventilator cannot be terminated once it is essential to a patient’s survival, so to choose TIV means to choose the possibility of entering a locked-in state. Previous studies have not, however, elucidated the changes in family members’ attitudes (...) that take place after they receive pertinent information about the social systems and services available to them. This study aims to fill this gap by collecting and analyzing patients’ and family members’ narratives. In Japan, about 30% of ALS patients utilize TIV. This rate is much higher than in most other developed countries. Patients’ narratives illuminate the psychological and especially the contextual factors of their decision-making. Many Japanese patients who currently use a ventilator say that their family members encouraged them to prolong their lives through ventilation. These family members have done so because patients are able to use long-term ventilation for only ¥1000 per month, and can also access the latest communication devices and round the clock caregiver services in their homes at very low cost. Japanese caregivers who are supported by social systems and services including communication assistance, empowering factors such as patients’ associations, care provided by people outside the patient’s family, and a public nursing care system are able to encourage patients to decide to use longterm ventilation. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work is in the "public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be (...) preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

This book presents emerging work in the co-evolving fields of design-led systemics, referred to as systemic design to distinguish it from the engineering and hard science epistemologies of system design or systems engineering. There are significant societal forces and organizational demands impelling the requirement for “better means of change” through integrated design practices of systems and services. Here we call on advanced design to lead programs of strategic scale and higher complexity while adapting systems thinking methods, creatively pushing the boundaries (...) beyond the popular modes of systems dynamics and soft systems. Systemic design is distinguished by its scale, social complexity and integration – it is concerned with higher-order systems that that entail multiple subsystems. By integrating systems thinking and its methods, systemic design brings human-centred design to complex, multi-stakeholder service systems. As designers engage with ever more complex problem areas, it is necessary to draw on a basis other than individual creativity and contemporary “design thinking” methods. Systems theories can co-evolve with a new school of design theory to resolve informed action on today’s highly resilient complex problems and can deal effectively with demanding, contested and high-stakes challenges. (shrink)

In recent years, neural networks have attracted much attention in the machine learning and the deep learning technologies. Bio-inspired functions and intelligence are also expected to process efficiently and improve existing technologies. In the visual pathway, the prominent features consist of nonlinear characteristics of squaring and rectification functions observed in the retinal and visual cortex networks, respectively. Further, adaptation is an important feature to activate the biological systems, efficiently. Recently, to overcome short-comings of the deep learning techniques, orthogonality for the (...) weights in the networks has been developed for the signal propagation and the efficient optimization of the learning. In this paper, bio-inspired asymmetric networks with nonlinear characteristics are proposed, which are derived from the retinal networks in the biological visual pathway. The asymmetric network proposed here was verified to detect the movement of the object, efficiently in our previous studies. This paper shows a new characteristic of the adaptive orthogonality in the asymmetric networks. First, it is shown that the asymmetric network with nonlinear characteristics is effective for generating orthogonality. Second, the proposed asymmetric network with Gabor filters is compared with the conventional energy model from the point of the orthogonality characteristics. Finally, the asymmetric networks with nonlinear characteristics can generate the extended orthogonal bases in independent subspaces, which are useful for classification and efficient learning. (shrink)

While changes in response to the different stages of the pandemic remain unknown, this study investigated the longitudinal impact of the COVID-19 pandemic on depressive symptoms in Japanese university students and identified factors associated with new onset of depression and suicidal ideation. Two surveys were conducted at one university in Akita, Japan, during the first COVID-19 outbreak period and 1 year later. Moderate depressive symptoms were defined as a Patient Health Questionnaire-9 score ≥ 10 and suicide-related ideation score ≥ 1 (...) on question 9 of the questionnaire. Among 985 students who completed surveys in T1 and T2, participants with moderate depressive symptoms and suicide-related ideation increased from 11 to 17% and from 5.8 to 11.8%, respectively. Among 872 students at risk after excluding those with moderate depressive symptoms at T1, 103 students developed moderate depressive symptoms at T2. Among the 928 students at risk, after excluding those who had suicidal ideation at T1, 79 developed suicidal ideation. Multivariate logistic modeling revealed financial insecurity and academic performance as risk factors, while having someone to consult about worries was a coping factor for depressive symptoms and suicidal ideation. Our findings demonstrated that socioenvironmental factors may determine depressive symptoms of university students. (shrink)

Humans can pronounce a nonword. Some researchers have interpreted this behavior as requiring a sequential mechanism by which a grapheme-phoneme correspondence rule is applied to each grapheme in turn. However, several parallel-distributed processing models in English have simulated human nonword reading accuracy without a sequential mechanism. Interestingly, the Japanese psycholinguistic literature went partly in the same direction, but it has since concluded that a sequential parsing mechanism is required to reproduce human nonword reading accuracy. In this study, by manipulating the (...) list composition, we demonstrated that past psycholinguistic studies in Japanese have overestimated human nonword reading accuracy. When the more fairly reevaluated human performance was targeted, a newly implemented Japanese PDP model simulated the target accuracy as well as the error patterns. These findings suggest that PDP models are a more parsimonious way of explaining reading across various languages. (shrink)