Need for enforcement of ethicolegal education – an analysis of the survey of postgraduate clinical trainees

BACKGROUND: The number of medical lawsuits in Japan was between 14 and 21 each year before 1998, but increased to 24 to 35 per year after 1999. There were 210 lawsuits during this 10-year period. There is a need for skills and knowledge related to ethics, which is as fundamental to the practice of medicine as basic sciences or clinical skills. in Japan education in ethics is relatively rare and its importance is not yet recognized. Establishing ethics education using legal precedents, which has already been achieved in Western countries, will be a very important issue in Japan. In the present study, a questionnaire survey was conducted among graduate intern doctors, in order to investigate whether ethics education using precedents might have a positive effect in Japan. METHODS: In 2002, a questionnaire survey entitled Physicians' Clinical Ethics was carried out in a compulsory orientation lecture given to trainees before they started clinical practice in our hospital. The attendees at this lecture were trainees who came from colleges in various districts of Japan. During the lecture, 102 questionnaires were distributed, completed by attendees and collected. The recovery rate was 100%. The questionnaire consisted of 22 questions (in three categories), of which 20 were answered by multiple choices, and the other two were answered by description. The time required to complete the questionnaire was about 10 minutes. RESULTS: The recovered questionnaires were analyzed using statistical analysis software (SPSS for Windows, Release 10.07J-1/June/2000), in addition to simple statistical analysis. answers using multiple choices for the 20 questions in the questionnaire were input into SPSS. The principal component analysis was performed for each question. As a result, the item that came to the fore was "legal precedent". Since many intern doctors were interested in understanding laws and precedents, learning about ethical considerations through education using precedents might better meet with their needs and interests. CONCLUSION: We applied a new method in which the results of principal component analysis and frequencies of answers to other questions were combined. From this we deduced that the precedent education used in Western countries was useful to help doctors acquire ethical sensitivity and was not against their will. A relationship was found between reading precedents and the influence of lawsuits, and it was thought that student participation-type precedent education would be useful for doctors in order to acquire ethical sensitivity

Recent Results from LHD Experiment with Emphasis on Relation to Theory from Experimentalist’s View

he Large Helical Device (LHD) has been extending an operational regime of net-current free plasmas towardsthe fusion relevant condition with taking advantage of a net current-free heliotron concept and employing a superconducting coil system. Heating capability has exceeded 10 MW and the central ion and electron temperatureshave reached 7 and 10 keV, respectively. The maximum value of β and pulse length have been extended to 3.2% and 150 s, respectively. Many encouraging physical findings have been obtained. Topics from recent experiments, which should be emphasized from the aspect of theoretical approaches, are reviewed. Those are (1) Prominent features in the inward shifted configuration, i.e., mitigation of an ideal interchange mode in the configuration with magnetic hill, and confinement improvement due to suppression of both anomalous and neoclassical transport, (2) Demonstration ofbifurcation of radial electric field and associated formation of an internal transport barrier, and (3) Dynamics of magnetic islands and clarification of the role of separatrix

Behavioral and oral characteristics of patients in a general dental clinic in Japan –Focus on cancellation without notice–

Introduction; Understanding patient behavior is important to ensure good clinical outcomes for patients and efficient use of resources. Few studies have investigated compliance of patients attending a general dental clinic with treatment requiring multiple visits. In Japan, general dental practitioners are the main providers of dental treatment. The objective of this study was to analyze information from dental patients first visit, with their subsequent attendance.Methods; The study involved 450 adult participants. Associations between data obtained from self-completed questionnaires, oral examination and subsequent attendance, were tested by logistic regression analyses. The main outcome examined was whether the patient failed to attend for further treatment (cancellation without notice).Results; The most common reason for subjects’ initial visit was for a dental problem with definite symptoms. Cancellation without notice was significantly higher in younger patients, those without referrals, those with non-responses to medical questions, had severe periodontal disease and two or more decayed teeth.Discussion; Certain patient characteristics are associated with the probability of subsequent failure to complete treatment. Those that present with two or more decayed teeth may be a useful indicator of requiring more intensive motivational intervention to prevent the risk of failing to complete dental treatment

Influence of Nurses’ Work Environment on Their Self-Evaluation of Nursing Work

This study examined nurses’ self-evaluation of their nursing work, determined whether there were variations in these self-evaluations, and explored how work environment factors influence them. Data were collected using a large-scale survey (31,657 objects). We extracted the essential principal components from the data on self-evaluation of nursing work and identified differences in principal component scores among workplace classifications and age groups. We also evaluated the relationships between scores for selfevaluation of nursing work and work environment factors using multiple regression models. Work environment factors significantly affected nurses’ intention to separate from employment (adjusted R² = 0.230) but exerted weaker effects on adequate nursing provision (adjusted R² = 0.028) and sense of fulfillment in nursing work (adjusted R² = 0.042). Both individual work environments (external factors) and nurses’ personal attributes (internal factors) should be considered major targets in implementing countermeasures for nurse turnover. Among the external factors, reduction of workload and organizational eradication of power harassment specifically demonstrated relationships with a sense of fulfillment in nursing work, and may act as additional countermeasures for nurse turnover