Applicability of care quality indicators for women with low-risk pregnancies planning hospital birth: a retrospective study of medical records

Practices for planned birth among women with low-risk pregnancies vary by birth setting, medical professional, and organizational system. Appropriate monitoring is essential for quality improvement. Although sets of quality indicators have been developed, their applicability has not been tested. To improve the quality of childbirth care for low-risk mothers and infants in Japanese hospitals, we developed 35 quality indicators using existing clinical guidelines and quality indicators. We retrospectively analysed data for 347 women in Japan diagnosed with low-risk pregnancy in the second trimester, admitted between April 2015 and March 2016. We obtained scores for 35 quality indicators and evaluated their applicability, i.e., feasibility, improvement potential, and reliability (intra- and inter-rater reliability: kappa score, positive and negative agreement). The range of adherence to each indicator was 0–95.7%. We identified feasibility concerns for six indicators with over 25% missing data. Two indicators with over 90% adherence showed limited potential for improvement. Three indicators had poor kappa scores for intra-rater reliability, with positive/negative agreement scores 0.94/0.33, 0.33/0.95, and 0.00/0.97, respectively. Two indicators had poor kappa scores for inter-rater reliability, with positive/negative agreement scores 0.25/0.92 and 0.68/0.61, respectively. The findings indicated that these 35 care quality indicators for low-risk pregnant women may be applicable to real-world practice, with some caveats

How and when do middle-aged women learn about menopause?

＜Aim＞ We investigated the knowledge and image of menopause among middle aged women．＜Procedures＞ We administrated questionnaires to 76 outpatients with climacteric disorder and 49 healthy middle-aged women. The questionnaire consisted of items on demographics, questions about the knowledge and image of menopause, and the Scale of Menopause Knowledge（SMK）which we developed. ＜Results＞ The rates of women who responded they knew menopause well were 89.3 ％ in the patient group and 65.3 ％ in the healthy group respectively. Patients got the knowledge more through books, doctors and health care professionals than the healthy women did. The women who got the knowledge mainly when they were under thirties were more knowledgeable than those who got it mainly when they were over forty. The scores in the former group were higher than the later group in the subscales of “decrease of estrogen” and “health issues related to the aging process” in the SMK. Regarding images of menopause, few women had positive image. ＜Conclusion＞ Health education about menopause for women in their early life stage is required to deal with menopause

Fulfillment of the premenstrual dysphoric disorder criteria confirmed using a self-rating questionnaire among Japanese women with depressive disorders

<p>Abstract</p> <p>Background</p> <p>Some women with depressive disorders experience severe premenstrual symptoms. However, there have been few studies in which premenstrual symptoms in women suffering from depressive disorders were assessed. In this study, we aimed to investigate premenstrual symptoms in women with depressive disorders using the premenstrual dysphoric disorder (PMDD) scale.</p> <p>Methods</p> <p>We administered questionnaires to 65 Japanese female outpatients who had been diagnosed with a major depressive disorder or dysthymic disorder and to 303 healthy women as control subjects. The questionnaire consisted of items on demographics and the PMDD scale, which was modified from the premenstrual symptoms screening tool (PSST) developed by Steiner et al. (<it>Arch Womens Ment Health </it>2003, <b>6</b>:203-209).</p> <p>Results</p> <p>Twenty-eight women (43.1%) with depressive disorder fulfilled certain items of the PMDD scale. These women are considered to have coexisting PMDD and a depressive disorder, or to have premenstrual exacerbation (PME) of a depressive disorder. On the other hand, 18 women (5.9%) in the control group were diagnosed as having PMDD. The depressive disorder group who fulfilled the PMDD criteria had more knowledge of the term premenstrual syndrome (PMS) and took more actions to attenuate premenstrual symptoms than the control group with PMDD.</p> <p>Conclusions</p> <p>Our findings demonstrated that the occurrence of severe premenstrual symptoms is much higher in women with depressive disorders than in healthy subjects. This is partially due to this group containing women with PME, but mainly due to it containing women with PMDD. The higher percentage of PMDD suggests similarity between PMDD and other depressive disorders. Furthermore, educating healthy Japanese women and women with depressive disorders about premenstrual symptoms and evidence-based treatment for them is necessary.</p

ショウヒシャ ノ ボクジョウ タイケン ガ ラクノウカ オヨビ ニュウセイヒン ヘノ タイド オヨビ コウバイ イト ニ アタエル エイキョウ ノ チョウサ

本稿では，消費者が牧場体験を行うことにより，経験価値を高めて牧場への関与を高め，結果的に牧場の生産物である牛乳を中心とする乳製品への態度に良い影響を及ぼし，乳製品の購買意図につながるかをチェックすることを目的としている。最初にデプスインタビューによって，仮説を導き，これに基づいて，モチベーションリサーチによるアプローチで質問票を作成し，仮説の検証を実施した。結果的には検証部分で牧場体験は，酪農家に対する感情的なコミットメントを通じて，牛乳に対する態度（好ましさ）に正の有意な影響を及ぼしていることが明らかとなった。またこの好ましさは牛乳の購買意図に正の影響を及ぼしていることも明らかとなった。しかしながら，牧場での飲用体験は統計的には有意となりにくかったが，テキストマイニングによる分析において牛乳・乳製品へ良い影響を及ぼしている事実が出現していた。結論的に言えることは，幼児体験学習においては入念な事前学習が必要であるが，大人の場合にはそれも難しいため，事前学習なしでも牛乳・乳製品に牧場体験が良い影響を及ぼし，購買意図にもつながりがあることを示せた

ニュウセイヒン ニオケル ショウヒシャ ノ テイカカク カンド リョウイキ ニ カンスル コウサツ グーテンベルグ カセツ ノ モデルカ ノ ココロミ ト サイコウ リエキ ヲ ウミダス コテイ カカク ポイント ノ ハッケン

本稿では，ID-POS データを使い，個人ごとの価格感度でグループ分けを行い，「価格の真の需要曲線」と言われるグーテンベルグ曲線を出現させ，消費者の価格感度グループ別でこのグーテンベルグ曲線形がどのように変化するかを検討する。さらに，曲線中央に低価格感度領域が存在するならば，どこまでの高価格が消費者に抵抗少なく受容されるかを明らかにする。また，消費者の商品に対する価格感度に着目し，利益最大化を生み出す（固定）価格ポイント（価格掛率）の推定を行う

ニューラル ネット ワーク ニヨル サイコウ リエキ ヲ ウミダス カカク カケリツ ノ シミュレーション ゼンタイ デ ワン プライス ノ バアイ ト グループ ベツ ノ ダイナミック プライシング ノ バアイ ノ ヒカク

本稿では，購買者の商品に対する価格感度に着目し，購買者を価格感度によりグループに分け，その価格感度グループごとに最高利益が得られる価格をニューラルネットワークモデルで推定し，ダイナミック・プライシング（ここではグループごとに価格を変えるという意味で用いる）の方が，全体で１つのプライス（ここではワンプライスと呼ぶ）より売上総利益が大きいことをシミュレーションによって示す。さらに，価格感度に代わる属性を決定木分析により探し，ダイナミック・プライシングとワンプライスの売上総利益を比較する