Survey on recipients expenses and degrees of satisfaction in the nursing insurance system

本研究は,介護保険法の利用者と家族の満足度や,介護保険法がどのように受け止めているのかを明らかにすることを目的とした｡対象は,介護保険法の中で訪問看護を受けている利用者の家族の方(主に介護を担当されている方)95名で,郵送法により52名の回答を得た(回収率54.7%)｡研究期間は,2000年7月から9月であり,アンケートは介護にかかる費用･介護サービスの2点に重点をおいて作成した｡その結果,以下の実態を把握することができた｡ 1.介護保険法を利用するにあたり,介護サービスにおける費用の問題が多い｡介護サービスの内容には満足していたが,介護サービスにかかる費用は高いと感じている｡ 2.介護者は,介護をしていて｢利用者のこれからのことが心配である｣,｢自分の時間が持てない｣と感じている人が多いことがわかった｡ 3.介護保険法や利用契約の手続きが複雑であるという意見が多かった｡今後,介護保険法の利用に向けて,これらの問題点に対する解決への取り組みが必要であることが示唆された｡We carried out a survey on the caregivers impression and degrees of satisfaction. The objects are 95 family members who mainly take care of the elderly receiving the visiting care under the nursing insurance law. Sheets of questionnaires were delivered and collected from July to September, 2000. They were mainly focused on the expenses, qualities and quantities of the nursing service. We found that : 1. Many people are unsatisfied with the expenses. They were satisfied with the qualities and quantities of the nursing service, but they think that the fees are expensive. 2. Many caregivers have anxieties about the future of the elderly and they feel that they have no free time for themselves. 3. Many have impression that the nursing insurance law itself and the procedure for a contract are complicated

Comparison of Moral Distress and Burnout Experienced by Mental Health Nurses in Japan and England : A Cross-sectional Questionnaire Survey

Aims: To compare moral distress and burnout experienced by mental health nurses in hospitals both in Japan and England. Methods: This is a cross-national study, and a cross-sectional design was adopted. An anonymous questionnaire containing 43 moral distress items, a 16 item burnout scale, and demographic data was administered to convenient samples; 391 nurses in Japan, and 460 nurses in England. Among the participants, 289 nurses (73.9%) in Japan, and 36 nurses (7.8%) in England responded. Results: The moral distress items which were commonly felt by nurses in both countries dealt with a lack of staff. Several differences, however, existed between the two, which reflected poor conditions such as long term social hospitalization in Japan. The nurses in England felt moral distress in a wider variety of situations, though they confront them less frequently than the nurses in Japan. Only in England was it found that the older nurses became, and the more experience they had accumulated, the less intensely they felt moral distress. The nurses in both countries felt the same levels of exhaustion, and cynicism, but as far as professional efficacy, the scores of the nurses in England were much higher than those of the nurses in Japan. Conclusions: If nurses feel no moral distress, there will be no improvements of care. Nurses should have moral sense, and do their best to improve the situations without being burned out

Low-grade B-cell lymphoma presenting primarily in the bone marrow

Cases of low-grade B-cell lymphoma presenting primarily in the bone marrow are rare, and its clinicopathology remains unclear. We retrospectively examined patients with low-grade B-cell lymphoma presenting primarily in the bone marrow. Fourteen patients met the inclusion criteria, including 5 with lymphoplasmacytic lymphoma (LPL), 3 with chronic lymphocytic leukemia/small lymphocytic lymphoma, 2 with follicular lymphoma (FL), and 4 with low-grade B-cell lymphoma not otherwise specified (LGBCL-NOS). The median age was 69.5 years (range, 42-89 years), and a slight male predominance was noted (9 men and 5 women, 1.8: 1). Immunohistochemically, all cases were positive for CD20. One case was positive for CD138. Both cases of FL were positive for CD10 and B-cell lymphoma 2 (BCL-2), and immunoglobulin heavy locus (IgH)/B-cell lymphoma 2 rearrangement was observed by fluorescence in situ hybridization. The myeloid differentiation primary response gene (88) leucine to proline mutation was observed in 3 of 5 LPL, 1 of 2 FL, and 2 of 4 LGBCL-NOS patients. Paraproteinemia was observed in 10 patients; IgM and IgG paraproteinemia were observed in 6 and 3 patients, respectively. In this patient series, 3 patients had died at a median follow-up of 36.5 months; the cause of death of 1 LPL patient was malignant lymphoma itself. Thus, low-grade B-cell lymphoma presenting primarily in the bone marrow has various subtypes, and approximately one-third of the patients had LGBCL-NOS. The immunophenotypic features and myeloid differentiation primary response gene (88) leucine to proline mutation data of LGBCL-NOS suggested that some cases present with characteristics similar to those of LPL or marginal zone lymphoma

Improvement of endocytoscopic findings after per oral endoscopic myotomy (POEM) in esophageal achalasia; does POEM reduce the risk of developing esophageal carcinoma? Per oral endoscopic myotomy, endocytoscopy and carcinogenesis

Background: Per oral endoscopic myotomy (POEM) has been reported to be a new therapeutic option for esophageal achalasia. The possibility that POEM could reduce the risk of developing esophageal squamous cell carcinoma was evaluated.Methods: This was a single-centre, retrospective study. Fifteen consecutive patients with esophageal achalasia who underwent POEM in our institution between August 2010 and January 2012 were enrolled. Ultra-high magnification with endocytoscopy was performed, and both histopathological and immunohistochemical evaluations for Ki-67 and p53 were assessed before and 3 months after POEM.Results: POEM was successfully performed and effectively released the dysphagia symptom in all patients without severe complications. Subjective symptoms (mean Ekcardt score, before 7.4 vs. after 0.5, p<0.05) and manometric pressure studies (mean lower esophageal sphincter pressure), before 82.7 vs. after 22.9 mmHg, p<0.05) showed substantial improvement following POEM. The average numbers of esophageal epithelial nuclei before and after POEM on endocytoscopic images were 128.0 and 78.0, respectively (p<0.05). The mean Ki-67-positive ratio was 26.0 (median 25.4, range, 10.3-33.2) before and 20.7 (median 20.0, 13.1-29.9; p=0.07) after POEM, and the mean p53-positive ratio was 2.35 (median 2.61, 0.32-4.23) before and 0.97 (median 1.49, 0.32-1.56; p<0.05) after POEM. A significant positive correlation was seen between the number of nuclei and the Ki-67-positive ratio (p<0.05).Conclusions: POEM appears to be an effective and less invasive treatment of choice against achalasia and may reduce the risk of esophageal carcinogenesis. Endocytoscopy can be useful for the assessment of esophageal cellular proliferation

Vection Is Enhanced by Increased Exposure to Optic Flow

2018, The Author(s) 2018. We examined whether vection strength could be modulated by altering the exposure duration to optic flow. Experiment 1 sourced 150 different video clips from various Japanese animation works which simulated self-motion. Despite large differences in the content of these video clips, we found a significant positive correlation between their play durations and their ratings of vection magnitude. Experiment 2 examined this relationship further using more tightly controlled visual motion stimuli. Vection was induced by presenting the motion of the same expanding grating stimulus for 8, 16, 32, or 64 seconds. While vection onset latencies remained constant across these four conditions, vection magnitude/strength was found to increase systematically with the exposure duration. As predicted by a recent computational model of vection, we conclude that subjective vection strength does depend on the exposure duration to optic flow