Journal articles on the topic 'Terminal care Japan'
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Babazono, Akira, Janet Weiner, Hirohisa Hamada, Toshihide Tsuda, Yoshio Mina, and Alan L. Hillman. "Health Policy in Transition: Terminal Care and Site of Death in Japan." Journal of Health Services Research & Policy 3, no. 2 (April 1998): 77–81. http://dx.doi.org/10.1177/135581969800300204.
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Objectives: In Japan, hospitals have replaced homes as the predominant site of death, especially for the elderly. Site of death is a reliable indicator of where older people receive care before they die. We conducted a population-based study to identify the factors that determine site of death in a typical rural area in Japan. Methods: Study subjects were residents of Kawakami town, aged 70 years or older, who died during 1981 and 1990. Death certificates provided information on age, gender, cause of death, duration of illness before death, family members, family occupation, and site of death. Results: Among 455 subjects, 52.7% died at home, while 47.3% died in hospital. Multiple logistic regression analyses indicated that subjects with cancer were 6.1 times more likely to die in hospitals than those with other diseases. Subjects who died in their seventies were 2.3 times more likely to die in hospital than older subjects. Members of non-farming families were 1.7 times more likely to die in hospital than members of farming families. Gender, duration of illness, and the presence of spouse or children in the household were not significantly related to site of death according to multivariate analyses, although trends did exist. Conclusion: This case study illustrates the importance of developing geriatric care systems in Japan, utilizing alternatives to hospitals, such as nursing homes and formal home care. This is particularly true for patients with cancer. As the older population rapidly increases in Japan, the need for alternatives in geriatric care grows more critical.
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Ogasawara, Chie, Yasuko Kume, and Masayo Andou. "Family Satisfaction With Perception of and Barriers to Terminal Care in Japan." Oncology Nursing Forum 30, no. 5 (September 1, 2003): E100—E105. http://dx.doi.org/10.1188/03.onf.e100-e105.
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Kai, Ichiro, Gen Ohi, Eiji Yano, Yasuki Kobayashi, Tomoyo Miyama, Naoakira Niino, and Koh-Ichi Naka. "Communication between patients and physicians about terminal care: A survey in Japan." Social Science & Medicine 36, no. 9 (May 1993): 1151–59. http://dx.doi.org/10.1016/0277-9536(93)90235-v.
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Abe, Koji, and Akira Ohashi. "Positive Effects of Experience in Terminal Care on Nursing Home Staff in Japan." American Journal of Hospice and Palliative Medicine® 28, no. 6 (January 16, 2011): 389–92. http://dx.doi.org/10.1177/1049909110396351.
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Ishiwata, Ryuji, and Akio Sakai. "The Physician–Patient Relationship and Medical Ethics in Japan." Cambridge Quarterly of Healthcare Ethics 3, no. 1 (1994): 60–66. http://dx.doi.org/10.1017/s0963180100004722.
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In April 1991, a general meeting of the Japanese Medical Conference (called ev 4 years) was held in Kyoto and attracted 32,500 participants, the largest number ever. The theme of the meeting was “Medicine and Health Care in Transition,” and the program Included panel discussions on “How to Promote the Quality of Health Care” and “How Terminal Care Should Be Provided” and symposia on “Diagnosis of Brain Death and Its Problems,” “The Propriety of Organ Transplantation,” and “Brain Death and Organ Transplantation.” These titles reveal not only how medical professionals in Japan perceive the present situatior healthcare but also the Issues that most concern them.
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Maeda, Nobuo, and Seiichi Takahashi. "Provision of care to the terminal ill in the home: Community experiences in Japan." Journal of Cross-Cultural Gerontology 8, no. 4 (October 1993): 439–46. http://dx.doi.org/10.1007/bf00972570.
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Sano, Tomomi, Etsuko Maeyama, Masako Kawa, Yuki Shirai, Mitsunori Miyashita, Keiko Kazuma, and Takeshi Okabe. "Family caregiver's experiences in caring for a patient with terminal cancer at home in Japan." Palliative and Supportive Care 5, no. 4 (October 25, 2007): 389–95. http://dx.doi.org/10.1017/s1478951507000582.
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ABSTRACTObjectives:The aim of the study was to clarify the care experience of primary caregivers when caring for a terminal cancer patient in the home with the assistance of a home palliative care service. Participants were asked to provide background data and to evaluate their experience of caregiving and of the patient's response throughout the period of home palliative care, up to the time of death.Methods:One hundred twelve primary family caregivers were a mailed self-report questionnaire, and 74 valid questionnaires were returned (response rate 66%).Results:Ninety percent felt that the patient's condition of mind and body was reasonably stable, and 75% felt that the death was peaceful. About 90% reported a deepening of their bond with the patient and that the bond of other family members deepened also. Sixty percent reported that the burden of caregiving was not too great or not felt at all. Approximately 90% judged that the patient retained his or her own personal qualities to the end. Ninety percent also felt that they had done their best in their caregiving and judged that home care had been beneficial for the deceased, for the primary caregiver him/herself, and for other family members. These primary caregivers' evaluations of caring for a terminally ill patient at home in conjunction with a home palliative care service were both high and positive.Significance of results:Our findings suggest that it is important to maintain the patient's personal qualities up to the time of death through appropriate symptom management, to respect the family bond of the household, and to provide professional support in order to reduce the load on the family. If appropriate care is provided, peaceful home death will be possible, resulting in significant benefits for patients and their families in Japan.
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Naito, Yumi, Yoko Tomita, Katrina Breaden, and Yvonne Parry. "Community Nurses' Perspective on Barriers to Effective Utilization of Advance Care Planning for Terminal Care of The Elderly in The Home Environment in Japan: A Systematic Review and Synthesis of Qualitative Studies." International Journal of Advanced Health Science and Technology 2, no. 3 (June 15, 2022): 150–55. http://dx.doi.org/10.35882/ijahst.v2i3.4.
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Advance care planning (ACP) allows individuals to plan the health care which dignifies their personal values at the terminal phase of their illnesses. The Japanese government previously endorsed the concept of ACP in the guideline on end-of-life care and community nurses in Japan could play an increased role to improve its utilization by patients. The current study aimed to identify challenges surrounding ACP practice in the home environment in Japan from the community nurses’ perspectives. Semi-structured interview was performed on eleven community nurses working in metropolitan areas in Japan. Qualitative data was collected and analyzed using Braun & Clarke’s six-step framework of thematic analysis (2006). Five themes were identified as barriers to effective ACP utilization: complexity surrounding family power, informed consent and discussion, cultural influence, longer life versus better life, and absence of frameworks and guidelines. The first three themes were further subdivided into subthemes: imbalance in family power and family guilt, inadequate information for decision-making and ‘no one talk about it’, and traditional ways of thinking and taboo surrounding talking about death, respectively. The identified issues surrounding the current ACP practice in Japan were interconnected and reflective of the social, cultural, legal, and ethical aspects of life and care in Japan. This study highlighted the importance of respecting patients’ preferences in care, which should be additionally protected by establishing clear policy and legal frameworks on ACP
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TAMURA, KEIKO, KAORI ICHIHARA, EIKO MAETAKI, KEIKO TAKAYAMA, KUMI TANISAWA, and MASAYUKI IKENAGA. "Development of a spiritual pain assessment sheet for terminal cancer patients: Targeting terminal cancer patients admitted to palliative care units in Japan." Palliative and Supportive Care 4, no. 2 (June 2006): 179–88. http://dx.doi.org/10.1017/s147895150606024x.
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Objective: This research explores the potential benefit of a spiritual pain assessment sheet to clinical practice. With spiritual pain defined as “pain caused by extinction of the being and meaning of the self,” the spiritual pain assessment sheet was developed by Hisayuki Murata from his conceptual framework reflecting the three dimensions of a human being as a being founded on temporality, a being in relationship, and a being with autonomy. The assessment sheet was developed from reviews of the literature and examinations from a philosophical perspective on the structure of spiritual pain.Methods: Patients admitted to palliative care units in Japan were interviewed using the assessment sheet. The responses were analyzed qualitatively. The usefulness of the assessment sheet and the burden placed on the patients by its use were also investigated.Results: The spiritual pain elucidated by the assessment sheet was the same as that revealed in the earlier research of Morita. The patients reported that they did not find the use of the assessment sheet a burden, and more than half reported that it was useful. The burden of the assessment sheet on the subjects was thus determined to be low. Positive feedback on the assessment sheet was also received from the nurses who conducted the patient interviews, who said the assessment sheet made it easier to talk with the patients about their spiritual pain.Significance of research: The research results indicate that the spiritual pain assessment sheet provided an appropriate assessment of spiritual pain among terminal cancer patients, showing that such a sheet could be used as an assessment tool in the future.
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AOKI, Tomokazu, Yoshitaka NARITA, Kazuhiko MISHIMA, and Masao MATSUTANI. "Current Status of Palliative and Terminal Care for Patients with Primary Malignant Brain Tumors in Japan." Neurologia medico-chirurgica 60, no. 12 (2020): 600–611. http://dx.doi.org/10.2176/nmc.oa.2020-0243.
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Oeki, Miki. "P174 Relationship Between Mental Health of Elderly Patients with Terminal Cancer and Family Care in Japan." Journal of Pain and Symptom Management 52, no. 6 (December 2016): e112-e113. http://dx.doi.org/10.1016/j.jpainsymman.2016.10.242.
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Iijima, Setsu. "A revised proposal for "Position Statement from the Japan Geriatrics Society: The Terminal Care of the Elderly"." Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 49, no. 1 (2012): 79–81. http://dx.doi.org/10.3143/geriatrics.49.79.
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Mine, Yuka, Masayuki Yokoi, and Takao Tashiro. "Why Did the Policy to Convert Hospitals Into Facilities Not Work in Japan?" Global Journal of Health Science 11, no. 10 (August 16, 2019): 89. http://dx.doi.org/10.5539/gjhs.v11n10p89.
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The government of Japan formulated measures to significantly reduce the number of hospital beds for long-term care in 2006. In particular, long-term care hospital beds covered by long-term care insurance (sanatorium medical facilities) were to be abolished in 2012, and existing sanatorium medical facilities were to be converted into long-term care insurance services such as geriatric health services facilities. However, the conversion did not progress in spite of various support measures, and the deadline for abolishment was extended. In order to clarify the reason for this, we selected 28 hospitals with 402 or more long-term care beds and 28 health services facilities with 158 or more beds and examined their management philosophies and analyzed the keywords included. The most popular keyword was “community” in both hospitals and facilities. Hospitals had a significantly higher rate of 60.7% (P< 0.05) of including “trust” or “feeling of relief” in their management philosophies. Facilities had higher rates of including any of the terms “return” or “independence” or “home” (32.1%, P= 0.051), and also of including either “service” or “care” (46.1%, P< 0.05). In conclusion, it is suggested that hospitals with long-term care beds differentiate themselves from neighboring facilities in that they are able to simply accept the situation and be responsible for terminal care whenever inpatients may have difficulty returning home. In addition, it seemed difficult for hospitals to convert into health service facilities, the aim of which is to enable residents to return home.
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Ito, Hideki. "Ten year retrospection after the position statement 2001 for terminal care in the elderly by Japan Geriatrics Society." Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 49, no. 1 (2012): 63–66. http://dx.doi.org/10.3143/geriatrics.49.63.
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Kizawa, Yoshiyuki, Satoru Tsuneto, Jun Hamano, Hiroka Nagaoka, Takami Maeno, and Yasuo Shima. "Advance Directives and Do-Not-Resuscitate Orders Among Patients With Terminal Cancer in Palliative Care Units in Japan." American Journal of Hospice and Palliative Medicine® 30, no. 7 (October 11, 2012): 664–69. http://dx.doi.org/10.1177/1049909112462860.
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Okamoto, Yoshiaki, Satoru Tsuneto, Tatsuya Morita, Tatsuya Takagi, Megumi Shimizu, Mitsunori Miyashita, Etsuko Uejima, and Yasuo Shima. "Desirable Information of Opioids for Families of Patients With Terminal Cancer." American Journal of Hospice and Palliative Medicine® 34, no. 3 (July 10, 2016): 248–53. http://dx.doi.org/10.1177/1049909115626701.
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Objective: The aims of this study are to clarify the state of information regarding opioids for families and what kinds of experiences they had with opioids while the patient was followed as an outpatient and inpatient. Participants: This study was part of a cross-sectional nationwide survey of bereaved families of patients with cancer, namely, the Japan Hospice and Palliative Care Evaluation 2 study. The participants in this study comprised 572 bereaved families who had experienced the death of a family member during the period from January 2008 to December 2009 at 1 of 103 certificated palliative care units. Main Outcome Measures: In response to the question of “how much improvement was needed for information regarding opioids,” 41% answered “improvement is not necessary at all,” 43% answered “improvement is slightly necessary,” 14% answered “improvement is necessary,” and 2% answered “improvement is extremely necessary.” Regarding anxiety about the use of opioid, it was found that 14% of respondents indicated “opioids are very safe,” 65% of respondents indicated “opioids are relatively safe,” 19% of respondents indicated “opioids are not so safe,” and 2% of respondents indicated “opioids are not so safe at all.” from the information obtained for opioids. It was found that 90% of families agreed with the item, “I would like to be clearly explained that drugs for medical purposes are safe and that the patient will not develop a drug addiction and their life expectancy will not be reduced.” Conclusion: From this study, it is important for families of patients with cancer to be explained profound and careful information of opioid.
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Kuo, TsuAnn, and Georgia Anetzberger. "WHAT NEEDS TO BE DONE TO PREVENT ELDER ABUSE IN JAPAN?" Innovation in Aging 6, Supplement_1 (November 1, 2022): 343. http://dx.doi.org/10.1093/geroni/igac059.1357.
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Abstract This symposium first introduces the Japanese Act on the Prevention of Elder Abuse, including its elder abuse definitions and trends in elder abuse in both institutional and domestic settings. It then describes a recent amendment to operational standards made by ministerial ordinance, which aims to reduce elder abuse. Second, it presents analysis of elder abuse data (N=497) from Matsudo-City in Chiba prefecture, which found that only about 65% of reported elder abuse cases were deemed to meet the legal definition of elder abuse and the rest were excluded due to how the law defines abusers. Findings suggest the definitions in the Act be broadened to encompass a wider set of abuse situations. Third, it presents analysis using the same data, of characteristics of abusers. Findings indicate that about 24% of abusers were caregivers with disabilities, suggesting the importance of supporting caregiver health and welfare to help prevent abuse. The symposium concludes by presenting findings from a longitudinal survey of older adults aged 75+ (N=769) indicating that physical restraints use is associated with “having been diagnosed as intractable neurological diseases,” “unstable general condition or at the terminal stage,” “higher levels of care-need,” “having medical treatment,” and “family members’ long-term care burdens.”
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Shaku, Fumio, Madoka Tsutsumi, Asumi Nakamura, Hiroshi Takagi, Takahiro Otsuka, and Shuichiro Maruoka. "Factors Relating to Caregivers’ Preference for Advance Care Planning of Patients in Japan: A Cross-Sectional Study." American Journal of Hospice and Palliative Medicine® 36, no. 8 (June 30, 2019): 727–33. http://dx.doi.org/10.1177/1049909119844517.
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Objectives:The aim of this study was to examine the preferences of home caregivers on patient advance care planning (ACP), including life-sustaining treatment (LST) and the factors relating to these preferences.Background:Personalized ACP aims to respect the autonomy and choices of terminally ill patients regarding end-of-life care. However, there have been cases wherein doctors must instead discuss ACP with surrogates (including caregivers) for various reasons such as dementia, intractable neurologic diseases, and cerebrovascular accident.Methods:In this cross-sectional study, self-written questionnaires (filled by individuals themselves) were distributed to 506 in-home caregivers in 6 Japanese prefectures; the questionnaires contained items on caregiver and patient demographics, number of people living together in a caregiver’s home (aside from patients), care duration, comprehension level of doctors’ explanations regarding their patient’s condition, patient diseases, whether caregivers have or have not told patients about their disease, level of nursing care, and caregiver LST preference (preferred or not preferred). The questionnaire package also contained the Burden Index of Caregiver-11, Patient Health Questionnaire-9, and Short Form-8 Health Survey.Results:Valid responses were obtained from 309 caregivers. More than half of them were not sure of their patient’s LST preference. Sex, number of people living together in a care home, comprehension level of doctors’ explanations, and care duration were found to be the significant factors relating to caregivers’ LST preference ( P < .05).Conclusion:Health providers should be cognizant of the background factors relating to caregiver ACP preference when deciding on LST for terminal patients.
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Yamamoto-Mitani, Noriko, Hanako Numata, and Chie Fukui. "PHYSICAL RESTRAINTS AT HOME AND THEIR FACTORS: A ONE-YEAR LONGITUDINAL SURVEY AMONG HOME CARE SERVICE USERS IN JAPAN." Innovation in Aging 6, Supplement_1 (November 1, 2022): 344. http://dx.doi.org/10.1093/geroni/igac059.1361.
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Abstract We conducted a one-year survey of homecare service users aged 75 years and older. Data from 769 clients were examined. Altogether 47 (6.1%) received physical restraint at least once among the five survey points conducted over a one-year period. Among them, 27 (57.4%) received restraint only at one point, and only 2 received restraint in all five points. In the bivariate analyses, the factors associated with the use of physical restraint were: diagnosis of neurological disease, unstable general condition or terminal stage, high level of care required, medical treatment, and family burden. When those who were released from the restraint at 12 months (n=30) were compared with those who were not (n=17), not having stroke, not receiving suctioning, and not having home-visit medical care were significant factors. Physical restraints at home were not common but we must be careful when we serve clients with significant factors of prolonged restraints.
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Shaku, Fumio, and Madoka Tsutsumi. "The Effect of Providing Life Support on Nurses’ Decision Making Regarding Life Support for Themselves and Family Members in Japan." American Journal of Hospice and Palliative Medicine® 33, no. 10 (July 10, 2016): 917–23. http://dx.doi.org/10.1177/1049909115624655.
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Decision making in terminal illness has recently received increased attention. In Japan, patients and their families typically make decisions without understanding either the severity of illness or the efficacy of life-supporting treatments at the end of life. Japanese culture traditionally directs the family to make decisions for the patient. This descriptive study examined the influence of the experiences of 391 Japanese nurses caring for dying patients and family members and how that experience changed their decision making for themselves and their family members. The results were mixed but generally supported the idea that the more experience nurses have in caring for the dying, the less likely they would choose to institute lifesupport measures for themselves and family members. The results have implications for discussions on end-of-life care.
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Yamanishi, Ryutaro, Miki Uchino, Motoko Kawashima, Yuichi Uchino, Norihiko Yokoi, and Kazuo Tsubota. "Characteristics of Individuals with Dry Eye Symptoms without Clinical Diagnosis: Analysis of a Web-Based Survey." Journal of Clinical Medicine 8, no. 5 (May 21, 2019): 721. http://dx.doi.org/10.3390/jcm8050721.
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Currently, the available treatment for dry eye disease (DED) varies. The present study aimed to investigate the characteristics of undiagnosed DED and patient-based self-care management for DED based on a web-based survey performed for Tear’s Day in Japan; 1030 participants (301 women) responded; 155 participants (72 women) had a clinical diagnosis of DED. We defined undiagnosed DED (n = 116; 54 women) as those with DED symptoms, as evaluated by a frequently used questionnaire despite not having a clinical diagnosis. A multivariate adjusted model indicated that younger age (odds ratio (OR), 0.97 for each one-year decrease; 95% confidence interval (CI), 0.95–0.99), female sex (OR, 2.12; 95% CI, 1.28–3.50), and prolonged visual display terminal usage (OR, 1.12; 95% CI, 1.04–1.21) were risk factors for undiagnosed DED. To investigate the efficacy of self-care management for DED, a sub-analysis was conducted. The number of self-care methods used was significantly higher among women than men. For undiagnosed DED, those with less than three self-care methods had a significantly worse Dry Eye-related Quality-of-Life Score compared with those with diagnosed DED. This study revealed risk factors for undiagnosed DED; individuals with those risk factors need to be clinically assessed and should not rely solely on self-care.
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Nakayama, Naomi, Takashi Higashiguchi, Kozue Hanada, Akiko Maniwa, Yukiko Kanemoto, Hiroaki Sugiura, Yoshie Hara, and Kentaro Nakayama. "Implementation of Intravenous Drip Infusion Therapy with Peripheral Venous Catheters and the Incidence of Related Complications in Home-Based Medical Care Settings in Japan." Annals of Nutrition and Metabolism 73, no. 2 (2018): 100–105. http://dx.doi.org/10.1159/000490801.
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Background/Aims: Home-based medical care is rapidly expanding in Japanese health care settings. We aimed to clarify the implementation status of drip injection with peripheral venous catheters (PVCs) and the incidence of related complications. Methods: We investigated the number of patients who required intravenous drip infusion therapy at home. We also examined the incidence rate of PVC-related complications and their statistical correlation with patients’ characteristics. Results: Of 139 patients, 30 (21.6%) received intravenous drip infusion therapy through PVCs at home. Patients’ activities of daily living (bed-ridden) and the presence of underlying disease (terminal cancer) were significantly correlated with the requirement for drip infusion therapy (p < 0.0001 and p < 0.0001, respectively). A high incidence of PVC-related complications (75%: 15 out of 20 patients) was observed. More than 50% of patients experienced multiple needling due to difficulty in securing venous access. Conclusions: This is the first report to reveal the relatively high incidence of PVC-related complications in home-based medical care settings. Safer vascular devises should be incorporated for more stable intervention.
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Matsushima, Tatsuko, Akira Akabayashi, Brian Taylor Slingsby, and Kenji Nishitateno. "Evaluation of a program to celebrate seasonal events for Japanese hospice patients." Palliative and Supportive Care 5, no. 3 (September 2007): 251–54. http://dx.doi.org/10.1017/s1478951507000417.
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Objective: Palliative care of the terminally ill requires not only treatment of physical pain, but also care for a patient's spiritual and social needs. In Japan, where many customs correlate closely with the seasons of fall, winter, spring, and summer, seasonal events carry significance for patients who have reached a terminal stage of disease. This study determined how Japanese hospice patients evaluate a program that celebrates seasonal events and considers the modality and significance of season events at hospices.Methods: A questionnaire survey was conducted for 1 year between August 2000 and July 2001 at a hospice located in the suburbs of Tokyo, Japan. Of the original 48 instruments, a total of 43 instruments were returned (response rate: 89.6%).Results: Results showed that 72.1% of respondents participated in seasonal events, and the majority of participants positively evaluated their experiences of seasonal events. Positive aspects included being able to get a feeling for the seasons (74.2%) and being able to interact with staff and volunteers (51.6%). Negative aspects included that the events were too long (9.7%) and tiring (6.5%), and that the events made one feel sad (6.5%). Reasons for participating in seasonal events included seeming fun (71.0%), recreative (58.1%), and being entertaining (48.4%).Significance of results: Overall findings suggest that there is significance in celebrating the seasons with a monthly event at hospices. Further research is needed on the modality and experiences of celebrating the seasons at hospices in other nations.
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Hayashi, Eriko, Maho Aoyama, Kento Masukawa, Mitsunori Miyashita, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, and Yasuo Shima. "Bathing in Terminal Care of Cancer Patients and Its Relation to Perceptions of a “Good Death”: A Nationwide Bereavement Survey in Japan." Palliative Medicine Reports 3, no. 1 (April 1, 2022): 55–64. http://dx.doi.org/10.1089/pmr.2021.0075.
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Uemura, Kazumasa. "Study on the present status of the Position Statement by the Japan Geriatrics Society about terminal medicine and care for the elderly." Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 49, no. 1 (2012): 75–78. http://dx.doi.org/10.3143/geriatrics.49.75.
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Uemura, Kazumasa, Setsu Iijima, and Japan Geriatrics Society Ethical Committee. "Survey of members of the Japan Geriatric Society regarding the revised version of their Position Statement on terminal medicine and care for elderly patients." Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 49, no. 4 (2012): 387–92. http://dx.doi.org/10.3143/geriatrics.49.387.
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Mori, Masanori, Miho Ogawa, Mashiho Nishimura, Hirohide Yamada, and Tatsuya Morita. "Prognosis disclosure to terminally ill cancer patients: A qualitative study among Japanese physicians." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e20717-e20717. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e20717.
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e20717 Background: Prognosis disclosure could facilitate end-of-life discussions and advance care planning in advanced cancer patients. However, many Japanese and Japanese American patients do not wish to know of their own prognosis, and physicians infrequently disclose terminal prognosis in Japan. We aimed to investigate Japanese physicians’ practice and emotion regarding prognosis disclosure. Methods: We adopted a qualitative design based on semi-structured interviews and content analysis. Attending physicians in a local cancer center were eligible if they had disclosed terminal prognosis to their cancer patients and/or families more than three times in the past year. The sample size was justified by recruiting participants through consistent comparison analysis until data saturation occurred. Results: We conducted 11 face-to-face interviews and detected the following categories; [practice in disclosure], [reasons for/against disclosure], and [emotion regarding disclosure]. [Practice] indicated that some physicians have almost always disclosed prognosis to their patients, while others have almost never done so. It included various skills such as “having families/nurses attend the meeting,” “asking families how much prognostic information physicians should provide to patients,” “asking patients why they want to know,” and “answering with a range of estimation.” [Reasons for disclosure] included “to help patients deal with unfinished business” and “to support realistic hope.” [Reasons against disclosure] included “uncertain prognosis,” “physicians’ concern about hurting patients,” “lack of time and staff support for physicians,” and “insufficient training in communication skills.” Lastly, many physicians felt “sad,” “nervous,” and “difficult,” while few felt “fulfilled” when disclosing prognosis. Conclusions: Practice patterns, reasons and emotional experiences vary widely in prognosis disclosure among Japanese physicians. Team approach, physician training in communication skills, and understanding of families’ as well as patients’ preferences may contribute to better-quality individualized cancer care based on patients’ goals, not on physicians’ personal preferences.
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Takazono, Takahiro, Yoshifumi Imamura, Kaoru Kawakami, Naoya Yamasaki, Hiroyoshi Shimizu, Katsuhiro Usuki, Maiko Kiyohara, et al. "Discrepancies in preferences regarding the care of terminal-phase pneumonia in elderly patients among patients, families, and doctors: A multicenter questionnaire survey in nagasaki, Japan." Respiratory Investigation 58, no. 6 (November 2020): 488–94. http://dx.doi.org/10.1016/j.resinv.2020.05.003.
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Masuda, Ken, Hiroto Ishiki, Naosuke Yokomichi, Takuhiro Yamaguchi, Tetsuya Ito, Hana Takatsu, Koji Amano, et al. "Effect of paracentesis on the survival of patients with terminal cancer and ascites: A propensity score-weighted analysis of the EASED study." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e24063-e24063. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e24063.
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e24063 Background: Malignant ascites (MA) is associated with progressive deterioration in quality of life and poor prognosis of patients with cancer. Paracentesis is among the most widely utilised treatments for MA. However, reports on the usefulness of paracentesis in patients with MA are limited. Thus, this study aimed to investigate whether paracentesis affects the duration of survival in such patients. Methods: We performed a post - hoc analysis of a prospective multicentre observational study that investigated the dying process and end-of-life care in patients with terminal cancer, who were admitted to 23 palliative care units in Japan. Survival duration was compared between patients who did (paracentesis group) and did not undergo paracentesis (non-paracentesis group). We used the inverse probability of treatment weighting (IPTW) method to control for baseline covariates between the two groups. Furthermore, subgroup analyses were performed to investigate the IPTW-adjusted hazard ratio (HR) of the paracentesis and non-paracentesis groups according to some of the baseline covariates, including age, sex, Karnofsky Performance Status, primary tumor site, liver dysfunction, and renal dysfunction. Results: Among the 1,896 patients, who were initially enrolled, 568 with ascites were included in the study cohort. Eighty-five (15.0%) patients underwent paracentesis. The most common primary tumour site was the gastrointestinal tract (51.9%, n = 295), followed by the pancreas (22.7%, n = 129). The non-adjusted median durations of survival were 22 days (95% confidence interval [CI]: 16–25) and 12 days (95% CI: 11–13) in the paracentesis and non-paracentesis groups, respectively (HR: 0.69, [95% CI: 0.54–0.88]; p = 0.003). The IPTW-adjusted median durations of survival were 22 days (95% CI: 16–25) and 16 days (95% CI: 12–22) in the paracentesis and non-paracentesis groups, respectively (HR: 0.89, 95% CI: 0.64–1.24; p = 0.492). There were no serious adverse events in the paracentesis group. According to the baseline covariates, a weighted subgroup analysis was performed to compare the survival of patients in the non-paracentesis and paracentesis groups. There was no significant heterogeneity across all subgroups. Paracentesis was not associated with a significant survival risk in any of the subgroups. Conclusions: Paracentesis does not negatively affect the survival of patients with cancer and MA; hence, it can be used as a standard treatment in palliative care settings.
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Chano, Tokuhiro, Shin-ya Morita, Tomoyuki Suzuki, Tomoko Yamashita, Hirokazu Fujimura, Tatsushi Yuri, Masakazu Menju, Masaaki Tanaka, and Fumihiko Kakuno. "Serology suggests adequate safety measures to protect healthcare workers from COVID-19 in Shiga Prefecture, Japan." PLOS ONE 17, no. 6 (June 24, 2022): e0270334. http://dx.doi.org/10.1371/journal.pone.0270334.
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Healthcare workers (HCWs), especially frontline workers against coronavirus disease 2019 (COVID-19), are considered to be risky because of occupational exposure to infected patients. This study evaluated the correlation between seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies among HCWs and the implementation of personal protective equipment (PPE) & infection prevention and control (IPC). We recruited 1237 HCWs from nine public COVID-19-designated hospitals in Shiga Prefecture, central Japan, between 15–26 February 2021. All participants answered a self-administered questionnaire and provided blood samples to evaluate SARS-CoV-2 antibodies. A total of 22 cases (1·78%) were seropositive among the 1237 study participants. An unavoidable outbreak of SARS-CoV-2 had occurred at the terminal care unit of one hospital, before identifying and securely isolating this cluster of cases. Excluding with this cluster, 0·68% of HCWs were suspected to have had previous SARS-CoV-2 infections. Binomial logistic regression from individual questionnaires and seropositivity predicted a significant correlation with N95 mask implementation under aerosol conditions (p = 8.63e-06, aOR = 2.47) and work duration in a red zone (p = 2.61e-04, aOR = 1.99). The institutional questionnaire suggested that IPC education was correlated with reduced seropositivity at hospitals. Seroprevalence and questionnaire analyses among HCWs indicated that secure implementation of PPE and re-education of IPC are essential to prevent SARS-CoV-2 infection within healthcare facilities. Occupational infections from SARS-CoV-2 in healthcare settings could be prevented by adhering to adequate measures and appropriate use of PPE. With these measures securely implemented, HCWs should not be considered against as significantly risky or dirty by local communities.
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Oosono, Yasufumi, Kazuhito Yokoyama, Hiroaki Itoh, Miyuki Enomoto, and Miki Ishiwata. "Discrepancies Between the Supports Needed for Discharge of Patients With Terminal Cancer to Family Caregivers and What Supports Were Actually Provided in Japan: Assessment of Palliative Care Unit Nurses." American Journal of Hospice and Palliative Medicine® 35, no. 4 (November 26, 2017): 704–11. http://dx.doi.org/10.1177/1049909117741586.
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Hadi Nugraha, Irfan. "Evaluasi Kinerja Operasional Terminal Cigasong Tipe C Kabupaten Majalengka Ditinjau Dari Penumpang Angkutan Umum." Jurnal Multidisiplin Indonesia 1, no. 1 (September 27, 2022): 154–66. http://dx.doi.org/10.58344/jmi.v1i1.11.
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Terminal merupakan prasarana transportasi yang berfungsi simpul dari sistem jaringan angkutan jalan yang berfungsi sebagai tempat naik turu penumpang. Permasalahan yang terjadi di Terminal Cigasong adalah bayank penumpang angkutan umum yang menggunakan terminal sebagai prasarana transportasi. Dalam penelitian ini membahas tentang evaluasi kinerja dan pelayanan terminal terhadap penumpang angkutan umum dengan metode analisis yang digunakan dengan cara Importance Performance Analisis (IPA) dan data yang digunakan adalah data primer yang didapatkan dari hasil suvei dengan cara penyebaran kuesioner kepada responden. Dari hasil penelitian didapatkan penilaian tentang kualitas pelayanan dan kepuasan pelanggan dengan variabel berwujud, kinerja, kenyamanan, kemudahan dan waktu terhadap terminal bahwa rata-rata kualitas pelayanan kurang baik dengan rata-rata tingkat harapan diperlukan untuk variabel yang telah ditentukan.
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Ishino, So, Yasushi Kawata, Hideki Taguchi, Katsumi Matsuzaki, and Masaru Hoshino. "1P075 Effect of C-terminal truncation of chaperonin GroEL on the yield of an in-cage folding of GFP(01D. Protein : Function,Poster,The 52nd Annual Meeting of the Biophysical Society of Japan(BSJ2014))." Seibutsu Butsuri 54, supplement1-2 (2014): S153. http://dx.doi.org/10.2142/biophys.54.s153_3.
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Ismail Ismail. "Prosedur dan Kendala Bongkar-Muat pada Terminal Petikemas PT. Pelindo Regional IV Cabang Makassar." Transformasi: Journal of Economics and Business Management 1, no. 4 (December 13, 2022): 80–86. http://dx.doi.org/10.56444/transformasi.v1i4.262.
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Penelitian ini bertujuan untuk mengetahui proses dan kegiatan bongkar-muat pada Terminal Petikemas Makassar, serta mengetahui kendala apa saja yang menghambat kelancaran proses kegiatan bongkar-muat di Petikemas PT. Pelindo Regional IV Cabang Makassar. Metode dalam penelitian ini yaitu dengan cara observasi langsung mengamati objek yang diselidiki atau langsung menyaksikan keadaan yang sebenarnya, serta melakukan wawancara kepada pegawai atau bagian perusahaan. Hasil yang diperoleh yaitu terdapat beberapa kendala yang menghambat kelancaran dalam proses bongkar muat, baik dalam proses penerimaan dan pengiriman petikemas tidak lain dari keterlambatan pengurusan dokumen, biasanya terjadi pembaharuan alat atau akses jalan diperbaiki di area pelabuhan terminal petikemas, gudang penyimpanan barang tidak mengikuti pola kerja terminal di terminal 7 hari/24 jam, sistem atau jaringan error dan bermasalah yang menimbulkan keterlambatan penginputan data dan lain-lain. Dalam pelayanannya terus berkomitmen untuk meningkatkan level of service yang jauh lebih bagus sebagai pelabuhan di wilayah timur Indonesia yang terdepan, yaitu dengan beberapa hal yang diterapkan untuk mengoptimalisasikan kinerja dan efisiensi waktu dalam proses pelayanan Receiving dan Delivery.
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Sulistyo, Aris Budi, Tumiran Anang Cundoko, Riz Rifai O. Sasue, Rahmat Ahmad, I. Putu Adi Suryasa, and Arif Devi Dwipayana. "Sistem Keselamatan Bagi Awak Kendaraan Bermotor Angkutan Barang Terminal." Madiun Spoor (JPM) 1, no. 2 (December 8, 2021): 57–62. http://dx.doi.org/10.37367/jpm.v1i2.188.
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Di era sekarang ini, Pengabdian kepada masyarakat (PKM) merupakan hal yang sangat berguna untuk dapat membina maupun untuk meningkatkan kualitas keselamatan hidup masyarakat. Angkutan Barang merupakan denyut nadi perpindahan barang dengan moda angkutan mobil barang ke daerah tujuan pengiriman dengan aman dan lancar dengan tujuan untuk memeuhikebutuhan masyarakat, kondisi sekarang masih banyak terjadinya kecelakann lalu lintas yang masih di dominasi oleh angkutan barang berserta awaknya, kedepan nya perlu mendapatkan perhatian khusus demi tercipta transportasi yang aman dan nyaman di masa mendatang. Dengan begitu, melalui beberapa dosen dan taruna yang terlibat, Politeknik Transportasi Darat (Poltrada) Bali melakukan kegiatan pengabdian masyarakat di sekitaran Terminal Barang di daerah Denpasar dengan merujuk terhadap sistem keselamatan bagi awak kendaraan bermotor angkutan barang. Dengan adanya sosialisasi PKM ini, tujuan yang diharapkan adalah angkutan barang beserta awaknya dapat memberikan rasa aman nyaman selama berkendara mengantarkan barang dalam hal ini adalah logistik tersebut sampai ke tujuan dalam keadaan aman dan lancar, dengan penyuluhan ini diharapkan awak kendaraan megetahui sistem keselamatan yang meliputi tata cara megemudi, memahami karakteristik angkutan barang dan persyaratan teknis angkutan barang. Kegiatan ini dilaksanakan dengan menggunakan metode mediasi dan pendidikan masyarakat dengan penyuluhan yang bertujuan untuk meningkatkan pemahaman serta kesadaran akan penting sistem keselamatan angkutan barang. Dari metode tersebut diharapkan sistem keselamatan angkutan barang menjadi tewujud, dan nantinya berpengaruh terhadap angka kecelakaan lalu lintas dari sektor angkutan barang menjadi menurun dari waktu ke waktu, sesuai program RUNK dapat terwujudnya Zero Ancident dari faktor pengguna jalan yang berkeselamatan (safer people)
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Permatasari, Nabilah Dinda, and Ertien Rining Nawangsari. "Pemberdayaan Anak Jalanan Oleh Komunitas “Save Street Child” Di Kabupaten Sidoarjo." JURNAL SOSIAL EKONOMI DAN HUMANIORA 8, no. 3 (September 30, 2022): 403–9. http://dx.doi.org/10.29303/jseh.v8i3.118.
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Proses pemberdayaan anak jalanan yang di lakukan oleh Komunitas Save Street Child di Kabupaten Sidoarjo. Sebagai upaya untuk anak jalanan, berbagai pengembangan dan kemajuan pembangunan belum mampu untuk mengatasi permasalahan tersebut. Maraknya anak jalanan merupakan sebuah isu serius yang perlu dicari jalan pemecahannya bersama. Anak jalanan timbul karena tingkat kemiskinan selalu meningkat dan jika dibiarkan dapat mengakibatkan kesenjangan sosial dan kriminalitas di lingkungan masyarakat. Keberadaan anak jalanan dapat ditemui dibanyak titik lokasi yang berada di Kabupaten Sidoarjo seperti perempatan jalan raya, terminal, Alun-Alun, jalan protokoler, bahkan mereka sering berlalu lalang di tempat makan/cafe yang dapat menyebabkan terganggunya ketertiban umum. Metode penelitian yang digunakan adalah kualitatif. Jenis data dan Sumber data penelitian berasal dari Informan/narasumber, dokumen, observasi, perpustakaan online, website, berita di media massa, dokumen, sumber buku, atau jurnal. Teknik pengumpulan data menggunakan observasi, wawancara, dan dokumentasi. Berdasarkan hasil penelitian dan pembahasan, menunjukkan bahwa proses pemberdayaan anak jalanan oleh komunitas Save Street Child Sidoarjo, belum sepenuhnya terlaksana. Karena dari tiga tahapan proses pemberdayaan yang meliputi tahap penyadaran, tahap pengkapasitasan dan tahap pendayaan, Hanya dua tahap yang terlaksana seutuhnya yaitu tahap penyadaran dan pengkapasitasan. Sedangkan tahap pendayaan belum terlaksana dengan maksimal
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Aji, Tri Prasetyo, and Dhita Utami. "Implementasi Program Corporate Social Responsibility (CSR) Pemberdayaan Disabilitas." Prospect: Jurnal Pemberdayaan Masyarakat 1, no. 3 (September 12, 2022): 95–105. http://dx.doi.org/10.55381/jpm.v1i3.40.
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Skizofrenia merupakan salah satu disabilitas mental yang tiap tahun semakin meningkat. Pun jumlah yang mengalami kekambuhan juga tergolong besar. Tergolong kelompok rentan, kota Denpasar memiliki cara unik dalam menangani Orang Dengan Skizofrenia (ODS). Melalui kolaborasi antara Dinas Sosial dan Pertamina Patra Niaga Fuel Terminal Sanggaran, program Rumah Berdaya hadir membantu Skizofrenia yang berada di area Kota Denpasar. ODS yang telah selesai melalui pengobatan di Rumah Sakit Jiwa Bali dapat melanjutkan tahap rehabilitasi jiwa di Rumah Berdaya. Fuel Terminal Sanggaran melalui program Corporate Social Responsibility (CSR) melihat peluang baik dalam pengembangan ekonomi produktif berbasis rehabillitasi dan pemberdayaan ODS Rumah Berdaya. Skizofrenia Entrepreneur (Skizopreneur) merupakan program pemberdayaan disabilitas berbasis rehabilitasi untuk ODS Rumah Berdaya melalui produksi dupa herbal Arusaji. Dupa herbal tersebut merupakan bentuk inovasi dengan menggunakan bahan baku kayu cendana sebagai bahan produksinya. Metode penelitian ini menggunakan metode studi kasus dengan pendekatan kualitatif dengan Teknik pengambilan data observasi dan wawancara. Program Skizopreneur tergolong program rintisan, namun berhasil dampak sosial, ekonomi, dan lingkungan. Pendampingan program terus dilakukan dalam periode peta jalan Skizopreneur dan pelaksanaan kegiatan ini bersifat kolaboratif.
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Yamafuji, Kazuo, and Takashi Kawamura. "Factory Tour to INA Facility, Nidec Sankyo." International Journal of Automation Technology 2, no. 2 (March 5, 2008): 141–43. http://dx.doi.org/10.20965/ijat.2008.p0141.
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1. Introduction of Nidec Sankyo and INA Facility Sankyo was established by three engineers in 1946 immediately after the Second World War as in the cases of Sony and Honda which were founded as venture enterprise and have developed to world leading companies. To begin with orgel, the company has produced high tech products such as machine tool, magnetic application machinery, optical instrument, card reader, and robot, appreciated by users. In 2003 the company became a member of Nidec group. The recent world market share of the company's product accounts for 80% in card reader for financial terminal, 70% in large LCD panel handling robot, 70% in COMBO type light pickup, and 40% in stepping motor for video camera. The company has sales of 112.6 billion yen and about 1,300 employees in 2007. The production and R&D facilities of Sankyo in Japan are located in Shimosuwa, Ina and Komagane. INA Facility we toured this time produces mainly industrial robot with the sales of 21 billion yen. The employees number about 180, 80 of them are engaged in design and development of machinery and electricity, 50 in manufacturing, and the rest, 50 in support business like purchase, production control and quality control.
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Lustyana, Astuteryanti Tri, and Adinda Viola Salsabila. "ANALISIS KUALITAS PELAYANAN TERHADAP KEPUASAN PENGGUNA BANDARA." Tekmapro : Journal of Industrial Engineering and Management 15, no. 2 (July 31, 2020): 13–24. http://dx.doi.org/10.33005/tekmapro.v15i2.178.
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Kualitas pelayanan yang ditawarkan kepada pelanggan harus diperhatikan oleh penyedia jasa, karena pelanggan semakin kritis dalam memilih penyedia jasa. Salah satu cara untuk mengukur kualitas pelayanan adalah dengan menggunakan metode Importance Performance Analysis yaitu dengan menghitung gap antara tingkat peformansi dengan tingkat kepentingan dari variable yang ditawarkan oleh perusahaan penyedia jasa. Salah satu bandara di Jakarta ingin mengetahui tingkat kepuasan pelanggan terhadap pelayanan yang telah diterima oleh pelanggan. Dari perhitungan terhadap kuesioner yang telah disebarkan oleh pengguna bandara ini, didapatkan hasil bahwa sebagian besar penumpang sangat puas terhadap keseluruhan pelayanan dan fasilitas yang disediakan oleh pihak bandara, ini ditunjukkan dari nilai CSI sebesar 95%. Namun jika dilihat dari nilai gap terdapat banyak layanan yang masih perlu ditingkatkan, tiga diantaranya adalah fasilitas berbelanja (0,43), harga fasilitas restoran/makanan (0,37), dan jarak jalan kaki di dalam terminal (0,37).
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Athena, Athena, Eva Laelasari, and Tities Puspita. "PELAKSANAAN DISINFEKSI DALAM PENCEGAHAN PENULARAN COVID-19 DAN POTENSI RISIKO TERHADAP KESEHATAN DI INDONESIA." JURNAL EKOLOGI KESEHATAN 19, no. 1 (June 25, 2020): 1–20. http://dx.doi.org/10.22435/jek.v19i1.3146.
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ABSTRACT
When the Covid-19 pandemic was established, various countries made efforts to prevent the transmission of the disease; Indonesia is no exception. One way to break the chain of transmission is to disinfect. This article is a scoping review with the aim of getting an overview of the implementation of disinfection in preventing Covid-19 transmission in public areas and possible health risks posed in several regions in Indonesia. The data/information were collected by searching websites of various ministries/institutions and online media within 3 (three) months, starting from March 2020 (establishment of the Covid-19 pandemic) until May 2020. Data and information collected includes location, procedures, and targets of disinfection, as well as disinfectants used, and their effects on health. Data analysis was performed descriptively. The results showed that disinfection in public areas were conducted in offices, health facilities (hospitals and health centers), housing, shopping centers/malls/market, transportation areas (highways, terminals, bus stops, and vehicles). Disinfection has been carried out by spraying directly on surfaces/objects that are often touched and by spraying in the disinfection booth using irritant disinfectants. It can be concluded that the implementation of disinfection in public areas has the potential to cause health risks. It needs supervision in the implementation of disinfection, socialization and education about potential health risks to the community.
Keywords: Disinfection, spraying, disinfection booths, public areas, disinfectants, health risks
ABSTRAK
Saat ditetapkannya status pandemi Covid-19, berbagai negara melakukan upaya pencegahan penularan penyakit tersebut; tidak terkecuali Indonesia. Salah satu cara untuk memutus rantai penularan adalah dengan melakukan disinfeksi. Artikel ini merupakan scoping review dengan tujuan untuk mendapatkan gambaran pelaksanaan disinfeksi dalam pencegahan penularan Covid-19 di area publik dan kemungkinan risiko kesehatan yang ditimbulkan. Cara pengumpulan data/informasi adalah dengan penelusuran website berbagai kementerian/lembaga dan media online dalam kurun 3 (tiga) bulan, yaitu mulai Maret 2020 (penetapan pandemi Covid-19) sampai dengan Mei 2020. Data dan informasi yang dikumpulkan meliputi acuan, lokasi, cara, sasaran disinfeksi, serta disinfektan yang digunakan, dan pengaruhnya terhadap kesehatan. Analisis data dilakukan secara deskriptif. Hasil menunjukkan bahwa disinfeksi di area publik, di perkantoran, fasilitas kesehatan (rumah sakit dan puskesmas), perumahan, pusat perbelanjaan/mall/pasar, dan area transportasi (jalan raya, terminal, halte, dan kendaraan) dilakukan dengan cara penyemprotan langsung terhadap permukaan/benda yang sering disentuh dan di dalam bilik disinfeksi, menggunakan disinfektan yang bersifat iritatif. Pelaksanaannya disinfeksi di beberapa area publik masih belum sesuai dengan Protokol/Pedoman Disinfeksi dalam Pencegahan Penularan Covid-19 sehingga berportensi menimbulkan risiko kesehatan. Dapat disimpulkan bahwa pelaksanaan disinfeksi di area publik berpotensi menimbulkan risiko kesehatan. Perlu adanya pengawasan dalam pelaksanaan disinfeksi dan sosialisasi serta edukasi tentang potensi risiko kesehatan terhadap masyarakat.
Kata kunci: Disinfeksi, penyemprotan, bilik disinfeksi, area publik, disinfektan, risiko kesehatan
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Khristoforova, Nadezhda K., Olga A. Gamayunova, and Andrey P. Afanasyev. "State of the Kozmin and Wrangel Bays (Peter the Great Bay, Japan Sea): dynamics of pollution with heavy metals." Izvestiya TINRO 180, no. 1 (March 30, 2015): 179–86. http://dx.doi.org/10.26428/1606-9919-2015-180-179-186.
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Pollution with heavy metals, as iron, manganese, zinc, copper, lead, nickel, and cadmium is considered for the coastal waters in two bights of Peter the Great Bay on the data of the metals content in tissues of the algae Sargassum miyabei and Saccharina japonica . The Fe and Mn indicate terrigenous runoff, the Zn and Cu - anthropogenic impact, and the Pb, Ni, and Cd are the tracers of industrial pollution. The content of Fe is the highest among heavy metals; its maximum concentrations are found in the top of the Kozmin Bay and at Cape Petrovsky in the Wrangel Bay. The Pb and Cd contents are higher at the small boats berthing in the Kozmin Bay. The Ni content is the highest (up to 4 mg/g) on reefs in front of the oil terminal in the Wrangel Bay and in the top of the Kozmin Bay that is possibly reasoned by shipping activity because Ni is included in all oils. The Zn concentration is the highest at the pier in the Wrangel Bay constructed of stone blocks. The contents of heavy metals in algae from these bights are compared with similar data from the Avachinsky Bay (Kamchatka), Nha-Trang Bay (Vietnam) and port Santos (Brazil); relatively high pollution of the Kozmin and Wrangel Bays by Pb is revealed. Pollution in these bights has mostly industrial and anthropogenic nature. The pollution with Ni and Cd decreased between 1995 and 2008, but became higher again in 2012-2013, the pollution with Mn, Zn and Fe also increased in 2012-2013.
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CHAN, Ho-mun. "末期病人的決策倫理: 三個模式的比較." International Journal of Chinese & Comparative Philosophy of Medicine 3, no. 4 (January 1, 2001): 45–55. http://dx.doi.org/10.24112/ijccpm.31411.
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LANGUAGE NOTE | Document text in Chinese; abstract also in English.本文討論末期病人的決策過程的三個模式，即個人主義、家長主義和家庭本位主義。個人主義過份偏重病人的抉擇，家長主義只強調從專業角度照顧病人的個人最佳利益，這兩個模式均會令家庭角色邊緣化。本丈認為家庭本位主義，更符合東方社會文化，從倫理角度來看亦較其他兩個模式可取。This paper critically examines the liberal, the medical paternalist, and the familial models of decision making for the terminally ill. It is argued that the liberal model is excessively patient centered while the medical paternalist model overemphasizes the role of the physician. The paper concludes that since both models marginalize the role of the family in the decision-making process, they are morally inadequate and not suitable for societies with strong family ethics, particularly those in Asia.The liberal model is predominant in the United States. According to this model, a competent patient can express in an advance directive her prior wish of how she is to be treated when she lapses into incompetency. In the absence of an advance directive or in cases where the directive is vague or ambiguous, the surrogate decision-making process will be invoked, which is normally a procedure in which the family makes the decision on the patient's behalf. In this process, the family serves to assist the incompetent patient to exercise her self-determination by figuring out and then following her counterfactual choice in accordance with the substituted judgment standard. If it is impossible to arrive at a decision by following this standard, the family, with the assistance of the physician, will follow the standard of best interests to promote the well-being of the patient. In sum, in the process of surrogate decision making, only the individual choice and interests of the patient are a matter of concern. Thus, the liberal model is entirely patient-centered. The role of the family is marginalized in the sense of being subordinated to the (previous or counterfactual) choice and interests of the patient. The family therefore becomes a "shadow" of the patient with no independent status and is deprived of its self-sufficiency.In the United Kingdom, medical paternalism is more influential. There is a preference for a code of practice to legislation for advance directives, and the prevalence of the best interest standard. Yet, unlike the liberal model, the best interests of the patient are not determined by the family in accordance with the standard of a reasonable person. Rather the doctor is expected to make decision for the patient in accordance with a responsible and competent body of relevant professional opinion in determining the patient's best interests. Though the family will often be consulted, the principal decision maker is the physician. So the role of the family is also marginal in this model.In Asian societies, e.g., Japan, Mainland China and Hong Kong, the family plays a fundamental role in the decision making for the terminally ill, so the model of familialism prevails. In these societies, it is common that the patient will not be informed directly of her terminal illness by the physician. The decision for the incompetent patient is regarded not as an individual but a family decision, and the dying process is viewed a sharing process, the last journey that the patient undergoes together with her significant others.In the familial model, the decision for a terminally ill patient is regarded not entirely as an individual matter because other members will be affected by the patient's choice. Should a son merely consider the wishes or the best interests of his father without considering the burden of care and the feelings of his mother while his father is going through the last stage of his life? Should the mother also consider the financial burden that her son might have to bear for his father if he were to be kept alive at all costs? Such issues would not have a place in the liberal and the medical paternalist models, for what matters is only the choice or the best interests of the patient. On the contrary, due considerations are given to these issues in the familial model, which makes it more plausible than the other two models.DOWNLOAD HISTORY | This article has been downloaded 15 times in Digital Commons before migrating into this platform.
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Farlinda, Sustin, Rinda Nurul, and Sapitri Adinta Rahmadani. "Pembuatan Aplikasi Filling Rekam Medis Rumah Sakit." Jurnal Kesehatan 5, no. 1 (February 11, 2019): 8–13. http://dx.doi.org/10.25047/j-kes.v5i1.47.
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Sistem informasi rekam medis sub bagian filling adalah informasi yang dihasilkan secara terkomputerisasi yang juga dapat digunakan untuk mempermudah petugas rekam medis di unit filling dalam pencarian dokumen rekam medis yang sedang dipinjam dan mempermudah dalam pelaksanaan retensi dengan studi kasus pada RSIA Srikandi IBI Jember. Filling adalah unit kerja rekam medis yang diakreditasi oleh Departemen Kesehatan yang berfungsi sebagai tempat pengaturan dan penyimpanan dokumen atas dasar sistem penataan tertentu melalui prosedur yang sistematis, sehingga sewaktu-waktu dibutuhkan dapat menyajikan secara cepat dan tepat. Pada sistem penyimpanan (filling) menggunakan Sentralisasi dengan penomoran Terminal Digit Filling, dengan jumlah rata-rata pasien rawat jalan 45-50 pasien dan rawat inap 10-15 pasien.Peneliti menggunakan jenis penelitian kualitatif yaitu untuk pengumpulan data dengan cara wawancara, observasi, FGD, serta dokumentasi dan menggunakan metode waterfall. Dalam proses perancangan sistem ini menggunakan Flowchart system, Contex Diagram, Data Flow Diagram, Entity Relationship Diagram serta dalam mengimplementasikan program menggunakan microsoft visual basic 6.0.Hasil dari penelitian ini adalah sistem informasi rekam medis filling untuk mempermudah petugas dalam mengontrol DRM di filling melalui peminjaman, pengembalian serta retensi. Peneliti selanjutnya diharapkan dapat mengintegrasikan pada SIMRS yang ada agar pengisian data rekam medis dapat secara otomatis muncul ketika di bagian filling.Kata kunci : Rekam Medis Filling, Waterfall, Contex Diagram ,Microsoft Visual Basic 6.0,
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Muizzatul Mukaromah. "PENERAPAN METODE FUZZY SUGENO UNTUK MENENTUKAN JALUR TERBAIK MENUJU LOKASI WISATA DI SURABAYA." Jurnal Matematika Sains dan Teknologi 20, no. 2 (September 27, 2019): 95–101. http://dx.doi.org/10.33830/jmst.v20i2.187.2019.
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This study aims to determine the best route to tourist sites in Surabaya. An optimal path will be obtained from three path choices. The method used is Sugeno Fuzzy Logic, by obtaining membership degrees with fuzzification and then being applied to the appropriate rules, followed by the deflation process to produce optimal and less optimal output. There are six tourist attractions to be visited including Tugu Pahlawan, Food Junction Pakuwon, Atlantis Land, Surabaya Zoo (KBS), Suroboyo Carnival, and Mangrove. There are three starting points (Surabaya City Hall, Purabaya Terminal, and Tanjung Perak Port). The criteria used in this study are distance to tourist attractions, time taken, and road density. These criteria were chosen based on almost all tourist locations in the city of Surabaya through the crowds along the main city lanes in Surabaya. Data is obtained through google maps by comparing three paths and the optimal path will be determined to be passed to get to tourist attractions in Surabaya. The results of this study obtained six optimal paths from each starting point.
Penelitian ini bertujuan untuk menentukan jalur terbaik menuju lokasi wisata di Surabaya. Akan diperoleh jalur optimal dari tiga pilihan jalur. Metode yang digunakan adalah logika fuzzy sugeno, dengan cara mendapatkan derajat keanggotaan dengan fuzzifikasi dan kemudian diimplikasikan ke dalam rule yang sesuai, dilanjutkan proses defuzzfikasi untuk menghasilkan output optimal dan kurang optimal. Terdapat enam tempat wisata yang akan dikunjungi diantaranya Tugu Pahlawan, Food Junction Pakuwon, Atlantis Land, Kebun Binatang Surabaya (KBS), Suroboyo Carnival, dan Mangrove. Ada tiga titik awal (Balaikota Surabaya, Terminal Purabaya, dan Pelabuhan Tanjung Perak). Kriteria yang digunakan pada penelitian ini adalah jarak ke tempat wisata, waktu yang ditempuh, dan kepadatan jalan. Kriteria tersebut dipilih berdasarkan hampir seluruh lokasi wisata yang ada di kota Surabaya melewati keramaian di sepanjang jalur utama kota yang ada di Surabaya. Data diperoleh melalui Google maps dengan membandingkan tiga jalur dan akan ditentukan jalur optimal yang akan dilewati untuk menuju tempat wisata di Surabaya. Hasil dari penelitian ini diperoleh enam jalur yang optimal dari setiap titik awal.
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Suparman, Suparman, Taruna Taruna, and Aljon Jekki Simbolon. "PROSES PEMUATAN COUNTAINER KE ATAS KAPAL KM.PAHALA PADA PT. SALAM PACIFIC INDONESIA LINES CABANG PALEMBANG." Journal of Maritime and Education (JME) 4, no. 1 (February 17, 2022): 353–57. http://dx.doi.org/10.54196/jme.v4i1.69.
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Pemuatan adalah barang berupa break bulk (barang yang tidak dimasukkan ke dalam peti kemas) yang akan dikapalkan atau barang yang dimasukkan ke dalam petikemas (container) untuk dikapalkan. Manfaat dari penulisan ini adalah untuk mengembangkan ilmu pengetahuan di bidang pengangkutan barang dengan melalui container, untuk mengetahui pelaksanaan kegiatan pemuatan container dari terminal petikemas ke kapal pada PT. Salam Pacific Indonesia Lines Cabang Palembang dan sebagai bahan masukan dan referensi bagi pembaca. Proses pemuatan container ke atas kapal KM. Pahala pada PT. Salam Pacific Indonesia Lines Cabang Palembang mencakup langkah-langkah, yaitu persiapan sebelum kapal tiba diadakan suatu pertemuan antara petugas yang akan terlibat di dalam pelaksanaan kegiatan muat. Juga alat-alat untuk memperlancar sistem operasional muatan container. Proses pemuatan container ke kapal harus berdasarkan bay plan yang sudah dibuat agar kapal aman saat berlayar. Hambatan-hambatan dalam kegiatan muat container pun kadang menjadi kendala seperti kerusakan peralatan muat di lapangan depo juga di pelabuhan, sering terjadi kemacetan di akses jalan dari lapangan depo menuju ke pelabuhan, pengaruh cuaca juga sangat menghambat proses kegiatan pemuatan container.Salah satu untuk dapat bertahan dalam era persaingan bebas adalah dengan cara meningkatkan efisiensi dan kinerja perusahaan. Lebih lanjut untuk mengetahui performa perusahaan dan meningkatkan efisiensi perusahaan secara menyeluruh adalah dengan cara mengetahui dengan baik aktivitas yang membangun perusahaan tersebut. Dengan adanya informasi yang cukup mendetail mengenai seberapa baik proses yang sedang dijalankan.Pengangkutan dengan menggunakan petikemas memungkinkan aktivitas muat dapat dimekanikasikan dengan lebih mudah. Hal ini bertujuan untuk memperoleh waktu pengoperasian yang lebih cepat, efektif, dan efisien baik proses pemuatan container maupun penanganan container di lapangan. Survei di lapangan dilakukan pada saat kapal sedang melakukan proses pemuatan container, dengan asumsi bahwa tiap kapal akan dilayani secepat mungkin dan juga apabila ada hambatan yang menghalangi pelaksanaan pemuatan container tentu harus ada solusinya yang sesuai dan efektif.
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Ohshima, Kazusato, Yuka Yamaguchi, Ryo Hirota, Tamaki Hamamoto, Kenta Tomimura, Zhongyang Tan, Teruo Sano, et al. "Molecular evolution of Turnip mosaic virus: evidence of host adaptation, genetic recombination and geographical spread." Journal of General Virology 83, no. 6 (June 1, 2002): 1511–21. http://dx.doi.org/10.1099/0022-1317-83-6-1511.
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Turnip mosaic virus (TuMV), a species of the genus Potyvirus, occurs worldwide. Seventy-six isolates of TuMV were collected from around the world, mostly from Brassica and Raphanus crops, but also from several non-brassica species. Host tests grouped the isolates into one or other of two pathotypes; Brassica (B) and Brassica–Raphanus (BR). The nucleotide sequences of the first protein (P1) and coat protein (CP) genes of the isolates were determined. One-tenth of the isolates were found to have anomalous and variable phylogenetic relationships as a result of recombination. The 5′-terminal 300 nt of the P1 gene of many isolates was also variable and phylogenetically anomalous, whereas the 380 nt 3′ terminus of the CP gene was mostly conserved. Trees calculated from the remaining informative parts of the two genes of the non-recombinant sequences by neighbour-joining, maximum-likelihood and maximum-parsimony methods were closely similar, and so these parts of the sequences were concatenated and trees calculated from the resulting 1150 nt. The isolates fell into four consistent groups; only the relationships of these groups with one another and with the outgroup differed. The ‘basal-B’ cluster of eight B-pathotype isolates was most variable, was not monophyletic, and came from both brassicas and non-brassicas from southwest and central Eurasia. Closest to it, and forming a monophyletic subgroup of it in most trees, and similarly variable, was the ‘basal-BR’ group of eight BR pathotype Eurasian isolates. The third and least variable group, the ‘Asian-BR’ group, was of 22 BR-pathotype isolates, all from brassicas, mostly Raphanus, and all from east Asia mostly Japan. The fourth group of 36 isolates, the ‘world-B’ group, was from all continents, most were isolated from brassicas and most were of the B-pathotype. The simplest of several possible interpretations of the trees is that TuMV originated, like its brassica hosts, in Europe and spread to the other parts of the world, and that the BR pathotype has recently evolved in east Asia.
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Marín Zuluaga, Dairo Javier. "La sociedad del conocimiento y las revistas depredadoras." Acta Odontológica Colombiana 9, no. 2 (July 1, 2019): 7–9. http://dx.doi.org/10.15446/aoc.v9n2.81692.
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Hace ya muchas décadas que la Odontología como profesión, se vinculó a la sociedad del conocimiento como mecanismo validador de su quehacer y motor de su evolución. En la actualidad, las universidades y las empresas del sector odontológico, cuentan con cada vez más personal vinculado a procesos de investigación, y la toma de decisiones clínicas hoy solo se concibe basada en la mejor evidencia científica disponible para cada caso.Se afirma que actualmente, cada 1 o 2 años aproximadamente, se renueva el conocimiento que la humanidad produce. Con ello, paralelamente se ha dado un desarrollo en la industria editorial, la cual se ha vuelto cada vez más competitiva para que los investigadores puedan realizar la publicación de sus trabajos; en tanto el objetivo de todo investigador es compartir sus resultados con la comunidad científica y académica con el fin de aportar al desarrollo de la sociedad.En esta constante evolución de la generación y transmisión del conocimiento, surgieron a finales de la década de 1980 las primeras publicaciones on-line de libre acceso (open acces), y hacia 1998, apareció la primera revista médica de este tipo, el Journal of Medical Internet Research (JMIR). Según un estudio de la Comisión Europea, para el año 2013 cerca del 50% de los artículos científicos publicados entre 2004 y 2011 en la Unión Europea (UE), Estados Unidos, Brazil, Canadá y Japón, se encontraban disponibles en libre acceso (1).Por otra parte, todas las publicaciones derivadas de los trabajos de investigación e innovación financiados por el programa de la UE, Horizonte 2020, entre 2014 y 2020, deberán ser de acceso abierto (2). Cada vez son más las instituciones y Estados que legislan en favor del libre acceso a la literatura científica, pues ha representado un gran avance para la expansión y democratización de la ciencia, en tanto elimina las barreras de acceso al conocimiento.A pesar de la innegable salud y futuro promisorio del movimiento de libre acceso; ha surgido un nuevo fenómeno, que, aunque sigue siendo residual, va en crecimiento y representa una trampa en la que pueden caer los investigadores en busca de revistas para la publicación de sus trabajos, o, que puede ser empleado por personas de ética cuestionable que ven aquí una oportunidad para inflar de manera fácil sus hojas de vida. Me refiero a la aparición de las revistas depredadoras (predatory journals and publishers).Cada vez es más frecuente recibir e-mails de revistas poco o completamente desconocidas, invitando a enviar nuestros trabajos, bajo la promesa de su publicación en un lapso de días o pocas semanas, asegurando una revisión por pares y ofreciendo unos costos de publicación que parecen bajos ante la posibilidad de una publicación asegurada.Sin embargo, estas revistas depredadoras, cometen al menos un triple fraude. Primero, engañan a los autores, pues no realizan la revisión por pares, con lo cual el investigador y el trabajo mismo a publicar, pierden la oportunidad de recibir retroalimentación por expertos en el tema de investigación. Segundo, afectan el acervo científico, al publicar trabajos que no han pasado por la validación de la comunidad científica, constituyéndose en un “negocio” económico cuyos réditos sociales constituyen la difusión de una ciencia de calidad cuestionable. Tercero, los dineros empleados en la financiación de los trabajos de investigación, terminan sin generar contraprestación alguna, con lo cual se está afectando no solo a los entes financiadores, sino a la sociedad entera.La publicación de un artículo de investigación, inicia con el proceso de evaluación por pares, lo cual, como ya se dijo, brinda al trabajo una gran oportunidad para su mejora. Además, los autores queremos que nuestras publicaciones tengan la mayor visibilidad posible, lo cual se logra solo si la revista donde publicamos cuenta con políticas editoriales rigurosas y se encuentra indexada en bases de datos de publicaciones científicas. Verificar la calidad de la revista a la que estamos pensando enviar uno de nuestros trabajos es hoy una tarea fácil; no habrá duda de que se trata de una revista académico–científica, si aparece en alguna de las siguientes fuentes:MIARDOAJERIH PlusDialnetScopus SourcesMaster Journal List – WoSCaso contrario, si la revista aparece en:List of predatory journalshttps://beallslist.weebly.comhttps://predatoryjournals.com/journals/https://beallslist.weebly.com/standalone-journals.htmlComo lo plantea Martínez “en la creación del nuevo conocimiento, sólo se supera la frontera de este, a través de la prevalencia del criterio de la verdad, es decir en que se constituya en un conocimiento verdadero” (3). Las revistas depredadoras, si bien son de acceso abierto, utilizan este sistema para conseguir fines económicos a través del engaño, en realidad no tienen que ver con el acceso abierto al conocimiento científico.
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"0457 Terminal care of ALS in Japan." Journal of the Neurological Sciences 238 (January 2005): S214—S215. http://dx.doi.org/10.1016/s0022-510x(05)80824-x.
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Funahara, Madoka, Sakiko Soutome, Mitsunobu Otsuru, Yuki Sakamoto, Hiromi Honda, Yumiko Ikegami, Nagato Natsume, Masahiro Umeda, and Atsuko Nakamichi. "Dental needs in palliative care and problems in dental hygienist education: survey study of palliative care ward homepage, university syllabus, and academic conference abstracts." BMC Palliative Care 21, no. 1 (July 30, 2022). http://dx.doi.org/10.1186/s12904-022-01029-9.
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Abstract Background Although end-of-life patients have a variety of oral-related symptoms, the involvement of dentists and dental hygienists in the palliative care teams is limited. This study investigates the current state of palliative care education in universities that train dentists and dental hygienists and the need for dentistry in the clinical setting of palliative medicine in Japan. Methods First, we investigated the involvement of dentistry in hospitals with palliative care units from a website. The number of reports on palliative care presented by dental hygienists at academic conferences around 2016, when the public medical insurance system in Japan covered oral care for patients with terminal illnesses, were examined. We also surveyed the syllabuses of the university that trained nurses, dentists, and dental hygienists to determine their education regarding palliative care. Results Of the 376 hospitals with palliative care units, 176 (46.8%) had dentistry in the hospital. Additionally, 321 hospitals (85.4%), which included those without dentistry, responded that they provided oral care by dentists and dental hygienists in the palliative care unit. There were only two presentations on palliative care in the annual meetings of the two major academic societies by dental hygienists between 2012 and 2016. However, this number increased rapidly to 47 between 2017 and 2020. The syllabus surveys showed that, compared to nursing universities, universities that trained dentists or dental hygienists had lesser education in palliative care. Furthermore, education in the universities that trained dental hygienists was mostly related to the oral care of patients with terminal illnesses, while the physical and mental conditions of end-of-life patients were not well educated. Conclusion Considering that society requires the involvement of dental hygienists in the field of palliative care, it is necessary to enhance basic and clinical education of palliative care in universities that train dentists and dental hygienists to provide good oral care to patients with terminal illnesses and contribute to improving their quality of life.
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"Announcement from The Japan Geriatrics Society Ethics Committee: the terminal care of the elderly." Geriatrics and Gerontology International 4, no. 1 (March 2004): 1–4. http://dx.doi.org/10.1111/j.1444-0594.2003.00122.x.
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