Relationship between structural characteristics and outcome quality indicators at health care facilities for the elderly requiring long-term care in Japan from a nationwide survey.

Aim: To clarify the performance situation of selected quality indicators: falls, pressure ulcers and dehydration, at health care facilities for the elderly in Japan, and what structural characteristics are related to them.

Methods: The operational population consisted of 1057 institutionalized users (approximately 10 randomly selected per facility) from a survey answered by the care staff. The facilities were divided into two groups according to their prevalence of negative outcomes (falls, pressure ulcers, dehydration): the best 25% (the very good performers) and the remaining 75% (not so good performers).

Factors associated with the use of home-visit nursing services covered by the long-term care insurance in rural Japan: a cross-sectional study.

Background: In Japan, there is a large increase in the number of elderly persons who potentially need home-visit nursing services (VNS). However, the number of persons using the VNS has increased only little in comparison to the number of individuals who use home social services, which are also covered by the Long-Term Care Insurance (LTCI) system. This cross-sectional study investigated the predictors of the VNS used under the LTCI system in Japan.

Factors that allow elderly individuals to stay at home with their families using the Japanese long-term care insurance system.

Aim: This study examined the factors that allow elderly individuals to stay at home continuously by considering the roles of the family caregiver, the use of services and characteristics of the elderly individual.

Methods: We analyzed 432 elderly individuals living at home with family. The outcome was that participants remained at home continuously over a 24-month period.

Factors that prolong the 'postmortem interval until finding' (PMI-f) among community-dwelling elderly individuals in Japan: analysis of registration data.

Objectives: To clarify the factors affecting 'postmortem interval until finding' (PMI-f) among elderly unexpected death cases.

Design: Cross-sectional study.

Setting: All area of Yamagata prefecture in Japan.

Effect of in-home and community-based services on the functional status of elderly in the long-term care insurance system in Japan.

Background: Japan is setting the pace among aging societies of the world. In 2005, Japan became the country with the highest proportion of elderly persons in the world. To deal with the accelerated ageing population and with an increased demand for long-term care services, in April 2000 the Japanese government introduced a mandatory social Long-Term Care Insurance System (LTCI), making long-term care services a universal entitlement for elderly.

Health benefits of reduced patient cost sharing in Japan.

Objective: To assess the effect on out-of-pocket medical spending and physical and mental health of Japan's reduction in health-care cost sharing from 30% to 10% when people turn 70 years of age.

Methods: Study data came from a 2007 nationally-representative cross-sectional survey of 10 293 adults aged 64 to 75 years. Physical health was assessed using a 16-point scale based on self-reported data on general health, mobility, self-care, activities of daily living and pain.

Scale development of health status for secondary data analysis using a nationally representative survey.

Objectives: Scale development of health-related quality of life (HRQOL) measures, including physical and mental health measures, among public datasets from Japan is needed for comparative studies on health conditions among different age, gender, and socio-economic subgroups. Multi-attributable scales of continuous/discrete variables on HRQOL could be more flexible for different kinds of epidemiologic and socio-econometric studies rather than single-item measures. The objectives of this study were to create multi-dimensional scales for physical, mental, and summary health measures and to describe the age-related trends of these scales in Japan.

Population ageing and wellbeing: lessons from Japan's long-term care insurance policy.

Japan's population is ageing rapidly because of long life expectancy and a low birth rate, while traditional supports for elderly people are eroding. In response, the Japanese Government initiated mandatory public long-term care insurance (LTCI) in 2000, to help older people to lead more independent lives and to relieve the burdens of family carers. LTCI operates on social insurance principles, with benefits provided irrespective of income or family situation; it is unusually generous in terms of both coverage and benefits.

Predictors of the highest long-term care expenditures in Japan.

Background: In Japan, as the number of elderly covered by the Long-term Care Insurance (LTCI) system has increased, demand for long-term care services has increased substantially and consequently growing expenditures are threatening the sustainability of the system. Understanding the predictive factors associated with long-term care expenditures among the elderly would be useful in developing future strategies to ensure the sustainability of the system. We report a set of predictors of the highest long-term care expenditures in a cohort of elderly persons who received consecutive long-term care services during a year in a Japanese city.

Studies on sea snake venom.

Erabutoxins a and b are neurotoxins isolated from venom of a sea snake Laticauda semifasciata (erabu-umihebi). Amino acid sequences of the toxins indicated that the toxins are members of a superfamily consisting of short and long neurotoxins and cytotoxins found in sea snakes and terrestrial snakes. The short neurotoxins to which erabutoxins belong act by blocking the nicotinic acetylcholine receptor on the post synaptic membrane in a manner similar to that of curare.

Mothers and daughters-in-law: a prospective study of informal care-giving arrangements and survival in Japan.

Background: Daughters-in-law have played an important role in informal care-giving arrangements within East Asian traditional norms. The aim of this study was to measure the impact of daughter-in-law care-giving on the survival of care recipients. We prospectively examined the associations between different types of kinship relationship between the main family caregiver and the care recipient in relation to survival among care recipients.

Collaboration between physicians and a hospital-based palliative care team in a general acute-care hospital in Japan.

Background: Continual collaboration between physicians and hospital-based palliative care teams represents a very important contributor to focusing on patients' symptoms and maintaining their quality of life during all stages of their illness. However, the traditionally late introduction of palliative care has caused misconceptions about hospital-based palliative care teams (PCTs) among patients and general physicians in Japan. The objective of this study is to identify the factors related to physicians' attitudes toward continual collaboration with hospital-based PCTs.

Comparison of public and private care management agencies under public long-term care insurance in Japan: a cross-sectional study.

Aim: Long-Term Care Insurance (LTCI), which started in April 2000, allowed private business corporations to provide long-term care services which had been provided by social welfare corporations or public agencies in the previous long-term care scheme. This study compared differences in care management plans for community-dwelling frail elderly people between public care management agencies and private care management agencies.

Methods: The subjects were 309 community-dwelling frail elderly people living in a suburban city with a population of approximately 55,000 and who had been using community-based long-term care services of the LTCI for 6 months from April 2000.

Relationship between home care service use and changes in the care needs level of Japanese elderly.

Background: With the introduction of long-term care insurance (LTCI) in Japan, more home care services are available for the community-dwelling elderly. To deliver effective home care services, it is important to know the effects of service use. In this study, as the first step to determine this, we sought to describe different home service use in the sustained/improved group and deteriorated group in their care needs levels, and to report the relationship between the use of home care services and changes in care needs levels.

Predictors of continuity in home care for the elderly under public long-term care insurance in Japan.

Background And Aims: With the rapid increase in the elderly population, the number of people requiring care is also increasing and the capacity of the family to provide care is decreasing. Because institutionalization costs are high, more research is needed to investigate predictors of preventing institutionalization. The aim of this study was to examine the impact of social engagement and other predictive factors, including disability, household composition, and formal services, on continuity in home care of the elderly.

[Two cases of complex sleep apnea syndrome].

Continuous positive airway pressure (CPAP) therapy of obstructive sleep apnea syndrome (OSAS) is widely accepted. Recently it is reported that central type apnea increases in some patients with OSAS with the application of CPAP, and this type of sleep-disordered breathing is called complex sleep apnea syndrome (comp. SAS).

Phase II trial of weekly gemcitabine and split-dose cisplatin for advanced non-small-cell lung cancer.

Objective: Cisplatin is widely used for the treatment of non-small-cell lung cancer. However, it can cause unpleasant side effects and also requires prolonged hydration. We conducted a Phase II study of weekly gemcitabine and split-dose cisplatin in patients with advanced non-small-cell lung cancer (NSCLC) in order to reduce toxicity and shorten the time taken by administration.

[The current situation regarding guarantees of legal rights to social welfare and nursing care in Japan: based on an analysis of adjudications spanning the period 1960 to 2005].

Purpose: To clarify whether people who need social care are legally guaranteed a "right to receive nursing-care services" as a living right in Japan.

Method: Using the database "Judicial Information System on CD-ROM" and journals which cover judicial precedents, such as "Supreme Court Reports" and "Judicial Reports", we searched for adjudications from 1960 to 2005 with 'living rights' as key words. The complete content of these adjudications was ascertained by reference to the journals.