Differences in facilities' acceptance of patients under long-term care insurance in Japan

OBJECTIVES: In April 2000, Japan launched a public, long-term care insurance (LTCI) plan for elderly people who need support. This study describes how medical support for the elderly is delivered at LTCI care facilities in Japan now and gaps between system goals and current activity. Recommendations are made for enhancing the implementation of LTCI. METHODS: We mailed questionnaires to all health service facilities for the elderly (HSF) and special nursing homes for the elderly (SNH) located in the Kyushu area of Japan, asking whether they would accept patients with nine specific conditions. RESULTS: We found that HSFs, which are required to employ a full-time doctor and are reimbursed at a higher rate, accept significantly fewer patients with four conditions that need medical support than are accepted by SNHs, which are not required to employ a full-time doctor. DISCUSSION: In this study, we find discrepancies between system goals and current activities at LTCI care facilities. For the Japanese LTCI system to work well in the limitation of medical resources, we must understand how it really works and to reform the system continuously.     

Explicit formulas for the smoother weights of the Whittaker–Henderson graduation of order 1

The Whittaker–Henderson (WH) graduation is a widely applied smoothing method. This paper contributes to the literature by providing explicit formulas for the smoother weights of the WH graduation of order 1 along with some related results, which leads to a richer understanding of the filter.     

Quantitative analyses of misclassification rates in the hazard classification of environmental chemicals: Evaluation of procedures for deriving predicted no-effect concentrations in the Chemical Substance Control Law in Japan

The quality of chemical management depends more or less on practical procedures used to assess chemicals. This study quantitatively assessed the efficacy of a derivation procedure for calculating no-effect concentrations for screening assessment of environmental hazards under the Chemical Substance Control Law in Japan. We first evaluated the derivation procedure by applying a series of test ecotoxicity datasets to the procedure and calculating the resulting misclassification rates of the hazardous class of chemicals. In this study, a chemical was deemed to have been misclassified if its classification differed from its classification based on the full dataset (chronic toxicity data for three trophic levels), which was defined as the correct assignment. We also calculated the effects of additional uncertainty factors to decrease the variance (i.e., to improve the consistency) of the misclassification rates among cases with different data availability in the derivation procedure. The results showed that the derivation procedure resulted in very high rates of misclassification when only particular sets of ecotoxicity data were available (e.g., only chronic toxicity data of algae were available). Our analyses also showed that the use of additional uncertainty factors improved the consistency of the misclassification rates within the derivation procedure. Our study presents a broadly applicable calculation framework for quantifying error rates in assessment procedures and serves as a case study for future development and reforms of chemical assessment processes and policies, while additional analyses using more extensive ecotoxicity data with various modes of actions are needed in the future.     

Records of rat control campaigns in a food market with the largest seafood trading volume worldwide

Urban Ecosystems - Brown rats (Rattus norvegicus) and roof rats (Rattus rattus) are among the most common mammals worldwide. Little is known about the effects of season on rat population size,...     

Asymptotic Distribution of Studentized Contribution Ratio in High-Dimensional Principal Component Analysis

In this article, we develop a nonparametric estimator for the Hölder constant of a density function. We consider a simulation study to evaluate the performance of the proposal and construct smooth bootstrap confidence intervals. Also, we give a brief review over the impossibility to decide whether a density function is Hölder.     

On Comparisons of Exact Powers of Bivariate GMANOVA Tests

Exact powers of four classical tests in a GMANOVA model are compared numerically when the order of the error sum of square matrix is 2. The four tests are likelihood ratio (=LR), Pillai's V, Hotelling's T ², and Roy's largest root tests. It turns out that for small sizes, there are a few cases in which Rothenberg's condition for the relative magnitude of asymptotic powers of three standard tests does not hold.     

Decline of Real Love and Rise of Virtual Love: Love in Asia

In Japan, marriage rates have declined since 1980, and interest in romantic relationships has declined in the 21st century. This article shows, mainly based on the official statistics and surveys, that (i) people in contemporary Japanese society have become less willing to get married or even date; (ii) various forms of virtual love have emerged; and (iii) they have spread in East Asian countries in general. Marriage stems from romantic relationships. Simultaneously, it brings with it new economic life. In Japan and other East Asian countries there is an unwritten norm that marriage should be part of economic life. Therefore, satisfying romantic emotions outside real love and marriage is accepted.