Lightning strikes twice: Lessons learned from two food poisoning incidents in Japan

This case study examines the unique occurrence of two food contamination crises at Snow Brand Milk Products Co., Ltd., the top company in the Japanese milk product industry. The separate incidents of food poisoning occurred in 1955 and 2000; the latter incident, involving more than 10,000 victims, was the worst case of food poisoning in Japanese history.     

An introduction to the theory of constraint and how it can be applied to medical management

This overview of a new way of thinking about medical management problems could help physicians executives think about those problems differently.     

Incorporating historical controls using a random-effects model with a normal prior

Employing a variance stabilization transformation, a random-effects model with a normal prior is proposed for incorporating historical controls in the estimation of dose-response relationships. The advantages and disadvantages of maximum likelihood and empirical Bayes estimators are discussed. A two-stage method is introduced for the prudent use of historical controls.     

Benzene Risk Estimation Using Radiation Equivalent Coefficients

We estimated benzene risk using a novel framework of risk assessment that employed the measurement of radiation dose equivalents to benzene metabolites and a PBPK model. The highest risks for 1 μg/m³ and 3.2 mg/m³ life time exposure of benzene estimated with a linear regression were 5.4 × 10⁻⁷ and 1.3 × 10⁻³, respectively. Even though these estimates were based on in vitro chromosome aberration test data, they were about one-sixth to one-fourteenth that from other studies and represent a fairly good estimate by using radiation equivalent coefficient as an "internal standard."     

Procrastination, prompts, and preferences: Evidence from daily records of self-directed learning activities

This paper presents evidence showing that a libertarian paternalistic intervention having significant but uneven effects on the student procrastination of a coursework assignment. We observe the degree of procrastination in a language course at a Japanese university with individuals’ electronic records of daily activities. With a quasi-experiment that generates variations in the frequency of interventions and the preference of students towards the course, we examine the effects of in-class verbal prompts by an instructor on the timing of task completion. We find that prompts affect behavior, especially when reinforced, but the responsiveness depends on the class preferences and the timing of interventions.     

Assessment of vocational opportunities and continuing job placement for persons with mental disabilities: factors indicating levels of necessary support

We determined primary factors in allocating support for vocational opportunities and continuing job placement for clients with mental disabilities. The study analyzed 29 items regarding work attitudes and vocational skills for 70 clients as assessed by the Tokyo Metropolitan Rehabilitation Center for the Physically and Mentally Disabled. The evaluations were performed using the situational assessment approach with a 3-point support scale system assigned through observation of behavior. The results of these evaluations placed 35 clients in employment groups (A and B) and 35 clients in a sheltered workshop group (C). The data was analyzed by multivariate analysis. Predictions of success and functional differences among the groups were indicated by the data. Differences were found among the three groups in work attitudes and skills such as "self-direction" and "directions for social participation". Out of the 35 clients currently employed, 11 were recognized as needing ongoing assistance from supported employment offices. For the supported employment group (B), the major work attitudes and skills for which they required continuous services for maintaining stable jobs were 'emotional stability' and 'learning of working skills and accomplishment of work.' In a previous study, the major differences between the competitive employment group (A) and the sheltered workshop group (C) were in areas of 'responsibilities,' 'goals for life,' 'motivation for the work and understanding of contents for work,' and 'safety during work.' Our study supports these findings. In addition, transition from the sheltered workshop to supported employment required training to improve skills and support for 'responsibilities,' 'goals for life,' 'participation in leisure activities and community-based activities,' and 'preparation and cleaning for work.'     

Daily living abilities and work abilities of people with Parkinson's disease

A questionaire survey was conducted on 60 items of daily living abilities linked to 13 basic work abilities such as memory, learning, planning, muscular power and concentration etc. covering a total of 133 subjects with Parkinson's disease. Results of the survey were as follows: 1. Daily living abilities and work abilities decreased in accordance with Yahr's stages and the degree of daily living abilities. 2. Daily living abilities provided clues for aging and prognosis of the Parkinson's disease. 3. "Cope well with heat and coldness", "Being confident in the strength of legs and loins" and "Keep balance in the train" were difficult to do from the early stages of the onset. 4. Audio-visual ability, memory and judgement were well maintained despite the severity of the disease. 5. All subjects showed poor endurance, while learning, planning and manual dexterity showed higher performance in those under 59.