http://hdl.handle.net/10564/2773 2014-07 2026-04-10T15:42:33Z http://hdl.handle.net/10564/2779 タイトル: 第133回奈良医学会 : 学会記事 著者: 西村, 忠己; 染川, 智; 山田, 高嗣; 谷口, 克 2014-07-30T15:00:00Z http://hdl.handle.net/10564/2778 タイトル: 混合病棟における転倒・転落に関連したインシデントの要因分析と新しいアセスメントスコアの提案 著者: 下倉, 良太 抄録: A slip-and-fall assessment score sheet is filled out by a nurse for all inpatients to recognize which of them are more likely to fall, and assist them. Although the sheet is used daily in a mixed medical ward (Departments of Internal Medicine, Otorhinolaryngology, and General Medicine) in Nara Medical University Hospital, the sheet was originally established based on slip-and-fall cases that had arisen in a department of neurosurgery or orthopedic surgery. So we wondered, whether the sheet would also work effectively in a mixed medical ward that manages a greater variety of medical treatments and disease situations. Therefore, in this study, we gathered the slip-and-fall incident reports (77 persons) and clarified the characteristics and actual condition of the inpatients who had fallen. And we compared the scores obtained by the inpatients who had fallen (78 persons) and the inpatients who had not fallen (178 persons) for each item, and found the items that showed a significant difference in the averaged scores between these groups of inpatients. Following the results, we calculated odds ratios by multiple logistic regression using only the items with the significant differences, and improved the scoring system to suit the mixed medical ward. The actual condition survey established the fact that the inpatients have often fallen in their own room during the night. Inpatients with a previous history of falling, aged inpatients, and inpatients with physical pain were especially likely to fall, because the scores obtained by the inpatients who had fallen were significantly higher than those of the inpatients who had not fallen in the items that related to falling history, age, and pain. The proposed scoring system could make the difference in the scores obtained by inpatients who have fallen and those who have not broader, making it possible to detect the inpatients who might fall with higher accuracy in a mixed medical ward. 2014-07-30T15:00:00Z http://hdl.handle.net/10564/2777 タイトル: 医師年齢を考慮した地域診療所医師数の評価 著者: 大西, 丈二 抄録: Objective: Foresight and data analysis are important factors that can help in developing the health care system to suit the local requirements. The present study was designed to develop methods for analyzing physician resources in various areas. Methods: Data on clinic administrators, including their names, ages, and clinical departments, were collected using the Medical Information Net of Nara Prefecture, whereas the National Confirmation System was used to collect information on medical doctors. The data were classified into 3 groups according to the physicians' ages: <65, 66-75, and ≥76 years old. The mean number of departments was calculated and the data was represented schematically according to each group and municipality. Results: Six hundred one doctors(77.6%) were identified from 774 clinics, excluding overlapping data. Among these, 491 doctors (81.7%) were correctly registered according to the registration year. Three hundred seventy-one doctors (72.5%) were registered in 1961 and later; these doctors were assumed to be <76 years old. Three hundred seventy-one doctors (58.4%) were registered in 1971 and later, while 247 were registered (31.6%) in 1981 and later. The number of medical practitioners per 100,000 people increased in a few municipalities, which was mainly attributable to a decrease in the population size. Conclusion: The method developed in the present study provides a useful approach for estimating medical practitioner resources using the prefectural Medical Information Net and National Confirmation System. However, the method has some limitations because of missing data in the registries and lack of information regarding physicians who are not administrators. 2014-07-30T15:00:00Z http://hdl.handle.net/10564/2776 タイトル: 過去5年間の奈良県内における身元不明死体解剖事例の統計的考察 著者: 粕田, 承吾; 森村, 佳史; 工藤, 利彩; 川島, 渉; 勇井, 克也; 中西, 真理; 石谷, 昭子; 玉置, 盛浩; 羽竹, 勝彦 抄録: The authors made statistica1 observations of medico-1egal autopsy cases of unidentified bodies in the Department of Legal Medicine, Nara Medica1 University School of Medicine, during the last half decade(2009-2013). This study revealed that cases of unidentified bodies have been increasing. DNA tests, tooth appraisal, and finger prints were common methods for persona1 identification. The bodies discovered in their own houses accounted for the large part of total unidentified death and they were left unattended for a long period. A decomposed or skeletonized body was the primary cause of the unidentified cases. "Unknown" was more frequent than any other cause of death among the unidentified bodies. Determining the cause of death is essential for exact mortality statistics and improvement of pub1ic hea1th. Therefore, administrative supports and regiona1 partnerships are very important to reduce unattended death. Since autopsies for unidentified cases are more complicated than for identified cases, increasing the staff size in the Department of Legal Medicine is an urgent issue to cope with the increasing number of autopsy cases. 2014-07-30T15:00:00Z