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Background Few studies have simultaneously collected quantitative data regarding the positive and negative effects of participating in post-bereavement surveys. Methods We conducted a cross-sectional postal questionnaire survey in October 2013. Potential participants were caregivers for family members who had died in four inpatient palliative care units, two home hospices, and a general hospital. We collected opinions regarding the distress and benefit of completing a post-bereavement survey. After collecting data, we provided feedback to participating institutions in the form of study results and de-identified open-ended comments. Results Of 692 potential participants, 596 were sent questionnaires; 393 returned questionnaires were valid and analyzed. Of the respondents, 62% reported being distressed by completing the questionnaire. Female participants and those who were mentally ill during the caregiving period reported more distress. However, 86% of respondents reported they found the questionnaire beneficial. Better quality of end-of-life care and respondent depression were associated with more benefit. Major benefits were: contributing to the development of end-of-life care as a family (63%); expressing gratitude to the hospital and medical staff (60%); and looking back and reflecting on the end-of-life period (40%). Feeling benefit was not correlated with feeling distressed (P = -0.02). Conclusion In this large-scale study on the effects of post-bereavement surveys in Japan, many bereaved family members reported that completing the survey was beneficial. In addition to possibly having feelings of distress, post-bereavement surveys might also be beneficial to end-of-life care facilities.

The Glasgow prognostic score (GPS), which uses C-reactive protein and albumin levels, is a good predictor of prognosis in cancer patients undergoing anti-tumor therapy. The objective of this study was to investigate the correlation between GPS and survival among cancer patients in palliative settings, as findings in such populations have not been well described. This was a subanalysis of a multicenter, prospective, cohort study in patients who were adults, diagnosed with advanced cancer, and first referred to palliative care service in Japan. Patients who were not receiving anti-tumor therapy and who had undergone laboratory examinations were eligible. Clinical features were analyzed to investigate prognostic factors. A total of 1160 patients were enrolled (41.6 % female; median age, 72 years). The independent predictors were Eastern Cooperative Oncology Group performance status (ECOG PS) score of 4 (hazard ratio (HR), 1.54), liver metastasis (HR, 1.21), dyspnea (HR, 1.35), edema (HR, 1.25), prognostic performance index (HR, 1.56), neutrophil-lymphocyte ratio (HR, 1.43), and GPS of 2 (HR, 1.36). The sensitivity and specificity for 3-week prognosis of a GPS of 2 were 0.879 and 0.410. Median survival time with GPS of 0, 1, and 2 was 58 days (95 % confidence interval, 48–81), 43 days (37–50), and 21 days (19–24), respectively (log-rank test, p

Background The Care Evaluation Scale (CES1.0) was designed to allow bereaved family members to evaluate the structure and process of care, but has been associated with a high frequency of misresponses. The objective of this study was to develop a modified version of CES1.0 (CES2.0) that would eliminate misresponses while maintaining good reliability and validity. Methods We conducted a cross-sectional questionnaire survey by mail in October 2013. The participants were bereaved family members of patients who died from cancer in seven institutions in Japan. All family members were asked to complete CES2.0, the short form CES1.0, items on overall care satisfaction, the Family Satisfaction with Advanced Cancer Care (FAMCARE) Scale, the Patient Health Questionnaire-9 (PHQ-9) and the Brief Grief Questionnaire (BGQ). To examine test-retest reliability, all participants were asked to complete a second CES2.0. Results Of 596 questionnaires sent, 461 (77%) were returned and 393 (66%) were analyzed. In the short form CES1.0, 17.1% of the responses were identified as misresponses. No misresponses were found in CES2.0. We identified 10 CES2.0 subscales similar to those in CES1.0 using exploratory factor analysis. Cronbach’s alpha was 0.96, and the intraclass correlation coefficient was 0.83. Correlations were found between CES2.0 and overall satisfaction (r = 0.83) and FAMCARE (r = 0.58). In addition, total CES2.0 scores were negatively correlated with the PHQ-9 (r = −0.22) and BGQ (r = −0.10). Conclusion These results suggest that CES2.0 eliminated misresponses associated with CES1.0 while maintaining good reliability and validity and greatly improving test-retest reliability.

Though G.P. zone formation had been widely recognized in Mg–Zn binary alloys, there still remained some ambiguity in resistivity increase by low temperature aging. Applying the previously improved method of reliable resistivity measurement, the increase in resistivity by low temperature aging of Mg–Zn binary and ZK60 alloys was quantitatively investigated. After solution treatment at 673 K for 86.4 ks, Mg–4~10mass%Zn alloy specimens sampled from ingots were aged at low temperatures below 373 K. The resistivity increase by aging at room temperature (R.T.: about 295 K) shows a clear and very long incubation period in all alloys and does not attain the peak until 40 Ms (1.25 year) aging. In the Mg–4mass%Zn alloy, the resistivity increase is not detected by the R.T. aging till 6 Ms. Because the ZK60 alloy containing 4.84%Zn shows a slight increase from 1 Ms, the incubation period of Mg–4mass%Zn alloy may be longer than 10 Ms. The highest aging temperature at which the resistivity increase due to G.P. zone formation is observed was 333 K. Very sharp resistivity peak on isothermal aging curve accompanying with a steep decrease is quite different from that of Al–10mass%Zn alloy. Up to the resistivity peak, a tendency is confirmed that the gradient of DMR corrected Matthiessen plot is smaller than that corresponding to precipitation of transition phases. Maximum increment in resistivity from as solution treated states is large in high alloys and low aging temperatures. Using these dependences of the maximum increment on solute concentration and aging temperature, a relation between composition and aging temperature is proposed for formation limit of G.P. zone which increases the resistivity.

A 73-year-old man was shot to death due to the misjudgment of his comrade while deer hunting. There were two wounds on the victim's body. One was a gunshot wound which had perforated his left brachium and constituted the entry wound on the outer brachium and the exit wound on the axilla. The other was the re-entry wound on the axilla just on the inner side of the former exit wound. These wounds were made by one pellet from nine-pellet-type buckshot ammunition. No other gunshot injury was found.

Resistivity changes during heat treatment and effects of solution treatment on aging behavior were investigated for an extruded ZK60 magnesium alloy containing 4.8%Zn, 0.52%Zr and Mn, Si and Pb less than 0.04% as impurities. Change in resistance ratio R(=ρ300/ρ77) with isochronal aging well corresponded with age-hardening. The increase in the solution treatment temperature resulted in the decreased R and increased resistivity ρ due to increased solute Zr concentration. The higher solution temperatures resulted in the increased maximum hardness and decreased incubation period aging. Particles containing Zn and Zr were observed remaining even after solution treatment at 773K for 36ks. Activation energy for the nucleation of precipitates below 473K was determined to be 70.5 to 76.3kJ/mol based on the incubation period for change in R. Empirical relation between R and ρD77. for the present alloy was obtained as follows: 11

With particular attention to the thermal stain and the specimen thickness effect, the energy and the entropy for the formation of a vacancy in pure aluminium were carefully determined from the measurement of quenched-in resistivities. The energy and the entropy thus obtained are 0.702±0.003 eV and 1.69±0.06 k , respectively. Free energies for the migration and the binding of a divacancy at temperatures 85±5°C were also determined from the initial decay rate on isothermal annealing of quenched-in resistivities, which are 0.43±0.02 eV and 0.14±0.02 eV, respectively.