Financial Sustainability of the Japanese Medical Payment System: Analysis of the Japanese Medical Expenditure for Educational Hospitalization of Patients with Type 2 Diabetes

Japanese medical expenditures have increased rapidly in recent years and are predicted to continue rising. Indeed, it remains uncertain whether the current Japanese medical system can be sustained. In this paper, we analyzed the medical expenditures for educational hospitalization of patients with type 2 diabetes. A dataset of 6173 patients from 36 hospitals was used in the analysis. The sample period was from July 2008 to March 2012. We analyzed the medical expenditures in two ways. First, we analyzed the length of hospital stay (LOS). Next, we analyzed the daily expenditure per patient. The Box-Cox transformation model was used in the first analysis and the ordinary least squares method in the second. Comorbidities and complications prolonged LOS and increased daily expenditures. The LOS was significantly different among hospitals. On the other hand, the differences in daily expenditures among hospitals were relatively small, such that LOS was the main determinant of medical expenditures. Previous studies suggested that LOS could be shortened without degradation of medical quality. Moreover, LOS could be controlled by introducing proper critical paths and improving and standardizing educational programs. Hence, it would be possible to control the medical expenditures for this disease.

Empirical Analysis of Evaluation of English Teachers＇ Educational Ability Under MOOC Environment

In order to improve the English teachers＇ education ability evaluation accuracy, promote the upgrading of the level of English teacher education, the evaluation model of English teacher education ability is proposed in MOOC environment. Data fusion model of English teacher education ability evaluation index is obtained based on big data analysis method, data clustering analysis of English teaching evaluation indicators is carried out, Characteristic data of English Teaching are extracted, and combining fuzzy C means algorithm to analyze the characteristics of English teachers＇ educational ability in MOOC environment, adaptive mining evaluation of English teachers＇ educational ability is realized. Then we develop and design the evaluation system of English teacher education ability under the MOOC environment. The empirical data analysis is taken, and results show that it has good accuracy by using this method for evaluation of English teacher＇s ability, it improves the comprehensive evaluation level of English teachers.

Effects of physical activity by the teach-back educational method on the physical ability and quality of life in hemodialysis patients:a clinical trial

Objective:To determine the effect of physical activity by using the teach-back educational method on hemodialysis patients’quality of life(QOL)and physical ability.Methods:This is a single-blind clinical trial study involving a control group.A total of 90 patients who admitted to the dialysis centers of Beheshti and Besat hospitals in Hamadan were selected using a convenience sampling method and were randomly assigned to intervention(n=45)and control(n=45)groups.Data were collected using a demographic information checklist,a kidney disease QOL questionnaire,and a 6-minute-walk distance(6MWD)checklist.The patients’QOL questionnaire was completed,and the 6MWD was recorded before and at the end of the 2nd,4th,6th,8th,and 12th weeks of the intervention.In the intervention group,the patients were taught to perform physical activities with Pilates stretches in different resistances using the teach-back educational method during dialysis sessions for 12 weeks.Data were analyzed by using the independent t-test and chi-square test using SPSS-22 software.Results:Before the intervention,no differences were observed between the experimental and control groups in terms of demographic characteristics,QOL,and physical ability(P>0.05).The physical ability and QOL levels of patients exercising in the test group were higher than those in the control group after the intervention(P<0.05).Based on the results,the 2 groups significantly differed with regard to the scores of various dimensions of QOL and physical ability after the intervention(P<0.05).Conclusions:Physical activity by using the teach-back method can effectively increase physical ability and improve QOL of hemodialysis patients.Therefore,the recommendations and inclusion of exercise in the dialysis care plan can effectively promote patients’health.

ZnO Additive Boosts Charging Speed and Cycling Stability of Electrolytic Zn–Mn Batteries

Electrolytic aqueous zinc-manganese(Zn–Mn) batteries have the advantage of high discharge voltage and high capacity due to two-electron reactions. However, the pitfall of electrolytic Zn–Mn batteries is the sluggish deposition reaction kinetics of manganese oxide during the charge process and short cycle life. We show that, incorporating ZnO electrolyte additive can form a neutral and highly viscous gel-like electrolyte and render a new form of electrolytic Zn–Mn batteries with significantly improved charging capabilities. Specifically, the ZnO gel-like electrolyte activates the zinc sulfate hydroxide hydrate assisted Mn^(2+) deposition reaction and induces phase and structure change of the deposited manganese oxide(Zn_(2)Mn_(3)O_8·H_(2)O nanorods array), resulting in a significant enhancement of the charge capability and discharge efficiency. The charge capacity increases to 2.5 mAh cm^(-2) after 1 h constant-voltage charging at 2.0 V vs. Zn/Zn^(2+), and the capacity can retain for up to 2000 cycles with negligible attenuation. This research lays the foundation for the advancement of electrolytic Zn–Mn batteries with enhanced charging capability.

A Probe into the Application Ability of College English Teachers’ Educational Information Technology in the Information Age

With the arrival of the age of large information data, the education also gradually tends to educate the information, which has forced the demand of the teachers’ educational information technology application ability of the major universities and universities to be higher and higher. Therefore, in order to meet the needs of the development of higher education in the information age and to meet the needs of the college English teaching innovation, this paper will explore the application ability of the educational information technology of the college English teachers from various angles.

A Study of Innovative Education Practice Model to Strengthen the Training of Educational and Teaching Ability for Normal-school Students

Educational practice is far from being paid enough attention to in normal colleges and universities in China, and it has become aweak link in normal education. This problem is mainly manifested in the following aspects: the concept and content of educationalpractice lag behind the educational reform;the time of educational practice is too short;and the practice base is lacking. Therefore,innovative education practice mode is extremely important. In this paper, the problems existing in the educational practice ofnormal universities in China were analyzed, and the main countermeasures for the reform of the educational practice model ofnormal universities were put forward.

Virtual reality for preoperative patient education: Impact on satisfaction, usability, and burnout from the perspective of new nurses

BACKGROUND Traditional paper-based preoperative patient education is a struggle for new nurses and requires extensive training.In this situation,virtual reality technology can help the new nurses.Despite its potential benefits,there are studies on patient satisfaction but there is limited information on the usability of virtual reality(VR)technology for new nurses in giving preoperative education to patients.AIM To investigate the impact on satisfaction,usability,and burnout of a system using VR technology in preoperative patient education.METHODS The study involved 20 nurses from the plastic surgery ward and 80 patients admitted between April and May 2019.Each nurse taught four patients:Two using traditional verbal education and two using virtual reality.The System Usability Scale,After-Scenario Questionnaire,and Maslach Burnout Inventory(MBI)were employed to evaluate the impact of these education methods.RESULTS The VR education groups showed a statistically higher satisfaction than the traditional verbal education groups.Among the three subscales of the MBI,emotional exhaustion and personal accomplishment improved statistically significantly.VR was also better in terms of usability.CONCLUSION This study suggests VR enhances usability and reduces burnout in nurses,but further research is needed to assess its impact on depersonalization and objective measures like stress and heart rate.

Whole-process case management effects on mental state and selfcare ability in patients with liver cancer

BACKGROUND Regarding the incidence of malignant tumors in China,the incidence of liver cancer ranks fourth,second only to lung,gastric,and esophageal cancers.The case fatality rate ranks third after lung and cervical cancer.In a previous study,the whole-process management model was applied to patients with breast cancer,which effectively reduced their negative emotions and improved treatment adherence and nursing satisfaction.METHODS In this single-center,randomized,controlled study,60 randomly selected patients with liver cancer who had been admitted to our hospital from January 2021 to January 2022 were randomly divided into an observation group(n=30),who received whole-process case management on the basis of routine nursing mea-sures,and a control group(n=30),who were given routine nursing measures.We compared differences between the two groups in terms of anxiety,depression,the level of hope,self-care ability,symptom distress,sleep quality,and quality of life.RESULTS Post-intervention,Hamilton anxiety scale,Hamilton depression scale,memory symptom assessment scale,and Pittsburgh sleep quality index scores in both groups were lower than those pre-intervention,and the observation group had lower scores than the control group(P<0.05).Herth hope index,self-care ability assessment scale-revision in Chinese,and quality of life measurement scale for patients with liver cancer scores in both groups were higher than those pre-intervention,with higher scores in the observation group compared with the control group(P<0.05).CONCLUSION Whole-process case management can effectively reduce anxiety and depression in patients with liver cancer,alleviate symptoms and problems,and improve the level of hope,self-care ability,sleep quality,and quality of life,as well as provide feasible nursing alternatives for patients with liver cancer.

Preventing Pregnant Women’s Exposure to Secondhand Smoke: Development and Suitability Assessment of an Educational Comic Booklet

Aim: The aim of this mixed methods research was to develop an educational comic booklet to prevent pregnant women’s exposure to secondhand smoke. Methods: We assessed the suitability of the comic booklet by measuring participant response to content, literacy demand, graphics, layout and typography, learning stimulation, motivation, and cultural appropriateness. The participants were 17 Indonesians living in Japan who were recruited through Respondent-Driven-Sampling and met all criteria for the survey. Means and standard deviations were used to determine the suitability of the educational comic. Results: About 80% of participants rated the comic as “superior” on a rating scale with options of “superior”, “adequate”, “not suitable”, or “not applicable”. The most successful aspects of the comic were content and cultural appropriateness, as it provided clear contents and the graphics showed realistic Indonesian smoking behavior. The least successful aspect of the comic was the literacy demand because there were long sentences using difficult words. Conclusions: The results of this study may be used to conduct a randomized controlled trial using this comic booklet with some modifications.

Sustainability Capacity Building Based on Educational Method: A Case Study on China and Sweden Joint Program

Environmental Education and Education for Sustainable Development (EE&ESD) have been widely accepted as an effective educational method to contribute to capacity development and processes of change in developing countries. This paper takes SIDA supported EE&ESD in formal educationadvanced international training program, China as an example. By analyzing and reflecting its orientation, implementation, outcomes and evaluation, experiences and lessons learned are expected to help improve the sorts of international cooperation capacity building programs both from international and also Chinese perspectives.

Parental Educational Expectations,Academic Pressure,and Adolescent Mental Health:An Empirical Study Based on CEPS Survey Data

Background:This study aimed to investigate the relationship between parental educational expectations and adolescent mental health problems,with academic pressure as a moderating variable.Methods:This study was based on the baseline data of the China Education Panel Survey,which was collected within one school year during 2013–2014.It included 19,958 samples from seventh and ninth graders,who ranged from 11 to 18 years old.After removing missing values and conducting relevant data processing,the effective sample size for analysis was 16344.The OLS(Ordinary Least Squares)multiple linear regression analysis was used to examine the relationship between parental educational expectations,academic pressure,and adolescents’mental health problems.In addition,we established an interaction term between parents’educational expectations and academic pressure to investigate the moderating effect of academic stress.Results:The study found that adolescents whose parents had high educational expectations reported less mental health problems.(β=−0.195;p<0.001).Additionally,adolescents who had high academic pressure reported more mental health problems.(β=0.649;p<0.001).Furthermore,the study found that academic pressure had a significant moderating effect on the relationship between parental educational expectations and adolescents’mental health problems(β=0.082;p<0.001).Conclusion:Parental educational expectations had a close relationship with adolescents’mental health problems,and academic pressure moderated this relationship.For those adolescents with high levels of academic pressure,the association between high parental educational expectations and mental health problems became stronger.On the contrary,for those adolescents with low levels of academic pressure,the association between high parental educational expectations and mental health problems became weaker.These findings shed new light on how parental educational expectations affected adolescent mental health problems and had significant implications for their healthy development.

Reform of Hospitality English Teaching Based on the Educational Concept of Outcome-Based Education(OBE)

The Outcome-Based Education(OBE)educational concept,proposed by renowned American educator Spady,aims to guide students in mastering learning laws and ultimately achieving expected learning outcomes.The application of OBE educational concept in Hospitality English curriculum not only can effectively enhance the learning effect but also promote the reform of the Hospitality English curriculum,thus improving students’learning enthusiasm.Therefore,taking the Hospitality English curriculum as an example,this paper points out the existing problems in the teaching of this course and suggests the reform measures based on the OBE teaching concept,hoping to provide guidelines for related educational work.

Investigation of the Current Situation of Innovation Ability Education of Vocational College Students Under the Guidance of Ideological and Political Education

Innovation ability is the ability to continuously provide new ideas,theories,methods,and inventions with economic,social,and ecological values in the fields of technology and various practical activities.The ideological and political education of vocational school students should be student-oriented and close to reality and life.It is necessary to improve the pertinence,effectiveness,attractiveness,and infectiousness of ideological and political education,and cultivate socialist builders and successors with all-round development of morality,intelligence,physique,and beauty.In this paper,we investigate and understand the practice of innovation ability education in colleges and universities at home and abroad,especially the current situation of professional practice teaching in Xinjiang Vocational Colleges.The construction of a professional practice base in vocational colleges is systematically studied.

Influencing factors of self-management ability among dry eye patients in west China

AIM:To investigate the current situation and influencing factors of self-management ability in dry eye patients in west China.METHODS:A total of 265 patients clinically diagnosed with dry eye received a convenience survey questionnaire at West China Hospital of Sichuan University.All participants completed the rating scale of health self-management skill for adults(AHSMSRS),Huaxi Emotional-Distress Index(HEI),e-health literacy scale(e-HEALS)and Brief Illness Perception Questionnaire(Brief-IPQ).A generalized linear model was employed to establish a multivariate linear model with demographic data,psychological state,e-HEALS,and illness perception as independent variables and health selfmanagement skill score as the dependent variable.RESULTS:The mean score for health self-management skill was 165.58±15.79.Multivariate analysis revealed that advanced age,better illness perception and improved psychological state were associated with better health selfmanagement ability among dry eye patients.Furthermore,the health self-management ability of patients with a disease duration less than 1y was found to be higher compared to those with a disease duration exceeding 1y.CONCLUSION:The health self-management ability of dry eye patients in west China is relatively high.Age,duration of disease,illness perception and psychological state are the influencing factors on the health selfmanagement ability of dry eye patients.

Experimental Study on Wire Melting Control Ability of Twin-Body Plasma Arc

The twin-body plasma arc has the decoupling control ability of heat transfer and mass transfer,which is beneficial to shape and property control in wire arc additive manufacturing.In this paper,with the wire feeding speed as a characteristic quantity,the wire melting control ability of twin-body plasma arc was studied by adjusting the current separation ratio(under the condition of a constant total current),the wire current/main current and the position of the wire in the arc axial direction.The results showed that under the premise that the total current remains unchanged(100 A),as the current separation ratio increased,the middle and minimum melting amounts increased approximately synchronously under the effect of anode effect power,the first melting mass range remained constant;the maximum melting amount increased twice as fast as the middle melting amount under the effect of the wire feeding speed,and the second melting mass range was expanded.When the wire current increased,the anode effect power and the plasma arc power were both factors causing the increase in the wire melting amount;however,when the main current increased,the plasma arc power was the only factor causing the increase in the wire melting amount.The average wire melting increment caused by the anode effect power was approximately 2.7 times that caused by the plasma arc power.The minimum melting amount was not affected by the wire-torch distance under any current separation ratio tested.When the current separation ratio increased and reached a threshold,the middle melting amount remained constant with increasing wire-torch distance.When the current separation ratio continued to increase and reached the next threshold,the maximum melting amount remained constant with the increasing wire-torch distance.The effect of the wire-torch distance on the wire melting amount reduced with the increase in the current separation ratio.Through this study,the decoupling mechanism and ability of this innovative arc heat source is more clearly.

Analysis on the Way of Integrating Educational Drama into Patriotism Education for Primary School Students

In the process of patriotism education for primary school students,educational drama can play a very important role.However,the premise is that educational drama should be successfully integrated into the process of patriotism education of primary school students,instead of simply and mechanically stuffing educational drama into patriotism education of primary school students.As far as the integration mode of educational drama is concerned,educational drama can be divided into three kinds,namely,discipline-oriented drama education,infiltration-oriented drama education and activity-oriented drama.Therefore,the integration methods are also divided into three categories,namely,setting up educational drama courses,using educational drama to infiltrate patriotic education into other disciplines and carrying out activity-oriented drama education.

Effect of Y element on atomic structure, glass forming ability,and magnetic properties of FeBC alloy

The atomic structure of amorphous alloys plays a crucial role in determining both their glass-forming ability and magnetic properties. In this study, we investigate the influence of adding the Y element on the glass-forming ability and magnetic properties of Fe_(86-x)Y_xB_7C_7(x = 0, 5, 10 at.%) amorphous alloys via both experiments and ab initio molecular dynamics simulations. Furthermore, we explore the correlation between local atomic structures and properties. Our results demonstrate that an increased Y content in the alloys leads to a higher proportion of icosahedral clusters, which can potentially enhance both glass-forming ability and thermal stability. These findings have been experimentally validated. The analysis of the electron energy density and magnetic moment of the alloy reveals that the addition of Y leads to hybridization between Y-4d and Fe-3d orbitals, resulting in a reduction in ferromagnetic coupling between Fe atoms. This subsequently reduces the magnetic moment of Fe atoms as well as the total magnetic moment of the system, which is consistent with experimental results. The results could help understand the relationship between atomic structure and magnetic property,and providing valuable insights for enhancing the performance of metallic glasses in industrial applications.

Cultivation Path of Nursing Undergraduates’Scientific Research and Innovation Ability

Objective: The cultivation of the innovation ability and scientific research is one of the nursing learning objectives for undergraduate students. To explore the method and effect of training system of scientific research innovation ability of nursing undergraduates based on “3332”. Methods: Three course learning modules are constructed: stage-based course learning module, systematic project practice training module and comprehensive practice training module. A practical training platform for scientific research innovation projects is built, and undergraduate scientific research innovation ability training is carried out from both in-class and out-of-class lines. Results: Since 2017, the students have obtained 7 national innovation and entrepreneurship training programs, 52 university-level undergraduate scientific research projects, published more than 10 academic papers, and obtained 2 patent authorization. Conclusions: The training system of scientific research innovation ability of nursing undergraduates based on “3332” is conducive to the development of scientific research innovation ability of nursing students, and to cultivate nursing talents who can adapt to the development of the new era and have better post competence.

Effect of comprehensive intervention model based on drugpsychology-society-skills on medication compliance and cognitive ability of chronic schizophrenia patients

BACKGROUND The intervention value of a drug-psycho-social-skill model on medication compliance and cognitive ability in patients with chronic schizophrenia was unknown.AIM To explore the intervention value of a drug-psycho-social-skill model on medication compliance and cognitive ability in patients with chronic schizophrenia.METHODS Overall,98 out-patients and in-patients with chronic schizophrenia treated in our hospital from February 2022 to January 2023 were included and randomly divided into the study(50 patients)and control groups(48 patients).For 3 months,the control group was treated with conventional drugs,and the research group with a comprehensive intervention model of drug-psychology-society-skills.Data were obtained for the mini mental assessment scale(MMSE),Montreal cognitive assessment scale(MoCA),positive and negative symptom scale,insight and treatment attitude scale,cognitive ability scale and social skills[personal and social function scale(PSP)].The adverse reactions were observed.RESULTS After the intervention,the MMSE and MoCA scores improved in both groups.MoCA scores in the study group(26.58±3.21)were significantly(P<0.05)higher than those in the control group(24.68±3.02),MMSE scores were not significantly higher.Post-intervention,positive and negative symptom scores improved in both groups,and the positive and negative symptom scores in the study group[(12.01±2.58)and(32.51±2.11)]were significantly(P<0.05)different than those in the control group[(14.54±2.33)and(33.74±2.55)].Post-intervention,insight and treatment attitudes questionnaire scores of both groups were improved and compared with the control group(7.97±3.02),the study group(13.56±6.35)had significantly(P<0.05)higher scores.Post-intervention,the MATRICS consensus cognitive battery score of both groups was improved and compared with the control group(38.44±6.23),the score of the study group was significantly(P<0.05)increased(43.51±6.01).Post-intervention,the PSP score of the study group(78.38±6.63)was significantly(P<0.05)higher than that of the control group(74.52±7.01).During the intervention period,the incidence of adverse reactions in the study group was 6.25%,not significantly different from that in the control group(8.33%).During the intervention,both groups experienced adverse reactions,with no significant difference between groups(P>0.05).CONCLUSION The comprehensive intervention model based on drug-psychology-society-skills has obvious intervention effects on patients with chronic schizophrenia,which improves their cognitive ability and reduces their positive and negative symptoms.Simultaneously,it improves the self-knowledge of patients,improves their attitude toward treatment,effectively promotes the recovery of patients'social functions,and is safe.Therefore,it is worthy of being vigorously promoted and widely used in clinics.

Relationship between clinical belonging,professional identity,and nursing information ability among nursing interns:Model construction

BACKGROUND Clinical belonging refers to the feeling that clinical medical staff feel recognized and accepted by others or groups.The level of clinical belonging of nursing interns affects students’learning motivation and confidence,which in turn affects their clinical practice behavior.AIM To explore the effects of professional identity and nursing information ability on clinical belonging among nursing interns and establish a relationship model for these factors.METHODS The researchers used the convenience sampling method to select 682 nursing interns from China.The survey was conducted using a general information questionnaire,clinical sense of belonging scale,nursing information ability self-assessment scale,and a nursing student professional identity questionnaire.The mediating effect of nursing information ability between their professional identity and clinical sense of belonging was analyzed using SPSS 21.0 and the path analysis in structural equation modeling.RESULTS The total scores of clinical belonging,professional identity,and nursing information ability of nursing interns were(104.29±13.11)points,(57.89±7.16)points,and(70.29±6.20)points,respectively.Nursing information ability had a direct effect on the clinical sense of belonging(effect value=0.46,P<0.05).Occupational identity had a direct effect(effect value=0.52,P<0.05)and an indirect effect(effect value=0.21,P<0.05)on clinical belonging.CONCLUSION Nursing administrators in nursing colleges and hospitals should take effective measures to improve the professional identity and nursing information ability of nursing interns,as well as the clinical sense of belonging among nursing interns.