scholarly journals Lessons Learned from the Japan Obstetric Compensation System for Cerebral Palsy: A Novel System of Data Aggregation, Investigation, Amelioration, and No-Fault Compensation

2020 ◽  
pp. 465-484
Author(s):  
Shin Ushiro ◽  
Antonio Ragusa ◽  
Riccardo Tartaglia
Keyword(s):  
Cerebral Palsy ◽  
Pathological Condition ◽  
Perinatal Care ◽  
Compensation System ◽  
Lessons Learned ◽  
Annual Reports ◽  
Perinatal Medicine ◽  
Quality Health ◽  
Fault Compensation ◽  
Risk Treatment

AbstractCerebral palsy is a pathological condition whose prevention and treatment have been immensely studied by experts in perinatal medicine and pediatric neurology. Despite this, it is still one of the main concerns nowadays in many countries, not only for scientific reasons but for legal ones also. For instance, in Japan, an increase in lawsuits relating to cerebral palsy was observed more than a decade ago, after healthcare resources in perinatal medicine had increasingly shrunk and had become fragile under the growing burden for physicians and midwives to provide advanced treatment, emergent care, high-risk treatment, and so on. Young physicians did not specialize in obstetrics because of the increased burden, which gave rise to a vicious cycle of shrinking resources in perinatal medicine. To address this issue, the Japan Obstetric Compensation System for Cerebral Palsy (JOCS-CP) was urgently introduced in 2009 to investigate, develop preventive measures, and award monetary compensation on a no-fault basis, with the Japan Council for Quality Health Care (JQ) as its operating organization (Fig. 33.1). It has so far produced annual reports on the prevention of cerebral palsy for nine consecutive years including numerical data and specific themes relating to the occurrence and prevention of cerebral palsy. The success of the system is a good reference for responding to adverse events which may happen in and have a vast impact on perinatal care. Therefore, this chapter focuses on cerebral palsy with primary reference to materials published by the JOCS-CP in the field of perinatal medicine. The aim of this chapter is to learn about the issues mentioned above and to discuss the significance and impact of introducing a nationwide system like the JOCS-CP. It describes knowledge and idea to questions of “Why cerebral palsy is highlighted among adverse event in obstetrics?”, “How the no-fault compensation/investigation/prevention system could be introduced?”, “What has been achieved by the system?”, and “How cerebral palsy is prevented?”.

scholarly journals Education in developing countries and reducing maternal mortality: a forgotten piece of the puzzle?

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Vedran Stefanovic
Keyword(s):  
Developing Countries ◽  
Maternal Mortality ◽  
Meta Analysis ◽  
Perinatal Care ◽  
Substantial Improvement ◽  
Global Strategy ◽  
Perinatal Medicine ◽  
Technological Advances ◽  
Women's Role

Abstract Despite substantial improvement in reducing maternal mortality during the recent decades, we constantly face tragic fact that maternal mortality (especially preventable deaths) is still unacceptably too high, particularly in the developing countries, where 99% of all maternal deaths worldwide occur. Poverty, lack of proper statistics, gender inequality, beliefs and corruption-associated poor governmental policies are just few of the reasons why decline in maternal mortality has not been as sharp as it was wished and expected. Education has not yet been fully recognized as the way out of poverty, improvement of women’s role in the society and consequent better perinatal care and consequent lower maternal mortality. Education should be improved on all levels including girls, women and their partners, medical providers, religious and governmental authorities. Teaching the teachers should be also an essential part of global strategy to lower maternal mortality. This paper is mostly a commentary, not a systematic review nor a meta-analysis with the aim to rise attention (again) to the role of different aspects of education in lowering maternal mortality. The International Academy of Perinatal Medicine should play a crucial role in pushing the efforts on this issue as the influential instance that promotes reflection and dialog in perinatal medicine, especially in aspects such as bioethics, the appropriate use of technological advances, and the sociological and humanistic dimensions of this specific problem of huge magnitude. The five concrete steps to achieve these goals are listed and discussed.

LEARNING THROUGH PLAYING FOR CHILDREN WITH CEREBRAL PALSY

2015 ◽  
Vol 78 (2-2) ◽  
Author(s):  
Nuraini Hidayah Sulaiman ◽  
Masitah Ghazali
Keyword(s):  
Cerebral Palsy ◽  
User Interface ◽  
Learning Process ◽  
Interface Design ◽  
User Study ◽  
Lessons Learned ◽  
Software Application ◽  
Children With Cerebral Palsy ◽  
Learning Software ◽  
Children Education

Guidelines for designing and developing a learning prototype that are compatible with the limited capabilities of children with Cerebral Palsy (CP) are established in the form of a model, known as Learning Software User Interface Design Model (LSUIDM), to ensure children with CP are able to grasp the concepts of a learning software application prototype. In this paper, the LSUIDM is applied in developing a learning software application for children with CP. We present a user study on evaluating a children education game for CP children at Pemulihan dalam Komuniti in Johor Bahru. The findings from the user study shows that the game, which was built, based on the LSUIDM can be applied in the learning process for children with CP and most notably, the children are engaged and excited using the software. This paper highlights the lessons learned from the user study, which should be significant especially in improving the application. The results of the study show that the application is proven to be interactive, useful and efficient as the users used it.

PREMATURITY AND CP: A COMMON CAUSE?

PEDIATRICS ◽  
1994 ◽  
Vol 93 (1) ◽  
pp. A72-A72
Keyword(s):  
Cerebral Palsy ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Perinatal Asphyxia ◽  
Perinatal Care ◽  
Developed Countries ◽  
Low Birth Weight Infants ◽  
Common Cause ◽  
Improvement In Survival

. . .cerebral palsy rates in infants with birth weights under 1500 g increased from 12.1 to 64.9 [per 1000 births]. These results, which are similar to those found in other developed countries, suggest that improved perinatal care, including increased use of interventions to prevent perinatal asphyxia, has improved neonatal survival but not the rate of cerebral palsy. In low-birth-weight infants the rising cerebral palsy rate has paralleled the improvement in survival; one explanation for this finding is that low birth weight and cerebral palsy both result from an insult that occurs well before birth.

scholarly journals Weekend and off-hour effects on the incidence of cerebral palsy: contribution of consolidated perinatal care

2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Satoshi Toyokawa ◽  
Junichi Hasegawa ◽  
Tsuyomu Ikenoue ◽  
Yuri Asano ◽  
Emi Jojima ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Cesarean Section ◽  
Medical Care ◽  
Perinatal Care ◽  
Night Shift ◽  
Significant Risk ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Emergent Cesarean Section ◽  
Spontaneous Delivery

Abstract Objective This study estimated the effects of weekend and off-hour childbirth and the size of perinatal medical care center on the incidence of cerebral palsy. Methods The cases were all children with severe cerebral palsy born in Japan from 2009 to 2012 whose data were stored at the Japan Obstetric Compensation System for Cerebral Palsy database, a nationally representative database. The inclusion criteria were the following: neonates born between January 2009 and December 2012 who had a birth weight of at least 2000 g and gestational age of at least 33 weeks and who had severe disability resulting from cerebral palsy independent of congenital causes or factors during the neonatal period or thereafter. Study participants were restricted to singletons and controls without report of death, scheduled cesarean section, or ambulance transportation. The controls were newborns, randomly selected by year and type of delivery (normal spontaneous delivery without cesarean section and emergency cesarean section) using a 1:10 case to control ratio sampled from the nationwide Japan Society of Obstetrics and Gynecology database. Results A total of 90 cerebral palsy cases and 900 controls having normal spontaneous delivery without cesarean section were selected, as were 92 cerebral palsy cases and 920 controls with emergent cesarean section. A significantly higher risk for cerebral palsy was found among cases that underwent emergent cesarean section on weekends (odds ratio [OR] 1.72, 95% confidence interval [CI] 1.06–2.81) and during the night shift (OR 2.29, 95% CI 1.30–4.02). No significant risk was found among normal spontaneous deliveries on weekends (OR 1.63, 95% CI 0.97–2.73) or during the quasi-night shift (OR 1.26, 95% CI 0.70–2.27). Regional perinatal care centers showed significantly higher risk for cerebral palsy in both emergent cesarean section (OR 2.35, 95% CI 1.47–3.77) and normal spontaneous delivery (OR 2.92, 95% CI 1.76–4.84). Conclusion Labor on weekends, during the night shift, and at regional perinatal medical care centers was associated with significantly elevated risk for cerebral palsy in emergency cesarean section.

scholarly journals Relevant Obstetric Factors for Cerebral Palsy: From the Nationwide Obstetric Compensation System in Japan

PLoS ONE ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. e0148122 ◽  
Author(s):  
Junichi Hasegawa ◽  
Satoshi Toyokawa ◽  
Tsuyomu Ikenoue ◽  
Yuri Asano ◽  
Shoji Satoh ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Compensation System ◽  
Obstetric Factors
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