[End-of-life care in a special elderly nursing home characteristics of patients who died in nursing home facilities and current status of end-of-life decision-making].

AIM: We investigated the characteristics of people who died in a special elderly nursing home and the current status of end-of-life decision-making. METHODS: Subjects comprised 168 residents who were discharged from a special elderly nurshing home in Yokohama between April 1998 and June 2008. A total of 3 patients were excluded from this study due to insufficient inclusion criteria. We collected and retrospectively examined the basic descriptive information regarding the terminal phase of care from medical records, death certificates, and the notes of nurses, caregivers and counseling staff. RESULT: Of a total of 165 subjects comprising 38 men (23%) and 127 women (77%), 30 (18%) died in a nursing home facility (facility mortality group), 101 (61%) died in hospitals (hospital mortality group) and 34 (21%) were discharged from special elderly nursing homes for transfer to long-term hospitalization (hospitalization group). To clarify the factors which led to death within the facilities, we analyzed: 1) age at discharge, 2) sex, 3) residency period, 4) number of hospitalizations, 5) length of hospital stay, 6) number of children, 7) number of conferences regarding end-of-life care in 2 groups: the facility mortality group and all others as the second group, as explanatory variables on multiple discriminant analysis. This revealed a higher number of conferences, a higher age at discharge, and a smaller number of hospitalizations in the facility mortality group. Only 12 (7%) people were able to convey by themselves how they wanted to spend the remainder of their lives, and 61 (37%) people conveyed this information via family members. However, 100 (61%) people were unable to confirm it by either self-report or family members. CONCLUSION: The people who died in special elderly nursing homes had a higher age, fewer hospitalizations, and had been involved in more conferences regarding terminal care. However, it was very hard to confirm individual intentions regarding terminal care periods. Further studies will be necessary to determine what kind of terminal care is needed in special elderly nursing homes when it is difficult to confirm individual or family intention regarding the terminal period.

Fe-Ni composition dependence of magnetic anisotropy in artificially fabricated L1 0-ordered FeNi films.

We prepared L10-ordered FeNi alloy films by alternate deposition of Fe and Ni monatomic layers, and investigated their magnetic anisotropy. We employed a non-ferromagnetic Au-Cu-Ni buffer layer with a flat surface and good lattice matching to L10-FeNi. An L10-FeNi film grown on Au6Cu51Ni43 showed a large uniaxial magnetic anisotropy energy (Ku = 7.0 × 10(6) erg cm(-)3). Ku monotonically increased with the long-range order parameter (S) of the L10 phase. We investigated the Fe-Ni composition dependence by alternating the deposition of Fe 1 − x and Ni 1 + x monatomic layers (− 0.4 < x < 0.4). Saturation magnetization (Ms) and Ku showed maxima (Ms = 1470 emu cm(-3), Ku = 9.3 × 10(6) erg cm(-3)) for Fe60Ni40 (x = -0.2) while S showed a maximum at the stoichiometric composition (x = 0). The change in the ratio of lattice parameters (c/a) was small for all compositions. We found that enrichment of Fe is very effective to enhance Ku. The large Ms and Ku of Fe60Ni40 indicate that Fe-rich L10-FeNi is promising as a rare-earth-free permanent magnet.