WorldWideScience

Sample records for survivors nationwide survey

  1. Awareness about past diagnosis and treatment history: nationwide survey of childhood cancer survivors and their parents.

    Science.gov (United States)

    Ahn, Eunmi; Park, Hyeon Jin; Baek, Hee Jo; Hwang, Pyoung Han; Lee, Young Ho; Park, Byung-Kiu; Kim, Young So; Shim, Hye-Young; Shin, Dongwook; Yang, Hyung Kook; Park, Jong Hyock; Park, Kyung Duk

    2017-10-01

    To assess the awareness of past medical history and long-term care issues of childhood cancer survivors (CCS) in Korea. A nationwide survey was conducted on CCS and their parents in 10 regional cancer centers in Korea. Answers regarding cancer diagnosis and treatment history were compared with the treatment summary and categorized into three ('specific,' 'general,' and 'no') or two ('yes' and 'no') groups. Out of 343 contacts, 293 dyads completed the survey, and 281 dyads were analyzed. Awareness of cancer diagnosis was mostly specific for parents (76.5%) and CCS (35.2%). Awareness of anti-cancer treatment exposure was mostly general (84.6% for surgery, 67.9% for chemotherapy, and 53.9% for hematopoietic stem cell transplantation) rather than specific. In particular, more than half of the parents were not aware of the exposure to cardiotoxic agents (72.9%) or radiation therapy (56.3%). Providing information about long-term side effects and prevention of secondary cancer was significantly correlated only with more concern and more follow-up visits (P ≤ 0.001, respectively), without correlation with more specific awareness of exposure to cardiotoxic agents or radiation. Most of the parents of CCS were not aware of treatment-related risk factors necessary for long-term care. Providing information was significantly correlated with more concern and more follow-up visits, without improving corresponding knowledge about their past medical history. Effort aimed towards improving awareness about risk factors, the manner of providing information, and the patient referral system within which we use this information is warranted. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  2. Health Behaviors of Cancer Survivors in Nationwide Cross-Sectional Survey in Korea: Higher Alcohol Drinking, Lower Smoking, and Physical Inactivity Pattern in Survivors with Higher Household Income.

    Science.gov (United States)

    Park, Boyoung; Kong, Sun-Young; Kim, Jeongseon; Kim, Yeol; Park, In Hae; Jung, So-Youn; Lee, Eun Sook

    2015-08-01

    This study investigated the prevalence of smoking, alcohol consumption, and physical activity in cancer survivors and examined the sociodemographic factors affecting these health-related behaviors.We used data from the 4th and 5th Korean National Health and Nutrition Examination Survey conducted between 2007 and 2012, which identified 1153 cancer cases and 36,451 people without a history of cancer ≥20 years of age. We used a structured questionnaire to obtain information concerning cancer diagnosis, health-related behaviors, and sociodemographic characteristics.The proportion of cancer survivors who were current drinkers, heavy drinkers, current smokers, or engaged in physical activity were 49.1, 9.0, 9.2, or 50.7%, respectively. Compared with people with no history of cancer, cancer survivors were less likely to be current drinkers (odds ratio [OR] = 0.45; 95% confidence interval [CI] 0.36-0.56), heavy drinkers (OR = 0.53; 95% CI 0.36-0.78), current smokers (OR = 0.37; 95% CI 0.24-0.55), or physically inactive (OR = 0.77; 95% CI 0.63-0.95). Cancer survivors with higher household incomes had higher odds of current drinking and heavy drinking (P trend = 0.039 and 0.033, respectively) and were less likely to be current smokers or physically inactive (P trend = 0.016 and 0.046, respectively). Age, sex, sites of cancer, and the time since diagnosis affected the health behaviors in cancer survivors. Furthermore, we confirmed that these unhealthy behaviors are interrelated.We found that household income had a bidirectional effect on health behaviors and confirmed an aggregation of unhealthy lifestyles. Identification of survivors vulnerable to unhealthy lifestyles, focusing on household income level would allow intervention programs to be more effective.

  3. Mode of primary cancer detection as an indicator of screening practice for second primary cancer in cancer survivors: a nationwide survey in Korea

    Directory of Open Access Journals (Sweden)

    Suh Beomseok

    2012-11-01

    Full Text Available Abstract Background While knowledge and risk perception have been associated with screening for second primary cancer (SPC, there are no clinically useful indicators to identify who is at risk of not being properly screened for SPC. We investigated whether the mode of primary cancer detection (i.e. screen-detected vs. non-screen-detected is associated with subsequent completion of all appropriate SPC screening in cancer survivors. Methods Data were collected from cancer patients treated at the National Cancer Center and nine regional cancer centers across Korea. A total of 512 cancer survivors older than 40, time since diagnosis more than 2 years, and whose first primary cancer was not advanced or metastasized were selected. Multivariate logistic regression was used to examine factors, including mode of primary cancer detection, associated with completion of all appropriate SPC screening according to national cancer screening guidelines. Results Being screen-detected for their first primary cancer was found to be significantly associated with completion of all appropriate SPC screening (adjusted odds ratio, 2.13; 95% confidence interval, 1.36–3.33, after controlling for demographic and clinical variables. Screen-detected cancer survivors were significantly more likely to have higher household income, have other comorbidities, and be within 5 years since diagnosis. Conclusions The mode of primary cancer detection, a readily available clinical information, can be used as an indicator for screening practice for SPC in cancer survivors. Education about the importance of SPC screening will be helpful particularly for cancer survivors whose primary cancer was not screen-detected.

  4. Nationwide rural well water survey

    International Nuclear Information System (INIS)

    Korkka-Niemi, K.; Sipilae, A.; Hatva, T.; Hiisvirta, L.; Lahti, K.; Alfthan, G.

    1993-01-01

    The quality of water in 1 421 drinking-water wells was monitored in a nationwide well water study. Samples were taken once from all wells, and during three seasons from 421 wells. The wells were selected in such a way that me sample would be as representative as possible of the quality of the drinking-water in households' own wells in rural areas. The study comprised general water quality parameters, influence of sampling season, and factors related to the type, the condition and the pollution of the wells. In part of the well waters selenium, radioactivity and pesticides were determined. The effect of plumbing materials on the quality of water was also examined. (33 refs., 148 figs., 71 tabs.)

  5. Prevalence and Risk Factors of Early Endocrine Disorders in Childhood Brain Tumor Survivors : A Nationwide, Multicenter Study

    NARCIS (Netherlands)

    Clement, Sarah C; Schouten-van Meeteren, Antoinette Y N; Boot, Annemieke M; Claahsen-van der Grinten, Hedy L; Granzen, Bernd; Sen Han, K; Janssens, Geert O; Michiels, Erna M; van Trotsenburg, A S Paul; Vandertop, W Peter; van Vuurden, Dannis G; Kremer, Leontien C M; Caron, Hubert N; van Santen, Hanneke M

    2016-01-01

    Purpose To evaluate the prevalence of, and risk factors for, early endocrine disorders in childhood brain tumor survivors (CBTS). Patients and Methods This nationwide study cohort consisted of 718 CBTS who were diagnosed between 2002 and 2012, and who survived ≥ 2 years after diagnosis. Patients

  6. Prevalence and Risk Factors of Early Endocrine Disorders in Childhood Brain Tumor Survivors: A Nationwide, Multicenter Study

    NARCIS (Netherlands)

    Clement, Sarah C.; Schouten-van Meeteren, Antoinette Y. N.; Boot, Annemieke M.; Claahsen-van der Grinten, Hedy L.; Granzen, Bernd; Sen Han, K.; Janssens, Geert O.; Michiels, Erna M.; van Trotsenburg, A. S. Paul; Vandertop, W. Peter; van Vuurden, Dannis G.; Kremer, Leontien C. M.; Caron, Hubert N.; van Santen, Hanneke M.

    2016-01-01

    Purpose To evaluate the prevalence of, and risk factors for, early endocrine disorders in childhood brain tumor survivors (CBTS). Patients and Methods This nationwide study cohort consisted of 718 CBTS who were diagnosed between 2002 and 2012, and who survived ≥ 2 years after diagnosis. Patients

  7. Prevalence and Risk Factors of Early Endocrine Disorders in Childhood Brain Tumor Survivors: A Nationwide, Multicenter Study

    NARCIS (Netherlands)

    Clement, S.C.; Schouten-van Meeteren, A.Y.; Boot, A.M.; Claahsen-van der Grinten, H.L.; Granzen, B.; Han, K.; Janssens, G.O.; Michiels, E.M.; Trotsenburg, A.S. van; Vandertop, W.P.; Vuurden, D.G. van; Kremer, L.C.; Caron, H.N.; Santen, H.M. van

    2016-01-01

    Purpose To evaluate the prevalence of, and risk factors for, early endocrine disorders in childhood brain tumor survivors (CBTS). Patients and Methods This nationwide study cohort consisted of 718 CBTS who were diagnosed between 2002 and 2012, and who survived >/= 2 years after diagnosis. Patients

  8. A Nationwide Survey of Environmental Protection.

    Science.gov (United States)

    Erdos & Morgan, Inc., New York, NY.

    This study was made in two phases. Phase I was conducted to obtain extensive information about "The Wall Street Journal's" subscribers on their business activities, purchasing influence, involvement in pollution control, personal resources, etc. Those personally active in anti-pollution programs received a second survey dealing with environmental…

  9. Pediatric radiation therapy. A Japanese nationwide survey

    International Nuclear Information System (INIS)

    Nemoto, Kenji; Nagata, Yasushi; Hirokawa, Yutaka

    2006-01-01

    A national survey on the current status of pediatric radiation therapy was performed in October 2004. We sent questionnaires to 638 radiotherapy facilities in Japan (except for Kansai area) and 245 responses were analyzed. According to the database of committee of Japanese Society of Therapeutic Radiology and Oncology (JASTRO), the number of pediatric patients who received radiation therapy during 2003 in Japan was 1,101. The most frequent pediatric malignancy was brain tumor, followed by leukemia and lymphoma. The total effort of radiation therapy for children was two to six times larger than that for adult patients. An additional fee seems to be necessary for the highly technical and laborious radiation therapy required for children. (author)

  10. Nationwide survey of resuscitation education in Finland.

    Science.gov (United States)

    Jäntti, H; Silfvast, T; Turpeinen, A; Paakkonen, H; Uusaro, A

    2009-09-01

    Good-quality cardiopulmonary resuscitation (CPR) is highlighted in the International Resuscitation Guidelines, but clinically the quality of CPR is often poor. Education of CPR has a major role in the primary skills imparted to students. Different methods can be used to teach CPR quality. We evaluated the current status of their usage in Finland institutes teaching students of emergency medicine at different levels. The following institutes were included in an anonymous survey: medical schools (teaching future physicians), universities of applied sciences (paramedics), colleges (emergency medical technicians) and emergency services college (fire-fighters). Hours of teaching theory lessons of CPR and hours of small group training were evaluated. In particular, we focussed on the teaching methods for adequate chest compression rate and depth. Twenty-one of 30 institutes responded to the questionnaire. The median for hours of theory lessons of CPR was 8h (range: 2-28 h). The median for hours of small group training was 10 (range: 3-40 h). The methods of teaching adequate chest compression rate were instructors' visual estimation in 28.5% of the institutions, watch in 33.3%, metronome in 9.5% and manikins' graphic in 28.5% of institutions. The methods of teaching adequate chest compression depth were instructors' visual estimation in 33.3%, in manikins light indicators in 23.8% and manikins' graphics in 52.3% of institutions. The hours of theoretic lessons and small group training vary widely among different institutes. In one-third of institutions, the instructor's visual estimation was a sole method used to teach adequate chest compression rate and depth. Different technical methods were surprisingly seldom used.

  11. Nutritional survey of atomic bomb survivors, 1

    International Nuclear Information System (INIS)

    Murakami, Fumiyo; Tanigawa, Junko; Ito, Chikako

    1978-01-01

    136 cases in which mild anemia was recognized but stomach disease was not recognized by the examination for a-bomb survivors, were investigated concerning living conditions, the habit of food, and the intake amount of nutrition, and the following results were obtained. 1. The mean intake amount of nutritive substances in a-bomb survivors almost reached the level as compared to the necessary amount of nutritive substances in control. 2. Shortage in intake of protein and iron which seemed to be a factor of occurrence of anemia (protein: 50% in men and 19.7% in women, iron: 25% in men and 22.5% in women), much and frequent intake of confectioneries and luxuries, and the rate of going without meal (33.3% of men went without meal one to 6 times a week) were recongized in each case of anemia with high rate. These tendency was marked in men. 3. Anemia was recognized in some of women, although they took all nutritive substances. This seemed to be caused by physiological loss of iron. Accordingly, it was desirable to take an excess amount of iron. (Tsunoda, M.)

  12. Anger and Impulsivity Among Japanese Adolescents: A Nationwide Representative Survey.

    Science.gov (United States)

    Itani, Osamu; Kaneita, Yoshitaka; Munezawa, Takeshi; Ikeda, Maki; Osaki, Yoneatsu; Higuchi, Susumu; Kanda, Hideyuki; Nakagome, Sachi; Suzuki, Kenji; Ohida, Takashi

    2016-07-01

    This study aimed to clarify the prevalence of anger and impulsivity and its associated factors through a nationwide survey of junior and senior high school adolescent students in Japan. A self-administered questionnaire covering (1) personal data, (2) lifestyle, (3) mental health status, and (4) feelings of anger and impulsivity was distributed to junior and senior high school students in Japan. Among the total of 10,955 junior high schools and 5,115 senior high schools nationwide, 130 and 110 were randomly selected, respectively. Of those, 92 junior and 80 senior high schools participated in the survey. The survey period was from December 2008 to the end of January 2009. A total of 95,680 questionnaires were collected. After excluding invalid responses, the remaining 94,777 responses (response rate: 62.3%) were analyzed. From the questions regarding anger and impulsivity, 8.7% (95% CI, 8.5%-8.9%) and 7.5% (95% CI, 7.3%-7.7%) of the participants were considered to have experienced intense anger and impulsivity, respectively. Logistic regression analysis indicated that the odds ratios for experiencing intense feelings of anger were significantly higher (all P values breakfast, did not wish to go to university, had short sleep duration, had decreased positive feelings, had increased depressive feelings, or used mobile phones for longer hours. The odds ratios for experiencing intense impulsivity were significantly higher among students who smoked, consumed alcohol, skipped breakfast, did not participate in club activities, had short sleep duration, had decreased positive feelings, had increased depressive feelings, or used mobile phones for longer hours. The results suggest that healthy lifestyle habits, good sleep habits, and improved mental health are important for preventing intense feelings of anger and impulsivity among adolescents. © Copyright 2016 Physicians Postgraduate Press, Inc.

  13. 75 FR 9277 - Proposed Information Collection (Nation-Wide Customer Satisfaction Surveys) Activity: Comment...

    Science.gov (United States)

    2010-03-01

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Proposed Information Collection (Nation-Wide Customer Satisfaction Surveys) Activity: Comment Request AGENCY: Veterans Health Administration... use of other forms of information technology. Title: Nation-wide Customer Satisfaction Surveys, VA...

  14. Internet use in radiology: results of a nationwide survey

    Energy Technology Data Exchange (ETDEWEB)

    Vorbeck, F; Zimmermann, C; Vorbeck-Meister, I; Kainberger, F; Imhof, H

    1999-08-01

    Purpose: To determine the number of radiologists who currently have Internet access, their use patterns on the Internet for Radiology purposes, the web sites they would recommend, and the potential site access to the Internet that they would like to see in the future. In addition, this study analyzed the best way to find nationwide radiological sites and their content. Materials and Methods: In a nationwide survey, 854 Austrian radiologist were asked to fill out and return a questionnaire about Internet access, current problems, current and future use, which web site they recommend, and about the use of e-mail. Next, the available nationwide radiological sites were searched with seven major search engines using 37 different keywords, as well as by category search, and by searching for links on the homepages of the radiological departments of all Universities of Austria. Then, the offered information of the founded pages was classified in categories. Results: Of the 210 (24.6%) radiologists who returned the questionnaire, 154 (73%) had Internet access. Time expenditure was considered the main problem using the Internet. The Internet was used for literature research by 69% of the radiologists with Internet access, for e-mail by 60%, and for congress information by 57%. In future, 43% would like to read electronic journals more often and 39% would like to use the web more intensively for scientific congresses. At the present time, we found 17 radiological web sites in Austria. The most promising way to find these sites was to use the search engines Alta Vista and Hotbot. Fifteen (88%) sites offered information for patients, seven (41%) for radiologists, five (29%) for students, and four (24%) for researchers. Summary: Many radiologists in Austria already have Internet access, although time expenditure was considered the main problem with Internet use. Survey responses showed a need for electronic journals. To our point of view, Universities and radiological societies

  15. Internet use in radiology: results of a nationwide survey

    International Nuclear Information System (INIS)

    Vorbeck, F.; Zimmermann, C.; Vorbeck-Meister, I.; Kainberger, F.; Imhof, H.

    1999-01-01

    Purpose: To determine the number of radiologists who currently have Internet access, their use patterns on the Internet for Radiology purposes, the web sites they would recommend, and the potential site access to the Internet that they would like to see in the future. In addition, this study analyzed the best way to find nationwide radiological sites and their content. Materials and Methods: In a nationwide survey, 854 Austrian radiologist were asked to fill out and return a questionnaire about Internet access, current problems, current and future use, which web site they recommend, and about the use of e-mail. Next, the available nationwide radiological sites were searched with seven major search engines using 37 different keywords, as well as by category search, and by searching for links on the homepages of the radiological departments of all Universities of Austria. Then, the offered information of the founded pages was classified in categories. Results: Of the 210 (24.6%) radiologists who returned the questionnaire, 154 (73%) had Internet access. Time expenditure was considered the main problem using the Internet. The Internet was used for literature research by 69% of the radiologists with Internet access, for e-mail by 60%, and for congress information by 57%. In future, 43% would like to read electronic journals more often and 39% would like to use the web more intensively for scientific congresses. At the present time, we found 17 radiological web sites in Austria. The most promising way to find these sites was to use the search engines Alta Vista and Hotbot. Fifteen (88%) sites offered information for patients, seven (41%) for radiologists, five (29%) for students, and four (24%) for researchers. Summary: Many radiologists in Austria already have Internet access, although time expenditure was considered the main problem with Internet use. Survey responses showed a need for electronic journals. To our point of view, Universities and radiological societies

  16. [Nationwide survey of alcohol drinking and alcoholism among Japanese adults].

    Science.gov (United States)

    Osaki, Yoneatsu; Matsushita, Sachio; Shirasaka, Tomonobu; Hiro, Hisanori; Higuchi, Susumu

    2005-10-01

    To investigate the characteristics of alcohol use among Japanese adults and prevalence of alcohol dependence in Japan, we conducted a nationwide survey on alcohol drinking behavior and alcohol dependence among Japanese adults using a representative sampling method. We sampled 3500 adults from throughout the entire country using a stratified random sampling method with two-step stratification, and carried out a home visit interview survey. A total of 2547 people (72.8%) responded to the survey. The survey period was June, 2003. The questionnaire contained questions about the frequency and quantity of alcohol use, 'hazardous use of alcohol' and 'alcohol dependence' according to the ICD-10 definition, several screening scales on problem use of alcohol (CAGE, KAST, AUDIT), life-time prevalence of 24 alcohol related diseases, smoking status, dysgryphia, and nightcap drinking. The number of respondents was, 1184 males, and 1363 females. Lifetime alcohol drinking, and weekly drinking, and daily drinking rates were 95.1%, 64.4%, and 36.2% for males, 79.0%, 27.5%, and 7.5% for females, respectively. Average daily alcohol consumption was 3.7 units for males, and 2.0 units for females (1 unit = 10 g pure alcohol). The proportion of drinkers who drank alcohol 4 units or more daily was 28.9% for males, and 7.6% for females, and that for 6 units or more was 12.7% for males, and 3.4% for females. The proportion of flasher was 41.2% for males, and 35.0% for females. Among screening questions, problem drinking was most frequently identified using AUDIT (score 12 points or more, 150 persons), followed by KAST (2 points or more, 100 persons) and CAGE (2 points or more, 98 persons). The number of subjects who met the ICD-10 criteria for alcohol dependence was 24, while the number who engaged in hazardous alcohol use was 64. This study revealed that problem drinking and alcohol dependence are a serious problem in Japanese general population. The problem of females drinking may be

  17. Endoscopic training: A nationwide survey of French fellows in gastroenterology.

    Science.gov (United States)

    Amiot, Aurélien; Conroy, Guillaume; Le Baleur, Yann; Winkler, Jérôme; Palazzo, Maxime; Treton, Xavier

    2018-04-01

    During their 4 years of training, French fellows in gastroenterology should acquire theoretical and practical competency in gastrointestinal (GI) endoscopy. To evaluate the delivery of endoscopy training to French GI fellows and perception of learning. A nationwide electronic survey was carried out of French GI fellows using an anonymous, 17-item electronic questionnaire. A total of 291 out of 484 (60%) GI fellows responded to the survey. Only 40% of subjects had access to theoretical training and/or virtual simulators. Only 49% and 35% of fourth year fellows had reached the threshold numbers of EGD and colonoscopies recommended by the European section and Board of gastroenterology and hepatology. Sixty-two percent and 57% of trainees reported having insufficient knowledge in interpreting gastric and colic lesions. Access to dedicated endoscopy activity for at least 8 weeks during the year was the only independent factor associated with the achievement of the recommended annual threshold number of procedures. The access of fellows to theoretical training and to preclinical virtual simulators is still insufficient. Personalized support and regular assessment of cognitive and technical acquisition over the 4 years of training seems to be necessary. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  18. Nationwide survey of cobalt-60 teletherapy. Final report

    International Nuclear Information System (INIS)

    Thompson, D.L.; Kearly, F.E.; Wyckoff, H.O.; Gitlin, J.N.; Reffit, E.B.; Shangold, E.J.

    1980-08-01

    The Bureau of Radiological Health and the National Bureau of Standards conducted a nationwide survey of cobalt-60 teletherapy facilities to determine their accuracy in delivery of a prescribed dose to a phantom. Participation was obtained from 684 respondents or 75 percent of US facilities. For each cobalt-60 unit the average dose recorded on five dosimeters was within 5 percent of the prescribed value for 83 percent of the respondents and only exceeded a 10 percent difference for 3 percent of the respondents. Sufficient information for reconstruction of dose calculations was available for 87 percent of the participating facilities. Of these reconstructed calculations, 56 percent were within 1 percent of the prescribed dose of 300 rads. The analysis of data from the survey showed that better performance were related to a number of factors. Among these were expressing the machine calibration in terms of dose rate, performing the machine calibration on an annual basis, and correcting for source decay on a monthly basis. Larger facilities achieved better results than smaller facilities when calculating the absorbed dose rate. Also, each 4 machine characteristics (isocentric mounting, short exposure time, high normalized output, and long treatment distance) were related to better performance with regard to both dosimeter readings and calculated doses. Larger facilities were more likely to be using a cobalt-60 unit having those characteristics

  19. 77 FR 64382 - Agency Information Collection (Nation-Wide Customer Satisfaction Surveys) Activities Under OMB...

    Science.gov (United States)

    2012-10-19

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Agency Information Collection (Nation-Wide Customer Satisfaction Surveys) Activities Under OMB Review AGENCY: Veterans Health Administration... ``OMB Control No. 2900-0712.'' SUPPLEMENTARY INFORMATION: Title: Nation-wide Customer Satisfaction...

  20. 77 FR 2349 - Proposed Information Collection (Nation-wide Customer Satisfaction Surveys) Activity: Comment...

    Science.gov (United States)

    2012-01-17

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Proposed Information Collection (Nation-wide Customer Satisfaction Surveys) Activity: Comment Request AGENCY: Veterans Health Administration... techniques or the use of other forms of information technology. Title: Nation-wide Customer Satisfaction...

  1. 75 FR 25320 - Agency Information Collection (Nation-wide Customer Satisfaction Surveys) Activities Under OMB...

    Science.gov (United States)

    2010-05-07

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Agency Information Collection (Nation-wide Customer Satisfaction Surveys) Activities Under OMB Review AGENCY: Veterans Health Administration... ``OMB Control No. 2900-0712.'' SUPPLEMENTARY INFORMATION: Title: Nation-wide Customer Satisfaction...

  2. Cancer risk among Holocaust survivors in Israel-A nationwide study.

    Science.gov (United States)

    Sadetzki, Siegal; Chetrit, Angela; Freedman, Laurence S; Hakak, Nina; Barchana, Micha; Catane, Raphael; Shani, Mordechai

    2017-09-01

    Holocaust survivors during World War II were exposed to various factors that are associated with cancer risk. The objective of this study was to determine whether Holocaust survivors had an increased risk for developing cancer. The study population included 152,622 survivors. The main analysis was based on a comparison between individuals who were entitled to compensation for suffering persecution during the war and individuals who were denied such compensation. A complementary analysis compared survivors who were born in countries governed by Nazi Germany with survivors born in nonoccupied countries. A Cox proportional hazards model was used, with the time at risk of cancer development starting on either January 1, 1960, or the date of immigration to the date of cancer diagnosis or death or the date of last follow-up (December 31, 2006). Cancer was diagnosed in 22.2% of those who were granted compensation versus 16% of those who were denied compensation (P cancer in those who were exposed. For those who were granted versus denied compensation, the hazard ratios were 1.06 (P cancer, and 1.37 (P = .008) for lung cancer. For those born in occupied countries versus nonoccupied countries, the hazard ratios were 1.08 (P cancer development. Cancer 2017;123:3335-45. © 2017 American Cancer Society. © 2017 American Cancer Society.

  3. Nationwide survey of US integrated 6-year cardiothoracic surgical residents.

    Science.gov (United States)

    Lebastchi, Amir H; Yuh, David D

    2014-08-01

    Integrated 6-year cardiothoracic surgical residency programs have recently been implemented in the United States. We report the results of the first published nationwide survey assessing the motivations, satisfaction, and ambitions of integrated 6-year residents. A 63-question web-based survey was distributed to 83 residents enrolled in 21 Accreditation Council for Graduate Medical Education-accredited integrated 6-year programs in November 2013. There was an outstanding 69% response rate. The median age of integrated 6-year residents was 29 years with women comprising 24%. A clear majority had faculty mentorship (95%) and significant clinical exposure in medical school. Focused (100%) and abbreviated (74%) training curricula were identified as the top advantages of integrated 6-year programs; the format itself was a significant factor (46%) in career choice. Most integrated 6-year residents (95%) were satisfied with their program; 80.7% were satisfied with their operative experience thus far. Career plans skewed toward adult cardiac surgery (67%), followed by pediatric cardiac (24%) and general thoracic (9%) surgery; 49% were not particularly concerned about future employment, with 65% foreseeing an increase in opportunities. Specialized training (eg, aortic, heart failure, minimally invasive, congenital) was anticipated by 77%. Most integrated 6-year residents envision an academic career (94.7%). This survey takes an important snapshot of the nascent integrated 6-year format. Mentorship and intense clinical exposure are critical in attracting applicants. Purported advantages of the format are holding true among integrated 6-year residents, with the majority satisfied with their programs. These early data indicate that this format holds significant promise in attracting and retaining highly qualified trainees to academic cardiothoracic surgery. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  4. Survey of survivors' perspective on return to work after stroke.

    Science.gov (United States)

    Hartke, Robert J; Trierweiler, Robert

    2015-10-01

    To describe the development and results of a detailed survey on return to work (RTW) after stroke completed by survivors at various stages of recovery. This study used a multi-method qualitative and quantitative research strategy to design and implement a 39-item survey for stroke survivors. Individual interviews, focus groups, and working committees were used to conceptualize the issues and translate them into a survey format. Surveys were distributed in regular and electronic mail. Groups of rehabilitation professionals, employers, and stroke survivors were assembled to review findings and obtain feedback to aide in interpretation. Overall 715 surveys were completed. The respondents were on average 54 years of age, mostly white, well-educated, urban dwelling, and in skilled occupations. Results are described in seven areas: financial, stroke impairments, organizational, work and psychological issues, interpersonal support, and therapy. Several salient findings are described including the role of fatigue, under utilization of vocational rehabilitation (VR) services, and motivational factors related to finances, self-esteem, work, and workplace relationships. Although earning an income is a strong motivation to RTW, salary decreases in importance when compared with other psychological benefits. Fatigue was rated as the second highest impairment barrier to RTW and persisted as a relevant impediment over time. Attitudes of co-workers and flexibility in work schedule were viewed as most helpful to the RTW process, whereas work stress was viewed as the greatest impediment to return. Only 24% of the sample received VR counseling with more respondents receiving counseling if they returned 6 months or longer after their stroke. Other trends and clinical and research implications are discussed.

  5. Fifth nationwide survey on radiation oncology of China in 2006

    International Nuclear Information System (INIS)

    Yin Weibo; Yuyun; Chen Bo; Tian Fenghua

    2007-01-01

    Objective: In order to find out the present status of Chinese Radiation Oncology, the Chinese Society of Radiation Oncology did the fifth nationwide survey on Radiation Oncology in China. Methods: Questionnaire forms had been sent through the board member of Chinese Society of Radiation Oncology to each center throughout the country. The forms, after filing, were returned for analysis. Results: On September 30th, 2006, there were 952 radiation oncology centers. They possess personnel: 5247 doctors including 2 110 residents, 1181 physicists, 6864 nurses, 4559 technicians and 1141 engineers. For equipment: There were 918 linear accelerators, 472 telecobalt units, 146 deep X-ray machine, 827 simulators, 214 CT simulators, 400 brachytherapy units, 400 treatment planning system, 796 dosimeters, 467 X-knife, 149 γ-knife (74 for head only, 75 for the head and body). Treatment: 35 503 beds (35 centers did not report the number of beds), 42 109 patients treated per day, 409 440 new patients were treated per year (no report from 45 centers). Conclusion: Radiation oncology has been developing rapidly in the last 5 years either in quantity or in quality. They are still being considered insufficient in proportion to our population. Training programs and development of QA and QC system ate needed. (authors)

  6. A nationwide survey of pediatric acquired demyelinating syndromes in Japan

    Science.gov (United States)

    Yamaguchi, Y.; Kira, R.; Ishizaki, Y.; Sakai, Y.; Sanefuji, M.; Ichiyama, T.; Oka, A.; Kishi, T.; Kimura, S.; Kubota, M.; Takanashi, J.; Takahashi, Y.; Tamai, H.; Natsume, J.; Hamano, S.; Hirabayashi, S.; Maegaki, Y.; Mizuguchi, M.; Minagawa, K.; Yoshikawa, H.; Kira, J.; Kusunoki, S.; Hara, T.

    2016-01-01

    Objective: To investigate the clinical and epidemiologic features of pediatric acquired demyelinating syndromes (ADS) of the CNS in Japan. Methods: We conducted a nationwide survey and collected clinical data on children with ADS aged 15 years or younger, who visited hospitals between 2005 and 2007. Results: Among 977 hospitals enrolled, 723 (74.0%) responded to our inquiries and reported a total of 439 patients as follows: 244 with acute disseminated encephalomyelitis (ADEM), 117 with multiple sclerosis (MS), 14 with neuromyelitis optica (NMO), and 64 with other ADS. We collected and analyzed detailed data from 204 cases, including those with ADEM (66), MS (58), and NMO (10). We observed the following: (1) the estimated annual incidence rate of pediatric ADEM in Japan was 0.40 per 100,000 children (95% confidence interval [CI], 0.34–0.46), with the lowest prevalence in the north; (2) the estimated prevalence rate of MS was 0.69 per 100,000 children (95% CI, 0.58–0.80), with the lowest prevalence in the south; (3) NMO in Japan was rare, with an estimated prevalence of 0.06 per 100,000 children (95% CI, 0.04–0.08); and (4) the sex ratio and mean age at onset varied by ADS type, and (5) male/female ratios correlated with ages at onset in each ADS group. Conclusions: Our results clarify the characteristic clinical features of pediatric ADS in the Japanese population. PMID:27742816

  7. Mass survey of lung cancer in atomic bomb survivors

    International Nuclear Information System (INIS)

    Sasaki, Hideo; Itoh, Chikako; Mitsuyama, Toyofumi; Mishima, Yasuhiro; Ohmura, Toshio.

    1980-01-01

    Mass survey of lung cancer was performed only by questionnaire together with general health examinations of a-bomb survivors during 3 years between April 1976 and March 1979, and the following results were obtained. The number of men aged more than 40 years old who had questionnaire was 89,778, and those who were required to have detailed examinations because they had bloody sputum and paroxysmal cough + a history of smoking were 1,453. Out of them, 861 a-bomb survivors had detailed examinations. The performance rate of detailed examinations was 59.3%. Lung cancer was found in 23 a-bomb survivors. The discovery rate was 25.6 per 100,000 persons, and it was a little higher than discovery rates reported by many researchers. It was low in men aged more than 40 years old. There was a straight line relationship between logarithm values of the discovery rate of lung cancer and age, and the discovery rate increased markedly with aging. Cytodiagnosis of sputum by Saccomanno method showed a positive test which was 20% higher than that by 3 days serial smear method. To discover lung cancer at an early stage, it is advisable to perform the first screening by chest x-ray examination and questionnaire on men aged over 40 years old, and to perform cytodiagnosis by Saccomanno method on men who were required to have detailed examinations. (Tsunoda, M.)

  8. Mass survey of lung cancer in atomic bomb survivors

    International Nuclear Information System (INIS)

    Sasaki, Hideo; Itoh, Chikako; Mitsuyama, Toyofumi; Mishima, Yasuhiro; Katsuta, Shizutomo.

    1978-01-01

    Men atomic bomb survivors over the age of 40 years received a survey of lung cancer by questionnaire together with the general survey for atomic bomb survivors, and the following results were obtained. The survey by questionnaire was carried out on 29780 cases during one year 1977 to 1978, and 6 cases of lung cancer were discovered. The discovery rate was 20.1 persons against a hundred thousand persons. Lung cancer discovered during 2 years from April, 1976 was 14 cases, and the discovery rate was 23.9 persons against a hundred thousand persons. The discovery rate according to exposure conditions was higher in order of a group entering Hiroshima city after A-bomb explosion and other group (33.2 persons), a group directly exposed over 2 km from the center of explosion (20.0 persons), and a group directly exposed within 2 km (1.5 persons). Therefore, results that the discovery rate of lung cancer was higher in short-distance group could not be obtained. (Tsunoda, M.)

  9. Biochemical survey for children of A-bomb survivors

    International Nuclear Information System (INIS)

    Sato, Chiyoko

    1992-01-01

    The Radiation Effects Research Foundation has conducted biochemical survey in children of A-bomb survivors, with the purpose of elucidating whether or not the rate of genetic mutation in genital cells is increased. This paper describes the previous surveys done at protein levels. Two kinds of indicators have been used: (1) 'rare mutation type' reflecting base substitution mutation, base deletion, and insertion; (2) 'mutation type' reflecting the decrease of red cell enzyme activity. According to the DS86 dosimetry system, the children population of A-bomb survivors were examined by dividing into the exposed group (n=11,364) of their parents exposed to 0.01 Sv or more and the control group (n=12,297) of those exposed to less than 0.01 Sv. 'Rare mutation type' was detected using electrophoresis in a total of 1,233 children in both groups. Of these children, 2 in the exposed group and 4 in the control group had a new 'mutation', i.e., mutation that was considered to have occurred in genital cells of their parents. Survey for genetic foci has revealed mutation in 2 children in the exposed group and 4 children in the control group, with the rate of mutation being 0.37 x 10 -5 /genetic foci/generation and 0.68 x 10 -5 /genetic foci/generation, respectively. Mutation type reflecting the decrease in red cell enzyme activity was seen in 26 in the exposed group and 21 in the control group. A total of 41 children were found to have been inherited from their parents. In the survey for genetic foci, only one had mutation in the exposed group, with the rate of mutation being 1.7 x 10 -5 /genetic foci/generation. These findings have revealed no evidence of significant difference in the rate of mutation between the exposed and control groups. Finally, the future genetic surveys at molecular levels are briefly discussed. (N.K.)

  10. Chromosome survey for children of A-bomb survivors

    International Nuclear Information System (INIS)

    Awa, Akio

    1992-01-01

    To investigate chromosomes from children of A-bomb survivors, cytogenetic survey has been started in 1967 by the ABCC and completed in 1985 by the succeeding RERF. This paper is designed to overview the cytogenetic survey and to discuss the cytogenetic effects of A-bomb radiation. A cohort of 16,298 children of A-bomb survivors, which were collected from mortality survey population in 1974, was enrolled in this survey and was divided into two groups: the proximally exposed group (n=8,322, whose parents exposed to estimated doses of 0.01 Gy or more within 2,000 m from the hypocenter) and the distally exposed group (n=7,976, those exposed to 0.005 Gy or less far from 2,500 m or not in the city). Three chromosomal aberrations were identified: sex chromosome aberrations consisting mainly of XYY, XXY, and mosaic; structural abnormality of autosomes consisting mainly of translocation and inversion; and trisomy of autosomes. Overall, the incidence of chromosomal aberrations was higher in the distally exposed group (6.39%) than the proximally exposed group (5.17%). According to the type of chromosomal aberrations, the incidences of both sex chromosomes and structural abnormality of autosomes were slightly higher in the distally exposed group (0.30% and 0.34%) than the proximally exposed group (0.23% and 0.28%). Trisomy of autosomes was identified in only one child in the proximally exposed group. These findings failed to demonstrate the rationale for the cytogenetic effects of A-bomb radiation; however, cytogenetic risk of radiation has not been denied completely. (N.K.)

  11. Health survey of atomic bomb survivors in South Korea

    Energy Technology Data Exchange (ETDEWEB)

    Arita, Ken-ichi; Iwamori, Hiroshi; Kishi, Akihiro; Koutoku, Michiya

    1988-05-01

    Health survey was undertaken among Korea survivors exposed to atomic bomb in Japan who now reside in South Korea. Of 232 A-bomb survivors on whom raditation exposure information was available, all were exposed to atomic bomb in Hiroshima. According to the distance from the hypocenter, one (0.4 %) A-bomb survior was exposed at < 1,000 m, 60 (25.9 %) at 1,000 - 2,000 m, 124 (53.4 %) at > 2,000 - 3,000 m, and 43 (18.5 %) at < 3,000 m. In the four remaining, it was unknown. According to age, 14.7 % were in their forties, 33.6 % in their fifties, 32.6 % in their sixties, 16.0 % in their severties, and 3.1 % in their eighties, indicating the tendency for the aging of older persons. Common subjective symptoms were lumbar pain and joint pain, which seemed atributable to osteoarthritis. Other diseases included hypertension, chronic obstructive pulmonary disease, sequelae of cerebral stroke, eczema, and mycosis. (Namekawa, K.).

  12. Report on results of medical survey of atomic bomb survivors residing in South America

    International Nuclear Information System (INIS)

    Mitsuhashi, Akio; Monzen, Tetsuo; Inamizu, Tsutomu; Oguma, Nobuo; Yotsuya, Koichi; Ozaki, Shinpei; Takamatsu, Katsuro; Kawaguchi, Kiyoshi.

    1986-01-01

    Medical survey of A-bomb survivors was made from October 21 through November 7, 1985 in Brazil, Argentine, and Paraguay. One hundred fifty four A-bomb survivors were identified in these three countries. Of these A-bomb survivors, 133 (86 %) participated in this survey. Eighy six survivors came from Hiroshima and the other 47 from Nagasaki. The average age of them was 55.8 +- 11.1 yr for men and 56.3 +- 9.9 yr for women. Abnormal findings requiring detailed examinations and life instruction were seen in 56 % of the participants. Common findings were hypertension, heart disease, and obesity. (Namekawa, K.)

  13. A Nationwide Survey of Nonspeech Oral Motor Exercise Use: Implications for Evidence-Based Practice

    Science.gov (United States)

    Lof, Gregory L.; Watson, Maggie M.

    2008-01-01

    Purpose: A nationwide survey was conducted to determine if speech-language pathologists (SLPs) use nonspeech oral motor exercises (NSOMEs) to address children's speech sound problems. For those SLPs who used NSOMEs, the survey also identified (a) the types of NSOMEs used by the SLPs, (b) the SLPs' underlying beliefs about why they use NSOMEs, (c)…

  14. Polydrug use among college students in Brazil: a nationwide survey

    OpenAIRE

    Oliveira,Lúcio Garcia de; Alberghini,Denis Guilherme; Santos,Bernardo dos; Andrade,Arthur Guerra de

    2013-01-01

    Objective: To estimate the frequency of polydrug use (alcohol and illicit drugs) among college students and its associations with gender and age group. Methods: A nationwide sample of 12,544 college students was asked to complete a questionnaire on their use of drugs according to three time parameters (lifetime, past 12 months, and last 30 days). The co-use of drugs was investigated as concurrent polydrug use (CPU) and simultaneous polydrug use (SPU), a subcategory of CPU that involves the ...

  15. Diagnostic criteria, clinical features, and incidence of thyroid storm based on nationwide surveys.

    Science.gov (United States)

    Akamizu, Takashi; Satoh, Tetsurou; Isozaki, Osamu; Suzuki, Atsushi; Wakino, Shu; Iburi, Tadao; Tsuboi, Kumiko; Monden, Tsuyoshi; Kouki, Tsuyoshi; Otani, Hajime; Teramukai, Satoshi; Uehara, Ritei; Nakamura, Yosikazu; Nagai, Masaki; Mori, Masatomo

    2012-07-01

    Thyroid storm (TS) is life threatening. Its incidence is poorly defined, few series are available, and population-based diagnostic criteria have not been established. We surveyed TS in Japan, defined its characteristics, and formulated diagnostic criteria, FINAL-CRITERIA1 and FINAL-CRITERIA2, for two grades of TS, TS1, and TS2 respectively. We first developed diagnostic criteria based on 99 patients in the literature and 7 of our patients (LIT-CRITERIA1 for TS1 and LIT-CRITERIA2 for TS2). Thyrotoxicosis was a prerequisite for TS1 and TS2 as well as for combinations of the central nervous system manifestations, fever, tachycardia, congestive heart failure (CHF), and gastrointestinal (GI)/hepatic disturbances. We then conducted initial and follow-up surveys from 2004 through 2008, targeting all hospitals in Japan, with an eight-layered random extraction selection process to obtain and verify information on patients who met LIT-CRITERIA1 and LIT-CRITERIA2. We identified 282 patients with TS1 and 74 patients with TS2. Based on these data and information from the Ministry of Health, Labor, and Welfare of Japan, we estimated the incidence of TS in hospitalized patients in Japan to be 0.20 per 100,000 per year. Serum-free thyroxine and free triiodothyroine concentrations were similar among patients with TS in the literature, Japanese patients with TS1 or TS2, and a group of patients with thyrotoxicosis without TS (Tox-NoTS). The mortality rate was 11.0% in TS1, 9.5% in TS2, and 0% in Tox-NoTS patients. Multiple organ failure was the most common cause of death in TS1 and TS2, followed by CHF, respiratory failure, arrhythmia, disseminated intravascular coagulation, GI perforation, hypoxic brain syndrome, and sepsis. Glasgow Coma Scale results and blood urea nitrogen (BUN) were associated with irreversible damages in 22 survivors. The only change in our final diagnostic criteria for TS as compared with our initial criteria related to serum bilirubin concentration >3 mg

  16. A Nationwide Random Sampling Survey of Potential Complicated Grief in Japan

    Science.gov (United States)

    Mizuno, Yasunao; Kishimoto, Junji; Asukai, Nozomu

    2012-01-01

    To investigate the prevalence of significant loss, potential complicated grief (CG), and its contributing factors, we conducted a nationwide random sampling survey of Japanese adults aged 18 or older (N = 1,343) using a self-rating Japanese-language version of the Complicated Grief Brief Screen. Among them, 37.0% experienced their most significant…

  17. Polydrug use among college students in Brazil: a nationwide survey.

    Science.gov (United States)

    Oliveira, Lúcio Garcia de; Alberghini, Denis Guilherme; Santos, Bernardo dos; Andrade, Arthur Guerra de

    2013-01-01

    To estimate the frequency of polydrug use (alcohol and illicit drugs) among college students and its associations with gender and age group. A nationwide sample of 12,544 college students was asked to complete a questionnaire on their use of drugs according to three time parameters (lifetime, past 12 months, and last 30 days). The co-use of drugs was investigated as concurrent polydrug use (CPU) and simultaneous polydrug use (SPU), a subcategory of CPU that involves the use of drugs at the same time or in close temporal proximity. Almost 26% of college students reported having engaged in CPU in the past 12 months. Among these students, 37% had engaged in SPU. In the past 30 days, 17% college students had engaged in CPU. Among these, 35% had engaged in SPU. Marijuana was the illicit drug mostly frequently used with alcohol (either as CPU or SPU), especially among males. Among females, the most commonly reported combination was alcohol and prescribed medications. A high proportion of Brazilian college students may be engaging in polydrug use. College administrators should keep themselves informed to be able to identify such use and to develop educational interventions to prevent such behavior.

  18. Workplace Victimization and Discrimination in China: A Nationwide Survey.

    Science.gov (United States)

    Zhang, Huiping

    2017-09-01

    Workplace victimization and discrimination have been intensively studied in the West, especially on the antecedents and consequences of this phenomenon. Surprisingly, little is known about the incidence and associated health problems of workplace victimization and discrimination in contemporary China. Using a representative nationwide sample of 1,138 Chinese employees conducted in 2015, this study attempted to estimate the prevalence, risk factors, and associated consequences of workplace victimization and discrimination in China. It is found that the prevalence rate of preceding 5-year workplace discrimination and victimization was 33% and 12.9%, respectively. Male employees who perceived higher work gains were less likely to experience workplace victimization and those who had higher career efficacy and unemployment anxiety were more likely to experience job discrimination or victimization. Female employees who received tertiary education were less likely to experience job discrimination and being married tended not to experience workplace victimization. Perceived job discrimination had negative impact on male employees' job satisfaction as well as on female employees' happiness. The implications of these findings are finally discussed in the Chinese context.

  19. Birth order and paediatric allergic disease: A nationwide longitudinal survey.

    Science.gov (United States)

    Kikkawa, T; Yorifuji, T; Fujii, Y; Yashiro, M; Okada, A; Ikeda, M; Doi, H; Tsukahara, H

    2018-05-01

    Environmental factors seem to be related to the incidence of allergic disease. Children with a later birth order are often exposed to environments, where pathogens and endotoxins can be found, and thus have a higher risk of developing infectious diseases. Therefore, birth order is regarded as an indicator that reflects post-natal environment. However, longitudinal studies are limited on this subject. This study sought to elucidate the relationships between birth order and allergic disease. From a nationwide longitudinal study that followed children born in 2001 (n = 47 015), we selected doctors' visits for 3 types of allergic disease-bronchial asthma, food allergy and atopic dermatitis-from infancy to 12 years of age and conducted binomial log-linear regression analysis to evaluate the associations between birth order and these diseases. We adjusted for the child and parental factors and estimated risk ratio (RR) and 95% confidence interval (CI) for each outcome. The associations between birth order and bronchial asthma were diverse; later birth order increased the risk in early childhood, but decreased the risks during school age. For example, the adjusted RR comparing third-born or higher and first-born children was 1.19 (95% CI, 1.05-1.35) between 30 and 42 months of age, but was 0.76 (95% CI, 0.65-0.89) between 10 and 11 years. Later birth order was generally protective for food allergy but increased the risk of atopic dermatitis. The influence of birth order depended on the type of allergic disease and the childhood period. Childhood is unique in terms of physical and immunological development, and the immune response to the post-natal environment in childhood appears to be heterogeneous. © 2018 John Wiley & Sons Ltd.

  20. Stress and Depressive Symptoms in Cancer Survivors and Their Family Members: Korea Community Health Survey, 2012.

    Science.gov (United States)

    Han, Mi Ah

    2017-09-01

    This study examined the prevalence of perceived stress and depressive symptoms in cancer survivors and their family members compared with subjects without cancer and without family members with cancer. The subjects of this cross-sectional study were adults ≥19 years old who participated in the 2012 Korea Community Health Survey. Stress and depressive symptoms in cancer survivors and their family members were assessed and compared to symptoms in control groups by chi-square tests and multiple logistic regression analyses. Of the 6783 cancer survivors, 26.9% and 8.7% reported having stress and depressive symptoms, respectively, and 27.7% and 5.9% of family members of cancer survivors reported having stress and depressive symptoms, respectively. Cancer survivors showed higher adjusted odds ratio (aOR) for stress (aOR = 1.26, 95% confidence interval (CI) = 1.16-1.37) and depressive symptoms (aOR = 1.82, 95% CI = 1.57-2.11) than subjects without cancer history. Family members of cancer survivors showed a higher OR for stress and depressive symptoms than subjects without a family member who survived cancer. Cancer survivors and family members of cancer survivors had more stress and depressive symptoms than controls. Careful management for cancer patients and their family members should include screening for stress and depression to improve mental health associated with cancer survivorship.

  1. Atmospheric deposition of heavy metals in Norway. Nationwide survey 2010

    International Nuclear Information System (INIS)

    Steinnes, Eiliv; Berg, Torunn; Uggerud, Hilde Thelle; Pfaffhuber, Katrine Aspmo

    2011-01-01

    The geographical distribution of atmospheric deposition of heavy metals in Norway was mapped in 2010 by analysis of moss samples from 464 sites all over the country. This report provides a presentation of the results and a comparison with data from a series of corresponding moss surveys starting 1977. The survey is part of an international program comprising large parts of Europe. The survey primarily concerns the ten metals of priority in the European program: vanadium, chromium, iron, nickel, copper, zinc, arsenic, cadmium, mercury, and lead. In addition data are reported for another 42 elements in the moss. The discussion of the obtained data mainly refers to contributions from air pollution. In addition influence from natural processes to the elemental composition of the moss and how it may influence the interpretation of the data is discussed. (Author)

  2. Pediatric Gastrointestinal Endoscopic Sedation: A 2010 Nationwide Survey in Taiwan

    Directory of Open Access Journals (Sweden)

    Po-Hon Chen

    2012-06-01

    Conclusion: A majority of pediatric EGD in Taiwan was performed under sedation and applied more often to younger children. Endoscopists were more satisfied during EGD when practicing sedation. This survey should help formulate updated practice guidelines and policies regarding endoscopic sedation.

  3. Osteoarthritis in Spain: A nationwide survey of medical specialists.

    Science.gov (United States)

    Arriaza, Rafael; Sancho, Carlos; Fernandez-Gutierrez, Benjamin

    2017-11-25

    To determine the reality of the resources and care needs in Spain for the management of patients with osteoarthritis. An online survey. Description of 190 responses to a structured questionnaire (141 orthopedic surgeons and 49 rheumatologists). Osteoarthritis has yet to receive appropriate medical attention and a patient management model. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  4. Nationwide Survey of Work Environment, Work-Life Balance and Burnout among Psychiatrists in Japan

    OpenAIRE

    Umene-Nakano, Wakako; Kato, Takahiro A.; Kikuchi, Saya; Tateno, Masaru; Fujisawa, Daisuke; Hoshuyama, Tsutomu; Nakamura, Jun

    2013-01-01

    BACKGROUND: Psychiatry has been consistently shown to be a profession characterised by 'high-burnout'; however, no nationwide surveys on this topic have been conducted in Japan. AIMS: The objective of this study was to estimate the prevalence of burnout and to ascertain the relationship between work environment satisfaction, work-life balance satisfaction and burnout among psychiatrists working in medical schools in Japan. METHOD: We mailed anonymous questionnaires to all 80 psychiatry depart...

  5. Imbalanced Nutrient Intake in Cancer Survivors from the Examination from the Nationwide Health Examination Center-Based Cohort

    Directory of Open Access Journals (Sweden)

    Boyoung Park

    2018-02-01

    Full Text Available This study was conducted to examine the nutrient intake status of cancer survivors. A total of 5224 cancer survivors, 19,926 non-cancer individuals without comorbidities (non-cancer I, and 20,622 non-cancer individuals with comorbidities, matched by age, gender, and recruitment center location were included in the analysis. Generally, the proportion of total energy from carbohydrates was higher and the proportion from fat was lower in cancer survivors. The odds ratios (ORs for total energy (OR = 0.92, 95% confidence interval (CI = 0.86–0.99, proportion of total energy from fat (OR = 0.54, 95% CI = 0.35–0.83, and protein (OR = 0.85, 95% CI = 0.79–0.90 were significantly lower, and the OR for the proportion of total energy from carbohydrates was higher (OR = 1.21, 95% CI = 1.10–1.33 in the cancer survivors than in non-cancer I. Additionally, the cancer survivors’ protein, vitamin B1, vitamin B2, niacin, and phosphorus intakes were lower, whereas their vitamin C intake was higher. When divided by cancer type, the ORs for the carbohydrate percentages were significantly higher in the colon and breast cancer survivors, whereas protein intake was lower in gastric, breast, and cervical cancer survivors. The nutrient intake patterns in Asian cancer survivors are poor, with higher carbohydrate and lower fat and protein intakes.

  6. Diet quality of cancer survivors and noncancer individuals: Results from a national survey.

    Science.gov (United States)

    Zhang, Fang Fang; Liu, Shanshan; John, Esther M; Must, Aviva; Demark-Wahnefried, Wendy

    2015-12-01

    Patterns of poor nutritional intake may exacerbate the elevated morbidity experienced by cancer survivors. It remains unclear whether cancer survivors adhere to existing dietary guidelines and whether survivors' diets differ from those of individuals without cancer over the long term. The authors evaluated dietary intake and quality in 1533 adult cancer survivors who participated in the National Health and Nutrition Examination Survey from 1999 to 2010 compared with dietary intake and quality in 3075 individuals who had no history of cancer and were matched to the cancer survivors by age, sex, and race/ethnicity. Dietary intake was assessed using 24-hour dietary recalls. The 2010 Healthy Eating Index (HEI-2010) was used to evaluate diet quality. The mean ± standard deviation HEI-2010 total score was 47.2 ± 0.5 in the cancer survivors and 48.3 ± 0.4 in the noncancer group (P = .03). Compared with the noncancer group, cancer survivors had a significantly lower score for empty calories (13.6 vs 14.4; P = .001), which corresponded to worse adherence to dietary intake of calories from solid fats, alcohol, and added sugars. Cancer survivors also had significantly lower dietary intake of fiber than the noncancer group (15.0 vs 15.9 g per day; P = .02). In relation to recommended intake, survivors' mean dietary intake of vitamin D, vitamin E, potassium, fiber, and calcium was 31%, 47%, 55%, 60%, and 73%, respectively; whereas their mean dietary intake of saturated fat and sodium was 112% and 133%, respectively, of the recommended intake. Cancer survivors had poor adherence to the US Department of Agriculture 2010 Dietary Guidelines for Americans, and their intake patterns were worse than those in the general population for empty calories and fiber. © 2015 American Cancer Society.

  7. Nationwide epidemiological survey of early chronic pancreatitis in Japan.

    Science.gov (United States)

    Masamune, Atsushi; Kikuta, Kazuhiro; Nabeshima, Tatsuhide; Nakano, Eriko; Hirota, Morihisa; Kanno, Atsushi; Kume, Kiyoshi; Hamada, Shin; Ito, Tetsuhide; Fujita, Motokazu; Irisawa, Atsushi; Nakashima, Masanori; Hanada, Keiji; Eguchi, Takaaki; Kato, Ryusuke; Inatomi, Osamu; Shirane, Akio; Takeyama, Yoshifumi; Tsuji, Ichiro; Shimosegawa, Tooru

    2017-08-01

    The world's first diagnostic criteria for early CP were proposed in 2009 in Japan. This study aimed to clarify the clinico-epidemiological features of early CP in Japan. Patients with early CP who were diagnosed according to the diagnostic criteria for early CP and had visited the selected hospitals in 2011 were surveyed. The study consisted of two-stage surveys: the number of patients with early CP was estimated by the first questionnaire and their clinical features were assessed by the second questionnaire. The estimated number of early CP patients was 5410 (95% confidence interval 3675-6945), with an overall prevalence of 4.2 per 100,000 persons. The number of patients who were newly diagnosed with early CP was estimated to be 1330 (95% confidence interval 1058-1602), with an annual incidence of 1.0 per 100,000 persons. Detailed clinical information was obtained in 151 patients in the second survey. The male-to-female sex ratio was 1.32:1. The mean age was 60.4 and the mean age at disease onset was 55.4. Idiopathic (47.7%) and alcoholic (45.0%) were the two most common etiologies. Proportions of female and idiopathic cases were higher in early CP than in definite CP. Hyperechoic foci without shadowing and stranding were the most common findings on endoscopic ultrasonography. The clinical profiles of early CP patients who showed lobularity with honeycombing on endoscopic ultrasonography or previous episodes of acute pancreatitis were similar to those of definite CP patients. We clarified the current status of early CP in Japan.

  8. Nationwide survey on barriers for dental research in India

    Directory of Open Access Journals (Sweden)

    Kundendu Arya Bishen

    2015-01-01

    Full Text Available Objective: Research in the dental field is progressing at mightier speed worldwide, but an unfortunately representation of India at this platform is negligible. The present study was undertaken to unearth the barriers for dental research among dental professionals in Indian scenario. Materials and Methods: A cross-sectional questionnaire study was conducted on 1514 participant′s (Master of Dental Surgery and Bachelor of Dental Surgery staff and postgraduates in 40 dental colleges of India selected by multistage random sampling. The response rate was 75.7%. The survey was undertaken from July 2013 to December 2013. The survey instrument was 24-item, investigator developed, self-structured, close-ended, and self-administered questionnaire grouped into four categories that are, institutional/departmental support related barriers, financial/training support related barriers, time-related barriers, and general barriers. Results: Among all respondents 47.23% informed that they are administrative and educational work rather than research work as (P < 0.001. Overall 57.53% of study participants reported lack of administrative and technical support for research work as (P < 0.001. Overall 64.9% reported meager college funding was the barrier (P < 0.001. Overall 61.5% respondents reported lack of time to do research work due to clinical and teaching responsibilities (P < 0.001 was the barrier for research. Largely 80.25% agreed that, the lack of documentation and record maintenance are an obvious barrier for research (P < 0.001. Conclusions: Present study unearths certain barriers for research in an Indian scenario, which includes administrative overburden, lack of funds, and lack of documentation of the dental data. Governing authorities of dentistry in India have to make major interventions to make research non-intensive environment to research-friendly environment.

  9. Napping and associated factors: a Japanese nationwide general population survey.

    Science.gov (United States)

    Furihata, Ryuji; Kaneita, Yoshitaka; Jike, Maki; Ohida, Takashi; Uchiyama, Makoto

    2016-04-01

    The objective of this study was to investigate napping habits and their associated factors in the Japanese adult general population. The cross-sectional survey was conducted in November 2007 for subjects selected randomly from among 300 districts throughout Japan. Data from 7664 people (3527 men and 4137 women), aged 20-99 years, were analyzed. Participants completed a self-administered questionnaire on frequency and duration of napping. The percentage of responders for high-frequency napping, four or more days per week, was 21.2% among men and 17.1% among women. The percentage of responders for long-duration napping, 2 h or more per one nap, was 2.9% among men and 2.6% among women. Multivariate logistic regression analyses revealed that men, older age, smoking, insomnia symptoms, long sleep duration, excessive daytime sleepiness, and having sufficient rest obtained by sleep were positively associated with high-frequency napping, whereas alcohol drinking showed a negative association. Older age was negatively associated with long-duration napping whereas living in a large community, smoking, long sleep duration, excessive daytime sleepiness, and psychological stress showed a positive association. These findings provide important data for future studies aimed at improvement of sleep habits. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Use of Facebook by Hospitals in Taiwan: A Nationwide Survey

    Directory of Open Access Journals (Sweden)

    Po-Chin Yang

    2018-06-01

    Full Text Available Background: Social media advertising has become increasingly influential in recent years. Because Facebook has the most active users worldwide, many hospitals in Taiwan have created official Facebook fan pages. Our study was to present an overview of official Facebook fan pages of hospitals in Taiwan. Methods: All 417 hospitals were surveyed about their use of Facebook fan pages in December 2017. The last update time, posts in the past 30 days, number of “Likes”, and other features were analyzed and stratified according to the accreditation statuses of the hospitals. Results: In Taiwan, only 51.1% (n = 213 of the hospitals had an official Facebook fan page. Among these hospitals, 71.8% (n = 153 had updated their pages in the past 30 days, although 89.2% (n = 190 provided online interactions. Academic medical centers tended to have more “Likes” than regional and local community hospitals (on average 5947.4, 2644.8, and 1548.0, respectively. Conclusions: In spite of the popularity of Facebook among the general population, most hospitals in Taiwan do not seem to make good use of this kind of social media. The reasons for the use and nonuse of Facebook on the part of both hospitals and patients deserve further investigation.

  11. Use of Facebook by Hospitals in Taiwan: A Nationwide Survey.

    Science.gov (United States)

    Yang, Po-Chin; Lee, Wui-Chiang; Liu, Hao-Yen; Shih, Mei-Ju; Chen, Tzeng-Ji; Chou, Li-Fang; Hwang, Shinn-Jang

    2018-06-06

    Background : Social media advertising has become increasingly influential in recent years. Because Facebook has the most active users worldwide, many hospitals in Taiwan have created official Facebook fan pages. Our study was to present an overview of official Facebook fan pages of hospitals in Taiwan. Methods : All 417 hospitals were surveyed about their use of Facebook fan pages in December 2017. The last update time, posts in the past 30 days, number of “Likes”, and other features were analyzed and stratified according to the accreditation statuses of the hospitals. Results : In Taiwan, only 51.1% ( n = 213) of the hospitals had an official Facebook fan page. Among these hospitals, 71.8% ( n = 153) had updated their pages in the past 30 days, although 89.2% ( n = 190) provided online interactions. Academic medical centers tended to have more “Likes” than regional and local community hospitals (on average 5947.4, 2644.8, and 1548.0, respectively). Conclusions : In spite of the popularity of Facebook among the general population, most hospitals in Taiwan do not seem to make good use of this kind of social media. The reasons for the use and nonuse of Facebook on the part of both hospitals and patients deserve further investigation.

  12. Nationwide survey of Helicobacter pylori antibiotic resistance in Thailand.

    Science.gov (United States)

    Vilaichone, Ratha-Korn; Gumnarai, Pornpen; Ratanachu-Ek, Thawee; Mahachai, Varocha

    2013-12-01

    The objectives of this study are to survey the antibiotic-resistant pattern of Helicobacter pylori infection in different geographical locations in Thailand and to determine factors associated with antibiotic resistance. Dyspeptic patients undergoing upper gastrointestinal endoscopy from the Northern, Northeastern, Central, and Southern regions of Thailand between January 2004 and December 2012 were enrolled in this study. Two antral gastric biopsies were obtained for culture; susceptibility tests were performed using E-test. A total of 3964 were enrolled, and 1350 patients (34.1%) were infected with H. pylori as identified by rapid urease test. Cultures were positive in 619 isolates. E-test for amoxicillin, clarithromycin, metronidazole, and tetracycline were successful in 400 isolates and for levofloxacin and ciprofloxacin in 208 isolates. Antibiotic resistance was present in 50.3% including amoxicillin 5.2%, tetracycline 1.7%, clarithromycin 3.7%, metronidazole 36%, ciprofloxacin 7.7%, levofloxacin 7.2%, and multi-drugs in 4.2%. Clarithromycin resistance was significantly more common in those older than 40 years (i.e., 100% versus 0%; P = 0.04). The prevalence of metronidazole resistant in Southern Thailand was significantly higher than in the Northeastern region (66.7% versus 33.3% P = 0.04). Metronidazole resistance remains the most common antibiotic resistant type of H. pylori in Thailand. The pattern of H. pylori antibiotic resistance over 9 years demonstrated a fall in clarithromycin resistance such that currently age >40 years is a predictor for clarithromycin resistance in Thailand. Quinolone resistance is a growing problem. © 2013.

  13. Survey of radiation doses received by atomic-bomb survivors residing in the United States

    International Nuclear Information System (INIS)

    Kerr, G.D.; Yamada, H.; Marks, S.

    1976-01-01

    A survey has been completed of 300 of an estimated 500 to 750 survivors of the atomic bombings in Hiroshima and Nagasaki who reside in the United States. Distributions with respect to age, sex, citizenship status, distance from the hypocenter at the time of bombing, and dose from immediate weapon radiation have been tabulated from the results and are presented for this group of 300 survivors. Also presented are survey results concerning exposures to residual radiation from fallout and neutron-induced radioactivity in the areas adjacent to the hypocenter

  14. Nationwide cross-sectional survey of schistosomiasis and soil-transmitted helminthiasis in Sudan: study protocol.

    Science.gov (United States)

    Cha, Seungman; Hong, Sung-Tae; Lee, Young-Ha; Lee, Keon Hoon; Cho, Dae Seong; Lee, Jinmoo; Chai, Jong-Yil; Elhag, Mousab Siddig; Khaled, Soheir Gabralla Ahmad; Elnimeiri, Mustafa Khidir Mustafa; Siddig, Nahid Abdelgadeir Ali; Abdelrazig, Hana; Awadelkareem, Sarah; Elshafie, Azza Tag Eldin; Ismail, Hassan Ahmed Hassan Ahmed; Amin, Mutamad

    2017-09-12

    Schistosomiasis and soil-transmitted helminthiasis (STHs) are target neglected tropical diseases (NTDs) of preventive chemotherapy, but the control and elimination of these diseases have been impeded due to resource constraints. Few reports have described study protocol to draw on when conducting a nationwide survey. We present a detailed methodological description of the integrated mapping of schistosomiasis and STHs on the basis of our experiences, hoping that this protocol can be applied to future surveys in similar settings. In addition to determining the ecological zones requiring mass drug administration interventions, we aim to provide precise estimates of the prevalence of these diseases. A school-based cross-sectional design will be applied for the nationwide survey across Sudan. The survey is designed to cover all districts in every state. We have divided each district into 3 different ecological zones depending on proximity to bodies of water. We will employ a probability-proportional-to-size sampling method for schools and systematic sampling for student selection to provide adequate data regarding the prevalence for schistosomiasis and STHs in Sudan at the state level. A total of 108,660 students will be selected from 1811 schools across Sudan. After the survey is completed, 391 ecological zones will be mapped out. To carry out the survey, 655 staff members were recruited. The feces and urine samples are microscopically examined by the Kato-Katz method and the sediment smears for helminth eggs respectively. For quality control, a minimum of 10% of the slides will be rechecked by the federal supervisors in each state and also 5% of the smears are validated again within one day by independent supervisors. This nationwide mapping is expected to generate important epidemiological information and indicators about schistosomiasis and STHs that will be useful for monitoring and evaluating the control program. The mapping data will also be used for overviewing

  15. Diet Quality of Cancer Survivors and Non-Cancer Individuals: Results from a National Survey

    Science.gov (United States)

    Zhang, Fang Fang; Liu, Shanshan; John, Esther; Must, Aviva; Demark-Wahnefried, Wendy

    2015-01-01

    Background Patterns of poor nutritional intake may exacerbate elevated morbidity experienced by cancer survivors. It remains unclear whether cancer survivors adhere to existing dietary guidelines, and whether survivors’ diet differs from individuals without cancer long-term. Methods We evaluated dietary intake and quality in 1,533 adult cancer survivors in the National Health and Nutrition Examination Survey (NHANES) 1999–2010 and compared that to 3,075 individuals without a history of cancer who were matched to cancer survivors by age, gender, and race/ethnicity. Dietary intake was assessed using 24-hour dietary recalls. The Healthy Eating Index (HEI)-2010 was used to evaluate diet quality. Results The mean HEI-2010 total score was 47.2 (SD=0.5) in cancer survivors and 48.3 (SD=0.4) in non-cancer individuals (p=0.03). Compared to non-cancer individuals, cancer survivors had a significantly lower score of empty calories (13.6 vs. 14.4, p=0.001), which corresponds to worse adherence to dietary intake of calories from solid fats, alcohol and added sugars. Cancer survivors also had a significantly lower dietary intake of fiber than non-cancer individuals (15.0 vs. 15.9 grams/day, p=0.02). Survivors’ mean dietary intakes of vitamin D, vitamin E, potassium, fiber, and calcium were 31%, 47%, 55%, 60%, and 73% in relation to the recommended intake whereas the mean dietary intake of saturated fat and sodium was 112% and 133% of the recommended intake. Conclusions Cancer survivors had a poor adherence to the 2010 Dietary Guidelines for Americans, and their intake patterns were worse than those in the general population for empty calories and fiber. PMID:26624564

  16. The need for decision and communication aids: a survey of breast cancer survivors.

    Science.gov (United States)

    Belkora, Jeffrey K; Miller, Melissa F; Dougherty, Kasey; Gayer, Christopher; Golant, Mitch; Buzaglo, Joanne S

    2015-03-01

    Qualitative studies have identified barriers to communication and informed decision making among breast cancer survivors making treatment decisions. The prevalence of these barriers is unknown. To quantify the need for decision support among breast cancer survivors. We surveyed 2,521 breast cancer survivors participating in an online registry hosted by the Cancer Support Community to find out what proportion of breast cancer patients: made decisions during their first visit with a specialist; received satisfactory information before that visit; asked questions and received responses; and endorsed expanded use of decision support. We received 1,017 (41%) responses and analyzed 917 surveys from women who lived in the United States. Most of the respondents recalled making treatment decisions during their first visit (52%). A minority (14%) received information before the first specialist visit. At least 25% of respondents rated their satisfaction below 7 on a scale of 10 for decision-making, information, and questions asked and answered. Respondents endorsed the need for assistance with obtaining information, listing questions, taking notes, and making audio-recordings of visits. The respondent sample skewed younger and had higher-stage cancer compared with all breast cancer survivors. Responses were subject to recall bias. Cancer survivors expressed gaps in their care with respect to reviewing information, asking questions, obtaining answers, and making decisions. Implementing decision and communication aids immediately upon diagnosis, when treatment decisions are being made, would address these gaps. ©2015 Frontline Medical Communications.

  17. A nationwide radon concentration survey project in Japan. Outdoor and workplaces

    International Nuclear Information System (INIS)

    Oikawa, S.; Kanno, N.; Ohashi, N.; Abukawa, J.

    2003-01-01

    Nationwide survey for outdoor and workplace radon ( 222 Rn) concentration in Japan were carried out to evaluate the effective dose to the general public due to 222 Rn and its progeny. The 222 Rn concentration was measured by using passive-type radon/thoron discriminative monitor equipped with polycarbonate films. Concentration of 222 Rn was calculated from etch pit counts appeared on the polycarbonate film after chemical and electrochemical etching. For outdoor 222 Rn survey, the monitors were installed at about 700 points throughout Japan on every quarters of the fiscal year 1997 to 1999. The mean concentration of outdoor 222 Rn concentration was 6.1 Bq m -3 from the results of 696 measurement points. Seasonal variation of outdoor 222 Rn was found to be minimal in July to September, and maximal in October to December. For workplace 222 Rn survey, the monitors were installed at about 700 points in four categories (office, factory, school and hospital) on every quarters of the fiscal year 2000 to 2002. Nationwide mean 222 Rn concentration in workplaces was found to be 22.7 Bq m -3 for 2000 and 20.7 Bq m -3 for 2001, respectively. Seasonal variation of 222 Rn concentration measured at office, factory, school and hospital were also found to be minimal in July to September, and maximal in October to December. (author)

  18. A nationwide survey of radon concentration in Japan. Indoor, outdoor and workplace

    International Nuclear Information System (INIS)

    Sanada, Tetsuya; Oikawa, Shinji; Kanno, Nobuyuki; Abukawa, Johji; Higuchi, Hideo

    2004-01-01

    The nationwide indoor, outdoor and workplace radon concentrations were surveyed in Japan. These surveys were conducted to estimate the natural radiation dose due to radon and its progeny for the general public. The radon concentration was measured using passive type radon monitor. The number of radon monitors were installed at indoor, outdoor and workplace for 940 houses, 705 points and 705 sites, respectively. The radon concentration was measured for one year at each measurement site. Annual mean radon concentration was obtained from four quarters measurements of 47 prefectures in Japan. The nationwide indoor, outdoor and workplace annual mean radon concentration were 15.5 Bq m -3 , 6.1 Bq m -3 and 20.8 Bq m -3 , respectively. Their radon concentration shows approximately a logarithmic normal distribution. Workplace showed relatively high radon concentration compared with other environments, may be due to construction materials and low ventilation rate. The indoor radon concentration found to be seasonal variation and architectural dependences. Seasonal variation and regional distribution of outdoor radon concentration was also observed. From the results of these radon surveys, the annual effective dose to the general public due to radon and its progeny was estimated to be 0.49 mSv y -1 in Japan. (author)

  19. Institutional racism in public health contracting: Findings of a nationwide survey from New Zealand.

    Science.gov (United States)

    Came, H; Doole, C; McKenna, B; McCreanor, T

    2018-02-01

    Public institutions within New Zealand have long been accused of mono-culturalism and institutional racism. This study sought to identify inconsistencies and bias by comparing government funded contracting processes for Māori public health providers (n = 60) with those of generic providers (n = 90). Qualitative and quantitative data were collected (November 2014-May 2015), through a nationwide telephone survey of public health providers, achieving a 75% response rate. Descriptive statistical analyses were applied to quantitative responses and an inductive approach was taken to analyse data from open-ended responses in the survey domains of relationships with portfolio contract managers, contracting and funding. The quantitative data showed four sites of statistically significant variation: length of contracts, intensity of monitoring, compliance costs and frequency of auditing. Non-significant data involved access to discretionary funding and cost of living adjustments, the frequency of monitoring, access to Crown (government) funders and representation on advisory groups. The qualitative material showed disparate provider experiences, dependent on individual portfolio managers, with nuanced differences between generic and Māori providers' experiences. This study showed that monitoring government performance through a nationwide survey was an innovative way to identify sites of institutional racism. In a policy context where health equity is a key directive to the health sector, this study suggests there is scope for New Zealand health funders to improve their contracting practices. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Current Cytology Practices in Korea: A Nationwide Survey by the Korean Society for Cytopathology

    Directory of Open Access Journals (Sweden)

    Eun Ji Oh

    2017-11-01

    Full Text Available Background Limited data are available on the current status of cytology practices in Korea. This nationwide study presents Korean cytology statistics from 2015. Methods A nationwide survey was conducted in 2016 as a part of the mandatory quality-control program by the Korean Society for Cytopathology. The questionnaire was sent to 208 medical institutions performing cytopathologic examinations in Korea. Individual institutions were asked to submit their annual cytology statistical reports and gynecologic cytology-histology correlation data for 2015. Results Responses were obtained from 206 medical institutions including 83 university hospitals, 87 general hospitals, and 36 commercial laboratories. A total of 8,284,952 cytologic examinations were performed in 2015, primarily in commercial laboratories (74.9%. The most common cytology specimens were gynecologic samples (81.3%. Conventional smears and liquid-based cytology were performed in 6,190,526 (74.7% and 2,094,426 (25.3% cases, respectively. The overall diagnostic concordance rate between cytologic and histologic diagnoses of uterine cervical samples was 70.5%. Discordant cases were classified into three categories: category A (minimal clinical impact, 17.4%, category B (moderate clinical impact, 10.2%, and category C (major clinical impact, 1.9%. The ratio of atypical squamous cells of undetermined significance to squamous intraepithelial lesion was 1.6 in university hospitals, 2.9 in general hospitals, and 4.9 in commercial laboratories. Conclusions This survey reveals the current status and trend of cytology practices in Korea. The results of this study can serve as basic data for the establishment of nationwide cytopathology policies and quality improvement guidelines in Korean medical institutions.

  1. A nationwide study on reproductive function, ovarian reserve, and risk of premature menopause in female survivors of childhood cancer: design and methodological challenges

    Directory of Open Access Journals (Sweden)

    Overbeek Annelies

    2012-08-01

    Full Text Available Abstract Background Advances in childhood cancer treatment over the past decades have significantly improved survival, resulting in a rapidly growing group of survivors. However, both chemo- and radiotherapy may adversely affect reproductive function. This paper describes the design and encountered methodological challenges of a nationwide study in the Netherlands investigating the effects of treatment on reproductive function, ovarian reserve, premature menopause and pregnancy outcomes in female childhood cancer survivors (CCS, the DCOG LATER-VEVO study. Methods The study is a retrospective cohort study consisting of two parts: a questionnaire assessing medical, menstrual, and obstetric history, and a clinical assessment evaluating ovarian and uterine function by hormonal analyses and transvaginal ultrasound measurements. The eligible study population consists of adult female 5-year survivors of childhood cancer treated in the Netherlands, whereas the control group consists of age-matched sisters of the participating CCS. To date, study invitations have been sent to 1611 CCS and 429 sister controls, of which 1215 (75% and 333 (78% have responded so far. Of these responders, the majority consented to participate in both parts of the study (53% vs. 65% for CCS and sister controls respectively. Several challenges were encountered involving the study population: dealing with bias due to the differences in characteristics of several types of (non- participants and finding an adequately sized and well-matched control group. Moreover, the challenges related to the data collection process included: differences in response rates between web-based and paper-based questionnaires, validity of self-reported outcomes, interpretation of clinical measurements of women using hormonal contraceptives, and inter- and intra-observer variation of the ultrasound measurements. Discussion The DCOG LATER-VEVO study will provide valuable information about the

  2. Postvention in the U.S. Military: Survey of Survivors of Suicide Loss from 2010-2014

    Science.gov (United States)

    2018-02-01

    were not met. Researchers synthesized the quantitative and qualitative results into nine key findings. Results indicated that NOK and fellow unit... researchers used a “survivor sensitive” recruitment method in which CAO LTMCs, who have existing relationships with survivors, conducted the initial...information, see AAPOR, 2015). SURVEY DESIGN Researchers reviewed the types of DoD bereavement support and postvention resources available to survivors in

  3. Providing written information increases patient satisfaction: a web-based questionnaire survey of Japanese cancer survivors.

    Science.gov (United States)

    Sakai, Hitomi; Katsumata, Noriyuki; Takahashi, Miyako

    2017-07-01

    The Institute of Medicine (IOM) of the United States recommends that all cancer survivors be provided with a survivorship care plan (SCP), which includes a patient treatment summary and a follow-up care plan. However, SCPs have not been widely adopted in Japan. To provide basic data necessary for implementing SCPs in Japan, we aimed to investigate the forms of clinical and survivorship-related information that Japanese cancer survivors receive from their healthcare providers, and to examine whether written information increases their satisfaction. We performed a cross-sectional online survey of cancer survivors who underwent acute cancer treatment and had at least one follow-up with a physician in the past year. Cancer survivors provided the elements and forms (verbally and/or written) of information they received, as well as the degree of satisfaction with the information provided. Responses were obtained from 545 cancer survivors. Information elements such as surgical procedure (98.3%), surgical outcome (98.1%), and names of administered chemotherapy agents (97.8%) were commonly provided, whereas mental care resources and providers (29.7%), effects on marital relationship and sexual health (35.7%), and effects on fertility (43.4%) were less common. A large proportion of cancer survivors received verbal information only. For 18 of 20 elements, except for effects on fertility and duration of hormonal therapy, satisfaction was significantly higher when both forms of information were provided (P information can better meet the needs of Japanese cancer survivors. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  4. Spirituality, resilience, and anger in survivors of violent trauma: a community survey.

    Science.gov (United States)

    Connor, Kathryn M; Davidson, Jonathan R T; Lee, Li-Ching

    2003-10-01

    This study evaluates the relationship between spirituality, resilience, anger and health status, and posttraumatic symptom severity in trauma survivors. A community sample (N = 1,200) completed an online survey that included measures of resilience, spirituality (general beliefs and reincarnation), anger, forgiveness, and hatred. In survivors of violent trauma (n = 648), these measures were evaluated with respect to their relationship to physical and mental health, trauma-related distress, and posttraumatic symptom severity. Using multivariate regression models, general spiritual beliefs and anger emerged in association with each outcome, whereas resilience was associated with health status and posttraumatic symptom severity only. Forgiveness, hatred, and beliefs in reincarnation were not associated with outcome. The importance of these findings to treating trauma survivors is discussed.

  5. Mental health survey among landmine survivors in Siem Reap province, Cambodia.

    Science.gov (United States)

    Lopes Cardozo, Barbara; Blanton, Curtis; Zalewski, Tami; Tor, Svang; McDonald, Laura; Lavelle, James; Brooks, Robert; Anderson, Mark; Mollica, Richard

    2012-01-01

    Many survivors of the Khmer Rouge period in Cambodia and the subsequent war with Vietnam have now returned to Cambodia. In this two-stage household cluster survey in Siem Reap Province in Cambodia, we explored the mental health consequences on 166 landmine injury survivors selected from 1000 household in 50 clusters and an oversample of all landmine survivors. We found a prevalence of anxiety of 62% for all respondents, 74% for depression, and 34% for post-traumatic stress disorder (PTSD). These prevalences were statistically significantly higher than among the adult population who had not been injured by landmines. These data underscore the importance of providing mental health care services for the people in Siem Reap Province in Cambodia who have been injured by landmines.

  6. Risk factors for feelings of sadness and suicide attempts among cancer survivors in South Korea: findings from nationwide cross-sectional study (KNHANES IV-VI).

    Science.gov (United States)

    Choi, Jeewoong; Lee, Mijo; Ki, Myung; Lee, Ju-Yeong; Song, Yeong-Jun; Kim, Miram; Lee, Sunyoung; Park, Soonjoo; Lim, Jiseun

    2017-12-14

    As the number of cancer survivors is rapidly increasing with the increased incidence of the disease and improved survival of patients, the prevalence of, and risk factors for, mental health problems and suicidality among cancer survivors should be examined. Using data obtained from the Korean National Health and Nutrition Examination Survey (2007-2013), we examined 1285 and 33 772 participants who had been and never been diagnosed with cancer, respectively. We investigated the risks of feelings of sadness and suicide attempts among cancer survivors and general population and examined differences in the risks of cancer survivors among subgroups according to cancer-related characteristics. The median age of survivors at the time of the survey and at diagnosis was 63 and 54 years, respectively. After adjusting for sex, level of education, household income, occupation, marital status, cancer type, current status of treatment, age at diagnosis and years since diagnosis, the risk of suicide attempts was significantly higher in participants diagnosed with cancer before 45 years of age compared with those diagnosed at 45-64 years (adjusted OR=3.81, 95% CI 1.07 to 13.60, P=0.039), and the higher risk of suicide attempts with borderline significance was found in those for whom more than 10 years had passed since diagnosis compared with those for whom the diagnosis was made only 2-10 years ago (adjusted OR=3.38, 95% CI 0.98 to 11.70, P=0.055). However, feelings of sadness were not significantly associated with any cancer-related characteristic. Our results reveal an increased risk of suicide attempts among cancer survivors diagnosed early in life and in those for whom more than 10 years has passed since the diagnosis, suggesting the need for intensive monitoring and support for mental health problems and suicidal risks in this population. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial

  7. Investigation of stomach diseases in atomic bomb survivors, 6. Gastric mass survey in atomic bomb survivors (1982 - 1984)

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Masafumi; Matsumoto, Yasuko; Mito, Kazuyo; Kumazawa, Toshihiko; Ito, Chikako

    1986-11-01

    This is a report of the results of gastric mass survey performed during a 3-year period from 1982 through 1984. Included in this survey were 16,781 A-bomb survivors. The subjects were divided into three groups: a group exposed at less than or equal to 2,000 m from ground zero (Group 1), a group exposed at > 2,000 m from ground zero (Group 2), and a group consisting of those who entered the city after the bombing or others (Group 3). Regarding the rate for necessity of detailed examinations, there was no difference among the groups. The incidence of abnormal findings was 6.1% in Group 1, 5.4% in Group 2, and 4.9% in Group 3, showing significant difference between Groups 1 and 3. Similarly, the incidence of respective disease was significantly higher in Group 1 than Group 3: gastritis was the most common (2.7% vs 2.0%), followed by gastric polyp (0.9% vs 0.5%) and gastric cancer (0.6% vs 0.2%). The age-adjusted incidence of gastric cancer and polyp was high, irrespective of sex, in Group 1. This was significant for gastric cancer in women and for gastric polyp in men. The incidence of gastric cancer in any age class was higher in Group 1 than Group 3. The incidence of gastric polyp tended to increase with aging in Group 1, being higher particularly for survivors over the age of 50 than those in Groups 2 and 3. (Namekawa, K.).

  8. Timing and risk of mood disorders requiring psychotropics in long-term survivors of adult cancers: A nationwide cohort study.

    Science.gov (United States)

    Huang, Wen-Kuan; Juang, Yeong-Yuh; Chung, Chia-Chi; Chang, Shu-Hao; Chang, John Wen-Cheng; Lin, Yung-Chang; Wang, Hung-Ming; Chang, Hsien-Kun; Chen, Jen-Shi; Tsai, Chieh-Sheng; Yu, Kuang-Hui; Kuo, Chang-Fu; See, Lai-Chu

    2018-08-15

    The increasing number of long-term cancer survivors over the past few decades poses the challenge of mental health care needs. However, little is known about risks of mood disorders in long-term cancer survivors. Long-term survivors (≥5 years) of adult cancers (LSAC) (n = 190,748) newly diagnosed between January 1, 2000 and December 31, 2007 were matched with one control. The primary outcome was diagnosis of mood disorders requiring psychotropics. Cumulative incidences and sub-hazard ratios (SHR) were calculated and multivariate analyses were conducted after accounting for mortality. The mood disorder risk was significantly higher in the LSAC cohort than in the control cohort (adjusted SHR = 1.16, 95% confidence interval [CI] = 1.13-1.18, P < 0.001). Patients with certain cancer types were at increased risk, particularly in the first 2 years after diagnosis. However, patients with head and neck cancers or esophageal cancers had a higher risk after the 5-year follow-up period. Multivariate analysis indicated that being female, aged 40-59 years, with more than two primary cancers, receiving two or more treatment modalities, having CCI scores higher than 3, a higher urbanization level, and lower monthly income were independently associated with an increased risk of mood disorders. Some potential confounders such as lifestyle factors were not available in the study. These findings call for increased mental health awareness not only in the early years after the cancer diagnosis, but also during long-term follow-up for certain cancer subtypes. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Who are the cancer survivors?

    DEFF Research Database (Denmark)

    Hovaldt, Hanna Birkbak; Suppli, N P; Olsen, M H

    2015-01-01

    was compared by social position with the non-cancer population. Results: Cancer survivors composed 4% of the Danish population. Somatic comorbidity was more likely among survivors (OR 1.59, 95% CI 1.57-1.60) and associated with higher age, male sex, short education, and living alone among survivors......Background: No nationwide studies on social position and prevalence of comorbidity among cancer survivors exist. Methods: We performed a nationwide prevalence study defining persons diagnosed with cancer 1943-2010 and alive on the census date 1 January 2011 as cancer survivors. Comorbidity....... Conclusions: Among cancer survivors, comorbidity is common and highly associated with social position....

  10. Physical activity and sedentary behavior of cancer survivors and non-cancer individuals: results from a national survey.

    Science.gov (United States)

    Kim, Roy B; Phillips, Allison; Herrick, Kirsten; Helou, Marieka; Rafie, Carlin; Anscher, Mitchell S; Mikkelsen, Ross B; Ning, Yi

    2013-01-01

    Increasing physical activity and decreasing sedentary behavior are associated with a higher quality of life and lower mortality rates for cancer survivors, a growing population group. Studies detailing the behavior of cancer survivors are limited. Therefore, we investigated physical activity and sedentary behavior of cancer survivors using data from the National Health and Nutrition Examination Survey (NHANES) 2007-2010. Participants were those who provided physical activity and sedentary behavior data. Those who were pregnant, physical activity, compared to non-cancer participants. These patterns are similar for breast and prostate cancer survivors, with prostate cancer survivors more likely to engage in physical activity for more than one hour per day (OR = 1.98, 95% CI (1.05, 3.71)). Our findings suggest that cancer survivors tend to have more physical activity, but they are also more likely to engage in sedentary behavior.

  11. Result of medical survey in atomic bomb survivors

    International Nuclear Information System (INIS)

    Ito, Chikako; Tsubota, Motoki; Kumasawa, Toshihiko

    1980-01-01

    General health examinations were performed on 242,296 a-bomb survivors during 5 years between 1972 and 1977. They were grouped according to exposure conditions, sex, and ages, and the results of examinations were compared. The rate of an erythrocyte count under 3,490,000 or the rate of a hemoglobin under 11.0 g/dl was higher in men of the group exposed within 1.9 km from the hypocenter than those in other exposed groups. The rate of an erythrocyte count under 3,490,000 and the incidence of hypertension were higher in women of the group exposed within 1.9 km than those of other exposed groups. There was a difference in an erythrocyte count, a hemoglobin, a white blood cell count, the rate of positive test for protein and glucose in urine, and blood pressure between men and women. The incidences of mild anemia and hypertension and the rate of positive test for glucose in urine increased with time. An erythrocyte count and a hemoglobin in women aged over 60 and men decreased linearly with their aging, but there was not a difference in them caused by exposure conditions. The maximum blood pressure in men and women increased with their aging, but there was not a difference in them caused by exposure conditions. (Tsunoda, M.)

  12. Perceptions of the Inpatient Training Experience: A Nationwide Survey of Gastroenterology Program Directors and Fellows.

    Science.gov (United States)

    Kumar, Navin L; Perencevich, Molly L; Trier, Jerry S

    2017-10-01

    Inpatient training is a key component of gastroenterology (GI) fellowship programs nationwide, yet little is known about perceptions of the inpatient training experience. To compare the content, objectives and quality of the inpatient training experience as perceived by program directors (PD) and fellows in US ACGME-accredited GI fellowship programs. We conducted a nationwide, online-based survey of GI PDs and fellows at the conclusion of the 2016 academic year. We queried participants about (1) the current models of inpatient training, (2) the content, objectives, and quality of the inpatient training experience, and (3) the frequency and quality of educational activities on the inpatient service. We analyzed five-point Likert items and rank assessments as continuous variables by an independent t test and compared proportions using the Chi-square test. Survey response rate was 48.4% (75/155) for PDs and a total of 194 fellows completed the survey, with both groups reporting the general GI consult team (>90%) as the primary model of inpatient training. PDs and fellows agreed on the ranking of all queried responsibilities of the inpatient fellow to develop during the inpatient service. However, fellows indicated that attendings spent less time teaching and provided less formal feedback than that perceived by PDs (p < 0.0001). PDs rated the overall quality of the inpatient training experience (p < 0.0001) and education on the wards (p = 0.0003) as better than overall ratings by fellows. Although GI fellows and PDs agree on the importance of specific fellow responsibilities on the inpatient service, fellows report experiencing less teaching and feedback from attendings than that perceived by PDs. Committing more time to education and assessment may improve fellows' perceptions of the inpatient training experience.

  13. Psychologists involved in cancer palliative care in Japan: A nationwide survey.

    Science.gov (United States)

    Nakajima, Kasumi; Iwamitsu, Yumi; Matsubara, Mei; Oba, Akira; Hirai, Kei; Morita, Tatsuya; Kizawa, Yoshiyuki

    2015-04-01

    The aim of this study was to clarify, using a nationwide survey, what is perceived as necessary knowledge and skills for psychologists involved in cancer palliative care in Japan, the expectations of medical staff members, and the degree to which these expectations are met. We conducted a questionnaire survey of psychologists involved in cancer palliative care. A total of 419 psychologists from 403 facilities were asked to fill out the questionnaire and return it anonymously. Some 401 psychologists (89 males, 310 females, and 2 unspecified; mean age, 37.2 ± 9.5 years) responded about necessary knowledge and skills for psychologists working in cancer palliative care, the necessity for training, expectations at their current workplace, and the degree to which expectations are met. More than 90% of participants responded that many kinds of knowledge and skills related to the field of cancer palliative care are necessary. Over 80% of participants indicated a necessity for training related to these knowledge and skills. Although more than 50% (range, 50.1-85.8%) of participants responded that such services as "cooperation with medical staff within a hospital," "handling patients for whom psychological support would be beneficial," and "assessment of patients' mental state" were expected at their workplace, fewer than 60% (31.4-56.9%) responded that they actually performed these roles. Our results show that many psychologists in cancer palliative care feel unable to respond to the expectations at their current workplace and that they require more adequate knowledge and skills related to cancer palliative care to work effectively. No other nationwide surveys have generated this type of information in Japan, so we believe that the results of our study are uniquely important.

  14. Test-Retest Reliability of the Short-Form Survivor Unmet Needs Survey.

    Science.gov (United States)

    Taylor, Karen; Bulsara, Max; Monterosso, Leanne

    2018-01-01

    Reliable and valid needs assessment measures are important assessment tools in cancer survivorship care. A new 30-item short-form version of the Survivor Unmet Needs Survey (SF-SUNS) was developed and validated with cancer survivors, including hematology cancer survivors; however, test-retest reliability has not been established. The objective of this study was to assess the test-retest reliability of the SF-SUNS with a cohort of lymphoma survivors ( n = 40). Test-retest reliability of the SF-SUNS was conducted at two time points: baseline (time 1) and 5 days later (time 2). Test-retest data were collected from lymphoma cancer survivors ( n = 40) in a large tertiary cancer center in Western Australia. Intraclass correlation analyses compared data at time 1 (baseline) and time 2 (5 days later). Cronbach's alpha analyses were performed to assess the internal consistency at both time points. The majority (23/30, 77%) of items achieved test-retest reliability scores 0.45-0.74 (fair to good). A high degree of overall internal consistency was demonstrated (time 1 = 0.92, time 2 = 0.95), with scores 0.65-0.94 across subscales for both time points. Mixed test-retest reliability of the SF-SUNS was established. Our results indicate the SF-SUNS is responsive to the changing needs of lymphoma cancer survivors. Routine use of cancer survivorship specific needs-based assessments is required in oncology care today. Nurses are well placed to administer these assessments and provide tailored information and resources. Further assessment of test-retest reliability in hematology and other cancer cohorts is warranted.

  15. Health care utilisation and characteristics of long-term breast cancer survivors: nationwide survey in Denmark

    DEFF Research Database (Denmark)

    Peuckmann, V; Ekholm, O; Sjøgren, P

    2008-01-01

    Cooperative Group register. A self-administered questionnaire assessed sociodemography, health care utilisation, employment, and health-related quality of life (HRQOL). Associations with breast cancer treatment were investigated. RESULTS: Response rate was 79%. Significantly more BCS than the general women......%, and 'stopped working/changed job due to sequelae' by 11% of BCS. In multiple logistic regression analysis, radiotherapy (odds ratio (OR) 2.54; 95% CI 1.34-4.80) and endocrine therapy (OR 2.48; 95% CI 1.13-5.45, postmenopausal women only) were significantly related to 'stopped working/changed job due...

  16. Chronic pain and other sequelae in long-term breast cancer survivors: Nationwide survey in Denmark

    DEFF Research Database (Denmark)

    Peuckmann, V.; Ekholm, O.; Rasmussen, N.K.

    2008-01-01

    %, chronic pain 29%, arm/shoulder swelling 25%, phantom sensations 19%, and allodynia 15%. Chronic pain related to breast cancer was significantly associated with poorer HRQOL and higher medicine consumption, and, in multiple logistic regression analysis, with age (education, being single...... (divorced, widowed, separated), radiotherapy, and time since operation

  17. Unhealthy lifestyle, poor mental health, and its correlation among adolescents: a nationwide cross-sectional survey.

    Science.gov (United States)

    Tanihata, Takeo; Kanda, Hideyuki; Osaki, Yoneatsu; Ohida, Takashi; Minowa, Masumi; Wada, Kiyoshi; Suzuki, Kenji; Hayashi, Kenji

    2015-03-01

    The objective was to study the relationship between mental health and lifestyles of adolescents using samples representative of Japanese adolescents nationwide. The survey was conducted between December 2004 and January 2005 among students enrolled in randomly selected junior and senior high schools. Self-administered questionnaires addressed lifestyles, sleeping habits, and mental health status. Of 103 650 questionnaires collected, 85 158 were analyzed. Population characteristics associated with poor mental health were being female, being a senior high school student, skipping breakfast, not participating in extracurricular activities, not consulting parents about personal matters, parental smoking, students' smoking or alcohol use, poor subjective sleep assessment, and short or long sleeping duration. Smoking and anxiety disorders are associated with an elevation in acculturative stress in adolescents. Prepossessing adolescents are in subclinical depression. Results suggest that lifestyles approaches in preventions that target students can be effective in reaching high-risk populations. © 2012 APJPH.

  18. Gender Differences in Depressive Symptom Profile: Results from Nationwide General Population Surveys in Korea.

    Science.gov (United States)

    Kim, Ji-Hyun; Cho, Maeng Je; Hong, Jin Pyo; Bae, Jae Nam; Cho, Seong-Jin; Hahm, Bong-Jin; Lee, Dong-Woo; Park, Jong-Ik; Lee, Jun-Young; Jeon, Hong Jin; Chang, Sung Man

    2015-11-01

    This study investigated gender differences in symptom profiles of major depressive disorder (MDD) in the Korean general population. Data were pooled from the series of nationwide Korean Epidemiologic Catchment Area surveys conducted in 2001, 2006 and 2011, respectively. Of the 18,807 participants, 507 (397 women and 110 men) were diagnosed with MDD within the prior 12 months. In agreement with previous studies, women with MDD appeared to be more vulnerable to experiencing atypical depressive episodes defined as depression with two or more symptoms of fatigue, increased appetite and hypersomnia (P differences in symptomatology of MDD in the general Korean population, and the results are comparable to previous investigations from western societies. Assumingly, the intercultural similarity in female preponderance to atypical depression might reflect the common biological construct underlying the gender difference in mechanism of MDD. In clinical settings, gender differences of MDD should be carefully considered, because these features could be related with treatment response and drug side effects.

  19. Diagnostic delay experienced among gynecological cancer patients: a nationwide survey in Denmark

    DEFF Research Database (Denmark)

    Robinson, Kirstine M; Ottesen, Bent; Christensen, Karl Bang

    2009-01-01

    OBJECTIVE: To examine diagnostic delay among gynecological cancer patients. DESIGN: Nationwide study. SETTING: The cohort comprised all women receiving their first treatment for cervical, endometrial, or ovarian cancer between 1 October 2006 and 1 December 2007 in four of the five centers...... for gynecological cancer surgery in Denmark. SAMPLE: Of the 911 women alive, 648 participated, resulting in a response rate of 71.1%; of these, 30.1% were diagnosed with cervical cancer, 31.0% with endometrial cancer, and 38.9% with ovarian cancer. METHODS: Questionnaire survey. MAIN OUTCOME MEASURES: Diagnostic...... experiencing very long delays. Ovarian cancer patients experienced significantly shorter delays compared with other gynecological cancer patients in all parts of the health care system. CONCLUSIONS: Delays occur in all parts of the diagnostic process, suggesting that a multifaceted approach should be adopted...

  20. Public attitudes toward practice by medical students: a nationwide survey in Japan.

    Science.gov (United States)

    Murata, Kyoko; Sakuma, Mio; Seki, Susumu; Morimoto, Takeshi

    2014-01-01

    It is essential for medical students to interact directly with patients. However, patients may be reluctant to be seen by medical students in settings in which they may also be seen by senior staff. To understand patients' attitudes toward practice by medical students and consider the factors involved in obtaining patients' cooperation, we conducted a nationwide cross-sectional survey. We randomly selected 2,400 adult participants from all over Japan. Trained research assistants inquired about participants' experiences and attitudes toward practice by medical students using a questionnaire. We compared differences in attitudes between participants who were accepting of practice by medical students and those who were not, as well as differences between participants who had experienced practice by a medical student versus those who had not. A total of 1,109 (46%) participants were included in the study. Eleven percent (117/1109) of the participants had experienced practice by a medical student. One fourth of participants were accepting of practice by medical students, and experienced participants were significantly more likely to be accepting of practice by medical students than inexperienced participants (45% vs. 24%, ppractice by medical students among accepting participants with previous experiences included "polite," "kind," and "hard-working." Fifty-nine percent (637/1088) of participants indicated that they would request a senior staff member's supervision when being seen by a medical student. The present nationwide survey suggests that education emphasizing bedside manner may be effective in promoting patients' cooperation of medical students. In addition, providing information to patients about medical students and efforts to increase supervision during clinical clerkship should be emphasized to foster the public's cooperation.

  1. Working and training conditions of residents in pediatric surgery: a nationwide survey in Germany.

    Science.gov (United States)

    Reismann, M; Ellerkamp, V; Dingemann, J

    2010-09-01

    As in other surgical specialties, increasing concern has been expressed worldwide about the shortage of trainees in pediatric surgery training programs. We performed a nationwide survey to investigate the current situation in Germany. An internet-based nationwide survey comprising 36 questions on training conditions in pediatric surgery was linked to the homepage of the German Society of Pediatric Surgery from June to September 2008. Statements on the following aspects were evaluated by responding residents using a scale from 1 (I do not agree at all) to 5 (I fully agree): workplace, cooperation with colleagues, head of the department, cooperation with other specialties, training and research conditions. A median value of 3 indicated an unsatisfactory assessment, with at least 50% of respondents giving an indifferent or negative response. 70 questionnaires were completed. Some of the evaluations revealed problematic areas. In particular, statements regarding working hours revealed dissatisfaction among the responding doctors. The median value accorded the statement "I am satisfied with the current working time regulation" was 2.9. With regard to departmental heads, some criticisms were directed against a perceived lack of soft skills. According to the respondents, their involvement in decision-making processes was insufficient ("We are involved in decision-making processes affecting our working conditions" - median value 2.4). Residents were also dissatisfied with the feedback they received for their work ("I get enough feedback regarding my achievement" - median value 2.6). Another problem area was career development ("I will finish my specialist training in time" - median value 2.9). However, these points did not affect overall satisfaction. Trainee satisfaction with regulations on working hours is low. Despite a general satisfaction with all fields appraised, improvements in various individual areas, e. g., the attitude of departmental heads and strategies of

  2. A nationwide survey concerning practices in pessary use for pelvic organ prolapse in The Netherlands : identifying needs for further research

    NARCIS (Netherlands)

    Velzel, Joost; Roovers, Jan Paul; van der Vaart, C. H.; Broekman, Bart; Vollebregt, Astrid; Hakvoort, Robert

    2015-01-01

    Introduction and hypothesis: To identify practice variation in management of patients with a vaginal pessary for pelvic organ prolapse (POP). Methods: A nationwide survey was sent to all Dutch gynecologists with a special interest in urogynecology. Results: The response rate was 59 %. Of the

  3. A nationwide survey concerning practices in pessary use for pelvic organ prolapse in The Netherlands: identifying needs for further research

    NARCIS (Netherlands)

    J. Velzel (Joost); J.P. Roovers (Jan Paul); C.H. Van der Vaart; B.M.W. Broekman (Bart); A. Vollebregt (Astrid); R. Hakvoort (Robert)

    2015-01-01

    textabstractIntroduction and hypothesis: To identify practice variation in management of patients with a vaginal pessary for pelvic organ prolapse (POP). Methods: A nationwide survey was sent to all Dutch gynecologists with a special interest in urogynecology. Results: The response rate was 59 %. Of

  4. A nationwide survey concerning practices in pessary use for pelvic organ prolapse in The Netherlands: identifying needs for further research

    NARCIS (Netherlands)

    Velzel, Joost; Roovers, Jan Paul; van der Vaart, C. H.; Broekman, Bart; Vollebregt, Astrid; Hakvoort, Robert

    2015-01-01

    To identify practice variation in management of patients with a vaginal pessary for pelvic organ prolapse (POP). A nationwide survey was sent to all Dutch gynecologists with a special interest in urogynecology. The response rate was 59 %. Of the respondents, 13 % had a written protocol for pessary

  5. Mortality and risk of cardiac complications among immediate survivors of accidental electric shock: a Danish nationwide cohort study.

    Science.gov (United States)

    Hansen, Steen Møller; Riahi, Sam; Hjortshøj, Søren; Mortensen, Rikke; Køber, Lars; Søgaard, Peter; Torp-Pedersen, Christian

    2017-08-28

    Exposure to electric shock has been associated with an increased risk of developing delayed cardiac arrhythmias and cardiac diseases. We examined whether electric shock patients have an increased risk of developing cardiac disease, cardiac arrhythmias or death compared with the general Danish population. Matched cohort study. A nationwide study in Denmark from 1994 to 2011. We identified 11 462 Danish patients who visited an emergency ward or were admitted to a hospital due to electric shock from 1994 to 2011. Each patient was matched for age and sex with five random controls from the Danish population. Mortality, cardiac procedures and cardiac diseases following electric shock. A total of 7390 electric shock patients were seen at an emergency ward and 4072 electric shock patients were admitted to a hospital. The median patient age was 28.6 years (Q1-Q3, 21.3-37.7) for the emergency ward patients and 26.4 years (Q1-Q3, 18.3-37.4) for admitted patients. In both groups, most patients were male (74.0% and 76.8%). Few of the electric shock patients had a record of cardiovascular disease at baseline (364/11 462, 3.2%). The 5-year cumulative incidence of death was 0.47% (95% CI 0.29% to 0.65%) for emergency ward patients and 1.04% (95% CI 0.71% to 1.37%) for admitted patients. No difference in 5-year survival was observed compared with matched controls (emergency ward, p=0.10; admitted patients, p=0.80). Fewer than four patients received a pacemaker within 30 days. This nationwide study did not demonstrate an increase in mortality among patients seen at hospitals after accidental electric shock compared with a background population. Cardiac procedures and diseases following electric shock were very rare. We suggest that nearly all patients can be discharged safely from the emergency room after electric shock without further observation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial

  6. Nationwide survey of radon levels in indoor workplaces in Mexico using Nuclear Track Methodology

    International Nuclear Information System (INIS)

    Espinosa, G.; Golzarri, J.I.; Angeles, A.; Griffith, R.V.

    2009-01-01

    This report presents the preliminary results of an indoor workplace radon survey conducted during 2006-2007. Monitoring was carried out in 24 of the 32 federal entities of Mexico, incorporating 26 cities and 288 locations. The area monitored was divided into 8 regions for the purposes of the study: Chihuahua (a state with uranium mines), North-Central, South-Central, Southeast, South, Northeast, Northwest, and West. These regions differ in terms of geographic and geological characteristics, climate, altitude, and building materials and architectonic styles. Nuclear Track Methodology (NTM) was employed for the survey, using a passive closed-end cup device with Poly Allyl Diglycol Carbonate (PADC), known by its trade name CR-39 (Lantrack), as detector material. Well-established protocols for making continuous indoor radon measurements were followed, including one-step chemical etching in a 6.25 M KOH solution at 60 ± 1 deg. C with an etching time of 18 h. The track densities were determined with an automatic digital system at the Instituto de Fisica de la Universidad Nacional Autonoma de Mexico (IFUNAM) (Physics Institute of the National Autonomous University of Mexico), and calibrated in facilities at the Oak Ridge National Laboratory (ORNL). The importance of this survey lies in the fact that it represents the first time a nationwide survey of radon levels in indoor workplaces has been carried out in Mexico. Mean indoor radon levels from continuous measurements taken during and after working hours ranged from 13 Bq m -3 (the lower limit of detection) to 196 Bq m -3 . Analogous official controls or regulations for radon levels in indoor workplaces do not exist in Mexico. The survey described here contributes to knowledge of the natural radiological environment in workplaces, and will aid the relevant authorities in establishing appropriate regulations. The survey was made possible by the efforts of both a private institutions and the Dosimeter Application Project

  7. Mortality of Stroke and Its Subtypes in China: Results from a Nationwide Population-Based Survey.

    Science.gov (United States)

    Chen, Zhenghong; Jiang, Bin; Ru, Xiaojuan; Sun, Haixin; Sun, Dongling; Liu, Xiangtong; Li, Yichong; Li, Di; Guo, Xiuhua; Wang, Wenzhi

    2017-01-01

    In China, stroke is the leading cause of death and contributes to a heavy disease burden. However, a nationwide population-based survey of the mortality of stroke and its subtypes is lacking for this country. Data derived from the National Epidemiological Survey of Stroke in China, which was a multistage, stratified clustering sampling-designed, cross-sectional survey, were analyzed. Mortality rate analyses were performed for 476,156 participants ≥20 years old from September 1, 2012 to August 31, 2013. Of the 476,156 participants in the investigated population, 364 died of ischemic stroke, 373 of hemorrhagic stroke, and 21 of stroke of undetermined pathological type. The age-standardized mortality rates per 100,000 person-years among those aged ≥20 years were 114.8 for total stroke, 56.5 for ischemic stroke, and 55.8 for hemorrhagic stroke. The age-standardized mortality rates of total stroke, ischemic stroke, and hemorrhagic stroke were all higher in rural areas than those in urban areas. The stroke mortality rate was higher in the northern regions than in the south. An estimated 1.12 million people aged ≥20 years in China died of stroke during the period from September 1, 2012 to August 31, 2013. The burden of stroke in China is still heavy. Greater attention should be paid to improve strategies for preventing stroke. © 2017 S. Karger AG, Basel.

  8. Survey on the frequency of somatic mutations in A-bomb survivors

    International Nuclear Information System (INIS)

    Akiyama, Mitoshi

    1992-01-01

    Several methods have recently been established for quantitatively detecting somatic cell mutations on a specific locus using human blood cells. These methods have enabled the biological estimation of A-bomb radiation doses in surveys on somatic cell mutations. This paper outlines HPRT, GPA, and TCR assays used to measure somatic cell mutations, focusing on the outcome in A-bomb survivors. HPRT assay is based on colony formation with interleukin-2. The frequency of HPRT mutant cells was significantly increased with advancing age in A-bomb survivors and was positively correlated with the frequency of chromosomal aberrations in lymphocytes. There was also a significantly positive correlation between HPRT mutant cell frequencies and DS86 estimated doses, although the slope was slow. In GPA assay, flow cytometric measurements of fluorescence-labeled erythrocytes are used to detect somatic cell mutations. There was a positive correlation between GPA mutant cell frequencies and age in A-bomb survivors. The GPA mutant cell frequencies showed much more positive correlation with lymphocyte chromosomal aberration frequencies than the HPRT mutant cell frequencies. When anti-CD3 antibody and anti-CD4 antibody are labeled with different fluorescences and are analyzed by using flow cytometry, TCR mutant cells having CD3 - 4 + can be detected. When the frequency of TCR mutant cells was examined in 342 A-bomb survivors, it did not correlate with radiation doses. This implies that TCR assay may be unadequate for biological estimation of A-bomb radiation doses throughout a lifetime of A-bomb survivors, because TCR mutant cells seems to be unable to live for a long time due to national selection. (N.K.)

  9. Nationwide survey of Arima syndrome: revised diagnostic criteria from epidemiological analysis.

    Science.gov (United States)

    Itoh, Masayuki; Iwasaki, Yuji; Ohno, Kohsaku; Inoue, Takehiko; Hayashi, Masaharu; Ito, Shuichi; Matsuzaka, Tetsuo; Ide, Shuhei; Arima, Masataka

    2014-05-01

    We have never known any epidemiological study of Arima syndrome since it was first described in 1971. To investigate the number of Arima syndrome patients and clarify the clinical differences between Arima syndrome and Joubert syndrome, we performed the first nationwide survey of Arima syndrome, and herein report its results. Furthermore, we revised the diagnostic criteria for Arima syndrome. As a primary survey, we sent out self-administered questionnaires to most of the Japanese hospitals with a pediatric clinic, and facilities for persons with severe motor and intellectual disabilities, inquiring as to the number of patients having symptoms of Arima syndrome, including severe psychomotor delay, agenesis or hypoplasia of cerebellar vermis, renal dysfunction, visual dysfunction and with or without ptosis-like appearance. Next, as the second survey, we sent out detailed clinical questionnaires to the institutes having patients with two or more typical symptoms. The response rate of the primary survey was 72.7% of hospitals with pediatric clinic, 63.5% of national hospitals and 66.7% of municipal and private facilities. The number of patients with 5 typical symptoms was 13 and that with 2-4 symptoms was 32. The response rate of the secondary survey was 52% (23 patients). After reviewing clinical features of 23 patients, we identified 7 Arima syndrome patients and 16 Joubert syndrome patients. Progressive renal dysfunction was noticed in all Arima syndrome patients, but in 33% of those with Joubert syndrome. It is sometimes difficult to distinguish Arima syndrome from Joubert syndrome. Some clinicians described a patient with Joubert syndrome and its complications of visual dysfunction and renal dysfunction, whose current diagnosis was Arima syndrome. Thus, the diagnosis of the two syndromes may be confused. Here, we revised the diagnostic criteria for Arima syndrome. Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights

  10. State of malaria diagnostic testing at clinical laboratories in the United States, 2010: a nationwide survey

    Directory of Open Access Journals (Sweden)

    Abanyie Francisca A

    2011-11-01

    Full Text Available Abstract Background The diagnosis of malaria can be difficult in non-endemic areas, such as the United States, and delays in diagnosis and errors in treatment occur too often. Methods A nationwide survey of laboratories in the United States and its nine dependent territories was conducted in 2010 to determine factors that may contribute to shortcomings in the diagnosis of malaria. This survey explored the availability of malaria diagnostic tests, techniques used, and reporting practices. Results The survey was completed by 201 participants. Ninety percent reported that their laboratories had at least one type of malaria diagnostic test available on-site. Nearly all of the respondents' laboratories performed thick and thin smears on-site; approximately 50% had access to molecular testing; and only 17% had access to rapid diagnostic tests on-site. Seventy-three percent reported fewer than five confirmed cases of malaria in their laboratory during the 12-month period preceding the survey. Twenty-eight percent stated that results of species identification took more than 24 hours to report. Only five of 149 respondents that performed testing 24 hours a day, 7 days a week complied with all of the Clinical and Laboratory Standards Institute (CLSI guidelines for analysis and reporting of results. Conclusion Although malaria diagnostic testing services were available to a majority of U.S. laboratories surveyed, very few were in complete compliance with all of the CLSI guidelines for analysis and reporting of results, and most respondents reported very few cases of malaria annually. Laboratories' difficulty in adhering to the rigorous CLSI guidelines and their personnel's lack of practice and proficiency may account for delays and errors in diagnosis. It is recommended that laboratories that infrequently process samples for malaria seek opportunities for practice and proficiency training annually and take advantage of available resources to assist in

  11. A nationwide survey of NDMA in raw and drinking water in Japan.

    Science.gov (United States)

    Asami, Mari; Oya, Masami; Kosaka, Koji

    2009-05-15

    A nationwide survey of N-nitrosodimethylamine (NDMA) in both raw and finished water samples from drinking water treatment plants (DWTPs) in Japan was conducted. NDMA was analyzed by solid-phase extraction (SPE) followed by ultra performance liquid chromatography (UPLC) coupled with tandem mass spectrometry (MS/MS). NDMA was detected in 15 of 31 raw water samples collected in the summer at concentrations up to 2.6 ng/L, and in 9 of 28 raw water samples collected in winter at concentrations up to 4.3 ng/L. The NDMA concentrations were higher in raw water samples collected from treatment plants with catchment areas that have high population densities. The NDMA concentrations were higher in river water samples collected from the east and west of Japan than in those collected from other areas. NDMA was detected in 10 of 31 finished samples collected in summer at reduced concentrations of up to 2.2 ng/L, while 5 of 28 finished samples collected in winter showed NDMA concentrations up to 10 ng/L. The highest NDMA levels were detected in finished water samples collected from the Yodo River basin DWTP, which uses ozonation. Furthermore, evaluation of the process water produced at six advanced water treatment plants was conducted. Influent from the Yodo River indicated that the NDMA concentration increased during ozonation to as high as 20 ng/L, and then decreased with subsequent biological activated carbon treatment. To our knowledge, this is the first nationwide evaluation of NDMA concentrations in water conducted in Japan to date.

  12. Gender differences in physical activity and health-related behaviors among stroke survivors: data from the 5th Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Lee, Yookyung; Kim, Won-Seok; Paik, Nam-Jong

    2017-07-01

    Physical activity and health-related behaviors are important in primary prevention of stroke and are also recommended for secondary prevention. Gender differences in physical activity and health-related behaviors have been reported in various populations and diseased states but data is lacking on stroke survivors. To assess gender disparities in physical activity in stroke patients and to investigate possible reasons for such disparities. This is a cross-sectional study using nationwide data from the 5th Korean National Health and Nutrition Examination Survey (2010-2012). A total of 9539 participants (stroke (n = 170), non-stroke (n = 9369)) between the ages of 40-80, with no problems walking were included. Physical activity, smoking, and alcohol drinking of stroke survivors were assessed by gender and compared with non-stroke groups. Multiple logistic regression was used to estimate the odds ratios (ORs) for insufficient physical activity and possible explanatory variables for gender differences. Women showed higher prevalence of insufficient physical activity after adjusting for age (OR = 7.32, 95% CI: 1.89-28.32) compared to men. Medical conditions such as depression and comorbidities failed to explain the low physical activity in women with stroke but adding socioeconomic factors to the model nullified the gender difference in physical activity. In order to reduce noted gender disparities in physical activity following stroke, more focused effort to increase physical activity in women, especially with lower socioeconomic status, has to be considered.

  13. The present state of nuclear medicine practice in Japan. A report of the 6th nationwide survey in 2007

    International Nuclear Information System (INIS)

    Koizumi, Kiyoshi; Kuwabara, Yasuo; Ushijima, Yo

    2008-01-01

    The Subcommittee of Japan Radioisotope Association on Survey of Nuclear Medicine Practice in Japan has performed a nationwide survey every five years since 1982. The 6th survey was performed in June 2007. The estimated total annual number of examinations was 1.41 million, 11.5% less than the previous survey (2002). The scintigraphy most frequently performed was bone (38%), followed by myocardium and brain perfusion scintigraphy. 18 F-fluorodeoxyglucose-positron emission tomography (FDG-PET) dramatically increased. 131 I therapy for thyroid cancer and hyperthyroidism has been also increasing steadily, while the number of in vitro radioassays has been decreasing continuously since 1992. (author)

  14. Information-searching behaviors of main and allied health professionals: a nationwide survey in Taiwan.

    Science.gov (United States)

    Weng, Yi-Hao; Kuo, Ken N; Yang, Chun-Yuh; Lo, Heng-Lien; Shih, Ya-Hui; Chiu, Ya-Wen

    2013-10-01

    There are a variety of resources to obtain health information, but few studies have examined if main and allied health professionals prefer different methods. The current study was to investigate their information-searching behaviours. A constructed questionnaire survey was conducted from January through April 2011 in nationwide regional hospitals of Taiwan. Questionnaires were mailed to main professionals (physicians and nurses) and allied professionals (pharmacists, physical therapists, technicians and others), with 6160 valid returns collected. Among all professional groups, the most commonly used resource for seeking health information was a Web portal, followed by colleague consultations and continuing education. Physicians more often accessed Internet-based professional resources (online databases, electronic journals and electronic books) than the other groups (P < 0.05). In contrast, physical therapists more often accessed printed resources (printed journals and textbooks) than the other specialists (P < 0.05). And nurses, physical therapists and technicians more often asked colleagues and used continuing education than the other groups (P < 0.01). The most commonly used online database was Micromedex for pharmacists and MEDLINE for physicians, technicians and physical therapists. Nurses more often accessed Chinese-language databases rather than English-language databases (P < 0.001). This national survey depicts the information-searching pattern of various health professionals. There were significant differences between and within main and allied health professionals in their information searching. The data provide clinical implications for strategies to promote the accessing of evidence-based information. © 2012 John Wiley & Sons Ltd.

  15. The use of telemedicine in Italian Blood Banks: a nationwide survey.

    Science.gov (United States)

    Berti, Pierluigi; Verlicchi, Franco; Fiorin, Francesco; Guaschino, Roberto; Cangemi, Adelio

    2014-01-01

    Telemedicine is defined as the use of electronic information and communication technologies to provide health care between distant people. Many activities in transfusion medicine could benefit from the application of telemedicine. To map the spread of the use of telemedicine in transfusion medicine in Italy, the Italian Society of Transfusion Medicine and Immunohaematology (SIMTI) performed a nationwide survey: the results are presented in this paper. A survey, dealing with different aspects of the use of telemedicine, was performed by sending a questionnaire to 280 Italian Blood Centres. The survey was designed to evaluate the diffusion of telemedicine and the features of the systems, with special attention to the systems' safety and legal adequacy. One section of the questionnaire was designed to identify the features of the systems considered essential by the respondents. Out of 280 Blood Services contacted, 196 (70%) filled in at least one of the questions of the online questionnaire. Globally the use of some form of telemedicine was reported by 70% of the respondents. Telemedicine is used for remote validation of laboratory tests by 32% of the Centres that responded, for remote biological validation of blood units by 34% and for assignment of blood components by 29%. Less frequently, telemedicine is used to control electronic refrigerators, for electronic blood requests and for bed-side identification of patients. The use of telemedicine is widespread in Italian Blood Services. There appears to be some heterogeneity between structures with regards to the evaluation of the systems' safety and their legal adequacy. No telemedicine system should be introduced into practice until it has proven to have the same standards of safety as the corresponding "on site" activity.

  16. A nationwide survey of factors influencing adherence to ocular hypotensive eyedrops in Japan.

    Science.gov (United States)

    Tsumura, Toyoaki; Kashiwagi, Kenji; Suzuki, Yasuyuki; Yoshikawa, Keiji; Suzumura, Hirotaka; Maeda, Toshine; Takeda, Ryuji; Saito, Hitomi; Araie, Makoto

    2018-01-12

    Few reports have investigated the status of adherence in Japan on a large scale. We aimed to investigate the status of adherence to topical glaucoma treatment and its associated factors. A nationwide survey was conducted as a prospective fashion. Participants in this survey were subjects with primary open-angle glaucoma, normal-tension glaucoma, or ocular hypertension or pseudoexfoliation glaucoma who had been prescribed anti-glaucoma ophthalmic eyedrops and whose ophthalmologist considered prescribing any fixed combination of ocular hypotensive eyedrops for the first time between 2011 and 2012. Subjects and their attending ophthalmologists independently completed a questionnaire by utilizing a fixed combination of ocular hypotensive eyedrops. A total of 1358 ophthalmologists from 1071 medical institutions participated in this survey. We registered 4430 subjects (2049 males and 2381 females). In total, data from 3853 subjects (87.6%) were analyzed after inclusion of subjects based on inclusion and exclusion criteria. Good adherence was defined as not forgetting instillation during the past week. Rates of good adherence reported by subjects and ophthalmologists were 72.4 and 78.5%, respectively (P < 0.0001). The consistency of adherence evaluation between subjects and ophthalmologists was moderate [kappa score 0.5025 (95% confidence interval 0.4740-0.5309)]. Significant factors associated with adherence were size of clinic, age, gender, number of types of ocular hypotensive eyedrops, ease of instillation, preferred number of eyedrops, preferred frequency of instillation of eyedrops, and knowledge of glaucoma. Adherence to ocular hypotensive eyedrops among Japanese subjects was relatively good. Concordance of adherence between subjects' reports and ophthalmologists' responses was moderate. Size of clinic, number of types of ocular hypotensive eyedrops, ease of instillation, preferred number of eyedrops, preferred frequency of instillation of eyedrops, and knowledge

  17. Reliability of Nationwide Prevalence Estimates of Dementia: A Critical Appraisal Based on Brazilian Surveys.

    Directory of Open Access Journals (Sweden)

    Flávio Chaimowicz

    Full Text Available The nationwide dementia prevalence is usually calculated by applying the results of local surveys to countries' populations. To evaluate the reliability of such estimations in developing countries, we chose Brazil as an example. We carried out a systematic review of dementia surveys, ascertained their risk of bias, and present the best estimate of occurrence of dementia in Brazil.We carried out an electronic search of PubMed, Latin-American databases, and a Brazilian thesis database for surveys focusing on dementia prevalence in Brazil. The systematic review was registered at PROSPERO (CRD42014008815. Among the 35 studies found, 15 analyzed population-based random samples. However, most of them utilized inadequate criteria for diagnostics. Six studies without these limitations were further analyzed to assess the risk of selection, attrition, outcome and population bias as well as several statistical issues. All the studies presented moderate or high risk of bias in at least two domains due to the following features: high non-response, inaccurate cut-offs, and doubtful accuracy of the examiners. Two studies had limited external validity due to high rates of illiteracy or low income. The three studies with adequate generalizability and the lowest risk of bias presented a prevalence of dementia between 7.1% and 8.3% among subjects aged 65 years and older. However, after adjustment for accuracy of screening, the best available evidence points towards a figure between 15.2% and 16.3%.The risk of bias may strongly limit the generalizability of dementia prevalence estimates in developing countries. Extrapolations that have already been made for Brazil and Latin America were based on a prevalence that should have been adjusted for screening accuracy or not used at all due to severe bias. Similar evaluations regarding other developing countries are needed in order to verify the scope of these limitations.

  18. Burden of Surgical Conditions in Uganda: A Cross-sectional Nationwide Household Survey.

    Science.gov (United States)

    Tran, Tu M; Fuller, Anthony T; Butler, Elissa K; Makumbi, Fredrick; Luboga, Samuel; Muhumuza, Christine; Ssennono, Vincent F; Chipman, Jeffrey G; Galukande, Moses; Haglund, Michael M

    2017-08-01

    To quantify the burden of surgical conditions in Uganda. Data on the burden of disease have long served as a cornerstone to health policymaking, planning, and resource allocation. Population-based data are the gold standard, but no data on surgical burden at a national scale exist; therefore, we adapted the Surgeons OverSeas Assessment of Surgical Need survey and conducted a nation-wide, cross-sectional survey of Uganda to quantify the burden of surgically treatable conditions. The 2-stage cluster sample included 105 enumeration areas, representing 74 districts and Kampala Capital City Authority. Enumeration occurred from August 20 to September 12, 2014. In each enumeration area, 24 households were randomly selected; the head of the household provided details regarding any household deaths within the previous 12 months. Two household members were randomly selected for a head-to-toe verbal interview to determine existing untreated and treated surgical conditions. In 2315 households, we surveyed 4248 individuals: 461 (10.6%) reported 1 or more conditions requiring at least surgical consultation [95% confidence interval (CI) 8.9%-12.4%]. The most frequent barrier to surgical care was the lack of financial resources for the direct cost of care. Of the 153 household deaths recalled, 53 deaths (34.2%; 95% CI 22.1%-46.3%) were associated with surgically treatable signs/symptoms. Shortage of time was the most frequently cited reason (25.8%) among the 11.6% household deaths that should have, but did not, receive surgical care (95% CI 6.4%-16.8%). Unmet surgical need is prevalent in Uganda. There is an urgent need to expand the surgical care delivery system starting with the district-level hospitals. Routine surgical data collection at both the health facility and household level should be implemented.

  19. West Nile Virus Seroprevalence in the Greek Population in 2013: A Nationwide Cross-Sectional Survey

    Science.gov (United States)

    Hadjichristodoulou, Christos; Pournaras, Spyros; Mavrouli, Maria; Marka, Andriani; Tserkezou, Persefoni; Baka, Agoritsa; Billinis, Charalambos; Katsioulis, Antonios; Psaroulaki, Anna; Papa, Anna; Papadopoulos, Nikos; Mamuris, Zissis; Tsakris, Athanasios; Kremastinou, Jenny

    2015-01-01

    Cases of West Nile Virus (WNV) disease were recorded for three consecutive years in Greece following the year 2010 outbreak. A cross-sectional serologic survey was conducted to estimate the WNV seroprevalence and assess the ratio of infection to neuroinvasive disease. A stratified left-over sampling methodology was used including age and residence strata. A total of 3,962 serum samples was collected and tested for WNV Immunoglobulin G (IgG) antibodies by Enzyme–Linked Immunosorbent Assay (ELISA). All positive samples were further tested by Plaque Reduction Neutralization Test (PRNT) and WNV Immunoglobulin M (IgM) antibodies. WNV IgG antibodies were detected in 82 samples and 61 were also positive in PRNT representing a weighted seroprevalence of 2.1% (95% C.I.: 1.7–2.6) and 1.5% (95% C.I.: 1.2–2.0), respectively. Multivariable analysis showed that seroprevalence was associated with age and residence. The overall ratio of neuroinvasive disease to infected persons was estimated at 1:376 (95% C.I.: 1:421–1:338), while the elderly people had the highest ratio. This nationwide study provided valuable data regarding the epidemiology of WNV in Greece based on the fact that elderly people have higher risk of being both infected and having severe disease. PMID:26605539

  20. Palliative sedation at home in the Netherlands: a nationwide survey among nurses.

    Science.gov (United States)

    Brinkkemper, Tijn; Klinkenberg, Marianne; Deliens, Luc; Eliel, Miriam; Rietjens, Judith A C; Zuurmond, Wouter W A; Perez, Roberto S G M

    2011-08-01

    This paper is a report of a nationwide study conducted to assess experiences of nurses involved in palliative sedation at home after introduction of a physicians' guideline for palliative sedation. Most studies investigating the practice of palliative sedation focus on physicians' practices and attitudes. However, little is known about experiences and attitudes of nurses. A web-based structured questionnaire was offered to 387 nurses providing medical technical care in 2007, assessing their experiences concerning decision-making, treatment policy and communication, focussing on the last patient receiving palliative sedation. The questionnaire was filled out by 201 nurses (response rate 52%). The majority of respondents agreed with the indication for palliative sedation. However, 21% reported to have refused carrying out a palliative sedation in the preceding year. The general practitioner was not present at the start of palliative sedation in a third of the cases, but was available when needed. The sedation was considered insufficiently effective by 42% of the respondents. According to a third of the respondents, the level of sedation was not related to the required level of symptom relief nor were changes in dosage based on the severity of symptoms. Although the guideline for palliative sedation appears to be followed adequately in the majority of cases with respect to indication for palliative sedation and reportage. The survey findings revealed shortcomings in medication policy, communication, medical control over the start and continued monitoring of palliative sedation. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  1. Explaining public satisfaction with health-care systems: findings from a nationwide survey in China.

    Science.gov (United States)

    Munro, Neil; Duckett, Jane

    2016-06-01

    To identify factors associated with health-care system satisfaction in China. Recent research suggests that socio-demographic characteristics, self-reported health, income and insurance, ideological beliefs, health-care utilization, media use and perceptions of services may affect health-care system satisfaction, but the relative importance of these factors is poorly understood. New data from China offer the opportunity to test theories about the sources of health-care system satisfaction. Stratified nationwide survey sample analysed using multilevel logistic regression. 3680 Chinese adults residing in family dwellings between 1 November 2012 and 17 January 2013. Satisfaction with the way the health-care system in China is run. We find only weak associations between satisfaction and socio-demographic characteristics, self-reported health and income. We do, however, find that satisfaction is strongly associated with having insurance and belief in personal responsibility for meeting health-care costs. We also find it is negatively associated with utilization, social media use, perceptions of access as unequal and perceptions of service providers as unethical. To improve satisfaction, Chinese policymakers - and their counterparts in countries with similar health-care system characteristics - should improve insurance coverage and the quality of health services, and tackle unethical medical practices. © 2015 The Authors. Health Expectations published by John Wiley & Sons Ltd.

  2. [Physician Shortage: How to Prevent Generation Y From Staying Away - Results of a Nationwide Survey].

    Science.gov (United States)

    Kasch, R; Engelhardt, M; Förch, M; Merk, H; Walcher, F; Fröhlich, S

    2016-04-01

    Medical students' attitudes and expectations about their future working life are changing. To hire the best talents from Generation Y, hospitals must pay attention to these factors to make working in patient care more attractive. However, little detailed knowledge about the professional and career expectations of today's medical students is available to date. In a nationwide online survey, a total of 9079 medical students from all German medical faculties returned the questionnaire. Twenty-one questions related to future career choices and work satisfaction, followed by 21 questions dealing with reasons for not working in patient care. Factor analysis yielded five factors: work-life balance, career, professional needs, working atmosphere, and prestige. A correlation analysis between these factors and respondents' socio-demographic data revealed significant correlations with sex, specialty choice, and marital/parental status. A correlation analysis with "reasons for not working in patient care" revealed that work-life balance, career, professional needs, and working atmosphere had high priority for both sexes. It is crucial to collect data on the work satisfaction of Generation Y, whose members are motivated and willing to perform in today's highly demanding work environment. However, sex-dependent/independent expectations must be met to make the medical profession more attractive, to overcome the Germany-wide shortage of physicians, and to attract young doctors to the hospitals. Georg Thieme Verlag KG Stuttgart · New York.

  3. Nationwide survey of dental radiographic examination and estimation of collective effective dose in Japan, 1999

    International Nuclear Information System (INIS)

    Iwai, Kazuo; Satomi, Chieko; Kawashima, Shoji; Hashimoto, Koji; Nishizawa, Kanae; Maruyama, Takashi

    2005-01-01

    A nationwide survey of dental X-ray examination in Japan was performed in 1999, and the effective exposure dose due to the dental X-ray examination was estimated. In Japan, most dental X-ray equipment are used at a tube voltage of 60 kV and a tube current of 10 mA. Dental film in speed group D is most frequently used for dental X ray examination. Fifty percent or more of dental clinics processed the films automatically. Seventy-five percent of dental clinics performed dental X-ray examinations in a separate X-ray room. The number of dental X-ray examinations in 1999 in Japan was estimated to be 82,301,000 for intra-oral radiography and 12,336,000 for panoramic radiography. The collective effective exposure dose in 1999 was estimated at 905.5 man·Sv, for intra-oral radiography and 128.9 man·Sv for panoramic radiography. (author)

  4. Clinic characteristics of psoriasis in China: a nationwide survey in over 12000 patients.

    Science.gov (United States)

    Chen, Kun; Wang, Gang; Jin, Hongzhong; Xu, Jinhua; Zhu, Xuejun; Zheng, Min; Gu, Heng

    2017-07-11

    Psoriasis is a worldwide chronic inflammatory disease, involving both skin and joints. In order to characterize psoriasis in Han Chinese population, we conducted this nationwide prospective and hospital based survey, in which 56 hospitals with departments of dermatology participated, located in 33 cities across China. A total of 12,031 outpatients with psoriasis were registered during 2009 to 2010, which the data was collected by standard questionnaires. The main data acquisition included demographics, family history, disease status and other comorbidities. Physical and dermatological examination, including body surface area (BSA) and psoriasis area severity index (PASI) were applied to evaluate the disease severity. Descriptive statistics, 2 tailed t-test and chi-square test were used appropriately for the statistical analysis. From the study, we found that the male and female ratio of the patients was 1.49:1. Mean age of onset was 30.2 ± 14.5 years for males and 27.1 ± 15.6 years for females (P psoriasis and the majority was psoriasis vulgaris (96.5%). Among 12,031 patients, 23.1% had a family history of psoriasis,16.1% had comorbidities, and 29.9% had nail changes. The most important aggravation factor was season change (60.2%), followed by psychological stress (34.5%), and there significant differences between genders on trigger factors. In conclusion, this study characterizing psoriasis in Han Chinese population, could be used as basic data for future study.

  5. Nationwide survey of work environment, work-life balance and burnout among psychiatrists in Japan.

    Science.gov (United States)

    Umene-Nakano, Wakako; Kato, Takahiro A; Kikuchi, Saya; Tateno, Masaru; Fujisawa, Daisuke; Hoshuyama, Tsutomu; Nakamura, Jun

    2013-01-01

    Psychiatry has been consistently shown to be a profession characterised by 'high-burnout'; however, no nationwide surveys on this topic have been conducted in Japan. The objective of this study was to estimate the prevalence of burnout and to ascertain the relationship between work environment satisfaction, work-life balance satisfaction and burnout among psychiatrists working in medical schools in Japan. We mailed anonymous questionnaires to all 80 psychiatry departments in medical schools throughout Japan. Work-life satisfaction, work-environment satisfaction and social support assessments, as well as the Maslach Burnout Inventory (MBI), were used. Sixty psychiatric departments (75.0%) responded, and 704 psychiatrists provided answers to the assessments and MBI. Half of the respondents (n = 311, 46.0%) experienced difficulty with their work-life balance. Based on the responses to the MBI, 21.0% of the respondents had a high level of emotional exhaustion, 12.0% had a high level of depersonalisation, and 72.0% had a low level of personal accomplishment. Receiving little support, experiencing difficulty with work-life balance, and having less work-environment satisfaction were significantly associated with higher emotional exhaustion. A higher number of nights worked per month was significantly associated with higher depersonalisation. A low level of personal accomplishment was quite prevalent among Japanese psychiatrists compared with the results of previous studies. Poor work-life balance was related to burnout, and social support was noted to mitigate the impact of burnout.

  6. General Overview of Psychotherapeutic Practice in Poland. Results from a Nationwide Survey.

    Science.gov (United States)

    Suszek, Hubert; Grzesiuk, Lidia; Styła, Rafał; Krawczyk, Krzysztof

    2017-09-01

    A total of 1196 persons conducting psychotherapy in Poland fully completed a nationwide online survey (or, alternatively, a paper and pencil enquiry) concerning their education, training, experience, and clinical work (professional environment, patients treated). The results are described in detail and compared with findings of similar studies from other countries. Among the primary findings were: (1) psychotherapy in Poland is conducted mostly by women (80 %); (2) almost all participants have an MA degree (91 %), including 75.2 % having graduated in psychology; (3) the therapists are well trained (mean number of training hours is above 942) and established (average experience is about 9.8 years), however, more than half of the therapists have no type of certificate; (4) 54 % of respondents identify with the integrative or eclectic orientation and, simultaneously, for 48.6 % of the therapists the most important approach is either psychodynamic or psychoanalytic; (5) the most common form of therapy is individual psychotherapy in private practice; (6) the majority of the therapists treat adult patients with anxiety or personality disorders. In sum, the results show that psychotherapeutic practice is well established in Poland and many indices are similar to those found in Western countries.

  7. American preferences for “smart” guns versus traditional weapons: Results from a nationwide survey

    Directory of Open Access Journals (Sweden)

    Lacey Nicole Wallace

    2016-12-01

    Full Text Available This study examines Americans' preferences regarding smart guns. The study builds on prior research by including previously unexamined factors, specifically victimization and comfort sharing gun ownership status with a doctor. Further, this study examines differences in preference patterns among gun owners and non-owners. Data were obtained from a nationwide online survey with 524 respondents in February 2016. The study finds that, among non-owners, older respondents and those with pro-gun attitudes are less likely to prefer smart guns to traditional firearms. Among gun owners, those with moderate political views, those with a history of victimization, and those residing in the Northeast are all more likely to prefer smart guns. Males and those with pro-gun attitudes are less likely to prefer smart guns. Education, income, race, marital status, presence of children in the home, and comfort discussing gun ownership with a doctor had no significant association with smart gun preference. Practical implications of these findings are discussed.

  8. Pre-operative fasting: a nationwide survey of German anaesthesia departments.

    Science.gov (United States)

    Breuer, J-P; Bosse, G; Seifert, S; Prochnow, L; Martin, J; Schleppers, A; Geldner, G; Soreide, E; Spies, C

    2010-03-01

    Shorter pre-operative fasting improves clinical outcome without an increased risk. Since October 2004, German Anaesthesiology Societies have officially recommended a fast of 2 h for clear fluids and 6 h for solid food before elective surgery. We conducted a nationwide survey to evaluate the current clinical practice in Germany. Between July 2006 and January 2007, standardized questionnaires were mailed to 3751 Anaesthesiology Society members in leading positions requesting anonymous response. The overall response rate was 66% (n=2418). Of those, 2148 (92%) claimed familiarity with the new guidelines. About a third (n=806, 34%) reported full adherence to the new recommendations, whereas 1043 (45%) reported an eased fasting practice. Traditional Nil per os after midnight was still recommended by 157 (7%). Commonest reasons reported for adopting the new guidelines were: 'improved pre-operative comfort' (84%), and 'increased patient satisfaction' (83%); reasons against were: 'low flexibility in operation room management' (19%), and 'increased risk of aspiration' (13%). Despite the apparent understanding of the benefits from reduced pre-operative fasting, full implementation of the guidelines remains poor in German anaesthesiology departments.

  9. Nuclear medicine practice in Japan. A report of the sixth nationwide survey in 2007

    International Nuclear Information System (INIS)

    Kuwabara, Yasuo; Koizumi, Kiyoshi; Ushijima, Yo

    2009-01-01

    The Subcommittee on the Survey of Nuclear Medicine Practice in Japan has performed a nationwide survey of nuclear medicine practice every 5 years since 1982 to provide detailed information on its present status. Questionnaires were sent to all institutions known to the Japan Radioisotope Association to conduct nuclear medicine examinations. The questionnaires addressed the number and kind of nuclear medicine examinations performed as well as the kind and dose of the radiopharmaceuticals used during the month of June 2007. The annual number of total or specific examinations was then estimated. Of the institutions sent questionnaires, 1219 were for in vivo study, 49 for in vitro study, and 212 for positron emission tomography (PET) study. Of these, 92.2% provided answers. A total of 1569 gamma cameras were installed in 1119 institutions, of which 70% were dual-head cameras. The estimated total annual number of in vivo examinations expressed by the number of administered radiopharmaceuticals was 1.41 million, representing a decrease of 11.5% when compared with that of the previous survey (2002). The frequency of study with respect to single-photon emission computed tomography (SPECT) slightly increased to 42.3% from 39.9% in the previous survey. The most frequently performed scintigraphy was bone (38.3%), followed by myocardium (26.2%) and brain perfusion (14.1%). Brain perfusion scintigraphy slightly increased, whereas tumor scintigraphy decreased by one-half when compared with the previous survey. The most commonly used radiopharmaceutical for each scintigraphy was 99m Tc-hydroxymethylene diphosphonate (HMDP) for bone, thallium-201 ( 201 Tl)-chloride for myocardium, gallium-67 ( 67 Ga)-citrate for tumor, and technetium-99m-ethylcysteinate dimmer ( 99m Tc-ECD) for brain. The number of PET institutes increased from 36 to 212. 18 F-fluorodeoxyglucose ( 18 F-FDG)-PET dramatically increased 14.8-fold during the past 5 years. Radionuclide therapy also increased. 131 I

  10. [Nationwide survey on radioactive waste management related to positron emission tomography in Japan].

    Science.gov (United States)

    Nagaoka, Hiroaki; Watanabe, Hiroshi; Yamaguchi, Ichiro; Fujibuchi, Toshioh; Kida, Tetsuo; Tanaka, Shinji

    2009-12-20

    A clearance system for medical radioactive solid waste has not yet been implemented in Japan. Since 2004 new regulations have allowed institutions using positron emission tomography(PET)to handle totally decayed radioactive waste as non-radioactive waste after decay-in-storage. It was expected that this new regulation would mediate the installation of clearance systems in Japan. In order to assess the current situation of radiation safety management in PET institutions, we conducted a nationwide survey. The study design was a cross-sectional descriptive study conducted by questionnaire. The subjects of this survey were all the PET institutions in Japan. Among 224 institutes, 128 institutes are equipped with cyclotrons and 96 institutes are not. The number of returned questionnaires was 138. Among institutes that are using delivered radiopharmaceuticals, 80% treat their waste as non-radioactive according to the new regulation. The impact of new regulations for reducing radioactive waste in PET institutes without a cyclotron was estimated at about $400 thousand per year. The main concern of medical institutes was assessment of the contamination caused by by-products of radioactive nuclides generated in target water during the operation of a cyclotron. It was thought that a rational rule based on scientific risk management should be established because these by-products of radioactive nuclides are negligible for radiation safety. New regulation has had a good influence on medical PET institutes, and it is expected that a clearance system for medical radioactive waste will be introduced in the near future, following these recent experiences in PET institutes.

  11. Epidemiology of adulthood drowning deaths in Bangladesh: Findings from a nationwide health and injury survey.

    Science.gov (United States)

    Hossain, Mohammad Jahangir; Biswas, Animesh; Mashreky, Saidur Rahman; Rahman, Fazlur; Rahman, Aminur

    2017-01-01

    Background: Annual global death due to drowning accounts for 372,000 lives, 90% of which occur in low and middle income countries. Life in Bangladesh exposes adults and children to may water bodies for daily household needs, and as a result drowning is common. In Bangladesh, due to lack of systemic data collection, drowning among adults is unknown; most research is focused on childhood drowning. The aim of the present study was to explore the epidemiology of adulthood drowning deaths in Bangladesh. Methodology: A nationwide cross-sectional survey was conducted from January to December in 2003 among 171,366 rural and urban households, with a sample of 819,429 individuals to determine the epidemiology of adulthood drowning in Bangladesh.   Results:   Annual fatal drowning incidence among adults was 5.85/100,000 individuals. Of these, 71.4% were male and 28.6% were female (RR 2.39). In total, 90% of the fatalities were from rural areas. Rural populations were also found to have a 8.58 times higher risk of drowning than those in urban areas. About 95% of drowning occurred in natural water bodies. About 61.6% of the deaths occurred at the scene followed by 33.5% at the home. Of the drowning fatalities, 67% took place in water bodies within 100 meters of the household. Among the drowning fatalities 78.4% occurred in daylight between 7.00 and 18.00. Over 97% of the victims were from poor socio economic conditions with a monthly income tk. 6,000 ($94) or less. Only 25.5% of incidences were reported to the police station. Conclusions: Every year a significant number of adults die due to drowning in Bangladesh.  Populations living in rural areas, especially men, were the main victims of drowning. This survey finding might help policy makers and scientists to understand the drowning scenario among adults in Bangladesh.

  12. Gynecologic oncologists' attitudes and practices relating to integrative medicine: results of a nationwide AGO survey.

    Science.gov (United States)

    Klein, Evelyn; Beckmann, Matthias W; Bader, Werner; Brucker, Cosima; Dobos, Gustav; Fischer, Dorothea; Hanf, Volker; Hasenburg, Annette; Jud, Sebastian M; Kalder, Matthias; Kiechle, Marion; Kümmel, Sherko; Müller, Andreas; Müller, Myrjam-Alice T; Paepke, Daniela; Rotmann, Andre-Robert; Schütz, Florian; Scharl, Anton; Voiss, Petra; Wallwiener, Markus; Witt, Claudia; Hack, Carolin C

    2017-08-01

    The growing popularity and acceptance of integrative medicine is evident both among patients and among the oncologists treating them. As little data are available regarding health-care professionals' knowledge, attitudes, and practices relating to the topic, a nationwide online survey was designed. Over a period of 11 weeks (from July 15 to September 30, 2014) a self-administered, 17-item online survey was sent to all 676 members of the Research Group on Gynecological Oncology (Arbeitsgemeinschaft Gynäkologische Onkologie) in the German Cancer Society. The questionnaire items addressed the use of integrative therapy methods, fields of indications for them, advice services provided, level of specific qualifications, and other topics. Of the 104 respondents (15.4%) using integrative medicine, 93% reported that integrative therapy was offered to breast cancer patients. The second most frequent type of tumor in connection with which integrative therapy methods were recommended was ovarian cancer, at 80% of the participants using integrative medicine. Exercise, nutritional therapy, dietary supplements, herbal medicines, and acupuncture were the methods the patients were most commonly advised to use. There is considerable interest in integrative medicine among gynecological oncologists, but integrative therapy approaches are at present poorly implemented in routine clinical work. Furthermore there is a lack of specific training. Whether future efforts should focus on extending counseling services on integrative medicine approaches in gynecologic oncology or not, have to be discussed. Evidence-based training on integrative medicine should be implemented in order to safely guide patients in their wish to do something by themselves.

  13. Nuclear medicine practice in Japan. A report of the 5th nationwide survey in 2002

    International Nuclear Information System (INIS)

    Koizumi, Kiyoshi; Inoue, Tomio

    2004-01-01

    The Subcommittee on Survey of Nuclear Medicine Practice in Japan has performed a nationwide survey of nuclear medicine practice every five years since 1982 to provide detailed information on its current status. Questionnaires were sent to every institution known to the Japan Radioisotope Association to provide nuclear medicine examinations. The questionnaires address the number and kind of nuclear medicine examinations performed as well as the kind and dose of the radiopharmaceuticals used during the month of June 2002. The annual number of total or specific examinations was then estimated. Of the institutions sent questionnaires, 1,204 were for in vivo study, 124 were for in vitro study, and 36 were for positron emission tomography (PET) study. Out of these, 95.8% answered them. A total of 1,697 gamma cameras were installed in 1,160 facilities, of which 50% were dual-head cameras. The estimated total annual number of examinations expressed by the number of administered radiopharmaceuticals was 1.60 million, similar to that of the previous survey (1997). The frequency of study with single photon emission computed tomography (SPECT) increased to 40%, from 30% in the previous survey. The scintigraphy most frequently performed was bone (35%), followed by myocardium (24%) and brain perfusion (12%). All showed a continuous increase over the past 20 years. Tumor imaging, however, fell from third to fourth place. The most commonly used radiopharmaceutical for each scintigraphy was 99m Tc-HMDP for bone, 201 Tl-chloride for myocardium, 67 Ga-citrate for tumor, and 123 1-IMP for brain. A total of 29,376 PET studies were performed yearly. Among them, 18 F-FDG rapidly increased 3.7-fold. 131 I therapy for thyroid cancer and hyperthyroidism was conducted yearly in 1,647 and 3,347 patients, respectively. A total of 31.35 million in vitro radioassays were carried out yearly, the number of which has been decreasing continuously since 1992. It was proved that the content of nuclear

  14. Health-Related Quality of Life in Cervical Cancer Survivors: A Population-Based Survey

    International Nuclear Information System (INIS)

    Korfage, Ida J.; Essink-Bot, Marie-Louise; Mols, Floortje; Poll-Franse, Lonneke van de; Kruitwagen, Roy; Ballegooijen, Marjolein van

    2009-01-01

    Purpose: In a population-based sample of cervical cancer survivors, health-related quality of life (HRQoL) was assessed 2-10 years postdiagnosis. Methods and Materials: All patients given a diagnosis of cervical cancer in 1995-2003 in the Eindhoven region, The Netherlands, and alive after Jan 2006 were identified through the cancer registry. Generic HRQoL (36-Item Short-Form Health Survey, EQ-5D), cervical cancer-specific HRQoL (European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire cervical cancer module), and anxiety (6-item State Trait Anxiety Inventory) were assessed and compared with a reference population (n = 349). Data for tumor characteristics at diagnosis and disease progression were available. Results: A total of 291 women responded (69%), with a mean age of 53 ± 13 (SD) years (range, 31-88 years). Treatment had consisted of surgery (n = 195) or a combination of therapies (n = 75); one woman had not been treated. Of all women, 85% were clinically disease free, 2% had a recurrence/metastasis, and in 13%, this was unknown. After controlling for background characteristics (age, education, job and marital status, having children, and country of birth), generic HRQoL scale scores were similar to the reference population, except for worse mental health in survivors. The most frequent symptoms were crampy pain in the abdomen or belly (17%), urinary leakage (15%), menopausal symptoms (18%), and problems with sexual activity. Compared with the 6-10-year survivors, more sexual worry and worse body image were reported by the 2-5-year survivors. Compared with surgery only, especially primary radiotherapy was associated with an increased frequency of treatment-related side effects, also after controlling for age and disease stage at diagnosis and follow-up. Conclusions: Most cervical cancer survivors were coping well, although their mental health was worse than in the reference population. Even after 2-10 years, radiotherapy was

  15. Factors affecting occupational exposure to needlestick and sharps injuries among dentists in Taiwan: a nationwide survey.

    Directory of Open Access Journals (Sweden)

    Hsin-Chung Cheng

    Full Text Available BACKGROUND: Although the risks of needlestick and sharps injuries (NSIs for dentists are well recognized, most papers published only described the frequency of occupational exposure to NSIs. Less has been reported assessing factors contributing to exposure to NSIs. The purpose of this study was to update the epidemiology of NSIs among dentists in Taiwan and identify factors affecting NSIs in order to find preventive strategies. METHODOLOGY/PRINCIPAL FINDINGS: A nationwide survey was conducted in dentists at 60 hospitals and 340 clinics in Taiwan. The survey included questions about factors supposedly affecting exposure to NSIs, such as dentist and facility characteristics, knowledge and attitudes about infectious diseases, and practices related to infection control. Univariate and multivariate logistic regression analyses were conducted to determine the association between risk factors and exposure to NSIs. In total, 434 (74.8% of 580 dentists returned the survey questionnaires, and 100 (23.0% reported that they had experienced more than one NSI per week. Our data showed that the risk of occupational NSIs is similarly heightened by an older age (odds ratio [OR], 3.18; 95% confidence interval [CI], 1.62-6.25, more years in practice (OR, 2.57; 95% CI, 1.41-4.69, working in clinics (OR, 1.73; 95% CI, 1.08-2.77, exhibiting less compliance with infection-control procedures (OR, 1.82; 95% CI, 1.04-3.18, having insufficient knowledge of blood-borne pathogens (OR, 1.67; 95% CI, 1.04-2.67, and being more worried about being infected by blood-borne pathogens (OR, 1.82; 95% CI, 1.05-3.13. CONCLUSIONS/SIGNIFICANCE: High rates of NSIs and low compliance with infection-control procedures highly contribute to the chance of acquiring a blood-borne pathogen infection and threaten occupational safety. This study reveals the possible affecting factors and helps in designing prevention strategies for occupational exposure to NSIs.

  16. A survey of radiation doses received by atomic-bomb survivors residing in the U.S

    International Nuclear Information System (INIS)

    Kerr, G.D.; Yamada, H.; Marks, S.

    1976-01-01

    A survey has been completed of 300 of an estimated 500 to 750 survivors of the atomic bombings in Hiroshima and Nagasaki who reside in the U.S. Distributions with respect to age, sex, citizenship status, distance from the hypocenter at the time of bombing, and dose from immediate weapon radiation have been tabulated from the results and are presented for this group of 300 survivors. Also presented are survey results concerning exposures to residual radiation from fallout and neutral-induced radioactivity in the areas adjacent to the hypocenter. (author)

  17. Nationwide survey of work environment, work-life balance and burnout among psychiatrists in Japan.

    Directory of Open Access Journals (Sweden)

    Wakako Umene-Nakano

    Full Text Available BACKGROUND: Psychiatry has been consistently shown to be a profession characterised by 'high-burnout'; however, no nationwide surveys on this topic have been conducted in Japan. AIMS: The objective of this study was to estimate the prevalence of burnout and to ascertain the relationship between work environment satisfaction, work-life balance satisfaction and burnout among psychiatrists working in medical schools in Japan. METHOD: We mailed anonymous questionnaires to all 80 psychiatry departments in medical schools throughout Japan. Work-life satisfaction, work-environment satisfaction and social support assessments, as well as the Maslach Burnout Inventory (MBI, were used. RESULTS: Sixty psychiatric departments (75.0% responded, and 704 psychiatrists provided answers to the assessments and MBI. Half of the respondents (n = 311, 46.0% experienced difficulty with their work-life balance. Based on the responses to the MBI, 21.0% of the respondents had a high level of emotional exhaustion, 12.0% had a high level of depersonalisation, and 72.0% had a low level of personal accomplishment. Receiving little support, experiencing difficulty with work-life balance, and having less work-environment satisfaction were significantly associated with higher emotional exhaustion. A higher number of nights worked per month was significantly associated with higher depersonalisation. CONCLUSIONS: A low level of personal accomplishment was quite prevalent among Japanese psychiatrists compared with the results of previous studies. Poor work-life balance was related to burnout, and social support was noted to mitigate the impact of burnout.

  18. Nationwide Survey of Work Environment, Work-Life Balance and Burnout among Psychiatrists in Japan

    Science.gov (United States)

    Umene-Nakano, Wakako; Kato, Takahiro A.; Kikuchi, Saya; Tateno, Masaru; Fujisawa, Daisuke; Hoshuyama, Tsutomu; Nakamura, Jun

    2013-01-01

    Background Psychiatry has been consistently shown to be a profession characterised by ‘high-burnout’; however, no nationwide surveys on this topic have been conducted in Japan. Aims The objective of this study was to estimate the prevalence of burnout and to ascertain the relationship between work environment satisfaction, work-life balance satisfaction and burnout among psychiatrists working in medical schools in Japan. Method We mailed anonymous questionnaires to all 80 psychiatry departments in medical schools throughout Japan. Work-life satisfaction, work-environment satisfaction and social support assessments, as well as the Maslach Burnout Inventory (MBI), were used. Results Sixty psychiatric departments (75.0%) responded, and 704 psychiatrists provided answers to the assessments and MBI. Half of the respondents (n = 311, 46.0%) experienced difficulty with their work-life balance. Based on the responses to the MBI, 21.0% of the respondents had a high level of emotional exhaustion, 12.0% had a high level of depersonalisation, and 72.0% had a low level of personal accomplishment. Receiving little support, experiencing difficulty with work-life balance, and having less work-environment satisfaction were significantly associated with higher emotional exhaustion. A higher number of nights worked per month was significantly associated with higher depersonalisation. Conclusions A low level of personal accomplishment was quite prevalent among Japanese psychiatrists compared with the results of previous studies. Poor work-life balance was related to burnout, and social support was noted to mitigate the impact of burnout. PMID:23418435

  19. Relationship between stress coping and sleep disorders among the general Japanese population: a nationwide representative survey.

    Science.gov (United States)

    Otsuka, Yuichiro; Kaneita, Yoshitaka; Itani, Osamu; Nakagome, Sachi; Jike, Maki; Ohida, Takashi

    2017-09-01

    To clarify the prevalence of stress, and examine the relationship between sleep disorders and stress coping strategies among highly stressed individuals in the general Japanese population. A cross-sectional nationwide survey was undertaken in November 2007. Men and women were randomly selected from 300 districts throughout Japan. Data from 7671 (3532 men (average age 53.5 ± 17.0 years) and 4139 women (average age 53.9 ± 17.7 years)) were analyzed. Participants completed a self-reported questionnaire on stress, sleep disorders, and stress coping strategies in the previous month. Highly stressed individuals comprised 16.6% (95% confidence interval 15.8-17.5%) of the total sample, and most were aged 20-49 years. In multiple logistic regression, symptoms of insomnia (ie, difficulty initiating sleep, difficulty maintaining sleep, and early morning awakening), excessive daytime sleepiness, nightmares, daytime malfunction, and lack of rest due to sleep deprivation were more prone to occur in highly stressed individuals. In addition, logistic regression analysis controlling for other adjustment factors revealed that stress coping strategies such as 'giving up on problem-solving', 'enduring problems patiently', 'smoking' and 'drinking alcohol' were positively associated with the above-mentioned sleep disorders. On the other hand, stress coping strategies such as 'exercising', 'enjoying hobbies', and 'sharing worries' were inversely associated with the above-mentioned sleep disorders. Distraction-based stress coping (eg, hobbies, exercise, and optimistic thinking) was found to be preferable to problem-based stress coping in a highly stressed Japanese general population. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Carbapenem use in French hospitals: A nationwide survey at the patient level.

    Science.gov (United States)

    Gauzit, Rémy; Pean, Yves; Alfandari, Serge; Bru, Jean-Pierre; Bedos, Jean-Pierre; Rabaud, Christian; Robert, Jérôme

    2015-12-01

    The objective of this study was to evaluate the characteristics of carbapenem use in French healthcare settings in order to guide future actions. Healthcare facilities voluntarily participated in a nationwide cross-sectional survey in 2011. Medical data and reasons for carbapenem treatment (CPR) and discontinuation were recorded for all patients treated with carbapenems. A total of 2338 patients were recorded by 207 facilities. The median duration of CPR was 8 days, and 31.4% of patients received CPR for >10 days. An antibiotic consultant was involved in the initial choice of CPR in 36.8% of cases. CPR was chosen on an empirical (EP) basis for 1229 patients (52.6%), mainly because of severe sepsis (48.6%) or a perceived risk of bacterial resistance (33.7%). Among EP patients, de-escalation was more frequent in the case of intervention of an antibiotic consultant (35.1%) than without intervention (22.9%) (Pcarbapenems or to fluoroquinolones. Among the latter, de-escalation was performed in 59 cases (14.9%). The intervention of an antibiotic consultant did not favour de-escalation in this group. In conclusion, carbapenems are frequently used for treating suspected or confirmed multidrug-resistant bacteria, and overall CPR duration is long. De-escalation is frequently not implemented despite isolates being susceptible to other drugs. More frequent antibiotic consultant intervention may help to decrease carbapenem use in the case of EP treatment. Copyright © 2015 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  1. Endosonography-related mortality and morbidity for pulmonary indications: a nationwide survey in the Netherlands.

    Science.gov (United States)

    von Bartheld, Martin B; Annema, Jouke T

    2015-12-01

    Endosonography is being implemented rapidly in pulmonary medicine for the diagnosis and staging of lung cancer, the assessment of sarcoidosis, and the assessment of mediastinal lesions. Although serious adverse events (SAEs) have been described, safety data outside cohort studies are scarce. To assess the SAE and mortality rate of EUS-guided FNA (EUS-FNA) and endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) for mediastinal and/or hilar analysis. Nationwide, retrospective survey by using questionnaires. All hospitals in the Netherlands. All patients undergoing EUS-FNA and EBUS-TBNA for intrathoracic analysis in the period 1999 to 2011. EUS-FNA and EBUS-TBNA. Occurrence of fatal outcomes and SAEs. Detailed information was obtained for each reported case, and all cases were reviewed independently by 2 investigators, including identification of risk factors. All 89 hospitals (100%) responded. An estimated 14,075 EUS-FNA and 2675 EBUS procedures were performed. Seven patients died after endosonography (5 EUS-FNA, 2 EBUS [mortality rate 0.04%]). All fatalities occurred in patients of poor performance status (American Society of Anesthesiologists Physical Status Classification System score of III/IV). Twenty-five SAEs were reported (22 EUS-FNA, 3 EBUS [SAE rate of 0.15%; EUS-FNA 0.16%, EBUS 0.11%]). SAEs were mostly (64%) of infectious origin. No specific risk factors for infectious adverse events could be identified. Retrospective study, possible recall bias, overrepresentation of EUS-FNA cases. Endosonography appears to be a safe technique for the analysis of mediastinal and/or hilar lesions. Poor performance status is a risk factor for fatal outcomes. Mediastinitis and/or mediastinal abscess formation is rare but is a potential and dangerous adverse event of endosonography. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  2. Employment prospects and trends for gastroenterology trainees in Canada: A nationwide survey

    Science.gov (United States)

    Razik, Roshan; Cino, Maria; Nguyen, Geoffrey C

    2013-01-01

    BACKGROUND: Many gastroenterology (GI) trainees face a variety of barriers to stable employment and are finding it increasingly difficult to secure employment in their chosen field. OBJECTIVE: To elucidate factors that contribute to the burden of unemployment and underemployment, and to examine solutions that may remedy this growing problem in the field of GI. METHODS: A nationwide survey of current, incoming and recently graduated individuals of GI training programs in Canada was conducted. Trainees in pediatric GI programs and those enrolled in sub-specialty programs within GI were also included. RESULTS: The response rate was 62%, with 93% of respondents enrolled in an adult GI training program. Many (73%) respondents planned to pursue further subspecialty training and the majority (53%) reported concerns regarding job security after graduation as contributory factors. Only 35% of respondents were confident that they would secure employment within six months of completing their training. Regarding barriers to employment, the most cited perceived reasons were lack of funding (both from hospitals and provincial governments) and senior physicians who continue to practice beyond retirement years. Sixty-nine per cent perceived a greater need for career guidance and 49% believed there were too many GI trainees relative to the current job market in their area. Most residents had a contingency plan if they remained unemployed >18 months, which often included moving to another province or to the United States. CONCLUSION: GI trainees throughout Canada reported substantial concerns about securing employment, citing national retirement trends and lack of funding as primary barriers to employment. Although these issues are not easily modifiable, certain problems should be targeted including optimizing training quotas, tailoring career guidance to the needs of the population, and emphasizing credentialing and quality control in endoscopy. PMID:24199210

  3. Nationwide survey of rotavirus-associated encephalopathy and sudden unexpected death in Japan.

    Science.gov (United States)

    Kawamura, Yoshiki; Ohashi, Masahiro; Ihira, Masaru; Hashimoto, Shuji; Taniguchi, Koki; Yoshikawa, Tetsushi

    2014-08-01

    Rotavirus can cause severe complications such as encephalopathy/encephalitis and sudden unexpected death. The incidence of rotavirus-associated encephalopathy/encephalitis or sudden unexpected death remains unknown. To clarify the clinical features of rotavirus-associated encephalitis/encephalopathy and sudden unexpected death, we conducted a nationwide survey in Japan. A two-part questionnaire was designed to determine the number of the cases and the clinical features of severe cases of rotavirus infection, including encephalitis/encephalopathy and sudden unexpected death, between 2009 and 2011. Of the 1365 questionnaires sent to hospitals, 963 (70.5%) were returned and eligible for analysis. We determined 58 cases of rotavirus-associated encephalitis/encephalopathy and 7 cases of sudden unexpected death. These patients were diagnosed with rotavirus infection by immunochromatography. Although 36/58 (62.1%) encephalitis/encephalopathy patients had no sequelae, 15/58 (25.9%) patients had neurological sequelae, and 7/58 (12.1%) patients had fatal outcomes. Pleocytosis was observed in 9/40 (22.5%) patients and cerebrospinal fluid protein levels were elevated in only 4/40 (10%) patients. Elevated lactate dehydrogenase (LDH) (>500 IU/L) or acidemia (pHdeath were 44.0 and 4.9 cases in Japan, respectively. Elevated LDH (>500 IU/L) or acidemia (pH<7.15) were related to a poor prognosis of the encephalitis/encephalopathy. Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  4. Predictors of home death of home palliative cancer care patients: a cross-sectional nationwide survey.

    Science.gov (United States)

    Fukui, Sakiko; Fujita, Junko; Tsujimura, Mayuko; Sumikawa, Yuka; Hayashi, Yayoi

    2011-11-01

    To identify factors influencing the place of death among home palliative cancer care patients, focusing on the role of nurses in terms of pre- and post-discharge from hospital to home care settings. A cross-sectional nationwide questionnaire survey was conducted at 1000 randomly selected homecare agencies in Japan. The questionnaires were completed by primary community nurses of home palliative patients just after their discharge. A total of 568 responses were analyzed (effective response rate, 69%). Multivariate logistic regression analysis revealed the following independent factors of place of death among those patients: desire for home death at referral by both patient and family caregiver; caregiver relationship to patient as daughter or daughter-in-law; totally bedridden functional status of patient; patient not suffering from depression and/or anxiety at referral; patients and caregivers duly informed about the dying process/death in detail, as well as instructed by community nurses about pain management and how to treat/prevent bedsores in home care settings. This study demonstrated the importance of both the hospital and community nurses' role in increasing the patients' chance of dying at home. Hospital nurses should support early transfer to home palliative care according to their assessment of the desire of patient/family caregiver for home death, the patients' clinical status, and caregivers' ability to provide patient care at home. Community nurses should inform patients/family caregiver in detail about the dying process/death just after discharge, relieve patient pain, treat/prevent bedsores, and instruct family caregivers on their symptom control. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  5. Employment prospects and trends for gastroenterology trainees in Canada: a nationwide survey.

    Science.gov (United States)

    Razik, Roshan; Cino, Maria; Nguyen, Geoffrey C

    2013-11-01

    Many gastroenterology (GI) trainees face a variety of barriers to stable employment and are finding it increasingly difficult to secure employment in their chosen field. To elucidate factors that contribute to the burden of unemployment and underemployment, and to examine solutions that may remedy this growing problem in the field of GI. A nationwide survey of current, incoming and recently graduated individuals of GI training programs in Canada was conducted. Trainees in pediatric GI programs and those enrolled in subspecialty programs within GI were also included. The response rate was 62%, with 93% of respondents enrolled in an adult GI training program. Many (73%) respondents planned to pursue further subspecialty training and the majority (53%) reported concerns regarding job security after graduation as contributory factors. Only 35% of respondents were confident that they would secure employment within six months of completing their training. Regarding barriers to employment, the most cited perceived reasons were lack of funding (both from hospitals and provincial governments) and senior physicians who continue to practice beyond retirement years. Sixty-nine per cent perceived a greater need for career guidance and 49% believed there were too many GI trainees relative to the current job market in their area. Most residents had a contingency plan if they remained unemployed >18 months, which often included moving to another province or to the United States. GI trainees throughout Canada reported substantial concerns about securing employment, citing national retirement trends and lack of funding as primary barriers to employment. Although these issues are not easily modifiable, certain problems should be targeted including optimizing training quotas, tailoring career guidance to the needs of the population, and emphasizing credentialing and quality control in endoscopy.

  6. Diversity of the definition of stable vital sign in trauma patients: results of a nationwide survey.

    Science.gov (United States)

    Mun, Seongpyo

    2015-12-01

    Hemodynamic stability (HS) based on vital sign (VS) is thought to be the most useful criteria for successful non-operative management (NOM) of blunt spleen injury (BSI). However, a consistent definition of HS has not been established. We wanted to evaluate the definition of HS through conducting a nationwide survey and find the factors affectting diversity. The questionnaire regarding the definition of HS was sent to the department of trauma surgery and emergency medicine of level I trauma center between October 2012 and November 2012. Data was compared using analysis of variance, t-test, χ2 test and logistic regression. Among five hundred and sixty-three doctors, 507 responded (90%). Forty-eight responses were incomplete, and hence, 459 (81.5%) responses were analyzed. There was a significant diversity in the definition of HS on the subject of type of blood pressure (BP), cut off value of hypotension, measuring technique of BP, duration of hypotension, whether or not using heart rate (HR) as a determinant of HS, cut off value of hypotension when the patient has comorbidity or when the patient is a pediatric patient. 91.5% replied that they were confused defining HS and felt the need to have more objective determinants. Nevertheless, 90% of the responders were not using laboratory test to define HS. Many trauma doctors are using only VS to define HS. This is why there is a confusion regarding how to define which patient is hemodynamically stable. More objective determinants such as base deficit or lactate can be useful adjuncts.

  7. The present state of nuclear medicine practice in Japan. A report of the 7th nationwide survey in 2012

    International Nuclear Information System (INIS)

    Kuwahara, Yasuo; Kinuya, Seigo; Inoue, Kentaro

    2013-01-01

    The Subcommittee on Survey of Nuclear Medicine Practice in Japan has performed a nationwide questionnaire surveys every five years since 1982. The latest questionnaire survey was performed in June 2012. The estimated total number of the annual examinations was 1.15 millions, 19% less than that of the last survey in 2007. The scintigraphic examination most frequently performed was bone scintigraphy, followed by myocardial and brain perfusion scintigraphy in order. The number of positron emission tomography (PET) studies and radionuclide targeted therapies increased by 40% and 62%, respectively, as compared to the 2007's survey. The increase was attributable to growing uses of commercially delivered fluorodexyglucose (FDG), and the newly started radionuclide targeted therapy for patients with metastatic bone tumor or malignant lymphoma, in addition to 131 I therapy for patients with thyroid cancer or Graves' disease. The number of in vitro radioassays has been decreasing continuously since 1992. (author)

  8. Lung cancer specialist physicians' attitudes towards e-cigarettes: A nationwide survey.

    Science.gov (United States)

    Shin, Dong Wook; Kim, Young Il; Kim, Seung Joon; Kim, Jung Soo; Chong, SeMin; Park, Young Sik; Song, Sang-Yun; Lee, Jin Han; Ahn, Hee Kyung; Kim, Eun Young; Yang, Sei Hoon; Lee, Myoung Kyu; Cho, Deog Gon; Jang, Tae Won; Son, Ji Woong; Ryu, Jeong-Seon; Cho, Moon-June

    2017-01-01

    Despite a sharp increase in e-cigarette use, there is debate about whether e-cigarettes are a viable alternative for harm reduction, and the forms that regulation should take. Healthcare providers can be effective in offering guidance to patients and their families and shaping regulatory policy. We described lung cancer specialists' attitudes toward e-cigarettes and its regulation. We undertook a nationwide survey of pulmonologists, thoracic surgeons, medical and radiological oncologists who are members of Korean Association for Lung Cancer. Survey items included beliefs and attitudes toward e-cigarettes, attitudes toward e-cigarette regulation and preparedness on discussing e-cigarettes with their patients. Most respondents believed that e-cigarettes are not safer than conventional tobacco cigarettes (75.7%) or smokeless tobacco (83.2%), and feared that discussing e-cigarettes with the patients would encourage use (65.4%). They did not consider it a smoking cessation treatment (78.3%), and thus would not recommend it to smokers who do not want to quit (82.2%) or who failed to quit with conventional smoking cessation treatment (74.1%). Most respondents supported all examples of e-cigarette regulations, including the safety and quality check (97.8%), warning label (97.8%), advertisement ban (95.1%), restriction of flavoring (78.4%), minimum purchasing age (99.5%), and restriction of indoor use (94.6%). Most learned about e-cigarettes from media and advertisements, or conversation with patients rather than through professional scientific resources, and reported discomfort when discussing e-cigarette with patients. Lung cancer specialist physicians in Korea doubt the safety of e-cigarette and use of e-cigarette as smoking cessation treatment, and supported strict regulation. However, only 20% reported that they obtained information on e-cigarettes from the scientific literature and many lacked adequate knowledge based on scientific evidence, suggesting the need for

  9. Patient safety education at Japanese medical schools: results of a nationwide survey.

    Science.gov (United States)

    Maeda, Shoichi; Kamishiraki, Etsuko; Starkey, Jay

    2012-05-10

    Patient safety education, including error prevention strategies and management of adverse events, has become a topic of worldwide concern. The importance of the patient safety is also recognized in Japan following two serious medical accidents in 1999. Furthermore, educational curriculum guideline revisions in 2008 by relevant the Ministry of Education includes patient safety as part of the core medical curriculum. However, little is known about the patient safety education in Japanese medical schools partly because a comprehensive study has not yet been conducted in this field. Therefore, we have conducted a nationwide survey in order to clarify the current status of patient safety education at medical schools in Japan. Response rate was 60.0% (n = 48/80). Ninety-eight-percent of respondents (n = 47/48) reported integration of patient safety education into their curricula. Thirty-nine percent reported devoting less than five hours to the topic. All schools that teach patient safety reported use of lecture based teaching methods while few used alternative methods, such as role-playing or in-hospital training. Topics related to medical error theory and legal ramifications of error are widely taught while practical topics related to error analysis such as root cause analysis are less often covered. Based on responses to our survey, most Japanese medical schools have incorporated the topic of patient safety into their curricula. However, the number of hours devoted to the patient safety education is far from the sufficient level with forty percent of medical schools that devote five hours or less to it. In addition, most medical schools employ only the lecture based learning, lacking diversity in teaching methods. Although most medical schools cover basic error theory, error analysis is taught at fewer schools. We still need to make improvements to our medical safety curricula. We believe that this study has the implications for the rest of the world as a

  10. Patient safety education at Japanese medical schools: results of a nationwide survey

    Directory of Open Access Journals (Sweden)

    Maeda Shoichi

    2012-05-01

    Full Text Available Abstract Background Patient safety education, including error prevention strategies and management of adverse events, has become a topic of worldwide concern. The importance of the patient safety is also recognized in Japan following two serious medical accidents in 1999. Furthermore, educational curriculum guideline revisions in 2008 by relevant the Ministry of Education includes patient safety as part of the core medical curriculum. However, little is known about the patient safety education in Japanese medical schools partly because a comprehensive study has not yet been conducted in this field. Therefore, we have conducted a nationwide survey in order to clarify the current status of patient safety education at medical schools in Japan. Results Response rate was 60.0% (n = 48/80. Ninety-eight-percent of respondents (n = 47/48 reported integration of patient safety education into their curricula. Thirty-nine percent reported devoting less than five hours to the topic. All schools that teach patient safety reported use of lecture based teaching methods while few used alternative methods, such as role-playing or in-hospital training. Topics related to medical error theory and legal ramifications of error are widely taught while practical topics related to error analysis such as root cause analysis are less often covered. Conclusions Based on responses to our survey, most Japanese medical schools have incorporated the topic of patient safety into their curricula. However, the number of hours devoted to the patient safety education is far from the sufficient level with forty percent of medical schools that devote five hours or less to it. In addition, most medical schools employ only the lecture based learning, lacking diversity in teaching methods. Although most medical schools cover basic error theory, error analysis is taught at fewer schools. We still need to make improvements to our medical safety curricula. We believe that this

  11. Results of a Nationwide Capacity Survey of Hospitals Providing Trauma Care in War-Affected Syria.

    Science.gov (United States)

    Mowafi, Hani; Hariri, Mahmoud; Alnahhas, Houssam; Ludwig, Elizabeth; Allodami, Tammam; Mahameed, Bahaa; Koly, Jamal Kaby; Aldbis, Ahmed; Saqqur, Maher; Zhang, Baobao; Al-Kassem, Anas

    2016-09-01

    The Syrian civil war has resulted in large-scale devastation of Syria's health infrastructure along with widespread injuries and death from trauma. The capacity of Syrian trauma hospitals is not well characterized. Data are needed to allocate resources for trauma care to the population remaining in Syria. To identify the number of trauma hospitals operating in Syria and to delineate their capacities. From February 1 to March 31, 2015, a nationwide survey of 94 trauma hospitals was conducted inside Syria, representing a coverage rate of 69% to 93% of reported hospitals in nongovernment controlled areas. Identification and geocoding of trauma and essential surgical services in Syria. Although 86 hospitals (91%) reported capacity to perform emergency surgery, 1 in 6 hospitals (16%) reported having no inpatient ward for patients after surgery. Sixty-three hospitals (70%) could transfuse whole blood but only 7 (7.4%) could separate and bank blood products. Seventy-one hospitals (76%) had any pharmacy services. Only 10 (11%) could provide renal replacement therapy, and only 18 (20%) provided any form of rehabilitative services. Syrian hospitals are isolated, with 24 (26%) relying on smuggling routes to refer patients to other hospitals and 47 hospitals (50%) reporting domestic supply lines that were never open or open less than daily. There were 538 surgeons, 378 physicians, and 1444 nurses identified in this survey, yielding a nurse to physician ratio of 1.8:1. Only 74 hospitals (79%) reported any salary support for staff, and 84 (89%) reported material support. There is an unmet need for biomedical engineering support in Syrian trauma hospitals, with 12 fixed x-ray machines (23%), 11 portable x-ray machines (13%), 13 computed tomographic scanners (22%), 21 adult (21%) and 5 pediatric (19%) ventilators, 14 anesthesia machines (10%), and 116 oxygen cylinders (15%) not functional. No functioning computed tomographic scanners remain in Aleppo, and 95 oxygen cylinders (42

  12. A survey on respiratory diseases of atomic bomb survivors using chest X-ray examination

    International Nuclear Information System (INIS)

    Komatsubara, Naoka; Isobe, Takeshi; Nakamura, Kenji

    1994-01-01

    Chest X-ray films, taken from 48,160 A-bomb survivors aged 40 years or more during a 5-year period 1988-1992, were reviewed. Abnormal X-ray findings were obtained in 26.7% for men and 18.2% for women. The incidence of necessary detailed examination was 2.6%. Of these A-bomb survivors, 93.7% participated in it. Pulmonary fibrosis, chronic emphysema, and pulmonary cyst yielded higher prevalence per population of 100,000 in men, irrespective of exposure distance. In comparing with the results obtained during a 5-year period 1981-1985, the detection rate of primary lung cancer was not different from that in the present 5-year survey. For active pulmonary tuberculosis, pulmonary fibrosis, and chronic emphysema, however, the prevalence tended to decrease. Primary lung cancer and pulmonary fibrosis were more frequently detected with aging in both men and women. This was independent of exposure distance. (N.K.)

  13. A nationwide survey on seroprevalence of Neospora caninum infection in beef cattle in Uruguay.

    Science.gov (United States)

    Bañales, Pedro; Fernandez, Leandro; Repiso, María V; Gil, Andres; Dargatz, David A; Osawa, Takeshi

    2006-06-30

    Bovine abortions due to Neospora caninum infection have been reported worldwide and its economic impact on the beef industry has been acknowledged as a problem. Uruguay has the largest export value of beef per acre in South America. However, no data on the prevalence of N. caninum infection have been available in this country. The objective of this study was to estimate the prevalence and distribution of N. caninum infection in beef cattle in Uruguay through a nationwide survey. A two stage sampling design was used with farms being selected in stage one and animals being selected in stage two. A brief questionnaire was administered on each farm. Seroprevalence of N. caninum in 4444 beef cattle from 229 farms in all the counties, except Montevideo, of Uruguay was determined by an ELISA. The data were then analyzed to identify associations between infection and variables such as type of animal (cow or heifer), herd size, use of veterinary advice, productivity of the soil in relation to the national average, use of improved grass, use of mineral salts, use of supplemental feed, and presence of a dog(s) on the farm. The estimated proportion of positive farms for all the beef cattle operations was 69.2% (95% confidence interval [CI], 53.7-84.7). The overall cattle seroprevalence was estimated as 13.9% (95% CI, 11.6-16.3). The prevalence estimation by animal category was 14.3% (95% CI, 11.4-17.2) for beef cows and 12.9% (95% CI, 10.0-15.8) for beef heifers. There was no significant difference in the estimated prevalence between the two animal types. There was no significant difference in the animal level prevalence of N. caninum infection among different herd sizes. None of the herd demographic or management variables was significantly associated with the seropositivity to N. caninum infection. In conclusion, these results show that N. caninum infection is common among beef herds across Uruguay. Since the beef industry is one of the key industries in Uruguay, the

  14. Environmental determinants of different blood lead levels in children: a quantile analysis from a nationwide survey.

    Science.gov (United States)

    Etchevers, Anne; Le Tertre, Alain; Lucas, Jean-Paul; Bretin, Philippe; Oulhote, Youssef; Le Bot, Barbara; Glorennec, Philippe

    2015-01-01

    Blood lead levels (BLLs) have substantially decreased in recent decades in children in France. However, further reducing exposure is a public health goal because there is no clear toxicological threshold. The identification of the environmental determinants of BLLs as well as risk factors associated with high BLLs is important to update prevention strategies. We aimed to estimate the contribution of environmental sources of lead to different BLLs in children in France. We enrolled 484 children aged from 6months to 6years, in a nationwide cross-sectional survey in 2008-2009. We measured lead concentrations in blood and environmental samples (water, soils, household settled dusts, paints, cosmetics and traditional cookware). We performed two models: a multivariate generalized additive model on the geometric mean (GM), and a quantile regression model on the 10th, 25th, 50th, 75th and 90th quantile of BLLs. The GM of BLLs was 13.8μg/L (=1.38μg/dL) (95% confidence intervals (CI): 12.7-14.9) and the 90th quantile was 25.7μg/L (CI: 24.2-29.5). Household and common area dust, tap water, interior paint, ceramic cookware, traditional cosmetics, playground soil and dust, and environmental tobacco smoke were associated with the GM of BLLs. Household dust and tap water made the largest contributions to both the GM and the 90th quantile of BLLs. The concentration of lead in dust was positively correlated with all quantiles of BLLs even at low concentrations. Lead concentrations in tap water above 5μg/L were also positively correlated with the GM, 75th and 90th quantiles of BLLs in children drinking tap water. Preventative actions must target household settled dust and tap water to reduce the BLLs of children in France. The use of traditional cosmetics should be avoided whereas ceramic cookware should be limited to decorative purposes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Community-Acquired Acute Kidney Injury: A Nationwide Survey in China.

    Science.gov (United States)

    Wang, Yafang; Wang, Jinwei; Su, Tao; Qu, Zhen; Zhao, Minghui; Yang, Li

    2017-05-01

    This study aimed to describe the burden of community-acquired acute kidney injury (AKI) in China based on a nationwide survey about AKI. Cross-sectional and retrospective study. A national sample of 2,223,230 hospitalized adult patients from 44 academic/local hospitals in Mainland China was used. AKI was defined according to the 2012 KDIGO AKI creatinine criteria or an increase or decrease in serum creatinine level of 50% during the hospital stay. Community-acquired AKI was identified when a patient had AKI that could be defined at hospital admission. The rate, cause, recognition, and treatment of community-acquired AKI were stratified according to hospital type, latitude, and economic development of the regions in which the patients were admitted. All-cause in-hospital mortality and recovery of kidney function at hospital discharge. 4,136 patients with community-acquired AKI were identified during the 2 single-month snapshots (January 2013 and July 2013). Of these, 2,020 (48.8%) had cases related to decreased kidney perfusion; 1,111 (26.9%), to intrinsic kidney disease; and 499 (12.1%), to urinary tract obstruction. In the north versus the south, more patients were exposed to nephrotoxins or had urinary tract obstructions. 536 (13.0%) patients with community-acquired AKI had indications for renal replacement therapy (RRT), but only 347 (64.7%) of them received RRT. Rates of timely diagnosis and appropriate use of RRT were higher in regions with higher per capita gross domestic product. All-cause in-hospital mortality was 7.3% (295 of 4,068). Delayed AKI recognition and being located in northern China were independent risk factors for in-hospital mortality, and referral to nephrology providers was an independent protective factor. Possible misclassification of AKI and community-acquired AKI due to nonstandard definitions and missing data for serum creatinine. The features of community-acquired AKI varied substantially in different regions of China and were closely

  16. Palliative sedation at home in the Netherlands: a nationwide survey among nurses

    NARCIS (Netherlands)

    Brinkkemper, T.; Klinkenberg, M.; Deliens, L.; Eliel, M.; Rietjens, J.A.C.; Zuurmond, W.W.A.; Perez, R.S.G.M.

    2011-01-01

    Aim. This paper is a report of a nationwide study conducted to assess experiences of nurses involved in palliative sedation at home after introduction of a physicians' guideline for palliative sedation. Background. Most studies investigating the practice of palliative sedation focus on physicians'

  17. Observational longitudinal study of symptom burden and time for recovery from community-acquired pneumonia reported by older adults surveyed nationwide using the CAP Burden of Illness Questionnaire

    Directory of Open Access Journals (Sweden)

    Wyrwich KW

    2015-07-01

    Full Text Available Kathleen W Wyrwich,1 Holly Yu,2 Reiko Sato,2 John H Powers31Evidera, Inc., Bethesda, MD, USA; 2Pfizer Inc., Collegeville, PA, USA; 3George Washington University School of Medicine and Health Sciences, Washington, DC, USABackground: Millions of older adults who develop community-acquired pneumonia (CAP each year survive, but there is a large knowledge gap on the burden of CAP and the recovery process in survivors from the patient perspective.Methods: The newly developed CAP Burden of Illness Questionnaire was administered through a Web survey to a nationwide sample of US adults aged ≥50 years who were recently diagnosed with CAP. Survey respondents with unresolved symptoms or other CAP-related health problems completed a second survey 30 days later; a third survey was completed another 30 days later by respondents with unresolved symptoms or problems. Nationally representative results describing the average time to recovery of symptoms and other CAP-related problems were achieved using post-stratification weights.Results: Five hundred participants completed the initial survey. The time to resolution for the CAP symptoms of weakness, shortness of breath, and tiredness exceeded 3 weeks on average. There was an average of 13 days of absenteeism, and 3 weeks (mean =21 days before achieving full work/activity productivity after CAP. For participants with health conditions that worsened from pneumonia, chronic emphysema and chronic obstructive pulmonary disease took the longest to return to baseline (mean =60 and 52.4 days, respectively.Conclusion: The results from this study demonstrate that older adults surviving a CAP episode experience a significant multi-symptom illness with long recovery periods to achieve pre-CAP health and productivity. These findings highlight the need for further research on effective clinician–patient communication, the need for patient-centered outcomes in clinical trials for CAP therapeutics, adequate home care during

  18. A Nationwide Survey of State-Mandated Evaluation Practices for Domestic Violence Agencies

    Science.gov (United States)

    Riger, Stephanie; Staggs, Susan L.

    2011-01-01

    Many agencies serving survivors of domestic violence are required to evaluate their services. Three possible evaluation strategies include: a) process measurement, which typically involves a frequency count of agency activities, such as the number of counseling hours given; b) outcome evaluation, which measures the impact of agency activities on…

  19. A nationwide study on reproductive function, ovarian reserve, and risk of premature menopause in female survivors of childhood cancer : design and methodological challenges

    NARCIS (Netherlands)

    Overbeek, Annelies; van den Berg, Marleen H.; Kremer, Leontien C. M.; van den Heuvel-Eibrink, Marry M.; Tissing, Wim J. E.; Loonen, Jacqueline J.; Versluys, Birgitta; Bresters, Dorine; Kaspers, Gertjan J. L.; Lambalk, Cornelis B.; van Leeuwen, Flora E.; van Dulmen-den Broeder, Eline

    2012-01-01

    Background: Advances in childhood cancer treatment over the past decades have significantly improved survival, resulting in a rapidly growing group of survivors. However, both chemo- and radiotherapy may adversely affect reproductive function. This paper describes the design and encountered

  20. A nationwide study on reproductive function, ovarian reserve, and risk of premature menopause in female survivors of childhood cancer: design and methodological challenges

    NARCIS (Netherlands)

    Overbeek, A.; van den Berg, M.H.; Kremer, L.C.; van den Heuvel-Eibrink, M.; Tissing, W.J.; Loonen, J.J.; Versluys, B.; Bresters, D.; Kaspers, G.J.L.; Lambalk, C.B.; van Leeuwen, F.E.; van Dulmen-den Broeder, E.

    2012-01-01

    Background: Advances in childhood cancer treatment over the past decades have significantly improved survival, resulting in a rapidly growing group of survivors. However, both chemo- and radiotherapy may adversely affect reproductive function. This paper describes the design and encountered

  1. Reanalysis of interviewing study data in the health attitude survey of A-bomb survivors, etc

    International Nuclear Information System (INIS)

    Satoh, Kenichi

    2012-01-01

    The interviewing study data in the title were initially contained in the official request of Hiroshima City and Prefecture, which had been presented to MHLW (Ministry of Health, Labor and Welfare) in 2010, concerning spread of previously defined A-bomb exposed regions and were statistically reanalyzed based on the requirement of the consequent MHLW council. The data were originally derived from the questionnaire in 2008 about the health attitude survey by Hiroshima authorities, from which 892 survivors had received the interview together with self-writing, and answers of 869 parsons (524 males) were finally subjected to the present reanalysis. Measures of the interview involved the SF-36 (Medical Outcome Study Short Form 36-item Health Survey) for QOL, GHQ28 (General Health Questionnaire 28-item) for screening of neurosis/depression, and CAPS (Clinician Administered PTSD Scale) for diagnosis of PTSD (post traumatic stress disorder), etc. These measures were analyzed along with classes of A-bomb experience with adjustment factors of sex, age and income by multiple-/multivariate logistic-regression. It was found that measures were tended to be worse in groups experiencing the black rain without effects of adjustment factors, which was similar to groups experiencing the heavier rainfall; however, these results were statistically insignificant. (T.T.)

  2. Beliefs in karma and reincarnation among survivors of violent trauma--a community survey.

    Science.gov (United States)

    Davidson, Jonathan R T; Connor, Kathryn M; Lee, Li-Ching

    2005-02-01

    This survey was designed to examine beliefs in karma and reincarnation among survivors of violent trauma in the general US population. Two community surveys were conducted in 2001. From a sample of 1,969 respondents, two groups were created based on level of agreement with karmic belief. This sample forms the basis of this report. Information was obtained as to mental and physical health, resilience, exposure to violent trauma, and posttraumatic stress disorder (PTSD) symptom severity, and the cohorts were compared on these variables. Five percent of the sample admitted strong agreement to a belief in karma and reincarnation (n=99), while 77% strongly disagreed with these beliefs (n=1,511). Characteristics associated with agreement included being non-white, unmarried, and in poor physical and mental health. Moreover, agreement was associated with more extensive traumatization, including abuse, rape, and loss of a family member through violent death, as well as more severe posttraumatic stress symptoms. Few people subscribe strongly to a belief in karma and reincarnation in the US population, but personal experience of trauma may be associated with greater acceptance, as well as certain demographic and health-associated variables. The importance of holding such beliefs, which may represent an important way of coping following violent trauma, deserves further study.

  3. Human Trafficking and Health: A Survey of Male and Female Survivors in England.

    Science.gov (United States)

    Oram, Siân; Abas, Melanie; Bick, Debra; Boyle, Adrian; French, Rebecca; Jakobowitz, Sharon; Khondoker, Mizanur; Stanley, Nicky; Trevillion, Kylee; Howard, Louise; Zimmerman, Cathy

    2016-06-01

    To investigate physical and mental health and experiences of violence among male and female trafficking survivors in a high-income country. Our data were derived from a cross-sectional survey of 150 men and women in England who were in contact with posttrafficking support services. Interviews took place over 18 months, from June 2013 to December 2014. Participants had been trafficked for sexual exploitation (29%), domestic servitude (29.3%), and labor exploitation (40.4%). Sixty-six percent of women reported forced sex during trafficking, including 95% of those trafficked for sexual exploitation and 54% of those trafficked for domestic servitude. Twenty-one percent of men and 24% of women reported ongoing injuries, and 8% of men and 23% of women reported diagnosed sexually transmitted infections. Finally, 78% of women and 40% of men reported high levels of depression, anxiety, or posttraumatic stress disorder symptoms. Psychological interventions to support the recovery of this highly vulnerable population are urgently needed.

  4. Patient Safety Activity Under the Social Insurance Medical Fee Schedule in Japan: An Overview of the 2010 Nationwide Survey.

    Science.gov (United States)

    Hirose, Masahiro; Kawamura, Toshihiko; Igawa, Mikio; Imanaka, Yuichi

    2017-11-16

    Little is known about patient safety performance under the social insurance medical fee schedule in Japan. The Health Ministry in Japan introduced the preferential patient safety countermeasure fee (PPSCF) to promote patient safety in 2006 and revised the PPSCF system in 2010. This study aims to address the patient safety performance status at hospitals implementing the PPSCF. A nationwide questionnaire survey targeting 2674 hospitals with the PPSCF was performed in 2010 to 2011. The 627 participant hospitals were divided into the following three groups: 178 hospitals implementing PPSCF 1 with 400 beds or more (group A), 286 hospitals implementing PPSCF 1 with 399 beds or fewer (group B), and 163 hospitals implementing PPSCF 2 (group C). The mean numbers (standard errors) of patient safety managers were 1.45 (0.07) in group A, 1.12 (0.04) in group B, and 0.37 (0.12) in group C (P fee schedule in Japan.

  5. Nation-wide anthropometric survey data in Japan to determine dimensions of total-body phantom for Reference Japanese Man

    International Nuclear Information System (INIS)

    Togo, Masami

    1990-01-01

    In order to estimate radiation dose in Japanese population accurately, a Reference Japanese Man, whose stature and body weight are 170cm and 60kg respectively, is indispensable. The MIRD 5 total-body phantom has only 8 dimensions, i.e. total head height, head length, head breadth, trunk length, trunk breadth, leg length, and breadth and depth of a leg model at its lower end. Based on Japanese anthropometric data, the dimensions were determined and its mathematical descriptions were given. In Japan, annual statistical data of stature, body weight, chest circumference and sitting height for all Japan by sex and age are published. But other nation-wide survey data necessary for determining dimensions of total-body phantom of Reference Japanese Man, are unavailable. Much more national anthropometric data of every kind necessary for defining phantoms must be compiled. (author)

  6. Insight from Public Surveys Related to Siting of Nuclear Waste Facilities: An Overview of Findings from a 2015 Nationwide Survey of US Residents

    Energy Technology Data Exchange (ETDEWEB)

    Jenkins-Smith, Hank C. [Univ. of Oklahoma, Norman, OK (United States); Gupta, Kuhika [Univ. of Oklahoma, Norman, OK (United States); Silva, Carol L. [Univ. of Oklahoma, Norman, OK (United States); Bonano, Evaristo J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Rechard, Robert P. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-09-01

    The results described in this report are an analysis of nationwide surveys, administered between 2006 and 2015, which measure preferences of US residents concerning the environment and energy sources. The Energy & Environment (EE) survey series is conducted annually by the Center for Energy, Security & Society (CES&S), a joint research collaboration of the University of Oklahoma and Sandia National Laboratories. The annual EE survey series is designed to track evolving public views on nuclear materials management in the US. The 2015 wave of the Energy and Environment survey (EE15) was implemented using a web-based questionnaire, and was completed by 2,021 respondents using an Internet sample that matches the characteristics of the adult US population as estimated in the US Census. A special focus of the EE15 survey is how survey respondents understand and evaluate “consent” in the context of the storage and transportation of spent nuclear fuel (SNF). This report presents an overview of key results from analyses of questions related to consent-based siting and other elements of the nuclear energy fuel cycle.

  7. A nationwide survey on the epidemiology and clinical features of eosinophilic granulomatosis with polyangiitis (Churg-Strauss) in Japan.

    Science.gov (United States)

    Sada, Ken-Ei; Amano, Koichi; Uehara, Ritei; Yamamura, Masahiro; Arimura, Yoshihiro; Nakamura, Yoshikazu; Makino, Hirofumi

    2014-07-01

    We conducted a cross-sectional nationwide survey to determine eosinophilic granulomatosis with polyangiitis (Churg-Strauss) (EGPA) prevalence and clinical features in Japan. Data for EGPA patients in 2008 were collected from 1,564 hospitals. In total, 965 patients were reported from 365 departments. In a second survey, clinical data for 473 patients were obtained. We estimated that 1,866 (95% CI: 1,640-2,092) patients have EGPA in Japan (prevalence, 17.8/1,000,000). Of the 473 patients in the second survey, 315 fulfilled American College of Rheumatology (ACR) criteria or Lanham's criteria for EGPA. The mean age (± SD) of the 315 at onset was 55 ± 14 years, male to female ratio 1:2. 93% of patients had neurological manifestations, which were the organ system most frequently involved. Among 277 patients tested for myeloperoxidase (MPO)-/p anti-neutrophil cytoplasmic antibody (ANCA), 139 (50%) were positive, while only 6 of 238 were positive for proteinase3 (PR3)-/cANCA. MPO-ANCA-positive patients had renal involvement, mucous membrane or ophthalmological symptoms, and ENT symptoms more frequently, whereas cutaneous lesions and cardiovascular involvement were less common. The prevalence of EGPA and the frequency of MPO-/p-ANCA-positivity in Japanese EGPA patients were mostly similar to those of Western countries. However, female predominance and a high frequency of neurological manifestations characterized Japanese patients.

  8. Quality of life, use of topical medications and socio-economic data in hand eczema: a Swedish nationwide survey.

    Science.gov (United States)

    Bingefors, Kerstin; Lindberg, Magnus; Isacson, Dag

    2011-06-01

    Hand eczema is common and has an adverse impact on the lives of patients. There is a need for population-based surveys on the pharmacoepidemiological aspects, quality of life and impact of socioeconomic factors in hand eczema. The aim of this cross-sectional study was to investigate these factors. A questionnaire-based nationwide survey of health was performed, including questions on hand eczema, use of pharmaceuticals and socioeconomic factors. Quality of life was estimated with the generic instrument Short Form 36 (SF-36). The questionnaire was sent to 7,985 persons (age range 18-84 years), response rate 61.1% (n = 4,875). The 1-year prevalence of hand eczema in the study population was 7.5%. In this group, quality of life was lower. All dimensions of SF-36 were affected, most markedly general health and those dimensions reporting on mental health. In the group with self-reported hand eczema, 51% reported using topical pharmaceuticals. Hand eczema was more common among women (9.1%, n = 2,630) than among men (5.6%, n = 2,245) and in the age group below 65 years (8.5%, n = 3,274) compared with those aged 65 years and over (4.3%, n = 1,151). This survey clearly demonstrates the impact of hand eczema on several dimensions of life and also highlights age, gender and socioeconomic differences.

  9. A nationwide survey of the quality of antimalarials in retail outlets in Tanzania.

    Science.gov (United States)

    Kaur, Harparkash; Goodman, Catherine; Thompson, Eloise; Thompson, Katy-Anne; Masanja, Irene; Kachur, S Patrick; Abdulla, Salim

    2008-01-01

    Retail pharmaceutical products are commonly used to treat fever and malaria in sub-Saharan African countries. Small scale studies have suggested that poor quality antimalarials are widespread throughout the region, but nationwide data are not available that could lead to generalizable conclusions about the extent to which poor quality drugs are available in African communities. This study aimed to assess the quality of antimalarials available from retail outlets across mainland Tanzania. We systematically purchased samples of oral antimalarial tablets from retail outlets across 21 districts in mainland Tanzania in 2005. A total of 1080 antimalarial formulations were collected including 679 antifol antimalarial samples (394 sulfadoxine/pyrimethamine and 285 sulfamethoxypyrazine/pyrimethamine), 260 amodiaquine samples, 63 quinine samples, and 51 artemisinin derivative samples. A systematic subsample of 304 products was assessed for quality by laboratory based analysis to determine the amount of the active ingredient and dissolution profile by following the published United States Pharmacopoeia (USP) monogram for the particular tablet being tested. Products for which a published analytical monogram did not exist were assessed on amount of active ingredient alone. Overall 38 or 12.2% of the samples were found to be of poor quality. Of the antifolate antimalarial drugs tested 13.4% were found to be of poor quality by dissolution and content analysis using high-performance liquid chromatography (HPLC). Nearly one quarter (23.8%) of quinine tablets did not comply within the tolerance limits of the dissolution and quantification analysis. Quality of amodiaquine drugs was relatively better but still unacceptable as 7.5% did not comply within the tolerance limits of the dissolution analysis. Formulations of the artemisinin derivatives all contained the stated amount of active ingredient when analysed using HPLC alone. Substandard antimalarial formulations were widely

  10. A nationwide survey of the quality of antimalarials in retail outlets in Tanzania.

    Directory of Open Access Journals (Sweden)

    Harparkash Kaur

    Full Text Available Retail pharmaceutical products are commonly used to treat fever and malaria in sub-Saharan African countries. Small scale studies have suggested that poor quality antimalarials are widespread throughout the region, but nationwide data are not available that could lead to generalizable conclusions about the extent to which poor quality drugs are available in African communities. This study aimed to assess the quality of antimalarials available from retail outlets across mainland Tanzania.We systematically purchased samples of oral antimalarial tablets from retail outlets across 21 districts in mainland Tanzania in 2005. A total of 1080 antimalarial formulations were collected including 679 antifol antimalarial samples (394 sulfadoxine/pyrimethamine and 285 sulfamethoxypyrazine/pyrimethamine, 260 amodiaquine samples, 63 quinine samples, and 51 artemisinin derivative samples. A systematic subsample of 304 products was assessed for quality by laboratory based analysis to determine the amount of the active ingredient and dissolution profile by following the published United States Pharmacopoeia (USP monogram for the particular tablet being tested. Products for which a published analytical monogram did not exist were assessed on amount of active ingredient alone. Overall 38 or 12.2% of the samples were found to be of poor quality. Of the antifolate antimalarial drugs tested 13.4% were found to be of poor quality by dissolution and content analysis using high-performance liquid chromatography (HPLC. Nearly one quarter (23.8% of quinine tablets did not comply within the tolerance limits of the dissolution and quantification analysis. Quality of amodiaquine drugs was relatively better but still unacceptable as 7.5% did not comply within the tolerance limits of the dissolution analysis. Formulations of the artemisinin derivatives all contained the stated amount of active ingredient when analysed using HPLC alone.Substandard antimalarial formulations were

  11. Psychosocial profiles of children with achondroplasia in terms of their short stature-related stress: a nationwide survey in Japan.

    Science.gov (United States)

    Nishimura, Naoko; Hanaki, Keiichi

    2014-11-01

    To assess psychosocial profiles of children with achondroplasia using a nationwide survey. Achondroplasia, showing short stature and disproportionately short limbs, causes physical inconvenience such as difficulty in reaching high objects. It is, however, still controversial whether the condition is associated with psychological problems, especially in childhood. A cross-sectional descriptive design was employed. To evaluate psychosocial profiles and adaptation processes in children with achondroplasia, we developed an inventory of scales based on the psychological stress model of which conceptual framework was comprised of stressor, coping process, coping resource and adaptation outcome domains. Participants were recruited nationwide through the largest advocacy support group for achondroplasia in Japan. Of the 130 group members, 73 X-ray-diagnosed patients, aged 8-18 years, completed the inventory of questionnaires to be analysed. As for the stressor domain, patients experienced short stature-related unpleasant experiences more frequently (z-score: +1·3 in average, +3·9 in physical inconvenience). Nevertheless, these experiences had little effect on the coping process (threat appraisal: -0·2, control appraisal: +0·1) and the adaptation outcome (stress response: +0·3, self-concept: 0·0). Interestingly, self-efficacy in the coping resource domain was noticeably increased (+3·1) and was strongly correlated with most variables in the coping process and in adaptation outcome domains. Although the children with achondroplasia experienced more short stature-related stressors, there was no evidence of any psychosocial maladaptation. This finding suggests that coping process as well as coping resources such as self-efficacy could be important targets for promoting psychological adjustment in children with achondroplasia. To help children with achondroplasia adapt socially, nurses and other healthcare providers should routinely assess their psychological adaptation

  12. Current status of collaborative relationships between dialysis facilities and dental facilities in Japan: results of a nationwide survey.

    Science.gov (United States)

    Yoshioka, Masami; Shirayama, Yasuhiko; Imoto, Issei; Hinode, Daisuke; Yanagisawa, Shizuko; Takeuchi, Yuko

    2015-02-12

    Recent studies have reported an association between periodontal disease and mortality among dialysis patients. Therefore, preventive dental care should be considered very important for this population. In Japan, no systematic education has been undertaken regarding the importance of preventive dental care for hemodialysis patients--even though these individuals tend to have oral and dental problems. The aim of this study was to investigate the current state of collaborative relationships between hemodialysis facilities and dental services in Japan and also to identify strategies to encourage preventive dental visits among hemodialysis outpatients. A nationwide questionnaire on the collaborative relationship between dialysis facilities and dental facilities was sent by mail to all medical facilities in Japan offering outpatient hemodialysis treatment. Responses were obtained from 1414 of 4014 facilities (35.2%). Among the 1414 facilities, 272 (19.2%) had a dental service department. Approximately 100,000 dialysis outpatients were receiving treatment at these participating facilities, which amounts to one-third of all dialysis patients in Japan. Of those patients, 82.9% received hemodialysis at medical facilities without dental departments. Only 87 of 454 small clinics without in-house dental departments (19.2%) had collaborative registered dental clinics. Medical facilities with registered dental clinics demonstrated a significantly more proactive attitude to routine collaboration on dental matters than facilities lacking such clinics. Our nationwide survey revealed that most dialysis facilities in Japan have neither an in-house dental department nor a collaborative relationship with a registered dental clinic. Registration of dental clinics appears to promote collaboration with dental facilities on a routine basis, which would be beneficial for oral health management in hemodialysis patients.

  13. Modifying Health Behavior to Prevent Cardiovascular Diseases: A Nationwide Survey among German Primary Care Physicians

    Directory of Open Access Journals (Sweden)

    Sven Schneider

    2014-04-01

    Full Text Available Cardiovascular diseases (CVD are a major public health concern as they are the leading cause of death in developed countries. Primary care is considered to be the ideal setting for CVD prevention. Therefore, more than 4,000 German primary care physicians (PCPs were asked about their attitudes towards and their activities regarding the prevention of CVD in the nationwide ÄSP-kardio Study. The focus of the study was on health behavior modification. Two thirds of the participating PCPs stated that they routinely provided brief inventions to assist patients in reducing both their tobacco (72% and alcohol (61% consumption, to encourage them to increase their levels of physical activity (72%, and to assist them in adjusting to a more healthy diet (66%, and in achieving a healthy body weight (69%. However, only between 23% (quitting smoking and 49% (diet modification of PCPs felt that they had been successful in helping patients modify their lifestyles. Insufficient reimbursement, cultural diversity and a lack of time were reported to be the most problematic barriers to successful intervention in the primary care setting. Despite these obstacles, the majority of German PCPs was engaged in prevention and health behavior intervention to reduce the incidence and progression of CVD.

  14. Birth Trends among Female Physicians in Taiwan: A Nationwide Survey from 1996 to 2013

    Science.gov (United States)

    Wang, Yi-Jen; Chiang, Shu-Chiung; Chen, Tzeng-Ji; Chou, Li-Fang; Hwang, Shinn-Jang; Liu, Jui-Yao

    2017-01-01

    Background: Although more and more women are becoming physicians, their decisions regarding pregnancy may be affected by the lengthy period of medical education and postgraduate training. The aim of this study was to explore the birth trends among female physicians in Taiwan; Methods: Retrospective analyses of maternal ages at delivery from 1996 to 2013, both for physicians and the general population, were conducted using a nationwide dataset called National Health Insurance Research Database; Results: During the study period, 8540 female physicians were identified. The physicians delivered a total of 4940 births in that time, with a rise from 210 in 1996 to 440 in 2013. In addition, the mean maternal age of the physicians at delivery increased from 32.19 years (standard deviations (SD) 2.80) in 1996 to 33.61 (SD 3.21) in 2013, values significantly higher than those for non-physicians of 27.81 (SD 4.74) in 1996 (p < 0.001) and 31.36 (SD 4.78) in 2013 (p < 0.001); Conclusion: Female physicians usually gave birth at an older age than non-physicians, but the discrepancy between the two groups gradually declined over the 18-year course of the study. The establishment of a maternity-friendly environment for female physicians should be considered by those who determine healthcare system policies. PMID:28698490

  15. Radon prevention in new construction in Finland: A nationwide sample survey in 2009

    International Nuclear Information System (INIS)

    Arvela, H.; Holmgren, O.; Reisbacka, H.

    2012-01-01

    The building code for radon prevention and the associated practical guidelines were revised in Finland in 2003-2004. Thereafter, preventive measures have become more common and effective and indoor radon concentrations have been markedly reduced. In this study, the indoor radon concentration was measured in 1500 new low-rise residential houses. The houses were randomly selected and represented 7 % of the houses that received building permission in 2006. The average radon concentration of all the houses measured, which were completed in 2006-2008, was 95 Bq m -3 , the median being 58 Bq m -3 . The average was 33 % lower than in houses completed in 2000-2005. The decrease was 47 % in provinces with the highest indoor radon concentration and 26 % elsewhere in the country. In houses with a slab-on-ground foundation that had both passive radon piping and sealing measures carried out using a strip of bitumen felt in the joint between the foundation wall and floor slab, the radon concentration was on average reduced by 57 % compared with houses with no preventive measures. Preventive measures were taken nationwide in 54 % of detached houses and in provinces with the highest radon concentration in 92 % of houses. (authors)

  16. A survey of exercise professionals' barriers and facilitators to working with stroke survivors.

    Science.gov (United States)

    Condon, Marie; Guidon, Marie

    2018-03-01

    Stroke survivors (SSs) are largely inactive despite the benefits of exercise. Exercise professionals (EPs), skilled in exercise prescription and motivation, may have a role in promoting exercise among SSs. However, the number of EPs working with SSs is estimated to be low. This study aimed to investigate EPs' opinions on working with SSs by rating their agreement of barriers and facilitators to working with SSs. The study also investigated EPs skills, interest and experience working with SSs and the relationship between EPs' barriers and facilitators with their training on stroke. A descriptive cross-sectional study was conducted using a researcher-designed online survey between October and December 2015. Purposive sampling was used to survey EPs on the Register of Exercise Professionals in Ireland (n = 277). The response rate was 31% (87/277). Only 22% (19/86) of EPs had experience working with SSs. The primary barriers rated by EPs included insufficient training on psychological problems post-stroke (84%; 61/73), unsuitable equipment for SSs (69%; 50/73) and the level of supervision SSs require (56%; 41/73). The primary facilitators rated included access to suitable equipment (97%; 69/71), practical (100%; 71/71) and theoretical training (93%; 66/71) on stroke. Respondents with no training on stroke were significantly more likely to agree that insufficient training on psychological problems post-stroke and lack of experience were barriers. Seventy-six per cent of EPs (58/76) were interested in one-to-one exercise sessions with SSs but only 53% (40/76) were interested in group sessions. Eighty-two per cent of EPs (62/76) rated their motivational skills as good or very good but 42% (32/76) indicated having only acceptable skills dealing with psychological problems. Results indicate that EPs are interested in working with SSs despite limited experience and practical barriers. Training opportunities on stroke need to be developed; taking into account EPs' barriers

  17. Mental health conditions in Korean atomic bomb survivors. A survey in Seoul

    International Nuclear Information System (INIS)

    Koshimoto, Rika; Nakane, Hideyuki; Kim, Hyen

    2011-01-01

    More than 60 years have elapsed since the atomic bombings to Hiroshima and Nagasaki, and since all of the atomic bomb survivors have become old, the importance of caring their mental health has become increasing in Japan. Although approximately 70% of overseas atomic bomb are living in Korea, there have been quite few studies on their mental health. The objectives of the present study were to elucidate whether the mental health conditions of atomic bomb survivor in Korea are similar to those in Japan. The subjects were 181 Korean atomic bomb survivors living in Korea (cases) and 209 outpatients of a hospital in Seoul who were not exposed to atomic bombs (controls). Interviewers administered them at the hospital a questionnaire with Impact of Event Scale-Revised, General Health Questionnaire 12 (GHQ-12), Korean version of short form Geriatric Depression Scale and the K scale of the Minnesota Multiphasic Personality Inventory. Excluding subjects with incomplete responses we analyzed 162 cases and 189 controls. The proportion of subjects with high score of GHQ-12 (≥4) was significantly higher in cases (78/162 or 48.1%) than in controls (42/189 or 22.2%) (p<0.0001, Fisher's exact test). The present results, though preliminary, indicate that atomic bomb survivors in Korea have also mental health problems similar to those observed in Japanese atomic bomb survivors, indicating the necessity of a larger study. (author)

  18. Prevalence, awareness, control, and treatment of hypertension and diabetes in korean cancer survivors: a cross-sectional analysis of the fourth and fifth Korea national health and nutrition examination surveys.

    Science.gov (United States)

    Choi, Kyung-Hyun; Park, Sang Min; Lee, Kiheon; Kim, Kyae Hyung; Park, Joo-Sung; Han, Seong Ho

    2013-01-01

    Management of hypertension and diabetes in cancer survivors is an important issue; however, not much is known about the level of management of such chronic disease in Korea. This study therefore assessed the prevalence, awareness, control, and treatment of hypertension and diabetes in Korean cancer survivors compared to non-cancer survivors. A cross-sectional design was employed, wherein data were obtained from standardized questionnaires completed by 943 cancer survivors and 41,233 non-cancer survivors who participated in the Fourth and Fifth Korea National Health and Nutrition Examination Surveys (2007-2011). We calculated adjusted proportions for prevalence and management of hypertension and diabetes in non-cancer survivors and cancer survivors. We also assessed the associated factors with prevalence and management of cancer survivors. Cancer survivors are more likely than the general population to have higher prevalence, awareness, treatment, and control of hypertension. However, diabetic management was not significantly higher in cancer survivors than in non-cancer survivors, despite their having a higher prevalence. Several factors, such as, age, drinking, years since cancer diagnosis, self-perceived health status, and specific cancer types were found to affect to management of hypertension and diabetes. These data suggest that cancer survivors appear to be better than non-cancer survivors at management of hypertension, but not diabetes. There is a need for healthcare providers to recognize the importance of long-term chronic disease management for cancer survivors and for the care model to be shared between primary care physicians and oncologists.

  19. Comparison of diabetes management status between cancer survivors and the general population: results from a Korean population-based survey.

    Directory of Open Access Journals (Sweden)

    Ji-Yeon Shin

    Full Text Available This study aimed to determine and compare the prevalences of diabetes awareness, treatment, and adequate glycemic control among cancer survivors in a Korean population and two non-cancer control groups, comprising individuals without a history of cancer but with other chronic diseases (non-cancer, chronic disease controls and individuals without a history of cancer or any other chronic disease (non-cancer, non-chronic disease controls.We analyzed data from 2,660 subjects with prevalent diabetes (aged ≥30 years, who had participated in the 2007-2011 Korea National Health and Nutrition Examination Survey. Awareness was defined as a subject having been diagnosed with diabetes by a clinician. Treatment was defined as a subject who was taking anti-diabetic medicine. Adequate glycemic control was defined as a hemoglobin A1c level of <7%. Multivariable logistic regression and predictive margins were used to evaluate whether awareness, treatment, or adequate glycemic control differed among cancer survivors and the two non-cancer control groups.Cancer survivors had greater awareness compared with the non-cancer, chronic disease and non-cancer, non-chronic disease control groups (85.1%, 80.4%, and 60.4%, respectively. Although the prevalences of treatment and adequate glycemic control were higher for survivors compared with the non-cancer, non-chronic disease controls, they were lower compared with the non-cancer, chronic disease controls. The prevalence of diabetes treatment was 67.5% for cancer survivors, 69.5% for non-cancer, chronic disease controls, and 46.7% for non-cancer, non-chronic disease controls; the prevalences of adequate glycemic control in these three groups were 31.7%, 34.6%, and 17.8%, respectively.Cancer survivors were less likely than the non-cancer chronic disease subjects to receive diabetes management and to achieve adequate glycemic targets. Special attention and education are required to ensure that this population receives

  20. Pharmacy Customers’ Experiences With Electronic Prescriptions: Cross-Sectional Survey on Nationwide Implementation in Finland

    Science.gov (United States)

    Timonen, Johanna; Ahonen, Riitta

    2018-01-01

    Background One of the forerunners in electronic health, Finland has introduced electronic prescriptions (ePrescriptions) nationwide by law. This has led to significant changes for pharmacy customers. Despite the worldwide ambition to develop ePrescription services, there are few reports of nationally adopted systems and particularly on the experiences of pharmacy customers. Objective The aim of this study was to investigate Finnish pharmacy customers’ (1) experiences with purchasing medicines with ePrescriptions; (2) experiences with renewing ePrescriptions and acting on behalf of someone else at the pharmacy; (3) ways in which customers keep up to date with their ePrescriptions; and (4) overall satisfaction with ePrescriptions. Methods Questionnaires were distributed to 2913 pharmacy customers aged ≥18 years purchasing prescription medicines for themselves with an ePrescription in 18 community pharmacies across Finland in autumn 2015. Customers’ experiences were explored with 10 structured questions. The data were stored in SPSS for Windows and subjected to descriptive analysis, chi-square, Fisher exact, Kolmogorov-Smirnov, the Mann-Whitney U, and Kruskal-Wallis tests. Results Completed questionnaires were returned by 1288 customers, a response rate of 44.19% (1288/2913). The majority of the respondents did not encounter any problems during pharmacy visits (1161/1278, 90.85%) and were informed about the current status of their ePrescriptions after their medication was dispensed (1013/1276, 79.44%). Over half of the respondents had usually received a patient instruction sheet from their physician (752/1255, 59.92%), and nearly all of them regarded its content as clear (711/724, 98.2%). Half of the respondents had renewed their ePrescriptions through the pharmacy (645/1281, 50.35%), and one-third of them had acted on behalf of someone else with ePrescriptions (432/1280, 33.75%). Problems were rarely encountered in the renewal process (49/628, 7.8%) or when

  1. Pharmacy Customers' Experiences With Electronic Prescriptions: Cross-Sectional Survey on Nationwide Implementation in Finland.

    Science.gov (United States)

    Lämsä, Elina; Timonen, Johanna; Ahonen, Riitta

    2018-02-23

    One of the forerunners in electronic health, Finland has introduced electronic prescriptions (ePrescriptions) nationwide by law. This has led to significant changes for pharmacy customers. Despite the worldwide ambition to develop ePrescription services, there are few reports of nationally adopted systems and particularly on the experiences of pharmacy customers. The aim of this study was to investigate Finnish pharmacy customers' (1) experiences with purchasing medicines with ePrescriptions; (2) experiences with renewing ePrescriptions and acting on behalf of someone else at the pharmacy; (3) ways in which customers keep up to date with their ePrescriptions; and (4) overall satisfaction with ePrescriptions. Questionnaires were distributed to 2913 pharmacy customers aged ≥18 years purchasing prescription medicines for themselves with an ePrescription in 18 community pharmacies across Finland in autumn 2015. Customers' experiences were explored with 10 structured questions. The data were stored in SPSS for Windows and subjected to descriptive analysis, chi-square, Fisher exact, Kolmogorov-Smirnov, the Mann-Whitney U, and Kruskal-Wallis tests. Completed questionnaires were returned by 1288 customers, a response rate of 44.19% (1288/2913). The majority of the respondents did not encounter any problems during pharmacy visits (1161/1278, 90.85%) and were informed about the current status of their ePrescriptions after their medication was dispensed (1013/1276, 79.44%). Over half of the respondents had usually received a patient instruction sheet from their physician (752/1255, 59.92%), and nearly all of them regarded its content as clear (711/724, 98.2%). Half of the respondents had renewed their ePrescriptions through the pharmacy (645/1281, 50.35%), and one-third of them had acted on behalf of someone else with ePrescriptions (432/1280, 33.75%). Problems were rarely encountered in the renewal process (49/628, 7.8%) or when acting on behalf of another person (25

  2. An Australian nationwide survey on medicinal cannabis use for epilepsy: History of antiepileptic drug treatment predicts medicinal cannabis use.

    Science.gov (United States)

    Suraev, Anastasia S; Todd, Lisa; Bowen, Michael T; Allsop, David J; McGregor, Iain S; Ireland, Carol; Lintzeris, Nicholas

    2017-05-01

    Epilepsy Action Australia conducted an Australian nationwide online survey seeking opinions on and experiences with the use of cannabis-based products for the treatment of epilepsy. The survey was promoted via the Epilepsy Action Australia's main website, on their Facebook page, and by word of mouth. The survey consisted of 39 questions assessing demographics, clinical factors, including diagnosis and seizure types, and experiences with and opinions towards cannabis use in epilepsy. A total of 976 responses met the inclusion criteria. Results show that 15% of adults with epilepsy and 13% of parents/guardians of children with epilepsy were currently using, or had previously used, cannabis products to treat epilepsy. Of those with a history of cannabis product use, 90% of adults and 71% of parents reported success in reducing seizure frequency after commencing cannabis products. The main reasons for medicinal cannabis use were to manage treatment-resistant epilepsy and to obtain a more favorable side-effect profile compared to standard antiepileptic drugs. The number of past antiepileptic drugs tried was a significant predictor of medicinal cannabis use in both adults and children with epilepsy. Fifty-six percent of adults with epilepsy and 62% of parents/guardians of children with epilepsy expressed willingness to participate in clinical trials of cannabinoids. This survey provides insight into the use of cannabis products for epilepsy, in particular some of the likely factors influencing use, as well as novel insights into the experiences of and attitudes towards medicinal cannabis in people with epilepsy in the Australian community. This article is part of a Special Issue entitled "Cannabinoids and Epilepsy". Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Nationwide survey of extended newborn screening by tandem mass spectrometry in Taiwan.

    Science.gov (United States)

    Niu, Dau-Ming; Chien, Yin-Hsiu; Chiang, Chuan-Chi; Ho, Hui-Chen; Hwu, Wuh-Liang; Kao, Shu-Min; Chiang, Szu-Hui; Kao, Chuan-Hong; Liu, Tze-Tze; Chiang, Hung; Hsiao, Kwang-Jen

    2010-10-01

    In Taiwan, during the period March 2000 to June 2009, 1,495,132 neonates were screened for phenylketonuria (PKU) and homocystinuria (HCU), and 1,321,123 neonates were screened for maple syrup urine disease (MSUD), methylmalonic academia (MMA), medium-chain acyl-coenzyme A (CoA) dehydrogenase (MCAD) deficiency, isovaleric academia (IVA), and glutaric aciduria type 1 (GA-1) using tandem mass spectrometry (MS/MS). In a pilot study, 592,717 neonates were screened for citrullinemia, 3-methylcrotonyl-CoA carboxylase deficiency (3-MCC) and other fatty acid oxidation defects in the MS/MS newborn screening. A total of 170 newborns and four mothers were confirmed to have inborn errors of metabolism. The overall incidence was approximately 1/5,882 (1/6,219 without mothers). The most common inborn errors were defects of phenylalanine metabolism [five classic PKU, 20 mild PKU, 40 mild hyperphenylalaninemia (HPA), and 13 6-pyruvoyl-tetrahydropterin synthase (PTPS) deficiency]. MSUD was the second most common amino acidopathy and, significantly, most MSUD patients (10/13) belonged to the Austronesian aboriginal tribes of southern Taiwan. The most frequently detected among organic acid disorders was 3-MCC deficiency (14 newborns and four mothers). GA-1 and MMA were the second most common organic acid disorders (13 and 13 newborns, respectively). In fatty acid disorders, five carnitine transport defect (CTD), five short-chain acyl-CoA dehydrogenase deficiency (SCAD), and two medium-chain acyl-CoA dehydrogenase (MCAD) deficiency were confirmed. This is the largest case of MS/MS newborn screening in an East-Asian population to date. We hereby report the incidences and outcomes of metabolic inborn error diseases found in our nationwide MS/MS newborn screening program.

  4. Clinical study of mass survey for lung cancer in atomic bomb survivors

    International Nuclear Information System (INIS)

    Sasaki, Hideo; Ito, Chikako; Mitsuyama, Toyofumi; Kamitsuna, Akimitsu; Nishimoto, Yukio; Katsuta, Shizutomo.

    1988-01-01

    In mass screening for lung cancer, chest roentgenography was performed in A-bomb survivors over the age of 50 years. Out of 47,960 A-bomb survivors examined during seven years from 1979 through 1986, 58 were found to have lung cancer. The prevalence of lung cancer was 120.9/100,000, which was extremely higher than previously reported. A-bomb survivors, as well as persons exposed to environmental pollution and occupational hazards, are considered to belong to the high risk group for lung cancer. Asymptomatic lung cancer was of earlier stage than symptomatic lung cancer. It was also associated with higher surgical rate and faborable prognosis. Primary screening failed to detect lung cancer in 20 %, requiring double checking by pulmonary disease specialists. The role of health care workers is stressed in view of the necessity of detailed examination and surgery for lung cancer. (Namekawa, K.)

  5. Mass survey of gastric diseases in over 60 years of atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Ito, C; Kawase, T; Sato, K; Kumasawa, T [Hiroshima A-Bomb Survivors Health Control Clinic

    1980-11-01

    Gastric diseases screening examination was received by 2165 of A-bomb survivors over 60 years for one year. The close investigation was required in 11.5% of them, and 96% of them received the close examination. The detection rate of gastric cancer was estimated to be 1.00% in males and 0.51% in females. This investigation disclosed 14 gastric cancers. The rate of early cancer was 64.2%, which was significantly higher than 24.2% in the investigation on A-bomb survivors who had anemia and occult blood positive test results. It is considered that 66.7% of the early cancer which was found this time could not have been detected unless the present general screening examination was used. Qualitative reevaluation of general screening examination is necessary for aged A-bomb survivors.

  6. Nationwide tobacco surveys and sales data in Denmark from 1920 to 2010

    DEFF Research Database (Denmark)

    Clemmensen, Kim K B; Lynge, Elsebeth; Clemmensen, Inge H

    2012-01-01

    Tobacco smoking is an important cause of premature death and morbidity in Denmark. It is therefore important to monitor tobacco consumption. In this paper, tobacco consumption in Denmark is illustrated by two methods: sale of tobacco products and smoking habit surveys.......Tobacco smoking is an important cause of premature death and morbidity in Denmark. It is therefore important to monitor tobacco consumption. In this paper, tobacco consumption in Denmark is illustrated by two methods: sale of tobacco products and smoking habit surveys....

  7. A survey on respiratory diseases of atomic bomb survivors using chest X-ray examination

    International Nuclear Information System (INIS)

    Sasaki, Hideo; Noma, Koji; Ito, Chikako; Mitsuyama, Toyofumi; Kamitsuna, Akimitsu; Nishimoto, Yukio; Katsuta, Shizutomo.

    1986-01-01

    From April 1981 through March 1986, 39,363 A-bomb survivors older than 50 years of age underwent chest X-ray examination. The incidence of abnormal findings was higher in men (28 %) than in women (13 %). The most common disease was old pulmonary tuberculosis in both men and women. The incidence of pulmonary fibrosis was remarkably high in survivors exposed directly to A-bomb radiation, when compared with controls. There was no data suggesting the relationship between the incidence of respiratory disease and exposure status such as the distance from ground zero. (Namekawa, K.)

  8. The seventh nationwide epidemiological survey for chronic pancreatitis in Japan: clinical significance of smoking habit in Japanese patients.

    Science.gov (United States)

    Hirota, Morihisa; Shimosegawa, Tooru; Masamune, Atsushi; Kikuta, Kazuhiro; Kume, Kiyoshi; Hamada, Shin; Kanno, Atsushi; Kimura, Kenji; Tsuji, Ichiro; Kuriyama, Shinichi

    2014-01-01

    A nationwide survey was conducted to clarify the epidemiological features of patients with chronic pancreatitis (CP) in Japan. In the first survey, both the prevalence and the incidence of CP in 2011 were estimated. In the second survey, the clinicoepidemiological features of the patients were clarified by mailed questionnaires. Patients were diagnosed by the Japanese diagnostic criteria for chronic pancreatitis 2009. The estimated annual prevalence and incidence of CP in 2011 were 52.4/100,000 and 14.0/100,000, respectively. The sex ratio (male/female) of patients was 4.6, with a mean age of 62.3 years. Alcoholic (67.5%) was the most common and idiopathic (20.0%) was the second most common cause of CP. Comorbidity with diabetes mellitus (DM) and pancreatic calcifications (PC) occurred more frequent in ever smokers independently of their drinking status. Among patients without drinking habit, the incidences of DM and PC were significantly higher in ever smokers than in never smokers. The multiple logistic regression analysis revealed smoking was an independent factor of DM and PC in CP patients: DM, Odds ratio (OR) 1.644, 95% confidence interval (CI) 1.202 to 2.247 (P = 0.002): PC, OR 2.010, 95% CI 1.458 to 2.773 (P smoking was not identified as an independent factor for the appearance of abdominal pain by this analysis. The prevalence of Japanese patients with CP has been increasing. Smoking was identified as an independent factor related to DM and PC in Japanese CP patients. Copyright © 2014 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  9. Programmatic Variation in Home Hemodialysis in Canada: Results from a Nationwide Survey of Practice Patterns

    Directory of Open Access Journals (Sweden)

    Robert P Pauly

    2014-06-01

    Full Text Available Background: Over 40% of patients with end stage renal disease in the United States were treated with home hemodialysis (HHD in the early 1970's. However, this number declined rapidly over the ensuing decades so that the overwhelming majority of patients were treated in-centre 3 times per week on a 3–4 hour schedule. Poor outcomes for patients treated in this fashion led to a renewed interest in home hemodialysis, with more intensive dialysis schedules including short daily (SDHD and nocturnal (NHD. The relative infancy of these treatment schedules means that there is a paucity of data on ‘how to do it’. Objective: We undertook a systematic survey of home hemodialysis programs in Canada to describe current practice patterns. Design: Development and deployment of a qualitative survey instrument. Setting: Community and academic HHD programs in Canada. Participants: Physicians, nurses and technologists. Measurements: Programmatic approaches to patient selection, delivery of dialysis, human resources available, and follow up. Methods: We developed the survey instrument in three phases. A focus group of Canadian nephrologists with expertise in NHD or SDHD discussed the scope the study and wrote questions on 11 domains. Three nephrologists familiar with all aspects of HHD delivery reviewed this for content validity, followed by further feedback from the whole group. Multidisciplinary teams at three sites pretested the survey and further suggestions were incorporated. In July 2010 we distributed the survey electronically to all renal programs known to offer HHD according to the Canadian Organ Replacement Registry. We compiled the survey results using qualitative and quantitative methods, as appropriate. Results: Of the academic and community programs that were invited to participate, 80% and 63%, respectively, completed the survey. We observed wide variation in programmatic approaches to patient recruitment, human resources, equipment, water

  10. Survey of cervical cancer survivors regarding quality of life and sexual function

    Directory of Open Access Journals (Sweden)

    Wenjuan Zhou

    2016-01-01

    Conclusion: The QOL and sexual function of cervical cancer survivors were lower than the general population. Treatment-related complications and sexual dysfunction significantly affected patients' QOL. Having health insurance was associated with better QOL. Sexual function was adversely affected by radiotherapy and radical hysterectomy.

  11. Participation in leisure activities after stroke: A survey of community-residing stroke survivors in Nigeria.

    Science.gov (United States)

    Vincent-Onabajo, Grace; Blasu, Cephas

    2016-01-01

    Leisure provides pleasure and relaxation, and has health benefits even after a stressful and life-changing event such as a stroke. This study examined leisure participation among a sample of community-residing stroke survivors in Nigeria. Fifty-five stroke survivors undergoing rehabilitation were consecutively recruited from two government hospitals in Northern Nigeria. Data on pre- and post-stroke participation, and socio-demographic (age, sex, marital, employment, and educational status) and clinical (level of disability, post-stroke duration, stroke type and side of hemiplegia/hemiparesis) attributes of the stroke survivors were obtained. Leisure participation was assessed in four domains of recreational, social, cognitive, and productive/creative activities. Associations between leisure participation and the socio-demographic and clinical variables were examined using bivariate analysis. Mean (SD) age of the stroke survivors was 53.55 (14.39) years. Prevalence of leisure participation was 89.1%. Participation in specific leisure domains however varied thus: social (83.6%), cognitive (60%), recreational (41.8%), productive/creative activities (30.9%). Significant associations were observed between participation in cognitive, productive/creative, and recreational leisure activities, and specific socio-demographic and clinical attributes. Leisure participation was high in a general sense but marginal in recreational and productive/creative activities. The observed socio-demographic and clinical associations with post-stroke leisure participation may assist in providing effective leisure rehabilitation strategies.

  12. The management of acute distal tibio-fibular syndesmotic injuries: Results of a nationwide survey

    NARCIS (Netherlands)

    Schepers, Tim; van Zuuren, Wouter J.; van den Bekerom, Michel P. J.; Vogels, Lucas M. M.; van Lieshout, Esther M. M.

    2012-01-01

    Ankle fractures are one of the most frequently encountered musculoskeletal injuries, and 10% of patients have a concomitant distal tibiofibular syndesmotic disruption necessitating surgical repair. A national survey was conducted to gain more insight into the current approaches in the management of

  13. Internet use and problematic Internet use among adolescents in Japan: A nationwide representative survey

    Directory of Open Access Journals (Sweden)

    Satoko Mihara

    2016-12-01

    Conclusions: A cross-sectional survey using YDQ of a large number of high school students yielded a PIU prevalence of 7.9% in Japan. This study showed that problems associated with Internet overuse have already become serious; therefore, planning and implementation of prevention and control measures is urgently required.

  14. Prevention of Status Epilepticus in Dravet Syndrome: Nationwide Survey in Japan

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2008-11-01

    Full Text Available Child neurologists and epileptologists at various university centers in Japan were surveyed by questionnaire to identify the most effective strategies for management of and prophylaxis against status epilepticus (SE in children with severe myoclonic epilepsy in infancy (SMEI; Dravet syndrome, especially when associated with fever.

  15. A nationwide Danish survey on the use of green spaces by people with mobility disabilities

    DEFF Research Database (Denmark)

    Stigsdotter, Ulrika K; Corazon, Sus Sola; Ekholm, Ola

    2017-01-01

    and Morbidity Survey in 2005. The study participants consisted of 11,238 adult Danes, 383 of whom reported mobility disabilities, meaning that they were dependent on assistive devices for walking or moving around. Multiple logistic regression analysis was used to investigate the association between mobility...

  16. Nationwide Practices for Screening and Reporting Prenatal Cocaine Abuse: A Survey of Teaching Programs.

    Science.gov (United States)

    Pelham, Trena L.; DeJong, Allan R.

    1992-01-01

    A survey of 81 pediatric and 81 obstetric training programs from 42 states determined that respondents favored screening pregnant patients for cocaine abuse by maternal history (81 percent) and urine toxicology (36 percent), though many fewer reported these as established policy. Physicians favored such interventions as voluntary drug…

  17. Nationwide rural well water survey, the quality of household water and factors influencing it

    International Nuclear Information System (INIS)

    Korkka-Niemi, K.; Sipilae, A.; Hatva, T.; Hiisvirta, L.; Lahti, K.; Alfthan, G.

    1993-01-01

    The quality of water in 1 421 drinking—water wells was monitored in a nationwide well water study. Samples were taken once from all wells, and during three seasons from 421 wells. The wells were selected in such a way that the sample would be as representative as possible of the quality of the drinking—water in households’ own wells in ru— ral areas. The study comprised general water quality parameters, influence of sampling season, and factors related to the type, the condition and the pollution of the wells. In part of the well waters selenium, radioactivity and pesticides were determined. The effect of plumbing materials on the quality of water was also examined. The health—based criteria of the quality of drinking—water were not met in 50 — 70 % of the well waters monitored, depending upon the sampling time. The most common defects were the occurrence of bacteria indicating faecal pollution (2— 25 %) and a high concentration of nitrate (11 — 13 %) and fluoride (7 — 16 %). The tar— get values set for the other properties affecting the usableness of water were not met in 80 % of the well waters examined. The most common defects in this respect were the turbidity and the colour of water (40 — 50 %), the occurrence of iron (20 — 25 %) and manganese (20 %), and a low ph value. Depending upon the area, only 11 — 15 % of the wells met all the criteria related to the corrosive effect of the water. About 17 % of the households in the study suffered from periodical or continuous insufficiency of water. The types of well were dug wells with concrete sink rings in 72 %, and drilled bedrock wells in 20 % of te cases. The rest were spring wells or dug wells with stone walls. The condition of a well was, according 10 the judgement of the sampler, good in 58 %, satisfactory in 36 % and poor in 6 % of the households. Seasonal variation could be seen mainly in the occurrence of faecal bacteria. Distinct differences in the quality of water appeared

  18. The Practice of Electroconvulsive Therapy in US Correctional Facilities: A Nationwide Survey.

    Science.gov (United States)

    Surya, Sandarsh; McCall, W Vaughn; Iltis, Ana S; Rosenquist, Peter B; Hogan, Elizabeth

    2015-09-01

    There are little data regarding the practice of electroconvulsive therapy (ECT) in correctional settings in the United States. A survey was conducted to study the current practice of ECT in US prisons. We hypothesize that ECT is underutilized in the correctional setting. We also review the ethical aspects of using ECT for the treatment of mental illness in the prison population. A 12-question survey via a Survey Monkey link was emailed to chiefs of psychiatry, or the equivalent, of each state's department of corrections. We examined the frequency of Likert-type responses, tabulated individual comments for qualitative review, and grouped for comparison. Email contacts for chiefs of psychiatry, or the equivalent, for the department of corrections in 45 states (90%) were obtained and a survey link was sent. Thirty-one (68.9%) of 45 responded to the survey. Respondent estimates of the number of inmates with mental illness in 31 prison systems varied from less than 500 to more than 4500. Of these 31, 12 (38.7%) had more than 4500 inmates with mental illness. Four systems reported the use of ECT within the last 5 years. Of those, one reported use in the last 1 to 6 months, and 3 reported use in the last 2 to 5 years. Of these 4 prison systems, all felt that they had up to 10 patients who would benefit if ECT continued to be offered or became available in the future. None of these systems provided ECT within the prison. The inmates were referred to a local state psychiatric facility, a university hospital, or other institutions. The reasons for not using ECT as reported by the respondents are grouped under subheadings of stigma, ethical concerns, logistical concerns, and others. Considering the high prevalence of mental illness in prisons, one might expect a high prevalence of ECT responsive mental illness and, hence, provision of ECT to some prisoners with mental illness. However, our survey suggests that the use of ECT in prisons in the United States is low. Stigma

  19. Complementary and Alternative Medicine Use Among Allergy Practices: Results of a Nationwide Survey of Allergists.

    Science.gov (United States)

    Land, Michael H; Wang, Julie

    The use of complementary and alternative practices in the field of Allergy/Immunology is growing. A recent survey of American Academy of Allergy, Asthma, and Immunology members examining patterns of complementary and alternative medicine (CAM) use and adverse effects from CAM revealed that a majority of practitioners (81% of respondents) had patients who are using CAM therapies over conventional treatments and many practitioners (60% of survey respondents) have encountered patients experiencing adverse reactions. During routine office visits, a majority of practitioners do not ask patients about CAM use, and when they do, most do not have a standard intake form to take a CAM history. There is a strong need to increase knowledge and improve measures to prevent adverse reactions to CAMs. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  20. Nationwide survey of energy conservation in public school districts: Institutional, organizational, and technical characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Collins, N.E.; Ettinger, G.A.; Gaines, L.L.; Kier, P.H.; Miller, K.L. (Argonne National Lab., IL (United States)); Kammerud, R.C. (Lawrence Berkeley Lab., CA (United States))

    1987-09-01

    This report summarizes the responses to a mail survey sent to superintendents and other administrators of public school districts. The survey was part of an evaluation project for the USDOE Institutional Conservation Program (ICP). The goal of the project is to identify the most successful energy conservation measures (equipment and activities) available to the institutional buildings sector. To accomplish this goal, four specific research objectives were defined: To determine the impact of the ICP grants program on fostering energy efficiency and saving energy; to determine key characteristics of institutional conservation efforts outside the federal program; To determine the technical, organizational, and Institutional conditions that create the opportunity for energy conservation measures (ECMS) to be most effective; and to identify key technology transfer opportunities. This report focuses on those characteristics of school districts (and the schools within those districts) that might influence the identification, implementation, operation, and impacts of institutional energy conservation efforts. Information about institutional characteristics was gathered through a mail survey of public school districts and private schools. The first mailing resulted in responses from 90 of the 823 public school districts selected through a combination cluster-and-stratification sampling technique and 64 of the 1,700 private schools selected as a stratified random sample. Remaining project resources were used to collect data to achieve a statistically sound sample of a total of 250 public school districts by telephone interviews. In doing so, some questions had to be dropped. Responses from both the mall surveys and the telephone interviews of public school districts were combined into one data set. This report describes results for all 250 districts.

  1. Nationwide survey of policies and practices related to capillary blood sampling in medical laboratories in Croatia

    OpenAIRE

    Lenicek Krleza, Jasna

    2014-01-01

    Introduction: Capillary sampling is increasingly used to obtain blood for laboratory tests in volumes as small as necessary and as non-invasively as possible. Whether capillary blood sampling is also frequent in Croatia, and whether it is performed according to international laboratory standards is unclear. Materials and methods: All medical laboratories that participate in the Croatian National External Quality Assessment Program (N = 204) were surveyed on-line to collect information about t...

  2. A nationwide survey of first aid training and encounters in Norway

    OpenAIRE

    Bakke, Håkon Kvåle; Steinvik, Tine; Angell, Johan; Wisborg, Torben

    2017-01-01

    Background Bystander first aid can improve survival following out-of-hospital cardiac arrest or trauma. Thus, providing first aid education to laypersons may lead to better outcomes. In this study, we aimed to establish the prevalence and distribution of first aid training in the populace, how often first aid skills are needed, and self-reported helping behaviour. Methods We conducted a telephone survey of 1000 respondents who were representative of the Norwegian population. Respondents were ...

  3. Breast cancer screening among shift workers: a nationwide population-based survey in Korea.

    Science.gov (United States)

    Son, Heesook; Kang, Youngmi

    2017-04-01

    We aimed to examine the association between shift work types and participation in breast cancer screening (BCS) programs by comparing rates of participation for BCS among regular daytime workers and alternative shift workers using data from a nationally representative, population-based survey conducted in Korea. In addition, the results were analyzed according to sociodemographic factors, including occupation, education, income, private health insurance, age, and number of working hours a week. This secondary cross-sectional analysis used data from the 2012 Korean National Health and Nutritional Examination Survey. The target population included women aged ≥ 40 years who responded as to whether they had undergone BCS in the previous year. Accordingly, we analyzed survey data for a total of 1,193 women and used a multivariate logistic regression analysis to evaluate the differences in factors affecting BCS between regular daytime and alternative shift workers. A logistic regression analysis was performed considering private health insurance as a significant sociodemographic factor for BCS among regular daytime shift workers. In contrast, none of the tested variables could significantly predict adherence to BCS among alternative shift workers. The results of this study suggest the need for the development of comprehensive workplace breast cancer prevention programs by considering shift work types. More attention should be given to female workers with low education levels, those who are uninsured, and young workers to improve the participation rate for BCS at the workplace.

  4. Radon levels in underground workplaces – results of a nationwide survey in Italy

    International Nuclear Information System (INIS)

    Trevisi, Rosabianca; Orlando, Claudia; Orlando, Paolo; Amici, Mario; Simeoni, Carla

    2012-01-01

    In Italy an extensive survey has been carried out with the aim to evaluate annual average radon concentration in underground workplaces. The survey covered 933 underground rooms located in 311 bank workplaces spread throughout in all Italian regions; at this scope the sampling was stratified random in order to be representative on national scale. The annual radon concentration was estimated by using passive radon dosemeters (NRPB/SSI type holder and CR-39 as detector): the devices were exposed for a period of about 3 months and 4 cycles were performed to cover a solar year. The radon levels in underground workplaces ranged from 27 to 4851 Bq/m 3 with an overall mean value of 153 Bq/m 3 . As expected, radon distribution is not uniform throughout Italy: in several regions high radon annual averages have been found, confirming previous surveys. The analysis of data shows a high variability among regions and intra-region but low spread among rooms belonging to the same workplace. About 5% of underground workplaces displayed radon concentration exceeding 400 Bq/m 3 , and the 4.4% exceeds 500 Bq/m 3 , the national action level for the exposure to natural radioactivity in workplaces.

  5. Seroepidemiology of diphtheria and tetanus among children and young adults in Tajikistan: nationwide population-based survey, 2010.

    Science.gov (United States)

    Khetsuriani, Nino; Zakikhany, Katherina; Jabirov, Shamsiddin; Saparova, Nargis; Ursu, Pavel; Wannemuehler, Kathleen; Wassilak, Steve; Efstratiou, Androulla; Martin, Rebecca

    2013-10-01

    Tajikistan had a major diphtheria outbreak (≈ 10,000 cases) in the 1990 s, which was controlled after nationwide immunization campaigns with diphtheria-tetanus toxoid in 1995 and 1996. Since 2000, only 52 diphtheria cases have been reported. However, in coverage surveys conducted in 2000 and 2005, diphtheria-tetanus-pertussis vaccine coverage was lower than administratively reported estimates raising concerns about potential immunity gaps. To further assess population immunity to diphtheria in Tajikistan, diphtheria antibody testing was included in a large-scale nationwide serosurvey for vaccine-preventable diseases conducted in connection with a poliomyelitis outbreak in 2010. In addition, the serosurvey provided an opportunity to assess population immunity to tetanus. Residents of all regions of Tajikistan aged 1-24 years were included in the serosurvey implemented during September-October 2010. Participants were selected through stratified cluster sampling. Specimens were tested for diphtheria antibodies using a Vero cell neutralization assay and for tetanus antibodies using an anti-tetanus IgG ELISA. Antibody concentrations ≥ 0.1 IU/mL were considered seropositive. Overall, 51.4% (95% CI, 47.1%-55.6%) of participants were seropositive for diphtheria and 78.9% (95% CI, 74.7%-82.5%) were seropositive for tetanus. The lowest percentages of seropositivity for both diseases were observed among persons aged 10-19 years: diphtheria seropositivity was 37.1% (95% CI, 31.0%-43.7%) among 10-14 year-olds, and 35.3% (95% CI, 29.9%-41.1%) among 15-19 year-olds; tetanus seropositivity in respective age groups was 65.3% (95% CI, 58.4%-71.6%) and 70.1% (95% CI, 64.5%-75.2%). Population immunity for diphtheria in Tajikistan is low, particularly among 10-19 year-olds. Population immunity to tetanus is generally higher than for diphtheria, but is suboptimal among 10-19 year-olds. These findings highlight the need to improve routine immunization service delivery, and support a

  6. Epidemiology of adulthood drowning deaths in Bangladesh: Findings from a nationwide health and injury survey [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Mohammad Jahangir Hossain

    2017-04-01

    Full Text Available Background: Annual global death due to drowning accounts for 372,000 lives, 90% of which occur in low and middle income countries. Life in Bangladesh exposes adults and children to may water bodies for daily household needs, and as a result drowning is common. In Bangladesh, due to lack of systemic data collection, drowning among adults is unknown; most research is focused on childhood drowning. The aim of the present study was to explore the epidemiology of adulthood drowning deaths in Bangladesh. Methodology: A nationwide cross-sectional survey was conducted from January to December in 2003 among 171,366 rural and urban households, with a sample of 819,429 individuals to determine the epidemiology of adulthood drowning in Bangladesh.   Results:  Annual fatal drowning incidence among adults was 5.85/100,000 individuals. Of these, 71.4% were male and 28.6% were female (RR 2.39. In total, 90% of the fatalities were from rural areas. Rural populations were also found to have a 8.58 times higher risk of drowning than those in urban areas. About 95% of drowning occurred in natural water bodies. About 61.6% of the deaths occurred at the scene followed by 33.5% at the home. Of the drowning fatalities, 67% took place in water bodies within 100 meters of the household. Among the drowning fatalities 78.4% occurred in daylight between 7.00 and 18.00. Over 97% of the victims were from poor socio economic conditions with a monthly income tk. 6,000 ($94 or less. Only 25.5% of incidences were reported to the police station. Conclusions: Every year a significant number of adults die due to drowning in Bangladesh.  Populations living in rural areas, especially men, were the main victims of drowning. This survey finding might help policy makers and scientists to understand the drowning scenario among adults in Bangladesh.

  7. A nationwide survey of ixodid tick species recovered from domestic dogs and cats in Japan in 2011.

    Science.gov (United States)

    Iwakami, Shinya; Ichikawa, Yasuaki; Inokuma, Hisashi

    2014-10-01

    A nationwide survey of ixodid ticks was performed in 2011, during which a total of 4237 and 298 ticks were recovered from 1162 dogs and 136 cats, respectively. Haemaphysalis longicornis was the most frequently found tick species on canine hosts (739 dogs), followed by H. flava (166), Ixodes ovatus (139), and Rhipicephalus sanguineus sensu lato (70). H. hystricis, H. japonica, H. megaspinosa, H. formosensis, H. campanulata, H. ias, I. nipponensis, I. persulcatus, and Amblyomma testudinarium were also recovered. H. longicornis was also the most frequently found species on feline hosts (52 cats), followed by I. ovatus (34), A. testudinarium (19), and H. flava (12). H. hystricis, H. japonica, H. megaspinosa, I. nipponensis, I. persulcatus, I. granulatus and R. sanguineus sensu lato were also recovered from cats. The three major species of ticks found on dogs and cats, H. longicornis, H. flava, and I. ovatus, displayed a wide geographical distribution, with specimens found throughout northern and southern Japan. R. sanguineus sensu lato was primarily recovered in Okinawa, but was also found in Kanagawa, Wakayama, Hiroshima, and Yamaguchi Prefectures. A. testudinarium was mainly distributed throughout western Japan, but small numbers were also recovered from Gumma and Shizuoka Prefectures. H. longicornis was more frequently found on dogs in rural areas than those in urban or suburban areas. Exposure to woodland environments was significantly associated with H. flava and I. ovatus in dogs. Dogs in urban or suburban areas encountered R. sanguineus sensu lato more often than other tick species. Most of the cats surveyed in the present study were from rural areas. In the present study, H. hystricis and R. sanguineus sensu lato were found on cats for the first time in Japan. Copyright © 2014 Elsevier GmbH. All rights reserved.

  8. The burden of selected chronic non-communicable diseases and their risk factors in Malawi: nationwide STEPS survey.

    Directory of Open Access Journals (Sweden)

    Kelias P Msyamboza

    Full Text Available Chronic non-communicable diseases (NCDs are becoming significant causes of morbidity and mortality, particularly in sub-Saharan African countries, although local, high-quality data to inform evidence-based policies are lacking.To determine the magnitude of NCDs and their risk factors in Malawi.Using the WHO STEPwise approach to chronic disease risk factor surveillance, a population-based, nationwide cross-sectional survey was conducted between July and September 2009 on participants aged 25-64 years. Socio-demographic and behaviour risk factors were collected in Step 1. Physical anthropometric measurements and blood pressure were documented in Step 2. Blood cholesterol and fasting blood glucose were measured in Step 3.A total of 5,206 adults (67% females were surveyed. Tobacco smoking, alcohol drinking and raised blood pressure (BP were more frequent in males than females, 25% vs 3%, 30% vs 4% and 37% vs 29%. Overweight, physical inactivity and raised cholesterol were more common in females than males, 28% vs 16%, 13% vs 6% and 11% vs 6%. Tobacco smoking was more common in rural than urban areas 11% vs 7%, and overweight and physical inactivity more common in urban than rural areas 39% vs 22% and 24% vs 9%, all with p<0.05. Overall (both sexes prevalence of tobacco smoking, alcohol consumption, overweight and physical inactivity was 14%, 17%, 22%, 10% and prevalence of raised BP, fasting blood sugar and cholesterol was 33%, 6% and 9% respectively. These data could be useful in the formulation and advocacy of NCD policy and action plan in Malawi.

  9. Medical Student Experiences on Consultation-Liaison Psychiatry Rotations: A Nationwide Survey.

    Science.gov (United States)

    Meyer, Fremonta; Abbasi, Omair; Kasick, David; Lee, Kewchang; Pelic, Christine; Zinser, Jennifer; Harris, Thomas; Funk, Margo

    Consultation-liaison (C-L) psychiatry clerkship rotations may improve medical students' understanding of psychiatric principles relevant to the settings in which they will ultimately practice. This study aimed to characterize students' experiences on C-L rotations. This cross-sectional survey study, sponsored by the Academy of Psychosomatic Medicine Subcommittee on Medical Student Education, was conducted at 5 US medical schools between 2012 and 2016. After the C-L rotation, students completed a voluntary 17-item survey. A total of 235 surveys were collected (mean response rate = 92%). The most frequently endorsed benefit of C-L was learning to manage psychiatric disorders in the context of medical illness (89%). The most frequently endorsed drawback was inconsistent/excessively variable workload (40%). Overall, 82% of respondents recommended C-L to other students; 80% reported that the ideal clerkship would include exposure to both C-L and inpatient psychiatry. Overall, 38% reported that their C-L experience increased their interest in psychiatry as a career. Effect of C-L on interest in psychiatry did not differ by study site, age, sex, clerkship length, or time spent on C-L. Respondents who noted more positive role-modeling on C-L compared to other clerkship rotations were more likely to report increased interest in a psychiatry career (odds ratio = 2.70). Most medical students perceive C-L rotations favorably. Positive role modeling may increase their consideration of psychiatry specialization. The findings that C-L rotation length did not correlate with attitudes and that most students preferred exposure to both inpatient and C-L psychiatry suggest that C-L exposure can beneficially be integrated into core clerkships containing other elements. Copyright © 2018 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  10. Benchmarking surgeon satisfaction at academic health centers: a nationwide comparative survey.

    Science.gov (United States)

    Drachman, D A

    1996-01-01

    Forty-six academic health centers (AHCs) belonging to the University HealthSystem consortium joined forces to compare the efficiency of their surgical services and to identify best practices. In addition to measures of operational performance, surgeon satisfaction with the surgical services provided was measured by using a standardized questionnaire. From hospital records, indicators of the efficiency of surgical services were collected in three main areas: scheduling, preoperative testing and assessment, and the intraoperative process. Responding to a mail questionnaire, a sample of surgeons rated their satisfaction with key aspects of surgical services including scheduling, operating room staff, and equipment/supplies. On the basis of a review of the operational measures and the survey results, high performers were identified. Site visits were made to several of these high performers to uncover the critical factors responsible for their success. The survey revealed distinct variations in surgeon satisfaction across the participating institutions. Numerical benchmarks were obtained for surgeon satisfaction with each key component of surgical services. Scheduling was the most important component of overall surgeon satisfaction, explaining 71% of the variance in the rating of overall satisfaction with surgical services. High operational efficiency and high surgeon satisfaction were not incompatible. Several of the participating institutions were able to achieve both. These results were disseminated to all of the participants at a national meeting as well as in written form. The surgeon satisfaction survey allowed the participants to establish benchmarks for surgeon satisfaction for each key component of the surgical services they receive. The site visits revealed several common characteristics of highly efficient surgical services. Taken by themselves, the participating institutions might have been reluctant to consider adopting these best practices for fear of

  11. Factors associated with career satisfaction and burnout among US neurosurgeons: results of a nationwide survey.

    Science.gov (United States)

    McAbee, Joseph H; Ragel, Brian T; McCartney, Shirley; Jones, G Morgan; Michael, L Madison; DeCuypere, Michael; Cheng, Joseph S; Boop, Frederick A; Klimo, Paul

    2015-07-01

    OBJECT :The object of this study was to identify and quantify predictors of burnout and career satisfaction among US neurosurgeons. All US members (3247) of the American Association of Neurological Surgeons (AANS) were invited to participate in a survey between September and December 2012. Responses were evaluated through univariate analysis. Factors independently associated with burnout and career satisfaction were determined using multivariable logistic regression. Subgroup analysis of academic and nonacademic neurosurgeons was performed as well. The survey response rate was 24% (783 members). The majority of respondents were male, 40-60 years old, in a stable relationship, with children, working in a group or university practice, and trained in a subspecialty. More than 80% of respondents reported being at least somewhat satisfied with their career, and 70% would choose a career in neurosurgery again; however, only 26% of neurosurgeons believed their professional lives would improve in the future, and 52% believed it would worsen. The overall burnout rate was 56.7%. Factors independently associated with both burnout and career satisfaction included achieving a balance between work and life outside the hospital (burnout OR 0.45, satisfaction OR 10.0) and anxiety over future earnings and/or health care reform (burnout OR 1.96, satisfaction OR 0.32). While the burnout rate for nonacademic neurosurgeons (62.9%) was higher than that for academic neurosurgeons (47.7%), academicians who had practiced for over 20 years were less likely to be satisfied with their careers. The rates of burnout and career satisfaction were both high in this survey study of US neurosurgeons. The negative effects of burnout on the lives of surgeons, patients, and their families require further study and probably necessitate the development of interventional programs at local, regional, and even national levels.

  12. Marriage and divorce among childhood cancer survivors

    DEFF Research Database (Denmark)

    Koch, Susanne Vinkel; Kejs, Anne Mette Tranberg; Engholm, Gerda

    2011-01-01

    Many childhood cancer survivors have psychosocial late effects. We studied the risks for cohabitation and subsequent separation. Through the Danish Cancer Register, we identified a nationwide, population-based cohort of all 1877 childhood cancer survivors born from 1965 to 1980, and in whom cance...

  13. Nationwide survey of policies and practices related to capillary blood sampling in medical laboratories in Croatia.

    Science.gov (United States)

    Krleza, Jasna Lenicek

    2014-01-01

    Capillary sampling is increasingly used to obtain blood for laboratory tests in volumes as small as necessary and as non-invasively as possible. Whether capillary blood sampling is also frequent in Croatia, and whether it is performed according to international laboratory standards is unclear. All medical laboratories that participate in the Croatian National External Quality Assessment Program (N = 204) were surveyed on-line to collect information about the laboratory's parent institution, patient population, types and frequencies of laboratory tests based on capillary blood samples, choice of reference intervals, and policies and procedures specifically related to capillary sampling. Sampling practices were compared with guidelines from the Clinical and Laboratory Standards Institute (CLSI) and the World Health Organization (WHO). Of the 204 laboratories surveyed, 174 (85%) responded with complete questionnaires. Among the 174 respondents, 155 (89%) reported that they routinely perform capillary sampling, which is carried out by laboratory staff in 118 laboratories (76%). Nearly half of respondent laboratories (48%) do not have a written protocol including order of draw for multiple sampling. A single puncture site is used to provide capillary blood for up to two samples at 43% of laboratories that occasionally or regularly perform such sampling. Most respondents (88%) never perform arterialisation prior to capillary blood sampling. Capillary blood sampling is highly prevalent in Croatia across different types of clinical facilities and patient populations. Capillary sampling procedures are not standardised in the country, and the rate of laboratory compliance with CLSI and WHO guidelines is low.

  14. [Vocational training in general practice in Germany: a nation-wide survey among trainees].

    Science.gov (United States)

    Roos, Marco; Blauth, Eckart; Steinhäuser, Jost; Ledig, Thomas; Joos, Stefanie; Peters-Klimm, Frank

    2011-01-01

    The increasing shortage of (primary care) physicians in Germany is currently being discussed within and outside the profession. A national survey among general practice trainees aimed to explore their perspectives of vocational training (VT). After translation, cultural adaptation and web implementation of the questionnaire of the "Vasco da Gama Movement," the survey was conducted during 2009. Descriptive analyses were performed. Among 436 participants (mean age 36 years, 64% female, 49 months of VT) discipline-specific ("medically diverse discipline", "one-to-one care", and "holistic approach"), but also gender-related (females: "compatibility with family life", males: "autonomy and independence", and "opportunities to start their own practice") aspects were important to their choice of career. Despite the heavy workload job satisfaction, but not salary satisfaction, was generally high. Participants rated the following general conditions and content of VT as important: "structured rotations", "rotations in hospitals", "management skills", "working in a local care setting and in a multidisciplinary team" (all>88%). These results provide clues to improving VT in General Practice with respect to organisation and content including the consideration of gender-related living conditions. Furthermore, improvement and further development of VT programmes should ideally be part of an area-wide, interdisciplinary and intersectoral approach. Copyright © 2010. Published by Elsevier GmbH.

  15. [Shared decision-making as a new quality indicator in nephrology: a nationwide survey in Germany].

    Science.gov (United States)

    Scheibler, Fülöp; Stoffel, Markus P; Barth, Claudia; Kuch, Christine; Steffen, Petra; Baldamus, Conrad A; Pfaff, Holger

    2005-04-15

    Shared decision-making (SDM) as a model in physician-patient interaction is gaining relevance in the German health system. By applying this model, mid- and long-term improvements are expected especially in the outcomes of chronic diseases. Up to now, there has hardly been any empirical data available in German health services research regarding the state and development of SDM. This study establishes a baseline and provides actual data on this subject based on a German-wide survey of end-stage renal disease (ESRD) patients. Standardized German-wide survey of 6,614 patients with ESRD. The questionnaire included an instrument to measure the patients' perceived involvement in care (PICS) which had been translated and validated before. 82% of the questioned patients feel their physicians facilitated involvement in decision making. 81% of the patients actively inform themselves concerning their disease and treatment options. 69% state that SDM has taken place. Age, years on dialysis and gender correlate with perceived involvement. This paper provides a valid baseline for the prospective research of SDM in ESRD. The results indicate that dialysis patients are willing to participate in the process of medical decision-making. Characteristics and preferences of the patients should be taken into account not only in everyday clinical interactions. They could be monitored systematically within the framework of quality management and used as potential for quality improvement.

  16. Preparedness for natural disasters among older US adults: a nationwide survey.

    Science.gov (United States)

    Al-Rousan, Tala M; Rubenstein, Linda M; Wallace, Robert B

    2015-10-01

    We sought to determine natural disaster preparedness levels among older US adults and assess factors that may adversely affect health and safety during such incidents. We sampled adults aged 50 years or older (n = 1304) from the 2010 interview survey of the Health and Retirement Study. The survey gathered data on general demographic characteristics, disability status or functional limitations, and preparedness-related factors and behaviors. We calculated a general disaster preparedness score by using individual indicators to assess overall preparedness. Participant (n = 1304) mean age was 70 years (SD = 9.3). Only 34.3% reported participating in an educational program or reading materials about disaster preparation. Nearly 15% reported using electrically powered medical devices that might be at risk in a power outage. The preparedness score indicated that increasing age, physical disability, and lower educational attainment and income were independently and significantly associated with worse overall preparedness. Despite both greater vulnerability to disasters and continuous growth in the number of older US adults, many of the substantial problems discovered are remediable and require attention in the clinical, public health, and emergency management sectors of society.

  17. Pregnancy among residents enrolled in general surgery: a nationwide survey of attitudes and experiences.

    Science.gov (United States)

    Merchant, Shaila J; Hameed, S Morad; Melck, Adrienne L

    2013-10-01

    Medical student interest in general surgery has declined, and the lack of adequate accommodation for pregnancy and parenting during residency training may be a deterrent. We explored resident and program director experiences with these issues in general surgery programs across Canada. Using a web-based tool, residents and program directors from 16 Canadian general surgery programs were surveyed regarding their attitudes toward and experiences with pregnancy during residency. One hundred seventy-six of 600 residents and 8 of 16 program directors completed the survey (30% and 50% response rate, respectively). Multiple issues pertaining to pregnancy during surgical residency were reported including the lack of adequate policies for maternity/parenting, the major obstacles to breast-feeding, and the increased workload for fellow resident colleagues. All program directors reported the lack of a program-specific maternity/parenting policy. General surgery programs lack program-specific maternity/parenting policies. Several issues have been highlighted in this study emphasizing the importance of creating and implementing such a policy. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by periodical health examination, (6)

    International Nuclear Information System (INIS)

    Abe, Tsutomu; Dohy, Hiroo; Okita, Hajime

    1980-01-01

    Serum ferritin was determined in A-bomb survivors, and its significance was evaluated. A low-ferritin group included many of the females under the age of 50, who mostly had iron deficient anemia. A high-ferritin group included many older-aged A-bomb survivors who had secondary anemia due to hemochromatosis, paroxismal nocturnal hemoglobinuria (PNH), and multiple myeloma. Secondary anemia due to hemochromatosis, PNH, leukemia, and sideroblastic anemia was detected in those who were old and had underlying moderate or severe anemia with a high ferritin level. As the results of this investigation, blood examination combined with serum ferritin determination is valuable for diagnosis of anemia and detection of underlying diseases. (Ueda, J.)

  19. Hospital safety culture in Taiwan: a nationwide survey using Chinese version Safety Attitude Questionnaire.

    Science.gov (United States)

    Lee, Wui-Chiang; Wung, Hwei-Ying; Liao, Hsun-Hsiang; Lo, Chien-Ming; Chang, Fei-Ling; Wang, Pa-Chun; Fan, Angela; Chen, Hsin-Hsin; Yang, Han-Chuan; Hou, Sheng-Mou

    2010-08-10

    Safety activities have been initiated at many hospitals in Taiwan, but little is known about the safety culture at these hospitals. The aims of this study were to verify a safety culture survey instrument in Chinese and to assess hospital safety culture in Taiwan. The Taiwan Patient Safety Culture Survey was conducted in 2008, using the adapted Safety Attitude Questionnaire in Chinese (SAQ-C). Hospitals and their healthcare workers participated in the survey on a voluntary basis. The psychometric properties of the five SAQ-C dimensions were examined, including teamwork climate, safety climate, job satisfaction, perception of management, and working conditions. Additional safety measures were asked to assess healthcare workers' attitudes toward their collaboration with nurses, physicians, and pharmacists, respectively, and perceptions of hospitals' encouragement of safety reporting, safety training, and delivery delays due to communication breakdowns in clinical areas. The associations between the respondents' attitudes to each SAQ-C dimension and safety measures were analyzed by generalized estimating equations, adjusting for the clustering effects at hospital levels. A total of 45,242 valid questionnaires were returned from 200 hospitals with a mean response rate of 69.4%. The Cronbach's alpha was 0.792 for teamwork climate, 0.816 for safety climate, 0.912 for job satisfaction, 0.874 for perception of management, and 0.785 for working conditions. Confirmatory factor analyses demonstrated a good model fit for each dimension and the entire construct. The percentage of hospital healthcare workers holding positive attitude was 48.9% for teamwork climate, 45.2% for perception of management, 42.1% for job satisfaction, 37.2% for safety climate, and 31.8% for working conditions. There were wide variations in the range of SAQ-C scores in each dimension among hospitals. Compared to those without positive attitudes, healthcare workers with positive attitudes to each SAQ

  20. Treatment and management of thyroid storm: analysis of the nationwide surveys: The taskforce committee of the Japan Thyroid Association and Japan Endocrine Society for the establishment of diagnostic criteria and nationwide surveys for thyroid storm.

    Science.gov (United States)

    Isozaki, Osamu; Satoh, Tetsurou; Wakino, Shu; Suzuki, Atsushi; Iburi, Tadao; Tsuboi, Kumiko; Kanamoto, Naotetsu; Otani, Hajime; Furukawa, Yasushi; Teramukai, Satoshi; Akamizu, Takashi

    2016-06-01

    Thyroid storm (TS) is a life-threatening endocrine emergency. This study aimed to achieve a better understanding of the management of TS by analyzing therapeutic modalities and prognoses reported by nationwide surveys performed in Japan. Retrospective analyses were performed on clinical parameters, outcomes, and treatments in 356 TS patients. Patient disease severities assessed via Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores significantly correlated with mortality. Free triiodothyronine (FT3) and the FT3/free thyroxine (FT4) ratio inversely correlated with disease severity. Methimazole (MMI) was used in the majority of patients (78·1%), and there were no significant differences in mortality or disease severity between those treated with MMI and those receiving propylthiouracil (PTU). Patients who received inorganic iodide (KI) demonstrated higher disease severity but no change in mortality compared to those who did not. Patients treated with corticosteroids (CSs) demonstrated significantly higher disease severity and mortality than those who were not. Disease severity in patients treated with intravenous administration of beta-adrenergic antagonists (AAs) was significantly higher than those treated with oral preparations, although no significant difference in mortality was observed between these groups. In addition, mortality was significantly higher in patients treated with non-selective beta-AAs as compared with other types of beta-AAs. In Japan, MMI was preferentially used in TS and showed no disadvantages compared to PTU. In severe TS, multimodal treatment, including administration of antithyroid drugs, KI, CSs and selective beta1 -AAs may be preferable to improve outcomes. © 2015 John Wiley & Sons Ltd.

  1. Cultural diversity training for UK healthcare professionals: a comprehensive nationwide cross-sectional survey.

    Science.gov (United States)

    Bentley, Paul; Jovanovic, Ana; Sharma, Pankaj

    2008-10-01

    Healthcare inequalities within the UK based on patients' ethnicity have been found over the last five years in a large number of medical specialties. One possible explanation for this lies in ignorance of ethnic minority healthcare needs among professionals. Cultural diversity programmes have been shown to improve patient outcomes including compliance, yet these are not as yet requirements for any UK healthcare professionals with the exception of psychiatrists. This paper documents the frequency, regional variation, characteristics and motivations for cultural diversity training through a questionnaire survey of the educational leads of every UK medical school, postgraduate deanery and schools of nursing, physiotherapy, occupational therapy, speech and language therapy, and pharmacy. The results showed a wide variation in teaching practices between healthcare professions and geographical regions. This study provides evidence for the need for national guidelines to incorporate cultural competency training by all UK healthcare professional training bodies.

  2. Use of medical photography among dermatologists: a nationwide online survey study.

    Science.gov (United States)

    Milam, E C; Leger, M C

    2018-02-06

    Medical photography enhances patient care, medical education and research. Despite medical photography's widespread use, little is known about how dermatologists choose to implement photography in routine clinical practice, and how they approach issues of image storage, image security and patient consent. To characterize dermatologists' medical photography habits and opinions. A 32-item anonymous, multiple-choice SurveyMonkey questionnaire about medical photography practices was emailed to programme directors of the 117 United States (US) dermatology residency programmes between May and August 2015, with a request to forward to faculty and affiliated dermatologists. Only board-certified dermatologists practicing in the United States were eligible. The Institutional Review Board exempted our study from full review. Our survey included 153 board-certified dermatologists, primarily representing the north-east (43.1%) and identifying as academic dermatologists (75.5%). Medical photography is prevalent: 61.8% report everyday use and 21.7% photograph every patient. Those reporting rare use (3.3%) were, on average, 20 years older. Dermatologists most commonly use photography to mark biopsy sites (87.5%), track disease (82.9%) and for education/teaching (72.4%). Nearly half (46%) use smartphone cameras. Emailing and texting photographs with patients or colleagues are common (69.1%). Most dermatologists (75.7%) always request patient consent for photographs. Only 23.7% adhere to a photography protocol and 73.9% desire more training opportunities. Dermatologists value medical photography. While patterns of image acquisition, storage and consent are noted, a variety of methods and preferences exist. Clearer photography guidelines and increased educational resources are likely to improve image quality, exchangeability and confidentiality. © 2018 European Academy of Dermatology and Venereology.

  3. Current knowledge of burn injury first aid practices and applied traditional remedies: a nationwide survey.

    Science.gov (United States)

    Kattan, Abdullah E; AlShomer, Feras; Alhujayri, Abdulaziz K; Addar, Abdullah; Aljerian, Albaraa

    2016-01-01

    Burn first aid awareness has been shown to reduce morbidity and mortality. We present a report on the knowledge and practices of the Saudi population with regard to burn first aid and the application of traditional remedies. An internet-based survey was conducted to assess the public's knowledge on first aid practices and home remedies applied for burn injuries among Saudi adults. A total of 2758 individuals responded to the survey. There were 1178 (42.7 %) respondents who had previously received burn first aid information. One thousand five hundred fifty respondents had a history of burn exposure in which burn injury first aid was applied as follows: 1118 (72.1 %) removed clothing and accessories from the injured area; water was applied by 990 (63.9 %); among those who applied water, 877 (88.6 %) applied cold water; and only 57 (5.8 %) did so for more than 15 min. Wrapping the burn area was performed by 526 (33.9 %), and 985 (63.5 %) sought medical assistance. When it comes to traditional remedies, 2134 (77.4 %) knew of and/or implemented these remedies as first aid or to treat burns. Honey and toothpaste were the commonest among these remedies with 1491 (69.9 %) and 1147 (53.7 %), respectively. This was associated with female gender ( r  = 0.87, P  first aid. Proper burn first aid is a simple, cheap, and accessible means of managing burns initially. Although the majority of the respondents were university graduates (51.1 %), knowledge and implementation of burn first aid was very poor. Major healthcare agencies should review and promote a consistent guideline for burn first aid in an effort to tackle and minimize the effect of this grave injury.

  4. Radiation dose from multidetector CT studies in children: results from the first Italian nationwide survey

    Energy Technology Data Exchange (ETDEWEB)

    Granata, Claudio [IRCCS Istituto Giannina Gaslini, Department of Radiology, Genoa (Italy); Origgi, Daniela; Palorini, Federica [Istituto Europeo di Oncologia, Department of Medical Physics, Milan (Italy); Matranga, Domenica [University of Palermo, Department of Sciences for Health Promotion and Mother and Child Care ' ' G. D' Alessandro' ' , Palermo (Italy); Salerno, Sergio [University of Palermo, Department of Medical and Forensic Biopathology and Biotechnologies, Section of Radiology, Palermo (Italy)

    2015-05-01

    Multidetector CT (MDCT) scanners have contributed to the widespread use of CT in paediatric imaging. However, concerns are raised for the associated radiation exposure. Very few surveys on radiation exposure from MDCT studies in children are available. The aim of this study was to outline the status of radiation exposure in children from MDCT practice in Italy. In this retrospective multicentre study we asked Italian radiology units with an MDCT scanner with at least 16 slices to provide dosimetric and acquisition parameters of CT examinations in three age groups (1-5, 6-10, 11-15 years) for studies of head, chest and abdomen. The dosimetric results were reported in terms of third-quartile volumetric CT dose index (CTDI{sub vol}) (mGy), size-specific dose estimate (SSDE) (mGy), dose length product (DLP) (mGy cm), and total DLP for multiphase studies. These results were compared with paediatric European and adult Italian published data. A multivariate analysis assessed the association of CTDI{sub vol} with patient characteristics and scanning modalities. We collected data from 993 MDCT examinations performed at 25 centres. For age groups 1-5 years, 6-10 years and 11-15 years, the CTDI{sub vol}, DLP and total DLP values were statistically significantly below the values observed in our analogous national survey in adults, although the difference decreased with increasing age. CTDI{sub vol} variability among centres was statistically significant (variance = 0.07; 95% confidence interval = 0.03-0.16; P < 0.001). This study reviewed practice in Italian centres performing paediatric imaging with MDCT scanners. The variability of doses among centres suggests that the use of standardised CT protocols should be encouraged. (orig.)

  5. Nationwide survey of policies and practices related to capillary blood sampling in medical laboratories in Croatia

    Science.gov (United States)

    Krleza, Jasna Lenicek

    2014-01-01

    Introduction: Capillary sampling is increasingly used to obtain blood for laboratory tests in volumes as small as necessary and as non-invasively as possible. Whether capillary blood sampling is also frequent in Croatia, and whether it is performed according to international laboratory standards is unclear. Materials and methods: All medical laboratories that participate in the Croatian National External Quality Assessment Program (N = 204) were surveyed on-line to collect information about the laboratory’s parent institution, patient population, types and frequencies of laboratory tests based on capillary blood samples, choice of reference intervals, and policies and procedures specifically related to capillary sampling. Sampling practices were compared with guidelines from the Clinical and Laboratory Standards Institute (CLSI) and the World Health Organization (WHO). Results: Of the 204 laboratories surveyed, 174 (85%) responded with complete questionnaires. Among the 174 respondents, 155 (89%) reported that they routinely perform capillary sampling, which is carried out by laboratory staff in 118 laboratories (76%). Nearly half of respondent laboratories (48%) do not have a written protocol including order of draw for multiple sampling. A single puncture site is used to provide capillary blood for up to two samples at 43% of laboratories that occasionally or regularly perform such sampling. Most respondents (88%) never perform arterialisation prior to capillary blood sampling. Conclusions: Capillary blood sampling is highly prevalent in Croatia across different types of clinical facilities and patient populations. Capillary sampling procedures are not standardised in the country, and the rate of laboratory compliance with CLSI and WHO guidelines is low. PMID:25351353

  6. Clinical practice of acute respiratory distress syndrome in Japan: A nationwide survey and scientific evidences.

    Science.gov (United States)

    Tasaka, Sadatomo; Tatsumi, Koichiro

    2017-07-01

    There has been limited information about epidemiology and clinical practice of acute respiratory distress syndrome (ARDS) in Japan. An invitation letter to the web-based survey was mailed to all 871 board certified hospitals of the Japanese Respiratory Society. The questionnaires were designed to collect data on epidemiology and clinical practice of ARDS, including diagnostic measures and therapeutics. Within 4 months of the survey period, valid responses were obtained from 296 (34%) hospitals. The incidence of ARDS was estimated to be 3.13 cases/100 hospital beds or 1.91 cases/ICU bed per year. The most frequent underlying disease was pneumonia (34%), followed by sepsis (29%). In hospitals with fewer ICU beds, pulmonologists tended to be in charge of management of ARDS patients. Routine diagnostic measures included computed tomography of the chest (69.6% of the hospitals) and Swan-Ganz catheterization was rarely performed for diagnosis. In 87.4% of the hospitals, non-invasive ventilation was applied to management of ARDS patients, especially those with mild disease. Prone positioning and extracorporeal membrane oxygenation (ECMO) for ARDS patients was more widely adopted in hospitals with larger numbers of ICU beds and intensivists. In 58.2% of the responding hospitals, corticosteroid was considered as a treatment option for ARDS, among which pulse therapy was routinely introduced to ARDS patients in 35.4%. The incidence of ARDS in Japan was estimated to be lower than that in the recent international study. The scale and equipment of hospitals and the number of intensivists might influence clinical practice of ARDS. Copyright © 2017 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

  7. Factors Associated With Burnout Among US Hospital Clinical Pharmacy Practitioners: Results of a Nationwide Pilot Survey.

    Science.gov (United States)

    Jones, G Morgan; Roe, Neil A; Louden, Les; Tubbs, Crystal R

    2017-12-01

    Background: In health care, burnout has been defined as a psychological process whereby human service professionals attempting to positively impact the lives of others become overwhelmed and frustrated by unforeseen job stressors. Burnout among various physician groups who primarily practice in the hospital setting has been extensively studied; however, no evidence exists regarding burnout among hospital clinical pharmacists. Objective: The aim of this study was to characterize the level of and identify factors independently associated with burnout among clinical pharmacists practicing in an inpatient hospital setting within the United States. Methods: We conducted a prospective, cross-sectional pilot study utilizing an online, Qualtrics survey. Univariate analysis related to burnout was conducted, with multivariable logistic regression analysis used to identify factors independently associated with the burnout. Results: A total of 974 responses were analyzed (11.4% response rate). The majority were females who had practiced pharmacy for a median of 8 years. The burnout rate was high (61.2%) and largely driven by high emotional exhaustion. On multivariable analysis, we identified several subjective factors as being predictors of burnout, including inadequate administrative and teaching time, uncertainty of health care reform, too many nonclinical duties, difficult pharmacist colleagues, and feeling that contributions are underappreciated. Conclusions: The burnout rate of hospital clinical pharmacy providers was very high in this pilot survey. However, the overall response rate was low at 11.4%. The negative effects of burnout require further study and intervention to determine the influence of burnout on the lives of clinical pharmacists and on other health care-related outcomes.

  8. Factors associated with burnout among US neurosurgery residents: a nationwide survey.

    Science.gov (United States)

    Attenello, Frank J; Buchanan, Ian A; Wen, Timothy; Donoho, Daniel A; McCartney, Shirley; Cen, Steven Y; Khalessi, Alexander A; Cohen-Gadol, Aaron A; Cheng, Joseph S; Mack, William J; Schirmer, Clemens M; Swartz, Karin R; Prall, J Adair; Stroink, Ann R; Giannotta, Steven L; Klimo, Paul

    2018-02-09

    OBJECTIVE Excessive dissatisfaction and stress among physicians can precipitate burnout, which results in diminished productivity, quality of care, and patient satisfaction and treatment adherence. Given the multiplicity of its harms and detriments to workforce retention and in light of the growing physician shortage, burnout has garnered much attention in recent years. Using a national survey, the authors formally evaluated burnout among neurosurgery trainees. METHODS An 86-item questionnaire was disseminated to residents in the American Association of Neurological Surgeons database between June and November 2015. Questions evaluated personal and workplace stressors, mentorship, career satisfaction, and burnout. Burnout was assessed using the previously validated Maslach Burnout Inventory. Factors associated with burnout were determined using univariate and multivariate logistic regression. RESULTS The response rate with completed surveys was 21% (346/1643). The majority of residents were male (78%), 26-35 years old (92%), in a stable relationship (70%), and without children (73%). Respondents were equally distributed across all residency years. Eighty-one percent of residents were satisfied with their career choice, although 41% had at some point given serious thought to quitting. The overall burnout rate was 67%. In the multivariate analysis, notable factors associated with burnout included inadequate operating room exposure (OR 7.57, p = 0.011), hostile faculty (OR 4.07, p = 0.008), and social stressors outside of work (OR 4.52, p = 0.008). Meaningful mentorship was protective against burnout in the multivariate regression models (OR 0.338, p = 0.031). CONCLUSIONS Rates of burnout and career satisfaction are paradoxically high among neurosurgery trainees. While several factors were predictive of burnout, including inadequate operative exposure and social stressors, meaningful mentorship proved to be protective against burnout. The documented negative effects of

  9. Effectiveness of malaria control interventions in Madagascar: a nationwide case-control survey.

    Science.gov (United States)

    Kesteman, Thomas; Randrianarivelojosia, Milijaona; Raharimanga, Vaomalala; Randrianasolo, Laurence; Piola, Patrice; Rogier, Christophe

    2016-02-11

    Madagascar, as other malaria endemic countries, depends mainly on international funding for the implementation of malaria control interventions (MCI). As these funds no longer increase, policy makers need to know whether these MCI actually provide the expected protection. This study aimed at measuring the effectiveness of MCI deployed in all transmission patterns of Madagascar in 2012-2013 against the occurrence of clinical malaria cases. From September 2012 to August 2013, patients consulting for non-complicated malaria in 31 sentinel health centres (SHC) were asked to answer a short questionnaire about long-lasting insecticidal nets (LLIN) use, indoor residual spraying (IRS) in the household and intermittent preventive treatment of pregnant women (IPTp) intake. Controls were healthy all-ages individuals sampled from a concurrent cross-sectional survey conducted in areas surrounding the SHC. Cases and controls were retained in the database if they were resident of the same communes. The association between Plasmodium infection and exposure to MCI was calculated by multivariate multilevel models, and the protective effectiveness (PE) of an intervention was defined as 1 minus the odds ratio of this association. Data about 841 cases (out of 6760 cases observed in SHC) and 8284 controls was collected. The regular use of LLIN provided a significant 51 % PE (95 % CI [16-71]) in multivariate analysis, excluding in one transmission pattern where PE was -11 % (95 % CI [-251 to 65]) in univariate analysis. The PE of IRS was 51 % (95 % CI [31-65]), and the PE of exposure to both regular use of LLIN and IRS was 72 % (95 % CI [28-89]) in multivariate analyses. Vector control interventions avoided yearly over 100,000 clinical cases of malaria in Madagascar. The maternal PE of IPTp was 73 %. In Madagascar, LLIN and IRS had good PE against clinical malaria. These results may apply to other countries with similar transmission profiles, but such case-control surveys could be

  10. Rate of electronic health record adoption in South Korea: A nation-wide survey.

    Science.gov (United States)

    Kim, Young-Gun; Jung, Kyoungwon; Park, Young-Taek; Shin, Dahye; Cho, Soo Yeon; Yoon, Dukyong; Park, Rae Woong

    2017-05-01

    The adoption rate of electronic health record (EHR) systems in South Korea has continuously increased. However, in contrast to the situation in the United States (US), where there has been a national effort to improve and standardize EHR interoperability, no consensus has been established in South Korea. The goal of this study was to determine the current status of EHR adoption in South Korean hospitals compared to that in the US. All general and tertiary teaching hospitals in South Korea were surveyed regarding their EHR status in 2015 with the same questionnaire as used previously. The survey form estimated the level of adoption of EHR systems according to 24 core functions in four categories (clinical documentation, result view, computerized provider order entry, and decision supports). The adoption level was classified into comprehensive and basic EHR systems according to their functionalities. EHRs and computerized physician order entry systems were used in 58.1% and 86.0% of South Korean hospitals, respectively. Decision support systems and problem list documentation were the functions most frequently missing from comprehensive and basic EHR systems. The main barriers cited to adoption of EHR systems were the cost of purchasing (48%) and the ongoing cost of maintenance (11%). The EHR adoption rate in Korean hospitals (37.2%) was higher than that in US hospitals in 2010 (15.1%), but this trend was reversed in 2015 (58.1% vs. 75.2%). The evidence suggests that these trends were influenced by the level of financial and political support provided to US hospitals after the HITECH Act was passed in 2009. The EHR adoption rate in Korea has increased, albeit more slowly than in the US. It is logical to suggest that increased funding and support tied to the HITECH Act in the US partly explains the difference in the adoption rates of EHRs in both countries. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. [Methods in neonatal abstinence syndrome (NAS): results of a nationwide survey in Austria].

    Science.gov (United States)

    Bauchinger, S; Sapetschnig, I; Danda, M; Sommer, C; Resch, B; Urlesberger, B; Raith, W

    2015-08-01

    Neonatal abstinence syndrome (NAS) occurs in neonates whose mothers have taken addictive drugs or were under substitution therapy during pregnancy. Incidence numbers of NAS are on the rise globally, even in Austria NAS is not rare anymore. The aim of our survey was to reveal the status quo of dealing with NAS in Austria. A questionnaire was sent to 20 neonatology departments all over Austria, items included questions on scoring, therapy, breast-feeding and follow-up procedures. The response rate was 95%, of which 94.7% had written guidelines concerning NAS. The median number of children being treated per year for NAS was 4. Finnegan scoring system is used in 100% of the responding departments. Morphine is being used most often, in opiate abuse (100%) as well as in multiple substance abuse (44.4%). The most frequent forms of morphine preparation are morphine and diluted tincture of opium. Frequency as well as dosage of medication vary broadly. 61.1% of the departments supported breast-feeding, regulations concerned participation in a substitution programme and general contraindications (HIV, HCV, HBV). Our results revealed that there is a big west-east gradient in patients being treated per year. NAS is not a rare entity anymore in Austria (up to 50 cases per year in Vienna). Our survey showed that most neonatology departments in Austria treat their patients following written guidelines. Although all of them base these guidelines on international recommendations there is no national consensus. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Interhospital differences and case-mix in a nationwide prevalence survey.

    Science.gov (United States)

    Kanerva, M; Ollgren, J; Lyytikäinen, O

    2010-10-01

    A prevalence survey is a time-saving and useful tool for obtaining an overview of healthcare-associated infection (HCAI) either in a single hospital or nationally. Direct comparison of prevalence rates is difficult. We evaluated the impact of case-mix adjustment on hospital-specific prevalences. All five tertiary care, all 15 secondary care and 10 (25% of 40) other acute care hospitals took part in the first national prevalence survey in Finland in 2005. US Centers for Disease Control and Prevention criteria served to define HCAI. The information collected included demographic characteristics, severity of the underlying disease, use of catheters and a respirator, and previous surgery. Patients with HCAI related to another hospital were excluded. Case-mix-adjusted HCAI prevalences were calculated by using a multivariate logistic regression model for HCAI risk and an indirect standardisation method. Altogether, 587 (7.2%) of 8118 adult patients had at least one infection; hospital-specific prevalences ranged between 1.9% and 12.6%. Risk factors for HCAI that were previously known or identified by univariate analysis (age, male gender, intensive care, high Charlson comorbidity and McCabe indices, respirator, central venous or urinary catheters, and surgery during stay) were included in the multivariate analysis for standardisation. Case-mix-adjusted prevalences varied between 2.6% and 17.0%, and ranked the hospitals differently from the observed rates. In 11 (38%) hospitals, the observed prevalence rank was lower than predicted by the case-mix-adjusted figure. Case-mix should be taken into consideration in the interhospital comparison of prevalence rates. Copyright 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

  13. Effects of an expressive writing intervention on cancer-related distress in Danish breast cancer survivors - results from a nationwide randomized clinical trial.

    Science.gov (United States)

    Jensen-Johansen, M B; Christensen, S; Valdimarsdottir, H; Zakowski, S; Jensen, A B; Bovbjerg, D H; Zachariae, R

    2013-07-01

    To examine the effects of an expressive writing intervention (EWI) on cancer-related distress, depressive symptoms, and mood in women treated for early stage breast cancer. A nationwide sample of 507 Danish women who had recently completed treatment for primary breast cancer were randomly assigned to three 20-min home-based writing exercises, one week apart, focusing on either emotional disclosure (EWI group) or a non-emotional topic (control group). Cancer-related distress [Impact of Event Scale (IES)], depressive symptoms (Beck Depression Inventory-Short Form), and negative (37-item Profile of Moods State) and positive mood (Passive Positive Mood Scale) were assessed at baseline and at 3 and 9 months post-intervention. Choice of writing topic (cancer versus other), alexithymia (20-item Toronto Alexithymia Scale), and social constraints (Social Constraints Scale) were included as possible moderators. Significant (ppsychological symptoms were seen in both groups (pwriting topic moderated effects on IES, with women writing about other themes showing greater reductions in cancer-related avoidance than women writing about their cancer. Fewer depressive symptoms and higher levels of positive mood were seen 3 months post-intervention in women writing about their cancer when compared with the control group. Difficulties describing feelings and externally oriented thinking (20-item Toronto Alexithymia Scale) moderated effects on positive mood and IES-total, while no moderating effects were found of social constraints. In concordance with the majority of previous results with cancer patients, no main effects of EWI were found for cancer-related distress, depressive symptoms, and mood. Moderator analyses suggested that choice of writing topic and ability to process emotional experiences should be studied further. Copyright © 2012 John Wiley & Sons, Ltd.

  14. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination, (3)

    Energy Technology Data Exchange (ETDEWEB)

    Taketomi, Y; Abe, T; Kamada, N; Kuramoto, A; Takahashi, H [Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology

    1978-04-01

    The actual condition of polycythemia in atomic bomb survivors was evaluated laying stress on the results of general clinical examinations in Hiroshima A-bomb Survivors Health Control Clinic in 1973. Of 40,410 subjects examined in 1973 (male 15,390; female 25,020), 218 males and 220 females, 438 in total, excluding the patients with cardiopulmonary diseases, satisfied the criteria for polycythemia that males show higher values over 17.1 g/dl of Hb and 51.5% of Ht and females over 15.2 g/dl of Hb and 46.0% of Ht. The incidence of this disease was higher in younger males but it increased with age in females. However, there was no correlationship between the incidence of this disease and the distance from the epicenter. Further, 10 males and 8 females, 18 in total, of these patients satisfied the Komiya's criteria for polycythemia (RBC 6,000,000, Ht 50% in males, and RBC 5,500,000, Ht>50% in females) in 1973 or before, and one of them was diagnosed as polycythemia vera by the present examination (1977). This survey was made on 40,410 subjects, one of which was diagnosed as polycythemia vera. Because of a lower incidence of polycythemia than that of leukemia, it was difficult to give an accurate diagnosis and it was also hard to evaluate the incidence of this disease in atomic bomb survivors comparing with that in healthy people. It is therefore required to pile up the data year after year. In various blood diseases such as chronic myelogenic leukemia and acute leukemia, the foregoing state of myeloid proliferation was sometimes observed preceding the onset of these blood diseases. Therefore, the 18 cases at least which satisfied the Komiya's criteria should be followed up carefully.

  15. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination, (3)

    International Nuclear Information System (INIS)

    Taketomi, Yoshinori; Abe, Tsutomu; Kamada, Nanao; Kuramoto, Atsushi; Takahashi, Hiroshi

    1978-01-01

    The actual condition of polycythemia in atomic bomb survivors was evaluated laying stress on the results of general clinical examinations in Hiroshima A-bomb Survivors Health Control Clinic in 1973. Of 40,410 subjects examined in 1973 (male 15,390; female 25,020), 218 males and 220 females, 438 in total, excluding the patients with cardiopulmonary diseases, satisfied the criteria for polycythemia that males show higher values over 17.1 g/dl of Hb and 51.5% of Ht and females over 15.2 g/dl of Hb and 46.0% of Ht. The incidence of this disease was higher in younger males but it increased with age in females. However, there was no correlationship between the incidence of this disease and the distance from the epicenter. Further, 10 males and 8 females, 18 in total, of these patients satisfied the Komiya's criteria for polycythemia (RBC 6,000,000, Ht 50% in males, and RBC 5,500,000, Ht>50% in females) in 1973 or before, and one of them was diagnosed as polycythemia vera by the present examination (1977). This survey was made on 40,410 subjects, one of which was diagnosed as polycythemia vera. Because of a lower incidence of polycythemia than that of leukemia, it was difficult to give an accurate diagnosis and it was also hard to evaluate the incidence of this disease in atomic bomb survivors comparing with that in healthy people. It is therefore required to pile up the data year after year. In various blood diseases such as chronic myelogenic leukemia and acute leukemia, the foregoing state of myeloid proliferation was sometimes observed preceding the onset of these blood diseases. Therefore, the 18 cases at least which satisfied the Komiya's criteria should be followed up carefully. (Ueda, J.)

  16. [E-learning in nuclear medicine - a nationwide survey in Germany].

    Science.gov (United States)

    Freudenberg, L S; Nattland, A; Jonas, G; Beyer, T; Bockisch, A

    2010-01-01

    To assess available e-learning concepts and programmes for nuclear medicine at university hospitals in Germany. All (34) departments of nuclear medicine at German university hospitals were asked to participate in an anonymized online survey. Questions were categorized into four topics: 1.) clinic and education; 2.) on-site strategies for e-learning; 3.) available e-learning offers and 4.) free text comments on experiences and expectations. All input was reviewed descriptively; free text was analyzed analytically. The response rate was 56% (19/34). 13/19 responses indicated well-defined e-learning strategies, mainly to support frontal teaching courses. Future e-learning perspectives focus on clinical case studies with sufficient imaging materials. Only 7/19 university hospitals operate a centralized e-learning platform (e. g. Moodle). The acceptance of the available e-learning options by the students is considered relatively poor. Today e-learning concepts for nuclear medicine are available at selected university hospitals only. All responders wish to expand on e-learning but many report the lack of administrative support to do so. These data could be regarded as a basis for discussions of inter-university teaching scenarios.

  17. A nationwide Danish survey on the use of green spaces by people with mobility disabilities.

    Science.gov (United States)

    Stigsdotter, Ulrika K; Corazon, Sus Sola; Ekholm, Ola

    2017-12-01

    There is increasing awareness of the importance and health benefits of living near green spaces. Research usually focuses on the general population's use of green spaces and there has been little focus on the use of green spaces by specific groups, such as people with mobility disabilities. This represents a significant knowledge gap with regard to facilitating access to healthy green environments by all population groups. This study aims to provide knowledge of the use of green spaces by people with mobility disabilities. The study was based on data from the Danish Health and Morbidity Survey in 2005. The study participants consisted of 11,238 adult Danes, 383 of whom reported mobility disabilities, meaning that they were dependent on assistive devices for walking or moving around. Multiple logistic regression analysis was used to investigate the association between mobility disability and use of green spaces. The results show that respondents who reported mobility disabilities visited green spaces less often than respondents without mobility disabilities. The severity of the mobility disability was associated with the frequency of visits. Frequency of visits was also related to the respondents' health-related quality of life status. These results highlight the need for further research into the constraints faced by people with mobility disabilities with regard to visiting green spaces.

  18. Family Medicine in Egypt From Medical Students' Perspective: A Nationwide Survey.

    Science.gov (United States)

    AlKot, Mohammad Mahmoud; Gouda, Mohamed Alaa; KhalafAllah, Mahmoud Tawfik; Zahran, Mohamed Salah; Kallaf, Mostafa Mohamed; Zayed, Ahmed Medhat

    2015-01-01

    PHENOMENON: Attitudes of medical students toward family medicine as a specialty choice can provide information on the future supply of family physicians. Due to the current worldwide shortage of family physicians, these attitudes, with their subsequent effects on the state and dynamics of the healthcare system, are important to investigate. A web-based questionnaire was sent to 600 medical students, selected by a systematic random sampling technique, in 7 Egyptian medical schools. Participants were surveyed to assess their perception of the family medicine specialty as a future career and explore the impact of different factors, including undergraduate family medicine clerkships, on their attitudes toward family medicine. We had a response rate of 75.2% (n = 451). Although 90.7% of students believed in the vital role that family medicine can play in Egypt's healthcare system, only 4.7% showed an intention to choose it as a future career. Students choosing family medicine as a first-career choice were more likely to have a prior contact with family physicians as consumers. Exposure to an undergraduate family medicine curriculum was associated with increased knowledge about family medicine but not the intentions to pursue it as a career. INSIGHTS: Medical students in Egypt have a positive perception of family medicine as an important specialty but low interest in its choice as a future career.

  19. Leech management before application on patient: a nationwide survey of practices in French university hospitals

    Directory of Open Access Journals (Sweden)

    Delphine Grau

    2018-02-01

    Full Text Available Abstract Background Leech therapy in plastic/reconstructive microsurgery significantly improves a successful outcome of flap salvage but the drawback is a risk of severe infection that results in a drop of the salvage rates from 70-80% to below 30%. We report the results of a national survey conducted in all the French university hospitals to assess the current extent of use of leech for medical practices in the hospital and to investigate maintenance, delivery practices and prevention of the risk of infection. Methods Data concerning conditions of storage, leech external decontamination, microbiological controls, mode of delivery and antibiotic prophylaxis were collected from all the French university hospitals in practicing leech therapy, on the basis of a standardized questionnaire. Results Twenty-eight of the 32 centers contacted filled the questionnaire, among which 23 practiced leech therapy, mostly with a centralized storage in the pharmacy; 39.1% of the centers declared to perform leech external decontamination and only 2 centers recurrent microbiological controls of the water storage. Leech delivery was mostly nominally performed (56.5%, but traceability of the leech batch number was achieved in only 39.1% of the cases. Only 5 centers declared that a protocol of antibiotic prophylaxis was systematically administered during leech therapy: either quinolone (2, sulfamethoxazole/trimethoprim (2 or amoxicillin/clavulanic acid (1. Conclusions Measures to prevent infectious complications before application to patient have to be better applied and guidelines of good practices are necessary.

  20. Nationwide radiation dose survey of computed tomography for fetal skeletal dysplasias

    Energy Technology Data Exchange (ETDEWEB)

    Miyazaki, Osamu [National Center for Child Health and Development, Department of Radiology, Setagaya-ku, Tokyo (Japan); Sawai, Hideaki [Hyogo College of Medicine, Department of Obstetrics and Gynecology, Nishinomiya-shi, Hyogo (Japan); Murotsuki, Jun [Miyagi Children' s Hospital, Department of Maternal and Fetal Medicine, Sendai-shi, Miyagi (Japan); Tohoku University Graduate School of Medicine, Department of Advanced Fetal and Developmental Medicine, Sendai-shi, Miyagi (Japan); Nishimura, Gen [Tokyo Metropolitan Children' s Medical Center, Department of Pediatric Imaging, Fuchu-shi, Tokyo (Japan); Horiuchi, Tetsuya [National Center for Child Health and Development, Department of Radiology, Setagaya-ku, Tokyo (Japan); Osaka University, Department of Medical Physics and Engineering, Division of Medical Technology and Science, Course of Health Science, Graduate School of Medicine, Suita, Osaka (Japan)

    2014-08-15

    Recently, computed tomography (CT) has been used to diagnose fetal skeletal dysplasia. However, no surveys have been conducted to determine the radiation exposure dose and the diagnostic reference level (DRL). To collect CT dose index volume (CTDIvol) and dose length product (DLP) data from domestic hospitals implementing fetal skeletal 3-D CT and to establish DRLs for Japan. Scan data of 125 cases of 20 protocols from 16 hospitals were analyzed. The minimum, first-quartile, median, third-quartile and maximum values of CTDIvol and DLP were determined. The time-dependent change in radiation dose setting in hospitals with three or more cases with scans was also examined. The minimum, first-quartile, median, third-quartile and maximum CTDIvol values were 2.1, 3.7, 7.7, 11.3 and 23.1 mGy, respectively, and these values for DLP were 69.0, 122.3, 276.8, 382.6 and 1025.6 mGy.cm, respectively. Six of the 12 institutions reduced the dose setting during the implementation period. The DRLs of CTDIvol and DLP for fetal CT were 11.3 mGy and 382.6 mGy.cm, respectively. Institutions implementing fetal CT should use these established DRLs as the standard and make an effort to reduce radiation exposure by voluntarily decreasing the dose. (orig.)

  1. Relationship between bone mineral density and alcohol intake: A nationwide health survey analysis of postmenopausal women.

    Directory of Open Access Journals (Sweden)

    Hae-Dong Jang

    Full Text Available Among a variety of relevant factors of osteoporosis, the association between alcohol intake and postmenopausal women's bone mineral density (BMD by using data from the Korean National Health and Nutrition Examination Survey was evaluated in this study.Among a total of 31,596 subjects, males, premenopausal women, participants without BMD data were excluded. Finally, a total number of subjects in the study was 3,312. The frequency and amount of alcohol intake were determined by self-reported questionnaires, and BMD was measured by dual-energy x-ray absorptiometry.Mean femoral BMD for light drinkers was statistically significantly greater than that for heavy drinkers and non-drinkers. We observed the characteristic trends for BMD by drinking frequency; the mean BMD gradually increased from non-drinkers to the participants who drank 2-3 times per week; these participants exhibited the highest BMD. Participants who drank alcohol greater than 4 times per week showed a lower BMD. In the risk factor analysis, the adjusted odds ratio for osteoporosis (at femoral neck was 1.68 in non-drinkers and 1.70 in heavy drinkers compared with light drinkers.Light alcohol intake (2-3 times per week and 1-2 or 5-6 glasses per occasion in South Korean postmenopausal women was related to high femoral BMD. Non-drinkers and heavy drinkers had approximately a 1.7-times greater risk for osteoporosis than light drinkers.

  2. Surgical management of acute cholecystitis. Results of a nation-wide survey among Spanish surgeons.

    Science.gov (United States)

    Badia, Josep M; Nve, Esther; Jimeno, Jaime; Guirao, Xavier; Figueras, Joan; Arias-Díaz, Javier

    2014-10-01

    There is a wide variability in the management of acute cholecystitis. A survey among the members of the Spanish Association of Surgeons (AEC) analyzed the preferences of Spanish surgeons for its surgical management. The majority of the 771 responders didn't declare any subspecialty (41.6%), 21% were HPB surgeons, followed by colorectal and upper-GI specialities. Early cholecystectomy during the first admission is the preferred method of management of 92.3% of surgeons, but only 42.7% succeed in adopting this practice. The most frequent reasons for changing their preferred practice were: Patients not fit for surgery (43.6%) and lack of availability of emergency operating room (35.2%). A total of 88.9% perform surgery laparoscopically. The majority of AEC surgeons advise index admission cholecystectomy for acute cholecystitis, although only half of them succeed in its actual implementation. There is room for improvement in the management of acute cholecystitis in Spanish hospitals. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

  3. Infections by carbapenem-resistant Klebsiella pneumoniae in SCT recipients: a nationwide retrospective survey from Italy.

    Science.gov (United States)

    Girmenia, C; Rossolini, G M; Piciocchi, A; Bertaina, A; Pisapia, G; Pastore, D; Sica, S; Severino, A; Cudillo, L; Ciceri, F; Scimè, R; Lombardini, L; Viscoli, C; Rambaldi, A

    2015-02-01

    Infections by carbapenem-resistant Klebsiella pneumoniae (CRKp) represent a challenging problem after SCT. A retrospective survey (January 2010 to July 2013) involving 52 Italian centers was performed to assess the epidemiology and the prognostic factors of CRKp infections in auto- and allo-SCT. Cases of CRKp infection were reported in 53.4% of centers. CRKp infections were documented in 25 auto-SCTs and 87 allo-SCTs, with an incidence of 0.4% (from 0.1% in 2010 to 0.7% in 2013) and 2% (from 0.4% in 2010 to 2.9% in 2013), respectively. A CRKp colonization documented before or after transplant was followed by an infection in 25.8% of auto-SCT and 39.2% of allo-SCT patients. The infection-related mortality rates were 16% and 64.4%, respectively. A pre-transplant CRKp infection (hazard ratio (HR) 0.33, 95% confidence intervals (CIs) 0.15-0.74; P=0.007) and a not CRKp-targeted first-line treatment (HR 2.67, 95% CI 1.43-4.99; P=0.002) were independent factors associated with an increased mortality in allo-SCT patients who developed a CRKp infection. Our study shows challenging findings of CRKp infections in SCT patients in Italy particularly after allo-SCT. The detection of carriers and the definition of early therapeutic strategies represent critical aspects of the management of CRKp infections after SCT.

  4. Health literacy and barriers to health information seeking: A nationwide survey in South Korea.

    Science.gov (United States)

    Jeong, Seok Hee; Kim, Hyun Kyung

    2016-11-01

    To identify the level of health literacy and barriers to information seeking and to explore the predictors of health literacy. A cross-sectional descriptive design was used. A total of 1000 Korean adults were recruited through proportional quota sampling. Health literacy, barriers to health information seeking, sociodemographics, and health-related characteristics were surveyed. Descriptive statistics and binary logistic regression were performed for data analysis. About 61% of participants were classified as inadequately health literate. "No health fairs/activities near home" was the most frequently reported barrier. Older age, lower education, living in the capital city, barriers regarding how to get information and access to expensive books and magazines were predictors of inadequate health literacy. Strategies for improving health literacy and reducing barriers to health information seeking should be designed. Education on how to access health-related information with easily accessible sources either free or inexpensive could be a way to help adults with limited health literacy. Health care professionals should assess clients' health literacy levels, particularly amongst those who are older or have less education. They should provide clients with information on how to access credible and readily available sources of health-related information, considering their health literacy level. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Do family meals affect childhood overweight or obesity?: nationwide survey 2008-2012.

    Science.gov (United States)

    Lee, H J; Lee, S Y; Park, E C

    2016-06-01

    The prevalence of childhood obesity is increasing worldwide and this trend is no exception for South Korea. A multidisciplinary approach is needed for the prevention and management of childhood obesity. To do so, among many other strategies, managing the family unit can be a very effective strategy. The purpose of this study was to identify the relationship between frequency of family meals and overweight/obesity in elementary students and to suggest the management and prevention strategies of childhood obesity. Data from a total of 2904 elementary students were analyzed from the 2008-2012 Korea National Health and Nutrition Examination Survey. Multiple logistic regression analysis was used to examine the association between overweight/obesity and family meals. Of the total 2904 elementary students, 573 (19.4%) were overweight or obese. The odds ratio of overweight or obese students who had family dinner only was 1.21 (95% CI: 0.89-1.64), that of those who had family breakfast only was 3.20 (95% CI: 1.70-6.02), and that of those who had neither family breakfast nor family dinner was 4.17 (95% CI: 1.98-8.78) compared with those who had both family breakfast and family dinner. The frequency of family meals was strongly an inverse association with childhood overweight or obesity. Therefore, we suggest that the intervention of childhood obesity should include family meals. © 2015 World Obesity.

  6. Asthma prescribing practices of government and private doctors in Malaysia--a nationwide questionnaire survey.

    Science.gov (United States)

    Loh, Li-Cher; Wong, Pel-Se

    2005-03-01

    A self-answered, anonymously completed questionnaire survey was performed between June 2002 and May 2003 where doctors from government and private sectors in Malaysia were invited to participate by post or during medical meetings. One hundred and sixteen government doctors and 110 private doctors provided satisfactorily completed questionnaires (effective respondent rate: 30.1%). The most preferred medications for 'first-line', 'second-line' and 'third-line' treatment were for government doctors: inhaled short-acting beta2-agonist (SABA) (98%), inhaled corticosteroids (CS) (75%), and leukotriene antagonist (52%); and for private doctors: oral SABA (81%), inhaled CS (68%), and oral CS (58%). The first choice inhaler device for most government and private doctors were metered dose inhalers, with cost and personal preferences (for private doctors), and technical ability (for government doctors) as the key considerations when deciding on the choice of device. This benchmark data on the asthma prescribing practices of a healthcare delivery system fully dichotomized into government and private sector, provides evidence for practice differences affected by the nature of the healthcare system, and might have implications on healthcare systems of other countries that share similarities with that of Malaysia.

  7. A nationwide population-based cross-sectional survey of health-related quality of life in patients with myeloproliferative neoplasms in Denmark (MPNhealthSurvey: survey design and characteristics of respondents and nonrespondents

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    Brochmann N

    2017-03-01

    Full Text Available Nana Brochmann,1 Esben Meulengracht Flachs,2 Anne Illemann Christensen,3 Christen Lykkegaard Andersen,1 Knud Juel,3 Hans Carl Hasselbalch,1 Ann-Dorthe Zwisler4 1Department of Hematology, Zealand University Hospital, University of Copenhagen, Roskilde, 2Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, 3National Institute of Public Health, University of Southern Denmark, Copenhagen, 4Danish Knowledge Centre for Rehabilitation and Palliative Care, University of Southern Denmark and Odense University Hospital, Odense, Denmark Objective: The Department of Hematology, Zealand University Hospital, Denmark, and the National Institute of Public Health, University of Southern Denmark, created the first nationwide, population-based, and the most comprehensive cross-sectional health-related quality of life (HRQoL survey of patients with myeloproliferative neoplasms (MPNs. In Denmark, all MPN patients are treated in public hospitals and treatments received are free of charge for these patients. Therefore, MPN patients receive the best available treatment to the extent of its suitability for them and if they wish to receive the treatment. The aims of this article are to describe the survey design and the characteristics of respondents and nonrespondents. Material and methods: Individuals with MPN diagnoses registered in the Danish National Patient Register (NPR were invited to participate. The registers of the Danish Civil Registration System and Statistics Denmark provided information regarding demographics. The survey contained 120 questions: validated patient-reported outcome (PRO questionnaires and additional questions addressing lifestyle. Results: A total of 4,704 individuals were registered with MPN diagnoses in the NPR of whom 4,236 were eligible for participation and 2,613 (62% responded. Overall, the respondents covered the broad spectrum of MPN patients, but patients 70–79 years old, living with

  8. Availability, cost, and prescription patterns of antihypertensive medications in primary health care in China: a nationwide cross-sectional survey.

    Science.gov (United States)

    Su, Meng; Zhang, Qiuli; Bai, Xueke; Wu, Chaoqun; Li, Yetong; Mossialos, Elias; Mensah, George A; Masoudi, Frederick A; Lu, Jiapeng; Li, Xi; Salas-Vega, Sebastian; Zhang, Anwen; Lu, Yuan; Nasir, Khurram; Krumholz, Harlan M; Jiang, Lixin

    2017-12-09

    Around 200 million adults in China have hypertension, but few are treated or achieve adequate control of their blood pressure. Available and affordable medications are important for successfully controlling hypertension, but little is known about current patterns of access to, and use of, antihypertensive medications in Chinese primary health care. We used data from a nationwide cross-sectional survey (the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project primary health care survey), which was undertaken between November, 2016 and May, 2017, to assess the availability, cost, and prescription patterns of 62 antihypertensive medications at primary health-care sites across 31 Chinese provinces. We surveyed 203 community health centres, 401 community health stations, 284 township health centres, and 2474 village clinics to assess variation in availability, cost, and prescription by economic region and type of site. We also assessed the use of high-value medications, defined as guideline-recommended and low-cost. We also examined the association of medication cost with availability and prescription patterns. Our study sample included 3362 primary health-care sites and around 1 million people (613 638 people at 2758 rural sites and 478 393 people at 604 urban sites). Of the 3362 sites, 8·1% (95% CI 7·2-9·1) stocked no antihypertensive medications and 33·8% (32·2-35·4) stocked all four classes that were routinely used. Village clinics and sites in the western region of China had the lowest availability. Only 32·7% (32·2-33·3) of all sites stocked high-value medications, and few high-value medications were prescribed (11·2% [10·9-11·6] of all prescription records). High-cost medications were more likely to be prescribed than low-cost alternatives. China has marked deficiencies in the availability, cost, and prescription of antihypertensive medications. High-value medications are not preferentially used. Future efforts to

  9. Cardiopulmonary Resuscitation Training in Schools Following 8 Years of Mandating Legislation in Denmark: A Nationwide Survey.

    Science.gov (United States)

    Malta Hansen, Carolina; Zinckernagel, Line; Ersbøll, Annette Kjær; Tjørnhøj-Thomsen, Tine; Wissenberg, Mads; Lippert, Freddy Knudsen; Weeke, Peter; Gislason, Gunnar Hilmar; Køber, Lars; Torp-Pedersen, Christian; Folke, Fredrik

    2017-03-14

    School cardiopulmonary resuscitation (CPR) training has become mandatory in many countries, but whether legislation has translated into implementation of CPR training is largely unknown. We assessed CPR training of students following 8 years of legislative mandates in Denmark. A nationwide cross-sectional survey of Danish school leadership (n=1240) and ninth-grade homeroom teachers (n=1381) was carried out for school year 2013-2014. Qualitative interviews and the Theory of Planned Behavior were used to construct the survey. Logistic regression models were employed to identify factors associated with completed CPR training. Information from 63.1% of eligible schools was collected: 49.3% (n=611) of leadership and 48.2% (n=665) of teachers responded. According to teachers, 28.4% (95% CI 25.0% to 32.0%) and 10.3% (95% CI 8.1% to 12.8%) of eligible classes had completed CPR and automated external defibrillator training, respectively. Among leadership, 60.2% (95% CI 56.2% to 64.1%) reported CPR training had occurred during the 3 years prior to the survey. Factors associated with completed CPR training included believing other schools were conducting training (odds ratio [OR] 9.68 [95% CI 4.65-20.1]), awareness of mandating legislation (OR 4.19 [95% CI 2.65-6.62]), presence of a school CPR training coordinator (OR 3.01 [95% CI 1.84-4.92]), teacher feeling competent to conduct training (OR 2.78 [95% CI 1.74-4.45]), and having easy access to training material (OR 2.08 [95% CI 1.57-2.76]). Despite mandating legislation, school CPR training has not been successfully implemented. Completed CPR training was associated with believing other schools were conducting training, awareness of mandating legislation, presence of a school CPR training coordinator, teachers teacher feeling competent to conduct training, and having easy access to training material. Facilitating these factors may increase rates of school CPR training. © 2017 The Authors. Published on behalf of the

  10. Measuring human rights violations in a conflict-affected country: results from a nationwide cluster survey in Central African Republic

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    Roberts Les

    2011-03-01

    Full Text Available Abstract Background Measuring human rights violations is particularly challenging during or after armed conflict. A recent nationwide survey in the Central African Republic produced estimates of rates of grave violations against children and adults affected by armed conflict, using an approach known as the "Neighborhood Method". Methods In June and July, 2009, a random household survey was conducted based on population estimates from the 2003 national census. Clusters were assigned systematically proportional to population size. Respondents in randomly selected households were interviewed regarding incidents of killing, intentional injury, recruitment into armed groups, abduction, sexual abuse and rape between January 1, 2008 and the date of interview, occurring in their homes' and those of their three closest neighbors. Results Sixty of the selected 69 clusters were surveyed. In total, 599 women were interviewed about events in 2,370 households representing 13,669 persons. Estimates of annual rates of each violation occurring per 1000 people in each of two strata are provided for children between the ages of five and 17, adults 18 years of age and older and the entire population five years and older, along with a combined and weighted national rate. The national rates for children age five to 17 were estimated to be 0.98/1000/year (95% CI: 0.18 - 1.78 for recruitment, 2.56/1000/year (95% CI: 1.50 - 3.62 for abduction, 1.13/1000/year (95% CI: 0.33 - 1.93 for intentional injury, 10.72/1000 girls/year (95% CI: 7.40 - 14.04 for rape, and 4.80/1000 girls/year (95% CI: 2.61 - 6.00 for sexual abuse. No reports of any violation against a person under the age of five were recorded and there were no reports of rape or sexual abuse of males. No children were reported to have been killed during the recall period. Rape and abduction were the most frequently reported events. Conclusions The population-based figures greatly augment existing information on

  11. The teaching of anesthesia history in US residency programs: results of a nationwide survey.

    Science.gov (United States)

    Desai, Manisha S; Chennaiahgari, Shirish R; Desai, Sukumar P

    2012-03-01

    To determine the extent to which history of anesthesia-related topics are included in the didactic curriculum of United States residency programs in anesthesiology. Survey instrument. University-affiliated hospital. In addition to information related to the identity of the respondent and institution, we inquired about the presence of faculty members with an interest in the history of anesthesia (HOA), the inclusion of HOA-related lectures in the didactic curriculum, whether the program would consider inviting an outside lecturer for a session devoted to HOA, the inclusion of HOA-related tours, and whether the program would allow residents an elective rotation of one to three months devoted to a research project related to HOA. On the basis of responses from 46 of 132 residency programs (35%), 54% of programs had at least one faculty member with an interest in HOA, and 45% of programs included lectures related to HOA in their didactic curriculum. An encouraging finding was that 83% of programs (without such didactic sessions) were willing to invite visiting professors to deliver lectures on HOA. The vast majority (91%) did not conduct tours related to HOA, while 74% indicated a willingness to allow residents interested in HOA to devote one to three months to undertake such projects. The low rate of interest in HOA among faculty members, and the lower rate of inclusion of lectures related to HOA during residency training, suggests that substantial barriers exist within the academic community towards a wider acceptance of the importance of HOA. Two positive indicators were the willingness to invite outside speakers and the receptivity to allowing residents to devote one to three months to projects related to HOA. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Undergraduate medical education in emergency medical care: a nationwide survey at German medical schools.

    Science.gov (United States)

    Beckers, Stefan K; Timmermann, Arnd; Müller, Michael P; Angstwurm, Matthias; Walcher, Felix

    2009-05-12

    Since June 2002, revised regulations in Germany have required "Emergency Medical Care" as an interdisciplinary subject, and state that emergency treatment should be of increasing importance within the curriculum. A survey of the current status of undergraduate medical education in emergency medical care establishes the basis for further committee work. Using a standardized questionnaire, all medical faculties in Germany were asked to answer questions concerning the structure of their curriculum, representation of disciplines, instructors' qualifications, teaching and assessment methods, as well as evaluation procedures. Data from 35 of the 38 medical schools in Germany were analysed. In 32 of 35 medical faculties, the local Department of Anaesthesiology is responsible for the teaching of emergency medical care; in two faculties, emergency medicine is taught mainly by the Department of Surgery and in another by Internal Medicine. Lectures, seminars and practical training units are scheduled in varying composition at 97% of the locations. Simulation technology is integrated at 60% (n = 21); problem-based learning at 29% (n = 10), e-learning at 3% (n = 1), and internship in ambulance service is mandatory at 11% (n = 4). In terms of assessment methods, multiple-choice exams (15 to 70 questions) are favoured (89%, n = 31), partially supplemented by open questions (31%, n = 11). Some faculties also perform single practical tests (43%, n = 15), objective structured clinical examination (OSCE; 29%, n = 10) or oral examinations (17%, n = 6). Emergency Medical Care in undergraduate medical education in Germany has a practical orientation, but is very inconsistently structured. The innovative options of simulation technology or state-of-the-art assessment methods are not consistently utilized. Therefore, an exchange of experiences and concepts between faculties and disciplines should be promoted to guarantee a standard level of education in emergency medical care.

  13. Publication pressure and burn out among Dutch medical professors: a nationwide survey.

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    Joeri K Tijdink

    Full Text Available BACKGROUND: Publication of scientific research papers is important for professionals working in academic medical centres. Quantitative measures of scientific output determine status and prestige, and serve to rank universities as well as individuals. The pressure to generate maximum scientific output is high, and quantitative aspects may tend to dominate over qualitative ones. How this pressure influences professionals' perception of science and their personal well-being is unknown. METHODS AND FINDINGS: We performed an online survey inviting all medical professors (n = 1206 of the 8 academic medical centres in The Netherlands to participate. They were asked to fill out 2 questionnaires; a validated Publication Pressure Questionnaire and the Maslach Burnout Inventory. In total, 437 professors completed the questionnaires. among them, 54% judge that publication pressure 'has become excessive', 39% believe that publication pressure 'affects the credibility of medical research' and 26% judge that publication pressure has a 'sickening effect on medical science'. The burn out questionnaire indicates that 24% of medical professors have signs of burn out. The number of years of professorship was significantly related with experiencing less publication pressure. Significant and strong associations between burn out symptoms and the level of perceived publication pressure were found. The main limitation is the possibility of response bias. CONCLUSION: A substantial proportion of medical professors believe that publication pressure has become excessive, and have a cynical view on the validity of medical science. These perceptions are statistically correlated to burn out symptoms. Further research should address the effects of publication pressure in more detail and identify alternative ways to stimulate the quality of medical science.

  14. Characteristics of Antimicrobial Stewardship Programs at Veterans Affairs Hospitals: Results of a Nationwide Survey.

    Science.gov (United States)

    Chou, Ann F; Graber, Christopher J; Jones, Makoto; Zhang, Yue; Goetz, Matthew Bidwell; Madaras-Kelly, Karl; Samore, Matthew; Kelly, Allison; Glassman, Peter A

    2016-06-01

    BACKGROUND Antimicrobial stewardship programs (ASPs) are variably implemented. OBJECTIVE To characterize variations of antimicrobial stewardship structure and practices across all inpatient Veterans Affairs facilities in 2012 and correlate key characteristics with antimicrobial usage. DESIGN A web-based survey regarding stewardship activities was administered to each facility's designated contact. Bivariate associations between facility characteristics and inpatient antimicrobial use during 2012 were determined. SETTING Total of 130 Veterans Affairs facilities with inpatient services. RESULTS Of 130 responding facilities, 29 (22%) had a formal policy establishing an ASP, and 12 (9%) had an approved ASP business plan. Antimicrobial stewardship teams were present in 49 facilities (38%); 34 teams included a clinical pharmacist with formal infectious diseases (ID) training. Stewardship activities varied across facilities, including development of yearly antibiograms (122 [94%]), formulary restrictions (120 [92%]), stop orders for antimicrobial duration (98 [75%]), and written clinical pathways for specific conditions (96 [74%]). Decreased antimicrobial usage was associated with having at least 1 full-time ID physician (P=.03), an ID fellowship program (P=.003), and a clinical pharmacist with formal ID training (P=.006) as well as frequency of systematic patient-level reviews of antimicrobial use (P=.01) and having a policy to address antimicrobial use in the context of Clostridium difficile infection (P=.01). Stop orders for antimicrobial duration were associated with increased use (P=.03). CONCLUSIONS ASP-related activities varied considerably. Decreased antibiotic use appeared related to ID presence and certain select practices. Further statistical assessments may help optimize antimicrobial practices. Infect Control Hosp Epidemiol 2016;37:647-654.

  15. Prevalence and energy intake from snacking in Brazil: analysis of the first nationwide individual survey.

    Science.gov (United States)

    Duffey, K J; Pereira, R A; Popkin, B M

    2013-08-01

    Snacking has increased globally. We examine snacking patterns and common snack foods in Brazil. Data from the first of two non-consecutive food diaries from 34,003 individuals (aged ≥ 10 years) in the first Brazillian nationally representative dietary survey (2008-2009) were used. Meals were defined as the largest (kcal) eating event reported during select times of the day (Breakfast, 0600-1000 hours; Lunch, 1200-1500 hours; Dinner, 1800-2100 hours); all other eating occasions were considered snacks. We estimate daily energy intake, percentage of persons consuming snacks, number of daily snacks and per capita and per consumer energy from snacks (kcal/day, kcal/snack and % of daily energy from snacks). In all, 74% of Brazilians (≥ 10 years) snacked, reporting an average 1.6 snacks/day. Also, 23% of the sample were heavy snackers (≥ 3 snacks/day). Snacking accounted for 21% of daily energy intake in the full sample but 35.5% among heavy snackers. Compared with non-snackers (1548 kcal/day), light (1-2 snacks/day) and heavy snackers consumed more daily energy (1929 and 2334 kcal/day, respectively). Taking into account time of day, the largest percentage of persons reported afternoon/early evening snacking (1501-1759 hours, 47.7%). Sweetened coffee and tea, sweets and desserts, fruit, sugar-sweetened beverages, and high-calorie salgados (fried/baked dough with meat/cheese/vegetable) were the top five most commonly consumed snacks. Differences were observed by age groups. Trends in commercial sales were observed, especially for sugar-sweetened beverages. Many commonly consumed snack foods in Brazil are classified, in the US, as being high in solid fats and added sugars. The public health impact of snacking in Brazil requires further exploration.

  16. Attractiveness of people-centred and integrated Dutch Home Care: A nationwide survey among nurses.

    Science.gov (United States)

    Maurits, Erica E M; de Veer, Anke J E; Groenewegen, Peter P; Francke, Anneke L

    2018-03-05

    The World Health Organization is calling for a fundamental change in healthcare services delivery, towards people-centred and integrated health services. This includes providing integrated care around people's needs that is effectively co-ordinated across providers and co-produced by professionals, the patient, the family and the community. At the same time, healthcare policies aim to scale back hospital and residential care in favour of home care. This is one reason for the home-care nursing staff shortages in Europe. Therefore, this study aimed to examine whether people-centred, integrated home care appeals to nurses with different levels of education in home care and hospitals. A questionnaire survey was held among registered nurses in Dutch home-care organisations and hospitals in 2015. The questionnaire addressed the perceived attractiveness of different aspects of people-centred, integrated home care. In total 328 nurses filled in the questionnaire (54% response rate). The findings showed that most home-care nurses (70% to 97%) and 36% to 76% of the hospital nurses regard the different aspects of people-centred, integrated home care as attractive. Specific aspects that home-care nurses find attractive are promoting the patient's self-reliance and having a network in the community. Hospital nurses are mainly attracted to health-related prevention and taking control in complex situations. No clear differences between the educational levels were found. It is concluded that most home-care nurses and a minority of hospital nurses feel attracted to people-centred, integrated home care, irrespective of their educational level. The findings are relevant to policy makers and home-care organisations who aim to expand the home-care nursing workforce. © 2018 John Wiley & Sons Ltd.

  17. A nationwide survey of first aid training and encounters in Norway.

    Science.gov (United States)

    Bakke, Håkon Kvåle; Steinvik, Tine; Angell, Johan; Wisborg, Torben

    2017-02-23

    Bystander first aid can improve survival following out-of-hospital cardiac arrest or trauma. Thus, providing first aid education to laypersons may lead to better outcomes. In this study, we aimed to establish the prevalence and distribution of first aid training in the populace, how often first aid skills are needed, and self-reported helping behaviour. We conducted a telephone survey of 1000 respondents who were representative of the Norwegian population. Respondents were asked where and when they had first aid training, if they had ever encountered situations where first aid was necessary, and stratified by occupation. First aid included cardio-pulmonary resuscitation (CPR) and basic life support (BLS). To test theoretical first aid knowledge, respondents were subjected to two hypothetical first aid scenarios. Among the respondents, 90% had received first aid training, and 54% had undergone first aid training within the last 5 years. The workplace was the most common source of first aid training. Of the 43% who had been in a situation requiring first aid, 89% had provided first aid in that situation. There were considerable variations among different occupations in first aid training, and exposure to situations requiring first aid. Theoretical first aid knowledge was not as good as expected in light of the high share who had first aid training. In the presented scenarios 42% of respondent would initiate CPR in an unconscious patient not breathing normally, and 46% would provide an open airway to an unconscious road traffic victim. First aid training was correlated with better theoretical knowledge, but time since first aid training was not. A high proportion of the Norwegian population had first aid training, and interviewees reported high willingness to provide first aid. Theoretical first aid knowledge was worse than expected. While first aid is part of national school curriculum, few have listed school as the source for their first aid training.

  18. Adult exposures from MDCT including multiphase studies: first Italian nationwide survey

    Energy Technology Data Exchange (ETDEWEB)

    Palorini, Federica; Origgi, Daniela [Fisica Sanitaria Istituto Europeo di Oncologia, Milan (Italy); Granata, Claudio [UOC di Radiologia Istituto Giannina Gaslini, Genoa (Italy); Matranga, Domenica [Universita degli Studi di Palermo, Dipartimento di Scienze per la Promozione della Salute e Materno-infantile ' ' G. D' Alessandro' ' , Palermo (Italy); Salerno, Sergio [Policlinico Universita di Palermo, Dipartimento di Scienze Radiologiche, Palermo (Italy)

    2014-02-15

    To evaluate the radiation dose in routine multidetector computed tomography (MDCT) examinations in Italian population. This was a retrospective multicentre study included 5,668 patients from 65 radiology departments who had undergone common CT protocols: head, chest, abdomen, chest-abdomen-pelvis (CAP), spine and cardiac. Data included patient characteristics, CT parameters, volumetric CT dose index (CTDI{sub vol}) and dose length product (DLP) for each CT acquisition phase. Descriptive statistics were calculated, and a multi-regression analysis was used to outline the main factors affecting exposure. The 75th percentiles of CTDI{sub vol} (mGy) and DLP (mGy cm) for whole head were 69 mGy and 1,312 mGy cm, respectively; for chest, 15 mGy and 569 mGy cm; spine, 42 mGy and 888 mGy cm; cardiac, 7 mGy and 131 mGy cm for calcium score, and 61 mGy and 1,208 mGy cm for angiographic CT studies. High variability was present in the DLP of abdomen and CAP protocols, where multiphase examinations dominated (71 % and 73 % respectively): for abdomen, 18 mGy, with 555 and 920 mGy cm in abdomen and abdomen-pelvis acquisitions respectively; for CAP, 17 mGy, with 508, 850 and 1,200 mGy cm in abdomen, abdomen-pelvis and CAP acquisitions respectively. The results of this survey could help in the definition of updated diagnostic reference levels (DRL). (orig.)

  19. The Etiology and Clinical Features of Anaphylaxis in a developing country: A nationwide survey in Turkey.

    Science.gov (United States)

    Civelek, Ersoy; Erkoçoğlu, Mustafa; Akan, Ayşegül; Özcan, Celal; Kaya, Ayşenur; Vezir, Emine; Giniş, Tayfur; Azkur, Dilek; Toyran, Müge; Tokaç, Mahmut; Kocabaş, Can Naci

    2017-12-01

    Despite the increasing frequency of anaphylaxis, there is inadequate information on the etiology and clinical features in various countries, regions and age groups, especially in developing countries. Our aim is to assess the etiology and clinical findings of anaphylaxis in Turkey. Gathering reliable data about the etiology and clinical findings of anaphylaxis in the general population will decrease the related morbidity and mortality. We obtained the names and phone numbers of individuals who had been prescribed an epinephrine auto-injector with a diagnosis of anaphylaxis from ministry of health. Demographic data, clinical history of the first episode of anaphylaxis including the triggering agent, clinical findings, course of hospitalization, and the management of anaphylaxis were obtained by phone survey. A total of 843 patients with a mean age of 21.4±17.3 years were evaluated. There was a significant male predominance among children younger than 10 years of age but a female predominance in older subjects. The most common causes of anaphylaxis were foods(40.1%) in children and bee venom(60.8%) in adults. The biphasic reaction rate was 4.3% and the median length of stay at an emergency department was 4.0 hours. Almost 60% of the patients had recurrent anaphylaxis episodes. Only 10.7% of the cases were prescribed an epinephrine auto-injector at their first anaphylaxis episode and only 59.2% of the patients were referred to an allergist during discharge from the emergency department. In Turkey, bee venom was the most common cause of anaphylaxis, followed by food and drug. While more than a half of patients reported recurrent attacks; only 10% had been prescribed epinephrine auto-injector kit after their first episode. Strategies to improve the anaphyalxis management are therefore urgently required.

  20. Are Canadian general surgery residents ready for the 80-hour work week? A nationwide survey.

    Science.gov (United States)

    Sudarshan, Monisha; Hanna, Wael C; Jamal, Mohammed H; Nguyen, Lily H P; Fraser, Shannon A

    2012-02-01

    The purpose of this study was to describe Canadian general surgery residents' perceptions regarding potential implementation of work-hour restrictions. An ethics review board-approved, Web-based survey was submitted to all Canadian general surgery residency programs between April and July 2009. Questions evaluated the perceived effects of an 80-hour work week on length of training, operative exposure, learning and lifestyle. We used the Fisher exact test to compare senior and junior residents' responses. Of 360 residents, 158 responded (70 seniors and 88 juniors). Among them, 79% reported working 75-100 hours per week. About 74% of seniors believed that limiting their work hours would decrease their operative exposure; 43% of juniors agreed (p seniors and juniors thought limiting their work hours would improve their lifestyle (86% v. 96%, p = 0.12). Overall, 60% of residents did not believe limiting work hours would extend the length of their training. Regarding 24-hour call, 60% of juniors thought it was hazardous to their health; 30% of seniors agreed (p = 0.001). Both senior and junior residents thought abolishing 24-hour call would decrease their operative exposure (84% v. 70%, p = 0.21). Overall, 31% of residents supported abolishing 24-hour call. About 47% of residents (41% seniors, 51%juniors, p = 0.26) agreed with the adoption of the 80-hour work week. There is a training-level based dichotomy of opinion among general surgery residents in Canada regarding the perceived effects of work hour restrictions. Both groups have voted against abolishing 24-hour call, and neither group strongly supports the implementation of the 80-hour work week.

  1. Factors affecting dengue prevention practices: nationwide survey of the Malaysian public.

    Directory of Open Access Journals (Sweden)

    Li Ping Wong

    Full Text Available Efforts to stamp dengue in many dengue endemic countries has met little success. There is a need to re-examine and understand how the public at large view the dengue prevention efforts. This study aimed to examine the demographic factors, theoretical constructs of the Health Belief Model and knowledge about dengue and how these influence the practice of dengue prevention.A national telephone survey was carried out with 2,512 individuals of the Malaysian public aged 18-60 years.The majority (73% of the Malaysian public had a total dengue prevention score of 51-100 (of a possible score of 1-100. Multivariate analysis suggests significant correlates of higher dengue prevention practices with demographic background, perception of susceptibility to dengue, perceived density of mosquitoes in the neighbourhood and knowledge about dengue. Households of lower income of which the majority (40.7% were from the rural areas, were associated with the highest odds [OR = 1.33; 95%CI = 1.09-1.67; p = 0.004] of dengue prevention. Dengue prevention practices were also less likely to be undertaken in neighbourhoods where the responders perceived there is no and/or low density of mosquitoes. Dengue prevention practices are also less likely to be practiced by skilled workers [OR = 0.78; 95%CI = 0.63-0.95; p = 0.029] compared to those unemployed. Higher perceived susceptibility to dengue was associated with higher dengue prevention practices and participants with higher dengue knowledge were found to have a higher level of involvement in dengue prevention practices.Results from the study suggest that in formulating approaches to contain dengue, strategies should be developed to cultivate dengue prevention practices among urban population and target areas with low density of mosquitoes where public perceived a less likely chance of getting dengue. Dengue prevention campaigns should focus on messages highlighting the risk of contracting dengue and education to increase

  2. [Daily routine in orthopedics and traumatology - results of a nationwide survey of residents].

    Science.gov (United States)

    Merschin, D; Münzberg, M; Stange, R; Schüttrumpf, J P; Perl, M; Mutschler, M

    2014-10-01

    The subject orthopedics and traumatology suffers by a loss of attractiveness which results in a lack of young blood. The aim of this study of the Youth Forum of the German Society of Orthopedics and Traumatology (DGOU) is to register the working conditions of residents in orthopedics. In the months September and October 2013 we performed a survey on members of the following German societies: German Society of Orthopedics and Traumatology (DGOU), German Society of Traumatology (DGU) and the German Society of Orthopedics and Orthopedic Surgery (DGOOC), (age working time per week is 55 hours. 73 % of all participants do more than 5 emergency services per month. 52 % are more than 3 times on duty for 24 hours. Only 13 % of all residents have well ordered working hours. Normally working time is divided into three parts: one third for bureaucracy, one for operation theatre and the last for other activities (e.g. ward round). 35,6 % do only one surgery per week, 12 % do not perform any surgeries. An annual report is performed only in 45 %. A structured concept of training only exists in 16 % of all hospitals. In addition to clinical work 45 % are involved in scientific projects, mostly in their spare-time. Finally 58 % of all surgeons would still recommend orthopedics and traumatology. In order to maintain orthopedics and traumatology as an attractive it is necessary to implement flexible working time models and to reorganize and improve training-concepts. Georg Thieme Verlag KG Stuttgart · New York.

  3. Undergraduate medical education in emergency medical care: A nationwide survey at German medical schools

    Directory of Open Access Journals (Sweden)

    Timmermann Arnd

    2009-05-01

    Full Text Available Abstract Background Since June 2002, revised regulations in Germany have required "Emergency Medical Care" as an interdisciplinary subject, and state that emergency treatment should be of increasing importance within the curriculum. A survey of the current status of undergraduate medical education in emergency medical care establishes the basis for further committee work. Methods Using a standardized questionnaire, all medical faculties in Germany were asked to answer questions concerning the structure of their curriculum, representation of disciplines, instructors' qualifications, teaching and assessment methods, as well as evaluation procedures. Results Data from 35 of the 38 medical schools in Germany were analysed. In 32 of 35 medical faculties, the local Department of Anaesthesiology is responsible for the teaching of emergency medical care; in two faculties, emergency medicine is taught mainly by the Department of Surgery and in another by Internal Medicine. Lectures, seminars and practical training units are scheduled in varying composition at 97% of the locations. Simulation technology is integrated at 60% (n = 21; problem-based learning at 29% (n = 10, e-learning at 3% (n = 1, and internship in ambulance service is mandatory at 11% (n = 4. In terms of assessment methods, multiple-choice exams (15 to 70 questions are favoured (89%, n = 31, partially supplemented by open questions (31%, n = 11. Some faculties also perform single practical tests (43%, n = 15, objective structured clinical examination (OSCE; 29%, n = 10 or oral examinations (17%, n = 6. Conclusion Emergency Medical Care in undergraduate medical education in Germany has a practical orientation, but is very inconsistently structured. The innovative options of simulation technology or state-of-the-art assessment methods are not consistently utilized. Therefore, an exchange of experiences and concepts between faculties and disciplines should be promoted to guarantee a standard

  4. Asthma-like symptoms, diagnostic tests, and asthma medication use in children and adolescents: a population-based nationwide survey.

    Science.gov (United States)

    Ferreira-Magalhães, Manuel; Sá-Sousa, Ana; Morais-Almeida, Mário; Pité, Helena; Azevedo, Luis Filipe; Azevedo, Maria Inês; Bugalho-Almeida, António; Fonseca, João Almeida

    2016-01-01

    This study aimed to estimate the prevalence of asthma-like symptoms, current asthma (CA), asthma diagnostic tests, and inhaled medication use in a nationwide pediatric population (Pediatric-specific data from a cross-sectional, population-based telephone survey (INAsma study) in Portugal were analyzed. CA was defined as lifetime asthma and (1) wheezing, (2) waking with breathlessness, or (3) asthma attack in the previous 12 months, and/or (4) taking asthma medication at the time of the interview. In total, 716 children were included. The prevalence of asthma-like symptoms was 39.4% [95% confidence interval (95% CI): 35.7-43.3]. The most common symptoms were waking with cough (30.9%) and wheezing (19.1%). The prevalence of CA was 8.4% (95% CI: 6.6-10.7). Among children with CA, 79.9% and 52.9% reported prior allergy testing and pulmonary function testing (PFT), respectively. Inhaled medication use in the previous 12 months was reported by 67.6% (reliever inhalers, 40.1%; controller inhalers, 41.5%). Those who only used inhaled reliever medications experienced more asthma attacks [odds ratio (OR): 2.69]. Significantly fewer children with CA living in rural areas than those living in urban areas had undergone PFT or used inhaled medication (OR: 0.06 for PFT, 0.20 for medication]. The prevalence of CA in the Portuguese pediatric population was 8.4%. Only half of children with CA had ever undergone PFT; more than half did not use controller inhalers, and those who only used reliever inhalers reported more asthma attacks. These findings suggest that asthma management has been substandard, mainly in rural areas.

  5. Involvement of herbal medicine as a cause of mesenteric phlebosclerosis: results from a large-scale nationwide survey.

    Science.gov (United States)

    Shimizu, Seiji; Kobayashi, Taku; Tomioka, Hideo; Ohtsu, Kensei; Matsui, Toshiyuki; Hibi, Toshifumi

    2017-03-01

    Mesenteric phlebosclerosis (MP) is a rare disease characterized by venous calcification extending from the colonic wall to the mesentery, with chronic ischemic changes from venous return impairment in the intestine. It is an idiopathic disease, but increasing attention has been paid to the potential involvement of herbal medicine, or Kampo, in its etiology. Until now, there were scattered case reports, but no large-scale studies have been conducted to unravel the clinical characteristics and etiology of the disease. A nationwide survey was conducted using questionnaires to assess possible etiology (particularly the involvement of herbal medicine), clinical manifestations, disease course, and treatment of MP. Data from 222 patients were collected. Among the 169 patients (76.1 %), whose history of herbal medicine was obtained, 147 (87.0 %) used herbal medicines. The use of herbal medicines containing sanshishi (gardenia fruit, Gardenia jasminoides Ellis) was reported in 119 out of 147 patients (81.0 %). Therefore, the use of herbal medicine containing sanshishi was confirmed in 70.4 % of 169 patients whose history of herbal medicine was obtained. The duration of sanshishi use ranged from 3 to 51 years (mean 13.6 years). Patients who discontinued sanshishi showed a better outcome compared with those who continued it. The use of herbal medicine containing sanshishi is associated with the etiology of MP. Although it may not be the causative factor, it is necessary for gastroenterologists to be aware of the potential risk of herbal medicine containing sanshishi for the development of MP.

  6. A preliminary nationwide survey of the presence of emerging contaminants in drinking and source waters in Brazil.

    Science.gov (United States)

    Machado, Kelly C; Grassi, Marco Tadeu; Vidal, Cristiane; Pescara, Igor C; Jardim, Wilson F; Fernandes, Andreia N; Sodré, Fernando F; Almeida, Fernanda V; Santana, Joyce S; Canela, Maria Cristina; Nunes, Camila R O; Bichinho, Kátia M; Severo, Flaviana J R

    2016-12-01

    This is the first nationwide survey of emerging contaminants in Brazilian waters. One hundred drinking water samples were investigated in 22 Brazilian state capitals. In addition, seven source water samples from two of the most populous regions of the country were evaluated. Samples were collected from June to September of 2011 and again during the same period in 2012. The study covered emerging contaminants of different classes, including hormones, plasticizers, herbicides, triclosan and caffeine. The analytical method for the determination of the compounds was based on solid-phase extraction followed by analysis via liquid chromatography electrospray triple-quadrupole mass spectrometry (LC-MS/MS). Caffeine, triclosan, atrazine, phenolphthalein and bisphenol A were found in at least one of the samples collected in the two sampling campaigns. Caffeine and atrazine were the most frequently detected substances in both drinking and source water. Caffeine concentrations in drinking water ranged from 1.8ngL -1 to values above 2.0μgL -1 while source-water concentrations varied from 40ngL -1 to about 19μgL -1 . For atrazine, concentrations were found in the range from 2.0 to 6.0ngL -1 in drinking water and at concentrations of up to 15ngL -1 in source water. The widespread presence of caffeine in samples of treated water is an indication of the presence of domestic sewage in the source water, considering that caffeine is a compound of anthropogenic origin. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. End-of-Life Care and Discussions in Japanese Geriatric Health Service Facilities: A Nationwide Survey of Managing Directors' Viewpoints.

    Science.gov (United States)

    Kanoh, Asako; Kizawa, Yoshiyuki; Tsuneto, Satoru; Yokoya, Shoji

    2018-01-01

    Geriatric health service facilities (GHSFs) play important roles as intermediate care facilities for elderly individuals temporarily when they need rehabilitation before returning home. However, the number of residents spending their end-of-life (EOL) period in such facilities is increasing. To improve the quality of EOL care, end-of-life discussions (EOLDs) are recommended by some guidelines and studies. This study aimed to clarify the current practice of EOL care and EOLDs in GHSFs in Japan. We conducted a nationwide cross-sectional survey by mailing questionnaires about EOL care and EOLDs to 3437 GHSF managing directors. The questionnaire was developed through a literature review and discussion among the researchers and experts. Descriptive statistics summarized the data. We also analyzed the factors related to GHSFs conducting EOLDs using Fisher exact tests. The response rate was 20.7% (713 of 3437). Among the respondents, 75.2% (536 of 713) of GHSFs provided EOL care and 73.1% (521 of 713) conducted EOLDs. The most common reasons for difficulties in providing EOL care included the lack of EOL education for nurses and care workers, and their fear about caring for dying residents. End-of-life discussions were mostly initiated after the deterioration of a resident's condition and were conducted with families by physicians. Statistically significant factors of GHSFs conducting EOLDs included providing EOL education for nurses and care workers, availability of private room for critically ill residents, emergency on-call doctors, and EOL care. Adequate practical staff education programs for EOL care including EOLDs may be crucial for quality of end-of-life care in aged care facilities.

  8. Clinical features and treatment outcomes of Langerhans cell histiocytosis: a nationwide survey from Korea histiocytosis working party.

    Science.gov (United States)

    Kim, Bo Eun; Koh, Kyung-Nam; Suh, Jin Kyung; Im, Ho Joon; Song, Joon Sup; Lee, Ji Won; Kang, Hyoung Jin; Park, Kyung Duck; Shin, Hee Young; Choi, Hyoung Soo; Lee, Soo Hyun; Yoo, Keon Hee; Sung, Ki Woong; Koo, Hong Hoe; Jung, Hye Lim; Chung, Nak-Gyun; Cho, Bin; Kim, Hack Ki; Lyu, Chuhl Joo; Baek, Hee Jo; Kook, Hoon; Park, Jun Eun; Park, Hyeon Jin; Park, Byung-Kiu; Yoo, Eun Sun; Ryu, Kyung Ha; Lee, Kun Soo; Kim, Heung Sik; Lee, Jae Min; Park, Eun Sil; Yoon, Hoi Soo; Lee, Kwang Chul; Lee, Mee Jeong; Lim, Young Tak; Kim, Hwang Min; Park, Sang Kyu; Park, Jeong-A; Kim, Soon Ki; Park, Meerim; Lim, Yeon-Jung; Lee, Young Ho; Seo, Jong Jin

    2014-03-01

    A nationwide survey was conducted to clarify the clinical features and outcomes of Korean children with Langerhans cell histiocytosis (LCH). Korea Histiocytosis Working Party analyzed the data of 603 patients who were diagnosed with LCH between 1986 and 2010 from 28 institutions in Korea. Median age at diagnosis was 65 months (range, 0 to 276 mo). Bone was the most frequently affected organ (79.6%) followed by skin (19.2%). Initially, 419 patients (69.5%) had single-system involvement (SS), 85 (14.1%) with multisystem (MS) disease without risk organ involvement (MS-RO), and 99 (16.4%) multisystem disease with risk organ involvement (MS-RO). The 5-year overall survival (OS) rates in the SS, MS-RO, and MS-RO groups were 99.8%, 98.4%, and 77.0%, respectively (P<0.001), and the 5-year reactivation rates were 17.9%, 33.5%, and 34.3%, respectively (P<0.001). The OS rate was lower in patients with RO involvement (P=0.025) and lack of response to initial treatment (P=0.001). MS involvement (P=0.036) was an independent risk factor for reactivation. Permanent consequences were documented in 99 patients (16.4%). Reactivation of disease, MS involvement, and age at diagnosis ≤ 2 years were associated with higher incidence of permanent consequences. This study emphasized that further efforts are required to improve survival of MS-RO patients and reduce reactivation in younger patients with MS involvement.

  9. Current status of in-hospital donation coordinators in Japan: nationwide survey.

    Science.gov (United States)

    Konaka, S; Shimizu, S; Iizawa, M; Ohkawara, H; Kato, O; Ashikari, J; Fukushima, N

    2013-05-01

    When the Japanese Organ Transplantation Act was issued, the Japanese Organ Transplantation Network (JOT) was established in 1997. JOT lists recipients, assesses and manages organ donors, and educates publics and headquarters for organ donations. JOT procurement transplant coordinators (PTC) play roles in obtaining consent from relatives for organ donation, donor evaluation and management, organ recovery management, organ transport, and care of donor families during and after donation. Every prefecture has at least one PTC who is mainly working in public education and hospital development. They also help the JOT PTC at the time of organ procurement. Most prefectures commission hospital staff in the procurement hospital to be an in-hospital PTC (In-Hp PTC), who make their hospital staff aware of organ donation and support organ procurement. Although the Act was revised in 2010 with brain-dead organ donation increased from 13 to 44 cases yearly, the number was still extremely smaller than other developed countries. In these circumstances, In-Hp PTC may play greater roles to increase donation and smooth procurement procedures Our primary aim was to describe the current status of In-Hp PTC in Japan. Between December 15, 2011, and January 31, 2012, we invited 1889 In-Hp PTC to complete a letter survey using a self-designed questionnaire. In all, 56 In-Hp PTC (40%) completed and returned it. The occupation of the respondents was nurse (66%), physician (18%), or other (16%). Although 52% of respondents belonged to the hospital, which was designated for brain-death organ donation by the government, only 46% had any experience with a cadaveric donor. Only 2% were full-time In-Hp PTC. They mainly played a role in preparing their own manual for organ procurement (57%), providing in-hospital lectures (44%) or their own simulation exercise (29%), as well as coordinating donation cases. Although 77% had attended seminar about organ donation provided by JOT or the prefecture PTC

  10. Knowledge and perceptions of physicians from private medical centres towards generic medicines: a nationwide survey from Malaysia.

    Science.gov (United States)

    Kumar, Rohit; Hassali, Mohamed Azmi; Saleem, Fahad; Alrasheedy, Alian A; Kaur, Navneet; Wong, Zhi Yen; Kader, Muhamad Ali Sk Abdul

    2015-01-01

    Generic medicine prescribing has become a common practice in public hospitals. However, the trend in private medical centres seems to be different. The objective of this study was to investigate knowledge, perceptions and behavior of physicians from private medical centres in Malaysia regarding generic medicines. This study was a cross-sectional nationwide survey targeting physicians from private medical centres in Malaysia. The survey was conducted using questionnaire having (i) background and demographic data of the physicians, volume of prescription in a day, stock of generic medicines in their hospital pharmacy etc. (ii) their knowledge about bioequivalence (iii) prescribing behavior (iv) physicians' knowledge of quality, safety and efficacy of generic medicines, and their cost (v) perceptions of physicians towards issues pertaining to generic medicines utilization. A total of 263 questionnaires out of 735 were received, giving a response rate of 35.8%. Of the respondents, 214 (81.4%) were male and 49 (18.6%) were females. The majority of the participants were in the age range of 41-50 years and comprised 49.0% of the respondents. Only 2.3% of physicians were aware of the regulatory limits of bioequivalence standards in Malaysia. Of the respondents, 23.2% agreed that they 'always' write their prescriptions using originator product name whereas 50.2% do it 'usually'. A number of significant associations were found between their knowledge, perceptions about generic medicines and their demographic characteristics. The majority of the physicians from private medical centres in Malaysia had negative perceptions about safety, quality and the efficacy of generic medicines. These negative perceptions could be the cause of the limited use of generic medicines in the private medical centres. Therefore, in order to facilitate their use, it is recommended that the physicians need to be reassured and educated about the drug regulatory authority approval system of generic

  11. Linking young men who have sex with men (YMSM) to STI physicians: a nationwide cross-sectional survey in China.

    Science.gov (United States)

    Cao, Bolin; Zhao, Peipei; Bien, Cedric; Pan, Stephen; Tang, Weiming; Watson, Julia; Mi, Guodong; Ding, Yi; Luo, Zhenzhou; Tucker, Joseph D

    2018-05-18

    Many young men who have sex with men (YMSM) are reluctant to seek health services and trust local physicians. Online information seeking may encourage YMSM to identify and see trustworthy physicians, obtain sexual health services, and obtain testing for sexually transmitted infections (STIs). This study examined online STI information seeking behaviors among Chinese YMSM and its association with offline physician visits. We conducted a nationwide online survey among YMSM through WeChat, the largest social media platform in China. We collected information on individual demographics, sexual behaviors, online STI information seeking, offline STI testing, and STI physician visits. We examined the most commonly used platforms (search engines, governmental websites, counseling websites, generic social media, gay mobile apps, and mobile medical apps) and their trustworthiness. We assessed interest and willingness to use an MSM-friendly physician finder function embedded within a gay mobile app. Logistic regression models were used to examine the correlation between online STI information searching and offline physician visits. A total of 503 men completed the survey. Most men (425/503, 84.5%) searched for STI information online. The most commonly used platform to obtain STI information were search engines (402/425, 94.5%), followed by gay mobile apps (201/425, 47.3%). Men reported high trustworthiness of information received from gay mobile apps. Men also reported high interest (465/503, 92.4%) and willingness (463/503, 92.0%) to use a MSM-friendly physician finder function within such apps. Both using general social media (aOR =1.14, 95%CI: 1.04-1.26) and mobile medical apps (aOR =1.16, 95%CI: 1.01-1.34) for online information seeking were associated with visiting a physician. Online STI information seeking is common and correlated with visiting a physician among YMSM. Cultivating partnerships with the emerging mobile medical apps may be useful for disseminating STI

  12. Magnitude of cardiovascular risk factors in rural and urban areas in Benin: findings from a nationwide steps survey.

    Directory of Open Access Journals (Sweden)

    Yessito Corine Nadège Houehanou

    Full Text Available To describe and compare the prevalences of CVRF in urban and rural populations of Benin.Subjects were drawn from participants in the Benin Steps survey, a nationwide cross-sectional study conducted in 2008 using the World Health Organisation (WHO stepwise approach to surveillance of chronic disease risk factors. Subjects aged above 24 and below 65 years were recruited using a five-stage random sampling process within households. Sociodemographic data, behavioral data along with medical history of high blood pressure and diabetes mellitus were collected in Step 1. Anthropometric parameters and blood pressure were measured in Step 2. Blood glucose and cholesterol levels were measured in Step 3. CVRF were defined according to WHO criteria. The prevalences of CVRF were assessed and the relationships between each CVRF and the area of residence (urban or rural, were evaluated using multivariable logistic regression models.Of the 6762 subjects included in the study, 2271 were from urban areas and 4491 were from rural areas. High blood pressure was more prevalent in urban than in rural areas, 29.9% (95% confidence intervals (95% CI: 27.4, 32.5 and 27.5% (95% CI: 25.6, 29.5 respectively, p = 0.001 (p-value after adjustment for age and gender. Obesity was more prevalent in urban than in rural areas, 16.4% (95% CI: 14.4, 18.4 and 5.9% (95% CI: 5.1, 6.7, p<0.001. Diabetes was more prevalent in urban than in rural areas, 3.3% (95% CI: 2.1, 4.5 and 1.8% (95% CI: 1.2, 2.4, p = 0.004. Conversely, daily tobacco smoking was more prevalent in rural than in urban areas, 9.3% (95% CI: 8.1, 10.4 and 4.3% (95% CI: 3.1, 5.6, p<0.001. No differences in raised blood cholesterol were noted between the two groups.According to our data, CVRF are prevalent among adults in Benin, and variations between rural and urban populations are significant. It may be useful to take account of the heterogeneity in the prevalence of CVRF when planning and implementing preventive

  13. Spatial distribution and partitioning behavior of selected poly- and perfluoroalkyl substances in freshwater ecosystems: A French nationwide survey

    Energy Technology Data Exchange (ETDEWEB)

    Munoz, Gabriel; Giraudel, Jean-Luc [University of Bordeaux, EPOC, UMR 5805, LPTC, 351 Cours de la Libération, F-33400 Talence, France. (France); Botta, Fabrizio; Lestremau, François [INERIS, Parc Technologique Alata, BP2, 60550 Verneuil-en-Halatte, France. (France); Dévier, Marie-Hélène [University of Bordeaux, EPOC, UMR 5805, LPTC, 351 Cours de la Libération, F-33400 Talence, France. (France); Budzinski, Hélène [CNRS, EPOC, UMR 5805, LPTC, 351 Cours de la Libération, F-33400 Talence, France. (France); Labadie, Pierre, E-mail: pierre.labadie@u-bordeaux.fr [CNRS, EPOC, UMR 5805, LPTC, 351 Cours de la Libération, F-33400 Talence, France. (France)

    2015-06-01

    The spatial distribution and partitioning of 22 poly- and perfluoroalkyl substances (PFASs) in 133 selected rivers and lakes were investigated at a nationwide scale in mainland France. ΣPFASs was in the range < LOD–725 ng L{sup −1} in the dissolved phase (median: 7.9 ng L{sup −1}) and < LOD–25 ng g{sup −1} dry weight (dw) in the sediment (median: 0.48 ng g{sup −1} dw); dissolved PFAS levels were significantly lower at “reference” sites than at urban, rural or industrial sites. Although perfluorooctane sulfonate (PFOS) was found to be the prevalent compound on average, a multivariate analysis based on neural networks revealed noteworthy trends for other compounds at specific locations and, in some cases, at watershed scale. For instance, several sites along the Rhône River displayed a peculiar PFAS signature, perfluoroalkyl carboxylates (PFCAs) often dominating the PFAS profile (e.g., PFCAs > 99% of ΣPFASs in the sediment, likely as a consequence of industrial point source discharge). Several treatments for data below detection limits (non-detects) were used to compute descriptive statistics, differences among groups, and correlations between congeners, as well as log K{sub d} and log K{sub oc} partition coefficients; in that respect, the Regression on Order Statistics (robust ROS) method was preferred for descriptive statistics computation while the Akritas–Theil–Sen estimator was used for regression and correlation analyses. Multiple regression results suggest that PFAS levels in the dissolved phase and sediment characteristics (organic carbon fraction and grain size) may be significant controlling factors of PFAS levels in the sediment. - Highlights: • A large-scale survey of PFASs in 133 French rivers and lakes is reported. • Descriptive statistics, correlations and partitioning coefficients were determined. • Non-detects were taken into account using functions from the NADA R-package. • Hot spots of PFAS contamination were found

  14. Do Health Reforms Impact Cost Consciousness of Health Care Professionals? Results from a Nation-Wide Survey in the Balkans

    Directory of Open Access Journals (Sweden)

    Mihajlo Jakovljevic

    2016-02-01

    Full Text Available Background: Serbia, as the largest market of the Western Balkans, has entered socioeconomic transition with substantial delay compared to most of Eastern Europe. Its health system reform efforts were bold during the past 15 years, but their results were inconsistent in various areas. The two waves of global recession that hit Balkan economies ultimately reflected to the financial situation of healthcare. Serious difficulties in providing accessible medical care to the citizens became a reality. A large part of the unbearable expenses actually belongs to the overt prescription of pharmaceuticals and various laboratory and imaging diagnostic procedures requested by physicians. Therefore, a broad national survey was conducted at all levels of the healthcare system hierarchy to distinguish the ability of cost containment strategies to reshape clinician’s mindsets and decision-making in practice. Aims: Assessment of healthcare professionals’ judgment on economic consequences of prescribed medical interventions and evaluation of responsiveness of healthcare professionals to policy measures targeted at increasing cost-consciousness. Study Design: Cross-sectional study. Methods: A nationwide cross-sectional survey was conducted through a hierarchy of medical facilities across diverse geographical regions before and after policy action, from January 2010 to April 2013. In the middle of the observed period, the National Health Insurance Fund (RFZO adopted severe cost-containment measures. Independently, pharmacoeconomic guidelines targeted at prescribers were disseminated. Administration in large hospitals and community pharmacies was forced to restrict access to high budget-impact medical care. Economic Awareness of Healthcare Professionals Questionnaire–29 (EAHPQ-29, developed in Serbian language, was used in face-to-face interviews. The questionnaire documented clinician’s attitudes on: Clinical

  15. Quality of life, physical diseases, and psychological impairment among survivors 3 years after Wenchuan earthquake: a population based survey.

    Directory of Open Access Journals (Sweden)

    Jin Wen

    Full Text Available BACKGROUND: Few research studies have addressed the long-term effects caused by catastrophes, and no study has ever explored the life quality, physical diseases, and psychological impairment of earthquake survivors at the same time. This study seeks to reveal survivors' quality of life, physical diseases, and mental health. METHODS: A cross-sectional survey was conducted through multi-stage sampling approach three years after the Wenchuan earthquake. RESULTS: A total of 2525 subjects were interviewed. Symptoms of PTSD were reported by 8.8% of the respondents from the seriously affected areas and 0.5%, the less hit areas. Prevalence of chronic diseases was 39.2% and 22.1% respectively, and two-week prevalence rate, 24.9% and 12.7% respectively. In the multivariate analysis, two-week prevalence, displacement, no regular income, receiving mental health support after the disaster, family members died or missing, injured due to the quake, and person who witnessed someone being killed or injured were independently associated with higher prevalence for symptoms of PTSD. Most subscales of SF-12 negatively correlated with age, chronic diseases, two-week prevalence, injured due to the disaster, home or property loss, and score of the 3-year PTSD symptoms, but positively correlated with higher education and higher household income. CONCLUSIONS: The rates of physical diseases and symptoms of PTSD were relatively high, and the quality of life was poor among victims in the hard-hit areas 3 years after the earthquake. Physical impairment correlated with symptom of PTSD, and both were negatively associated with quality of life.

  16. Characterization of type 2 diabetes mellitus burden by age and ethnic groups based on a nationwide survey.

    Science.gov (United States)

    Lopez, Janice M S; Bailey, Robert A; Rupnow, Marcia F T; Annunziata, Kathy

    2014-04-01

    Type 2 diabetes mellitus (T2DM) is the most common form of diabetes. Risk factors for its development include older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. The purpose of this study was to characterize T2DM burden, from a patient perspective, with respect to age and race/ethnicity. Adults aged ≥18 years with T2DM from a large, Internet-based, nationwide survey were retrospectively analyzed. Demographic and clinical characteristics (glycemic control, body mass index [BMI], comorbidities, and diabetes-related complications), hypoglycemic episodes, and medication adherence were used to assess diabetes burden. Degree of burden was compared across age (18-64, 65-74, and ≥75 years) and racial/ethnic (white, African American, Hispanic, Asian, and American Indian) groups. An apparent association was found between glycemic control and medication adherence. Hispanics had the lowest percentage of participants with a hemoglobin A1c (HbA1c) level groups. Conversely, American Indians and whites had the best glycemic control, HbA1c knowledge, and medication adherence. The 18- to 64-year age group had the poorest glycemic control (28.8%), the most with unknown HbA1c levels (46.3%), and the poorest medication adherence of the age groups. Mean BMIs were high (>30 mg/kg(2)) for all racial/ethnic groups other than the Asian group (28.9 mg/kg(2)). Approximately 71% of Asians were obese or overweight compared with ≥90% in the other racial/ethnic groups. Mean BMIs decreased with increasing age group (34.5, 32.6, and 29.8 kg/m(2) for the age groups of 18-64, 65-74, and ≥75 years, respectively). Regarding diabetes-related comorbidities, the Asian group had the lowest percentages of those with hypertension (39.1%) and hypercholesterolemia (46.6%). The Asian group had the lowest mean Charlson Comorbidity Index (CCI) score (score of 1.4); the American Indian group had the highest

  17. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination

    International Nuclear Information System (INIS)

    Taketomi, Yoshinori; Kamada, Nanao; Uchino, Haruto; Takahashi, Hiroshi; Ohkita, Takeshi

    1976-01-01

    For investigation of delayed effects on atomic bomb survivors, age, the association with exposure conditions, and individual pathological conditions were examined on 200 survivors for whom hypoplastic anemia was suspected in a year, April 1, 1972-March 31, 1973. Anemia was prevalent among the aged: in the females (170 cases) the incidence according to age was 1.2% in those aged 29 or below, 8.8% in those aged between 30 and 39, 12.4% in those aged between 40 and 49, 21.2% in those aged between 50 and 59, 28.8% in those aged between 60 and 69, and 24.1% aged between 70 and 79. In the males (30 cases) it was 73.3% in those aged 60 or above. The incidence according to exposure distance in the females was 4.1% in the group of 0.9km or less, 36.5% in the group of 1.9km or less, and 41.8% in the group of 2km or more, and the incidence in the males was 43.3% in the group of 1.9km or less. Anemia was not necessarily frequent among the short-distance victims. As for the distribution of hemoglobin, anemia with 10g/dl or less was found in 18%, and a white blood cell count of less than 3000 was rather infrequent (12%). Although, according to age, the amount of hemoglobin showed a slight increase in the subjects aged 70 or above, there was no significant difference. Neither of the values showed any particular decrease in relation to exposure diatance. Up to present, however, anemia has not been improved in many of the subjects in whom a mean of more than 10 years has elapsed. In addition to senile anemia, iron deficiency anemia and posthemorrhagic anemia represented most cases. There were 22 cases of hypoplastic anemia, of which three were aplastic. The exposure distance in these three cases was 1.3km, 1.5km, and 2.5km, but its relation to the incidence was not found because of the small number. (Kanao, K.)

  18. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination, (9)

    International Nuclear Information System (INIS)

    Dohy, Hiroo; Taketomi, Yoshinori; Oguma, Nobuo; Takamatsu, Yumiko; Kamada, Nanao

    1984-01-01

    Of 195,146 A-bomb survivors undergoing the periodic health examination, 607 in whom anemia was confirmed were investigated. Iron deficiency anemia was seen in 77.3% of the survivors (mostly consisting of women under the age of 54 years). There was no significant difference in other types of anemia between men and women. Renal anemia was frequent in survivors aged between 60 and 80 years. Refractory anemia was frequent in survivors older than those with renal anemia. The white blood cell count and platelet count were within the normal range in three types of anemia. (Namekawa, K.)

  19. Nationwide survey on pediatric CT among children of public health and school nurses to examine a possibility for a follow-up study on radiation effects

    International Nuclear Information System (INIS)

    Ono, K.; Ban, N.; Ojima, M.; Yoshinaga, S.; Akahane, K.; Fujii, K.; Toyota, M.; Hamada, F.; Kouriyama, C.; Akiba, S.; Kunugita, N.; Shimada, Y.; Kai, M.

    2011-01-01

    A nationwide survey was conducted in Japan on paediatric CT among children of public health and school nurses to examine a possibility for a follow-up study on radiation effects. A survey questionnaire was sent out to 3173 public primary and junior high schools and 317 public health centres during October to December in 2009. According to the collected responses, 410 (16.2 %) children received the CT scans and the total number of CT scans was 585. Most of respondents expressed a high interest in radiation health effects and an intent to participate in the epidemiological study that will follow-up the health conditions of children. This study provides information to discuss the feasibility of the epidemiological study on health effects in children who received CT scans. (authors)

  20. Procedural pain management in Italy: learning from a nationwide survey involving centers of the Italian Association of Pediatric Hematology-Oncology

    Directory of Open Access Journals (Sweden)

    Chiara Po'

    2011-12-01

    Full Text Available Procedural pain is an important aspect of care in pediatrics, and particularly in pediatric oncology where children often consider this to be the most painful experience during their illness. Best recommended practice to control procedural pain includes both sedative-analgesic administration and non-pharmacological treatments, practiced in an adequate and pleasant setting by skilled staff. A nationwide survey has been conducted among the Italian Centers of Pediatric Hematology-Oncology to register operators’ awareness on procedural pain, state of the art procedural pain management, operators’ opinions about pain control in their center, and possible barriers impeding sedation-analgesia administration. Based on indications in the literature, we discuss the results of the survey to highlight critical issues and suggest future directions for improvement. Future objectives will be to overcome differences depending on size, improve operators’ beliefs about the complexity of pain experience, and promote a global approach to procedural pain.

  1. Clinical survey of blood dyscrasias among Hiroshima a-bomb survivors by the periodical health examination, 5

    International Nuclear Information System (INIS)

    Taketomi, Yoshinori; Abe, Tsutomu; Okita, Hajime; Kamada, Nanao; Kuramoto, Atsushi

    1980-01-01

    Certain blood examinations were performed on a-bomb survivors having anemia more than moderate stage (the hemoglobin value under 9.0 g/dl), who were found out by the periodical health examination performed in Hiroshima-A-bomb Survivors Health Control Clinic during the latter period of the fiscal year 1975. The total number of a-bomb survivors who received the periodical health examination was 50,973, and the number of survivors whose hemoglobin value was under 9.0 g/dl was 201 (0.39%). The incidence of such anemia was high in women. There was not a relationship between this anemia and the exposure distance from the hypocenter. The incidence of this anemia was high in young a-bomb survivors, and more than 50% of a-bomb survivors having this anemia was under the age of 50. Iron-deficiency anemia was found in 88% of a-bomb survivors, and the course of their anemia ran in many years in many a-bomb survivors. (Tsunoda, M.)

  2. Danish obstetricians' personal preference and general attitude to elective cesarean section on maternal request: a nation-wide postal survey

    DEFF Research Database (Denmark)

    Bergholt, Thomas; Østberg, Birgitte; Legarth, Jesper

    2004-01-01

    OBJECTIVE: To assess Danish obstetricians' and gynecologists' personal preference and general attitude towards elective cesarean section on maternal request in uncomplicated single cephalic pregnancies at term. DESIGN: Nation-wide anonymous postal questionnaire. POPULATION: Four hundred and fifty......-five obstetricians and gynecologists identified in the records of the Danish Society of Obstetrics and Gynecology from January 2000. MAIN OUTCOME MEASURES: Personal preference on the mode of delivery and general attitude towards elective cesarean section on maternal request in an uncomplicated single cephalic...... and gynecologists would personally prefer vaginal delivery in uncomplicated pregnancies, but nearly 40% agree with the woman's right to request a cesarean section....

  3. Cancer survivors' experiences of a community-based cancer-specific exercise programme: results of an exploratory survey.

    Science.gov (United States)

    Catt, Susan; Sheward, J; Sheward, E; Harder, H

    2018-04-05

    Exercise levels often decline following cancer diagnosis despite growing evidence of its benefits. Treatment side effects, older age, lack of confidence and opportunity to exercise with others in similar circumstances influence this. Our study explored the experiences of people attending a cancer-specific community-based exercise programme (CU Fitter™). A survey distributed to those attending the programme gathered demographic/clinical information, self-reported exercise levels, information provision and barriers to/benefits of exercise. Sixty surveys were evaluable from 65/100 returned (62% female, 68% > 60 years, 66% breast/prostate cancer). Most (68%) were receiving treatment. Sixty-eight percent attended classes once or twice weekly. Fifty-five percent received exercise advice after diagnosis, usually from their hospital doctor/nurse. More (73%) had read about exercising, but less used the Internet to source information (32%). Self-reported exercise levels were higher currently than before diagnosis (p = 0.05). Forty-eight percent said their primary barrier to exercising was the physical impact of cancer/treatment. Improving fitness/health (40%) and social support (16%) were the most important gains from the programme. Many (67%) had made other lifestyle changes and intented to keep (50%) or increase (30%) exercising. This community-based cancer-specific exercise approach engaged people with cancer and showed physical, psychological, and social benefits. Community-grown exercise initiatives bring cancer survivors together creating their own supportive environment. Combining this with instructors familiar with the population and providing an open-ended service may prove particularly motivating and beneficial. Further work is required to provide evidence for this.

  4. Long-term consequences of landmine injury: A survey of civilian survivors in Bosnia-Herzegovina 20 years after the war.

    Science.gov (United States)

    Ryken, Katherine O; Hogue, Matthew; Marsh, J Lawrence; Schweizer, Marin

    2017-12-01

    Bosnia-Herzegovina is one of the most landmine-contaminated countries in Europe. Since the beginning of the war in 1992, there have been 7968 recorded landmine victims, with 1665 victims since the end of the war in 1995. While many of these explosions result in death, a high proportion of these injuries result in amputation, leading to a large number of disabled individuals. The purpose of this study is to conduct a survey of civilian landmine victims in Bosnia-Herzegovina in order to assess the effect of landmine injuries on physical, mental, and social well-being. Civilian survivors of landmine injuries were contacted while obtaining care through local non-governmental organizations (NGOs) throughout Bosnia-Herzegovina to inquire about their current level of independence, details of their injuries, and access to healthcare and public space. The survey was based upon Physicians for Human Rights handbook, "Measuring Landmine Incidents & Injuries and the Capacity to Provide Care." 42 survivors of landmines completed the survey, with an average follow up period of 22.0 years (±1.7). Of civilians with either upper or lower limb injuries, 83.3% underwent amputations. All respondents had undergone at least one surgery related to their injury: 42.8% had at least three total operations and 23.8% underwent four or more surgeries related to their injury. 26.2% of survivors had been hospitalized four or more times relating to their injury. 57.1% of participants reported they commonly experienced anxiety and 47.6% reported depression within the last year. On average, approximately 3% of household income each year goes towards paying medical bills, even given governmental and non-governmental assistance. Most survivors relied upon others to take care of them: only 41.5% responded they were capable of caring for themselves. 63.4% of respondents reported their injury had limited their ability to gain training, attend school, and go to work. The majority of civilian landmine

  5. XRAYS (eXamining Relevance of Articles to Young Survivors) Program Survey of Information Needs and Media Use by Young Breast Cancer Survivors and Young Women at High-Risk for Breast Cancer.

    Science.gov (United States)

    Yi, Robin H Pugh; Rezende, Lisa F; Huynh, Julie; Kramer, Karen; Cranmer, Melissa; Schlager, Lisa; Dearfield, Craig T; Friedman, Susan J

    2017-09-28

    Women age 45 years or younger with breast cancer, or who are at high-risk for breast cancer due to previously having the disease or to genetic risk, have distinct health risks and needs from their older counterparts. Young women frequently seek health information through the Internet and mainstream media, but often find it does not address their particular concerns, that it is difficult to evaluate or interpret, or even misleading. To help women better understand media coverage about new research, Facing Our Risk of Cancer Empowered (FORCE) developed the CDC-funded XRAYS (eXamining Relevance of Articles to Young Survivors) program. To assure that the XRAYS program is responsive to the community's needs, FORCE launched a web-based survey to assess where young women seek information about breast cancer, and to learn their unmet information needs. A total of 1,178 eligible women responded to the survey. In general, the breast cancer survivors and high-risk women between ages 18-45 years who responded to this survey, are using multiple media sources to seek information about breast cancer risk, prevention, screening, and treatment. They place trust in several media sources and use them to inform their medical decisions. Only about one-third of respondents to this survey report discussing media sources with their health care providers. Current survey results indicate that, by providing credible information on the quality of evidence and reporting in media reports on cancer, XRAYS is addressing a key need for health information. Results suggest that it will be useful for XRAYS to offer reviews of articles on a broad range of topics that can inform decisions at each stage of risk assessment and treatment.

  6. The challenge of comprehensively mapping children's health in a nation-wide health survey: Design of the German KiGGS-Study

    Directory of Open Access Journals (Sweden)

    Schlack Robert

    2008-06-01

    Full Text Available Abstract Background From May 2003 to May 2006, the Robert Koch Institute conducted the German Health Interview and Examination Survey for Children and Adolescents (KiGGS. Aim of this first nationwide interview and examination survey was to collect comprehensive data on the health status of children and adolescents aged 0 to 17 years. Methods/Design Participants were enrolled in two steps: first, 167 study locations (sample points were chosen; second, subjects were randomly selected from the official registers of local residents. The survey involved questionnaires filled in by parents and parallel questionnaires for children aged 11 years and older, physical examinations and tests, and a computer assisted personal interview performed by study physicians. A wide range of blood and urine testing was carried out at central laboratories. A total of 17 641 children and adolescents were surveyed – 8985 boys and 8656 girls. The proportion of sample neutral drop-outs was 5.3%. The response rate was 66.6%. Discussion The response rate showed little variation between age groups and sexes, but marked variation between resident aliens and Germans, between inhabitants of cities with a population of 100 000 or more and sample points with fewer inhabitants, as well as between the old West German states and the former East German states. By analysing the short non-responder questionnaires it was proven that the collected data give comprehensive and nationally representative evidence on the health status of children and adolescents aged 0 to 17 years.

  7. Calibration of individual dosemeters by using external beams of photon radiation. A nationwide survey among Personal Dosimetry Services, authorized by CSN

    International Nuclear Information System (INIS)

    Brosed, A.; Ginjaume, M.

    1995-12-01

    A nationwide survey in 1995 among Personal Dosimetry Services, authorized by the Spanish Nuclear Safety Council (CSN), has led the Spanish Dosimetry Laboratories to review and update the dosimetric conversion coefficients and correction factors in use in Spain since 1987. The recommendations of the ICRU Report 47(1992) are discussed and adopted. In addition differences in back-scattering form IRCU tissue and PMMA phantoms are analysed. Analytical functions used to calculate conversion coefficients and back-scattering correction factors due to the use of different phantom materials are presented, together with the adopted final values. Firstly, the above mentioned parameters are applied to ISO narrow spectra series, which are discribed in this report. Secondly, differences between 1995 and 1987 values are also shown. (Author)

  8. How to support teenagers who are losing a parent to cancer: Bereaved young adults' advice to healthcare professionals-A nationwide survey.

    Science.gov (United States)

    Alvariza, Anette; Lövgren, Malin; Bylund-Grenklo, Tove; Hakola, Pia; Fürst, Carl Johan; Kreicbergs, Ulrika

    2017-06-01

    The loss of a parent to cancer is considered one of the most traumatic events a teenager can experience. Studies have shown that teenagers, from the time of diagnosis, are already extremely worried about the consequences of a parent's cancer but tend to be left to manage these concerns on their own. The present study aimed to explore young adults' advice to healthcare professionals on how to support teenagers who are losing a parent to cancer. This work derives from a Swedish nationwide survey and employs a qualitative approach with a descriptive/interpretive design to obtain answers to an open-ended question concerning advice to healthcare professionals. Of the 851 eligible young adults who had lost a parent to cancer when they were 13-16 years of age within the previous 6 to 9 years, 622 participated in our survey (response rate = 73%). Of these 622 young adults, 481 responded to the open-ended question about what advice to give healthcare professionals. Four themes emerged: (1) to be seen and acknowledged; (2) to understand and prepare for illness, treatment, and the impending death; (3) to spend time with the ill parent, and (4) to receive support tailored to the individual teenager's needs. This nationwide study contributes hands-on suggestions to healthcare staff regarding attitudes, communication, and support from the perspective of young adults who, in their teenage years, lost a parent to cancer. Teenagers may feel better supported during a parent's illness if healthcare professionals take this manageable advice forward into practice and see each teenager as individuals; explain the disease, its treatments, and consequences; encourage teenagers to spend time with their ill parent; and recommend sources of support.

  9. Prevalence of and Factors Associated with Sarcopenia in Korean Cancer Survivors: Based on Data Obtained by the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2011.

    Science.gov (United States)

    Kim, Eun Young; Kim, Kirang; Kim, Young Saing; Ahn, Hee Kyung; Jeong, Yu Mi; Kim, Jeong Ho; Choi, Won-Jun

    2017-04-01

    Using a representative dataset from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2011, we analyzed anthropometric and dual-energy X-ray absorptiometry (DXA)-determined body composition findings for 493 cancer survivors (mean age a61.1 ± 12.6 years; 35.7% male). A much higher proportion of men (30.1%) than women (0.6%) met the criteria of sarcopenia. Subjects with a history of lung cancer, genitourinary cancer, or gastric cancer were prone to develop sarcopenia (31.6%, 26.3%, and 21.4%, respectively). Furthermore, sarcopenia was more prevalent among elderly (≥65 years; P sarcopenia was significantly associated with male gender (odds ratio [OR], 68.14; 95% CI, 15.52-299.13), a BMI of sarcopenia in Korean cancer survivors.

  10. Danish obstetricians' personal preference and general attitude to elective cesarean section on maternal request: a nation-wide postal survey

    DEFF Research Database (Denmark)

    Bergholt, Thomas; Østberg, Birgitte; Legarth, Jesper

    2004-01-01

    OBJECTIVE: To assess Danish obstetricians' and gynecologists' personal preference and general attitude towards elective cesarean section on maternal request in uncomplicated single cephalic pregnancies at term. DESIGN: Nation-wide anonymous postal questionnaire. POPULATION: Four hundred and fifty......-five obstetricians and gynecologists identified in the records of the Danish Society of Obstetrics and Gynecology from January 2000. MAIN OUTCOME MEASURES: Personal preference on the mode of delivery and general attitude towards elective cesarean section on maternal request in an uncomplicated single cephalic...... indication. Obstetricians and gynecologists who had experienced a noninstrumental vaginal delivery themselves or practiced as a private gynecologist only, were less likely to agree with the woman's right to elective cesarean section on maternal request. CONCLUSION: The vast majority of Danish obstetricians...

  11. Danish obstetricians' personal preference and general attitude to elective cesarean section on maternal request: a nation-wide postal survey

    DEFF Research Database (Denmark)

    Bergholt, Thomas; Østberg, Birgitte; Legarth, Jesper

    2004-01-01

    OBJECTIVE: To assess Danish obstetricians' and gynecologists' personal preference and general attitude towards elective cesarean section on maternal request in uncomplicated single cephalic pregnancies at term. DESIGN: Nation-wide anonymous postal questionnaire. POPULATION: Four hundred and fifty......-five obstetricians and gynecologists identified in the records of the Danish Society of Obstetrics and Gynecology from January 2000. MAIN OUTCOME MEASURES: Personal preference on the mode of delivery and general attitude towards elective cesarean section on maternal request in an uncomplicated single cephalic...... pregnancies at term. RESULTS: Of Danish specialists in obstetrics and gynecology, 1.1% would prefer an elective cesarean section in an uncomplicated pregnancy at 37 weeks of gestation with fetal weight estimation of 3.0 kg. This rose to 22.5% when the fetal weight estimation was 4.5 kg at 37 weeks. The main...

  12. Post-Polio Syndrome and Risk Factors in Korean Polio Survivors: A Baseline Survey by Telephone Interview

    Science.gov (United States)

    Bang, Hyun; Suh, Jee Hyun; Lee, Seung Yeol; Kim, Keewon; Yang, Eun Joo; Jung, Se Hee; Jang, Soong-Nang; Han, Soo Jeong; Kim, Wan-Ho; Oh, Min-Gyun; Kim, Jeong-Hwan; Lee, Sam-Gyu

    2014-01-01

    Objective To obtain information on the socioeconomic, medical, and functional status of polio survivors, and to use these results as the preliminary data for establishing the middle-aged cohort of polio survivors. Methods The subjects were recruited based on the medical records of multiple hospitals and centers. They were assessed through a structured questionnaire over the phone. Post-poliomyelitis syndrome (PPS) was identified according to the specified diagnostic criteria. Differences between polio survivors with or without PPS were evaluated, and the risk factors for PPS were analyzed by the odds ratio (OR). Results Majority of polio survivors were middle-aged and mean age was 51.2±8.3 years. A total of 188 out of 313 polio survivors met the adopted criteria for PPS based on the symptoms, yielding a prevalence of 61.6%. Mean interval between acute poliomyelitis and the development of PPS was 38.5±11.6 years. Female gender (OR 1.82; confidence interval [CI] 1.09-3.06), the age at onset of poliomyelitis (OR 1.75; CI 1.05-2.94), the use of orthoses or walking aids (OR 2.46; CI 1.44-4.20), and the history of medical treatment for paralysis, pain or gait disturbance (OR 2.62; CI 1.52-4.51) represented independent risk factors for PPS. Conclusion We found that the majority of Korean polio survivors entered middle age with many medical, functional, and social problems. Female gender, early age of onset of poliomyelitis, the use of orthoses or walking aids, and the history of medical treatment for paralysis, pain or gait disturbance were identified as the significant risk factors for PPS. A comprehensive and multidisciplinary plan should be prepared to manage polio survivors considering their need for health care services and the risk factors for late effects, such as PPS. PMID:25379493

  13. Internet Use and Breast Cancer Survivors

    Science.gov (United States)

    Muhamad, Mazanah; Afshari, Mojgan; Mohamed, Nor Aini

    2011-01-01

    A survey was administered to 400 breast cancer survivors at hospitals and support group meetings in Peninsular Malaysia to explore their level of Internet use and factors related to the Internet use by breast cancer survivors. Findings of this study indicated that about 22.5% of breast cancer survivors used Internet to get information about breast…

  14. Pulmonary Impairment in Tuberculosis Survivors: The Korean National Health and Nutrition Examination Survey 2008-2012.

    Science.gov (United States)

    Jung, Jae-Woo; Choi, Jae-Chol; Shin, Jong-Wook; Kim, Jae-Yeol; Choi, Byoung-Whui; Park, In-Won

    2015-01-01

    Pulmonary tuberculosis (TB) can affect lung function, but studies regarding long-term follow-up in patients with no sequelae on chest X-ray (CXR) have not been performed. We evaluated lung functional impairment and persistent respiratory symptoms in those with prior pulmonary TB and those with prior pulmonary TB with no residual sequelae on CXR, and determined risk factors for airflow obstruction. We used data from adults aged ≥ 40 years from the annual Korean National Health and Nutrition Examination Surveys conducted between 2008 and 2012. P values for comparisons were adjusted for age, sex, and smoking status. In total of 14,967 adults, 822 subjects (5.5%) had diagnosed and treated pulmonary TB (mean 29.0 years ago). The FVC% (84.9 vs. 92.6), FEV1% (83.4 vs. 92.4), and FEV1/FVC% (73.4 vs. 77.9) were significantly decreased in subjects with prior pulmonary TB compared to those without (p pulmonary TB (296, 2.3%) had significantly lower FEV1% (90.9 vs. 93.4, p = 0.001) and FEV1/FVC% (76.6 vs. 78.4, p pulmonary TB as well as subjects with no sequalae on CXR were more likely to experience cough and physical activity limitations due to pulmonary symptoms than those without prior pulmonary TB (p pulmonary TB (OR, 2.314; 95% CI, 1.922-2.785), along with age, male, asthma, and smoking mount was risk factor for airflow obstruction. In subjects with prior pulmonary tuberculosis, inactive TB lesion on chest x-ray (OR, 2.300; 95% CI, 1.606-3.294) were risk factors of airflow obstruction. In addition to subjects with inactive TB lesion on CXR, subjects with no sequelae on CXR can show impaired pulmonary function and respiratory symptoms. Prior TB is a risk factor for airflow obstruction and that the risk is more important when they have inactive lesions on chest X-ray. Hence, the patients with treated TB should need to have regular follow-up of lung function and stop smoking for early detection and prevention of the chronic airway disease.

  15. The Relation of Rapid Changes in Obesity Measures to Lipid Profile - Insights from a Nationwide Metabolic Health Survey in 444 Polish Cities

    Science.gov (United States)

    Kaess, Bernhard M.; Jóźwiak, Jacek; Nelson, Christopher P.; Lukas, Witold; Mastej, Mirosław; Windak, Adam; Tomasik, Tomasz; Grzeszczak, Władysław; Tykarski, Andrzej; Gąsowski, Jerzy; Ślęzak-Prochazka, Izabella; Ślęzak, Andrzej; Charchar, Fadi J.; Sattar, Naveed; Thompson, John R.; Samani, Nilesh J.; Tomaszewski, Maciej

    2014-01-01

    Objective The impact of fast changes in obesity indices on other measures of metabolic health is poorly defined in the general population. Using the Polish accession to the European Union as a model of political and social transformation we examined how an expected rapid increase in body mass index (BMI) and waist circumference relates to changes in lipid profile, both at the population and personal level. Methods Through primary care centres in 444 Polish cities, two cross-sectional nationwide population-based surveys (LIPIDOGRAM 2004 and LIPIDOGRAM 2006) examined 15,404 and 15,453 adult individuals in 2004 and 2006, respectively. A separate prospective sample of 1,840 individuals recruited in 2004 had a follow-up in 2006 (LIPIDOGRAM PLUS). Results Two years after Polish accession to European Union, mean population BMI and waist circumference increased by 0.6% and 0.9%, respectively. This tracked with a 7.6% drop in HDL-cholesterol and a 2.1% increase in triglycerides (all p<0.001) nationwide. The direction and magnitude of the population changes were replicated at the personal level in LIPIDOGRAM PLUS (0.7%, 0.3%, 8.6% and 1.8%, respectively). However, increases in BMI and waist circumference were both only weakly associated with HDL-cholesterol and triglycerides changes prospectively. The relation of BMI to the magnitude of change in both lipid fractions was comparable to that of waist circumference. Conclusions Moderate changes in obesity measures tracked with a significant deterioration in measures of pro-atherogenic dyslipidaemia at both personal and population level. These associations were predominantly driven by factors not measureable directly through either BMI or waist circumference. PMID:24497983

  16. Use of hand hygiene agents as a surrogate marker of compliance in Hungarian long-term care facilities: first nationwide survey.

    Science.gov (United States)

    Szabó, Rita; Morvai, Júlia; Bellissimo-Rodrigues, Fernando; Pittet, Didier

    2015-01-01

    Hand hygiene practice is an important measure for preventing infections in long-term care facilities (LTCFs). However, low compliance with hand hygiene has been reported in a number of studies. The purpose of this study was to provide an overview of the first reference data collected on alcohol-based handrub (ABHR) and antiseptic soap consumption, as surrogate markers for hand hygiene compliance by healthcare workers (HCWs) in Hungarian LTCFs. The objective was to inform stakeholders on the need of hand hygiene improvement in these settings. Between 5 May and 30 September 2014, we conducted a nationwide, cross-sectional survey using a standardized self-administered questionnaire; all Hungarian LTCFs were eligible. The Statistical Package for Social Sciences (SPSS) version 20.0 was used for data analysis. The questionnaire was completed by 354 LTCFs, representing 24 % of all Hungarian LTCFs. In total, the median consumption of ABHR and antimicrobial soap was 15.5 L (IQR, 0-800 L) and 60 L (IQR, 0-1,680 L) per LTCFs, and 2.2 mL (IQR, 0.4-9.1 mL) and 12.1 mL (IQR, 0.7-32.8 mL) per HCWs in 2013, respectively. The estimated number of hand hygiene actions was 0.6 hygienic handrub/HCW per day (IQR, 0-12.8/HCWs) and 2.4 hygienic handwashing/HCW per day (IQR, 0-21.9/HCWs; P = .001), respectively. This study suggests that non-compliance with hand hygiene is a significant problem in Hungarian LTCFs. Based on our results, there is an urgent need for a nationwide multimodal hand hygiene promotion strategy including education and performance monitoring and feedback in all LTCFs. Furthermore, monitoring of ABHR consumption constitute an additional component of the existing National Nosocomial Surveillance system.

  17. Permissive attitude toward suicide and future intent in individuals with and without depression: results from a nationwide survey in Korea.

    Science.gov (United States)

    Jeon, Hong Jin; Park, Jae-Hyun; Shim, Eun-Jung

    2013-04-01

    Many previous studies have revealed that individuals with depression have higher thought of suicide, although not always exhibiting intent. We investigated the associated factors with respect to intent for suicide in the future. A total of 1584 adults were selected through a nationwide multistage probability sampling, randomly one person per household, and through face-to-face interviews (response rate was 63.4%) using the suicidality module of the Mini-International Neuropsychiatric Interview and the Patient Health Questionnaire-9. The group with depression (n = 152) revealed a significantly higher level of future suicide intent (t = 4.65, p attitude (t = 4.32, p attitude (adjusted odds ratio, 3.69; 95% confidence interval, 1.97-6.89) was the only factor significantly associated with future suicide intent, whereas age; sex; education years; monthly income; financial, job, and family stress; physical illness; lifetime suicide attempt; and depression showed no statistical significance. The group with depression showed significantly higher levels of future suicide intent than did the group without depression in those who had a higher permissive attitude (t = 4.18, p attitudes (t = 1.98, p = 0.067). Permissive attitude toward suicide was associated with intent for suicide in the future in individuals with depression. Permissive attitude could be evaluated and corrected to prevent suicide.

  18. Reliability and validity of a survey to measure bowel function and quality of life in long-term rectal cancer survivors.

    Science.gov (United States)

    Wendel, Christopher S; Grant, Marcia; Herrinton, Lisa; Temple, Larissa K F; Hornbrook, Mark C; McMullen, Carmit K; Bulkley, Joanna E; Altschuler, Andrea; Krouse, Robert S

    2014-12-01

    Examination of reliability and validity of a specialized health-related quality of life questionnaire for rectal cancer (RC) survivors (≥5 years post-diagnosis). We mailed 1,063 Kaiser Permanente (KP) RC survivors (313 ostomy and 750 anastomosis) a questionnaire containing the Modified City of Hope Quality of Life-Ostomy (mCOH-QOL-O), SF-12v2, Duke-UNC Functional Social Support Questionnaire (FSSQ), and Memorial Sloan-Kettering Cancer Center Bowel Function Index (BFI). We adapted certain BFI items for use by subjects with intestinal ostomies. We evaluated reliability for all instruments with inter-item correlations and Cronbach's alpha. We assessed construct validity only for the BFI in the ostomy group, because such use has not been reported. The overall response rate was 60.5 % (577 respondents/953 eligible). Compared with non-responders, participants were on average 2 years younger and more likely non-Hispanic white, resided in educationally non-deprived areas, and had KP membership through a group. The mCOH-QOL-O, SF-12, and FSSQ were found to be highly reliable for RC survivors. In the ostomy group, BFI Urgency/Soilage and Dietary subscales were found to be reliable, but Frequency was not. Factor analysis supported the construct of Urgency/Soilage and Dietary subscales in the ostomy group, although one item had a moderate correlation with all three factors. The BFI also demonstrated good concurrent validity with other instruments in the ostomy group. With possible exception of the BFI Frequency subscale in populations with ostomies, components of our survey can be used for the entire population of RC survivors, no matter whether they received anastomosis or ostomy.

  19. Study on mass survey for cardiovascular diseases. An analysis of the electrocardiographic findings of atomic bomb survivors

    International Nuclear Information System (INIS)

    Inoue, Noriko; Harada, Hisako; Nakamura, Kenji; Fujita, Keiko; Ishida, Sakurako; Sasaki, Hideo; Ito, Chikako; Tanaka, Gaku; Maeda, Ryo.

    1996-01-01

    Electrocardiographic findings obtained at authors' center in 1993 of 12,534 survivors (5,500 males and 7,034 females), aged 47-99 y, were analyzed in relation to irradiation conditions such as distance from the explosion site by Minnesota code to give the following results. The rate of survivors without abnormalities was higher in females than in males. In males and females, there was an increasing tendency with age of the appearance of QRS high potential, ischemic electrocardiographic abnormalities, bundle-branch block and arrhythmia. The frequency of appearance of ischemic abnormalities was correlated with sex and blood pressure but not with irradiation conditions. (H.O.)

  20. A Nationwide Survey of Disability Support Personnel regarding Transition and Services for Postsecondary Students with Autism Spectrum Disorder

    Science.gov (United States)

    Muenke, Raychel C.

    2011-01-01

    The purpose of this exploratory study was to analyze the perceptions (through survey data) of Disability Support Services (DSS) personnel regarding the transition process for students with Autism Spectrum Disorder (ASD) from secondary to postsecondary institutions. Participants from 408 postsecondary institutions completed the survey with 60.4%…

  1. The Use of the Bethesda System for Reporting Thyroid Cytopathology in Korea: A Nationwide Multicenter Survey by the Korean Society of Endocrine Pathologists

    Directory of Open Access Journals (Sweden)

    Mimi Kim

    2017-07-01

    Full Text Available Background The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC has standardized the reporting of thyroid cytology specimens. The objective of the current study was to evaluate the nationwide usage of TBSRTC and assess the malignancy rates in each category of TBSRTC in Korea. Methods Questionnaire surveys were used for data collection on the fine needle aspiration (FNA of thyroid nodules at 74 institutes in 2012. The incidences and follow-up malignancy rates of each category diagnosed from January to December, 2011, in each institute were also collected and analyzed. Results Sixty out of 74 institutes answering the surveys reported the results of thyroid FNA in accordance with TBSRTC. The average malignancy rates for resected cases in 15 institutes were as follows: nondiagnostic, 45.6%; benign, 16.5%; atypical of undetermined significance, 68.8%; suspicious for follicular neoplasm (SFN, 30.2%; suspicious for malignancy, 97.5%; malignancy, 99.7%. Conclusions More than 80% of Korean institutes were using TBSRTC as of 2012. All malignancy rates other than the SFN and malignancy categories were higher than those reported by other countries. Therefore, the guidelines for treating patients with thyroid nodules in Korea should be revisited based on the malignancy rates reported in this study.

  2. Incidence and Characteristics of Adrenal Crisis in Children Younger than 7 Years with 21-Hydroxylase Deficiency: A Nationwide Survey in Japan.

    Science.gov (United States)

    Ishii, Tomohiro; Adachi, Masanori; Takasawa, Kei; Okada, Satoshi; Kamasaki, Hotaka; Kubota, Takuo; Kobayashi, Hironori; Sawada, Hirotake; Nagasaki, Keisuke; Numakura, Chikahiko; Harada, Shohei; Minamitani, Kanshi; Sugihara, Shigetaka; Tajima, Toshihiro

    2018-01-01

    We aimed to evaluate the incidence and characteristics of adrenal crisis in Japanese children with 21-hydroxylase deficiency (21-OHD). We conducted a retrospective nationwide survey for the councilors of the Japanese Society for Pediatric Endocrinology (JSPE) regarding adrenal crisis in children under 7 years with 21-OHD, admitted to hospitals from 2011 through 2016. We defined adrenal crisis as the acute impairment of general health due to glucocorticoid deficiency with at least two of symptoms, signs, or biochemical abnormalities. The councilors of the JSPE in 83 institutions responded to this survey (response rate, 60.1%). Data analyses of 378 patients with 1,101.4 person-years (PYs) revealed that 67 patients (17.7%) experienced at least 1 episode of hospital admission for adrenal crisis at the median age of 2 years. The incidence of adrenal crisis was calculated as 10.9 per 100 PYs (95% confidence interval [CI] 9.6-12.2). Infections were the most common precipitating factors, while no factor was observed in 12.5%. Hypoglycemia occurred concomitantly in 27.4%. One patient died from severe hypoglycemia, resulting in a mortality rate of 0.09 per 100 PYs (95% CI 0.0-0.2). Adrenal crisis is not rare and can be accompanied by disastrous hypoglycemia in children with 21-OHD. © 2018 S. Karger AG, Basel.

  3. Professional identity, career choices, and working conditions of future and young dentists in Germany - study design and methods of a nationwide comprehensive survey.

    Science.gov (United States)

    Kettler, Nele; Frenzel Baudisch, Nicolas; Micheelis, Wolfgang; Klingenberger, David; Jordan, A Rainer

    2017-10-18

    Little is known regarding young and future dentists' career choices, professional identity, and working conditions in Germany. While the dental healthcare environment and demands in treatment are changing, it remains unclear what job perceptions young dentists have developed at the beginning of their work life and if and how these perceptions change during the subsequent years. The aim of this study was to survey future and young dentists regarding their professional identity, planned career paths, and working conditions and strains to understand career decisions and choices and enable policy makers to include future dentists' views and expectations in their decisions. This study is a longitudinal nationwide survey over a time span of 4 years of dental students and young dentists in Germany and is comprised of three waves. The first wave focuses on dental students in their final year before the state examination and is composed of a qualitative pre-study in the form of focus groups and a quantitative main survey in the form of a questionnaire. The end points were established to analyse (1) the professional identity of the young future dentists; (2) their career paths, preparation for a career, and basic career conditions; and (3) perceived conditions and strains. The aim of the overall survey was to depict the development of these three aspects during the first years of work life. All of the questions were evaluated with a descriptive univariate analysis. The analysed subgroups were grouped according to gender, target working condition (employed/self-employed), and primary socialisation (parents dentists/parents not dentists). To our knowledge, this is the only study which focuses on career choices, professional identity, and working conditions of future and young dentists in Germany. The longitudinal observation provides information that is essential for professional and purposive dental health care planning, and to meet the oral health demands and needs of the

  4. Diffusion of an e-learning programme among Danish General Practitioners: A nation-wide prospective survey

    Directory of Open Access Journals (Sweden)

    Nielsen Bente

    2008-04-01

    Full Text Available Abstract Background We were unable to identify studies that have considered the diffusion of an e-learning programme among a large population of general practitioners. The aim of this study was to investigate the uptake of an e-learning programme introduced to General Practitioners as part of a nation-wide disseminated dementia guideline. Methods A prospective study among all 3632 Danish GPs. The GPs were followed from the launching of the e-learning programme in November 2006 and 6 months forward. Main outcome measures: Use of the e-learning programme. A logistic regression model (GEE was used to identify predictors for use of the e-learning programme. Results In the study period, a total of 192 different GPs (5.3% were identified as users, and 17% (32 had at least one re-logon. Among responders at first login most have learnt about the e-learning programme from written material (41% or from the internet (44%. A total of 94% of the users described their ability of conducting a diagnostic evaluation as good or excellent. Most of the respondents used the e-learning programme due to general interest (90%. Predictors for using the e-learning programme were Males (OR = 1.4, 95% CI 1.1; 2.0 and members of Danish College of General Practice (OR = 2.2, 95% CI 1.5; 3.1, whereas age, experience and working place did not seem to be influential. Conclusion Only few Danish GPs used the e-learning programme in the first 6 months after the launching. Those using it were more often males and members of Danish College of General Practice. Based on this study we conclude, that an active implementation is needed, also when considering electronic formats of CME like e-learning. Trial Registration ClinicalTrials.gov Identifier: NCT00392483.

  5. [Prevention of neonatal group B streptococcal sepsis in Hungary in 2012. Preliminary data of a nation-wide survey].

    Science.gov (United States)

    Sziller, István; Szabó, Miklós; Valek, Andrea; Rigó, Barbara; Ács, Nándor

    2014-07-20

    At present, there is no obligatory guideline for the prevention of early-onset neonatal group B streptococcal disease in Hungary. The aim of the present study was to gain insight into the spontaneously developed preventive strategy of the domestic obstetric divisions and departments in Hungary. Standardized questionnaire was sent out to each of the 71 obstetric divisions and departments in Hungary. Overall, 20 (27.4%) of the chairpersons replied, and thus, 39.9% of the total number of live births in Hungary were included in the study. Despite missing public health guidelines, each of the divisions and departments developed their own strategy to prevent neonatal group B streptococcal disease. In 95% of cases, bacterial culture of the lower vagina was the method of identifying pregnant women at risk. In 5% of the cases intrapartum antibiotic prophylaxis was based on risk assessment only. Of the departments using culture-based prophylaxis, 58% departments sampled women after completion of 36th gestational weeks. Antibiotic of choice was penicillin or ampicillin in 100% of cases. Of the study participants, 80% reported on multiple administration of colonized pregnant women after onset of labor or rupture of the membranes. The authors concluded that the rate of participation in the study was low. However, prevention of early-onset neonatal group B streptococcal infection is a priority of obstetric care in Hungary. Lack of a nation-wide public health policy did not prevent obstetric institutions in this country to develop their own prevention strategy. In the majority of cases and institutions, the policy is consistent with the widely accepted international standards.

  6. Atmospheric deposition of heavy metals in Norway. Nationwide survey 2010.; Atmosfareisk nedfall av tungmetaller i Norge. Landsomfattende undersoekelse i 2010,

    Energy Technology Data Exchange (ETDEWEB)

    Steinnes, Eiliv; Berg, Torunn; Uggerud, Hilde Thelle; Pfaffhuber, Katrine Aspmo

    2011-07-01

    The geographical distribution of atmospheric deposition of heavy metals in Norway was mapped in 2010 by analysis of moss samples from 464 sites all over the country. This report provides a presentation of the results and a comparison with data from a series of corresponding moss surveys starting 1977. The survey is part of an international program comprising large parts of Europe. The survey primarily concerns the ten metals of priority in the European program: vanadium, chromium, iron, nickel, copper, zinc, arsenic, cadmium, mercury, and lead. In addition data are reported for another 42 elements in the moss. The discussion of the obtained data mainly refers to contributions from air pollution. In addition influence from natural processes to the elemental composition of the moss and how it may influence the interpretation of the data is discussed. (Author)

  7. Management of infection during chemotherapy for acute leukemia in Japan: a nationwide questionnaire-based survey by the Japan Adult Leukemia Study Group.

    Science.gov (United States)

    Kimura, Shun-Ichi; Fujita, Hiroyuki; Kato, Hideaki; Hiramoto, Nobuhiro; Hosono, Naoko; Takahashi, Tsutomu; Shigeno, Kazuyuki; Hatsumi, Naoko; Minamiguchi, Hitoshi; Miyatake, Junichi; Handa, Hiroshi; Akiyama, Nobu; Kanda, Yoshinobu; Yoshida, Minoru; Kiyoi, Hitoshi; Miyazaki, Yasushi; Naoe, Tomoki

    2017-11-01

    We performed a nationwide questionnaire-based survey to evaluate the current clinical practices of infectious complications during chemotherapy for acute leukemia in Japan. We e-mailed a questionnaire to member institutions of the Japan Adult Leukemia Study Group in September, 2013. The questionnaire consisted of 50 multiple-choice questions covering therapeutic environment, antimicrobial prophylaxis, screening test during neutropenia, empirical therapy for febrile neutropenia, and the use of granulocyte-colony stimulating factor. The results were compared to those of previous surveys conducted in 2001 and 2007, and also to the recommendations described in the guidelines. Usable responses were received from 141 out of 222 (63.5%) institutions. Chemotherapy for acute myeloid leukemia was performed in protective environment in 90% of the institutions, which increased compared to previous survey (76%). Fluoroquinolones and fluconazole were the most commonly used antimicrobial agents for antibacterial and antifungal prophylaxis, followed by sulfamethoxazole-trimethoprim and itraconazole, respectively. In empirical therapy for febrile neutropenia, monotherapy with β-lactum antibiotics was the first-line therapy in most of the institutions. While empirical antifungal therapy was adopted for persistent fever in more than half of the institutions, preemptive/presumptive therapy was also used in approximately 40% of the institutions. Most of the clinicians were reluctant to use granulocyte-colony stimulating factor routinely in chemotherapy for acute myeloid leukemia. This study clarified the current clinical practices of infectious complications during chemotherapy for acute leukemia and would provide important information for the development of a suitable guideline in Japan.

  8. Gender-Related Differential Effects of Obesity on Health-Related Quality of Life via Obesity-Related Comorbidities: A Mediation Analysis of a French Nationwide Survey.

    Science.gov (United States)

    Audureau, Etienne; Pouchot, Jacques; Coste, Joël

    2016-05-01

    Negative effects of obesity on health-related quality of life (HRQoL) have been reported, especially in women, but the relative contribution of cardiometabolic and other obesity-related comorbidities to such effects remains unclear. Our objective was to model the association by sex between body mass index and HRQoL and to precisely quantify the indirect effects mediated by obesity-related comorbidities. Data were drawn from the latest French Decennial Health Survey, a nationwide cross-sectional study conducted in 2003 (21 239 adults aged 25-64 years analyzed). HRQoL was measured by the 36-item short-form health survey questionnaire. A mediation analysis based on the counterfactual framework was performed to quantify the proportion of obesity effects on HRQoL mediated by related comorbidities, including cardiometabolic risk factors (diabetes mellitus, hypertension, dyslipidemia) and diseases (ischemic heart disease, cerebrovascular, and peripheral vascular disease), musculoskeletal disorders, and asthma. After multiple linear regression, inverse associations were found between increasing body mass index category and physically oriented and most mentally oriented 36-item short-form health survey dimensions, with evidence of greater effects in women. Mediation analysis revealed that obesity effects were significantly mediated by several comorbidities, more apparently in men (eg, proportion of obesity class II total effect mediated via cardiometabolic factors: general health 27.0% [men] versus 13.6% [women]; proportion of obesity class II total effect mediated via total count of comorbidities: physical functioning 17.8% [men] versus 7.7% [women] and general health 37.1% [men] versus 20.3% [women]). Women have a greater overall impact of obesity on HRQoL, but with proportionally lower effects mediated by cardiometabolic and other obesity-related conditions, suggesting the possible role of other specific psychosocial processes. © 2016 American Heart Association, Inc.

  9. Mapping indoor radon-222 in Denmark: Design and test of the statistical model used in the second nationwide survey

    DEFF Research Database (Denmark)

    Andersen, C.E.; Ulbak, K.; Damkjær, A.

    2001-01-01

    In Denmark, a new survey of indoor radon-222 has been carried out. 1-year alpha track measurements (CR-39) have been made in 3019 single-family houses. There are from 3 to 23 house measurements in each of the 275 municipalities. Within each municipality, houses have been selected randomly. One...... important outcome of the survey is the prediction of the fraction of houses in each municipality with an annual average radon concentration above 200 Bq m(-3). To obtain the most accurate estimate and to assess the associated uncertainties, a statistical model has been developed. The purpose of this paper...

  10. Laying a Foundation for Comparing Departmental Structures between Reference and Instructional Services: Analysis of a Nationwide Survey.

    Science.gov (United States)

    Johnson, Kristin; Fountain, Kathleen Carlisle

    2002-01-01

    Describes a survey of midsized academic libraries that measured the departmental relationship between librarians who provide reference services and librarians who provide instructional services. Discusses satisfaction levels with various organizational arrangements as well as pros and cons of integrated or separate reference and instruction…

  11. Trend, characteristics, and pharmacotherapy of adults diagnosed with attention-deficit/hyperactivity disorder: a nationwide survey in Taiwan

    Directory of Open Access Journals (Sweden)

    Cheng YS

    2017-03-01

    Full Text Available Yu-Shian Cheng,1,2 Yu-Chiau Shyu,3,4 Sheng-Yu Lee,5,6 Shin-Sheng Yuan,7 Chun-Ju Yang,8 Kang-Chung Yang,8,9 Tung-Liang Lee,10 Liang-Jen Wang1 1Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 2Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai’s Home, Kaohsiung, 3Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, 4Institute of Molecular Biology, Academia Sinica, Nankang, Taipei, 5Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, 6Department of Psychiatry, College of Medicine and Hospital, National Cheng Kung University, Tainan, 7Institute of Statistical Science, Academia Sinica, 8Institute of Biopharmaceutical Sciences, National Yang-Ming University, 9Genome and Systems Biology Degree Program, National Taiwan University, Taipei, Taiwan; 10Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA Objective: Attention-deficit/hyperactivity disorder (ADHD in adults may result in functional impairment warranting clinical interventions. However, few studies have investigated the diagnosis and treatment rates of adult ADHD in non-Caucasian ethnic groups. This study used nationwide population-based data to investigate the rate of diagnosis, associated characteristics, and pharmacological treatment for adult ADHD in Taiwan. Methods: Adults (age ≥18 years newly diagnosed with ADHD (n=5,397 between January 2000 and December 2011 were enrolled from the National Health Insurance database in Taiwan. All patients were monitored until December 31, 2011. Patients who received treatment with immediate-release methylphenidate (IR-MPH, osmotic release oral system-methylphenidate (OROS-MPH, and atomoxetine (ATX were analyzed. Results: The cumulative prevalence of adult ADHD was 0.028%, and the incidence increased 10.9-fold from 2000 to 2011. The male to female ratio

  12. Investigation and analysis to the content of natural radionuclides at rate-earth ore and solid waste in China through the first nationwide pollution source survey

    International Nuclear Information System (INIS)

    Lou Jianjun; Liu Guifang; Sun Qinghong

    2011-01-01

    China has launched the First Nationwide Pollution Source Survey (FNPSS) during 2006-2009. Ministry Environmental Protection (MEP) sponsored the campaign of measuring the natural radionuclide contents. And the Ministry Environmental Protection (MEP) organized the measurements of natural radionuclide contents of in the factories and mines associated with rare-earth, niobium/tantalum, zircon, tin, lead/zinc, copper, iron, phosphate, coal, aluminum and vanadium. This paper analyzes mainly the data on the contents of U, 232 Th and 226 Ra in the rare-earth ore and solid waste produced by the rare-earth industry in China, as one of a series of papers on naturally occurring radioactive materials (NORM) s investigation. It is concluded that the average of the U, 232 Th and 226 Ra for the monazite sand of rare-earth ore is 16911, 49683, and 20072 Bq/kg, respectively. The average of U, 232 Th and 226 Ra in bastnaesite is 42, 701 and 91 Bq/kg, respectively. The average of U, 232 Th and 226 Ra in the ionic type rare-earth ore is 3918.6, 2315 and 1221 Bq/kg, respectively. (authors)

  13. Death losses due to stillbirth, neonatal death and diseases in cloned cattle derived from somatic cell nuclear transfer and their progeny: a result of nationwide survey in Japan.

    Science.gov (United States)

    Watanabe, Shinya; Nagai, Takashi

    2009-06-01

    To obtain the data concerning death losses due to stillbirth, neonatal death and diseases in cloned cattle derived from somatic cell nuclear transfer (SCNT) and their progeny produced by Japanese institutions, a nationwide survey was carried out in July-August, 2006. As a result, lifetime data concerning 482 SCNT cattle (97.5% of cattle produced in the country at that time) and 202 progeny of SCNT cattle were accumulated and the death loss of these cattle was analyzed. Although 1/3 of delivered SCNT calves died during the perinatal period due to stillbirth and neonatal death, incidence of death loss due to diseases in SCNT cattle surviving more than 200 days after birth seems to be the same as these in conventionally bred cattle. In contrast, progeny of SCNT cattle showed the same level in death loss as observed in conventionally bred cattle throughout their lifetime. These results suggest that robust health would be expected in SCNT cattle surviving to adulthood and their progeny.

  14. Association of elevated blood pressure with low distress and good quality of life: results from the nationwide representative German Health Interview and Examination Survey for Children and Adolescents.

    Science.gov (United States)

    Berendes, Angela; Meyer, Thomas; Hulpke-Wette, Martin; Herrmann-Lingen, Christoph

    2013-05-01

    Quality of life is often impaired in patients with known hypertension, but it is less or not at all reduced in people unaware of their elevated blood pressure. Some studies have even shown less self-rated distress in adults with elevated blood pressure. In this substudy of the nationwide German Health Interview and Examination Survey for Children and Adolescents (KIGGS), we addressed the question whether, also in adolescents, hypertensive blood pressure is linked to levels of distress and quality of life. Study participants aged 11 to 17 years (N = 7688) received standardized measurements of blood pressure, quality of life (using the Children's Quality of Life Questionnaire), and distress (Strengths and Difficulties Questionnaire). Elevated blood pressure was twice as frequent as expected, with 10.7% (n = 825) above published age-, sex- and height-adjusted 95th percentiles. Hypertensive participants were more likely to be obese and to report on adverse health behaviors, but they showed better academic success than did normotensive participants. Elevated blood pressure was significantly and positively associated with higher self- and parent-rated quality of life (for both, p ≤ .006), less hyperactivity (for both, p parent-rated emotional (p pressure to better well-being and low distress can partly be explained by the absence of confounding physical comorbidity and the unawareness of being hypertensive. It also corresponds to earlier research suggesting a bidirectional relationship with repressed emotions leading to elevated blood pressure and, furthermore, elevated blood pressure serving as a potential stress buffer.

  15. Public Perspectives of Mobile Phones' Effects on Healthcare Quality and Medical Data Security and Privacy: A 2-Year Nationwide Survey.

    Science.gov (United States)

    Richardson, Joshua E; Ancker, Jessica S

    2015-01-01

    Given growing interest in mobile phones for health management (mHealth), we surveyed consumer perceptions of mHealth in security, privacy, and healthcare quality using national random-digit-dial telephone surveys in 2013 and 2014. In 2013, 48% thought that using a mobile phone to communicate data with a physician's electronic health record (EHR) would improve the quality of health care. By 2014, the proportion rose to 57% (p privacy concerns yet nearly two-thirds expressed privacy concerns. In 2013 alone, respondents were more likely to express privacy concerns about medical data on mobile phones than they were to endorse similar concerns with EHRs or health information exchange (HIE). Consumers increasingly believe that mHealth improves healthcare quality, but security and privacy concerns need to be addressed for quality improvement to be fully realized.

  16. High School Physics Courses & Enrollments: Results from the 2012-13 Nationwide Survey of High School Physics Teachers. Focus On

    Science.gov (United States)

    White, Susan; Tesfaye, Casey Langer

    2014-01-01

    This report examines enrollments in high school physics during the 2012-13 school year. Based on data from the most recent survey (which includes both public and private high schools in the U.S.), it is estimated that 39% of the class of 2013 took high school physics before graduating. During the 2012-13 school year, 1.38 million students were…

  17. Differences in contraceptive use between family planning providers and the U.S. population: results of a nationwide survey.

    Science.gov (United States)

    Stern, Lisa F; Simons, Hannah R; Kohn, Julia E; Debevec, Elie J; Morfesis, Johanna M; Patel, Ashlesha A

    2015-06-01

    To describe contraceptive use among U.S. female family planning providers and to compare their contraceptive choices to the general population. We surveyed a convenience sample of female family planning providers ages 25-44 years, including physicians and advanced practice clinicians, via an internet-based survey from April to May 2013. Family planning providers were compared to female respondents ages 25-44 years from the 2011-2013 National Survey of Family Growth. A total of 488 responses were eligible for analysis; 331 respondents (67.8%) were using a contraceptive method. Providers' contraceptive use differed markedly from that of the general population, with providers significantly more likely to use intrauterine contraception, an implant, and the vaginal ring. Providers were significantly less likely to use female sterilization and condoms. There were no significant differences between providers and the general population in use of partner vasectomy or the pill. Long-acting reversible contraception (LARC) use was significantly higher among providers than in the general population (41.7% vs. 12.1%, pfamily planning providers differed significantly from the general population. These findings have implications for clinical practice, patient education, and health policy. Family planning providers report higher use of LARC than the general population. This may reflect differences in preferences and access. Providers might consider sharing these findings with patients, while maintaining patient choice and autonomy. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Age and marital status linked to quality of life of long term survivors of head and neck or prostate cancer: report from a survey of radiation therapy oncology group patients

    International Nuclear Information System (INIS)

    Scott, C.; Stern, J.; Asbell, S.; Osborne, D.; Peer, J.; Wasserman, T.; Hinrich, S.; Paulus, R.; Scarantino, C.; Bruner, D.W.

    2001-01-01

    Purpose: This research project was designed to evaluate the QOL of prostate cancer survivors (PCS) or head and neck cancer survivors (HNCS) enrolled on RTOG clinical trials. Materials and Methods: Patients alive >4 years from registration on RTOG clinical trials were eligible to participate. Potential PCS or HNCS were identified in the RTOG database and institutions (INST) that agreed to participate were sent surveys and a list of eligible survivors. All eligible PCS or HNCS at that INST were given an informed consent and a survey. The survey consists of questionnaires on QOL, insurance issues, mood, sexual function, alcohol and tobacco use, and mental status. Results: To date, 460 survivors were approached from 40 INST and 276 (60%) have signed the informed consent. Twenty-one percent are HNCS. Sixteen percent of PCS are African American, as are 12% in HNCS. The current average age of PCS is 75 (range of 55-91 years); 65 (41-84) for HNCS. PCS were less likely to be current smokers (8%) compared to HNCS (15%, p=0.057). In HNCS age was associated with speech impairment: 61% under 65 had normal speech vs. 88%>65, p=0.023. Elderly HNCS reported less disfigurement (p=0.037) and greater spiritual well-being than younger survivors (p=0.0005). HNCS reported greater distress from illness (p=0.002) and anger (p=0.03) than PCS. HNCS reported more sexual dysfunction than PCS (p=0.017). In PCS married survivors had greater sexual dysfunction than non-married survivors (p=0.04). Conclusion: Survivors over age 65 that had head and neck cancer had less chronic effects of disease and treatment than their younger counterparts. They also had greater spiritual well-being. Survivors of head and neck cancer had greater sexual dysfunction than prostate cancer survivors, likely linked to their younger age. In addition, sexual function was of greater interest to married patients; therefore, of greater consequence with dysfunction. Younger patients report more long term effects of disease

  19. Employee stress status during the past decade (1982-1992) based on a nation-wide survey conducted by the Ministry of Labour in Japan.

    Science.gov (United States)

    Shimizu, Y; Makino, S; Takata, T

    1997-07-01

    In this paper we will report the results of nation-wide surveys on employee health conducted and published by the Ministry of Labour in 1982, 1987, and 1992. The subjects were approximately 20,000 employees in 1982, approximately 15,000 in 1987, and approximately 16,000 in 1992, from throughout Japan. Using the results of the surveys, we will show trends in the status of employee work-related stress, as well as trends in means of relaxation over the past decade. The percentage of employees with work-related stress among all subjects gradually increased as follows: 50.6% in 1982, 55.0% in 1987, and 57.3% in 1992. The percentage of employees with work-related stress increased remarkably from 1982 through 1992 among the following groups: the 50-59 age group in males; employees in the electricity, gas, heat and water-supply industries; those in the real estate industry; administrative and managerial workers; employees of large establishments with more than 5,000 employees; and employees performing shift work involving no night duty. The problem of "human relationships in the workplace" was associated with the increasing stress levels among 50-59-year-old males, 40-49-year-old females, employees of large establishments with more than 5,000 employees, those in the real estate industry, and service workers. In terms of means of relaxing to relieve fatigue and stress, employees tended to engage in active pursuits such as "eating out and shopping" and "driving and traveling" over the past decade. In 1992, on the other hand, 22.0% of males and 5.9% of females selected "smoking" as a means of relaxation. This shows the need for stress management in the workplace in order to prevent health problems related to smoking.

  20. The Association between Use of Mobile Phones after Lights Out and Sleep Disturbances among Japanese Adolescents: A Nationwide Cross-Sectional Survey

    Science.gov (United States)

    Munezawa, Takeshi; Kaneita, Yoshitaka; Osaki, Yoneatsu; Kanda, Hideyuki; Minowa, Masumi; Suzuki, Kenji; Higuchi, Susumu; Mori, Junichiro; Yamamoto, Ryuichiro; Ohida, Takashi

    2011-01-01

    Study Objective: The objective of this study was to examine the association between the use of mobile phones after lights out and sleep disturbances among Japanese adolescents. Design and Setting: This study was designed as a cross-sectional survey. The targets were students attending junior and senior high schools throughout Japan. Sample schools were selected by cluster sampling. Self-reported anonymous questionnaires were sent to schools for all students to fill out. Participants: A total of 95,680 adolescents responded. The overall response rate was 62.9%, and 94,777 questionnaires were subjected to analysis. Intervention: N/A Measurements and Results: Daily mobile phone use, even if only for a brief moment every day, was reported by 84.4%. Moreover, as for use of mobile phones after lights out, 8.3% reported using their mobile phone for calling every day and 17.6% reported using it for sending text messages every day. Multiple logistic regression analysis showed that mobile phone use for calling and for sending text messages after lights out was associated with sleep disturbances (short sleep duration, subjective poor sleep quality, excessive daytime sleepiness, and insomnia symptoms) independent of covariates and independent of each other. Conclusion: This study showed that the use of mobile phones for calling and for sending text messages after lights out is associated with sleep disturbances among Japanese adolescents. However, there were some limitations, such as small effect sizes, in this study. More studies that examine the details of this association are necessary to establish strategies for sleep hygiene in the future. Citation: Munezawa T; Kaneita Y; Osaki Y; Kanda H; Minowa M; Suzuki K; Higuchi S; Mori J; Yamamoto R; Ohida T. The association between use of mobile phones after lights out and sleep disturbances among Japanese adolescents: a nationwide cross-sectional survey. SLEEP 2011;34(8):1013-1020. PMID:21804663

  1. Nationwide Survey of Patient Knowledge and Attitudes towards Human Experimentation Using Stem Cells or Bee Venom Acupuncture for Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    2014-10-01

    Full Text Available ObjectiveStem cell treatment is a well-recognized experimental treatment among patients with Parkinson’s disease (PD, for which there are high expectations of a positive impact. Acupuncture with bee venom is one of the most popular complementary and alternative treatments for PD. Patient knowledge and attitudes towards these experimental treatments are unknown. MethodsUsing a 12-item questionnaire, a nationwide survey was conducted of 963 PD patients and 267 caregivers in 44 Korean Movement Disorders Society member hospitals from April 2013 to June 2013. The survey was performed by trained interviewers using conventional methods. ResultsRegarding questions on experimental treatments using stem cells or bee venom acupuncture, 5.1–17.7% of PD patients answered questions on safety, efficacy, and evidence-based practice incorrectly; however, more than half responded that they did not know the correct answer. Although safety and efficacy have not been established, 55.5% of PD patients responded that they were willing to receive stem cell treatment. With regard to participating in experimental treatments, there was a strong correlation between stem cell treatment and bee venom acupuncture (p < 0.0001, odds ratio = 5.226, 95% confidence interval 3.919–6.969. Younger age, higher education, and a longer duration of PD were all associated with a correct understanding of experimental treatments. ConclusionsOur data suggest that relatively few PD patients correctly understand the safety and efficacy of experimental treatments and that PD patients are greatly interested in new treatments. We hope that our data will be used to educate or to plan educational programs for PD patients and caregivers.

  2. Clinician-scientist MB/PhD training in the UK: a nationwide survey of medical school policy.

    Science.gov (United States)

    Barnett-Vanes, Ashton; Ho, Guiyi; Cox, Timothy M

    2015-12-30

    This study surveyed all UK medical schools regarding their Bachelor of Medicine (MB), Doctor of Philosophy (PhD) (MB/PhD) training policy in order to map the current training landscape and to provide evidence for further research and policy development. Deans of all UK medical schools registered with the Medical Schools Council were invited to participate in this survey electronically. The number of medical schools that operate institutional MB/PhD programmes or permit self-directed student PhD intercalation. Medical school recruitment procedures and attitudes to policy guidance. 27 of 33 (81%) registered UK medical schools responded. Four (14%) offer an institutional MB/PhD programme. However, of those without institutional programmes, 17 (73%) permit study interruption and PhD intercalation: two do not (one of whom had discontinued their programme in 2013), three were unsure and one failed to answer the question. Regarding student eligibility, respondents cited high academic achievement in medical studies and a bachelor's or master's degree. Of the Medical schools without institutional MB/PhD programmes, 5 (21%) have intentions to establish a programme, 8 (34%) do not and 3 were unsure, seven did not answer. 19 medical schools (70%) considered national guidelines are needed for future MB/PhD programme development. We report the first national survey of MB/PhD training in the UK. Four medical schools have operational institutional MB/PhD programmes, with a further five intending to establish one. Most medical schools permit study interruption and PhD intercalation. The total number MB/PhD students yet to graduate from medical school could exceed 150, with 30 graduating per year. A majority of medical school respondents to this survey believe national guidelines are required for MB/PhD programme development and implementation. Further research should focus on the MB/PhD student experience. Discussion regarding local and national MB/PhD policies between medical

  3. Risk Factors for Child Malnutrition in Bangladesh: A Multilevel Analysis of a Nationwide Population-Based Survey.

    Science.gov (United States)

    Chowdhury, Mohammad Rocky Khan; Rahman, Mohammad Shafiur; Khan, Mohammad Mubarak Hossain; Mondal, Mohammad Nazrul Islam; Rahman, Mohammad Mosiur; Billah, Baki

    2016-05-01

    To identify the prevalence and risk factors of child malnutrition in Bangladesh. Data was extracted from the Bangladesh Demographic Health Survey (2011). The outcome measures were stunting, wasting, and underweight. χ(2) analysis was performed to find the association of outcome variables with selected factors. Multilevel logistic regression models with a random intercept at each of the household and community levels were used to identify the risk factors of stunting, wasting, and underweight. From the 2011 survey, 7568 children less than 5 years of age were included in the current analysis. The overall prevalence of stunting, wasting, and underweight was 41.3% (95% CI 39.0-42.9). The χ(2) test and multilevel logistic regression analysis showed that the variables age, sex, mother's body mass index, mother's educational status, father's educational status, place of residence, socioeconomic status, community status, religion, region of residence, and food security are significant factors of child malnutrition. Children with poor socioeconomic and community status were at higher risk of malnutrition. Children from food insecure families were more likely to be malnourished. Significant community- and household-level variations were found. The prevalence of child malnutrition is still high in Bangladesh, and the risk was assessed at several multilevel factors. Therefore, prevention of malnutrition should be given top priority as a major public health intervention. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Business administration of PET facilities. A nationwide survey for prices of PET screening and a cost analysis of three facilities

    International Nuclear Information System (INIS)

    Mitsutake, Naohiro; Fujii, Ryo; Oku, Shinya; Furui, Yuji; Yasunaga, Hideo

    2007-01-01

    The purpose of this study is to analyze the business administration of positron emission tomography (PET) facilities based on the survey of the price of PET cancer screening and cost analysis of PET examination. The questionnaire survey of the price of PET cancer screening was implemented for all PET facilities in Japan. Cost data of PET examination, including fixed costs and variable costs, were obtained from three different medical institutions. The marked price of the PET cancer screening was yen111,499 in average, and the most popular range of prices was between yen80,000 and yen90,000. Costs of PET per examination were accounted for yen110,675, yen79,158 and yen111,644 in facility A, B and C, respectively. The results suggested that facilities with two or more PET/CT per a cyclotron could only secure profits. In Japan, the boom in PET facility construction could not continue in accordance with increasing number of PET facilities. It would become more essential to analyze the appropriate distribution of PET facilities and the adequate amount of PET procedures from the perspective of efficient utilization of the PET equipments and supply of PET-related healthcare. (author)

  5. Use of complementary and alternative therapies by patients with self-reported chronic back pain: a nationwide survey in Canada.

    Science.gov (United States)

    Foltz, Violaine; St Pierre, Yvan; Rozenberg, Sylvie; Rossignol, Michel; Bourgeois, Pierre; Joseph, Lawrence; Adam, Viviane; Penrod, John R; Clarke, Ann E; Fautrel, Bruno

    2005-12-01

    Complementary and alternative medicine (CAM) is gaining popularity among patients with chronic back pain. We looked for factors associated with CAM use. The data came from the cross-sectional household component of the 1996-1997 National Population Health Survey on the health status and behaviors of Canadians. The sample comprising 66.999 individuals aged 20 years or older represented 21 million adults. Cross tabulations were used to estimate the percentage of CAM use among adults with chronic back pain. Factors independently associated with CAM use during the year before the surveys were identified using multiple logistic regression. CAM use was highest in the subgroup of Canadian adults reporting chronic back pain (39.07%). CAM use was associated with younger age, being married, having a higher level of education, and earning a higher income. Overall, the CAM users reported less pain, greater analgesic use, more depression, and more co-morbidities. In addition to CAM, these patients used conventional medical services. Our results show that patients with chronic back pain who use CAM are more active, more involved in social life, and healthier, suggesting better management of their condition. They use CAM in addition to, rather than instead of, conventional care. CAM use in these patients may be ascribable to dissatisfaction with mainstream physicians.

  6. Fertility-related knowledge and reproductive goals in childhood cancer survivors: short communication.

    Science.gov (United States)

    Lehmann, V; Keim, M C; Nahata, L; Shultz, E L; Klosky, J L; Tuinman, M A; Gerhardt, C A

    2017-11-01

    Do young adult survivors of childhood cancer know their fertility status, in the context of their parenthood goals and screening for gonadal functioning? While 80% of survivors (who were without children) wanted children in the future, most did not know their fertility status, and screening for gonadal functioning was underutilized. Survivors of childhood cancer are at risk for infertility, but fertility counseling and assessment are underutilized. Separate studies indicated that survivors' fertility-related knowledge is poor and that they often wanted to have children. Yet, studies have not investigated the intersection of both issues, as well as potential distress if parenthood goals are not met. Young adult male and female survivors of childhood cancer (N = 149) completed cross-sectional surveys, and data for those without children (n = 105, 70.5%) are presented here. Participants were 20-40 years old (M = 26.5), diagnosed 5-33 years prior to study participation, and completed questionnaires online. Knowledge of fertility status, parenthood goals, and potential distress if survivors were unable to have children were assessed. Medical records were reviewed for hormone levels as indicators of screening for gonadal functioning. Most survivors (n = 81; 77.1%) did not know their fertility status, while over 80% (n = 89) wanted children (neither aspect varied by socio-demographic/cancer-specific factors). Two-thirds of survivors indicated they would be distressed if parenthood goals remained unfulfilled; especially female (versus male, t = 2.64; P = 0.01) or partnered (versus single, t = -3.45; P fertility status. Relevant risk factors may have not been identified owing to limited sample size and missing treatment information. The underutilization of screening for gonadal functioning needs further exploration in other pediatric centers. Most adult childhood cancer survivors want to become parents, but do not know their fertility status, which could cause significant

  7. Pregnancy and parental leave among obstetrics and gynecology residents: results of a nationwide survey of program directors.

    Science.gov (United States)

    Hariton, Eduardo; Matthews, Benjamin; Burns, Abigail; Akileswaran, Chitra; Berkowitz, Lori R

    2018-04-16

    The health and economic benefits of paid parental leave have been well-documented. In 2016, the American College of Obstetricians and Gynecologists released a policy statement about recommended parental leave for trainees; however, data on adoption of said guidelines are nonexistent, and published data on parental leave policies in obstetrics-gynecology are outdated. The objective of our study was to understand existing parental leave policies in obstetrics-gynecology training programs and to evaluate program director opinions on these policies and on parenting in residency. A Web-based survey regarding parental leave policies and coverage practices was sent to all program directors of accredited US obstetrics-gynecology residency programs. Cross-sectional Web-based survey. Sixty-five percent (163/250) of program directors completed the survey. Most program directors (71%) were either not aware of or not familiar with the recommendations of the American College of Obstetricians and Gynecologists 2016 policy statement on parental leave. Nearly all responding programs (98%) had arranged parental leave for ≥1 residents in the past 5 years. Formal leave policies for childbearing and nonchildbearing parents exist at 83% and 55% of programs, respectively. Program directors reported that, on average, programs offer shorter parental leaves than program directors think trainees should receive. Coverage for residents on leave is most often provided by co-residents (98.7%), usually without compensation or schedule rearrangement to reduce work hours at another time (45.4%). Most program directors (82.8%) believed that becoming a parent negatively affected resident performance, and approximately one-half of the program directors believed that having a child in residency decreased well-being (50.9%), although 19.0% believed that it increased resident well-being. Qualitative responses were mixed and highlighted the complex challenges and competing priorities related to parental

  8. The first nationwide survey of MD-PhDs in the social sciences and humanities: training patterns and career choices.

    Science.gov (United States)

    Holmes, Seth M; Karlin, Jennifer; Stonington, Scott D; Gottheil, Diane L

    2017-03-21

    While several articles on MD-PhD trainees in the basic sciences have been published in the past several years, very little research exists on physician-investigators in the social sciences and humanities. However, the numbers of MD-PhDs training in these fields and the number of programs offering training in these fields are increasing, particularly within the US. In addition, accountability for the public funding for MD-PhD programs requires knowledge about this growing population of trainees and their career trajectories. The aim of this paper is to describe the first cohorts of MD-PhDs in the social sciences and humanities, to characterize their training and career paths, and to better understand their experiences of training and subsequent research and practice. This paper utilizes a multi-pronged recruitment method and novel survey instrument to examine an understudied population of MD-PhD trainees in the social sciences and humanities, many of whom completed both degrees without formal programmatic support. The survey instrument was designed to collect demographic, training and career trajectory data, as well as experiences of and perspectives on training and career. It describes their routes to professional development, characterizes obstacles to and predictors of success, and explores career trends. The average length of time to complete both degrees was 9 years. The vast majority (90%) completed a clinical residency, almost all (98%) were engaged in research, the vast majority (88%) were employed in academic institutions, and several others (9%) held leadership positions in national and international health organizations. Very few (4%) went into private practice. The survey responses supply recommendations for supporting current trainees as well as areas for future research. In general, MD-PhDs in the social sciences and humanities have careers that fit the goals of agencies providing public funding for training physician-investigators: they are involved

  9. Rectal Cancer Survivors' Participation in Productive Activities.

    Science.gov (United States)

    Hornbrook, Mark C; Grant, Marcia; Wendel, Christopher; Bulkley, Joanna E; Mcmullen, Carmit K; Altschuler, Andrea; Temple, Larissa Kf; Herrinton, Lisa J; Krouse, Robert S

    2017-01-01

    Rectal cancer and its treatment impair survivors' productivity. To assess determinants of market and nonmarket employment, job search, volunteering, and homemaking among survivors five years or longer after diagnosis. We mailed questionnaires to 1063 survivors who were members of Kaiser Permanente (Northern California, Northwest) during 2010 and 2011. Productive activities, functional health status, and bowel management at the time of the survey. Response rate was 60.5% (577/953). Higher comorbidity burdens were associated with lower productivity for men and women rectal cancer survivors. Productive survivors were younger and had lower disease stage and age at diagnosis, higher household income and educational attainment, and fewer comorbidity burdens and workplace adjustments than did nonproductive survivors (p < 0.05 each; 2-sided). Productive rectal cancer survivors were evenly split by sex. Staying productive is associated with better mental health for rectal cancer survivors. Rectal cancer survivors with multiple chronic conditions, higher disease stage, lower productive activities, and older age need better access to medical care and closer monitoring of the quality of their care, including self-care. To capture the full extent of the involvement of survivors in all types of productive activities, research should routinely include measures of employment, searching for employment, homemaking, and volunteering. Counting market and nonmarket productive activities is innovative and recognizes the continuum of contributions survivors make to families and society. Health care systems should routinely monitor rectal cancer survivors' medical care access, comorbidities, health-related quality of life, and productive activities.

  10. A sub-nationwide survey of outdoor and indoor 222Rn concentrations in China by passive method

    International Nuclear Information System (INIS)

    Jin Yihe; Ikebe, Y.; Iida, T.

    1996-01-01

    From Nov. 1988 to Mar. 1993, cooperated by China and Japan, a survey of outdoor and indoor 222 Rn concentrations in 10 cities which were highly populated in China was carried out by means of passive method. the annual mean of outdoor 222 Rn concentration in 10 cities was 8.8 Bq·m -3 . The highest of 13.5 Bq·m -3 was in Wuhan, the lowest of 3.3 Bq·m -3 was in Chongming Island of Shanghai; and there were no significant differences among the different years in the same areas. During the northwest wind seasons, about 50% of outdoor 222 Rn concentration in Taiwan was contributed by the airflow from the mainland. Typical apartment houses and offices built of brick and concrete were also surveyed for indoor 222 Rn concentration. The annual mean of indoor 222 Rn concentration in the 10 cities was 19.5 Bq·m - 3. The highest of 33.9 Bq·m -3 was observed in Guiyang, the lowest of 9.0 Bq·m -3 was observed in Chongming Island of Shanghai. The outdoor and indoor 222 Rn concentrations showed a clear seasonal pattern with the minimum in summer and the maximum in winter. And they also showed a clear geographic distribution tendency; they were higher in inland than in seashores, and higher in the south than in the north. The ratios of indoor to outdoor 222 Rn concentrations were from 1.1 to 4.6. The annual effective dose equivalents resulting from outdoor and indoor 222 Rn concentrations amounted to about 0.64 mSv·a -1 . The highest was in Guiyang, and the lowest was in Nantong, being 1.12 and 0.39 mSv·a -1 , respectively

  11. Pregnancy and Parenthood among Surgery Residents: Results of the First Nationwide Survey of General Surgery Residency Program Directors.

    Science.gov (United States)

    Sandler, Britt J; Tackett, John J; Longo, Walter E; Yoo, Peter S

    2016-06-01

    Although family and lifestyle are known to be important factors for medical students choosing a specialty, there is a lack of research about general surgery residency program policies regarding pregnancy and parenthood. Similarly, little is known about program director attitudes about these issues. We performed a cross-sectional survey of United States (US) general surgery residency program directors. Sixty-six respondents completed the survey: 70% male, 59% from university-based programs, and 76% between 40 and 59 years of age. Two-thirds (67%) reported having a maternity leave policy. Less than half (48%) reported having a leave policy for the non-childbearing parent (paternity leave). Leave duration was most frequently reported as 6 weeks for maternity leave (58%) and 1 week for paternity leave (45%). Thirty-eight percent of general surgery residency program directors (PDs) reported availability of on-site childcare, 58% reported availability of lactation facilities. Forty-six percent of university PDs said that the research years are the best time to have a child during residency; 52% of independent PDs said that no particular time during residency is best. Sixty-one percent of PDs reported that becoming a parent negatively affects female trainees' work, including placing an increased burden on fellow residents (33%). Respondents perceived children as decreasing female trainees' well-being more often than male trainees' (32% vs 9%, p leave, length of leave, as well as inconsistency in access to childcare and availability of spaces to express and store breast milk. Program directors perceived parenthood to affect the training and well-being of female residents more adversely than that of male residents. Copyright © 2016 American College of Surgeons. All rights reserved.

  12. Physical Therapists’ Use of Cognitive-Behavioral Therapy for Older Adults With Chronic Pain: A Nationwide Survey

    Science.gov (United States)

    Beissner, Katherine; Henderson, Charles R; Papaleontiou, Maria; Olkhovskaya, Yelena; Wigglesworth, Janet; Reid, MC

    2009-01-01

    Background: Increasing evidence supports the use of cognitive-behavioral therapy (CBT) for patients with chronic pain. Objective: This study determined whether physical therapists incorporate CBT techniques (eg, relaxation, activity pacing) when treating older patients with chronic pain, ascertained their interest in and barriers to using CBT, and identified participant-related factors associated with interest in CBT. Design: This cross-sectional study used a telephone survey. Methods: One hundred fifty-two members of the Geriatrics and Orthopaedics sections of the American Physical Therapy Association completed the survey. Associations between participant-related factors and interest in CBT were assessed in statistical general linear models. Results: Commonly used CBT interventions included activity pacing and pleasurable activity scheduling, frequently used by 81% and 30% of the respondents, respectively. Non-CBT treatments included exercises focusing on joint stability (94%) and mobility (94%), and strengthening and stretching programs (91%). Respondents’ overall interest in CBT techniques was 12.70 (SD=3.4, scale range=5–20). Barriers to use of CBT included lack of knowledge of and skill in the techniques, reimbursement concerns, and time constraints. Practice type and the interaction of percentage of patients with pain and educational degree of the physical therapist were independently associated with provider interest in CBT in a general linear model that also included 6 other variables specified a priori. Limitations: Data are based on self-report without regard to treatment emphasis. Conclusions: Although only a minority of physical therapists reported use of some CBT techniques when treating older patients with chronic pain, their interest in incorporating these techniques into practice is substantial. Concerns with their skill level using the techniques, time constraints, and reimbursement constitute barriers to use of the interventions. PMID:19270046

  13. Major food sources contributing to energy intake--a nationwide survey of Brazilians aged 10 years and older.

    Science.gov (United States)

    Sichieri, Rosely; Bezerra, Ilana Nogueira; Araújo, Marina Campos; de Moura Souza, Amanda; Yokoo, Edna Massae; Pereira, Rosangela Alves

    2015-05-28

    Identification of major sources of energy in the diet helps to implement dietary recommendations to reduce obesity. To determine the food sources of energy consumed by Brazilians, we used the traditional method of ranking energy contribution of selected food groups and also compared days with and without consumption of specific food groups. Analysis was based on two non-consecutive days of dietary record from the Brazilian National Dietary Survey, conducted among 34,003 Brazilians (aged 10 years or more), taking into account the complex design of the survey. Comparison of days with and without consumption gave more consistent results, with sweets and cookies as the most important contributors to energy intake, increasing 992 kJ/d (95% CI 883, 1096) for those days when consumption of cakes, cookies and desserts was reported compared to days without their consumption. Savoury snacks, cheese and sugar-sweetened beverages (SSB) also increase energy intake by about 600 kJ. The only group associated with decreased energy intake was vegetable (-155 kJ; 95% CI -272, -37). Consumption of beans, milk and fruits increased the energy intake by about 210 kJ. In total, the mean energy intake of the group was 8000 kJ. Except for the consumption of vegetables, all of the other ten food groups analysed were associated with increased energy intake. Sweets and cookies may increase the energy intake by 12% and SSB by 7%, indicating that these two groups are major targets for improving healthy eating by reducing energy intake; whereas vegetable intake is associated with the reduction of energy content of the diet.

  14. Questionnaire survey of treatment choice for breast cancer patients with brain metastasis in Japan. Results of a nationwide survey by the task force of the Japanese Breast Cancer Society

    International Nuclear Information System (INIS)

    Matsumoto, Koji; Ando, Masashi; Yamauchi, Chikako

    2009-01-01

    A nationwide survey was performed to investigate the current patterns of care for brain metastasis (BM) from breast cancer in Japan. A total of 351 survey questionnaires were sent to community or academic breast oncologists who were members of the Japanese Breast Cancer Society as of December 2005. The questionnaire consists of 40 multiple choice questions in eight categories. Of 240 institutions sent survey questionnaires, 161 (67.1%) answered; 60% of institutions answered with '<5' patients with BM every year; almost half (83 of 161) screened for BM in asymptomatic patients; surgical resection was rarely performed, as ∼75% of institutions (118 of 160 institutions) answered 'none or one case of surgery per year'; 27% (41 of 154) preferred stereotactic radiosurgery (SRS) over whole-brain radiotherapy (WBRT) as the initial treatment in all cases, although ∼70% (100 of 154) of them answered 'depend on cases'. The preference for SRS over WBRT mainly depends on the impressions of breast oncologists about both safety (late normal tissue damage and dementia in WBRT) and efficacy (better local control by SRS). Eighty-one percent (117 of 144) of institutions did not limit the number of SRS sessions as far as technically applicable. SRS is widely used as the first choice for BM from breast cancer in Japan. Considerable numbers of Japanese breast oncologists prefer SRS over WBRT as the initial treatment for BM. A randomized trial comparing SRS and WBRT is warranted. (author)

  15. Ophthalmologic survey of atomic bomb survivors in Japan, 1949. Atomic bomb radiation cataract case report with histopathologic study. Medical examination of Hiroshima patients with radiation cataracts

    Energy Technology Data Exchange (ETDEWEB)

    Cogan, D.G.; Martin, S.F.; Kimura, S.J.; Ikui, Hiroshi; Fillmore, P.G.

    1959-01-01

    This document contains 3 reports dealing with the delayed effects of radiation on the eyes of survivors of the atomic explosions in Hiroshima and Nagasaki. In the first study, 1000 persons who were listed as having been in the open and within two kilometers of the hypocenter at the time of the explosion were selected at random from the census files of the Atomic Bomb Casualty Commission for study. In addition, 231 others, comprising the total available number of surviving persons listed at present in the census files as having been within one kilometer of the hypocenter, were examined, as were several hundred others who were contacted through newspaper publicity, referrals from local ophthalmologists, or through hearsay. The survey resulted in bringing in persons having, or having had, a variety of ocular conditions. Those connected with the atomic bomb included the following diagnoses; multiple injuries of eyes and eyelids; keratoconjunctivitis from ultraviolet and ionizing radiations; thermal burn of the cornea and of the retina; retinitis proliferans; and radiation cataracts. The cataracts were the only delayed manifestations of ocular injury from the atomic bomb. The second paper is a case report of a histopathologic study of atomic bomb radiation cataract. The third paper presents the results of medical examinations of survivors having radiation induced cataracts. 32 references, 8 figures. (DMC)

  16. Racial and Ethnic Differences in Dietary Intake, Physical Activity, and Body Mass Index (BMI) Among Cancer Survivors: 2005 and 2010 National Health Interview Surveys (NHIS).

    Science.gov (United States)

    Byrd, Doratha A; Agurs-Collins, Tanya; Berrigan, David; Lee, Richard; Thompson, Frances E

    2017-12-01

    This paper reports racial/ethnic differences in mean dietary and alcohol intake, physical activity, and body mass index (BMI) among cancer survivors and examines adherence to the American Cancer Society and the US Dietary Guidelines for Americans. Data are from the cross-sectional 2005 and 2010 National Health Interview Surveys (NHIS). The total sample of cancer survivors (N = 3367) included non-Hispanic Whites (NHW; N = 2698), non-Hispanic Blacks (NHBs; N = 379), and Hispanics (N = 290). We compared mean reported dietary intake, moderate/vigorous physical activity, and BMI among racial/ethnic groups. Predicted marginals and multivariate logistic regression analysis were used to compare prevalence of non-adherence with recommendations among groups. Among the three racial/ethnic groups, Hispanics had the highest mean intake of vegetables, fiber, and calcium (p = 0.0003; p < 0.0001; p = 0.001). In the logistic regression model adjusting for sociodemographic covariates, smoking and BMI, Hispanics had lower non-adherence to fiber guidelines (OR = 0.38; CI = 0.24-0.58) than NHWs. NHBs had significantly higher non-adherence to vegetable guidelines (OR = 1.63; CI = 1.07-2.47). NHBs and Hispanics had lower non-adherence with alcohol guidelines than NHWs (OR = 0.35 and 0.38; CI = 0.18-0.69 and 0.19-0.76, respectively). NHBs and Hispanics were more likely to be overweight/obese (OR = 1.66 and 1.57; CI = 1.24-2.23 and CI = 1.11-2.21, respectively). There are racial/ethnic differences in certain health behaviors of cancer survivors. However, non-adherence to guidelines is high in all three racial/ethnic groups. Achieving the recommended guidelines for diet, physical activity, and a healthy BMI is a concern for all cancer survivors, indicating the need for intervention among this growing group of at-risk individuals.

  17. Cancer survivors. Work related issues.

    Science.gov (United States)

    Schultz, Pamela N; Beck, Martha L; Stava, Charles; Sellin, Rena V

    2002-05-01

    New and more effective treatments for cancer have resulted in individuals living longer with a better quality of life. Many more survivors are employed in the workplace. Cancer is no longer only an issue for survivors and their families; it has become an issue for the employer and the workplace. This article describes survey results of 4,364 long term cancer survivors in which they were asked to respond to items describing their ability to work, job discrimination, and quality of life. Thirty-five percent of survivors were working at the time they completed the survey, and 8.5% considered themselves unable to work. This research has shown that age, gender, ethnic group, and cancer type affected the working status of the survivors. Of survivors continuing to work, 7.3% indicated they had experienced job discrimination. The results indicate most cancer survivors do not perceive employment related problems, and are readily assimilated into the work force. Job discrimination and the ability to work is a quality of life issue.

  18. Association between pain severity, depression severity, and use of health care services in Japan: results of a nationwide survey

    Directory of Open Access Journals (Sweden)

    Vietri J

    2015-03-01

    Full Text Available Jeffrey Vietri,1 Tempei Otsubo,2 William Montgomery,3 Toshinaga Tsuji,4 Eiji Harada5 1Health Outcomes Practice, Kantar Health, Milan, Italy; 2Tokyo Shinjuku Medical Center, Tokyo, Japan; 3Eli Lilly Australia Pty Ltd., West Ryde, Australia; 4Medical Affairs, Shionogi & Co., Ltd., Osaka, Japan; 5Eli Lilly Japan KK, Kobe, Japan Background: Depression is often associated with painful physical symptoms. Previous research has seldom assessed the relationship between the severity of physical symptoms and the severity of mental and emotional symptoms of depression or other health outcomes, and no such studies have been conducted previously among individuals with depression in Japan. The aim of this study was to assess the relationship between the severity of physical pain and depression and other outcomes among individuals in Japan diagnosed with depression.Methods: Data for individuals aged 18 and older in Japan who reported being diagnosed with depression and also reported physical pain were obtained from the Japan National Health and Wellness Survey. These respondents were characterized on sociodemographics and health characteristics, and the relationship between ratings of severity on pain in the last week and health outcomes were assessed using bivariate correlations and generalized linear models. Measures included the Patient Health Questionnaire for depression severity, Medical Outcomes Study 12-Item Short Form Survey Instrument for health-related quality of life, the Work Productivity and Activity Impairment for work and activity impairment, and 6-month report of health care use.Results: More severe physical pain in the past week was correlated with more severe depression, worse health-related quality of life, lower health utility, greater impairment at work, and more health care provider visits. These relationships remained significant after incorporating sociodemographics and health characteristics in the statistical models

  19. Use of Folk Therapy in Taiwan: A Nationwide Cross-Sectional Survey of Prevalence and Associated Factors

    Directory of Open Access Journals (Sweden)

    Chun-Chuan Shih

    2015-01-01

    Full Text Available Background. This study investigates the prevalence of and factors associated with users of folk therapy in Taiwan. Methods. Using data from the 2005 National Health Interview Survey and the National Health Insurance Research Database, we identified 16,750 adults aged 20 years and older. Sociodemographic factors, lifestyle, medical utilization, and health behaviors were compared between people using and not using folk therapy. Adjusted odds ratios (ORs and 95% confidence intervals (CIs of factors associated with folk therapy were analyzed. Results. The one-month prevalence of folk therapy use was 6.8%, which was significantly associated with ages of 30–59 years (OR = 1.98, 95% CI = 1.49–2.63, women (OR = 1.63, 95% CI = 1.40–1.90, nonindigenous population (OR = 1.90, 95% CI = 1.14–3.17, having two or more unhealthy lifestyle habits (OR = 1.51, 95% CI = 1.26–1.81, high density of traditional Chinese medicine (TCM physicians (OR = 1.40, 95% CI = 1.20–1.62, and being ill without receiving medical care in past six months (OR = 2.11, 95% CI = 1.76–2.53. Medical care utilization of TCM and Western medicine were also associated factors for folk therapy. Conclusions. The use of folk therapy is correlated with sociodemographics, lifestyle and health behaviors.

  20. [Nationwide Survey on Informed Consent and Ethical Review at Hospitals Conducting Post-marketing Studies Sponsored by Pharmaceutical Companies].

    Science.gov (United States)

    Urushihara, Hisashi; Murakami, Yuka; Matsui, Kenji; Tashiro, Shimon

    2018-01-01

     Under the Japanese drug regulatory system, post-marketing studies (PMS) must be in compliance with Good Post-marketing Study Practice (GPSP). The GPSP Ordinance lacks standards for the ethical conduct of PMSs; although only post-marketing clinical trials are subject to Good Clinical Practice. We conducted a web-based questionnaire survey on the ethical conduct of PMSs in collaboration with the Japanese Society of Hospital Pharmacists and pharmacists belonging to the Society. 1819 hospitals around Japan answered the questionnaire, of which 503 hospitals had conducted company-sponsored PMSs in 2015. 40.2% of the hospitals had obtained informed consent from participating patients in at least one PMS conducted in 2015, the majority of which was in written form. The first and second most frequent reasons for seeking informed consent in PMSs were to meet protocol requirements, followed by the requirement to meet institutional standard operational procedures and the request of the ethical review board of the hospital. Ethical review of PMSs was conducted in 251 hospitals. Despite a lack of standards for informed consent and ethical review in PMSs, a considerable number of study sites employed informed consent and ethical review for PMSs. While company policies and protocols are likely to be major determinants of the ethical conduct of PMSs, the governmental regulatory agency should also play a significant role in implementing a standardized ethical code for the conduct of PMSs.

  1. Treatment errors resulting from use of lasers and IPL by medical laypersons: results of a nationwide survey.

    Science.gov (United States)

    Hammes, Stefan; Karsai, Syrus; Metelmann, Hans-Robert; Pohl, Laura; Kaiser, Kathrine; Park, Bo-Hyun; Raulin, Christian

    2013-02-01

    The demand for hair and tattoo removal with laser and IPL technology (intense pulsed light technology) is continually increasing. Nowadays these treatments are often carried out by medical laypersons without medical supervision in franchise companies, wellness facilities, cosmetic institutes and hair or tattoo studios. This is the first survey is to document and discuss this issue and its effects on public health. Fifty patients affected by treatment errors caused by medical laypersons with laser and IPL applications were evaluated in this retrospective study. We used a standardized questionnaire with accompanying photographic documentation. Among the reports there were some missing or no longer traceable parameters, which is why 7 cases could not be evaluated. The following complications occurred, with possible multiple answers: 81.4% pigmentation changes, 25.6% scars, 14% textural changes and 4.6% incorrect information. The sources of error (multiple answers possible) were the following: 62.8% excessively high energy, 39.5% wrong device for the indication, 20.9% treatment of patients with darker skin or marked tanning, 7% no cooling, and 4.6% incorrect information. The causes of malpractice suggest insufficient training, inadequate diagnostic abilities, and promising unrealistic results. Direct supervision by a medical specialist, comprehensive experience in laser therapy, and compliance with quality guidelines are prerequisites for safe laser and IPL treatments. Legal measures to make such changes mandatory are urgently needed. © The Authors | Journal compilation © Blackwell Verlag GmbH, Berlin.

  2. [Psychosocial counselling in gynecological practices : Results from a nationwide, representative survey of gynecologists in Germany].

    Science.gov (United States)

    Metzner, Franka; Siefert, Sönke; Pawils, Silke

    2017-02-01

    Due to their high social acceptance gynecologists provide ideal conditions for approaching families. Psychosocial stress (PSS), e. g. in the context of partnership conflicts, poverty or social isolation can be identified and support can be initiated. The aim of the study was to capture attitudes and engagement of gynecologists dealing with patients with PSS in gynecological practices in Germany. Out of 3000 randomly selected gynecologists in private practices, 1034 (response rate: 35%) took part in a Germany-wide questionnaire study on gynecologists' sense of responsibility, procedures and barriers when dealing with women with PSS. Ninety-six percent of the surveyed gynecologists felt responsible for patients with PSS. On average, gynecologists assumed PSS in 23% of their patients. Most of the gynecologists counseled patients with PSS and referral into the regional help system often occurred. When asked about the German early intervention system, 74% responded that they could imagine their own practice participating in this system. A need for improvement was observed in networking and financing. Significant differences in screening and interventions were found mainly in terms of professional experience, old vs. new federal states as well as between single and joint practices. Surprisingly, openness and engagement for patients with PSS were found in gynecological practices. The majority of gynecologists already offered psychosocial interventions. It may be deduced from these results that gynecologists in practices would contribute to the psychosocial aid network if key basic conditions including the financing were fulfilled.

  3. Medication assisted treatment in US drug courts: results from a nationwide survey of availability, barriers and attitudes.

    Science.gov (United States)

    Matusow, Harlan; Dickman, Samuel L; Rich, Josiah D; Fong, Chunki; Dumont, Dora M; Hardin, Carolyn; Marlowe, Douglas; Rosenblum, Andrew

    2013-01-01

    Drug treatment courts are an increasingly important tool in reducing the census of those incarcerated for non-violent drug offenses; medication assisted treatment (MAT) is proven to be an effective treatment for opioid addiction. However, little is known about the availability of and barriers to MAT provision for opioid-addicted people under drug court jurisdiction. Using an online survey, we assessed availability, barriers, and need for MAT (especially agonist medication) for opioid addiction in drug courts. Ninety-eight percent reported opioid-addicted participants, and 47% offered agonist medication (56% for all MAT including naltrexone). Barriers included cost and court policy. Responses revealed significant uncertainty, especially among non-MAT providing courts. Political, judicial and administrative opposition appear to affect MAT's inconsistent use and availability in drug court settings. These data suggest that a substantial, targeted educational initiative is needed to increase awareness of the treatment and criminal justice benefits of MAT in the drug courts. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Radiation exposure in multi-slice versus single-slice spiral CT: results of a nationwide survey

    International Nuclear Information System (INIS)

    Brix, G.; Nagel, H.D.; Stamm, G.; Veit, R.; Lechel, U.; Griebel, J.; Galanski, M.

    2003-01-01

    Multi-slice (MS) technology increases the efficacy of CT procedures and offers new promising applications. The expanding use of MSCT, however, may result in an increase in both frequency of procedures and levels of patient exposure. It was, therefore, the aim of this study to gain an overview of MSCT examinations conducted in Germany in 2001. All MSCT facilities were requested to provide information about 14 standard examinations with respect to scan parameters and frequency. Based on this data, dosimetric quantities were estimated using an experimentally validated formalism. Results are compared with those of a previous survey for single-slice (SS) spiral CT scanners. According to the data provided for 39 dual- and 73 quad-slice systems, the average annual number of patients examined at MSCT is markedly higher than that examined at SSCT scanners (5500 vs 3500). The average effective dose to patients was changed from 7.4 mSv at single-slice to 5.5 mSv and 8.1 mSv at dual- and quad-slice scanners, respectively. There is a considerable potential for dose reduction at quad-slice systems by an optimisation of scan protocols and better education of the personnel. To avoid an increase in the collective effective dose from CT procedures, a clear medical justification is required in each case. (orig.)

  5. Medical education in a foreign language and history-taking in the native language in Lebanon – a nationwide survey

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    Vanda Abi Raad

    2016-11-01

    Full Text Available Abstract Background With the adoption of the English language in medical education, a gap in clinical communication may develop in countries where the native language is different from the language of medical education. This study investigates the association between medical education in a foreign language and students’ confidence in their history-taking skills in their native language. Methods This cross-sectional study consisted of a 17-question survey among medical students in clinical clerkships of Lebanese medical schools. The relationship between the language of medical education and confidence in conducting a medical history in Arabic (the native language was evaluated (n = 457. Results The majority (88.5% of students whose native language was Arabic were confident they could conduct a medical history in Arabic. Among participants enrolled in the first clinical year, high confidence in Arabic history-taking was independently associated with Arabic being the native language and with conducting medical history in Arabic either in the pre-clinical years or during extracurricular activities. Among students in their second clinical year, however, these factors were not associated with confidence levels. Conclusions Despite having their medical education in a foreign language, the majority of students in Lebanese medical schools are confident in conducting a medical history in their native language.

  6. Use of Folk Therapy in Taiwan: A Nationwide Cross-Sectional Survey of Prevalence and Associated Factors

    Science.gov (United States)

    Shih, Chun-Chuan; Huang, Lu-Hsiang; Lane, Hsin-Long; Tsai, Chin-Chuan; Lin, Jaung-Geng; Chen, Ta-Liang; Yeh, Chun-Chieh; Liao, Chien-Chang

    2015-01-01

    Background. This study investigates the prevalence of and factors associated with users of folk therapy in Taiwan. Methods. Using data from the 2005 National Health Interview Survey and the National Health Insurance Research Database, we identified 16,750 adults aged 20 years and older. Sociodemographic factors, lifestyle, medical utilization, and health behaviors were compared between people using and not using folk therapy. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of factors associated with folk therapy were analyzed. Results. The one-month prevalence of folk therapy use was 6.8%, which was significantly associated with ages of 30–59 years (OR = 1.98, 95% CI = 1.49–2.63), women (OR = 1.63, 95% CI = 1.40–1.90), nonindigenous population (OR = 1.90, 95% CI = 1.14–3.17), having two or more unhealthy lifestyle habits (OR = 1.51, 95% CI = 1.26–1.81), high density of traditional Chinese medicine (TCM) physicians (OR = 1.40, 95% CI = 1.20–1.62), and being ill without receiving medical care in past six months (OR = 2.11, 95% CI = 1.76–2.53). Medical care utilization of TCM and Western medicine were also associated factors for folk therapy. Conclusions. The use of folk therapy is correlated with sociodemographics, lifestyle and health behaviors. PMID:26170878

  7. The patient experience of services for thyroid eye disease in the United Kingdom: results of a nationwide survey.

    Science.gov (United States)

    Estcourt, Stephanie; Hickey, Janis; Perros, Petros; Dayan, Colin; Vaidya, Bijay

    2009-09-01

    A recent consensus statement from the European Group on Graves' Orbitopathy recommends referring all patients with thyroid eye disease (TED), except the mildest cases, to a specialist multidisciplinary clinic. To study the patients' experiences of accessing services for the treatment of TED in the UK. A postal questionnaire survey of 395 members of two patients support organisations for TED in the UK, the TED Charitable Trust and the British Thyroid Foundation. The response rate was 67%. The majority of responders were females (91%) and aged above 45 (74%). There were delays in the diagnosis and referral. In 26% of responders, the time lapsed from the first symptoms to the diagnosis of TED for over 12 months. There was a wide variation in the type of clinic and healthcare professionals involved in the treatment of TED. Only 25% of the responders attended a specialist TED clinic. Out of these, 33% waited over 6 months from the first consultation with a doctor to being seen at a specialist TED clinic. Only 56% of responders were satisfied with the treatment they received for TED. More responders who had attended a specialist TED clinic were satisfied with the treatment than those who had not attended a specialist clinic (67 vs 52%, P<0.05). Only a minority of patients with TED are treated at a specialist TED clinic in the UK. Those patients who are treated at a specialist TED clinic are more likely to be satisfied with the treatment.

  8. A nationwide survey of healthcare personnel’s attitude, knowledge, and interest toward renal supportive care in Taiwan

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    Hung-Bin Tsai

    2017-07-01

    Full Text Available Background Renal supportive care (RSC is an important option for elderly individuals reaching end-stage renal disease; however, the frequency of RSC practice is very low among Asian countries. We evaluated the attitude, the knowledge, and the preference for specific topics concerning RSC among participants who worked in different medical professions in Taiwan. Methods A cross-sectional questionnaire-based survey was employed. Healthcare personnel (N = 598 who were involved in caring for end-stage renal disease patients at more than 40 facilities in Taiwan participated in this study. Participants were asked about their motivation for learning about RSC, the topics of RSC they were most and least interested in, their willingness to provide RSC, and to rate their knowledge and perceived importance of different topics. Results The vast majority of respondents (81.9% were self-motivated about RSC, among whom nephrologists (96.8% and care facilitators (administrators/volunteers (45% exhibited the highest and the least motivation, respectively (p < 0.01. Overall, respondents indicated that they had adequate knowledge about the five pre-specified RSC topics between medical professions (p = 0.04. Medical professions and institutional size exerted significant influence on the willingness to provide RSC. Conclusions Our results facilitate the understanding of the knowledge and attitude toward different RSC topics among varied medical professions, and can guide the design of RSC education content for healthcare personnel.

  9. Diagnostic reference levels for common computed tomography (CT) examinations: results from the first Nigerian nationwide dose survey.

    Science.gov (United States)

    Ekpo, Ernest U; Adejoh, Thomas; Akwo, Judith D; Emeka, Owujekwe C; Modu, Ali A; Abba, Mohammed; Adesina, Kudirat A; Omiyi, David O; Chiegwu, Uche H

    2018-01-29

    To explore doses from common adult computed tomography (CT) examinations and propose national diagnostic reference levels (nDRLs) for Nigeria. This retrospective study was approved by the Nnamdi Azikiwe University and University Teaching Hospital Institutional Review Boards (IRB: NAUTH/CS/66/Vol8/84) and involved dose surveys of adult CT examinations across the six geographical regions of Nigeria and Abuja from January 2016 to August 2017. Dose data of adult head, chest and abdomen/pelvis CT examinations were extracted from patient folders. The median, 75th and 25th percentile CT dose index volume (CTDI vol ) and dose-length-product (DLP) were computed for each of these procedures. Effective doses (E) for these examinations were estimated using the k conversion factor as described in the ICRP publication 103 (E DLP  =  k × DLP ). The proposed 75th percentile CTDI vol for head, chest, and abdomen/pelvis are 61 mGy, 17 mGy, and 20 mGy, respectively. The corresponding DLPs are 1310 mGy.cm, 735 mGy.cm, and 1486 mGy.cm respectively. The effective doses were 2.75 mSv (head), 10.29 mSv (chest), and 22.29 mSv (abdomen/pelvis). Findings demonstrate wide dose variations within and across centres in Nigeria. The results also show CTDI vol comparable to international standards, but considerably higher DLP and effective doses.

  10. Equity of the essential public health service in rural china: evidence from a nationwide survey of hypertensive patients.

    Science.gov (United States)

    Zhou, Donghua; Feng, Zhanchun; He, Shasha; Sun, Xi; Ma, Caihui; Lv, Benyan; Zou, Xiong

    2013-07-01

    To explore healthcare disparities in rural China two years after the implementation of the Essential Public Health Service (EPHS) reform in 2009. A cross-sectional study was conducted by surveying 930 hypertension patients (HPs) from different regions in rural China in 2011. The percentages of patients using recommended four or more follow-up visits in a year were calculated by patient socio-demographic characteristics and statistically examined using chi-square and logistic regression to uncover disparities and correlated factors in EPHS use. The rates were not significantly different by age, gender, education, insurance status or income, but significantly different by region and hypertension history (p<0.01). Higher rates were also observed on patients who sought actively follow-up service at clinics, making appointment for the next follow-up with doctors, awareness of the need of follow-up, more satisfied with the follow-up services, and better medication adherence (p<0.01). There were no disparities observed among HPs in the use of follow-up services, suggesting that the reform has to some extent achieved its goal in ensuring equal access to EPHS. In this regard, regional implementation of the national policies and improvement of EPHS management at local level should be further improved.

  11. Nationwide shifts in the double burden of overweight and underweight in Vietnamese adults in 2000 and 2005: two national nutrition surveys

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    Mai Le B

    2011-01-01

    Full Text Available Abstract Background In developing countries, overweight prevalence is increasing while underweight prevalence is still high. This situation is known as the double nutrition burden. Both underweight and overweight are related to increased risk of chronic non-communicable diseases, reduced well-being and quality of life. This study aims to compare the prevalence of overweight and underweight among Vietnamese adults in 2000 and 2005. Methods The study was based on two nationally representative surveys, the National Nutrition Survey 2000 (14,452 subjects and the National Adult Obesity Survey 2005 (17,213 subjects. Adults aged 25-64 years were sampled to be nationally representative. Multiple multinomial logistic regression analysis was used to investigate the association of underweight and overweight with socio-economic indicators. Results The distribution of BMI across the population and population groups indicated a shift towards higher BMI levels in 2005 as compared to 2000. The nationwide prevalence of overweight (BMI ≥ 25 kg/m2 and obesity (BMI ≥ 30 kg/m2 was 6.6% and 0.4% respectively in 2005, almost twice the rates of 2000 (3.5% and 0.2%. Using the Asian BMI cut-off of 23 kg/m2 the overweight prevalence was 16.3% in 2005 and 11.7% in 2000. In contrast, the underweight prevalence (BMI 2 of 20.9% in 2005 was lower than the rate of 25.0% in 2000. Women were more likely to be both underweight and overweight as compared to men in both 2000 and 2005. Urban residents were more likely to be overweight and less likely to be underweight as compared to rural residents in both years. The shifts from underweight to overweight were clearer among the higher food expenditure levels. Conclusions The double nutrition burden was clearly present in Vietnam. The distribution of BMI across the population groups generally indicated a shift towards higher BMI levels in 2005 as compared to 2000. The prevalence of overweight was increased while the declined level

  12. Prevalence of anemia in children 1 to 12 years of age: results from a nationwide probabilistic survey in Mexico

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    Villalpando Salvador

    2003-01-01

    Full Text Available OBJECTIVE: To describe the epidemiology and analyze factors associated with iron deficiency anemia in a probabilistic sample of the Encuesta Nacional de Nutrición 1999 (ENN-99 [National Nutritional Survey 1999 (NNS-99]. MATERIAL AND METHODS: The sample included 8 111 children aged 1 to 12 years, and was nationaly representative by rural and urban strata and by four geographical regions. Capillary hemoglobin was measured using a portable photometer (HemoCue. The analysis of the determining factors of anemia was performed by odds ratios derived from a logistic regression model and multiple regression models. RESULTS: The prevalence of anemia was 50% in infants <2 years of age, with no significant differences between urban and rural strata or among regions. It varied between 14 and 22% in 6-11 year-old children and was higher in the South region and among the indigenous children. Dietary intake of iron was 50% of the recommended daily allowance in children <2 years of age, but not in older children. Phytate (»500-800 mg/d and tannin (»19 mg/d intakes were very high in children over 7 years of age. Hemoglobin was positively associated with nutritional status of children (p=0.01, socioeconomic status (p range 0.05-0.001, duration of lactation in children under 2 years of age (p=0.1, and iron and calcium intake (p=0.02, but not with folic acid or vitamin B12 intake. Hemoglobin was negatively associated with maternal education (p=0.01 in older children, but not in those under 2 years of age. CONCLUSIONS: We present evidence of an alarming national epidemic of anemia, particularly marked in children 12 to 24 months of age. The control of anemia should be considered as an urgent national concern given its grave consequences on the physical and mental development of these children and on their long-term health.

  13. Suicidal ideation and suicide attempts in anxious or depressed family caregivers of patients with cancer: a nationwide survey in Korea.

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    Boyoung Park

    Full Text Available PURPOSE: To describe the prevalence of suicidal ideation and suicide attempts in family caregivers (FCs of patients with cancer and to identify the factors associated with suicidal ideation and suicide attempts in FCs with anxiety or depression. METHODS: A national, multicenter survey administered to 897 FCs asked questions concerning suicidal ideation and suicide attempts during the previous year and assessed anxiety, depression, socio-demographic factors, caregiving burden, patient factors, and quality of life (QOL. RESULTS: A total of 17.7% FCs reported suicidal ideation, and 2.8% had attempted suicide during the previous year. Among FCs with anxiety, 31.9% had suicidal ideation and 4.7% attempted suicide; the corresponding values for FCs with depression were 20.4% and 3.3%, respectively. Compared with FCs without anxiety and depression, FCs with anxiety or depression showed a higher adjusted odds ratios (aOR for suicidal ideation (aOR= 4.07 and 1.93, respectively and attempts (OR= 3.00 and 2.43, respectively. Among FCs with anxiety or depression, being female, unmarried, unemployed during caregiving, and having a low QOL were associated with increased odds of suicidal ideation. FCs with anxiety who became unemployed during caregiving constituted a high-risk group for suicide. Being unmarried and having a low QOL with respect to financial matters were associated with increased suicide attempts among FCs with depression. CONCLUSION: FCs with anxiety or depression were at high risk of suicide. Interventions to enhance social support and to improve perceived QOL may help prevent suicide and manage suicidal ideation in FCs with anxiety or depression.

  14. Suicidal ideation and suicide attempts in anxious or depressed family caregivers of patients with cancer: a nationwide survey in Korea.

    Science.gov (United States)

    Park, Boyoung; Kim, So Young; Shin, Ji-Yeon; Sanson-Fisher, Robert W; Shin, Dong Wook; Cho, Juhee; Park, Jong Hyock

    2013-01-01

    To describe the prevalence of suicidal ideation and suicide attempts in family caregivers (FCs) of patients with cancer and to identify the factors associated with suicidal ideation and suicide attempts in FCs with anxiety or depression. A national, multicenter survey administered to 897 FCs asked questions concerning suicidal ideation and suicide attempts during the previous year and assessed anxiety, depression, socio-demographic factors, caregiving burden, patient factors, and quality of life (QOL). A total of 17.7% FCs reported suicidal ideation, and 2.8% had attempted suicide during the previous year. Among FCs with anxiety, 31.9% had suicidal ideation and 4.7% attempted suicide; the corresponding values for FCs with depression were 20.4% and 3.3%, respectively. Compared with FCs without anxiety and depression, FCs with anxiety or depression showed a higher adjusted odds ratios (aOR) for suicidal ideation (aOR= 4.07 and 1.93, respectively) and attempts (OR= 3.00 and 2.43, respectively). Among FCs with anxiety or depression, being female, unmarried, unemployed during caregiving, and having a low QOL were associated with increased odds of suicidal ideation. FCs with anxiety who became unemployed during caregiving constituted a high-risk group for suicide. Being unmarried and having a low QOL with respect to financial matters were associated with increased suicide attempts among FCs with depression. FCs with anxiety or depression were at high risk of suicide. Interventions to enhance social support and to improve perceived QOL may help prevent suicide and manage suicidal ideation in FCs with anxiety or depression.

  15. Bystander cardiopulmonary resuscitation training experience and self-efficacy of age and gender group: a nationwide community survey.

    Science.gov (United States)

    Ro, Young Sun; Shin, Sang Do; Song, Kyoung Jun; Hong, Sung Ok; Kim, Young Taek; Cho, Sung-Il

    2016-08-01

    We hypothesized that recent hands-on practice for cardiopulmonary resuscitation (CPR) would be strongly associated with a higher likelihood of self-efficacy in bystander CPR among laypersons according to age and gender group. We used the National Korean Community Health Survey database of 228921 representatively sampled responders from 253 counties in 2012. Laypersons who had previous CPR training were eligible. Exposure variables were having had CPR training with hands-on practice session with a manikin (Practical-CPR-Training) and CPR training within the last 2 years (Recent-CPR-Training). Primary outcome was self-efficacy in bystander CPR. Multivariable logistic regression analysis was performed. The final model with an interaction term was evaluated to compare the effects of CPR training across different age and gender groups. Of 62425 eligible respondents who have had CPR training, 20213 (32.4%) had Practical-CPR-Training. Adjusted odds ratios (AORs) for self-efficacy were 4.08 (3.78-4.41) in Practical-CPR-Training, 2.61 (2.50-2.73) in male, 1.26 (1.16-1.36) in good self-rated health, 1.19 (1.10-1.29) in high school graduate, 1.19 (1.01-1.39) in persons living with stroke patients in household, and 1.17 (1.10-1.24) in Recent-CPR-Training. In interaction models, Practical-CPR-Training showed higher self-efficacy in all age and gender groups, whereas Recent-CPR-Training was not associated with better self-efficacy in elderly group, male (AOR, 0.90 [0.69-1.18]) and female (AOR, 0.94 [0.72-1.23]). Self-efficacy in bystander CPR was higher in person with recent CPR training with hands-on practice with a manikin. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. The association between delusional-like experiences, and tobacco, alcohol or cannabis use: a nationwide population-based survey

    Directory of Open Access Journals (Sweden)

    Saha Sukanta

    2011-12-01

    Full Text Available Abstract Background Previous population-based studies have found that delusional-like experiences (DLE are prevalent in the community, and are associated with a wide range of mental health disorders including substance use. The aim of the study was to explore the association between DLE and three commonly used substances - tobacco, alcohol and cannabis. Methods Subjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007. The Composite International Diagnostic Interview was used to identify DLE, common psychiatric disorders, and substance use. We examined the relationship between the variables of interest using logistic regression, adjusting for potential confounding factors. Results Of 8 773 participants, 8.4% (n = 776 subjects endorsed one or more DLE. With respect to tobacco use, compared to nonusers, DLE were more common in those who (a had daily use, (b commenced usage aged 15 years or less, and (c those who smoked heavily (23 or more cigarettes per day. Participants with cannabis use disorders were more likely to endorse DLE; this association was most prominent in those with an onset of 16 years or younger. In contrast, the pattern of association between DLE versus alcohol use or dependence was less consistent, however those with early onset alcohol use disorders were more likely to endorse DLE probe items. Conclusions While cannabis use disorders have been previously linked with DLE, our findings linking alcohol and tobacco use and DLE suggest that the influence of these substances on psychosis-related outcomes warrants closer scrutiny in longitudinal prospective studies.

  17. Relationship of sleep pattern and snoring with chronic disease: findings from a nationwide population-based survey.

    Science.gov (United States)

    Yunus, Fakir Md; Khan, Safayet; Mitra, Dipak K; Mistry, Sabuj Kanti; Afsana, Kaosar; Rahman, Mahfuzar

    2018-02-01

    To investigate the association of total sleep time and presence or absence of snoring with chronic disease among the Bangladeshi adult population. Cross-sectional survey. Urban and rural Bangladesh. A total of 12,338 men and women aged ≥35 years. Total sleep time was considered as the total hours of sleep in 24 hours. Furthermore, sleep time was categorized into 9 hours according to National Sleep Foundation (2015) guidelines. Self-reported snoring history was captured and corroborated with their respective sleep partner/spouse in more than 80% cases. Registered physician-diagnosed current and/or previous cases of hypertension, diabetes, coronary heart disease, cancer, stroke, chronic obstructive pulmonary disease, and any other chronic conditions were counted. Overall prevalence of at least 1 chronic disease in our study population was around 18%: men (15.4%) and women (20.0%). Hypertension has the highest prevalence (overall: 12.7%, men: 12.2%, women: 15%) followed by diabetes (4.9%), coronary heart diseases (3.2%), stroke (1.8%), chronic obstructive pulmonary disease (0.9%), and cancer (any type: 0.1%). Sleep pattern and snoring are significantly associated with all individual chronic disease except cancer. Sociodemographic, behavioral, and lifestyle variables were adjusted, and inadequate total sleep time (<7 hours) and snoring (yes/no) showed significant association with chronic disease status (risk ratio = 1.11, 95% confidence interval 1.00-1.22 and risk ratio = 1.20, 95% confidence interval 1.11-1.29, respectively). Inadequate sleep and snoring are independently associated with chronic disease in Bangladeshi adult population and perhaps elsewhere. Copyright © 2017 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

  18. Expansion of discharge planning system in Japan: Comparison of results of a nationwide survey between 2001 and 2010

    Directory of Open Access Journals (Sweden)

    Nagata Satoko

    2012-08-01

    Full Text Available Abstract Background In response to the rapid aging of the population in Japan, many care systems have been created in quick succession. Establishment of discharge planning departments (DPDs in hospitals is one of them. In this study, we compared the distribution and characteristics of DPDs and the characteristics of the hospitals that have DPDs between 2001 and 2010 in Japan. Methods We mailed a questionnaire about the characteristics of hospitals and existence and situation of DPDs to all general hospitals with 100 or more general beds in 2001 and in 2010. Results In 2001, of the 3,268 hospitals queried, 1,568 (48.0% responded and 1,357 (41.5% were selected for data analysis. In 2010, among 2,600 hospitals, 940 hospitals (36.1% responded and 913 (35.1% met the inclusion criteria. The percentage of hospitals with DPDs increased from 30% to more than 70% between the two surveys. More departments were under the direct control of the hospital director and more physicians participated in discharge planning activities in 2010 than in 2001. In 2001, private hospitals and hospitals with an affiliated institution or agency tended to have a DPD; however, the relationship between these factors and the presence of a DPD had disappeared in 2010. Larger hospitals and hospitals with more nurses per patient tended to have a DPD both in 2001 and 2010. Conclusions Since 2008, the establishment of a DPD has been directly connected to medical fees so hospital administrators might have recognized the DPD as a “necessary and paid for” department. Having a DPD was the majority’s policy in Japan, and we must recognize the importance of quality assurance through DPDs from now on, especially in small hospitals.

  19. Helping veterans achieve work: A Veterans Health Administration nationwide survey examining effective job development practices in the community.

    Science.gov (United States)

    Kukla, Marina; McGuire, Alan B; Strasburger, Amy M; Belanger, Elizabeth; Bakken, Shana K

    2018-06-01

    Veterans Health Administration vocational services assist veterans with mental illness to acquire jobs; one major component of these services is job development. The purpose of this study was to characterize the nature of effective job development practices and to examine perceptions and intensity of job development services. A national mixed-methods online survey of 233 Veterans Health Administration vocational providers collected data regarding frequency of employer contacts, perceptions of job development ease/difficulty, and effective job development practices when dealing with employers. Qualitative responses elucidating effective practices were analyzed using content analysis. Vocational providers had a modest number of job development employer contacts across 2 weeks (M = 11.0, SD = 10.6) and fewer were face-to-face (M = 7.6, SD = 8.4). Over 70% of participants perceived job development to be difficult. Six major themes emerged regarding effective job development practices with employers: using an employer-focused approach; utilizing a targeted marketing strategy; engaging in preparation and follow-up; going about the employer interaction with genuineness, resilience, and a strong interpersonal orientation; serving as an advocate for veterans and educator of employers; utilizing specific employer-tailored strategies, such as arranging a one-on-one meeting with a decision maker and touring the business, individualizing a prescripted sales pitch, connecting on a personal level, and engaging in ongoing communication to solidify the working relationship. Respondents highlight several potentially effective job development strategies; tools and resources may be developed around these strategies to bolster job development implementation and allow opportunities for fruitful employer interactions. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  20. A Nationwide Survey About Palliative Sedation Involving Japanese Palliative Care Specialists: Intentions and Key Factors Used to Determine Sedation as Proportionally Appropriate.

    Science.gov (United States)

    Hamano, Jun; Morita, Tatsuya; Ikenaga, Masayuki; Abo, Hirofumi; Kizawa, Yoshiyuki; Tunetou, Satoru

    2018-03-01

    Although there has long been debate about physicians' intentions and what physicians consider to be proportionally appropriate when performing palliative sedation, few large studies have been performed. To identify physicians' intentions when starting continuous deep sedation and to clarify what factors determine whether physicians regard sedation as proportionally appropriate in relation to expected survival, the patients' wishes, and refractoriness. A nationwide questionnaire survey of Japanese palliative care specialists was performed from August to December 2016. We defined continuous deep sedation as the continuous use of sedatives to relieve intolerable and refractory symptoms with the loss of consciousness until death. Of the 695 palliative care specialists enrolled, 440 were analyzed (response rate, 69%). A total of 95% and 87% of the physicians reported that they explicitly intended to perform symptom palliation and decrease consciousness levels, respectively. Moreover, 38% answered that they explicitly intended to maintain unconsciousness until death, and 11% reported that they intended to shorten survival to some extent. The respondents considered that continuous deep sedation is more appropriate when the predicted survival is shorter, the patients' wishes are consistent and clear, and confidence in the refractoriness of symptoms is higher. Japanese palliative care specialists explicitly intend to control symptoms and reduce the level of consciousness when performing continuous deep sedation, but there are differences in their intentions with regard to maintaining unconsciousness until death. Predicted survival, patients' wishes, and confidence in refractoriness are associated with physicians' judgment that sedation is proportionally appropriate. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  1. Home-care nursing staff in self-directed teams are more satisfied with their job and feel they have more autonomy over patient care: a nationwide survey.

    Science.gov (United States)

    Maurits, Erica E M; de Veer, Anke J E; Groenewegen, Peter P; Francke, Anneke L

    2017-10-01

    The aims of this study were: (1) To examine whether working in a self-directed team is related to home-care nursing staff's job satisfaction; (2) To assess the mediating effect of self-perceived autonomy over patient care; (3) To investigate the moderating effect of educational level on the association between autonomy over patient care and job satisfaction. Self-directed teams are being introduced in home care in several countries. It is unknown whether working in a self-directed team is related to nursing staff's job satisfaction. It is important to gain insight into this association since self-directed teams may help in retaining nursing staff. A cross-sectional study based on two questionnaire surveys in 2014 and 2015. The study involved 191 certified nursing assistants and registered nurses employed in Dutch home-care organizations (mean age of 50). These were members of the Dutch Nursing Staff Panel, a nationwide panel of nursing staff working in various healthcare settings. Self-direction is positively related to nursing staff's job satisfaction. This relationship is partly mediated by autonomy over patient care. For certified nursing assistants and registered nurses with a bachelor's degree, a greater sense of autonomy over patient care in self-directed teams is positively related to job satisfaction. No significant association was found between autonomy over patient care and job satisfaction for registered nurses with an associate degree. This study suggests that home-care organizations should consider the use of self-directed teams as this increases nursing staff's job satisfaction and may therefore help to retain nursing staff in home care. © 2017 John Wiley & Sons Ltd.

  2. The impact of awareness of terminal illness on quality of death and care decision making: a prospective nationwide survey of bereaved family members of advanced cancer patients.

    Science.gov (United States)

    Ahn, Eunmi; Shin, Dong Wook; Choi, Jin Young; Kang, Jina; Kim, Dae Kyun; Kim, Hyesuk; Lee, Eunil; Hwang, Kwan Ok; Oh, Bumjo; Cho, BeLong

    2013-12-01

    We aimed to assess whether awareness of a terminal illness can affect care decision making processes and the achievement of a good death in advanced cancer patients receiving palliative care services. Awareness of terminal illness at the time of palliative care service admission was assessed by the health care professionals during the routine initial comprehensive assessment process and was recorded in the national terminal cancer patient registry. A follow-up nationwide bereavement survey was conducted, which contained questions regarding decision making processes and the Korean version of the Good Death Inventory. Among the 345 patients included in the final analysis, the majority (68.4%) of the patients were aware of the terminal illness. Awareness of the terminal illness tended to reduce discordances in care decision making (adjusted odds ratio = 0.55; 95% CI: 0.29-1.07), and increased the patients' own decision making when there were discordances between patients and their families (adjusted odds ratio = 3.79; 95% CI: 1.31-10.94). The Good Death Inventory score was significantly higher among patients who were aware of their terminal illnesses compared with those who were not (5.04 vs. 4.80; p = 0.013) and especially in the domains of 'control over the future' (5.18 vs. 4.04; p Awareness of the terminal illness had beneficial effect on the harmonious decision making, patient autonomy, and patient's quality of death. Disclosure of terminal illness should be encouraged. Copyright © 2013 John Wiley & Sons, Ltd.

  3. A Japanese nationwide survey on the FDG-PET scans for dementia. Analysis on the predicted costs and benefits of FDG-PET for early diagnosis of Alzheimer

    International Nuclear Information System (INIS)

    Senda, Michio; Ouchi, Yasuomi; Ishii, Kazunari

    2003-01-01

    A nation-wide survey was carried out on the FDG-PET scans for the diagnosis of dementia by the FDG-PET Working Group organized by both the Japan Radioisotope Association and the Japanese Society of Nuclear Medicine. A total of 406 case reports were presented by 15 PET centers for one year. The purpose of the PET scans included early diagnosis of Alzheimer-type Dementia (154 cases, group A) and differential diagnosis of degenerative dementia (144 cases, group B), which was achieved by the PET scan in most cases. The PET scan turned out to allow omitting cerebral blood flow (CBF)-SPECT scans. Since donepezil treatment of the Alzheimer patients prevents the progress of the disease and reduces the care cost, an economic evaluation was performed on the two-year projected cost and benefit of FDG-PET. The reduction of the total cost by incorporating PET into the protocol was predicted to be 61500 yen (group A) and 13700 yen (group B) per person. The increase of the quality adjusted life year (QALY) was predicted to be 0.0442 (group A) and 0.0137 (group B). Therefore, incorporation of PET into the clinical pass was shown to be an economically dominant. As the number of potential subjects for early diagnosis of dementia is estimated to be 9000 across the country every year, PET is expected to increase their quality of life equivalent to 398 intact persons per year while reducing the cost of health care by 554 million yen. (author)

  4. Contribution of foods consumed away from home to energy intake in Brazilian urban areas: the 2008-9 Nationwide Dietary Survey.

    Science.gov (United States)

    Bezerra, Ilana Nogueira; de Moura Souza, Amanda; Pereira, Rosangela Alves; Sichieri, Rosely

    2013-04-14

    The objectives of the present study were to estimate the dietary contribution of away-from-home food consumption, to describe the contribution of away-from-home foods to energy intake, and to investigate the association between eating away from home and total energy intake in Brazilian urban areas. In the first Brazilian Nationwide Dietary Survey, conducted in 2008-9, food records were collected from 25 753 individuals aged 10 years or older, living in urban areas of Brazil. Foods were grouped into thirty-three food groups, and the mean energy intake provided by away-from-home food consumption was estimated. Linear regression models were used to evaluate the association between away-from-home food consumption and total energy intake. All analyses considered the sample design effect. Of the total population, 43 % consumed at least one food item away from home. The mean energy intake from foods consumed away from home was 1408 kJ (337 kcal), averaging 18 % of total energy intake. Eating away from home was associated with increased total energy intake, except for men in the highest income level. The highest percentage of away-from-home energy sources was for food with a high content of energy, such as alcoholic beverages (59 %), baked and deep-fried snacks (54 %), pizza (42 %), soft drinks (40 %), sandwiches (40 %), and sweets and desserts (30 %). The consumption of foods away from home was related to a greater energy intake. The characterisation of away-from-home food habits is necessary in order to properly design strategies to promote healthy food consumption in the away-from-home environment.

  5. Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: Results of a cross-sectional, nationwide survey

    Directory of Open Access Journals (Sweden)

    Freiberg Florentina

    2010-02-01

    Full Text Available Abstract Background Myofascial pain is a common dysfunction with a lifetime prevalence affecting up to 85% of the general population. Current guidelines for the management of myofascial pain are not available. In this study we investigated how physicians on the basis of prescription behaviour evaluate the effectiveness of treatment options in their management of myofascial pain. Methods We conducted a cross-sectional, nationwide survey with a standardized questionnaire among 332 physicians (79.8% male, 25.6% female, 47.5 ± 9.6 years experienced in treating patients with myofascial pain. Recruitment of physicians took place at three German meetings of pain therapists, rheumatologists and orthopaedists, respectively. Physicians estimated the prevalence of myofascial pain amongst patients in their practices, stated what treatments they used routinely and then rated the perceived treatment effectiveness on a six-point scale (with 1 being excellent. Data are expressed as mean ± standard deviation. Results The estimated overall prevalence of active myofascial trigger points is 46.1 ± 27.4%. Frequently prescribed treatments are analgesics, mainly metamizol/paracetamol (91.6%, non-steroidal anti-inflammatory drugs/coxibs (87.0% or weak opioids (81.8%, and physical therapies, mainly manual therapy (81.1%, TENS (72.9% or acupuncture (60.2%. Overall effectiveness ratings for analgesics (2.9 ± 0.7 and physical therapies were moderate (2.5 ± 0.8. Effectiveness ratings of the various treatment options between specialities were widely variant. 54.3% of all physicians characterized the available treatment options as insufficient. Conclusions Myofascial pain was estimated a prevalent condition. Despite a variety of commonly prescribed treatments, the moderate effectiveness ratings and the frequent characterizations of the available treatments as insufficient suggest an urgent need for clinical research to establish evidence-based guidelines for the

  6. Who was concerned about radiation, food safety, and natural disasters after the great East Japan earthquake and Fukushima catastrophe? A nationwide cross-sectional survey in 2012.

    Science.gov (United States)

    Sugimoto, Takashi; Shinozaki, Tomohiro; Naruse, Takashi; Miyamoto, Yuki

    2014-01-01

    Disaster-related concerns by sub-populations have not been clarified after the great East Japan earthquake and the Fukushima nuclear power plant incidents. This paper assesses who was concerned about radiation, food safety, and natural disasters among the general population in order to buffer such concerns effectively. The hypothesis that women, parents, and family caregivers were most concerned about radiation, food safety, and natural disaster was tested using a varying-intercept multivariable logistic regression with 5809 responses from a nationwide cross-sectional survey random-sampled in March 2012. Many people were at least occasionally concerned about radiation (53.5%), food safety (47.3%), and about natural disaster (69.5%). Women were more concerned than men about radiation (OR = 1.67; 95% CI = 1.35-2.06), food safety (1.70; 1.38-2.10), and natural disasters (1.74; 1.39-2.19). Parents and family care needs were not significant. Married couples were more concerned about radiation (1.53; 1.33-1.77), food safety (1.38; 1.20-1.59), and natural disasters (1.30; 1.12-1.52). Age, child-cohabitation, college-completion, retirement status, homemaker status, and the house-damage certificate of the last disaster were also associated with at least one concern. Participants from the Kanto region were more concerned about radiation (2.08; 1.58-2.74) and food safety (1.30; 1.07-1.59), which demonstrate similar positive associations to participants from Tohoku where a disaster relief act was invoked (3.36; 2.25-5.01 about radiation, 1.49; 1.08-2.06 about food safety). Sectioning the populations by gender and other demographics will clarify prospective targets for interventions, allow for a better understanding of post-disaster concerns, and help communicate relevant information effectively.

  7. Occupational health physicians have better work conditions for handling sickness certification compared with general practitioners: results from a nationwide survey in Sweden.

    Science.gov (United States)

    Ljungquist, Therese; Alexanderson, Kristina; Kjeldgård, Linnea; Arrelöv, Britt; Nilsson, Gunnar H

    2015-02-01

    To study whether occupational health physicians (OPs) have a better work situation regarding handling of sickness certification compared with other physicians, in particular general practitioners (GPs), and to analyze associations between OPs' experiences of assessing and providing a long-term prognosis of patients' work capacity and some potentially interrelated factors. Answers to a nationwide survey from physicians who had sickness certification consultations at least once monthly were analyzed. Differences among OPs (n=481), GPs (n=4257) and physicians working in other clinical settings (n=9452) were estimated by chi square tests. Associations between OPs' experiences as above and potentially interrelated factors were estimated using logistic regression analyses. Among OPs, a lower proportion experienced clinical work situations related to sickness certifications as 'very problematic', compared with the other physicians, and especially so compared with GPs. A higher proportion of OPs also had organizational support for handling sickness certifications. For OPs, experience of sickness certification consultations as problematic once a month or less often, not experiencing sickness certification tasks as a work environment problem, and having a well-established workplace policy regarding sickness certification matters were significantly positively associated with finding assessing and providing a long-term prognosis of work capacity as 'not at all/somewhat problematic'. OPs' work situation regarding sickness certifications was favorable compared with that of other physicians, and especially compared with that of GPS. Our results underline the importance of organizational support for ensuring physicians' experience of having professional competence in handling assessments of patients' work capacity. © 2014 the Nordic Societies of Public Health.

  8. Severe hypoglycemia and diabetic ketoacidosis in young persons with preschool onset of type 1 diabetes mellitus: An analysis of three nationwide population-based surveys.

    Science.gov (United States)

    Lindner, Lena M E; Gontscharuk, Veronika; Bächle, Christina; Castillo, Katty; Stahl-Pehe, Anna; Tönnies, Thaddäus; Yossa, Rhuphine; Holl, Reinhard W; Rosenbauer, Joachim

    2018-06-01

    To describe incidence rates and temporal trends of severe hypoglycemia (SH) and of hospitalizations for SH or diabetic ketoacidosis (DKA) in persons with early-onset, long-term type 1 diabetes (T1D) and associations of these short-term complications with potential risk factors. This study includes data of 1,875 persons 11.2 to 21.9 years of age with early-onset (10 years) T1D from 3 cross-sectional nationwide, population-based surveys conducted in 2009/2010, 2012/2013 and 2015/2016 using standardized questionnaires. Negative binomial regression was used to estimate incidence rates per 100 person-years (py), temporal trends and associations between potential risk factors and outcomes. The crude incidence rate of SH showed a decreasing trend over time (P for trend = .004), disappearing after adjustment for confounders (P for trend = .341). In contrast, adjusted rates of SH- and DKA-associated hospitalizations did not change significantly between 2009 and 2016 (P for trend = .306 and .774, respectively). Associations between sex, diabetes duration, insulin treatment regimen, hypoglycemia awareness as well as physical activity and SH were found, while family structure was associated with hospitalizations for SH. Family structure, socioeconomic status (SES), diabetes duration, and hemoglobin A1c values showed associations with DKA-related hospitalizations. After adjustment, rates of SH and SH- or DKA-associated hospitalization showed no significant changes in recent years. Structured education programs focusing on high-risk groups as, for example, persons with T1D living with 1 biological parent and the parents' partner or those with a low SES, should be implemented to reduce incidence rates of hospitalizations. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Factors related to intention to stay in the current workplace among long-term care nurses: A nationwide survey.

    Science.gov (United States)

    Eltaybani, Sameh; Noguchi-Watanabe, Maiko; Igarashi, Ayumi; Saito, Yumiko; Yamamoto-Mitani, Noriko

    2018-04-01

    Keeping long-term care nurses employed is necessary to sustain the current and future demand for high-quality long-term care services. Understanding the factors relating to intention to stay among long-term care nurses is limited by the scarcity of studies in long-term care settings, lack of investigation of multiple factors, and the weakness of existing explanatory models. To identify the factors associated with long-term care nurses' intention to stay in their current workplace. A cross-sectional questionnaire survey. Two hundred and fifty-seven hospitals with long-term care wards across Japan. A total of 3128 staff nurses and 257 nurse managers from the long-term care wards of the participating hospitals. The questionnaire assessed nurses' intention to continue working in the current workplace as well as potential related factors, including individual factors (demographic data, reason for choosing current workplace, burnout, work engagement, somatic symptom burden) and unit factors (unit size, nurse-manager-related data, patients' medical acuity, average number of overtime hours, recreational activities, social support, perceived quality of care process, educational opportunities, feeling of loneliness, and ability to request days off). Multilevel logistic regression analysis was used to determine which variables best explained nurses' intention to stay in their workplace. Only 40.1% of the respondents reported wanting to continue working at their current workplace. The regression analysis revealed that long-term care nurses' intention to stay was positively associated with nurses' age (odds ratio [95% confidence interval]: 1.02 [1.01-1.03]), work engagement (1.24 [1.14-1.35]), getting appropriate support from nurse managers (2.78 [1.60-4.82]), perceived quality of care process (1.04 [1.01-1.06]), educational opportunities (1.06 [1.0-1.13]), and various specific reasons for choosing their workplace (e.g., a good workplace atmosphere, being interested in

  10. Conflict-of-interest disclosure at medical journals in Japan: a nationwide survey of the practices of journal secretariats.

    Science.gov (United States)

    Kojima, Takako; Green, Joseph; Barron, J Patrick

    2015-08-26

    Medical journals in Japan generally have appropriate policies regarding disclosure of conflicts of interest (COI). However, COI management depends on the staff members of each journal's editorial secretariat. This study's objectives were to find out (A) whether COI disclosure and the journal's role in it are clearly understood by the journal's secretariat staff, (B) how much experience the editorial secretariat has in actually handling issues related to disclosure and (C) what kind of help or support they need. In January 2014, questionnaires were sent to the editorial secretariats of journal-publishing societies belonging to the Japanese Association of Medical Sciences (JAMS). The response rate was 100%, and the respondents represented 121 journals published by the 118 JAMS member societies (at the time of the survey). Information was collected on the history of COI policies and on how those policies were implemented. At the end of the questionnaire, there was an open-ended call for comments. Compulsory COI disclosure began between 2010 and 2013 for 60.3% of the journals (73/121). Handling of COI issues was not uniform: 17.4% (21/121) of respondents do not pursue cases of dubious disclosure, and 47.9% (58/121) do not require COI disclosures from editorial board members. Very few of the editorial secretariats had clearly-stated consequences for violations of COI-disclosure policy (33/121, 27.3%), and only 28.9% offered COI education (35/121). Respondents' comments indicated that uniform, easily-searchable guidance regarding COI policies and implementation would be welcome. Although commitment is widespread, policy implementation is inconsistent and COI experience is lacking. Clear, easy-to-use guidelines are desired by many societies. The JAMS is to be commended for supporting this country-wide investigation; other countries and regions are encouraged to perform similar investigations to respond to needs regarding COI management. Published by the BMJ Publishing

  11. Substance use and sexual behaviours of Japanese men who have sex with men: A nationwide internet survey conducted in Japan

    Directory of Open Access Journals (Sweden)

    Kimura Hirokazu

    2006-09-01

    Full Text Available Abstract Background Japanese men who have sex with men (MSM, especially those living in large metropolitan areas such as Tokyo and Osaka, are facing a growing HIV/AIDS epidemic. Although the Internet is used as a new venue for meeting sex partners, it can also serve as a useful research tool for investigating the risk behaviours of Japanese MSM. This Internet survey explored the extent of substance use and its association with sexual risk behaviours among Japanese MSM. Methods Between 28 February 2003 and 16 May 2003 MSM were recruited through 57 Japanese gay-oriented Web sites, gay magazines, and Internet mailing lists. Participants completed a structured questionnaire anonymously through the Internet. Results In total, 2,062 Japanese MSM completed the questionnaire. The average age of participants was 29.0 years and 70.5% identified as gay, 20.8% as bisexual, and 8.7% as other. Overall, 34.5% reported never using a substance, 45% reported ever using one type of substance (lifetime reported single substance users, and 19.6% had used more than 1 type of substance (lifetime reported multiple substance users in their lifetimes. The substances most commonly used were amyl nitrite (63.2%, 5-methoxy-N, N-diisopropyltryptamine (5MEO-DIPT (9.3%, and marijuana (5.7%. In the multivariate analysis, unprotected anal intercourse, having had 6 or more sexual partners, visiting a sex club/gay venue in the previous 6 months, a lower education level, and being 30 to 39 years of age were associated with both lifetime single and lifetime multiple substance use. Lifetime reported multiple substance use was also correlated with having a casual sex partner, having symptoms of depression, being diagnosed as HIV-positive, and greater HIV/AIDS-related knowledge. Conclusion This is the first Internet-based research focused on the sexual and substance use behaviours of MSM in Asia. Our findings suggest a compelling need for prevention interventions to reduce HIV risk

  12. Marriage and divorce among childhood cancer survivors.

    Science.gov (United States)

    Koch, Susanne Vinkel; Kejs, Anne Mette Tranberg; Engholm, Gerda; Møller, Henrik; Johansen, Christoffer; Schmiegelow, Kjeld

    2011-10-01

    Many childhood cancer survivors have psychosocial late effects. We studied the risks for cohabitation and subsequent separation. Through the Danish Cancer Register, we identified a nationwide, population-based cohort of all 1877 childhood cancer survivors born from 1965 to 1980, and in whom cancer was diagnosed between 1965 and 1996 before they were 20 years of age. A sex-matched and age-matched population-based control cohort was used for comparison (n=45,449). Demographic and socioeconomic data were obtained from national registers and explored by discrete-time Cox regression analyses. Childhood cancer survivors had a reduced rate of cohabitation [rate ratio (RR) 0.78; 95% confidence interval (CI): 0.73-0.83], owing to lower rates among survivors of both noncentral nervous system (CNS) tumors (RR 0.88; 95% CI: 0.83-0.95) and CNS tumors (RR 0.52; 95% CI: 0.45-0.59). Male CNS tumor survivors had a nonsignificantly lower rate (RR 0.47; 95% CI: 0.38-0.58) than females (RR 0.56; 95% CI: 0.47-0.68). The rates of separation were almost identical to those of controls. In conclusion, the rate of cohabitation was lower for all childhood cancer survivors than for the population-based controls, with the most pronounced reduction among survivors of CNS tumors. Mental deficits after cranial irradiation are likely to be the major risk factor.

  13. Do Perceived Needs Affect Willingness to Use Traditional Chinese Medicine for Survivorship Care Among Chinese Cancer Survivors? A Cross-Sectional Survey.

    Science.gov (United States)

    Sun, Lingyun; Yang, Yufei; Vertosick, Emily; Jo, SungHwa; Sun, Guilan; Mao, Jun J

    2017-12-01

    Purpose We aimed to quantify Chinese cancer survivors' perceived needs for survivorship care and to evaluate whether these needs could impact their willingness to use traditional Chinese medicine (TCM). Methods We conducted a cross-sectional survey with members of the Beijing Anti-Cancer Association in China. We measured perceived needs with the seven-item Brief Chinese Cancer Survivorship Needs Scale that assesses psychological, functional, nutritional, social, body image, pain, and symptom needs. The outcome variable was willingness to use TCM for survivorship care. We performed multivariable logistic regression analyses to evaluate whether perceived needs are associated with willingness. Results A total of 600 patients were invited, with a response rate of 81%. The mean (standard deviation) score of the perceived needs scale (0 to 10) was 4.4 (2.2), with the majority of participants endorsing nutritional (72%), symptom (65%), and psychological (54%) needs. Among survivors, 387 (80%; 95% CI, 76% to 83%) were willing to use TCM for survivorship care. In multivariable analysis, a higher perceived needs score (adjusted odds ratio [OR], 1.33; 95% CI, 1.14 to 1.56; P < .001) was associated with greater willingness to use TCM. Specifically, nutritional (OR, 3.17; 95% CI, 1.79 to 5.62; P < .001) and symptom needs (OR, 3.15; 95% CI, 1.79 to 5.55; P < .001) had the strongest relationship. Conclusion A higher level of perceived needs, especially in the areas of nutrition and symptoms, was associated with greater willingness to use TCM for survivorship care.

  14. Clinical and Genetic Characteristics of Non-Insulin-Requiring Glutamic Acid Decarboxylase (GAD Autoantibody-Positive Diabetes: A Nationwide Survey in Japan.

    Directory of Open Access Journals (Sweden)

    Junichi Yasui

    Full Text Available Glutamic acid decarboxylase autoantibodies (GADAb differentiate slowly progressive insulin-dependent (type 1 diabetes mellitus (SPIDDM from phenotypic type 2 diabetes, but many GADAb-positive patients with diabetes do not progress to insulin-requiring diabetes. To characterize GADAb-positive patients with adult-onset diabetes who do not require insulin therapy for >5 years (NIR-SPIDDM, we conducted a nationwide cross-sectional survey in Japan.We collected 82 GADAb-positive patients who did not require insulin therapy for >5 years (NIR-SPIDDM and compared them with 63 patients with insulin-requiring SPIDDM (IR-SPIDDM. Clinical and biochemical characteristics, HLA-DRB1-DQB1 haplotypes, and predictive markers for progression to insulin therapy were investigated.Compared with the IR-SPIDDM group, the NIR-SPIDDM patients showed later diabetes onset, higher body mass index, longer duration before diagnosis, and less frequent hyperglycemic symptoms at onset. In addition, C-peptide, LDL-cholesterol, and TG were significantly higher in the NIR-SPIDDM compared to IR-SPIDDM patients. The NIR-SPIDDM group had lower frequency of susceptible HLA-DRB1*04:05-DQB1*04:01 and a higher frequency of resistant HLA-DRB1*15:01-DQB1*06:02 haplotype compared to IR-SPIDDM. A multivariable analysis showed that age at diabetes onset (OR = 0.82, duration before diagnosis of GADAb-positive diabetes (OR = 0.82, higher GADAb level (≥10.0 U/ml (OR = 20.41, and fasting C-peptide at diagnosis (OR = 0.07 were independent predictive markers for progression to insulin-requiring diabetes. An ROC curve analysis showed that the optimal cut-off points for discriminating two groups was the GADAb level of 13.6 U/ml, age of diabetes onset of 47 years, duration before diagnosis of 5 years, and fasting C-peptide of 0.65 ng/ml.Clinical, biochemical and genetic characteristics of patients with NIR-SPIDDM are different from those of IR-SPIDDM patients. Age of diabetes onset, duration before

  15. [Correlation between childhood traumatic stress and present drug abuse: results of a nationwide survey of drug addiction rehabilitation facilities in Japan].

    Science.gov (United States)

    Umeno, Mitsuru; Morita, Nobuaki; Ikeda, Tomohiro; Koda, Minoru; Abe, Yukie; Endo, Keiko; Yabe, Yohko; Hirai, Hideyuki; Takahashi, Koji; Aikawa, Yuzo; Senoo, Eiichi; Nakatani, Yoji

    2009-12-01

    Child abuse is known to correlate with drug abuse and interferes with recovery from substance-related disorders. To determine the prevalence and severity of child abuse among drug addicts, we conducted a nationwide cross-sectional survey of residents and outpatients at drug addiction rehabilitation centers (DARC) in Japan. A total of 445 participants gave informed consent and completed a self-reporting questionnaire. Sixty-eight percent of participants had experienced some kind of child abuse by the time they reached junior high school. The kinds of abuse experienced were physical (53.7%), psychological (60.4%), sexual (5.4%) abuse and neglect (24.5%). Comparison of female and male participants revealed that more female than male participants had experienced psychological (76.9% vs. 58.2%) and sexual (17.5% vs. 4.0%) abuse. Comparison of participants who had experienced some kind of child abuse ("Abused" group 68.3%) and those who had not experienced abuse ("Non-abused" group 24.3%) revealed that the "Abused" group was younger than the "Non-abused" group (35.7 SD9.0 vs. 39.7 SD10.8). Participants in the "Abused" group were found to have more severe psychological difficulties than those in the "Non-abused" group for the following: anxiety (73.0% vs. 61.1%), delusional atmosphere (48.0% vs. 28.7%), lack of energy (53.9% vs. 40.7%), ideas of persecution (48.7% vs. 29.6%), depression (62.2% vs. 43.5%) and suicidal ideation in the previous year (50.7% vs. 24.3%). The present results suggest that additional program that prepared to care the drug addicts who experienced child abuse and are experiencing suicidal ideation is needed. Furthermore, intervention for families with risk factors for child abuse should be developed in order to prevent the victim from suffering not only from post traumatic stress disorder but also from substance related disorders.

  16. Who was concerned about radiation, food safety, and natural disasters after the great East Japan earthquake and Fukushima catastrophe? A nationwide cross-sectional survey in 2012.

    Directory of Open Access Journals (Sweden)

    Takashi Sugimoto

    Full Text Available BACKGROUND: Disaster-related concerns by sub-populations have not been clarified after the great East Japan earthquake and the Fukushima nuclear power plant incidents. This paper assesses who was concerned about radiation, food safety, and natural disasters among the general population in order to buffer such concerns effectively. METHODS: The hypothesis that women, parents, and family caregivers were most concerned about radiation, food safety, and natural disaster was tested using a varying-intercept multivariable logistic regression with 5809 responses from a nationwide cross-sectional survey random-sampled in March 2012. RESULTS: Many people were at least occasionally concerned about radiation (53.5%, food safety (47.3%, and about natural disaster (69.5%. Women were more concerned than men about radiation (OR = 1.67; 95% CI = 1.35-2.06, food safety (1.70; 1.38-2.10, and natural disasters (1.74; 1.39-2.19. Parents and family care needs were not significant. Married couples were more concerned about radiation (1.53; 1.33-1.77, food safety (1.38; 1.20-1.59, and natural disasters (1.30; 1.12-1.52. Age, child-cohabitation, college-completion, retirement status, homemaker status, and the house-damage certificate of the last disaster were also associated with at least one concern. Participants from the Kanto region were more concerned about radiation (2.08; 1.58-2.74 and food safety (1.30; 1.07-1.59, which demonstrate similar positive associations to participants from Tohoku where a disaster relief act was invoked (3.36; 2.25-5.01 about radiation, 1.49; 1.08-2.06 about food safety. CONCLUSIONS: Sectioning the populations by gender and other demographics will clarify prospective targets for interventions, allow for a better understanding of post-disaster concerns, and help communicate relevant information effectively.

  17. Nursing staff and euthanasia in the Netherlands. A nation-wide survey on attitudes and involvement in decision making and the performance of euthanasia.

    NARCIS (Netherlands)

    Francke, A.L.; Albers, G.; Bilsen, J.; Veer, A.J.E. de; Onwuteaka-Philipsen, B.D.

    2016-01-01

    Objectives: To give insight into Dutch nursing staff’s attitudes and involvement regarding euthanasia. Methods: The sample was recruited from a nation-wide existent research panel of registered nurses and certified nursing assistants. Descriptive analyses and multivariate logistic regression

  18. Age at diagnosis of inflammatory bowel disease influences early development of colorectal cancer in inflammatory bowel disease patients: A nationwide, long-term survey

    NARCIS (Netherlands)

    J.E. Baars (Judith); E.J. Kuipers (Ernst); M. van Haastert (M.); J.J. Nicolai (Jan); A.C. Poen (Alexander); C.J. van der Woude (Janneke)

    2012-01-01

    textabstractBackground: Data on clinical characteristics of patients with inflammatory bowel disease (IBD)-related colorectal cancer (CRC) are scarce and mainly originate from tertiary referral centres. We studied patient and disease characteristics of IBD-related CRC in a nationwide IBD cohort in

  19. Changes from 1992 to 2002 in the pretreatment delay for patients with squamous cell carcinoma of larynx or pharynx: a Danish nationwide survey from DAHANCA

    DEFF Research Database (Denmark)

    Primdahl, Hanne; Nielsen, Anni Linnet; Larsen, Susanne

    2006-01-01

    In Denmark, a general impression of prolonged pretreatment delay for patients with head and neck cancer led to a nationwide study of time spans from symptom debut over first health care contact to start of treatment. Charts of consecutive new patients with squamous cell carcinoma of the pharynx a...

  20. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination, (4)

    Energy Technology Data Exchange (ETDEWEB)

    Taketomi, Y; Abe, T; Kamada, N; Kuramoto, A; Takahashi, H [Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology

    1978-09-01

    Status of leukopenia in a-bomb survivors was studied on 202 cases in which leukopenia (white cell count of below 3900) was recognized during successive 3 years in the periodical health examination of the fiscal years from 1973 to 1975. A white cell count of below 3900 was recogenized in about 4% of the total subjects of the year, and the half overlapped in other years. Incidence of leukopenia was higher in the aged, and there was not a marked difference according to the distance from the explosion center. As to a relationship to anemia, hemoglobin amount of below 11.5 g/dl was recognized in 98 of 202 cases, and aplastic anemia was recognized in 3 cases under medical treatment. Concerning a relationship to other disease, chronic liver dysfunction was recognized in 33 of 202 cases, and anemia, in 14 cases. As to classification of leukocyte, abnormality (neutrocytopenia, lymphocytosis) was not recognized in 70 of 202 cases. About a relationship to anemia and liver dysfunction in cases of lymphocytic abnormality, the incidence of lymphocytic abnormality was higher in cases of liver dysfunction (23 of 33 cases of chronic liver dysfunction, 69.7%), and there was not difference between cases of anemia alone and cases without anemia and liver dysfunction (54 of 84 cases, 64.3%). The incidence of lymphocytic abnormality was higher in cases of liver dysfunction and cases without anemia.

  1. [A Survey of the Factors of Influence and Interventional Strategies for Breast Cancer Survivors' Transition Care Across Multiple Theoretical Perspectives].

    Science.gov (United States)

    Chao, Yu-Huan; Lee, Tzu-I; Sheu, Shuh-Jen

    2018-02-01

    Breast cancer significantly threatens the life of women, while the adverse effects of cancer treatment degrade quality of life and psychological well-being. The quality of transitional care following the completion of treatment significantly affects the ability of breast cancer patients to transition successfully into survivorship. This paper introduces multiple theoretical perspectives and provides an overview of the tenets of each in order to identify the positions of breast cancer survivors and to highlight the factors and strategies that influence their transitional care. The theoretical perspectives that are introduced include the social-ecological model, transition theory, and the strengths perspective. In order to improve the holistic care of women with breast cancer, factors relevant to transition are categorized into the individual, interpersonal, organizational, community, and policy levels. Furthermore, empirical interventions, which are based on the respective advantages of the various levels of the social-ecological model, are proposed in order to conform to the sociocultural context and clinical practices. Healthcare providers should leverage the strengths and resources at each level to develop feasible strategies and to provide quality of care in order to assist breast cancer patients to transition successfully from treatment to survivorship and to holistically improve their subsequent quality of life and function.

  2. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination, (4)

    International Nuclear Information System (INIS)

    Taketomi, Yoshinori; Abe, Tsutomu; Kamada, Nanao; Kuramoto, Atsushi; Takahashi, Hiroshi

    1978-01-01

    Status of leukopenia in a-bomb survivors was studied on 202 cases in which leukopenia (white cell count of below 3900) was recognized during successive 3 years in the periodical health examination of the fiscal years from 1973 to 1975. A white cell count of below 3900 was recogenized in about 4% of the total subjects of the year, and the half overlapped in other years. Incidence of leukopenia was higher in the aged, and there was not a marked difference according to the distance from the explosion center. As to a relationship to anemia, hemoglobin amount of below 11.5 g/dl was recognized in 98 of 202 cases, and aplastic anemia was recognized in 3 cases under medical treatment. Concerning a relationship to other disease, chronic liver dysfunction was recognized in 33 of 202 cases, and anemia, in 14 cases. As to classification of leukocyte, abnormality (neutrocytopenia, lymphocytosis) was not recognized in 70 of 202 cases. About a relationship to anemia and liver dysfunction in cases of lymphocytic abnormality, the incidence of lymphocytic abnormality was higher in cases of liver dysfunction (23 of 33 cases of chronic liver dysfunction, 69.7%), and there was not difference between cases of anemia alone and cases without anemia and liver dysfunction (54 of 84 cases, 64.3%). The incidence of lymphocytic abnormality was higher in cases of liver dysfunction and cases without anemia. (Tsunoda, M.)

  3. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination, 2

    International Nuclear Information System (INIS)

    Taketomi, Yoshinori; Kamada, Nanao; Takahashi, Hiroshi; Ohkita, Takeshi; Ito, Chikako.

    1976-01-01

    An actual condition of anemia in A-bomb survivors was discussed from the periodical health examination of the fiscal years 1972 and 1973. Under 11.5 g/dl of hemoglobin was determined as anemia. An actual number of cases with anemia in both fiscal years was nearly the same, but ratio of anemia to the total number of recipient of periodical health examination increased 1.9% in the fiscal year 1973. 35.3% of the subjects with anemia in both fiscal years was the same persons. In the following examination of 478 subjects with under 10.0 g/dl of hemoglobin, in the fiscal year 1972, 96 subjects (20.1%) still showed under 10.0 g/dl of hemoglobin in the fiscal year 1975. Characteristics of anemia were that hypochromic anemia was comparatively frequent in the young, and normochromic anemia was frequent in the aged. In the former, marked decrease of value of iron in serum was recognized, and in the latter, fall of hematopoiesis by old age and secondary anemia were recognized. Marked relationship between exposure distance and anemia in each group was not recognized. 17.9% of cases with moderate anemia showed positive in stool guaiac test and 8.9% and past history of duodenal or peptic ulcer. (Kanao, N.)

  4. SLJ's Spending Survey: As the Economy Limps along and Federal Dollars Dwindle, School Librarians Are Turning into Resourceful Survivors

    Science.gov (United States)

    Farmer, Lesley

    2011-01-01

    This article presents the results of the latest "SLJ" survey of school expenditures and collections for 2009-2010. The survey reveals that librarians have used a variety of coping techniques to weather this economic storm, whether it is servicing more than one school, using additional volunteers, taking on more tasks, or seeking outside funding.…

  5. Self-reported competence in long term care provision for adult cancer survivors: A cross sectional survey of nursing and allied health care professionals.

    Science.gov (United States)

    Faithfull, S; Samuel, Carol; Lemanska, Agnieszka; Warnock, Clare; Greenfield, Diana

    2016-01-01

    Cancer survival is increasing as patients live longer with a cancer diagnosis. This success has implications for health service provision in that increasing numbers of adults who have received cancer therapy are requiring monitoring and long-term health care by a wide range of practitioners. Given these recent trends there is a need to explore staff perceptions and confidence in managing the consequences of cancer diagnosis and treatment in cancer survivors to enhance an integrated cancer service delivery. This study examines the self-reported perceptions of competence in nurses and professionals allied to medicine providing survivorship services caring for adults after cancer treatment in both secondary and primary care. A cross sectional survey of the adult cancer workforce using a self-assessment tool for assessing confidence in providing long-term cancer patient management. This study was a health service evaluation. The study was conducted within the United Kingdom. Respondents were 618 health care professionals of these 368 were specialist adult cancer nurses in oncology and the community setting and 250 cancer allied health professionals. The survey tool was developed with experts in cancer management, nurses professionals allied to medicine such as physiotherapists and dieticians, educationalists, patient groups as well as health service managers. Competence was assessed in 4 domains clinical practice, symptom management, care co-ordination and proactive management. Perceptions of training needs were also ascertained. Data were collected using an Internet survey distributed through cancer services, community settings and professional institutions. In total 618 practitioners who responded were providing services for adults' 1-year post cancer therapy. Practitioners felt confident in managing psychosocial care and communicating with patients. Deficits in self-reported confidence were found in long-term medications management, care planning, long-term and

  6. Marriage and divorce among childhood cancer survivors

    DEFF Research Database (Denmark)

    Koch, Susanne Vinkel; Kejs, Anne Mette Tranberg; Engholm, Gerda

    2011-01-01

    was diagnosed between 1965 and 1996 before they were 20 years of age. A sex-matched and age-matched population-based control cohort was used for comparison (n=45,449). Demographic and socioeconomic data were obtained from national registers and explored by discrete-time Cox regression analyses. Childhood cancer......Many childhood cancer survivors have psychosocial late effects. We studied the risks for cohabitation and subsequent separation. Through the Danish Cancer Register, we identified a nationwide, population-based cohort of all 1877 childhood cancer survivors born from 1965 to 1980, and in whom cancer...... a nonsignificantly lower rate (RR 0.47; 95% CI: 0.38-0.58) than females (RR 0.56; 95% CI: 0.47-0.68). The rates of separation were almost identical to those of controls. In conclusion, the rate of cohabitation was lower for all childhood cancer survivors than for the population-based controls, with the most...

  7. Prevalence and Mental Health Outcomes of Homicide Survivors in a Representative US Sample of Adolescents: Data from the 2005 National Survey of Adolescents

    Science.gov (United States)

    Rheingold, Alyssa A.; Zinzow, Heidi; Hawkins, Alesia; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2012-01-01

    Background: Each homicide leaves behind several friends and family members, or homicide survivors. However, limited information is available on the impact of homicide on adolescent survivors. The purpose of the current study was to identify the prevalence of homicide survivorship and to determine mental health outcomes within a sample of US…

  8. Effect of dialyzer membrane materials on survival in chronic hemodialysis patients: Results from the annual survey of the Japanese Nationwide Dialysis Registry

    OpenAIRE

    Abe, Masanori; Hamano, Takayuki; Wada, Atsushi; Nakai, Shigeru; Masakane, Ikuto

    2017-01-01

    Background Little information is available regarding which type of dialyzer membrane results in good prognosis in patients on chronic hemodialysis. Therefore, we conducted a cohort study from a nationwide registry of hemodialysis patients in Japan to establish the association between different dialyzer membranes and mortality rates. Methods We followed 142,412 patients on maintenance hemodialysis (female, 39.1%; mean age, 64.8 ? 12.3 years; median dialysis duration, 7 [4?12] years) for a year...

  9. Protocol for a nationwide survey of primary health care in China: the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) MPP (Million Persons Project) Primary Health Care Survey.

    Science.gov (United States)

    Su, Meng; Zhang, Qiuli; Lu, Jiapeng; Li, Xi; Tian, Na; Wang, Yun; Yip, Winnie; Cheng, Kar Keung; Mensah, George A; Horwitz, Ralph I; Mossialos, Elias; Krumholz, Harlan M; Jiang, Lixin

    2017-08-28

    China has pioneered advances in primary health care (PHC) and public health for a large and diverse population. To date, the current state of PHC in China has not been subjected to systematic assessments. Understanding variations in primary care services could generate opportunities for improving the structure and function of PHC. This paper describes a nationwide PHC study (PEACE MPP Primary Health Care Survey) conducted across 31 provinces in China. The study leverages an ongoing research project, the China Patient-centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project (MPP). It employs an observational design with document acquisition and abstraction and in-person interviews. The study will collect data and original documents on the structure and financing of PHC institutions and the adequacy of the essential medicines programme; the education, training and retention of the PHC workforce; the quality of care; and patient satisfaction with care. The study will provide a comprehensive assessment of current PHC services and help determine gaps in access and quality of care. All study instruments and documents will be deposited in the Document Bank as an open-access source for other researchers. The central ethics committee at the China National Centre for Cardiovascular Disease (NCCD) approved the study. Written informed consent has been obtained from all patients. Findings will be disseminated in future peer reviewed papers, and will inform strategies aimed at improving the PHC in China. NCT02953926. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. DBA Survivor

    CERN Document Server

    LaRock, Thomas

    2010-01-01

    DBA Survivor is a book to help new DBAs understand more about the world of database administration. More and more people are moving into the DBA profession, and many are looking for a getting-started guide. Blogs are written about how to be an exceptional DBA and what to do in your first 100 days. This book takes a different approach, injecting some humor into helping you understand how to hit the ground running, and most importantly how to survive as a DBA. And it's not just survival that matters. Author Thomas LaRock wants much more for you than mere survival. He wants you to have excellence

  11. Results from a Nationwide Cohort Temporary Utilization Authorization (ATU) Survey of Patients in France Treated with Pheburane® (Sodium Phenylbutyrate) Taste-Masked Granules

    OpenAIRE

    Kibleur, Yves; Dobbelaere, Dries; Barth, Magalie; Brassier, Anaïs; Guffon, Nathalie

    2014-01-01

    Objectives The aim of this study was to describe a nationwide system for pre-marketing follow-up (cohort temporary utilization authorization [ATU] protocol; i.e., ‘therapeutic utilization’) of a new taste-masked formulation of sodium phenylbutyrate (NaPB) granules (Pheburane®) in France and to analyze safety and efficacy in this treated cohort of patients with urea cycle disease (UCD). Methods In October 2012, a cohort ATU was established in France to monitor the use of Pheburane® on a named-...

  12. Changes from 1992 to 2002 in the pretreatment delay for patients with squamous cell carcinoma of larynx or pharynx: a Danish nationwide survey from DAHANCA

    DEFF Research Database (Denmark)

    Primdahl, Hanne; Nielsen, Anni Linnet; Larsen, Susanne

    2006-01-01

    In Denmark, a general impression of prolonged pretreatment delay for patients with head and neck cancer led to a nationwide study of time spans from symptom debut over first health care contact to start of treatment. Charts of consecutive new patients with squamous cell carcinoma of the pharynx...... and larynx, seen at the five Danish oncology centers in January-April 1992 and 2002, respectively, were reviewed. Of the 288 patients identified, definitive treatment was radiotherapy in 264 cases, surgery in one case. Twenty-three patients had neither surgery nor radiotherapy. Total time from first health...

  13. Leisure-time physical activity and circulating 25-hydroxyvitamin D levels in cancer survivors: a cross-sectional analysis using data from the US National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Yang, Lin; Toriola, Adetunji T

    2017-07-10

    Circulating 25-hydroxyvitamin D (25-OHD) is associated with improved cancer prognosis in some studies, yet it may be a surrogate marker for physical activity. We investigated the associations of leisure-time physical activity (LTPA) with circulating 25-OHD levels in cancer survivors, and determined whether associations differ by indoor and outdoor activity. Cross-sectional study. The US National Health and Nutrition Examination Survey (NHANES). Cancer survivors with available data on demographic information, measures of adiposity, smoking history, self-reported LTPA and circulating 25-OHD levels in five waves of NHANES (2001-2010). Circulating 25-OHD levels. Multivariable linear regression and logistic regression models were used to evaluate the associations of self-reported LTPA with 25-OHD, adjusting for potential confounders. Due to the differences in LTPA measure, the analyses were conducted separately for 2001-2006 and 2007-2010 data. We further estimated associations by indoor and outdoor activity in the 2001-2006 data. There were 1530 cancer survivors (mean age=60.5 years, mean body mass index=28.6 kg/m 2 ). The prevalent cancer sites were breast (19.3%), prostate (18.8%), cervix (10.4%) and colon (8.6%). Compared with inactive cancer survivors, being physically active was associated with higher circulating 25-OHD levels (8.07 nmol/L, 95% CI 4.63 to 11.52) for 2001-2006 data. In the mutually adjusted model, higher outdoor activity (5.83 nmol/L, 95% CI 1.64 to 10.01), but not indoor activity (2.93 nmol/L, 95% CI -1.80 to 7.66), was associated with statistically significantly higher 25-OHD levels. The interaction between indoor and outdoor activities was, however, not significant (p=0.29). The only statistically significant association seen in the 2007-2010 data was among obese cancer survivors. Physical activity, particularly outdoor activity, is associated with higher 25-OHD levels in cancer survivors. In view of the possible beneficial effects

  14. Psychological distress, optimism and general health in breast cancer survivors: a data linkage study using the Scottish Health Survey.

    Science.gov (United States)

    Leung, Janni; Atherton, Iain; Kyle, Richard G; Hubbard, Gill; McLaughlin, Deirdre

    2016-04-01

    The aim of this study is to examine the association between optimism and psychological distress in women with breast cancer after taking into account their self-rated general health. Data were aggregated from the Scottish Health Survey (2008 to 2011) to derive a nationally representative sample of 12,255 women (11,960 cancer-free controls, and 295 breast cancer cases identified from linked cancer registry data). The explanatory variables were optimism and general health, and the outcome variable was symptoms of psychological distress. Logistic regression analyses were conducted, with optimism entered in step 1 and general health entered in step 2. In an unadjusted model, higher levels of optimism were associated with lower odds of psychological distress in both the control group (OR = 0. 57, 95 % CI = 0.51-0.60) and breast cancer group (OR = 0. 64, 95 % CI = 0.47-0.88). However, in a model adjusting for general health, optimism was associated with lower odds of psychological distress only in the control group (OR = 0.50, 95 % CI = 0.44-0.57), but not significantly in the breast cancer group (OR = 1.15, 95 % CI = 0.32-4.11). In the breast cancer group, poor general health was a stronger associate of psychological distress (OR = 4. 98, 95 % CI = 1.32-18.75). Results were consistent after adjusting for age, years since breast cancer diagnosis, survey year, socioeconomic status, education, marital status, body mass index, smoking status, and alcohol consumption. This research confirms the value of multicomponent supportive care interventions for women with breast cancer. Specifically, it suggests that following breast cancer diagnosis, health care professionals need to provide advice and signpost to services that assist women to maintain or improve both their psychological and general health.

  15. Do Perceived Needs Affect Willingness to Use Traditional Chinese Medicine for Survivorship Care Among Chinese Cancer Survivors? A Cross-Sectional Survey

    Directory of Open Access Journals (Sweden)

    Lingyun Sun

    2017-12-01

    Full Text Available Purpose: We aimed to quantify Chinese cancer survivors’ perceived needs for survivorship care and to evaluate whether these needs could impact their willingness to use traditional Chinese medicine (TCM. Methods: We conducted a cross-sectional survey with members of the Beijing Anti-Cancer Association in China. We measured perceived needs with the seven-item Brief Chinese Cancer Survivorship Needs Scale that assesses psychological, functional, nutritional, social, body image, pain, and symptom needs. The outcome variable was willingness to use TCM for survivorship care. We performed multivariable logistic regression analyses to evaluate whether perceived needs are associated with willingness. Results: A total of 600 patients were invited, with a response rate of 81%. The mean (standard deviation score of the perceived needs scale (0 to 10 was 4.4 (2.2, with the majority of participants endorsing nutritional (72%, symptom (65%, and psychological (54% needs. Among survivors, 387 (80%; 95% CI, 76% to 83% were willing to use TCM for survivorship care. In multivariable analysis, a higher perceived needs score (adjusted odds ratio [OR], 1.33; 95% CI, 1.14 to 1.56; P < .001 was associated with greater willingness to use TCM. Specifically, nutritional (OR, 3.17; 95% CI, 1.79 to 5.62; P < .001 and symptom needs (OR, 3.15; 95% CI, 1.79 to 5.55; P < .001 had the strongest relationship. Conclusion: A higher level of perceived needs, especially in the areas of nutrition and symptoms, was associated with greater willingness to use TCM for survivorship care.

  16. Factors associated with adenoma detection rate and diagnosis of polyps and colorectal cancer during colonoscopy in France: results of a prospective, nationwide survey.

    Directory of Open Access Journals (Sweden)

    Maximilien Barret

    Full Text Available INTRODUCTION: Colonoscopy can prevent deaths due to colorectal cancer (CRC through early diagnosis or resection of colonic adenomas. We conducted a prospective, nationwide study on colonoscopy practice in France. METHODS: An online questionnaire was administered to 2,600 French gastroenterologists. Data from all consecutive colonoscopies performed during one week were collected. A statistical extrapolation of the results to a whole year was performed, and factors potentially associated with the adenoma detection rate (ADR or the diagnosis of polyps or cancer were assessed. RESULTS: A total of 342 gastroenterologists, representative of the overall population of French gastroenterologists, provided data on 3,266 colonoscopies, corresponding to 1,200,529 (95% CI: 1,125,936-1,275,122 procedures for the year 2011. The indication for colonoscopy was CRC screening and digestive symptoms in 49.6% and 38.9% of cases, respectively. Polypectomy was performed in 35.5% of cases. The ADR and prevalence of CRC were 17.7% and 2.9%, respectively. The main factors associated with a high ADR were male gender (p=0.0001, age over 50 (p=0.0001, personal or family history of CRC or colorectal polyps (p<0.0001 and p<0.0001, respectively, and positive fecal occult blood test (p=0.0005. The prevalence of CRC was three times higher in patients with their first colonoscopy (4.2% vs. 1.4%; p<0.0001. CONCLUSIONS: For the first time in France, we report nationwide prospective data on colonoscopy practice, including histological results. We found an average ADR of 17.7%, and observed reduced CRC incidence in patients with previous colonoscopy.

  17. Cancer survivor identity shared in a social media intervention.

    Science.gov (United States)

    Song, Hayeon; Nam, Yujung; Gould, Jessica; Sanders, W Scott; McLaughlin, Margaret; Fulk, Janet; Meeske, Kathleen A; Ruccione, Kathleen S

    2012-01-01

    This study investigates how cancer survivors construct their identities and the impact on their psychological health, as measured by depression and survivor self-efficacy. Fourteen young adult survivors of pediatric cancer participated in a customized social networking and video blog intervention program, the LIFECommunity, over a 6-month period. Survivors were asked to share their stories on various topics by posting video messages. Those video blog postings, along with survey data collected from participants, were analyzed to see how cancer survivors expressed their identities, and how these identities are associated with survivors' psychosocial outcomes. In survivors who held negative stereotypes about cancer survivors, there was a positive relationship with depression while positive stereotypes had a marginal association with cancer survivor efficacy. Findings indicate that although pediatric cancer survivors often do not publicly discuss a "cancer survivor identity," they do internalize both positive and negative stereotypes about cancer survivorship. It is important for practitioners to be aware of the long-term implications of cancer survivor identity and stereotypes.

  18. Report on comprehensive surveys of nationwide geothermal resources in fiscal 1979. Conceptual design of a database system; 1979 nendo zenkoku chinetsu shigen sogo chosa hokokusho. Database system gainen sekkei

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1980-03-31

    Conceptual design was made on a database system as part of the comprehensive surveys of nationwide geothermal resources. Underground hot water in depths of several kilometers close to the ground surface is a utilizable geothermal energy. Exploration using the ground surface survey is much less expensive than the test drilling survey, but has greater error in estimation because of being an indirect method. However, integrating data by freely using a number of exploration methods can improve the accuracy of estimation on the whole. In performing the conceptual design of a geothermal resource information system, the functions of this large scale database were used as the framework. Further data collection, distribution and interactive type man-machine communication, modeling, and environment surveillance functions were incorporated. Considerations were also given on further diversified utilization patterns and on support to users in remote areas and end users. What is important in designing the system is that constituting elements of hardware and software should function while being combined organically as one system, rather than the elements work independently. In addition, sufficient expandability and flexibility are indispensable. (NEDO)

  19. Results from a Nationwide Cohort Temporary Utilization Authorization (ATU) survey of patients in france treated with Pheburane(®) (Sodium Phenylbutyrate) taste-masked granules.

    Science.gov (United States)

    Kibleur, Yves; Dobbelaere, Dries; Barth, Magalie; Brassier, Anaïs; Guffon, Nathalie

    2014-10-01

    The aim of this study was to describe a nationwide system for pre-marketing follow-up (cohort temporary utilization authorization [ATU] protocol; i.e., 'therapeutic utilization') of a new taste-masked formulation of sodium phenylbutyrate (NaPB) granules (Pheburane(®)) in France and to analyze safety and efficacy in this treated cohort of patients with urea cycle disease (UCD). In October 2012, a cohort ATU was established in France to monitor the use of Pheburane(®) on a named-patient basis. All treated UCD patients were included in a follow-up protocol developed by the Laboratory (Lucane Pharma) and the French Medicines Agency (ANSM), which recorded demographics, dosing characteristics of NaPB, concomitant medications, adverse events, and clinical outcome during the period of treatment. Following the granting of the Marketing Authorization in Europe, the cohort ATU was terminated approximately 1 year after its initiation, as the product was launched on the French market. The ease of administration and acceptability were much better with the new taste-masked formulation than with the previous treatment. No episodes of metabolic decompensation were observed over a treatment period ranging from 3 to 11 months with Pheburane(®) and the range of ammonia and glutamine plasma levels improved and remained within the normal range. In all, no adverse events were reported with Pheburane(®) treatment. The recently developed taste-masked formulation of NaPB granules improved the quality of life for UCD patients. This may translate into improved compliance, efficacy, and safety, which may be demonstrated either in further studies or in the post-marketing use of the product.

  20. Nationwide survey of radiation exposure during pediatric computed tomography examinations and proposal of age-based diagnostic reference levels for Japan

    International Nuclear Information System (INIS)

    Takei, Yasutaka; Miyazaki, Osamu; Matsubara, Kosuke; Koshida, Kichiro; Shimada, Yoshiya; Akahane, Keiichi; Muramatsu, Yoshihisa; Fujii, Keisuke; Suzuki, Shoichi

    2016-01-01

    Diagnostic reference levels (DRLs) have not been established in Japan. To propose DRLs for CT of the head, chest and abdomen for three pediatric age groups. We sent a nationwide questionnaire by post to 339 facilities. Questions focused on pediatric CT technology, exposure parameters, CT protocols, and radiation doses for age groups <1 year, 1-5 years, and 6-10 years. For the three age groups in the 196 facilities that responded, the 75th percentile values of volume CT dose index based on a 16-cm phantom (CTDI vol 16 [mGy]) for head, chest and abdominal CT were for infants 39.1, 11.1 and 12.0, respectively; for 1-to 5-year-olds 46.9, 14.3 and 16.7, respectively; and for 6-to 10-year-olds 67.7, 15.0 and 17.0, respectively. The corresponding dose-length products (DLP 16 [mGy·cm]) for head, chest and abdominal CT were for infants 526.1, 209.1 and 261.5, respectively; for 1-to 5-year-olds 665.5, 296.0 and 430.8, respectively; and for 6-to 10-year-olds 847.9, 413.0 and 532.2, respectively. The majority of CTDI vol 16 and DLP 16 values for the head were higher than DRLs reported from other countries. For risk reduction, it is necessary to establish DRLs for pediatric CT in Japan. (orig.)

  1. Clinical predictors of in-hospital death and early surgery for infective endocarditis: results of CArdiac Disease REgistration (CADRE), a nation-wide survey in Japan.

    Science.gov (United States)

    Ohara, Takahiro; Nakatani, Satoshi; Kokubo, Yoshihiro; Yamamoto, Haruko; Mitsutake, Kotaro; Hanai, Sotaro

    2013-09-10

    The benefit of early surgery for IE is yet to be determined in non-Western countries. We conducted this study to evaluate the role of early surgery in infective endocarditis (IE) in Japan. IE admissions in Japan were prospectively registered using a nation-wide WEB-based registration system (CArdiac Disease REgistration, CADRE). The impact of early surgery on in-hospital mortality was assessed in native valve endocarditis (NVE) and prosthetic valve endocarditis (PVE). Risk factors for in-hospital death were assessed by multiple logistic regression analysis. The propensity score for early surgery was calculated to adjust the impact of early surgery. From September 2006 to May 2009, 348 NVE and 81 PVE were registered. In NVE, early surgery was preferable in every quartile stratified with the propensity score and the summary odds ratio (OR) and 95% confidence interval (CI) was 0.12 (0.05-0.31). The predictors of in-hospital death were Staphylococcus aureus infection (OR 3.5, 95% CI 1.26-9.7), heart failure (OR 6.74, 95% CI 2.43-18.7) and early surgery (OR 0.07, 95% CI 0.03-0.2). In PVE, the predictors of in-hospital death were age (OR 1.09, 95% CI 1.01-1.18), S. aureus infection (OR 5.8, 95% CI 1.4-24.01) and heart failure (OR 7.44, 95% CI 1.81-30.67), whereas early surgery was not (OR 0.51, 95% CI 0.12-2.16). Early surgery for NVE is associated with improved survival in a wide range of clinical subgroups in Japan. In PVE a survival benefit of early surgery is not clear. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  2. Nationwide survey of radiation exposure during pediatric computed tomography examinations and proposal of age-based diagnostic reference levels for Japan

    Energy Technology Data Exchange (ETDEWEB)

    Takei, Yasutaka [Kanazawa University, Department of Quantum Medical Technology, Division of Health Sciences, Graduate School of Medical Science, Kanazawa, Ishikawa (Japan); Miyazaki, Osamu [National Center for Child Health and Development, Department of Radiology, Tokyo (Japan); Matsubara, Kosuke; Koshida, Kichiro [Kanazawa University, Department of Quantum Medical Technology, Faculty of Health Sciences, Ishikawa (Japan); Shimada, Yoshiya; Akahane, Keiichi [National Institute of Radiological Sciences, Medical Exposure Research Project, Chiba (Japan); Muramatsu, Yoshihisa [National Cancer Center Hospital East, Department of Radiology, Chiba (Japan); Fujii, Keisuke [Nagoya University, Radiological Technology, Graduate School of Medicine, Aichi (Japan); Suzuki, Shoichi [Fujita Health University, Faculty of Radiological Technology, School of Health Sciences, Aichi (Japan)

    2016-02-15

    Diagnostic reference levels (DRLs) have not been established in Japan. To propose DRLs for CT of the head, chest and abdomen for three pediatric age groups. We sent a nationwide questionnaire by post to 339 facilities. Questions focused on pediatric CT technology, exposure parameters, CT protocols, and radiation doses for age groups <1 year, 1-5 years, and 6-10 years. For the three age groups in the 196 facilities that responded, the 75th percentile values of volume CT dose index based on a 16-cm phantom (CTDI{sub vol} 16 [mGy]) for head, chest and abdominal CT were for infants 39.1, 11.1 and 12.0, respectively; for 1-to 5-year-olds 46.9, 14.3 and 16.7, respectively; and for 6-to 10-year-olds 67.7, 15.0 and 17.0, respectively. The corresponding dose-length products (DLP 16 [mGy·cm]) for head, chest and abdominal CT were for infants 526.1, 209.1 and 261.5, respectively; for 1-to 5-year-olds 665.5, 296.0 and 430.8, respectively; and for 6-to 10-year-olds 847.9, 413.0 and 532.2, respectively. The majority of CTDI{sub vol} 16 and DLP 16 values for the head were higher than DRLs reported from other countries. For risk reduction, it is necessary to establish DRLs for pediatric CT in Japan. (orig.)

  3. Practice and Perceived Importance of Advance Care Planning and Difficulties in Providing Palliative Care in Geriatric Health Service Facilities in Japan: A Nationwide Survey.

    Science.gov (United States)

    Yokoya, Shoji; Kizawa, Yoshiyuki; Maeno, Takami

    2018-03-01

    The provision of end-of-life (EOL) care by geriatric health service facilities (GHSFs) in Japan is increasing. Advance care planning (ACP) is one of the most important issues to provide quality EOL care. This study aimed to clarify the practice and perceived importance of ACP and the difficulties in providing palliative care in GHSFs. A self-report questionnaire was mailed to head nurses at 3437 GHSFs nationwide. We asked participants about their practices regarding ACP, their recognition of its importance, and their difficulties in providing palliative care. We also analyzed the relationship between these factors and EOL care education. Among 844 respondents (24.5% response rate), approximately 69% to 81% of head nurses confirmed that GHSF residents and their families understood disease conditions and goals of care. There was a large discrepancy between the actual practice of ACP components and the recognition of their importance (eg, asking residents about existing advance directive [AD; 27.5% practiced it, while 79.6% considered it important]; recommending completion of an AD [18.1% vs 68.4%], and asking for designation of a health-care proxy [30.4% vs 76.8%]). The EOL care education was provided at 517 facilities (61.3%). Head nurses working at EOL care education-providing GHSFs practiced ACP significantly more frequently and had significantly fewer difficulties in providing palliative care. A large discrepancy was found between GHSF nurses' practice of ACP and their recognition of its importance. Providing EOL care education in GHSFs may increase ACP practices and enhance respect for resident's preferences concerning EOL care.

  4. Effect of dialyzer membrane materials on survival in chronic hemodialysis patients: Results from the annual survey of the Japanese Nationwide Dialysis Registry.

    Science.gov (United States)

    Abe, Masanori; Hamano, Takayuki; Wada, Atsushi; Nakai, Shigeru; Masakane, Ikuto

    2017-01-01

    Little information is available regarding which type of dialyzer membrane results in good prognosis in patients on chronic hemodialysis. Therefore, we conducted a cohort study from a nationwide registry of hemodialysis patients in Japan to establish the association between different dialyzer membranes and mortality rates. We followed 142,412 patients on maintenance hemodialysis (female, 39.1%; mean age, 64.8 ± 12.3 years; median dialysis duration, 7 [4-12] years) for a year from 2008 to 2009. We included patients treated with seven types of high-flux dialyzer membranes at baseline, including cellulose triacetate (CTA), ethylene vinyl alcohol (EVAL), polyacrylonitrile (PAN), polyester polymer alloy (PEPA), polyethersulfone (PES), polymethylmethacrylate (PMMA), and polysulfone (PS). Cox regression was used to estimate the association between baseline dialyzers and all-cause mortality as hazard ratios (HRs) and 95% confidence intervals for 1-year mortality adjusting for potential confounders, and propensity score matching analysis was performed. The distribution of patients treated with each membrane was as follows: PS (56.0%), CTA (17.3%), PES (12.0%), PEPA (7.5%), PMMA (4.9%), PAN (1.2%), and EVAL (1.1%). When data were adjusted using basic factors, with PS as a reference group, the mortality rate was significantly higher in all groups except for the PES group. When data were further adjusted for dialysis-related factors, HRs were significantly higher for the CTA, EVAL, and PEPA groups. When the data were further adjusted for nutrition-and inflammation-related factors, HRs were significantly lower for the PMMA and PES groups compared with the PS group. After propensity score matching, HRs were significantly lower for the PMMA group than for the PS group. The results suggest that the use of different membrane types may affect mortality in hemodialysis patients. However, further long-term prospective studies are needed to clarify these findings, including whether the

  5. Drug and Therapeutics (D & T) committees in Dutch hospitals : a nation-wide survey of structure, activities, and drug selection procedures

    NARCIS (Netherlands)

    Fijn, R; Brouwers, JRBJ; Knaap, RJ; De Jong-Van den Berg, LTW

    Aims To determine structure, activities and drug selection processes used by Dutch hospital drug and therapeutics (D & T) committees. Methods A pretested structured survey questionnaire based on the Australian process and impact indicators, previous research, and consultation of professionals was

  6. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by periodical health examination, (6). Serum ferritin determination of anemic patients

    Energy Technology Data Exchange (ETDEWEB)

    Abe, T.; Dohy, H.; Okita, H. (Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology)

    1980-11-01

    Serum ferritin was determined in A-bomb survivors, and its significance was evaluated. A low-ferritin group included many of the females under the age of 50, who mostly had iron deficient anemia. A high-ferritin group included many older-aged A-bomb survivors who had secondary anemia due to hemochromatosis, paroxismal nocturnal hemoglobinuria (PNH), and multiple myeloma. Secondary anemia due to hemochromatosis, PNH, leukemia, and sideroblastic anemia was detected in those who were old and had underlying moderate or severe anemia with a high ferritin level. As the results of this investigation, blood examination combined with serum ferritin determination is valuable for diagnosis of anemia and detection of underlying diseases.

  7. CIRCUMSTANCES AND CONSEQUENCES OF FALLS IN POLIO SURVIVORS

    NARCIS (Netherlands)

    Bickerstaffe, Alice; Beelen, Anita; Nollet, Frans

    2010-01-01

    Objectives: Many polio survivors have symptoms that are known risk factors for falls in elderly people. This study aims to determine the: (i) frequency; (ii) consequences; (iii) circumstances; and (iv) factors associated with falls in polio survivors. Methods: A survey was conducted among 376 polio

  8. Clinical features and outcomes of patients with primary myelofibrosis in Japan: report of a 17-year nationwide survey by the Idiopathic Disorders of Hematopoietic Organs Research Committee of Japan.

    Science.gov (United States)

    Takenaka, Katsuto; Shimoda, Kazuya; Uchida, Naoyuki; Shimomura, Taizo; Nagafuji, Koji; Kondo, Tadakazu; Shibayama, Hirohiko; Mori, Takehiko; Usuki, Kensuke; Azuma, Taichi; Tsutsumi, Yutaka; Tanaka, Junji; Dairaku, Hitomi; Matsuo, Keitaro; Ozawa, Keiya; Kurokawa, Mineo; Arai, Shunya; Akashi, Koichi

    2017-01-01

    We conducted a 17-year nationwide survey (1999-2015) to elucidate the clinical outcomes of patients with primary myelofibrosis (PMF) in Japan. Questionnaires were sent annually to approximately 500 hematology departments. Newly diagnosed patients with PMF were enrolled in this study, and were followed up annually to collect prognostic information. Approximately 50 patients were enrolled per year, yielding a total of 780 patients with PMF included in this study. The median age at diagnosis was 66 years. At the time of analysis, the median survival duration was 47 months, and the 3-year overall survival rate was 59 %. Infection and disease transformation into acute leukemia were the most frequent causes of death. Of the proposed prognostic models for predicting the outcomes of PMF patients in Japan, the Dynamic International Prognostic Scoring System of PMF plus model was the most feasible. Forty-three patients received allogeneic hematopoietic stem cell transplantation (alloSCT) at a median of 343 days after diagnosis. This treatment significantly prolonged the survival of PMF patients, and the 3-year overall survival rate after first alloSCT was 84 %. A long-term registration study is required for further evaluation of prognosis and the impact of treatments on survival.

  9. Pain in cancer survivors

    International Nuclear Information System (INIS)

    Mladosievicova, B.

    2017-01-01

    Pain is a common problem among cancer survivors, especially in the first few years after treatment. In the longer term, approximately 5% to 10% of survivors have chronic severe pain. Overall prevalence of all types pain is about 40% in some cancer survivors with previous specific diagnosis. Until recently, impact of pain in cancer survivors have largely been unexamined. This complication can be predicted by type of malignancy, its therapy, time elapsed from completion of anticancer treatment and effectivity of previous pain interventions. As the purpose of this article is to update readers on more recent data about prevalence of pain in cancer survivors and common treatment-related chronic pain etiologies in patients with a history of cancer who are beyond the acute diagnosis and treatment phase, previously known information about acute pain, pain in terminally ill patients. Some new studies in certain subpopulations of cancer survivors will be explored in more detail. (author)

  10. A nationwide survey of pharmacists' perception of pharmacogenetics in the context of a clinical decision support system containing pharmacogenetics dosing recommendations.

    Science.gov (United States)

    Bank, Paul Cd; Swen, Jesse J; Guchelaar, Henk-Jan

    2017-02-01

    To benchmark Dutch pharmacists knowledge, experience and attitudes toward pharmacogenetics (PGx) with a specific focus on the effects of awareness of the Dutch Pharmacogenetics Working Group guidelines. A web-based survey containing 41 questions was sent to all certified Dutch pharmacists. A total of 667 pharmacists completed the survey (18.8%). Virtually all responders believed in the concept of PGx (99.7%). However, only 14.7% recently ordered a PGx test (≤6 months), 14.1% felt adequately informed and 88.8% would like to receive additional training on PGx. Being aware of the Dutch Pharmacogenetics Working Group guidelines did not have any significant effect on knowledge or adoption of PGx. Dutch pharmacists are very positive toward PGx. However, test adoption is low and additional training is warranted.

  11. Changes in the distribution of red foxes (Vulpes vulpes in urban areas in Great Britain: findings and limitations of a media-driven nationwide survey.

    Directory of Open Access Journals (Sweden)

    Dawn M Scott

    Full Text Available Urbanization is one of the major forms of habitat alteration occurring at the present time. Although this is typically deleterious to biodiversity, some species flourish within these human-modified landscapes, potentially leading to negative and/or positive interactions between people and wildlife. Hence, up-to-date assessment of urban wildlife populations is important for developing appropriate management strategies. Surveying urban wildlife is limited by land partition and private ownership, rendering many common survey techniques difficult. Garnering public involvement is one solution, but this method is constrained by the inherent biases of non-standardised survey effort associated with voluntary participation. We used a television-led media approach to solicit national participation in an online sightings survey to investigate changes in the distribution of urban foxes in Great Britain and to explore relationships between urban features and fox occurrence and sightings density. Our results show that media-based approaches can generate a large national database on the current distribution of a recognisable species. Fox distribution in England and Wales has changed markedly within the last 25 years, with sightings submitted from 91% of urban areas previously predicted to support few or no foxes. Data were highly skewed with 90% of urban areas having <30 fox sightings per 1000 people km(-2. The extent of total urban area was the only variable with a significant impact on both fox occurrence and sightings density in urban areas; longitude and percentage of public green urban space were respectively, significantly positively and negatively associated with sightings density only. Latitude, and distance to nearest neighbouring conurbation had no impact on either occurrence or sightings density. Given the limitations associated with this method, further investigations are needed to determine the association between sightings density and actual fox

  12. Social Media Engagement and HIV Testing Among Men Who Have Sex With Men in China: A Nationwide Cross-Sectional Survey

    OpenAIRE

    Cao, Bolin; Liu, Chuncheng; Durvasula, Maya; Tang, Weiming; Pan, Stephen; Saffer, Adam J; Wei, Chongyi; Tucker, Joseph D

    2017-01-01

    Background Many interventions find that social media engagement with health promotion materials can translate into behavioral changes. However, only a few studies have examined the ways in which specific actions on various social media platforms are correlated with health behaviors. Objective The objective of this study was to examine the association between social media use and HIV testing behaviors among Chinese men who have sex with men (MSM). Methods In July 2016, a Web-based survey was c...

  13. Palliative care nursing education features more prominently in 2015 than 2005: Results from a nationwide survey and qualitative analysis of curricula.

    Science.gov (United States)

    Martins Pereira, Sandra; Hernández-Marrero, Pablo

    2016-10-01

    Making palliative care accessible to all citizens who are in need of this type of care requires effective policies and education. Moreover, healthcare professionals have an ethical and legal responsibility to ensure quality palliative care. Nevertheless, palliative care has had traditionally a limited emphasis in healthcare professionals' undergraduate education. To study the current status of palliative care education in nursing undergraduate curricula and compare 2005 and 2015 findings. An online survey was sent to all state schools providing nursing undergraduate education in Portugal (N = 21). The survey assessed if and how palliative care was included in the curricula, and whether or not national and international recommendations for palliative care nursing education were followed. Further analysis included the content of available curricula/syllabi. A total of 19 schools completed the survey (90% of response rate). These institutions are geographically dispersed and representative of state nursing educational institutions in Portugal. In 2015, all participant schools integrated palliative care in their curricula; nine schools had palliative care as an independent curricular unit (an 800% increase compared to 2005). While in 2005, only 14 out of 23 (61%) schools included palliative care explicitly in their curricula; in 2015, all 19 participant schools did so. National and international recommendations were followed. The inclusion of palliative care within nursing undergraduate curricula strongly increased from 2005 to 2015. Further research is needed to understand the contribution of education in the access, care provision, quality and development of palliative care in this country. © The Author(s) 2016.

  14. Survivorship care needs among LGBT cancer survivors.

    Science.gov (United States)

    Seay, Julia; Mitteldorf, Darryl; Yankie, Alena; Pirl, William F; Kobetz, Erin; Schlumbrecht, Matthew

    2018-05-23

    To better understand survivorship care needs among LGBT cancer survivors. We administered an anonymous online survey. LGBT cancer survivors living in the United States. Participants were recruited via the National LGBT Cancer Project. The survey measured sociodemographic characteristics, social support, posttraumatic stress, and survivorship care needs. Approximately 72% of our 114 participants were cisgender male and 87% were white. Almost all participants reported at least some unmet survivorship care needs (73%), with over half of participants reporting unmet psychological and sexuality care needs. Participants who reported their oncologist was not LGBT-competent had greater unmet needs (t(82) = 2.5, p = 0.01) and greater posttraumatic stress (t(91) = 2.1, p = 0.035). LGBT cancer survivors have significant unmet survivorship care needs, and lack of oncologist LGBT-competence is associated with unmet needs. Implications for Psychosocial Providers: Our results suggest the need for LGBT competency training for providers.

  15. [Investigation of community support measures for patients with comorbid substance use disorder and psychotic disorder: nationwide survey of drug addiction rehabilitation centers].

    Science.gov (United States)

    Ikeda, Tomohiro; Koike, Junko; Kouda, Minoru; Inamoto, Atsuko; Morota, Nobuaki

    2014-12-01

    In psychiatric care practice, patients are often seen who have difficulty with their social lives due to protracted psychiatric symptoms despite years without drug abuse. The difficulty of dealing with such cases and the lack of preparedness of the legal system leave circumstantial care as the only option. Western.countries have recently begun using the name 'concurrent disorder' as a diagnosis for patients deemed unable to recover solely through such treatment for drug addiction, signifying the presence of both a substance use disorder (SUD) and a mental health disorder. Various assessment and intervention methods are being investigated, and many studies have been reported. Based on the hypothesis that Drug Addiction Rehabilitation Center (DARC) are partly involved in supporting those with psychotic concurrent disorders (PSCD) in Japan, we conducted a survey to clarify the actual support for PSCD patients at DARC and the challenges they face. Surveys were administered to DARC-related institutions all over Japan (44 governing organizations and 66 institutions). Complete responses from 86 full-time employees and 445 DARC users were analyzed. DARC users were divided into two groups: psychiatric concurrent disorders (PSCD group, n = 178) and those without such symptoms (SUD group, n = 267), with the PSCD group accounting for 40% of the DARC users surveyed. Compared to the SUD group, the PSCD group was significantly less satisfied with their lifestyle and interpersonal relations at the DARC and a significantly higher proportion of the PSCD group requested assistance in communicating with others. When employees were presented with a hypothetical PSCD case and asked what was needed to deal with it, some responses were, "an institution that can treat both drug addiction and other mental health disorders," "a psychiatric care institution that provides 24-hour care," and "sufficient manpower and training." In the future, a treatment system must be established based on

  16. Temporal Trends in Geographical Variation in Breast Cancer Mortality in China, 1973–2005: An Analysis of Nationwide Surveys on Cause of Death

    Directory of Open Access Journals (Sweden)

    Changfa Xia

    2016-09-01

    Full Text Available To describe geographical variation in breast cancer mortality over time, we analysed breast cancer mortality data from three retrospective national surveys on causes of death in recent decades in China. We first calculated the age-standardized mortality rate (ASMR for each of the 31 provinces in mainland China stratified by survey period (1973–1975, 1990–1992 and 2004–2005. To test whether the geographical variation in breast cancer mortality changed over time, we then estimated the rate ratio (RR for the aggregated data for seven regions and three economic zones using generalized linear models. Finally, we examined the correlation between mortality rate and several macro-economic measures at the provincial level. We found that the overall ASMR increased from 2.98 per 100,000 in 1973–1975 to 3.08 per 100,000 in 1990–1992, and to 3.85 per 100,000 in 2004–2005. Geographical variation in breast cancer mortality also increased significantly over time at the regional level (p = 0.002 but not at the economic zone (p = 0.089 level, with RR being generally lower for Western China (Northwest and Southwest and higher in Northeast China over the three survey periods. These temporal and spatial trends in breast cancer mortality were found to be correlated with per capita gross domestic product, number of hospitals and health centres’ beds per 10,000 population and number of practicing doctors per 10,000 population, and average number of live births for women aged 15–64. It may be necessary to target public health policies in China to address the widening geographic variation in breast cancer mortality, and to take steps to ensure that the ease of access and the quality of cancer care across the country is improved for all residents.

  17. Temporal Trends in Geographical Variation in Breast Cancer Mortality in China, 1973–2005: An Analysis of Nationwide Surveys on Cause of Death

    Science.gov (United States)

    Xia, Changfa; Kahn, Clare; Wang, Jinfeng; Liao, Yilan; Chen, Wanqing; Yu, Xue Qin

    2016-01-01

    To describe geographical variation in breast cancer mortality over time, we analysed breast cancer mortality data from three retrospective national surveys on causes of death in recent decades in China. We first calculated the age-standardized mortality rate (ASMR) for each of the 31 provinces in mainland China stratified by survey period (1973–1975, 1990–1992 and 2004–2005). To test whether the geographical variation in breast cancer mortality changed over time, we then estimated the rate ratio (RR) for the aggregated data for seven regions and three economic zones using generalized linear models. Finally, we examined the correlation between mortality rate and several macro-economic measures at the provincial level. We found that the overall ASMR increased from 2.98 per 100,000 in 1973–1975 to 3.08 per 100,000 in 1990–1992, and to 3.85 per 100,000 in 2004–2005. Geographical variation in breast cancer mortality also increased significantly over time at the regional level (p = 0.002) but not at the economic zone (p = 0.089) level, with RR being generally lower for Western China (Northwest and Southwest) and higher in Northeast China over the three survey periods. These temporal and spatial trends in breast cancer mortality were found to be correlated with per capita gross domestic product, number of hospitals and health centres’ beds per 10,000 population and number of practicing doctors per 10,000 population, and average number of live births for women aged 15–64. It may be necessary to target public health policies in China to address the widening geographic variation in breast cancer mortality, and to take steps to ensure that the ease of access and the quality of cancer care across the country is improved for all residents. PMID:27690073

  18. Temporal Trends in Geographical Variation in Breast Cancer Mortality in China, 1973-2005: An Analysis of Nationwide Surveys on Cause of Death.

    Science.gov (United States)

    Xia, Changfa; Kahn, Clare; Wang, Jinfeng; Liao, Yilan; Chen, Wanqing; Yu, Xue Qin

    2016-09-28

    To describe geographical variation in breast cancer mortality over time, we analysed breast cancer mortality data from three retrospective national surveys on causes of death in recent decades in China. We first calculated the age-standardized mortality rate (ASMR) for each of the 31 provinces in mainland China stratified by survey period (1973-1975, 1990-1992 and 2004-2005). To test whether the geographical variation in breast cancer mortality changed over time, we then estimated the rate ratio (RR) for the aggregated data for seven regions and three economic zones using generalized linear models. Finally, we examined the correlation between mortality rate and several macro-economic measures at the provincial level. We found that the overall ASMR increased from 2.98 per 100,000 in 1973-1975 to 3.08 per 100,000 in 1990-1992, and to 3.85 per 100,000 in 2004-2005. Geographical variation in breast cancer mortality also increased significantly over time at the regional level ( p = 0.002) but not at the economic zone ( p = 0.089) level, with RR being generally lower for Western China (Northwest and Southwest) and higher in Northeast China over the three survey periods. These temporal and spatial trends in breast cancer mortality were found to be correlated with per capita gross domestic product, number of hospitals and health centres' beds per 10,000 population and number of practicing doctors per 10,000 population, and average number of live births for women aged 15-64. It may be necessary to target public health policies in China to address the widening geographic variation in breast cancer mortality, and to take steps to ensure that the ease of access and the quality of cancer care across the country is improved for all residents.

  19. Perceived Motor Competence Differs From Actual Performance in 8-Year-Old Neonatal ECMO Survivors

    NARCIS (Netherlands)

    Toussaint, L.C.; Cammen-van Zijp, M.H. van der; Janssen, A.J.; Tibboel, D.; Heijst, A.F. van; Ijsselstijn, H.

    2016-01-01

    OBJECTIVE: To assess perceived motor competence, social competence, self-worth, health-related quality of life, and actual motor performancein 8-year-old survivors of neonatal extracorporeal membrane oxygenation (ECMO). METHODS: In a prospective nationwide study, 135 children completed the extended

  20. Attitudes toward clinical autopsy in unexpected patient deaths in Japan: a nation-wide survey of the general public and physicians.

    Science.gov (United States)

    Kamishiraki, Etsuko; Maeda, Shoichi; Starkey, Jay; Ikeda, Noriaki

    2012-12-01

    Autopsy is a useful tool for understanding the cause and manner of unexpected patient death. However, the attitudes of the general public and physicians in Japan about clinical autopsy are limited. To describe the beliefs of the general public about whether autopsy should be performed and ascertain if they would actually request one given specific clinical situations where patient death occurred with the additional variable of medical error. To compare these attitudes with previously obtained attitudes of physicians practising at Japanese teaching hospitals. We conducted a cross-sectional study of the general public. We sent standardised questionnaires in 2010 to a randomly selected non-physician adult population using a survey company for participant selection. Respondents gave their opinions about the necessity of autopsy and how they might act given various clinical scenarios of patient death. We compared these results with those of a previous survey of Japanese physicians conducted in 2009. Of the 2300 eligible general adult population, 1575 (68.5%) responded. The majority of the general public indicated they believed an autopsy was necessary. However, in cases of unclear medical error or unclear cause and effect relationship of medical care and patient death, the general public were much less likely to indicate they would actually request an autopsy than were physicians (pcase of error related to death is underway. The results from this study will be important in informing related decisions.

  1. The Need for Social Ethics in Interdisciplinary Environmental Science Graduate Programs: Results from a Nation-Wide Survey in the United States.

    Science.gov (United States)

    Hall, Troy E; Engebretson, Jesse; O'Rourke, Michael; Piso, Zach; Whyte, Kyle; Valles, Sean

    2017-04-01

    Professionals in environmental fields engage with complex problems that involve stakeholders with different values, different forms of knowledge, and contentious decisions. There is increasing recognition of the need to train graduate students in interdisciplinary environmental science programs (IESPs) in these issues, which we refer to as "social ethics." A literature review revealed topics and skills that should be included in such training, as well as potential challenges and barriers. From this review, we developed an online survey, which we administered to faculty from 81 United States colleges and universities offering IESPs (480 surveys were completed). Respondents overwhelmingly agreed that IESPs should address values in applying science to policy and management decisions. They also agreed that programs should engage students with issues related to norms of scientific practice. Agreement was slightly less strong that IESPs should train students in skills related to managing value conflicts among different stakeholders. The primary challenges to incorporating social ethics into the curriculum were related to the lack of materials and expertise for delivery, though challenges such as ethics being marginalized in relation to environmental science content were also prominent. Challenges related to students' interest in ethics were considered less problematic. Respondents believed that social ethics are most effectively delivered when incorporated into existing courses, and they preferred case studies or problem-based learning for delivery. Student competence is generally not assessed, and respondents recognized a need for both curricular materials and assessment tools.

  2. When parents face the death of their child: a nationwide cross-sectional survey of parental perspectives on their child's end-of life care.

    Science.gov (United States)

    Zimmermann, Karin; Bergstraesser, Eva; Engberg, Sandra; Ramelet, Anne-Sylvie; Marfurt-Russenberger, Katrin; Von der Weid, Nicolas; Grandjean, Chantal; Fahrni-Nater, Patricia; Cignacco, Eva

    2016-03-09

    Parents facing the death of their child have a strong need for compassionate professional support. Care services should be based on empirical evidence, be sensitive to the needs of the families concerned, take into account the heterogeneity within the medical field of paediatrics, and fit into the local health care system. We need to better understand the perspectives of parents facing the death of their child in order to guide further development and evaluation of specialised paediatric palliative and end-of-life (EOL) care services. Questionnaire survey to assess the EOL care perspectives of a Swiss population-based sample of bereaved parents who had lost a child due to a cardiac, neurological or oncological condition, or during the neonatal period in the years 2011 or 2012. The parental perspective was assessed with a newly developed and tested instrument that was structured according to six evidence-based quality domains. Responses regarding parental experiences and perceived satisfaction are described. Differences between the four diagnostic groups are analysed using a generalized estimation equation to account for the dyadic data structure. Of 307 eligible families, 267 could be contacted and 135 (51%) consented to participate in this questionnaire survey. Our findings show positive parental experiences of their child's EOL care and high perceived satisfaction with the care their child received. Parents of a child with cancer rated their experiences highest in most of the six quality domains and reported the highest satisfaction with care. The lowest scores were mainly reported by parents from the neurology group, with the exception of the shared decision making domain, where parents of neonates reported significantly less positive experiences. Although positive in general, our study results suggest some areas for improvement. The integration of specialised paediatric palliative care has the potential to minimise lost opportunities to support and assist

  3. Hypertension and diabetes prevalence among adults with moderately increased BMI (23·0-24·9 kg/m2): findings from a nationwide survey in Bangladesh.

    Science.gov (United States)

    Rahman, Muntasirur; Williams, Gail; Mamun, Abdullah Al

    2017-06-01

    BMI is a proxy for fat accumulation in the body. Increased diabetes and CVD risks have been observed for Asian populations at lower BMI than the WHO-recommended BMI cut-off points for overweight (≥25·0 kg/m2) and obesity (≥30·0 kg/m2). The current study aimed to quantify the increased hypertension (HTN) and type 2 diabetes mellitus (T2DM) prevalence in Bangladeshi adults with moderately increased BMI (23·0-24·9 kg/m2). Data from the most recent Bangladesh Demographic and Health Survey (2011) were analysed. Modified Poisson regression models with robust error variance were used to calculate prevalence ratios (PR) for HTN or T2DM by BMI category, considering BMI=18·5-22·9 kg/m2 as the reference. All analyses incorporated the complex sampling design of the survey. BMI, blood pressure, blood sugar and related information were collected from a nationally representative sample. Adults (n 7433) aged≥35 years. About 12 % of Bangladeshi adults, both male and female, were within the BMI range 23·0-24·9 kg/m2 or moderately overweight. Compared with the reference BMI group (18·5-22·9 kg/m2), they had an increased PR for HTN (1·55-1·77) and T2DM (1·54-1·93). These increased PR are similar to those for the WHO-defined overweight group (BMI=25·0-29·9 kg/m2). Our findings support the recommendation that calls for setting the optimum BMI for Asian populations to 18·5-23·0 kg/m2 for health promotion and for public health interventions like leisure-time physical activity. WHO cut-off points for overweight (≥25 kg/m2) should be used to facilitate international comparisons.

  4. Exposure-response relationship of wind turbine noise with self-reported symptoms of sleep and health problems: A nationwide socioacoustic survey in Japan

    Directory of Open Access Journals (Sweden)

    Takayuki Kageyama

    2016-01-01

    Full Text Available The association of wind turbine noise (WTN with sleep and physical/mental health has not been fully investigated. To investigate the relationship of WTN with the prevalence of self-reported symptoms of sleep and health problems, a socioacoustic survey of 1079 adult residents was conducted throughout Japan (2010-2012: 747 in 34 areas surrounding wind turbine plants and 332 in 16 control areas. During face-to-face interviews, the respondents were not informed of the purpose of the survey. Questions on symptoms such as sleeplessness and physical/mental complaints were asked without specifying reasons. Insomnia was defined as having one or any combination of the following that occurs three or more times a week and bothers a respondent: Difficulty initiating sleep, difficulty maintaining sleep, premature morning awakening, and feeling of light overnight sleep. Poor health was defined as having high scores for health complaints, as determined using the Total Health Index, exceeding the criteria proposed by the authors of the index. The noise descriptor for WTN was LAeq,n outdoor, estimated from the results of actual measurement at some locations in each site. Multiple logistic analysis was applied to the LAeq,n and insomnia or poor health. The odds ratio (OR of insomnia was significantly higher when the noise exposure level exceeded 40 dB, whereas the self-reported sensitivity to noise and visual annoyance with wind turbines were also independently associated with insomnia. OR of poor health was not significant for noise exposure, but significant for noise sensitivity and visual annoyance. The above two moderators appear to indicate the features of respondents who are sensitive to stimuli or changes in their homeostasis.

  5. Does the duration and time of sleep increase the risk of allergic rhinitis? Results of the 6-year nationwide Korea youth risk behavior web-based survey.

    Directory of Open Access Journals (Sweden)

    Jeoung A Kwon

    Full Text Available Allergic rhinitis (AR is the most common chronic disorder in the pediatric population. Although several studies have investigated the correlation between AR and sleep-related issues, the association between the duration and time of sleep and AR has not been analyzed in long-term national data. This study investigated the relationship between sleep time and duration and AR risk in middle- and high-school students (adolescents aged 12-18. We analyzed national data from the Korea Youth Risk Behavior Web-based Survey by the Korea Centers for Disease Control and Prevention from 2007-2012. The sample size was 274,480, with an average response rate of 96.2%. Multivariate logistic regression analyses were conducted to determine the relationship between sleep and AR risk. Furthermore, to determine the best-fitted model among independent variables such as sleep duration, sleep time, and the combination of sleep duration and sleep time, we used Akaike Information Criteria (AIC to compare models. A total of 43,337 boys and 41,665 girls reported a diagnosis of AR at baseline. The odds ratio increased with age and with higher education and economic status of the parents. Further, students in mid-sized and large cities had stronger relationships to AR than those in small cities. In both genders, AR was associated with depression and suicidal ideation. In the analysis of sleep duration and sleep time, the odds ratio increased in both genders when sleep duration was <7 hours, and when the time of sleep was later than 24:00 hours. Our results indicate an association between sleep time and duration and AR. This study is the first to focus on the relationship between sleep duration and time and AR in national survey data collected over 6 years.

  6. Does the duration and time of sleep increase the risk of allergic rhinitis? Results of the 6-year nationwide Korea youth risk behavior web-based survey.

    Science.gov (United States)

    Kwon, Jeoung A; Lee, Minjee; Yoo, Ki-Bong; Park, Eun-Cheol

    2013-01-01

    Allergic rhinitis (AR) is the most common chronic disorder in the pediatric population. Although several studies have investigated the correlation between AR and sleep-related issues, the association between the duration and time of sleep and AR has not been analyzed in long-term national data. This study investigated the relationship between sleep time and duration and AR risk in middle- and high-school students (adolescents aged 12-18). We analyzed national data from the Korea Youth Risk Behavior Web-based Survey by the Korea Centers for Disease Control and Prevention from 2007-2012. The sample size was 274,480, with an average response rate of 96.2%. Multivariate logistic regression analyses were conducted to determine the relationship between sleep and AR risk. Furthermore, to determine the best-fitted model among independent variables such as sleep duration, sleep time, and the combination of sleep duration and sleep time, we used Akaike Information Criteria (AIC) to compare models. A total of 43,337 boys and 41,665 girls reported a diagnosis of AR at baseline. The odds ratio increased with age and with higher education and economic status of the parents. Further, students in mid-sized and large cities had stronger relationships to AR than those in small cities. In both genders, AR was associated with depression and suicidal ideation. In the analysis of sleep duration and sleep time, the odds ratio increased in both genders when sleep duration was sleep was later than 24:00 hours. Our results indicate an association between sleep time and duration and AR. This study is the first to focus on the relationship between sleep duration and time and AR in national survey data collected over 6 years.

  7. Exposure-response relationship of wind turbine noise with self-reported symptoms of sleep and health problems: A nationwide socioacoustic survey in Japan.

    Science.gov (United States)

    Kageyama, Takayuki; Yano, Takashi; Kuwano, Sonoko; Sueoka, Shinichi; Tachibana, Hideki

    2016-01-01

    The association of wind turbine noise (WTN) with sleep and physical/mental health has not been fully investigated. To investigate the relationship of WTN with the prevalence of self-reported symptoms of sleep and health problems, a socioacoustic survey of 1079 adult residents was conducted throughout Japan (2010-2012): 747 in 34 areas surrounding wind turbine plants and 332 in 16 control areas. During face-to-face interviews, the respondents were not informed of the purpose of the survey. Questions on symptoms such as sleeplessness and physical/mental complaints were asked without specifying reasons. Insomnia was defined as having one or any combination of the following that occurs three or more times a week and bothers a respondent: Difficulty initiating sleep, difficulty maintaining sleep, premature morning awakening, and feeling of light overnight sleep. Poor health was defined as having high scores for health complaints, as determined using the Total Health Index, exceeding the criteria proposed by the authors of the index. The noise descriptor for WTN was LAeq,n outdoor, estimated from the results of actual measurement at some locations in each site. Multiple logistic analysis was applied to the LAeq,n and insomnia or poor health. The odds ratio (OR) of insomnia was significantly higher when the noise exposure level exceeded 40 dB, whereas the self-reported sensitivity to noise and visual annoyance with wind turbines were also independently associated with insomnia. OR of poor health was not significant for noise exposure, but significant for noise sensitivity and visual annoyance. The above two moderators appear to indicate the features of respondents who are sensitive to stimuli or changes in their homeostasis.

  8. Financial Burden in Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Nipp, Ryan D; Kirchhoff, Anne C; Fair, Douglas; Rabin, Julia; Hyland, Kelly A; Kuhlthau, Karen; Perez, Giselle K; Robison, Leslie L; Armstrong, Gregory T; Nathan, Paul C; Oeffinger, Kevin C; Leisenring, Wendy M; Park, Elyse R

    2017-10-20

    Purpose Survivors of childhood cancer may experience financial burden as a result of health care costs, particularly because these patients often require long-term medical care. We sought to evaluate the prevalence of financial burden and identify associations between a higher percentage of income spent on out-of-pocket medical costs (≥ 10% of annual income) and issues related to financial burden (jeopardizing care or changing lifestyle) among survivors of childhood cancer and a sibling comparison group. Methods Between May 2011 and April 2012, we surveyed an age-stratified, random sample of survivors of childhood cancer and a sibling comparison group who were enrolled in the Childhood Cancer Survivor Study. Participants reported their household income, out-of-pocket medical costs, and issues related to financial burden (questions were adapted from national surveys on financial burden). Logistic regression identified associations between participant characteristics, a higher percentage of income spent on out-of-pocket medical costs, and financial burden, adjusting for potential confounders. Results Among 580 survivors of childhood cancer and 173 siblings, survivors of childhood cancer were more likely to have out-of-pocket medical costs ≥ 10% of annual income (10.0% v 2.9%; P report spending a higher percentage of their income on out-of-pocket medical costs, which may influence their health-seeking behavior and potentially affect health outcomes. Our findings highlight the need to address financial burden in this population with long-term health care needs.

  9. HBV and HCV test uptake and correlates among men who have sex with men in China: a nationwide cross-sectional online survey.

    Science.gov (United States)

    Fitzpatrick, Thomas; Pan, Stephen W; Tang, Weiming; Guo, Wilson; Tucker, Joseph D

    2018-05-19

    Hepatitis B virus (HBV) and hepatitis C virus (HCV) cause substantial morbidity and mortality in low-income and middle-income countries, including China. WHO guidelines recommend men who have sex with men (MSM) receive HBV and HCV screening. The purpose of this study was to determine the proportion of MSM in China who have HBV and HCV tested and identify correlates of test uptake. We conducted an online cross-sectional survey of young MSM in China. Respondents were asked to report previous HBV and HCV testing, sociodemographic information, sexual risk factors for hepatitis infection, other STI testing and primary care physician (PCP) status. Associations were analysed by logistic regression. 503 eligible MSM completed the survey. 41.0% (206/503) of MSM had HCV tested, and 38.2% (60/157) of MSM with no or uncertain HBV vaccination had HBV tested. In multivariate analysis, HCV testing was correlated with HBV testing (adjusted OR (aOR) 22.98, 95% CI 12.11 to 43.60), HIV testing (aOR 3.64, 95% CI 1.92 to 6.91), HIV-positive status (aOR 1.78, 95% CI 1.07 to 2.98) and having a PCP (aOR 2.40, 95% CI 1.44 to 3.98). Among MSM with no or uncertain HBV vaccination, HBV testing was correlated with HCV testing (aOR 80.85, 95% CI 20.80 to 314.33), HIV testing (aOR 5.26, 95% CI 1.81 to 15.28), HIV-positive status (aOR 3.00, 95% CI 1.22 to 7.37) and having a PCP (aOR 2.69, 95% CI 1.00 to 7.26). Our data suggest many young MSM in China have not received hepatitis testing. HCV testing rates were lower than those recently reported among MSM in Australia and the USA. The strong correlation between HBV and HCV testing suggests bundled testing interventions may be useful for MSM in China. Men with a PCP were more likely to have received hepatitis testing, consistent with literature demonstrating the importance of primary care in expanding access to testing. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No

  10. Prevalence of self-reported tuberculosis, knowledge about tuberculosis transmission and its determinants among adults in India: results from a nation-wide cross-sectional household survey

    Directory of Open Access Journals (Sweden)

    Sreeramareddy Chandrashekhar T

    2013-01-01

    Full Text Available Abstract Background Knowledge about symptoms and transmission of tuberculosis determines health seeking behavior and helps in prevention of tuberculosis transmission in the community. Such data is useful for policy makers to formulate information, education and communication strategies for tuberculosis control. Methods A secondary data analysis of India demographic and health survey, 2005/6 was carried out. Questions about self-reported tuberculosis, transmission and curability of tuberculosis were analysed. Correct knowledge (without misconceptions about tuberculosis transmission was used as a dependant variable and the explanatory variables tested were: demographic data, education, wealth quintiles, frequency of exposure to media and the curability of tuberculosis. Determinants of correct knowledge without misconceptions were tested by univariate and multivariate analyses using national weighting factor to adjust for complex sampling design. Results A total of 109,070 households (response rate of 93.5% and 198,718 participants (response rate of 91.6% completed the survey. The samples of men and women interviewed were 74,360 and 124,358 respectively. Prevalence rate of self-reported tuberculosis was 445 per 100,000 usual household residents and 4.60 per 1,000 participants. The number of respondents who had “heard of an illness called tuberculosis” was 177,423 (89.3%. Of these 47,487 (26.8% participants did not know and 55.5% knew about the correct mode of tuberculosis transmission i.e. “Through the air when coughing or sneezing”. The common misconceptions about transmission were “Through food” (32.4%, “Sharing utensils” (18.2%, and “Touching a person with tuberculosis” (12.3%. Only 52,617 (29.7% participants had correct knowledge without misconceptions. Being male (aOR 1.17, 95% CIs 1.14, 1.21, being a Hindu (aOR 1.20, 95% CIs 1.14, 1.26 or Muslim (aOR 1.26, 95% CIs 1.18, 1.34, listening to radio (aOR 1.08, 95% CIs 1.04, 1

  11. Lost Productivity in Stroke Survivors: An Econometrics Analysis.

    Science.gov (United States)

    Vyas, Manav V; Hackam, Daniel G; Silver, Frank L; Laporte, Audrey; Kapral, Moira K

    2016-01-01

    Stroke leads to a substantial societal economic burden. Loss of productivity among stroke survivors is a significant contributor to the indirect costs associated with stroke. We aimed to characterize productivity and factors associated with employability in stroke survivors. We used the Canadian Community Health Survey 2011-2012 to identify stroke survivors and employment status. We used multivariable logistic models to determine the impact of stroke on employment and on factors associated with employability, and used Heckman models to estimate the effect of stroke on productivity (number of hours worked/week and hourly wages). We included data from 91,633 respondents between 18 and 70 years and identified 923 (1%) stroke survivors. Stroke survivors were less likely to be employed (adjusted OR 0.39, 95% CI 0.33-0.46) and had hourly wages 17.5% (95% CI 7.7-23.7) lower compared to the general population, although there was no association between work hours and being a stroke survivor. We found that factors like older age, not being married, and having medical comorbidities were associated with lower odds of employment in stroke survivors in our sample. Stroke survivors are less likely to be employed and they earn a lower hourly wage than the general population. Interventions such as dedicated vocational rehabilitation and policies targeting return to work could be considered to address this lost productivity among stroke survivors. © 2016 S. Karger AG, Basel.

  12. Anemia and Iron Status Among Different Body Size Phenotypes in Chinese Adult Population: a Nation-Wide, Health and Nutrition Survey.

    Science.gov (United States)

    Li, Jiang; Xiao, Cheng; Yang, Hui; Zhou, Yun; Wang, Rui; Cao, Yongtong

    2017-12-09

    Previous studies have shown that there is a controversial relationship between iron homeostasis and obesity. This study aims to explore the relationship of anemia and iron status with different body size phenotypes in adult Chinese population. Using information on iron status-related parameters and lifestyle data from 8462 participants of the 2009 wave of China Health and Nutrition Survey (2009 CHNS), we performed multivariable logistic regression analyses to estimate the odds ratios (ORs) for the risk of anemia and iron parameters according to different body size phenotypes. Participants with higher body mass index (BMI) had a lower anemia prevalence with significant trends in both metabolic status groups (P different metabolic status groups and in different body size phenotypes, respectively. The ORs for higher ferritin and transferrin increased across different body size phenotypes in both genders, and for sTfR/log ferritin index decreased (P < 0.01 for trend). This association was still statistically significant after adjustment for multiple confounders. We found an inverse association of BMI levels with the prevalence of anemia and strong association of serum ferritin and transferrin with higher risk of obesity or overweight in both metabolic status groups.

  13. Gender and socio-economic inequalities in health and living conditions among co-resident informal caregivers: a nationwide survey in Spain.

    Science.gov (United States)

    Abajo, María; Rodríguez-Sanz, Maica; Malmusi, Davide; Salvador, María; Borrell, Carme

    2017-03-01

    To explore the associations between social determinants, caregiver's network support, burden of care and their consequences in health and living conditions of informal caregivers. The socio-demographic trends regarding population ageing and changes in family models trigger an increased demand for care. Cross-sectional study based on the 2008 edition of the National Disability, Independence and Dependency Situations Survey (DIDSS-2008) conducted by the National Statistics Institute in Spain. Analyses focused on persons identified as primary caregivers who co-reside with the dependent person. The associations between social determinants of caregivers, burden of care, support network and problems attributed to informal care (impaired health, depression, professional, economic and personal issues) were estimated by fitting robust Poisson regression models. Analyses were conducted separately for women and men. The study sample included 6923 caregivers, 73% of women and 27% of men. Gender and socio-economic inequalities were found in assumption of responsibilities and burden of caring for dependents, which tend to fall more on women and persons of lower socio-economic level, who in turn have less access to formal support. These aspects translate into a higher prevalence of health, professional, economic and personal problems. The study highlights gender and socio-economic inequalities in informal caregiving and its negative consequences. These findings may be useful in the design of policies and support programmes targeting the most affected groups of informal caregivers. © 2016 John Wiley & Sons Ltd.

  14. Exploring the public-private and company size differences in employees' work characteristics and burnout: data analysis of a nationwide survey in Taiwan.

    Science.gov (United States)

    Yeh, Wan-Yu; Yeh, Ching-Ying; Chen, Chiou-Jong

    2018-05-15

    Distinct differences exist between public-private sector organizations with respect to the market environment and operational objectives; furthermore, among private sector businesses, organizational structures and work conditions often vary between large- and small-sized companies. Despite these obvious structural distinctions, however, sectoral differences in employees' psychosocial risks and burnout status in national level have rarely been systematically investigated. Based on 2013 national employee survey data, 15,000 full-time employees were studied. Sector types were classified into "public," "private enterprise-large (LE)," and "private enterprise-small and medium (SME);" based on the definition of SMEs by Taiwan Ministry of Economic Affairs, and the associations of sector types with self-reported burnout status (measured by the Chinese version of Copenhagen Burnout Inventory) were examined, taking into account other work characteristics and job instability indicators. Significantly longer working hours and higher perceived job insecurity were found among private sector employees than their public sector counterparts. With further consideration of company size, greater dissatisfaction of job control and career prospect were found among SME employees than the other two sector type workers. This study explores the pattern of public-private differences in work conditions and employees' stress-related problems to have policy implications for supporting mechanism for disadvantaged workers in private sectors.

  15. Long-term disease-specific and cognitive quality of life after intensity-modulated radiation therapy: a cross-sectional survey of nasopharyngeal carcinoma survivors

    International Nuclear Information System (INIS)

    Kiang, Alan; Weinberg, Vivian K.; Cheung, Ka Ho Nicholas; Shugard, Erin; Chen, Josephine; Quivey, Jeanne M.; Yom, Sue S.

    2016-01-01

    There is a lack of data on quality of life in long-term survivors of nasopharyngeal carcinoma (NPC) who have been treated with intensity-modulated radiation therapy (IMRT). We characterized long-term disease-specific and cognitive QoL in NPC survivors after IMRT. We conducted a cross-sectional study of surviving patients diagnosed and treated for NPC at our center with curative-intent IMRT, with or without chemotherapy. Patients who were deceased, still undergoing treatment, with known recurrent disease, or treated with RT modality other than IMRT were excluded. QoL was measured by FACT-NP and FACT-Cog. Between May and November 2013, 44 patients completed cognitive (FACT-Cog), general (FACT-G), and NPC-specific (NPCS) QoL assessments. Patients were categorized into 4 cohorts based on duration since IMRT (≤2.5, >2.5–6, >6–10, and >10–16 years). There was no significant difference in age (p = 0.20) or stage ((I/II vs III/IV: p = 0.78) among the cohorts. The 4 cohorts differed overall for all QoL measures (ANOVA: p < 0.02 for each), due to improved scores >2.5–6 years post-IMRT compared with ≤2.5 years post-IMRT (post hoc tests: p ≤ 0.04 for each). No differences were observed between >2.5–6 and >6–10 years post-IMRT, but lower mean FACT-Cog and NPCS scores were observed for >10 years compared to >2.5–6 years post-IMRT (post hoc: p < 0.05 for each). All QoL measures were low during the initial recovery period (≤2.5 years) and were higher by 6 years post-IMRT. At >10 years post-IMRT, lower scores were observed in the domains of NPC-specific and cognitive QoL. Survivors of NPC, even if treated with IMRT, are at risk for detriment in domain-specific QoL measures at very long-term follow-up

  16. Social Media Engagement and HIV Testing Among Men Who Have Sex With Men in China: A Nationwide Cross-Sectional Survey.

    Science.gov (United States)

    Cao, Bolin; Liu, Chuncheng; Durvasula, Maya; Tang, Weiming; Pan, Stephen; Saffer, Adam J; Wei, Chongyi; Tucker, Joseph D

    2017-07-19

    Many interventions find that social media engagement with health promotion materials can translate into behavioral changes. However, only a few studies have examined the ways in which specific actions on various social media platforms are correlated with health behaviors. The objective of this study was to examine the association between social media use and HIV testing behaviors among Chinese men who have sex with men (MSM). In July 2016, a Web-based survey was conducted to recruit MSM in 8 Chinese cities through Blued (Blue City Holdings Ltd.), the world's largest gay mobile phone app. Data on sociodemographic variables, social media use platforms and behaviors, sexual behaviors, and HIV testing histories were collected. HIV testing-related social media use was defined as having ever engaged with HIV testing content on social media, which was further divided into observing (ie, receiving), endorsing (eg, liking and sharing), and contributing (eg, posting or commenting on HIV testing materials). Confirmatory factor analysis (CFA) was conducted to determine the best division of HIV testing-related social media use. Univariate and multivariable logistic regressions were used to examine the association between HIV testing-related social media use and HIV testing behaviors. A total of 2105 individuals participated in the survey. Among them, 46.75% (984) were under the age of 24 years, 35.43% (746) had high school education or less, and 47.74% (587) had condomless sex in the last 3 months. More than half of the respondents (58.14%, 1224/2105) reported HIV testing-related social media use. Additionally, HIV testing-related social media use, especially on multifunctional platforms such as WeChat, was found to be associated with recent HIV testing (adjusted odds ratio [aOR] 2.32, 95% CI 1.66-3.24). Contributing on social media was correlated with recent HIV testing (aOR 2.10, 95% CI 1.40-3.16), but neither observing (aOR 0.66, 95% CI 0.38-1.15) nor endorsing (aOR 1.29, 95

  17. Use of cancer screening services in Greece and associated social factors: results from the nation-wide Hellas Health I survey.

    Science.gov (United States)

    Dimitrakaki, Christine; Boulamatsis, Dimitris; Mariolis, Anargiros; Kontodimopoulos, Nick; Niakas, Dimitris; Tountas, Yannis

    2009-06-01

    This study estimated the rates of age-appropriate screening practices for breast, cervical, colon and prostate cancer within the general population in Greece and explored the influences of social factors on their use. Data were based on the cross-sectional Hellas Health I survey (2006) conducted on a representative sample of 1005 adults, aged 18-69 years. The percentage of women aged 21-69 years having received the papanicolaou smear test within the past 3 years was 59.4%, and the percentage of women aged 50-69 years having received mammography and the faecal occult blood test (FOBT) within the past 3 years was 53.8 and 8.3%, respectively. There were significant effects of age, education and marital status on carrying out the papanicolaou smear test, age on carrying out mammography, and existence of a family doctor on carrying out the FOBT. In men aged 50-69 years, 40.6% had received the prostate-specific antigen test and 10.9% of men had received the FOBT during the past 3 years. The percentage of men aged 50-69 years who had undergone digital rectal examination within the past 5 years was 20.3%. Multivariate analyses showed significant effects of age, social class, smoking status and type of insurance on carrying out the prostate-specific antigen test and of age on carrying out the digital rectal examination. No effects were revealed for the FOBT in men. The percentage of the population in Greece receiving screening services recommended by the European Council is low and seriously affected by social factors. Public health policies should direct their efforts towards introducing good-quality universal cancer screening and find culturally sensitive ways of addressing the barriers that prevent Greek people from adopting poor-quality cancer screening practices.

  18. Factors that Determine Academic Versus Private Practice Career Interest in Radiation Oncology Residents in the United States: Results of a Nationwide Survey

    International Nuclear Information System (INIS)

    Chang, Daniel T.; Shaffer, Jenny L.; Haffty, Bruce G.; Wilson, Lynn D.

    2013-01-01

    Purpose: To determine what factors US radiation oncology residents consider when choosing academic or nonacademic careers. Methods and Materials: A 20-question online survey was developed and sent to all US radiation oncology residents to assess factors that influence their career interest. Residents were asked to rate their interest in academics (A) versus private practice (PP) on a 0 (strong interest in A) to 100 (strong interest in PP) scale. Responses were classified as A (0-30), undecided (40-60), and PP (70-100). Residents were also asked to rank 10 factors that most strongly influenced their career interest. Results: Three hundred thirty-one responses were collected, of which 264 were complete and form the basis for this analysis. Factors that correlated with interest in A included having a PhD (P=.018), postgraduate year level (P=.0006), research elective time (P=.0003), obtaining grant funding during residency (P=.012), and number of publications before residency (P=.0001), but not number of abstracts accepted in the past year (P=.65) or publications during residency (P=.67). The 3 most influential factors for residents interested in A were: (1) baseline interest before residency; (2) academic role models; and (3) research opportunities during residency. The 3 most influential factors for residents interested in PP were: (1) baseline interest before residency; (2) academic role models; and (3) academic pressure and obligations. Conclusions: Interest in A correlated with postgraduate year level, degree, and research time during residency. Publications before but not during residency correlated with academic interest, and baseline interest was the most influential factor. These data can be used by residency program directors to better understand what influences residents' career interest

  19. Pathways to Academic Leadership in Plastic Surgery: A Nationwide Survey of Program Directors, Division Chiefs, and Department Chairs of Plastic Surgery.

    Science.gov (United States)

    Fishman, Jordan E; Pang, John Henry Y; Losee, Joseph E; Rubin, J Peter; Nguyen, Vu T

    2018-06-01

    Many aspire to leadership in academic plastic surgery yet there is no well-documented pathway. Information regarding plastic surgery residencies and program directors was obtained from the American Medical Association's FREIDA database. The division chief or department chair (academic head) of every academic plastic surgery program was identified. One Internet-based survey was distributed to academic heads; another, to program directors. Ninety academic heads were identified, 35 of whom also serve as program director. Sixty-seven unique program directors were identified. There was a 51 percent academic head response rate and a 65 percent program director response rate. Academic plastic surgery is overwhelmingly administered by midcareer men. The average program director was appointed at age 45 and has served for 7 years. She or he was trained through the independent track, completed additional training in hand surgery, and is a full professor. She or he publishes two or three peer-reviewed manuscripts per year and spends 9 hours per week in administration. The average academic head was appointed at age 45 and has held the position for 12 years. She or he was trained in the independent model, completed fellowship training, and is a full professor. She or he publishes five peer-reviewed manuscripts per year and spends 12 hours per week involved in administration. Program directors and academic heads serve nonoverlapping roles. Few program directors will advance to the role of academic head. Successful applicants to the program director position often serve as an associate program director and are seen as motivated resident educators. In contrast, those faculty members selected for the academic head role are academically accomplished administrators with business acumen.

  20. Twelve-month prevalence and predictors of self-reported suicidal ideation and suicide attempt among Korean adolescents in a web-based nationwide survey.

    Science.gov (United States)

    Kang, Eun-Ho; Hyun, Min Kyung; Choi, Seong Mi; Kim, Ji-Min; Kim, Gyung-Mee; Woo, Jong-Min

    2015-01-01

    The suicide rate in South Korea was the highest among the Organisation for Economic Co-operation and Development (OECD) countries in 2011. Although the suicide rate in adolescents is lower than that of adults and is reported to be decreasing in young males in some countries, it has consistently increased in recent years in South Korea. We aimed to determine the prevalence, pattern, and predictors of suicidal ideation and attempt in the past 12 months. A total sample of 72,623 adolescents aged 12-18 years who responded to a web-based anonymous self-reported survey between September and October 2010 was used for the analysis. The suicidal ideation and suicide attempt rates were 19.1% and 4.9%, respectively. Being female, having a poor perceived socioeconomic status and a poor perceived academic performance, subjective feelings of depression, cigarette smoking, alcohol use, perceived general medical health, and experiences of any involvement with sexual intercourse were the contributing factors that predicted elevated risks for suicidal ideation and suicide attempt. In contrast to previous reports in other countries, the suicide attempt rate in Korean female adolescents peaked at age 13 years, and there were no differences in suicidal ideation in females by age. There were no differences in both suicidal ideation and attempt rates in males by age. A multidisciplinary approach that takes into consideration the characteristics of Korean adolescents with suicidal ideation or suicide attempt is warranted for developing prevention and treatment programs. © The Royal Australian and New Zealand College of Psychiatrists 2014.

  1. Are current case-finding methods under-diagnosing tuberculosis among women in Myanmar? An analysis of operational data from Yangon and the nationwide prevalence survey.

    Science.gov (United States)

    Khan, M S; Khine, T M; Hutchison, C; Coker, R J; Hane, K M; Innes, A L; Aung, S

    2016-03-03

    Although there is a large increase in investment for tuberculosis control in Myanmar, there are few operational analyses to inform policies. Only 34% of nationally reported cases are from women. In this study, we investigate sex differences in tuberculosis diagnoses in Myanmar in order to identify potential health systems barriers that may be driving lower tuberculosis case finding among women. From October 2014 to March 2015, we systematically collected data on all new adult smear positive tuberculosis cases in ten township health centres across Yangon, the largest city in Myanmar, to produce an electronic tuberculosis database. We conducted a descriptive cross-sectional analysis of sex differences in tuberculosis diagnoses at the township health centres. We also analysed national prevalence survey data to calculate additional case finding in men and women by using sputum culture when smear microscopy was negative, and estimated the sex-specific impact of using a more sensitive diagnostic tool at township health centres. Overall, only 514 (30%) out of 1371 new smear positive tuberculosis patients diagnosed at the township health centres were female. The proportion of female patients varied by township (from 21% to 37%, p = 0.0172), month of diagnosis (37% in February 2015 and 23% in March 2015 p = 0.0004) and age group (26% in 25-64 years and 49% in 18-25 years, p Myanmar, found that substantially fewer women than men were diagnosed in all study townships. The sex ratio of newly diagnosed cases varied by age group, month of diagnosis and township of diagnosis. Low sensitivity of tuberculosis diagnosis may lead to a potential under-diagnosis of tuberculosis among women.

  2. Prevalence and predictors of anxiety and depression among family caregivers of cancer patients: a nationwide survey of patient-family caregiver dyads in Korea.

    Science.gov (United States)

    Park, Boyoung; Kim, So Young; Shin, Ji-Yeon; Sanson-Fisher, Robert W; Shin, Dong Wook; Cho, Juhee; Park, Jong-Hyock

    2013-10-01

    This study aimed to identify the prevalence and predictors of anxiety and depression among family caregivers of patients with cancer in Korea. A national, multicenter, cross-sectional survey was conducted with 897 family caregivers. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression in patient-family caregiver dyads. The prevalence of anxiety in family caregivers was 38.1 %:20.3 % reported mild anxiety, 13.3 % reported moderate anxiety, and 4.6 % reported severe anxiety. The prevalence of depression was 82.2 %:40.4 % reported mild depression, 25.5 % reported moderate depression, and 16.3 % reported severe depression. Family caregivers who were younger, were caring for male patients, or had a low quality of life (QOL) in relation to three of the variables measured in the Korean Caregiver Quality of Life Index-Cancer (CQOLC-K): burden, disturbance, and financial concerns reported increased anxiety. Becoming unemployed during caregiving, being the spouse of a patient and having low QOL in relation to three of the variables measured by the CQOLC-K: burden, disturbance, and positive adaptation were associated with depression among family caregivers. The predictive validity of the selected variables were 0.861 (95 % CI: 0.844-0.892) for anxiety and 0.794 (95 % CI: 0.751-0.828) for depression. Family caregivers of patients with cancer experienced high levels of anxiety and depression. Socio-demographic factors and QOL were predictors of anxiety and depression in family caregivers.

  3. Relationship between Long Working Hours and Suicidal Thoughts: Nationwide Data from the 4th and 5th Korean National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Yoon, Jin-Ha; Jung, Pil Kyun; Roh, Jaehoon; Seok, Hongdeok; Won, Jong-Uk

    2015-01-01

    Long working hours are a worldwide problem and may increase the risk of various health issues. However, the health effects of long working hours on suicidal thoughts have not been frequently studied. Our goal was to investigate the relationship between long working hours and suicidal thoughts in the rapidly developing country of Korea. Data from 12,076 participants (7,164 men, 4,912 women) from the 4th and 5th Korean National Health and Nutrition Examination Surveys were used for the current analysis. Multivariate logistic regression models were used to estimate odds ratios and 95% confidence intervals for suicidal thoughts. Combined effects of long working hours and lower socioeconomic status or sleep disturbance were also estimated. Compared to groups who worked less than 52 hours per week, odds ratios (95% confidence intervals) for suicidal thoughts in groups who worked 60 hours or more per week were 1.36 (1.09-1.70) for males and 1.38 (1.11-1.72) for females, even after controlling for household income, marital status, history of hypertension or diabetes mellitus, health-related behaviors, and past two weeks' experience of injury, intoxication, or acute or chronic diseases, as well as type of work. The combined effects of long working hours with lower socioeconomic status, or with sleep disturbance, were also significantly higher compared to participants who worked less than 52 hours per week with higher socioeconomic status, or with 6-8 hours of nighttime sleep. In this study, long working hours were linked to suicidal thoughts for both genders. Additionally, the odds of those suicidal thoughts were higher for lower socioeconomic groups. To prevent adverse psychological health problems such as suicidal thoughts, a strategy regarding long working hours should be investigated.

  4. Hospital organizational factors influence work-family conflict in registered nurses: Multilevel modeling of a nation-wide cross-sectional survey in Sweden.

    Science.gov (United States)

    Leineweber, C; Chungkham, H S; Westerlund, H; Tishelman, C; Lindqvist, R

    2014-05-01

    The present shortage of registered nurses (RNs) in many European countries is expected to continue and worsen, which poses a substantial threat to the maintenance of healthcare in this region. Work-family conflict is a known risk factor for turnover and sickness absence. This paper empirically examines whether the nurse practice environment is associated with experienced work-family conflict. A multilevel model was fit with the individual RN at the 1st, and the hospital department at the 2nd level using cross-sectional RN survey data from the Swedish part of RN4CAST, an EU 7th framework project. The data analyzed here is based on a national sample of 8356 female and 592 male RNs from 369 hospital departments. We found that 6% of the variability in work-family conflict experienced by RNs was at the department level. Organizational level factors significantly accounted for most of the variability at this level with two of the work practice environment factors examined, staffing adequacy and nurse involvement in hospital affairs, significantly related to work-family conflict. Due to the design of the study, factors on ward and work group levels could not be analyzed, but are likely to account for additional variance which in the present analysis appears to be on the individual level, with private life factors likely explaining another major part. These results suggest that higher level organizational factors in health care have a significant impact on the risk of work-family conflict among RNs through their impact on the nurse practice environment. Lower level organizational factors should be investigated in future studies using hierarchical multilevel sampling. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Relationship between Long Working Hours and Suicidal Thoughts: Nationwide Data from the 4th and 5th Korean National Health and Nutrition Examination Survey.

    Directory of Open Access Journals (Sweden)

    Jin-Ha Yoon

    Full Text Available Long working hours are a worldwide problem and may increase the risk of various health issues. However, the health effects of long working hours on suicidal thoughts have not been frequently studied. Our goal was to investigate the relationship between long working hours and suicidal thoughts in the rapidly developing country of Korea.Data from 12,076 participants (7,164 men, 4,912 women from the 4th and 5th Korean National Health and Nutrition Examination Surveys were used for the current analysis. Multivariate logistic regression models were used to estimate odds ratios and 95% confidence intervals for suicidal thoughts. Combined effects of long working hours and lower socioeconomic status or sleep disturbance were also estimated.Compared to groups who worked less than 52 hours per week, odds ratios (95% confidence intervals for suicidal thoughts in groups who worked 60 hours or more per week were 1.36 (1.09-1.70 for males and 1.38 (1.11-1.72 for females, even after controlling for household income, marital status, history of hypertension or diabetes mellitus, health-related behaviors, and past two weeks' experience of injury, intoxication, or acute or chronic diseases, as well as type of work. The combined effects of long working hours with lower socioeconomic status, or with sleep disturbance, were also significantly higher compared to participants who worked less than 52 hours per week with higher socioeconomic status, or with 6-8 hours of nighttime sleep.In this study, long working hours were linked to suicidal thoughts for both genders. Additionally, the odds of those suicidal thoughts were higher for lower socioeconomic groups. To prevent adverse psychological health problems such as suicidal thoughts, a strategy regarding long working hours should be investigated.

  6. A Nationwide Survey of Quality of End-of-Life Cancer Care in Designated Cancer Centers, Inpatient Palliative Care Units, and Home Hospices in Japan: The J-HOPE Study.

    Science.gov (United States)

    Miyashita, Mitsunori; Morita, Tatsuya; Sato, Kazuki; Tsuneto, Satoru; Shima, Yasuo

    2015-07-01

    End-of-life (EOL) cancer care in general hospitals and home care has not previously been evaluated in Japan. This study aimed to evaluate EOL cancer care from the perspective of bereaved family members in nationwide designated cancer centers, inpatient palliative care units (PCUs), and home hospices in Japan. We conducted a cross-sectional, anonymous, self-report questionnaire survey for bereaved family members of cancer patients in March 2008 for 56 designated cancer centers and in June 2007 for 100 PCUs and 14 home hospices. Outcomes were overall care satisfaction, structure and process of care (Care Evaluation Scale), and achievement of a good death (Good Death Inventory). In designated cancer centers, PCUs, and home hospices, 2794 (response rate 59%), 5312 (response rate 69%), and 292 (response rate 67%) bereaved family members participated, respectively. Mean scores for overall care satisfaction were high for all places of death, at 4.3 ± 1.2 for designated cancer centers, 5.0 ± 1.2 for PCUs, and 5.0 ± 1.0 for home hospices. Designated cancer centers showed significantly lower ratings than PCUs and home hospices for structure and process of care and achievement of a good death (P = 0.0001 each). Home hospices were rated significantly higher than PCUs for achievement of a good death (P = 0.0001). The main findings of this study were: (1) overall, bereaved family members were satisfied with end-of-life care in all three places of death; (2) designated cancer centers were inferior to PCUs and home hospices and had more room for improvement; and 3) home hospices were rated higher than PCUs for achieving a good death, although home hospices remain uncommon in Japan. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  7. Changes in Patterns of Care for Limited-Stage Small-Cell Lung Cancer: Results of the 99-01 Patterns of Care Study-A Nationwide Survey in Japan

    International Nuclear Information System (INIS)

    Uno, Takashi; Sumi, Minako; Ishihara, Yoshitomo M.S.; Numasaki, Hodaka M.S.; Mitsumori, Michihide; Teshima, Teruki

    2008-01-01

    Background: This study was undertaken to analyze the practice process of thoracic radiotherapy (TRT) and evaluate changes in patterns of care for patients with limited-stage small-cell lung cancer (LS-SCLC) in Japan. Methods and Materials: The Patterns of Care Study (PCS) conducted the second nationwide survey of care process for patients with LS-SCLC treated by using TRT between 1999 and 2001. Results: The PCS collected data for 139 patients with LS-SCLC (man-woman ratio, 5:1; median age, 69 years; age > 70 years, 43%; Karnofsky Performance Status > 70, 73%; and Stage III, 88%). Median total dose was 50 Gy. Twice-daily TRT was used in 44% of patients. Median field size was 12 x 14 cm. The most commonly used photon energy was 10 MV (77%), whereas obsolete techniques using 60 Co or X-ray energy less than 6 MV comprised 12%. Three-dimensional conformal therapy was used with 12% of patients. Computed tomography simulation was performed in 40% of cases. Only 12 patients (8.6%) received prophylactic cranial irradiation (PCI). Concurrent chemotherapy and TRT (CCRT) was used for 94 patients (68%). Only 6 patients (4.4%) entered clinical trials. Compared with the previous PCS 95-97, significant increases in the use of CCRT (34-68%; p < 0.0001), twice-daily TRT (15-44%; p < 0.0001), and PCI (1.7-8.6%; p =0.0045) were observed, although the absolute number of patients receiving PCI was still extremely low. Conclusions: Evidence-based CCRT and twice-daily TRT has penetrated into clinical practice. However, PCI is not yet widely accepted in Japan

  8. Measuring financial strain in the lives of survivors of intimate partner violence.

    Science.gov (United States)

    Hetling, Andrea; Stylianou, Amanda Mathisen; Postmus, Judy L

    2015-03-01

    Agencies serving survivors of intimate partner violence (IPV) often include economic empowerment programs and approaches as a way to assist survivors struggling with avoiding poverty and gaining financial independence. Understanding and addressing the economic needs of IPV survivors are more complex than just knowing their income. Indeed, survivors' ability to manage their finances and any financial stress or strain should also be assessed to fully understand their needs. The Financial Strain Survey (FSS) provides a useful tool for screening and understanding survivors' complex financial needs. Using data from 457 IPV survivors from seven U.S. states and Puerto Rico, the current study evaluates the factor structure, reliability, and validity of using the FSS with IPV survivors. Findings indicate that the FSS is a reliable instrument for use with IPV survivors. The conclusion discusses the FSS as a practical tool for both practice and research with this population. © The Author(s) 2014.

  9. Towards global benchmarking of food environments and policies to reduce obesity and diet-related non-communicable diseases: design and methods for nation-wide surveys.

    Science.gov (United States)

    Vandevijvere, Stefanie; Swinburn, Boyd

    2014-05-15

    Unhealthy diets are heavily driven by unhealthy food environments. The International Network for Food and Obesity/non-communicable diseases (NCDs) Research, Monitoring and Action Support (INFORMAS) has been established to reduce obesity, NCDs and their related inequalities globally. This paper describes the design and methods of the first-ever, comprehensive national survey on the healthiness of food environments and the public and private sector policies influencing them, as a first step towards global monitoring of food environments and policies. A package of 11 substudies has been identified: (1) food composition, labelling and promotion on food packages; (2) food prices, shelf space and placement of foods in different outlets (mainly supermarkets); (3) food provision in schools/early childhood education (ECE) services and outdoor food promotion around schools/ECE services; (4) density of and proximity to food outlets in communities; food promotion to children via (5) television, (6) magazines, (7) sport club sponsorships, and (8) internet and social media; (9) analysis of the impact of trade and investment agreements on food environments; (10) government policies and actions; and (11) private sector actions and practices. For the substudies on food prices, provision, promotion and retail, 'environmental equity' indicators have been developed to check progress towards reducing diet-related health inequalities. Indicators for these modules will be assessed by tertiles of area deprivation index or school deciles. International 'best practice benchmarks' will be identified, against which to compare progress of countries on improving the healthiness of their food environments and policies. This research is highly original due to the very 'upstream' approach being taken and its direct policy relevance. The detailed protocols will be offered to and adapted for countries of varying size and income in order to establish INFORMAS globally as a new monitoring initiative

  10. Social Exclusion Index-for Health Surveys (SEI-HS): a prospective nationwide study to extend and validate a multidimensional social exclusion questionnaire.

    Science.gov (United States)

    van Bergen, Addi P L; Hoff, Stella J M; Schreurs, Hanneke; van Loon, Annelies; van Hemert, Albert M

    2017-03-14

    Social exclusion (SE) refers to the inability of certain groups or individuals to fully participate in society. SE is associated with socioeconomic inequalities in health, and its measurement in routine public health monitoring is considered key to designing effective health policies. In an earlier retrospective analysis we demonstrated that in all four major Dutch cities, SE could largely be measured with existing local public health monitoring data. The current prospective study is aimed at constructing and validating an extended national measure for SE that optimally employs available items. In 2012, a stratified general population sample of 258,928 Dutch adults completed a version of the Netherlands Public Health Monitor (PHM) questionnaire in which 9 items were added covering aspects of SE that were found to be missing in our previous research. Items were derived from the SCP social exclusion index, a well-constructed 15-item instrument developed by the Netherlands Institute for Social Research (SCP). The dataset was randomly divided into a development sample (N =129,464) and a validation sample (N = 129,464). Canonical correlation analysis was conducted in the development sample. The psychometric properties were studied and compared with those of the original SCP index. All analyses were then replicated in the validation sample. The analysis yielded a four dimensional index, the Social Exclusion Index for Health Surveys (SEI-HS), containing 8 SCP items and 9 PHM items. The four dimensions: "lack of social participation", "material deprivation", "lack of normative integration" and "inadequate access to basic social rights", were each measured with 3 to 6 items. The SEI-HS showed adequate internal consistency for both the general index and for two of four dimension scales. The internal structure and construct validity of the SEI-HS were satisfactory and similar to the original SCP index. Replication of the SEI-HS in the validation sample confirmed its

  11. The present state of nuclear medicine practice in Japan. A report of the 4th nation-wide survey in 1997

    International Nuclear Information System (INIS)

    Kubo, Atsushi; Tamaki, Nagara; Ichiya, Yuichi

    1998-01-01

    The present state of nuclear medicine practice was surveyed for 1 month in June, 1997 by questionnaire. There was an answer from 1,195 of 1,241 facilities in Japan. Total number of in-vivo test were 151,746 per year which increased by 13% from five years ago, and by 19% from ten years ago. Enforcement ratio of SPECT was 30.1%, and increased remarkably compared with ratio (17%) of five years ago. About 90% of profits of SPECT were myocardium and brain blood flow. As to the test frequency of each organs, it increased remarkably in brain·spinal cord (1.5 fold). On the other hand, it decreased to 0.6 fold from five years ago in thyroid gland and liver·cholecyst. Frequency according to test item and its increase rate compared with five years ago was as follows. In scintigraphy, bone 26.9% (1.3 fold), myocardium 19.6% (1.9 fold), tumor 11.9%, brain blood flow 9.4% (1.5 fold), pulmonary blood flow 2.7%, thyroid gland 2.5% (0.6 fold), and renogram 2.3% (0.7 fold). As to the dosage ratio of medicine used in each organs, 99m Tc-HMDP was 69% in bone·joint, 201 Tl for the myocardium scintigraphy was 81% in heart·blood vessel, 99m Tc was 58% in brain·spinal cord, and the ratio of 67 Ga cytrate was 84% in tumor·inflammation. PET was enforced in 24 facilities. The total number of test for one year was 11,470 which was about 2 fold of that of five years ago. 18 F-FDG was the most used medicine and increased to 3.2 fold of five years ago. Total number of in-vitro test was 47,820,000 per year which decreased compared to the number 60,180,000 of five years ago. As to frequency, tumor marker was 29.3%, thyroid gland function was 13.3%, and a hepatitis virus antigen·antibody was 12.9%. As to the subject of examination, CEA was 7.9%, HCV antibody (the third generation) was 5.0%, and CA19-9 was 4.8%. Usage of IgE made a sudden drop and number of order became less than 10. (K.H.)

  12. Antiretroviral pre-exposure prophylaxis preferences among men who have sex with men in Vietnam: results from a nationwide cross-sectional survey.

    Science.gov (United States)

    Oldenburg, Catherine E; Le, Bao; Huyen, Hoang Thi; Thien, Dinh Duc; Quan, Nguyen Hoang; Biello, Katie B; Nunn, Amy; Chan, Philip A; Mayer, Kenneth H; Mimiaga, Matthew J; Colby, Donn

    2016-07-22

    Background: The HIV/AIDS epidemic in Vietnam is concentrated in subgroups of the population, including men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) is a viable strategy for HIV prevention, but knowledge about and preferences for PrEP delivery among Vietnamese MSM are not well understood. Methods: In 2015, an online survey was conducted with recruitment via social networking websites for MSM and peer recruitment. A description of daily oral, long-acting injectable, and rectal microbicide formulations of PrEP was provided to participants. Participants were asked about their prior awareness of and interest in PrEP, and ranked their most preferred PrEP modality. Multivariable logistic regression models were used to assess factors associated with having heard of PrEP and preference for each PrEP modality. Results: Of 548 participants who answered demographic and PrEP-related questions, 26.8% had previously heard of PrEP and most (65.7%) endorsed rectal microbicides as their most preferred PrEP delivery modality. Commonly-cited perceived barriers to uptake of PrEP included concern about side-effects, perception about being HIV positive, and family or friends finding out about their sexual behaviour. In multivariable models, older participants less often endorsed rectal microbicides (adjusted odds ratio (AOR) 0.95 per year, 95% confidence interval (CI) 0.91-0.99) and more often endorsed long-acting injectables (AOR 1.08 per year, 95% CI 1.03 to 1.14) as their preferred PrEP modality. Participants who were willing to pay more for PrEP less often endorsed rectal microbicides (AOR 0.81, 95% CI 0.72-0.92) and more often endorsed long-acting injectables (AOR 1.17, 95% CI 1.01-1.35) and daily oral pills (AOR 1.16, 95% CI 1.00-1.35) as their preferred form of PrEP. Conclusions: A variety of PrEP modalities were acceptable to MSM in Vietnam, but low knowledge of PrEP may be a barrier to implementation.

  13. Prevalence and Risk Factors of Overweight and Obesity among Children Aged 6–59 Months in Cameroon: A Multistage, Stratified Cluster Sampling Nationwide Survey

    Science.gov (United States)

    Tchoubi, Sébastien; Sobngwi-Tambekou, Joëlle; Noubiap, Jean Jacques N.; Asangbeh, Serra Lem; Nkoum, Benjamin Alexandre; Sobngwi, Eugene

    2015-01-01

    Background Childhood obesity is one of the most serious public health challenges of the 21st century. The prevalence of overweight and obesity among children (overweight and obesity among children aged 6 months to 5 years in Cameroon in 2011. Methods Four thousand five hundred and eighteen children (2205 boys and 2313 girls) aged between 6 to 59 months were sampled in the 2011 Demographic Health Survey (DHS) database. Body Mass Index (BMI) z-scores based on WHO 2006 reference population was chosen to estimate overweight (BMI z-score > 2) and obesity (BMI for age > 3). Regression analyses were performed to investigate risk factors of overweight/obesity. Results The prevalence of overweight and obesity was 8% (1.7% for obesity alone). Boys were more affected by overweight than girls with a prevalence of 9.7% and 6.4% respectively. The highest prevalence of overweight was observed in the Grassfield area (including people living in West and North-West regions) (15.3%). Factors that were independently associated with overweight and obesity included: having overweight mother (adjusted odds ratio (aOR) = 1.51; 95% CI 1.15 to 1.97) and obese mother (aOR = 2.19; 95% CI = 155 to 3.07), compared to having normal weight mother; high birth weight (aOR = 1.69; 95% CI 1.24 to 2.28) compared to normal birth weight; male gender (aOR = 1.56; 95% CI 1.24 to 1.95); low birth rank (aOR = 1.35; 95% CI 1.06 to 1.72); being aged between 13–24 months (aOR = 1.81; 95% CI = 1.21 to 2.66) and 25–36 months (aOR = 2.79; 95% CI 1.93 to 4.13) compared to being aged 45 to 49 months; living in the grassfield area (aOR = 2.65; 95% CI = 1.87 to 3.79) compared to living in Forest area. Muslim appeared as a protective factor (aOR = 0.67; 95% CI 0.46 to 0.95).compared to Christian religion. Conclusion This study underlines a high prevalence of early childhood overweight with significant disparities between ecological areas of Cameroon. Risk factors of overweight included high maternal BMI, high

  14. Prevalence and Risk Factors of Overweight and Obesity among Children Aged 6-59 Months in Cameroon: A Multistage, Stratified Cluster Sampling Nationwide Survey.

    Science.gov (United States)

    Tchoubi, Sébastien; Sobngwi-Tambekou, Joëlle; Noubiap, Jean Jacques N; Asangbeh, Serra Lem; Nkoum, Benjamin Alexandre; Sobngwi, Eugene

    2015-01-01

    Childhood obesity is one of the most serious public health challenges of the 21st century. The prevalence of overweight and obesity among children (overweight and obesity among children aged 6 months to 5 years in Cameroon in 2011. Four thousand five hundred and eighteen children (2205 boys and 2313 girls) aged between 6 to 59 months were sampled in the 2011 Demographic Health Survey (DHS) database. Body Mass Index (BMI) z-scores based on WHO 2006 reference population was chosen to estimate overweight (BMI z-score > 2) and obesity (BMI for age > 3). Regression analyses were performed to investigate risk factors of overweight/obesity. The prevalence of overweight and obesity was 8% (1.7% for obesity alone). Boys were more affected by overweight than girls with a prevalence of 9.7% and 6.4% respectively. The highest prevalence of overweight was observed in the Grassfield area (including people living in West and North-West regions) (15.3%). Factors that were independently associated with overweight and obesity included: having overweight mother (adjusted odds ratio (aOR) = 1.51; 95% CI 1.15 to 1.97) and obese mother (aOR = 2.19; 95% CI = 155 to 3.07), compared to having normal weight mother; high birth weight (aOR = 1.69; 95% CI 1.24 to 2.28) compared to normal birth weight; male gender (aOR = 1.56; 95% CI 1.24 to 1.95); low birth rank (aOR = 1.35; 95% CI 1.06 to 1.72); being aged between 13-24 months (aOR = 1.81; 95% CI = 1.21 to 2.66) and 25-36 months (aOR = 2.79; 95% CI 1.93 to 4.13) compared to being aged 45 to 49 months; living in the grassfield area (aOR = 2.65; 95% CI = 1.87 to 3.79) compared to living in Forest area. Muslim appeared as a protective factor (aOR = 0.67; 95% CI 0.46 to 0.95).compared to Christian religion. This study underlines a high prevalence of early childhood overweight with significant disparities between ecological areas of Cameroon. Risk factors of overweight included high maternal BMI, high birth weight, male gender, low birth rank

  15. Health education needs of intimate partner violence survivors: Perspectives from female survivors and social service providers.

    Science.gov (United States)

    Ferranti, Dina; Lorenzo, Dalia; Munoz-Rojas, Derby; Gonzalez-Guarda, Rosa M

    2018-03-01

    To explore the health education needs and learning preferences of female intimate partner violence (IPV) survivors in a social service agency located in South Florida, United States. An exploratory two-phase sequential mixed-methods study was completed through semistructured interviews with social service providers (n = 10), followed by a survey with predominately female IPV survivors (n = 122, 98.4%). Data obtained from interviews with social service providers were analyzed through conventional thematic content analysis. Data from interviews were used in developing a health survey completed by IPV survivors and analyzed utilizing descriptive statistics, chi-square tests and t tests. Three themes emerged from interviews including multidimensional health needs, navigating barriers to health care, and self-improvement specific to survivors of intimate partner violence. Survey results indicated that depression and self-esteem were the health education needs of highest priority. Demographic characteristics, including age and language use, were significantly associated to preferred methods of learning, p education needs. Current study findings can inform public health nurses in developing interventions or health-based programs for female IPV survivors in social service agency settings. © 2017 Wiley Periodicals, Inc.

  16. Potential role of tele-rehabilitation to address barriers to implementation of physical therapy among West African stroke survivors: A cross-sectional survey.

    Science.gov (United States)

    Sarfo, Fred S; Adamu, Sheila; Awuah, Dominic; Sarfo-Kantanka, Osei; Ovbiagele, Bruce

    2017-10-15

    The greatest burden from stroke-related disability is borne by Low-and-Middle Income countries (LMICs) where access to rehabilitation after stroke is severely challenged. Tele-rehabilitation could be a viable avenue to address unmet rehabilitation needs in LMICs. To assess the burden of post-stroke physical deficits, rates of utilization of physiotherapy services, and perceptions of tele-rehabilitation among recent Ghanaian stroke survivors. Using a consecutive sampling strategy, 100 stroke survivors attending an outpatient Neurology clinic in a Ghanaian tertiary medical center were enrolled into this cross-sectional study. After collecting basic demographic data, clinical history on stroke type, severity and level of disability, we administered the validated 20-item Functional Independence Measure questionnaire to evaluate functional status of study participants and an 8-item questionnaire to assess participants' attitudes towards telemedicine administered rehabilitation intervention. Mean±SD age of study participants was 57.2±13.3years of which 51.0% were males with a mean duration of stroke of 1.3±2.2years. 53% had Modified Rankin scores of ≥3, 57% were fully independent and only 27% reported utilizing any physiotherapy services. Barriers to access to physiotherapy included financial constraints due to cost of physiotherapy services and transportation as well as premature discharge from physiotherapy to avoid overburdening of available physiotherapy services. These factors led to the limited provision of rehabilitative therapy. Participants held positive views of the potential for tele-rehabilitation interventions (80-93%). However, while 85% owned mobile phones, only 35% had smart phones. Despite, a high burden of residual disability, only about 1 out of 4 stroke patients in this Ghanaian cohort was exposed to post-stroke physiotherapy services, largely due to relatively high costs and limited health system resources. These Ghanaian stroke patients viewed

  17. Evaluating measurement invariance across assessment modes of phone interview and computer self-administered survey for the PROMIS measures in a population-based cohort of localized prostate cancer survivors.

    Science.gov (United States)

    Wang, Mian; Chen, Ronald C; Usinger, Deborah S; Reeve, Bryce B

    2017-11-01

    To evaluate measurement invariance (phone interview vs computer self-administered survey) of 15 PROMIS measures responded by a population-based cohort of localized prostate cancer survivors. Participants were part of the North Carolina Prostate Cancer Comparative Effectiveness and Survivorship Study. Out of the 952 men who took the phone interview at 24 months post-treatment, 401 of them also completed the same survey online using a home computer. Unidimensionality of the PROMIS measures was examined using single-factor confirmatory factor analysis (CFA) models. Measurement invariance testing was conducted using longitudinal CFA via a model comparison approach. For strongly or partially strongly invariant measures, changes in the latent factors and factor autocorrelations were also estimated and tested. Six measures (sleep disturbance, sleep-related impairment, diarrhea, illness impact-negative, illness impact-positive, and global satisfaction with sex life) had locally dependent items, and therefore model modifications had to be made on these domains prior to measurement invariance testing. Overall, seven measures achieved strong invariance (all items had equal loadings and thresholds), and four measures achieved partial strong invariance (each measure had one item with unequal loadings and thresholds). Three measures (pain interference, interest in sexual activity, and global satisfaction with sex life) failed to establish configural invariance due to between-mode differences in factor patterns. This study supports the use of phone-based live interviewers in lieu of PC-based assessment (when needed) for many of the PROMIS measures.

  18. Working situation of cancer survivors versus the general population.

    Science.gov (United States)

    Lee, Myung Kyung; Yun, Young Ho

    2015-06-01

    The purposes of this study were to compare the working situation of cancer survivors and the general (cancer-free) population and investigate characteristics associated with the increased likelihood of unemployment between the two groups. We selected 1927 cancer survivors from the 2008 Korean Community Health Survey data less than 65 years of age and used propensity score matching to randomly select 1924 individuals from the general population who closely resembled the cancer survivors. Compared to the general population, cancer survivors were less likely to be engaged in paid work, particularly as permanent workers, and were more likely to work regular hours. Additionally, they tended to do less work that involved lifting or moving heavy objects and uncomfortable postures and were more willing to express their emotions. An increased probability of unemployment among cancer survivors was associated with being over 50 years old, being female, having a lower monthly income, having multiple comorbidities, belonging to a nuclear family, being a National Basic Livelihood Act beneficiary, and having a recent diagnosis. Cancer survivors may want to pursue flexible occupations and improve their working situation. Further, they perceive their workplace more positively compared to the general population. Respecting the cancer survivor's choice to find flexible working conditions that suit their health needs and status, health-care providers involved in managing work-related issues among cancer survivors should be aware of the interaction between work-related concerns and post-cancer disease management.

  19. Mental health insurance access and utilization among childhood cancer survivors: a report from the childhood cancer survivor study.

    Science.gov (United States)

    Perez, Giselle K; Kirchhoff, Anne C; Recklitis, Christopher; Krull, Kevin R; Kuhlthau, Karen A; Nathan, Paul C; Rabin, Julia; Armstrong, Gregory T; Leisenring, Wendy; Robison, Leslie L; Park, Elyse R

    2018-04-15

    To describe and compare the prevalence of mental health access, preference, and use among pediatric cancer survivors and their siblings. To identify factors associated with mental health access and use among survivors. Six hundred ninety-eight survivors in the Childhood Cancer Survivor Study (median age = 39.4; median years from diagnosis = 30.8) and 210 siblings (median age = 40.4) were surveyed. Outcomes included having mental health insurance coverage, delaying care due to cost, perceived value of mental health benefits, and visiting a mental health provider in the past year. There were no differences in mental health access, preferences, and use between survivors and siblings (p > 0.05). Among respondents with a history of distress, most reported not having seen a mental health provider in the past year (80.9% survivors vs. 77.1% siblings; p = 0.60). Uninsured survivors were more likely to defer mental health services due to cost (24.6 vs. 8.4%; p mental health coverage. Most childhood cancer survivors value having mental healthcare benefits; however, coverage and use of mental health services remain suboptimal. The most vulnerable of survivors, specifically the uninsured and those with a history of distress, are at risk of experiencing challenges accessing mental health care. Childhood cancer survivors are at risk for experiencing high levels of daily life stress that is compounded by treatment-related sequelae. Integrative, system-based approaches that incorporate financial programs with patient education about insurance benefits can help reduce some of the financial barriers survivors face.

  20. Are cancer survivors at an increased risk for divorce? A Danish cohort study

    DEFF Research Database (Denmark)

    Carlsen, Kathrine; Dalton, Susanne Oksbjerg; Frederiksen, Kirsten

    2007-01-01

    for survivors of cervix cancer, who had an increased risk for divorce, we found that cancer survivors were not at greater risk for divorce than the general populati