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Nationwide Survey (nationwide + survey)

Distribution by Scientific Domains

Medical Sciences	76%
Humanities and Social Sciences	5%
4 Other Domains	19%

Selected Abstracts

STILL A PATCHWORK QUILT: A NATIONWIDE SURVEY OF STATE LAWS REGARDING STEPPARENT RIGHTS AND OBLIGATIONS

FAMILY COURT REVIEW, Issue 3 2010
Susan L. Pollet
This article surveys state laws regarding stepparents and stepchildren throughout the United States with regard to custody and visitation rights, child support obligations, adoption and inheritance rights. It provides background information, statistics and general definitions regarding stepparents, a review of some of the psychological and legal literature, information regarding websites and articles for the general public on the topic, and a description of the survey of the states nationwide. Finally, it provides some suggestions regarding future goals for the law in this arena. [source]

A NATIONWIDE SURVEY OF MANDATORY PARENT EDUCATION*

FAMILY COURT REVIEW, Issue 2 2008
Susan L. Pollet
In an effort to take positive steps toward coping with problems for families and children created by high levels of separation and divorce, ever increasing civil caseloads and the exposure of children to interparental conflict, court-affiliated educational programs have emerged in the United States for parents separating from their spouse or partner or going through a divorce. This article will provide an overview of the creation of such programs and their development, which includes a discussion regarding the numerous states currently mandating parents to attend. It will summarize some of the research which has been conducted as to the efficacy of the programs and will provide the results of our nationwide research for each state's parent education status. There is a discussion of domestic violence issues and sensitivities in the context of parent education programs and possible future directions for mandatory parent education. [source]

RURAL DOCTORS, SATISFACTION IN JAPAN: A NATIONWIDE SURVEY

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 2 2004
Masatoshi Matsumoto
Objectives: The purpose of this paper was to discover to what degree Japanese rural doctors are satisfied with various aspects of their jobs and lives, and to find out whether they intend to continue their rural careers. Design: Nationwide postal survey Setting: Public clinics or hospitals in municipalities that are authorised as ,rural' by the national government. Subjects: A total of 4896 doctors working for public clinics or hospitals. Interventions: Self-evaluation questionnaires were mailed. The rural doctors were asked to evaluate their satisfaction with 19 items related to their job conditions and 10 items concerning life conditions, using a four-point scale. They also were asked to evaluate their intent to stay in rural practice until retirement. Results: The response rate was 64%. Overall, rural doctors were satisfied with both their work and life conditions. However, only 27% of respondents hoped to continue rural practice beyond the usual age of retirement. Among job-related items, continuing medical education and interactions with municipal governments were rated as least satisfactory. Among lifestyle-related items, duration of holidays and workload were unsatisfactory. Subgroup analysis revealed male doctors showed greater intent to stay in rural practice. Doctors aged > 50 years were more satisfied with most aspects of their job and lifestyle than younger doctors. A strong correlation was found between the degree of intent to stay and several items such as interactions with municipal government, human interactions salary and job fulfilment. Conclusions: Strategies, based on the results of this survey, should be implemented. Particularly in Japan, positive interaction between doctors and municipal governments is crucial. [source]

Use of instrumental variables in the presence of heterogeneity and self-selection: an application to treatments of breast cancer patients

HEALTH ECONOMICS, Issue 11 2007
Anirban Basu
Abstract Instrumental variable (IV) methods are widely used in the health economics literature to adjust for hidden selection biases in observational studies when estimating treatment effects. Less attention has been paid in the applied literature to the proper use of IVs if treatment effects are heterogeneous across subjects and individuals select treatments based on expected idiosyncratic gains or losses from treatments. In this paper we compare conventional IV analysis with alternative approaches that use IVs to estimate treatment effects in models with response heterogeneity and self-selection. Instead of interpreting IV estimates as the effect of treatment at an unknown margin of patients, we identify the marginal patients and we apply the method of local IVs to estimate the average treatment effect and the effect on the treated on 5-year direct costs of breast-conserving surgery and radiation therapy compared with mastectomy in breast cancer patients. We use a sample from the Outcomes and Preferences in Older Women, Nationwide Survey which is designed to be representative of all female Medicare beneficiaries (aged 67 or older) with newly diagnosed breast cancer between 1992 and 1994. Our results reveal some of the advantages and limitations of conventional and alternative IV methods in estimating mean treatment effect parameters. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Religious Attendance, Health Maintenance Beliefs, and Mammography Utilization: Findings from a Nationwide Survey of Presbyterian Women

JOURNAL FOR THE SCIENTIFIC STUDY OF RELIGION, Issue 4 2006
MAUREEN R. BENJAMINS
Preventive health services, such as mammography, play an increasingly important role in maintaining women's health. Social factors, such as religion, may influence utilization rates by expanding access, offering information, and increasing motivation. The current study examines the relationship between religious involvement, religious beliefs, and mammography usage in a nationally representative sample of Presbyterian women (N= 1,070). We use multivariate logistic regression models to estimate the influence of religious service attendance and two health-related religious beliefs on self-reported mammography use. The findings show that religious attendance is significantly associated with mammogram use. Women who attend services nearly every week are almost twice as likely to use mammograms compared to women who attend services less frequently or never. Furthermore, the belief that spiritual health is related to physical health is also associated with the use of mammograms. [source]

Urologist Practice Patterns in the Management of Premature Ejaculation: A Nationwide Survey

THE JOURNAL OF SEXUAL MEDICINE, Issue 1 2008
Alan Shindel MD
ABSTRACT Introduction., Contemporary U.S. urologist's "real world" practice patterns in treating premature ejaculation (PE) are unknown. Aim., To ascertain contemporary urologist practice patterns in the management of PE. Method., A randomly generated mailing list of 1,009 practicing urologists was generated from the American Urologic Association (AUA) member directory. A custom-designed survey was mailed to these urologists with a cover letter and a return-address envelope. Responses were compared with the AUA 2004 guidelines for the treatment of PE. Main Outcome Measures., The survey assessed several practice-related factors and asked questions of how the subject would handle various presentations of PE in their practice. Results., Responses from practicing urologists totaled 207 (21%). Eighty-four percent of the respondents were in private practice and 11% were in academics. Most urologists (73%) saw less than one PE patient per week. On-demand selective serotonin reuptake inhibitor (SSRI) therapy was the most commonly selected first line treatment (26%), with daily dosing a close second (22%). Combination SSRI therapy, the "stop/start" technique, the "squeeze" technique, and topical anesthetics were favored by 13, 18, 18, and 11% of the respondents, respectively. If primary treatment failed, changing dosing of SSRIs, topical anesthetics, and referral to psychiatry were increasingly popular options. Ten percent of urologists would treat PE before erectile dysfunction (ED) in a patient with both conditions, with the remainder of the respondents treating ED first, typically with a phosphodiesterase type 5 inhibitor (78% of total). Fifty-one percent of urologists report that they would inquire about the sexual partner, but only 8, 7, and 4% would evaluate, refer, or treat the partner, respectively. Conclusions., The majority of our respondents diagnose PE by patient complaint, and treat ED before PE, as per the 2004 PE guidelines. Very few urologists offer referral or treatment to sexual partners of men suffering from PE. Additional randomized studies in the treatment of PE are needed. Shindel A, Nelson C, and Brandes S. Urologist practice patterns in the management of premature ejaculation: A nationwide survey. J Sex Med 2008;5:199,205. [source]

Alcohol-Related Disorders in Beijing, China: Prevalence, Socio-Demographic Correlates, and Unmet Need for Treatment

ALCOHOLISM, Issue 6 2009
Yu-Tao Xiang
Background:, The study aimed to determine the prevalence of alcohol use, episodic heavy drinking, and alcohol dependence and their socio-demographic correlates in Beijing, China. Methods:, A total of 5,926 subjects were randomly selected in Beijing and interviewed using the Composite International Diagnostic Interview (CIDI 1.0). Data on basic socio-demographic and current major medical conditions were also collected. Results:, The 12-month prevalence of alcohol use and episodic heavy drinking were 32.5 and 13.8%, respectively. The 12-month and lifetime prevalence of alcohol dependence were 1.7 and 4.3%, respectively. Age above 24 years, male sex, being married and employed, low education level (junior high school, primary school or illiterate), rural residence, and having comorbid psychiatric disorders were all significantly associated with a higher likelihood of alcohol-related disorders. Only 2.4% of the subjects with alcohol dependence were receiving treatment, and a mere 1.4% had sought treatment from mental health professionals. Conclusions:, Nationwide surveys are urgently needed to further explore the prevalence of alcohol-related disorders in China. [source]

Clinical features of non-hypertensive lobar intracerebral hemorrhage related to cerebral amyloid angiopathy

EUROPEAN JOURNAL OF NEUROLOGY, Issue 6 2010
M. Hirohata
Background and purpose: The present study aims to clarify the clinical features of non-hypertensive cerebral amyloid angiopathy-related lobar intracerebral hemorrhage (CAA-L-ICH). Methods: We investigated clinical, laboratory, and neuroimaging findings in 41 patients (30, women; 11, men) with pathologically supported CAA-L-ICH from 303 non-hypertensive Japanese patients aged ,55, identified via a nationwide survey as symptomatic CAA-L-ICH. Results: The mean age of patients at onset of CAA-L-ICH was 73.2 ± 7.4 years; the number of patients increased with age. The corrected female-to-male ratio for the population was 2.2, with significant female predominance. At onset, 7.3% of patients received anti-platelet therapy. In brain imaging studies, the actual frequency of CAA-L-ICHs was higher in the frontal and parietal lobes; however, after correcting for the estimated cortical volume, the parietal lobe was found to be the most frequently affected. CAA-L-ICH recurred in 31.7% of patients during the average 35.3-month follow-up period. The mean interval between intracerebral hemorrhages (ICHs) was 11.3 months. The case fatality rate was 12.2% at 1 month and 19.5% at 12 months after initial ICH. In 97.1% of patients, neurosurgical procedures were performed without uncontrollable intraoperative or post-operative hemorrhage. Conclusions: Our study revealed the clinical features of non-hypertensive CAA-L-ICH, including its parietal predilection, which will require further study with a larger number of patients with different ethnic backgrounds. [source]

Salvage laryngectomy and pharyngocutaneous fistulae after primary radiotherapy for head and neck cancer: A national survey from DAHANCA

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 9 2003
Cai Grau MD, DMSc
Objective. In 1998, the Danish Society for Head and Neck Oncology decided to conduct a nationwide survey at the five head and neck oncology centers with the aim of evaluating the surgical outcome of salvage laryngectomy after radiotherapy with special emphasis on identifying factors that could contribute to the development of pharyngocutaneous fistulae. Patients. A total of 472 consecutive patients undergoing postirradiation salvage laryngectomy in the period July 1, 1987,June 30, 1997 were recorded at the five head and neck oncology centers in Denmark. Age ranged from 36 to 84 years, median 63 years, 405 men and 67 women. Primary tumor site was glottic larynx (n = 242), supraglottic larynx (n = 149), other larynx (n = 45), pharynx (n = 27), and other (n = 9). All patients had received prior radiotherapy. Results. Median time between radiotherapy and laryngectomy was 10 months (range, 1,348 months). A total of 89 fistulae lasting at least 2 weeks were observed, corresponding to an overall average fistulae risk of 19%. The number of performed laryngectomies per year decreased linearly (from 58 to 37), whereas the annual number of fistulae increased slightly (from 7 to 11), which meant that the corresponding estimated fistulae risk increased significantly from 12% in 1987 to 30% in 1997. Other significant risk factors for fistulae in univariate analysis included younger patient age, primary advanced T and N stage, nonglottic primary site, resection of hyoid bone, high total radiation dose, and large radiation fields. Multiple logistic regression analysis of these parameters suggested that nonglottic tumor site, late laryngectomy period (1987,1992 vs 1993,1997), and advanced initial T stage were independent prognostic factors for fistulae risk. Surgical parameters like resection of thyroid/tongue base/trachea or radiotherapy parameters like overall treatment time or fractions per week did not influence fistulae risk. Conclusions. The risk of fistulae is especially high in patients initially treated with radiotherapy for nonglottic advanced stage tumors. A significant decrease in the number of performed salvage laryngectomies over the 10 years was seen. Over the same time period, the annual number of fistulae remained almost constant. The resulting more than doubling of fistulae rate could thus in part be explained by less surgical routine. © 2003 Wiley Periodicals, Inc. Head Neck 25: 711,716, 2003 [source]

Prevalence of coinfection with human immunodeficiency virus and hepatitis C virus in Japan

HEPATOLOGY RESEARCH, Issue 1 2007
Kazuhiko Koike
People with human immunodeficiency virus (HIV) infection are frequently infected with hepatitis C virus (HCV), because of the common transmission routes. Since the dissemination of hyperactive antiretrovirus therapy (HAART), the morbidity and mortality associated with HIV infection have declined. However, the reduction in mortality due to opportunistic infection has made HCV-associated liver diseases the leading cause of mortality in Western countries. A similar situation is assumed in Japan, but the status of coinfection with HIV and HCV is unclear. We conducted a nationwide survey to determine the prevalence of coinfection with HIV and HCV by distributing a questionnaire to the hospitals in the HIV/AIDS Network of Japan. Among 4877 patients reported to be HIV-positive, 935 (19.2%) were also positive for the anti-HCV antibody. Most (84.1%) of the patients coinfected with HIV and HCV were recipients of blood products. These data, for the first time, show the current status of coinfection with HIV and HCV in Japan. A detailed analysis of the progression and severity of liver diseases in the coinfected patients is expected. [source]

Current use of the artificial urinary sphincter and its long-term durability: A nationwide survey in Japan

INTERNATIONAL JOURNAL OF UROLOGY, Issue 1 2009
Yoichi Arai
Objectives: Although the artificial urinary sphincter (AUS) is one of the most effective surgical treatments for severe urinary incontinence, little is known about its use in Japan. A nationwide survey was done to determine contemporary trends in AUS use and its long-term durability. Methods: Data on AUS units sold in Japan were provided directly by Takai Hospital Supply Co., Ltd., Tokyo, Japan, and a survey form was sent to all 44 institutes where AUS implantation had been carried out. The survey included various demographic and preoperative variables, surgical variables, and postoperative outcomes. Results: Between 1994 and 2007, a total of 100 AUS devices had been provided in Japan. Of the 44 institutes, 24 responded to the survey, and a total of 64 patients were enrolled in the study. Post-urological surgery incontinence accounted for 81.3% of the indications. During the mean follow-up of 50 months, mechanical failure occurred in four (6.2%), and the device was removed in 13 (20.3%) due to infection (14.0%), erosion (4.7%), or urination difficulty (1.5%). Of the 58 patients evaluated, 91.4% reported social continence. Five- and 10-year failure-free rates were 74.8% and 70.1%, respectively. On multivariate analysis, operative time was an independent predictor of treatment failure (P = 0.0334). Conclusions: Considering recent trends in prostate surgery, the AUS may be significantly underused in Japan. Although excellent long-term durability has been achieved, a learning effect appears to be evident. The Japanese urological community needs to provide appropriate patients with this treatment option. [source]

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

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 3 2010
J.-P. BREUER
Background: 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. Methods: Between July 2006 and January 2007, standardized questionnaires were mailed to 3751 Anaesthesiology Society members in leading positions requesting anonymous response. Results: 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%). Conclusion: Despite the apparent understanding of the benefits from reduced pre-operative fasting, full implementation of the guidelines remains poor in German anaesthesiology departments. [source]

Quality of medical care of patients with acne vulgaris in Germany , nationwide survey of pharmacy clients

JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 12 2009
Nadine Franzke
Summary Background: No empirical "real world" data on the health care of patients with acne vulgaris in Germany currently exist. The objective of this study was to get an informative basis of health care of patients with acne vulgaris in Germany, taking into account both doctor-prescribed medication and self-medication. Patients and Methods: Surveying both medically and self-treated patients, n = 504 patients with acne vulgaris were interviewed in 48 pharmacies nationwide. In addition to socio-demographic data, the duration of illness, localization and therapy as well as patient-relevant outcomes such as patient benefit, psychological strain and markers of compliance were evaluated. The participation and significance of individual treatment providers were also evaluated. Results: A large percentage of the patients found acne vulgaris to be burdensome. Despite the longstanding necessity of treatment and the chronic course of the illness, the treatment of acne vulgaris was deemed a rather satisfactory experience by most of those affected. Dermatologists were most frequently consulted for treatment. A great number of medicinal products were further acquired through self-medication or after consulting with a pharmacist. The medically regulated therapies predominantly complied with the latest guidelines. Conclusions: Acne vulgaris is a burdensome, socio-economically relevant illness, and dermatologists treat most cases in Germany. Surveying across a network of pharmacies offers a unique access to relevant treatment data. Selection effects, particularly by choice of doctors and self-medication, were minimized. [source]

Sturgeon aquaculture in China: status of current difficulties as well as future strategies based on 2002,2006/2007 surveys in eleven provinces

JOURNAL OF APPLIED ICHTHYOLOGY, Issue 6 2009
By R. Li
Summary A nationwide survey in July and August 2007 employed a representative sample of Chinese sturgeon farms from 2002,2006/2007, including data from previous surveys and official statistics dating back to 1998, showing that the development of China's sturgeon aquaculture has progressed steadily in the past few years. Acipenser baerii and Amur hybrids (Acipenser schrenckii × Huso dauricus) have become the dominant cultured species, accounting for 80% of total production. Production centers moved from the southeastern coast towards the midwestern inland provinces, where cold freshwater resources are available in abundance. The paper presents production trends as well as the price structure for commercial fish/meat and juveniles in the various provinces and also considers import and export data for products, fertilized eggs and fingerlings. Results show that: (i) production of juveniles in hatcheries has risen only slightly during the survey period; (ii) the number of larvae obtained from the wild gradually declines each year; (iii) the price for commercial fish/meat drastically declined between 1998 to 2002, but remained stable from 2002 to 2007; and (iv) total production from the 83 surveyed farms was almost stable from 2002 to 2007. Major problems influencing sustainable development of sturgeon aquaculture were identified, including: (i) insufficient domestic supply of larvae and the ban for commercial use of A. sinensis; (ii) disorganized hybridization; (iii) the potential threat to the genetics of natural stocks in the Yangtze River; (iv) diseases originating from environmental pollution and poor-quality fish feed; (v) limited domestic markets; (vi) low volume of sturgeon export due to lack of intensive processing; and (vii) lack of organizational structure in the industry. [source]

The dynamics of obstetricians and gynecologists in Japan: A retrospective cohort model using the nationwide survey of physicians data

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4 2009
Hiroo Ide
Abstract Aim:, A shortage of obstetricians and gynecologists (OB/GYNs) in Japan has been highlighted. We conducted a descriptive and retrospective cohort study using data from the Survey of Physicians in Japan, and analyzed the dynamics of OB/GYNs. Methods:, We calculated the total numbers of OB/GYNs, their average age, the percentage of female OB/GYNs, hospital OB/GYNs, and the number of OB/GYNs in rural areas in 1974, 1984, 1994 and 2004. We determined the number of physicians who participated in and left the specialty of obstetrics and gynecology. The withdrawal rates of OB/GYNs who graduated in 1972, 1982 and 1992 were retrospectively followed using survival analysis. Results:, The overall number of physicians has increased, while the number of OB/GYNs has remained almost unchanged over the past 30 years. The percentage of female OB/GYNs has increased. Fewer new graduates chose obstetrics and gynecology, the withdrawal rate of current OB/GYNs decreased, and their average age (50.8 years) increased. The trend in withdrawal rates did not differ significantly among the generations. Conclusions:, The gravest problem in the OB/GYNs workforce is the continued decline in newly graduated OB/GYNs. Improvements in working conditions and job satisfaction are considered vital. [source]

Surveying Supported Employment in Finland: A Follow-up

JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 4 2007
Timo Saloviita
Abstract, The longitudinal status of supported employment in Finland was examined via a 2003 nationwide survey sent to job coaches involved in supporting workers with intellectual and other disabilities. Sustained supported employment, defined as "paid work in integrated settings with ongoing supports that contained at least two on-site visits per month at the worksite" was identified at 22 organizations that supported 52 workers. The results of the current survey were compared with those gained from similar surveys conducted in 1998, 1999, and 2001. Comparison of data over a 6-year period showed a decline in the provision of intensive employment supports and appeared to reflect both a change in European public policy on employment supports, and a conceptual shift in supported employment from a paradigm for people with significant disabilities to a technical tool for the employment of people with limited support needs. Along with this change, supported employment agencies in Finland were found to have progressively barred people with significant disabilities from being their customers. [source]

Do College Students Drink More Than They Think?

ALCOHOLISM, Issue 11 2003
Use of a Free-Pour Paradigm to Determine How College Students Define Standard Drinks
Rationale: Much of what is known about college drinking comes from self-report survey data. Such surveys typically ask students to indicate how many drinks they consume within a given period of time. It is currently unclear whether college students and researchers use similar operational definitions of a single drink. This information is critical given the widespread reliance on survey data for assessing the correlates and consequences of college drinking. Objectives: This study investigated whether college students define standard drink volumes in a way that is consistent with the operational definitions commonly used by researchers. Methods: Students (n= 106) were administered an alcohol survey and then asked to perform three tasks. The tasks involved free-pouring fluid into empty cups of different sizes and estimating the volume of a single beer, a shot of liquor, or the amount of liquor in a mixed drink. The volumes poured by students then were compared with standards used in a well-known nationwide survey (i.e., 12 oz of beer and 1.25 oz of liquor in a shot or mixed drink). Results: In every cup size of every task, students overestimated how much fluid they should pour to create a standard drink. In all three tasks, the magnitude of the discrepancy increased with cup size. Collapsed across cup sizes, students overpoured shots by 26%, mixed drinks by 80%, and beer by 25%. When a more liberal serving size of liquor (1.5 oz) was used as the standard, the results of the mixed drink task remained unchanged. However, the volumes poured by students during the shot free-pour task differed from the standard in only one cup size. Conclusions: The data suggest that college students drink more alcohol than indicated by their survey responses, raising questions about the validity of widely used alcohol surveys. Efforts to educate students about the alcohol content of standard drinks should be enhanced. [source]

Acquired pure red cell aplasia associated with malignant lymphomas: A nationwide cohort study in Japan for the PRCA Collaborative Study Group

AMERICAN JOURNAL OF HEMATOLOGY, Issue 3 2009
Makoto Hirokawa
Pure red cell aplasia (PRCA) has been reported in association with lymphoma as one of the autoimmune diseases seen during the course of lymphoid malignancies. However, the relation of PRCA with the underlying lymphomas remains unclear. The aim of this study was to clarify the histologic subtypes of lymphomas, the chronological sequence of anemia and lymphoma, and the response to treatment. We conducted a nationwide survey in Japan. From a cohort of 185 PRCA patients, 8 patients with lymphoma were evaluated. Histologic subtypes varied and the lymphoma was of the B-cell type in four cases and of the T-cell type in four. Four patients simultaneously developed PRCA and lymphoma. Three patients developed PRCA following lymphoma, two of whom developed anemia during remission of lymphoma. PRCA preceded lymphoma in one patient. Effective chemotherapy was associated with remission of anemia in concurrent lymphoma and PRCA. Overall, anemia responded to chemotherapy and/or immunosuppressive therapy in seven patients. In four responding patients, PRCA remained in durable remission without maintenance immunosuppressive therapy, which is different from a recurrent feature of idiopathic PRCA. We suggest that the mechanism of lymphoma-associated PRCA is heterogeneous and that durable maintenance-free remission of anemia can be obtained in some patients. Am. J. Hematol., 2009. © 2008 Wiley-Liss, Inc. [source]

Re-treatment regimens for acute stage of Kawasaki disease patients who failed to respond to initial intravenous immunoglobulin therapy: Analysis from the 17th nationwide survey

PEDIATRICS INTERNATIONAL, Issue 4 2007
RITEI UEHARA
Abstract Background: Current regimens for re-treatment of patients with Kawasaki disease who failed to respond to the initial intravenous immunoglobulin (IVIG) therapy are still uncertain. The purpose of this study is to reveal what regimens were used as the initial therapy and re-treatment for acute stage of Kawasaki disease in the current Japanese medical setting. Methods: The 17th nationwide survey on Kawasaki disease covered patients whose onset was in 2001 and 2002. In questionnaires sent to all hospitals with a bed capacity of 100 or more and a pediatric department, several questions related to therapeutic regimens for Kawasaki disease were posed. The authors observed the proportions of hospitals that had regimens for patients who failed to respond to the initial therapy. Results: Among those hospitals that responded to the survey, 1052 (64.1%) reported that at least one patient with Kawasaki disease visited the hospital. Among these 1052 hospitals, 73.3% had a regimen to administer 30,39 mg/kg per day of oral aspirin with initial IVIG. The proportion of hospitals that used 1 g/kg per day of IVIG for 2 days was the largest among the options for the initial treatment. For those patients who fail to respond to the initial therapy, 464 hospitals (44.1%) reported that their pediatricians would use additional IVIG only. The number of hospitals that planned to administer high-dose IVIG and ulinastatin was 185 (17.6%). The number of hospitals having regimens of additional IVIG and steroids was 54 (5.1%). Conclusions: The current status of the treatment for patients with Kawasaki disease not responding to the initial IVIG therapy in Japan was revealed. A randomized trial of a large sample is needed to ascertain the effectiveness of several options for re-treating Kawasaki disease. [source]

Allogeneic hematopoietic stem cell transplantation for Epstein,Barr virus-associated T/natural killer-cell lymphoproliferative disease in Japan

AMERICAN JOURNAL OF HEMATOLOGY, Issue 9 2008
Emiko Sato
Epstein,Barr virus (EBV)-associated T/NK-cell lymphoproliferative disease (LPD) has been linked to several different disorders. Its prognosis is generally poor and a treatment strategy has yet to be established. There are reports, however, that hematopoietic stem cell transplantation (HSCT) can cure this disease. To clarify the current situation regarding allogeneic hematopoietic stem cell transplantation (allo-HSCT) for EBV-associated T/NK-LPD, a nationwide survey was performed in Japan. Data for 74 patients were collected. There were 42 cases of chronic active EBV infection (CAEBV), 10 cases of EBV-associated hemophagocytic lymphohistiocytosis (EBV-HLH), and 22 cases of EBV-associated lymphoma/leukemia (EBV-lymphoma/leukemia). Of those with CAEBV, 54% had the EBV-infected T-cell type and 59% with EBV-lymphoma/leukemia had the EBV-infected NK-cell type. Most patients with EBV-HLH and EBV-lymphoma/leukemia received allo-HSCT within 1 year after onset compared to only 14% of patients with CAEBV. The event-free survival (EFS) rate following allo-HSCT was 0.561 ± 0.086 for CAEBV, 0.614 ± 0.186 for EBV-HLH, and 0.309 ± 0.107 for EBV-lymphoma/leukemia. The EFS of allo-HSCT with conventional conditioning was 0.488 ± 0.074 and with reduced-intensity conditioning was 0.563 ± 0.124. Thus, in a substantial number of cases, EBV-associated T/NK-LPD can be cured by either allogeneic conventional stem cell transplantation or reduced-intensity stem cell transplantation. © 2008 Wiley-Liss, Inc. Am. J. Hematol., 2008. [source]

A Rational Choice Approach to Explaining Policy Preferences and Concern for Representing Women among State Legislators

POLITICS & POLICY, Issue 1 2010
DONALD E. WHISTLER
Rational choice theory predicts that women, when significantly involved in the production of private competitive goods and services, will adopt the same self-interested political orientation as similarly economically situated men. Guided by this approach, this nationwide survey of state legislators finds that competitive occupational background significantly reduces support for representing distributive,redistributive policy among both women and men legislators. However, it also finds that women legislators in general, as well as women holding leadership positions, retain a significant concern for representing women. Democratic Party affiliation and noncompetitive occupational background predict support for distributive,redistributive policies among women and men legislators, while only Democratic Party affiliation predicts concern for representing women among women and men legislators. Other explanatory variables (i.e., lower education, liberal ideology, African-Americans, lower-socioeconomic status districts, and political ambition) are in the direction hypothesized to influence representing distributive,redistributive policies and women but are not all statistically significant. La teoría de la decisión racional predice que cuando las mujeres se involucran significativamente en la producción de bienes y servicios competitivos, adoptarán la misma orientación política de búsqueda de sus intereses personales que los hombres similarmente situados económicamente. Guiados por este enfoque, esta encuesta nacional de los legisladores estatales encuentra que los antecedentes profesionales competitivos reducen significativamente el apoyo entre mujeres así como hombres legisladores para representar políticas distributivas-redistributivas. Sin embargo, encuentra que en general, las mujeres legisladoras, así como aquellas mujeres que desempeñan posiciones de autoridad, conservan una preocupación significativa por representar a las mujeres. Por su parte, tanto afiliación al Partido Demócrata como antecedentes ocupacionales no-competitivos, predicen apoyo entre las mujeres y los hombres legisladores, a políticas distributivas-redistributivas, mientras que sólo afiliación al Partido Demócrata predice preocupación entre las mujeres y los hombres legisladores por representar a las mujeres. Otras variables que pueden explicar esto (i.e., educación baja, ideología liberal, Afroamericanos, distritos con bajo nivel socioeconómico, y ambición política) están en la dirección hipotetizada para influir la representación de las políticas distributivas-redistributivas y de mujeres, pero no todas son estadísticamente significativas. [source]

Burnout and psychiatric morbidity among physicians engaged in end-of-life care for cancer patients: a cross-sectional nationwide survey in Japan

PSYCHO-ONCOLOGY, Issue 5 2007
Mariko Asai
Abstract Purpose: To determine the prevalence of burnout and psychiatric morbidity among physicians engaged in end-of-life care for cancer patients in Japan and to explore associated factors related to end-of-life care. Methods: Questionnaires were mailed to 1436 Japanese clinical oncologists and palliative care physicians with a request to complete the Maslach Burnout Inventory (MBI), the General Health Questionnaire (GHQ-12), and to report on individual factors, including confidence in patient care. High levels of burnout and psychiatric morbidity were identified using cut-off scores of the MBI and GHQ-12. Results: A total of 697 physicians returned the questionnaires (response rate, 49.6%). Twenty-two percent of the respondents had a high level of emotional exhaustion, 11% had a high level of depersonalization, 62% had a low level of personal accomplishment, and 20% had psychiatric morbidity. Clinical oncologists showed a significantly higher psychiatric morbidity than palliative care physicians. Confidence in having sufficient time to communicate with patients was significantly associated with all the burnout subscales. Conclusions: A low level of personal accomplishment was relatively high among Japanese physicians compared with previous studies. Insufficient confidence in the psychological care of patients was associated with physician burnout rather than involvement in end-of-life care. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Association between stress and asthma symptoms: A population-based study

RESPIROLOGY, Issue 3 2004
Yeon-Mok OH
Objective: Although it is believed that stress contributes to asthma, there are no data from studies in the general population to support this belief. To determine whether stress influences asthma in the general population, a database from a nationwide survey to evaluate the relationship between stress and asthma symptoms was used in the present study. Methodology: A database generated by the National Health and Nutrition Examination Survey I (in South Korea, 1998) was used for this cross-sectional study. Stratified random samples of 9263 subjects, aged 20 years or older, were selected from the entire population of the country; 95% of these subjects responded. Among the responders, 5048 subjects aged 20,44 years were included in the study. Subjects were interviewed using a questionnaire. Multivariate analysis was performed using multiple logistic regression. Results: The prevalence of wheeze and waking in the night because of cough or shortness of breath in the preceding 12 months was 12.9 and 13.5%, respectively. Multivariate analysis showed that the odds ratios for asthma symptoms increased according to the severity of stress reported by the subjects. When stress levels were classified into four categories of little, some, much and very much stress, the odds ratios for wheeze in the preceding 12 months were 1.7 (95% confidence interval (CI) 1.1, 2.5), 2.6 (95% CI 1.7, 4.0) and 3.6 (95% CI 2.1, 5.9) for subjects reporting some, much and very much stress, respectively, relative to those reporting little stress. Using the same stress-level classifications, the odds ratios for waking in the night because of cough or shortness of breath in the preceding 12 months were 1.5 (95% CI 1.0, 2.3), 2.4 (95% CI 1.6, 3.6) and 4.0 (95% CI 2.5, 6.4), respectively. Conclusion: This cross-sectional study shows an association between stress and asthma symptoms in the general population of South Korea. [source]

Clinicopathological features of chronic hypersensitivity pneumonitis

RESPIROLOGY, Issue 4 2002
HIROSHI HAYAKAWA
Objective: Only limited information exists concerning the clinical and pathological features of chronic hypersensitivity pneumonitis (HP) in Japan and elsewhere. We present data on clinicopathological features of chronic HP obtained through a Japanese nationwide survey. Methodology: We studied the clinical and pathological findings in 10 patients with chronic HP who underwent surgical lung biopsy or postmortem examination. Results: There were three types of clinical course: six of the 10 patients had persistent symptoms followed by repeated acute episodes; two showed a subacute onset with persistent symptoms; and two exhibited an insidious onset. Five patients made no attempt to avoid antigen exposure and they all had progressive disease. Pathological findings indicated that lesions were mainly centrilobular with or without epithelioid cell granulomas in specimens obtained during the acute or subacute stage. In contrast, most patients in the chronic stage predominantly showed interstitial fibrosis with a usual interstitial pneumonia pattern. Conclusions: The pathological findings of chronic HP depend on the stage of the disease at tissue sampling. [source]

Urologist Practice Patterns in the Management of Premature Ejaculation: A Nationwide Survey

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

ANIMAL SCIENCE JOURNAL, Issue 3 2009
Shinya WATANABE
ABSTRACT 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. [source]

Current trends of laparoscopic gastrectomy for gastric cancer in Japan

ASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 1 2009
T Etoh
Abstract Laparoscopic gastrectomy with lymph node dissection, such as laparoscopy-assisted distal gastrectomy (LADG), is widely accepted for the treatment of early gastric cancer with a risk of lymph node metastasis. In Japan, a nationwide survey conducted by the Japan Society of Endoscopic Surgery has shown that the number of laparoscopic gastrectomies is gradually increasing. So far, the following advantages of laparoscopic surgery for the treatment of gastric cancer have been well documented: favorable clinical course after operation, pulmonary function and immune response. A retrospective multicenter study in Japan has shown that the short-term outcomes of laparoscopic gastrectomy are beneficial and that the long-term outcomes are the same as those for open surgery. Recently, the Gastric Cancer Surgical Study Group of the Japan Clinical Oncology Group conducted a multi-institutional, phase II trial (JCOG0703) to evaluate the safety of LADG for clinical stage I gastric cancer. In the future, laparoscopic surgeons will need to design and implement education and training systems for standard laparoscopic procedures, evaluate clinical outcomes through multicenter randomized controlled trials and clarify the oncological aspects of laparoscopic surgery in basic studies. [source]

Is laparoscopic surgery acceptable for advanced colon cancer?

CANCER SCIENCE, Issue 4 2009
Seigo Kitano
Laparoscopic surgery is widespread in the treatment of colorectal cancer. In Japan, a nationwide survey has shown that the rate of advanced colorectal cancer has increased gradually to 65% of total laparoscopic surgeries in 2007. Many randomized controlled trials have demonstrated that in the short term, laparoscopic surgery is feasible, safe, and has many benefits, including reduction of peri-operative mortality. In terms of long-term outcomes, four randomized controlled trials suggest that there are no differences in laparosupic and open surgery for colon cancer. However, important issues, including long-term oncological outcome, cost effectiveness, and the impact on the quality of life of patients, should be addressed in well-designed large-scale trials. In Japan, a retrospective multicenter study has demonstrated that the short-term outcomes of laparoscopic surgery are beneficial, and the long-term outcomes are the same as for open surgery. In 2004, a prospective large-scale randomized controlled trial (JCOG0404) to compare laparoscopic surgery with open surgery was started to evaluate oncological outcomes for advanced colon cancer. This trial is supported in part by a Grant-in-Aid for Cancer Research from the Japanese Ministry of Health, Labour, and Welfare. In the present study, laparoscopic surgery is found to be acceptable for stage I disease of colon cancer, whereas it is controversial for stage II/III disease because of inadequate clinical evidence. Whether laparoscopic surgery is acceptable for advanced colon cancer or not should be confirmed by the Japanese large-scale prospective randomized controlled trial (JCOG0404) in the near future. (Cancer Sci 2009; 100: 567,571) [source]

Decrease in the Prevalence of Adolescent Alcohol Use and its Possible Causes in Japan: Periodical Nationwide Cross-Sectional Surveys

ALCOHOLISM, Issue 2 2009
Yoneatsu Osaki
Background:, Trends in alcohol drinking prevalence were assessed among Japanese adolescents, and possible reasons for a decrease in drinking prevalence observed in 2004. Methods:, Cross-sectional nationwide surveys were conducted periodically. High schools were randomly sampled from throughout Japan in 1996, 2000, and 2004. All enrolled students in sampled schools were subjects of the surveys. Self-reporting anonymous questionnaires were collected from 115,814 students in 1996, 106,297 in 2000, and 102,451 in 2004. Questions about drinking prevalence of students and family members, proportion of students who have no friends, and sources of alcohol were included. Students who drunk at least one day of the 30 days preceding the survey were defined as the current drinkers. Results:, The drinking prevalence in 2004 was decreased in comparison to that in 1996 and 2000 in both sexes and in all school grades. The current drinking rate (monthly drinker) among junior high school boys was 29.4% in 1996, 29.0% in 2000, and 20.5% in 2004, while that among senior high school boys was 49.7%, 48.7%, and 36.2%, respectively. The respective prevalence among junior and senior girls was 24.0%, 25.5%, and 20.0% and 40.8%, 42.1%, and 34.1%. The prevalent sources of alcohol beverages were searching in home, stores (convenience store, supermarket, or gas-stand), liquor shops, and bars. An analysis of the reasons for this decrease identified a decrease in drinking prevalence in students' families, especially by fathers and older brothers, and an increase in the proportion of students who had no friends. Conclusions:, A decrease in drinking prevalence of male family members and a limitation of sources of alcoholic beverages may contribute to the decrease in adolescent drinking prevalence. [source]

Incidence of Kawasaki disease in Japan: the nationwide surveys of 1999,2002

PEDIATRICS INTERNATIONAL, Issue 4 2006
HIROSHI YANAGAWA
Abstract Objective: The purpose of the present study was to describe the results of nationwide epidemiologic surveys of Kawasaki disease for the 4 year period 1999,2002. Methods: The design is a retrospective incidence survey. The patients reported in these two surveys are all new patients who were reported during the two study periods (1999,2000 and 2001,2002), although the data were collected retrospectively. A questionnaire was sent to all pediatric departments of hospitals with 100 beds or more throughout Japan, requesting data on patients with Kawasaki disease, such as sex, age, date of first hospital visit, recurrence, and cardiac lesions. Results: The total number of patients reported in the 4 year period 1999,2002 was 32 266 (18 604 male, 13 662 female), with an average annual incidence of 137.7 per 100 000 children younger than 5 years old. The male/female ratio was 1.30. The incidence peaked at 9,11 months of age, and the proportion of patients under 1 year of age was 26%. The monthly distribution had a high peak in January and a gradual increase in summer. Geographically, the high-incidence areas were limited to certain prefectures and moved from year to year. The cardiac lesions at acute stage and cardiac sequelae occurred more in children under 1 year and older than 4 years. Among the principal symptoms, fever persisting ,5 days occurred most commonly, followed by conjunctival congestion, changes in lips and oral cavity, polymorphous exanthema, and changes of extremities. Cervical lymphadenopathy occurred less. Conclusion: More than 32 000 patients with Kawasaki disease during the 4 year period 1999,2002 were reported to the nationwide incidence surveys. The number of patients is steadily increasing despite the decrease of children. The seasonal variation, geographical distribution, and age-specific distribution support the infection theory for the etiology of Kawasaki disease. [source]