ABSTRACT
Spina bifida is a disease that requires cross-disciplinary treatment for each life stage from the neonatal period to adulthood. Various rehabilitation therapies are required depending on the life stage of patients. In this study, we aimed to clarify the current status of rehabilitation services at children's hospitals in order to improve quality of rehabilitation care for children with spina bifida. We performed a survey targeted at the Japanese Association of Children's Hospitals and Related Institutions. The framework of the cross-disciplinary co-operation of medical treatments for spina bifida existed in 67% of children's hospitals surveyed. In most of these hospitals, the departments of rehabilitation medicine participated in these frameworks. In the medical treatment for children with spina bifida, acute phase rehabilitation after orthopaedic surgery was adequately provided in children's hospitals. However, convalescent and community-based phase rehabilitation therapies, and the co-operation with education institutions or habilitation/rehabilitation facilities for children were determined to be inadequate. Regarding general paediatric rehabilitation, convalescent and community-based phase rehabilitation therapies were mainly provided outside children's hospitals：habilitation/rehabilitation facilities for children mainly provided convalescent and community-based phase rehabilitation therapies and were considered to be the desirable setting for such therapies. To improve paediatric rehabilitation, including the rehabilitation for children with spina bifida, several factors need to be considered. These include the construction of appropriate frameworks for medical services (such as personnel training and the recruitment of rehabilitation doctors, therapists, and related staff), and co-operation with regional education institutions or habilitation/rehabilitation facilities for children.
ABSTRACT
Spina bifida is a disease that requires cross-disciplinary treatment for each life stage from the neonatal period to adulthood. Various rehabilitation therapies are required depending on the life stage of patients. In this study, we aimed to clarify the current status of rehabilitation services at children's hospitals in order to improve quality of rehabilitation care for children with spina bifida. We performed a survey targeted at the Japanese Association of Children's Hospitals and Related Institutions. The framework of the cross-disciplinary co-operation of medical treatments for spina bifida existed in 67% of children's hospitals surveyed. In most of these hospitals, the departments of rehabilitation medicine participated in these frameworks. In the medical treatment for children with spina bifida, acute phase rehabilitation after orthopaedic surgery was adequately provided in children's hospitals. However, convalescent and community-based phase rehabilitation therapies, and the co-operation with education institutions or habilitation/rehabilitation facilities for children were determined to be inadequate. Regarding general paediatric rehabilitation, convalescent and community-based phase rehabilitation therapies were mainly provided outside children's hospitals：habilitation/rehabilitation facilities for children mainly provided convalescent and community-based phase rehabilitation therapies and were considered to be the desirable setting for such therapies. To improve paediatric rehabilitation, including the rehabilitation for children with spina bifida, several factors need to be considered. These include the construction of appropriate frameworks for medical services (such as personnel training and the recruitment of rehabilitation doctors, therapists, and related staff), and co-operation with regional education institutions or habilitation/rehabilitation facilities for children.
ABSTRACT
Children's hospitals and related institutions, along with habilitation/rehabilitation facilities for children with disabilities, practice pediatric rehabilitation medicine. However, the status of rehabilitation medical services at children's hospitals has not been examined. To help improve pediatric rehabilitation medicine, we aimed to clarify it with this study. We performed a nationwide survey targeting the Japanese Association of Children's Hospitals and Related Institutions. The median numbers of full-time rehabilitation doctors, board-certified rehabilitation doctors, and board-certified instructors per institution were one, zero, and zero, respectively. The median numbers of full-time physical therapists, occupational therapists, speech-language-hearing therapists, and clinical psychologists were nine, five, three, and two, respectively. Demand for increasing the number of rehabilitation staff members was high across all specialties. Only about half the institutions surveyed were certified as training facilities by the Japanese Association of Rehabilitation Medicine. Some institutions did not meet the health insurance system's higher-level criteria for rehabilitation facilities. The construction of an appropriate medical service framework and an increase in hospital services, including staff assignment, will be needed to improve pediatric rehabilitation and to expand research and education in this field.
ABSTRACT
Children's hospitals and related institutions, along with habilitation/rehabilitation facilities for children with disabilities, practice pediatric rehabilitation medicine. However, the status of rehabilitation medical services at children's hospitals has not been examined. To help improve pediatric rehabilitation medicine, we aimed to clarify it with this study. We performed a nationwide survey targeting the Japanese Association of Children's Hospitals and Related Institutions. The median numbers of full-time rehabilitation doctors, board-certified rehabilitation doctors, and board-certified instructors per institution were one, zero, and zero, respectively. The median numbers of full-time physical therapists, occupational therapists, speech-language-hearing therapists, and clinical psychologists were nine, five, three, and two, respectively. Demand for increasing the number of rehabilitation staff members was high across all specialties. Only about half the institutions surveyed were certified as training facilities by the Japanese Association of Rehabilitation Medicine. Some institutions did not meet the health insurance system's higher-level criteria for rehabilitation facilities. The construction of an appropriate medical service framework and an increase in hospital services, including staff assignment, will be needed to improve pediatric rehabilitation and to expand research and education in this field.
ABSTRACT
BACKGROUND@#School teachers have a possibility toward at-risk Internet addiction (IA) due to increased opportunities to use the Internet, along with the spread of the Internet in recent years. Burnout syndrome (BOS) is found to be one of the symptoms related to unhealthy mental health, especially among teachers. This study aims to research the relationship between at-risk IA and the Internet usage or BOS by conducting a nationwide cross-sectional survey and examining the factors associated with IA.@*METHOD@#This study was a cross-sectional survey by anonymous questionnaire. This survey was a random sampling survey of junior high schools across Japan in 2016. The participants were 1696 teachers at 73 schools (response rate in teachers 51.0%). We asked participants for details of their backgrounds, Internet usage, the Internet Addiction Test (IAT) by Young, and the Japanese Burnout Scale (JBS). We divided the participants into either the at-risk IA group (IAT score ≧ 40, n = 96) or the non-IA group (IAT score < 40, n = 1600). To compare the difference between at-risk IA and non-IA, we used nonparametric tests and t test according to variables. To analyze the relationship between the IAT score and the scores of three factors of the JBS (emotional exhaustion, depersonalization, and personal accomplishment), we used both ANOVA and ANCOVA, adjusted by relevant confounding factors. To clarify the contribution of each independent variable to IAT scores, we used multiple logistic regression analysis.@*RESULTS@#In our study, at-risk IA was associated with using the internet many hours privately, being on the Internet both on weekdays and weekends, playing games, and surfing the Internet. In the relationship between IAT score and BOS factor score, a higher score for "depersonalization" had a positive relationship with at-risk IA, and the highest quartile for "decline of personal accomplishment" had a lower odds ratio with at-risk IA by multiple logistic regression analysis.@*CONCLUSION@#We clarified there is a significant relationship between at-risk IA and BOS among junior high school teachers in a nationwide survey. Our results suggest that finding depersonalization at the early stage may lead to the prevention of at-risk IA among teachers. Those who are at-risk of IA may feel personal accomplishment through use of the Internet.
Subject(s)
Adult , Humans , Male , Middle Aged , Analysis of Variance , Behavior, Addictive , Psychology , Burnout, Psychological , Psychology , Cross-Sectional Studies , Internet , Japan , Personal Satisfaction , Risk Factors , School Teachers , Psychology , Schools , Surveys and QuestionnairesABSTRACT
[Introduction] During the 10-year period between 2006 to 2016, the number of acupuncture-moxibustion clinics has increased by 59%. There have been some nationwide surveys on the business conditions of massage-acupuncture-moxibustion clinics, but there have been no studies focusing on acupuncture-moxibustion clinics. It is necessary to investigate their actual business conditions as part of the basic data required for considering the future of such clinics. In this paper, we focus and report on the business conditions of the clinics from our nationwide survey data base.[Method] A survey was conducted on a total of 20,000 massage-acupuncture-moxibustion clinics in Japan extracted with a stratified random sampling, including 15,000 private management clinics, 2,000 corporate clinics and 3,000 house call service suppliers. The survey was mailed out in October 2016. Replies from active acupuncture-moxibustion licensees were extracted and the questionnaires on the following items were analyzed; the number of patients, treatment fees, annual income, business type, and licenses. The calculated values are expressed as real values, percentiles, median values, and interquartile range.[Results and Conclusion] The average number of patients per month: 98, average treatment fee: 3,000 yen, and average annual income: 3,240,000 yen were shown to be the standard features of the business conditions for acupuncture-moxibustion clinics in Japan. The distribution of the aggregate values showed a large dispersion. Extreme bipolarization is shown in the annual income. It seemed to affect the low rate for receiving acupuncture-moxibustion treatments, and the unnecessary expenditure for judo therapies. More detailed analysis is required to clarify the actual business conditions of acupuncture-moxibustion clinics.
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We have conducted a nationwide survey on faculty development for simulation-based medical education in Japan. The response rate was 90%. Forty-seven (68%) schools have implemented faculty development programs for simulation-based education. The most commonly implemented contents were standardized patient development, task trainer, high fidelity manikin operation, and student evaluation, which were related to objective structured clinical examination objective clinical skill assessment. Only 15 percent of medical schools implemented topics on reflective practice, and scientific writing. A constraint on faculty time was the most commonly perceived barrier to simulation use (mentioned by 62 schools; 90%).
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Objective To survey cognitive and processing mode of urethral distraction defect associated with pelvic fracture (PFUDD) in China and hope to find a reasonable treatment scheme for (PFUDD).Methods From Jan 2011 to Dem 2015,a questionnaire on surgical treatment for PFUDD was sent to 286 Chinese consultant urologists in more than 56 comprehensive hospitals throughout the China.The investigation includes the age of urologsit,the type of hospital,the number of patients treated during the last 5years,operation mode and optional time to do the surgery,the selection of operation approach,evaluation of the treatment effect were analyzed.At same time,we also investigated the methods of 260 cases about PFUDD.Results The age of the urologist were 30-55 years old.Over the past five years,229 urologists had fewer than 10 patients diagnosed each year,and only 57 had 10 patients diagnosed each year.There were many different kinds of operation method,including urethral realignment 36 (14％),direct vision internal urethrotomy 121 (46％),internal urethrotomy plus laser 57 (22％),trans-perineal urethral anastomosis 46(18％).The success rates were 58％ (21/36),50％ (60/121),46％ (26/57),76％ (35/46)respectively.70％ (200/286) of specialists did an open exploration urethral realignment or cystostomy when patients were injured in 2-6 hours.28％ (80/286) of specialists did urethral realignment with endoscopic surgery.About 75％ (216/286) of specialists believed that the treatment of patients with posterior urethral atresia should follow the ladder principle.Minimally invasive methods at the start,including urethral dilation,direct vision internal urethrotomy was the first choice.They would prefer open surgery only after intial treatment failure.65％ (186/286) of doctors believed that the overall outcome of the surgery was moderated.Conclusions Urethral distraction defect associated with pelvic fracture (PFUDD) was rare to be done.The direct vision internal urethrotomy was the first choice for most of the urologists(75％).They considered the urethroplast only after the failure of initial mini-invasive surgery.Trans-perineal urethral anastomosis had the best results.
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<p>The aim of this study was to investigate the dementia provision for elderly cancer patients in designated regional cancer centers. A survey was mailed to 389 designated regional cancer centers from February to June, 2015. A total of 188 facilities responded (response rate: 48.3%). 5.3% of the respondents used two manuals (on basic dementia care and the behavioral and psychological symptoms of dementia) to check whether these centers were following appropriate measures. About 50% of the respondents performed dementia assessments by the primary care team. 29.3% of the respondents maintained the system of the education and training of dementia care. Therefore, dementia provision for elderly cancer patients in designated regional cancer centers needs to improve the education of dementia care.</p>
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Suicide, the fourth leading cause of death in Korea, is a serious national problem. The Korea National Suicide Survey (KNSS) is the result of the first legislation to address this issue, "Article 11 of THE ACT FOR THE PREVENTION OF SUICIDE AND THE CREATION OF A CULTURE OF RESPECT FOR LIFE" (the "Act for the Prevention of Suicide"). To overcome the limitations of previous studies, the KNSS was designed by collaborators from a variety of fields : psychology, epidemiology, social welfare, and psychiatry. The KNSS was composed of four substudies that addressed the multifaceted process involved in suicide-related behavior over time, exploring general attitudes toward suicide and suicidal ideation, suicide planning, suicide attempts, and completed suicides. Study 1 examined the risk factors for suicide based on data regarding completed suicides ; Study 2 adopted the approach of a psychological autopsy ; Study 3 focused on suicide attempters ; and Study 4 explored attitudes toward suicide in the general population. The KNSS was designed to provide a comprehensive understanding of suicide from a longitudinal, multifaceted perspective to serve as a basis for policies aimed at suicide prevention.
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Autopsy , Cause of Death , Epidemiology , Korea , Psychology , Risk Factors , Social Welfare , Suicidal Ideation , SuicideABSTRACT
We have always attempted to create a standard treatment protocol for patients with gastric cancer. However, many debates still exist regarding gastric cancer treatment. For the past 2 years, at the Annual Congress of the Korean Gastric Cancer Association, we have presented a grand symposium on the "Debates on the strategy for treating gastric cancer". In 2008, four major topics were discussed and voted on after discussion. The four major topics were proximal location treatment for early gastric cancer, management choices for pyloric obstruction with advanced gastric cancer, management of liver metastasis, and reconstruction methods after a distal gastrectomy. The opinions of the audience for six minor topics were expressed by an electronic voting system. In 2009, the four main topics were treatment for submucosal tumor sized around 2 cm, laparoscopic gastrectomy in T2N1 gastric cancer, choices for managing gastric lymphoma, and application of a pylorus preserving procedure for early gastric cancer at the antrum. The opinions of the audience for these six minor topics were expressed by an electronic voting system, as was conducted in 2008. It was good opportunity to identify a point of contact about the debates on managing gastric cancer. The results of these debates and studies will identify the best methods to treat patients with gastric cancer.
Subject(s)
Humans , Clinical Protocols , Electronics , Electrons , Gastrectomy , Liver , Lymphoma , Lymphoma, Non-Hodgkin , Neoplasm Metastasis , Politics , Pylorus , Stomach NeoplasmsABSTRACT
The role of standardized patients (SPs) has developed rapidly over the last10years because of medical education curriculum reform and the introduction of the objective structured clinical examination (OSCE). As the participation of SPs in medical education has increased, the anxieties and frustrations of SPs have also increased. We believe that an understanding of the attitudes of SPs would improve the quality of their activities. The purpose of this survey was to study the activities and psychological needs of Japanese SPs in the OSCE.<BR>1) The response rate to the nationwide survey was62% (332of532SPs).<BR>2) Role-playing and group discussion were the most common training methods, and the length of training varied from 0 to 40 hours.<BR>3) The factors that SPs felt difficult were judging how much to respond in their performances (73%) and maintaining consistent standards in evaluating examinees (66%).<BR>4) Our results suggest that SPs require more training and that the number of SP educators should be increased.
ABSTRACT
SPs have made a dramatic development in medical education over 10 years, due to the influence of medical education curriculum reform and the introduction of the Objective Structured Clinical Examination. However the quality of SPs' activities varies. In order to increase the quality it is necessary to analyze the psychological needs of SPs. The purpose of this survey is to explore SPs' personal characteristics and how they feel during their activities.<BR>1) In a nationwide survey of Japanese SPs, 332 SPs (62%) out of 532 responded.<BR>2) Sixty percent of SPs were between the ages of 50 and 69 years and the ratio of male to female SPs was 1: 4. The ratio of workers and non-workers was 1: 2.<BR>3) A qualitative analysis found that SP motivations were derived mainly from making a contribution to society and self-improvement. Ninety six percent of SPs were satisfied with being an SP, especially when they saw improvements in the students.<BR>4) However, 67% of SPs expressed difficulty with the three core skills of feedback, evaluation and performance.
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This nationwide survey was conducted to evaluate the current status of clinical practice for gastric cancer patients in Korea. The Information Committee of the Korean Gastric Cancer Association (KGCA) sent questionnaires containing 45 items about the preoperative diagnosis, medical and surgical treatment, and postoperative follow-up for gastric cancer patients to all 298 KGCA members in 108 institutes. Response rates were 32.6% (97/298) for individuals and 59.3% (64/108) for institutes. Most university hospitals responded (response rate of university hospitals: 71.6%, 48/67). The preoperative staging work up was performed primarily by abdominal CT, followed by bone scans, abdominal ultrasound, endoscopic ultrasound, and so on. Gastric cancer patients with stages II, III, and IV usually received adjuvant chemotherapy after a curative operation. About half of the surgeons regarded 2 cm as a safe resection margin in early gastric cancer and 5 cm in advanced gastric cancer. More than half of surgeons usually performed a D2 lymph node dissection in early gastric cancer and D2+alpha lymph node dissection in advanced gastric cancer. About 20% of surgeons performed less invasive surgery and/or function-preserving surgery, such as a pylorus-preserving gastrectomy, a laparoscopic wedge resection, or a laparoscopy-assisted distal gastrectomy.
Subject(s)
Humans , Academies and Institutes , Chemotherapy, Adjuvant , Diagnosis , Follow-Up Studies , Gastrectomy , Hospitals, University , Korea , Lymph Node Excision , Surveys and Questionnaires , Stomach Neoplasms , Tomography, X-Ray Computed , UltrasonographyABSTRACT
This nationwide survey was conducted to evaluate the current status of the database system on gastric cancer patients in Korea. The Information Committee of Korean Gastric Cancer Association (KGCA) sent questionnaires about the database management to all 402 KGCA members in 110 institutes. In addition, we asked them to send the gastric cancer sheet and the pathologic report of gastric cancer used in their institutes. Response rates were 18.9% (76/402) for individuals and 51.8% (57/110) for institutes, respectively. Most of the university hospitals responded to the questionnaire (response rate of university hospital: 74.6%, 44/59). A regular conference of gastric cancer and a digitalization of the database on gastric cancer patients were performed in 29 (50.9%) and 43 (75.4%) out of 57 institutes, respectively. MS excel was most commonly used for the digitalization of the database, followed by MS access and SPSS. A regularly formed gastric cancer sheet and pathologic report were used in 38 (66.7%) and 49 (86.0%) institutes, respectively. Hospital computerization, such as an Order Communicating System, an Electric Medical Record, and a Picture Archiving/Communicating System had been set up previously or would be set up in the near future in most institutes. In 25 gastric cancer sheets collected, the mean number of total items was 72.9 (15~177). Identification data for the patients, surgical data, and pathologic data were included on most of the sheets, but preoperative status, preoperative diagnostic data, and postoperative hospital course were not.
Subject(s)
Humans , Academies and Institutes , Hospitals, University , Korea , Medical Records , Surveys and Questionnaires , Stomach NeoplasmsABSTRACT
PURPOSE: Behcet's disease is a chronic, recurrent, multisystemic disorder, which visual prognosis is poor. The clinical and epidemiological characteristics of Behcet's disease in Korean were evaluated. METHODS: The clinical records on 3,175 patients with Behcet's disease diagnosed at Behcet's disease clinic in Severance Hospital between November 1983 and December 1999 were reviewed. RESULTS: Among all 3,175 patients, the men/women ratio of Behcet's disease was 1:1.6. The age of disease onset was the highest in the thirties (33.8%). The most frequent major and minor symptom was oral ulcer (97.7%) and arthritis (32.8%) respectively, and the proportion of ocular symptom was 19.3%. The most frequent initial symptom was oral ulcer (77.4%). The ratio of men/women with ocular symptom was 1:0.98. The mean interval between the initial symptom and ocular symptom was 34 months, and the most common ocular symptom was iritis (79.0%). The most frequent systemic drug administered in patients with ocular involvement was colchicines (35%). Visual acuity was worsened in 56% of the eyes followed for over 24 months. CONCLUSIONS: The authors notice the characteristics of Behcet's disease in Korean and suggest that the continuous and nationwide survey is further necessary.
Subject(s)
Humans , Arthritis , Iritis , Oral Ulcer , Prognosis , Visual AcuityABSTRACT
BACKGROUND: This nationwide survey was undertaken to characterize the general pathological features of colorectal cancer in Korea, and especially to elucidate the geographical characteristics by means of their anatomical distribution. METHODS: We analysed 1,676 colorectal cancers (from 1,602 patients) surgically resected in 1998 at 15 institutions from nine geographical sites in Korea. RESULTS: The topographic incidence of colorectal cancer in seven out of the total nine geographical sites, was the highest in the rectum (32-54%); and those from Wonju and Cheongju were in the sigmoid colon (28% for both). The right colon cancer incidence was 42% in Wonju and 36% in Cheongju, while it was 17-22% in the other areas. The cecal cancer incidences in Wonju and in Taegu were 7% and 8%, respectively, but 0-4% in the other areas. As for histology, moderately differentiated adenocarcinoma was the most frequent (46-84%), except for in Wonju and Chonju, where the most predominant type was well differentiated (63% and 52%, respectively). CONCLUSION: The incidence of right colon cancer was higher in Wonju and Cheongju, than in the other geographical sites. The cecal predilection was prominent in Taegu and Wonju. The Elucidation of geographical differences in degree of differentiation for tubular adenocarcinoma seems to require further cumulative study with strict guidelines.