Physicians' Perceptions of Income-related Disparities in Medical Care Utilization: a Mail Survey in Tokyo / 日本プライマリ・ケア連合学会誌

<b>Introduction</b>: The rising poverty rate has spurred concerns regarding income-related disparities in medical-care utilization. This study attempted to investigate physicians'recognition of patients'refraining from medical care for financial reasons and the characteristics of physicians who made efforts to improve such situations.<br><b>Methods</b>: A mail survey was conducted between July 1 and September 30, 2014. All internal medicine clinics (n=1989) in 12 municipalities in Tokyo were included. One physician from each clinic was requested to answer the 60-item questionnaire.<br><b>Results</b>: Of the 617 questionnaires returned (response rate 31 %), 550 (454 male physicians) complete responses were analyzed. About 90% of physicians recognized that patients refrained from seeking medical care for financial reasons, and used various methods to encourage receipt of treatment (e.g., prescribing inexpensive medicines). Physicians who were 40-59 years old, specialized in general practice, implementing informed consent or shared decision making, and frequently recognizing that patients refrained from seeking medical care were more likely to engage in efforts to encourage treatment seeking.<br><b>Conclusion</b>: Our results suggest that physicians in primary care roles such as general practice and utilizing shared decision making are more likely to engage in efforts to encourage medical care utilization in patients who refrain due to financial reasons.

A survey on the use of composite resin in Class II restoration in Korea / 대한치과보존학회지

The purpose of this study was to assess the current materials, methods and difficulties according to the year of licence and educational background of Korean dentists in Class II direct composite resin restorations. Total 17 questions were included in the questionnaire. Questions were broadly divided into two parts; first, operator's information, and second, the materials and methods used in Class II posterior composite restoration. The questionnaire was sent to dentists enrolled in Korean Dental Association via e-mail. Total 12,193 e-mails were distributed to dentists, 2,612 e-mails were opened, and 840 mails (32.2%) were received from respondents. The data was statically analyzed by chi-square test using SPSS(v. 12.0.1, SPSS Inc, Chicago, IL, USA). Male dentists among respondents was 79%. 60.3% of the respondents acquired their licences recently (1998-2007), and 77% practiced in private offices. 83.4% have acquired their knowledge through school lectures, conferences and seminars. For the Class II restorations, gold inlays were preferred by 65.7% of respondents, while direct composite resin restorations were used by 12.1% amalgam users were only 4.4% of respondents. For the restorative technique, 74.4% of respondents didn't use rubber dam as needed. For the matrix, mylar strip (53.4%), metal matrix (33.8%) and Palodent system (6.5%) were used. 99.6% of respondents restored the Class II cavity by incremental layering. Obtaining of the tight interproximal contact was considered as the most difficult procedure (57.2%) followed by field isolation (21%). Among various bonding systems, 22.6% of respondents preferred SE Bond and 20.2% used Single Bond. Z-250 was used most frequently among a variety of composite resins.

Comparison of the Perceptions of City Residents and Physicians Regarding “Good Death” in a Terminal Cancer Setting in Fukushima, Japan / General Medicine

BACKGROUND: In recent years, various studies have analyzed the concepts of “good death” and “quality of dying and death” in the world. The objective of this study was to compare community residents and physicians regarding their perceptions of “good death” in a terminal cancer setting in Fukushima, Japan.<BR>METHODS: One thousand residents of Fukushima City (40 years or older) were randomly selected for comparison to the 483 physicians working in the same city. A self-administered questionnaire was used to query residents and physicians on 52 items about “good death.”<BR>RESULTS: The response rate was 73.6% for the residents and 53.0% for the physicians. The concept of “good death” was composed of 14 factors for both groups. We elucidated the structure of the concept of “good death” in the general population and physicians in Japan, and only the third factor, “religion and spiritual beliefs, ” was the same between the general population and physician.<BR>CONCLUSION: The data offers useful information pertaining to palliative care education for medical providers. Specifically, physicians should understand the differences between concepts held by the general population and physicians. For example, some same items were included in factor X (continuance of one's lifestyle) for citizen and factor II for physician. But contribution ratios of factor X for citizen and factor II for physician were different. This should lead to the better palliative care provision.