Good Death Scale (GDS) is a provider assessment scale of quality of dying of terminally ill cancer patients, and its reliability and validity has been confirmed. The aim of this study is translating the GDS into Japanese (GDS-J) according to the standard methods of conducting linguistic validation. In the forward translation, there was a disagreement in the translation of “will” into Japanese translation of “will” of GDS question 3 “Has the patient arranged everything according to his/her own will?” We confirmed linguistic validity in the research team and eventually got approval from the original author in writing and decided on GDS-J. Using the GDS-J, a quality assessment scale for palliative care by provider, it will be possible to evaluate the quality of palliative care to be done by themselves and to be expected to be useful for providing higher-quality palliative care.

In 1999, an insecticide-treated net (ITN) distribution project was started in several malaria-endemic villages in Lao P.D.R., namely Vientiane, Bolikhamxay and Khammouanne Provinces. After the completion of the project, it was found that the ITNs were effective for malaria control based on the analysis of the slide positivity rate for malaria parasites between 1999 and 2000 [6]. We conducted malariometric, entomological and KAP surveys in 2005-06 to confirm the status of malaria and to determine the effectiveness of ITNs in three different socioepidemiological areas (near city, rural and remote), represented by the Xebangfay and Boualapha districts, Khammouanne Province.
A marked decrease in the annual malaria incidence and slide positivity rate was noted from 1999 to 2006 in the two districts. The malaria prevalence was significantly reduced in near city areas (5.6%-10.7% in 1999 to 0% in 2005-06) and rural areas (21.4%-50.9% in 1999 to 0%-1% in 2005-06). Twelve positive cases were recorded in remote areas (3.4 - 7.7% in 2006).
The illiteracy rate was significantly higher among the respondents in the remote (83.9%) than among those in the near city (32.7%) and rural (54%) areas. In all areas, more than 50% of the villagers indicated that they were not aware of malaria. Similarly, about 60% of the respondents were found to have incorrect knowledge concerning malaria transmission. In remote, 40.9% of the respondents were aware of the methods to prevent malaria infection and 49.5% used mosquito nets throughout the year, rates significantly lower than the corresponding rates in near city and rural. The density of persons per net in remote (3.1-5.9) was considerably higher than that in near city (1.8-2.1) and rural (1.2-2.7). Malaria vector mosquitoes, such as An. minimus and An. nivipes were collected by human-baited adult collection, and cow-baited and CDC light traps. The results of the analysis suggested that the lower the number of persons per net the more effective the reduction of malaria morbidity in these areas. It is imperative that ITN distribution and health education regarding malaria be strengthened, especially in remote, but also in other areas.

Objective: The benefits of combining cancer screenings with clinical surveys have become increasingly obvious as cancer morbidity and mortality have steadily increased. This paper discusses a study on the current status of and issues surrounding breast cancer screening in a clinical survey. The study also investigated the patients' awareness of the benefits of breast cancer screening. A secondary aim of the study was to promote mammographic screening.;Subjects and Methods: During the 72 months between April 1999 and March 2005, a total of 36,505 women underwent clinical surveys in our hospital. In October 2002, mammographic examination was included as an optional part of the routine physical examination. We evaluated the results of breast cancer screening with or without mammographic examination and used a questionnaire to investigate the patients' awareness of the benefits of breast cancer screening.;Results: Compared with the pre-2001 results, the detection rate of breast cancer significantly increased after 2003 when physical examination was combined with mammographic examination. Our study also found that both elderly patients and those residing in the suburbs of Sapporo City tended to choose physical examination alone rather than combining it with mammographic examination. An analysis of the questionnaires collected from these patients indicates they had a poor understanding of and lacked awareness of the benefits of mammographic examinations during breast cancer screenings.;Conclusions: The inclusion of mammographic screenings with clinical surveys was found to be significantly useful in the detection of breast cancer. Further continued education is needed for women, particularly the elderly and residents in the suburbs, so they understand the benefits of breast cancer screening by mammographic examination for the early detection of breast cancer and, consequently, decreased mortality of the disease.
Breast neoplasm screen NOS ; Clinical ; benefits ; Awareness ; Surveys

BACKGROUND/AIMS: Oral mesalazine is an important treatment for ulcerative colitis (UC), and non-adherence to mesalazine increases the risk of relapse. Controlled-release (CR) mesalazine has 2 formulations: tablets and granules. The relative acceptabilities of these formulations may influence patient adherence; however, they have not been compared to date. This study aimed to evaluate the acceptabilities of the 2 formulations of CR mesalazine in relation to patient adherence using a crossover questionnaire survey. METHODS: UC patients were randomly assigned to 2 groups in a 1:1 ratio. Patients in each group took either 4 g of CR mesalazine tablets or granules for 6 to 9 weeks, and then switched to 4 g of the other formulation for a further 6 to 9 weeks. The acceptability and efficacy were evaluated by questionnaires, and adherence was assessed using a visual analog scale. The difference in acceptabilities between the 2 formulations and its impact on adherence were assessed. RESULTS: A total of 49 patients were prospectively enrolled and 33 patients were included in the analysis. Significantly more patients found the tablets to be less acceptable than the granules (76% vs. 33%, P=0.0005). The granules were preferable to the tablets when the 2 formulations were compared directly (73% vs. 21%, P=0.004), for their portability, size, and numbers of pills. The adherence rate was slightly better among patients taking the granules (94% vs. 91%) during the observation period, but the difference was not significant (P=0.139). CONCLUSIONS: CR mesalazine granules are more acceptable than tablets, and may therefore be a better option for long-term medication.
Colitis, Ulcerative ; Drug Compounding ; Humans ; Medication Adherence ; Mesalamine ; Patient Acceptance of Health Care ; Patient Compliance ; Prospective Studies ; Recurrence ; Tablets ; Ulcer ; Visual Analog Scale

Background/Aims: Endoscopic self-expandable metal stent (SEMS) placement is currently the standard technique for treating unresectable malignant distal biliary obstructions (MDBO). Therefore, covered SEMS with longer stent patency and fewer migrations are required. This study aimed to assess the clinical performance of a novel, fully covered SEMS for unresectable MDBO. Methods: This was a multicenter single-arm prospective study. The primary outcome was a non-obstruction rate at 6 months. The secondary outcomes were overall survival (OS), recurrent biliary obstruction (RBO), time to RBO (TRBO), technical and clinical success, and adverse events. Results: A total of 73 patients were enrolled in this study. The non-obstruction rate at 6 months was 61%. The median OS and TRBO were 233 and 216 days, respectively. The technical and clinical success rates were 100% and 97%, respectively. Furthermore, the rate of occurrence of RBO and adverse events was 49% and 21%, respectively. The length of bile duct stenosis (<2.2 cm) was the only significant risk factor for stent migration. Conclusions The non-obstruction rate of a novel fully covered SEMS for MDBO is comparable to that reported earlier but shorter than expected. Short bile duct stenosis is a significant risk factor for stent migration.