Understanding the symptoms of the general population has an important role in assessing and improving the quality of palliative care systems. However, there are no reliable epidemiological data on the symptoms of the general population in Japan. The aim of this study was to survey the actual status of the symptoms experienced by the general population in Japan. A large nationwide postal survey was conducted from January through February 2013 in Japan. A total of 2400 subjects were selected randomly from among members of the general population who were 20 to 79 years of age and lived in Japan. The Memorial Symptom Assessment Scale (MSAS) was used to multi-dimensionally evaluate symptoms experienced within the past week, and the Short Form 8™ (SF-8™) was used to assess the health-related quality of life (QOL). A total of 978 (41.1%) self-completed questionnaires were analyzed. The prevalences, severity rates, and distress rates of 35 physical and psychological symptoms were analyzed according to sex and age group. In addition, the relation between symptom severity and the health-related QOL score was evaluated. From the perspectives of public health and administrative policy, the results of this survey will most likely provide important basic data, with the ultimate goal of establishing a palliative care system in Japan.

Purpose: This study was to examine both the reliability and validity of the Japanese version of the Caregiver Quality of Life Index-Cancer (CQOLC), which was developed to measure the quality of life of family caregivers of cancer patients. Methods & Results: Study subjects comprised 400 family caregivers who were registered at an Internet research company. The explanatory factor analysis yielded the following 4 domains: psychological burden (8 items); positive emotions (5 items); and financial burden (3 items); disruption of daily living (5 items). The Cronbach's alpha coefficients of the total score and each domain were 0.85 and 0.75 to 0.88, respectively. The total score and each domain were moderately correlated with mental health, vitality, social functioning, general health, role emotinal scores from the SF-36. The intraclass correlation coefficients of the total score and each domain were 0.78 and 0.67 to 0.74, respectively. Conclusion: These results suggest that the Japanese version of the CQOLC has sufficient reliability and validity.

East Japan earthquake after cancer is not little survey about patients with palliative care and home health care. In this study, the cancer during an earthquake which aims to make recommendations for future large－scale disasters, and investigation of actual conditions of palliative care and home health care system or manual for basic data. Healthcare in the stricken coastal region 53 conducted semi－structured interviews. Results than cancer healthcare for patients with palliative care and home health care experience is 【cancer providing healthcare to patients with disabilities】【patient lost during the tsunami damage and evacuation oral medication continued failure】【failure of the medical provision of in－home patients by disruption of lifeline】【regional health providers and backward medical assistance and emergency medical group with disabilities】【mental care to medical staff】【disorder of the nuclear power plant accident community health providers】 of 6 organized by category. Be prepared for major disasters, disasters when cancer patients with palliative care and home care issues and how to respond it became evident.

The aim of this study was to clarify the prevalence and characteristics of breakthrough pain in cancer patients. We conducted a cross-sectional survey of consecutive patients older than 20 years of age admitted to a University Hospital with a cancer diagnosis Breakthrough pain was defined as meeting all of the following criteria： Pain 1）with background pain present most of the time, 2）which is well controlled, 3）with short-lived episodes of exacerbation. One hundred and sixty-nine patients were recruited and 118（69.8％）completed the survey. Of these 118 patients, 11％（95％CI：7–18％）had breakthrough pain. Breakthrough pain occurred in 23％（14–35％）of patients with cancer-related pain and 29％（17–45％）of patients with pain from the cancer itself. Patients reported episodes occurring up to three times a day,a time to peak intensity of within 5 minutes, and a duration of untreated episodes of up to 15 minutes are 54％（29–77％）, 54％（29–77％）, 54％（29–77％）, respectively.

To monitor the quality of life （QOL）of cancer patients through the Patient Behavior Survey, a large population-based survey, we developed a short QOL and quality of care （QOC）questionnaire. In order to help evaluate QOL in cancer patients, we also conducted a web–based survey designed to evaluate the content validity and interpretability of the questionnaire. In total, 630 cancer patients completed the survey. For each item, the result that more than 90% responses determined the item was of importance indicated that the item was important for living with cancer. Regarding items related to QOC, satisfaction with care, we consolidated responses; for example, the answer of “neutral” could also be interpreted as “almost satisfied” and patients who answered “other” may also mean that the item does not apply to them. We found that this questionnaire accurately evaluated the QOL of cancer patients and the responses were interpretable and presentable.

Purpose: The aim of this study was to clarify the factors contributing to the evaluation of perceived care in inpatient palliative care services from the aspect of informal caregiver after their loss of the patient to cancer. Method: A questionnaire was mailed to 9,684 bereaved subjects who had lost family members at one of 103 palliative care units in Japan to evaluate their sociodemographic characteristics and the evaluation of perceived care. An institution survey was performed to collect organization-related variables. The evaluation of perceived care was rated by the Care Evalutaion Scale (CES), the Good Death Inventory (GDI) and single item of overall satisfation. Result: A total of 5,810 responses were analyzed (response rate＝60％). Uni-variate and multivariate analysis was performed to clarify the determinants of each scale. Significant determinants of the score in the evaluation of care identified were: the rate of private room (100％), independent facility, palliative care physician being night-time duty, the number of nurses at night (＞0.1 per bed), sending a letter to every bereaved family, holding a memorial services for every bereaved family and having a religious background. Conclusion: In conclusion, the evaluation of palliative care from the aspect of informal caregiver was influenced by various organization-related variables.

Objective: The purpose of this study is to compare the clinical efficacy between original drugs and generic products.  Candidate drugs included two types of hydroxymethylglutaryl-CoA (HMG-CoA) reductase inhibitors, simvastatin and pravastatin, because of their importance at reducing the health expenditure for hyperlipidemia.
Design: We retrospectively evaluated the efficacy (total cholesterol, triglyceride, low-density lipoprotein and high-density lipoprotein levels), safety (biochemical parameters), and medication adherence based on patient data.  We set the follow-up period at 6 months before and after substitution.  Data were analyzed by paired-sample t-tests (statistical significance level of 0.05).
Methods: The subjects included in this study were ambulatory patients visiting Nakajima Hospital for dyslipidemia treatment.  Selected patients included those taking both the original drug and the generic product; i.e., patients who had substituted the original drug Lipovas® for the generic product Simvastatin OHARA, or those who had substituted the original drug Mevalotin® for the generic drug Pravatin®.
Results: A total of 118 patients in the simvastatin study and 43 patients in the pravastatin study were candidates for the present study.  We found that there were no significant differences before and after substitution.  Even though there were differences in some of the biochemical parameters, the range remained within normal levels.  With regard to medication adherence, we found no significant differences.
Conclusion: In this study, we found no significant differences before and after substituting medications with generic drugs.  Additionally, we found no subjective symptom changes after substitution.  To develop clinical information on generic products and to store such information, it is important that pharmaceutical products be used appropriately.

In the present study, we report on the occurrence of paramphistomes, Fischoederius cobboldi and Paramphistomum epiclitum, in Lao PDR with the basis of molecular data. Parasite materials were collected from bovines bred in Ban Lahanam area, Savannakhet Province, Lao PDR at Lahanam public market. Morphological observations indicated 2 different species of paramphistomes. The mitochondrial gene cox1 of the specimens was successfully amplified by PCR and DNA sequencing was carried out for diagnosis of 11 specimens. Pairwise alignment of cox1 sequences were performed and confirmed F. cobboldi and P. epiclitum infecting bovines in Laos. Although there were many limiting points, as the small number of worm samples, and the restricted access of the animal host materials, we confirmed for the first time that 2 species of paramphistomes, F. cobboldi and P. epiclitum, are distributed in Lao PDR. More studies are needed to confirm the paramphistome species present in Savannakhet and its hosts to clear the natural history of these parasites of ruminants in the region and measure the impact of this parasite infection in the life and health of the local people.
Animals ; Cattle ; Diagnosis ; Genes, Mitochondrial ; Helminths ; Laos ; Natural History ; Paramphistomatidae* ; Parasites ; Polymerase Chain Reaction ; Rumen* ; Ruminants ; Sequence Analysis, DNA

Quantitative fecal egg counts represented as the number of eggs per gram of feces (EPG) are generally a reliable parameter to estimate the worm burden of intestinal and hepatic parasitoses. Although Haplorchis taichui (Digenea: Heterophyidae) is one of the most common minute human intestinal flukes, little is known about the relationship between EPG and the actual worm burden in patients or the severity of the disease. In the present study, fecal samples were collected from 25 villagers in northern Thailand before and after praziquantel treatment. The EPG values of each participant were determined by the modified cellophane thick smear method, and adult worms were collected from the whole stool after the treatment. Eggs per day per worm (EPDPW) of H. taichui were estimated 82 from egg counts and expelled worms. The EPG was not well correlated with the worm burden, and a reverse correlation was observed between the EPDPW and the worm burden.
Animals ; Feces/parasitology ; Heterophyidae/isolation & purification/*physiology ; Humans ; Parasite Egg Count ; Trematode Infections/*parasitology