Programs for calculating the statistical powers of detecting susceptibility genes in case–control studies based on multistage designs

Motivation: A two-stage association study is the most commonly used method among multistage designs to efficiently identify disease susceptibility genes. Recently, some SNP studies have utilized more than two stages to detect disease genes. However, there are few available programs for calculating statistical powers and positive predictive values (PPVs) of arbitrary n-stage designs

Referral from secondary care and to aftercare in a tertiary care university hospital in Japan

BACKGROUND: In Japan, all citizens are covered by the national insurance system in which universal free access to healthcare services is promised to everybody. There are no general physicians or gatekeepers in the Japanese healthcare system. METHODS: We studied the pattern of referral of inpatients from secondary care hospitals to a tertiary care university hospital and the reverse referral under the situations using a geographic information system (GIS), taking paediatric inpatients as an example. RESULTS: The results showed that 61.2% of the patients were directly admitted to the hospital without referral from other hospitals or clinics and that 82.8% of the inpatients were referred to the outpatient department of the hospital to which they had been admitted. GIS analysis for the inpatients service area showed the hospital functions as both a secondary care hospital and tertiary care hospital. Patients who lived near the hospital tended to be admitted directly to the hospital, and patients who lived far from the hospital tended to utilize the hospital as a tertiary care provider. There were territorial disputes with other secondary care hospitals. To estimate spatial differences in referral to aftercare, we analyzed the spatial distribution of inpatients with focus on their length of hospital stay (LOS). GIS analysis revealed apparent foci of patients with long LOS and those with low LOS. CONCLUSION: These results suggest that the function of university hospital in Japan is unspecialized and that the referral route from the university hospital to aftercare is also unequipped

Profit and loss analysis for an intensive care unit (ICU) in Japan: a tool for strategic management

BACKGROUND: Accurate cost estimate and a profit and loss analysis are necessary for health care practice. We performed an actual financial analysis for an intensive care unit (ICU) of a university hospital in Japan, and tried to discuss the health care policy and resource allocation decisions that have an impact on critical intensive care. METHODS: The costs were estimated by a department level activity based costing method, and the profit and loss analysis was based on a break-even point analysis. The data used included the monthly number of patients, the revenue, and the direct and indirect costs of the ICU in 2003. RESULTS: The results of this analysis showed that the total costs of US$2,678,052 of the ICU were mainly incurred due to direct costs of 88.8$ 2,295,044. However, it was determined that the ICU required at least 1,986 patient days within one fiscal year based on a break-even point analysis. As a result, an annual deficit of US$ 383,008 has occurred in the ICU. CONCLUSION: These methods are useful for determining the profits or losses for the ICU practice, and how to evaluate and to improve it. In this study, the results indicate that most ICUs in Japanese hospitals may not be profitable at the present time. As a result, in order to increase the income to make up for this deficit, an increase of 437 patient days in the ICU in one fiscal year is needed, and the number of patients admitted to the ICU should thus be increased without increasing the number of beds or staff members. Increasing the number of patients referred from cooperating hospitals and clinics therefore appears to be the best strategy for achieving these goals

Impaired psychological recovery in the elderly after the Niigata-Chuetsu Earthquake in Japan:a population-based study

BACKGROUND: An earthquake measuring 6.8 on the Richter scale struck the Niigata-Chuetsu region of Japan at 5.56 P.M. on the 23rd of October, 2004. The earthquake was followed by sustained occurrence of numerous aftershocks, which delayed reconstruction of community lifelines. Even one year after the earthquake, 9,160 people were living in temporary housing. Such a devastating earthquake and life after the earthquake in an unfamiliar environment should cause psychological distress, especially among the elderly. METHODS: Psychological distress was measured using the 12-item General Health Questionnaire (GHQ-12) in 2,083 subjects (69% response rate) who were living in transient housing five months after the earthquake. GHQ-12 was scored using the original method, Likert scoring and corrected method. The subjects were asked to assess their psychological status before the earthquake, their psychological status at the most stressful time after the earthquake and their psychological status at five months after the earthquake. Exploratory and confirmatory factor analysis was used to reveal the factor structure of GHQ12. Multiple regression analysis was performed to analyze the relationship between various background factors and GHQ-12 score and its subscale. RESULTS: GHQ-12 scores were significantly elevated at the most stressful time and they were significantly high even at five months after the earthquake. Factor analysis revealed that a model consisting of two factors (social dysfunction and dysphoria) using corrected GHQ scoring showed a high level of goodness-of-fit. Multiple regression analysis revealed that age of subjects affected GHQ-12 scores. GHQ-12 score as well as its factor 'social dysfunction' scale were increased with increasing age of subjects at five months after the earthquake. CONCLUSION: Impaired psychological recovery was observed even at five months after the Niigata-Chuetsu Earthquake in the elderly. The elderly were more affected by matters relating to coping with daily problems

Factor structure of the General Health Questionnaire (GHQ-12) in subjects who had suffered from the 2004 Niigata-Chuetsu Earthquake in Japan: a community-based study

<p>Abstract</p> <p>Background</p> <p>Factor structure of the 12-item General Health Questionnaire (GHQ-12) was studied by a survey of subjects who had experienced the 2004 Niigata-Chuetsu earthquake (6.8 on the Richter scale) in Japan.</p> <p>Methods</p> <p>Psychological distress was measured at two years after the earthquake by using GHQ-12 in 2,107 subjects (99.0% response rate) who suffered the earthquake. GHQ-12 was scored by binary, chronic and Likert scoring method. Confirmatory factor analysis was used to reveal the factor structure of GHQ-12. Categorical regression analysis was performed to evaluate the relationships between various background factors and GHQ-12 scores.</p> <p>Results</p> <p>Confirmatory factor analysis revealed that the model consisting of the two factors and using chronic method gave the best goodness-of-fit among the various models for factor structure. Recovery in the scale for the factor 'social dysfunction' was remarkably impaired compared with that of the factor 'dysphoria'. Categorical regression analysis revealed that various factors, including advanced age, were associated with psychological distress. Advanced age affected the impaired recovery of factor 'social dysfunction' score as well as total GHQ score.</p> <p>Conclusion</p> <p>The two-factor structure of GHQ-12 was conserved between the survey at five month and that at two years after the earthquake. Impaired recovery in the ability to cope with daily problems in the subjects who had experienced the earthquake was remarkable even at two years after the earthquake.</p

Referral from secondary care and to aftercare in a tertiary care university hospital in Japan-1

<p><b>Copyright information:</b></p><p>Taken from "Referral from secondary care and to aftercare in a tertiary care university hospital in Japan"</p><p>BMC Health Services Research 2006;6():11-11.</p><p>Published online 17 Feb 2006</p><p>PMCID:PMC1388212.</p><p>Copyright © 2006 Toyabe and Kouhei; licensee BioMed Central Ltd.</p>ere plotted on a map with 2 km mesh. (B) Magnification of (A). (C) The relationship between travel time by car from Niigata University Hospital (closed circle) or five other hospitals (open circles) in Niigata City and the number of inpatients covered within each area

Referral from secondary care and to aftercare in a tertiary care university hospital in Japan-3

<p><b>Copyright information:</b></p><p>Taken from "Referral from secondary care and to aftercare in a tertiary care university hospital in Japan"</p><p>BMC Health Services Research 2006;6():11-11.</p><p>Published online 17 Feb 2006</p><p>PMCID:PMC1388212.</p><p>Copyright © 2006 Toyabe and Kouhei; licensee BioMed Central Ltd.</p>University Hospital. (B) Kernel density plot of patients who were referred to outpatient departments of other hospitals. Dots represent the locations of hospitals with paediatricians

KOSEN’s Role in Promoting Tri-Institutional Collaborative/Cooperative Educational Reformation Project

The Japanese government has been strongly promoting the globalization of policies in the field of education. The Ministry of Education, Culture, Sports, Science and Technology developed some implementation plans to accomplish this ambitious objective. The 'English Education Reform Plan Corresponding to Globalization' targets elementary and lower/upper secondary schools, while the 'National University Reform Plan' targets institutions of higher education: Japan’s colleges and universities. The 'Tri-Institutional Collaborative/Cooperative Educational Reformation Project', represented by Nagaoka University of Technology and Toyohashi University of Technology (TUT), was adopted as a relevant project. The National Institute of Technology are also related to this project. Japanese faculty participating in this project are receiving tutoring in English language skills by means of an English special course offered at TUT in Japan and an English Language Institute course at Queens College in the United States. We are also learning about best practices in higher education with a special focus on teaching diverse students in a non-native language. The mandatory expansion of English instruction, through the adoption of specialized subjects to be taught in English, in both universities and National Institute of Technology is a process to be addressed seriously. This report first described this program and then attempted to predict the future trend at KOSEN using evidence from the Ministry of Education, Culture, Sports, Science and Technology and both universities