Original Japanese version:
Since October 2 2013, I have been conducting a "National Residents Nosebleed Survey" to ascertain the realities of the massive nosebleeds that have been reported nationwide since the end of September:
In this first survey ("Survey I"), the aim was to collect THREE types of basic data:
1. Basic profile information (i.e, sex, age, academic level (if any), region where symptoms were observed);
2. Details on the symptoms and severity of current nosebleed episode; and
3. Confirmation of existence and/or types of symptoms other than nosebleed (i.e., nausea, headache, throat pain, etc.) .
This survey ("Survey II") focuses on TWO things; treatment and progress on treating symptoms in the past and present:
1. Diagnosis, Treatment, and Medications administered in the past 5 years and present;
2. Any self-treatment administered on those symptoms and its effectiveness in the past 5 years and present;
OBJECTIVE AND INTENDED EFFECT:
The objective of this survey is to supplement Survey I so it could be used as a reference to be delivered to the medical community, associations, institutions, and the mass media to enhance the visibility of the issue to recognize it as a national problem. It would also function as a reference material in case of getting any medical attention for the observed symptoms, whether or not the patient have or have not responded to this survey. Anyone can print out the results and show it to your doctor as a reference.
For parents with children please DO NOT enter your own data but that of your children UNLESS you yourself is affected by the symptoms. Your identity will be kept in strict confidentiality unless you expose yourself through your own comments. Please be aware that the results are automatically posted on a Google Forms spreadsheet and a summary overview that are viewable for anyone with the link shown below.
SURVEY RESULTS (OVERVIEW):
The results are automatically posted on a Google Drive spreadsheet and a summary overview. You can check the results on this page (*for response details, click the "View all responses" link at the top of the page): https://docs.google.com/forms/d/1FLykLcDsZ37e12OYOT0fDmd4kcqoX414Ac_xLLEmab4/viewanalytics
Bearing this in mind, please answer the following questions.
Note that in this survey questions will branch out depending on your responses.
Please be patient and continue to proceed until the [SEND] button appears.
FOR MORE INFORMATION:
[Revsion History] Created: 10.20.2013 (Test Release) Ver1.0