Attitudes of Japanese Medical Students towards Disclosure of a Diagnosis of Life-threatening Illness

In this study we investigated the attitudes of Japanese medical students toward being informed of a diagnosis of life-threatening illness. Fourth-year medical students from 20 randomly sampled universities were administered questionnaires that examined their opinion about whether they would welcome disclosure of medical information if they were diagnosed as having an ultimately fatal disease. Data from 1,619 students (male 1,074, female 545, effective collection rate 90.6%) were analyzed. With regard to attitudes about disclosure of a diagnosis of life-threatening illness, 87.7% of the students stated that they would wish to be informed even if there was little chance of recovery, and 11.6% expressed a wish to be informed of their condition only if there was a chance of recovery. Students who did not wish to be informed even if there was a chance of recovery accounted for 0.7% of those surveyed. Our study reveals that medical students are more positive than are members of the general population with regard to being informed of the truth. The proportion of those who wished to be informed even if there was little chance of recovery was higher among students from national and public universities than among those from private universities, and the inter-group difference was statistically significant. Among male students, answers to the survey were significantly correlated with 12-item General Health Questionnaire scores and mental health status, suggesting that mental health status may have affected how this study population viewed being informed of their diagnosis.</p

Association of Blood Pressure and Body Mass Index with Intraocular Pressure in Middle-aged and Older Japanese Residents:A Cross-sectional and Longitudinal Study

To clarify whether high blood pressure (BP) and high body mass index (BMI) are associated with elevated intraocular pressure (IOP), a cross-sectional and longitudinal study was conducted. This epidemiological study analyzed health examination data obtained between 2001 and 2005 from 896 Japanese individuals (aged 32-79 years) who had not undergone any ocular surgery or medical treatment for hypertension, ocular hypertension, or glaucoma. Multiple-regression analysis of our cross-sectional data showed that systolic and diastolic BP (SBP and DBP) and BMI had significant and near-significant positive associations with IOP in men (p＜0.05) and women (p＜0.1). Our longitudinal study from analyses of covariance found that the adjusted mean level of changes in IOP tended to increase with increased levels of SBP, DBP, and BMI in men (p＜0.1). In women also, changes in SBP and BMI tended to be positively related with that of IOP (p＜0.1). The results of this study suggested that BP and BMI were positively associated with IOP in middle-aged and older Japanese. Therefore, management of BP and improvement of obesity might be especially important to Japanese patients with open-angle glaucoma or ocular hypertension as they have a higher incidence of normal-tension glaucoma than Europeans and Americans

Mental Health Status among Japanese Medical Students: A Cross-Sectional Survey of 20 Universities

The purposes of this study were to evaluate the mental health status of Japanese medical students and to examine differences based on gender, as well as on university type and location, using the results of a nationwide survey. Between December 2006 and March 2007, we conducted a questionnaire survey among fourth-year medical students at 20 randomly selected medical schools in Japan. The data from 1,619 students (response rate:90.6%;male:1,074;female:545) were analyzed. We used the Japanese version of the 12-item General Health Questionnaire (GHQ-12) to measure mental health status. Poor mental health status (GHQ-12 score of 4 points or higher) was observed in 36.6% and 48.8% of the male and female medical students, respectively. The ratio of the age-adjusted prevalence of poor mental health status in female versus male medical students was 1.33 (95% confidence interval:1.10-1.62). The universities were categorized into two groups based on the university type (national/public:15 vs. private:5) or location (in a large city:7 vs. in a local city:13 cities). The prevalence of poor mental health status in both men and women differed between these groups, although not significantly. The GHQ-12 scores in men significantly differed between the categorized groups of universities. These results suggest that adequate attention must be paid to the mental health of medical students, especially females, and that a system for providing mental health care for medical students must be established in the context of actual conditions at each university

Longevity-associated NADH Dehydrogenase Subunit-2 237 Leu/Met Polymorphism Modulates the Effects of Daily Alcohol Drinking on Yearly Changes in Serum Total and LDL Cholesterol in Japanese Men

Reduced nicotinamide adenine dinucleotide (NADH) dehydrogenase subunit 2 237 leucine/methionine (ND2-237 Leu/Met) polymorphism, is reportedly associated with longevity in the Japanese population. The ND2-237Met genotype may exert resistance to atherogenic diseases, such as myocardial infarction or cerebrovascular disorders. To investigate whether ND2-237 Leu/Met polymorphism is associated with yearly changes in serum lipid levels, we conducted a longitudinal study of 107 healthy Japanese male subjects. Analysis of covariance revealed that the interaction between the ND2-237 Leu/Met genotypes and habitual drinking was significantly associated with yearly changes in serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDLC) levels (p0.036 and p0.006, respectively). In multiple regression analysis, daily drinking was significantly and positively associated with yearly changes in serum LDLC levels in men with ND2-237Met (p0.026). After adjusting for covariates, yearly changes in serum LDLC levels were significantly lower in non-daily drinkers with ND2-237Met than in those with ND2-237Leu (p0.047). These results suggest that ND2-237Met has a beneficial impact on yearly changes in serum LDLC in non-daily drinkers but not in daily drinkers.</p

Changes in body mass index, leptin and adiponectin in Japanese children during a three-year follow-up period: a population-based cohort study

<p>Abstract</p> <p>Objective</p> <p>The study examined changes in and relationship between body mass index (BMI), leptin and adiponectin levels over a 3-year period in a pediatric population-based cohort.</p> <p>Study design</p> <p>A 3-year prospective cohort study of 268 boys and 251 girls aged 9–10 in Ina, Saitama, Japan.</p> <p>Results</p> <p>Median body mass index (BMI) significantly increased from baseline (age 9–10) to follow up (age 12–13) in boys from 17.1 to 18.3 kg/m²(<it>P </it>< 0.001) and in girls from 16.5 to 18.5 kg/m²(<it>P </it>< 0.001), respectively. Adiponectin values significantly decreased from baseline to follow up in boys (13.5 to 8.9 μg/ml, respectively) (<it>P </it>< 0.001) and in girls (12.4 to 9.5 μg/ml, respectively) (<it>P </it>< 0.001). Leptin values at follow up significantly decreased from baseline in boys (4.9 to 2.3 ng/dl, respectively) (<it>P </it>< 0.001) and also in girls (5.3 to 5.1 ng/dl, respectively) (<it>P </it>= 0.049).</p> <p>A relatively strong correlation was seen in BMI (Spearman's correlation coefficient, <it>r </it>= 0.864, <it>P </it>< 0.001 in boys; <it>r </it>= 0.873, <it>P </it>< 0.001 in girls), adiponectin (<it>r </it>= 0.705, <it>P </it>< 0.001 in boys; <it>r </it>= 0.695, <it>P </it>< 0.001 in girls), and leptin (<it>r </it>= 0.449, <it>P </it>< 0.001 in boys; <it>r </it>= 0.610, <it>P </it>< 0.001 in girls) before and after the three-year period.</p> <p>The ratio of follow up to baseline BMI was negatively correlated with that for adiponectin (<it>r </it>= -0.224, <it>P </it>< 0.001 in boys; <it>r </it>= -0.165, <it>P </it>= 0.001 in girls) and positively correlated with that for leptin (<it>r </it>= 0.518, <it>P </it>< 0.001 in boys; <it>r </it>= 0.609, <it>P </it>< 0.001 in girls).</p> <p>Conclusion</p> <p>This study demonstrated that baseline adiponectin, leptin and BMI values measured at ages 9–10 correlated with those measured three years later. However, adiponectin values decreased and leptin values increased in those subjects whose BMI increased during over this period.</p

Blue Monday Phenomenon among Men:Suicide Deaths in Japan

The number of suicide deaths in Japan has continued to be high, and is a pressing social problem. Although the weekly distribution of suicide deaths has been documented, no nationwide analysis has yet been conducted. In the present study, the ratios of the number of suicide deaths per day, by day of the week, and on weekdays relative to holidays were calculated using the data for all suicide deaths recorded in 2003. The suicide deaths recorded on holidays were treated as the reference, and a confidence interval of 95% (95% CI) was used. We calculated the suicide death ratios among men and women of all ages (men:23,396, women:8,713, total:32,109) and also among those of productive age (age:15-64 years, men:18,552, women:5,481, total:24,033). Among men of all ages, the suicide death ratio on Mondays was found to be significantly high at 1.49 (95% CI:1.04-2.14), and the ratios were found to decrease over the course of the week from Monday to Friday. On each weekday, the suicide death ratios among men of productive age were found to be higher than those among men of all ages. Among women, the suicide death ratios on any weekday were found to be higher than 1, but there was no significant difference between the days. Among both men and women, the number of suicide deaths on holidays was lower than that on weekdays. This study revealed that the number of suicide deaths recorded per day on Mondays is 1.5 times higher than that on holidays among men. This suggests that the structure of the work week may possibly influence suicide deaths among men. Future discussions regarding the arrangement and distribution of weekly holidays should be conducted in order to reduce the number of suicide deaths.</p