ニホンジン ノ キュウセイ シンキン コウソク ハッショウ ハ ゾウカシテイルカ ： タカシマ ジュンカンキ ハッショウ トウロク ジギョウ 1990 2001ネン ヨリ

学位授与機関：　滋賀医科大学　博士（医学）第582号　平成21年3月25日American Journal of Epidemiology. 167(11), p.1358-1364

A rare case of bacteremia due to Acinetobacter junii in an immunocompetent adult

The genus Acinetobacter comprises a complex and heterogeneous group of bacteria, many of which are capable of causing a range of opportunistic, often nosocomial, infections in humans. Acinetobacter junii is a rare human pathogen associated with bacteraemia in neonates and paediatric oncology patients. We report a unique case of bacteremia caused by Acinetobacter junii, in a patient with no risk factors identified

Experiences of communication barriers between physicians and immigrant patients: A systematic review and thematic synthesis

Frequent immigration of peoples from outside often challenges various systems of any country; healthcare sector is the most confronted one. One of the most prominent reasons for this confrontation is communication gap between physicians and immigrant patients. In this systematic narrative review, we studied existing literature on physician-immigrant patient communication. We systematically searched the repositories of literature and followed some criteria to select literature. We selected 32 literatures for information extraction. Three themes emerged from the synthesis: Physicians’ viewpoint about communication barrier with their immigrant patients, Immigrant patients’ viewpoint about the communication barrier with their physicians, and Interpreter as a mitigation process of communication barrier and associated challenges. Physicians are mostly concerned about the fidelity of their conversation with immigrant patients while the Immigrant patients are mostly concerned about their culture and sometimes fearful that the physicians will misunderstand them due to lack of language proficiency. This review provides an updated summary of communication barriers that may arise between physicians and immigrant patients, and their effects on quality of care

Sleep disturbances among medical students: A global perspective

Medical students carry a large academic load which could potentially contribute to poor sleep quality above and beyond that already experienced by modern society. In this global literature review of the medical students' sleep experience, we find that poor sleep is not only common among medical students, but its prevalence is also higher than in non-medical students and the general population. Several factors including medical students' attitudes, knowledge of sleep, and academic demands have been identified as causative factors, but other potential mechanisms are incompletely understood. A better understanding about the etiology of sleep problems in medical trainees is essential if we hope to improve the overall quality of medical students' lives, including their academic performance. Sleep selfawareness and general knowledge appear insufficient in many studied cohorts, so increasing education for students might be one beneficial intervention. We conclude that there is ample evidence for a high prevalence of the problem, and research in this area should now expand towards initiatives to improve general sleep education for medical students, identify students at risk, and target them with programs to improve sleep. © 2015 Clinical Sleep Medicine

A rare case of bacteremia due to Acinetobacter junii in an immunocompetent adult

The genus Acinetobacter comprises a complex and heterogeneous group of bacteria, many of which are capable of causing a range of opportunistic, often nosocomial, infections in humans. Acinetobacter junii is a rare human pathogen associated with bacteraemia in neonates and paediatric oncology patients. We report a unique case of bacteremia caused by Acinetobacter junii, in a patient with no risk factors identified

Employing diffusion of innovation theory for ‘not missing the mass’ in community-engaged research

Introduction Engaging with minority communities, such as immigrants and ethnic minorities, often involves adopting top-down approaches, wherein researchers and policymakers provide solutions based on their perspective. However, these approaches may not adequately address the needs and preferences of the community members, who have valuable insights and experiences to share. Therefore, community-engaged approaches, which involve collaborative partnerships between community members and researchers to identify issues, co-create solutions, and recommend policy changes, are becoming more recognized for their effectiveness and relevance. Yet, prevailing community engagement efforts often focus on easily reachable and already engaged segments of the community, sometimes overlooking the broader population.Methods When working with immigrant and racialized communities, we encountered difficulties in engaging the wider community through traditional researcher-led approaches. We realized that overcoming these challenges required innovative strategies rooted in community-based participatory research principles and the diffusion of innovation theory. We recognized that a nuanced understanding of the community's dynamics and preferences was crucial in shaping our approach and building trust and rapport with the community members.Results The need to bridge the gap between researcher-led initiatives and community-driven involvement has never been more pronounced. Our experience, chronicled in this article, highlights the journey of our research program with an immigrant/racialized community. This reflection enhances our comprehension of community engagement that deliberately strives to reach a larger cross-section of the community. By providing practical methods for reaching the broader community and navigating the intricacies of engagement, we aim to assist fellow researchers in conducting effective community-engaged research across various minority communities.Conclusion In sharing our insights and successful strategies for community engagement, we hope to contribute to the field's knowledge. Our commitment to fostering meaningful collaboration underscores the importance of co-creating solutions that resonate with the diverse voices within these communities. Through these efforts, we envision a more inclusive and impactful approach to addressing the complex challenges faced by minority populations

Partnering with organisations beyond academia through strategic collaboration for research and mobilisation in immigrant/ethnic-minority communities

Community-engaged research needs involving community organisations as partners in research. Often, however, considerations regarding developing a meaningful partnership with community organisations are not highlighted. Researchers need to identify the most appropriate organisation with which to engage and their capacity to be involved. Researchers tend to involve organisations based on their connection to potential participants, which relationship often ends after achieving this objective. Further, the partner organisation may not have the capacity to contribute meaningfully to the research process. As such, it is the researchers’ responsibility to build capacity within their partner organisations to encourage more sustainable and meaningful community-engaged research. Organisations pertinent to immigrant/ethnic-minority communities fall into three sectors: public, private and non-profit. While public and private sectors play an important role in addressing issues among immigrant/ethnic-minority communities, their contribution as research partners may be limited. Involving the non-profit sector, which tends to be more accessible and utilitarian and includes both grassroots associations (GAs) and immigrant service providing organisations (ISPOs), is more likely to result in mutually beneficial research partnerships and enhanced community engagement. GAs tend to be deeply rooted within, and thus are often truly representative of, the community. As they may not fully understand their importance from a researcher’s perspective, nor have time for research, capacity-building activities are required to address these limitations. Additionally, ISPOs may have a different understanding of research and research priorities. Understanding the difference in perspectives and needs of these organisations, building trust and creating capacity building opportunities are important steps for researchers to consider towards building durable partnerships

Barriers to cervical cancer screening faced by immigrant women in Canada: a systematic scoping review

Abstract Background The objective of this scoping study is to review the published literature and summarize findings related to barriers experienced by immigrant women in Canada while accessing cervical cancer screening. Methods Electronic databases of peer-reviewed articles and grey literature were searched using comprehensive sets of keywords, without restricting the time period or language. Articles were selected based on the following criteria: (a) the study population consisted of Canadian immigrant women and healthcare providers and other stakeholders serving immigrant women, (b) the research focused on the barriers to accessing cervical cancer screening, and (c) the study was conducted in Canada. Results Extracted data were grouped and analyzed, resulting in barriers comprised of six themes: economic barriers, cultural barriers, language barriers, healthcare system-related barriers, knowledge-related barriers, and individual-level barriers. Lack of education, low income, preference for a female physician, lack of knowledge, lack of effective communication, and embarrassment were some of the most common barriers mentioned. Conclusions Immigrant access to health services, including cervical cancer screening, is a complex issue concerning a wide range of barriers. Our findings offer insights into barriers to cervical cancer screening in immigrant communities in Canada that can be used to assist policymakers, healthcare providers, and researchers enhance the health and well-being of these populations by mitigating barriers and improving screening