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

Targeted screening for primary immunodeficiency disorders in the neonatal period and early infancy

Background: Primary immunodeficiency diseases (PID) comprise a group of more than 300 diseases that affect development and /or function of the immune system.Objectives: The aim of this study was diagnosis of PID among a suspected group of neonates and infants within the first six months of life as well as identifying the warning signs of PID characteristic to this period.Method: Fifty neonates presenting with warning signs of PID were enrolled in the study.Results: The study revealed that twenty six patients (52%) were diagnosed with Primary Immunodeficiency, T cell/combined immunodeficiency were noted as the most common PID class (88.5%) with fourteen T-B-SCID patients (70%) and six T-B+ SCID patients (30%), phagocytic disorders were estimated to be 7.7% while 3.8% were unclassified immunodeficiency. The mean age of presentation for PID group was 1.42±1.38 months with a diagnostic lag of 3.08±1.78 months. Consanguinity was positive in 76.9% of the PID group. Lower respiratory tract infections ,persistent fungal infections and lymphopenia were the most significant warning signs for diagnosing PID with a p value of (0.01). Combined, lower respiratory tract infections, fungal infections and lymphopenia were 12.3 times more likely to be associated with PID.Conclusion: Focused screening in high risk neonates proved to be a valuable tool for diagnosis of PID disorders.Keywords: Primary immunodeficiency disorders, neonatal period, early infancy

Usage of the .9 Codes of the ICD-10 for Japanese Mortality Statistics

The structural deficits and problems associated with application of the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) were investigated. For this purpose, mortality statistics in Japan were examined for bias in the proportions of death causes classified using the ICD-10 four-character subcategory system, particularly the large distribution of cases classified under the .9 (unspecified) codes. The results showed that most deaths due to the 3 major causes were coded into the .9 subcategories. For example, 97.6% of the 607,065 deaths between 1995 and 2007 classified as I21 (acute myocardial infarction) were coded as I21.9 (acute myocardial infarction, unspecified). This suggests that the quality of the data recorded on many death certificates is poor. Thus, to ensure that the fourth-digit-level subcategories of the ICD-10 code system are effectively used to represent mortality data and actual causes of death in Japan, future studies should address the following objectives:(1) to minimize the discrepancy between the ICD classification terms and the names of diseases actually used in clinical practice, and (2) to actively raise awareness among physicians about the need to accurately record death causes on death certificates, since these records form the basis for determining mortality statistics in Japan.</p

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

Parental Smoking and Smoking Status of Japanese Dental Hygiene Students: A Pilot Survey at a Dental Hygiene School in Japan

This study aimed to determine the frequency of smoking and to explore factors associated with the smoking habits of female students at a dental hygiene school in Japan. Questionnaires regarding cigarette smoking were given to 168 female students. The response rate was 97.6%. The prevalence of smoking, including current and occasional smokers, was 20.3%. Among family members, only the smoking status of their mother significantly influenced the smoking status of the students. The odds ratio for smoking among dental hygiene students whose mothers were smokers in comparison to students whose mothers were not smokers was 5.1 (95% confidence interval 2.1–12.2, p=0.000). Decision tree analysis showed that the smoking habit of dental hygiene students was correlated with their mothers’ smoking history, as well as the smoking status of junior high school teachers, the smoking habits of close friends and a history of participating in a smoking prevention program when in elementary school. The increased smoking rate of young females, including dental hygienists, is a growing problem in Japan. The smoking statuses of dental hygiene students might be closely influenced by their mothers’ smoking status

Association between reduced serum BDNF levels and insomnia with short sleep duration among female hospital nurses

Objective: Previous studies have suggested that brain-derived neurotrophic factor (BDNF) is associated with sleep regulation in humans. However, its relationship with self-reported sleep problems has not been clarified. The aim of the present study was to examine the association between serum BDNF levels and sleep problems among hospital nurses. Methods: Participants were enrolled from among nurses working at a general hospital in Tokyo, Japan. Data from 577 women (age: 35.45 ± 10.90 years) were analyzed. This cross-sectional survey was conducted from November to December 2015. Serum BDNF concentrations were evaluated. Participants completed a self-reported questionnaire on sleep including the presence or absence of insomnia symptoms (ie, difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening [EMA]), and sleep duration. Insomnia with short sleep duration (ISS) was defined as: DIS, or DMS, or EMA; and <6 h sleep duration. Results: Among 577 participants, 21.3% reported insomnia, 41.4% slept less than 6 h, and finally 12.5% suffered from ISS. Serum BDNF levels were significantly lower in subjects with ISS than in those without ISS. The serum BDNF levels in insomniacs were significantly lower than in non-insomniacs for short sleep duration (<6 h), while serum BDNF levels did not differ between insomniacs and non-insomniacs for normal sleep duration (≥6 h). Conclusion: This is the first documented study to indicate that ISS is associated with reduced serum BDNF levels. These results may lead to clarification of the underlying pathophysiological relationship between BDNF and poor sleep

Targeted screening for primary immunodeficiency disorders in the neonatal period and early infancy

Background: Primary immunodeficiency diseases (PID) comprise a group of more than 300 diseases that affect development and /or function of the immune system. Objectives: The aim of this study was diagnosis of PID among a suspected group of neonates and infants within the first six months of life as well as identifying the warning signs of PID characteristic to this period. Method: Fifty neonates presenting with warning signs of PID were enrolled in the study. Results: The study revealed that twenty six patients (52%) were diagnosed with Primary Immunodeficiency, T cell/combined immunodeficiency were noted as the most common PID class (88.5%) with fourteen T-B-SCID patients (70%) and six T-B+SCID patients (30%), phagocytic disorders were estimated to be 7.7% while 3.8% were unclassified immunodeficiency. The mean age of presentation for PID group was 1.42\ub11.38 months with a diagnostic lag of 3.08\ub11.78 months. Consanguinity was positive in 76.9% of the PID group. Lower respiratory tract infections ,persistent fungal infections and lymphopenia were the most significant warning signs for diagnosing PID with a p value of (0.01). Combined, lower respiratory tract infections, fungal infections and lymphopenia were 12.3 times more likely to be associated with PID. Conclusion: Focused screening in high risk neonates proved to be a valuable tool for diagnosis of PID disorders. DOI: https://dx.doi.org/10.4314/ahs.v19i1.18 Cite as: Galal N, Ohida M, Meshaal S, Abd Elaziz D, I E. Targeted screening for primary immunodeficiency disorders in the neonatal period and early infancy. Afri Health Sci. 2019;19(1). 1449-1459. https://dx.doi. org/10.4314/ahs.v19i1.1

Internet use and problematic Internet use among adolescents in Japan: A nationwide representative survey

AbstractIntroductionJapan is assumed to have serious health and social problems due to Internet overuse, but little is known about the actual conditions. This study was conducted to investigate the prevalence of problematic Internet use (PIU) and associated Internet use in adolescents in Japan.MethodsA nationwide survey of adolescent Internet use was conducted in 2012 and 2013. The participants were 100,050 students from randomly selected junior and senior high schools nationwide who gave valid responses to a self-reported questionnaire. The questionnaire included questions on Internet use and the Japanese version of the Young's Diagnostic Questionnaire (YDQ) as well as other questions related to lifestyle habits. Internet users were classified by gender according to three categories on the basis of their YDQ scores: adaptive use, maladaptive use, and PIU.ResultsThe estimated prevalence of PIU was 6.2% in males, 9.8% in females, and 7.9% in total; it closely correlated with female gender, school grades, and number of Internet hours. The following common and gender-specific applications that conferred a risk of PIU were identified: downloading (both genders), online gaming (males), social networking services, blogs, and bulletin boards (females).ConclusionsA cross-sectional survey using YDQ of a large number of high school students yielded a PIU prevalence of 7.9% in Japan. This study showed that problems associated with Internet overuse have already become serious; therefore, planning and implementation of prevention and control measures is urgently required

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